Journal articles on the topic 'Sweden. (1707 September 1)'
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Heyder, J., M. Dahlbäck, and G. Smaldone. "European Aerosol Conference, September 1988, Lund, Sweden." Journal of Aerosol Science 20, no. 6 (January 1989): 723–24. http://dx.doi.org/10.1016/0021-8502(89)90062-1.
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Pettersson, Martin, John Frampton, Jonas Rönnberg, and Venche Talgø. "Neonectria Canker Found on Spruce and Fir in Swedish Christmas Tree Plantations." Plant Health Progress 17, no. 3 (January 2016): 202–5. http://dx.doi.org/10.1094/php-br-16-0017.
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In May 2015, a Christmas tree disease and pest survey was carried out in southern Sweden. Neonectria canker found on spruce and fir was the most prominent disease problem. Accepted for publication 1 September 2016.
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Stolt, Bengt-Olov. "The Swedish Reed Warbler Acrocephalus scirpaceus population estimated by a capture-recapture technique." Ornis Svecica 9, no. 1–2 (April 1, 1999): 35–46. http://dx.doi.org/10.34080/os.v9.22914.
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The number of Reed Warblers Acrocephalus scirpaceus leaving Sweden on autumn migration was estimated by a capture-recapture technique. A large number of Reed Warblers are ringed annually, mainly in July–September. During the same period, shortly after ringing, these birds leave Sweden on autumn migration directed south-west. One sample is recaptured at the south-western corner of Sweden, at Falsterbo Bird Observatory, and the capture-recapture technique can be used to estimate the size of the total population. The result of the calculation for the total number of Reed Warblers leaving Sweden each autumn was 3.3 million (95 % confidence interval ±0.86 million). The corresponding number for the juvenile birds was 1.8 million (±0.63 million). Due to a low rate of recaptures of ringed adult birds at Falsterbo, the calculated total number may be too high, whereas the number achieved for juvenile birds was judged to be more correct. Detailed analyses of available data support that about 1.8 million juvenile birds leave Sweden on autumn migration. Among them, 5.7 % are assumed to be of Finnish origin and 1 % are assumed to come from other areas outside Sweden. On the basis of available data on survival, breeding success, pair density and reed areas, the mean annual breeding population of Reed Warblers in Sweden, 1988–1993, was estimated to be about 500,000 to 600,000 pairs, which is a larger population than previously assumed.
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Lõhmus, Mare, Tomas Lind, Laura MacLachlan, Agneta Ekebom, Björn Gedda, Pia Östensson, and Antonios Georgelis. "Combined Exposure to Birch Pollen and Thunderstorms Affects Respiratory Health in Stockholm, Sweden—A Time Series Analysis." International Journal of Environmental Research and Public Health 19, no. 10 (May 11, 2022): 5852. http://dx.doi.org/10.3390/ijerph19105852.
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Background: Thunderstorm asthma is a term used to describe surges in acute respiratory illnesses following a thunderstorm and is often attributed to an intense exposure to aeroallergens. Several episodes of thunderstorm asthma have been observed worldwide; however, no such cases have been described in Sweden. In Sweden, the most prominent exposure to air-borne pollen occurs during the blooming of the birch. We aimed to explore the associations between respiratory health and the combined exposure to thunderstorms and birch pollen. Methods: We investigated the association between the daily numbers of outpatient visits due to respiratory cases and the combined exposure to thunderstorms and birch pollen during the period of 1 May–31 September in 2001–2017, in Stockholm County, Sweden, by using time series analysis with log linear models. Results: We detected noticeable increases in the number of outpatient visits on both the same day (max 26%; 95% CI 1.16–1.37) and the day after (max 50%; 95% CI 1.32–1.70) the occurrence of a thunderstorm, when the concentrations of birch pollen and the number of lightning discharges were within the highest categories. Conclusions: It is possible that co-exposure to heavy thunderstorms and high concentrations of birch pollen affects the respiratory health of the Stockholm population. To the best of our knowledge, this is the first study addressing the thunderstorm-related respiratory illnesses in Sweden and the effects of birch pollen. Our study may be important for future public health advice related to thunderstorm asthma.
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Polstianoy, A. M., K. K. Gubarev, O. Yu Polstianaya, and I. V. Rendashkin. "Issues of preparation for implementing uterine transplantation in clinical practice." Transplantologiya. The Russian Journal of Transplantation 15, no. 1 (March 19, 2023): 79–88. http://dx.doi.org/10.23873/2074-0506-2023-15-1-79-88.
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The absolute uterine factor infertility is a non-treatable cause of female infertility. Surrogacy has become the only option that allows this group of patients to achieve genetic, although biological motherhood. According to statistics there are more than 30 thousand women of fertile age in Russia who cannot get pregnant due to the absolute uterine factor infertility. The recently emerged possibility of uterine transplantation has become the only treatment for this kind of female infertility.Prior to the very first clinical study of human uterine transplantation which was carried out in 2013 in Sweden, scientists had conducted systematic studies in animals (rodents, pigs, cattle and primates). The first clinical trial with the uterine transplantation performed resulted in a live birth in September 2014. Currently, cases of successful uterine transplantation in humans have been reported in Sweden, Brazil, USA and Italy. Experience and practice in animal research played a key role in the success of the first clinical study on uterine transplantation. The application of this method is fundamental in the introduction of the scientifically grounded technology of uterine transplantation in Russia.Aim. Analysis of the problems of the clinical application of the uterine transplantation based on a literature review.
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Källander, Hans. "Intraspecific kleptoparasitism in flock-fishing Great Crested Grebes (Podiceps cristatus) and Great Cormorants (Phalacrocorax carbo) – a cost to participants?" Ornis Hungarica 21, no. 1 (June 1, 2013): 36–40. http://dx.doi.org/10.2478/orhu-2013-0014.
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Abstract Intraspecific kleptoparasitism was studied in flock-fishing Great Crested Grebes Podiceps cristatus during May and June 2011 and in Great Cormorants Phalacrocorax carbo during September 2011 and August 2012 at Lake Krankesjön, South Sweden, for a total of c.11 h for grebes and c.6 h for cormorants. Only attempts to steal large fish (relative to a bird’s gape) were recorded, because small fish mostly did not elicit kleptoparasitic attempts and those seen appeared never to be successful. Attempts to steal large fish were rare, 0.14 h-1 grebe-1 (N = 96) and 0.39 h-1 cormorant-1 (N = 163). In both species, the host lost its fish in about 20% of cases. Based on the observed low parasitism and success rates, it is concluded that kleptoparasitism was a minor cost of participating in flock-fishing
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Elgesem, Dag, and Andrea Kronstad Felde. "‘How dare you!’ – anklager og mot-anklager på Facebook knyttet til Greta Thunbergs FN-tale 23. september 2019." Rhetorica Scandinavica, no. 82 (September 3, 2021): 34–49. http://dx.doi.org/10.52610/xdnv7734.
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The contribution analyzes accusations related to Greta Thunberg’s speech in the UN on September 2019, posted on public Facebook pages in Denmark, Norway and Sweden. The accusations we analyze are of three types: 1. Accusations that amplify and mirror Thunberg’s accusations, 2. Accusations against Thunberg, her followers, and supporters, and 3. Accusations against people who are bullying Thunberg and her followers online. None of the accusations is the first move in an apologetic discourse. We argue that the rhetorical functions of accusations that are not met with an apology have two important characteristics: 1. they attribute responsibility to the accused by expressing a reactive attitude towards his or her action, 2. they express a judgement that the action is blameworthy. We use these perspectives to analyze the accusations related to Thunberg’s speech on the public Facebook pages and characterize the rhetorical functions of the three types of accusations
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Bayes-Genis, Antoni, Pablo Avanzas, Leopoldo Pérez de Isla, Juan Sanchis, and Magda Heras. "Summary of the Clinical Studies Reported in the European Society of Cardiology Congress 2010 (August 28-September 1, 2010, Stockholm, Sweden)." Revista Española de Cardiología (English Edition) 63, no. 11 (January 2010): 1292–303. http://dx.doi.org/10.1016/s1885-5857(10)70254-1.
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Nilsson, Lars Owe, and Tom Ericsson. "Influence of shoot age on growth and nutrient uptake patterns in a willow plantation." Canadian Journal of Forest Research 16, no. 2 (April 1, 1986): 185–90. http://dx.doi.org/10.1139/x86-034.
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The seasonal patterns of growth and nutrient uptake of a short-rotation Salixviminalis L. plantation located along the southeastern coast of Sweden were investigated during 1981. One-year-old shoots of clone 683 yielded 9.6 t dry weight ha−1 of stems and 4.2 t dry weight ha−1 of leaves; whereas the same cultural treatment during the 2nd year after coppicing yielded 13.3 and 8.2 t dry weight ha−1, respectively. Maximums in foliage dry weight occurred between early August and early September in the older shoots (6.3 t ha−1) and in late September in the younger shoots (3.5 t ha−1). Foliage and stem growth early in the season were markedly higher in the 2-year-old shoots than in the 1-year-old shoots. N uptake increased rapidly shortly after the first fertilizer application in all three investigated plots. Aboveground N uptake ranged from 140 to 191 kg ha−1 year−1. From the onset of liquid fertilization until the end of the growing season the aboveground N uptake ranged from 92 to 98 kg N ha−1; the total N fertilization during this period was 120 kg N ha−1. Nitrogen productivity varied between clones and was higher for 2- than for 1-year-old shoots. Greater relative amounts of biomass and N were allocated to leaves on the 2-year-old shoots. The amount of N allocated to stems for producing 11 of stem biomass decreased from 4.3 to 2.5 kg during the 2nd year after coppicing.
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Hooke, Roger LeB, Peter Calla, Per Holmlund, Mats Nilsson, and Arjen Stroeven. "A 3 Year Record of Seasonal Variations in Surface Velocity, StorglaciÄren, Sweden." Journal of Glaciology 35, no. 120 (1989): 235–47. http://dx.doi.org/10.3189/s0022143000004561.
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Abstract Between 3 June 1982 and 8 July 1985, a stake net consisting of up to 32 stakes covering the greater part of Storglaciären was surveyed 70 times, yielding roughly 2000 separate determinations of vertical and horizontal velocity. The time interval between surveys averaged about 1 week during the summer and 2 months during the winter. Horizontal velocities were normally highest during periods of high daily temperature or heavy rain early in the melt season. Comparable or sometimes higher temperatures or rainfalls later in the season usually had less effect, though minor velocity peaks were often present in August and early September. During periods for which bore-hole water-level measurements are available, velocity peaks generally coincided with periods of high basal water pressure, but not all periods of high water pressure resulted in velocity peaks. Despite increasing basal water pressures, velocity decreased gradually during the winter. Vertical velocities also vary seasonally. Beneath the upper part of the ablation area the glacier bed is overdeepened. Vertical velocities here are ˜3 mm/d higher during the summer. Down-glacier from the overdeepening, vertical velocities are ˜1 mm/d lower during the summer. These and other characteristics of the vertical velocity pattern are best explained by appealing to: (1) a decrease in strain-rate with depth, and (2) seasonal variations in this depth-dependence. Five periods of high velocity lasting from 3 to 11d were studied in detail. In an area where the bed is overdeepened, force-balance calculations suggest that basal drag decreased between 16 and 40% during these high-velocity events. This resulted in a decrease in compressive strain-rate at the up-glacier end of the overdeepening, an increase at the down-glacier end, and a slight increase in lateral shear strain-rates. Down-glacier from the overdeepening, basal drag increased during two events owing to an increased push from up-glacier and pull from down-glacier. Lateral shear strain-rates increased sharply here.
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Opatowski, Marion, Unnur Anna Valdimarsdóttir, Anna Sara Oberg, Elizabeth R. Bertone-Johnson, and Donghao Lu. "Mortality Risk Among Women With Premenstrual Disorders in Sweden." JAMA Network Open 7, no. 5 (May 28, 2024): e2413394. http://dx.doi.org/10.1001/jamanetworkopen.2024.13394.
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ImportancePremenstrual disorders (PMDs) adversely affect the quality of life of millions of women worldwide, yet research on the long-term consequences of PMDs is limited, and the risk of mortality has not been explored.ObjectiveTo estimate the associations of PMDs with overall and cause-specific mortality.Design, Setting, and ParticipantsThis nationwide, population-based, matched cohort study used data from population and health registers in Sweden. Participants included women of reproductive age with a first diagnosis of PMDs between January 1, 2001, and December 31, 2018. Data analysis was performed from September 2022 to April 2023.ExposuresPMDs were identified through inpatient and outpatient diagnoses and drug dispensing.Main Outcomes and MeasuresDates of death and underlying causes were ascertained from the National Cause of Death Register. Conditional Cox regression was used to estimate the hazard ratios (HRs) of overall and cause-specific death (eg, death due to natural or nonnatural cause, suicide, or cardiovascular events), adjusting for age, socioeconomic status, and somatic and psychiatric comorbidities; in a separate sibling comparison, models were also adjusted for all factors that sisters share.ResultsA total of 67 748 women with clinically diagnosed PMDs and 338 740 matched unaffected women were included, for a total of 406 488 women. Women with PMDs received a diagnosis at a mean (SD) age of 35.8 (8.2) years. During a mean (SD) follow-up of 6.2 (4.6) years (range, 1-18 years), 367 deaths were observed among women with PMDs (rate, 8.4 deaths per 10 000 person-years; 95% CI, 7.6-9.3 deaths per 10 000 person-years), and 1958 deaths were observed among women without PMDs (rate, 9.1 deaths per 10 000 person-years; 95% CI, 8.7-9.6 deaths per 10 000 person-years). Compared with unaffected women, women with PMDs had increased risk of death due to nonnatural causes (HR, 1.59; 95% CI, 1.25-2.04), particularly suicide (HR, 1.92; 95% CI, 1.43-2.60), but they did not have increased risk of overall mortality (adjusted HR, 0.91; 95% CI, 0.82-1.02). Notably, women who received a diagnosis before the age of 25 years experienced higher all-cause mortality (HR, 2.51; 95% CI, 1.42-4.42) and death from both suicide (HR, 3.84; 95% CI, 1.18-12.45) and natural causes (HR, 2.59; 95% CI, 1.21-5.54).Conclusions and RelevanceThe findings of this matched cohort study suggest that women with PMDs are not at increased risk of early death overall. However, the risk was elevated among young women and for death by suicide. This supports the importance of careful follow-up for young patients and highlights the need to develop suicide prevention strategies for all women with PMDs.
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Seco, Roger, Thomas Holst, Mikkel Sillesen Matzen, Andreas Westergaard-Nielsen, Tao Li, Tihomir Simin, Joachim Jansen, et al. "Volatile organic compound fluxes in a subarctic peatland and lake." Atmospheric Chemistry and Physics 20, no. 21 (November 11, 2020): 13399–416. http://dx.doi.org/10.5194/acp-20-13399-2020.
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Abstract. Ecosystems exchange climate-relevant trace gases with the atmosphere, including volatile organic compounds (VOCs) that are a small but highly reactive part of the carbon cycle. VOCs have important ecological functions and implications for atmospheric chemistry and climate. We measured the ecosystem-level surface–atmosphere VOC fluxes using the eddy covariance technique at a shallow subarctic lake and an adjacent graminoid-dominated fen in northern Sweden during two contrasting periods: the peak growing season (mid-July) and the senescent period post-growing season (September–October). In July, the fen was a net source of methanol, acetaldehyde, acetone, dimethyl sulfide, isoprene, and monoterpenes. All of these VOCs showed a diel cycle of emission with maxima around noon and isoprene dominated the fluxes (93±22 µmol m−2 d−1, mean ± SE). Isoprene emission was strongly stimulated by temperature and presented a steeper response to temperature (Q10=14.5) than that typically assumed in biogenic emission models, supporting the high temperature sensitivity of arctic vegetation. In September, net emissions of methanol and isoprene were drastically reduced, while acetaldehyde and acetone were deposited to the fen, with rates of up to -6.7±2.8 µmol m−2 d−1 for acetaldehyde. Remarkably, the lake was a sink for acetaldehyde and acetone during both periods, with average fluxes up to -19±1.3 µmol m−2 d−1 of acetone in July and up to -8.5±2.3 µmol m−2 d−1 of acetaldehyde in September. The deposition of both carbonyl compounds correlated with their atmospheric mixing ratios, with deposition velocities of -0.23±0.01 and -0.68±0.03 cm s−1 for acetone and acetaldehyde, respectively. Even though these VOC fluxes represented less than 0.5 % and less than 5 % of the CO2 and CH4 net carbon ecosystem exchange, respectively, VOCs alter the oxidation capacity of the atmosphere. Thus, understanding the response of their emissions to climate change is important for accurate prediction of the future climatic conditions in this rapidly warming area of the planet.
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Sund, Malin, Osvaldo Fonseca-Rodríguez, Andreas Josefsson, Karin Welen, and Anne-Marie Fors Connolly. "Association between pharmaceutical modulation of oestrogen in postmenopausal women in Sweden and death due to COVID-19: a cohort study." BMJ Open 12, no. 2 (February 2022): e053032. http://dx.doi.org/10.1136/bmjopen-2021-053032.
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ObjectiveDetermine whether augmentation of oestrogen in postmenopausal women decreases the risk of death following COVID-19.DesignNationwide registry-based study in Sweden based on registries from the Swedish Public Health Agency (all individuals who tested positive for SARS-CoV-2); Statistics Sweden (socioeconomical variables) and the National Board of Health and Welfare (causes of death).ParticipantsPostmenopausal women between 50 and 80 years of age with verified COVID-19.InterventionsPharmaceutical modulation of oestrogen as defined by (1) women with previously diagnosed breast cancer and receiving endocrine therapy (decreased systemic oestrogen levels); (2) women receiving hormone replacement therapy (increased systemic oestrogen levels) and (3) a control group not fulfilling requirements for group 1 or 2 (postmenopausal oestrogen levels). Adjustments were made for potential confounders such as age, annual disposable income (richest group as the reference category), highest level of education (primary, secondary and tertiary (reference)) and the weighted Charlson Comorbidity Index (wCCI).Primary outcome measureDeath following COVID-19.ResultsFrom a nationwide cohort consisting of 49 853 women diagnosed with COVID-19 between 4 February and 14 September 2020 in Sweden, 16 693 were between 50 and 80 years of age. We included 14 685 women in the study with 11 923 (81%) in the control group, 227 (2%) women in group 1 and 2535 (17%) women in group 2. The unadjusted ORs for death following COVID-19 were 2.35 (95% CI 1.51 to 3.65) for group 1 and 0.45 (0.34 to 0.6) for group 2. Only the adjusted OR for death remained significant for group 2 with OR 0.47 (0.34 to 0.63). Absolute risk of death was 4.6% for the control group vs 10.1% and 2.1%, for the decreased and increased oestrogen groups, respectively. The risk of death due to COVID-19 was significantly associated with: age, OR 1.15 (1.14 to 1.17); annual income, poorest 2.79 (1.96 to 3.97), poor 2.43 (91.71 to 3.46) and middle 1.64 (1.11 to 2.41); and education (primary 1.4 (1.07 to 1.81)) and wCCI 1.13 (1.1 to 1.16).ConclusionsOestrogen supplementation in postmenopausal women is associated with a decreased risk of dying from COVID-19 in this nationwide cohort study. These findings are limited by the retrospective and non-randomised design. Further randomised intervention trials are warranted.
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BAYEFSKY, MICHELLE J., and BENJAMIN E. BERKMAN. "The Ethics of Allocating Uterine Transplants." Cambridge Quarterly of Healthcare Ethics 25, no. 3 (February 11, 2016): 350–65. http://dx.doi.org/10.1017/s0963180115000687.
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Abstract:In September 2014, a healthy male child was born in Sweden following a successful uterine transplantation (UTx). The event brought hope to many women without functional uteruses around the world. Having a child with a transplanted uterus is now possible, and as knowledge of the procedure proliferates and interest in UTx grows, it is important to begin thinking about how a scarce supply of uteruses will be allocated. This article represents a first discussion of the range of factors that must be considered in answering the allocation question. The primary issues addressed are (1) the motivation to seek treatment, (2) allocation by age, (3) child-rearing capacity, and (4) the amount of infertility treatment required. A set of eligibility and ranking criteria are presented. These criteria are not exhaustive but are intended to spark discussion about how uteruses can be allocated in a just manner.
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Yang, Fen, Imre Janszky, Mika Gissler, Nathalie Roos, Anna-Karin Wikström, Yongfu Yu, Hua Chen, Anna-Karin Edstedt Bonamy, Jiong Li, and Krisztina D. László. "Association of Maternal Preeclampsia With Offspring Risks of Ischemic Heart Disease and Stroke in Nordic Countries." JAMA Network Open 5, no. 11 (November 15, 2022): e2242064. http://dx.doi.org/10.1001/jamanetworkopen.2022.42064.
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ImportanceAn association between maternal preeclampsia and an increased risk of cardiovascular disease in the offspring is plausible, but evidence in this area is limited.ObjectiveTo investigate (1) the association between maternal preeclampsia and risks of ischemic heart disease (IHD) and stroke in the offspring, (2) whether the association varies by severity or timing of onset of preeclampsia, and (3) the role of preterm birth and small for gestational age (SGA) birth, both of which are related to preeclampsia and cardiovascular diseases, in this association.Design, Setting, and ParticipantsThis multinational population-based cohort study obtained data from Danish, Finnish, and Swedish national registries. Live singleton births from Denmark (1973-2016), Finland (1987-2014), and Sweden (1973-2014) were followed up until December 31, 2016, in Denmark and December 31, 2014, in Finland and Sweden. Data analyses were performed between September 2020 and September 2022.ExposuresPreeclampsia and its subtypes, including early onset (<34 gestational weeks) and late onset (≥34 gestational weeks), severe and mild or moderate, and with and without SGA birth.Main Outcomes and MeasuresDiagnoses of IHD and stroke were extracted from patient and cause-of-death registers. Cox proportional hazards regression models and flexible parametric survival models were used to analyze the associations. Sibling analyses were conducted to control for unmeasured familial factors.ResultsThe cohort included of 8 475 819 births (2 668 697 [31.5%] from Denmark, 1 636 116 [19.3%] from Finland, and 4 171 006 [49.2%] from Sweden, comprising 4 350 546 boys [51.3%]). Of these offspring, 188 670 (2.2%) were exposed to maternal preeclampsia, 7446 (0.1%) were diagnosed with IHD, and 10 918 (0.1%) were diagnosed with stroke during the median (IQR) follow-up of 19.3 (9.0-28.1) years. Offspring of individuals with preeclampsia had increased risks of IHD (adjusted hazard ratio [HR], 1.33; 95% CI, 1.12-1.58) and stroke (adjusted HR, 1.34; 95% CI, 1.17-1.52). These associations were largely independent of preterm or SGA birth. Severe forms of preeclampsia were associated with a higher stroke risk than less severe forms (severe vs mild or moderate: adjusted HR, 1.81 [95% CI, 1.41-2.32] vs 1.22 [95% CI, 1.05-1.42]; early vs late onset: adjusted HR, 2.55 [95% CI, 1.97-3.28] vs 1.18 [95% CI, 1.01-1.39]; with vs without SGA birth: adjusted HR, 1.84 [95% CI, 1.44-2.34] vs 1.25 [95% CI, 1.07-1.48]). Sibling analyses suggested that the associations were partially explained by unmeasured familial factors.Conclusions and RelevanceResults of this study suggest that offspring born to individuals with preeclampsia had increased IHD and stroke risk that were not fully explained by preterm or SGA birth, and that the associated risks for stroke were higher for severe forms of preeclampsia.
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Baran, A. "The opportunities and challenges of working with the development of the ellipse-project before, during and after the COVID-19 pandemic." European Psychiatry 64, S1 (April 2021): S61. http://dx.doi.org/10.1192/j.eurpsy.2021.190.
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COVID-19 pandemics has influenced many research and educational projects, and it influenced also ELLIPSE-project, aiming at the creation of a free online curriculum in suicide prevention for students in the higher education in Sweden, Austria, Hungary, Norway and Poland (September 2019-August 2022). The ELLIPSE (E-Lifelong Learning In Prevention of Suicide in Europe) (www.e-llipse.com) is the first international project in the area of education in suicide prevention in the higher education co-founded by the European Union Erasmus+ programme. We will reflect on some opportunities and challenges due to COVID-19 pandemics. Identified opportunities: 1) learning a new way of communicating, 2) reaching more participants (in case of Sweden we were able to get participants from more regions, 3) more frequent meetings heightening the quality of the project, 4) travelling less (online is the more eco-friendly solution). But there were also some challenges: 1) not be able to proceed according to the preliminary plan generated much more administrative work, 2) online meetings was a challenge for those partners who had problems adjusting to the online form of communication, 3) more negative attitudes to the canal of communication resulted in avoiding it, leading to less frequent interactions what resulted in diminished motivation to the project, and being unable to proceed with project tasks, 4) resignation of some patients from participation because of difficulties in accepting the online form of communication. We will discuss these issues in a more detailed way during the interactive workshop.DisclosureThe E-Lifelong Learning In Prevention of Suicide In Europe (ELLIPSE)-project is co-funded by the European Union’s Programme Erasmus+ (Project ID: 2019-1-SE01-KA203-060571). The EU Commission’s support for this project does not mean that the Commission end
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Sjödin, Henrik, Anders F. Johansson, Åke Brännström, Zia Farooq, Hedi Katre Kriit, Annelies Wilder-Smith, Christofer Åström, Johan Thunberg, Mårten Söderquist, and Joacim Rocklöv. "COVID-19 healthcare demand and mortality in Sweden in response to non-pharmaceutical mitigation and suppression scenarios." International Journal of Epidemiology 49, no. 5 (September 20, 2020): 1443–53. http://dx.doi.org/10.1093/ije/dyaa121.
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Abstract Background While the COVID-19 outbreak in China now appears suppressed, Europe and the USA have become the epicentres, both reporting many more deaths than China. Responding to the pandemic, Sweden has taken a different approach aiming to mitigate, not suppress, community transmission, by using physical distancing without lockdowns. Here we contrast the consequences of different responses to COVID-19 within Sweden, the resulting demand for care, intensive care, the death tolls and the associated direct healthcare related costs. Methods We used an age-stratified health-care demand extended SEIR (susceptible, exposed, infectious, recovered) compartmental model for all municipalities in Sweden, and a radiation model for describing inter-municipality mobility. The model was calibrated against data from municipalities in the Stockholm healthcare region. Results Our scenario with moderate to strong physical distancing describes well the observed health demand and deaths in Sweden up to the end of May 2020. In this scenario, the intensive care unit (ICU) demand reaches the pre-pandemic maximum capacity just above 500 beds. In the counterfactual scenario, the ICU demand is estimated to reach ∼20 times higher than the pre-pandemic ICU capacity. The different scenarios show quite different death tolls up to 1 September, ranging from 5000 to 41 000, excluding deaths potentially caused by ICU shortage. Additionally, our statistical analysis of all causes excess mortality indicates that the number of deaths attributable to COVID-19 could be increased by 40% (95% confidence interval: 0.24, 0.57). Conclusion The results of this study highlight the impact of different combinations of non-pharmaceutical interventions, especially moderate physical distancing in combination with more effective isolation of infectious individuals, on reducing deaths, health demands and lowering healthcare costs. In less effective mitigation scenarios, the demand on ICU beds would rapidly exceed capacity, showing the tight interconnection between the healthcare demand and physical distancing in the society. These findings have relevance for Swedish policy and response to the COVID-19 pandemic and illustrate the importance of maintaining the level of physical distancing for a longer period beyond the study period to suppress or mitigate the impacts from the pandemic.
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Nilsson, U., U. Carlson-Nilsson, and G. Svedelius. "First Report of Anthracnose Fruit Rot Caused by Colletotrichum acutatum on Strawberry in Sweden." Plant Disease 89, no. 11 (November 2005): 1242. http://dx.doi.org/10.1094/pd-89-1242c.
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Strawberries (Fragaria × ananassa) are the most important soft fruit crop in Sweden and most commonly grown as a perennial crop. Colletotrichum acutatum J.H. Simmond was detected on strawberries in Sweden for the first time in the autumn of 2003. Anthracnose caused by C. acutatum has previously been found on rhododendron in Sweden (2). The infected strawberry plants, cv. Kimberly, were found in a field in the northeastern part of Skåne in southern Sweden. The first plant sample was collected during September 2003, and a second sample was collected during the end of June 2004. Symptoms were seen on stolons as elliptical, black, sunken lesions and irregular black leaf spots originating from the tip. No symptoms were seen on immature green fruits. However, the farmer had observed black spots on the fruits the previous year. Immature fruits were collected in the field, surface sterilized with 70% ethanol, dipped for 1 min in 1.25% NaOCl, and thereafter rinsed in distilled water. Fruits were incubated in a moist chamber at 23°C. The first symptoms were seen as black spots after 3 days; later, salmon-colored conidial masses were produced from acervuli in the center of the lesions. The fungus was isolated on potato dextrose agar (PDA) as single-conidia cultures. Colonies were white-to-pale gray with abundant salmon-colored masses of conidia in the center of the culture. Mycelial growth rate on PDA was 7.5 to 7.9 mm per day at 21 ± 1°C. Conidia (11.0 to 16.5 × 3.9 to 5.7 μm) were cylindrical and hyaline with pointed ends, which is consistent with previous reports for C. acutatum (1). Symptoms were reproduced by artificial inoculation on ripe strawberries (cv. Elsanta). A conidia suspension was prepared from single-conidia cultures and each strawberry was sprayed with 0.5 ml of suspension (2.2 × 107 conidia per ml). The strawberries were incubated in a moist chamber at 22°C. The first typical symptoms were seen after 3 days. Single conidia were isolated from infected fruits and plated on PDA. Stolons and leaves of cv. Alice were inoculated with mycelial plugs of C. acutatum, sealed in a plastic bag for 2 days, and then placed in a greenhouse environment at 70% relative humidity and 21°C. Black, sunken lesions were found on stolons after 7 days. A sample of 300 petioles from the infected field was sent to the Central Science Laboratory, York, England that identified the pathogen as C. acutatum using enzyme-linked immunosorbent assay and plating rinse water from petioles onto selective media. With this report, anthracnose caused by C. acutatum on strawberry has now been reported from all the Nordic countries. References: (1) B. J. Smith. Plant Dis. 74:69, 1990. (2) O. Vinnere et al. Mycol. Res. 106:60, 2002.
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Karabin, Robert. "Wiktor Wachtang Łomidze pierwszy oficer Gruzin w Polskiej Marynarce Wojennej." Pro Georgia 33, no. 1 (August 10, 2023): 245–66. http://dx.doi.org/10.61097/12301604/pg33/2023/245-266.
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Victor Vakhtang Lomidze was the first Georgian officer to serve in the Polish Navy. A student of the military academy in Tiflis, he defended Georgia against the Bolsheviks in 1921. After the conquest of Georgia he reached Poland via Turkey and Greece, where he volunteered to join the army. He was a first promotion graduate of the Officers’ School of the Navy and as a foreigner, he became a contract officer of the Polish Navy. He served on board of numerous Polish ships and in staffs. On 1 September 1939, taking command of the mine-layer “Gryf”, he saved the ship and its crew. Wounded on 3 September 1939. Not fully recovered, he undertakes, together with Commander Hryniewiecki’s group, one of the most unusual and at the same time mysterious actions of our Navy. He was interned in Latvia, where he made an escape attempt, together with 60 other officers. After it failed, he continued trying to join his fighting colleagues. Through Sweden he finally got to England, where he served in the Polish Navy, training young sailors working in the Navy Leadership and in staffs. Due to his health, he was unable to sail on combat ships. Twice promoted during the war, he fought for a country that was not his homeland and shed blood for it.
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Prasetyo, Salsabila Putri, Soni Pratomo, Rusydi Sakran, and Fetty Febriasti Bahar. "Pengaruh Ukuran Bukaan Jendela terhadap Pencahayaan Alami pada Perencanaan Ruang Rawat Inap Rumah Sakit Ibu dan Anak di Kota Jambi." Jurnal Daur Lingkungan 5, no. 1 (March 14, 2022): 23. http://dx.doi.org/10.33087/daurling.v5i1.99.
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Meeting the needs of light in hospitals can be obtained through natural and artificial lighting. Natural lighting comes from sunlight that enters the room through window openings. Sunlight is believed to have many benefits, especially in terms of health effects. The purpose of this study was to determine the difference in natural lighting obtained from the difference in the size of the openings in the inpatient ward of the Maternal and Child Hospital Design in Jambi City. The research method was carried out through computer simulation with DIALUX Evo 9.1 software by comparing the size of the 2x2m aperture and the 4x2m aperture. The simulation was carried out on September 1, 2021, with average sky conditions at 09.00, 12.00, and 16.00 WIB. The simulation results show that an opening with a size of 4x2m placed in the middle of the wall produces a greater lighting power (397 lux at 09.00, 467 lux at 12.00, and 1707 lux at 16.00) than two openings with a size of 2x2m ( 318 lux at 09.00, 378 lux at 12.00, and 1202 lux at 16.00). From these values, it is shown that the lighting received in the inpatient room is more than adequate following the Standard Regulation of the Minister of Health of the Republic of Indonesia, which is 250 lux. The results of this simulation show that the lighting in the afternoon is greater than in the noon and the morning.
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Pennycuick, C. J., T. Alerstam, and A. Hedenström. "A new low-turbulence wind tunnel for bird flight experiments at Lund University, Sweden." Journal of Experimental Biology 200, no. 10 (May 1, 1997): 1441–49. http://dx.doi.org/10.1242/jeb.200.10.1441.
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A new wind tunnel for experiments on bird flight was completed at Lund University, Sweden, in September 1994. It is a closed-circuit design, with a settling section containing five screens and a contraction ratio of 12.25. The test section is octagonal, 1.20 m wide by 1.08 m high. The first 1.2 m of its length is enclosed by acrylic walls, and the last 0.5 m is open, giving unrestricted access. Experiments can be carried out in both the open and closed parts, and comparison between them can potentially be used to measure the lift effect correction. The fan is driven by an a.c. motor with a variable-frequency power supply, allowing the wind speed to be varied continuously from 0 to 38 m s-1. The whole machine can be tilted to give up to 8 ° descent and 6 ° climb. A pitot-static survey in the test section showed that the air speed was within ±1.3 % of the mean at 116 out of 119 sample points, exceeding this deviation at only three points at the edges. A hot-wire anemometer survey showed that the turbulence level in the closed part of the test section was below 0.04 % of the wind speed throughout most of the closed part of the test section, rising to approximately 0.06 % in the middle of the open part. No residual rotation from the fan could be detected in the test section. No decrease in wind speed was detectable beyond 3 cm from the side walls of the closed part, and turbulence was minimal beyond 10 cm from the walls. The installation of a safety net at the entrance to the test section increased the turbulence level by a factor of at least 30, to 1.2 % longitudinally and 1.0 % transversely.
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Granbom Koski, Malin, Natalie Glaser, Anders Franco-Cereceda, Ulrik Sartipy, and Michael Dismorr. "Comparative Long-Term Clinical Performance of Mechanical Aortic Valve Prostheses." JAMA Network Open 7, no. 4 (April 19, 2024): e247525. http://dx.doi.org/10.1001/jamanetworkopen.2024.7525.
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ImportanceAggregated data and long-term follow-up in national health data registers offer the opportunity to compare the performance of mechanical aortic prostheses within the same population.ObjectiveTo investigate the clinical performance of mechanical aortic valve prostheses.Design, Setting, and ParticipantsThis nationwide cohort study included all 5224 patients who underwent primary mechanical aortic valve replacement in Sweden between January 1, 2003, and December 31, 2018. Statistical analysis was performed between May and September 2023.ExposuresSurgical aortic valve replacement with the On-X, Carbomedics, Bicarbon, Standard, Regent, Open Pivot, Masters, or Advantage valve models.Main Outcomes and MeasuresThe primary outcome was all-cause mortality, and secondary outcomes were reintervention, heart failure, major bleeding, stroke, and embolic events. Regression standardization was used to account for baseline differences.ResultsOverall, 5224 patients (mean [SD] age, 56.8 [11.7] years; 3908 men [74.8%]) were included. Total follow-up time was 43 982 person-years (mean [SD], 8.4 [4.6] years; maximum, 17.2 years). After regression standardization, there was a significant difference in 10-year mortality between the Carbomedics model group (17%; 95% CI, 15%-18%), Regent model group (17%; 95% CI, 13%-20%), and Standard model group (17%; 95% CI, 14%-19%) compared with the Bicarbon model group (27%; 95% CI, 21%-34%).Conclusions and RelevanceIn this cohort study of mechanical valve surgical aortic replacement outcomes in Sweden, the rate of all-cause mortality was higher in the Bicarbon group than in the Carbomedics, Regent, and Standard model groups. These findings warrant further research on the long-term clinical performance of the Bicarbon valve.
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De Souza, Monique, Raghuwinder Singh, Nathan E. Harms, John McPhedran, and Alicyn N. Smart. "First Report of Leaf Spot Caused by Septoria villarsiae on Nymphoides peltata in the United States." Plant Health Progress 22, no. 2 (January 1, 2021): 157–58. http://dx.doi.org/10.1094/php-12-20-0104-br.
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Nymphoides peltata, commonly known as yellow floating heart, is a freshwater aquatic plant with floating leaves. It is a highly invasive aquatic weed that has been introduced into several countries, including Ireland, New Zealand, Sweden, and the United States. In September 2019, N. peltata plants exhibiting leaf spots were collected from a private pond near Buxton, York County, Maine. Leaf spots were present on a majority of plants, and pycnidia were observed in the center of the spots. Individual pycnidia were aseptically transferred to 1/4-strength potato dextrose agar. Dark gray to black slow-growing colonies were observed between 7 and 14 days. Based on the morphological characteristics, the fungus was identified as Septoria sp. Translation elongation factor 1-alpha gene was amplified, and a 570-bp sequence resulted in 100 and 99.74% homology with Septoria villarsiae strains CBS565.88 and CBS514.78 isolated from N. peltata in the Netherlands, respectively. Previously, S. villarsiae has been reported on Limnanthemum nymphoides from India and on N. peltata from Korea, Poland, Romania, and the Netherlands. To our knowledge, this is the first report of leaf spot caused by S. villarsiae on N. peltata in the United States.
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Kulling, Per E. J., and Jonas E. A. Holst. "Educational and Training Systems in Sweden for Prehospital Response to Acts of Terrorism." Prehospital and Disaster Medicine 18, no. 3 (September 2003): 184–88. http://dx.doi.org/10.1017/s1049023x00001035.
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AbstractSweden has a long tradition in planning for disaster situations in which the National Board of Health and Welfare has a key responsibilty within the health sector. One important part of this disaster preparedness is education and training. Since 11 September 2001, much focus has been placed on the acts of terrorism with special reference to the effects of the use of chemical, biological, or nuclear/radiological (CBNR) agents. In the health sector, the preparedness for such situations is much the same as for other castastrophic events. The National Board of Health and Welfare of Sweden is a national authority under the government, and one of its responsibilities is planning and the provision of supplies for health and medical services, environmental health, and social services in case of war or crises. “Joint Central Disaster Committees” in each County Council/Region in the country are responsible for overseeing major incident planning for their respective counties/regions. The “Disaster Committee” is responsible for ensuring that: (1) plans are established and revised; (2) all personnel involved in planning receive adequate information and training; (3) equipment and supplies are available; and (4) maintenance arrangements are in place.Sweden adopts a “Total Defense” strategy, which means that it places a high value in preparing for peacetime and wartime major incidents. The Swedish Emergency Management Agency coordinates the civilian Total Defense strategy, and provides funding to the relevant responsible authority to this end. The National Board of Health and Welfare takes responsibility in this process. In this area, the main activities of the National Board of Health and Welfare are: (1) the establishment of national guidelines and supervision of standards in emergency and disaster medicine, social welfare, public health, and prevention of infectious diseases; (2) the introduction of new principles, standards, and equipment; (3) the conducting education and training programmes; and (4) the provision of financial support. The budget for National Board of Health and Welfare in this area is approximately 160 million SEK (US$18 million). The National Board of Health and Welfare also provides funding to the County Councils/Regions for the training of healthcare professionals in disaster medicine and crises management by arranging (and financing) courses primarily for teachers and by providing financial support to the County Councils/Regions for providing their own educational and training programmes. The National Board of Health and Welfare provides funding of approximately 20 million SEK (US$2.4 million) to the County Councils/Regions for this training of healthcare professionals in disaster medicine and crises.
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Amein, T., C. H. B. Olsson, M. Wikström, R. Findus, D. AB, and S. A. I. Wright. "First Report in Sweden of Downy Mildew on Parsley Caused by Plasmopara petroselini." Plant Disease 90, no. 1 (January 2006): 111. http://dx.doi.org/10.1094/pd-90-0111a.
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During September 2004, downy mildew of parsley caused by a species of Plasmopara was observed in an experimental field of parsley (Petroselinum crispum subsp. crispum L. cv. Gigante d'Italia/Hilmar) in Borgeby in southern Sweden. The summer of 2004 was exceptionally wet and humid. Disease became widespread throughout the field in just a few days. Local growers reported that symptoms consistent with downy mildew had appeared in their parsley fields every year since 2001. Plasmopara, under P. nivea, has been reported on parsley in Europe since the middle of the 19th century (4). In recent years, this disease has caused severe damage to parsley grown in several European countries, e.g., France, Germany, Switzerland, and Belgium (1,3). The first symptoms appeared as faint chlorotic spots on the upper surfaces of the leaves. On the corresponding lower surfaces, mycelium and sporangiophores grew profusely and developed a white mat that in part turned dark gray. Eventually, the leaves and stalks became necrotic and died. The sporangiophores were monopodially branched, 248.4 ± 13.36 μm long (n = 17), each branch ending in 2 to 5 ultimate branchlets tapered toward the tip. The trunk diameter measured 7.0 ± 0.77 μm (n = 9) above the basal part and 6.1 ± 0.81 μm just below the first branch. The sporangia were broadly ellipsoidal to ellipsoidal, hyaline, 22.5 ± 0.73 μm long and 16.6 ± 0.48 μm wide (n μ 40). They were mostly nonpapillate when young, although exit pores 4.8 ± 0.32 μm (n = 10) were visible. Mature sporangia exhibited a dehiscence apparatus and a plug in the exit pore. On the basis of the characteristics above, the pathogen was identified as P. petroselini (= P. nivea pro parte [2]). Independent verification of the identity was done by O. Constantinescu at the Botanical Museum, Uppsala, Sweden. A voucher specimen was deposited at the Herbarium UPS, in Uppsala under the number UPS F-118873. To our knowledge, this is the first report of P. petroselini on parsley in Sweden. References: (1) E. Bèliard and J. Thibault. Phytoma 554:2, 2002. (2) O. Constantinescu. Taxon 54:813, 2005. (3) C. Crepel and S. Inghelbrecht. Plant Dis. 87:1266, 2003. (4) A. de Bary, Ann. Sci. Nat. Bot., Sér. 4, 20:5, 1863.
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Belova, Evgenia, Peter Voelger, Sheila Kirkwood, Susanna Hagelin, Magnus Lindskog, Heiner Körnich, Sourav Chatterjee, and Karathazhiyath Satheesan. "Validation of wind measurements of two mesosphere–stratosphere–troposphere radars in northern Sweden and in Antarctica." Atmospheric Measurement Techniques 14, no. 4 (April 12, 2021): 2813–25. http://dx.doi.org/10.5194/amt-14-2813-2021.
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Abstract. Two atmospheric VHF radars: ESRAD (Esrange MST radar) located near Kiruna in the Swedish Arctic and MARA (Moveable Atmospheric Radar for Antarctica) at the Indian research station Maitri in Antarctica perform wind measurements in the troposphere and lower stratosphere on a regular basis. We compared horizontal winds at altitudes between about 0.5 and 14 km derived from the radar data using the full correlation analysis (FCA) technique with radiosonde observations and models. The comparison with 28 radiosondes launched from January 2017 to August 2019 showed that ESRAD underestimates the zonal and meridional winds by about 8 % and 25 %, respectively. This is likely caused by the receiver group arrangement used for the FCA together with a high level of non-white noise. A similar result was found when comparing with the regional numerical weather prediction model HARMONIE-AROME (Bengtsson et al., 2017) for the period September 2018–May 2019. The MARA winds were compared with winds from radiosondes for the period February–October 2014 (291 occasions). In contrast to ESRAD, there is no indication that MARA underestimates the winds compared to the sondes. The mean difference between the radar and radiosonde winds is close to zero for both zonal and meridional components. The comparison of MARA with the ECMWF ERA5 reanalysis for January–December 2019 reveals good agreement with the mean difference between 0.1 and −0.5 m/s depending on the component and season. The random errors in the wind components (standard deviations over all estimates in 1 h averages) are typically 2–3 m/s for both radars. Standard deviation of the differences between radars and sondes are 3–5 m/s.
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Bergström, Johanna, Emilia Möller Rydberg, David Wennergren, and Karin Svensson Malchau. "Incidence and Risk Factors for Surgical Site Infection in Ankle Fractures: An Observational Study of 480 Patients in Sweden." Journal of Clinical Medicine 12, no. 20 (October 11, 2023): 6464. http://dx.doi.org/10.3390/jcm12206464.
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Introduction: Surgical site infection (SSI) is a frequently reported complication after ankle fracture surgery. To our knowledge, no study has been conducted on its incidence in Sweden. The present study aimed to determine the incidence of, risk factors for, and most common causative pathogen of SSI. Methods: Patients who underwent primary surgery for an ankle fracture between 1 September 2017 and 31 August 2019 at the Sahlgrenska University Hospital were identified. Data on potential SSI risk factors and clinical outcome (infected/non-infected) were retrieved from medical records. Cox regression analysis and descriptive statistics were used. Results: Of the 480 reviewed patients, 49 developed SSI (10.2%), of which 35 (7.3%) were superficial and 14 (2.9%) were deep. Open fractures (p < 0.001) and age (p = 0.016) were statistically significant risk factors for SSI in the univariate analysis. In the multivariable analysis, only open fracture was statistically significant (HR = 3.0; 95% C.I. = 1.3–6.9, p = 0.013). Cases of Staphylococcus aureus (S. aureus) were most common (n = 12, 24.5%). Methicillin resistance was uncommon (n = 2, 4.1%). Conclusions: An incidence of 10.2% was established, which is comparable to international findings. Infection monitoring is an important part of tackling the global challenge of antibiotic resistance. Future prospective studies to further establish risk factors are warranted to decrease the incidence of SSI.
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Karlsson, Tomas, Riikka Rinnan, and Thomas Holst. "Variability of BVOC Emissions from Commercially Used Willow (Salix spp.) Varieties." Atmosphere 11, no. 4 (April 7, 2020): 356. http://dx.doi.org/10.3390/atmos11040356.
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Willow (Salix spp.) trees are commonly used in short rotation coppices (SRC) to produce renewable energy. However, these plants are also known to emit high concentrations of biogenic volatile organic compounds (BVOCs), which have a large influence on air quality. Many different clones of commercially used Salix varieties exist today, but only a few studies have focused on BVOC emissions from these newer varieties. In this study, four varieties commercially propagated for biofuel production have been studied on a leaf-scale in the southern part of Sweden. The trees had either their first or second growing season, and measurements on BVOC emissions were done during the growing season in 2017 from the end of May to the beginning of September. Isoprene was the dominant emitted compound for all varieties but the average emission amongst varieties varied from 4.00 to 12.66 µg gdw−1 h−1. Average monoterpene (MT) (0.78–1.87 µg gdw−1 h−1) and sesquiterpene (SQT) emission rates (0.22–0.57 µg gdw−1 h−1) differed as well among the varieties. Besides isoprene, other compounds like ocimene, linalool and caryophyllene also showed a response to light but not for all varieties. Younger plants had several times higher emissions of non-isoprenoids (other VOCs) than the corresponding 1-year-old trees. The conclusions from this study show that the choice of variety can have a large impact on the regional BVOC emission budget. Genetics, together with stand age, should be taken into account when modelling BVOC emissions on a regional scale, for example, for air quality assessments.
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Åkeson, Margaretha, Britt-Marie Zetterqvist, Erik Holmberg, and György Horvath. "Improved survival with clinical guidelines? Evaluation of a quality register linked to clinical guidelines for ovarian cancer in the western health care region in Sweden between 1 September 1993 and 1 June 1998." Acta Obstetricia et Gynecologica Scandinavica 84, no. 11 (October 17, 2005): 1113–18. http://dx.doi.org/10.1111/j.0001-6349.2005.00850.x.
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Persson, Johanna, Albert Gyllencreutz Castellheim, Mikael Dellborg, Kok Wai Giang, Christina Karazisi, Araz Rawshani, and Zacharias Mandalenakis. "Survival Trends in Children With Tetralogy of Fallot in Sweden From 1970 to 2017." JAMA Network Open 6, no. 5 (May 22, 2023): e2314504. http://dx.doi.org/10.1001/jamanetworkopen.2023.14504.
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ImportanceMortality in patients with tetralogy of Fallot (TOF) has decreased substantially since the start of surgical correction of this abnormality in the 1950s. However, nationwide data in Sweden comparing survival trends among pediatric patients with TOF with the general population are still limited.ObjectiveTo study survival trends in pediatric patients with TOF and compare them with matched controls.Design, Setting, and ParticipantsA Swedish registry-based, nationwide, matched cohort study was conducted; data were collected from national health registers from January 1, 1970, to December 31, 2017. Patients with a registered diagnosis of TOF as well as controls without TOF matched by birth year and sex were included in the study. Follow-up data were collected from birth to age 18 years, death, or the end of follow-up (December 31, 2017), whichever occurred first. Data analysis was performed from September 10 to December 20, 2022. Survival trends among patients with TOF were compared with matched controls using Cox proportional hazards regression and Kaplan-Meier survival analyses.Main Outcomes and MeasuresAll-cause mortality during childhood in patients with TOF and matched controls.ResultsThe population included 1848 patients (1064 [57.6%] males; mean [SD] age, 12.4 [6.7] years) with TOF and 16 354 matched controls. The number of patients who underwent congenital cardiac surgery (henceforth, surgery group) was 1527 (897 [58.7%] males). In the whole TOF population from birth until age 18 years, 286 patients (15.5%) died during a mean (SD) follow-up time of 12.4 (6.7) years. In the surgery group, 154 of 1527 patients (10.1%) died during a follow-up time of 13.6 (5.7) years with a mortality risk of 21.9 (95% CI, 16.2-29.7) compared with matched controls. When stratified by birth period, a substantial decrease in the mortality risk was noted in the surgery group, from 40.6 (95% CI, 21.9-75.4) in those born in the 1970s to 11.1 (95% CI, 3.4-36.4) in those born in the 2010s. Survival increased from 68.5% to 96.0%. The risk of mortality for surgery decreased from 0.52 in the 1979s to 0.19 in the 2010s.Conclusions and RelevanceThe findings of this study suggest there has been substantial improvement in survival in children with TOF who underwent surgery from 1970 to 2017. However, the mortality rate is still significantly higher in this group compared with matched controls. Predictors of good and poor outcomes in this group need to be further explored, with the modifiable ones evaluated for further outcome improvements.
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Borger van der Burg, Boudewijn L. S., T. M. Hörer, D. Eefting, T. T. C. F. van Dongen, J. F. Hamming, J. J. DuBose, M. Bowyer, and R. Hoencamp. "Vascular access training for REBOA placement: a feasibility study in a live tissue-simulator hybrid porcine model." Journal of the Royal Army Medical Corps 165, no. 3 (September 17, 2018): 147–51. http://dx.doi.org/10.1136/jramc-2018-000972.
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BackgroundThe use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with severe haemorrhagic shock is increasing. Obtaining vascular access is a necessary prerequisite for REBOA placement in these situations.MethodsDuring the EVTM workshop (September 2017, Örebro, Sweden), 21 individuals participated in this study, 16 participants and five instructors. A formalised curriculum was constructed including basic anatomy of the femoral region and basic training in access materials for REBOA placement in zone 1. Key skills: (1) preparation of endovascular toolkit, (2) achieving vascular access in the model and (3) bleeding control with REBOA. Scoring ranged from 0 to 5 for non-anatomical skills. Identification of anatomical structures was either sufficient (score=1) or insufficient (score=0). Five consultants performed a second identical procedure as a post test.ResultsConsultants had significantly better overall technical skills in comparison with residents (p=0.005), while understanding of surgical anatomy showed no difference. Procedure times differed significantly (p<0.01), with residents having a median procedure time of 3 min and 24 s, consultants 2:33 and instructors 1:09.ConclusionThis comprehensive training model using a live tissue-simulator hybrid porcine model can be used for femoral access and REBOA placement training in medical personnel with different prior training levels. Higher levels of training are associated with faster procedure times. Further research in open and percutaneous access training is necessary to simulate real-life situations. This training method can be used in a multistep training programme, in combination with realistic moulage and perfused cadaver models.
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McCluskey, Gillean. "Closing the attainment gap in Scottish schools: Three challenges in an unequal society." Education, Citizenship and Social Justice 12, no. 1 (January 9, 2017): 24–35. http://dx.doi.org/10.1177/1746197916683468.
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Scotland’s First Minister Nicola Sturgeon has recently said, ‘Improving school attainment is arguably the single most important objective in this programme for Government’ (Parliamentary address, 1 September 2015). Scotland’s levels of academic attainment have become an increasing focus for debate amid continuing concerns that children living in the most deprived areas in Scotland are ‘6 to 13 months behind their peers in problem-solving at age 5; 11 to 18 months behind their peers in expressive vocabulary at age 5; and around two years of schooling behind their peers at age 15’. The link between educational disadvantage and low levels of attainment is well documented in many countries, but particularly troubling in the United Kingdom, where overall levels of inequality are greater than in many other Organisation for Economic Co-operation and Development countries, including Sweden. This article draws on recent research in three fields of interest, namely student participation, home–school relationships and relationships within school, to explore the challenges for education in improving overall attainment. It considers how these fields of interest connect with each other and with issues of inequality and, finally, argues that they each have the potential to offer a new set of ‘guidewires’ for tackling this challenge.
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Saraste, Deborah, Daniel J. Öhman, Marika Sventelius, K. Miriam Elfström, Johannes Blom, and Sven Törnberg. "Initial participation as a predictor for continuous participation in population-based colorectal cancer screening." Journal of Medical Screening 25, no. 3 (August 8, 2017): 126–33. http://dx.doi.org/10.1177/0969141317717757.
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Objectives To assess patterns and probabilities of participation in multiple rounds of colorectal cancer screening. Methods All individuals who were invited to participate in population-based colorectal cancer screening in the Stockholm-Gotland region in Sweden between 1 January 2008 and 30 September 2015 were included in the study. Guaiac-based faecal occult blood testing was used. All individuals invited to the three first consecutive screening rounds were included in the analysis. Results There were 346,168 individuals eligible for invitation to screening. The average participation rate during the follow-up period was 60%. Eligible individuals could be invited 1–4 times, depending on age at first invitation. Of 48,959 individuals invited to the three first consecutive rounds of screening, 71% participated at least once, and 50% participated in all three rounds. Participation at first invitation was a predictor for participation in subsequent rounds, and the likelihood of continuous participation following participation in the first round was 84%. Of those who attended the first and second rounds, 93% also participated in the third round. Similar patterns of consistency were seen among non-participants. For individuals not participating in the first screening round, the likelihood of consistent non-participation was 71. Conclusions Participation in the first round of screening is a strong predictor for participation in subsequent rounds. Therefore, reducing barriers for initial participation is a key for achieving consistent participation over several rounds in organized colorectal cancer screening programmes.
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Tornhammar, Per, Tomas Jernberg, Göran Bergström, Anders Blomberg, Gunnar Engström, Jan Engvall, Tove Fall, et al. "Association of cardiometabolic risk factors with hospitalisation or death due to COVID-19: population-based cohort study in Sweden (SCAPIS)." BMJ Open 11, no. 9 (September 2021): e051359. http://dx.doi.org/10.1136/bmjopen-2021-051359.
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ObjectiveTo assess the association of cardiometabolic risk factors with hospitalisation or death due to COVID-19 in the general population.Design, setting and participantsSwedish population-based cohort including 29 955 participants.ExposuresCardiometabolic risk factors assessed between 2014 and 2018.Main outcome measuresHospitalisation or death due to COVID-19, as registered in nationwide registers from 31 January 2020 through 12 September 2020. Associations of cardiometabolic risk factors with the outcome were assessed using logistic regression adjusted for age, sex, birthplace and education.ResultsMean (SD) age was 61.2 (4.5) and 51.5% were women. 69 participants experienced hospitalisation or death due to COVID-19. Examples of statistically significant associations between baseline factors and subsequent hospitalisation or death due to COVID-19 included overweight (adjusted OR (aOR) vs normal weight 2.73 (95% CI 1.25 to 5.94)), obesity (aOR vs normal weight 4.09 (95% CI 1.82 to 9.18)), pre-diabetes (aOR vs normoglycaemia 2.56 (95% CI 1.44 to 4.55)), diabetes (aOR vs normoglycaemia 3.96 (95% CI 2.13 to 7.36)), sedentary time (aOR per hour/day increase 1.10 (95% CI 1.02 to 1.17)), grade 2 hypertension (aOR vs normotension 2.44 (95% CI 1.10 to 5.44)) and high density lipoprotein cholesterol (aOR per mmol/L increase 0.33 (95% CI 0.17 to 0.65)). Statistically significant associations were not observed for grade 1 hypertension (aOR vs normotension 1.03 (95% CI 0.55 to 1.96)), current smoking (aOR 0.56 (95% CI 0.24 to 1.30)), total cholesterol (aOR per mmol/L increase 0.90 (95% CI 0.71 to 1.13)), low density lipoprotein cholesterol (aOR per mmol/L increase 0.90 (95% CI 0.69 to 1.15)) and coronary artery calcium score (aOR per 10 units increase 1.00 (95% CI 0.99 to 1.01)).ConclusionsIn a large population-based sample from the general population, several cardiometabolic risk factors were associated with hospitalisation or death due to COVID-19.
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Abzhandadze, Tamar, Erik Lundström, Dongni Buvarp, Marie Eriksson, Terence J. Quinn, and Katharina S Sunnerhagen. "Development of a short-form Swedish version of the Montreal Cognitive Assessment (s-MoCA-SWE): protocol for a cross-sectional study." BMJ Open 11, no. 5 (May 2021): e049035. http://dx.doi.org/10.1136/bmjopen-2021-049035.
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IntroductionShort forms of the Montreal Cognitive Assessment (MoCA) have allowed quick cognitive screening. However, none of the available short forms has been created or validated in a Swedish sample of patients with stroke.The aim is to develop a short-form Swedish version of the MoCA (s-MoCA-SWE) in a sample of patients with acute and subacute stroke. The specific objectives are: (1) to identify a subgroup of MoCA items that have the potential to form the s-MoCA-SWE; (2) to determine the optimal cut-off value of s-MoCA-SWE for predicting cognitive impairment and (3) and to compare the psychometric properties of s-MoCA-SWE with those of previously developed MoCA short forms.Methods and analysisThis is a statistical analysis protocol for a cross-sectional study. The study sample will comprise patients from Väststroke, a local stroke registry from Gothenburg, Sweden and Efficacy oF Fluoxetine—a randomisEd Controlled Trial in Stroke (EFFECTS), a randomised controlled trial in Sweden. The s-MoCA-SWE will be developed by using exploratory factor analysis and the boosted regression tree algorithm. The cut-off value of s-MoCA-SWE for impaired cognition will be determined based on binary logistic regression analysis. The psychometric properties of s-MoCA-SWE will be compared with those of other MoCA short forms by using cross-tabulation and area under the receiving operating characteristic curve analyses.Ethics and disseminationThe Väststroke study has received ethical approval from the Regional Ethical Review Board in Gothenburg (346–16) and the Swedish Ethical Review Authority (amendment 2019–04299). The handling of data generated within the framework of quality registers does not require written informed consent from patients. The EFFECTS study has received ethical approval from the Stockholm Ethics Committee (2013/1265-31/2 on 30 September 2013). All participants provided written consent. Results will be published in an international, peer-reviewed journal, presented at conferences and communicated to clinical practitioners in local meetings and seminars.
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Açbay, Özer, and Sadi Gündoğdu. "Can metformin reduce insulin resistance in polycystic ovary syndrome?**Presented in part at the 31st Annual Meeting of The European Association for the Study of Diabetes, Stockholm, Sweden, September 12 to 16, 1995." Fertility and Sterility 65, no. 5 (May 1996): 946–49. http://dx.doi.org/10.1016/s0015-0282(16)58266-1.
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Geale, K., I. Lindberg, E. Paulsson, C. Wennerström, A. Tjärnlund, V. Taliadouros, W. Noel, D. Enkusson, E. Theander, and S. Bruce Wirta. "OP0056 PERSISTENCE OF BIOLOGIC TREATMENT IN PSORIATIC ARTHRITIS: A POPULATION-BASED STUDY IN SWEDEN." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 37.2–38. http://dx.doi.org/10.1136/annrheumdis-2020-eular.390.
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Background:Psoriatic arthritis (PsA) is a chronic, heterogeneous, immune-mediated seronegative arthritis characterized by joint inflammation in people with skin psoriasis (PsO). In recent years several effective biologic treatments such as tumour necrosis factor inhibitors (TNFi), interleukin (IL) 12 and 23 inhibitors (IL-12/23i), and IL 17 inhibitors (IL-17i) have been introduced for PsA. Discontinuation (non-persistence) of therapy is usually a consequence of lack of effect and intolerability.Objectives:Compare time to discontinuation of TNFi (adalimumab, ADA), IL-17i (secukinumab, SEC), and IL-12/23i (ustekinumab, UST) treatment exposures and the association with previous biologic treatment experience.Methods:Population-based national health data from the Swedish Patient Registry, Prescribed Drug Registry and Cause of Death Registry were linked at the patient level and used to identify treatment exposures in PsA patients initiating ADA, SEC, or UST between January 2008 and September 2018. Discontinuation was defined as a treatment switch to any other PsA-indicated biologic, or failure to re-dispense treatment within a grace period following end of drug supplied. The grace period, defined as the number of days between end of drug supply and re-dispensation during which a patient is considered to be on active treatment, was set dynamically to the number of days of drug supplied in the primary analysis. As a sensitivity analysis, a fixed 90-day grace period was used. Supply was calculated as total milligrams dispensed divided by maintenance dose posology, where the following assumptions were made due to the limitations of the administrative data used: UST patients’ weight corresponded to the amount of drug dispensed (both 45mg and 90mg dispensations last 84 days), SEC patients with prior TNFi experience consumed 300mg/28 days and all others consumed 150mg/28 days, and ADA patients consumed 40mg/14 days. Adjusted hazard ratios (HR) for time to discontinuation were calculated using a Cox proportional hazards model. Covariates for age, marital status, and previous biologic treatment experience were assessed at the initiation of treatment exposure, while comorbidity including skin PsO was assessed during the two years prior. Exposures without discontinuation events were censored at death or end of follow-up. The study was approved by the Stockholm Regional Ethical Review Board.Results:3,620 discontinuation events were observed in the main analysis across 4,649 treatment exposures (ADA: 3,255; SEC: 887; UST: 507) (Figure 1, unadjusted). 3,162 events were observed in the sensitivity analysis. Average age at treatment initiation was 50, 54% were female, 47% were biologic treatment naïve, and 39% had skin PsO. In the multivariate main analysis, UST exhibited lower discontinuation rates vs ADA (HR=0.56, 95% CI: 0.49-0.64) while there was no significant difference between SEC and ADA (HR=1.01, 95% CI: 0.88-1.15). In the multivariate sensitivity analysis, both UST (HR=0.81, 95% CI: 0.70-0.94) and SEC (HR=0.82, 95% CI: 0.70-0.95) were associated with significantly lower discontinuation rates ratio relative to ADA. Overall, patients with more biologic treatment experience were statistically significantly (p<0.05) associated with higher risk of treatment discontinuation.Figure 1.Unadjusted Kaplan-Meier curves of time to treatment discontinuation (main analysis, dynamic grace period)Conclusion:UST exhibits a favourable treatment persistency profile relative to ADA, regardless of the grace period definition. The relative risk of discontinuing SEC vs ADA is sensitive to the grace period. Treatment discontinuation was higher in treatment exposures with more biologic experience.Disclosure of Interests:Kirk Geale Consultant of: Quantify Research, Speakers bureau: Indirectly as a consultant, Ingrid Lindberg Consultant of: Quantify Research, Emma Paulsson Consultant of: Quantify Research, Christina Wennerström Employee of: Janssen-Cilag Sweden AB, Anna Tjärnlund Employee of: Janssen-Cilag Sweden AB, Virginia Taliadouros Shareholder of: JnJ, Employee of: Janssen Pharmaceuticals NV, Wim Noel Employee of: Janssen Pharmaceuticals NV, Dana Enkusson Employee of: Janssen-Cilag AB, Elke Theander Employee of: Janssen-Cilag Sweden AB, Sara Bruce Wirta Employee of: Janssen-Cilag Sweden AB
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Bosi, Alessandro, Catherine M. Clase, Laura Ceriani, Arvid Sjölander, Edouard L. Fu, Björn Runesson, Zheng Chang, et al. "Absolute and Relative Risks of Kidney Outcomes Associated With Lithium vs Valproate Use in Sweden." JAMA Network Open 6, no. 7 (July 7, 2023): e2322056. http://dx.doi.org/10.1001/jamanetworkopen.2023.22056.
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ImportanceAmong patients with bipolar disorder, discordant findings have been published on the nephrotoxic effects of lithium therapy.ObjectiveTo quantify absolute and relative risks of chronic kidney disease (CKD) progression and acute kidney injury (AKI) in people who initiated lithium compared with valproate therapy and to investigate the association between cumulative use and elevated lithium levels and kidney outcomes.Design, Setting, and ParticipantsThis cohort study had a new-user active-comparator design and used inverse probability of treatment weights to minimize confounding. Included patients initiated therapy with lithium or valproate from January 1, 2007, to December 31, 2018, and had a median follow-up of 4.5 years (IQR, 1.9-8.0 years). Data analysis began in September 2021, using routine health care data from the period 2006 to 2019 from the Stockholm Creatinine Measurements project, a recurrent health care use cohort of all adult residents in Stockholm, Sweden.ExposuresNew use of lithium vs new use of valproate and high (&gt;1.0 mmol/L) vs low serum lithium levels.Main Outcomes and MeasuresProgression of CKD (composite of &gt;30% decrease relative to baseline estimated glomerular filtration rate [eGFR] and kidney failure), AKI (by diagnosis or transient creatinine elevations), new albuminuria, and annual eGFR decrease. Outcomes by attained lithium levels were also compared in lithium users.ResultsThe study included 10 946 people (median [IQR] age, 45 [32-59] years; 6227 female [56.9%]), of whom 5308 initiated lithium therapy and 5638 valproate therapy. During follow-up, 421 CKD progression events and 770 AKI events were identified. Compared with patients who received valproate, those who received lithium did not have increased risk of CKD (hazard ratio [HR], 1.11 [95% CI, 0.86-1.45]) or AKI (HR, 0.88 [95% CI, 0.70-1.10]). Absolute 10-year CKD risks were low and similar: 8.4% in the lithium group and 8.2% in the valproate group. No difference in the risk of developing albuminuria or the annual rate of eGFR decrease was found between groups. Among more than 35 000 routine lithium tests, only 3% of results were in the toxic range (&gt;1.0 mmol/L). Lithium values greater than 1.0 mmol/L, compared with lithium values of 1.0 mmol/L or less, were associated with increased risk of CKD progression (HR, 2.86; 95% CI, 0.97-8.45) and AKI (HR, 3.51; 95% CI, 1.41-8.76).Conclusions and RelevanceIn this cohort study, compared with new use of valproate, new use of lithium was meaningfully associated with adverse kidney outcomes, with low absolute risks that did not differ between therapies. However, elevated serum lithium levels were associated with future kidney risks, particularly AKI, emphasizing the need for close monitoring and lithium dose adjustment.
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Waterloo, M. J., J. Schelleken, L. A. Bruijnzeel, H. F. Vugts, P. N. Assenberg, and T. T. Rawaqa. "Chemistry of bulk precipitation in southwestern Viti Levu, Fiji." Journal of Tropical Ecology 13, no. 3 (May 1997): 427–47. http://dx.doi.org/10.1017/s0266467400010609.
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ABSTRACTThe amounts and chemical composition of bulk precipitation were investigated over a continuous 21-mo period (January 1990 to September 1991) at four sites along an East-West transect perpendicular to the coast of Southwest Viti Levu, Fiji. Measured rainfall totals in 1990 ranged from 1796 mm at the coastal Korokula station to 2113 mm at the inland Tulasewa station, which is somewhat higher than the long-term average of 1707 mm at a reference weather station located in the centre of the study area. The first 9 mo of 1991 were relatively dry (range 1027–1533 mm) with a total of 1157 mm at the reference site as compared to a long-term average of 1330 mm. Concentrations of all investigated constituents in bulk rainfall were low, except during the passage of cyclone Sina due to the deposition of large amounts of, especially, chloride, sodium and sulphate in sea spray. Concentrations of sodium and magnesium could be explained fully by maritime contributions to the rainfall composition at all sites. Maritime contributions to the concentrations of calcium, sulphate and potassium accounted for 10–40% of the total, whereas bicarbonate, ammonium, nitrate, silicon, aluminium, iron and manganese were derived exclusively from terrestrial sources. The annual atmospheric nutrient deposition rates were low by pan-tropical standards, particularly when the contribution of cyclone Sina was excluded. Annual totals (in kg ha−1) ranged from 2.4–8.8 for nitrogen, 0.4–1.1 for phosphorus, 2.3–4.9 for potassium, 1.4–1.9 for calcium and from 1.1–1.3 for magnesium. The inclusion of the contribution by the cyclone more than doubled the deposition of potassium, calcium and magnesium, although values still remained well within the range reported for humid tropical areas. The estimated atmospheric deposition of nutrients over a typical rotation period (16 y) was sufficient to balance losses in harvestedPinus caribaealogs (stemwood plus bark) of potassium, calcium and magnesium, but not of nitrogen and, probably, phosphorus. Nutrient losses associated with the harvesting of stemwood alone were compensated entirely by the atmospheric inputs.
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Leith, F. I., K. J. Dinsmore, M. B. Wallin, M. F. Billett, K. V. Heal, H. Laudon, M. G. Öquist, and K. Bishop. "Carbon dioxide transport across the hillslope–riparian–stream continuum in a boreal headwater catchment." Biogeosciences 12, no. 6 (March 23, 2015): 1881–92. http://dx.doi.org/10.5194/bg-12-1881-2015.
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Abstract. Headwater streams export CO2 as lateral downstream export and vertical evasion from the stream surface. CO2 in boreal headwater streams generally originates from adjacent terrestrial areas, so determining the sources and rate of CO2 transport along the hillslope–riparian–stream continuum could improve estimates of CO2 export via the aquatic pathway, especially by quantifying evasion at higher temporal resolutions. Continuous measurements of dissolved CO2 concentrations and water table were made along the hillslope–riparian–stream continuum in the Västrabäcken sub-catchment of the Krycklan catchment, Sweden. Daily water and CO2 export from the hillslope and riparian zone were estimated over one hydrological year (October 2012–September 2013) using a flow-concentration model and compared with measured lateral downstream CO2 export. Total water export over the hydrological year from the hillslope was 230 mm yr−1 compared with 270 mm yr−1 from the riparian zone. This corresponds well (proportional to the relative upslope contributing area) to the annual catchment runoff of 265 mm yr−1. Total CO2 export from the riparian zone to the stream was 3.0 g CO2-C m−2 yr−1. A hotspot for riparian CO2 export was observed at 30–50 cm depth (accounting for 71 % of total riparian export). Seasonal variability was high with export peaks during the spring flood and autumn storm events. Downstream lateral CO2 export (determined from stream water dissolved CO2 concentrations and discharge) was 1.2 g CO2-C m−2 yr−1. Subtracting downstream lateral export from riparian export (3.0 g CO2-C m−2 yr−1) gives 1.8 g CO2-C m−2 yr−1 which can be attributed to evasion losses (accounting for 60 % of export via the aquatic pathway). The results highlight the importance of terrestrial CO2 export, especially from the riparian zone, for determining catchment aquatic CO2 losses and the importance of the CO2 evasion component to carbon export via the aquatic conduit.
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Leith, F. I., K. J. Dinsmore, M. B. Wallin, M. F. Billett, K. V. Heal, H. Laudon, M. G. Öquist, and K. Bishop. "Carbon dioxide transport across the hillslope–riparian–stream continuum in a boreal headwater catchment." Biogeosciences Discussions 11, no. 11 (November 7, 2014): 15585–619. http://dx.doi.org/10.5194/bgd-11-15585-2014.
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Abstract. Headwater streams export CO2 as lateral downstream export and vertical evasion from the stream surface. CO2 in boreal headwater streams generally originates from adjacent terrestrial areas, so determining the sources and rate of CO2 transport along the hillslope–riparian–stream continuum could improve estimates of CO2 export via the aquatic pathway, especially by quantifying evasion at higher temporal resolutions. Continuous measurements of dissolved CO2 concentrations and water table were made along the hillslope–riparian–stream continuum in the Västrabäcken sub-catchment of the Krycklan Catchment, Sweden. Daily water and CO2 export from the hillslope and riparian zone were estimated over one hydrological year (October 2012–September 2013) using a flow-concentration model and compared with measured lateral downstream CO2 export. Total water export over the hydrological year from the hillslope was 230 mm yr-1 compared with 270 mm yr-1 from the riparian zone. This corresponds well (proportional to the relative upslope contributing area) to the annual catchment runoff of 265 mm yr-1. Total CO2 export from the riparian zone to the stream was 3.0 g CO2-C m-2 yr-1. A hotspot for riparian CO2 export was observed at 30–50 cm depth (accounting for 71% of total riparian export). Seasonal variability was high with export peaks during the spring flood and autumn storm events. Downtream lateral CO2 export (determined from stream water dissolved CO2 concentrations and discharge) was 1.2 g CO2-C m-2 yr-1. Subtracting downstream lateral export from riparian export (3.0 g CO2-C m-2 yr-1) gives 1.8 g CO2-C m-2 yr-1 which can be attributed to evasion losses (accounting for 60% of export via the aquatic pathway). The results highlight the importance of terrestrial CO2 export, especially from the riparian zone, for determining catchment aquatic CO2 losses and the importance of the CO2 evasion component to carbon export via the aquatic conduit.
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Rekand, Tiina, Bo Biering-Sörensen, Jun He, Ole Jakob Vilholm, Peter Brøgger Christensen, Trandur Ulfarsson, Roger Belusa, et al. "Botulinum toxin treatment of spasticity targeted to muscle endplates: an international, randomised, evaluator-blinded study comparing two different botulinum toxin injection strategies for the treatment of upper limb spasticity." BMJ Open 9, no. 5 (May 2019): e024340. http://dx.doi.org/10.1136/bmjopen-2018-024340.
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ObjectivesThe therapeutic effects of botulinum neurotoxin (BoNT) are well documented in upper limb spasticity. However, several factors may influence treatment efficacy, including targeting of neuromuscular junctions (NMJs). We examined whether NMJ-targeted BoNT injections were non-inferior, in terms of efficacy, to current injection practices.DesignOpen-label prospective evaluator-blinded study.SettingConducted across 20 medical centres in Denmark, Finland, Norway and Sweden (24 September 2012 to 11 March 2015).ParticipantsAged ˃18 years with upper limb spasticity (Modified Ashworth Scale [MAS] score of 2 or 3) following stroke or traumatic brain injury, had received ≥2 consecutive BoNT-A treatment cycles (the latest of which was abobotulinumtoxinA [aboBoNT-A]) and needed BoNT-A retreatment (same modality as previous cycle). Patients requiring aboBoNT-A doses >800units were excluded. In total, 88 patients were randomised (intention-to-treat [ITT] population), most were male (n=58/88, 65.9%) and 54/88 (61.4%) completed the study (per protocol [PP] population).InterventionsRandomisation (1:1) to receive a single dose of aboBoNT-A (≤800 U) according to either current clinical practice (300 U/mL) or as an NMJ-targeted injection (100 U/mL).Primary outcome measureProportion of patients with a ≥1 level reduction from baseline in MAS score at week 4 post-injection (responders).ResultsIn the ITT population, the proportion of responders at elbow flexors was 72.7% in the current practice group and 56.8% in the NMJ-targeted group (adjusted difference −0.1673 [95% CIs: −0.3630 to 0.0284]; p=0.0986). Similar results were observed in the PP population (69.0% vs 68.0%, respectively, adjusted difference 0.0707 [−0.1948 to 0.3362]; p=0.6052).ConclusionsOwing to the limited number of participants, non-inferiority of NMJ-targeted injections could not be determined. However, there was no statistical difference between groups. Larger studies are needed confirm whether the two techniques offer comparable efficacy.Trial registration numberNCT01682148.
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Holst, T., A. Arneth, S. Hayward, A. Ekberg, M. Mastepanov, M. Jackowicz-Korczynski, T. Friborg, P. M. Crill, and K. Bäckstrand. "BVOC ecosystem flux measurements at a high latitude wetland site." Atmospheric Chemistry and Physics 10, no. 4 (February 15, 2010): 1617–34. http://dx.doi.org/10.5194/acp-10-1617-2010.
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Abstract. In this study, we present summertime concentrations and fluxes of biogenic volatile organic compounds (BVOCs) measured at a sub-arctic wetland in northern Sweden using a disjunct eddy-covariance (DEC) technique based on a proton transfer reaction mass spectrometer (PTR-MS). The vegetation at the site was dominated by Sphagnum, Carex and \\textit{Eriophorum} spp. The measurements reported here cover a period of 50 days (1 August to 19 September 2006), approximately one half of the growing season at the site, and allowed to investigate the effect of day-to-day variation in weather as well as of vegetation senescence on daily BVOC fluxes, and on their temperature and light responses. The sensitivity drift of the DEC system was assessed by comparing H3O+-ion cluster formed with water molecules (H3O+(H2O) at m37) with water vapour concentration measurements made using an adjacent humidity sensor, and the applicability of the DEC method was analysed by a comparison of sensible heat fluxes for high frequency and DEC data obtained from the sonic anemometer. These analyses showed no significant PTR-MS sensor drift over a period of several weeks and only a small flux-loss due to high-frequency spectrum omissions. This loss was within the range expected from other studies and the theoretical considerations. Standardised (20 °C and 1000 μmol m−2 s−1 PAR) summer isoprene emission rates found in this study of 329 μg C m−2 (ground area) h−1 were comparable with findings from more southern boreal forests, and fen-like ecosystems. On a diel scale, measured fluxes indicated a stronger temperature dependence than emissions from temperate or (sub)tropical ecosystems. For the first time, to our knowledge, we report ecosystem methanol fluxes from a sub-arctic ecosystem. Maximum daytime emission fluxes were around 270 μg m−2 h−1 (ca. 100 μg C m−2 h−1), and during most nights small negative fluxes directed from the atmosphere to the surface were observed.
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Dell’isola, A., A. Kiadaliri, A. Turkiewicz, V. Hughes, K. Magnusson, J. Runhaar, S. M. A. Bierma-Zeinstra, and M. Englund. "AB0678 RATES OF SURGICAL PROCEDURES OF THE KNEE AND HIP DURING THE “FIRST WAVE” OF COVID 19 IN SWEDEN." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1372.1–1372. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2494.
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Background:Many countries imposed lockdowns in March 2020, in anticipation of the “first wave” of COVID-19 and the massive healthcare resources required to meet its acute medical needs. Sweden adopted a different strategy to contain the epidemic, opting for non-binding recommendations. Nonetheless, elective and acute surgical procedures in health care may have been affected.Objectives:To investigate the effect of the “first-wave” of COVID-19 and the government’s response in Sweden on the rates of total joint replacements (TJR), arthroscopies, and fracture surgeries of the knee and hip.Methods:We used register data for the entire population of Skåne, the southernmost region in Sweden with 1.3 million inhabitants (13% of the total Swedish population). We identified all residents aged ≥18 years who between 1st January 2015 and 31st November 2020 underwent any of the following surgical procedures of the knee or hip: TJR (TJR due to fracture excluded), arthroscopy, and surgery due to fracture (including TJR). To demarcate pre-event and post-event periods, we established a differentiation point corresponding to mid-March 2020, the timepoint at which the the Swedish Public Health Agency began recommending social distancing, working from home, distance learning for secondary schools and universities,. At the aggregate level, we modelled the number of surgeries per 10,000 adults from January 2015 up to September 2020. We did an interrupted time-series (ITSA) analysis using segmented ordinary least-squares regression to estimate changes in the levels and trends of surgical procedures compared to pre-COVID-19 levels, adjusting for seasonal variations. The month of March was treated as a “phase-in” period to give time for the new recommendations to be implemented. In addition, we estimated the absolute and relative difference (with its 95% confidence interval [CI]) between the predicted and the counterfactual scenario in the monthly number of surgeries from April 2020, where the counterfactual is the rate of surgery that would have been expected if COVID-19 had not happened. To account for the possibility that other co-occurring events may be responsible for the observed changes, we assessed changes in the number of surgeries due to fractures, which are normally treated as emergencies that cannot be cancelled or rescheduled, and thus should be less affected, at least by policies at the hospital level.Results:We identified a total of 20,831 TJRs, 12,156 arthroscopies and 15,041 fracture surgeries of the knee or hip over the study period. The monthly rate of surgeries and ITSAs are presented in Figure 1, with the pre-COVID period starting from February 2019 for readability (Figure 1). The results suggest that in April 2020, there was a decrease of 2.08 (95%CI 1.81; 2.35) TJRs per 10,000 adults which corresponds to a decrease of 74% (95%CI 65%; 85%) when compared to the counterfactual scenario. This was followed by a positive trend signifying a monthly increase of 0.36 (95%CI 0.31; 0.40) TJRs per 10,000 adults. The rate of arthroscopies followed a similar pattern with a decrease of 0.55 (95%CI 0.39; 0.71) arthroscopies per 10,000 adults in April, which corresponds to a 49% decrease (95%CI 28%; 63%) followed by a positive trend signifying a monthly increase of 0.11 (95%CI 0.07; 0.15) arthroscopies per 10,000 adults. The rate of surgery due to knee or hip fractures showed no decrease in April and was followed by a negative trend signifying a monthly decrease of 0.03 (95%CI 0.002; 0.04) surgeries per 10,000 adults.Conclusion:In Sweden, we observed a marked decrease in the number of typical elective knee and hip surgeries such as TJRs and arthroscopies, following the government’s response to Covid-19. We then observed a slow but steady recovery that brought the rates of procedures towards expected levels by Fall 2020, before the “second wave” hit the country. The number of acute fracture surgeries showed no sharp drop, instead showing a steady and slow decline potentially due to reduction in commuting and in physical activities linked to recommendations of socialDisclosure of Interests:None declared
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Leta, Tesfaye H., Stein Atle Lie, Anne Marie Fenstad, Stein Håkon L. Lygre, Martin Lindberg-Larsen, Alma B. Pedersen, Annette W-Dahl, et al. "Periprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement." JAMA Network Open 7, no. 5 (May 23, 2024): e2412898. http://dx.doi.org/10.1001/jamanetworkopen.2024.12898.
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ImportanceDespite increased use of antibiotic-loaded bone cement (ALBC) in joint arthroplasty over recent decades, current evidence for prophylactic use of ALBC to reduce risk of periprosthetic joint infection (PJI) is insufficient.ObjectiveTo compare the rate of revision attributed to PJI following primary total knee arthroplasty (TKA) using ALBC vs plain bone cement.Design, Setting, and ParticipantsThis international cohort study used data from 14 national or regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, New Zealand, Norway, Romania, Sweden, Switzerland, the Netherlands, the UK, and the US. The study included primary TKAs for osteoarthritis registered from January 1, 2010, to December 31, 2020, and followed-up until December 31, 2021. Data analysis was performed from April to September 2023.ExposurePrimary TKA with ALBC vs plain bone cement.Main Outcomes and MeasuresThe primary outcome was risk of 1-year revision for PJI. Using a distributed data network analysis method, data were harmonized, and a cumulative revision rate was calculated (1 − Kaplan-Meier), and Cox regression analyses were performed within the 10 registries using both cement types. A meta-analysis was then performed to combine all aggregated data and evaluate the risk of 1-year revision for PJI and all causes.ResultsAmong 2 168 924 TKAs included, 93% were performed with ALBC. Most TKAs were performed in female patients (59.5%) and patients aged 65 to 74 years (39.9%), fully cemented (92.2%), and in the 2015 to 2020 period (62.5%). All participating registries reported a cumulative 1-year revision rate for PJI of less than 1% following primary TKA with ALBC (range, 0.21%-0.80%) and with plain bone cement (range, 0.23%-0.70%). The meta-analyses based on adjusted Cox regression for 1 917 190 TKAs showed no statistically significant difference at 1 year in risk of revision for PJI (hazard rate ratio, 1.16; 95% CI, 0.89-1.52) or for all causes (hazard rate ratio, 1.12; 95% CI, 0.89-1.40) among TKAs performed with ALBC vs plain bone cement.Conclusions and RelevanceIn this study, the risk of revision for PJI was similar between ALBC and plain bone cement following primary TKA. Any additional costs of ALBC and its relative value in reducing revision risk should be considered in the context of the overall health care delivery system.
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Markasz, Laszlo, Alkwin Wanders, Laszlo Szekely, and Helene Engstrand Lilja. "Diminished DEFA6 Expression in Paneth Cells Is Associated with Necrotizing Enterocolitis." Gastroenterology Research and Practice 2018 (October 21, 2018): 1–7. http://dx.doi.org/10.1155/2018/7345426.
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Background. Necrotizing enterocolitis (NEC) is the most common gastrointestinal disorder in premature infants with a high morbidity and mortality. Paneth cell dysfunction has been suggested to be involved in the pathogenesis of NEC. Defensin alpha-6 (DEFA6) is a specific marker for Paneth cells acting as part of the innate immunity in the human intestines. The aim of this study was to investigate the expression of DEFA6 in infants with NEC.Materials and Methods. Infants who underwent bowel resection for NEC at level III NICU in Sweden between August 2004 and September 2013 were eligible for the study. Macroscopically vital tissues were selected for histopathological evaluation. All infants in the control group underwent laparotomy and had ileostomy due to dysmotility, and samples were taken from the site of the stoma. DEFA6 expression was studied by immunohistochemistry. Digital image analysis was used for an objective and precise description of the samples.Results. A total of 12 infants were included in the study, eight with NEC and four controls. The tissue samples were taken from the colon (n=1), jejunum (n=1), and ileum (n=10). Both the NEC and control groups consisted of extremely premature and term infants (control group: 25–40 gestational weeks, NEC group: 23–39 gestational weeks). The postnatal age at the time of surgery varied in both groups (control group: 4–47 days, NEC group: 4–50 days). DEFA6 expression in the NEC group was significantly lower than that in the control group and did not correlate with gestational age.Conclusion. The diminished DEFA6 expression in Paneth cells associated with NEC in this study supports the hypothesis that alpha-defensins are involved in the pathophysiology of NEC. Future studies are needed to elucidate the role of alpha-defensins in NEC aiming at finding preventive and therapeutic strategies against NEC.
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Jansson, Hanna, Terese Stenfors, Sara Riggare, Henna Hasson, and Maria Reinius. "Patient lead users experience of the COVID-19 pandemic: a qualitative interview study." BMJ Open 12, no. 8 (August 2022): e059003. http://dx.doi.org/10.1136/bmjopen-2021-059003.
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ObjectivesPatient lead users can be defined as patients or relatives who use their knowledge and experience to improve their own or a relative’s care situation and/or the healthcare system, and who are active beyond what is usually expected. The objective of this study is to explore patient lead users’ experiences and engagement during the early COVID-19 pandemic.DesignQualitative in-depth interviews with a cross-sectional time horizon.SettingThe early COVID-19 pandemic in Sweden, from 1 June through 14 September, 2020.ParticipantsA total of 10 patient lead users were recruited from the Swedish patient lead users (spetspatient) network. All participants were living with different long-term conditions and matched the definition of being patient lead users.ResultsWe found that during the early pandemic, patient lead users experienced that they no longer knew how to best manage their own health and care situations. On an individual level, they described an initial lack of knowledge, new routines, including a change in their health and an experience of people without a disease being in the same situation as them, for a while. On a systemic level, they described a fear of imminent unmet-care backlogs and decreased opportunities for sharing patient perspectives in care organisation, but also described increased networking.ConclusionsPatient lead users can be seen as an emerging community of practice, and as such could be a valuable resource as a complementary communication channel for an improved health system. The health systems were not able to fully acknowledge and engage with the resource of patient lead users during the pandemic.
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Baumann, Pia, Jan Nyman, Morten Hoyer, Berit Wennberg, Giovanna Gagliardi, Ingmar Lax, Ninni Drugge, et al. "Outcome in a Prospective Phase II Trial of Medically Inoperable Stage I Non–Small-Cell Lung Cancer Patients Treated With Stereotactic Body Radiotherapy." Journal of Clinical Oncology 27, no. 20 (July 10, 2009): 3290–96. http://dx.doi.org/10.1200/jco.2008.21.5681.
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Purpose The impact of stereotactic body radiotherapy (SBRT) on 3-year progression-free survival of medically inoperable patients with stage I non–small-cell lung cancer (NSCLC) was analyzed in a prospective phase II study. Patients and Methods Fifty-seven patients with T1NOMO (70%) and T2N0M0 (30%) were included between August 2003 and September 2005 at seven different centers in Sweden, Norway, and Denmark and observed up to 36 months. SBRT was delivered with 15 Gy times three at the 67% isodose of the planning target volume. Results Progression-free survival at 3 years was 52%. Overall- and cancer-specific survival at 1, 2, and 3 years was 86%, 65%, 60%, and 93%, 88%, 88%, respectively. There was no statistically significant difference in survival between patients with T1 or T2 tumors. At a median follow-up of 35 months (range, 4 to 47 months), 27 patients (47%) were deceased, seven as a result of lung cancer and 20 as a result of concurrent disease. Kaplan-Meier estimated local control at 3 years was 92%. Local relapse was observed in four patients (7%). Regional relapse was observed in three patients (5%). Nine patients (16%) developed distant metastases. The estimated risk of all failure (local, regional, or distant metastases) was increased in patients with T2 (41%) compared with those with T1 (18%) tumors (P = .027). Conclusion With a 3-year local tumor control rate higher than 90% with limited toxicity, SBRT emerges as state-of-the-art treatment for medically inoperable stage I NSCLC and may even challenge surgery in operable instances.
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Luscher, T. F., M. L. Simoons, and E. Silove. "Abstracts selected for presentation at the XXIII Congress of the European Society of Cardiology, together with the 36th Annual General Meeting of the Association for European Paediatric Cardiology (AEPC), September 1-5,2001, Stockholm, Sweden." European Heart Journal 22, Abstract Supplement (September 2, 2001): iii—vi. http://dx.doi.org/10.1093/eurheartj/22.abstract_supplement.iii.
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Patsch, Hermann. "Ludwig von Mühlenfels als Advocatus Schleiermacheri. Ein Nachtrag zu: Der unpfäffische Schleiermacher. Karl Gutzkow und das Schleiermacher-Bild des Jungen Deutschlands – Zur Konstruktion eines Gegenmythos (JHMTh/ZNThG 24, 2017, 240–299)." Journal for the History of Modern Theology / Zeitschrift für Neuere Theologiegeschichte 25, no. 1-2 (May 25, 2018): 235–76. http://dx.doi.org/10.1515/znth-2018-0010.
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Abstract Ludwig von Mühlenfels as Advocatus Schleiermacheri. An addendum. The editorial copy of the “Allgemeine Zeitung” has survived in the Cotta-Archive with the names of the contributors. This has made it possible to identify belatedly the author of the apologia “Another word about Schleiermacher” in the “Außerordentliche Beilage der Allgemeinen Zeitung” (Augsburg) of April 2, 1834. It was Ludwig Friedrich von Mühlenfels (1793–1861). Mühlenfels, who led a rather varied life, was related to Schleiermacher’s wife Henriette, and thus belonged to Schleiermacher’s extended family. (1) Member of Lützow’s Freicorps. On Schleiermacher’s suggestion, Mühlenfels participated in the war of liberation against Napoleon as a volunteer with the “Black Hunters”, in the end in the so-called Battle of the Nations at Leipzig. He finished the study of law in 1816 and, on probation, joined the prosecutor’s office in Cologne where the French legal code was still in force. (2) Incarcerated as a demagogue under the investigating judge E. T. A. Hoffmann. Mühlenfels became one of the formative figures in the early history of German fraternities and participated in the Wartburg Festival in October 1817. He was arrested in July 1819 by the authorities in Berlin, charged with activities as a demagogue and incarcerated in Berlin on September 17. Mühlenfels contested the jurisdiction of the authorities in Berlin and refused to testify. The investigative judge was the writer and composer E. T. A. Hoffmann who wanted to have Mühlenfels released, and who later used him as a literary figure in a satirical novel. (3) Flight from Berlin – Exile in Sweden. On May 5, 1821, Mühlenfels succeeded in fleeing to Sweden where he made a meagerly living as a private tutor. (4) Professor for German and Scandinavian Literature in London – Return to Prussia. In October 1827, Mühlenfels reached London. Supported by some German scholars, he obtained the Chair for German and Scandinavian at the newly founded University College. He taught there until 1831 and publishedseveral textbooks. When he was acquitted by a court ruling in 1830, he returned to the Prussian public service in August 1831 and gradually built a solid career. (5) The defender of Schleiermacher. His apologia of Schleiermacher written in opposition to the obituary by Gutzkow is a masterpiece of literary and legal writing. – First publication: Six letters between Mühlenfels, Henriette and Friedrich Schleiermacher, and Georg Andreas Reimer.