Showing papers by "Lund University published in 2017"
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Theo Vos1, Amanuel Alemu Abajobir, Kalkidan Hassen Abate2, Cristiana Abbafati3 +775 more•Institutions (305)
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016.
10,401 citations
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Mohsen Naghavi1, Amanuel Alemu Abajobir2, Cristiana Abbafati3, Kaja Abbas4 +598 more•Institutions (31)
TL;DR: The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016 as discussed by the authors, which includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends.
3,228 citations
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Simon I. Hay, Amanuel Alemu Abajobir1, Kalkidan Hassen Abate2, Cristiana Abbafati3 +800 more•Institutions (32)
TL;DR: At a global level, DALYs and HALE continue to show improvements and the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning.
3,029 citations
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Valery L. Feigin1, Amanuel Alemu Abajobir2, Kalkidan Hassen Abate3, Foad Abd-Allah4 +267 more•Institutions (138)
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors (GBD) study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions as discussed by the authors.
Abstract: Summary Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services. Funding Bill & Melinda Gates Foundation.
2,995 citations
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Mayo Clinic1, Southampton General Hospital2, Memorial Sloan Kettering Cancer Center3, Lund University4, University of Amsterdam5, Trinity College, Dublin6, Karolinska University Hospital7, Vita-Salute San Raffaele University8, University of Barcelona9, Harvard University10, Medical University of Graz11, Heidelberg University12, University of Hamburg13, University of Liverpool14, University of Colorado Boulder15, Tata Memorial Hospital16, Teikyo University17, Kyoto University18, Johns Hopkins University19, Thomas Jefferson University20
TL;DR: This new definition and grading system of postoperative pancreatic Fistula should lead to a more universally consistent evaluation of operative outcomes after pancreatic operation and will allow for a better comparison of techniques used to mitigate the rate and clinical impact of a pancreatic fistula.
2,313 citations
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TL;DR: A Human Pathology Atlas has been created as part of the Human Protein Atlas program to explore the prognostic role of each protein-coding gene in 17 different cancers, and reveals that gene expression of individual tumors within a particular cancer varied considerably and could exceed the variation observed between distinct cancer types.
Abstract: Cancer is one of the leading causes of death, and there is great interest in understanding the underlying molecular mechanisms involved in the pathogenesis and progression of individual tumors. We used systems-level approaches to analyze the genome-wide transcriptome of the protein-coding genes of 17 major cancer types with respect to clinical outcome. A general pattern emerged: Shorter patient survival was associated with up-regulation of genes involved in cell growth and with down-regulation of genes involved in cellular differentiation. Using genome-scale metabolic models, we show that cancer patients have widespread metabolic heterogeneity, highlighting the need for precise and personalized medicine for cancer treatment. All data are presented in an interactive open-access database (www.proteinatlas.org/pathology) to allow genome-wide exploration of the impact of individual proteins on clinical outcomes.
2,276 citations
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University of Cambridge1, Wellcome Trust Sanger Institute2, University of Melbourne3, Netherlands Cancer Institute4, University of Amsterdam5, University of Warwick6, Cancer Council Victoria7, University of Utah8, Columbia University9, Central Manchester University Hospitals NHS Foundation Trust10, Chapel Allerton Hospital11, Guy's and St Thomas' NHS Foundation Trust12, National Institute for Health Research13, University of Glasgow14, St George's, University of London15, Curie Institute16, Paris Descartes University17, Erasmus University Rotterdam18, Radboud University Nijmegen19, VU University Medical Center20, Cancer Prevention Institute of California21, Lunenfeld-Tanenbaum Research Institute22, University of Toronto23, Fox Chase Cancer Center24, Huntsman Cancer Institute25, Leipzig University26, German Cancer Research Center27, University of Cologne28, Hospital Clínico San Carlos29, Pomeranian Medical University30, Laval University31, University of New South Wales32, Peter MacCallum Cancer Centre33, St. Vincent's Health System34, QIMR Berghofer Medical Research Institute35, Medical University of Vienna36, Copenhagen University Hospital37, Karolinska Institutet38, Lund University39
TL;DR: To estimate age-specific risks of breast, ovarian, and contralateral breast cancer for mutation carriers and to evaluate risk modification by family cancer history and mutation location, a large cohort study recruited in 1997-2011 provides estimates of cancer risk based on BRCA1 and BRCa2 mutation carrier status.
Abstract: Importance: The clinical management of BRCA1 and BRCA2 mutation carriers requires accurate, prospective cancer risk estimates. Objectives: To estimate age-specific risks of breast, ovarian, and contralateral breast cancer for mutation carriers and to evaluate risk modification by family cancer history and mutation location. Design, Setting, and Participants: Prospective cohort study of 6036 BRCA1 and 3820 BRCA2 female carriers (5046 unaffected and 4810 with breast or ovarian cancer or both at baseline) recruited in 1997-2011 through the International BRCA1/2 Carrier Cohort Study, the Breast Cancer Family Registry and the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer, with ascertainment through family clinics (94%) and population-based studies (6%). The majority were from large national studies in the United Kingdom (EMBRACE), the Netherlands (HEBON), and France (GENEPSO). Follow-up ended December 2013; median follow-up was 5 years. Exposures: BRCA1/2 mutations, family cancer history, and mutation location. Main Outcomes and Measures: Annual incidences, standardized incidence ratios, and cumulative risks of breast, ovarian, and contralateral breast cancer. Results: Among 3886 women (median age, 38 years; interquartile range [IQR], 30-46 years) eligible for the breast cancer analysis, 5066 women (median age, 38 years; IQR, 31-47 years) eligible for the ovarian cancer analysis, and 2213 women (median age, 47 years; IQR, 40-55 years) eligible for the contralateral breast cancer analysis, 426 were diagnosed with breast cancer, 109 with ovarian cancer, and 245 with contralateral breast cancer during follow-up. The cumulative breast cancer risk to age 80 years was 72% (95% CI, 65%-79%) for BRCA1 and 69% (95% CI, 61%-77%) for BRCA2 carriers. Breast cancer incidences increased rapidly in early adulthood until ages 30 to 40 years for BRCA1 and until ages 40 to 50 years for BRCA2 carriers, then remained at a similar, constant incidence (20-30 per 1000 person-years) until age 80 years. The cumulative ovarian cancer risk to age 80 years was 44% (95% CI, 36%-53%) for BRCA1 and 17% (95% CI, 11%-25%) for BRCA2 carriers. For contralateral breast cancer, the cumulative risk 20 years after breast cancer diagnosis was 40% (95% CI, 35%-45%) for BRCA1 and 26% (95% CI, 20%-33%) for BRCA2 carriers (hazard ratio [HR] for comparing BRCA2 vs BRCA1, 0.62; 95% CI, 0.47-0.82; P=.001 for difference). Breast cancer risk increased with increasing number of first- and second-degree relatives diagnosed as having breast cancer for both BRCA1 (HR for ≥2 vs 0 affected relatives, 1.99; 95% CI, 1.41-2.82; P<.001 for trend) and BRCA2 carriers (HR, 1.91; 95% CI, 1.08-3.37; P=.02 for trend). Breast cancer risk was higher if mutations were located outside vs within the regions bounded by positions c.2282-c.4071 in BRCA1 (HR, 1.46; 95% CI, 1.11-1.93; P=.007) and c.2831-c.6401 in BRCA2 (HR, 1.93; 95% CI, 1.36-2.74; P<.001). Conclusions and Relevance: These findings provide estimates of cancer risk based on BRCA1 and BRCA2 mutation carrier status using prospective data collection and demonstrate the potential importance of family history and mutation location in risk assessment.
1,733 citations
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TL;DR: An overview of 5G research, standardization trials, and deployment challenges is provided, with research test beds delivering promising performance but pre-commercial trials lagging behind the desired 5G targets.
Abstract: There is considerable pressure to define the key requirements of 5G, develop 5G standards, and perform technology trials as quickly as possible. Normally, these activities are best done in series but there is a desire to complete these tasks in parallel so that commercial deployments of 5G can begin by 2020. 5G will not be an incremental improvement over its predecessors; it aims to be a revolutionary leap forward in terms of data rates, latency, massive connectivity, network reliability, and energy efficiency. These capabilities are targeted at realizing high-speed connectivity, the Internet of Things, augmented virtual reality, the tactile internet, and so on. The requirements of 5G are expected to be met by new spectrum in the microwave bands (3.3-4.2 GHz), and utilizing large bandwidths available in mm-wave bands, increasing spatial degrees of freedom via large antenna arrays and 3-D MIMO, network densification, and new waveforms that provide scalability and flexibility to meet the varying demands of 5G services. Unlike the one size fits all 4G core networks, the 5G core network must be flexible and adaptable and is expected to simultaneously provide optimized support for the diverse 5G use case categories. In this paper, we provide an overview of 5G research, standardization trials, and deployment challenges. Due to the enormous scope of 5G systems, it is necessary to provide some direction in a tutorial article, and in this overview, the focus is largely user centric, rather than device centric. In addition to surveying the state of play in the area, we identify leading technologies, evaluating their strengths and weaknesses, and outline the key challenges ahead, with research test beds delivering promising performance but pre-commercial trials lagging behind the desired 5G targets.
1,659 citations
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TL;DR: The number of adults with raised blood pressure increased from 594 million in 1975 to 1·13 billion in 2015, with the increase largely in low-income and middle-income countries, and the contributions of changes in prevalence versus population growth and ageing to the increase.
1,573 citations
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Brigham and Women's Hospital1, Harvard University2, Massachusetts Institute of Technology3, Lund University4, Icahn School of Medicine at Mount Sinai5, Mayo Clinic6, Centro Nacional de Investigaciones Cardiovasculares7, British Heart Foundation8, University of Cambridge9, Wellcome Trust10, University of Pennsylvania11
TL;DR: The presence of CHIP in peripheral‐blood cells was associated with nearly a doubling in the risk of coronary heart disease in humans and with accelerated atherosclerosis in mice.
Abstract: BackgroundClonal hematopoiesis of indeterminate potential (CHIP), which is defined as the presence of an expanded somatic blood-cell clone in persons without other hematologic abnormalities, is common among older persons and is associated with an increased risk of hematologic cancer. We previously found preliminary evidence for an association between CHIP and atherosclerotic cardiovascular disease, but the nature of this association was unclear. MethodsWe used whole-exome sequencing to detect the presence of CHIP in peripheral-blood cells and associated such presence with coronary heart disease using samples from four case–control studies that together enrolled 4726 participants with coronary heart disease and 3529 controls. To assess causality, we perturbed the function of Tet2, the second most commonly mutated gene linked to clonal hematopoiesis, in the hematopoietic cells of atherosclerosis-prone mice. ResultsIn nested case–control analyses from two prospective cohorts, carriers of CHIP had a risk of c...
1,536 citations
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Leibniz Association1, University of Zurich2, James Hutton Institute3, Murdoch University4, University of Minnesota5, National Institutes of Health6, University of California, Riverside7, European Bioinformatics Institute8, University of Udine9, University of Helsinki10, Norwich University11, Zhejiang University12, Kansas State University13, University of Adelaide14, University of East Anglia15, National Institute of Agricultural Botany16, Technische Universität München17, Lund University18, Government of Western Australia19, Yangtze University20, University of Dundee21, University of Western Australia22
TL;DR: The importance of the barley reference sequence for breeding is demonstrated by inspecting the genomic partitioning of sequence variation in modern elite germplasm, highlighting regions vulnerable to genetic erosion.
Abstract: Cereal grasses of the Triticeae tribe have been the major food source in temperate regions since the dawn of agriculture. Their large genomes are characterized by a high content of repetitive elements and large pericentromeric regions that are virtually devoid of meiotic recombination. Here we present a high-quality reference genome assembly for barley (Hordeum vulgare L.). We use chromosome conformation capture mapping to derive the linear order of sequences across the pericentromeric space and to investigate the spatial organization of chromatin in the nucleus at megabase resolution. The composition of genes and repetitive elements differs between distal and proximal regions. Gene family analyses reveal lineage-specific duplications of genes involved in the transport of nutrients to developing seeds and the mobilization of carbohydrates in grains. We demonstrate the importance of the barley reference sequence for breeding by inspecting the genomic partitioning of sequence variation in modern elite germplasm, highlighting regions vulnerable to genetic erosion.
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Kyriaki Michailidou1, Kyriaki Michailidou2, Sara Lindström3, Sara Lindström4 +393 more•Institutions (127)
TL;DR: A genome-wide association study of breast cancer in 122,977 cases and 105,974 controls of European ancestry and 14,068 cases and 13,104 controls of East Asian ancestry finds that heritability of Breast cancer due to all single-nucleotide polymorphisms in regulatory features was 2–5-fold enriched relative to the genome- wide average.
Abstract: Breast cancer risk is influenced by rare coding variants in susceptibility genes, such as BRCA1, and many common, mostly non-coding variants. However, much of the genetic contribution to breast cancer risk remains unknown. Here we report the results of a genome-wide association study of breast cancer in 122,977 cases and 105,974 controls of European ancestry and 14,068 cases and 13,104 controls of East Asian ancestry. We identified 65 new loci that are associated with overall breast cancer risk at P < 5 × 10-8. The majority of credible risk single-nucleotide polymorphisms in these loci fall in distal regulatory elements, and by integrating in silico data to predict target genes in breast cells at each locus, we demonstrate a strong overlap between candidate target genes and somatic driver genes in breast tumours. We also find that heritability of breast cancer due to all single-nucleotide polymorphisms in regulatory features was 2-5-fold enriched relative to the genome-wide average, with strong enrichment for particular transcription factor binding sites. These results provide further insight into genetic susceptibility to breast cancer and will improve the use of genetic risk scores for individualized screening and prevention.
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University of the Basque Country1, University of Cambridge2, National Autonomous University of Mexico3, University of Córdoba (Spain)4, Corvinus University of Budapest5, University of Southern Denmark6, University of Gothenburg7, University of East Anglia8, Lund University9, University of Kiel10, United Nations11, Helmholtz Centre for Environmental Research - UFZ12, University of Khartoum13, King Abdulaziz City for Science and Technology14, University of Washington15, University of Oxford16, Ministry of Forestry17, University College Dublin18, National University of Cordoba19, Carthage University20, University of Chile21, Harvard University22, Norwegian University of Life Sciences23, University of Pretoria24, University of Antwerp25, Wetlands International26, Universidade Federal Rural do Rio de Janeiro27, International Union for Conservation of Nature and Natural Resources28, Council for Scientific and Industrial Research29, University of Western Australia30, National University of General Sarmiento31, Calcutta Institute of Engineering and Management32, European Commission33, Government of Canada34, Finnish Environment Institute35, International Institute of Minnesota36, Pontifical Catholic University of Rio de Janeiro37, Federal University of Rio de Janeiro38, Victoria University of Wellington39, Indian Institute of Forest Management40, University of Tokyo41
TL;DR: In this paper, the authors present the rationale for the inclusive valuation of nature's contributions to people (NCP) in decision making, as well as broad methodological steps for doing so, and argue that transformative practices aiming at sustainable futures would benefit from embracing such diversity, which require recognizing and addressing power relationships across stakeholder groups that hold different values on human nature-relations and NCP.
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University of California, Los Angeles1, University of Utah2, University of South Florida3, University of Helsinki4, Primary Children's Hospital5, University of Groningen6, Norfolk and Norwich University Hospital7, Lund University8, Netherlands Cancer Institute9, University of Michigan10, Wake Forest University11, Ohio State University12, Peter MacCallum Cancer Centre13, University of Zurich14, University of Padua15, Pennsylvania State University16, Saint Louis University17, Tom Baker Cancer Centre18, University of Washington19, University of Lausanne20, Guy's and St Thomas' NHS Foundation Trust21, University of Kiel22, Thomas Jefferson University23, Sunnybrook Research Institute24, Vanderbilt University25, University of Queensland26, Fox Chase Cancer Center27, Greenville Health System28, Stony Brook University29, University Health Network30, Memorial Sloan Kettering Cancer Center31, Roswell Park Cancer Institute32, Northwestern University33, University of Wisconsin-Madison34, Rush University Medical Center35, Tel Aviv Sourasky Medical Center36, Dartmouth College37, Johns Hopkins University38, University of Louisville39, University of Barcelona40, University of Sydney41
TL;DR: Immediate completion lymph‐node dissection increased the rate of regional disease control and provided prognostic information but did not increase melanoma‐specific survival among patients with melanoma and sentinel‐node metastases.
Abstract: BackgroundSentinel-lymph-node biopsy is associated with increased melanoma-specific survival (i.e., survival until death from melanoma) among patients with node-positive intermediate-thickness melanomas (1.2 to 3.5 mm). The value of completion lymph-node dissection for patients with sentinel-node metastases is not clear. MethodsIn an international trial, we randomly assigned patients with sentinel-node metastases detected by means of standard pathological assessment or a multimarker molecular assay to immediate completion lymph-node dissection (dissection group) or nodal observation with ultrasonography (observation group). The primary end point was melanoma-specific survival. Secondary end points included disease-free survival and the cumulative rate of nonsentinel-node metastasis. ResultsImmediate completion lymph-node dissection was not associated with increased melanoma-specific survival among 1934 patients with data that could be evaluated in an intention-to-treat analysis or among 1755 patients in t...
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30 Mar 2017
TL;DR: A cure is not available, and patients depend on lifelong insulin injections; novel approaches to insulin treatment, such as insulin pumps, continuous glucose monitoring and hybrid closed-loop systems, are in development.
Abstract: Type 1 diabetes mellitus (T1DM), also known as autoimmune diabetes, is a chronic disease characterized by insulin deficiency due to pancreatic β-cell loss and leads to hyperglycaemia. Although the age of symptomatic onset is usually during childhood or adolescence, symptoms can sometimes develop much later. Although the aetiology of T1DM is not completely understood, the pathogenesis of the disease is thought to involve T cell-mediated destruction of β-cells. Islet-targeting autoantibodies that target insulin, 65 kDa glutamic acid decarboxylase, insulinoma-associated protein 2 and zinc transporter 8 - all of which are proteins associated with secretory granules in β-cells - are biomarkers of T1DM-associated autoimmunity that are found months to years before symptom onset, and can be used to identify and study individuals who are at risk of developing T1DM. The type of autoantibody that appears first depends on the environmental trigger and on genetic factors. The pathogenesis of T1DM can be divided into three stages depending on the absence or presence of hyperglycaemia and hyperglycaemia-associated symptoms (such as polyuria and thirst). A cure is not available, and patients depend on lifelong insulin injections; novel approaches to insulin treatment, such as insulin pumps, continuous glucose monitoring and hybrid closed-loop systems, are in development. Although intensive glycaemic control has reduced the incidence of microvascular and macrovascular complications, the majority of patients with T1DM are still developing these complications. Major research efforts are needed to achieve early diagnosis, prevent β-cell loss and develop better treatment options to improve the quality of life and prognosis of those affected.
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TL;DR: In this article, a mass model of the Milky Way is presented to fit observational constraints and to be consistent with expectations from theoretical modelling, and a best-fitting model, as well as estimates of the properties of the galaxy are provided.
Abstract: We present mass models of the Milky Way created to fit observational constraints and to be consistent with expectations from theoretical modelling. The method used to create these models is that demonstrated in our previous study, and we improve on those models by adding gas discs to the potential, considering the effects of allowing the inner slope of the halo density profile to vary, and including new observations of maser sources in the Milky Way amongst the new constraints. We provide a best-fitting model, as well as estimates of the properties of the Milky Way. Under the assumptions in our main model, we find that the Sun is R0 = 8.20 ± 0.09 kpc from the Galactic Centre, with the circular speed at the Sun being v0 = 232.8 ± 3.0 kms-1; and that the Galaxy has a total stellar mass of (54.3 ± 5.7) × 109 M⊙, a total virial mass of (1.30 ± 0.30) × 1012M⊙ and a local dark-matter density of 0.40 ± 0.04 GeV cm-3, where the quoted uncertainties are statistical. These values are sensitive to our choice of priors and constraints. We investigate systematic uncertainties, which in some cases may be larger. For example, if we weaken our prior on R0, we find it to be 7.97 ± 0.15 kpc and that v0 = 226.8 ± 4.2 kms-1.We find that most of these properties, including the local dark-matter density, are remarkably insensitive to the assumed power-law density slope at the centre of the dark-matter halo. We find that it is unlikely that the local standard of rest differs significantly from that found under assumptions of axisymmetry. We have made code to compute the force from our potential, and to integrate orbits within it, publicly available. (Less)
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Wellcome Trust Sanger Institute1, Guy's and St Thomas' NHS Foundation Trust2, Lund University3, AstraZeneca4, Erasmus University Medical Center5, University of Queensland6, Memorial Sloan Kettering Cancer Center7, University of Iceland8, Hanyang University9, Wellcome Trust10, Radboud University Nijmegen11, University of Amsterdam12, University of Oslo13, Royal Brisbane and Women's Hospital14, Curie Institute15, Université libre de Bruxelles16, King's College London17, University of Antwerp18, Harvard University19, Cambridge University Hospitals NHS Foundation Trust20
TL;DR: In this article, a weighted model called HRDetect was developed to accurately detect BRCA1/BRCA2-deficient samples with 98.7% sensitivity (area under the curve (AUC) = 0.98).
Abstract: Approximately 1-5% of breast cancers are attributed to inherited mutations in BRCA1 or BRCA2 and are selectively sensitive to poly(ADP-ribose) polymerase (PARP) inhibitors. In other cancer types, germline and/or somatic mutations in BRCA1 and/or BRCA2 (BRCA1/BRCA2) also confer selective sensitivity to PARP inhibitors. Thus, assays to detect BRCA1/BRCA2-deficient tumors have been sought. Recently, somatic substitution, insertion/deletion and rearrangement patterns, or 'mutational signatures', were associated with BRCA1/BRCA2 dysfunction. Herein we used a lasso logistic regression model to identify six distinguishing mutational signatures predictive of BRCA1/BRCA2 deficiency. A weighted model called HRDetect was developed to accurately detect BRCA1/BRCA2-deficient samples. HRDetect identifies BRCA1/BRCA2-deficient tumors with 98.7% sensitivity (area under the curve (AUC) = 0.98). Application of this model in a cohort of 560 individuals with breast cancer, of whom 22 were known to carry a germline BRCA1 or BRCA2 mutation, allowed us to identify an additional 22 tumors with somatic loss of BRCA1 or BRCA2 and 47 tumors with functional BRCA1/BRCA2 deficiency where no mutation was detected. We validated HRDetect on independent cohorts of breast, ovarian and pancreatic cancers and demonstrated its efficacy in alternative sequencing strategies. Integrating all of the classes of mutational signatures thus reveals a larger proportion of individuals with breast cancer harboring BRCA1/BRCA2 deficiency (up to 22%) than hitherto appreciated (∼1-5%) who could have selective therapeutic sensitivity to PARP inhibition.
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TL;DR: There is an urgent need for public health measures to prevent obesity in order to save societal resources and international consensus is required on standardized methods to calculate the cost of obesity to improve homogeneity and comparability.
Abstract: Background: The rising prevalence of obesity represents an important public health issue. An assessment of its costs may be useful in providing recommendations for policy and decision makers. This systematic review aimed to assess the economic burden of obesity and to identify, measure and describe the different obesity-related diseases included in the selected studies. Methods: A systematic literature search of studies in the English language was carried out in Medline (PubMed) and Web of Science databases to select cost-of-illness studies calculating the cost of obesity in a study population aged ≥18 years with obesity, as defined by a body mass index of ≥30 kg/m², for the whole selected country. The time frame for the analysis was January 2011 to September 2016. Results: The included twenty three studies reported a substantial economic burden of obesity in both developed and developing countries. There was considerable heterogeneity in methodological approaches, target populations, study time frames, and perspectives. This prevents an informative comparison between most of the studies. Specifically, there was great variety in the included obesity-related diseases and complications among the studies. Conclusions: There is an urgent need for public health measures to prevent obesity in order to save societal resources. Moreover, international consensus is required on standardized methods to calculate the cost of obesity to improve homogeneity and comparability. This aspect should also be considered when including obesity-related diseases.
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International Agency for Research on Cancer1, University of Bristol2, University Hospitals Bristol NHS Foundation Trust3, Vanderbilt University Medical Center4, University of Kentucky5, University of Copenhagen6, Lund University7, Technische Universität München8, Fred Hutchinson Cancer Research Center9, Harvard University10, Dartmouth College11, University of Liverpool12, Umeå University13, National Institute of Occupational Health14, New Generation University College15, Radboud University Nijmegen16, BC Cancer Agency17, Washington State University18, University of Hawaii19, Ontario Institute for Cancer Research20, University of Southern California21, Technion – Israel Institute of Technology22, University of Salzburg23, Curie Institute24, Nofer Institute of Occupational Medicine25, University of Ostrava26, Charles University in Prague27, Nanjing Medical University28, University of Oviedo29, University of Sheffield30, University of Texas MD Anderson Cancer Center31, University of Pittsburgh32, Lunenfeld-Tanenbaum Research Institute33
TL;DR: The results are consistent with a causal role of fasting insulin and low-density lipoprotein cholesterol in lung cancer etiology, as well as for BMI in squamous cell and small cell carcinoma, and the latter relation may be mediated by a previously unrecognized effect of obesity on smoking behavior.
Abstract: Background: Assessing the relationship between lung cancer and metabolic conditions is challenging because of the confounding effect of tobacco. Mendelian randomization (MR), or the use of genetic ...
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TL;DR: This article conducted a meta-analysis of genome-wide association data from 26,676 T2D case and 132,532 control subjects of European ancestry after imputation using the 1000 Genomes multiethnic reference panel.
Abstract: To characterize type 2 diabetes (T2D)-associated variation across the allele frequency spectrum, we conducted a meta-analysis of genome-wide association data from 26,676 T2D case and 132,532 control subjects of European ancestry after imputation using the 1000 Genomes multiethnic reference panel Promising association signals were followed up in additional data sets (of 14,545 or 7,397 T2D case and 38,994 or 71,604 control subjects) We identified 13 novel T2D-associated loci (P < 5 × 10-8), including variants near the GLP2R, GIP, and HLA-DQA1 genes Our analysis brought the total number of independent T2D associations to 128 distinct signals at 113 loci Despite substantially increased sample size and more complete coverage of low-frequency variation, all novel associations were driven by common single nucleotide variants Credible sets of potentially causal variants were generally larger than those based on imputation with earlier reference panels, consistent with resolution of causal signals to common risk haplotypes Stratification of T2D-associated loci based on T2D-related quantitative trait associations revealed tissue-specific enrichment of regulatory annotations in pancreatic islet enhancers for loci influencing insulin secretion and in adipocytes, monocytes, and hepatocytes for insulin action-associated loci These findings highlight the predominant role played by common variants of modest effect and the diversity of biological mechanisms influencing T2D pathophysiology
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University of Bern1, University of British Columbia2, Netherlands Cancer Institute3, University of Washington4, Erasmus University Rotterdam5, Lund University6, University of North Carolina at Chapel Hill7, Baylor College of Medicine8, University of Texas MD Anderson Cancer Center9, University of Alberta10, University of California, Davis11
TL;DR: Although cisplatin-based neoadjuvant chemotherapy improves patient outcomes, the results suggest that patients with basal tumors should be prioritized for NAC, and the first single-sample genomic subtyping classifier to subtype MIBC is discovered, which may be suitable for integration into routine clinical practice.
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TL;DR: Plasma NFL is associated with AD diagnosis and with cognitive, biochemical, and imaging hallmarks of the disease and implies a potential usefulness for plasma NFL as a noninvasive biomarker in AD.
Abstract: IMPORTANCE: Existing cerebrospinal fluid (CSF) or imaging (tau positron emission tomography) biomarkers for Alzheimer disease (AD) are invasive or expensive. Biomarkers based on standard blood test results would be useful in research, drug development, and clinical practice. Plasma neurofilament light (NFL) has recently been proposed as a blood-based biomarker for neurodegeneration in dementias. OBJECTIVE: To test whether plasma NFL concentrations are increased in AD and associated with cognitive decline, other AD biomarkers, and imaging evidence of neurodegeneration. DESIGN, SETTING, AND PARTICIPANTS: In this prospective case-control study, an ultrasensitive assay was used to measure plasma NFL concentration in 193 cognitively healthy controls, 197 patients with mild cognitive impairment (MCI), and 180 patients with AD dementia from the Alzheimer's Disease Neuroimaging Initiative. The study dates were September 7, 2005, to February 13, 2012. The plasma NFL analysis was performed in September 2016. MAIN OUTCOMES AND MEASURES: Associations were tested between plasma NFL and diagnosis, Aβ pathologic features, CSF biomarkers of neuronal injury, cognition, brain structure, and metabolism. RESULTS: Among 193 cognitively healthy controls, 197 patients with mild cognitive impairment, and 180 patients with AD with dementia, plasma NFL correlated with CSF NFL (Spearman ρ = 0.59, P < .001). Plasma NFL was increased in patients with MCI (mean, 42.8 ng/L) and patients with AD dementia (mean, 51.0 ng/L) compared with controls (mean, 34.7 ng/L) (P < .001) and had high diagnostic accuracy for patients with AD with dementia vs controls (area under the receiver operating characteristic curve, 0.87, which is comparable to established CSF biomarkers). Plasma NFL was particularly high in patients with MCI and patients with AD dementia with Aβ pathologic features. High plasma NFL correlated with poor cognition and AD-related atrophy (at baseline and longitudinally) and with brain hypometabolism (longitudinally). CONCLUSIONS AND RELEVANCE: Plasma NFL is associated with AD diagnosis and with cognitive, biochemical, and imaging hallmarks of the disease. This finding implies a potential usefulness for plasma NFL as a noninvasive biomarker in AD.
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Haidong Wang1, Amanuel Alemu Abajobir2, Kalkidan Hassen Abate3, Cristiana Abbafati4 +781 more•Institutions (41)
TL;DR: Age-specific and sex-specific all-cause mortality between 1970 and 2016 is estimated for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016 to identify countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone.
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TL;DR: It is suggested that Aβ fibrils start to accumulate predominantly within certain parts of the DMN in preclinical AD and already then affect brain connectivity before neurodegeneration occurs.
Abstract: It is not known exactly where amyloid-β (Aβ) fibrils begin to accumulate in individuals with Alzheimer's disease (AD). Recently, we showed that abnormal levels of Aβ42 in cerebrospinal fluid (CSF) can be detected before abnormal amyloid can be detected using PET in individuals with preclinical AD. Using these approaches, here we identify the earliest preclinical AD stage in subjects from the ADNI and BioFINDER cohorts. We show that Aβ accumulation preferentially starts in the precuneus, medial orbitofrontal, and posterior cingulate cortices, i.e., several of the core regions of the default mode network (DMN). This early pattern of Aβ accumulation is already evident in individuals with normal Aβ42 in the CSF and normal amyloid PET who subsequently convert to having abnormal CSF Aβ42. The earliest Aβ accumulation is further associated with hypoconnectivity within the DMN and between the DMN and the frontoparietal network, but not with brain atrophy or glucose hypometabolism. Our results suggest that Aβ fibrils start to accumulate predominantly within certain parts of the DMN in preclinical AD and already then affect brain connectivity.
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TL;DR: This work sequenced bacterial 16S rRNA from fecal samples of Aβ precursor protein (APP) transgenic mouse model and found a remarkable shift in the gut microbiota as compared to non-transgenic wild-type mice, indicating a microbial involvement in the development of Abeta amyloid pathology and suggesting that microbiota may contribute to the developed neurodegenerative diseases.
Abstract: Alzheimer's disease is the most common form of dementia in the western world, however there is no cure available for this devastating neurodegenerative disorder. Despite clinical and experimental evidence implicating the intestinal microbiota in a number of brain disorders, its impact on Alzheimer's disease is not known. To this end we sequenced bacterial 16S rRNA from fecal samples of Aβ precursor protein (APP) transgenic mouse model and found a remarkable shift in the gut microbiota as compared to non-transgenic wild-type mice. Subsequently we generated germ-free APP transgenic mice and found a drastic reduction of cerebral Aβ amyloid pathology when compared to control mice with intestinal microbiota. Importantly, colonization of germ-free APP transgenic mice with microbiota from conventionally-raised APP transgenic mice increased cerebral Aβ pathology, while colonization with microbiota from wild-type mice was less effective in increasing cerebral Aβ levels. Our results indicate a microbial involvement in the development of Abeta amyloid pathology, and suggest that microbiota may contribute to the development of neurodegenerative diseases.
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University of Leicester1, National Institute for Health Research2, Wellcome Trust Centre for Human Genetics3, University of Oxford4, University of Cambridge5, Queen Mary University of London6, Technische Universität München7, Stanford University8, Icahn School of Medicine at Mount Sinai9, London North West Healthcare NHS Trust10, Imperial College Healthcare11, Imperial College London12, University of Dundee13, University of Leeds14, Massachusetts Institute of Technology15, Tartu University Hospital16, University of Ioannina17, Harvard University18, Lund University19, Umeå University20, Peking Union Medical College21, University College London22, University of Tampere23, Vanderbilt University24, Synlab Group25, Heidelberg University26, Medical University of Graz27, University of Ottawa28, University of Tartu29, Lebanese American University30, King Abdulaziz University31, University of Manchester32, Central Manchester University Hospitals NHS Foundation Trust33, National Institutes of Health34, St Bartholomew's Hospital35, Manchester Academic Health Science Centre36, Wellcome Trust Sanger Institute37, University of Lübeck38, Harokopio University39, Karolinska University Hospital40
TL;DR: This approach identified 13 new loci at genome-wide significance, 12 of which were on the previous list of loci meeting the 5% FDR threshold, thus providing strong support that the remaining loci identified by FDR represent genuine signals.
Abstract: Genome-wide association studies (GWAS) in coronary artery disease (CAD) had identified 66 loci at 'genome-wide significance' (P < 5 × 10-8) at the time of this analysis, but a much larger number of putative loci at a false discovery rate (FDR) of 5% (refs. 1,2,3,4). Here we leverage an interim release of UK Biobank (UKBB) data to evaluate the validity of the FDR approach. We tested a CAD phenotype inclusive of angina (SOFT; ncases = 10,801) as well as a stricter definition without angina (HARD; ncases = 6,482) and selected cases with the former phenotype to conduct a meta-analysis using the two most recent CAD GWAS. This approach identified 13 new loci at genome-wide significance, 12 of which were on our previous list of loci meeting the 5% FDR threshold, thus providing strong support that the remaining loci identified by FDR represent genuine signals. The 304 independent variants associated at 5% FDR in this study explain 21.2% of CAD heritability and identify 243 loci that implicate pathways in blood vessel morphogenesis as well as lipid metabolism, nitric oxide signaling and inflammation.
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TL;DR: This paper presents a short overview of the changes to the trigger and data acquisition systems during the first long shutdown of the LHC and shows the performance of the trigger system and its components based on the 2015 proton–proton collision data.
Abstract: During 2015 the ATLAS experiment recorded 3.8 fb(-1) of proton-proton collision data at a centre-of-mass energy of 13 TeV. The ATLAS trigger system is a crucial component of the experiment, respons ...
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TL;DR: This preclinical study using a primate model indicates that human iPS cell-derived dopaminergic progenitors are clinically applicable for the treatment of patients with PD.
Abstract: Induced pluripotent stem cells (iPS cells) are a promising source for a cell-based therapy to treat Parkinson's disease (PD), in which midbrain dopaminergic neurons progressively degenerate. However, long-term analysis of human iPS cell-derived dopaminergic neurons in primate PD models has never been performed to our knowledge. Here we show that human iPS cell-derived dopaminergic progenitor cells survived and functioned as midbrain dopaminergic neurons in a primate model of PD (Macaca fascicularis) treated with the neurotoxin MPTP. Score-based and video-recording analyses revealed an increase in spontaneous movement of the monkeys after transplantation. Histological studies showed that the mature dopaminergic neurons extended dense neurites into the host striatum; this effect was consistent regardless of whether the cells were derived from patients with PD or from healthy individuals. Cells sorted by the floor plate marker CORIN did not form any tumours in the brains for at least two years. Finally, magnetic resonance imaging and positron emission tomography were used to monitor the survival, expansion and function of the grafted cells as well as the immune response in the host brain. Thus, this preclinical study using a primate model indicates that human iPS cell-derived dopaminergic progenitors are clinically applicable for the treatment of patients with PD.
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TL;DR: In this article, the authors consider a broad range of individual lifestyle choices and calculate their potential to reduce greenhouse gas emissions in developed countries, based on 148 scenarios from 39 sources, and recommend four widely applicable high-impact (i.e. low emissions) actions with the potential to contribute to systemic change and substantially reduce annual personal emissions: having one fewer child (an average for developed countries of 58.6 tonnes CO2-equivalent (tCO2e) emission reductions per year), living car-free (2.4 tCO 2e saved per year).
Abstract: Current anthropogenic climate change is the result of greenhouse gas accumulation in the atmosphere, which records the aggregation of billions of individual decisions. Here we consider a broad range of individual lifestyle choices and calculate their potential to reduce greenhouse gas emissions in developed countries, based on 148 scenarios from 39 sources. We recommend four widely applicable high-impact (i.e. low emissions) actions with the potential to contribute to systemic change and substantially reduce annual personal emissions: having one fewer child (an average for developed countries of 58.6 tonnes CO2-equivalent (tCO2e) emission reductions per year), living car-free (2.4 tCO2e saved per year), avoiding airplane travel (1.6 tCO2e saved per roundtrip transatlantic flight) and eating a plant-based diet (0.8 tCO2e saved per year). These actions have much greater potential to reduce emissions than commonly promoted strategies like comprehensive recycling (four times less effective than a plant-based diet) or changing household lightbulbs (eight times less). Though adolescents poised to establish lifelong patterns are an important target group for promoting high-impact actions, we find that ten high school science textbooks from Canada largely fail to mention these actions (they account for 4% of their recommended actions), instead focusing on incremental changes with much smaller potential emissions reductions. Government resources on climate change from the EU, USA, Canada, and Australia also focus recommendations on lower-impact actions. We conclude that there are opportunities to improve existing educational and communication structures to promote the most effective emission-reduction strategies and close this mitigation gap.
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University of Amsterdam1, Wageningen University and Research Centre2, Institut national de la recherche agronomique3, University of Lorraine4, University of Cologne5, National Research Council6, University of Turin7, Lund University8, Aarhus University9, University of A Coruña10, University College Dublin11, Leiden University12
TL;DR: It is proposed that relationships between soil food web structure and carbon cycling in soils need to be reconsidered and the efficiency of nutrient cycling and carbon uptake can increase by a shift in fungal composition and/or fungal activity during nature restoration.
Abstract: Soil organisms have an important role in aboveground community dynamics and ecosystem functioning in terrestrial ecosystems. However, most studies have considered soil biota as a black box or focussed on specific groups, whereas little is known about entire soil networks. Here we show that during the course of nature restoration on abandoned arable land a compositional shift in soil biota, preceded by tightening of the belowground networks, corresponds with enhanced efficiency of carbon uptake. In mid- and long-term abandoned field soil, carbon uptake by fungi increases without an increase in fungal biomass or shift in bacterial-to-fungal ratio. The implication of our findings is that during nature restoration the efficiency of nutrient cycling and carbon uptake can increase by a shift in fungal composition and/or fungal activity. Therefore, we propose that relationships between soil food web structure and carbon cycling in soils need to be reconsidered.