| 1. |
- Ludvigsson, Johnny, et al.
(författare)
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GAD65 antigen therapy in recently diagnosed type 1 diabetes mellitus
- 2012
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Ingår i: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 366:5, s. 433-442
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The 65-kD isoform of glutamic acid decarboxylase (GAD65) is a major autoantigen in type 1 diabetes. We hypothesized that alum-formulated GAD65 (GAD-alum) can preserve beta-cell function in patients with recent-onset type 1 diabetes.METHODS: We studied 334 patients, 10 to 20 years of age, with type 1 diabetes, fasting C-peptide levels of more than 0.3 ng per milliliter (0.1 nmol per liter), and detectable serum GAD65 autoantibodies. Within 3 months after diagnosis, patients were randomly assigned to receive one of three study treatments: four doses of GAD-alum, two doses of GAD-alum followed by two doses of placebo, or four doses of placebo. The primary outcome was the change in the stimulated serum C-peptide level (after a mixed-meal tolerance test) between the baseline visit and the 15-month visit. Secondary outcomes included the glycated hemoglobin level, mean daily insulin dose, rate of hypoglycemia, and fasting and maximum stimulated C-peptide levels.RESULTS: The stimulated C-peptide level declined to a similar degree in all study groups, and the primary outcome at 15 months did not differ significantly between the combined active-drug groups and the placebo group (P=0.10). The use of GAD-alum as compared with placebo did not affect the insulin dose, glycated hemoglobin level, or hypoglycemia rate. Adverse events were infrequent and mild in the three groups, with no significant differences.CONCLUSIONS: Treatment with GAD-alum did not significantly reduce the loss of stimulated C peptide or improve clinical outcomes over a 15-month period.
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| 2. |
- Gyllenberg, A, et al.
(författare)
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Age-dependent variation of genotypes in MHC II transactivator gene (CIITA) in controls and association to type 1 diabetes
- 2012
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Ingår i: Genes and Immunity. - Stockholm : Springer Science and Business Media LLC. - 1476-5470 .- 1466-4879. ; 76:2, s. 202-203
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Tidskriftsartikel (refereegranskat)abstract
- The major histocompatibility complex class II transactivator (CIITA) gene (16p13) has been reported to associate with susceptibility to multiple sclerosis, rheumatoid arthritis and myocardial infarction, recently also to celiac disease at genome-wide level. However, attempts to replicate association have been inconclusive. Previously, we have observed linkage to the CIITA region in Scandinavian type 1 diabetes (T1D) families. Here we analyze five Swedish T1D cohorts and a combined control material from previous studies of CIITA. We investigate how the genotype distribution within the CIITA gene varies depending on age, and the association to T1D. Unexpectedly, we find a significant difference in the genotype distribution for markers in CIITA (rs11074932, P=4 × 10(-5) and rs3087456, P=0.05) with respect to age, in the collected control material. This observation is replicated in an independent cohort material of about 2000 individuals (P=0.006, P=0.007). We also detect association to T1D for both markers, rs11074932 (P=0.004) and rs3087456 (P=0.001), after adjusting for age at sampling. The association remains independent of the adjacent T1D risk gene CLEC16A. Our results indicate an age-dependent variation in CIITA allele frequencies, a finding of relevance for the contrasting outcomes of previously published association studies.
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| 3. |
- Mak, Jonathan K. L., et al.
(författare)
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Development of an Electronic Frailty Index for Hospitalized Older Adults in Sweden
- 2022
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Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press. - 1079-5006 .- 1758-535X. ; 77:11, s. 2311-2319
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Tidskriftsartikel (refereegranskat)abstract
- Background Frailty assessment in the Swedish health system relies on the Clinical Frailty Scale (CFS), but it requires training, in-person evaluation, and is often missing in medical records. We aimed to develop an electronic frailty index (eFI) from routinely collected electronic health records (EHRs) and assess its association with adverse outcomes in hospitalized older adults. Methods EHRs were extracted for 18 225 patients with unplanned admissions between 1 March 2020 and 17 June 2021 from 9 geriatric clinics in Stockholm, Sweden. A 48-item eFI was constructed using diagnostic codes, functioning and other health indicators, and laboratory data. The CFS, Hospital Frailty Risk Score, and Charlson Comorbidity Index were used for comparative assessment of the eFI. We modeled in-hospital mortality and 30-day readmission using logistic regression; 30-day and 6-month mortality using Cox regression; and length of stay using linear regression. Results Thirteen thousand one hundred and eighty-eight patients were included in analyses (mean age 83.1 years). A 0.03 increment in the eFI was associated with higher risks of in-hospital (odds ratio: 1.65; 95% confidence interval: 1.54-1.78), 30-day (hazard ratio [HR]: 1.43; 1.38-1.48), and 6-month mortality (HR: 1.34; 1.31-1.37) adjusted for age and sex. Of the frailty and comorbidity measures, the eFI had the highest area under receiver operating characteristic curve for in-hospital mortality of 0.813. Higher eFI was associated with longer length of stay, but had a rather poor discrimination for 30-day readmission. Conclusions An EHR-based eFI has robust associations with adverse outcomes, suggesting that it can be used in risk stratification in hospitalized older adults.
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| 4. |
- Mak, Jonathan K. L., et al.
(författare)
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Two Years with COVID-19 : The Electronic Frailty Index Identifies High-Risk Patients in the Stockholm GeroCovid Study
- 2023
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Ingår i: Gerontology. - : S. Karger. - 0304-324X .- 1423-0003. ; 69:4, s. 396-405
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Frailty, a measure of biological aging, has been linked to worse COVID-19 outcomes. However, as the mortality differs across the COVID-19 waves, it is less clear whether a medical record-based electronic frailty index (eFI) that we have previously developed for older adults could be used for risk stratification in hospitalized COVID-19 patients. Objectives: The aim of the study was to examine the association of frailty with mortality, readmission, and length of stay in older COVID-19 patients and to compare the predictive accuracy of the eFI to other frailty and comorbidity measures. Methods: This was a retrospective cohort study using electronic health records (EHRs) from nine geriatric clinics in Stockholm, Sweden, comprising 3,980 COVID-19 patients (mean age 81.6 years) admitted between March 2020 and March 2022. Frailty was assessed using a 48-item eFI developed for Swedish geriatric patients, the Clinical Frailty Scale, and the Hospital Frailty Risk Score. Comorbidity was measured using the Charlson Comorbidity Index. We analyzed in-hospital mortality and 30-day readmission using logistic regression, 30-day and 6-month mortality using Cox regression, and the length of stay using linear regression. Predictive accuracy of the logistic regression and Cox models was evaluated by area under the receiver operating characteristic curve (AUC) and Harrell's C-statistic, respectively. Results: Across the study period, the in-hospital mortality rate decreased from 13.9% in the first wave to 3.6% in the latest (Omicron) wave. Controlling for age and sex, a 10% increment in the eFI was significantly associated with higher risks of in-hospital mortality (odds ratio = 2.95; 95% confidence interval = 2.42-3.62), 30-day mortality (hazard ratio [HR] = 2.39; 2.08-2.74), 6-month mortality (HR = 2.29; 2.04-2.56), and a longer length of stay (beta-coefficient = 2.00; 1.65-2.34) but not with 30-day readmission. The association between the eFI and in-hospital mortality remained robust across the waves, even after the vaccination rollout. Among all measures, the eFI had the best discrimination for in-hospital (AUC = 0.780), 30-day (Harrell's C = 0.733), and 6-month mortality (Harrell's C = 0.719). Conclusion: An eFI based on routinely collected EHRs can be applied in identifying high-risk older COVID-19 patients during the continuing pandemic.
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| 5. |
- Aad, G., et al.
(författare)
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Measurement of the H→ γγ and H→ ZZ∗→ 4 ℓ cross-sections in pp collisions at √s=13.6 TeV with the ATLAS detector
- 2024
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Ingår i: European Physical Journal C. - : Institute for Ionics. - 1434-6044 .- 1434-6052. ; 84:1
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Tidskriftsartikel (refereegranskat)abstract
- The inclusive Higgs boson production cross-section is measured in the di-photon and the ZZ∗→ 4 ℓ decay channels using 31.4 and 29.0 fb - 1 of pp collision data respectively, collected with the ATLAS detector at a centre-of-mass energy of s=13.6 TeV . To reduce the model dependence, the measurement in each channel is restricted to a particle-level phase space that closely matches the channel’s detector-level kinematic selection, and it is corrected for detector effects. These measured fiducial cross-sections are σfid,γγ= 76-13+14 fb, and σfid,4ℓ= 2.80±0.74 fb, in agreement with the corresponding Standard Model predictions of 67.6 ± 3.7 fb and 3.67 ± 0.19 fb. Assuming Standard Model acceptances and branching fractions for the two channels, the fiducial measurements are extrapolated to the full phase space yielding total cross-sections of σ(pp→H)=67-11+12 pb and 46 ± 12 pb at 13.6 TeV from the di-photon and ZZ∗→ 4 ℓ measurements respectively. The two measurements are combined into a total cross-section measurement of σ(pp→ H) = 58.2 ± 8.7 pb, to be compared with the Standard Model prediction of σ(pp→ H) SM= 59.9 ± 2.6 pb.
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| 6. |
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Africa's return migrants : the new developers?
- 2015
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Samlingsverk (redaktörskap) (refereegranskat)abstract
- Many African migrants residing abroad nurture a hope to one day return, at least temporarily, to their home country. In the wake of economic crises in the developed world, alongside rapid economic growth in parts of Africa, the impetus to 'return' is likely to increase. Such returnees are often portrayed as agents of development, bringing with them capital, knowledge and skills as well as connections and experience gained abroad. Yet, the reality is altogether more complex.In this much-needed volume, based on extensive original fieldwork, the authors reveal that there is all too often a gaping divide between abstract policy assumptions and migrants' actual practices. In contrast to the prevailing optimism of policies on migration and development, Africa's Return Migrants demonstrates that the capital obtained abroad is not always advantageous and that it can even hamper successful entrepreneurship and other forms of economic, political and social engagement.
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| 7. |
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| 8. |
- Akram, Asif, 1978-, et al.
(författare)
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A Research Framework to Study how Digital Service Innovation Transforms Value Networks
- 2011
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Ingår i: Proceedings of IRIS 2011. - Turku, Finland : Turku Center for Computer Science. - 9789521226489 ; , s. 29-40
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Konferensbidrag (refereegranskat)abstract
- This paper reports from preparations in an ongoing research study concerning how digital service innovation transforms value networks in manufacturing industries. The research study is in the context of the vehicle industry and concerns digital e-maintenance services based on remote diagnostics systems. This digital service innovation in particular is of great importance since manufacturing industries have great potential to expand their business and found new and extended boundaries and relationships with other stakeholder in a network they are attached to. Core challenges and opportunities for digital service innovation will lead us to the study of its influence on the business and innovation environment i.e. the value network. This paper presents a framework to study how digital service innovation transforms value networks based on literature reviews on value network, digital innovation and transformation of value networks.
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| 9. |
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| 10. |
- Akram, Asif, 1978-, et al.
(författare)
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Digital Visions vs. Product Practices : Understanding Tensions in Incumbent Manufacturing Firms
- 2014
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Ingår i: Proceedings of the Annual Hawaii International Conference on System Sciences. - Los Alamitos, CA : IEEE Computer Society. - 9781479925049 - 9781479925056 ; , s. 4516-4525
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Konferensbidrag (refereegranskat)abstract
- Incumbent manufacturing firms face challenges when expanding their product focus with digital services. Such expansion creates tensions in organizations in the servitization process. While management visions and conceptualizes new service oriented businesses, the actual practice of implementing these service concepts is influenced by the product paradigmatic way of thinking in the organization. This dominant thinking creates tensions between business visions and business practice. We use the case of remote diagnostics services to provide insights into a manufacturing firm’s attempt to transform the dominant oriented business models into a new networked environment. We suggest that such acts that may or may not lead to transition are lingered by dominant logics related to the product focus. This indicates that firms are required to embed new logics into their existing practice in order to exploit the full potential of digital technology. © 2014 IEEE.
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