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Sökning: WFRF:(Golledge Jonathan)

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1.
  • Gregson, J., et al. (författare)
  • Cardiovascular Risk Factors Associated With Venous Thromboembolism
  • 2019
  • Ingår i: JAMA Cardiology. - : AMER MEDICAL ASSOC. - 0965-2590 .- 2380-6583 .- 2380-6591. ; 4:2, s. 163-173
  • Tidskriftsartikel (refereegranskat)abstract
    • IMPORTANCE It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE). OBJECTIVE To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism. DESIGN, SETTING, AND PARTICIPANTS This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February 2016). Participants without cardiovascular disease at baseline were included. Data were analyzed from June 2017 to September 2018. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) per 1-SD higher usual risk factor levels (or presence/absence). Incident fatal outcomes in ERFC (VTE, 1041; coronary heart disease [CND], 25131) and incident fatal/nonfatal outcomes in UK Biobank (VTE, 2321; CHD, 3385). Hazard ratios were adjusted for age, sex, smoking status, diabetes, and body mass index (BMI). RESULTS Of the 731728 participants from the ERFC. 403 396 (55.1%) were female, and the mean (SD) age at the time of the survey was 51.9 (9.0) years; of the 421537 participants from the UK Biobank, 233 699 (55.4%) were female, and the mean (SD) age at the time of the survey was 56.4 (8.1) years. Risk factors for VTE included older age (ERFC: HR per decade, 2.67; 95% CI, 2.45-2.91; UK Biobank: HR, 1.81; 95% CI, 1.71-1.92), current smoking (ERFC: HR, 1.38; 95% CI, 1.20-1.58; UK Biobank: HR, 1.23; 95% CI, 1.08-1.40), and BMI (ERFC: HR per 1-SD higher BMI, 1.43; 95% CI, 1.35-1.50; UK Biobank: HR, 1.37; 95% CI, 1.32-1.41). For these factors, there were similar HRs for pulmonary embolism and deep vein thrombosis in UK Biobank (except adiposity was more strongly associated with pulmonary embolism) and similar HRs for unprovoked vs provoked VTE. Apart from adiposity, these risk factors were less strongly associated with VTE than CHD. There were inconsistent associations of VTEs with diabetes and blood pressure across ERFC and UK Biobank, and there was limited ability to study lipid and inflammation markers. CONCLUSIONS AND RELEVANCE Older age, smoking, and adiposity were consistently associated with higher VTE risk.
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2.
  • Jones, Gregory T., et al. (författare)
  • Meta-Analysis of Genome-Wide Association Studies for Abdominal Aortic Aneurysm Identifies Four New Disease-Specific Risk Loci
  • 2017
  • Ingår i: Circulation Research. - 0009-7330 .- 1524-4571. ; 120:2, s. 341-
  • Tidskriftsartikel (refereegranskat)abstract
    • Rationale: Abdominal aortic aneurysm (AAA) is a complex disease with both genetic and environmental risk factors. Together, 6 previously identified risk loci only explain a small proportion of the heritability of AAA. Objective: To identify additional AAA risk loci using data from all available genome-wide association studies. Methods and Results: Through a meta-analysis of 6 genome-wide association study data sets and a validation study totaling 10 204 cases and 107 766 controls, we identified 4 new AAA risk loci: 1q32.3 (SMYD2), 13q12.11 (LINC00540), 20q13.12 (near PCIF1/MMP9/ZNF335), and 21q22.2 (ERG). In various database searches, we observed no new associations between the lead AAA single nucleotide polymorphisms and coronary artery disease, blood pressure, lipids, or diabetes mellitus. Network analyses identified ERG, IL6R, and LDLR as modifiers of MMP9, with a direct interaction between ERG and MMP9. Conclusions: The 4 new risk loci for AAA seem to be specific for AAA compared with other cardiovascular diseases and related traits suggesting that traditional cardiovascular risk factor management may only have limited value in preventing the progression of aneurysmal disease.
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4.
  • Khosla, S., et al. (författare)
  • Meta-analysis of peak wall stress in ruptured, symptomatic and intact abdominal aortic aneurysms
  • 2014
  • Ingår i: British Journal of Surgery. - 0007-1323 .- 1365-2168. ; 101:11, s. 1350-1357
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Abdominal aortic aneurysm (AAA) is an important cause of sudden death; however, there are currently incomplete means to predict the risk of AAA rupture. AAA peak wall stress (PWS) can be estimated using finite element analysis (FEA) methods from computed tomography (CT) scans. The question is whether AAA PWS can predict AAA rupture. The aim of this systematic review was to compare PWS in patients with ruptured and intact AAA. Methods: The MEDLINE database was searched on 25 May 2013. Case-control studies assessing PWS in asymptomatic intact, and acutely symptomatic or ruptured AAA from CT scans using FEA were included. Data were extracted independently. A random-effects model was used to calculate standard mean differences (SMDs) for PWS measurements. Results: Nine studies assessing 348 individuals were identified and used in the meta-analysis. Results from 204 asymptomatic intact and 144 symptomatic or ruptured AAAs showed that PWS was significantly greater in the symptomatic/ruptured AAAs compared with the asymptomatic intact AAAs (SMD 0.95, 95 per cent confidence interval 0. 71 to 1.18; P < 0. 001). The findings remained significant after adjustment for mean systolic blood pressure, standardized at 120 mmHg(SMD 0.68, 0.39 to 0.96; P < 0. 001). Minimal heterogeneity between studies was noted (I-2 = 0 per cent). Conclusion: This study suggests that PWS is greater in symptomatic or ruptured AAA than in asymptomatic intact AAA.
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5.
  • Rainsley, Eleanor, et al. (författare)
  • Pleistocene glacial history of the New Zealand subantarctic islands
  • 2019
  • Ingår i: Climate of the Past. - 1814-9324 .- 1814-9332. ; 15:2, s. 423-448
  • Tidskriftsartikel (refereegranskat)abstract
    • The New Zealand subantarctic islands of Auckland and Campbell, situated between the subtropical front and the Antarctic Convergence in the Pacific sector of the Southern Ocean, provide valuable terrestrial records from a globally important climatic region. Whilst the islands show clear evidence of past glaciation, the timing and mechanisms behind Pleistocene environmental and climate changes remain uncertain. Here we present a multidisciplinary study of the islands-including marine and terrestrial geomorphological surveys, extensive analyses of sedimentary sequences, a comprehensive dating programme, and glacier flow line modelling-to investigate multiple phases of glaciation across the islands. We find evidence that the Auckland Islands hosted a small ice cap 384 000 +/- 26 000 years ago (384 +/- 26 ka), most likely during Marine Isotope Stage 10, a period when the subtropical front was reportedly north of its present-day latitude by several degrees, and consistent with hemispheric-wide glacial expansion. Flow line modelling constrained by field evidence suggests a more restricted glacial period prior to the LGM that formed substantial valley glaciers on the Campbell and Auckland Islands around 72-62 ka. Despite previous interpretations that suggest the maximum glacial extent occurred in the form of valley glaciation at the Last Glacial Maximum (LGM; similar to 21 ka), our combined approach suggests minimal LGM glaciation across the New Zealand subantarctic islands and that no glaciers were present during the Antarctic Cold Reversal (ACR; similar to 15-13 ka). Instead, modelling implies that despite a regional mean annual air temperature depression of similar to 5 degrees C during the LGM, a combination of high seasonality and low precipitation left the islands incapable of sustaining significant glaciation. We suggest that northwards expansion of winter sea ice during the LGM and subsequent ACR led to precipitation starvation across the middle to high latitudes of the Southern Ocean, resulting in restricted glaciation of the subantarctic islands.
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6.
  • Singh, Tejas P., et al. (författare)
  • Systematic Review and Meta-Analysis of Peak Wall Stress and Peak Wall Rupture Index in Ruptured and Asymptomatic Intact Abdominal Aortic Aneurysms
  • 2021
  • Ingår i: Journal of the American Heart Association. - : WILEY. - 2047-9980 .- 2047-9980. ; 10:8
  • Forskningsöversikt (refereegranskat)abstract
    • Background Prior studies have suggested aortic peak wall stress (PWS) and peak wall rupture index (PWRI) can estimate the rupture risk of an abdominal aortic aneurysm (AAA), but whether these measurements have independent predictive ability over assessing AAA diameter alone is unclear. The aim of this systematic review was to compare PWS and PWRI in participants with ruptured and asymptomatic intact AAAs of similar diameter. Methods and Results Web of Science, Scopus, Medline, and The Cochrane Library were systematically searched to identify studies assessing PWS and PWRI in ruptured and asymptomatic intact AAAs of similar diameter. Random-effects meta-analyses were performed using inverse variance-weighted methods. Leave-one-out sensitivity analyses were conducted to assess the robustness of findings. Risk of bias was assessed using a modification of the Newcastle-Ottawa scale and standard quality assessment criteria for evaluating primary research papers. Seven case-control studies involving 309 participants were included. Meta-analyses suggested that PWRI (standardized mean difference, 0.42; 95% CI, 0.14-0.70; P=0.004) but not PWS (standardized mean difference, 0.13; 95% CI, -0.18 to 0.44; P=0.418) was greater in ruptured than intact AAAs. Sensitivity analyses suggested that the findings were not dependent on the inclusion of any single study. The included studies were assessed to have a medium to high risk of bias. Conclusions Based on limited evidence, this study suggested that PWRI, but not PWS, is greater in ruptured than asymptomatic intact AAAs of similar maximum aortic diameter.
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7.
  • Thomas, Zoë A., et al. (författare)
  • Tipping elements and amplified polar warming during the Last Interglacial
  • 2020
  • Ingår i: Quaternary Science Reviews. - : Elsevier. - 0277-3791. ; 233
  • Forskningsöversikt (refereegranskat)abstract
    • Irreversible shifts of large-scale components of the Earth system (so-called ‘tipping elements’) on policy-relevant timescales are a major source of uncertainty for projecting the impacts of future climate change. The high latitudes are particularly vulnerable to positive feedbacks that amplify change through atmosphere-ocean-ice interactions. Unfortunately, the short instrumental record does not capture the full range of past or projected climate scenarios (a situation particularly acute in the high latitudes). Natural archives from past periods warmer than present day, however, can be used to explore drivers and responses to forcing, and provide data against which to test models, thereby offering insights into the future. The Last Interglacial (129–116,000 years before present) — the warmest interglacial of the last 800,000 years — was the most recent period during which global temperatures were comparable with low-end 21st Century projections (up to 2 °C warmer, with temperature increase amplified over polar latitudes), providing a potentially useful analogue for future change. Substantial environmental changes happened during this time. Here we synthesise the nature and timing of potential high-latitude tipping elements during the Last Interglacial, including sea ice, extent of the boreal forest, permafrost, ocean circulation, and ice sheets/sea level. We also review the thresholds and feedbacks that likely operated through this period. Notably, substantial ice mass loss from Greenland, the West Antarctic, and possibly sectors of the East Antarctic drove a 6–9 m rise in global sea level. This was accompanied by reduced summer sea-ice extent, poleward-extended boreal forest, and reduced areas of permafrost. Despite current chronological uncertainties, we find that tipping elements in the high latitudes all experienced rapid and abrupt change (within 1–2 millennia of each other) across both hemispheres, while recovery to prior conditions took place over multi-millennia. Our synthesis demonstrates important feedback loops between tipping elements, amplifying polar and global change during the Last Interglacial. The high sensitivity and tight interconnections between polar tipping elements suggests that they could exhibit similar thresholds of vulnerability in the future, particularly if the aspirations of the Paris Agreement are not met.
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8.
  • Turney, Chris S M, et al. (författare)
  • Rapid global ocean-atmosphere response to Southern Ocean freshening during the last glacial
  • 2017
  • Ingår i: Nature Communications. - : Nature Publishing Group. - 2041-1723. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Contrasting Greenland and Antarctic temperatures during the last glacial period (115,000 to 11,650 years ago) are thought to have been driven by imbalances in the rates of formation of North Atlantic and Antarctic Deep Water (the 'bipolar seesaw'). Here we exploit a bidecadally resolved 14C data set obtained from New Zealand kauri (Agathis australis) to undertake high-precision alignment of key climate data sets spanning iceberg-rafted debris event Heinrich 3 and Greenland Interstadial (GI) 5.1 in the North Atlantic (~30,400 to 28,400 years ago). We observe no divergence between the kauri and Atlantic marine sediment 14C data sets, implying limited changes in deep water formation. However, a Southern Ocean (Atlantic-sector) iceberg rafted debris event appears to have occurred synchronously with GI-5.1 warming and decreased precipitation over the western equatorial Pacific and Atlantic. An ensemble of transient meltwater simulations shows that Antarctic-sourced salinity anomalies can generate climate changes that are propagated globally via an atmospheric Rossby wave train.
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10.
  • Wanhainen, Anders, et al. (författare)
  • Surrogate Markers of Abdominal Aortic Aneurysm Progression
  • 2016
  • Ingår i: Arteriosclerosis, Thrombosis and Vascular Biology. - 1079-5642 .- 1524-4636. ; 36:2, s. 236-244
  • Tidskriftsartikel (refereegranskat)abstract
    • The natural course of many abdominal aortic aneurysms (AAA) is to gradually expand and eventually rupture and monitoring the disease progression is essential to their management. In this publication, we review surrogate markers of AAA progression. AAA diameter remains the most widely used and important marker of AAA growth. Standardized reporting of reproducible methods of measuring AAA diameter is essential. Newer imaging assessments, such as volume measurements, biomechanical analyses, and functional and molecular imaging, as well as circulating biomarkers, have potential to add important information about AAA progression. Currently, however, there is insufficient evidence to recommend their routine use in clinical practice.
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