| 1. |
- Forouzanfar, Mohammad H, et al.
(författare)
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Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks 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. - 0140-6736 .- 1474-547X. ; 386:10010, s. 2287-2323
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.FUNDING: Bill & Melinda Gates Foundation.
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| 2. |
- Jansen, Willemijn J, et al.
(författare)
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Association of Cerebral Amyloid-β Aggregation With Cognitive Functioning in Persons Without Dementia.
- 2018
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Ingår i: JAMA psychiatry. - : American Medical Association (AMA). - 2168-6238 .- 2168-622X. ; 75:1, s. 84-95
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral amyloid-β aggregation is an early event in Alzheimer disease (AD). Understanding the association between amyloid aggregation and cognitive manifestation in persons without dementia is important for a better understanding of the course of AD and for the design of prevention trials.To investigate whether amyloid-β aggregation is associated with cognitive functioning in persons without dementia.This cross-sectional study included 2908 participants with normal cognition and 4133 with mild cognitive impairment (MCI) from 53 studies in the multicenter Amyloid Biomarker Study. Normal cognition was defined as having no cognitive concerns for which medical help was sought and scores within the normal range on cognitive tests. Mild cognitive impairment was diagnosed according to published criteria. Study inclusion began in 2013 and is ongoing. Data analysis was performed in January 2017.Global cognitive performance as assessed by the Mini-Mental State Examination (MMSE) and episodic memory performance as assessed by a verbal word learning test. Amyloid aggregation was measured with positron emission tomography or cerebrospinal fluid biomarkers and dichotomized as negative (normal) or positive (abnormal) according to study-specific cutoffs. Generalized estimating equations were used to examine the association between amyloid aggregation and low cognitive scores (MMSE score ≤27 or memory z score≤-1.28) and to assess whether this association was moderated by age, sex, educational level, or apolipoprotein E genotype.Among 2908 persons with normal cognition (mean [SD] age, 67.4 [12.8] years), amyloid positivity was associated with low memory scores after age 70 years (mean difference in amyloid positive vs negative, 4% [95% CI, 0%-7%] at 72 years and 21% [95% CI, 10%-33%] at 90 years) but was not associated with low MMSE scores (mean difference, 3% [95% CI, -1% to 6%], P=.16). Among 4133 patients with MCI (mean [SD] age, 70.2 [8.5] years), amyloid positivity was associated with low memory (mean difference, 16% [95% CI, 12%-20%], P<.001) and low MMSE (mean difference, 14% [95% CI, 12%-17%], P<.001) scores, and this association decreased with age. Low cognitive scores had limited utility for screening of amyloid positivity in persons with normal cognition and those with MCI. In persons with normal cognition, the age-related increase in low memory score paralleled the age-related increase in amyloid positivity with an intervening period of 10 to 15 years.Although low memory scores are an early marker of amyloid positivity, their value as a screening measure for early AD among persons without dementia is limited.
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| 3. |
- Jansen, Willemijn J, et al.
(författare)
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Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis.
- 2015
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Ingår i: JAMA. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 313:19, s. 1924-38
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies.
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| 4. |
- Mencuccini, Maurizio, et al.
(författare)
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Leaf economics and plant hydraulics drive leaf : wood area ratios
- 2019
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Ingår i: New Phytologist. - : Wiley. - 0028-646X .- 1469-8137. ; 224:4, s. 1544-1556
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Tidskriftsartikel (refereegranskat)abstract
- Biomass and area ratios between leaves, stems and roots regulate many physiological and ecological processes. The Huber value H-v (sapwood area/leaf area ratio) is central to plant water balance and drought responses. However, its coordination with key plant functional traits is poorly understood, and prevents developing trait-based prediction models. Based on theoretical arguments, we hypothesise that global patterns in H-v of terminal woody branches can be predicted from variables related to plant trait spectra, that is plant hydraulics and size and leaf economics. Using a global compilation of 1135 species-averaged H-v, we show that H-v varies over three orders of magnitude. Higher H-v are seen in short small-leaved low-specific leaf area (SLA) shrubs with low K-s in arid relative to tall large-leaved high-SLA trees with high K-s in moist environments. All traits depend on climate but climatic correlations are stronger for explanatory traits than H-v. Negative isometry is found between H-v and K-s, suggesting a compensation to maintain hydraulic supply to leaves across species. This work identifies the major global drivers of branch sapwood/leaf area ratios. Our approach based on widely available traits facilitates the development of accurate models of above-ground biomass allocation and helps predict vegetation responses to drought.
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| 5. |
- Rosner, Sabine, et al.
(författare)
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Hydraulic and mechanical dysfunction of Norway spruce sapwood due to extreme summer drought in Scandinavia
- 2018
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Ingår i: Forest Ecology and Management. - : Elsevier BV. - 0378-1127 .- 1872-7042. ; 409, s. 527-540
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Tidskriftsartikel (refereegranskat)abstract
- Projected climate change scenarios such as frequently occurring dry summer spells are an enormous threat to the health of boreal conifer forests. We identified visible features indicating wood with tracheids predisposed for hydraulic and mechanical dysfunction in Norway spruce, suggest why this is formed during severe summer drought and hypothesised on mechanism that would cause tracheid collapse and stem cracks. Trees from southern Sweden that showed signs of severe reaction to drought, i.e. stem cracks along the trunk, were compared to healthy, undamaged trees. Rings investigated included those formed in 2006, a year with an extremely dry summer season in the study region. In southern Norway, we investigated trees with and without drought-induced top dieback symptoms. We analysed anatomical features such as tracheid lumen diameter, thickness of cell wall and its various layers (S1, S2 and S3), applied Raman imaging in order to get information on the lignin distribution in the cell wall and the compound middle lamellae and performed hydraulic flow and shrinkage experiments. Although tracheids in annual rings with signs of collapse had higher tangential lumen diameters than those in “normal†annual rings, we conclude that collapse of tracheid walls depends mainly on wall thickness, which is genetically determined to a large extent. Spruce trees that produce earlywood with extremely thin cell walls can develop wall collapse and internal cracks under the impact of dry spells. We also present a new diagnostic tool for detecting individuals that are prone to cell wall collapse and stem cracks: Lucid bands, i.e. bands in the fresh sapwood with very thin cell walls and inhomogeneous lignin distribution in the S-layers and the compound middle lamellae that lost their hydraulic function due to periods of severe summer drought. The detection of genotypes with lucid bands could be useful for an early selection against individuals that are prone to stem cracks under the impact of severe summer drought, and also for early downgrading of logs prone to cracking during industrial kiln drying.
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| 6. |
- Schuldt, Bernhard, et al.
(författare)
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How adaptable is the hydraulic system of European beech in the face of climate change-related precipitation reduction?
- 2015
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Ingår i: New Phytologist. - : Wiley. - 1469-8137 .- 0028-646X.
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Tidskriftsartikel (refereegranskat)abstract
- Climate warming will increase the drought exposure of many forests world-wide. It is not well understood how trees adapt their hydraulic architecture to a long-term decrease in water availability. We examined 23 traits characterizing the hydraulic architecture and growth rate of branches and the dependent foliage of mature European beech (Fagus sylvatica) trees along a precipitation gradient (855-594 mm yr(-1) ) on uniform soil. A main goal was to identify traits that are associated with xylem efficiency, safety and growth. Our data demonstrate for the first time a linear increase in embolism resistance with climatic aridity (by 10%) across populations within a species. Simultaneously, vessel diameter declined by 7% and pit membrane thickness (Tm ) increased by 15%. Although specific conductivity did not change, leaf-specific conductivity declined by 40% with decreasing precipitation. Of eight plant traits commonly associated with embolism resistance, only vessel density in combination with pathway redundancy and Tm were related. We did not confirm the widely assumed trade-off between xylem safety and efficiency but obtained evidence in support of a positive relationship between hydraulic efficiency and growth. We conclude that the branch hydraulic system of beech has a distinct adaptive potential to respond to a precipitation reduction as a result of the environmental control of embolism resistance.
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