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- 2019
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Vos, Theo, et al.
(författare)
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Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
- 2015
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 386:9995, s. 743-800
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2.4 billion and 1.6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537.6 million in 1990 to 764.8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114.87 per 1000 people to 110.31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21.1% in 1990 to 31.2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
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| 3. |
- Hollestelle, Antoinette, et al.
(författare)
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No clinical utility of KRAS variant rs61764370 for ovarian or breast cancer
- 2016
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Ingår i: Gynecologic Oncology. - : Elsevier BV. - 0090-8258 .- 1095-6859. ; 141:2, s. 386-401
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Tidskriftsartikel (refereegranskat)abstract
- Objective Clinical genetic testing is commercially available for rs61764370, an inherited variant residing in a KRAS 3′ UTR microRNA binding site, based on suggested associations with increased ovarian and breast cancer risk as well as with survival time. However, prior studies, emphasizing particular subgroups, were relatively small. Therefore, we comprehensively evaluated ovarian and breast cancer risks as well as clinical outcome associated with rs61764370. Methods Centralized genotyping and analysis were performed for 140,012 women enrolled in the Ovarian Cancer Association Consortium (15,357 ovarian cancer patients; 30,816 controls), the Breast Cancer Association Consortium (33,530 breast cancer patients; 37,640 controls), and the Consortium of Modifiers of BRCA1 and BRCA2 (14,765 BRCA1 and 7904 BRCA2 mutation carriers). Results We found no association with risk of ovarian cancer (OR = 0.99, 95% CI 0.94-1.04, p = 0.74) or breast cancer (OR = 0.98, 95% CI 0.94-1.01, p = 0.19) and results were consistent among mutation carriers (BRCA1, ovarian cancer HR = 1.09, 95% CI 0.97-1.23, p = 0.14, breast cancer HR = 1.04, 95% CI 0.97-1.12, p = 0.27; BRCA2, ovarian cancer HR = 0.89, 95% CI 0.71-1.13, p = 0.34, breast cancer HR = 1.06, 95% CI 0.94-1.19, p = 0.35). Null results were also obtained for associations with overall survival following ovarian cancer (HR = 0.94, 95% CI 0.83-1.07, p = 0.38), breast cancer (HR = 0.96, 95% CI 0.87-1.06, p = 0.38), and all other previously-reported associations. Conclusions rs61764370 is not associated with risk of ovarian or breast cancer nor with clinical outcome for patients with these cancers. Therefore, genotyping this variant has no clinical utility related to the prediction or management of these cancers.
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| 4. |
- Brooks, Ian M., et al.
(författare)
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The Turbulent Structure of the Arctic Summer Boundary Layer During The Arctic Summer Cloud-Ocean Study
- 2017
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Ingår i: Journal of Geophysical Research - Atmospheres. - 2169-897X .- 2169-8996. ; 122:18, s. 9685-9704
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Tidskriftsartikel (refereegranskat)abstract
- The mostly ice covered Arctic Ocean is dominated by low-level liquid-or mixed-phase clouds. Turbulence within stratocumulus is primarily driven by cloud top cooling that induces convective instability. Using a suite of in situ and remote sensing instruments we characterize turbulent mixing in Arctic stratocumulus, and for the first time we estimate profiles of the gradient Richardson number at relatively high resolution in both time (10 min) and altitude (10 m). It is found that the mixing occurs both within the cloud, as expected, and by wind shear instability near the surface. About 75% of the time these two layers are separated by a stably stratified inversion at 100-200 m altitude. Exceptions are associated with low cloud bases that allow the cloud-driven turbulence to reach the surface. The results imply that turbulent coupling between the surface and the cloud is sporadic or intermittent.Plain Language Summary: The lower atmosphere over the summertime Arctic Ocean often consists of two well-mixed layers-a surface mixed layer and a cloud mixed layer-that are separated by a weak decoupling layer at about 100 to 300 m above the surface. In these cases, the cloud cannot interact directly with the surface. Large-scale forecast and climate models consistently fail to reproduce this observed structure and may thus fail to correctly reproduce the cloud properties and the amount of energy absorbed by or emitted from the surface as solar and infrared radiation. This contributes to errors in reproducing changes in sea ice concentration over time. Here we use measurements made in the central Arctic to study the processes controlling whether or not the cloud is coupled to the surface. The effect of wind at the surface is found not to be a controlling factor. The depth of the cloud mixed layer is critical, but the multiple processes influencing it cannot be separated using the data available here. However, cooling at cloud top by infrared radiation is key, as is the extension of cloud into the temperature inversion-a unique feature of Arctic clouds.
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| 5. |
- Prytherch, John, et al.
(författare)
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Direct determination of the air-sea CO2 gas transfer velocity in Arctic sea ice regions
- 2017
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 44:8, s. 3770-3778
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Tidskriftsartikel (refereegranskat)abstract
- The Arctic Ocean is an important sink for atmospheric CO2. The impact of decreasing sea ice extent and expanding marginal ice zones on Arctic air-sea CO2 exchange depends on the rate of gas transfer in the presence of sea ice. Sea ice acts to limit air-sea gas exchange by reducing contact between air and water but is also hypothesized to enhance gas transfer rates across surrounding open-water surfaces through physical processes such as increased surface-ocean turbulence from ice-water shear and ice-edge form drag. Here we present the first direct determination of the CO2 air-sea gas transfer velocity in a wide range of Arctic sea ice conditions. We show that the gas transfer velocity increases near linearly with decreasing sea ice concentration. We also show that previous modeling approaches overestimate gas transfer rates in sea ice regions.
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| 6. |
- Sotiropoulou, Georgia, et al.
(författare)
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Atmospheric conditions during the Arctic Clouds in Summer Experiment (ACSE) : Contrasting open-water and sea-ice surfaces during melt and freeze-up seasons
- 2016
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Ingår i: Journal of Climate. - 0894-8755 .- 1520-0442. ; 29:24, s. 8721-8744
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Tidskriftsartikel (refereegranskat)abstract
- The Arctic Clouds in Summer Experiment (ACSE) was conducted during summer and early autumn 2014, providing a detailed view of the seasonal transition from ice melt into freeze-up. Measurements were taken over both ice-free and ice-covered surfaces, near the ice edge, offering insight to the role of the surface state in shaping the atmospheric conditions. The initiation of the autumn freeze-up was related to a change in air mass, rather than to changes in solar radiation alone; the lower atmosphere cooled abruptly leading to a surface heat loss. During melt season, strong surface inversions persisted over the ice, while elevated inversions were more frequent over open water. These differences disappeared during autumn freeze-up, when elevated inversions persisted over both ice-free and ice-covered conditions. These results are in contrast to previous studies that found a well-mixed boundary layer persisting in summer and an increased frequency of surface-based inversions in autumn, suggesting that our knowledge derived from measurements taken within the pan-Arctic area and on the central ice-pack does not necessarily apply closer to the ice-edge. This study offers an insight to the atmospheric processes that occur during a crucial period of the year; understanding and accurately modeling these processes is essential for the improvement of ice-extent predictions and future Arctic climate projections.
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| 7. |
- Tjernström, Michael, et al.
(författare)
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Warm-air advection, air mass transformation and fog causes rapid ice melt
- 2015
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 42:13, s. 5594-5602
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Tidskriftsartikel (refereegranskat)abstract
- Direct observations during intense warm-air advection over the East Siberian Sea reveal a period of rapid sea-ice melt. A semistationary, high-pressure system north of the Bering Strait forced northward advection of warm, moist air from the continent. Air-mass transformation over melting sea ice formed a strong, surface-based temperature inversion in which dense fog formed. This induced a positive net longwave radiation at the surface while reducing net solar radiation only marginally; the inversion also resulted in downward turbulent heat flux. The sum of these processes enhanced the surface energy flux by an average of similar to 15Wm(-2) for a week. Satellite images before and after the episode show sea-ice concentrations decreasing from > 90% to similar to 50% over a large area affected by the air-mass transformation. We argue that this rapid melt was triggered by the increased heat flux from the atmosphere due to the warm-air advection.
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| 8. |
- Tjernström, Michael, et al.
(författare)
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Arctic Summer Airmass Transformation, Surface Inversions, and the Surface Energy Budget
- 2019
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Ingår i: Journal of Climate. - 0894-8755 .- 1520-0442. ; 32:3, s. 769-789
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Tidskriftsartikel (refereegranskat)abstract
- During the Arctic Clouds in Summer Experiment (ACSE) in summer 2014 a weeklong period of warm-air advection over melting sea ice, with the formation of a strong surface temperature inversion and dense fog, was observed. Based on an analysis of the surface energy budget, we formulated the hypothesis that, because of the airmass transformation, additional surface heating occurs during warm-air intrusions in a zone near the ice edge. To test this hypothesis, we explore all cases with surface inversions occurring during ACSE and then characterize the inversions in detail. We find that they always occur with advection from the south and are associated with subsidence. Analyzing only inversion cases over sea ice, we find two categories: one with increasing moisture in the inversion and one with constant or decreasing moisture with height. During surface inversions with increasing moisture with height, an extra 10-25 W m(-2) of surface heating was observed, compared to cases without surface inversions; the surface turbulent heat flux was the largest single term. Cases with less moisture in the inversion were often cloud free and the extra solar radiation plus the turbulent surface heat flux caused by the inversion was roughly balanced by the loss of net longwave radiation.
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