| 1. |
- 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. |
- Smith, Stuart W., et al.
(författare)
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Tree species that 'live slow, die older' enhance tropical peat swamp restoration : Evidence from a systematic review
- 2022
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Ingår i: Journal of Applied Ecology. - : Wiley. - 0021-8901 .- 1365-2664. ; 59:8, s. 1950-1966
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Forskningsöversikt (refereegranskat)abstract
- 1. Degraded tropical peatlands lack tree cover and are often subject to seasonal flooding and repeated burning. These harsh environments for tree seedlings to survive and grow are therefore challenging to revegetate. Knowledge on species performance from previous plantings represents an important evidence base to help guide future tropical peat swamp forest (TPSF) restoration efforts.2. We conducted a systematic review of the survival and growth of tree species planted in degraded peatlands across Southeast Asia to examine (1) species differences, (2) the impact of seedling and site treatments on survival and growth and (3) the potential use of plant functional traits to predict seedling survival and growth rates.3. Planted seedling monitoring data were compiled through a systematic review of journal articles, conference proceedings, reports, theses and unpublished datasets. In total, 94 study-sites were included, spanning three decades from 1988 to 2019, and including 141 indigenous peatland tree and palm species. Accounting for variable planting numbers and monitoring durations, we analysed three measures of survival and growth: (1) final survival weighted by the number of seedlings planted, (2) half-life, that is, duration until 50% mortality and (3) relative growth rates (RGR) corrected for initial planting height of seedlings.4. Average final survival was 62% and half-life was 33 months across all species, sites and treatments. Species differed significantly in survival and half-life. Seedling and site treatments had small effects with the strongest being higher survival of mycorrhizal fungi inoculated seedlings; lower survival, half-life and RGR when shading seedlings; and lower RGR and higher survival when fertilising seedlings. Leaf nutrient and wood density traits predicted TPSF species survival, but not half-life and RGR. RGR and half-life were negatively correlated, meaning that slower growing species survived for longer.5. Synthesis and applications. To advance tropical peat swamp reforestation requires expanding the number and replication of species planted and testing treatments by adopting control vs. treatment experimental designs. Species selection should involve slower growing species (e.g. Lophopetalum rigidum, Alstonia spatulata, Madhuca motleyana) that survive for longer and explore screening species based on functional traits associated with nutrient acquisition, flooding tolerance and recovery from fire.
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| 3. |
- Fuchs, Boris, et al.
(författare)
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High concentrations of lead (Pb) in blood and milk of free-ranging brown bears (Ursus arctos) in Scandinavia
- 2021
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Ingår i: Environmental Pollution. - : Elsevier. - 0269-7491 .- 1873-6424. ; 287
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Tidskriftsartikel (refereegranskat)abstract
- Exposure to lead (Pb) is a global health problem for both humans and wildlife. Despite a dramatic decline in human Pb exposure following restrictions of leaded gasoline and industry and thereby an overall reduction of Pb entering the environment, Pb exposure continues to be a problem for wildlife species. Literature on scavenging terrestrial mammals, including interactions between Pb exposure and life history, is however limited.We quantified Pb concentration in 153 blood samples from 110 free-ranging Scandinavian brown bears (Ursus arctos), 1–25 years old, using inductively coupled plasma sector field mass spectrometry. We used generalized linear models to test effects of age, body mass, reproduction status and spatial distribution on the blood Pb concentrations of 56 female bears. We sampled 28 females together with 56 dependent cubs and paired their blood Pb concentrations. From 20 lactating females, we measured the Pb concentration in milk.The mean blood Pb concentration was 96.6 μg/L (range: 38.7.0–220.5 μg/L). Both the mean and range are well above established threshold concentrations for developmental neurotoxicity (12 μg/L), increased systolic blood pressure (36 μg/L) and prevalence of kidney disease in humans (15 μg/L). Lactating females had higher Pb blood concentrations compared to younger, non-lactating females. Blood Pb concentrations of dependent cubs were correlated with their mother's blood Pb concentration, which in turn was correlated with the Pb concentration in the milk.Life-long Pb exposure in Scandinavian brown bears may have adverse effects both on individual and population levels. The high blood Pb concentrations found in brown bears contrast the general reduction in environmental Pb contamination over the past decades in Scandinavia and more research is needed to identify the sources and pathways of Pb exposure in the brown bears.
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