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- Sjöström, Lars, et al.
(författare)
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Bariatric surgery and long-term cardiovascular events.
- 2012
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Ingår i: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598. ; 307:1, s. 56-65
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Tidskriftsartikel (refereegranskat)abstract
- Obesity is a risk factor for cardiovascular events. Weight loss might protect against cardiovascular events, but solid evidence is lacking.
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| 2. |
- Sjöström, Lars, et al.
(författare)
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Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial.
- 2009
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Ingår i: The lancet oncology. - 1474-5488. ; 10:7, s. 653-62
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obesity is a risk factor for cancer. Intentional weight loss in the obese might protect against malignancy, but evidence is limited. To our knowledge, the Swedish Obese Subjects (SOS) study is the first intervention trial in the obese population to provide prospective, controlled cancer-incidence data. METHODS: The SOS study started in 1987 and involved 2010 obese patients (body-mass index [BMI] >or=34 kg/m(2) in men, and >or=38 kg/m(2) in women) who underwent bariatric surgery and 2037 contemporaneously matched obese controls, who received conventional treatment. While the main endpoint of SOS was overall mortality, the main outcome of this exploratory report was cancer incidence until Dec 31, 2005. Cancer follow-up rate was 99.9% and the median follow-up time was 10.9 years (range 0-18.1 years). FINDINGS: Bariatric surgery resulted in a sustained mean weight reduction of 19.9 kg (SD 15.6 kg) over 10 years, whereas the mean weight change in controls was a gain of 1.3 kg (SD 13.7 kg). The number of first-time cancers after inclusion was lower in the surgery group (n=117) than in the control group (n=169; HR 0.67, 95% CI 0.53-0.85, p=0.0009). The sex-treatment interaction p value was 0.054. In women, the number of first-time cancers after inclusion was lower in the surgery group (n=79) than in the control group (n=130; HR 0.58, 0.44-0.77; p=0.0001), whereas there was no effect of surgery in men (38 in the surgery group vs 39 in the control group; HR 0.97, 0.62-1.52; p=0.90). Similar results were obtained after exclusion of all cancer cases during the first 3 years of the intervention. INTERPRETATION: Bariatric surgery was associated with reduced cancer incidence in obese women but not in obese men. FUNDING: Swedish Research Council, Swedish Foundation for Strategic Research, Swedish Federal Government under the LUA/ALF agreement, Hoffmann La Roche, Cederoths, AstraZeneca, Sanofi-Aventis, Ethicon Endosurgery.
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| 3. |
- Sjöström, Lars, et al.
(författare)
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Effects of bariatric surgery on mortality in Swedish obese subjects.
- 2007
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Ingår i: The New England journal of medicine. - 1533-4406. ; 357:8, s. 741-52
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obesity is associated with increased mortality. Weight loss improves cardiovascular risk factors, but no prospective interventional studies have reported whether weight loss decreases overall mortality. In fact, many observational studies suggest that weight reduction is associated with increased mortality. METHODS: The prospective, controlled Swedish Obese Subjects study involved 4047 obese subjects. Of these subjects, 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (matched control group). We report on overall mortality during an average of 10.9 years of follow-up. At the time of the analysis (November 1, 2005), vital status was known for all but three subjects (follow-up rate, 99.9%). RESULTS: The average weight change in control subjects was less than +/-2% during the period of up to 15 years during which weights were recorded. Maximum weight losses in the surgical subgroups were observed after 1 to 2 years: gastric bypass, 32%; vertical-banded gastroplasty, 25%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, 16%, and 14%, respectively. There were 129 deaths in the control group and 101 deaths in the surgery group. The unadjusted overall hazard ratio was 0.76 in the surgery group (P=0.04), as compared with the control group, and the hazard ratio adjusted for sex, age, and risk factors was 0.71 (P=0.01). The most common causes of death were myocardial infarction (control group, 25 subjects; surgery group, 13 subjects) and cancer (control group, 47; surgery group, 29). CONCLUSIONS: Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality.
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| 4. |
- Carlsson, Anna-Lena, 1964-
(författare)
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’’... is it hunger or superabundance that has here become creative?’’ : Nietzsche on Creativity in Art and Life
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Art and the artistic are concepts Friedrich Nietzsche uses in a narrow sense regarding works of art and in a broader sense concerning our lives. He thereby attempts to vitalise the philosophical theme that links life and art. In this dissertation, I suggest that he distinguishes between life-negation and life-affirmation, concerning both the narrow and broader sense of art and the artistic. I firstly approach life-negation and life-affirmation in Nietzsche’s images of life. This part is arranged chronologically and its aim is to present a theme of life-negation and life-affirmation in Nietzsche’s writings and to acknowledge some changes that occur during his production. I consider the Apollonian, the Dionysian and the Socratic type of life and creativity and compare the metaphysical life-affirmation in The Birth of Tragedy with the will to life in Arthur Schopenhauer’s work. I also turn to later images related to life-negation and life-affirmation without the metaphysical perspective from his early thought, for example, the free and the fettered spirit. I moreover address the physiological will to power in Nietzsche’s later writings, in relation to the question of metaphysics and art. I secondly analyse Nietzsche’s notion of art and the artistic in a narrow and a broader sense in association with the theme of a two-fold type of life. This part is arranged thematically and I focus on Nietzsche’s later thought. His emphasis on the perspective of production is demarcated from the aesthetic paradigm that emphasises the reception of art. I then consider Nietzsche’s writings on works of art and the broader sense of art in association with life-negation and life-affirmation. Finally, I compare Nietzsche’s life-affirming type of existence with some contemporary views on the aestheticization of our lives. I suggest that the life-affirming artistic type of being differs in some significant senses from the proposed contemporary aestheticization processes.
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| 5. |
- Ekstrom, Klas, et al.
(författare)
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Tissue IGF-I Measured by Microdialysis Reflects Body Glucose Utilization After rhIGF-I Injection in Type 1 Diabetes
- 2015
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : ENDOCRINE SOC. - 0021-972X .- 1945-7197. ; 100:11, s. 4299-4306
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Tidskriftsartikel (refereegranskat)abstract
- Context: Type 1 diabetes is associated with portal insulin deficiency and disturbances in the GH-IGF axis including low circulating IGF-I and GH hypersecretion. Whether peripheral hyperinsulinemia and GH hypersecretion, which are relevant to the development of vascular complications, result in elevated tissue IGF-I remains unknown. Objective: The purpose of this study was to determine the relationship between whole-body glucose uptake and tissue IGF-I measured by microdialysis. Design: This was a single-blind placebo-controlled crossover study. Setting: The setting was a tertiary pediatric endocrine referral center. Participants: The participants were seven young male adults with type 1 diabetes. Intervention: After an overnight fast, a 6-h lasting euglycemic clamp was performed (constant insulin infusion at 0.5mU/kg x minute and variable glucose infusion rate [GIR]) and a subcutaneous injection of recombinant human (rh) IGF-I (120 mu g/kg) or saline was given after 2 hours. In parallel, tissue IGF-I levels were determined by microdialysis (md-IGF-I). Main Outcome Measures: md-IGF-I levels in muscle and subcutaneous fat, and GIR were determined. Results: md-IGF-I levels were detectable but unchanged after saline. After rhIGF-I, muscle and subcutaneous fat md-IGF-I increased during the second and third hour and then reached a plateau up to 10-fold higher than baseline (P less than .001). GIR was unchanged after saline, whereas it increased 2.5-fold concomitantly with the increase in md-IGF-I (P less than .0001). In contrast, serum IGF-I was increased already at 30 minutes after rhIGF-I and reached a plateau 2-fold above baseline (P less than .0001). Conclusion: We demonstrate that md-IGF-I measurements are valid and physiologically relevant by reflecting rhIGF-I-induced glucose uptake. Future studies should be conducted to elucidate the role of local tissue IGF-I in diabetic vascular complications.
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| 6. |
- Sjödin, Carina, 1964-
(författare)
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User-involved service innovation : Three participating perspectives on co-creation
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The involvement of customers and other stakeholders in the innovation process is proposed to be a key success factor and something that makes companies more competitive. As a consequence, more and more organizations alter their innovation strategy accordingly. In order for a company to open up innovation processes, it is vital to foster a practice where there is openness for external ideas and knowledge. However, when external ideas meet internal innovation practices complex organizational situations appear. Creativity, for example, involves co-dependence of other persons’ strategies and actions. New roles for those involved affect hierarchies and knowledge sharing opportunities.This thesis involves three different perspectives of the same process provides an opportunity to study both individual and structural challenges. This research aims to identify on-going challenges for an organization during the transformational processes that adjustment from a traditional product innovation structure to an open service innovation culture implies. This qualitative case study involves two main cases and three supporting cases and aims to understand how users and other external parties, top management and middle managers experience open innovation processes. The results describe interactions between organizations and users or external stakeholders as well as internal interactions within the organization. Top management were dedicated to the idea of increased openness, but detected structural issues to deal with in order to implement user involved innovation. Among middle management, some individual aspects such as attitudes and relational issues matter, as well as organizational structures and practices. Users had mixed opinions about their participation in the process. Favorable experiences, such as benevolence and deepened relationships, were balanced by un-favorable experiences such as incapability and intrusion. Different dimensions of openness regarding open innovation practice are discussed. In this work a relational focus is emphasized. The findings assist managers in their work to create conditions for open innovation. Managers can benefit from this research by getting a better understanding of how different stakeholders’ experience co-creation of value. This is relevant for innovation managers in the process of redesigning innovation processes to understand different aspects of the interactions involved.
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