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De Luna-Bonilla OÁ, Valencia-Á S, Ibarra-Manríquez G, Morales-Saldaña S, Tovar-Sánchez E, González-Rodríguez A. Leaf morphometric analysis and potential distribution modelling contribute to taxonomic differentiation in the Quercus microphylla complex. J Plant Res 2024; 137:3-19. [PMID: 37740854 PMCID: PMC10764464 DOI: 10.1007/s10265-023-01495-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/31/2023] [Indexed: 09/25/2023]
Abstract
Mexico is a major center of evolutionary radiation for the genus Quercus, with oak species occurring across different habitat types and showing a wide variation in morphology and growth form. Despite representing about 20% of Mexican species, scrub oaks have received little attention and even basic aspects of their taxonomy and geographic distribution remain unresolved. In this study, we analyzed the morphological and climatic niche differentiation of scrub oak populations forming a complex constituted by six named species, Quercus cordifolia, Quercus frutex, Quercus intricata, Quercus microphylla, Quercus repanda, Quercus striatula and a distinct morphotype of Q. striatula identified during field and herbarium work (hereafter named Q. striatula II). Samples were obtained from 35 sites covering the geographic distribution of the complex in northern and central Mexico. Morphological differentiation was analyzed through geometric morphometrics of leaf shape and quantification of trichome traits. Our results indicated the presence of two main morphological groups with geographic concordance. The first was formed by Q. frutex, Q. microphylla, Q. repanda and Q. striatula, distributed in the Trans-Mexican Volcanic Belt, the Sierra Madre Occidental and a little portion of the south of the Mexican Altiplano (MA). The second group consists of Q. cordifola, Q. intricata and Q. striatula II, found in the Sierra Madre Oriental and the MA. Therefore, our evidence supports the distinctness of the Q. striatula II morphotype, indicating the need for a taxonomic revision. Within the two groups, morphological differentiation among taxa varied from very clear to low or inexistent (i.e. Q. microphylla-Q. striatula and Q. cordifolia-Q. striatula II) but niche comparisons revealed significant niche differentiation in all pairwise comparisons, highlighting the relevance of integrative approaches for the taxonomic resolution of complicated groups such as the one studied here.
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Affiliation(s)
- Oscar Ángel De Luna-Bonilla
- Instituto de Investigaciones en Ecosistemas y Sustentabilidad, Universidad Nacional Autónoma de México, 58190, Morelia, México
- Posgrado en Ciencias Biológicas, Unidad de Posgrado, Edificio A, 1° Piso, Circuito de Posgrados, Ciudad Universitaria, Coyoacán, 04510, Ciudad de Mexico, México
| | - Susana Valencia-Á
- Herbario de la Facultad de Ciencias, Departamento de Biología Comparada, Universidad Nacional Autónoma de México, Circuito Exterior, s.n, Ciudad Universitaria, Coyoacán, 04510, México City, México
| | - Guillermo Ibarra-Manríquez
- Instituto de Investigaciones en Ecosistemas y Sustentabilidad, Universidad Nacional Autónoma de México, 58190, Morelia, México
| | - Saddan Morales-Saldaña
- Instituto de Investigaciones en Ecosistemas y Sustentabilidad, Universidad Nacional Autónoma de México, 58190, Morelia, México
| | - Efraín Tovar-Sánchez
- Centro de Investigación en Biodiversidad y Conservación, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Col. Chamilpa, CP, 62209, Cuernavaca, Morelos, Mexico
| | - Antonio González-Rodríguez
- Instituto de Investigaciones en Ecosistemas y Sustentabilidad, Universidad Nacional Autónoma de México, 58190, Morelia, México.
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Takeuchi Y, Kashiwabara K, Hosoi H, Imai H, Matsuyama Y. Longitudinal effects of a nationwide lifestyle intervention program on cardiometabolic outcomes in Japan: An observational cohort study. Prev Med 2020; 141:106301. [PMID: 33164885 DOI: 10.1016/j.ypmed.2020.106301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023]
Abstract
The Japanese government launched a nationwide health screening and lifestyle intervention program in 2008 to prevent and reduce metabolic syndrome in at-risk individuals. This study examined the longitudinal effects of the program's lifestyle interventions on metabolic outcomes using health insurance data from one prefecture. The study population comprised 16,317 individuals aged 40-74 years who met the recommendation criteria for the interventions between 2009 and 2015. Participants were categorized into an overall intervention group (comprising a single-session motivational intervention group and a multi-session intensive intervention group) and a non-intervention group. We evaluated the interventions' effects on the initiation of medications for metabolic disorders (hyperlipidemia, hypertension, and hyperglycemia) and metabolic syndrome incidence for 6 years using discrete hazard models that adjusted for sex, age, health screening measurements, and smoking habit. The longitudinal effects on health screening measurements were also evaluated using regression models for repeated measures. The adjusted hazard ratios (aHRs) (95% confidence interval [CI]) for initiation of medications were 0.83 (0.77-0.90), 0.77 (0.71-0.84), and 0.66 (0.57-0.77) for overall, motivational, and intensive interventions, respectively. The aHRs (95%CI) for metabolic syndrome incidence were 0.84 (0.75-0.94), 0.80 (0.71-0.91), and 0.67 (0.51-0.89) for overall, motivational, and intensive interventions, respectively. The interventions reduced body mass index and waist circumference, but had modest effects on blood lipids, blood glucose, and hemoglobin A1c levels; blood pressure was unaffected. These interventions represent an effective strategy to prevent the progression of preclinical metabolic syndrome, but further studies are needed to evaluate their long-term preventive effects on cardiovascular disease and diabetes.
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Ando S, Koyama T, Kuriyama N, Ozaki E, Uehara R. The Association of Daily Physical Activity Behaviors with Visceral Fat. Obes Res Clin Pract 2020; 14:531-535. [PMID: 33168484 DOI: 10.1016/j.orcp.2020.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/28/2020] [Accepted: 10/14/2020] [Indexed: 02/06/2023]
Abstract
The association between health benefits and physical activity has received increasing attention among researchers working on the prevention of noncommunicable disease. However, the number of studies on the association between daytime activities and visceral fat is limited. In this study, we evaluated how daily physical activity behaviors impact the visceral adipose tissue (VAT) and body mass index (BMI). A total of 3543 participants (1240 men, 2303 women) were included in this cross-sectional study. The duration of daily physical activities (sedentary time, standing time, and walking time) was classified into the six categories. Multiple regression analysis was carried out to compare continuous variables. VAT and BMI were used as dependent variables, and the daily physical activities were used as independent variables. All results were expressed after adjusting for confounders, including sex, age, Brinkman index, daily alcohol consumption, sleeping time, and medication for hypertension, dyslipidemia, and diabetes. The multiple regression analysis showed that sedentary time was significantly associated with VAT (beta = 1.145, p value = 0.002), whereas standing time was negatively associated with VAT (beta = -0.763, p value = 0.043). Walking time was negatively and robustly associated with all depending variables as follows: BMI (beta = -0.172, p value = 0.001) and VAT (beta = -2.023, p value <0.001). This study showed that a daily behavior time affects the accumulation of VAT and BMI. A shift from sedentary time to standing or walking time might be a key population approach to prevent cardiometabolic diseases.
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Affiliation(s)
- Shinto Ando
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ritei Uehara
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Mannan H. Gains in life expectancy in the Australian population due to reductions in smoking: comparisons between interventions targeting the population versus interventions in a specific high risk group. BMC Public Health 2020; 20:1478. [PMID: 32993598 PMCID: PMC7526239 DOI: 10.1186/s12889-020-09600-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022] Open
Abstract
Background Four decades of population-based tobacco control strategies have contributed to substantial reduction in smoking prevalence in Australia. However, smoking prevalence is still double in socially disadvantaged groups compared to those that are not. But not all tobacco control strategies successfully used in the general population is effective in specific high-risk population groups. Hence, an effective way to reduce smoking in high risk population groups may include targeting them specifically to identify and support smokers to quit. In this backdrop, we examined whether tobacco control interventions at the population-level are more effective in increasing life expectancy among Australians compared to interventions targeting a high risk group or a combination of the two when smoking prevalence is reduced to 10 and 0% respectively. Methods Using the risk percentiles approach, analyses were performed separately for men and women using data from various sources such as the 2014–15 National Health Survey linked to death registry, simulated data for high risk groups, and the Australian population and deaths data from the census. Indigenous status was simulated by preferentially assigning those who are indigenous to lower SES quintiles. The age-sex distribution of mental disorder status was simulated using its distribution from 2016 National Drug Strategy Household Survey with 25.9% of mentally ill being assigned to current smoking category and the rest to non-smoking category. The age-sex distribution of prisoners was simulated based on 2014 ABS Prisoners Australia survey with 74% of prisoners being assigned to current smoker category and the rest to non-smoker category. Homelessness status was simulated according to age, sex and indigenous status for 2011 census with all homeless being allocated to the lowest SES category. The age-sex distribution of total cholesterol level was simulated based on 2011–13 Australian Health Survey. Results The results showed that the combined approach for reducing smoking is most effective for improving life expectancy of Australians particularly for the socially disadvantaged and mentally ill groups both of which have high fraction of smokers in the population. For those who were mentally ill the gain in ALE due to reduction of smoking to 10% was 0.53 years for males and 0.36 years for females which were around 51 and 42% respectively of the maximal gains in ALE that could be achieved through complete cessation. Conclusions Targeting high-risk population groups having substantial fraction of smokers in the population can strongly complement the existing population-based smoking reduction strategies. As population and high risk approaches are both important, the national prevention policies should make judicious use of both to maximize health gain.
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Affiliation(s)
- Haider Mannan
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia.
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Kogure M, Nakaya N, Hirata T, Tsuchiya N, Nakamura T, Narita A, Suto Y, Honma Y, Sasaki H, Miyagawa K, Ushida Y, Ueda H, Hozawa A. Sodium/potassium ratio change was associated with blood pressure change: possibility of population approach for sodium/potassium ratio reduction in health checkup. Hypertens Res 2021; 44:225-31. [PMID: 32801312 DOI: 10.1038/s41440-020-00536-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/02/2020] [Accepted: 07/15/2020] [Indexed: 11/09/2022]
Abstract
Recently, the sodium (Na)/potassium (K) ratio was reported to be associated with blood pressure (BP). A Na/K ratio self-monitoring device using spot urine was established recently. Here, we assessed whether the urinary Na/K ratio change measured using the Na/K device was associated with BP change in a health checkup setting. We targeted 12,890 participants who attended the health checkup in Tome City, Miyagi between 2017 and 2018. Tome City introduced urinary Na/K ratio measurements during health checkups since 2017. For each year, we compared the baseline characteristics according to the urinary Na/K ratio and BP level. We assessed the relationship between change in urinary Na/K ratio and BP change using multiple regression analyses adjusted for age, sex, and change in body mass index (BMI) and alcohol intake. The average urinary Na/K ratio was significantly lower in 2018 than in 2017 (5.4 ± 3.0 to 4.9 ± 2.2, P < 0.01). The systolic BP of the participants in 2018 (130.9 ± 17.4 mmHg) was lower than that in 2017 (132.1 ± 17.9 mmHg). Moreover, the change in systolic BP and diastolic BP was positively associated with the change in urinary Na/K ratio. In conclusion, the association of the change in urinary Na/K ratio with hypertension and changes in systolic and diastolic BP can be explained by a change in alcohol intake, BMI, and urinary Na/K ratio. Therefore, measuring the urinary Na/K ratio in community settings is a potential population approach for counteracting hypertension.
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Koyama T, Kuriyama N, Ozaki E, Tomida S, Uehara R, Nishida Y, Shimanoe C, Hishida A, Tamura T, Tsukamoto M, Kadomatsu Y, Oze I, Matsuo K, Mikami H, Nakamura Y, Ibusuki R, Takezaki T, Suzuki S, Nishiyama T, Kuriki K, Takashima N, Kadota A, Uemura H, Katsuura-Kamano S, Ikezaki H, Murata M, Takeuchi K, Wakai K. Sedentary Time is Associated with Cardiometabolic Diseases in A Large Japanese Population: A Cross-Sectional Study. J Atheroscler Thromb 2020; 27:1097-1107. [PMID: 32269208 PMCID: PMC7585914 DOI: 10.5551/jat.54320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: Accumulating evidence reveals that sedentary behavior is associated with mortality and cardiometabolic disease; however, there are potential age and sex differences in sedentary behavior and health outcomes that have not been adequately addressed. This study aimed to determine the association of sedentary behavior with cardiometabolic diseases such as hypertension, dyslipidemia, diabetes mellitus, and its risk factors in a large Japanese population according to age and sex. Methods: Using data from the Japan Multi-Institutional Collaborative Cohort Study obtained from baseline surveys, data of 62,754 participants (27,930 males, 34,824 females) were analyzed. This study uses a cross-sectional design and self-administered questionnaires to evaluate sedentary time and anamnesis. For the logistic regression analysis, sedentary time < 5 h/day was used as the reference and then adjusted for age, research areas, leisure-time metabolic equivalents, and alcohol and smoking status. From the analysis of anthropometric and blood examinations, 35,973 participants (17,109 males, 18,864 females) were analyzed. Results: For hypertension and diabetes, sedentary time was associated with a significantly higher proportion of male participants. Both sexes were associated with a significantly higher proportion of participants with dyslipidemia. Participants who had longer sedentary time tended to have increased levels of blood pressure, triglycerides, and non-high-density lipoprotein cholesterol (HDL-C), and decreased levels of HDL-C, especially in the 60–69 years group. Conclusions: Independent of leisure-time physical activity, sedentary time was associated with cardiometabolic diseases in a large Japanese population classified by age and sex. Our findings indicate that regularly interrupting and replacing sedentary time may contribute to better physical health-related quality of life.
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Affiliation(s)
- Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
| | - Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
| | - Satomi Tomida
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine.,Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine
| | - Ritei Uehara
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
| | - Yuichiro Nishida
- Department of Preventive Medicine, Faculty of Medicine, Saga University
| | | | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Mineko Tsukamoto
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Yuka Kadomatsu
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute.,Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine
| | - Haruo Mikami
- Cancer Prevention Center, Chiba Cancer Center Research Institute
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute
| | - Rie Ibusuki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Kiyonori Kuriki
- Laboratory of Public Health, School of Food and Nutritional Sciences, University of Shizuoka
| | - Naoyuki Takashima
- Department of Public Health, Faculty of Medicine, Kindai University.,Department of Public Health, Shiga University of Medical Science
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science
| | - Hirokazu Uemura
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
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Katoh K. Health advocacy for reducing smoking rates in Hamamatsu, Japan. Hypertens Res 2020; 43:634-47. [PMID: 32144401 DOI: 10.1038/s41440-020-0418-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 11/08/2022]
Abstract
Efforts to reduce smoking at the Olympics that will be hosted in Tokyo in 2020 are spreading across the country, but they are not enough. In general, it is said that (1) smoke prevention education for minors, (2) smoking cessation support for smokers, and (3) smoking restriction in the social environment are necessary to reduce the smoking rate. Healthy Japan 21 called for achieving a numerical target for the reduction of youth smoking by 2010. The author is a principal school doctor at Hamamatsu Municipal Yuto Elementary School and has been teaching antismoking classes to elementary school students since 1999. In this area (Yuto District, Hamamatsu City in Shizuoka Prefecture, Japan), there is the Oki-jinja Shrine, which was built in 705, and a large event (Oki-jinja grand festival) is held there each autumn, attracting 2500 people. Since many people gather there, it is worthwhile to provide information about passive smoking prevention on shrine grounds. Since 1999, smoking prevention classes have been held at elementary schools, and in 2008, smoking was prohibited in the grounds of the Oki-jinja Shrine, making the festival there totally nonsmoking within the shrine grounds, among additional measures taken against smoking. In addition, measures against smoking at large events in Shizuoka Prefecture and Hamamatsu City have also been effective, and the smoking rate among Hamamatsu citizens has dropped to 10.2% (From Health Promotion Division, Hamamatsu City, 2016), which is expected to extend their healthy life expectancy. To reduce the smoking rate, it is important not only to provide administrative support but also to engage in steady civic activities.
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Oñatibia GR, Aguiar MR. Grasses and grazers in arid rangelands: Impact of sheep management on forage and non-forage grass populations. J Environ Manage 2019; 235:42-50. [PMID: 30669092 DOI: 10.1016/j.jenvman.2019.01.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 06/09/2023]
Abstract
Ecological modeling that includes plant population processes as a critical determinant of vegetation dynamics is useful for sustainable rangeland management. However, we know little about how long-term sheep grazing pressure drives the plant community structure through changes in different native grass species at both individual and population levels. In this study, we hypothesized that plant populations perform differently under different grazing management due to their specified preference by livestock animals. We also tested whether grazing-rest management, aimed at increasing long-term rangeland sustainability, improves the plant growth of forage grass species. We evaluated plant density, individual morphology and plant-size distribution of dominant grass populations in permanent exclosures and open fields under moderate and intensive grazing pressures in Patagonian steppes (South America). We also examined the effects of seasonal grazing-rest managements on the growth and tillering (asexual reproduction) of forage species plants, using temporary mobile exclosures. Grazing intensity changed population density and structure according to species. Compared to permanent exclosures, moderate grazing maintained the plant density of palatable species highly preferred by sheep, reduced the standing-dead biomass proportion of individual plants, and promoted the green biomass of tussocks. Conversely, intensive grazing (double stocking rates) decreased the plant density and individual size of species highly preferred by sheep, and increased the plant density of non-preferred species. Grazing-rest enhanced forage grass species growth and reproduction compared with year-round grazing management, especially during the growing season of a wet year. Our studies support that sheep can be managed to control the plant-size distribution of dominant grass species, their population dynamics, and thereby the overall forage availability at the community level. Both moderate grazing and grazing-rest management can improve the forage availability and preserve the dominant native grasses. We suggest applying a plant population dynamics perspective to facilitate sustainable management of global rangelands.
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Affiliation(s)
- Gastón R Oñatibia
- IFEVA, Departamento de Recursos Naturales y Ambiente, Facultad de Agronomía, Universidad de Buenos Aires, CONICET, Av. San Martín 4453, Buenos Aires, C1417DSE, Argentina.
| | - Martín R Aguiar
- IFEVA, Departamento de Recursos Naturales y Ambiente, Facultad de Agronomía, Universidad de Buenos Aires, CONICET, Av. San Martín 4453, Buenos Aires, C1417DSE, Argentina
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Wilbaux M, Kasser S, Gromann J, Mancino I, Coscia T, Lapaire O, van den Anker JN, Pfister M, Wellmann S. Personalized weight change prediction in the first week of life. Clin Nutr 2018; 38:689-696. [PMID: 29703559 DOI: 10.1016/j.clnu.2018.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/24/2018] [Accepted: 04/02/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS Almost all neonates show physiological weight loss and consecutive weight gain after birth. The resulting weight change profiles are highly variable as they depend on multiple neonatal and maternal factors. This limits the value of weight nomograms for the early identification of neonates at risk for excessive weight loss and related morbidities. The objective of this study was to characterize weight changes and the effect of supplemental feeding in late preterm and term neonates during the first week of life, to identify and quantify neonatal and maternal influencing factors, and to provide an educational online prediction tool. METHODS Longitudinal weight data from 3638 healthy term and late preterm neonates were prospectively recorded up to 7 days of life. Two-thirds (n = 2425) were randomized to develop a semi-mechanistic model characterizing weight change as a balance between time-dependent rates of weight gain and weight loss. The dose-dependent effect of supplemental feeding on weight gain was characterized. A population analysis applying nonlinear mixed-effects modeling was performed using NONMEM 7.3. The model was evaluated on the remaining third of neonates (n = 1213). RESULTS Key population characteristics (median [range]) of the whole sample were gestational age 39.9 [34.4-42.4] weeks, birth weight 3400 [1980-5580] g, maternal age 32 [15-51] years, cesarean section 26%, and girls 50%. The model demonstrated good predictive performance (bias 0.01%, precision 0.56%), and is able to accurately predict individual weight change (bias 0.15%, precision 1.43%) and the dose-dependent effects of supplemental feeding up to 1 week after birth based on weight measurements during the first 3 days of life, including birth weight, and the following characteristics: gestational age, gender, delivery mode, type of feeding, maternal age, and parity. CONCLUSIONS We present the first mathematical model not only to describe weight change in term and late preterm neonates but also to provide an educational online tool for personalized weight prediction in the first week of life.
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Affiliation(s)
- Mélanie Wilbaux
- Paediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
| | - Severin Kasser
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
| | - Julia Gromann
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
| | - Isabella Mancino
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
| | - Tania Coscia
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
| | - Olav Lapaire
- Division of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland.
| | - Johannes N van den Anker
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland; Division of Clinical Pharmacology, Children's National Health System, Washington, DC, USA.
| | - Marc Pfister
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland; Quantitative Solutions LP, Menlo Park, CA, USA.
| | - Sven Wellmann
- Division of Neonatology, University of Basel Children's Hospital (UKBB), Basel, Switzerland.
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Marostica E, Russu A, Gomeni R, Zamuner S, De Nicolao G. Population modelling of patient responses in antidepressant studies: a stochastic approach. Math Biosci 2014; 261:37-47. [PMID: 25481225 DOI: 10.1016/j.mbs.2014.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 10/09/2014] [Accepted: 11/22/2014] [Indexed: 11/29/2022]
Abstract
This paper addresses the problem of modelling longitudinal data describing patients' responses in clinical trials. In particular, a systematic approach relying on a system theoretic paradigm is proposed to deal with contexts where limited physiopathological knowledge is available on disease, drug response, and patients' characteristics. The model relies on the notion of patient's health state which summarizes the patient's condition. In order to cope with the limited number of clinical data usually available, the paper considers a very parsimonious realization where the two state variables are the clinical endpoint and its derivative. Within a population framework, the individual response is modelled as the sum of an individual shift and the average response of subjects belonging to the same study, both described as Markovian processes and identified by empirical Bayes techniques. The proposed approach is validated with experimental data from a Phase II, flexible-dose, depression trial. The dose changes due to the flexible-dose scheme are handled as perturbations on the state. The connection between inter-individual variability and model stability is evaluated showing that the introduction of stable poles helps to describe populations whose range of individual responses does not diverge with time. In this way, good individual fittings and visual predictive checks were obtained for the clinical data. The proposed analysis provides a systematic approach to semi-mechanistic modelling when a precise knowledge of the physiological mechanisms of the disease is incomplete or missing.
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Affiliation(s)
| | - Alberto Russu
- Model-Based Drug Development, Janssen Research & Development, Beerse, Belgium
| | | | - Stefano Zamuner
- Clinical Pharmacology Modeling & Simulation, GlaxoSmithKline, Stockley Park, UK
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