Ectopic fat is associated with cardiac remodeling—A comprehensive assessment of regional fat depots in type 2 diabetes using multi-parametric MRI

BackgroundDifferent regional depots of fat have distinct metabolic properties and may relate differently to adverse cardiac remodeling. We sought to quantify regional depots of body fat and to investigate their relationship to cardiac structure and function in Type 2 Diabetes (T2D) and controls.MethodsFrom the SCAPIS cohort in Linköping, Sweden, we recruited 92 subjects (35% female, mean age 59.5 ± 4.6 years): 46 with T2D and 46 matched controls. In addition to the core SCAPIS data collection, participants underwent a comprehensive magnetic resonance imaging examination at 1.5 T for assessment of left ventricular (LV) structure and function (end-diastolic volume, mass, concentricity, ejection fraction), as well as regional body composition (liver proton density fat fraction, visceral adipose tissue, abdominal subcutaneous adipose tissue, thigh muscle fat infiltration, fat tissue-free thigh muscle volume and epicardial adipose tissue).ResultsCompared to the control group, the T2D group had increased: visceral adipose tissue volume index (P < 0.001), liver fat percentage (P < 0.001), thigh muscle fat infiltration percentage (P = 0.02), LV concentricity (P < 0.001) and LV E/e'-ratio (P < 0.001). In a multiple linear regression analysis, a negative association between liver fat percentage and LV mass (St Beta −0.23, P < 0.05) as well as LV end-diastolic volume (St Beta −0.27, P < 0.05) was found. Epicardial adipose tissue volume and abdominal subcutaneous adipose tissue volume index were the only parameters of fat associated with LV diastolic dysfunction (E/e'-ratio) (St Beta 0.24, P < 0.05; St Beta 0.34, P < 0.01, respectively). In a multivariate logistic regression analysis, only visceral adipose tissue volume index was significantly associated with T2D, with an odds ratio for T2D of 3.01 (95% CI 1.28–7.05, P < 0.05) per L/m2 increase in visceral adipose tissue volume.ConclusionsEctopic fat is predominantly associated with cardiac remodeling, independently of type 2 diabetes. Intriguingly, liver fat appears to be related to LV structure independently of VAT, while epicardial fat is linked to impaired LV diastolic function. Visceral fat is associated with T2D independently of liver fat and abdominal subcutaneous adipose tissue

If I can taste it, I want it... : sensory marketing in grocery retail stores

Avhandlingen syftar till att undersöka hur man kan utveckla ett kognitivt baserat sensoriskt språk för olika produkter i detaljhandel och därefter använda det i marknadsföringen i butiksledet. Vidare undersökts om denna marknadsföring har någon effekt på konsumenternas val av produkt. Inom forskningsprocessen, tvärvetenskapligprocess, används metodik och teorier inom sensorik, lingvistik (semantik) och marknadsföring (konsumentbeteende). I en sensorisk studie jämfördes en tränad sensorisk panel och en grupp konsumenters förmåga att beskriva och analysera olika produkters sensoriska egenskaper. Resultatet visade på att de två gruppernas beskrivningar av de olika produkterna var relativt överensstämmande. Att beskriva smak verbalt anses som relativt svårt och komplext. Baserat på det sensoriska resultatet analyserades egenskapsorden ytterligare utifrån ett lingvistiskt perspektiv, semantik. Den semantiska analysen, empiriska resultat och teori, påvisade en möjlighet att utvinna värdefulla attribut från mer diffusa attribut, t.ex. ”nötig smak” – som kan härledas från sort, e.g. ”mandel” som i sin tur innefattar olika egenskaper i form a smak, doft, textur etc. För att ta reda på om de sensoriska beskrivningarna hade någon effekt på konsumenternas beteende och val i butik genomfördes två empiriska studier. Konsumenternas val av produkt i butik studerades utifrån olika variabler; sensoriska beskrivningar, sensoriska och semantiska beskrivningar, sortnamn, pris, och smak preferens. Resultatet visade att de sensoriska beskrivningarna påverkade konsumenternas val av produkt, t.ex. när bara sort namn kommunicerades var man benägen att välja en känd sort, men när man använde sig av sensoriska beskrivningar skiftade konsumenternas val och de var inte längre styrda av det mer välkända sortnamnet. Vidare visade det sig att konsumenterna vara mindre priskänslig när sensoriska beskrivningar visades. Konklusion: Användningen av ett sensoriskt språk i marknadsföringen av de undersökta livsmedlen påverkade konsumenternas val av produkt i butik samt att konsumenterna tenderade till att vara mindre priskänslig när sensoriska beskrivningar användes.Denna avhandling är ett resultat av ett forskningsprojekt med arbetstiteln ”Det sensoriska språket-ett marknadsföringsverktyg” vars syfte var att utveckla ett sen­soriska språk för frukt och grönsaker för att se om detta språk i marknads­föringen kan påverka konsumenternas preferens, val, av olika livsmedel i detaljhandeln.Forskningsprojektet var ett samarbetsprojekt mellan Örebro universitet, Restaurang- och hotellhögskolan, Grythytte Akademi och ICA Sverige AB med delfinansiering av Kunskaps & Kompetensstiftelsen. Forskargruppen bestod av:Professor emerita Inga-Britt Gustafsson, Örebro universitetDocent Åsa Öström, Örebro universitetProfessor Lena Mossberg, Handelshögskolan i GöteborgFil.Dr. Ulf Larsson, Örebro universitetLisbeth Kohls, ICA Sverige A

Model or Muddle? Governance and Management of Radioactive Waste in Sweden

The governance and management of radioactive waste in Sweden is often seen as a model for the world. Since the 1980s, the radioactive waste company SKB, which is owned by the Swedish nuclear operators and is legally responsible for radioactive management, has internationally encouraged the idea that Sweden “has solved the radioactive waste problem”. The government has generally been pleased with this situation and has for many years presented the Swedish legislation as a governance model for other nations to follow

Model or Muddle? Governance and Management of Radioactive Waste in Sweden

The governance and management of radioactive waste in Sweden is often seen as a model for the world. Since the 1980s, the radioactive waste company SKB, which is owned by the Swedish nuclear operators and is legally responsible for radioactive management, has internationally encouraged the idea that Sweden “has solved the radioactive waste problem”. The government has generally been pleased with this situation and has for many years presented the Swedish legislation as a governance model for other nations to follow

Surveillance for patients with precancerous lesions in the stomach

Ievads. Intestinālā tipa kuņģa adenokarcinomas attīstība notiek sekojoši kuņģa pirmsvēža stāvokļu attīstības kaskādei. Izsekojot pacientus ar kuņģa pirmsvēža stāvokļiem, ir iespējams savlaicīgi konstatēt agrīnas neoplastiskas izmaiņas. Darba mērķis. Analizēt kuņģa pirmsvēža stāvokļu izplatību pētījumā iekļauto pacientu grupā un izvērtēt kuņģa pirmsvēža stāvokļu dinamiskas izmaiņas GASTRO centra pacientiem. Materiāli un metodes. Retrospektīvi tika analizēti 909 pirmreizēji izmeklēto pacientu dati un 95 atkārtoti izmeklēto pacientu dati, kuriem veiktas augšējās endoskopijas ar biopsijas paraugu ņemšanu atbilstoši vadlīniju prasībām laika periodā no 2013. līdz 2018. gadam. Pacienti tika iedalīti četrās dažāda riska grupās, analizētas kuņģa gļotādas pirmsvēža stāvokļu dinamiskas izmaiņas šajās riska grupās. Rezultāti. No izmeklēto pacientu kopskaita 66,9% bija sievietes (biežākais vecums- 60-80 gadi) un 33,1%- vīrieši (biežākais vecums- 50-80 gadi). 82% gļotādas biopsiju tika veiktas atbilstoši standartprasībām. 82,2% pacientiem tika konstatēta kuņģa gļotādas atrofija (jebkuras pakāpes), 81,4%- intestinālā metaplāzija (IM) (jebkuras pakāpes), 50,7%- displāzija (viegla, smaga). Sieviešu populācijā 36% tika konstatēta mērena atrofijas pakāpe un 39% mērena IM pakāpe, bet vīriešu populācijā- 38% zema atrofijas pakāpe un 34% mērena, 33% augsta IM pakāpe. 66% GASTRO centra pacientu konstatēta OLGA I-II un 56%- OLGIM I-II stadijas. Visās vecuma grupās līdz 80 gadiem vīriešiem konstatēta lielāka displāzijas incidence, biežākā displāzijas lokalizācija visās pacientu grupās- kuņģa antrālā daļa (64%), visbiežāk skarts kuņģa mazais loks (80%). Sievietēm visbiežāk displāzija konstatēta 50- 60 gadu vecumā, vīriešiem- 40- 70 gadu vecumā. Atkārtoti izmeklēto pacientu grupā minimālais laika intervāls starp pirmreizējo un atkārtoto izmeklējumu- 3,5 gadi, maksimālais- 5 gadi, mediāna- 4,1 gads. Atkārtoti izmeklēto pacientu grupā 79% displāzija netika konstatēta ne pirmreizējā, ne atkārtotā izmeklējumā, 14% tās pakāpe mainījās no vieglas uz neesošu, taču nevienā gadījumā nemainījās uz augstāku; 61% atrofijas pakāpe mainījās uz zemāku, 23%- nemainījās, 16%- mainījās uz augstāku; 57% IM pakāpe mainījās uz zemāku, 30%- nemainījās; 13% mainījās uz augstāku. Secinājumi. Statistiski nozīmīga atšķirība atkarībā no dzimuma ir kuņģa gļotādas atrofijas un IM smaguma pakāpei, savukārt displāzijai- nav, kā arī atkarībā no vecuma- kuņģa gļotādas atrofijai un displāzijai, savukārt IM- nav. Atkārtoti izmeklēto pacientu grupā 68% gadījumu kuņģa gļotādas pirmsvēža stāvokļi dinamikā mainījās uz zemāku pakāpi: 17%- par vienu pakāpi, 27%- par divām, 16%- par trīs, 8%- par četrām. Atrofijas un IM gadījumā būtiskas dinamikas izmaiņas atkarībā no lokalizācijas netika konstatētas. 40% pacientu pēc kontroles izmeklējumiem turpina kuņģa pirmsvēža stāvokļu dinamisku novērošanu.Introduction. The development of intestinal type gastric adenocarcinoma occurs following a cascade of specific gastric precancerous lesions. By following- up the patients with gastric precancerous lesions, neoplastic changes can be detected early. Aim. To analyze the prevalence of gastric precancerous lesions and to evaluate the dynamic changes in the cascade of the gastric precancerous lesions in patients from GASTRO center. Materials and methods. In a retrospective analysis, data from 909 first- examined patients and 95 re-examined patients undergoing upper endoscopy with biopsy sampling in accordance with the guidelines for the period from 2013 to 2018 was obtained. Patients were divided into four different risk groups and analysed according to the dynamic changes of the precancerous lesions of the gastric mucosa in these risk groups. Results. 66.9% of all examined patients were women (most commonly 60-80 years old) and 33.1% - men (most commonly 50-80 years old). 82% of the mucosal biopsies were performed according to the standard requirements. Gastric mucosal atrophy (any grade) was found in 82.2% of patients, intestinal metaplasia (IM) (any grade) in 81.4%, dysplasia (mild, severe) in 50.7% of patients. In the female population moderate atrophy was detected in 36%, and moderate IM in 39% of cases, while in the male population mild atrophy was detected in 38% of the cases, moderate in 34%, and severe IM - in 33% of the cases. OLGA I-II was detected in 66% and OLGIM I-II in 56% of cases. In all age groups up to 80 years, men exhibited greater incidence of dysplasia, the most frequent localization of the dysplasia in all patient groups- gastric antrum (64%), the most commonly affected area- lesser curvature (80%). In women, dysplasia was most commonly found at the age of 50-60, in men- at the age of 40-70. In the re-examined patient group, the minimum time interval between the first and repeated examination was 3,5 years, maximum- 5 years, median- 4,1 years. In the re-examined patient group, 79% of the dysplasia was not detected either in the first-time or in the repeated examination, in 14% of cases it changed from mild to none, but in none of cases it changed to higher grade; in 61% atrophy grade changed to lower, 23% - did not change, 16% - changed to higher; 57% of the IM grade changed to lower, 30% - did not change; 13% changed to higher. Conclusion. When testing for statistically significant differences in observations comparing genders and different age groups, statistically significant differences were found for the severity of atrophy (gender, age group), IM (gender) and dysplasia (age group). In the re-examined patient group, in 68% of cases, gastric precancerous lesions changed to lower grade: 17% one grade lower, 27% -two, 16% -three, and 8% four grades lower. In the case of atrophy and IM, no significant changes after follow-up were detected based on localization. 40% of patients continue to be monitored

Similar outcome with an invasive strategy in men and women with non-ST-elevation acute coronary syndromes From the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)

Aims To assess gender differences in outcome with an early invasive or non-invasive strategy in patients with non-ST-elevation acute coronary syndromes (NSTE ACS). less thanbrgreater than less thanbrgreater thanMethods and results We included 46 455 patients [14 819 women (32%) and 31 636 men (68%)] from the SWEDEHEART register, with NSTE ACS, between 2000 and 2006, and followed them for 1 year. In the non-invasive strategy arm, the relative risk (RR) of death was (women vs. men) 1.02 [95% confidence interval (CI), 0.94-1.11] and in the invasive strategy arm 1.12 (95% CI, 0.96-1.29). After adjustment for baseline differences between the genders, with propensity score and discharge medication, there was a similar trend towards better outcome among women in both the early non-invasive cohort [RR 0.90 (95% CI, 0.82-0.99)] and the early invasive cohort [RR 0.90 (95% CI, 0.76-1.06)], although it did not reach statistical significance in the early invasive cohort. Results were similar with the combined endpoint death/myocardial infarction. An early invasive treatment was associated with a marked, and similar, mortality reduction in women [RR 0.46 (95% CI, 0.38-0.55)] and men [RR 0.45 (95% CI, 0.40-0.52)], without interaction with gender. less thanbrgreater than less thanbrgreater thanConclusion In this large cohort of patients with NSTE ACS, reflecting real-life management, women and men had similar and better outcome associated with an invasive strategy.Funding Agencies|County Council of Ostergotland||National Board of Health and Welfare||Swedish Society of Cardiology||Swedish Association of Local Authorities and Regions|