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A report on a four-axis ultra-high-stability manipulator developed for use at the Veritas and Species RIXS beamlines at MAX IV Laboratory, Lund, Sweden, is presented. The manipulator consists of a compact, light-weight X-Y table with a stiffened Z tower carrying a platform with a rotary seal to which a manipulator rod holding the sample can be attached. Its design parameters have been optimized to achieve high eigen-frequencies via a light-weight yet stiff construction, to absorb forces without deformations, provide a low center of gravity, and have a compact footprint without compromising access to the manipulator rod. The manipulator system can house a multitude of different, easily exchangeable, manipulator rods that can be tailor-made for specific experimental requirements without having to rebuild the entire sample positioning system. It is shown that the manipulator has its lowest eigen-frequency at 48.5 Hz and that long-term stability is in the few tens of nanometres. Position accuracy is shown to be better than 100 nm. Angular accuracy is in the 500 nrad range with a long-term stability of a few hundred nanoradians.

With the introduction of the multi-bend achromats in the new fourth-generation storage rings the emittance has decreased by an order of magnitude resulting in increased brightness. However, the higher brightness comes with smaller beam sizes and narrower radiation cones. As a consequence, the requirements on mechanical stability regarding the beamline components increases. Here an innovative five-axis parallel kinematic mirror unit for use with soft X-ray beamlines using off-axis grazing-incidence optics is presented. Using simulations and measurements from the HIPPIE beamline at the MAX IV Laboratory it is shown that it has no Eigen frequencies below 90 Hz. Its positioning accuracy is better than 25 nm linearly and 17-35 mu rad angularly depending on the mirror chamber dimensions.

Aims: Obesity is associated with type 2 diabetes mellitus, left ventricular diastolic dysfunction and heart failure but it is unclear to which extent it is related to left ventricular systolic dysfunction. The aim of the study was to explore the effects of overweight and obesity on left ventricular systolic function in patients with type 2 diabetes mellitus and a control group of non-diabetic persons. Methods: We prospectively investigated 384 patients with type 2 diabetes mellitus, and 184 controls who participated in the CARDIPP and CAREFUL studies. The participants were grouped according to body mass index (normal weight amp;lt; 25 kg/m(2), overweight 25-29 kg/m(2), and obesity amp;gt;= 30 kg/m(2) ). Echocardiography was performed at the beginning of the study and after 4-years in the patient group. Results: Univariable and multivariable regression analysis revealed that variations in left ventricular ejection fraction, global longitudinal strain, left ventricular mass and diastolic function expressed as E/e (the ratio between early diastolic mitral flow and annular motion velocities) all are related to body mass index. The mean and standard deviation of left ventricular ejection fraction and global longitudinal strain values were 57% (8%) vs. - 18.6% (2.3%) for normal weight patients, 53% (8%) vs. - 17.5% (2.3%) for overweight, and 49% (9%) vs. - 16.2% (3.0%) for obese (p amp;lt; 0.05 vs. p amp;lt;0.05). Corresponding results in the control group were 58% (6%) vs. -22.3% (3.0%), 55% (7%) vs. - 20.8% (3.1%) and 54% (8%) - 19.6% (4.0%) (p amp;lt;0.05 vs. p amp;lt;0.05). Patients who gained weight from baseline to follow-up changed left ventricular ejection fraction (median and interquartile range) by - 1.0 (9.0) % (n =187) and patients who lost weight changed left ventricular ejection fraction by 1.0 (10.0) % (n =179) (p amp;lt;0.05). Conclusion: Overweight and obesity impair left ventricular ejection fraction and global longitudinal strain in both patients with t, Funding Agencies|FORSS; Research Council of Southeastern Sweden; Swedish Heart-Lung foundation; King Gustaf V and Queen Victoria Freemason Foundation, Sweden

SPECIES is an undulator-based soft X-ray beamline that replaced the old I511 beamline at the MAX II storage ring. SPECIES is aimed at high-resolution ambient-pressure X-ray photoelectron spectroscopy (APXPS), near-edge X-ray absorption fine-structure (NEXAFS), X-ray emission spectroscopy (XES) and resonant inelastic X-ray scattering (RIXS) experiments. The beamline has two branches that use a common elliptically polarizing undulator and monochromator. The beam is switched between the two branches by changing the focusing optics after the monochromator. Both branches have separate exit slits, refocusing optics and dedicated permanent endstations. This allows very fast switching between two types of experiments and offers a unique combination of the surface-sensitive XPS and bulk-sensitive RIXS techniques both in UHV and at elevated ambient-pressure conditions on a single beamline. Another unique property of the beamline is that it reaches energies down to approximately 27 eV, which is not obtainable on other current APXPS beamlines. This allows, for instance, valence band studies under ambient-pressure conditions. In this article the main properties and performance of the beamline are presented, together with selected showcase experiments performed on the new setup.

AIM: This study explored the association between reduced estimated glomerular filtration rate (eGFR) and microalbuminuria vs. subclinical organ damage in patients with type 2 diabetes. METHODS: Data from middle-aged patients with type 2 diabetes (n=706) treated in primary care were analyzed for microalbuminura, defined as a urinary albumin/creatinine ratio (uACR)≥3.0mmol/mol, and reduced eGFR, defined as<60mL/min/1.73m(2), in relation to blood pressure, pulse wave velocity (PWV), left ventricular mass index (LVMI), and carotid intima-media thickness (IMT) and lumen diameter (LD). RESULTS: Patients with microalbuminuria had significantly higher 24-h ambulatory systolic blood pressure (ASBP) compared with subjects with uACR<3mg/mmol: 137 vs. 128mmHg (P<0.001). There were no differences in ASBP in patients with eGFR<60mL/min/1.73m(2). However, patients with vs. without microalbuminuria had increased PWV (11.4 vs. 10.1m/s; P<0.001), LVMI (134.4 vs. 118.6g/m(2); P<0.001), LD (7.01±0.93 vs. 6.46±0.74mm; P<0.001) and IMT (0.78 vs. 0.74mm; P=0.047), respectively. The associations between uACR vs. PWV and LVMI were more robust after adjusting for age, diabetes duration, ASBP, HbA1c, LDL-cholesterol, and antihypertensive and lipid-lowering therapy compared with uACR vs. IMT. There were no statistically significant differences in PWV, LVMI or IMT between patients with reduced (<60mL/min/1.73m(2)) vs. normal eGFR. CONCLUSION: Levels of urinary albumin excretion, but not reduced eGFR, were associated with increased arterial stiffness, left ventricular mass and atherosclerosis in patients with type 2 diabetes.

Sjukdomsbegreppet har ­genom samhällets utveckling förändrats och omfattar dimensioner som inte är enbart biologiskt medicinska. Vi ­läkare saknar objektiva redskap att röra oss med, vilket riskerar att styra kompetens och resurser bort från det som vi borde ägna oss åt.

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Hypoglykemier kan orsaka försämring av intellektuella funktioner och ge symtom som oro och agitation. Äldre multisjuka patienter torde vara särskilt känsliga för sådana bieffekter. Vi har på patienter med typ 2-diabetes i särskilt boende genomfört en öppen strukturerad utsättningsstudie av insulin och perorala diabetesläkemedel hos patienter med HbA1c ≤6,0 procent. Av de 32 patienter som fick sina diabetesläkemedel minskade eller utsatta kunde 24 fullfölja studien. I denna grupp steg HbA1c under stu­dien från 5,2 procent till måttliga 5,8 procent efter såväl 3 som 6 månader. Resultaten bör kunna tjäna som stöd för att under kontrollerade former minska eller avveckla diabetesbehandlingen i livets slutskede hos svårt mul­ti­sjuka patien­­ter med låga HbA1c-nivåer.