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1.
  • Bentham, James, et al. (author)
  • A century of trends in adult human height
  • 2016
  • In: eLIFE. - 2050-084X. ; 5
  • Journal article (peer-reviewed)abstract
    • Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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2.
  • Bentham, James, et al. (author)
  • A century of trends in adult human height
  • 2016
  • In: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5
  • Journal article (peer-reviewed)abstract
    • Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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4.
  • Zhou, Bin, et al. (author)
  • Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants
  • 2016
  • In: The Lancet. - : Elsevier B.V.. - 0140-6736 .- 1474-547X. ; 387:10027, s. 1513-1530
  • Journal article (peer-reviewed)abstract
    • Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes.Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.Findings: We used data from 751 studies including 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.
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5.
  • Danaei, Goodarz, et al. (author)
  • Effects of diabetes definition on global surveillance of diabetes prevalence and diagnosis: a pooled analysis of 96 population-based studies with 331288 participants
  • 2015
  • In: The Lancet Diabetes & Endocrinology. - 2213-8595 .- 2213-8587. ; 3:8, s. 624-637
  • Journal article (peer-reviewed)abstract
    • Background Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA(1c). We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions. Methods We used data from 96 population-based health examination surveys that had measured at least two of the biomarkers used for defining diabetes. Diabetes was defined using HbA(1c) (HbA(1c) >= 6 . 5% or history of diabetes diagnosis or using insulin or oral hypoglycaemic drugs) compared with either FPG only or FPG-or-2hOGTT definitions (FPG >= 7 . 0 mmol/L or 2hOGTT >= 11 . 1 mmol/L or history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated diabetes prevalence, taking into account complex survey design and survey sample weights. We compared the prevalences of diabetes using different definitions graphically and by regression analyses. We calculated sensitivity and specificity of diabetes diagnosis based on HbA1c compared with diagnosis based on glucose among previously undiagnosed individuals (ie, excluding those with history of diabetes or using insulin or oral hypoglycaemic drugs). We calculated sensitivity and specificity in each survey, and then pooled results using a random-effects model. We assessed the sources of heterogeneity of sensitivity by meta-regressions for study characteristics selected a priori. Findings Population prevalence of diabetes based on FPG- or-2hOGTT was correlated with prevalence based on FPG alone (r= 0 . 98), but was higher by 2-6 percentage points at different prevalence levels. Prevalence based on HbA(1c) was lower than prevalence based on FPG in 42 . 8% of age-sex-survey groups and higher in another 41 . 6%; in the other 15 . 6%, the two definitions provided similar prevalence estimates. The variation across studies in the relation between glucose-based and HbA(1c)-based prevalences was partly related to participants' age, followed by natural logarithm of per person gross domestic product, the year of survey, mean BMI, and whether the survey population was national, subnational, or from specific communities. Diabetes defined as HbA(1c) 6 . 5% or more had a pooled sensitivity of 52 . 8% (95% CI 51 . 3-54 . 3%) and a pooled specificity of 99 . 74% (99 . 71-99 . 78%) compared with FPG 7 . 0 mmol/L or more for diagnosing previously undiagnosed participants; sensitivity compared with diabetes defined based on FPG-or-2hOGTT was 30 . 5% (28 . 7-32 . 3%). None of the preselected study-level characteristics explained the heterogeneity in the sensitivity of HbA(1c) versus FPG. Interpretation Different biomarkers and definitions for diabetes can provide different estimates of population prevalence of diabetes, and differentially identify people without previous diagnosis as having diabetes. Using an HbA(1c)-based definition alone in health surveys will not identify a substantial proportion of previously undiagnosed people who would be considered as having diabetes using a glucose-based test.
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7.
  • Bergström, Ulf, et al. (author)
  • Long-term effects of no-take zones in Swedish waters
  • 2022
  • Reports (other academic/artistic)abstract
    • Marine protected areas (MPAs) are increasingly established worldwide to protect and restore degraded ecosystems. However, the level of protection varies among MPAs and has been found to affect the outcome of the closure. In no-take zones (NTZs), no fishing or extraction of marine organisms is allowed. The EU Commission recently committed to protect 30% of European waters by 2030 through the updated Biodiversity Strategy. Importantly, one third of these 30% should be of strict protection. Exactly what is meant by strict protection is not entirely clear, but fishing would likely have to be fully or largely prohibited in these areas. This new target for strictly protected areas highlights the need to evaluate the ecological effects of NTZs, particularly in regions like northern Europe where such evaluations are scarce. The Swedish NTZs made up approximately two thirds of the total areal extent of NTZs in Europe a decade ago. Given that these areas have been closed for at least 10 years and can provide insights into long-term effects of NTZs on fish and ecosystems, they are of broad interest in light of the new 10% strict protection by 2030 commitment by EU member states.In total, eight NTZs in Swedish coastal and offshore waters were evaluated in the current report, with respect to primarily the responses of focal species for the conservation measure, but in some of the areas also ecosystem responses. Five of the NTZs were established in 2009-2011, as part of a government commission, while the other three had been established earlier. The results of the evaluations are presented in a synthesis and also in separate, more detailed chapters for each of the eight NTZs. Overall, the results suggest that NTZs can increase abundances and biomasses of fish and decapod crustaceans, given that the closed areas are strategically placed and of an appropriate size in relation to the life cycle of the focal species. A meta-regression of the effects on focal species of the NTZs showed that CPUE was on average 2.6 times higher after three years of protection, and 3.8 times higher than in the fished reference areas after six years of protection. The proportion of old and large individuals increased in most NTZs, and thereby also the reproductive potential of populations. The increase in abundance of large predatory fish also likely contributed to restoring ecosystem functions, such as top-down control. These effects appeared after a 5-year period and in many cases remained and continued to increase in the longer term (>10 years). In the two areas where cod was the focal species of the NTZs, positive responses were weak, likely as an effect of long-term past, and in the Kattegat still present, recruitment overfishing. In the Baltic Sea, predation by grey seal and cormorant was in some cases so high that it likely counteracted the positive effects of removing fisheries and led to stock declines in the NTZs. In most cases, the introduction of the NTZs has likely decreased the total fishing effort rather than displacing it to adjacent areas. In the Kattegat NTZ, however, the purpose was explicitly to displace an unselective coastal mixed bottom-trawl fishery targeting Norway lobster and flatfish to areas where the bycatches of mature cod were smaller. In two areas that were reopened to fishing after 5 years, the positive effects of the NTZs on fish stocks eroded quickly to pre-closure levels despite that the areas remained closed during the spawning period, highlighting that permanent closures may be necessary to maintain positive effects.We conclude from the Swedish case studies that NTZs may well function as a complement to other fisheries management measures, such as catch, effort and gear regulations. The experiences from the current evaluation show that NTZs can be an important tool for fisheries management especially for local coastal fish populations and areas with mixed fisheries, as well as in cases where there is a need to counteract adverse ecosystem effects of fishing. NTZs are also needed as reference for marine environmental management, and for understanding the effects of fishing on fish populations and other ecosystem components in relation to other pressures. MPAs where the protection of both fish and their habitats is combined may be an important instrument for ecosystembased management, where the recovery of large predatory fish may lead to a restoration of important ecosystem functions and contribute to improving decayed habitats.With the new Biodiversity Strategy, EUs level of ambition for marine conservation increases significantly, with the goal of 30% of coastal and marine waters protected by 2030, and, importantly, one third of these areas being strictly protected. From a conservation perspective, rare, sensitive and/or charismatic species or habitats are often in focus when designating MPAs, and displacement of fisheries is then considered an unwanted side effect. However, if the establishment of strictly protected areas also aims to rebuild fish stocks, these MPAs should be placed in heavily fished areas and designed to protect depleted populations by accounting for their home ranges to generate positive outcomes. Thus, extensive displacement of fisheries is required to reach benefits for depleted populations, and need to be accounted for e.g. by specific regulations outside the strictly protected areas. These new extensive EU goals for MPA establishment pose a challenge for management, but at the same time offer an opportunity to bridge the current gap between conservation and fisheries management.
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8.
  • Eggertsen, Maria, et al. (author)
  • Seascape Configuration and Fine-Scale Habitat Complexity Shape Parrotfish Distribution and Function across a Coral Reef Lagoon
  • 2020
  • In: Diversity. - : MDPI AG. - 1424-2818. ; 12:10
  • Journal article (peer-reviewed)abstract
    • Structural complexity spanning fine to broad spatial scales can influence the distribution and activity of key organisms within marine ecosystems. However, the relative importance of hard (e.g., corals) and/or soft (e.g., macroalgae) structural complexity for marine organisms is often unclear. This study shows how both broad-scale (seascape configuration of coral structure) and fine-scale habitat complexity (structure height, number of holes, and presence of macroalgae) can influence the abundance and spatial ecology of reef fish. Underwater visual census of fish, surveys of habitats, remote underwater videos, and behavioral observations by following individual fish were used to quantify fine-scale habitat characteristics (e.g., complexity, coral structure height, macroalgae presence) and the abundance, size structure, and behavior (rates of herbivory, tortuosity ratios and total distance travelled) of abundant parrotfish. Both seascape configuration and macroalgae influenced the patterns of fish abundance and rates of herbivory. However, these relationships varied with trophic groups and ontogenetic stages. Abundance of adult and intermediate-phase parrotfishes was positively influenced by densely aggregated coral structures, whereas juvenile abundance was positively influenced by the presence of macroalgae. Foraging path and bite rates of an abundant parrotfish, Chlorurus spilurus, were not influenced by coral structure configuration or height, but the presence of macroalgae increased the bite rates of all juvenile parrotfish. Our results suggest that a combination of seascape configuration, fine-scale habitat complexity, and microhabitat selectivity influence reef fish community structure and foraging behavior, thus altering herbivory. However, these relationships can differ among functional groups of fish and life-history stages. Information on these fish–habitat interactions is critical for identifying habitats that facilitate ecological functions and ensures the successful management and conservation of essential habitats.
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  • Eggertsen, Maria, 1981-, et al. (author)
  • Seascape configuration and microhabitat condition shapes parrotfish distribution and function across a coral reef lagoon
  • Other publication (other academic/artistic)abstract
    • Structural complexity spanning fine to coarse spatial scales can influence the distribution and activity of key organisms within marine ecosystems. The current study shows how both broad-scale (seascape configuration of coral structure) and fine-scale habitat complexity (structural height, number of holes, and macroalgae) can influence the abundance and spatial ecology of reef fishes in a shallow tropical lagoon. Visual surveys, remote underwater video, and field observations were used to quantify habitat characteristics and the abundance, size structure and behavior (rates of herbivory, tortuosity ratios and total distance travelled) of abundant reef fishes. Both seascape configuration and macroalgae influenced patterns of fish abundance and rates of herbivory. However, these relationships varied with fish trophic groups and ontogenetic stages. High levels of hard complexity increased abundance of adult and intermediate-phase parrotfishes, whereas juvenile abundance was positively influenced by the presence of macroalgae, irrespective of the spatial configuration of coral structure in the seascape. Foraging path patterns (directed vs. convoluted) and bite rates of an abundant excavating parrotfish, Chlorurus spilurus, was not influenced by coral structure configuration in the seascape (dense/sparse) or coral structure height (high/low), but the presence of macroalgae increased the bite rates of all juvenile parrotfishes (including C. spilurus). Our results suggest a combination of microhabitat selectivity, fine-scale habitat complexity, and seascape configuration influence reef fish community structure and foraging behaviour, with consequences for the important ecological function of herbivory.
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10.
  • Fulton, Christopher J., et al. (author)
  • Macroalgal meadow habitats support fish and fisheries in diverse tropical seascapes
  • 2020
  • In: Fish and Fisheries. - : Wiley. - 1467-2960 .- 1467-2979. ; 21:4, s. 700-717
  • Journal article (peer-reviewed)abstract
    • Canopy-forming macroalgae can construct extensive meadow habitats in tropical seascapes occupied by fishes that span a diversity of taxa, life-history stages and ecological roles. Our synthesis assessed whether these tropical macroalgal habitats have unique fish assemblages, provide fish nurseries and support local fisheries. We also applied a meta-analysis of independent surveys across 23 tropical reef locations in 11 countries to examine how macroalgal canopy condition is related to the abundance of macroalgal-associated fishes. Over 627 fish species were documented in tropical macroalgal meadows, with 218 of these taxa exhibiting higher local abundance within this habitat (cf. nearby coral reef) during at least one life-history stage. Major overlap (40%-43%) in local fish species richness among macroalgal and seagrass or coral reef habitats suggest macroalgal meadows may provide an important habitat refuge. Moreover, the prominence of juvenile fishes suggests macroalgal meadows facilitate the triphasic life cycle of many fishes occupying diverse tropical seascapes. Correlations between macroalgal canopy structure and juvenile abundance suggests macroalgal habitat condition can influence levels of replenishment in tropical fish populations, including the majority of macroalgal-associated fishes that are targeted by commercial, subsistence or recreational fisheries. While many macroalgal-associated fishery species are of minor commercial value, their local importance for food and livelihood security can be substantial (e.g. up to 60% of landings in Kenyan reef fisheries). Given that macroalgal canopy condition can vary substantially with sea temperature, there is a high likelihood that climate change will impact macroalgal-associated fish and fisheries.
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  • Henriksson, Malin, et al. (author)
  • Effects of exercise on symptoms of anxiety in primary care patients: A randomized controlled trial.
  • 2022
  • In: Journal of affective disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 297, s. 26-34
  • Journal article (peer-reviewed)abstract
    • There is a need for high-quality research regarding exercise interventions for persons with anxiety disorders. We investigate whether a 12-week exercise intervention, with different intensities, could reduce anxiety symptoms in patients with anxiety disorders.286 patients were recruited from primary care in Sweden. Severity of symptoms was self-assessed using the Beck Anxiety Inventory (BAI) and the Montgomery Åsberg Depression Rating Scale (MADRS-S). Participants were randomly assigned to one of two group exercise programs with cardiorespiratory and resistance training and one control/standard treatment non-exercise group, with 1:1:1 allocation.Patients in both exercise groups showed larger improvements in both anxiety and depressive symptoms compared to the control group. No differences in effect sizes were found between the two groups. To study a clinically relevant improvement, BAI and MADRS-S were dichotomized with the mean change in the control group as reference. In adjusted models the odds ratio for improved symptoms of anxiety after low-intensity training was 3.62 (CI 1.34-9.76) and after moderate/high intensity 4.88 (CI 1.66-14.39), for depressive symptoms 4.96 (CI 1.81-13.6) and 4.36 (CI 1.57-12.08) respectively. There was a significant intensity trend for improvement in anxiety symptoms.The use of self-rating measures which bears the risk of an under- or overestimation of symptoms.A 12-week group exercise program proved effective for patients with anxiety syndromes in primary care. These findings strengthen the view of physical exercise as an effective treatment and could be more frequently made available in clinical practice for persons with anxiety issues.
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13.
  • Lind, Lars, et al. (author)
  • Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)
  • 2021
  • In: eLife. - : eLife Sciences Publications Ltd. - 2050-084X. ; 10
  • Journal article (peer-reviewed)abstract
    • From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
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14.
  • Massei, Karina, et al. (author)
  • Analysis of marine diversity and anthropogenic pressures on Seixas coral reef ecosystem (northeastern Brazil)
  • 2023
  • In: Science of the Total Environment. - 0048-9697 .- 1879-1026. ; 905
  • Journal article (peer-reviewed)abstract
    • Coral reefs, vital and ecologically significant ecosystems, are among the most jeopardized marine environments in the Atlantic Ocean, particularly along the northeastern coast of Brazil. The persistent lack of effective management and conservation has led to fragmented information on reef use and pressures, hindering the under-standing of these ecosystems' health. Major difficulties and challenges include inadequate data, diverse anthropogenic pressures, and the complex interaction between marine species. This study sought to bridge this knowledge gap by conducting a comprehensive analysis of marine diversity and anthropogenic pressures, specifically focusing on Seixas coral reef near Joa similar to o Pessoa city, an area notably impacted by tourism. Utilizing 25 monitoring transects, subdivided into 1 m2 quadrants, the marine diversity was meticulously evaluated through innovative procedures including (a) sedimentological and geochemical field surveys, (b) application of Shannon -Weaver diversity and Simpson dominance indices, (c) cluster analysis, (d) species identification of macroalgae, coral, and fish, and (e) an examination of anthropogenic interactions and pressures on the coral reef. The assessment encompassed three distinct zones: Back Reef, Reef Top, and Fore Reef, and identified a total of 25 species across 15 genera and 10 fish families. The findings revealed the prevalence of brown macroalgae, fish, and coral, with heightened abundance of red macroalgae in the Fore Reef, which also exhibited the greatest diversity (2.816) and dominance (0.894). Original achievements include the identification of specific spatial variations, recognition of the anthropogenic factors leading to ecological changes, and the formulation of evidence-based recommendations. The study concludes that escalating urbanization and burgeoning daily tourist visits to the reef have exacerbated negative impacts on Seixas coral reef's marine ecosystem. These insights underscore the urgent need for strategic planning and resource management to safeguard the reef's biodiversity and ecological integrity.
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15.
  • Mishra, A, et al. (author)
  • Diminishing benefits of urban living for children and adolescents' growth and development
  • 2023
  • In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 615:7954, s. 874-883
  • Journal article (peer-reviewed)abstract
    • Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
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16.
  • Nyberg, Jenny, 1976, et al. (author)
  • Anxiety severity and cognitive function in primary care patients with anxiety disorder: a cross-sectional study.
  • 2021
  • In: BMC psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 21:1
  • Journal article (peer-reviewed)abstract
    • Deficits in cognitive performance are reported in patients with anxiety disorders, but research is limited and inconsistent. We aimed to investigate cross-sectional associations between cognitive function, with focus on executive function, and anxiety severity in primary care patients diagnosed with anxiety disorders.189 Swedish patients aged 18-65years (31% men) with anxiety disorders diagnosed according to Mini International Neuropsychiatric Interview were included. Severity of anxiety was assessed using Beck Anxiety Inventory self-assessment scale. Digit span, block design and matrix reasoning tests from the Wechsler Adult Intelligence Scale IV, and the design fluency test from the Delis-Kaplan Executive Function System were used. Multivariable linear regression models were applied to investigate the relationship of anxiety severity and cognitive functioning. Comparisons were also performed to a normed non-clinical population, using the Wilcoxon signed rank test.More severe anxiety was associated with lower digit span test scores (R2=0.109, B=-0.040, p=0.018), but not with block design, matrix reasoning or design fluency tests scores, after adjustment for comorbid major depression in a multivariable model. When compared to a normed population, patients with anxiety performed significantly lower on the block design, digit span forward, digit span sequencing and matrix reasoning tests.Severity of anxiety among patients with anxiety disorder was associated with executive functions related to working memory, independently of comorbid major depression, but not with lower fluid intelligence. A further understanding of the executive behavioral control in patients with anxiety could allow for more tailored treatment strategies including medication, therapy and interventions targeted to improve specific cognitive domains.
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18.
  • Taddei, C, et al. (author)
  • Repositioning of the global epicentre of non-optimal cholesterol
  • 2020
  • In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 582:7810, s. 73-
  • Journal article (peer-reviewed)abstract
    • High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
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19.
  • Wikberg, Carl, et al. (author)
  • Comparison Between the Montgomery-Asberg Depression Rating Scale–Self and the Beck Depression Inventory II in Primary Care
  • 2015
  • In: The Primary Care Companion for CNS Disorders. - 0160-6689 .- 1555-2101 .- 2155-7772. ; 17:3
  • Journal article (peer-reviewed)abstract
    • Objective: The Montgomery-Asberg Depression Rating Scale–Self (MADRS-S) and the Beck Depression Inventory II (BDI-II) are commonly used self-assessment instruments for screening and diagnosis of depression. The BDI-II has 21 items and the MADRS-S has 9 items. These instruments have been tested with psychiatric inpatients but not in outpatient primary care, where most patients with symptoms of depression initially seek treatment. The purpose of this study was to compare these 2 instruments in the primary care setting. Method: Data were collected from 2 primary care randomized controlled trials that were performed from 2010 to 2013 in Sweden: the Primary Care Self-Assessment MADRS-S Study and Primary Care Internet-Based Cognitive Behavioral Therapy Study. There were 146 patients (73 patients each from both trials) who had newly diagnosed mild or moderate depression (per DSM-IV recommendations) and who had assessment with both the MADRS-S and BDI-II at primary care centers. Comparability and reliability of the instruments were estimated by Pearson product moment correlation and Cronbach α. Results: A good correlation was observed between the 2 instruments: 0.66 and 0.62 in the 2 study cohorts. The reliability within the 2 study cohorts was good for both MADRS-S (Cronbach α: 0.76 for both cohorts) and BDI-II items (Cronbach α: 0.88 and 0.85). Conclusions: The 2 instruments showed good comparability and reliability for low, middle, and high total depression scores. The MADRS-S may be used as a rapid, easily administered, and inexpensive tool in primary care and has results comparable to the BDI-II in all domains.
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20.
  • Wilson, Shaun K., et al. (author)
  • The contribution of macroalgae-associated fishes to small-scale tropical reef fisheries
  • 2022
  • In: Fish and Fisheries. - : Wiley. - 1467-2960 .- 1467-2979. ; 23:4, s. 847-861
  • Journal article (peer-reviewed)abstract
    • Macroalgae-dominated reefs are a prominent habitat in tropical seascapes that support a diversity of fishes, including fishery target species. To what extent, then, do macroalgal habitats contribute to small-scale tropical reef fisheries? To address this question we: (1) Quantified the macroalgae-associated fish component in catches from 133 small-scale fisheries, (2) Compared life-history traits relevant to fishing (e.g. growth, longevity) in macroalgal and coral-associated fishes, (3) Examined how macroalgae-associated species can influence catch diversity, trophic level and vulnerability and (4) Explored how tropical fisheries change with the expansion of macroalgal habitats using a case study of fishery-independent data for Seychelles. Fish that utilised macroalgal habitats comprise 24% of the catch, but very few fished species relied entirely on macroalgal or coral habitats post-settlement. Macroalgal and coral-associated fishes had similar life-history traits, although vulnerability to fishing declined with increasing contribution of macroalgae association to the catch, whilst mean trophic level and diversity peaked when macroalgal-associated fish accounted for 20%–30% of catches. The Seychelles case study revealed similar total fish biomass on macroalgal and coral reefs, although the biomass of primary target species increased as macroalgae cover expanded. Our findings reinforce that multiple habitat types are needed to support tropical fishery stability and sustainability. Whilst coral habitats have been the focus of tropical fisheries management, we show the potential for macroalgae-associated fish to support catch size and diversity in ways that reduce vulnerability to overfishing. This is pertinent to seascapes where repeated disturbances are facilitating the replacement of coral reef with macroalgal habitats.
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21.
  • Almokhtar, Mokhtar, 1977- (author)
  • Expression and regulation of steroid metabolizing enzymes in cells of the nervous and skeletal systems : Special focus on vitamin D metabolism
  • 2018
  • Doctoral thesis (other academic/artistic)abstract
    • Little is known about the mechanisms of vitamin D actions in the brain and bone. In this study, the metabolism of vitamin D and its regulation in various cell cultures of the nervous and skeletal systems were examined.Human osteosarcoma Saos-2 cells, human primary osteoblasts (hOB) and murine motor neuron-like NSC-34 cells were found to express mRNA for all enzymes required in vitamin D3 metabolism as well as the vitamin D receptor (VDR) that mediates vitamin D actions. Also, production of 24,25-dihydroxyvitamin D3 was found in these cells. Studies on vitamin D metabolism in NSC-34 cells and in primary neuron-enriched cells from rat cerebral cortex indicate formation of a previously unknown major metabolite formed from 25-hydroxyvitamin D3. Evaluation of the NSC-34 cells suggests that this cell line could be a novel model for studies of neuronal vitamin D metabolism and its regulation by endogenous and exogenous compounds.Treatment with glucocorticoids down regulated mRNA expression for the CYP24A1 gene in Saos-2 and hOB cells. Additionally, the glucocorticoid prednisolone showed suppression of CYP24A1-mediated metabolism and CYP24A1 promoter activity in Saos-2 cells. In NSC-34 cells, CYP24A1 mRNA levels were up-regulated by prednisolone, 1α,25-dihydroxyvitamin D3 and its synthetic analogues, EB1089 and tacalcitol. Formation of an endogenous glucocorticoid, 11-deoxycortisol, was observed in Saos-2 cells. Effects of glucocorticoids on the vitamin D system in bone cells may contribute to the adverse side effects in long-term treatment with glucocorticoids. Also, there may be a correlation between the administration of corticosteroids and adverse effects in the CNS.Expression and effects of vitamin D on steroidogenic enzymes were studied in primary neuron-enriched rat cortex cells, primary rat astrocytes and human neuroblastoma SH-SY5Y cells. These different cell cultures all expressed CYP17A1, whereas only astrocytes expressed 3β-hydroxysteroid dehydrogenase (3β-HSD). 1α,25-Dihydroxyvitamin D3 suppressed mRNA levels and enzyme activity of CYP17A1 in SH-SY5Y cells and astrocytes. 1α,25-Dihydroxyvitamin D3 suppressed enzyme activity and mRNA levels of 3β-HSD in astrocytes. The results suggest that vitamin D-mediated regulation of CYP17A1 and 3β-HSD may play a role in the nervous system.The results presented here contribute to our understanding of vitamin D metabolism and effects of glucocorticoids in the brain and bone.
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22.
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23.
  • Berkström, Charlotte, et al. (author)
  • Securing sustainable access to aquatic foods
  • 2023
  • Reports (other academic/artistic)abstract
    • Global nutrition needs are increasing and aquatic foods have recently been identified as crucial in addressing many of the world’s urgent challenges, including hunger and malnutrition. This synthesis highlights the importance of aquatic foods as a source of protein, micronutrients and income, its potential to meet increasing food demands, as well as the challenges in aquatic food production and harvesting.Most importantly, it provides an overview of management initiatives and innovative solutions for secured sustainable access to aquatic foods in the future. Aquatic foods provide micronutrient-rich foods for 3.3 billion people and support the livelihoods of more than 800 million people. Small-scale fisheries, in particular, play a key role in supporting the diversity and nutritional benefits of aquatic foods. However, the capture and production of aquatic foods is not always sustainable, and access to these foods may be unequal. At the water-land nexus, new ways of producing aquatic foods hold the potential to reduce the climate footprint in the food system.The governance of, and investment in, aquatic food systems needs to aim to preserve, support and improve aquatic species diversity and to improve access to this highly nutritious food. These efforts need to include multiple stakeholders, such as fishers, community agencies, policy makers and researchers, and be firmly established in both the latest research and in a local/regional context - ecologically and socially. By incorporating different aspects of aquatic foods, this synthesis aims to inspire and inform the reader about the importance of these systems, and means for a sustainable way forward.
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24.
  • Bernhardsson, Susanne, 1958, et al. (author)
  • Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial
  • 2014
  • In: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14:1
  • Journal article (peer-reviewed)abstract
    • Abstract Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s χ2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. Conclusions A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.
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25.
  • Bixby, H., et al. (author)
  • Rising rural body-mass index is the main driver of the global obesity epidemic in adults
  • 2019
  • In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4
  • Journal article (peer-reviewed)abstract
    • Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
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26.
  • Bodin, Karl, et al. (author)
  • Metabolism of 4 beta -hydroxycholesterol in humans
  • 2002
  • In: Journal of Biological Chemistry. - 0021-9258 .- 1083-351X. ; 277:35, s. 31534-31540
  • Journal article (peer-reviewed)abstract
    • One of the major oxysterols in the human circulation is 4 beta-hydroxycholesterol formed from cholesterol by the drug-metabolizing enzyme cytochrome P450 3A4. Deuterium-labeled 4 beta-hydroxycholesterol was injected into two healthy volunteers, and the apparent half-life was found to be 64 and 60 h, respectively. We have determined earlier the half-lives for 7 alpha-, 27-, and 24-hydroxycholesterol to be approximately 0.5, 0.75, and 14 h, respectively. Patients treated with certain antiepileptic drugs have up to 20-fold increased plasma concentrations of 4 beta-hydroxycholesterol. The apparent half-life of deuterium-labeled 4 beta-hydroxycholesterol in such a patient was found to be 52 h, suggesting that the high plasma concentration was because of increased synthesis rather than impaired clearance. 4 beta-Hydroxycholesterol was converted into acidic products at a much slower rate than 7 alpha-hydroxycholesterol in primary human hepatocytes, and 4 beta-hydroxycholesterol was 7 alpha-hydroxylated at a slower rate than cholesterol by recombinant human CYP7A1. CYP7B1 and CYP39A1 had no activity toward 4 beta-hydroxycholesterol. These results suggest that the high plasma concentration of 4 beta-hydroxycholesterol is because of its exceptionally slow elimination, probably in part because of the low rate of 7 alpha-hydroxylation of the steroid. The findings are discussed in relation to a potential role of 4 beta-hydroxycholesterol as a ligand for the nuclear receptor LXR.
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27.
  • Bornhöft, Lena, et al. (author)
  • Health effects of direct triaging to physiotherapists in primary care for patients with musculoskeletal disorders: a pragmatic randomized controlled trial
  • 2019
  • In: Therapeutic Advances in Musculoskeletal Disease. - : SAGE Publications. - 1759-720X .- 1759-7218. ; 11
  • Journal article (peer-reviewed)abstract
    • Background: Physiotherapists and general practitioners (GPs) both act as primary assessors for patients with musculoskeletal disorders in primary care. Previous studies have shown that initial triaging to physiotherapists at primary healthcare centres has advantages regarding efficiency in the work environment and utilization of healthcare. In this study, we aimed primarily to determine whether triaging to physiotherapists affects the progression of health aspects over time differently than traditional management with initial GP assessment. The secondary aim was to determine whether triaging to physiotherapists affects patients' attitudes of responsibility for musculoskeletal disorders. Methods: This was a pragmatic trial where both recruitment and treatment strategies were determined by clinical, not study-related parameters, and was initiated at three primary care centres in Sweden. Working-age patients of both sexes seeking primary care for musculoskeletal disorders and nurse assessed as suitable for triaging to physiotherapists were randomized to initial consultations with either physiotherapists or GPs. They received self-assessment questionnaires before the initial consultation and were followed up at 2, 12, 26 and 52 weeks with the same questionnaires. Outcome measures were current and mean (3 months) pain intensities, functional disability, risk for developing chronic musculoskeletal pain, health-related quality of life and attitudes of responsibility for musculoskeletal conditions. Trends over time were analysed with a regression model for repeated measurements. Results: The physiotherapist-triaged group showed significant improvement for health-related quality of life at 26 weeks and showed consistent but nonsignificant tendencies to greater reductions of current pain, mean pain in the latest 3 months, functional disability and risk for developing chronic pain compared with traditional management. The triage model did not consistently affect patients' attitudes of responsibility for musculoskeletal disorders. Conclusions: Triaging to physiotherapists for primary assessment in primary care leads to at least as positive health effects as primary assessment by GPs and can be recommended as an alternative management pathway for patients with musculoskeletal disorders. ClinicalTrials.gov identifier: NCT148611.
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28.
  • Bornhöft, Lena, et al. (author)
  • More cost-effective management of patients with musculoskeletal disorders in primary care after direct triaging to physiotherapists for initial assessment compared to initial general practitioner assessment.
  • 2019
  • In: BMC musculoskeletal disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 20:1
  • Journal article (peer-reviewed)abstract
    • A model for triaging patients in primary care to provide immediate contact with the most appropriate profession to treat the condition in question has been developed and implemented in parts of Sweden. Direct triaging of patients with musculoskeletal disorders (MSD) to physiotherapists at primary healthcare centres has been proposed as an alternative to initial assessment by general practitioners (GPs) and has been shown to have many positive effects. The aim of this study was to evaluate the cost-effectiveness from the societal perspective of this new care-pathway through primary care regarding triaging patients with MSD to initial assessment by physiotherapists compared to standard practice with initial GP assessment.Nurse-assessed patients with MSD (N=55) were randomised to initial assessment and treatment with either physiotherapists or GPs and were followed for 1year regarding health-related quality of life, utilization of healthcare resources and absence from work for MSD. Quality-adjusted life-years (QALYs) were calculated based on EQ5D measured at 5 time-points. Costs for healthcare resources and production loss were compiled. Incremental cost-effectiveness ratios (ICERS) were calculated. Multiple imputation was used to compensate for missing values and bootstrapping to handle uncertainty. A cost-effectiveness plane and a cost-effectiveness acceptability curve were construed to describe the results.The group who were allocated to initial assessment by physiotherapists had slightly larger gains in QALYs at lower total costs. At a willingness-to-pay threshold of 20,000 €, the likelihood that the intervention was cost-effective from a societal perspective including production loss due to MSD was 85% increasing to 93% at higher thresholds. When only healthcare costs were considered, triaging to physiotherapists was still less costly in relation to health improvements than standard praxis.From the societal perspective, this small study indicated that triaging directly to physiotherapists in primary care has a high likelihood of being cost-effective. However, further larger randomised trials will be necessary to corroborate these findings.ClinicalTrials.gov NCT02218749 . Registered August 18, 2014.
  •  
29.
  • Chacin, D. H., et al. (author)
  • Altered tropical seascapes influence patterns of fish assemblage and ecological functions in the Western Indian Ocean
  • 2020
  • In: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
  • Journal article (peer-reviewed)abstract
    • The arrangement and composition of habitats within landscapes and fine-scale habitat characteristics influence community structure and ecological processes. These aspects can be altered by anthropogenic activities, thus influencing associated assemblages. Farming of macroalgae is a common practice in tropical settings and alters the natural composition of seascapes by introducing monoculture patches. The farmed macroalgae may also differ in palatability compared to naturally-occurring macroalgae, influencing herbivory. This study assessed how these farms may differ from natural macroalgal beds in terms of habitat heterogeneity, fish assemblages, and herbivory. We surveyed fish assemblages and deployed macroalgal assays within macroalgal beds, farms and at varying distances from these habitats near Mafia Island, Tanzania. Fish composition and herbivory differed between the habitats likely due to different macrophyte species richness, underlying hard substrate in natural macroalgal beds, and high abundance of browsers nearby the farms. Additionally, fish assemblage patterns and herbivory were not consistent across the seascapes and varied with distance from the focal habitats possibly due to the presence of other habitats. The results suggest alterations of seascapes by farming practices may have consequences on fish assemblages and the ecological functions performed, thus positioning of farms should be carefully considered in management and conservation plans.
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30.
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31.
  • Eggertsen, Maria, et al. (author)
  • Contrasting distribution and foraging patterns of herbivorous and detritivorous fishes across multiple habitats in a tropical seascape
  • 2019
  • In: Marine Biology. - : Springer Science and Business Media LLC. - 0025-3162 .- 1432-1793. ; 166:4
  • Journal article (peer-reviewed)abstract
    • Understanding drivers behind patterns of functionally important groups of fishes is crucial for successful management and conservation of tropical seascapes. Herbivorous fishes are the most prominent consumers of marine primary production which can have profound effects on reef resilience. We explored environmental variables affecting distribution and foraging patterns of herbivorous and detritivorous fish assemblages (siganids, acanthurids and parrotfish) across distinct shallow-water habitats (coral reefs, macroalgae beds and seagrass meadows) during September-November 2016 at Mafia Island, Tanzania (8 degrees 00S, 39 degrees 41E). We performed underwater visual census to quantify fish assemblages, measured habitat features, deployed macroalgal assays and conducted inventories of grazing scars. Multi-dimensional scaling and mixed-effects linear models were used to evaluate differences in fish assemblages and environmental variables influencing abundance and foraging patterns of fishes. Fish communities of focal functional groups differed among habitats. Abundance of herbivores and detritivores as well as relative browsing and scraping was highest on coral reefs compared to macroalgae and seagrass meadows.Adult fish were more abundant on coral reefs while juveniles were abundant in macroalgal beds. Coral cover and crustose coralline algal cover had a positive effect on the abundance of fish in coral reef areas, while macroalgal cover had a negative effect. Contrastingly, in macroalgae habitats, macroalgal cover had a positive effect on the abundance of parrotfish. These results highlight the importance of considering connectivity between macroalgal beds and coral reefs through ontogenetic shifts in habitat use by primarily microphagous parrotfish and of incorporating a range of habitats within coastal management plans.
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32.
  • Eggertsen, Maria, 1981-, et al. (author)
  • Coral-macroalgae interactions : herbivory and substrate type influence growth of the macroalgae Eucheuma denticulatum on a tropical reef
  • Other publication (other academic/artistic)abstract
    • Invasive macroalgae can alter coral reef habitats by causing phase shifts from coral to macroalgal domination with negative ecological effects and dramatic reductions in coral cover. In Tanzania, South East Asian haplotypes of the macroalgae Eucheuma denticulatum, documented to overgrow reef corals in other locations, have been introduced through seaweed farming practices. In this study we examine growth and holdfast development of introduced and native E. denticulatum on live and dead branches of Acropora sp. in the presence and absence of herbivores in Unguja Island, Zanzibar. Coral and macroalgae health were also estimated. Macroalgae did not attach to any live coral. Coral health was not impacted by the presence of E. denticulatum regardless of origin and gene expression analyses did not indicate any additional stress in corals. Necrotic tissue on the macroalgae in areas of direct contact indicated damage inflicted by the coral. The biomass of E. denticulatum did not differ between live or dead corals but was strongly influenced by herbivory.  The study indicates that E. denticulatum may not pose a strong immediate threat to healthy acroporids in the WIO region but stresses the importance to keep corals healthy and maintaining viable populations of macroalgae feeding species.
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33.
  • Eggertsen, Maria, et al. (author)
  • Coral-macroalgal interactions : Herbivory and substrate type influence growth of the macroalgae Eucheuma denticulatum (N.L. Burman) Collins & Hervey, 1917 on a tropical coral reef
  • 2021
  • In: Journal of Experimental Marine Biology and Ecology. - : Elsevier BV. - 0022-0981 .- 1879-1697. ; 542
  • Journal article (peer-reviewed)abstract
    • Introduced macroalgae becoming invasive may alter ecological functions and habitats in recipient ecosystems. In the Western Indian Ocean (WIO), non-native strains of the native macroalgae Eucheuma denticulatum were introduced for farming practices and consequently spread into the surrounding seascape. We investigated potential effects of non-native and native strains of this macroalgae on a branching coral. We conducted a four-factor field experiment where we examined growth and holdfast development of introduced and native E. denticulatum on live and dead branches of Acropora sp. in the presence and absence of herbivores in Unguja Island, Zanzibar. Moreover, we estimated coral and macroalgae condition by visual examinations, gene expression analyses, and photosynthetic measurements. Macroalgae did not attach to any live coral and coral condition was not impacted by the presence of E. denticulatum, regardless of geographical origin. Instead, necrotic tissue on the macroalgae in areas of direct contact with corals indicated damage inflicted by the coral. The biomass of E. denticulatum did not differ between the replicates attached to live or dead corals in the experiment, yet biomass was strongly influenced by herbivory and replicates without protection from herbivores had a significantly lower biomass. In the absence of herbivory, introduced E. denticulatum had significantly higher growth rates than native algae based on wet weight measurements. These results contribute to an increased understanding of environmental effects by the farming of a non-native strain of algae on corals and stresses the importance to maintain viable populations of macroalgal feeding fishes in such areas.
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34.
  • Eggertsen, Maria, 1981-, et al. (author)
  • Different environmental variables predict distribution and cover of the introduced red seaweed Eucheuma denticulatum in two geographical locations
  • 2021
  • In: Biological Invasions. - : Springer. - 1387-3547 .- 1573-1464. ; 23, s. 1049-1067
  • Journal article (peer-reviewed)abstract
    • In this study we examined abiotic and biotic factors that could potentially influence the presence of a non-indigenous seaweed, Eucheuma denticulatum, in two locations, one outside (Kane’ohe Bay, Hawai’i, USA) and one within (Mafia Island, Tanzania) its natural geographical range. We hypothesized that the availability of hard substrate and the amount of wave exposure would explain distribution patterns, and that higher abundance of herbivorous fishes in Tanzania would exert stronger top–down control than in Hawai’i. To address these hypotheses, we surveyed E. denticulatum in sites subjected to different environmental conditions and used generalized linear mixed models (GLMM) to identify predictors of E. denticulatum presence. We also estimated grazing intensity on E. denticulatum by surveying the type and the amount of grazing scars. Finally, we used molecular tools to distinguish between indigenous and non-indigenous strains of E. denticulatum on Mafia Island. In Kane’ohe Bay, the likelihood of finding E. denticulatum increased with wave exposure, whereas on Mafia Island, the likelihood increased with cover of coral rubble, and decreased with distance from areas of introduction (AOI), but this decrease was less pronounced in the presence of coral rubble. Grazing intensity was higher in Kane’ohe Bay than on Mafia Island. However, we still suggest that efforts to reduce non-indigenous E. denticulatum should include protection of important herbivores in both sites because of the high levels of grazing close to AOI. Moreover, we recommend that areas with hard substrate and high structural complexity should be avoided when farming non-indigenous strains of E. denticulatum.
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35.
  • Eggertsen, Maria, 1981-, et al. (author)
  • Different environmental variables predict distribution of the introduced red seaweed Eucheuma denticulatum in two geographical locations
  • Other publication (other academic/artistic)abstract
    • In this study we examined abiotic and biotic factors that could potentially influence the presence of a non-indigenous seaweed, Eucheuma denticulatum, in two locations, one outside (Kane’ohe Bay, Hawai’i, USA) and one within (Mafia Island, Tanzania) its natural geographical range. We hypothesized that the availability of hard substrate and the amount of wave exposure would explain distribution patterns, and that higher abundance of herbivorous fishes in Tanzania would exert stronger top-down control than in Hawai’i. To address these hypotheses, we surveyed E. denticulatum in sites subjected to different environmental conditions and used generalized linear mixed models (GLMM) to identify predictors of E. denticulatum presence. We also estimated grazing intensity on E. denticulatum by surveying the type and the amount of grazing scars. Finally, we used molecular tools to distinguish between indigenous and non-indigenous strains of E. denticulatum on Mafia Island. In Kane’ohe Bay, the likelihood of finding E. denticulatum increased with wave exposure, whereas on Mafia Island, the likelihood increased with cover of coral rubble, and decreased with distance from areas of introduction (AOI), but this decrease was less pronounced in the presence of coral rubble. Grazing intensity was higher in Kane’ohe Bay than on Mafia Island. However, we still suggest that efforts to reduce non-indigenous E. denticulatum should include protection of important herbivores in both sites,    because of the high amount of grazing damages close to AOI. Moreover, we recommend that areas with hard substrate and high structural complexity should be avoided when farming non-indigenous strains of E. denticulatum.
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36.
  • Eggertsen, Maria, et al. (author)
  • Economic value of small-scale sea cucumber fisheries under two contrasting management regimes
  • 2020
  • In: Ecology and Society. - 1708-3087. ; 25:2
  • Journal article (peer-reviewed)abstract
    • Small-scale fisheries supplying tropical sea cucumbers to Asian markets frequently overharvest stocks, incurring unknown loss of economic value. An indication of such value loss can provide economic incentives for better conservation and management. However, before and after time-series by which loss could be calculated are generally not available for most sea cucumber fisheries. In this study we provide a snapshot comparison of stocks of three characteristic sea cucumber species in two islands in the Western Indian Ocean: Zanzibar (open-access fishery) and Mayotte (stocks protected since 2004). Our aim is to provide an indication of reference economic value of holothurian populations under two contrasting management regimes. Comparisons were made from stock appraisals using transects, linked to the species-specific market value, and compared between similar habitats from both locations. Surveyed habitats in Mayotte held sea cucumber stocks with a mean economic value of USD556.90 +/- 110.30/ha, compared with USD1.73 +/- 0.58/ ha in Zanzibar. A 5% harvest of sea cucumbers from surveyed areas in Mayotte would yield about 20 times greater income than harvesting the total surveyed stock in Zanzibar. By illustrating the economic value when strong management measures are implemented, this study highlights existing economic values and shows that sea cucumber fisheries in the tropics are a resource worth investing in and with high potential for social-economic benefits if properly managed.
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37.
  • Eggertsen, Maria, 1981- (author)
  • Introduced and indigenous macroalgae : Ecological effects, functions and regulating factors in tropical seascapes
  • 2020
  • Doctoral thesis (other academic/artistic)abstract
    • Tropical marine shallow-water areas are highly productive systems that promote important ecological functions and biodiversity. Stressors on these systems are intensifying due to increasing anthropogenic disturbances on multiple scales. The need to increase understanding of ongoing patterns and processes within the near-shore seascape is therefore imperative.In Tanzania in the Western Indian Ocean (WIO), introductions of South East Asian (SEA) strains of the red macroalgae Eucheuma denticulatum are made through seaweed farming, with unknown environmental consequences. Because this species occurs naturally in East Africa (EA), an ongoing introduction is difficult to assess. Also, there is limited knowledge about the extent of a possible spread and environmental factors that regulate this. Hence, ecological consequences are difficult to predict. The aims of this thesis are therefore to 1) identify and address important knowledge gaps concerning environmental effects of introduced E. denticulatum on the surrounding tropical seascape, and 2) study ecological processes and factors that influence spread, distribution and interactions with indigenous species. In doing so, the thesis also includes herbivorous fishes associated with macroalgal habitats and environmental variables influencing these fish assemblages.Paper I reviews the current scientific knowledge on introductions of SEA E. denticulatum in the WIO, and identifies knowledge gaps such as potential competition with native benthic taxa and environmental factors impacting spread. Paper II investigates environmental factors that affect the distribution and presence of SEA E. denticulatum in two geographical locations; one where E. denticulatum has turned into a nuisance and one where this is still unknown. We found that hard substrate and distance to areas of introduction best predicted SEA algal presence. Paper III examines the potential effects of E. denticulatum on corals. A field experiment showed that E. denticulatum did not induce any stress responses in corals, nor could it attach to live corals. Fish herbivory was the strongest factor controlling biomass of algae. In Paper IV and V, we focus on how seascape configuration and environmental factors influence the distribution and herbivory of reef fishes. In Paper IV, we show that macroalgal consumption was density dependent (inversely related to macroalgal cover) and that different habitats held distinct herbivorous fish communities. Moreover, Paper IV and V showed that presence and traits of macroalgae had a positive influence on the abundance of juvenile parrotfish, suggesting the potential of macroalgae to provide important nursery functions.In conclusion, this thesis indicates that negative effects by farming of  SEA E. denticulatum in the WIO are minor, and might be problematic only in areas already subjected to environmental disturbances. In marine systems with high cover of live coral and healthy populations of herbivorous fishes, competition with indigenous benthic taxa is limited. Furthermore, the thesis highlights that the abundance and ontogeny of herbivorous fishes can be affected by the presence of macroalgal habitats and plant traits, suggesting macroalgal beds are key habitats with important ecological functions to be included in marine spatial planning and conservation efforts.
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38.
  • Eggertsen, Maria, et al. (author)
  • Knowledge gaps and management recommendations for future paths of sustainable seaweed farming in the Western Indian Ocean
  • 2021
  • In: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 50:1, s. 60-73
  • Research review (peer-reviewed)abstract
    • Farming of eucheumatoid seaweeds is a widespread, promising activity and an important livelihood option in many tropical coastal areas as for example in East Africa, Western Indian Ocean (WIO). Compared to other types of aquaculture, seaweed farming has generally low impact on the environment. Nonetheless, there are potential direct or indirect negative effects of seaweed farming, such as introduction of alien species and changes in local environmental conditions. Although farming has been practiced in this region during several decades, the knowledge concerning the actual environmental impacts from faming non-native eucheumatoid haplotypes and consequently how to manage farming activities to mitigate those is highly limited. In this review, we provide a summary of the current scientific knowledge of potential direct and indirect negative environmental effects linked to eucheumatoid seaweed farming such as alterations of benthic macrophyte habitats and loss of native biodiversity. Furthermore, we highlight knowledge gaps that are of importance to address in the near future, e.g., large-scale ecosystem effects and farms as potential vectors of pathogens. We also provide a number of feasible management recommendations to be implemented for a continued development of environmentally sustainable seaweed farming practices in the WIO region, which includes spatial planning of farms to avoid sensitive areas and farming of native haplotypes of eucheumatoids instead of introduced specimens.
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39.
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40.
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41.
  • Gullström, Martin, et al. (author)
  • Blue Carbon Storage in Tropical Seagrass Meadows Relates to Carbonate Stock Dynamics, Plant–Sediment Processes, and Landscape Context : Insights from the Western Indian Ocean
  • 2018
  • In: Ecosystems (New York. Print). - : Springer Science and Business Media LLC. - 1432-9840 .- 1435-0629. ; 21:3, s. 551-566
  • Journal article (peer-reviewed)abstract
    • Globally, seagrass ecosystems are considered major blue carbon sinks and thus indirect contributors to climate change mitigation. Quantitative estimates and multi-scale appraisals of sources that underlie long-term storage of sedimentary carbon are vital for understanding coastal carbon dynamics. Across a tropical–subtropical coastal continuum in the Western Indian Ocean, we estimated organic (Corg) and inorganic (Ccarb) carbon stocks in seagrass sediment. Quantified levels and variability of the two carbon stocks were evaluated with regard to the relative importance of environmental attributes in terms of plant–sediment properties and landscape configuration. The explored seagrass habitats encompassed low to moderate levels of sedimentary Corg (ranging from 0.20 to 1.44% on average depending on species- and site-specific variability) but higher than unvegetated areas (ranging from 0.09 to 0.33% depending on site-specific variability), suggesting that some of the seagrass areas (at tropical Zanzibar in particular) are potentially important as carbon sinks. The amount of sedimentary inorganic carbon as carbonate (Ccarb) clearly corresponded to Corg levels, and as carbonates may represent a carbon source, this could diminish the strength of seagrass sediments as carbon sinks in the region. Partial least squares modelling indicated that variations in sedimentary Corg and Ccarb stocks in seagrass habitats were primarily predicted by sediment density (indicating a negative relationship with the content of carbon stocks) and landscape configuration (indicating a positive effect of seagrass meadow area, relative to the area of other major coastal habitats, on carbon stocks), while seagrass structural complexity also contributed, though to a lesser extent, to model performance. The findings suggest that accurate carbon sink assessments require an understanding of plant–sediment processes as well as better knowledge of how sedimentary carbon dynamics are driven by cross-habitat links and sink–source relationships in a scale-dependent landscape context, which should be a priority for carbon sink conservation.
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42.
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43.
  • Halling, Christina, et al. (author)
  • The introduction of South East Asian seaweed and its ecological implications; Can native East African Eucheuma denticulatum and Kappaphycus alvarezii be a potential alternative for farming?
  • Other publication (other academic/artistic)abstract
    • The seaweed farming of eucheumoids in East Africa is solely based on introduced South East Asian (SEA) haplotypes of the carrageenophytes Eucheuma and Kappaphycus. As overexploitation of natural seaweed resources lead to a decline in harvest and export, commercial seaweed farming was started using highly productive SEA strains of the same genus introduced from the Philippines to Zanzibar in 1989.  Initially, productivity was high, the sector grew rapidly and seaweed farming soon became an important livelihood. Today, the industry faces various challenges such as decreased productivity and high rates of diseases and epiphytic infestations. Continuous introduction of foreign stock for cultivation vitalization might not be the solution, as escapees of SEA Eucheuma denticulatum have been found spreading into natural environments around Zanzibar with uncertain ecological consequences.  We suggest that indigenous haplotypes of E. denticulatum and Kappaphycus alvarezii should be re-evaluated for farming potential,  for increasing the genetic diversity and hence resilience within stocks.This study is a first step towards a reassessment of farming potential of East African (EA) haplotypes. Molecularly identified haplotypes of E. denticulatum and K. alvarezii were tested in in-situ farming conditions in Zanzibar, and growth rates, grazing and epiphytes were compared between EA and SEA haplotypes. Results show, except for an overall decreased growth compared to previous studies, that growth rate was site dependent and that SEA Eucheuma haplotypes have a higher growth rate (1.3 ±1.8 - 3.6 ±1.9% per day) compared to EA haplotypes (0.2 ±1.0 - 2.0 ±0.4% per day). No significant differences were found in grazing rate between native and introduced Eucheuma haplotypes, while native Kappaphycus was more prone to grazing. In conclusion the farming potential for native E. denticulatum, is not rejected but underlines that there is an urgent need of continued search for native East African seaweed resources and a further identification of their desirable traits. If successful, this would enable East African seaweed industry to further expansion and secure its ecological and economical sustainability.
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44.
  • Magnusson, Yvonne, 1957, et al. (author)
  • Ser49Gly of beta1-adrenergic receptor is associated with effective beta-blocker dose in dilated cardiomyopathy.
  • 2005
  • In: Clinical pharmacology and therapeutics. - : Springer Science and Business Media LLC. - 0009-9236. ; 78:3, s. 221-31
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE: Our objective was to evaluate the influence of polymorphisms at codons 49 and 389 of the beta1-adrenergic receptor (beta1-AR) on the response to beta-blockers and outcome in patients with dilated cardiomyopathy. METHODS: We genotyped both codons of the beta1-AR in 375 patients with dilated cardiomyopathy and 492 control subjects. RESULTS: Neither of the polymorphisms was associated with susceptibility for dilated cardiomyopathy. In a retrospective analysis of patients receiving beta-blockers, there was a significant association between long-term survival rate and codon 49 (P = .014) but not codon 389 (P = .08). Despite a similar mean heart rate (69 beats/min), patients with the Ser49 genotype tended to have higher doses of beta-blockade compared with Gly49 carriers (P = .065). In patients receiving a low dose of beta-blockade (< or = 50% of targeted full dose), the 5-year mortality rate was lower among Gly49 carriers than Ser49 patients (risk ratio [RR], 0.24; 95% confidence interval [CI], 0.07-0.80; P = .020). In patients receiving high doses of beta-blockers, there was no significant difference in outcome between genotypes (P = .20), which was attributable to a better outcome for Ser49 patients treated with a high dose of beta-blockade as compared with a low dose. Gly49 carriers had a similar survival rate with different doses of beta-blockers. With low-dose beta-blockers, both codon 49 (RR, 0.26; 95% CI, 0.08-0.89; P = .029) and codon 389 (RR, 2.42; 95% CI, 1.04-5.63, P = .039) were related to 5-year mortality rate. CONCLUSION: In patients with heart failure, the influence of codon 49 on the outcome and effect of beta-blockers appeared to be more pronounced than that of codon 389. The more common Ser49Ser genotype responded less beneficially to beta-blockade and would motivate genotyping to promote higher doses for the best outcome effect.
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45.
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46.
  • Manousou, Sofia, 1979, et al. (author)
  • Iodine deficiency in pregnant women in Sweden: a national cross-sectional study.
  • 2020
  • In: European journal of nutrition. - : Springer Science and Business Media LLC. - 1436-6215 .- 1436-6207. ; 59:6, s. 2535-2545
  • Journal article (peer-reviewed)abstract
    • Voluntary salt iodization at 50mg/kg salt ensures adequate iodine nutrition in Swedish school-aged children, but iodine status in pregnant women is uncertain.We conducted a cross-sectional national study of 743 pregnant women, at median gestational age of 23weeks (IQR 9, 38), recruited from maternal health care centers. We measured: urinary iodine concentration (UIC) and urinary creatinine concentration in spot urine samples; thyroglobulin (Tg), thyroid-stimulating hormone (TSH), and total thyroxine (tT4) on dried blood spots (DBS); and thyreoperoxidase antibodies in serum samples. Data on dietary supplement use were obtained, and women were classified as supplement users (consuming multivitamins containing≥150µg iodine/day) and non-supplement users (no supplements or<150µg iodine/day from supplements).Overall median UIC [bootstrapped 95% confidence interval (CI)] was 101µg/L (95, 108; n=737): 149µg/L (132, 164) in supplement users (n=253) and 85µg/L (79, 92) in non-supplement users (n=440) (p<0.001). Overall geometric mean DBS-Tg (95% CI) was 22.1μg/L (20.8, 23.5; n=675) and the prevalence of elevated DBS-Tg was 19%. DBS-Tg was lower in supplement users (n=229) than in non-supplement users (n=405) (19.1 vs 24.4μg/L, p<0.001). DBS-TSH, DBS-tT4, and S-TPOab positivity did not differ between the two groups.Pregnant women in Sweden have inadequate iodine nutrition. Women not taking iodine supplements containing≥150µg iodine/day are affected by mild iodine deficiency and are at higher risk for increased thyroid activity, while maintaining euthyroidism. Iodine intake should be improved in women both before and after conception by promotion of iodized salt instead of non-iodized salt. We urge regular monitoring of iodine status in the general Swedish population, as well as in risk groups.
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47.
  • Nastase Mannila, Maria, et al. (author)
  • Identification of a Functional Apolipoprotein E Promoter Polymorphism Regulating Plasma Apolipoprotein E Concentration
  • 2013
  • In: Arteriosclerosis, Thrombosis and Vascular Biology. - 1079-5642 .- 1524-4636. ; 33:5, s. 1063-1069
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE:There is compelling evidence that the plasma apolipoprotein E (APOE) concentration, in addition to the APOE ε2/ε3/ε4 genotype, influences plasma lipoprotein levels, but the functional genetic variants influencing the plasma APOE concentration have not been identified.APPROACH AND RESULTSGenome-wide association studies in 2 cohorts of healthy, middle-aged subjects identified the APOE locus as the only genetic locus showing robust associations with the plasma APOE concentration. Fine-mapping of the APOE locus confirmed that the rs7412 ε2-allele is the primary genetic variant responsible for the relationship with plasma APOE concentration. Further mapping of the APOE locus uncovered that rs769446 (-427T/C) in the APOE promoter is independently associated with the plasma APOE concentration. Expression studies in 199 human liver samples demonstrated that the rs769446 C-allele is associated with increased APOE mRNA levels (P=0.015). Transient transfection studies and electrophoretic mobility shift assays in human hepatoma HepG2 cells corroborated the role of rs769446 in transcriptional regulation of APOE. However, no relationships were found between rs769446 genotype and plasma lipoprotein levels in 2 cohorts (n=1648 and n=1039) of healthy middle-aged carriers of the APOE ε3/ε3 genotype.CONCLUSIONS:rs769446 is a functional polymorphism involved in the regulation of the plasma APOE concentration.
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48.
  • Nyberg, Jenny, 1976, et al. (author)
  • Effects of exercise on symptoms of anxiety, cognitive ability and sick leave in patients with anxiety disorders in primary care: study protocol for PHYSBI, a randomized controlled trial
  • 2019
  • In: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 19:1
  • Journal article (peer-reviewed)abstract
    • BackgroundAnxiety disorders are common and associated with reduced quality of life, impaired physical and mental health and an increased economic burden for society. While evidence exists for the effectiveness of exercise treatment for depression, there is a need for high-quality randomized clinical trials (RCT) with a focus on anxiety disorders. Further research is also warranted regarding outcomes of cognitive function, other health-related variables, dose-response effects, work ability and potential mechanisms.Method/designUsing a parallel, RCT design with three assessment points (baseline, post-intervention and one-year follow-up), we aim to assess the effect of a 12-week exercise intervention in primary care patients with anxiety disorders (n=180), diagnosed using the Mini International Neuropsychiatric Interview (M.I.N.I; Swedish version 6.0.0d DSM-IV). Participants are randomly assigned to three physical exercise groups: one low-intensity training group, one moderate- to high intensity training group and one control non-exercise group. Assessments include measures of anxiety symptoms, cognitive function, physical health variables such as cardiovascular fitness, sick-leave and levels of hormones/cytokines in blood samples.DiscussionFindings from this study will provide novel insights regarding the effects of exercise treatment on not only anxiety symptoms but also other outcomes including mental and physical health, cognitive function, dose-response effects, work ability/sick leave and on biomarkers that may help explain underlying mechanisms.Trial registrationThe trial was registered at ClinicalTrial.gov NCT03247270 August 8, 2017.
  •  
49.
  • Schaufelberger, Maria, 1954, et al. (author)
  • Can brain natriuretic peptide (BNP) be used as a screening tool in general practice?
  • 2004
  • In: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 22:3, s. 187-90
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE:To investigate plasma brain natriuretic peptide (p-BNP) in consecutive primary care patients for heart failure screening. DESIGN: Open, descriptive. SETTING: Three primary care clinics, university hospital. SUBJECTS: 291 consecutive patients, > or =40 years. MAIN OUTCOME MEASURES: p-BNP and general practitioners estimated probability of CHF. RESULTS: Median p-BNP was 29 ng/L. In 42% p-BNP was >40 ng/L in the first sample. In 41 patients further investigated, median p-BNP was 98 ng/L, with a correlation between p-BNP and physicians' estimation of probability of heart failure (r=0.469, p<0.0001). New York Heart Association class was correlated to p-BNP (r=0.343, p=0.034). No correlation between ejection fraction and p-BNP was seen. CONCLUSION:P-BNP concentrations in unselected primary care patients of 40 years of age or above were elevated in a larger proportion of patients than previously reported. Owing to the low specificity, p-BNP concentration limits have to be defined before the test can be used for screening in primary care.
  •  
50.
  • Tang, Wanjin, et al. (author)
  • Estrogen-mediated regulation of CYP7B1 : a possible role for controlling DHEA levels in human tissues
  • 2006
  • In: Journal of Steroid Biochemistry and Molecular Biology. - : Elsevier BV. - 0960-0760 .- 1879-1220. ; 100:1-3, s. 42-51
  • Journal article (peer-reviewed)abstract
    • The current study examines regulation of CYP7B1, a DHEA 7alpha-hydroxylase, by sex hormones. Transfection with estrogen receptor alpha and treatment with 17beta-estradiol in human embryonic kidney 293 cells significantly increased CYP7B1 catalytic activity and mRNA, and stimulated a human CYP7B1 reporter gene. Transfection with estrogen receptor beta showed similar but less significant effects. In the absence of receptors, 17beta-estradiol suppressed CYP7B1 activity, suggesting that estrogenic effects may be different in cells not expressing receptors. Quantitation of CYP7B1 mRNA in adult and fetal human tissues showed markedly higher CYP7B1 mRNA levels in fetal tissues compared with the corresponding adult ones, except in the liver. This indicates a tissue-specific, developmental regulation of CYP7B1 and suggests an important function for this enzyme in fetal life. DHEA secreted by fetal adrenals is an essential precursor for placental estrogen formation. Since CYP7B1 diverts DHEA from the sex hormone biosynthetic pathway, estrogen receptor-mediated up-regulation of CYP7B1 should lead to less DHEA available for sex hormone synthesis and may help to maintain normal levels of estrogens and androgens in human tissues, especially during fetal development. Regulation by estrogens may also be of importance in other processes where CYP7B1 is involved, including cholesterol homeostasis, cellular proliferation, and CNS function.
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