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- Carlstedt, Anders, et al.
(författare)
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Management of Diastasis of the Rectus Abdominis Muscles : Recommendations for Swedish National Guidelines
- 2021
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Ingår i: Scandinavian Journal of Surgery. - : Sage Publications. - 1457-4969 .- 1799-7267. ; 10:3, s. 452-459
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diastasis of the rectus abdominis muscle is a common condition. There are no generally accepted criteria for diagnosis or treatment of diastasis of the rectus abdominis muscle, which causes uncertainty for the patient and healthcare providers alike. Methods: The consensus document was created by a group of Swedish surgeons and based on a structured literature review and practical experience. Results: The proposed criteria for diagnosis and treatment of diastasis of the rectus abdominis muscle are as follows: (1) Diastasis diagnosed at clinical examination using a caliper or ruler for measurement. Diagnostic imaging by ultrasound or other imaging modality, should be performed when concurrent umbilical or epigastric hernia or other cause of the patient's symptoms cannot be excluded. (2) Physiotherapy is the firsthand treatment for diastasis of the rectus abdominis muscle. Surgery should only be considered in diastasis of the rectus abdominis muscle patients with functional impairment, and not until the patient has undergone a standardized 6-month abdominal core training program. (3) The largest width of the diastasis should be at least 5 cm before surgical treatment is considered. In case of pronounced abdominal bulging or concomitant ventral hernia, surgery may be considered in patients with a smaller diastasis. (4) When surgery is undertaken, at least 2 years should have elapsed since last childbirth and future pregnancy should not be planned. (5) Plication of the linea alba is the firsthand surgical technique. Other techniques may be used but have not been found superior. Discussion: The level of evidence behind these statements varies, but they are intended to lay down a standard strategy for treatment of diastasis of the rectus abdominis muscle and to enable uniformity of management.
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- Kiviniemi, T., et al.
(författare)
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A randomized prospective multicenter trial for stroke prevention by prophylactic surgical closure of the left atrial appendage in patients undergoing bioprosthetic aortic valve surgery––LAA-CLOSURE trial protocol
- 2021
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 237, s. 127-134
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Tidskriftsartikel (refereegranskat)abstract
- Patients undergoing surgical aortic valve replacement (SAVR) are at high risk for atrial fibrillation (AF) and stroke after surgery. There is an unmet clinical need to improve stroke prevention in this patient population. The LAA-CLOSURE trial aims to assess the efficacy and safety of prophylactic surgical closure of the left atrial appendage for stroke and cardiovascular death prevention in patients undergoing bioprosthetic SAVR. This randomized, open-label, prospective multicenter trial will enroll 1,040 patients at 13 European sites. The primary endpoint is a composite of cardiovascular mortality, stroke and systemic embolism at 5 years. Secondary endpoints include cardiovascular mortality, stroke, systemic embolism, bleed fulfilling academic research consortium (BARC) criteria, hospitalization for decompensated heart failure and health economic evaluation. Sample size is based on 30% risk reduction in time to event analysis of primary endpoint. Prespecified reports include 30-day safety analysis focusing on AF occurrence and short-term outcomes and interim analyses at 1 and 3 years for primary and secondary outcomes. Additionally, substudies will be performed on the completeness of the closure using transesophageal echocardiography/cardiac computed tomography and long-term ECG recording at one year after the operation. © 2021 The Author(s)
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- Appelstrand, Marie, et al.
(författare)
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Påståendet om äldre skogar baseras på en föråldrad hypotes
- 2021
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Ingår i: Dagens nyheter (DN debatt). - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- REPLIK DN DEBATT 20/4.Fem Lunda-forskare: Modern forskning som direkt mäter koldioxidutbytet mellan skog och atmosfär visar att gamla skogar fortsätter att ta upp och binda koldioxid.Detta är en opinionstext i Dagens Nyheter. Skribenten svarar för åsikter i artikeln.
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- Floudas, Dimitrios, et al.
(författare)
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X-ray scattering reveals two mechanisms of cellulose microfibril degradation by filamentous fungi
- 2022
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Ingår i: Applied and Environmental Microbiology. - : American Society for Microbiology. - 0099-2240 .- 1098-5336. ; 88:17
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Tidskriftsartikel (refereegranskat)abstract
- Mushroom-forming fungi (Agaricomycetes) employ enzymatic and nonenzymatic cellulose degradation mechanisms, the latter presumably relying on Fenton-generated radicals. The effects of the two mechanisms on the cellulose microfibrils structure remain poorly understood. We examined cellulose degradation caused by litter decomposers and wood decomposers, including brown-rot and white-rot fungi and one fungus with uncertain wood decay type, by combining small- and wide-angle X-ray scattering. We also examined the effects of commercial enzymes and Fenton-generated radicals on cellulose using the same method. We detected two main degradation or modification mechanisms. The first characterized the mechanism used by most fungi and resembled enzymatic cellulose degradation, causing simultaneous microfibril thinning and decreased crystalline cellulose. The second mechanism was detected in one brown-rot fungus and one litter decomposer and was characterized by patchy amorphogenesis of crystalline cellulose without substantial thinning of the fibers. This pattern did not resemble the effect of Fenton-generated radicals, suggesting a more complex mechanism is involved in the destruction of cellulose crystallinity by fungi. Furthermore, our results showed a mismatch between decay classifications and cellulose degradation patterns and that even within litter decomposers two degradation mechanisms were found, suggesting higher functional diversity under current ecological classifications of fungi.IMPORTANCE Cellulose degradation by fungi plays a fundamental role in terrestrial carbon cycling, but the mechanisms by which fungi cope with the crystallinity of cellulose are not fully understood. We used X-ray scattering to analyze how fungi, a commercial enzyme mix, and a Fenton reaction-generated radical alter the crystalline structure of cellulose. Our data revealed two mechanisms involved in crystalline cellulose degradation by fungi: one that results in the thinning of the cellulose fibers, resembling the enzymatic degradation of cellulose, and one that involves amorphogenesis of crystalline cellulose by yet-unknown pathways, resulting in a patchy-like degradation pattern. These results pave the way to a deeper understanding of cellulose degradation and the development of novel ways to utilize crystalline cellulose.
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5. |
- Neij, Lena, et al.
(författare)
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Lunds kommuns klimatpolitiska råd : Rapport 2021
- 2021
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Rapport (populärvet., debatt m.m.)abstract
- Lunds kommuns klimatpolitiska råd (Rådet) bildades hösten 2018 med uppdrag att utvärdera hur Lunds kommuns samlade politik är förenlig med de klimatmål som antagits av kommunfullmäktige. Rådet, som består av forskare från Lunds universitet (LU) och SLU Alnarp, har sammantaget en bred tvär- och mångvetenskaplig kompetens och en gedigen erfarenhet av samverkan med olika samhällsaktörer.Samarbetet mellan Lunds kommun och akademin har sedan länge stimulerat utvecklingen i Lund och utgör en viktig källa till nytänkande och problemlösning.Rådet uppskattar förtroendet att utvärdera kommunens klimatarbete men uttrycker samtidigt en ödmjukhet inför komplexiteten i detta arbete. Rådets ambition är att sträva efter att vara kritiskt granskande men också konstruktiv och lösningsorienterad för att kunna bidra till utvecklingen av det lokala klimatarbetet.Rådet presenterar årligen en rapport i vilken Lunds kommuns klimatarbete granskas. Detta är Rådets tredje rapport i vilken Rådet valt att fokusera på Lunds kommuns förslag till nya klimatmål i miljömålsprogrammet LundaEko. Denna granskningkompletteras med en uppföljning av de klimatmål som antagits i den tidigare versionen av LundaEko (LundaEko II 2014-2020) inom områdena Minstamöjliga klimatpåverkan och Klimatanpassning. Rådet har i sin granskning utgått från tillgängliga planer, dokument, redovisningar och data. Detta material har kompletterats med samtal med ansvariga tjänstepersoner. Under arbetets gång har Rådet även fört dialog med Ungdomspolitiken i Lund, som på egen hand granskat LundaEko ur ett ungdomsperspektiv.Under 2020 har mandatet för några rådsledamöter löpt ut – Lena Hiselius (LU), Anna Peterson (SLU Alnarp), Markku Rummukainen (LU) och Catharina Sternudd (LU) – och de har avtackats för sina insatser under de inledande två åren. Samtidigt har nya ledamöter tillkommit – Cecilia Akselsson (LU), Susanne Arvidsson (LU), Anders Larsson (SLU Alnarp) och Lars J Nilsson (LU) – som tillsammans med övriga ledamöter har deltagit i den granskning som presenteras i denna rapport.
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7. |
- Olsson, Anders, 1973-, et al.
(författare)
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Performance of timber board models for prediction of local bending stiffness and strength-with application on douglas fir sawn timber
- 2022
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Ingår i: Wood and Fiber Science. - : Society of Wood Science Technology. - 0735-6161. ; 54:4, s. 226-245
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Tidskriftsartikel (refereegranskat)abstract
- Efficient utilization of structural timber requires accurate methods for machine strength grad-ing. One of the most accurate methods presented this far is based on data of local fiber orientation on board surfaces, obtained from laser scanning. In this paper, two potential improvements of this method are exam-ined. The first one consists of replacing a model based on simple integration over cross sections of boards for calculation of local bending stiffness by a 3D solid finite element (FE) model from which local bending stiffness is derived. The second improvement concerns replacement of a simple model for the fiber orienta-tion in the interior of board by a more advanced one taking location of pith and growth direction of knots into account. Application of the alternative models on a sample of more than 200 Douglas fir boards, size 40 mm x 100 mm x 3000 mm, cut from large logs, show that each of the evaluated model improvements contributes to improved grading accuracy. When local bending stiffness is calculated utilizing the herein suggested FE model in combination with the improved model of fiber orientation in the interior of boards, a coefficient of determination to bending strength as high as 0.76 is obtained. For comparison, a coefficient of determination of 0.71 is obtain using the simpler original models.
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8. |
- Penvern, H., et al.
(författare)
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3D fibre orientation reconstruction around a knot in Douglas fir
- 2023
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Ingår i: 3rd ECCOMAS Thematic Conference on Computational Methods in Wood Mechanics (CompWood 2023), September 5-8, 2023, Dresden, Germany. - : International Center for Numerical Methods in Engineering (CIMNE). - 9788412322279 ; , s. 137-138
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Konferensbidrag (refereegranskat)
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9. |
- Salahuddin, Taufiq, et al.
(författare)
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Association of high-density lipoprotein particle concentration with cardiovascular risk following acute coronary syndrome: A case-cohort analysis of the dal-Outcomes trial
- 2020
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Ingår i: American Heart Journal. - : MOSBY-ELSEVIER. - 0002-8703 .- 1097-6744. ; 221, s. 60-66
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Tidskriftsartikel (refereegranskat)abstract
- Background High-density lipoprotein cholesterol (HDL-C) concentration is inversely related to risk of major adverse cardiovascular events (MACE) in epidemiologic studies but is a poorer predictor of MACE in patients with established coronary heart disease. HDL particle concentration (HDLP) has been proposed as a better predictor of risk. We investigated whether HDLP is associated with risk of MACE after acute coronary syndrome (ACS). Methods The dal-Outcomes trial compared the CETP inhibitor dalcetrapib with placebo in patients with recent ACS. In a nested case-cohort analysis, total, large, medium, and small HDLPs were measured by nuclear magnetic resonance spectroscopy at baseline (4-12 weeks after ACS) in 476 cases with MACE and 902 controls. Hazard ratios (HRs; case-control) for 1-SD increment of HDLP or HDL-C at baseline were calculated with and without adjustment for demographic, clinical, laboratory, and treatment variables. Similarly, HRs for MACE were calculated for changes in HDLP or HDL-C from baseline to month 3 of assigned treatment. Results Over median follow-up of 28 months, the risk of MACE was not associated with baseline HDLP (adjusted HR = 0.98, 95% CI = 0.84-1.15, P =.81), any HDLP subclass, or HDL-C. Dalcetrapib increased HDL-C and total, medium, and large HDLP and decreased small HDLP but had no effect on MACE compared with placebo. There were no association of risk of MACE with change in HDLP or HDL-C and no interaction with assigned study treatment. Conclusions Neither baseline HDLP nor the change in HDLP on treatment with dalcetrapib or placebo was associated with risk of MACE after ACS.
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10. |
- Schwartz, Gregory G., et al.
(författare)
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Dalcetrapib Reduces Risk of New-Onset Diabetes in Patients With Coronary Heart Disease
- 2020
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Ingår i: Diabetes Care. - : AMER DIABETES ASSOC. - 0149-5992 .- 1935-5548. ; 43:5, s. 1077-1084
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE Incident type 2 diabetes is common among patients with recent acute coronary syndrome and is associated with an adverse prognosis. Some data suggest that cholesteryl ester transfer protein (CETP) inhibitors reduce incident type 2 diabetes. We compared the effect of treatment with the CETP inhibitor dalcetrapib or placebo on incident diabetes in patients with recent acute coronary syndrome. RESEARCH DESIGN AND METHODS In the dal-OUTCOMES trial, 15,871 patients were randomly assigned to treatment with dalcetrapib 600 mg daily or placebo, beginning 4-12 weeks after an acute coronary syndrome. Absence of diabetes at baseline was based on medical history, no use of antihyperglycemic medication, and hemoglobin A(1c) and serum glucose levels below diagnostic thresholds. Among these patients, incident diabetes after randomization was defined by any diabetes-related adverse event, new use of antihyperglycemic medication, hemoglobin A(1c) >= 6.5%, or a combination of at least two measurements of serum glucose >= 7.0 mmol/L (fasting) or >= 11.1 mmol/L (random). RESULTS At baseline, 10,645 patients (67% of the trial cohort) did not have diabetes. During a median follow-up of 30 months, incident diabetes was identified in 403 of 5,326 patients (7.6%) assigned to dalcetrapib and in 516 of 5,319 (9.7%) assigned to placebo, corresponding to absolute risk reduction of 2.1%, hazard ratio of 0.77 (95% CI 0.68-0.88; P < 0.001), and a need to treat 40 patients for 3 years to prevent 1 incident case of diabetes. Considering only those with prediabetes at baseline, the number needed to treat for 3 years to prevent 1 incident case of diabetes was 25. Dalcetrapib also decreased the number of patients who progressed from normoglycemia to prediabetes and increased the number who regressed from diabetes to no diabetes. CONCLUSIONS In patients with a recent acute coronary syndrome, incident diabetes is common and is reduced substantially by treatment with dalcetrapib.
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