Fibroblast growth factor 23, mineral metabolism and mortality among elderly men (Swedish MrOs)

Background: Fibroblast growth factor 23 (FGF23) is the earliest marker of disturbed mineral metabolism as renal function decreases. Its serum levels are associated with mortality in dialysis patients, persons with chronic kidney disease (CKD) and prevalent cardiovascular disease (CVD), and it is associated with atherosclerosis, endothelial dysfunction and left ventricular hypertrophy in the general population. The primary aim of this study is to examine the association between FGF23 and mortality, in relation to renal function in the community. A secondary aim is to examine the association between FGF23 and CVD related death. Methods: The population-based cohort of MrOS Sweden included 3014 men (age 69-81 years). At inclusion intact FGF23, intact parathyroid hormone (PTH), 25 hydroxyl vitamin D (25D), calcium and phosphate were measured. Mortality data were collected after an average of 4.5 years follow-up. 352 deaths occurred, 132 of CVD. Association between FGF23 and mortality was analyzed in quartiles of FGF23. Kaplan-Meier curves and Log-rank test were used to examine time to events. Cox proportional hazards regression was used to examine the association between FGF23, in quartiles and as a continuous variable, with mortality. The associations were also analyzed in the sub-cohort with estimated glomerular filtration rate (eGFR) above 60 ml/min/1.73 m(2). Results: There was no association between FGF23 and all-cause mortality, Hazard ratio (HR) 95% confidence interval (CI): 1.02 (0.89-1.17). For CVD death the HR (95% CI) was 1.26 (0.99 - 1.59)/(1-SD) increase in log(10) FGF23 after adjustment for eGFR, and other confounders. In the sub-cohort with eGFR > 60 ml/min/1.73 m(2) the HR (95% CI) for CVD death was 55% (13-111)/(1-SD) increase in log(10) FGF23. Conclusions: FGF23 is not associated with mortality of all-cause in elderly community living men, but there is a weak association with CVD death, even after adjustment for eGFR and the other confounders. The association with CVD death is noticeable only in the sub-cohort with preserved renal function

"Precooking: The function and role of expert groups in the European Union"

In every political system there is an inbuilt tension between how a government is supposed to be organized and operate and how it really functions. The official version of how a government is organized is always complemented and sometimes even contradicted by an informal version. How the informal structure or the shadow world of government is formatted, and by whom, is of crucial importance for how power and influence is distributed in a political system. This study has carried out an analysis of one part of the informal structure of the EU and its relationship with the formal structure. Thus the focus of the study has been on expert groups and their primary instigator-the Commission. In this framework three questions have been raised. Firstly, taking into account the Commission's tight to set up expert groups, to what extent is this tool used and what type of expert groups ere set up? Secondly, by what means does the Commission-in organizational terms-control the work of the expert groups? Thirdly, why ere expert groups set up and in what way can expert groups be used to model the decision-making structure of the EU

Forvaltningsteori och forvaltningspraktik i Sverige

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An augmented Lagrangean scheme for capacitated traffic assignment problems

The inclusion of explicit bounds on the link ows in tra c assignment models has been proposed as a means to obtain a more accurate description of the tra c behaviour than that given by the basic, uncapacitated, model. Although the capacitated problem has the advantage of being numerically more tractable than models involving travel cost functions which tend to in nity as ows approach the link capacities, it has received very limited attention in the past. The main reason for this is that the explicit capacities make the problem computationally more demanding, since they destroy the Cartesian product structure of the feasible set of the uncapacitated model, which enables the development of highly e cient solution procedures for that problem. The availability of e cient procedures for the basic model motivates the use of dualization approaches for handling the capacity constraints of the more complex model � we propose and evaluate an augmented Lagrangean method in which uncapacitated tra c assignment subproblems are solved with the disaggregate simplicial decomposition algorithm. This algorithm fully exploits the subproblems ' structure and also has very favourable reoptimization facilities. Both these properties are of greatest importance for achievin

After Hierarchy? Domestic Executive Governance and the Differentiated Impact of the European Commission and the Council of Ministers

This study offers an organisation theory approach that claims that the differentiated organisational constellation of the European Union contributes to a differentiated Europeanisation of domestic core-executives. It is argued that the European Commission mainly activates the lower echelons of the domestic government hierarchies, notably professional experts within sector ministries and agencies. Furthermore, the European Commission arguably weakens domestic politico-administrative leadership, the Foreign Office and the Prime Ministers Office. By contrast, the Council of Ministers arguably strengthens domestic politico-administrative leadership, the Foreign Office and the Prime Ministers Office. A comparative analysis of the decision-making processes within the central administrations of Norway and Sweden is offered. Based on a rich body of survey and interview data this analysis reveals that multi-level interaction of administrative systems between the European Commission and the Norwegian and Swedish central administrations occur largely outside the control of the domestic politico-administrative leadership, Prime Ministers Office and Foreign Office. In Sweden this tendency is to some extent counterbalanced by the inter-sectorally interlocking effect of the Council of Ministers.European Commission; Council of Ministers; Norway; Sweden; organization theory; differentiation; governance; political science

Modifiable risk factors for epilepsy : A two-sample Mendelian randomization study

Introduction We conducted a two-sample Mendelian randomization study to determine the associations of modifiable risk factors with epilepsy. Methods Fourteen potential risk factors for epilepsy were selected based on a systematic review of risk factors for epilepsy. Single-nucleotide polymorphisms associated with each exposure at the genome-wide significance threshold (p < 5x10(-8)) were proposed as instrumental variables from corresponding genome-wide association studies. Summary-level data for epilepsy were obtained from the FinnGen consortium (4,588 cases and 144 780 noncases). Potential causal associations (p < .05) were attempted for replication using UK Biobank data (901 cases and 395 209 controls). Results Among 14 potential risk factors, 4 showed significant associations with epilepsy in FinnGen. All associations were directionally similar in UK Biobank and associated with epilepsy at p <= .004 in meta-analyses of FinnGen and UK Biobank data. The odds ratios of epilepsy were 1.46 (95% CI, 1.18, 1.82) for one unit increase in log odds ratio of having depression, 1.44 (95% CI, 1.13, 1.85) for one standard deviation increase in serum ferritin, 1.12 (95% CI, 1.04, 1.21) for one standard deviation increase in transferrin saturation, and 1.25 (95% CI, 1.09, 1.43) for one standard deviation increase in the prevalence of smoking initiation. There were suggestive associations of serum iron and magnesium with epilepsy. No association was observed for insomnia, blood pressure, alcohol consumption, or serum vitamin B12, 25-hydroxyvitamin D and calcium levels. Conclusion This MR study identified several modifiable risk factors for adulthood epilepsy. Reducing prevalence of depression and smoking initiation should be considered as primary prevention strategies for epilepsy