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- Ahlqvist, Emma, et al.
(författare)
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Novel subgroups of adult-onset diabetes and their association with outcomes : a data-driven cluster analysis of six variables
- 2018
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Ingår i: The Lancet Diabetes and Endocrinology. - 2213-8587 .- 2213-8595. ; 6:5, s. 361-369
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDiabetes is presently classified into two main forms, type 1 and type 2 diabetes, but type 2 diabetes in particular is highly heterogeneous. A refined classification could provide a powerful tool to individualise treatment regimens and identify individuals with increased risk of complications at diagnosis.MethodsWe did data-driven cluster analysis (k-means and hierarchical clustering) in patients with newly diagnosed diabetes (n=8980) from the Swedish All New Diabetics in Scania cohort. Clusters were based on six variables (glutamate decarboxylase antibodies, age at diagnosis, BMI, HbA1c, and homoeostatic model assessment 2 estimates of β-cell function and insulin resistance), and were related to prospective data from patient records on development of complications and prescription of medication. Replication was done in three independent cohorts: the Scania Diabetes Registry (n=1466), All New Diabetics in Uppsala (n=844), and Diabetes Registry Vaasa (n=3485). Cox regression and logistic regression were used to compare time to medication, time to reaching the treatment goal, and risk of diabetic complications and genetic associations.FindingsWe identified five replicable clusters of patients with diabetes, which had significantly different patient characteristics and risk of diabetic complications. In particular, individuals in cluster 3 (most resistant to insulin) had significantly higher risk of diabetic kidney disease than individuals in clusters 4 and 5, but had been prescribed similar diabetes treatment. Cluster 2 (insulin deficient) had the highest risk of retinopathy. In support of the clustering, genetic associations in the clusters differed from those seen in traditional type 2 diabetes.InterpretationWe stratified patients into five subgroups with differing disease progression and risk of diabetic complications. This new substratification might eventually help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes.
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- Bengtson, Erik, 1985-, et al.
(författare)
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A Philosophical-Anthropological Case for Cassirer in Rhetoric
- 2017
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Ingår i: Rhetorica - A Journal of the History of Rhetoric. - : Project Muse. - 0734-8584 .- 1533-8541. ; 35:3, s. 346-365
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Tidskriftsartikel (refereegranskat)abstract
- In this article We argue that Ernst Cassirer's philosophy of symbolic forms is an indispensible philosophical-anthropological companion to rhetoric. We propose that appropriating Cassirer's understanding of symbolic forms enables rhetoric to go beyond the dominant perspective of language oriented theory and fully commit to a widened -Understanding of rhetoric as the study of how social meaning is created, performed and transformed. To clearly bring out the thrust of our enlarged rhetorical-philosophical anthropological approach we have structured our argument partly as a contrastive critique of Thomas A. Discenna's recent (Rhetorica 32/3; 2014) attempt to include Cassirer in the rhetorical tradition through a reading of the 1929 debate in Davos between Cassirer and Martin Heidegger; partly through a presentation of the aspects of Cassirer's thought that we find most important for developing a rhetorical-philosophical-anthropology of social meaning.
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- Bengtson, Erik, 1985-
(författare)
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The Epistemology of Rhetoric : Plato, Doxa and Post-Truth
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis aims to develop an epistemology of rhetoric in light of the apparent contemporary post-truth condition of society. Epistemology is hereby understood as concerned with principles for knowledge production within the academic discipline of rhetoric, as well as with an understanding of knowledge production in the public realm.The first part of the thesis investigates the opposition between opinion (doxa) and true knowledge (epistēmē), which has been said to be at the very heart of the birth of rhetoric itself. I show through readings of Plato's Gorgias, Phaedrus, Theaetetus, Meno and Republic that the contemporary rendering of this birth is, however, haunted by simplification and misrepresentation. Nevertheless, locating and scrutinising these cracks provides avenues toward a contemporary epistemology of rhetoric, and thus to an alternative to the traditional way of re-assessing rhetoric in the wake of Aristotle.Part 2 investigates fives routes for a contemporary re-invention of doxa. Barthes represents the structuralist and poststructuralist route, Hariman rhetorical ontology, Amossy the pragmatic study of doxa, and Rosengren rhetorical-philosophical anthropology. These engagements draw inspiration from the general direction of Rosengren’s work, while striving for the analytical sharpness of Barthes and Amossy, as well as highlighting the importance of understanding of the function of metadiscourse. In part 3, I present ways to reconsider rhetorical theory and how rhetoricians tend to understand argumentation. Seven principles for rhetorical theory are presented, sketching an understanding of the human position that includes embodiment, takes all forms of symbolic influence into account, and considers the sociality and historicity of being, as well as the capacity for human agency. The thesis concludes by presenting a model for rhetorical argumentation which portrays rhetoric as a process of sedimentation and erosion, constituted from an acknowledgement of the reasonableness of everyday wisdom, the establishment of new myths, and the denaturalisation of prevalent beliefs, desires and identities. In its final section, I return to the ethical challenge at the heart of the post-truth narrative, arguing for the potential inherent in the heroic figure of a champion of autonomy.
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- Ekblom-Bak, Elin, et al.
(författare)
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Fitness attenuates the prevalence of increased coronary artery calcium in individuals with metabolic syndrome.
- 2018
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 25:3, s. 309-316
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Tidskriftsartikel (refereegranskat)abstract
- Background The association between cardiorespiratory fitness, physical activity and coronary artery calcium (CAC) is unclear, and whether higher levels of fitness attenuate CAC prevalence in subjects with metabolic syndrome is not fully elucidated. The present study aims to: a) investigate the independent association of fitness on the prevalence of CAC, after adjustment for moderate-to-vigorous physical activity and sedentary time, and b) study the possible attenuation of increased CAC by higher fitness, in participants with metabolic syndrome. Design Cross-sectional. Methods In total 678 participants (52% women), 50-65 years old, from the SCAPIS pilot study were included. Fitness (VO2max) was estimated by submaximal cycle ergometer test and moderate-to-vigorous physical activity and sedentary time were assessed using hip-worn accelerometers. CAC score (CACS) was quantified using the Agatston score. Results The odds of having a significant CACS (≥100) was half in participants with moderate/high fitness compared with their low fitness counterparts. Further consideration of moderate-to-vigorous physical activity, sedentary time and number of components of the metabolic syndrome did only slightly alter the effect size. Those with metabolic syndrome had 47% higher odds for significant CAC compared with those without metabolic syndrome. However, moderate/high fitness seems to partially attenuate this risk, as further joint analysis indicated an increased odds for having significant CAC only in the unfit metabolic syndrome participants. Conclusions Being fit is associated with a reduced risk of having significant CAC in individuals with metabolic syndrome. While still very much underutilized, fitness should be taken into consideration in everyday clinical risk prediction in addition to the traditional risk factors of the metabolic syndrome.
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- Ekblom, Örjan, 1971-, et al.
(författare)
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Cardiorespiratory Fitness, Sedentary Behaviour and Physical Activity Are Independently Associated with the Metabolic Syndrome, Results from the SCAPIS Pilot Study
- 2015
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 10:6
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Tidskriftsartikel (refereegranskat)abstract
- Background Previous studies on the relation between lifestyle and the metabolic syndrome lack one or several aspects of the physical activity pattern in the analyses or cardiorespiratory fitness. Likewise, both uni- and triaxial accelerometry have been used, though, the predictive validity of these two modes has not been compared. The aims of the present study were firstly to investigate the independent relation between cardiorespiratory fitness and physical activity pattern to the metabolic syndrome (MetS) and secondly to examine the predictive validity of uni- and triaxial accelerometry, respectively. Data was extracted from the SCAPIS pilot study (n=930, mean age 57.7 yrs). Physical activity pattern was assessed by accelerometry. Cardiorespiratory fitness was estimated using cycle ergometry. MetS was defined per the Adult Treatment Panel III from the National Cholesterol Education Program definition. Time spent sedentary (OR: 2.38, 95% CI: 1.54-4.24 for T3 vs T1), in light intensity (OR: 0.50, 95% CI: 0.28-0.90) and in moderate-to-vigorous activity (OR: 0.33, 95% CI: 0.18-0.61), as well as cardiorespiratory fitness (OR: 0.24, 95% CI: 0.12-0.48), were all independently related to the prevalence of MetS after adjustment for potential confounders, fitness and/or the other aspects of the physical activity pattern. In addition, we found that triaxial analyses were more discriminant, with ORs farther away from the reference group and additional significant ORs. The finding that several aspects of the physical activity pattern reveal independent relations to the MetS makes new possible targets for behaviour change of interest, focusing on both exercise and everyday life. When assessing the risk status of a patient, it is advised that triaxial accelerometry is used.
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- Eliasson, Mats, et al.
(författare)
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Nya SCORE bättre på att skatta risk för död i hjärtinfarkt och stroke : Viktigt att riskmodeller rekalibreras och implementeras i den kliniska vardagen
- 2017
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Ingår i: Läkartidningen. - : Läkartidningen förlag. - 0023-7205 .- 1652-7518. ; 114:15/16
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Att skatta risk för kardiovaskulär sjukdom är ett viktigt redskap i primärpreventivt arbete och ger stöd för råd om ändrade levnadsvanor och ställningstagande till läkemedelsbehandling för hypertoni eller höga kolesterolvärden. En ny version av SCORE baserad på aktuella svenska data har nyligen publicerats och visar god förmåga att skatta risk att dö i stroke eller infarkt inom 10 år. Få personer i åldrarna 40–65 år har hög risk men desto fler har fortfarande en måttlig risk. SCORE 2015 kan användas vid konsultationer om kardiovaskulär risk.
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