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- 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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| 2. |
- Ståhl, H., et al.
(författare)
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Respiration and sequestering of organic carbon in shelf sediments of the oligotrophic northern Aegean Sea
- 2004
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Ingår i: Marine Ecology-Progress Series. ; 269, s. 33-48
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Tidskriftsartikel (refereegranskat)abstract
- Respiration and sequestering of organic carbon was investigated in northern Aegean Sea sediments (NE Mediterranean). Benthic total carbonate (C-T, also called SigmaCO(2) or dissolved inorganic carbon, DIC) fluxes and O-2 uptake rates were measured in situ using a benthic lander. Dissolved organic carbon (DOC) fluxes were calculated from pore water gradients, taking into account the influence of biodiffusion/bioirrigation. Macrofaunal biomass was determined in the sediment collected by the chambers of the benthic lander. Chl a distributions were used as a tracer of high-quality sedimentary organic carbon. The measured benthic C-T fluxes were positively correlated with the O-2 uptake rates. The obtained average apparent respiration ratio (C-T flux:O-2 flux) of 0.90 +/- 0.36 suggests a clear dominance of aerobic respiration in these organic carbon-poor shelf sediments. The C-T efflux, the 02 uptake rate, and the DOC flux were significantly higher in spring than in fall at 2 of the stations. The Black Sea water, which enters the Aegean Sea in the study area, did not influence benthic respiration rates or organic carbon sequestering rates. A strong positive correlation between both the C-T and O-2 fluxes and the mean chl a concentration in surficial sediment suggests that benthic respiration, to a large extent, was controlled by the availability of labile phytodetrital organic matter. There was no influence of macrofaunal biomass (dry weight) on C-T fluxes or oxygen uptake rates. The calculated benthic DOC fluxes made up 7.2 to 27 % (average 14 +/- 8.1 %) of the C-T fluxes, indicating that their contribution to the overall recycling of organic carbon in these sediments was important. The organic carbon burial efficiency ranged from 0.1 to 5.3 %, but at Stn KA1 it was considerably higher (average 4%) than at the other stations (average 0.3%). Except for this station, the obtained burial efficiencies were very low compared to other sediments with similar accumulation rates. The average burial flux of organic carbon corresponded to less than 1 % of the annual mean primary production (PP) for the Aegean Sea at Stn KA1, and to less than 0.1 % of PP at the other stations.
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| 7. |
- Phelan, Suzanne, et al.
(författare)
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One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials
- 2020
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 44, s. 57-68
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Tidskriftsartikel (refereegranskat)abstract
- Background/objectives: Excess gestational weight gain (GWG) is a risk factor for maternal postpartum weight retention and excessive neonatal adiposity, especially in women with overweight or obesity. Whether lifestyle interventions to reduce excess GWG also reduce 12-month maternal postpartum weight retention and infant weight-for-length z score is unknown. Randomized controlled trials from the LIFE-Moms consortium investigated lifestyle interventions that began in pregnancy and tested whether there was benefit through 12 months on maternal postpartum weight retention (i.e., the difference in weight from early pregnancy to 12 months) and infant-weight-for-length z scores. Subjects/methods: In LIFE-Moms, women (N = 1150; 14.1 weeks gestation at enrollment) with overweight or obesity were randomized within each of seven trials to lifestyle intervention or standard care. Individual participant data were combined and analyzed using generalized linear mixed models with trial entered as a random effect. The 12-month assessment was completed by 83% (959/1150) of women and 84% (961/1150) of infants. Results: Compared with standard care, lifestyle intervention reduced postpartum weight retention (2.2 ± 7.0 vs. 0.7 ± 6.2 kg, respectively; difference of −1.6 kg (95% CI −2.5, −0.7; p = 0.0003); the intervention effect was mediated by reduction in excess GWG, which explained 22% of the effect on postpartum weight retention. Lifestyle intervention also significantly increased the odds (OR = 1.68 (95% CI, 1.26, 2.24)) and percentage of mothers (48.2% vs. 36.2%) at or below baseline weight at 12 months postpartum (yes/no) compared with standard care. There was no statistically significant treatment group effect on infant anthropometric outcomes at 12 months. Conclusions: Compared with standard care, lifestyle interventions initiated in pregnancy and focused on healthy eating, increased physical activity, and other behavioral strategies resulted in significantly less weight retention but similar infant anthropometric outcomes at 12 months postpartum in a large, diverse US population of women with overweight and obesity.
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| 8. |
- Johansson, J, et al.
(författare)
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Time-resolved NIR/Vis spectroscopy for analysis of solids: Pharmaceutical tablets
- 2002
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Ingår i: Applied Spectroscopy. - : SAGE Publications. - 1943-3530 .- 0003-7028. ; 56:6, s. 725-731
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Tidskriftsartikel (refereegranskat)abstract
- Time-resolved spectroscopy in the visible and near-infrared (NIR) regions was used in a feasibility study for analysis of solid pharmaceuticals. The objective of the experiments was to study the interaction of light with pharmaceutical solids and to investigate the usefulness of the method as an analytical toot for spectroscopic analysis. In these experiments, a pulsed Ti:sapphire laser and white light generation in water was utilized to form a pulsed light source in the visible/NIR region. The light was focused onto the surface of tablets, and the transmitted light was detected by a time-resolving streak camera. Two types of measurements were performed. First, a spectrometer was put in front of the streak camera for spectral resolution. Secondly, the signal originating from different locations of the sample was collected. Time-resolved and wavelength/spatially resolved data were generated and compared for a number of different samples. The most striking result from the experiments is that the typical optical path length through a 3.5-mm-thick tablet is about 20-25 cm. This indicates very strong multiple scattering in these samples. Monte Carlo simulations and comparison with experimental data support very high scattering coefficients on the order of 500 cm(-1). Furthermore, the data evaluation shows that photons with a particular propagation time through the sample contain a higher chemical contrast than other propagation times or than steady-state information. In conclusion, time-resolved NIR spectroscopy yields more information about solid pharmaceutical samples than conventional steady-state spectroscopy.
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- Josefson, A. B., et al.
(författare)
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Burial and decomposition of plant pigments in surface sediments of the Baltic Sea: role of oxygen and benthic fauna
- 2012
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Ingår i: Marine Ecology-Progress Series. - : Inter-Research Science Center. - 0171-8630 .- 1616-1599. ; 455, s. 33-49
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Tidskriftsartikel (refereegranskat)abstract
- Degradation and burial of organic matter in sediments are important processes for oxygen dynamics and thus for the outcome of eutrophication. To assess the influences of bottom-water oxygen and macroinvertebrate fauna function on these processes, we investigated distributions of phytopigments as markers of phytoplankton detritus in surface sediments across the Baltic Sea. We compared pigment concentrations among sites with different oxygen levels and different values of a bioturbation potential index combining abundance, individual size and species-specific rankings of mobility and sediment reworking (BPI). BPI was positively influenced by oxygen availability, with a threshold at 45 to 90 mu mol l(-1), below which it decreased rapidly to zero in anoxic sediments. There was significant co-variation between pigments and both oxygen and BPI after accounting for differences in pigment concentrations with sediment depth and among different sub-areas, which were largely attributed to different inputs of phytoplankton. Negative correlations between pigments and both BPI and oxygen in communities dominated by Macoma balthica and Scoloplos armiger, and between pigments and BPI in the upper sediment layers inhabited by Monoporeia affinis and Pontoporeia femorata, suggested increased degradation with increasing bioturbation. Positive correlations between pigments and BPI in communities dominated by Marenzelleria spp. suggested mainly burial, which also was supported by positive correlations between Marenzelleria abundance and both sediment water content and the freshness of buried organic material. It is hypothesised that a shift from sensitive resident species like Monoporeia or Scoloplos to the more hypoxia-tolerant Marenzelleria will slow down overall degradation rates, counteracting hypoxia formation in the bottom water. ELEOESCHGER D, 1991, MARINE ECOLOGY-PROGRESS SERIES, V70, P83
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