| 41. |
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| 42. |
- McMurray, John J, et al.
(författare)
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Effect of valsartan on the incidence of diabetes and cardiovascular events
- 2010
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 362:16, s. 1477-1490
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is not known whether drugs that block the renin-angiotensin system reduce the risk of diabetes and cardiovascular events in patients with impaired glucose tolerance. METHODS: In this double-blind, randomized clinical trial with a 2-by-2 factorial design, we assigned 9306 patients with impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors to receive valsartan (up to 160 mg daily) or placebo (and nateglinide or placebo) in addition to lifestyle modification. We then followed the patients for a median of 5.0 years for the development of diabetes (6.5 years for vital status). We studied the effects of valsartan on the occurrence of three coprimary outcomes: the development of diabetes; an extended composite outcome of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, arterial revascularization, or hospitalization for unstable angina; and a core composite outcome that excluded unstable angina and revascularization. RESULTS: The cumulative incidence of diabetes was 33.1% in the valsartan group, as compared with 36.8% in the placebo group (hazard ratio in the valsartan group, 0.86; 95% confidence interval [CI], 0.80 to 0.92; P<0.001). Valsartan, as compared with placebo, did not significantly reduce the incidence of either the extended cardiovascular outcome (14.5% vs. 14.8%; hazard ratio, 0.96; 95% CI, 0.86 to 1.07; P=0.43) or the core cardiovascular outcome (8.1% vs. 8.1%; hazard ratio, 0.99; 95% CI, 0.86 to 1.14; P=0.85). CONCLUSIONS: Among patients with impaired glucose tolerance and cardiovascular disease or risk factors, the use of valsartan for 5 years, along with lifestyle modification, led to a relative reduction of 14% in the incidence of diabetes but did not reduce the rate of cardiovascular events. (ClinicalTrials.gov number, NCT00097786.)
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| 43. |
- Mills, Nicholas L., et al.
(författare)
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Combustion-derived nanoparticulate induces the adverse vascular effects of diesel exhaust inhalation
- 2011
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Ingår i: European Heart Journal. - London : Academic Press. - 0195-668X .- 1522-9645. ; 32:21, s. 2660-2671
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Exposure to road traffic and air pollution may be a trigger of acute myocardial infarction, but the individual pollutants responsible for this effect have not been established. We assess the role of combustion-derived-nanoparticles in mediating the adverse cardiovascular effects of air pollution. Methods and results: To determine the in vivo effects of inhalation of diesel exhaust components, 16 healthy volunteers were exposed to (i) dilute diesel exhaust, (ii) pure carbon nanoparticulate, (iii) filtered diesel exhaust, or (iv) filtered air, in a randomized double blind cross-over study. Following each exposure, forearm blood flow was measured during intra-brachial bradykinin, acetylcholine, sodium nitroprusside, and verapamil infusions. Compared with filtered air, inhalation of diesel exhaust increased systolic blood pressure (145 +/- 4 vs. 133 +/- 3 mmHg, P < 0.05) and attenuated vasodilatation to bradykinin (P = 0.005), acetylcholine (P = 0.008), and sodium nitroprusside (P < 0.001). Exposure to pure carbon nanoparticulate or filtered exhaust had no effect on endothelium-dependent or -independent vasodilatation. To determine the direct vascular effects of nanoparticulate, isolated rat aortic rings (n = 6-9 per group) were assessed in vitro by wire myography and exposed to diesel exhaust particulate, pure carbon nanoparticulate and vehicle. Compared with vehicle, diesel exhaust particulate (but not pure carbon nanoparticulate) attenuated both acetylcholine (P < 0.001) and sodium-nitroprusside (P = 0.019)-induced vasorelaxation. These effects were partially attributable to both soluble and insoluble components of the particulate. Conclusion: Combustion-derived nanoparticulate appears to predominately mediate the adverse vascular effects of diesel exhaust inhalation. This provides a rationale for testing environmental health interventions targeted at reducing traffic-derived particulate emissions.
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| 44. |
- Mills, Nicholas L, et al.
(författare)
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Diesel exhaust inhalation does not affect heart rhythm or heart rate variability
- 2011
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 97:7, s. 544-550
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Tidskriftsartikel (refereegranskat)abstract
- Objective Exposure to air pollution is associated with increases in cardiovascular morbidity and mortality. This study was undertaken to determine the effect of diesel exhaust inhalation on heart rhythm and heart rate variability in healthy volunteers and patients with coronary heart disease.Design and setting Double-blind randomised crossover studies in a university teaching hospital.Patients 32 healthy non-smoking volunteers and 20 patients with prior myocardial infarction.Interventions All 52 subjects were exposed for 1 h to dilute diesel exhaust (particle concentration 300 μg/m(3)) or filtered air.Main outcome measures Heart rhythm and heart rate variability were monitored during and for 24 h after the exposure using continuous ambulatory electrocardiography and assessed using standard time and frequency domain analysis.Results No significant arrhythmias occurred during or following exposures. Patients with coronary heart disease had reduced autonomic function in comparison to healthy volunteers, with reduced standard deviations of the NN interval (SDNN, p<0.001) and triangular index (p<0.001). Diesel exhaust did not affect heart rate variability compared with filtered air (p>0.05 for all) in healthy volunteers (SDNN 101±6 vs 91±6, triangular index 20±1 vs 21±1) or patients with coronary heart disease (SDNN 47±5 vs 38±4, triangular index 8±1 vs 7±1).Conclusions Brief exposure to dilute diesel exhaust does not alter heart rhythm or heart rate variability in healthy volunteers or well-treated patients with stable coronary heart disease. Autonomic dysfunction does not appear to be a dominant mechanism that can explain the observed excess in cardiovascular events following exposure to combustion-derived air pollution.
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| 45. |
- Muala, Ala, et al.
(författare)
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Assessment of the capacity of vehicle cabin air inlet filters to reduce diesel exhaust-induced symptoms in human volunteers
- 2014
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Ingår i: Environmental Health. - : BioMed Central (BMC). - 1476-069X. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exposure to particulate matter (PM) air pollution especially derived from traffic is associated with increases in cardiorespiratory morbidity and mortality. In this study, we evaluated the ability of novel vehicle cabin air inlet filters to reduce diesel exhaust (DE)-induced symptoms and markers of inflammation in human subjects.METHODS: Thirty healthy subjects participated in a randomized double-blind controlled crossover study where they were exposed to filtered air, unfiltered DE and DE filtered through two selected particle filters, one with and one without active charcoal. Exposures lasted for one hour. Symptoms were assessed before and during exposures and lung function was measured before and after each exposure, with inflammation assessed in peripheral blood five hours after exposures. In parallel, PM were collected from unfiltered and filtered DE and assessed for their capacity to drive damaging oxidation reactions in a cell-free model, or promote inflammation in A549 cells.RESULTS: The standard particle filter employed in this study reduced PM10 mass concentrations within the exposure chamber by 46%, further reduced to 74% by the inclusion of an active charcoal component. In addition use of the active charcoal filter was associated by a 75% and 50% reduction in NO2 and hydrocarbon concentrations, respectively. As expected, subjects reported more subjective symptoms after exposure to unfiltered DE compared to filtered air, which was significantly reduced by the filter with an active charcoal component. There were no significant changes in lung function after exposures. Similarly diesel exhaust did not elicit significant increases in any of the inflammatory markers examined in the peripheral blood samples 5 hour post-exposure. Whilst the filters reduced chamber particle concentrations, the oxidative activity of the particles themselves, did not change following filtration with either filter. In contrast, diesel exhaust PM passed through the active charcoal combination filter appeared less inflammatory to A549 cells.CONCLUSIONS: A cabin air inlet particle filter including an active charcoal component was highly effective in reducing both DE particulate and gaseous components, with reduced exhaust-induced symptoms in healthy volunteers. These data demonstrate the effectiveness of cabin filters to protect subjects travelling in vehicles from diesel exhaust emissions.
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| 46. |
- Muala, Ala, 1971-
(författare)
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Diesel exhaust and wood smoke : mechanisms, inflammation and intervention
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Particulate matter (PM) air pollution is associated with increased respiratory and cardiovascular morbidity and mortality. Diesel engine exhaust (DE) and wood combustion are major contributors to ambient air pollution and adverse health effects. The aim of this thesis was to investigate the fate of inhaled combustion-derived PM, the subsequent effects on pulmonary inflammation and symptomatology and to explore the potential for particle filters to improve public health. Additionally, it aimed at increasing the understanding of the pathophysiological mechanisms underlying the adverse vascular effects of PM inhalation in man.Methods In study I, lung deposition of wood smoke-derived particulates from incomplete combustion was determined in healthy and COPD subjects. In study II, airway inflammation was assessed in healthy subjects exposed to wood smoke and filtered air. In study III, vehicle cabin air inlet filters were evaluated regarding filtering capacity for DE and whether they affected the toxicological potential of the filtered PM. Healthy subjects were then exposed to filtered air and unfiltered DE, as well as DE filtered through two selected filters. In study IV, healthy subjects were exposed to filtered air and DE. Nitric oxide bioavailability was assessed by plethysmography in the presence of an NO clamp (NO synthase inhibitor NG-monomethyl locally and systemically administered) with measurements of arterial stiffness, cardiac output and blood pressure (BP).Results Study I: The total PM number deposition fraction of the wood smoke was 0.32 and 0.35 for healthy and COPD subjects respectively. Study II: Inhalation of wood smoke caused CD3+ and mast cell infiltration in the bronchial submucosa along with CD8+ cell recruitment to the epithelium. In bronchial wash, inflammatory cells, myeloperoxidase and matrix metalloproteinase 9 levels decreased. Study III: An efficient cabin air filter with an active charcoal component was most favourable in in-vitro tests and reduced symptoms in the human exposure study. Study IV: Local NO synthase inhibition caused similar vasoconstriction after exposure to DE and filtered air, along with an increase in plasma nitrate concentrations, suggesting an increase in the basal NO release due to oxidative stress. Systemic NO synthase inhibition increased arterial stiffness and blood pressure after DE exposure along with an increase in systemic vascular resistance and reduced cardiac output, implying that the increased basal NO release could not compensate for the reduced NO bioavailability in the conduit vessels.Conclusion Wood smoke particles from incomplete combustion tend to have a greater airway deposition than particles from better combustion. The airway inflammatory responses to the former particles differ from what have been shown for other PM pollutants, which may be of importance for subsequent health effects. The vasomotor dysfunction shown after DE exposure may largely be explained by reduced NO bioavailability. A vehicle cabin air inlet particle filter with active charcoal was effective to reduce DE exposure and subsequent symptoms. This may conceptually be of benefit when it comes to decreasing engine exhaust-related adverse health effects.
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| 47. |
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| 48. |
- Nilsson, Anders, et al.
(författare)
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Sustainability communication in the mining industry : a pre-study
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report is based on a pre‐study aiming to provide an overview of what andhow the largest mining companies, internationally and in Sweden, communicate in terms of sustainability on their websites. The report presents a broad understanding of what large mining companies ‘say’ when it comes to sustainability. Conceptually, the study draws on writings in the areas of organizational communication, institutional theory and sustainability accounting. Methodologically, the study is based on qualitative textual analyses, to some extent aided by the text analytic tool Leximancer. The main findings of the study are that while most companies communicate all relevant sustainability issues and all the global leaders publish sustainability reports with the Global Reporting Initiative level A+, all companies distinctively communicate sustainability in unique ways. In this report, these similarities and differences in sustainability communication are retold in four main tensions and four main stories.
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| 49. |
- Nitze, Florian, 1981, et al.
(författare)
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Direct support mixture painting, using Pd(0) organo-metallic compounds - an easy and environmentally sound approach to combine decoration and electrode preparation for fuel cells
- 2014
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Ingår i: Journal of Materials Chemistry A. - : Royal Society of Chemistry (RSC). - 2050-7488 .- 2050-7496. ; 2:48, s. 20973-20979
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Tidskriftsartikel (refereegranskat)abstract
- An inventive, fast and straight-forward approach for the direct preparation of fuel cell electrodes has been developed and tested. Our approach avoids long catalyst preparation and post-synthesis treatment. It reduces the use of chemicals and thereby concomitantly lowers the environmental impact and improves cost efficiency. It combines decoration of the support by palladium nanoparticles with electrode preparation through a simple one-step ink-painting and annealing process. Composites have been investigated by high resolution transmission electron microscopy, scanning electron microscopy, and Xray diffraction. Crystalline particles are well-attached and well-distributed on the support. Particles are of few nanometers in size and spherical for decorated Vulcan whereas they are larger and irregularly shaped for decorated helical carbon nanofibers (HCNFs). Electrodes with a metal loading of 0.8 mg cm(-2) have been tested in a direct formic acid fuel cell. Both the Vulcan and the HCNF electrodes show a similar and high power output of up to 120 mW mg(-1). They also show similar performances in deactivation experiments conducted at 200 mA cm(-2) even when using only high purity grade formic acid. After deactivation the electrodes show no structural damage, making them superior to most commercial catalysts. The electrodes can be completely regenerated to initial activity by simple treatment with water. The easy regeneration process indicates that CO-adsorption on the fuel cell anode catalyst is not the main poisoning mechanism responsible for electrode degeneration.
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| 50. |
- Norrby, Thomas, et al.
(författare)
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Framtidens Flexibla Förvaltningsformer? : En utvärdering av projektet Samverkansplaner för värdefulla kust- och havsområden
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet Samverkansplaner för värdefulla kust- och havsområden startades 2008 på initiativ av Naturvårdsverket utifrån behovet att utveckla förvaltningsformer för bevarande och hållbart nyttjande av större värdefulla kustoch havsområden. Det övergripande syftet med projektet var att bidra till att uppfylla Sveriges åtaganden inom Helsingforskommissionen (HELCOM) och Oslo-Paris konventionen (OSPAR), samt åtagandet inom FN:s konvention om biologisk mångfald. Projektet har bestått av fem regionala pilotprojekt som drivits av länsstyrelserna i Västernorrlands, Stockholms, Östergötlands, Blekinge och Västra Götalands län. Fyra av projektområdena är helt eller delvis klassade som Baltic Sea Protected Areas (BSPA). Det femte är delvis klassat som Marine Protected Area (MPA). Samtliga områden saknade en plan för framtida förvaltning. Pilotprojektens uppdrag var att utveckla samverkansplaner för respektive område med ekosystemansatsen som vägledning. SLU har fått i uppdrag att utvärdera projektet av Naturvårdsverket. Utvärderingen fokuserar på processerna i pilotprojekten, dvs. hur projekten kom igång och hur arbetet med samverkansplanerna genomförts. Utvärderingens ansats är kvalitativ och har som huvudsaklig inriktning att undersöka hur viktiga aspekter av ekosystemansatsen förståtts och operationaliserats i de olika piloterna. Syftet är också att undersöka på vilket sätt detta givit avtryck i det fortsatta arbetet med samverkansplanerna. De enskilda piloterna har analyserats var och en för sig. Analysen har varit inriktad på att ringa in piloternas 1) förutsättningar, 2) arbetsprocess och 3) resultat (samverkansplanerna) med avseende på centrala aspekter av ekosystemansatsen. Dessa aspekter har speglats i tre begreppspar: delaktighet och samverkan, förankring och legitimitet, samt lärande och adaptivitet. Analysen av de enskilda pilotprojekten ligger till grund för en jämförande analys av de olika pilotprojekten, och därefter för rapportens slutsatser och rekommendationer. Dessa finns sammanfattade i kapitel 6. Det finns ett fortsatt behov av att undersöka, praktiskt pröva och utveckla förståelse för hur vi kan utveckla nya förvaltningsformer för bevarande och hållbart nyttjande av naturresurser, med ekosystemansatsen som bas. Men det finns inga entydiga svar på frågor om hur man skapar ett brett och kontinuerligt deltagande, hur man initierar och upprätthåller ett adaptivt, reflekterat och lärande arbetssätt, hur man organiserar flernivåförvaltningen eller vilken roll myndigheter och andra berörda kan och ska ha. Därför måste nya förvaltningsformer fortgående prövas, samtidigt som det är viktigt att utnyttja lärdomar från tidigare projekt.
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