Cystatin C and cardiovascular disease : A mendelian randomization study

BACKGROUND: Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease (CVD), independent of creatinine-based renal function measurements. It is unclear whether this relationship is causal, arises from residual confounding, and/or is a consequence of reverse causation. OBJECTIVES: The aim of this study was to use Mendelian randomization to investigate whether cystatin C is causally related to CVD in the general population. METHODS We incorporated participant data from 16 prospective cohorts (n ¼ 76,481) with 37,126 measures of cystatin C and added genetic data from 43 studies (n ¼ 252,216) with 63,292 CVD events. We used the common variant rs911119 in CST3 as an instrumental variable to investigate the causal role of cystatin C in CVD, including coronary heart disease, ischemic stroke, and heart failure. RESULTS: Cystatin C concentrations were associated with CVD risk after adjusting for age, sex, and traditional risk factors (relative risk: 1.82 per doubling of cystatin C; 95% confidence interval [CI]: 1.56 to 2.13; p ¼ 2.12 1014). The minor allele of rs911119 was associated with decreased serum cystatin C (6.13% per allele; 95% CI: 5.75 to 6.50; p ¼ 5.95 10211), explaining 2.8% of the observed variation in cystatin C. Mendelian randomization analysis did not provide evidence for a causal role of cystatin C, with a causal relative risk for CVD of 1.00 per doubling cystatin C (95% CI: 0.82 to 1.22; p ¼ 0.994), which was statistically different from the observational estimate (p ¼ 1.6 105 ). A causal effect of cystatin C was not detected for any individual component of CVD. CONCLUSIONS: Mendelian randomization analyses did not support a causal role of cystatin C in the etiology of CVD. As such, therapeutics targeted at lowering circulating cystatin C are unlikely to be effective in preventing CVD. 

Den goda viljan och framtida lönsamhet : En studie om nedskrivning av goodwill är en ledande indikator på framtida minskad lönsamhet i svenska och finska börsnoterade bolag

Bakgrund: Goodwill är en omdebatterad immateriell tillgångspost. En nedskrivning ska enligt redovisningsstandarden IAS 36 baseras på bolagens framtida ekonomiska utveckling. Därmed kan en nedskrivning vara en indikation på hur bolagets ekonomiska framtid kommer att gestalta sig. Tidigare forskning visar att bolagsledningens subjektiva bedömningar kan leda till att nedskrivningens relevans kan ifrågasättas. Syfte: Enligt IFRS 3 och IAS 36 ska goodwill värderas till det framtida uppskattade värde som tillgången ska generera. Grundtanken med standarderna är att öka tillförlitligheten och relevansen för att bättre återspegla bolagens ekonomi i de finansiella rapporterna. Utifrån grundtanken bör en nedskrivning av goodwill vara en ledande indikator på framtida minskad lönsamhet. Vi avser därmed att undersöka om det finns ett samband mellan nedskrivning av goodwill och minskad framtida lönsamhet i svenska och finska börsnoterade bolag samt om det finns en skillnad mellan länderna när det gäller sambandet. Metod: Uppsatsen är baserad på en kvantitativ metod med en deduktiv ansats där sekundärdata hämtats från databas samt årsredovisningar. Informationen har samlats in för att därefter testas med regressionsanalyser. Slutsats: Studien kan inte styrka att standarden ger en bättre återspegling av bolagens ekonomi i de finansiella rapporterna. Resultatet visar att hanteringen av goodwill kan ske utifrån ett opportunistiskt beteende då nedskrivningen kan vara baserad på en redan realiserad försämring av goodwill istället för att vara baserad på framtida bedömningar. Resultatet antyder att tillsynen inte är harmoniserad inom EU, då det finns en signifikant skillnad mellan Sverige och Finland två år efter nedskrivningen. Studiens resultat kan användas till att ifrågasätta gällande standardens utformning.

Evaluation of a versatile energy auditing tool

Energy auditing can be an important contribution for identification and assessment of energy conservation measures (ECMs) in buildings. Numerous tools and software have been developed, with varying degree of precision and complexity and different areas of use.   This paper evaluates PHPP as a versatile, easy-to-use energy auditing tool and gives examples of how it has been compared to a dynamic simulation tool, within the EU-project iNSPiRe. PHPP is a monthly balance energy calculation tool based on EN13790. It is intended for assisting the design of Passive Houses and energy renovation projects and as guidance in the choice of appropriate ECMs.   PHPP was compared against the transient simulation software TRNSYS for a single family house and a multi-family house. It should be mentioned that dynamic building simulations might strongly depend on the model assumptions and simplifications compared to reality, such as ideal heating or real heat emission system. Setting common boundary conditions for both PHPP and TRNSYS, the ideal heating and cooling loads and demands were compared on monthly and annual basis for seven European locations and buildings with different floor area, S/V ratio, U-values and glazed area of the external walls.   The results show that PHPP can be used to assess the heating demand of single-zone buildings and the reduction of heating demand with ECMs with good precision. The estimation of cooling demand is also acceptable if an appropriate shading factor is applied in PHPP. In general, PHPP intentionally overestimates heating and cooling loads, to be on the safe side for system sizing. Overall, the agreement with TRNSYS is better in cases with higher quality of the envelope as in cold climates and for good energy standards. As an energy auditing tool intended for pre-design it is a good, versatile and easy-to-use alternative to more complex simulation tools.