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Sökning: WFRF:(Dugic A)

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  • Vujasinovic, M, et al. (författare)
  • Risk of Developing Pancreatic Cancer in Patients with Chronic Pancreatitis
  • 2020
  • Ingår i: Journal of clinical medicine. - : MDPI AG. - 2077-0383. ; 9:11
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patients with chronic pancreatitis (CP) have an increased risk of developing pancreatic ductal adenocarcinoma (PDAC). We present data on PDAC in one of the most extensive European single-centre cohort studies of patients with CP. Methods: Retrospective analysis of prospectively collected data of patients with CP was performed. Aetiology of CP was determined according to the M-ANNHEIM classification system and only patients with definite CP > 18 years at data analysis were included. The final dataset included 581 patients with definite CP diagnosed between 2003 and 2018. Results: At CP diagnosis, there were 371 (63.9%) males and 210 (36.1%) females (median age 57 years, range 2–86). During 3423 person-years of observation, six pancreatic cancers were diagnosed (0.2% year). The mean time between diagnosis of CP and the occurrence of PDAC was 5.0 years (range 2.7–8.6). None of the cancer patients had a family history of PDAC. Diabetes mellitus (DM) was present in five of six (83.3%) patients with PDAC: in three patients before and in two after CP diagnosis. Clinical/laboratory signs of pancreatic exocrine insufficiency (PEI) were present in five of six (83.3%) patients with PDAC: in two at diagnosis of CP and in three after diagnosis. The mean survival time was 4 months after the diagnosis of PDAC (range 0.5–13). PDAC occurred significantly more often (p < 0.001) in two groups of patients without previous acute pancreatitis (AP): 2 of 20 patients (10%) with low body mass index (BMI) and PEI and in 3 of 10 (30%) patients with high BMI and DM at diagnosis of CP. Conclusions: Patients with CP have a high risk of developing PDAC, although risk is low in absolute terms. Our data suggest the possibility of defining subgroups of patients with a particularly elevated risk of PDAC. Such a possibility would open a path to personalised decision making on initiation of PDAC surveillance of patients with no previous episode of AP, (i) with low BMI and PEI, or (ii) elevated BMI and DM.
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  • Bagni, Tommaso, et al. (författare)
  • Modeling Results of the Quench Behavior of a Nb-Ti Canted-Cosine-Theta Corrector Magnet for LHC
  • 2024
  • Ingår i: IEEE transactions on applied superconductivity (Print). - : Institute of Electrical and Electronics Engineers (IEEE). - 1051-8223 .- 1558-2515. ; 34:5, s. 1-5
  • Tidskriftsartikel (refereegranskat)abstract
    • A newly designed superconducting magnet of the Canted-Cosine-Theta (CCT) type was developed as a result of a collaboration between Swedish universities (Uppsala and Linneaus) and Swedish industries. This magnet was designed to function as a replacement of the present LHC orbit corrector magnets, which are approaching their end of life due to the radiation load. As a result, the new CCT magnet was developed to be more radiation tolerant and to constitute a one-to-one replacement to the currently installed version, which is a 1 m long 70 mm double aperture dipole magnet. The final magnet, which is currently under construction, will be tested at FREIA laboratory at Uppsala University and generate a magnetic field of 3.3 T and an integrated field of 2.8 Tm at about 85 A. To examine the magnet quench behavior and to identify a suitable quench protection system, the 3D electro-magnetic and thermal behavior of the coil was modeled using the RAT-Raccoon software. Based on the simulation results, a Metrosil varistor was selected to protect the magnet during the test. In this article, we report the results of the numerical analysis. The magnet model is equipped with a spot heater to initialize the quench and the temperature and voltages are monitored during the avalanche effect. The simulated current decay and the hot-spot temperature are analyzed with a focus on the impact of quench-back on the magnet protection.
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  • Bagni, T., et al. (författare)
  • Modeling Results of the Quench Behavior of a Nb-Ti Canted-Cosine-Theta Corrector Magnet for LHC
  • 2024
  • Ingår i: IEEE transactions on applied superconductivity (Print). - : IEEE. - 1051-8223 .- 1558-2515. ; 34:5
  • Tidskriftsartikel (refereegranskat)abstract
    • A newly designed superconducting magnet of the Canted-Cosine-Theta (CCT) type was developed as a result of a collaboration between Swedish universities (Uppsala and Linneaus) and Swedish industries. This magnet was designed to function as a replacement of the present LHC orbit corrector magnets, which are approaching their end of life due to the radiation load. As a result, the new CCT magnet was developed to be more radiation tolerant and to constitute a one-to-one replacement to the currently installed version, which is a 1 m long 70 mm double aperture dipole magnet. The final magnet, which is currently under construction, will be tested at FREIA laboratory at Uppsala University and generate a magnetic field of 3.3 T and an integrated field of 2.8 Tm at about 85 A. To examine the magnet quench behavior and to identify a suitable quench protection system, the 3D electro-magnetic and thermal behavior of the coil was modeled using the RAT-Raccoon software. Based on the simulation results, a Metrosil varistor was selected to protect the magnet during the test. In this article, we report the results of the numerical analysis. The magnet model is equipped with a spot heater to initialize the quench and the temperature and voltages are monitored during the avalanche effect. The simulated current decay and the hot-spot temperature are analyzed with a focus on the impact of quench-back on the magnet protection.
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6.
  • Burra, P, et al. (författare)
  • UEG position paper: Obesity and digestive health
  • 2022
  • Ingår i: United European gastroenterology journal. - : Wiley. - 2050-6414 .- 2050-6406. ; 10:10, s. 1199-1201
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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  • Pepitone, K., et al. (författare)
  • Design and Fabrication of a Canted-Cosine-Theta Double Aperture Orbit Corrector Dipole for the LHC
  • 2023
  • Ingår i: IEEE transactions on applied superconductivity (Print). - : IEEE. - 1051-8223 .- 1558-2515 .- 2378-7074. ; 33:5
  • Tidskriftsartikel (refereegranskat)abstract
    • A prototype CCT dipole magnet developed by a collaboration between Swedish universities, Swedish industry and CERN will be tested at Uppsala University. This 1 m long double-aperture magnet can provide a field strength of 3.3 T at 85 A in a 70 mm aperture with an integrated field of 2.8 Tm. It is intended to replace the current LHC orbit corrector magnets which are reaching the end of their expected life due to the radiation load. The new magnet is designed to handle the radiation dose of the upgrade to the high-luminosity LHC, which will deliver about ten times the current radiation dose. It must therefore be more resistant to radiation and meet strict requirements in terms of electrical insulation while matching the original field quality and self-protective capability, mechanical volume, and maximum excitation current. This paper will present the latest of the design and manufacturing work, including the results of simulations of the mechanical field and the mechanical stress. Details of the various tests performed before machining the parts are also presented.
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9.
  • Pepitone, Kevin, Dr, 1988-, et al. (författare)
  • Design and Fabrication of a Canted-Cosine-Theta Double Aperture Orbit Corrector Dipole for the LHC
  • 2023
  • Ingår i: IEEE transactions on applied superconductivity (Print). - : IEEE. - 1051-8223 .- 1558-2515. ; 33:5
  • Tidskriftsartikel (refereegranskat)abstract
    • A prototype CCT dipole magnet developed by a collaboration between Swedish universities, Swedish industry and CERN will be tested at Uppsala University. This 1 m long double-aperture magnet can provide a field strength of 3.3 T at 85 A in a 70 mm aperture with an integrated field of 2.8 Tm. It is intended to replace the current LHC orbit corrector magnets which are reaching the end of their expected life due to the radiation load. The new magnet is designed to handle the radiation dose of the upgrade to the high-luminosity LHC, which will deliver about ten times the current radiation dose. It must therefore be more resistant to radiation and meet strict requirements in terms of electrical insulation while matching the original field quality and self-protective capability, mechanical volume, and maximum excitation current. This paper will present the latest of the design and manufacturing work, including the results of simulations of the mechanical field and the mechanical stress. Details of the various tests performed before machining the parts are also presented.
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10.
  • Pepitone, Kevin, Dr, 1988-, et al. (författare)
  • Design of a Canted-Cosine-Theta Orbit Corrector for the High Luminosity LHC
  • 2022
  • Ingår i: IEEE transactions on applied superconductivity (Print). - : IEEE. - 1051-8223 .- 1558-2515. ; 32:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The High Luminosity LHC requires dipole orbit correctors grouped in double aperture magnet assemblies. They provide a field of 3.1 T at 100 A in an aperture of 70 mm. The current standard design is a classical cosine-theta layout made with ribbon cable. However, the electric insulation of this cable is not radiation-resistant enough to withstand the radiation load expected in the coming years of LHC operation. A new design, based on a cable with polyimide insulator, that can replace the existing orbit correctors, is needed. The challenge is to design a magnet that fits directly into the existing positions and that can operate with the same busbars, passive quench protection, and power supplies. The new orbit corrector design meets high requirements on the field quality while keeping within the same mechanical volume and maximum excitation current. A collaboration of Swedish universities and Swedish industry has been formed for the development and production of a prototype magnet following a concurrent engineering methodology to reduce the time needed to produce a CCT magnet. The magnet has a 1 m long CCT dipole layout consisting of two coils. The superconductor is a commercially available 0.33 mm wire with polyimide insulation in a 6-around-1 cable. The channels in the coil formers, that determine the CCT layout, allow for 2 x 5 cable layers. A total of 70 windings makes that the coil current can be kept below 100 A. We will present the detailed design and preliminary quench simulations.
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  • Vujasinovic, M, et al. (författare)
  • Vascular Complications in Patients with Chronic Pancreatitis
  • 2021
  • Ingår i: Journal of clinical medicine. - : MDPI AG. - 2077-0383. ; 10:16
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Chronic pancreatitis (CP) is a long-standing progressive inflammation of the pancreas, which can lead to a variety of vascular complications, such as splanchnic venous thrombosis (VT) and arterial pseudoaneurysm (PA). There is a lack of studies on vascular complications in Scandinavian countries. Methods: We performed a retrospective analysis of medical records of patients with CP identified from the Karolinska University Hospital database between 2003 and 2018. A total of 394 patients with definite CP were included in the study. Results: There were 33 patients with vascular complications, with a median age of 62 (IQR 55–72) years. The cumulative incidence of vascular events was 3.2% at 5 years. Thirty patients had isolated VT, whereas three patients had PA (7.6% and 0.8%, respectively). Isolated splenic vein thrombosis was most common (53.3%), followed by a combination with other splanchnic veins. PA was found in the splenic artery in two patients and in the left gastric artery in one patient. Varices were present in three (10%) patients; variceal bleeding was not recorded. All patients had asymptomatic splanchnic VT, most with chronic VT with developed collaterals (83.3% had abdominal collateral vessels). Nearly two-thirds of patients with VT (63.3%) received no treatment, whereas 11 (36.6%) were treated with anticoagulants. Pseudocysts and alcoholic etiology of CP are risk factors for vascular complications. Conclusions: The cumulative incidence of vascular complications was 3.2% at 5 years. Splanchnic VT is more common than PA. Patients were asymptomatic with no variceal bleeding, explained by well-developed collateral vessels and strong study inclusion criteria.
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  • Dugic, A, et al. (författare)
  • The Clinical Utility of Soluble Serum Biomarkers in Autoimmune Pancreatitis: A Systematic Review
  • 2022
  • Ingår i: Biomedicines. - : MDPI AG. - 2227-9059. ; 10:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Autoimmune pancreatitis (AIP) is a rare etiological type of chronic pancreatitis. The clinical and radiological presentation of AIP often resembles that of pancreatic cancer. Identifying non-invasive markers for their early distinction is of utmost importance to avoid unnecessary surgery or a delay in steroid therapy. Thus, this systematic review was conducted to revisit all current evidence on the clinical utility of different serum biomarkers in diagnosing AIP, distinguishing AIP from pancreatic cancer, and predicting disease course, steroid therapy response, and relapse. A systematic review was performed for articles published up to August 2021 by searching electronic databases such as MEDLINE, Web of Science, and EMBASE. Among 5123 identified records, 92 studies were included in the qualitative synthesis. Apart from immunoglobulin (Ig) G4, which was by far the most studied biomarker, we identified autoantibodies against the following: lactoferrin, carboanhydrase II, plasminogen-binding protein, amylase-α2A, cationic (PRSS1) and anionic (PRSS2) trypsinogens, pancreatic secretory trypsin inhibitor (PSTI/SPINK1), and type IV collagen. The identified novel autoantigens were laminin 511, annexin A11, HSP-10, and prohibitin. Other biomarkers included cytokines, decreased complement levels, circulating immune complexes, N-glycan profile changes, aberrant miRNAs expression, decreased IgA and IgM levels, increased IgE levels and/or peripheral eosinophil count, and changes in apolipoprotein isoforms levels. To our knowledge, this is the first systematic review that addresses biomarkers in AIP. Evolving research has recognized numerous biomarkers that could help elucidate the pathophysiological mechanisms of AIP, bringing us closer to AIP diagnosis and its preoperative distinction from pancreatic cancer.
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  • Dugic, Izudin, 1962-, et al. (författare)
  • Metal Expansion Penetration on Concave Casting Surfaces of Grey Cast Iron Cylinder Heads
  • 2010
  • Ingår i: International Foundry Research/Giessereiforschung. - 0046-5933. ; 62:1, s. 38-23
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Cylinder heads have an extremely complex shape withlarge areas of concave casting surfaces. The concavecasting surfaces are often associated with metalexpansion penetration problems or other surfacedefects, e. g. surface shrinkage. The defects cause highproduction costs due to component rejection andincreased fettling time. This report presents aninvestigation of the microstructure in grey cast ironclose to the sand-metal interface affected bymetal penetration in a complex shaped casting.The dominant penetration defect observedin the cylinder heads was expansion penetration.Even pre-solidification penetration and sandcrack defects were observed. The microstructurefound in the non penetrated areas is typicalfor solidification of grey iron cast in sand moulds.
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  • Mellenthin, C, et al. (författare)
  • Risk Factors for Pancreatic Cancer in Patients with New-Onset Diabetes: A Systematic Review and Meta-Analysis
  • 2022
  • Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 14:19
  • Tidskriftsartikel (refereegranskat)abstract
    • (1) Background: Patients with new-onset diabetes (NOD) are at risk of pancreatic ductal adenocarcinoma (PDAC), but the most relevant additional risk factors and clinical characteristics are not well established. (2) Objectives: To compare the risk for PDAC in NOD patients to persons without diabetes. Identify risk factors of PDAC among NOD patients. (3) Methods: Medline, Embase, and Google Scholar were last searched in June 2022 for observational studies on NOD patients and assessing risk factors for developing PDAC. Data were extracted, and Meta-Analysis was performed. Pooled effect sizes with 95% confidence intervals (CI) were estimated with DerSimonian & Laird random effects models. (4) Findings: Twenty-two studies were included, and 576,210 patients with NOD contributed to the analysis, of which 3560 had PDAC. PDAC cases were older than controls by 6.14 years (CI 3.64–8.65, 11 studies). The highest risk of PDAC involved a family history of PDAC (3.78, CI 2.03–7.05, 4 studies), pancreatitis (5.66, CI 2.75–11.66, 9 studies), cholecystitis (2.5, CI 1.4–4.45, 4 studies), weight loss (2.49, CI 1.47–4.22, 4 studies), and high/rapidly increasing glycemia (2.33, CI 1.85–2.95, 4 studies) leading to more insulin use (4.91, CI 1.62–14.86, 5 studies). Smoking (ES 1.20, CI 1.03–1.41, 9 studies) and alcohol (ES 1.23, CI 1.09–1.38, 9 studies) have a smaller effect. (5) Conclusion: Important risk factors for PDAC among NOD patients are age, family history, and gallstones/pancreatitis. Symptoms are weight loss and rapid increase in glycemia. The identified risk factors could be used to develop a diagnostic model to screen NOD patients.
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  • Vujasinovic, M, et al. (författare)
  • Low Bone Mineral Density and Risk for Osteoporotic Fractures in Patients with Chronic Pancreatitis
  • 2021
  • Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 13:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Chronic pancreatitis (CP) can lead to malnutrition, an established risk factor for low bone mineral density (BMD) and fractures. This study aims to determine the prevalence of low BMD, assess fracture incidence and explore risk factors for fractures in patients with CP. Patients and methods: We performed a retrospective analysis of all patients treated for CP at Karolinska University Hospital between January 1999 and December 2020. Electronic medical records were retrieved to assess demographic, laboratory and clinical data. Patients subjected to dual-energy X-ray absorptiometry (DXA) were categorised as either low BMD or normal BMD. We investigated whether the rate of fractures, defined by chart review, differed between these groups using Cox regression, adjusting the model for age, sex and body mass index (BMI). Additional within-group survival analysis was conducted to identify potential risk factors. Results: DXA was performed in 23% of patients with definite CP. Some 118 patients were included in the final analysis. Low BMD was present in 63 (53.4%) patients. Mean age at CP diagnosis in the total cohort was 53.1 years and was significantly lower in patients with normal BMD than in patients with low BMD (45.5 vs. 59.8, p < 0.001). Significant differences were observed in smoking status and disease aetiology, i.e., a higher proportion of patients with low BMD were current or former smokers, with nicotine or alcohol being a more common cause of CP (p < 0.05). Total follow-up time was 898 person-years. Fractures were found in 33 (28.0%) patients: in 5 of 55 patients (16.7%) with normal DXA and in 28 of 63 patients (44.4%) with low BMD (adjusted hazard ratio = 3.4, 95% confidence interval (CI) = 1.2–9.6). Patients with at least 3 months of consecutive pancreatic enzyme replacement therapy (PERT) or vitamin D treatment had a longer median time to fracture after CP diagnosis. Conclusion: DXA was only performed in 23% of patients with definite CP in this study, indicating a low adherence to current European guidelines. A low BMD was found in 53.4% of patients with CP, and 44% of the patients with a low BMD experienced a fracture during follow-up. Moreover, the fracture rate in patients with low BMD increased compared to those with normal BMD.
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