| 1. |
- Naeser, Ylva, et al.
(författare)
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TRIM study protocol - a prospective randomized multicenter Trial to assess the Role of Imaging during follow-up after radical surgery of stage IIB-C and III cutaneous malignant Melanoma
- 2020
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe incidence of cutaneous malignant melanoma (CMM) is increasing worldwide. In Sweden, over 4600 cases were diagnosed in 2018. The prognosis after radical surgery varies considerably with tumor stage. In recent years, new treatment options have become available for metastatic CMM. Early onset of treatment seems to improve outcome, which suggests that early detection of recurrent disease should be beneficial. Consequently, in several countries imaging is a part of the routine follow-up program after surgery of high risk CMM. However, imaging has drawbacks, including resources required (costs, personnel, equipment) and the radiation exposure. Furthermore, many patients experience anxiety in waiting for the imaging results and investigations of irrelevant findings is another factor that also could cause worry and lead to decreased quality of life. Hence, the impact of imaging in this setting is important to address and no randomized study has previously been conducted. The Swedish national guidelines stipulate follow-up for 3years by clinical examinations only.MethodsThe TRIM study is a prospective randomized multicenter trial evaluating the potential benefit of imaging and blood tests during follow-up after radical surgery for high-risk CMM, compared to clinical examinations only. Primary endpoint is overall survival (OS) at 5years. Secondary endpoints are survival from diagnosis of relapse and health-related quality of life (HRQoL). Eligible for inclusion are patients radically operated for CMM stage IIB-C or III with sufficient renal function for iv contrast-enhanced CT and who are expected to be fit for treatment in case of recurrence. The planned number of patients is >1300. Patients are randomized to clinical examinations for 3years +/- whole-body imaging with CT or FDG-PET/CT and laboratory tests including S100B protein and LDH. This academic study is supported by the Swedish Melanoma Study Group.DiscussionThis is the first randomized prospective trial on the potential benefit of imaging as a part of the follow-up scheme after radical surgery for high-risk CMM.ResultsThe first patient was recruited in June 2017 and as of April 2020, almost 500 patients had been included at 19 centers in Sweden.Trial registrationClinicalTrials.gov, NCT 03116412. Registered 17 April 2017, https://clinicaltrials.gov/ct2/show/study/NCT03116412
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| 2. |
- Sundström, Johan, Professor, 1971-, et al.
(författare)
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A registry-based randomised trial comparing an SGLT2 inhibitor and metformin as standard treatment of early stage type 2 diabetes (SMARTEST): Rationale, design and protocol
- 2021
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Ingår i: Journal of Diabetes and Its Complications. - : Elsevier BV. - 1056-8727 .- 1873-460X. ; 35:10
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Tidskriftsartikel (refereegranskat)abstract
- Aim: SGLT2 inhibitors have been shown to reduce cardiovascular and renal complications in type 2 diabetes (T2D) patients at high cardiovascular risk. Metformin is currently widely used as initial monotherapy in T2D but lacks convincing data to show that it reduces risk of complications. We aim to compare the SGLT2 inhibitor dapagliflozin and metformin as first-line T2D medication with regard to development of complications in a registry-based randomised controlled trial. Methods: The SGLT2 inhibitor or metformin as standard treatment of early stage type 2 diabetes (SMARTEST) trial will enrol 4300 subjects at 30-40 study sites in Sweden who will be randomised 1:1 to either metformin or dapagliflozin. Participants must have T2D duration <4 years, no prior cardiovascular disease, and be either drug-naive or on monotherapy for T2D. Results: The primary endpoint is a composite of all-cause death, major adverse cardiovascular events and occurrence or progression of microvascular complications (retinopathy, nephropathy, diabetic foot lesions). Secondary endpoints include individual components of the primary endpoint, start of insulin therapy, risk factor biomarkers, patient-reported outcome measures, and cost-effectiveness analysis. Outcomes will primarily be assessed using nationwide healthcare registries. Conclusions: The SMARTEST trial will investigate whether dapagliflozin is superior to metformin in preventing complications in early stage T2D. (Clinicaltrials.gov identifier NCT03982381, EudraCT 2019-001046-17).
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| 3. |
- Sundström, Johan, Professor, 1971-, et al.
(författare)
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Weight gain and blood pressure
- 2020
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Ingår i: Journal of Hypertension. - : Lippincott Williams & Wilkins. - 0263-6352 .- 1473-5598. ; 38:3, s. 387-394
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Although the causality of the obesity—hypertension association is established, the potential for prevention is not. We hypothesized that weight gain between early adulthood and mid-life is associated with higher mid-life blood pressure.METHODS: We investigated the hypothesis using a large contemporaneous population-based mid-life cohort of men and women aged 50-64 years. Recalled body weight at age 20 years was self-reported, and mid-life body weight and office blood pressures were measured in accordance with a detailed protocol.RESULTS: On average, men had gained 14.9 (95% CI 14.6-15.2) kg of weight, and women 14.6 (95% CI 14.4-14.9) kg, between age 20 years and the mid-life examination, corresponding to 0.40 (95% CI 0.39-0.41) kg/year for men and women. Both weight at age 20 years and weight at the mid-life examination were associated with mid-life blood pressures. On average, a 10 kg weight increase between age 20 years and mid-life was associated with 2.2 (95% CI 0.9-3.5) mmHg higher systolic and 1.7 (95% CI 0.9-2.5) mmHg higher diastolic mid-life blood pressure in men, and 3.2 (2.5-4.0) mmHg higher systolic and 2.4 (1.9-2.9) mmHg higher diastolic mid-life blood pressure in women. Mid-life weight was more closely associated than weight at age 20 years with mid-life blood pressure. For a given mid-life weight, blood pressure was higher in persons with higher weight gain from age 20 years.CONCLUSION: In sum, weight gain between early adulthood and mid-life was associated with higher mid-life blood pressure. The magnitude of the association indicates a potentially great public health impact of strategies to prevent weight gain throughout adulthood.
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| 4. |
- Andersson, Peter, 1981-, et al.
(författare)
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Simulation of the response of a segmented High-Purity Germanium detector for gamma emission tomography of nuclear fuel
- 2020
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Ingår i: SN Applied Sciences. - : Springer. - 2523-3963 .- 2523-3971. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Irradiation testing of nuclear fuel is routinely performed in nuclear test reactors. For qualification and licensing of Accident Tolerant Fuels or Generation IV reactor fuels, an extensive increase in irradiation testing is foreseen in order to fill the gaps of existing validation data, both in normal operational conditions and in order to identify operational limits.Gamma Emission Tomography (GET) has been demonstrated as a viable technique for studies of the behavior of irradiated nuclear fuel, e.g. measurement of fission gas release and inspection of fuel behavior under Loss-Of-Coolant Accident conditions. In this work, the aim is to improve the technique of GET for irradiated nuclear fuel by developing a detector concept for an improved tomography system that allows for a higher spatial resolution and/or faster interrogation.We present the working principles of a novel concept for gamma emission tomography using a segmented High Purity Germanium (HPGe) detector. The performance of this concept was investigated using the Monte Carlo particle transport code MCNP. In particular, the data analysis of the proposed detector was evaluated, and the performance, in terms of full energy efficiency and localization failure rate, has been evaluated.We concluded that the segmented HPGe detector has an advantageous performance as compared to the traditional single-channel detector systems. Due to the scattering nature of gamma rays, a trade-off is presented between efficiency and cross-talk; however, the performance is nevertheless a substantial improvement over the currently used single-channel HPGe detector systems.
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| 5. |
- Bengtsson, Stina, 1971-, et al.
(författare)
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Media and basic desires : An approach to measuring the mediatization of daily human life
- 2021
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Ingår i: Communications. - : Mouton de Gruyter. - 0341-2059 .- 1613-4087. ; 46:2, s. 275-296
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Tidskriftsartikel (refereegranskat)abstract
- The extended reliance on media can be seen as one indicator of mediatization. But even though we can assume that the pervasive character of digital media essentially changes the way people experience everyday life, we cannot take these experiences for granted. There has recently been a formulation of three tasks for mediatization research; historicity, specificity and measurability, needed to empirically verify mediatization processes across time and space. In this article, we present a tool designed to handle these tasks, by measuring the extent to which people experience that media reach into the deeper layers of daily human life. The tool was tested in an empirical study conducted in Sweden in 2017. The results show that perceived media reliance is played out in relation to three types of basic desires: (1) (re)productive desires, (2) recognition desires, and (3) civic desires, and is socially structured and structuring. We argue this tool, in diachronic analyses, can measure one important aspect of mediatization.
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| 6. |
- Bennet, Louise, et al.
(författare)
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Mortality in first- and second-generation immigrants to Sweden diagnosed with type 2 diabetes : a 10 year nationwide cohort study
- 2021
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Ingår i: Diabetologia. - : Springer. - 0012-186X .- 1432-0428. ; 64:1, s. 95-108
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis: Non-Western immigrants to Europe are at high risk for type 2 diabetes. In this nationwide study including incident cases of type 2 diabetes, the aim was to compare all-cause mortality (ACM) and cause-specific mortality (CSM) rates in first- and second-generation immigrants with native Swedes.Methods: People living in Sweden diagnosed with new-onset pharmacologically treated type 2 diabetes between 2006 and 2012 were identified through the Swedish Prescribed Drug Register. They were followed until 31 December 2016 for ACM and until 31 December 2012 for CSM. Analyses were adjusted for age at diagnosis, sex, socioeconomic status, education, treatment and region. Associations were assessed using Cox regression analysis.Results: In total, 138,085 individuals were diagnosed with type 2 diabetes between 2006 and 2012 and fulfilled inclusion criteria. Of these, 102,163 (74.0%) were native Swedes, 28,819 (20.9%) were first-generation immigrants and 7103 (5.1%) were second-generation immigrants with either one or both parents born outside Sweden. First-generation immigrants had lower ACM rate (HR 0.80 [95% CI 0.76, 0.84]) compared with native Swedes. The mortality rates were particularly low in people born in non-Western regions (0.46 [0.42, 0.50]; the Middle East, 0.41 [0.36, 0.47]; Asia, 0.53 [0.43, 0.66]; Africa, 0.47 [0.38, 0.59]; and Latin America, 0.53 [0.42, 0.68]). ACM rates decreased with older age at migration and shorter stay in Sweden. Compared with native Swedes, first-generation immigrants with <= 24 years in Sweden (0.55 [0.51, 0.60]) displayed lower ACM rates than those spending >24 years in Sweden (0.92 [0.87, 0.97]). Second-generation immigrants did not have better survival rates than native Swedes but rather displayed higher ACM rates for people with both parents born abroad (1.28 [1.05, 1.56]).Conclusions/interpretation: In people with type 2 diabetes, the lower mortality rate in first-generation non-Western immigrants compared with native Swedes was reduced over time and was equalised in second-generation immigrants. These findings suggest that acculturation to Western culture may impact ACM and CSM in immigrants with type 2 diabetes but further investigation is needed.
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| 7. |
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Culture, Creativity and Economy : Collaborative Practices, Value Creation and Spaces of Creativity
- 2021
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Samlingsverk (redaktörskap) (refereegranskat)abstract
- This book nuances our understanding of the contemporary creative economy by engaging with a set of three key tensions which emerged over the course of eight European Colloquiums on Culture, Creativity and Economy (CCE): 1) the tension between individual and collaborative creative practices, 2) the tension between tradition and innovation, and 3) the tension between isolated and interconnected spaces of creativity.Rather than focusing on specific processes, such as production, industries or locations, the tensions acknowledge and engage with the messy and restless nature of the creative economy. Individual chapters offer insights into poorly understood practices, locations and contexts such as co-working spaces in Berlin and rural Spain, creative businesses in Leicester and the role and importance of cultural intermediaries in creative economies within Africa. Others examine the nature of trans-local cultural flows, the evolving "field" of fashion, and the implications of social media and crowdfunding platforms.This book will be of interest to students, scholars and professionals researching the creative economy, as well as specific cultural and creative industries, across the humanities and social sciences.
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| 8. |
- Drott, Carl Johan, 1984-
(författare)
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Influence of Islet-derived Factors in Islet Microcirculation and Endocrine Function
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Diabetes mellitus is a disorder with complex pathology and is frequently associated with vascular complications. In the islet micro milieu locally generated factors may affect both the physiology and the morphology of the tissue. This thesis examines the impact of four different islet-derived factors; thrombospondin-1 (TSP-1), ghrelin, Cocaine and amphetamine regulated transcript (CART) and irisin, and how they influence the endocrine pancreas.TSP-1 is an angiogenesis inhibitor. Islets from TSP-1 deficient mice were hypervascular, but with normal endocrine mass. Beta-cell dysfunction was present in islets of TSP-1 deficient mice, both in vivo and in vitro. When trying to reconstitute TSP-1 in islets of TSP-1 deficient animals through a transplantation model, adult islets failed to recover, showing the importance of TSP-1 for glucose stimulated insulin secretion and thereby glucose homeostasis.Ghrelin inhibited glucose stimulated insulin secretion and decreased the islet blood flow, while the ghrelin receptor antagonist GHRP-6 in fasted, but not fed, rats increased the islet blood flow fourfold and improved the peak insulin response to glucose. The ghrelin receptor GHS-R1α was identified in the alpha cells and the islet arterioles.CART selectively reduced the islet blood flow in the pancreas, and this effect was unaltered by simultaneous administration of an endothelin-A receptor antagonist. CART administration did not affect insulin release, neither in insulin release from isolated islets or in an intravenous glucose tolerance test. Irisin was confirmed located within the pancreatic islets predominately in the alpha-cells. Irisin reduced islet and white adipose tissue blood flow. Irisin was secreted as a response to increased glucose concentrations in vivo. Irisin had no direct effect on insulin secretion.In conclusion, all factors investigated proved to have roles locally in the endocrine pancreas. TSP-1 deficiency caused vascular morphological alterations, and chronic β-cell dysfunction. Ghrelin, CART and irisin all decreased islet blood flow. Ghrelin acted directly through its receptor GHS-R1α in islet arterioles, thereby restricting the insulin response to hyperglycemia, whereas for CART and irisin the specific mechanism continues to be unknown, without identification of a receptor. In order to reach full physiological understanding, the receptors for CART and irisin need to be identified. All four islet-derived factors hold potential for the treatment of type 2 diabetes.
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| 9. |
- Ekström, Ylva, 1971-, et al.
(författare)
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En studie om att leda digitala transformationer i komplexa verksamheter : Institutionella normer, fysiska rum och digitala verktyg
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Föreliggande rapport sammanfattar forskningsprojektet “Att leda digital transformation av fysiska rum” som genomförts av forskare vid Uppsala universitet i samverkan med tre partnerorganisationer: Uppsala stadsteater, Svenska Kyrkan, och en nordeuropeisk finanskoncern med huvudkontor i Sverige; projektet samfinansierades av Vinnova under åren 2019-2020. Projektets syfte var att utveckla kunskap om, och verktyg för förståelse av, hur det fysiska rummet och dess digitalisering påverkar interaktionen mellan aktörer bland annat med avseende på kommunikation, tillit och legitimitet. Projektet har genomförts som en komparativ studie av dessa tre tämligen skilda organisationer, som kommit olika långt i relation till digital transformation av deras respektive verksamheter. Forskarna har genomfört intervjuer och observationer på de tre partnerorganisationerna samt gemensamma och organisations-överskridande diskussioner och analyser vid ett flertal workshoppar, där såväl forskare som representanter från partnerorganisationerna deltagit. Rapporten presenterar resultat i form av beskrivningar av specifika situationer i respektive partnerorganisation med betoning på digitaliseringsprocesser med direkt inverkan på det fysiska rummet och de utmaningar som detta leder till. Vidare presenteras analyser och insikter i relation till utmaningarna som digitaliseringen kan ge upphov till och generella, normativa rekommendationer för att vägleda organisationer genom digitala transformationsprocesser. I analysen har framför allt institutionella logiker tillämpats som teoretiskt perspektiv. Studien påvisar betydelsen som de fysiska platserna (t.ex. kontor, scen) utgör för skilda verksamheter, och att användningen av digitala verktyg med syfte att eliminera användningen av fysiska platser kan ge upphov till oförutsedda konsekvenser.
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| 10. |
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