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- Rosell, A., et al.
(författare)
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Microbiologic determinants of exacerbation in chronic obstructive pulmonary disease
- 2005
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Ingår i: Arch Intern Med. - 0003-9926. ; 165:8, s. 891-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The culture of bronchial secretions from the lower airway has been reported to be positive for potentially pathogenic microorganisms (PPMs) in patients with stable chronic obstructive pulmonary disease (COPD), but the determinants and effects of this bacterial load in the airway are not established. METHODS: To determine the bronchial microbial pattern in COPD and its relationship with exacerbation, we pooled analysis of crude data from studies that used protected specimen brush sampling, with age, sex, smoking, lung function, and microbiologic features of the lower airway as independent variables and exacerbation as the outcome, using logistic regression modeling. RESULTS: Of 337 study participants, 70 were healthy, 181 had stable COPD, and 86 had exacerbated COPD. Differences in the microbial characteristics in the participating laboratories were not statistically significant. A cutoff point of 10(2) colony-forming units (CFU) per milliliter or greater for the identification of abnormal positive culture results for PPMs was defined using the 95th percentile in the pooled analysis of healthy individuals. Bronchial colonization of 10(2) CFU/mL or greater by PPMs was found in 53 patients with stable COPD (29%) and in 46 patients with exacerbated COPD (54%) (P<.001, chi(2) test), with a predominance of Haemophilus influenzae and Pseudomonas aeruginosa. Higher microbial loads were associated with exacerbation and showed a statistically significant dose-response relationship after adjustment for covariates (odds ratio, 3.62; 95% confidence interval, 1.47-8.90), but P aeruginosa persisted as a statistically significant risk factor after adjustment for microbial load (odds ratio, 11.12; 95% confidence interval, 1.17-105.82). CONCLUSIONS: One quarter of the patients with COPD are colonized by PPMs during their stable periods. Exacerbation is associated with the overgrowth of PPMs and with the appearance of P aeruginosa in the lower airway, which is associated with exacerbation symptoms independent of load.
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| 4. |
- Nordenskjöld, Bo, 1940-, et al.
(författare)
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Coronary heart disease mortality after 5 years of adjuvant tamoxifen therapy: results from a randomized trial
- 2005
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Ingår i: J Natl Cancer Inst. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 97:21, s. 1609-10
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Tidskriftsartikel (refereegranskat)abstract
- From January 1, 1983, through December 31, 1992, a total of 4610 patients entered a randomized trial that compared mortality among patients receiving 2 years of adjuvant tamoxifen therapy with that in patients receiving 5 years of adjuvant tamoxifen therapy, 4175 of whom were recurrence free after 2 years of tamoxifen therapy. Among the 2046 patients randomly assigned to the 5-year group all-cause mortality, breast cancer-specific mortality, and the incidence of contralateral breast cancer were reduced, compared with those among 2129 patients randomized in the 2-year group, but the incidence of endometrial cancer was increased. In addition, mortality from coronary heart disease was statistically significantly reduced in the 5-year group, compared with that in the 2-year group (hazard ratio = 0.67, 95% confidence interval = 0.47 to 0.94; P = .022 [two-sided Wald test]). Ten years after surgery, 2.1% of the patients in the 5-year group and 3.5% of those in the 2-year group had died from coronary heart disease. No statistically significant increases in mortality from other heart diseases, cerebrovascular diseases, or other vascular diseases were observed.
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- Plos, M., et al.
(författare)
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Non-Linear Analysis and Remaining Fatigue Life of Reinforced Concrete Bridges
- 2007
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Rapport (refereegranskat)abstract
- The work provides methods for non-linear structural analysis and fatigue safety evaluation in assessment of existing railway bridges. The use of non-linear analysis leads to higher load carrying capacities, but also to improved understanding of the structural response, forming a better basis for decisions in the assessment. The methods for fatigue assessment lead to increased remaining service life of reinforced concrete railway bridges.The achievements of the work are:• Models for assessment of concrete bridges by non-linear analysis are described, and examples and general recommendations for practical application of the methods aregiven.• An overview of the effect of corrosion on the bond properties has been developed through non-linear analyses and tests found in literature. Recommendations for practical assessment of anchorage capacity in corroded railway concrete bridges are presented.• The determination of reliable in-situ material properties in old concrete bridges is described,including properties for fully probabilistic analysis. A particular aim was to develop better methods to describe development of concrete properties with age and degree of hydration.• Recommendations are given regarding re-distribution of sectional forces and moments, obtained through linear structural analysis (with FEM). In a case study, a typical slab bridge was designed using different methods, and its response evaluated through nonlinearanalyses.• A good understanding of the load-carrying mechanisms in combined bending-shear-torsion gives a possibility to make more accurate assessments than with standard code methods. Methods and examples are presented.• A state-of-the-art review of fatigue behaviour of reinforced concrete railway bridges is presented and a methodology to assess the remaining fatigue life of existing reinforced concrete bridges subjected to railway traffic is developed.
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| 6. |
- Plos, Mario, et al.
(författare)
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Structural assessment of railway concrete bridges : non-linear analysis and remaining fatigue life
- 2006
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Ingår i: Bridge Maintenance, Safety, Management, Life-Cycle Performance and Cost. - London : Taylor and Francis Group. - 0415403154 ; , s. 271-
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Konferensbidrag (refereegranskat)abstract
- For a sustainable development in Europe, there is a need to at least double the railway transports in the coming 20 years. In order to reach this, the residual service lives of existing concrete bridges need to be extended at the same time as they are subjected to higher axle loads, higher railway speeds and heavier traffic intensity. Today, many concrete bridges are replaced or strengthened because their reliability cannot be guaranteed based on the structural assessments made. The aim of the work presented here is to provide enhanced assessment methods that are able to prove higher load carrying capacities and longer fatigue lives for existing concrete railway bridges. One main objective is to facilitate the use of non-linear analysis for structural assessment. In addition to higher load carrying capacities, the methods give improved understanding of the structural response, forming a better basis for decisions in the assessment. Another main objective is to improve knowledge about the fatigue behaviour of concrete bridges and to develop realistic methods for the evaluation of remaining fatigue life of existing bridges. The emphasis here is on short-span bridges and secondary elements. The work presented is a part of the ongoing EU-project Sustainable Bridges. The results will be implemented in the Guideline for Load and Resistance Assessment of existing European Railway Bridges that is being developed
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| 8. |
- Sjögren, P, et al.
(författare)
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Fatty acid desaturases in human adipose tissue : relationships between gene expression, desaturation indexes and insulin resistance
- 2008
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 51:2, s. 328-335
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis Fatty acid desaturases introduce double bonds into growing fatty acid chains. The key desaturases in humans are Delta(5)desaturase (D5D), Delta(6)-desaturase (D6D) and stearoyl-CoA desaturase (SCD). Animal and human data implicate hepatic desaturase activities in insulin resistance, obesity and dyslipidaemia. However, the role of desaturase activity in adipose tissue is uncertain. We therefore evaluated relationships between adipose mRNA expression, estimated desaturase activities (fatty acid ratios) in adipose tissue and insulin resistance. Methods Subcutaneous adipose tissue mRNA expression of D5D (also known as FADS1), D6D (also known as FADS2) and SCD was determined in 75 individuals representative of the study population of 294 healthy 63-year-old men. Desaturation indexes (product/substrate fatty acid ratios) were generated from adipose tissue fatty acid composition in all individuals. Insulin resistance was defined as the upper quartile of the updated homeostasis model assessment (HOMA-2) index. Results The relevant desaturation indexes (16:1/16:0, 18:1/18:0, 20:4/20:3 and 18:3/18:2) reflected expression of SCD, but not of D5D or D6D in adipose tissue. Insulin-resistant individuals had a higher adipose tissue 18:1/18:0, but not 16:1/16:0 ratio than insulin-sensitive individuals. Individuals with a high adipose tissue 18:1/18:0 ratio were 4.4-fold (95% CI 1.8-11.8) more likely to be insulin resistant [threefold (95% CI 1.1-8.6) after adjustment for waist circumference and plasma triacylglycerol]. In a multiple regression model predicting HOMA-2, the independent effect of the 18:1/18:0 ratio was borderline (p=0.086). Conclusions/interpretation Adipose tissue desaturation indexes of SCD reflect the expression of the gene encoding the enzyme in this tissue. Elevated SCD activity within adipose tissue is closely coupled to the development of insulin resistance.
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