Commentary: Laudable but incremental improvements ahead of a sea change.
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ABSTRACT:
SUBMITTER: Winlaw DS
PROVIDER: S-EPMC9390774 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
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Commentary: Laudable but incremental improvements ahead of a sea change.
JTCVS open 20200930
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Project description: Not available
| S-EPMC11616306 | biostudies-literature
Project description:ObjectivePatients with type 2 diabetes are encouraged to lose weight, but excessive weight loss in older adults may be a marker of poor health and subsequent mortality. We examined weight change during the postintervention period of Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) with diabetes support and education (DSE) (control) in overweight/obese individuals with type 2 diabetes and sought to identify predictors of excessive postintervention weight loss and its association with mortality.Research design and methodsThese secondary analyses compared postintervention weight change (year 8 to final visit; median 16 years) in ILI and DSE in 3,999 Look AHEAD participants. Using empirically derived trajectory categories, we compared four subgroups: weight gainers (n = 307), weight stable (n = 1,561), steady losers (n = 1,731), and steep losers (n = 380), on postintervention mortality, demographic variables, and health status at randomization and year 8.ResultsPostintervention weight change averaged -3.7 ± 9.5%, with greater weight loss in the DSE than the ILI group. The steep weight loss trajectory subgroup lost on average 17.7 ± 6.6%; 30% of steep losers died during postintervention follow-up versus 10-18% in other trajectories (P < 0001). The following variables distinguished steep losers from weight stable: baseline, older, longer diabetes duration, higher BMI, and greater multimorbidity; intervention, randomization to control group and less weight loss in years 1-8; and year 8, higher prevalence of frailty, multimorbidity, and depressive symptoms and lower use of weight control strategies.ConclusionsSteep weight loss postintervention was associated with increased risk of mortality. Older individuals with longer duration of diabetes and multimorbidity should be monitored for excessive unintentional weight loss.
| S-EPMC9277114 | biostudies-literature
Project description:Urbanization represents an unintentional global experiment that can provide insights into how species will respond and interact under future global change scenarios. Cities produce many conditions that are predicted to occur widely in the future, such as warmer temperatures, higher carbon dioxide (CO2) concentrations and exacerbated droughts. In using cities as surrogates for global change, it is challenging to disentangle climate variables-such as temperature-from co-occurring or confounding urban variables-such as impervious surface-and then to understand the interactive effects of multiple climate variables on both individual species and species interactions. However, such interactions are also difficult to replicate experimentally, and thus the challenges of cities are also their unique advantage. Here, we review insights gained from cities, with a focus on plants and arthropods, and how urban findings agree or disagree with experimental predictions and historical data. We discuss the types of hypotheses that can be best tested in cities, caveats to urban research and how to further validate cities as surrogates for global change. Lastly, we summarize how to achieve the goal of using urban species responses to predict broader regional- and ecosystem-level patterns in the future.
| S-EPMC6053926 | biostudies-literature
Project description: Not available
| S-EPMC10692840 | biostudies-literature
Project description:IntroductionHepatitis C virus (HCV) infection is one of the principle causes of chronic liver disease. Successful treatment significantly decreases the risk of hepatic morbidity and mortality. Current standard of care achieves sustained virologic response (SVR) rates of 40-80%; however, the HCV therapy landscape is rapidly evolving. The objective of this study was to quantify the clinical and economic benefit associated with increasing levels of SVR.MethodsA published Markov model (MONARCH) that simulates the natural history of hepatitis C over a lifetime horizon was used. Discounted and non-discounted life-years (LYs), quality-adjusted life-years (QALYs) and cost of complication management were estimated for various plausible SVR rates. To demonstrate the robustness of projections obtained, the model was validated to ten UK-specific HCV studies.ResultsQALY estimates ranged from 18.0 years for those treated successfully in fibrosis stage F0 to 7.5 years (discounted) for patients in fibrosis stage F4 who remain untreated. Predicted QALY gains per 10% improvement in SVR ranged from 0.23 (F0) to 0.64 (F4) and 0.58 (F0) to 1.35 (F4) in 40 year old patients (discounted and non-discounted results respectively). In those aged 40, projected discounted HCV-related costs are minimised with successful treatment in F0/F1 (at approximately £ 300), increasing to £ 49,300 in F4 patients who remain untreated. Validation of the model to published UK cost-effectiveness studies produce R2 goodness of fit statistics of 0.988, 0.978 and of 0.973 for total costs, QALYs and incremental cost effectiveness ratios, respectively.ConclusionProjecting the long-term clinical and economic consequences associated with chronic hepatitis C is a necessary requirement for the evaluation of new treatments. The principle analysis demonstrates the significant impact on expected costs, LYs and QALYs associated with increasing SVR. A validation analysis demonstrated the robustness of the results reported.
| S-EPMC4311930 | biostudies-literature
Project description:Accumulating research points to the importance of incremental theories of emotion. Yet, little is known about whether these beliefs change in adulthood across long time spans, and if so, whether such changes are prospectively linked to emotion regulation outcomes. In the present investigation, we tested how incremental theories of emotion change during college, and whether such changes are linked to emotion regulation practices. We followed 394 undergraduates as they entered and ultimately graduated from college. Focusing on the temporal dynamics of incremental theories of emotion, we found that they were somewhat stable, and their mean-level increased over time. Focusing on the correlates of such changes, we found that students who during college came to believe that emotions (but not intelligence) are more controllable, ended up using more cognitive reappraisal (but not expressive suppression) at the end of college. Similarly, students who during college came to use cognitive reappraisal (but not expressive suppression) more frequently, ended up believing that emotion (but not intelligence) is more controllable at the end of college. This pattern could not be explained by differences in initial levels or by differences in underlying affective experiences. We discuss potential implications of these findings for understanding the interplay between beliefs and emotion regulation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
| S-EPMC8613704 | biostudies-literature
Project description:We investigate whether communication strategies that portray climate change as a nonlinear phenomenon provoke increases in laypeople's climate change risk perceptions. In a high-powered, preregistered online experiment, participants were exposed to linear or nonlinear predictions of future temperature increases that would be expected if global greenhouse gas emissions were not reduced. We hypothesized that the type of climate change portrayal would impact perceptions of qualitative risk characteristics (catastrophic potential, controllability of consequences) which would, in turn, affect laypeople's holistic risk perceptions. The results of the study indicate that the type of climate change portrayal did not affect perceptions of risk or other social-cognitive variables such as efficacy beliefs. While participants who were exposed to a nonlinear portrayal of climate change perceived abrupt changes in the climate system as more likely, they did not perceive the consequences of climate change as less controllable or more catastrophic. Notably, however, participants who had been exposed to a linear or nonlinear portrayal of climate change were willing to donate more money to environmental organizations than participants who had not been presented with a climate-related message. Limitations of the present study and directions for future research are discussed.
| S-EPMC9676726 | biostudies-literature
Project description:Marine protected area (MPA) designs are likely to require iterative refinement as new knowledge is gained. In particular, there is an increasing need to consider the effects of climate change, especially the ability of ecosystems to resist and/or recover from climate-related disturbances, within the MPA planning process. However, there has been limited research addressing the incorporation of climate change resilience into MPA design. This study used Marxan conservation planning software with fine-scale shallow water (<20 m) bathymetry and habitat maps, models of major benthic communities for deeper water, and comprehensive human use information from Ningaloo Marine Park in Western Australia to identify climate change resilience features to integrate into the incremental refinement of the marine park. The study assessed the representation of benthic habitats within the current marine park zones, identified priority areas of high resilience for inclusion within no-take zones and examined if any iterative refinements to the current no-take zones are necessary. Of the 65 habitat classes, 16 did not meet representation targets within the current no-take zones, most of which were in deeper offshore waters. These deeper areas also demonstrated the highest resilience values and, as such, Marxan outputs suggested minor increases to the current no-take zones in the deeper offshore areas. This work demonstrates that inclusion of fine-scale climate change resilience features within the design process for MPAs is feasible, and can be applied to future marine spatial planning practices globally.
| S-EPMC4986976 | biostudies-literature
Project description:Variety adaptation to future climate for wheat is important but lacks comprehensive understanding. Here, we evaluate genetic advancement under current and future climate using a dataset of wheat breeding nurseries in North America during 1960-2018. Results show that yields declined by 3.6% per 1 °C warming for advanced winter wheat breeding lines, compared with -5.5% for the check variety, indicating a superior climate-resilience. However, advanced spring wheat breeding lines showed a 7.5% yield reduction per 1 °C warming, which is more sensitive than a 7.1% reduction for the check variety, indicating climate resilience is not improved and may even decline for spring wheat. Under future climate of SSP scenarios, yields of winter and spring wheat exhibit declining trends even with advanced breeding lines, suggesting future climate warming could outpace the yield gains from current breeding progress. Our study highlights that the adaptation progress following the current wheat breeding strategies is challenging.
| S-EPMC9525655 | biostudies-literature
Project description:Adipose tissue dysfunction plays a key role in the development of the metabolic abnormalities characteristic of type 2 diabetes (T2DM) and participates actively in lipid metabolism. Adiponectin, found abundantly in circulation and a marker of adipose health, is decreased in obese persons with T2DM. We investigated whether the changes in adiponectin with an intensive lifestyle intervention (ILI) for weight loss could potentially mediate the increase in low HDL-cholesterol (HDL-C) with ILI. Adiponectin and its fractions were determined using an ELISA with selective protease treatment in 1,397 participants from Look AHEAD, a trial examining whether ILI will reduce cardiovascular events in overweight/obese subjects with T2DM when compared with a control arm, diabetes support and education (DSE). Multivariable regression and mediational analyses were performed for adiponectin and its high-molecular-weight (HMW) and non-HMW fractions. ILI increased baseline HDL-C by 9.7% and adiponectin by 11.9%; changes with DSE were 1.3% and 0.2%, respectively (P < 0.0001). In a model including changes in weight, fitness, triglycerides, and glucose control and that adjusted for demographics and medical history, adiponectin changes remained significantly associated with HDL-C change. Data supported the contribution of changes in both HMW- and non-HMW-adiponectin to the improvement in HDL-C with ILI.
| S-EPMC3494242 | biostudies-literature