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1.
  • 2019
  • Tidskriftsartikel (refereegranskat)
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2.
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3.
  • Falster, Daniel, et al. (författare)
  • AusTraits, a curated plant trait database for the Australian flora
  • 2021
  • Ingår i: Scientific Data. - : Nature Portfolio. - 2052-4463. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • We introduce the AusTraits database - a compilation of values of plant traits for taxa in the Australian flora (hereafter AusTraits). AusTraits synthesises data on 448 traits across 28,640 taxa from field campaigns, published literature, taxonomic monographs, and individual taxon descriptions. Traits vary in scope from physiological measures of performance (e.g. photosynthetic gas exchange, water-use efficiency) to morphological attributes (e.g. leaf area, seed mass, plant height) which link to aspects of ecological variation. AusTraits contains curated and harmonised individual- and species-level measurements coupled to, where available, contextual information on site properties and experimental conditions. This article provides information on version 3.0.2 of AusTraits which contains data for 997,808 trait-by-taxon combinations. We envision AusTraits as an ongoing collaborative initiative for easily archiving and sharing trait data, which also provides a template for other national or regional initiatives globally to fill persistent gaps in trait knowledge.
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4.
  • Ademuyiwa, Adesoji O., et al. (författare)
  • Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
  • 2016
  • Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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5.
  • Arndt, D. S., et al. (författare)
  • STATE OF THE CLIMATE IN 2017
  • 2018
  • Ingår i: Bulletin of The American Meteorological Society - (BAMS). - : American Meteorological Society. - 0003-0007 .- 1520-0477. ; 99:8, s. S1-S310
  • Forskningsöversikt (refereegranskat)
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6.
  • Hudson, Lawrence N, et al. (författare)
  • The database of the PREDICTS (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems) project
  • 2017
  • Ingår i: Ecology and Evolution. - : John Wiley & Sons. - 2045-7758. ; 7:1, s. 145-188
  • Tidskriftsartikel (refereegranskat)abstract
    • The PREDICTS project-Projecting Responses of Ecological Diversity In Changing Terrestrial Systems (www.predicts.org.uk)-has collated from published studies a large, reasonably representative database of comparable samples of biodiversity from multiple sites that differ in the nature or intensity of human impacts relating to land use. We have used this evidence base to develop global and regional statistical models of how local biodiversity responds to these measures. We describe and make freely available this 2016 release of the database, containing more than 3.2 million records sampled at over 26,000 locations and representing over 47,000 species. We outline how the database can help in answering a range of questions in ecology and conservation biology. To our knowledge, this is the largest and most geographically and taxonomically representative database of spatial comparisons of biodiversity that has been collated to date; it will be useful to researchers and international efforts wishing to model and understand the global status of biodiversity.
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7.
  • Cashmore, Matthew, et al. (författare)
  • Evaluating the effectiveness of impact assessment instruments : Theorising the nature and implications of their political constitution
  • 2010
  • Ingår i: Environmental impact assessment review. - : Elsevier. - 0195-9255 .- 1873-6432. ; 30:6, s. 371-379
  • Tidskriftsartikel (refereegranskat)abstract
    • The central role of impact assessment instruments globally in policy integration initiatives has been cemented in recent years. Associated with this trend, but also reflecting political emphasis on greater accountability in certain policy sectors and a renewed focus on economic competitiveness in Western countries, demand has increased for evidence that these instruments are effective (however defined). Resurgent interest in evaluation has not, however, been accompanied by the conceptual developments required to redress longstanding theoretical problems associated with such activities. In order to sharpen effectiveness evaluation theory for impact assessment instruments this article critically examines the neglected issue of their political constitution. Analytical examples are used to concretely explore the nature and significance of the politicisation of impact assessment. It is argued that raising awareness about the political character of impact assessment instruments, in itself, is a vital step in advancing effectiveness evaluation theory. Broader theoretical lessons on the framing of evaluation research are also drawn from the political analysis. We conclude that, at least within the contemporary research context, learning derived from analysing the meaning and implications of plural interpretations of effectiveness represents the most constructive strategy for advancing impact assessment and policy integration theory.
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8.
  • Cashmore, Matthew, et al. (författare)
  • Seeing power in international development cooperation : Environmental policy integration and the World Bank
  • 2014
  • Ingår i: Transactions of the Institute of British Geographers. - : Wiley. - 0020-2754 .- 1475-5661. ; 39:1, s. 155-168
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this paper is to sharpen the ways in which power dynamics can be analytically 'seen' in complex governance contexts where particular ways of governing, and their associated horizons of thought, shape and are in turn shaped by intricate interactions between actors. A theoretical approach is proposed, combining a governmentality perspective with Stewart Clegg's theory of circuits of power. The framework is applied in a case study of experimentation by the World Bank with a new tool for Environmental Policy Integration (EPI).Rather than conceptualising the EPI tool as a governmental technology through which the World Bank could promote its favoured vision of political culture in a local setting (here urban planning in Dhaka, Bangladesh), an alternative account is generated that reveals a will to power among the international development community, realised through the construction of knowledge. This alternative approach suggests that the primary motivation for the will to power is not, as a neo-colonial perspective might suggest, power over developing countries, but relational power at the international scale.It is concluded that the narrative generated through our hybrid analytical perspective demonstrates the usefulness of multi-theoretic approaches and offers a useful extension to the analytical purchase of governmentality.
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9.
  • Hudson, Lawrence N., et al. (författare)
  • The PREDICTS database : a global database of how local terrestrial biodiversity responds to human impacts
  • 2014
  • Ingår i: Ecology and Evolution. - : Wiley. - 2045-7758. ; 4:24, s. 4701-4735
  • Tidskriftsartikel (refereegranskat)abstract
    • Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species' threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project - and avert - future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups - including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems - ). We make site-level summary data available alongside this article. The full database will be publicly available in 2015.
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10.
  • Kattge, Jens, et al. (författare)
  • TRY plant trait database - enhanced coverage and open access
  • 2020
  • Ingår i: Global Change Biology. - : Wiley-Blackwell. - 1354-1013 .- 1365-2486. ; 26:1, s. 119-188
  • Tidskriftsartikel (refereegranskat)abstract
    • Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives.
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11.
  • Santangelo, James S., et al. (författare)
  • Global urban environmental change drives adaptation in white clover
  • 2022
  • Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 375
  • Tidskriftsartikel (refereegranskat)abstract
    • Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural dines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale.
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12.
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13.
  • Ades, M., et al. (författare)
  • Global Climate : in State of the climate in 2019
  • 2020
  • Ingår i: Bulletin of The American Meteorological Society - (BAMS). - : American Meteorological Society. - 0003-0007 .- 1520-0477. ; 101:8, s. S17-S127
  • Tidskriftsartikel (refereegranskat)
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14.
  • Ades, M., et al. (författare)
  • GLOBAL CLIMATE
  • 2020
  • Ingår i: BULLETIN OF THE AMERICAN METEOROLOGICAL SOCIETY. - 0003-0007 .- 1520-0477. ; 101:8
  • Tidskriftsartikel (refereegranskat)
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15.
  • Alexandrov, Ludmil B., et al. (författare)
  • Signatures of mutational processes in human cancer
  • 2013
  • Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 500:7463, s. 415-421
  • Tidskriftsartikel (refereegranskat)abstract
    • All cancers are caused by somatic mutations; however, understanding of the biological processes generating these mutations is limited. The catalogue of somatic mutations from a cancer genome bears the signatures of the mutational processes that have been operative. Here we analysed 4,938,362 mutations from 7,042 cancers and extracted more than 20 distinct mutational signatures. Some are present in many cancer types, notably a signature attributed to the APOBEC family of cytidine deaminases, whereas others are confined to a single cancer class. Certain signatures are associated with age of the patient at cancer diagnosis, known mutagenic exposures or defects in DNA maintenance, but many are of cryptic origin. In addition to these genome-wide mutational signatures, hypermutation localized to small genomic regions, 'kataegis', is found in many cancer types. The results reveal the diversity of mutational processes underlying the development of cancer, with potential implications for understanding of cancer aetiology, prevention and therapy.
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16.
  • Campbell, PJ, et al. (författare)
  • Pan-cancer analysis of whole genomes
  • 2020
  • Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 578:7793, s. 82-
  • Tidskriftsartikel (refereegranskat)abstract
    • Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale1–3. Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4–5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter4; identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation5,6; analyses timings and patterns of tumour evolution7; describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity8,9; and evaluates a range of more-specialized features of cancer genomes8,10–18.
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17.
  • Cashmore, Matthew, et al. (författare)
  • Power and environmental assessment: Introduction to the special issue
  • 2013
  • Ingår i: Environmental Impact Assessment Review. - : Elsevier BV. - 0195-9255. ; 39, s. 1-4
  • Annan publikation (refereegranskat)abstract
    • The significance of politics and power dynamics has long been recognised in environmental assessment (EA) research, but there has not been sustained attention to power, either theoretically or empirically. The aim of this special issue is to encourage the EA community to engage more consistently with the issue of power. The introduction represents a ground-clearing exercise intended to clarify the terms of the debate about power in the EA field, and to contribute to the development of a research agenda. Research trends in the field are outlined, and potential analytic and normative lines of inquiry are identified. The contributions to this special issue represent contrasting conceptual and methodological approaches that navigate the analytical and normative terrain of power dynamics in EA. Together, they demonstrate that power cannot be removed from EA policy or practices, and is a necessary research focus for the development of the field. (C) 2012 Elsevier Inc. All rights reserved.
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18.
  • de Bruijn, Robert, et al. (författare)
  • Erythropoietin production as a result of repeated apneas
  • 2004
  • Konferensbidrag (refereegranskat)abstract
    • Background: It has been known for decades that high altitude hypoxia will lead to increased erythropoiesis. Hypoxia in mainly the kidney results in an increased production of erythropoietin (EPO) stimulating erythropoiesis. High altitude natives display a higher haemoglobin concentration than sea level residents, which in turn increase their haemoglobin concentration as part of the adaptation to altitude. Another group of humans exposed to hypoxia is apneic divers, which may endure transient acute hypoxia, spaced by periods of normal breathing. We recently found higher haemoglobin levels in elite apneic divers, compared to groups of elite skiers and untrained subjects, suggesting that apnea training may induce erythropoiesis in humans. It is well known that diving mammals display high haemoglobin concentrations, and the beneficial effects are obvious: A larger oxygen store before diving prolongs the aerobic dive limit, and a higher haemoglobin concentration may speed up recovery after apneas and act as a buffer against acidosis during the dive. Although our group comparisons reveal a higher haemoglobin concentration in divers, it cannot be determined whether this is a training effect or genetically determined i.e. if individuals with higher concentrations of haemoglobin are more prone to take up apneic diving. Methods: To investigate if apnea training can induce EPO production, 5 previously untrained volunteers (3 men and 2 women, mean ageSD 28 5.5 years) performed 15 maximal apneas in a horizontal position in air. The apneas were grouped in 3 series of 5 apneas and spaced by 2 minutes of which 1 minute was spent slightly hyperventilating, to produce apneas sufficiently long to induce hypoxia. Series were spaced by 10 minutes resting periods. To determine EPO levels, venous blood samples were taken before apneas and directly after the last apnea series, followed by samples 1, 2, 3 and 5 hours after the apneas. Results: Mean baseline EPO before the apneas was 10.2 U/L. In all subjects EPO levels increased during the 5 hours period after the apneas. The time for EPO-peak values were different among individuals. The mean peak value occurred after 3 h, where the mean increase was 12 % of the pre apnea reference value. Conclusion: The results suggest that apnea induced intermittent hypoxia could lead to increased erythropoiesis. The evaluation of these findings in a larger group of subjects, including measurements of the individual circadian variations in EPO production, is in progress.
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19.
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20.
  • de Bruijn, Robert, et al. (författare)
  • High hemoglobin levels in divers may be a result of apnea induced EPO-production
  • 2005
  • Ingår i: FASEB JOURNAL. ; , s. A211-A212
  • Konferensbidrag (refereegranskat)abstract
    • Oxygen storage capacity is important for apneic duration and affects performance in endurance sports. We studied if hemoglobin concentration (Hb) was different in divers compared to endurance athletes and untrained subjects and if any differences could be connected to training-induced erythropoietin (EPO) -production. We first compared Hb in 3 groups of subjects: 13 elite apneic divers (35±4 years), 13 elite cross-country skiers (20±1 years) and 23 untrained subjects (29±1 years) with similar weight and height. After 20 min of horizontal rest blood samples were drawn and analysed for Hb using standard methods. In a second experiment, we compared EPO levels before and after a series of 15 maximal apneas in air in 9 previously untrained volunteers (302 years). Apneas were spaced by 2 minutes, the last minute with hyperventilation to produce durations long enough to induce hypoxia. Values were also compared to the EPO levels of a control day without apneas. The apneic divers had higher Hb than untrained subjects (P<0.05) and skiers (P<0.01). After apnea training in untrained subjects EPO levels increased in all subjects, with a mean peak value after 3 h, where the increase was 135 % of the pre apnea value (P<0.05). No increase was observed during the same time period of the control day. We concluded that higher Hb levels in apneic divers may be a result of enhanced EPO-production due to the apnea training.
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21.
  • de Bruijn, Robert, et al. (författare)
  • Increased erythropoietin concentration after repeated apneas in humans
  • 2008
  • Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 102:5, s. 609-613
  • Tidskriftsartikel (refereegranskat)abstract
    • Hypoxia-induced increases in red blood cell production have been found in both altitudeadapted populations and acclimatized lowlanders. This process is mediated by erythropoietin (EPO) released mainly by the hypoxic kidney. We have previously observed high hemoglobin concentrations in elite breath-hold divers and our aim was to investigate whether apnea-induced hypoxia could increase EPO concentration. Ten healthy volunteers performed 15 voluntary maximal duration apneas, divided into three seriesof five apneas, each series separated by 10 min of rest. Apneas within series were separated by 2 min and preceded by 1 min of hyperventilation to increase apnea duration and arterial oxygen desaturation. When EPO concentration after serial apneas was compared to baseline values, an average maximum increase of 24% was found (P<0.01). No changes in EPO concentration were observed during a control day without apnea, eliminating possible effects of a diurnal rhythm or blood loss. We therefore conclude that serial apneas increase circulating EPO concentration in humans.
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22.
  • de Bruijn, Robert, et al. (författare)
  • Oxygen-conserving effect of the diving response in the immersed human
  • 2009
  • Ingår i: Diving and hyperbaric medicine. - 1833-3516. ; 39:4, s. 193-199
  • Tidskriftsartikel (refereegranskat)abstract
    • Research involving the human diving response has often simulated diving by apneic face immersion. However, no comparisons of cardiovascular responses and their oxygen- conserving function have been made between simulated diving and apneic face immersion when the body is constantly immersed as during diving. We compared the diving response and its effects on arterial oxygen saturation during apneas in horizontal dry body and immersed body positions. Both air and water temperatures were 23ºC. Twelve near-maximal apneas of the same duration were completed by 17 subjects. Four series of 3 apneas each were conducted: dry body apnea (DA), dry body, face-immersion apnea (DFIA), immersed body apnea (IA), and immersed body, face-immersion apnea (IFIA). Heart rate, skin capillary blood flow, arterial blood pressure, arterial hemoglobin saturation, lung volume and end-tidal PACO2 and PAO2 were recorded non-invasively and responses during apneas were compared among series. Cardiovascular responses showed similar patterns in all series. Face immersion led to a greater reduction in heart rate during apnea, regardless of body immersion. Both DFIA and DA resulted in a transient skin vasoconstriction, more pronounced during DFIA (p<0.001). During body immersion skin vasoconstriction was constant, and neither IA nor IFIA reduced blood flow further. Less arterial desaturation occurred after both FIA series, suggesting an oxygen-conserving effect of the more powerful diving response associated with face immersion in both body positions. We conclude that a similar oxygen-conserving diving response is triggered by apnea and face immersion during full-body immersion in cool water, as in the dry body model.
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23.
  • Duffy, J. Emmett, et al. (författare)
  • A Pleistocene legacy structures variation in modern seagrass ecosystems
  • 2022
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 119:32
  • Tidskriftsartikel (refereegranskat)abstract
    • Distribution of Earth's biomes is structured by the match between climate and plant traits, which in turn shape associated communities and ecosystem processes and services. However, that climate-trait match can be disrupted by historical events, with lasting ecosystem impacts. As Earth's environment changes faster than at any time in human history, critical questions are whether and how organismal traits and ecosystems can adjust to altered conditions. We quantified the relative importance of current environmental forcing versus evolutionary history in shaping the growth form (stature and biomass) and associated community of eelgrass (Zostera marina), a widespread foundation plant of marine ecosystems along Northern Hemisphere coastlines, which experienced major shifts in distribution and genetic composition during the Pleistocene. We found that eelgrass stature and biomass retain a legacy of the Pleistocene colonization of the Atlantic from the ancestral Pacific range and of more recent within-basin bottlenecks and genetic differentiation. This evolutionary legacy in turn influences the biomass of associated algae and invertebrates that fuel coastal food webs, with effects comparable to or stronger than effects of current environmental forcing. Such historical lags in phenotypic acclimatization may constrain ecosystem adjustments to rapid anthropogenic climate change, thus altering predictions about the future functioning of ecosystems. 
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24.
  • Forouzanfar, Mohammad H, et al. (författare)
  • 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
  • Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 386:10010, s. 2287-2323
  • 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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25.
  • George, Leena, et al. (författare)
  • Blood eosinophil count and airway epithelial transcriptome relationships in COPD versus asthma
  • 2020
  • Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : WILEY. - 0105-4538 .- 1398-9995. ; 75:2, s. 370-380
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Whether the clinical or pathophysiologic significance of the "treatable trait" high blood eosinophil count in COPD is the same as for asthma remains controversial. We sought to determine the relationship between the blood eosinophil count, clinical characteristics and gene expression from bronchial brushings in COPD and asthma.Methods: Subjects were recruited into a COPD (emphysema versus airway disease [EvA]) or asthma cohort (Unbiased BIOmarkers in PREDiction of respiratory disease outcomes, U-BIOPRED). We determined gene expression using RNAseq in EvA (n = 283) and Affymetrix microarrays in U-BIOPRED (n = 85). We ran linear regression analysis of the bronchial brushings transcriptional signal versus blood eosinophil counts as well as differential expression using a blood eosinophil > 200 cells/mu L as a cut-off. The false discovery rate was controlled at 1% (with continuous values) and 5% (with dichotomized values).Results: There were no differences in age, gender, lung function, exercise capacity and quantitative computed tomography between eosinophilic versus noneosinophilic COPD cases. Total serum IgE was increased in eosinophilic asthma and COPD. In EvA, there were 12 genes with a statistically significant positive association with the linear blood eosinophil count, whereas in U-BIOPRED, 1197 genes showed significant associations (266 positive and 931 negative). The transcriptome showed little overlap between genes and pathways associated with blood eosinophil counts in asthma versus COPD. Only CST1 was common to eosinophilic asthma and COPD and was replicated in independent cohorts.Conclusion: Despite shared "treatable traits" between asthma and COPD, the molecular mechanisms underlying these clinical entities are predominately different.
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