| 1. |
- Akerblom, H., et al.
(författare)
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Association of Gastric Bypass Surgery With Risk of Developing Diabetic Retinopathy Among Patients With Obesity and Type 2 Diabetes in Sweden: An Observational Study
- 2021
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Ingår i: Jama Ophthalmology. - : American Medical Association (AMA). - 2168-6165 .- 2168-6173. ; 139:2, s. 200-205
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. OBJECTIVE To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have not undergone GBP. DESIGN, SETTING, AND PARTICIPANTS Data from 2 nationwide registers in Sweden, the Scandinavian Obesity Surgery Registry and the National Diabetes Register, were used for this cohort study. A total of 5321 patients with diabetes from the Scandinavian Obesity Surgery Registry who had undergone GBP from January 1, 2007, to December 31, 2013, were matched with 5321 patients with diabetes from the National Diabetes Register who had not undergone GBP, based on sex, age, body mass index (BMI), and calendar time (2007-2013). Follow-up data were obtained until December 31, 2015. Statistical analysis was performed from October 5, 2018, to September 30, 2019. EXPOSURE Gastric bypass surgery. MAIN OUTCOMES AND MEASURES Incidence of new DR and other diabetic ocular complications. RESULTS The study population consisted of 5321 patients who had undergone GBP (3223 women [60.6%]; mean [SD] age, 49.0 [9.5] years) and 5321 matched controls (3395 women [63.8%]; mean [SD] age, 47.1 [11.5] years). Mean (SD) follow-up was 4.5 (1.6) years. The mean (SD) BMI and hemoglobin A1c concentration at baseline were 42.0 (5.7) and 7.6%(1.5%), respectively, in the GBP group and 40.9 (7.3) and 7.5%(1.5%), respectively, in the control group. The mean (SD) duration of diabetes was 6.8 (6.3) years in the GBP group and 6.4 (6.4) years in the control group. The risk for new DR was reduced in the patients who underwent GBP (hazard ratio, 0.62 [95% CI, 0.49-0.78]; P <.001). The dominant risk factors for development of DR at baseline were diabetes duration, hemoglobin A1c concentration, use of insulin, glomerular filtration rate, and BMI. CONCLUSIONS AND RELEVANCE This nationwide matched cohort study suggests that there is a reduced risk of developing new DR associated with GBP, and no evidence of an increased risk of developing DR that threatened sight or required treatment. (c) 2021 American Medical Association. All rights reserved.
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| 2. |
- Andersson, Tobias, 1976, et al.
(författare)
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The effect of statins on mortality and cardiovascular disease in primary care hypertensive patients without other cardiovascular disease or diabetes.
- 2023
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Ingår i: European journal of preventive cardiology. - 2047-4881. ; 30:17, s. 1883-1894
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Tidskriftsartikel (refereegranskat)abstract
- Studies in primary health care (PHC) assessing the effect of primary prevention with statins on mortality and cardiovascular disease (CVD) are scarce. This study aimed to estimate the effect of statins on all-cause mortality, cardiovascular mortality, myocardial infarction (MI) and stroke in individuals in PHC with hypertension without CVD or diabetes.Using the Swedish PHC quality assurance register QregPV, the study included 13 193 individuals with hypertension without CVD or diabetes, who had filled a first statin prescription between 2010 and 2016, and 13 193 matched controls without a filled statin prescription at index date. Controls were matched on sex and propensity score using clinical data and data from national registers on co-morbidities, prescriptions, and socioeconomic status. The effect of statins was estimated in Cox regression models.During a median of 4.2 years of follow-up, 395 individuals in the statin group versus 475 in the control group died, 197 versus 232 died of cardiovascular disease, 171 versus 191 had a MI, and 161 versus 181 had a stroke. The treatment effect of statins was significant for all-cause mortality (HR 0.83, 95% confidence interval [CI] 0.74-0.93) and cardiovascular mortality (HR 0.85, 95% CI 0.72-0.998). Overall, no significant treatment effect of statins was seen for MI (HR 0.89, 95% CI 0.74-1.07), but there was a significant interaction with sex (p=0.008) with decreased risk of MI for women but not for men (HR 0.66, 95% CI 0.49-0.88 versus HR 1.09, 95% CI 0.86-1.38).Primary prevention with statins in PHC was associated with reduced risk of all-cause mortality, cardiovascular mortality, and in women, lower risk of MI.
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| 3. |
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| 4. |
- Edelbro, Catrin, et al.
(författare)
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Implementering av 2:a generationens Eurokod inom bergbyggande
- 2022
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Ingår i: Bergdagarna 2022. - Stockholm.
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Konferensbidrag (populärvet., debatt m.m.)abstract
- I november 2020 publicerades de första kompletta utkasten till 2:a generationen av Eurokod inom geoteknikområdet (EN 1997-1, EN 1997-2 samt EN 1997-3). Dessa reviderade Europastandarder förväntas vara implementerade i branschen år 2026. Denna artikel belyser delar av det pågående arbetet inom Implementeringskommissionen för Europastandarder inom Geotekniken (IEG 2.0). Indelning i delområden som IEG 2.0 valt att fokusera på och etablering av arbetsformer för dessa områden presenteras. Inom varje delområden genomförs olika typer av projekt med syfte att bidra till en fungerande och kommunicerad standard i branschen. Konkreta exempel på projekt som pågår och som fångar upp de förändringar som blir med den nya generationen beskrivs. Vidare presenteras projekt som berör nya definitioner och beskrivningar som bedömts ha en stor nationell påverkan på bergbranschen. Under år 2021 utfördes i huvudsak projekt som berör grundläggande frågeställningar. Projekt som berör tillämpning och samordning startade under början av år 2022.
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| 5. |
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| 6. |
- Franzen, Bjorn, et al.
(författare)
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Where to stand when playing darts?
- 2021
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Ingår i: Alea. - 1980-0436. ; 18:1, s. 1561-1583
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Tidskriftsartikel (refereegranskat)abstract
- This paper analyzes the question of where one should stand when playing darts. If one stands at distance d>0 and aims at a in R^n, then the dart (modelled by a random vector X in R^n hits a random point given by a+dX. Next, given a payoff function f, one considers sup_a Ef(a+dX) and asks if this is decreasing in d; i.e., whether it is better to stand closer rather than farther from the target. Perhaps surprisingly, this is not always the case and understanding when this does or does not occur is the purpose of this paper. We show that if X has a so-called selfdecomposable distribution, then it is always better to stand closer for any payoff function. This class includes all stable distributions as well as many more. On the other hand, if the payoff function is cos(x), then it is always better to stand closer if and only if the characteristic function |phi_X(t)| is decreasing on [0,infty). We will then show that if there are at least two point masses, then it is not always better to stand closer using cos(x). If there is a single point mass, one can find a different payoff function to obtain this phenomenon. Another large class of darts X for which there are bounded continuous payoff functions for which it is not always better to stand closer are distributions with compact support. This will be obtained by using the fact that the Fourier transform of such distributions has a zero in the complex plane. This argument will work whenever there is a complex zero of the Fourier transform. Finally, we analyze if the property of it being better to stand closer is closed under convolution and/or limits.
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| 7. |
- Franzén, Carl Johan, 1966, et al.
(författare)
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The lignocellulosic biorefinery concept is sound: a commentary on Zhao et al.
- 2024
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Ingår i: Trends in Biotechnology. - 0167-7799 .- 1879-3096. ; 42:4, s. 395-396
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In the opinion paper by Zhao et al. ‘Making the biochemical conversion of lignocellulose more robust’, the authors claim that ‘…lignocellulose biorefinery is conceptually wrong’. In response, we argue that this claim itself has already been proved wrong by several companies.
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| 8. |
- Franzén, Cecilia, et al.
(författare)
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Trust as an analytical concept for the study of welfare programmes to reduce child health disparities : the case of a Swedish postnatal home visiting programme
- 2020
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Ingår i: Children and youth services review. - : Elsevier. - 0190-7409 .- 1873-7765. ; 118, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to outline a theoretical framework for how the concept of trust can be used as analytical tool for a study of the aim, design, output and societal legitimacy of a Swedish welfare programme conducted to reduce disparities in health and social inequities and to give newborn a positive start in life. This programme, labelled Grow Safely, implies that home visits will be conducted at six occasions at first-time parents by different professionals: child health care nurses, midwifes, dental hygienists and counsellors from the social services. Prior to when the intervention is carried out, the involved professionals in the programme will be participating in training in order to increase the possibility that the home visits will be carried out in similar ways and be followed the same manual throughout the programme.The welfare programme will be based on relationships on different levels: between professionals and parents, between different professionals, between professionals and managers, and between organisations. Trust is believed to be of significance for the development of relationships as well as for the social legitimacy of the implantation of welfare programmes. Therefore, our ambition is to embrace a broad perspective on trust, combining insights from a variety of research traditions and analyses on macro, meso and micro levels in the outline a model for how the concept of trust can be used as an analytical tool for studying welfare programmes like Grow Safely. We argue for that the model can capture the significance of trust at different levels: individual, professional, organisational and societal levels as well as interplays between these levels, and consequently be useful in to analyse implementations of welfare programmes.
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| 9. |
- Franzén, Gunilla, et al.
(författare)
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National implementation commission for Eurocode 7 for joint development of geotechnical engineering practice
- 2022
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Ingår i: Proceedings of 20th International Conference on Soil Mechanics and Geotechnical Engineering. - St Ives. ; , s. 4759-4764
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Konferensbidrag (refereegranskat)abstract
- The objective of this paper is to describe how upcoming design code revisions can be used to facilitate a national joint development of geotechnical engineering practice. The paper describes the Swedish experience with establishing a national implementation commission for the second generation of Eurocode 7. The purpose is to inspire others to take similar initiatives when new design codes and standards are introduced. The paper covers how stakeholders from all parts of the Swedish geotechnical construction industry established the implementation commission IEG 2.0 as a non-profit organization and how obstacles were solved. This includes financing and establishing an efficient work process to analyze the many upcoming changes to the Eurocode clauses. This in fact being the second Swedish implementation commission for Eurocode 7, the paper concludes that this procedure of working together in the industry is a great success, facilitating an increased competence among Swedish geotechnical engineers and therefore also increased competitiveness of the Swedish geotechnical construction industry.
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| 10. |
- Franzén, Stephanie, et al.
(författare)
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Renal function during sevoflurane or total intravenous propofol anaesthesia a single-centre parallel randomised controlled study.
- 2022
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Ingår i: British Journal of Anaesthesia. - : Elsevier. - 0007-0912 .- 1471-6771. ; 128:5, s. 838-848
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The choice of anaesthetic may influence regulation of renal perfusion and function. We investigated renal function in patients anaesthetised with propofol or sevoflurane before surgery and postoperatively.METHODS: Patients with ASA physical status 1-2 planned for spinal surgery were randomised to propofol or sevoflurane anaesthesia. Blood and urine were collected before anaesthesia, during anaesthesia (before surgery), during postoperative care, and the day after surgery.RESULTS: Twenty-seven patients completed the study protocol (average age, 51 yr; average BMI, 28 kg m-2) and 11 were women. Urine output and sodium excretion were lower during sevoflurane anaesthesia (n=14) than during propofol anaesthesia (n=13) (0.3 vs 1.1 ml kg-1 h-1 [P=0.01] and 2.6 vs 6.0 mmol h-1 [P=0.04], respectively). Urinary potassium excretion was lower during anaesthesia than after, without intergroup difference (2.3 vs 5.7 mmol h-1, P<0.001). Sevoflurane anaesthesia increased plasma renin compared with baseline (138 vs 23 mIU L-1, P<0.001) and propofol anaesthesia (138 vs 27 mIU L-1, P=0.008). Plasma arginine-vasopressin did not change significantly during anaesthesia, but was elevated postoperatively compared with baseline irrespective of anaesthetic (21 vs 12 ng L-1, P=0.02). Sevoflurane caused higher postoperative plasma creatinine than propofol (83 vs 66 mmol L-1, P=0.01). Kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin did not change significantly in either group.CONCLUSIONS: Sevoflurane anaesthesia reduced urine output and sodium excretion and increased plasma renin compared with propofol anaesthesia. The impact of this on acute kidney injury and fluid resuscitation during surgery warrants further investigation.CLINICAL TRIAL REGISTRATION: EudraCT: 2017-001646-10; Clinicaltrials.gov: NCT0333680.
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