Debbie A Lawlor

Bio: Debbie A Lawlor is an academic researcher from University of Bristol. The author has contributed to research in topics: Population & Body mass index. The author has an hindex of 147, co-authored 1114 publications receiving 101123 citations. Previous affiliations of Debbie A Lawlor include Southampton General Hospital & University of Vermont.

Accuracy of height and weight data from child health records

Abstract: Background: There is limited knowledge of the accuracy of height and weight measurements from child health records, despite widespread use for research and clinical care. We assess the accuracy of such measurements, using research measurements as the gold standard. Methods: We compare height/length and weight measurements from clinics of the Avon Longitudinal Study of Parents and Children with routinely collected child health records within 2 months of the clinic date at age 4 (n = 345), 8 (n = 1051), 12 (n = 139), 18 (n = 649), 25 (n = 183), and 43 months (n = 123). To adjust for age differences at measurement, growth data were converted into standard deviation scores using the UK 1990 growth reference. Results: Mean weight standard deviation score (SDS) differences were ⩽0.08, with mean predicted differences ⩽0.1 kg (eg, mean predicted difference at 8 months −0.011 kg, 95% level of agreement −0.64 to 0.62 kg). Mean height SDS differences were ⩽0.45, with mean predicted differences ⩽0.9 cm (eg, mean predicted difference at 8 months −0.59 cm, 95% level of agreement −3.84 to 2.66 cm). There was indication of lower accuracy at 4 months old (mean predicted height difference at 4 months −0.91 cm, 95% level of agreement −4.61 to 2.79 cm), but this decreased when the age difference between measurements was reduced. Routine measurements slightly overestimated heights of tall children and underestimated those of short children, but otherwise differences were not associated with sex, social class, birth weight, birth length, or maternal anthropometry. Conclusion: Routinely collected child health record height/length and weight data are compatible with no systematic bias, at least in children over 8 months old, supporting their use in clinical practice and research.

A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients : results of a quasi-randomised controlled trial

Abstract: Aim The aim of the study was to compare the effect of different dietary interventions on alanine aminotransferase (ALT) in obese patients with diabetes.

Comparisons between countries are essential for the control of COVID-19.

Abstract: On 6 May 2020, the UK Prime Minister Boris Johnson quoted statistician David Spiegelhalter, arguing that it was not appropriate to compare the COVID-19 death rate in the UK with other countries. Within a few hours, Spiegelhalter tweeted a request for the Prime Minister to stop quoting him and affirmed that ‘of course we should now use other countries to try and learn why our numbers are high’. The issue was that, although it is difficult to reliably compare COVID-19 population fatality rates between countries, it is also quite clear that some countries (e.g. UK, USA, Italy, Spain, Belgium, France) have markedly higher burdens of COVID-19 mortality than others (e.g. New Zealand, Australia, Singapore, South Korea, Germany). Although one could not say definitively that the UK was the worst in the world, it was performing worse than some countries which had tried alternative control strategies, and there are things that we can learn from that contrast. Indeed, epidemiology is built on the idea of studying differences between populations. Much of what we have learnt about the causes of disease has had its origins in comparisons of countries. For example, in the 1950s, it was realiz ed that colorectal cancer risks were high in Europe and low in Africa, possibly due to dietary differences in fibre from fruit and vegetable intake. Similarly, liver cancer was common in Asia, which eventually provided a link to hepatitis B. International differences in cervical cancer incidence and mortality suggested an infectious cause, later established as human papillomavirus (HPV). COVID-19 is different. The causative agent, SARSCoV-2, is clear; the task is to learn how to best block the virus’s transmission and to prevent infections from progressing to severe disease and death. As the pandemic unfolds, there are numerous natural experiments in progress, as countries adopt different approaches. Although international comparisons are often disparaged because of different data quality and fears of the ‘ecological fallacy’, if done carefully they can play a major role in our learning what works best for controlling COVID-19. Furthermore, these natural experiments are yielding clear results within weeks or months (e.g. on the success of the Asian approaches). Thus, there needs to be more thoughtful and thorough analyses of country differences, done by experienced epidemiologists, as it is probably the most important and most valid evidence for informing COVID-19 policy in real time. And after all, what is the alternative? It is impossible or unethical to randomize a lockdown, or other aspects of physical distancing. There could be trials of intensive population testing, or prophylactic treatment of household contacts, but few have been launched to date. And all the time, the COVID-19-clock ticks relentlessly on, accumulating more deaths and more survivors with debilitating longterm health problems.

Is There a Sex Difference in the Association between Birth Weight and Systolic Blood Pressure in Later Life? Findings from a Meta-Regression Analysis

Abstract: The aim of this study was to determine whether a sex difference exists in the association between birth weight and systolic blood pressure. A meta-analysis of all observational studies (n = 57) in which the study population contained both males and females and the association between birth weight and blood pressure was presented as a linear regression coefficient was undertaken. There were no differences in the pooled regression coefficients between males and females combining all studies; the regression of blood pressure on birth weight for males was -1.27 (95% confidence interval: -1.77, -0.77) mmHg/kg and for females was -1.24 (95% confidence interval: -1.90, -0.58) mmHg/kg. When studies in which blood pressure had been measured in childhood were considered separately from those in which it was measured in adulthood, there were no sex differences in either age group. The pooled regression coefficient tended to be weaker in studies reporting sex-specific results than in those reporting combined results. These findings suggest that reports of sex differences in the association between birth weight and blood pressure are chance findings.

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

Abstract: 抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.

Abstract: Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

Abstract: ABCD : Appropriate Blood pressure Control in Diabetes ABI : ankle–brachial index ABPM : ambulatory blood pressure monitoring ACCESS : Acute Candesartan Cilexetil Therapy in Stroke Survival ACCOMPLISH : Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension ACCORD : Action to Control Cardiovascular Risk in Diabetes ACE : angiotensin-converting enzyme ACTIVE I : Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events ADVANCE : Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation AHEAD : Action for HEAlth in Diabetes ALLHAT : Antihypertensive and Lipid-Lowering Treatment to Prevent Heart ATtack ALTITUDE : ALiskiren Trial In Type 2 Diabetes Using Cardio-renal Endpoints ANTIPAF : ANgioTensin II Antagonist In Paroxysmal Atrial Fibrillation APOLLO : A Randomized Controlled Trial of Aliskiren in the Prevention of Major Cardiovascular Events in Elderly People ARB : angiotensin receptor blocker ARIC : Atherosclerosis Risk In Communities ARR : aldosterone renin ratio ASCOT : Anglo-Scandinavian Cardiac Outcomes Trial ASCOT-LLA : Anglo-Scandinavian Cardiac Outcomes Trial—Lipid Lowering Arm ASTRAL : Angioplasty and STenting for Renal Artery Lesions A-V : atrioventricular BB : beta-blocker BMI : body mass index BP : blood pressure BSA : body surface area CA : calcium antagonist CABG : coronary artery bypass graft CAPPP : CAPtopril Prevention Project CAPRAF : CAndesartan in the Prevention of Relapsing Atrial Fibrillation CHD : coronary heart disease CHHIPS : Controlling Hypertension and Hypertension Immediately Post-Stroke CKD : chronic kidney disease CKD-EPI : Chronic Kidney Disease—EPIdemiology collaboration CONVINCE : Controlled ONset Verapamil INvestigation of CV Endpoints CT : computed tomography CV : cardiovascular CVD : cardiovascular disease D : diuretic DASH : Dietary Approaches to Stop Hypertension DBP : diastolic blood pressure DCCT : Diabetes Control and Complications Study DIRECT : DIabetic REtinopathy Candesartan Trials DM : diabetes mellitus DPP-4 : dipeptidyl peptidase 4 EAS : European Atherosclerosis Society EASD : European Association for the Study of Diabetes ECG : electrocardiogram EF : ejection fraction eGFR : estimated glomerular filtration rate ELSA : European Lacidipine Study on Atherosclerosis ESC : European Society of Cardiology ESH : European Society of Hypertension ESRD : end-stage renal disease EXPLOR : Amlodipine–Valsartan Combination Decreases Central Systolic Blood Pressure more Effectively than the Amlodipine–Atenolol Combination FDA : U.S. Food and Drug Administration FEVER : Felodipine EVent Reduction study GISSI-AF : Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation HbA1c : glycated haemoglobin HBPM : home blood pressure monitoring HOPE : Heart Outcomes Prevention Evaluation HOT : Hypertension Optimal Treatment HRT : hormone replacement therapy HT : hypertension HYVET : HYpertension in the Very Elderly Trial IMT : intima-media thickness I-PRESERVE : Irbesartan in Heart Failure with Preserved Systolic Function INTERHEART : Effect of Potentially Modifiable Risk Factors associated with Myocardial Infarction in 52 Countries INVEST : INternational VErapamil SR/T Trandolapril ISH : Isolated systolic hypertension JNC : Joint National Committee JUPITER : Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin LAVi : left atrial volume index LIFE : Losartan Intervention For Endpoint Reduction in Hypertensives LV : left ventricle/left ventricular LVH : left ventricular hypertrophy LVM : left ventricular mass MDRD : Modification of Diet in Renal Disease MRFIT : Multiple Risk Factor Intervention Trial MRI : magnetic resonance imaging NORDIL : The Nordic Diltiazem Intervention study OC : oral contraceptive OD : organ damage ONTARGET : ONgoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial PAD : peripheral artery disease PATHS : Prevention And Treatment of Hypertension Study PCI : percutaneous coronary intervention PPAR : peroxisome proliferator-activated receptor PREVEND : Prevention of REnal and Vascular ENdstage Disease PROFESS : Prevention Regimen for Effectively Avoiding Secondary Strokes PROGRESS : Perindopril Protection Against Recurrent Stroke Study PWV : pulse wave velocity QALY : Quality adjusted life years RAA : renin-angiotensin-aldosterone RAS : renin-angiotensin system RCT : randomized controlled trials RF : risk factor ROADMAP : Randomized Olmesartan And Diabetes MicroAlbuminuria Prevention SBP : systolic blood pressure SCAST : Angiotensin-Receptor Blocker Candesartan for Treatment of Acute STroke SCOPE : Study on COgnition and Prognosis in the Elderly SCORE : Systematic COronary Risk Evaluation SHEP : Systolic Hypertension in the Elderly Program STOP : Swedish Trials in Old Patients with Hypertension STOP-2 : The second Swedish Trial in Old Patients with Hypertension SYSTCHINA : SYSTolic Hypertension in the Elderly: Chinese trial SYSTEUR : SYSTolic Hypertension in Europe TIA : transient ischaemic attack TOHP : Trials Of Hypertension Prevention TRANSCEND : Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease UKPDS : United Kingdom Prospective Diabetes Study VADT : Veterans' Affairs Diabetes Trial VALUE : Valsartan Antihypertensive Long-term Use Evaluation WHO : World Health Organization ### 1.1 Principles The 2013 guidelines on hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology …