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- Lindholm, Eero, et al.
(författare)
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Diabetic Neuropathy assessed with Multifrequency Vibrometry Develops Earlier than Nephropathy but Later than Retinopathy
- 2023
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Ingår i: Experimental and Clinical Endocrinology & Diabetes. - : Georg Thieme Verlag KG. - 1439-3646 .- 0947-7349. ; 131:4, s. 187-193
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diabetes is associated with systemic complications. Prevalence of diabetic nephropathy, and retinopathy, in type 1 diabetes is declining but it is not known if this is true also for diabetic neuropathy.Aim: To investigate the relationship between large fiber diabetic neuropathy and other diabetic complications.Materials and methods: Neuropathy, defined here as large fiber neuropathy, was assessed by measuring vibration perception thresholds at four different frequencies on the sole of the foot using a standard VibroSense Meter and/or neuropathic symptoms, in 599 type 1 diabetic individuals. Retinopathy status was graded using the International Clinical Disease Severity Scale. Grade of albuminuria and previous history of any macrovascular complications, were registered.Results: Diabetic individuals without retinopathy had similar vibration thresholds as age- and gender-matched control persons without diabetes, whereas those without microalbuminuria had higher thresholds than controls. Two persons out of 599 (0.3%) had microalbuminuria, but not retinopathy or neuropathy, and 12/134 (9%) without retinopathy had signs of neuropathy. Totally 119/536 (22%) of the patients without microalbuminuria had neuropathy. Vibration thresholds increased with rising severity of retinopathy and grade of albuminuria. In a multinomial logistic regression analysis, neuropathy was associated with retinopathy (OR 2.96 [1.35-6.49], p=0.007), nephropathy (OR 6.25 [3.21-12.15]; p=6.7x10-8) and macrovascular disease (OR 2.72 [1.50-4.93], p=0.001).Conclusions: Despite recent changes in the incidence of diabetic complications, the onset of large fiber neuropathy follows that of retinopathy but precedes the onset of nephropathy in type 1 diabetes.
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- Adamson, Carly, et al.
(författare)
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Dapagliflozin for Heart Failure According to Body Mass Index : The DELIVER Trial.
- 2022
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 43:41, s. 4406-4417
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Obesity is common and associated with unique phenotypic features in heart failure with preserved ejection fraction (HFpEF). Therefore, understanding the efficacy and safety of new therapies in HFpEF patients with obesity is important. The effects of dapagliflozin were examined according to body mass index (BMI) among patients in the Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure trial. METHODS AND RESULTS: Body mass index was analysed by World Health Organization (WHO) categories and as a continuous variable using restricted cubic splines. Body mass index ranged from 15.2 to 50 kg/m2 with a mean value of 29.8 (standard deviation +/- 6.1) kg/m2. The proportions, by WHO category, were: normal weight 1343 (21.5%); overweight 2073 (33.1%); Class I obesity 1574 (25.2%); Class II obesity 798 (12.8%); and Class III obesity 415 (6.6%). Compared with placebo, dapagliflozin reduced the risk of the primary outcome to a similar extent across these categories: hazard ratio (95% confidence interval): 0.89 (0.69-1.15), 0.87 (0.70-1.08), 0.74 (0.58-0.93), 0.78 (0.57-1.08), and 0.72 (0.47-1.08), respectively (P-interaction = 0.82). The placebo-corrected change in Kansas City Cardiomyopathy Questionnaire total symptom score with dapagliflozin at 8 months was: 0.9 (-1.1, 2.8), 2.5 (0.8, 4.1), 1.9 (-0.1, 3.8), 2.7 (-0.5, 5.8), and 8.6 (4.0, 13.2) points, respectively (P-interaction = 0.03). The placebo-corrected change in weight at 12 months was: -0.88 (-1.28, -0.47), -0.65 (-1.04, -0.26), -1.42 (-1.89, -0.94), -1.17 (-1.94, -0.40), and -2.50 (-4.4, -0.64) kg (P-interaction = 0.002). CONCLUSIONS: Obesity is common in patients with HFpEF and is associated with higher rates of heart failure hospitalization and worse health status. Treatment with dapagliflozin improves cardiovascular outcomes across the spectrum of BMI, leads to greater symptom improvement in patients with obesity, compared with those without, and has the additional benefit of causing modest weight loss.
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- Amin, Khabat, et al.
(författare)
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Analysis of road safety trends 2020 : Management by objectives for road safety work towards the 2020 interim targets
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The Swedish road safety management is based on the Vision Zero and designated interim targets to track progress towards its achievement. 2020 was the final year for achieving the interim target of halving the number of fatalities between 2007 and 2020, i.e., a maximum of 220 fatalities in 2020. The interim target also specifies that the number of seriously injured in road traffic must be reduced by a quarter. This report describes and analyses the current road safety trends in terms of road safety performance indicators and the numbers of fatalities and seriously injured. As this report is the last for the 2007-2020 interim target period, it can be seen as a final summary of how well the targets were achieved for fatalities and seriously injured and for the safety performance indicators. However, it is also important to remember that the year 2020 coincided with the COVID-19 pandemic, which had a profound impact on virtually the entire society. This affected travel in a number of different ways, and consequently it is impossible to estimate the impact this has had on the outcome in 2020, although it probably has led to a slightly lower outcome. The table below shows starting and final values together with an overview of whether the safety performance indicators have met the 2020 targets.
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- Andersson, Charlotta, et al.
(författare)
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Testbäddar för utveckling av högskolepedagogik i framtidens lärandemijöer
- 2024
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Konferensbidrag (refereegranskat)abstract
- Learning Lab är Akademiska Hus koncept med testbäddar som i nära samverkan med lärosäten utformas för att främja innovation, forskning om och utveckling av framtidens lärandemiljöer. En testbädd utgörs av en fysisk plats där rumsdesign, pedagogik, teknik, m.m ges utrymme att prototypas, utforskas och utvärderas för att generera erfarenheter och kunskaper om våra lärandemiljöer. För närvarande driver Akademiska Hus Learning Lab på tre orter tillsammans med Göteborgs universitet, Umeå universitet och Örebro universitet. Miljöerna är designade med olika fokusområden men med en gemensam inriktning – att utforska samspelet mellan pedagogik, sociala förutsättningar, rum och teknik – i syfte att driva högskolepedagogisk utveckling.Syftet med rundabordssamtalet äratt diskutera hur konceptet med testbäddar kan spridas vidare samtatt dela erfarenheter från testbäddarnas arbete med att arbeta med högskolepedagogisk utveckling och utforskandet av fysiska och hybrida lärandemiljöer samtatt stimulera erfarenhetsutbyte inför gemensamma frågeställningar kring högskolepedagogisk utveckling i skärningspunkt mellan pedagogik, rum & teknikRundabordssamtalet genomförs genom att representanter från respektive Learning Lab tillsammans med projektgruppen från Akademiska hus leder ett samtal om hur vi kan sätta pedagogiken i centrum vid utveckling av lärandemiljöer, hur vi skapar nödvändiga stödstrukturer för lärare som utforskar lärandemiljöer och utmaningarna i samverkan inom och mellan lärosätena.Rundabordssamtalet avslutas genom en gemensam digital dokumentation av deltagarnas samtal som görs tillgänglig för konferensens deltagare genom qr-kod/länk efter rundabordssamtalet.För att uppmuntra till deltagande så synliggörs några frågeställningar som rundabordssamtalet strävar efter att behandla:Learning Lab är ett uttryck för en kontext där högskolepedagogisk utveckling uppmuntras, stöttas och utvärderas. Hur uttrycker sig samma fenomen på andra håll utanför Learning Labs ramar?Vilka samtalsforum finns idag där fokus omfattar didaktisk spatial kompetens?Hur upplevs samverkan/samarbete mellan stödfunktioner som IT, lokalförsörjning m.m. i relation till högskolepedagogisk utveckling vid lärosätet? Mellan lärosäten?Hur ser den idealiska lärmiljön ut för en given undervisningssituation med förankring i min pedagogiska grundsyn?Keywords: aktivt lärande, digitalisering, driva förändring, framtidens lärandemiljöer
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- Andersson, Urban, 1965, et al.
(författare)
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Research.chalmers.se : building the next generation research information infrastructure at Chalmers University of Technology
- 2016
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- research.chalmers.se is the new research infrastructure - repository platform and CRIS - that is currently being developed by the library at Chalmers University of Technology, Sweden.With the aim of eventually becoming the place for all relevant research information at the university, and built in accordance with the principles of UX (User eXperience) and agile development (SCRUM) and with a steady focus on value and continuous deliveries, research.chalmers.se is set to replace most of the current research information infrastructure at the university. It will provide new services for collecting, curating and providing quality data, as well as tools for analysis, sharing and promotion of research output by new and up-to-date means.research.chalmers.se is (or will be)- creating and preserving values - research output and data repository with qualitativedata, researcher profiles, open access.- promoting open access publishing, by proving the value of knowledge sharing, visibilityand impact as a researcher.- collecting and curating all kinds of research information, including publications,research data and information about research projects and other research activities.- built with responsive design that is adapted to current user needs. - using current standards for validity and sustainability, such as ORCID, DOI andFundRef IDs.- providing new ways of exploring and analyzing data, such as altmetrics, open APIs andvisualization tools.In the first phase (starting in 2014) a complete system for handling research project and grant information has been developed, together with integration of the local HR system for persistent and structured data about staff and organisation.In the current phase (2016-) repository services are being developed, such as a new publication database and a new digital repository, along with services for sharing and collecting data.The next phase(s) will include handling of research data, research activities, learning objects and tools for bibliometric analysis.This poster will show some of the current and future features and the principles of UX and agile development, as well as the experiences of moving out of the comfort zone and dealing with new, non-publication related data, while sustaining and enhancing existing data and current services. It will discuss the challenges and possible solutions, when handling different kinds of research information for use and re-use, in the long run enabling the comprehension of the big picture of research at Chalmers University of Technology.
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- Aronson, Torbjörn, et al.
(författare)
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Confessio Augustana : Augsburgska Bekännelsen: Nyöversatt och kommenterad
- 2017
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Confessio Augustana utgavs år 1530 och utgör en av den reformatoriska rörelsens centrala dokument och har även använts som en ekumenisk utgångspunkt. Denna utgåva av Augsburgska bekännelsen är en nyöversättning med kommentarer av Rune Söderlund. Utgåvan innehåller även en parafrasering, av Hans Lindholm, som gör texten ännu mer lättillgänglig. Den svenska texten presenteras parallellt med originaltexten på latin.Augsburgska bekännelsen är en nyöversättning med kommentarer av Rune Söderlund. Utgåvan innehåller även en parafrasering, av Hans Lindholm, som gör texten ännu mer lättillgänglig. Den svenska texten presenteras parallellt med originaltexten på latin.
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9. |
- Bhatt, Ankeet S., et al.
(författare)
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Operational Challenges and Mitigation Measures during the COVID-19 Pandemic-Lessons from DELIVER.
- 2023
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Ingår i: American heart journal. ; 263, s. 133-140
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Catastrophic disruptions in care delivery threaten the operational efficiency and potentially the validity of clinical research efforts, in particular randomized clinical trials. Most recently, the COVID-19 pandemic affected essentially all aspects of care delivery and clinical research conduct. While consensus statements and clinical guidance documents have detailed potential mitigation measures, few real- world experiences detailing clinical trial adaptations to the COVID-19 pandemic exist, particularly among, large, global registrational cardiovascular trials. METHODS: We outline the operational impact of COVID-19 and resultant mitigation measures in the Dapagliflozin Evaluation to Improve the LIVEs of Patients with Preserved Ejection Fraction Heart Failure (DELIVER) trial, one of the largest and most globally diverse experiences with COVID-19 of any cardiovascular clinical trial to date. Specifically, we address the needed coordination between academic investigators, trial leadership, clinical sites, and the supporting sponsor to ensure the safety of participants and trial staff, to maintain the fidelity of trial operations, and to prospectively adapt statistical analyses plans to evaluate the impact of COVID-19 and the pandemic at large on trial participants. These discussions included key operational issues such as ensuring delivery of study medications, adaptations to study visits, enhanced COVID-19 related endpoint adjudication, and protocol and analytical plan revisions. CONCLUSION: Our findings may have important implications for establishing consensus on prospective contingency planning in future clinical trials. CLINICALTRIAL: gov: NCT03619213. CLINICALTRIAL: GOV: NCT03619213.
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10. |
- Butt, Jawad H., et al.
(författare)
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Atrial Fibrillation and Dapagliflozin Efficacy in Patients With Preserved or Mildly Reduced Ejection Fraction.
- 2022
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 80:18, s. 1705-1717
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Atrial fibrillation (AF) is common in heart failure (HF), is associated with worse outcomes compared with sinus rhythm, and may modify the effects of therapy. OBJECTIVES: This study examined the effects of dapagliflozin according to the presence or not of AF in the DELIVER (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure) trial. METHODS: A total of 6,263 patients with HF with New York Heart Association functional class II-IV, left ventricular ejection fraction $>$40%, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomized to dapagliflozin or placebo. Clinical outcomes and the effect of dapagliflozin, according to AF status, were examined. The primary outcome was a composite of cardiovascular death or worsening HF. RESULTS: Of the 6,261 patients with data on baseline AF, 43.3% had no AF, 18.0% had paroxysmal AF, and 38.7% had persistent/permanent AF. The risk of the primary endpoint was higher in patients with AF, especially paroxysmal AF, driven by a higher rate of HF hospitalization: no AF, HF hospitalization rate per 100 person-years (4.5 [95% CI: 4.0-5.1]), paroxysmal AF (7.5 [95% CI: 6.4-8.7]), and persistent/permanent AF (6.4 [95% CI: 5.7-7.1]) (P $<$ 0.001). The benefit of dapagliflozin on the primary outcome was consistent across AF types: no AF, HR: 0.89 (95% CI: 0.74-1.08); paroxysmal AF, HR: 0.75 (95% CI: 0.58-0.97); persistent/permanent AF, HR: 0.79 (95% CI: 0.66-0.95) (Pinteraction = 0.49). Consistent effects were observed for HF hospitalization, cardiovascular death, all-cause mortality, and improvement in the KCCQ- TSS. CONCLUSIONS: In DELIVER, the beneficial effects of dapagliflozin compared with placebo on clinical events and symptoms were consistent, irrespective of type of AF at baseline. (Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure. [DELIVER]; NCT03619213).
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