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- Tobias, Deirdre K, et al.
(author)
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Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine
- 2023
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In: Nature Medicine. - 1546-170X. ; 29:10, s. 2438-2457
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Research review (peer-reviewed)abstract
- Precision medicine is part of the logical evolution of contemporary evidence-based medicine that seeks to reduce errors and optimize outcomes when making medical decisions and health recommendations. Diabetes affects hundreds of millions of people worldwide, many of whom will develop life-threatening complications and die prematurely. Precision medicine can potentially address this enormous problem by accounting for heterogeneity in the etiology, clinical presentation and pathogenesis of common forms of diabetes and risks of complications. This second international consensus report on precision diabetes medicine summarizes the findings from a systematic evidence review across the key pillars of precision medicine (prevention, diagnosis, treatment, prognosis) in four recognized forms of diabetes (monogenic, gestational, type 1, type 2). These reviews address key questions about the translation of precision medicine research into practice. Although not complete, owing to the vast literature on this topic, they revealed opportunities for the immediate or near-term clinical implementation of precision diabetes medicine; furthermore, we expose important gaps in knowledge, focusing on the need to obtain new clinically relevant evidence. Gaps include the need for common standards for clinical readiness, including consideration of cost-effectiveness, health equity, predictive accuracy, liability and accessibility. Key milestones are outlined for the broad clinical implementation of precision diabetes medicine.
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| 2. |
- Nikulina, Anastasia, et al.
(author)
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Tracking Hunter-Gatherer Impact on Vegetation in Last Interglacial and Holocene Europe : Proxies and Challenges
- 2022
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In: Journal of archaeological method and theory. - : Springer Nature. - 1072-5369 .- 1573-7764. ; 29, s. 989-1033
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Journal article (peer-reviewed)abstract
- We review palaeoenvironmental proxies and combinations of these relevant for understanding hunter-gatherer niche construction activities in pre-agricultural Europe. Our approach consists of two steps: (1) identify the possible range of hunter-gatherer impacts on landscapes based on ethnographic studies; (2) evaluate proxies possibly reflecting these impacts for both the Eemian (Last Interglacial, Middle Palaeolithic) and the Early-Middle Holocene (Mesolithic). We found these paleoenvironmental proxies were not able to unequivocally establish clear-cut differences between specific anthropogenic, climatic and megafaunal impacts for either time period in this area. We discuss case studies for both periods and show that published evidence for Mesolithic manipulation of landscapes is based on the interpretation of comparable data as available for the Last Interglacial. If one applies the 'Mesolithic' interpretation schemes to the Neanderthal record, three common niche construction activities can be hypothesised: vegetation burning, plant manipulation and impact on animal species presence and abundance. Our review suggests that as strong a case can be made for a Neanderthal impact on landscapes as for anthropogenic landscape changes during the Mesolithic, even though the Neanderthal evidence comes from only one high-resolution site complex. Further research should include attempts (e.g. by means of modelling studies) to establish whether hunter-gatherer impact on landscapes played out at a local level only versus at a larger scale during both time periods, while we also need to obtain comparative data on the population sizes of Last Interglacial and Holocene hunter-gatherers, as these are usually inferred to have differed significantly.
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| 3. |
- Ronkainen, Justiina, et al.
(author)
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LongITools: Dynamic longitudinal exposome trajectories in cardiovascular and metabolic noncommunicable diseases
- 2022
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In: Environmental Epidemiology. - 2474-7882. ; 6:1
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Journal article (peer-reviewed)abstract
- The current epidemics of cardiovascular and metabolic noncommunicable diseases have emerged alongside dramatic modifications in lifestyle and living environments. These correspond to changes in our "modern" postwar societies globally characterized by rural-to-urban migration, modernization of agricultural practices, and transportation, climate change, and aging. Evidence suggests that these changes are related to each other, although the social and biological mechanisms as well as their interactions have yet to be uncovered. LongITools, as one of the 9 projects included in the European Human Exposome Network, will tackle this environmental health equation linking multidimensional environmental exposures to the occurrence of cardiovascular and metabolic noncommunicable diseases.
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