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| 2. |
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- 2019
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Wilman, H. R., et al.
(författare)
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Genetic studies of abdominal MRI data identify genes regulating hepcidin as major determinants of liver iron concentration
- 2019
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Ingår i: Journal of Hepatology. - : Elsevier. - 0168-8278 .- 1600-0641. ; 71:3, s. 594-602
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Excess liver iron content is common and is linked to the risk of hepatic and extrahepatic diseases. We aimed to identify genetic variants influencing liver iron content and use genetics to understand its link to other traits and diseases. Methods: First, we performed a genome-wide association study (GWAS) in 8,289 individuals from UK Biobank, whose liver iron level had been quantified by magnetic resonance imaging, before validating our findings in an independent cohort (n = 1,513 from IMI DIRECT). Second, we used Mendelian randomisation to test the causal effects of 25 predominantly metabolic traits on liver iron content. Third, we tested phenome-wide associations between liver iron variants and 770 traits and disease outcomes. Results: We identified 3 independent genetic variants (rs1800562 [C282Y] and rs1799945 [H63D] in HFE and rs855791 [V736A] in TMPRSS6) associated with liver iron content that reached the GWAS significance threshold (p <5 × 10−8). The 2 HFE variants account for ∼85% of all cases of hereditary haemochromatosis. Mendelian randomisation analysis provided evidence that higher central obesity plays a causal role in increased liver iron content. Phenome-wide association analysis demonstrated shared aetiopathogenic mechanisms for elevated liver iron, high blood pressure, cirrhosis, malignancies, neuropsychiatric and rheumatological conditions, while also highlighting inverse associations with anaemias, lipidaemias and ischaemic heart disease. Conclusion: Our study provides genetic evidence that mechanisms underlying higher liver iron content are likely systemic rather than organ specific, that higher central obesity is causally associated with higher liver iron, and that liver iron shares common aetiology with multiple metabolic and non-metabolic diseases. Lay summary: Excess liver iron content is common and is associated with liver diseases and metabolic diseases including diabetes, high blood pressure, and heart disease. We identified 3 genetic variants that are linked to an increased risk of developing higher liver iron content. We show that the same genetic variants are linked to higher risk of many diseases, but they may also be associated with some health advantages. Finally, we use genetic variants associated with waist-to-hip ratio as a tool to show that central obesity is causally associated with increased liver iron content.
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| 4. |
- Giordano, Giuseppe, 1985, et al.
(författare)
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A Time-Domain Fractional Approach for Wiener-Hammerstein Systems Identification
- 2015
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Ingår i: IFAC-PapersOnLine. - : Elsevier BV. - 2405-8963. ; 48:28, s. 1232-1237
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Konferensbidrag (refereegranskat)abstract
- This paper describes a new approach to initialize Wiener-Hammerstein models for iterative prediction error minimization. The key idea is to parameterize the division of poles and zeros of the best linear approximation (BLA), between the two linear subsystems. Taylor expansion is used to handle the parameterization in the time-domain. Identifiability aspects are investigated on a low order example. Results regarding uniqueness of the estimation are proved. The initial estimate generated with this approach allows to avoid problems with local minima and the identification problem is solved performing only two iterative optimizations.
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| 5. |
- Giordano, Giuseppe, 1985, et al.
(författare)
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An improved method for Wiener–Hammerstein system identification based on the Fractional Approach
- 2018
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Ingår i: Automatica. - : Elsevier BV. - 0005-1098. ; 94, s. 349-360
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Tidskriftsartikel (refereegranskat)abstract
- This paper develops and analyses a novel method for identifying Wiener–Hammerstein models, i.e. models consisting of two linear dynamic parts with a static non-linearity in between. Starting from the best linear model, which is a consistent estimate of the system dynamics for Gaussian excitation, the identification problem includes the partitioning of the poles and zeros between the two linear parts. This partitioning can be formulated as a discrete optimization problem. The fractional approach considers a relaxation of this problem into a continuous one, by parameterizing the partition of each pole and zero in a fractional way, and carrying out the computations in the frequency domain. In this paper it is shown that the fractional approach becomes ill-conditioned for some configurations of the poles and zeros of the linear dynamic parts, causing identifiability issues. A modification of the original fractional approach is then introduced, based on series expansion of the fractional transfer functions. This modification shares most of the properties of the fractional approach. However, it is shown that it provides an implicit regularization of the identification problem. It addresses the ill-conditioning problem while preserving meaningful statistical properties of the estimation. Furthermore, a lifted formulation of the estimation problem is proposed, which improves the algorithmic performance in the framework of Newton-based methods.
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| 6. |
- Giordano, Giuseppe, 1985, et al.
(författare)
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Black- and white-box approaches for cascaded tanks benchmark system identification
- 2018
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Ingår i: Mechanical Systems and Signal Processing. - : Elsevier BV. - 0888-3270 .- 1096-1216. ; 108, s. 387-397
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Tidskriftsartikel (refereegranskat)abstract
- This contribution consists of the identification and comparison of different models for a non-linear system: the Cascaded Tanks system. The identification of this system is challenging due to the combination of soft and hard non-linearities. Model structures with different levels of flexibility and prior knowledge are compared. The most simple ones are linear black-box models. They are extended to become non-linear black-box models, whose performances are compared with the linear ones. A second track is the investigation of a series of models with increasing complexity based on physical prior knowledge. Results show that while linear black-box models perform good in prediction, a fairly precise description of the non-linear effects is needed to achieve good performances in simulation. All models have been estimated and validated using benchmark data from a real cascaded tanks system. The contribution represents also an overview on how standard modelling techniques perform on a real identification problem.
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| 7. |
- Giordano, Giuseppe, 1985, et al.
(författare)
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Consistency aspects of Wiener-Hammerstein model identification in presence of process noise
- 2016
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Ingår i: 2016 IEEE 55th Conference on Decision and Control, CDC 2016. - 9781509018376 ; , s. Art no 7798724, Pages 3042-3047
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Konferensbidrag (refereegranskat)abstract
- The Wiener-Hammerstein model is a block-oriented model consisting of two linear blocks and a static nonlinearity in the middle. Several identification approaches for this model structure rely on the fact that the best linear approximation of the system is a consistent estimate of the two linear parts, under the hypothesis of Gaussian excitation. But, these approaches do not consider the presence of other disturbance sources than measurement noise. In this paper we consider the presence of a disturbance entering before the nonlinearity (process noise) and we show that, also in this case, the best linear approximation is a consistent estimate of underlying linear dynamics. Furthermore, we analyse the impact of the process noise on the nonlinearity estimation, showing that a standard prediction error method approach can lead to biased results.
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| 8. |
- Giordano, Giuseppe, 1985
(författare)
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Inference techniques for stochastic nonlinear system identification with application to the Wiener-Hammerstein models
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stochastic nonlinear systems are a specific class of nonlinear systems where unknown disturbances affect the system's output through a nonlinear transformation. In general, the identification of parametric models for this kind of systems can be very challenging. A main statistical inference technique for parameter estimation is the Maximum Likelihood estimator. The central object of this technique is the likelihood function, i.e. a mathematical expression describing the probability of obtaining certain observations for given values of the parameter. For many stochastic nonlinear systems, however, the likelihood function is not available in closed-form. Several methods have been developed to obtain approximate solutions to the Maximum Likelihood problem, mainly based on the Monte Carlo method. However, one of the main difficulties of these methods is that they can be computationally expensive, especially when they are combined with numerical optimization techniques for likelihood maximisation. This thesis can be divided in three parts. In the first part, a background on the main statistical techniques for parameter estimation is presented. In particular, two iterative methods for finding the Maximum Likelihood estimator are introduced. They are the gradient-based and the Expectation-Maximisation algorithms. In the second part, the main Monte Carlo methods for approximating the Maximum Likelihood problem are analysed. Their combinations with gradient-based and Expectation-Maximisation algorithms is considered. For ensuring convergence, these algorithms require the use of enormous Monte Carlo effort, i.e. the number of random samples used to build the Monte Carlo estimates. In order to reduce this effort and make the algorithms usable in practice, iterative solutions solutions alternating \emph{local} Monte Carlo approximations and maximisation steps are derived. In particular, a procedure implementing an efficient samples simulation across the steps of a Newton's method is developed. The procedure is based on the sensitivity of the parameter search with respect to the Monte Carlo samples and it results into an accurate and fast algorithm for solving the MLE problem. The considered Maximum Likelihood estimation methods proceed through local explorations of the parameter space. Hence, they have guaranteed convergence only to a local optimizer of the likelihood function. In the third part of the thesis, this issue is addressed by deriving initialization algorithms. The purpose is to generate initial guesses that increase the chances of converging to the global maximum. In particular, initialization algorithms are derived for the Wiener-Hammerstein model, i.e. a nonlinear model where a static nonlinearity is sandwiched between two linear parts. For this type of model, it can be proved that the best linear approximation of the system provides a consistent estimates of the two linear parts. This estimate is then used to initialize a Maximum Likelihood Estimation problem in all model parameters.
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| 9. |
- Giordano, Giuseppe, 1985, et al.
(författare)
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Maximum Likelihood identification of Wiener-Hammerstein system with process noise
- 2018
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Ingår i: IFAC-PapersOnLine. - : Elsevier BV. - 2405-8963. ; 51:15, s. 401-406
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Konferensbidrag (refereegranskat)abstract
- The Wiener-Hammerstein model is a block-oriented model consisting of two linear blocks and a static nonlinearity in the middle. We address the identification problem of this model, when a disturbance affects the input of the non-linearity, i.e. process noise. For this case, a Maximum Likelihood estimator is derived, which delivers a consistent estimate of the model parameters. In the presence of process noise, in fact, a standard Prediction Error Method normally leads to biased results. The Maximum Likelihood estimate is then used together with the Best Linear Approximation of the system, in order to implement a complete identification scheme when the parametrization of the linear blocks is not known a priori. The computation of the likelihood function requires numerical integration, which is solved by Monte Carlo and Metropolis-Hastings techniques. Numerical examples show the effectiveness of the identification scheme.
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| 10. |
- Giordano, Giuseppe, 1985, et al.
(författare)
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Model-Based Lithium-Ion Battery Resistance Estimation From Electric Vehicle Operating Data
- 2018
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Ingår i: IEEE Transactions on Vehicular Technology. - : Institute of Electrical and Electronics Engineers (IEEE). - 0018-9545 .- 1939-9359. ; 67:5, s. 3720-3728
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Tidskriftsartikel (refereegranskat)abstract
- State-of-health estimates of batteries are essential for onboard electric vehicles in order to provide safe, reliable, and cost-effective battery operation. This paper suggests a method to estimate the 10-s discharge resistance, which is an established battery figure of merit from laboratory testing, without performing the laboratory test. Instead, a state-of-health estimate of batteries is obtained using data directly from their operational use, e.g., onboard electric vehicles. It is shown that simple dynamical battery models, based on a current input and a voltage output, with model parameters dependent on temperature and state of charge, can be derived using AutoRegressive with eXogenous input models, whose order can be adjusted to describe the complex battery behavior. Then, the 10-s discharge resistance can be conveniently computed from the identified model parameters. Moreover, the uncertainty of the estimated resistance values is provided by the method. The suggested method is validated with usage data from emulated electric vehicle operation of an automotive lithium-ion battery cell. The resistance values are estimated accurately for a state-of-charge and temperature range spanning typical electric vehicle operating conditions. The identification of the model parameters and the resistance computation are very fast, rendering the method suitable for onboard application.
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| 11. |
- Giordano, Giuseppe N., et al.
(författare)
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The 2005 London terror attacks : An investigation of changes in psychological wellbeing and social capital pre- and post-attacks (2003-07)-A UK panel study
- 2016
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Ingår i: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 2, s. 485-494
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Tidskriftsartikel (refereegranskat)abstract
- The London public transport suicide bombings, which occurred on 7th July 2005, were described as the worst single terrorist atrocity on British soil to date. Past acts of terrorism have been associated with deterioration in population mental health. They may also negatively impact levels of social capital, which is considered a buffer against poor mental health outcomes. By employing panel data from the British Household Panel Survey and following the same individuals (NT=9287) three times over a five-year period (2003, 2005 and 2007), the aim of this longitudinal multilevel study was to investigate: (i) the impact of terrorism on individual-level social capital (generalised trust and social participation) across the UK; and (ii) the buffering effects of social capital on psychological wellbeing (GHQ-12). By comparing 2005 and 2007 covariate values (including the two social capital proxies) against their pre-terror baseline (2003) measurements in two separate multilevel logistic regression models, we examined the immediate and longer-term effects of the 2005 attacks on our GHQ-12 outcome. Compared to baseline, generalised trust dropped from 44% to 36% immediately post-terror attacks in 2005, while local participation increased from 45.8% to 47.5%. Social capital levels started to return to baseline levels by 2007, yet both proxies maintained independent buffering effects against poor GHQ-12 scores in years 2005 and 2007. From this empirical evidence, it seems that though generalised trust levels are negatively affected by acts of terrorism, the accompanying increase in local active participation may aid in the re-establishment of societal norms and beliefs in later years. Decision makers should be aware that such atrocities may negatively impact on populations' generalised trust in the shorter-term. To safeguard against losing this buffer against poor mental health outcomes, local active participation should be encouraged.
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| 12. |
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| 13. |
- Giordano, Giuseppe Nicola, et al.
(författare)
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Trust and all-cause mortality : a multilevel study of US General Social Survey data (1978–2010)
- 2019
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 73:1, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- Background Within public health research, generalised trust has been considered an independent predictor of morbidity and mortality for over two decades. However, there are no population-based studies that have scrutinised both contextual-level and individual-level effects of generalised trust on all-cause mortality. We, therefore, aim to investigate such associations by using pooled nationally representative US General Social Survey (GSS) data linked to the National Death Register (NDI).Methods The combined GSS–NDI data from the USA have 90 contextual units. Our sample consisted of 25 270 respondents from 1972 to 2010, with 6424 recorded deaths by 2014. We used multilevel parametric Weibull survival models reporting HRs and 95% CI (credible intervals for Bayesian analysis). Individual-level and contextual-level generalised trust were the exposures of interest; covariates included age, race, gender, marital status, education and household income.Results We found a robust, significant impact of individual-level and contextual-level trust on mortality (HR=0.92, 95% CI 0.88 to 0.97; and HR=0.96, 95% CI 0.93 to 0.98, respectively). There were no discernible gender differences. Neither did we observe any significant cross-level interactions.Conclusion High levels of individual and contextual generalised trust protect against mortality, even after considering numerous individual and aggregated socioeconomic conditions. Its robustness at both levels hints at the importance of psychosocial mechanisms, as well as a trustworthy environment. Declining trust levels across the USA should be of concern; decision makers should consider direct and indirect effects of policy on trust with the view to halting this decline.
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| 14. |
- Giordano, Giuseppe Nicola, et al.
(författare)
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Trust and health: testing the reverse causality hypothesis.
- 2016
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 70:1
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Tidskriftsartikel (refereegranskat)abstract
- Social capital research has consistently shown positive associations between generalised trust and health outcomes over 2 decades. Longitudinal studies attempting to test causal relationships further support the theory that trust is an independent predictor of health. However, as the reverse causality hypothesis has yet to be empirically tested, a knowledge gap remains. The aim of this study, therefore, was to investigate if health status predicts trust.
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| 15. |
- Koivula, Robert W., et al.
(författare)
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Discovery of biomarkers for glycaemic deterioration before and after the onset of type 2 diabetes : descriptive characteristics of the epidemiological studies within the IMI DIRECT Consortium
- 2019
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Ingår i: Diabetologia. - : Springer. - 0012-186X .- 1432-0428. ; 62:9, s. 1601-1615
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis: Here, we describe the characteristics of the Innovative Medicines Initiative (IMI) Diabetes Research on Patient Stratification (DIRECT) epidemiological cohorts at baseline and follow-up examinations (18, 36 and 48 months of follow-up).Methods: From a sampling frame of 24,682 adults of European ancestry enrolled in population-based cohorts across Europe, participants at varying risk of glycaemic deterioration were identified using a risk prediction algorithm (based on age, BMI, waist circumference, use of antihypertensive medication, smoking status and parental history of type 2 diabetes) and enrolled into a prospective cohort study (n = 2127) (cohort 1, prediabetes risk). We also recruited people from clinical registries with type 2 diabetes diagnosed 6-24 months previously (n = 789) into a second cohort study (cohort 2, diabetes). Follow-up examinations took place at similar to 18 months (both cohorts) and at similar to 48 months (cohort 1) or similar to 36 months (cohort 2) after baseline examinations. The cohorts were studied in parallel using matched protocols across seven clinical centres in northern Europe.Results: Using ADA 2011 glycaemic categories, 33% (n = 693) of cohort 1 (prediabetes risk) had normal glucose regulation and 67% (n = 1419) had impaired glucose regulation. Seventy-six per cent of participants in cohort 1 was male. Cohort 1 participants had the following characteristics (mean +/- SD) at baseline: age 62 (6.2) years; BMI 27.9 (4.0) kg/m(2); fasting glucose 5.7 (0.6) mmol/l; 2 h glucose 5.9 (1.6) mmol/l. At the final follow-up examination the participants' clinical characteristics were as follows: fasting glucose 6.0 (0.6) mmol/l; 2 h OGTT glucose 6.5 (2.0) mmol/l. In cohort 2 (diabetes), 66% (n = 517) were treated by lifestyle modification and 34% (n = 272) were treated with metformin plus lifestyle modification at enrolment. Fifty-eight per cent of participants in cohort 2 was male. Cohort 2 participants had the following characteristics at baseline: age 62 (8.1) years; BMI 30.5 (5.0) kg/m(2); fasting glucose 7.2 (1.4) mmol/l; 2 h glucose 8.6 (2.8) mmol/l. At the final follow-up examination, the participants' clinical characteristics were as follows: fasting glucose 7.9 (2.0) mmol/l; 2 h mixed-meal tolerance test glucose 9.9 (3.4) mmol/l.Conclusions/interpretation: The IMI DIRECT cohorts are intensely characterised, with a wide-variety of metabolically relevant measures assessed prospectively. We anticipate that the cohorts, made available through managed access, will provide a powerful resource for biomarker discovery, multivariate aetiological analyses and reclassification of patients for the prevention and treatment of type 2 diabetes.
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| 16. |
- Lindström, Martin, et al.
(författare)
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Changes in social capital and cigarette smoking behavior over time : A population-based panel study of temporal relationships
- 2016
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Ingår i: Nicotine & Tobacco Research. - : Oxford University Press (OUP). - 1469-994X .- 1462-2203. ; 18:11, s. 2106-2114
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Identifying factors that influence individuals' smoking behavior remains a huge public health concern. This study aimed to investigate changes in individuals' cigarette smoking while considering well-known smoking determinants, including social capital, its presence being postulated to reduce smoking. Methods: From British Household Panel Survey data, two baseline smoking cohorts were created ("smoking" and "not smoking"). The same individuals from this nationally representative sample (NT = 8114, aged 16-91 years) were interviewed on four occasions between years 2000 and 2007 to investigate changes in cigarette smoking behavior. Logistic regression models with random effects compensated for within-individual behavior over time. Temporal pathways were investigated by lagging independent variables (t - 1) in relation to our cigarette-use outcome at time (t). Results: Active social participation at (t - 1) was positively associated with smoking cessation at (t) (odds ratio [OR] = 1.39; 95% confidence interval [CI] [1.07-1.82]). Separating from one's spouse at (t - 1) increased risk for smoking relapse/initiation at (t) (OR = 6.63; 95% CI [1.70-28.89]). Conversely, being married protected against smoking cigarettes (OR = 1.87; 95% CI [1.15-3.04]). These associations held in our robustness checks. Conclusions: Initial marital breakdown predicted a high risk of smoking relapse/initiation. The timing of this life event provides a critical window where adverse smoking behavior might occur. Conversely, the positive effects of active social participation on cigarette cessation remained consistent, its absence further predicting smoking relapse/initiation. Robustness of results confirms the important role that active participation has on cigarette smoking behavior. Group smoking cessation interventions could harness participatory elements to better achieve their goals. Implications: By investigating temporal relationships between well-known smoking determinants and cigarette smoking outcomes, we identified that being "separated" (not "divorced") at time (t) predicted a higher risk of smoking relapse/initiation at (t). Tailored health messages could be employed to highlight the increased risk of cigarette smoking relapse/initiation during this stressful life event. Conversely, active social participation (a common social capital proxy) consistently predicted smoking cessation over time. Future group smoking cessation interventions could be designed explicitly to harness participatory elements to better achieve their goals.
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| 17. |
- Lindström, Martin, et al.
(författare)
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The 2008 financial crisis: Changes in social capital and its association with psychological wellbeing in the United Kingdom - A panel study.
- 2016
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 1873-5347 .- 0277-9536. ; 153, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- The global financial crisis of 2008 was described by the IMF as the worst recession since the Great Depression. This historic event provided the backdrop to this United Kingdom (UK) longitudinal study of changes in associations between social capital and psychological wellbeing. Past longitudinal studies have reported that the presence of social capital may buffer against adverse mental health outcomes. This study adds to existing literature by employing data from the British Household Panel Survey and tracking the same individuals (N = 11,743) pre- and immediately post-crisis (years 2007-09). With longitudinal, multilevel logistic regression modelling, we aimed to compare the buffering effects of individual-level social capital (generalised trust and social participation) against worse psychological wellbeing (GHQ-12) during and immediately after the 2008 financial crisis. After comparing the same individuals over time, results showed that stocks of social capital (generalised trust) were significantly depleted across the UK during the crisis, from 40% trusting others in 2007 to 32% in 2008. Despite this drop, the buffering effect of trust against worse psychological wellbeing was pronounced in 2008; those not trusting had an increased risk of worse psychological wellbeing in 2008 compared with the previous year in fully adjusted models (OR = 1.49, 95% CI (1.34-1.65). Levels of active participation increased across the timeframe of this study but were not associated with psychological health. From our empirical evidence, decision makers should be made aware of how events such as the crisis (and the measures taken to counter its effects) could negatively impact on a Nation's trust levels. Furthermore, past research implies that the positive effects of trust on psychological wellbeing evident in this study may only be short-term; therefore, decision makers should also prioritise policies that restore trust levels to improve the psychological wellbeing of the population.
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| 18. |
- Mewes, Jan, et al.
(författare)
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Self-rated health, generalized trust, and the Affordable Care Act : a US panel study, 2006–2014
- 2017
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 190, s. 48-56
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Tidskriftsartikel (refereegranskat)abstract
- Previous research shows that generalized trust, the belief that most people can be trusted, is conducive to people's health. However, only recently have longitudinal studies suggested an additional reciprocal pathway from health back to trust. Drawing on a diverse body of literature that shows how egalitarian social policy contributes to the promotion of generalized trust, we hypothesize that this other ‘reverse’ pathway could be sensitive to health insurance context. Drawing on nationally representative US panel data from the General Social Survey, we examine whether the Affordable Care Act of 2010 could have had influence on the deteriorating impact of worsening self-rated health (SRH) on generalized trust. Firstly, using two-wave panel data (2008–2010, N = 1403) and employing random effects regression models, we show that a lack of health insurance coverage negatively determines generalized trust in the United States. However, this association is attenuated when additionally controlling for (perceived) income inequality. Secondly, utilizing data from two separate three-wave panel studies from the US General Social Survey (2006–10; N = 1652; 2010–2014; N = 1187), we employ fixed-effects linear regression analyses to control for unobserved heterogeneity from time-invariant factors. We demonstrate that worsening SRH was a stronger predictor for a decrease in generalized trust prior (2006–2010) to the implementation of the Affordable Care Act. Further, the negative effect of fair/poor SRH seen in the 2006–2010 data becomes attenuated in the 2010–2014 panel data. We thus find evidence for a substantial weakening of the previously established negative impact of decreasing SRH on generalized trust, coinciding with the most significant US healthcare reforms in decades. Social policy and healthcare policy implications are discussed.
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| 19. |
- Mutie, Pascal, et al.
(författare)
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Lifestyle precision medicine : the next generation in type 2 diabetes prevention?
- 2017
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Ingår i: BMC Medicine. - : BIOMED CENTRAL LTD. - 1741-7015. ; 15
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Forskningsöversikt (refereegranskat)abstract
- The driving force behind the current global type 2 diabetes epidemic is insulin resistance in overweight and obese individuals. Dietary factors, physical inactivity, and sedentary behaviors are the major modifiable risk factors for obesity. Nevertheless, many overweight/obese people do not develop diabetes and lifestyle interventions focused on weight loss and diabetes prevention are often ineffective. Traditionally, chronically elevated blood glucose concentrations have been the hallmark of diabetes; however, many individuals will either remain 'prediabetic' or regress to normoglycemia. Thus, there is a growing need for innovative strategies to tackle diabetes at scale. The emergence of biomarker technologies has allowed more targeted therapeutic strategies for diabetes prevention (precision medicine), though largely confined to pharmacotherapy. Unlike most drugs, lifestyle interventions often have systemic health-enhancing effects. Thus, the pursuance of lifestyle precision medicine in diabetes seems rational. Herein, we review the literature on lifestyle interventions and diabetes prevention, describing the biological systems that can be characterized at scale in human populations, linking them to lifestyle in diabetes, and consider some of the challenges impeding the clinical translation of lifestyle precision medicine.
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| 20. |
- Shah, Nisha, et al.
(författare)
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Motivations for data sharing—views of research participants from four European countries : A DIRECT study
- 2019
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Ingår i: European Journal of Human Genetics. - : Springer Science and Business Media LLC. - 1018-4813 .- 1476-5438.
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to explore and compare different countries in what motivated research participants’ decisions whether to share their de-identified data. We investigated European DIRECT (Diabetes Research on Patient Stratification) research project participants’ desire for control over sharing different types of their de-identified data, and with who data could be shared in the future after the project ends. A cross-sectional survey was disseminated among DIRECT project participants. The results found that there was a significant association between country and attitudes towards advancing research, protecting privacy, and beliefs about risks and benefits to sharing data. When given the choice to have control, some participants (<50% overall) indicated that having control over what data is shared and with whom was important; and control over what data types are shared was less important than respondents deciding who data are shared with. Danish respondents indicated higher odds of desire to control data types shared, and Dutch respondents showed higher odds of desire to control who data will be shared with. Overall, what research participants expect in terms of control over data sharing needs to be considered and aligned with sharing for future research and re-use of data. Our findings show that even with de-identified data, respondents prioritise privacy above all else. This study argues to move research participants from passive participation in biomedical research to considering their opinions about data sharing and control of de-identified biomedical data.
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| 21. |
- Shah, Nisha, et al.
(författare)
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Sharing data for future research—engaging participants’ views about data governance beyond the original project : a DIRECT Study
- 2019
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Ingår i: Genetics in Medicine. - : Elsevier BV. - 1098-3600. ; 21:5, s. 1131-1138
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Biomedical data governance strategies should ensure that data are collected, stored, and used ethically and lawfully. However, research participants’ preferences for how data should be governed is least studied. The Diabetes Research on Patient Stratification (DIRECT) project collected substantial amounts of health and genetic information from patients at risk of, and with type II diabetes. We conducted a survey to understand participants’ future data governance preferences. Results will inform the postproject data governance strategy. Methods: A survey was distributed in Denmark, Sweden, The Netherlands, and the United Kingdom. Results: In total 855 surveys were returned. Ninety-seven percent were supportive of sharing data postproject, and 90% were happy to share data with universities, and 56% with commercial companies. The top three priorities for data sharing were highly secure database, DIRECT researchers to monitor data used by other researchers, and researchers cannot identify participants. Respondents frequently suggested that a postproject Data Access Committee should involve a DIRECT researcher, diabetes clinician, patient representative, and a DIRECT participant. Conclusion: Preferences of how data should be governed, and what data could be shared and with whom varied between countries. Researchers are considered as key custodians of participant data. Engaging participants aids in designing governance to support their choices.
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