| 1. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Ekström, Magnus Pär, et al.
(författare)
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The association of body mass index, weight gain and central obesity with activity-related breathlessness : the Swedish Cardiopulmonary Bioimage Study
- 2019
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Ingår i: Thorax. - : BMJ Publishing Group Ltd. - 0040-6376 .- 1468-3296. ; 74:10, s. 958-964
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m(2)) is rapidly increasing globally and its impact on breathlessness is unclear.Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score >= 1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex.Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m(2); and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p<0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness.Conclusion: Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.
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| 3. |
- Eriksson, Eva, 1976, et al.
(författare)
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Digital Fabrication by IDAC – Aims, Steps and Transferable Principles
- 2014
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Ingår i: FabLearn Europe 2014.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper aims to present the digital fabrication approach driven by Gothenburg Working group for Interaction Design and Children – IDAC in Sweden. In addition to supporting local makerspace environments, educating teachers, school leaders and politicians, and conducting hacker clubs for children, we suggest including children in special education in a European agenda for digital fabrication at school, and make the maker movement matter for all children. In this paper, we identify three transferable principles for this.
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| 4. |
- Abrahamsson, Niclas, 1976-, et al.
(författare)
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Gastric bypass reduces symptoms and hormonal responses to hypoglycemia
- 2016
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Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 65:9, s. 2667-2675
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Tidskriftsartikel (refereegranskat)abstract
- Gastric bypass (GBP) surgery, one of the most common bariatric procedures, induces weight loss and metabolic effects. The mechanisms are not fully understood, but reduced food intake and effects on gastrointestinal hormones are thought to contribute. We recently observed that GBP patients have lowered glucose levels and frequent asymptomatic hypoglycemic episodes. Here, we subjected patients before and after undergoing GBP surgery to hypoglycemia and examined symptoms and hormonal and autonomic nerve responses. Twelve obese patients without diabetes (8 women, mean age 43.1 years [SD 10.8] and BMI 40.6 kg/m(2) [SD 3.1]) were examined before and 23 weeks (range 19-25) after GBP surgery with hyperinsulinemic-hypoglycemic clamp (stepwise to plasma glucose 2.7 mmol/L). The mean change in Edinburgh Hypoglycemia Score during clamp was attenuated from 10.7 (6.4) before surgery to 5.2 (4.9) after surgery. There were also marked postsurgery reductions in levels of glucagon, cortisol, and catecholamine and the sympathetic nerve responses to hypoglycemia. In addition, growth hormone displayed a delayed response but to a higher peak level. Levels of glucagon-like peptide 1 and gastric inhibitory polypeptide rose during hypoglycemia but rose less postsurgery compared with presurgery. Thus, GBP surgery causes a resetting of glucose homeostasis, which reduces symptoms and neurohormonal responses to hypoglycemia. Further studies should address the underlying mechanisms as well as their impact on the overall metabolic effects of GBP surgery.
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| 5. |
- Abrahamsson, Niclas, 1976-
(författare)
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On the Impact of Bariatric Surgery on Glucose Homeostasis
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Obesity has grown to epidemic proportions, and in lack of efficient life-style and medical treatments, the bariatric surgeries are performed in rising numbers. The most common surgery is the Gastric Bypass (GBP) surgery, with the Biliopancreatic diversion with duodenal switch (DS) as an option for the most extreme cases with a BMI>50 kg/m2.In paper I 20 GBP-patients were examined during the first post-operative year regarding the natriuretic peptide, NT-ProBNP, which is secreted from the cardiac ventricles. Levels of NT-ProBNP quickly increased during the first post-surgery week, and later established itself on a higher level than pre-surgery.In paper II we report of 5 patient-cases after GBP-surgery with severe problems with postprandial hypoglycaemia that were successfully treated with GLP-1-analogs. The effect of treatment could be observed both symptomatically and in some cases using continuous glucose measuring systems (CGMS).In paper III three groups of subjects; 15 post-GBP patients, 15 post-DS, and 15 obese controls were examined for three days using CGMS during everyday life. The post-GBP group had high glucose variability as measured by MAGE and CONGA, whereas the post-DS group had low variability. Both post-operative groups exhibited significant time in hypoglycaemia, about 40 and 80 minutes per day <3.3mmol/l and 20 and 40 minutes < 2.8mmol/l, respectively, longer time for DS-group. Remarkably, only about 20% of these hypoglycaemic episodes were accompanied with symptoms.In Paper IV the hypoglycaemia counter regulatory system was investigated; 12 patients were examined before and after GBP-surgery with a stepped hypoglycaemic hyperinsulinemic clamp. The results show a downregulation of symptoms, counter regulatory hormones (glucagon, cortisol, epinephrine, norepinephrine, growth hormone), incretin hormones (GLP-1 and GIP), and sympathetic nervous response.In conclusion patients post bariatric surgery exhibit a downregulated counter regulatory response to hypoglycaemia, accompanied by frequent asymptomatic hypoglycaemic episodes in everyday life. Patients suffering from severe hypoglycaemic episodes can often be treated successfully with GLP-1-analogues.
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| 6. |
- Almby, Kristina E., et al.
(författare)
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Effects of Gastric Bypass Surgery on the Brain : Simultaneous Assessment of Glucose Uptake, Blood Flow, Neural Activity, and Cognitive Function During Normo- and Hypoglycemia
- 2021
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Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 70:6, s. 1265-1277
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Tidskriftsartikel (refereegranskat)abstract
- While Roux-en-Y gastric bypass (RYGB) surgery in obese individuals typically improves glycemic control and prevents diabetes, it also frequently causes asymptomatic hypoglycemia. Previous work showed attenuated counterregulatory responses following RYGB. The underlying mechanisms as well as the clinical consequences are unclear. In this study, 11 subjects without diabetes with severe obesity were investigated pre- and post-RYGB during hyperinsulinemic normo-hypoglycemic clamps. Assessments were made of hormones, cognitive function, cerebral blood flow by arterial spin labeling, brain glucose metabolism by F-18-fluorodeoxyglucose (FDG) positron emission tomography, and activation of brain networks by functional MRI. Post- versus presurgery, we found a general increase of cerebral blood flow but a decrease of total brain FDG uptake during normoglycemia. During hypoglycemia, there was a marked increase in total brain FDG uptake, and this was similar for post- and presurgery, whereas hypothalamic FDG uptake was reduced during hypoglycemia. During hypoglycemia, attenuated responses of counterregulatory hormones and improvements in cognitive function were seen postsurgery. In early hypoglycemia, there was increased activation post- versus presurgery of neural networks in brain regions implicated in glucose regulation, such as the thalamus and hypothalamus. The results suggest adaptive responses of the brain that contribute to lowering of glycemia following RYGB, and the underlying mechanisms should be further elucidated.
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| 7. |
- Almby, Kristina E., et al.
(författare)
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Effects of GLP-1 on counter-regulatory responses during hypoglycemia after GBP surgery
- 2019
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Ingår i: European Journal of Endocrinology. - : Bioscientifica. - 0804-4643 .- 1479-683X. ; 181:2, s. 161-171
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the study was to explore the role of GLP-1 receptor activation on the counter-regulation and symptoms of hypoglycemia in subjects who have undergone gastric bypass surgery (GBP).Design: Experimental hyperinsulinemic–hypoglycemic clamp study.Methods: Twelve post-GBP subjects participated in a randomized cross-over study with two hyperinsulinemic, hypoglycemic clamps (glucose nadir 2.7 mmol/L) performed on separate days with concomitant infusions of the GLP-1 analog exenatide or with saline, respectively. Continuous measurements of metabolites and counter-regulatory hormones as well as assessments of heart rate variability and symptoms of hypoglycemia were performed throughout the clamps.Results: No effect of GLP-1 receptor activation on counter-regulatory hormones (glucagon, catecholamines, cortisol, GH) or glucose infusion rate was seen, but we found indications of a downregulation of the sympathetic relative to the parasympathetic nerve activity, as reflected in heart rate variability. No significant differences in symptom of hypoglycemia were observed.Conclusions/interpretation: Short-term exposure to a GLP-1 receptor agonist does not seem to impact the counter-regulatory hormonal and metabolic responses in post-GBP subjects during hypoglycemic conditions, suggesting that the improvement in symptomatic hypoglycemia post-GBP seen following treatment with GLP-1 receptor agonists may be mediated by mechanism not directly involved in counter-regulation.
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| 8. |
- Ander, Magnus, et al.
(författare)
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Elchockvapen som hjälpmedel vid polisiära ingripanden : En vetenskaplig utvärdering av Polismyndighetens försöksverksamhet med elchockvapen 2018-2019
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- BAKGRUND: Ur ett internationellt perspektiv har det, inom polisen, under de senaste åren skett en ökning i användandet av mindre dödliga vapen. Dessa vapen används för att ta kontroll över potentiellt farliga och icke samarbetsvilliga personer. Ett vanligt förekommande mindre dödligt vapen är elchockvapen (ECV). Elchockvapen har fram till 2018 inte använts i Sverige, men Polismyndigheten har under åren 2018–2019 genomfört en försöksverksamhet med ECV.SYFTE: Syftet med undersökningen var att utvärdera Polismyndighetens försöksverksamhet med ECV, samt att undersöka vilken legitimitet polisens användning av ECV har bland allmänheten.METOD: Både kvantitativa och kvalitativa data samlades in för att utvärdera försöket med ECV. Mätningar före, under, och i slutet av försöksverksamheten genomfördes med hjälp av en enkät. Enkäten besvarades av två grupper av poliser; en grupp som ingick i försöksverksamheten med ECV samt en kontrollgrupp poliser som inte ingick i försöksverksamheten. För att fördjupa förståelsen för enkätresultaten genomfördes djupintervjuer och fokusgruppsintervjuer med poliser som hade erfarenhet av ECV under försöksverksamheten. För att undersöka legitimitetsaspekter utifrån ett medborgarperspektiv genomfördes fokusgrupper med deltagare från allmänheten. Data från Polisens arbetsskadesystem LISA inhämtades för att undersöka ECV:s inverkan på skador hos poliserna.RESULTAT: Enkätresultaten visade inga skillnader mellan delaktiga och kontrollgrupp när det gäller upplevelse av stressfulla situationer. Upplevelsen av trygghet vid ingripanden med hög grad av motstånd eller när polisen blir fysisk angripen har dock ökat för de poliser som deltagit i ECVförsöket, jämfört med kontrollgruppen. Intervjuresultaten åskådliggör också att tillgången till ECV bidrar till att minska upplevelsen av stress i våldsamma situationer genom att ECV ökar tryggheten i sådana situationer. Intervjuresultaten påvisar även att tillgången till ECV gör att man slipper använda andra potentiellt skadligare våldshjälpmedel såsom fysiska metoder och skjutvapen. Enkätresultatet visar ingen skillnad mellan de som ingick i försöksverksamheten och kontrollgruppen när det gäller att utsättas för hot, våld eller motstånd, eller att polis eller motpart blir skadade. Resultaten från intervjuer och fokusgrupper synliggör att poliserna upplever att ECV fyller en viktig funktion. Poliserna ser enbart fördelar med ECV och vissa menar att det är det bästa verktyg som de har fått. ECV upplevs kunna rädda liv, minska skador på polis och motpart, samt förbättra arbetsmiljön för poliser. Intervjuer och fokusgrupper pekar på att deltagarna upplever att ECV har en deeskalerande inverkan, vilket både kan minska våldsanvändningen, och förebygga våld mot polisen. Enkät och intervjuresultaten indikerar att ECV bidrar till en minskad användning av andra hjälpmedel såsom batong och pepparspray, vilka ofta ger mer skador på både motpart och polis. Deltagarna från allmänheten har uppfattningen att ECV är ett effektivt och bra verktyg för polisen, men lyfter vikten av att det finns en lyhördhet gällande vilka situationer som den används i och mot vem.SLUTSATSER: Utifrån våra enkätresultat är det svårt att dra några säkra slutsatser kring hur användandet av ECV inverkar på skador hos poliser och motpart. Erfarenheterna bland de delaktiga är dock att risken för våld och skador minskar markant, vilket är en viktig indikator. Tillgången till ECV kan öka trygghet och minska stress i ingripandesituationer där kraftigt motstånd och våld förekommer. ECV kan även minska användandet av pepparspray och batong, och det finns indikationer på att ECV har använts istället för skjutvapen. ECV kan underlätta val av hjälpmedel vid ingripanden med hög grad av hot och våld och kan ha en deeskalerande inverkan. Polisens användande av våldshjälpmedel, inklusive ECV, upplevs berättigat av informanterna från allmänheten.
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| 9. |
- Benesch, Henric, 1972, et al.
(författare)
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Ingreppsfestival
- 2010
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Ingår i: Kanaltorgsgatan, Heurlins plats, Stenpiren, Verkstadsgatan (Göteborg).
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- I samband med det forskningsprojektet Ingrepp genomfördes en Ingreppfestival med avseende på att i ett öppet publikt sammanhang diskutera utgångspunkterna forskningsgruppen formulerat i tabloiden Ingrepp – en tidning om städer, planering och konst, vilket delades ut gratis en vecka innan festivalen. I tidningen hittade man läsning kring städer, stadsutveckling, konst och konstnärlig forskning vilken hade bäring på den utvecklingsprocess som pågick och pågår på Södra Älvstranden i Göteborg. Både tabloiden och festivalen var ett direkt uttryck för gruppen vilja att ta ut diskussionen på gatan och i sitt sammanhang, men också ett sätt att pröva konstens och akademins möjligheter att gripa in och delta i samhälleliga skeenden. Festivalen vilken turnerade runt på fyra platser under fyra dagar längs Södra Älvstranden innefattade allt ifrån inbjudna samtal/debatter/seminarier till workshops kring Södra Älvstrandens framtid till tipspromenader, picnics och olika former av performativa iscensättningar under bar himmel.
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| 10. |
- Bengtsson, Johan, 1985, et al.
(författare)
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Metaxa: Automated detection and discrimination among ribosomal small subunit (12S/16S/18S) sequences of archaea, bacteria, eukaryotes, mitochondria, and chloroplasts
- 2011
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Ingår i: SocBiN Bioinformatics Conference, Helsinki, Finland, 2011.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The ribosomal small subunit (SSU) rRNA gene has emerged as an important genetic marker for taxonomic identification in environmental sequencing datasets. However, the gene is not only present in the nuclear genome of eukaryotes and the core genome of prokaryotes, but also in the mitochondria and chloroplasts of eukaryotes. The SSU genes in the core genome, mitochondria and chloroplast are conceptually paralogous and should in most situations not be aligned and analyzed jointly, e.g. when estimating species diversity. Identifying the origin of SSU sequences in complex sequence datasets is a time-consuming and largely manual undertaking. To ease this situation, we have created Metaxa, an automated software tool to extract full-length and partial SSU sequences from larger sequence datasets and assign them to an archaeal, bacte- rial, nuclear eukaryote, mitochondrial, or chloroplast origin. Metaxa very efficiently detects SSU sequences from fragments as short as 200 base pairs, and correctly classifies 97% of the identified genes at read lengths typically obtained from pyrosequencing. In addition, Metaxa shows a false positive rate of 0.00012% when run on random DNA fragments, showing the robustness of the method. We believe that this tool will be useful in microbial and evolutionary ecology as well as in metagenomics.
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