| 1. |
- Tong, Tammy Y. N., et al.
(författare)
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Dietary amino acids and risk of stroke subtypes : a prospective analysis of 356,000 participants in seven European countries
- 2024
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Ingår i: European Journal of Nutrition. - : Springer Nature. - 1436-6207 .- 1436-6215. ; 63, s. 209-220
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study.Methods: We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood pressure as a potential mechanism was assessed in 267,642 (75%) participants.Results: After a median follow-up of 12.9 years, 4295 participants had an ischaemic stroke and 1375 participants had a haemorrhagic stroke. After correction for multiple testing, a higher intake of proline (as a percent of total protein) was associated with a 12% lower risk of ischaemic stroke (HR per 1 SD higher intake 0.88; 95% CI 0.82, 0.94). The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure. The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing.Conclusion: Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.
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| 2. |
- Amare, Azmeraw, et al.
(författare)
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Association of Polygenic Score and the involvement of Cholinergic and Glutamatergic Pathways with Lithium Treatment Response in Patients with Bipolar Disorder.
- 2023
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Ingår i: Research square. - : Research Square Platform LLC.
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Tidskriftsartikel (refereegranskat)abstract
- Lithium is regarded as the first-line treatment for bipolar disorder (BD), a severe and disabling mental disorder that affects about 1% of the population worldwide. Nevertheless, lithium is not consistently effective, with only 30% of patients showing a favorable response to treatment. To provide personalized treatment options for bipolar patients, it is essential to identify prediction biomarkers such as polygenic scores. In this study, we developed a polygenic score for lithium treatment response (Li+PGS) in patients with BD. To gain further insights into lithium's possible molecular mechanism of action, we performed a genome-wide gene-based analysis. Using polygenic score modeling, via methods incorporating Bayesian regression and continuous shrinkage priors, Li+PGS was developed in the International Consortium of Lithium Genetics cohort (ConLi+Gen: N=2,367) and replicated in the combined PsyCourse (N=89) and BipoLife (N=102) studies. The associations of Li+PGS and lithium treatment response - defined in a continuous ALDA scale and a categorical outcome (good response vs. poor response) were tested using regression models, each adjusted for the covariates: age, sex, and the first four genetic principal components. Statistical significance was determined at P<����������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������.
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| 3. |
- Amare, Azmeraw T, et al.
(författare)
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Association of polygenic score and the involvement of cholinergic and glutamatergic pathways with lithium treatment response in patients with bipolar disorder.
- 2023
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Ingår i: Molecular psychiatry. - 1476-5578. ; 28, s. 5251-5261
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Tidskriftsartikel (refereegranskat)abstract
- Lithium is regarded as the first-line treatment for bipolar disorder (BD), a severe and disabling mental healthdisorder that affects about 1% of the population worldwide. Nevertheless, lithium is not consistently effective, with only 30% of patients showing a favorable response to treatment. To provide personalized treatment options for bipolar patients, it is essential to identify prediction biomarkers such as polygenic scores. In this study, we developed a polygenic score for lithium treatment response (Li+PGS) in patients with BD. To gain further insights into lithium's possible molecular mechanism of action, we performed a genome-wide gene-based analysis. Using polygenic score modeling, via methods incorporating Bayesian regression and continuous shrinkage priors, Li+PGS was developed in the International Consortium of Lithium Genetics cohort (ConLi+Gen: N=2367) and replicated in the combined PsyCourse (N=89) and BipoLife (N=102) studies. The associations of Li+PGS and lithium treatment response - defined in a continuous ALDA scale and a categorical outcome (good response vs. poor response) were tested using regression models, each adjusted for the covariates: age, sex, and the first four genetic principal components. Statistical significance was determined at P<0.05. Li+PGS was positively associated with lithium treatment response in the ConLi+Gen cohort, in both the categorical (P=9.8×10-12, R2=1.9%) and continuous (P=6.4×10-9, R2=2.6%) outcomes. Compared to bipolar patients in the 1st decile of the risk distribution, individuals in the 10th decile had 3.47-fold (95%CI: 2.22-5.47) higher odds of responding favorably to lithium. The results were replicated in the independent cohorts for the categorical treatment outcome (P=3.9×10-4, R2=0.9%), but not for the continuous outcome (P=0.13). Gene-based analyses revealed 36 candidate genes that are enriched in biological pathways controlled by glutamate and acetylcholine. Li+PGS may be useful in the development of pharmacogenomic testing strategies by enabling a classification of bipolar patients according to their response to treatment.
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| 4. |
- Carlsen, Henrik, et al.
(författare)
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A sustainable trajectory for the 2030 Agenda: Targeting historical lock‐ins to accelerate progress on all SDGs
- 2024
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Ingår i: Sustainable Development. - 0968-0802 .- 1099-1719.
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Tidskriftsartikel (refereegranskat)abstract
- The 2030 Agenda states that the 17 sustainable development goals (SDGs) make parts of an indivisible whole, and research on SDG implementation highlights how managing goal interactions—synergies and trade-offs—is key for implementation to be successful. Here, we present an empirically based and transparent method for developing “consistent scenarios” that identifies which SDGs will be unattainable if historical patterns of interaction between SDGs are maintained. Using historical data on SDG indicators and correlation analysis together with cross-impact balance analysis, we identify such scenarios for a set of high- to low-income countries. Finding no consistent scenario where progress can be made on all 17 SDGs for any of the countries, our findings demonstrate the importance of policies that target interactions and resolve trade-offs rather than individual goals to unlock a sustainable future trajectory. This reflects what was novel about the SDGs as a framework for global development; that the goals are indivisible and achieving them all require systemic changes that alter how social and economic processes interact with the environment.
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| 5. |
- Gemzell-Danielsson, Kristina, et al.
(författare)
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Comprehensive counseling about combined hormonal contraceptives changes the choice of contraceptive methods : results of the CHOICE program in Sweden
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 90:8, s. 869-877
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To study the influence of counseling on women's contraceptive decisions. Design. A cross-sectional multicenter study. Setting. Seventy Swedish family planning clinics. Population. Women aged 15-40 years attending for a contraceptive consultation who expressed interest in a combined hormonal contraceptive (CHC) method. Methods. Structured counseling about three CHCs and questionnaires completed after counseling from the healthcare professional. Main Outcome Measures. Method originally requested, perceptions of CHC attributes, method chosen and reasons for the choice. Results. In all, 173 healthcare professionals and 1 944 women participated. The mean standard deviation (SD) age of the women was 22.6(6.1) years. After structured counseling, a majority of women (56.0%; n=1 069; 95% confidence interval (CI) 53.1-58.9) chose the daily pill, 6.2% (n=118; 95% CI 4.9-7.8) chose the weekly patch, and 22.5% ( n=430; 95% CI 20.2-25.1) chose the monthly ring. The weekly patch was chosen more often after counseling (6.2 vs 2.4% before counseling; p<0.0001). The greatest change was in the proportion of women who chose the contraceptive ring after counseling (22.5% vs. 8.5% before counseling; p<0.0001). The proportion of undecided women after counseling was reduced considerably (3.9% vs. 27.8% before counseling). Among the 523 women who were undecided before counseling, 50.6% chose the pill, 10.2% the patch and 24.6% the ring, while 20.9% of women who initially requested the pill changed to another method. Conclusions. Structured counseling facilitated choice of contraceptive method for most women, leading to changes in women's selection of a CHC method.
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| 6. |
- Godman, Brian, et al.
(författare)
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Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe : Findings and Implications
- 2021
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Ingår i: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141. ; 2021
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Tidskriftsartikel (refereegranskat)abstract
- Background. Diabetes mellitus rates and associated costs continue to rise across Europe enhancing health authority focus on its management. The risk of complications is enhanced by poor glycaemic control, with long-acting insulin analogues developed to reduce hypoglycaemia and improve patient convenience. There are concerns though with their considerably higher costs, but moderated by reductions in complications and associated costs. Biosimilars can help further reduce costs. However, to date, price reductions for biosimilar insulin glargine appear limited. In addition, the originator company has switched promotional efforts to more concentrated patented formulations to reduce the impact of biosimilars. There are also concerns with different devices between the manufacturers. As a result, there is a need to assess current utilisation rates for insulins, especially long-acting insulin analogues and biosimilars, and the rationale for patterns seen, among multiple European countries to provide future direction.Methodology. Health authority databases are examined to assess utilisation and expenditure patterns for insulins, including biosimilar insulin glargine. Explanations for patterns seen were provided by senior-level personnel.Results. Typically increasing use of long-acting insulin analogues across Europe including both Western and Central and Eastern European countries reflects perceived patient benefits despite higher prices. However, activities by the originator company to switch patients to more concentrated insulin glargine coupled with lowering prices towards biosimilars have limited biosimilar uptake, with biosimilars not currently launched in a minority of European countries. A number of activities were identified to address this. Enhancing the attractiveness of the biosimilar insulin market is essential to encourage other biosimilar manufacturers to enter the market as more long-acting insulin analogues lose their patents to benefit all key stakeholder groups.Conclusions. There are concerns with the availability and use of insulin glargine biosimilars among European countries despite lower costs. This can be addressed.
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| 7. |
- Hegre, Håvard, 1964-, et al.
(författare)
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Synergies and Trade-Offs in Reaching the Sustainable Development Goals
- 2020
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 12:20
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Tidskriftsartikel (refereegranskat)abstract
- The Sustainable Development Goals (SDGs) adopted in 2015 integrate diverse issues such as addressing hunger, gender equality and clean energy and set a common agenda for all United Nations member states until 2030. The 17 SDGs interact and by working towards achieving one goal countries may further—or jeopardise—progress on others. However, the direction and strength of these interactions are still poorly understood and it remains an analytical challenge to capture the relationships between the multi-dimensional goals, comprising 169 targets and over 200 indicators. Here, we use principal component analysis (PCA), an in this context novel approach, to summarise each goal and interactions in the global SDG agenda. Applying PCA allows us to map trends, synergies and trade-offs at the level of goals for all SDGs while using all available information on indicators. While our approach does not allow us to investigate causal relationships, it provides important evidence of the degree of compatibility of goal attainment over time. Based on global data 2000–2016, our results indicate that synergies between and within the SDGs prevail, both in terms of levels and over time change. An exception is SDG 10 ‘Reducing inequalities’ which has not progressed in tandem with other goals.
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| 8. |
- Hegre, Håvard, 1964-, et al.
(författare)
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ViEWS : A political violence early-warning system
- 2019
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Ingår i: Journal of Peace Research. - : SAGE Publications. - 0022-3433 .- 1460-3578. ; 56:2, s. 155-174
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Tidskriftsartikel (refereegranskat)abstract
- This article presents ViEWS – a political violence early-warning system that seeks to be maximally transparent, publicly available, and have uniform coverage, and sketches the methodological innovations required to achieve these objectives. ViEWS produces monthly forecasts at the country and subnational level for 36 months into the future and all three UCDP types of organized violence: state-based conflict, non-state conflict, and one-sided violence in Africa. The article presents the methodology and data behind these forecasts, evaluates their predictive performance, provides selected forecasts for October 2018 through October 2021, and indicates future extensions. ViEWS is built as an ensemble of constituent models designed to optimize its predictions. Each of these represents a theme that the conflict research literature suggests is relevant, or implements a specific statistical/machine-learning approach. Current forecasts indicate a persistence of conflict in regions in Africa with a recent history of political violence but also alert to new conflicts such as in Southern Cameroon and Northern Mozambique. The subsequent evaluation additionally shows that ViEWS is able to accurately capture the long-term behavior of established political violence, as well as diffusion processes such as the spread of violence in Cameroon. The performance demonstrated here indicates that ViEWS can be a useful complement to non-public conflict-warning systems, and also serves as a reference against which future improvements can be evaluated.
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| 9. |
- Leis, Maxine, et al.
(författare)
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Determining distress-related mobility at the household level - an interpretative machine learning framework.
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The UNHCR counted approximately 89 million displaced persons worldwide at the end of 2021. Such population dynamics often occur in places that are vulnerable to the consequences of extreme weather events, but that are also experiencing protracted violence. While the impact of conflict and disasters has mainly been studied in isolation, we contribute to the literature by, first, examining potential interactions between the two events and, second, studying their heterogeneous effects, which we suggest are shaped by a set of household attributes that predispose individuals to move and precipitate action. We test theoretical expectations regarding drivers of distress mobility, relying on an “aspiration and ability” framework, which accounts for people’s agency in shaping migratory decisions. To conduct our analysis, we combine geo-referenced administrative-level data on different conflict types and natural-hazard-related disasters. Using a nationally representative geo-referenced household survey, focusing on Bangladesh for the period between 2011-2018, we include responses on the migration status of households’ members, as well as individual- and household-level characteristics. Given the complex nature of distress mobility, we rely on a machine learning out-of-sample prediction framework to evaluate theoretical expectations. Machine learning algorithms, such as XGBoost Classifiers, are highly flexible and can reveal hidden interactions in the data generating process without having to pre-specify these interactions. To communicate our results, we rely on Shapley values as interpretative machine learning tools.
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| 10. |
- Nohrstedt, Daniel, 1974-, et al.
(författare)
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Disaster risk reduction and the limits of truisms : Improving the knowledge and practice interface
- 2022
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Ingår i: International Journal of Disaster Risk Reduction. - : Elsevier. - 2212-4209. ; 67
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Tidskriftsartikel (refereegranskat)abstract
- Action toward strengthened disaster risk reduction (DRR) ideally builds from evidence-based policymaking to inform decisions and priorities. This is a guiding principle for the Sendai Framework for Disaster Risk Reduction (SFDRR), which outlines priorities for action to reduce disaster risk. However, some of these practical guidelines conceal oversimplified or unsubstantiated claims and assumptions, what we refer to as 'truisms', which, if not properly addressed, may jeopardize the long-term goal to reduce disaster risks. Thus far, much DRR research has focused on ways to bridge the gap between science and practice while devoting less attention to the premises that shape the understanding of DRR issues. In this article, written in the spirit of a perspective piece on the state of the DRR field, we utilize the SFDRR as an illustrative case to identify and interrogate ten selected truisms, from across the social and natural sciences, that have been prevalent in shaping DRR research and practice. The ten truisms concern forecasting, loss, conflict, migration, the local level, collaboration, social capital, prevention, policy change, and risk awareness. We discuss central claims associated with each truism, relate those claims to insights in recent DRR scholarship, and end with suggestions for developing the field through advances in conceptualization, measurement, and causal inference.
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