| 291. |
- Strikwerda-Brown, Cherie, et al.
(författare)
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Association of Elevated Amyloid and Tau Positron Emission Tomography Signal with Near-Term Development of Alzheimer Disease Symptoms in Older Adults Without Cognitive Impairment
- 2022
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Ingår i: JAMA Neurology. - : American Medical Association (AMA). - 2168-6149. ; 79:10, s. 975-985
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Tidskriftsartikel (refereegranskat)abstract
- Importance: National Institute on Aging-Alzheimer's Association (NIA-AA) workgroups have proposed biological research criteria intended to identify individuals with preclinical Alzheimer disease (AD). Objective: To assess the clinical value of these biological criteria to identify older individuals without cognitive impairment who are at near-term risk of developing symptomatic AD. Design, Setting, and Participants: This longitudinal cohort study used data from 4 independent population-based cohorts (PREVENT-AD, HABS, AIBL, and Knight ADRC) collected between 2003 and 2021. Participants were older adults without cognitive impairment with 1 year or more of clinical observation after amyloid β and tau positron emission tomography (PET). Median clinical follow-up after PET ranged from 1.94 to 3.66 years. Exposures: Based on binary assessment of global amyloid burden (A) and a composite temporal region of tau PET uptake (T), participants were stratified into 4 groups (A+T+, A+T-, A-T+, A-T-). Presence (+) or absence (-) of neurodegeneration (N) was assessed using temporal cortical thickness. Main Outcomes and Measures: Each cohort was analyzed separately. Primary outcome was clinical progression to mild cognitive impairment (MCI), identified by a Clinical Dementia Rating score of 0.5 or greater in Knight ADRC and by consensus committee review in the other cohorts. Clinical raters were blind to imaging, genetic, and fluid biomarker data. A secondary outcome was cognitive decline, based on a slope greater than 1.5 SD below the mean of an independent subsample of individuals without cognitive impairment. Outcomes were compared across the biomarker groups. Results: Among 580 participants (PREVENT-AD, 128; HABS, 153; AIBL, 48; Knight ADRC, 251), mean (SD) age ranged from 67 (5) to 76 (6) years across cohorts, with between 55% (137/251) and 74% (95/128) female participants. Across cohorts, 33% to 83% of A+T+ participants progressed to MCI during follow-up (mean progression time, 2-2.72 years), compared with less than 20% of participants in other biomarker groups. Progression further increased to 43% to 100% when restricted to A+T+(N+) individuals. Cox proportional hazard ratios for progression to MCI in the A+T+ group vs other biomarker groups were all 5 or greater. Many A+T+ nonprogressors also showed longitudinal cognitive decline, while cognitive trajectories in other groups remained predominantly stable. Conclusions and Relevance: The clinical prognostic value of NIA-AA research criteria was confirmed in 4 independent cohorts, with most A+T+(N+) older individuals without cognitive impairment developing AD symptoms within 2 to 3 years..
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| 292. |
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| 293. |
- 't Hart, Paul, et al.
(författare)
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Crisis Leadership of the Bush Presidency : advisory Capacity and Presidential Performance in the Acute Stages of the 9/11 and Katrina Crises
- 2009
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Ingår i: Presidential Studies Quarterly. - 0360-4918 .- 1741-5705. ; 39:3, s. 473-493
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Tidskriftsartikel (refereegranskat)abstract
- This paper examines the operation of the presidential advisory system during the 9/11 and Hurricane Katrina crises in order to explain the marked differences in presidential crisis leadership performance during the acute phase of both crises. It first presents a conceptual framework for the systematic study of “crisis advisory configurations” around presidents, based on an integrated review of the advisory systems and crisis management literatures. Second, the framework is applied to George W. Bush's performance in three crucial crisis leadership task domains—sense making, decision making, and meaning making. The article concludes by identifying key challenges of building crisis management capacity around heads of government such as the U.S. president.
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| 294. |
- Tobias, Deirdre K, et al.
(författare)
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Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine
- 2023
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Ingår i: Nature Medicine. - 1546-170X. ; 29:10, s. 2438-2457
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Forskningsöversikt (refereegranskat)abstract
- Precision medicine is part of the logical evolution of contemporary evidence-based medicine that seeks to reduce errors and optimize outcomes when making medical decisions and health recommendations. Diabetes affects hundreds of millions of people worldwide, many of whom will develop life-threatening complications and die prematurely. Precision medicine can potentially address this enormous problem by accounting for heterogeneity in the etiology, clinical presentation and pathogenesis of common forms of diabetes and risks of complications. This second international consensus report on precision diabetes medicine summarizes the findings from a systematic evidence review across the key pillars of precision medicine (prevention, diagnosis, treatment, prognosis) in four recognized forms of diabetes (monogenic, gestational, type 1, type 2). These reviews address key questions about the translation of precision medicine research into practice. Although not complete, owing to the vast literature on this topic, they revealed opportunities for the immediate or near-term clinical implementation of precision diabetes medicine; furthermore, we expose important gaps in knowledge, focusing on the need to obtain new clinically relevant evidence. Gaps include the need for common standards for clinical readiness, including consideration of cost-effectiveness, health equity, predictive accuracy, liability and accessibility. Key milestones are outlined for the broad clinical implementation of precision diabetes medicine.
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| 295. |
- van Es, Michael A, et al.
(författare)
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Genome-wide association study identifies 19p13.3 (UNC13A) and 9p21.2 as susceptibility loci for sporadic amyotrophic lateral sclerosis
- 2009
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Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 41:10, s. 1083-1087
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Tidskriftsartikel (refereegranskat)abstract
- We conducted a genome-wide association study among 2,323 individuals with sporadic amyotrophic lateral sclerosis (ALS) and 9,013 control subjects and evaluated all SNPs with P < 1.0 x 10(-4) in a second, independent cohort of 2,532 affected individuals and 5,940 controls. Analysis of the genome-wide data revealed genome-wide significance for one SNP, rs12608932, with P = 1.30 x 10(-9). This SNP showed robust replication in the second cohort (P = 1.86 x 10(-6)), and a combined analysis over the two stages yielded P = 2.53 x 10(-14). The rs12608932 SNP is located at 19p13.3 and maps to a haplotype block within the boundaries of UNC13A, which regulates the release of neurotransmitters such as glutamate at neuromuscular synapses. Follow-up of additional SNPs showed genome-wide significance for two further SNPs (rs2814707, with P = 7.45 x 10(-9), and rs3849942, with P = 1.01 x 10(-8)) in the combined analysis of both stages. These SNPs are located at chromosome 9p21.2, in a linkage region for familial ALS with frontotemporal dementia found previously in several large pedigrees.
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| 296. |
- Van Hoecke, Annelies, et al.
(författare)
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EPHA4 is a disease modifier of amyotrophic lateral sclerosis in animal models and in humans
- 2012
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Ingår i: Nature Medicine. - New York : Nature Publishing Group. - 1078-8956 .- 1546-170X. ; 18:9, s. 1418-
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Tidskriftsartikel (refereegranskat)abstract
- Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease affecting motor neurons. Disease onset and progression are variable, with survival ranging from months to decades. Factors underlying this variability may represent targets for therapeutic intervention. Here, we have screened a zebrafish model of ALS and identified Epha4, a receptor in the ephrin axonal repellent system, as a modifier of the disease phenotype in fish, rodents and humans. Genetic as well as pharmacological inhibition of Epha4 signaling rescues the mutant SOD1 phenotype in zebrafish and increases survival in mouse and rat models of ALS. Motor neurons that are most vulnerable to degeneration in ALS express higher levels of Epha4, and neuromuscular re-innervation by axotomized motor neurons is inhibited by the presence of Epha4. In humans with ALS, EPHA4 expression inversely correlates with disease onset and survival, and loss-of-function mutations in EPHA4 are associated with long survival. Furthermore, we found that knockdown of Epha4 also rescues the axonopathy induced by expression of mutant TAR DNA-binding protein 43 (TDP-43), another protein causing familial ALS, and the axonopathy induced by knockdown of survival of motor neuron 1, a model for spinomuscular atrophy. This suggests that Epha4 generically modulates the vulnerability of (motor) neurons to axonal degeneration and may represent a new target for therapeutic intervention.
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| 297. |
- van Rheenen, Wouter, et al.
(författare)
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Genome-wide association analyses identify new risk variants and the genetic architecture of amyotrophic lateral sclerosis
- 2016
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 48:9, s. 1043-1048
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Tidskriftsartikel (refereegranskat)abstract
- To elucidate the genetic architecture of amyotrophic lateral sclerosis (ALS) and find associated loci, we assembled a custom imputation reference panel from whole-genome-sequenced patients with ALS and matched controls (n = 1,861). Through imputation and mixed-model association analysis in 12,577 cases and 23,475 controls, combined with 2,579 cases and 2,767 controls in an independent replication cohort, we fine-mapped a new risk locus on chromosome 21 and identified C21orf2 as a gene associated with ALS risk. In addition, we identified MOBP and SCFD1 as new associated risk loci. We established evidence of ALS being a complex genetic trait with a polygenic architecture. Furthermore, we estimated the SNP-based heritability at 8.5%, with a distinct and important role for low-frequency variants (frequency 1-10%). This study motivates the interrogation of larger samples with full genome coverage to identify rare causal variants that underpin ALS risk.
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| 298. |
- Viñuela, Ana, et al.
(författare)
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Genetic variant effects on gene expression in human pancreatic islets and their implications for T2D
- 2020
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1, s. 4912-4912
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Tidskriftsartikel (refereegranskat)abstract
- Most signals detected by genome-wide association studies map to non-coding sequence and their tissue-specific effects influence transcriptional regulation. However, key tissues and cell-types required for functional inference are absent from large-scale resources. Here we explore the relationship between genetic variants influencing predisposition to type 2 diabetes (T2D) and related glycemic traits, and human pancreatic islet transcription using data from 420 donors. We find: (a) 7741 cis-eQTLs in islets with a replication rate across 44 GTEx tissues between 40% and 73%; (b) marked overlap between islet cis-eQTL signals and active regulatory sequences in islets, with reduced eQTL effect size observed in the stretch enhancers most strongly implicated in GWAS signal location; (c) enrichment of islet cis-eQTL signals with T2D risk variants identified in genome-wide association studies; and (d) colocalization between 47 islet cis-eQTLs and variants influencing T2D or glycemic traits, including DGKB and TCF7L2. Our findings illustrate the advantages of performing functional and regulatory studies in disease relevant tissues.
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| 299. |
- Vogelezang, Suzanne, et al.
(författare)
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Novel loci for childhood body mass index and shared heritability with adult cardiometabolic traits.
- 2020
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Ingår i: PLoS genetics. - : Public Library of Science (PLoS). - 1553-7404. ; 16:10
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Tidskriftsartikel (refereegranskat)abstract
- The genetic background of childhood body mass index (BMI), and the extent to which the well-known associations of childhood BMI with adult diseases are explained by shared genetic factors, are largely unknown. We performed a genome-wide association study meta-analysis of BMI in 61,111 children aged between 2 and 10 years. Twenty-five independent loci reached genome-wide significance in the combined discovery and replication analyses. Two of these, located near NEDD4L and SLC45A3, have not previously been reported in relation to either childhood or adult BMI. Positive genetic correlations of childhood BMI with birth weight and adult BMI, waist-to-hip ratio, diastolic blood pressure and type 2 diabetes were detected (Rg ranging from 0.11 to 0.76, P-values <0.002). A negative genetic correlation of childhood BMI with age at menarche was observed. Our results suggest that the biological processes underlying childhood BMI largely, but not completely, overlap with those underlying adult BMI. The well-known observational associations of BMI in childhood with cardio-metabolic diseases in adulthood may reflect partial genetic overlap, but in light of previous evidence, it is also likely that they are explained through phenotypic continuity of BMI from childhood into adulthood.
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| 300. |
- Wagner, Michelle, et al.
(författare)
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ORAMA Project - D6-6 Technical Final Report and Recommendations
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Securing the sustainable access to and supply of raw materials, and particularly of Critical Raw Materials (CRM), is of high importance for the European economy. Complex primary and secondary resources contain many different raw materials. The inability to easily produce reliable statistics about reserves, resources, stocks, and flows of raw materials limits the understanding of global trends in resource availability and hampers formulation of mineral and waste policies. This ultimately affects supply chain security and strategic decisions by industry. Hence, it is an issue of great concern for the European Commission (EC) and many other stakeholders. The ORAMA project (Optimising quality of information in RAw MAterial data collection across Europe) seeks to contribute to better supply of raw materials by improving the quality of harmonised raw materials data collection and information sharing among the different levels within the European Union (EU). Data collection practices for primary and secondary raw materials (PRM and SRM) face specific challenges in EU Member States (MS). For PRM data, the main concerns are related to data availability, geographical coverage, accessibility, harmonisation, interoperability, quality, and thematic coverage. The reporting of primary mineral resources and reserves statistics is currently carried out by a wide variety of systems, standards or codes which are not directly comparable. Hence, it is currently impossible to produce reliable pan-European figures for resources for any mineral commodity. ORAMA addresses these issues by recommending a single standard for reporting of resource data, the United Nations Framework Classification (UNFC), a framework for reporting mineral resource data developed by the UN. To enable and encourage data providers to adopt this standard for European PRM data, the ORAMA project has developed resources in the form of a range of training materials and good practice examples. The ORAMA project demonstrates that the analysis of various classifications and reporting systems that sit within the INSPIRE (Infrastructure for Spatial Information in the European Community) concept and data services, are not opposing but rather integral elements of the proper European level data collection and production of information for PRM and SRM. The use of UNFC/UNRMS (United Nations Resource Management System) in the framework of the INSPIRE compliant data service can significantly contribute to sustainable resource management taking into account not only geological knowledge and raw materials potential but also environmental and social issues, based on using the national/regional legislative elements for exploration and exploitation as well. In the case of SRM, the challenges are somewhat different. Regarding mining waste (MIN), the lack of information on deposit characteristics (composition, volumes, and suitable processing technology) is a huge barrier in the identification of recovery potential of the valuable materials that remain in the waste. Furthermore, the lack of a single reporting standard commonly accepted at EU level has created a dispersion of existing information in various systems and project deliverables. In the case of electrical and electronic equipment (EEE) and batteries, beyond the lack of harmonisation, substantial data gaps exist for the market inputs, materials consumption and stocks, and for waste electrical and electronic equipment (WEEE) for unaccounted flows ending up being scavenged, metal scrap and export channels. For vehicles, huge amounts of data, both on stocks and flows and on composition, are systematically collected by authorities and the manufacturing industry, but are only publicly available in a somewhat too aggregated form (placed on market (POM), stock, waste flows) or not at all (composition data). Even when collected, the reporting of the composition of these flows on a product, component and materials level are currently poorly described across all MS, and when actually ending up in recycling processes, the recovery efficiency for all elements and CRMs, in particular, is disappointing. In order to improve the data collection and reporting practices for SRM a structured review and inventory were made followed by a data gap analysis which resulted in the developments of recommendations and subsequently the selection of 6 case studies. The SRM case studies tackle the main data gaps encountered in the analysis and developed tools that will enable the improvement and harmonisation of collection and reporting practices in MS, treatment facilities, data providers, academia among others. The ORAMA project recommends to establish more structured and continuous funding for realising and maintaining a European data infrastructure for tracking both PRM and SRM. The current project-by-project based financing is insufficient and not sustainable to properly track and understand Europe’s strengths and weaknesses in the early resource intensive stages of global supply chains.
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