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- Lam, P. H., et al.
(författare)
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Digoxin use and lower risk of 30-day all-cause readmission in older patients with heart failure and reduced ejection fraction receiving β-blockers
- 2018
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Ingår i: Clinical Cardiology. - : Wiley. - 0160-9289. ; 41:3, s. 406-412
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Tidskriftsartikel (refereegranskat)abstract
- Background: Digoxin use has been associated with a lower risk of 30-day all-cause admission and readmission in patients with heart failure and reduced ejection fraction (HFrEF). Hypothesis: Digoxin use will be associated with improved outcomes in patients with HFrEF receiving β-blockers. Methods: Of the 3076 hospitalized Medicare beneficiaries with HFrEF (EF <45%), 1046 received a discharge prescription for β-blockers, of which 634 were not on digoxin. Of the 634, 204 received a new discharge prescription for digoxin. Propensity scores for digoxin use, estimated for each of the 634 patients, were used to assemble a matched cohort of 167 pairs of patients receiving and not receiving digoxin, balanced on 30 baseline characteristics. Matched patients (n = 334) had a mean age of 74 years and were 46% female and 30% African American. Results: 30-day all-cause readmission occurred in 15% and 27% of those receiving and not receiving digoxin, respectively (hazard ratio [HR]: 0.51, 95% confidence interval [CI]: 0.31-0.83, P = 0.007). This beneficial association persisted during 4 years of follow-up (HR: 0.72, 95% CI: 0.57-0.92, P = 0.008). Digoxin use was also associated with a lower risk of the combined endpoint of all-cause readmission or all-cause mortality at 30 days (HR: 0.54, 95% CI: 0.34-0.86, P = 0.009) and at 4 years (HR: 0.76, 95% CI: 0.61-0.96, P = 0.020). Conclusions: In hospitalized patients with HFrEF receiving β-blockers, digoxin use was associated with a lower risk of 30-day all-cause readmission but not mortality, which persisted during longer follow-up. © 2018 Wiley Periodicals, Inc.
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- DeWitt, Jamie C., et al.
(författare)
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Zürich II Statement on Per- and Polyfluoroalkyl Substances (PFASs) : Scientific and Regulatory Needs
- 2024
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Ingår i: Environmental Science and Technology Letters. - 2328-8930. ; 11:8, s. 786-797
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Forskningsöversikt (refereegranskat)abstract
- Per- and polyfluoroalkyl substances (PFASs) are a class of synthetic organic chemicals of global concern. A group of 36 scientists and regulators from 18 countries held a hybrid workshop in 2022 in Zürich, Switzerland. The workshop, a sequel to a previous Zürich workshop held in 2017, deliberated on progress in the last five years and discussed further needs for cooperative scientific research and regulatory action on PFASs. This review reflects discussion and insights gained during and after this workshop and summarizes key signs of progress in science and policy, ongoing critical issues to be addressed, and possible ways forward. Some key take home messages include: 1) understanding of human health effects continues to develop dramatically, 2) regulatory guidelines continue to drop, 3) better understanding of emissions and contamination levels is needed in more parts of the world, 4) analytical methods, while improving, still only cover around 50 PFASs, and 5) discussions of how to group PFASs for regulation (including subgroupings) have gathered momentum with several jurisdictions proposing restricting a large proportion of PFAS uses. It was concluded that more multi-group exchanges are needed in the future and that there should be a greater diversity of participants at future workshops.
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- MacLeod, K. J., et al.
(författare)
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Compensating for a stressful pregnancy? Glucocorticoid treatment during gravidity reduces metabolic rate in female fence lizards post-parturition
- 2021
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Ingår i: Hormones and Behavior. - : Elsevier BV. - 0018-506X. ; 136
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Tidskriftsartikel (refereegranskat)abstract
- Reproduction is a critical part of an animal's life history, but one which incurs significant costs to survival and future reproductive potential. These physiological consequences are likely to be influenced by context – for example, if an individual is subject to environmental stressors, physiological and behavioral changes associated with reproduction may be altered. Glucocorticoids, hormones produced as part of the physiological response to stressors, may alter how reproduction affects female physiology and behavior, and therefore the outcomes of reproductive trade-offs. Glucocorticoids prioritize immediate survival over reproduction, for example through changes in immune function, metabolic rate, and foraging, which may reduce energy expenditure or increase energy gain. However, we previously found that female eastern fence lizards (Sceloporus undulatus) experiencing elevated glucocorticoid levels during gestation were nevertheless able to maintain reproductive output and body condition. Here we investigate compensatory mechanisms by which eastern fence lizard females may maintain reproduction under experimental increases in a glucocorticoid, corticosterone (CORT). We found that, although CORT-treated females had similar immune function and behavior, they had reduced metabolic rates 3-5 days post-parturition compared to control females. Given that CORT-treated females spent a similar time basking and had equal food intake compared to control females, we suggest that the reduced metabolic rate is a mechanism by which CORT-treated females maintain their energy balance and reduce the energetic costs of gestation during periods of stress. This study suggests that physiological responses to reproduction may be context-dependent and could act to minimize costs of reproduction in situations where CORT is elevated (such as during periods of environmental stress).
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- MacLeod, Kirsty J., et al.
(författare)
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Predator-induced transgenerational plasticity in animals : a meta-analysis
- 2022
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Ingår i: Oecologia. - : Springer Science and Business Media LLC. - 0029-8549 .- 1432-1939. ; 200:3-4, s. 371-383
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Tidskriftsartikel (refereegranskat)abstract
- There is growing evidence that the environment experienced by one generation can influence phenotypes in the next generation via transgenerational plasticity (TGP). One of the best-studied examples of TGP in animals is predator-induced transgenerational plasticity, whereby exposing parents to predation risk triggers changes in offspring phenotypes. Yet, there is a lack of general consensus synthesizing the predator–prey literature with existing theory pertaining to ecology and evolution of TGP. Here, we apply a meta-analysis to the sizable literature on predator-induced TGP (441 effect sizes from 29 species and 49 studies) to explore five hypotheses about the magnitude, form and direction of predator-induced TGP. Hypothesis #1: the strength of predator-induced TGP should vary with the number of predator cues. Hypothesis #2: the strength of predator-induced TGP should vary with reproductive mode. Hypothesis #3: the strength and direction of predator-induced TGP should vary among offspring phenotypic traits because some traits are more plastic than others. Hypothesis #4: the strength of predator-induced TGP should wane over ontogeny. Hypothesis #5: predator-induced TGP should generate adaptive phenotypes that should be more evident when offspring are themselves exposed to risk. We found strong evidence for predator-induced TGP overall, but no evidence that parental predator exposure causes offspring traits to change in a particular direction. Additionally, we found little evidence in support of any of the specific hypotheses. We infer that the failure to find consistent evidence reflects the heterogeneous nature of the phenomena, and the highly diverse experimental designs used to study it. Together, these findings set an agenda for future work in this area.
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- Martins Dos Santos, Vitor, et al.
(författare)
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Systems Biology in ELIXIR: modelling in the spotlight
- 2022
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Ingår i: F1000Research. - : F1000 Research Ltd. - 1759-796X .- 2046-1402. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- In this white paper, we describe the founding of a new ELIXIR Community - the Systems Biology Community - and its proposed future contributions to both ELIXIR and the broader community of systems biologists in Europe and worldwide. The Community believes that the infrastructure aspects of systems biology - databases, (modelling) tools and standards development, as well as training and access to cloud infrastructure - are not only appropriate components of the ELIXIR infrastructure, but will prove key components of ELIXIR's future support of advanced biological applications and personalised medicine. By way of a series of meetings, the Community identified seven key areas for its future activities, reflecting both future needs and previous and current activities within ELIXIR Platforms and Communities. These are: overcoming barriers to the wider uptake of systems biology; linking new and existing data to systems biology models; interoperability of systems biology resources; further development and embedding of systems medicine; provisioning of modelling as a service; building and coordinating capacity building and training resources; and supporting industrial embedding of systems biology. A set of objectives for the Community has been identified under four main headline areas: Standardisation and Interoperability, Technology, Capacity Building and Training, and Industrial Embedding. These are grouped into short-term (3-year), mid-term (6-year) and long-term (10-year) objectives.
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