| 51. |
- Lertratanakul, Apinya, et al.
(author)
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25-Hydroxyvitamin D and Cardiovascular Disease in Patients With Systemic Lupus Erythematosus: Data From a Large International Inception Cohort
- 2014
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In: Arthritis Care and Research. - : Wiley. - 2151-4658 .- 2151-464X. ; 66:8, s. 1167-1176
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Journal article (peer-reviewed)abstract
- Objective. An association between 25-hydroxyvitamin D (25[ OH] D; vitamin D) deficiency and increased cardiovascular (CV) risk factors and CV disease (CVD) has been shown in general population studies. Vitamin D deficiency has been noted in systemic lupus erythematosus (SLE), and CVD is a major cause of morbidity and mortality in SLE. The objectives of this study were to estimate the associations of 25(OH) D levels with CV risk factors and to determine whether low baseline 25(OH) D levels predict future CV events in patients participating in an international inception cohort. Methods. Data were collected on 890 participants, including demographics, SLE activity and damage assessments, CV risk factors and events, medications, laboratory assessments of 25(OH) D levels, and inflammatory markers. Multiple logistic and Cox regressions were used to estimate the associations of baseline 25(OH) D levels with baseline CV risk factors and CVD events. The models were adjusted for age, sex, race, season, and country, with and without body mass index. Results. Patients in the higher quartiles of 25(OH) D were less likely to have hypertension and hyperlipidemia and were more likely to have lower C-reactive protein levels and lower Systemic Lupus Erythematosus Disease Activity Index 2000 scores at baseline when compared with the first quartile. Vitamin D levels were not independently associated with CVD event incidence; however, hazard ratios for CVD event incidence decreased with successively higher quartiles. Conclusion. Lower baseline 25(OH) D levels are associated with higher risk for CV risk factors and more active SLE at baseline. There may be a trend toward a lower likelihood of CVD events in those with higher baseline 25(OH) D levels.
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| 52. |
- Little, Jayne, et al.
(author)
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Glucocorticoid use and factors associated with variability in this use in the Systemic Lupus International Collaborating Clinics Inception Cohort
- 2018
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In: Rheumatology (United Kingdom). - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 57:4, s. 677-687
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Journal article (peer-reviewed)abstract
- Objectives. To describe glucocorticoid (GC) use in the SLICC inception cohort and to explore factors associated with GC use. In particular we aimed to assess temporal trends in GC use and to what extent physician-related factors may influence use. Methods. Patients were recruited within 15 months of diagnosis of SLE from 33 centres between 1999 and 2011 and continue to be reviewed annually. Descriptive statistics were used to detail oral and parenteral GC use. Cross sectional and longitudinal analyses were performed to explore factors associated with GC use at enrolment and over time. Results. We studied 1700 patients with a mean (S.D.) follow-up duration of 7.26 (3.82) years. Over the entire study period, 1365 (81.3%) patients received oral GCs and 447 (26.3%) received parenteral GCs at some point. GC use was strongly associated with treatment centre, age, race/ethnicity, sex, disease duration and disease activity. There was no change in the proportion of patients on GCs or the average doses of GC used over time according to year of diagnosis. Conclusion. GCs remain a cornerstone in SLE management and there have been no significant changes in their use over the past 10-15 years. While patient and disease factors contribute to the variation in GC use, between-centre differences suggest that physician-related factors also contribute. Evidence-based treatment algorithms are needed to inform a more standardized approach to GC use in SLE.
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| 53. |
- Lunt, Daniel J., et al.
(author)
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DeepMIP : model intercomparison of early Eocene climatic optimum (EECO) large-scale climate features and comparison with proxy data
- 2021
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In: Climate of the Past. - : Copernicus GmbH. - 1814-9324 .- 1814-9332. ; 17:1, s. 203-227
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Journal article (peer-reviewed)abstract
- We present results from an ensemble of eight climate models, each of which has carried out simulations of the early Eocene climate optimum (EECO, similar to 50 million years ago). These simulations have been carried out in the framework of the Deep-Time Model Intercomparison Project (DeepMIP; http://www.deepmip.org , last access: 10 January 2021); thus, all models have been configured with the same paleogeographic and vegetation boundary conditions. The results indicate that these non-CO2 boundary conditions contribute between 3 and 5 degrees C to Eocene warmth. Compared with results from previous studies, the DeepMIP simulations generally show a reduced spread of the global mean surface temperature response across the ensemble for a given atmospheric CO2 concentration as well as an increased climate sensitivity on average. An energy balance analysis of the model ensemble indicates that global mean warming in the Eocene compared with the preindustrial period mostly arises from decreases in emissivity due to the elevated CO2 concentration (and associated water vapour and long-wave cloud feedbacks), whereas the reduction in the Eocene in terms of the meridional temperature gradient is primarily due to emissivity and albedo changes owing to the non-CO2 boundary conditions (i.e. the removal of the Antarctic ice sheet and changes in vegetation). Three of the models (the Community Earth System Model, CESM; the Geophysical Fluid Dynamics Laboratory, GFDL, model; and the Norwegian Earth System Model, NorESM) show results that are consistent with the proxies in terms of the global mean temperature, meridional SST gradient, and CO2, without prescribing changes to model parameters. In addition, many of the models agree well with the first-order spatial patterns in the SST proxies. However, at a more regional scale, the models lack skill. In particular, the modelled anomalies are substantially lower than those indicated by the proxies in the southwest Pacific; here, modelled continental surface air temperature anomalies are more consistent with surface air temperature proxies, implying a possible inconsistency between marine and terrestrial temperatures in either the proxies or models in this region. Our aim is that the documentation of the large-scale features and model-data comparison presented herein will pave the way to further studies that explore aspects of the model simulations in more detail, for example the ocean circulation, hydrological cycle, and modes of variability, and encourage sensitivity studies to aspects such as paleogeography, orbital configuration, and aerosols.
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| 54. |
- Lunt, Daniel J., et al.
(author)
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The DeepMIP contribution to PMIP4 : experimental design for model simulations of the EECO, PETM, and pre-PETM (version 1.0)
- 2017
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In: Geoscientific Model Development. - : Copernicus GmbH. - 1991-959X .- 1991-9603. ; 10:2, s. 889-901
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Journal article (peer-reviewed)abstract
- Past warm periods provide an opportunity to evaluate climate models under extreme forcing scenarios, in particular high (>800 ppmv) atmospheric CO2 concentrations. Although a post hoc intercomparison of Eocene (similar to 50 Ma) climate model simulations and geological data has been carried out previously, models of past high-CO2 periods have never been evaluated in a consistent framework. Here, we present an experimental design for climate model simulations of three warm periods within the early Eocene and the latest Paleocene (the EECO, PETM, and pre-PETM). Together with the CMIP6 pre-industrial control and abrupt 4 x CO2 simulations, and additional sensitivity studies, these form the first phase of DeepMIP - the Deep-time Model Intercomparison Project, itself a group within the wider Paleo-climate Modelling Intercomparison Project (PMIP). The experimental design specifies and provides guidance on boundary conditions associated with palaeogeography, greenhouse gases, astronomical configuration, solar constant, land surface processes, and aerosols. Initial conditions, simulation length, and output variables are also specified. Finally, we explain how the geological data sets, which will be used to evaluate the simulations, will be developed.
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| 55. |
- Margaryan, Ashot, et al.
(author)
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Population genomics of the Viking world
- 2020
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In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 585:7825, s. 390-396
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Journal article (peer-reviewed)abstract
- The maritime expansion of Scandinavian populations during the Viking Age (about ad750–1050) was a far-flung transformation in world history1,2. Here we sequenced the genomes of 442humans from archaeological sites across Europe and Greenland (to a median depth of about 1×) to understand the global influence of this expansion. We find the Viking period involved gene flow into Scandinavia from the south and east. We observe genetic structure within Scandinavia, with diversity hotspots in the south and restricted gene flow within Scandinavia. We find evidence for a major influx of Danish ancestry into England; a Swedish influx into the Baltic; and Norwegian influx into Ireland, Iceland and Greenland. Additionally, we see substantial ancestry from elsewhere in Europe entering Scandinavia during the Viking Age. Our ancient DNA analysis also revealed that a Viking expedition included close family members. By comparing with modern populations, we find that pigmentation-associated loci have undergone strong population differentiation during the past millennium, and trace positively selected loci—including the lactase-persistence allele of LCT and alleles of ANKA that are associated with the immune response—in detail. We conclude that the Viking diaspora was characterized by substantial transregional engagement: distinct populations influenced the genomic makeup of different regions of Europe, and Scandinavia experienced increased contact with the rest of the continent.
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| 56. |
- Matthews, Nathaniel, et al.
(author)
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Elevating the role of water resilience in food system dialogues
- 2022
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In: Water Security. - : Elsevier B.V.. - 2468-3124. ; 17
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Journal article (peer-reviewed)abstract
- Ensuring resilient food systems and sustainable healthy diets for all requires much higher water use, however, water resources are finite, geographically dispersed, volatile under climate change, and required for other vital functions including ecosystems and the services they provide. Good governance for resilient water resources is a necessary precursor to deciding on solutions, sourcing finance, and delivering infrastructure. Six attributes that together provide a foundation for good governance to reduce future water risks to food systems are proposed. These attributes dovetail in their dual focus on incorporating adaptive learning and new knowledge, and adopting the types of governance systems required for water resilient food systems. The attributes are also founded in the need to greater recognise the role natural, healthy ecosystems play in food systems. The attributes are listed below and are grounded in scientific evidence and the diverse collective experience and expertise of stakeholders working across the science-policy interface: Adopting interconnected systems thinking that embraces the complexity of how we produce, distribute, and add value to food including harnessing the experience and expertise of stakeholders s; adopting multi-level inclusive governance and supporting inclusive participation; enabling continual innovation, new knowledge and learning, and information dissemination; incorporating diversity and redundancy for resilience to shocks; ensuring system preparedness to shocks; and planning for the long term. This will require food and water systems to pro-actively work together toward a socially and environmentally just space that considers the water and food needs of people, the ecosystems that underpin our food systems, and broader energy and equity concerns.
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| 57. |
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| 58. |
- Mendel, Arielle, et al.
(author)
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Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen
- 2019
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In: Rheumatology (United Kingdom). - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 58:7, s. 1259-1267
-
Journal article (peer-reviewed)abstract
- Objectives. To assess the prevalence of combined hormonal contraceptives (CHCs) in reproductive-age women with SLE with and without possible contraindications and to determine factors associated with their use in the presence of possible contraindications. Methods. This observational cohort study included premenopausal women ages 18-45 years enrolled in the SLICC Registry ≤15 months after SLE onset, with annual assessments spanning 2000-2017. World Health Organization Category 3 or 4 contraindications to CHCs (e.g. hypertension, aPL) were assessed at each study visit. High disease activity (SLEDAI score >12 or use of >0.5 mg/kg/day of prednisone) was considered a relative contraindication. Results. A total of 927 SLE women contributed 6315 visits, of which 3811 (60%) occurred in the presence of one or more possible contraindication to CHCs. Women used CHCs during 512 (8%) visits, of which 281 (55%) took place in the setting of one or more possible contraindication. The most frequently observed contraindications were aPL (52%), hypertension (34%) and migraine with aura (22%). Women with one or more contraindication were slightly less likely to be taking CHCs [7% of visits (95% CI 7, 8)] than women with no contraindications [9% (95% CI 8, 10)]. Conclusion. CHC use was low compared with general population estimates (>35%) and more than half of CHC users had at least one possible contraindication. Many yet unmeasured factors, including patient preferences, may have contributed to these observations. Further work should also aim to clarify outcomes associated with this exposure.
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| 59. |
- Nguyen, Yann, et al.
(author)
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Association Between Severe Nonadherence to Hydroxychloroquine and Systemic Lupus Erythematosus Flares, Damage, and Mortality in 660 Patients From the SLICC Inception Cohort
- 2023
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In: Arthritis and Rheumatology. - 2326-5191. ; 75:12, s. 2195-2206
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Journal article (peer-reviewed)abstract
- Objective: The goals of this study were to assess the associations of severe nonadherence to hydroxychloroquine (HCQ), objectively assessed by HCQ serum levels, and risks of systemic lupus erythematosus (SLE) flares, damage, and mortality rates over five years of follow-up. Methods: The Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort is an international multicenter initiative (33 centers throughout 11 countries). The serum of patients prescribed HCQ for at least three months at enrollment were analyzed. Severe nonadherence was defined by a serum HCQ level <106 ng/mL or <53 ng/mL for HCQ doses of 400 or 200 mg/day, respectively. Associations with the risk of a flare (defined as a Systemic Lupus Erythematosus Disease Activity Index 2000 increase ≥4 points, initiation of prednisone or immunosuppressive drugs, or new renal involvement) were studied with logistic regression, and associations with damage (first SLICC/American College of Rheumatology Damage Index [SDI] increase ≥1 point) and mortality with separate Cox proportional hazard models. Results: Of the 1,849 cohort participants, 660 patients (88% women) were included. Median (interquartile range) serum HCQ was 388 ng/mL (244–566); 48 patients (7.3%) had severe HCQ nonadherence. No covariates were clearly associated with severe nonadherence, which was, however, independently associated with both flare (odds ratio 3.38; 95% confidence interval [CI] 1.80–6.42) and an increase in the SDI within each of the first three years (hazard ratio [HR] 1.92 at three years; 95% CI 1.05–3.50). Eleven patients died within five years, including 3 with severe nonadherence (crude HR 5.41; 95% CI 1.43–20.39). Conclusion: Severe nonadherence was independently associated with the risks of an SLE flare in the following year, early damage, and five-year mortality. (Figure presented.).
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| 60. |
- Obura, David O., et al.
(author)
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Achieving a nature- and people-positive future
- 2023
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In: One Earth. - : Elsevier BV. - 2590-3330 .- 2590-3322. ; 6:2, s. 105-117
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Research review (peer-reviewed)abstract
- Despite decades of increasing investment in conservation, we have not succeeded in “bending the curve” of biodiversity decline. Efforts to meet new targets and goals for the next three decades risk repeating this outcome due to three factors: neglect of increasing drivers of decline; unrealistic expectations and time frames of biodiversity recovery; and insufficient attention to justice within and between generations and across countries. Our Earth system justice approach identifies six sets of actions that when tackled simultaneously address these failings: (1) reduce and reverse direct and indirect drivers causing decline; (2) halt and reverse biodiversity loss; (3) restore and regenerate biodiversity to a safe state; (4) raise minimum wellbeing for all; (5) eliminate over-consumption and excesses associated with accumulation of capital; and (6) uphold and respect the rights and responsibilities of all communities, present and future. Current conservation campaigns primarily address actions 2 and 3, with urgent upscaling of actions 1, 4, 5, and 6 needed to help deliver the post-2020 global biodiversity framework.
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