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1.
  • Ahmad, Nouman, et al. (författare)
  • Voxel-wise body composition analysis using image registration of a three-slice CT imaging protocol : methodology and proof-of-concept studies
  • 2024
  • Ingår i: Biomedical engineering online. - : Springer Nature. - 1475-925X. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Computed tomography (CT) is an imaging modality commonly used for studies of internal body structures and very useful for detailed studies of body composition. The aim of this study was to develop and evaluate a fully automatic image registration framework for inter-subject CT slice registration. The aim was also to use the results, in a set of proof-of-concept studies, for voxel-wise statistical body composition analysis (Imiomics) of correlations between imaging and non-imaging data.Methods The current study utilized three single-slice CT images of the liver, abdomen, and thigh from two large cohort studies, SCAPIS and IGT. The image registration method developed and evaluated used both CT images together with image-derived tissue and organ segmentation masks. To evaluate the performance of the registration method, a set of baseline 3-single-slice CT images (from 2780 subjects including 8285 slices) from the SCAPIS and IGT cohorts were registered. Vector magnitude and intensity magnitude error indicating inverse consistency were used for evaluation. Image registration results were further used for voxel-wise analysis of associations between the CT images (as represented by tissue volume from Hounsfield unit and Jacobian determinant) and various explicit measurements of various tissues, fat depots, and organs collected in both cohort studies.Results Our findings demonstrated that the key organs and anatomical structures were registered appropriately. The evaluation parameters of inverse consistency, such as vector magnitude and intensity magnitude error, were on average less than 3 mm and 50 Hounsfield units. The registration followed by Imiomics analysis enabled the examination of associations between various explicit measurements (liver, spleen, abdominal muscle, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), thigh SAT, intermuscular adipose tissue (IMAT), and thigh muscle) and the voxel-wise image information.Conclusion The developed and evaluated framework allows accurate image registrations of the collected three single-slice CT images and enables detailed voxel-wise studies of associations between body composition and associated diseases and risk factors.
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2.
  • Arvidsson, Daniel, 1974, et al. (författare)
  • Fundament for a methodological standard to process hip accelerometer data to a measure of physical activity intensity in middle-aged individuals.
  • 2024
  • Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 34:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: There is a lack of a methodological standard to process accelerometer data to measures of physical activity, which impairs data quality and comparability. This study investigated the effect of different combinations of settings of multiple processing components, on the measure of physical activity and the association with measures of cardiometabolic health in an unselected population of middle-aged individuals.METHODS: Free-living hip accelerometer data, aerobic fitness, body mass index, HDL:total cholesterol ratio, blood glucose, and systolic blood pressure were achieved from 4391 participants 50-64 years old included in The Swedish CArdioPulmonary bioImage Study (SCAPIS) baseline measurement (cross-sectional). Lab data were also included for calibration of accelerometers to provide comparable measure of physical activity intensity and time spent in different intensity categories, as well as to enhance understanding. The accelerometer data processing components were hardware recalibration, frequency filtering, number of accelerometer axes, epoch length, wear time criterium, time composition (min/24 h vs. % of wear time). Partial least regression and ordinary least regression were used for the association analyses.RESULTS: The setting of frequency filter had the strongest effect on the physical activity intensity measure and time distribution in different intensity categories followed by epoch length and number of accelerometer axes. Wear time criterium and recalibration of accelerometer data were less important. The setting of frequency filter and epoch length also showed consistent important effect on the associations with the different measures of cardiometabolic health, while the effect of recalibration, number of accelerometer axes, wear time criterium and expression of time composition was less consistent and less important. There was a large range in explained variance of the measures of cardiometabolic health depending on the combination of processing settings, for example, 12.1%-20.8% for aerobic fitness and 5.8%-14.0% for body mass index.CONCLUSIONS: There was a large variation in the physical activity intensity measure and the association with different measures of cardiometabolic health depending on the combination of settings of accelerometer data processing components. The results provide a fundament for a standard to process hip accelerometer data to assess the physical activity in middle-aged populations.
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3.
  • Baldanzi, Gabriel, et al. (författare)
  • Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS.
  • 2024
  • Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 100
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Previous population-based studies investigating the relationship between physical activity and the gut microbiota have relied on self-reported activity, prone to reporting bias. Here, we investigated the associations of accelerometer-based sedentary (SED), moderate-intensity (MPA), and vigorous-intensity (VPA) physical activity with the gut microbiota using cross-sectional data from the Swedish CArdioPulmonary bioImage Study.METHODS: In 8416 participants aged 50-65, time in SED, MPA, and VPA were estimated with hip-worn accelerometer. Gut microbiota was profiled using shotgun metagenomics of faecal samples. We applied multivariable regression models, adjusting for sociodemographic, lifestyle, and technical covariates, and accounted for multiple testing.FINDINGS: Overall, associations between time in SED and microbiota species abundance were in opposite direction to those for MPA or VPA. For example, MPA was associated with lower, while SED with higher abundance of Escherichia coli. MPA and VPA were associated with higher abundance of the butyrate-producers Faecalibacterium prausnitzii and Roseburia spp. We observed discrepancies between specific VPA and MPA associations, such as a positive association between MPA and Prevotella copri, while no association was detected for VPA. Additionally, SED, MPA and VPA were associated with the functional potential of the microbiome. For instance, MPA was associated with higher capacity for acetate synthesis and SED with lower carbohydrate degradation capacity.INTERPRETATION: Our findings suggest that sedentary and physical activity are associated with a similar set of gut microbiota species but in opposite directions. Furthermore, the intensity of physical activity may have specific effects on certain gut microbiota species.FUNDING: European Research Council, Swedish Heart-Lung Foundation, Swedish Research Council, Knut and Alice Wallenberg Foundation.
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4.
  • Bergfeldt, Lennart, 1950, et al. (författare)
  • Abnormal QRS-T angles in 5796 women and men aged 50-64: an electrocardiographic analysis providing mechanistic insights.
  • 2024
  • Ingår i: Journal of electrocardiology. - 1532-8430. ; 86
  • Tidskriftsartikel (refereegranskat)abstract
    • Abnormal QRS-T angles are prognostic markers for cardiovascular deaths including sudden cardiac death. They occur in ∼5-6% of population-based cohorts but in ∼20% of patients with diabetes. The mechanistic background, electrical activation and/or recovery disturbances, is not known and the topic of this study.Applying Frank vectorcardiography (VCG) and simultaneously recorded scalar 12‑lead ECG, electrical activation and recovery of abnormal QRS-T angles were studied in 311 participants (5.4%) from a population-based cohort of 5796 women and men in the main Swedish CArdio-Pulmonary bio-Imaging Study (SCAPIS) in Gothenburg. Cut-off values for the peak and mean QRS-T angles were>124° and>119°, based on the >95th percentile among all 1080 participants in the pilot SCAPIS and reference values for normal directions (Q1-Q3) from 319 apparently healthy (30%) of them.Of 311 cases 17% had known cardiac disease. Deviations of QRS and QRSarea-vectors from reference limits (90%) were significantly more common than deviations of T- and Tarea-vectors (65%). Standard ECG signs suggested pathophysiology in 20%; left bundle branch block (LBBB) and voltage criteria for left ventricular hypertrophy being most frequent (9-10%) each. Sub-group analysis of the 30 with LBBB showed very large variability in vector directions.Our observations provide mechanistic insights about abnormal QRS-T angles of potential value for future prognostic and interventional studies. The results also have potential implications for LBB area pacing and the approach to left ventricular hypertrophy.
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5.
  • Bergström, Göran, et al. (författare)
  • Self-Report Tool for Identification of Individuals With Coronary Atherosclerosis : The Swedish CardioPulmonary BioImage Study
  • 2024
  • Ingår i: Journal of the American Heart Association. - : American Heart Association. - 2047-9980. ; 13:14
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Coronary atherosclerosis detected by imaging is a marker of elevated cardiovascular risk. However, imaging involves large resources and exposure to radiation. The aim was, therefore, to test whether nonimaging data, specifically data that can be self-reported, could be used to identify individuals with moderate to severe coronary atherosclerosis. METHODS AND RESULTS: We used data from the population-based SCAPIS (Swedish CardioPulmonary BioImage Study) in individuals with coronary computed tomography angiography (n=25 182) and coronary artery calcification score (n=28 701), aged 50 to 64 years without previous ischemic heart disease. We developed a risk prediction tool using variables that could be assessed from home (self-report tool). For comparison, we also developed a tool using variables from laboratory tests, physical examinations, and self-report (clinical tool) and evaluated both models using receiver operating characteristic curve analysis, external validation, and benchmarked against factors in the pooled cohort equation. The self-report tool (n=14 variables) and the clinical tool (n=23 variables) showed high-to-excellent discriminative ability to identify a segment involvement score ≥4 (area under the curve 0.79 and 0.80, respectively) and significantly better than the pooled cohort equation (area under the curve 0.76, P<0.001). The tools showed a larger net benefit in clinical decision-making at relevant threshold probabilities. The self-report tool identified 65% of all individuals with a segment involvement score ≥4 in the top 30% of the highest-risk individuals. Tools developed for coronary artery calcification score ≥100 performed similarly. CONCLUSIONS: We have developed a self-report tool that effectively identifies individuals with moderate to severe coronary atherosclerosis. The self-report tool may serve as prescreening tool toward a cost-effective computed tomography-based screening program for high-risk individuals.
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6.
  • Björkvall, Anders, 1972-, et al. (författare)
  • Analyzing Text and Discourse in the Social Sciences
  • 2024. - Second
  • Ingår i: Analyzing Text and Discourse. - London : Sage Publications. - 9781529601954 - 9781529601961 - 9781529679595
  • Bokkapitel (refereegranskat)
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7.
  • Björnson, Elias, 1988, et al. (författare)
  • The relationship between genetic liver fat and coronary heart disease is explained by apoB-containing lipoproteins
  • 2024
  • Ingår i: ATHEROSCLEROSIS. - 0021-9150 .- 1879-1484. ; 388
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The relationship between genetically -driven liver fat and coronary heart disease (CHD) remains unclear. ApoB-containing lipoproteins are known causal factors for CHD and may explain this relationship. Methods and Results: We conducted a genome-wide association study (GWAS) in the UK Biobank to identify genetic variants associated with liver fat. We then investigated the effects that these genetic variants had on both apoB-containing lipoproteins and CHD. Using Mendelian Randomization (MR) analyses, we examined if the relationship between genetically -driven liver fat and CHD could be attributed to its effect on apoB-containing lipoproteins. We found 25 independent liver -fat associated single -nucleotide polymorphisms (SNPs) with differing effects on lipoprotein metabolism. The SNPs were classified into three groups/clusters. The first cluster (N = 3 SNPs) displayed lipoprotein -raising effects. The second cluster (N = 12 SNPs) displayed neutral effects on lipoproteins and the third cluster (N = 10 SNPs) displayed lipoprotein -lowering effects. For every 1% higher liver fat, the first cluster showed an increased risk of CHD (OR = 1.157 [95% CI: 1.108-1.208]). The second cluster showed a non -significant effect on CHD (OR = 0.988 [95% CI: 0.965-1.012], whereas the third cluster showed a protective effect of increased liver fat on CHD (OR = 0.942 [95% CI: 0.897-0.989]). When adjusting for apoB, the risk for CHD became null. Conclusions: Here, we identify 25 liver -fat associated SNPs. We find that SNPs that increase, decrease or have neutral effects on apoB-containing lipoproteins show increased, decreased or neutral effects on CHD, respectively. Therefore, the relationship between genetically -driven liver fat and CHD is mediated by the causal effect of apoB.
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8.
  • Blomberg, Anders, et al. (författare)
  • Chronic Airflow Limitation, Emphysema and Impaired Diffusing Capacity in Relation to Smoking Habits in a Swedish Middle-Aged Population.
  • 2024
  • Ingår i: Annals of the American Thoracic Society. - 2329-6933 .- 2325-6621.
  • Tidskriftsartikel (refereegranskat)abstract
    • RATIONALE: Chronic obstructive pulmonary disease (COPD) includes respiratory symptoms and chronic airflow limitation (CAL). In some cases, emphysema and impaired diffusing capacity for carbon monoxide (DLCO) are present, but characteristics and symptoms vary with smoking exposure.OBJECTIVES: To study the prevalence of CAL, emphysema and impaired DLCO in relation to smoking and respiratory symptoms in a middle-aged population.METHODS: We investigated 28,746 randomly invited individuals (52% women) aged 50-64 years across six Swedish sites. We performed spirometry, DLCO, high-resolution computed tomography (HRCT) and asked for smoking habits and respiratory symptoms. CAL was defined as post-bronchodilator forced expiratory volume in 1 second divided by forced expiratory volume (FEV1/FVC)<0.7.RESULTS: The overall prevalence was for CAL 8.8%, for impaired DLCO (DLCOCONCLUSIONS: In this large population-based study of middle-aged people, CAL and impaired DLCO were associated with common respiratory symptoms. Self-reported asthma was not associated with CAL in never-smokers. Our findings suggest that CAL in never-smokers signifies a separate clinical phenotype that may be monitored and, possibly, treated differently from smoking-related COPD. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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9.
  • Ekström, Linda, et al. (författare)
  • Three Poststructural Approaches to Discourse Analysis
  • 2024. - 2
  • Ingår i: Analyzing Text and Discourse. - Thousand Oaks : Sage Publications. - 9781529601954 - 9781529679595 ; , s. 135-167
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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10.
  • Engström, Gunnar, et al. (författare)
  • Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
  • 2024
  • Ingår i: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
  • Tidskriftsartikel (refereegranskat)abstract
    • Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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11.
  • Fridolfsson, Jonatan, et al. (författare)
  • Fitness-related physical activity intensity explains most of the association between accelerometer data and cardiometabolic health in persons 50-64 years old.
  • 2024
  • Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480.
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To investigate the physical activity (PA) intensity associated with cardiometabolic health when considering the mediating role of cardiorespiratory fitness (CRF).METHODS: A subsample of males and females aged 50-64 years from the cross-sectional Swedish CArdioPulmonary bioImage Study was investigated. PA was measured by accelerometry and CRF by a submaximal cycle test. Cardiometabolic risk factors, including waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides and glycated haemoglobin, were combined to a composite score. A mediation model by partial least squares structural equation modelling was used to analyse the role of CRF in the association between PA and the composite score.RESULTS: The cohort included 4185 persons (51.9% female) with a mean age of 57.2 years. CRF mediated 82% of the association between PA and the composite score. The analysis of PA patterns revealed that moderate intensity PA explained most of the variation in the composite score, while vigorous intensity PA explained most of the variation in CRF. When including both PA and CRF as predictors of the composite score, the importance of vigorous intensity increased.CONCLUSION: The highly interconnected role of CRF in the association between PA and cardiometabolic health suggests limited direct effects of PA on cardiometabolic health beyond its impact on CRF. The findings highlight the importance of sufficient PA intensity for the association with CRF, which in turn is linked to better cardiometabolic health.
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12.
  • Guldbrand, Carl, 1997, et al. (författare)
  • Low-level exposure to lead and atherosclerosis in the carotid arteries : Results from the Swedish population-based cohort SCAPIS
  • 2024
  • Ingår i: Environmental Research. - 0013-9351 .- 1096-0953. ; 244
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Lead exposure is associated with cardiovascular disease. Atherosclerosis has been hypothesized to be one of the underlying mechanisms behind this association. Aim: To investigate whether lead exposure is associated with an increased risk of atherosclerosis in the carotid arteries in a large Swedish population-based cohort. Methods: We performed a cross-sectional study using data from the population-based Swedish CardioPulmonary bioImage Study (SCAPIS), including 5622 middle-aged men and women, enrolled 2013–2018. Blood lead (B–Pb), measured by inductively coupled plasma mass spectrometry, was used as exposure biomarker. The presence of atherosclerotic plaque in the carotid arteries (yes/no), total plaque area (mm2) and the presence of large plaques (>25 mm2) were determined by ultrasonography. Associations between B–Pb and the different outcomes were analysed using Poisson and linear regression models, adjusted for potential confounders. Results: Atherosclerotic plaque was present in 57% of the individuals, for whom the median total plaque area was 16 mm2 (range: 0.2–222). The median B–Pb concentration was 14 μg/L (range: 0.75–203). After adjusting for potential confounders, individuals in the fourth quartile of B–Pb (Q4) had a prevalence ratio (PR) for plaque of 1.08 (95% CI: 1.01, 1.16) when compared with the first quartile (Q1). A 10 μg/L increase in B–Pb concentrations was associated with an increase of 0.92 mm2 (95% CI: 0.14, 1.71) in total plaque area. The PR for large plaque was 1.09 (95% CI: 0.84, 1.42 for Q4 vs Q1). Conclusions: This study shows an association between B–Pb and atherosclerosis in the carotid arteries providing some support for the hypothesis that atherosclerosis is one of the mechanisms underlying the association between lead exposure and cardiovascular disease.
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13.
  • Karady, Julia, et al. (författare)
  • Coronary plaque in people with HIV vs non-HIV asymptomatic community and symptomatic higher-risk populations
  • 2024
  • Ingår i: JACC: Advances. - : Elsevier. - 2772-963X. ; 3:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification.Objectives: The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH.Methods: Nonstatin using participants from 3 contemporary populations without known coronary plaques with coronary CT were compared: the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) studying PWH without cardiovascular symptoms at low-to-moderate risk (n = 755); the SCAPIS (Swedish Cardiopulmonary Bioimage Study) of asymptomatic community PwoH at low-to-intermediate cardiovascular risk (n = 23,558); and the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) of stable chest pain PwoH (n = 2,291). The coronary plaque prevalence on coronary CT was compared, and comparisons were stratified by 10-year atherosclerotic cardiovascular disease (ASCVD) risk, age, and coronary artery calcium (CAC) presence.Results: Compared to SCAPIS and PROMISE PwoH, REPRIEVE PWH were younger (50.8 ± 5.8 vs 57.3 ± 4.3 and 60.0 ± 8.0 years; P < 0.001) and had lower ASCVD risk (5.0% ± 3.2% vs 6.0% ± 5.3% and 13.5% ± 11.0%; P < 0.001). More PWH had plaque compared to the asymptomatic cohort (48.5% vs 40.3%; P < 0.001). When stratified by ASCVD risk, PWH had more plaque compared to SCAPIS and a similar prevalence of plaque compared to PROMISE. CAC = 0 was more prevalent in PWH (REPRIEVE 65.2%; SCAPIS 61.6%; PROMISE 49.6%); among CAC = 0, plaque was more prevalent in PWH compared to the PwoH cohorts (REPRIEVE 20.8%; SCAPIS 5.4%; PROMISE 12.3%, P < 0.001).Conclusions: Asymptomatic PWH in REPRIEVE had more plaque than asymptomatic PwoH in SCAPIS but had similar prevalence to a higher-risk stable chest pain cohort in PROMISE. In PWH, CAC = 0 does not reliably exclude plaque.
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14.
  • Kilbo Edlund, Karl, et al. (författare)
  • Long-term ambient air pollution and coronary atherosclerosis : results from the Swedish SCAPIS study
  • 2024
  • Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484.
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis.Methods: We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders.Results: Median 10-year average PM2.5 exposure was 6.2 μg/m3 (range 3.5–13.4 μg/m3). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m3). Associations with significant stenoses were inconsistent.Conclusions: In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.
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15.
  • Kobayashi Frisk, Mio, et al. (författare)
  • Eveningness is associated with coronary artery calcification in a middle-aged Swedish population
  • 2024
  • Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 113, s. 370-377
  • Tidskriftsartikel (refereegranskat)abstract
    • Coronary artery calcification (CAC) is an established imaging biomarker of subclinical atherosclerosis, but its relationship to diurnal preference is not well studied. We investigated the association between chronotype and CAC in the Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot cohort. Participants aged 50–64 years were randomly recruited and underwent extensive examination including imaging and accelerometry-assessed physical activity. 771 participants (47.3 % male, 57.6 ± 4.4 years) were included in this cross-sectional analysis. CAC was assessed by non-contrast computed tomography, and a CAC score > 10 was considered significant calcification. Self-assessed chronotype was classified as extreme morning, moderate morning, intermediate, moderate evening, or extreme evening. 10-year risk of first-onset cardiovascular disease was estimated by the Systemic Coronary Risk Evaluation 2 (SCORE2). Significant CAC was present in 29 % of the cohort. CAC prevalence increased from extreme morning to extreme evening type (22 %, 28 %, 29 %, 27 %, 41 % respectively, p = 0.018). In a multivariate logistic regression model controlling for confounders, extreme evening chronotype was independently associated with increased CAC prevalence compared to extreme morning type (OR 1.90, [95%CI 1.04–3.46], p = 0.037). When stratified by SCORE2 risk category (low: <5 %; moderate: 5 to <10 %; high: ≥10 %), significant CAC was most prevalent among extreme evening chronotypes in the low and moderate-risk groups, while chronotype seemed less important in the high-risk group (p = 0.011, p = 0.023, p = 0.86, respectively). Our findings suggest circadian factors may play an important role in atherosclerosis and should be considered in early cardiovascular prevention.
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16.
  • Larsson, Stefan, et al. (författare)
  • Bedömning av status för nationellt förvaltade fisk- och skaldjursbestånd
  • 2024
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) presenterar årligen statusbedömningar för nationellt förvaltade fisk- och skaldjursbestånd i svenska vatten på webbportalen www.fiskbarometern.se. Fiskbarometerns statusbedömningar av fisk- och skaldjursbestånd, utgör ett viktigt underlag för hållbart nyttjande, bevarandeåtgärder och uppföljning inom fisk-, vatten- och miljöförvaltningen. I denna rapport redovisas metodiken för dessa statusbedömningar. Metodiken bidrar till en standardiserad och kvalitetssäkrad bedömningsprocess som är transparent och som vilar på vetenskaplig grund. För de flesta bestånd i Fiskbarometern baseras bedömningen på indikatorer indelade i dödlighet, biomassa/abundans och storleks-/åldersstruktur, vilka motsvarar Havsmiljödirektivets tre kriterier för bedömning av kommersiellt nyttjade bestånd (2008/56/EC). Baserat på sammanvägningen av de tre kriterierna ges respektive bestånd sedan en av fem möjliga statusbedömningar:• kan ej bedömas • mycket sannolikt inte inom biologiskt säkra gränser • sannolikt inte inom biologiskt säkra gränser • sannolikt inom biologiskt säkra gränser • mycket sannolikt inom biologiskt säkra gränserFör några nationellt förvaltade bestånd finns eller pågår arbete med att utveckla analytiska beståndsmodeller. I den här rapporten presenteras riktlinjer för kvalitetssäkring och tillämpning av dem översiktligt, men den vetenskapliga granskningen av sådana modeller hanteras separat inom en process som kallas riktmärkning, vilken inte beskrivs i denna rapport. Utfall från dessa modeller översätts till samma statuskategorier som för de indikatorbaserade bedömningarna.
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17.
  • Lidén, Mats, 1976-, et al. (författare)
  • Machine learning slice-wise whole-lung CT emphysema score correlates with airway obstruction
  • 2024
  • Ingår i: European Radiology. - : Springer. - 0938-7994 .- 1432-1084. ; 34:1, s. 39-49
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Quantitative CT imaging is an important emphysema biomarker, especially in smoking cohorts, but does not always correlate to radiologists' visual CT assessments. The objectives were to develop and validate a neural network-based slice-wise whole-lung emphysema score (SWES) for chest CT, to validate SWES on unseen CT data, and to compare SWES with a conventional quantitative CT method.MATERIALS AND METHODS: Separate cohorts were used for algorithm development and validation. For validation, thin-slice CT stacks from 474 participants in the prospective cross-sectional Swedish CArdioPulmonary bioImage Study (SCAPIS) were included, 395 randomly selected and 79 from an emphysema cohort. Spirometry (FEV1/FVC) and radiologists' visual emphysema scores (sum-visual) obtained at inclusion in SCAPIS were used as reference tests. SWES was compared with a commercially available quantitative emphysema scoring method (LAV950) using Pearson's correlation coefficients and receiver operating characteristics (ROC) analysis.RESULTS: SWES correlated more strongly with the visual scores than LAV950 (r = 0.78 vs. r = 0.41, p < 0.001). The area under the ROC curve for the prediction of airway obstruction was larger for SWES than for LAV950 (0.76 vs. 0.61, p = 0.007). SWES correlated more strongly with FEV1/FVC than either LAV950 or sum-visual in the full cohort (r =  - 0.69 vs. r =  - 0.49/r =  - 0.64, p < 0.001/p = 0.007), in the emphysema cohort (r =  - 0.77 vs. r =  - 0.69/r =  - 0.65, p = 0.03/p = 0.002), and in the random sample (r =  - 0.39 vs. r =  - 0.26/r =  - 0.25, p = 0.001/p = 0.007).CONCLUSION: The slice-wise whole-lung emphysema score (SWES) correlates better than LAV950 with radiologists' visual emphysema scores and correlates better with airway obstruction than do LAV950 and radiologists' visual scores.CLINICAL RELEVANCE STATEMENT: The slice-wise whole-lung emphysema score provides quantitative emphysema information for CT imaging that avoids the disadvantages of threshold-based scores and is correlated more strongly with reference tests than LAV950 and reader visual scores.KEY POINTS: • A slice-wise whole-lung emphysema score (SWES) was developed to quantify emphysema in chest CT images. • SWES identified visual emphysema and spirometric airflow limitation significantly better than threshold-based score (LAV950). • SWES improved emphysema quantification in CT images, which is especially useful in large-scale research.
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18.
  • Memarian, Ensieh, et al. (författare)
  • Associations between physical activity and ankle-brachial index: the Swedish CArdioPulmonary bioImage Study (SCAPIS)
  • 2024
  • Ingår i: BMC CARDIOVASCULAR DISORDERS. - : BMC. - 1471-2261. ; 24:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The ankle-brachial index (ABI) is the ratio of the ankle and brachial systolic blood pressures. In the clinical setting, low ABI (< 0.9) is an indicator of peripheral atherosclerosis, while high ABI (> 1.4) is a sign of arterial stiffness and calcification. The purpose of the current study was to investigate the association between ABI and physical activity levels, measured by accelerometer. Methods The Swedish CArdioPulmonary bioImage Study (SCAPIS) is a Swedish nationwide population-based cross-sectional cohort for the study of cardiovascular and pulmonary diseases, in which individuals aged 50-64 years were randomly invited from the general population. The study population with data on ABI, physical activity, and sedentary time based on accelerometry was 27,737. Differences between ABI categories and associations to sedentary behavior, moderate to vigorous physical activity (MVPA), and other metabolic characteristics were compared. ABI was categorized as low, ABI <= 0.9, borderline, ABI 0.91-0.99, normal, ABI 1.0-1.39, and high, ABI >= 1.4. Results Prevalence of low ABI was higher in the most sedentary quartiles compared to the least sedentary (0.6% vs. 0.1%, p < 0.001). The most sedentary individuals also exhibited higher BMI, higher prevalence of diabetes and hypertension. The proportion of wake time spent in MVPA was lowest in those with low ABI (0.033 +/- 0.004; p < 0.001) and highest in those with ABI > 1.4 (0.069 +/- 0.001; p < 0.001) compared to those with normal ABI. Compared to normal ABI, the proportion of sedentary time was highest in those with low ABI (0.597 +/- 0.012; p < 0.001) and lowest in those with ABI > 1.4 (0.534 +/- 0.002; p = 0.004). Conclusion This population-based study shows that middle-aged individuals with ABI > 1.4 have the highest level of physical activity, while individuals with a lower ABI, especially those with ABI < 0.9, are less active and spend more time sedentary. Future studies are needed to understand the relationships between ABI, physical activity, and the risk of peripheral arterial and cardiovascular disease in the general population.
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19.
  • Mravinacová, Sára, et al. (författare)
  • CSF protein ratios with enhanced potential to reflect Alzheimer’s disease pathology and neurodegeneration
  • 2024
  • Ingår i: Molecular Neurodegeneration. - : Springer Nature. - 1750-1326. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Amyloid and tau aggregates are considered to cause neurodegeneration and consequently cognitive decline in individuals with Alzheimer’s disease (AD). Here, we explore the potential of cerebrospinal fluid (CSF) proteins to reflect AD pathology and cognitive decline, aiming to identify potential biomarkers for monitoring outcomes of disease-modifying therapies targeting these aggregates. Method: We used a multiplex antibody-based suspension bead array to measure the levels of 49 proteins in CSF from the Swedish GEDOC memory clinic cohort at the Karolinska University Hospital. The cohort comprised 148 amyloid- and tau-negative individuals (A-T-) and 65 amyloid- and tau-positive individuals (A+T+). An independent sample set of 26 A-T- and 26 A+T+ individuals from the Amsterdam Dementia Cohort was used for validation. The measured proteins were clustered based on their correlation to CSF amyloid beta peptides, tau and NfL levels. Further, we used support vector machine modelling to identify protein pairs, matched based on their cluster origin, that reflect AD pathology and cognitive decline with improved performance compared to single proteins. Results: The protein-clustering revealed 11 proteins strongly correlated to t-tau and p-tau (tau-associated group), including mainly synaptic proteins previously found elevated in AD such as NRGN, GAP43 and SNCB. Another 16 proteins showed predominant correlation with Aβ42 (amyloid-associated group), including PTPRN2, NCAN and CHL1. Support vector machine modelling revealed that proteins from the two groups combined in pairs discriminated A-T- from A+T+ individuals with higher accuracy compared to single proteins, as well as compared to protein pairs composed of proteins originating from the same group. Moreover, combining the proteins from different groups in ratios (tau-associated protein/amyloid-associated protein) significantly increased their correlation to cognitive decline measured with cognitive scores. The results were validated in an independent cohort. Conclusions: Combining brain-derived proteins in pairs largely enhanced their capacity to discriminate between AD pathology-affected and unaffected individuals and increased their correlation to cognitive decline, potentially due to adjustment of inter-individual variability. With these results, we highlight the potential of protein pairs to monitor neurodegeneration and thereby possibly the efficacy of AD disease-modifying therapies.
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20.
  • Nielsen, Rikke V., et al. (författare)
  • Personalized intervention based on early detection of atherosclerosis : JACC state-of-the-art review
  • 2024
  • Ingår i: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 83:21, s. 2112-2127
  • Forskningsöversikt (refereegranskat)abstract
    • Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide and challenges the capacity of health care systems globally. Atherosclerosis is the underlying pathophysiological entity in two-thirds of patients with CVD. When considering that atherosclerosis develops over decades, there is potentially great opportunity for prevention of associated events such as myocardial infarction and stroke. Subclinical atherosclerosis has been identified in its early stages in young individuals; however, there is no consensus on how to prevent progression to symptomatic disease. Given the growing burden of CVD, a paradigm shift is required—moving from late management of atherosclerotic CVD to earlier detection during the subclinical phase with the goal of potential cure or prevention of events. Studies must focus on how precision medicine using imaging and circulating biomarkers may identify atherosclerosis earlier and determine whether such a paradigm shift would lead to overall cost savings for global health.
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21.
  • Royer, Patrick, et al. (författare)
  • Large-scale plasma proteomics in the UK Biobank modestly improves prediction of major cardiovascular events in a population without previous cardiovascular disease
  • 2024
  • Ingår i: EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. - 2047-4873 .- 2047-4881.
  • Tidskriftsartikel (refereegranskat)abstract
    • [ ' A i m s I m p r o v e d i d e n t i f i c a t i o n o f i n d i v i d u a l s a t h i g h r i s k o f d e v e l o p i n g c a r d i o v a s c u l a r d i s e a s e w o u l d e n a b l e t a r g e t e d i n t e r v e n t i o n s a n d p o t e n t i a l l y l e a d t o r e d u c t i o n s i n m o r t a l i t y a n d m o r b i d i t y . O u r a i m w a s t o d e t e r m i n e w h e t h e r u s e o f l a r g e - s c a l e p r o t e o m i c s i m p r o v e s p r e d i c t i o n o f c a r d i o v a s c u l a r e v e n t s b e y o n d t r a d i t i o n a l r i s k f a c t o r s ( T R F s ) . M e t h o d s a n d r e s u l t s U s i n g p r o x i m i t y e x t e n s i o n a s s a y s , 2 9 1 9 p l a s m a p r o t e i n s w e r e m e a s u r e d i n 3 8 3 8 0 p a r t i c i p a n t s o f t h e U K B i o b a n k . B o t h d a t a - a n d l i t e r a t u r e - b a s e d f e a t u r e s e l e c t i o n a n d t r a i n e d m o d e l s u s i n g e x t r e m e g r a d i e n t b o o s t i n g m a c h i n e l e a r n i n g w e r e u s e d t o p r e d i c t r i s k o f m a j o r c a r d i o v a s c u l a r e v e n t s ( M A C E s : f a t a l a n d n o n - f a t a l m y o c a r d i a l i n f a r c t i o n , s t r o k e , a n d c o r o n a r y a r t e r y r e v a s c u l a r i z a t i o n ) d u r i n g a 1 0 - y e a r f o l l o w - u p . A r e a u n d e r t h e c u r v e ( A U C ) a n d n e t r e c l a s s i f i c a t i o n i n d e x ( N R I ) w e r e u s e d t o e v a l u a t e t h e a d d i t i v e v a l u e o f s e l e c t e d p r o t e i n p a n e l s t o M A C E p r e d i c t i o n b y S y s t e m a t i c C O r o n a r y R i s k E v a l u a t i o n 2 ( S C O R E 2 ) o r t h e 1 0 T R F s u s e d i n S C O R E 2 . S C O R E 2 a n d S C O R E 2 r e f i t t e d t o U K B i o b a n k d a t a p r e d i c t e d M A C E w i t h A U C s o f 0 . 7 4 0 a n d 0 . 7 4 9 , r e s p e c t i v e l y . D a t a - d r i v e n s e l e c t i o n i d e n t i f i e d 1 1 4 p r o t e i n s o f g r e a t e s t r e l e v a n c e f o r p r e d i c t i o n . P r e d i c t i o n o f M A C E w a s n o t i m p r o v e d b y u s i n g t h e s e p r o t e i n s a l o n e ( A U C o f 0 . 7 5 8 ) b u t w a s s i g n i f i c a n t l y i m p r o v e d b y c o m b i n i n g t h e s e p r o t e i n s w i t h S C O R E 2 o r t h e 1 0 T R F s ( A U C = 0 . 7 7 1 , P < 0 0 1 , N R I = 0 . 1 4 0 , a n d A U C = 0 . 7 6 7 , P = 0 . 0 3 , N R I 0 . 0 5 3 , r e s p e c t i v e l y ) . L i t e r a t u r e - b a s e d p r o t e i n s e l e c t i o n ( 1 1 3 p r o t e i n s f r o m f i v e p r e v i o u s s t u d i e s ) a l s o i m p r o v e d r i s k p r e d i c t i o n b e y o n d T R F s w h i l e a r a n d o m s e l e c t i o n o f 1 1 4 p r o t e i n s d i d n o t . C o n c l u s i o n L a r g e - s c a l e p l a s m a p r o t e o m i c s w i t h d a t a - d r i v e n a n d l i t e r a t u r e - b a s e d p r o t e i n s e l e c t i o n m o d e s t l y i m p r o v e s p r e d i c t i o n o f f u t u r e M A C E b e y o n d T R F s . L a y s u m m a r y T h e r i s k o f h a v i n g a m y o c a r d i a l i n f a r c t i o n o r s t r o k e i s u s u a l l y a s s e s s e d b y c l i n i c a l s c o r e s i n c l u d i n g t r a d i t i o n a l r i s k f a c t o r s f o r c a r d i o v a s c u l a r d i s e a s e . T h e d e v e l o p m e n t o f n e w t e c h n o l o g i e s e n a b l e s t h e r a p i d m e a s u r e m e n t o f a n i n c r e a s i n g n u m b e r o f b l o o d p r o t e i n s . I n t h i s s t u d y , w e a p p l i e d m a c h i n e l e a r n i n g t e c h n i q u e s i n a U K - b a s e d c o h o r t o f 3 8 3 8 0 p a r t i c i p a n t s w i t h 2 9 1 9 b l o o d p r o t e i n s m e a s u r e d . W e o b t a i n e d a s e t o f 1 1 4 p r o t e i n s t h a t i m p r o v e d t h e p r e d i c t i o n o f t h e 1 0 - y e a r r i s k o f m a j o r c a r d i o v a s c u l a r e v e n t w h e n a d d e d t o t r a d i t i o n a l r i s k f a c t o r s . I m p r o v e m e n t s w e r e a l s o a c h i e v e d u s i n g a s e t o f 1 1 3 p r o t e i n s f o u n d i n p r e v i o u s s t u d i e s . H o w e v e r , t h e m a g n i t u d e o f t h e s e i m p r o v e m e n t s w a s r e l a t i v e l y l o w a n d t h e c l i n i c a l u t i l i t y o f c o m b i n i n g t h e s e p r o t e i n s w i t h t r a d i t i o n a l r i s k f a c t o r s i n p r i m a r y p r e v e n t i o n w i l l h a v e t o b e f u r t h e r i n v e s t i g a t e d . ' , ' [ G R A P H I C S ] ' , ' . ' ]
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22.
  • Royer, Patrick, et al. (författare)
  • Plasma proteomics for prediction of subclinical coronary artery calcifications in primary prevention
  • 2024
  • Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 271, s. 55-67
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: Recent developments in high-throughput proteomic technologies enable the discovery of novel biomarkers of coronary atherosclerosis. The aims of this study were to test if plasma protein subsets could detect coronary artery calcifications (CAC) in asymptomatic individuals and if they add predictive value beyond traditional risk factors. Methods: Using proximity extension assays, 1,342 plasma proteins were measured in 1,827 individuals from the Impaired Glucose Tolerance and Microbiota (IGTM) study and 883 individuals from the Swedish Cardiopulmonary BioImage Study (SCAPIS) aged 50-64 years without history of ischaemic heart disease and with CAC assessed by computed tomography. After data-driven feature selection, extreme gradient boosting machine learning models were trained on the IGTM cohort to predict the presence of CAC using combinations of proteins and traditional risk factors. The trained models were validated in SCAPIS. Results: The best plasma protein subset (44 proteins) predicted CAC with an area under the curve (AUC) of 0.691 in the validation cohort. However, this was not better than prediction by traditional risk factors alone (AUC = 0.710, P = .17). Adding proteins to traditional risk factors did not improve the predictions (AUC = 0.705, P = .6). Most of these 44 proteins were highly correlated with traditional risk factors. Conclusions: A plasma protein subset that could predict the presence of subclinical CAC was identified but it did not outperform nor improve a model based on traditional risk factors. Thus, support for this targeted proteomics platform to predict subclinical CAC beyond traditional risk factors was not found.
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23.
  • Sdougkou, Kalliroi, et al. (författare)
  • Longitudinal Exposomics in a Multiomic Wellness Cohort Reveals Distinctive and Dynamic Environmental Chemical Mixtures in Blood
  • 2024
  • Ingår i: ENVIRONMENTAL SCIENCE & TECHNOLOGY. - 0013-936X .- 1520-5851.
  • Tidskriftsartikel (refereegranskat)abstract
    • Chemical exposomes can now be comprehensively measured in human blood, but knowledge of their variability and longitudinal stability is required for robust application in cohort studies. Here, we applied high-resolution chemical exposomics to plasma of 46 adults, each sampled 6 times over 2 years in a multiomic cohort, resulting in 276 individual exposomes. In addition to quantitative analysis of 83 priority target analytes, we discovered and semiquantified substances that have rarely or never been reported in humans, including personal care products, pesticide transformation products, and polymer additives. Hierarchical cluster analysis for 519 confidently annotated substances revealed unique and distinctive coexposures, including clustered pesticides, poly(ethylene glycols), chlorinated phenols, or natural substances from tea and coffee; interactive heatmaps were publicly deposited to support open exploration of the complex (meta)data. Intraclass correlation coefficients (ICC) for all annotated substances demonstrated the relatively low stability of the exposome compared to that of proteome, microbiome, and endogenous small molecules. Implications are that the chemical exposome must be measured more frequently than other omics in longitudinal studies and four longitudinal exposure types are defined that can be considered in study design. In this small cohort, mixed-effect models nevertheless revealed significant associations between testosterone and perfluoroalkyl substances, demonstrating great potential for longitudinal exposomics in precision health research.
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24.
  • Venkateshvaran, Ashwin, et al. (författare)
  • Left ventricular dysfunction in pulmonary arterial hypertension is attributed to underfilling rather than intrinsic myocardial disease : a CMR 2D phase contrast study
  • 2024
  • Ingår i: Scientific Reports. - 2045-2322. ; 14:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The pathophysiology underlying impaired LV function in PAH remains unclear, with some studies implicating intrinsic myocardial dysfunction and others pointing to LV underfilling. Evaluation of pulmonary vein area (PVA) and flow may offer novel, mechanistic insight by distinguishing elevated LV filling pressure common in myocardial dysfunction from LV underfilling. This study aimed to elucidate LV filling physiology in PAH by assessing PVA and flow using cardiac magnetic resonance (CMR) and compare pulmonary vein flow in PAH with HFrEF as a model representing elevated filling pressures, in addition to healthy controls. Patients with PAH or heart failure with reduced ejection fraction (HFrEF) referred for CMR were retrospectively reviewed, and healthy controls were included as reference. Pulmonary vein S, D and A-wave were compared between groups. Associations between pulmonary vein area (PVA) by CMR and echocardiographic indices of LV filling pressure were evaluated. Nineteen patients with PAH, 25 with HFrEF and 24 controls were included. Both PAH and HFrEF had lower ejection fraction and S-wave velocity than controls. PAH displayed smaller LV end-diastolic volumes than controls, while HFrEF demonstrated larger PVA and higher A-wave reversal. PVA was associated with mitral E/e' ratio (r 2 = 0.10; p = 0.03), e' velocity (r 2 = 0.23; p = 0.001) and left atrial volume (r 2 = 0.07; p = 0.005). Among PAH, PVA was not associated with LV-GLS. A PVA cut-off of 2.3cm 2 displayed 87% sensitivity and 72% specificity to differentiate HFrEF and PAH (AUC = 0.82). PAH displayed lower pulmonary vein S-wave velocity, smaller LV volume and reduced function compared with controls. Reduced LV function in PAH may be owing to underfilling rather than intrinsic myocardial disease. PVA demonstrates promise as a novel, non-invasive imaging marker to assess LV filling status.
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25.
  • Wahlström, Annika, 1975, et al. (författare)
  • Production of deoxycholic acid by low-abundant microbial species is associated with impaired glucose metabolism
  • 2024
  • Ingår i: NATURE COMMUNICATIONS. - 2041-1723. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Alterations in gut microbiota composition are suggested to contribute to cardiometabolic diseases, in part by producing bioactive molecules. Some of the metabolites are produced by very low abundant bacterial taxa, which largely have been neglected due to limits of detection. However, the concentration of microbially produced metabolites from these taxa can still reach high levels and have substantial impact on host physiology. To explore this concept, we focused on the generation of secondary bile acids by 7 alpha-dehydroxylating bacteria and demonstrated that addition of a very low abundant bacteria to a community can change the metabolic output dramatically. We show that Clostridium scindens converts cholic acid into the secondary bile acid deoxycholic acid (DCA) very efficiently even though the abundance of C. scindens is low, but still detectable by digital droplet PCR. We also show that colonization of germ-free female mice with a community containing C. scindens induces DCA production and affects host metabolism. Finally, we show that DCA correlates with impaired glucose metabolism and a worsened lipid profile in individuals with type 2 diabetes, which implies that this metabolic pathway may contribute to the development of cardiometabolic disease. Secondary bile acids are microbially produced metabolites linked to metabolic diseases. A challenge in microbiota research is to understand how bacteria collaborate to produce such bioactive molecules. Here, the authors show that adding a single low-abundance bacterial species to a community can significantly affect the metabolic output and host physiology.
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26.
  • Ahmad, Nouman, et al. (författare)
  • Automatic segmentation of large-scale CT image datasets for detailed body composition analysis
  • 2023
  • Ingår i: BMC BIOINFORMATICS. - : BioMed Central (BMC). - 1471-2105. ; 24:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundBody composition (BC) is an important factor in determining the risk of type 2-diabetes and cardiovascular disease. Computed tomography (CT) is a useful imaging technique for studying BC, however manual segmentation of CT images is time-consuming and subjective. The purpose of this study is to develop and evaluate fully automated segmentation techniques applicable to a 3-slice CT imaging protocol, consisting of single slices at the level of the liver, abdomen, and thigh, allowing detailed analysis of numerous tissues and organs.MethodsThe study used more than 4000 CT subjects acquired from the large-scale SCAPIS and IGT cohort to train and evaluate four convolutional neural network based architectures: ResUNET, UNET++, Ghost-UNET, and the proposed Ghost-UNET++. The segmentation techniques were developed and evaluated for automated segmentation of the liver, spleen, skeletal muscle, bone marrow, cortical bone, and various adipose tissue depots, including visceral (VAT), intraperitoneal (IPAT), retroperitoneal (RPAT), subcutaneous (SAT), deep (DSAT), and superficial SAT (SSAT), as well as intermuscular adipose tissue (IMAT). The models were trained and validated for each target using tenfold cross-validation and test sets.ResultsThe Dice scores on cross validation in SCAPIS were: ResUNET 0.964 (0.909-0.996), UNET++ 0.981 (0.927-0.996), Ghost-UNET 0.961 (0.904-0.991), and Ghost-UNET++ 0.968 (0.910-0.994). All four models showed relatively strong results, however UNET++ had the best performance overall. Ghost-UNET++ performed competitively compared to UNET++ and showed a more computationally efficient approach.ConclusionFully automated segmentation techniques can be successfully applied to a 3-slice CT imaging protocol to analyze multiple tissues and organs related to BC. The overall best performance was achieved by UNET++, against which Ghost-UNET++ showed competitive results based on a more computationally efficient approach. The use of fully automated segmentation methods can reduce analysis time and provide objective results in large-scale studies of BC.
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27.
  • Baldanzi, Gabriel, et al. (författare)
  • OSA Is Associated With the Human Gut Microbiota Composition and Functional Potential in the Population-Based Swedish CardioPulmonary bioImage Study
  • 2023
  • Ingår i: Chest. - : Elsevier. - 0012-3692 .- 1931-3543. ; 164:2, s. 503-516
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep-breathing disorder linked to increased risk of cardiovascular disease. Intermittent hypoxia and intermittent airway obstruction, hallmarks of OSA, have been shown in animal models to induce substantial changes to the gut microbiota composition and subsequent transplantation of fecal matter to other animals induced changes in blood pressure and glucose metabolism.RESEARCH QUESTION: Does obstructive sleep apnea in adults associate with the composition and metabolic potential of the human gut microbiota?STUDY DESIGN AND METHODS: We used respiratory polygraphy data from up to 3,570 individuals aged 50-64 from the population-based Swedish CardioPulmonary bioImage Study combined with deep shotgun metagenomics of fecal samples to identify cross-sectional associations between three OSA parameters covering apneas and hypopneas, cumulative sleep time in hypoxia and number of oxygen desaturation events with gut microbiota composition. Data collection about potential confounders was based on questionnaires, on-site anthropometric measurements, plasma metabolomics, and linkage with the Swedish Prescribed Drug Register.RESULTS: We found that all three OSA parameters were associated with lower diversity of species in the gut. Further, the OSA-related hypoxia parameters were in multivariable-adjusted analysis associated with the relative abundance of 128 gut bacterial species, including higher abundance of Blautia obeum and Collinsela aerofaciens. The latter species was also independently associated with increased systolic blood pressure. Further, the cumulative time in hypoxia during sleep was associated with the abundance of genes involved in nine gut microbiota metabolic pathways, including propionate production from lactate. Lastly, we observed two heterogeneous sets of plasma metabolites with opposite association with species positively and negatively associated with hypoxia parameters, respectively.INTERPRETATION: OSA-related hypoxia, but not the number of apneas/hypopneas, is associated with specific gut microbiota species and functions. Our findings lay the foundation for future research on the gut microbiota-mediated health effects of OSA.
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28.
  • Bergström, Göran, 1964, et al. (författare)
  • Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
  • 2023
  • Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
  • Tidskriftsartikel (refereegranskat)abstract
    • Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p<0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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29.
  • Bergström, Ola, 1968, et al. (författare)
  • Klimatomställning på lika villkor? Vägval för Sverige och svensk industri
  • 2023
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Föreliggande rapport belyser huruvida Sverige och svensk industri också skall utnyttja de utökade möjligheter till statliga stöd som erbjuds av EU:s nya industripolitik. Den europeiska industri- och klimatpolitiken tillsammans med motsvarande ansats i USA genom Inflation Reduction Act samt den geopolitiska situationen innebär att det inte längre går att luta sig tillbaka mot invanda förhållningssätt utan en lämplig hållning till vertikala (företags- eller sektorsvisa) stöd behöver analyseras inom ramen för denna nya kontext. Vi presenterar en analysram där, utöver traditionell samhällsekonomisk analys kring marknadsmisslyckanden, hänsyn även behöver tas till konkurrensförhållanden, geopolitik inklusive eventuellt behov av strategisk autonomi inom vissa områden samt andra politiska avvägningar.
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30.
  • Bergström, Ulf, et al. (författare)
  • Storskarvens (Phalacrocorax carbo) ekologi, roll i ekosystemet och effekter på fiskbestånd : Sammanställning av kunskap och kunskapsbehov
  • 2023
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Det råder kunskapsbrist om storskarvens ekologi i svenska akvatiska ekosystem och hur fiskpopulationer och ekosystem påverkas av storskarv i olika områden. Framförallt behövs bättre underlag om skarvarnas födoval, födosöksbeteende, antal och migrationer för att kunna bedöma påverkan på fiskpopulationer och ekosystem. Grundläggande underlag om storskarvens biologi, för bättre förståelse av dess ekologiska roll, bör samlas in genom standardiserad och internationellt samordnad övervakning. Akvatiska ekosystem är komplexa och sammanlänkade, med flera arter och ekologiska processer som samverkar med varandra. Fiskpopulationer påverkas även av en rad andra faktorer än predation från storskarv, både biologiska och icke-biologiska. Det kan därför vara svårt att separera effekter från storskarv från annan påverkan. Att dra generella slutsatser om storskarvens påverkan på olika fiskpopulationer i olika områden och under olika tidsperioder är därför svårt. Generellt verkar påverkan från storskarv på fiskpopulationer vara liten i friska ekosystem. Dock verkar skarvpredation kunna ha negativ påverkan på specifika fiskpopulationer, i synnerhet svaga populationer som även påverkas negativt av andra faktorer. För att förbättra kunskapsläget är det viktigt att förvaltningsåtgärder som syftar till att minska storskarvens påverkan på fiskpopulationer följs upp vetenskapligt. Dessa förvaltningsåtgärder bör om möjligt samordnas med andra åtgärder för att öka förståelsen av vilka påverkansfaktorer som har störst betydelse för olika fiskpopulationer.
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31.
  • Björnson, Elias, 1988, et al. (författare)
  • Mediating role of atherogenic lipoproteins in the relationship between liver fat and coronary artery calcification
  • 2023
  • Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Non-alcoholic fatty liver disease (NAFLD) is associated with increased secretion of apoB-containing lipoproteins and increased risk of coronary heart disease (CHD). ApoB-containing lipoproteins include low-density lipoproteins (LDLs) and triglyceride-rich lipoproteins (TRLs); and since both LDLs and TRLs are causally related to CHD, they may mediate a portion of the increased risk of atherosclerosis seen in people with NAFLD. In a cohort of 4161 middle aged men and women, we performed mediation analysis in order to quantify the mediating effect of apoB-containing lipoproteins in the relationship between liver fat and atherosclerosis-as measured by coronary artery calcium score (CACS). We found plasma apoB to mediate 17.6% (95% CI 11-24) of the association between liver fat and CACS. Plasma triglycerides and TRL-cholesterol (both proximate measures of TRL particles) mediated 22.3% (95% CI 11-34) and 21.6% (95% CI 10-33) of the association respectively; whereas LDL-cholesterol mediated 5.4% (95% CI 2.0-9.4). In multivariable models, the mediating effect of TRL-cholesterol and plasma triglycerides showed, again, a higher degree of mediation than LDL-cholesterol, corroborating the results seen in the univariable models. In summary, we find around 20% of the association between liver fat and CACS to be mediated by apoB-containing lipoproteins. In addition, we find that TRLs mediate the majority of this effect whereas LDLs mediate a smaller effect. These results explain part of the observed CAD-risk burden for people with NAFLD and further suggest that TRL-lowering may be particularly beneficial to mitigate NAFLD-associated coronary artery disease risk.
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32.
  • Fagman, Erika, et al. (författare)
  • High-quality annotations for deep learning enabled plaque analysis in SCAPIS cardiac computed tomography angiography
  • 2023
  • Ingår i: Heliyon. - : Elsevier BV. - 2405-8440. ; 9:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Plaque analysis with coronary computed tomography angiography (CCTA) is a promising tool to identify high risk of future coronary events. The analysis process is time-consuming, and requires highly trained readers. Deep learning models have proved to excel at similar tasks, however, training these models requires large sets of expert-annotated training data. The aims of this study were to generate a large, high-quality annotated CCTA dataset derived from Swedish CArdioPulmonary BioImage Study (SCAPIS), report the reproducibility of the annotation core lab and describe the plaque characteristics and their association with established risk factors.Methods and results: The coronary artery tree was manually segmented using semi-automatic software by four primary and one senior secondary reader. A randomly selected sample of 469 subjects, all with coronary plaques and stratified for cardiovascular risk using the Systematic Coronary Risk Evaluation (SCORE), were analyzed. The reproducibility study (n = 78) showed an agreement for plaque detection of 0.91 (0.84-0.97). The mean percentage difference for plaque volumes was-0.6% the mean absolute percentage difference 19.4% (CV 13.7%, ICC 0.94). There was a positive correlation between SCORE and total plaque volume (rho = 0.30, p < 0.001) and total low attenuation plaque volume (rho = 0.29, p < 0.001).Conclusions: We have generated a CCTA dataset with high-quality plaque annotations showing good reproducibility and an expected correlation between plaque features and cardiovascular risk. The stratified data sampling has enriched high-risk plaques making the data well suited as training, validation and test data for a fully automatic analysis tool based on deep learning.
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33.
  • Fransson, Nathalie, et al. (författare)
  • Ett klimatneutralt Kiruna 2025 med hjälp av spillvärme
  • 2023
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Den pågående stadsomvandlingen i Kiruna, att en stor del av staden måste flyttastill följd av LKAB:s fortsatta gruvverksamhet, skapar möjligheter att etablera etteffektivare energisystem och bidra till att uppnå stadens klimatmål. I dag tillgodosescirka 15% av stadens fjärrvärmebehov med restvärme från LKAB och målsättningenpå sikt är att nå 100% restvärme i systemet. Investeringsbeslut som togs 2021kommer att resultera i en ökning av restvärmeandelen på upp mot 70% till 2024 dåLKAB frigör högvärdig restvärme genom att internt ta tillvara på lågtempereradvärme. För att öka andelen restvärme ytterligare finns ett behov av att lagra värmefrån sommarperioden då det finns ett överskott till vinterperioden när behovet ärsom störst.I projektet skapas en helhetsbild av restvärmelösningen i Kiruna frånsamspel mellan aktörer till teknik vilket genererar ny kunskap om effektivenergiomställning till hållbara städer med restvärmeåtervinning.Det finns flera alternativ för termiska säsongslager vars tillämplighet baseras påtermogeologisk förutsättningar. Borrhålslager och bergrumslager valdes ut förvidare analys givet förutsättningarna i Kiruna. Genom energisystemmodelleringoptimerades Kirunas fjärrvärmesystem fram till år 2040 genom scenarioanalys. Medett energilager i systemet möjliggörs att en större mängd restvärme kan användastotalt sett över året och särskilt minskar det behovet av värmeproduktion underperioden med störst värmebehov (vintermånaderna), vilket innebär minskadanvändning av spetslastpannor. En nyttokostnadsanalys genomfördes på tvåmodellscenarier.Båda scenarierna resulterar i ekonomiska kostnadsbesparingar ochminskade externa kostnader (förbättrad folkhälsa som minskar till exempel uteblivetarbete, sjukvårdskostnader och förtidiga dödsfall) jämfört med referensscenariet, attinte uppföra ett energilager.Ett energilager, borrhålslager och bergrumslager, i storleksordningarna 30 GWh och20 MW simulerades i Kirunas fjärrvärmesystem. Baserat på det värmebehov ochrestvärmeleverans som ligger till grund för lagersimuleringar visar resultaten pågod prestanda framför allt för ett borrhålslager kombinerat med värmepumpar. Förde simulerade alternativen, samt ett jämförelsealternativ med en biobränslepanna,togs investeringskalkyler fram som visade på en övervägande positiv kalkyl för ettborrhålslager med värmepumpar.Totalinvesteringen för alternativet med borrhåloch värmepump uppgår till ca. 300 Mkr. Borrhål och värmeväxlare är ungefär 1/3 avinvestering, värmepumpskostnad 1/3 och resterande projektkostnader ochinstallation. Återbetalningstiden är drygt 9 år. Investeringskostnaden för anläggningav bergrumslager är hög vilket försämrar lönsamheten. Troligen skulle investeringskostnaden vara betydligt lägre om befintlig geologisk formation finnstillgänglig att konvertera till energilager. Sådan formation har inte identifierats idetta projekt men givet Kirunas långa gruvverksamhet är det möjligt att fleralternativ finns som skulle kunna utredas.Underlaget som är framtaget inom ramarna för detta projekt pekar på att ettsäsongsenergilager för att ta tillvara på mer restvärme är den långsiktigt optimala lösningen för Kirunas värmeförsörjning. En initial uppskattning av tidplan visar påatt ett sådant lager skulle kunna tas i drift 2028. För det valda energilagret har enhandlingsplan tagits fram som visar nästa steg som behöver tas i Kiruna för attkomma närmare att realisera energilagret och därmed kunna nyttja mer restvärme.Lågtempererad fjärrvärme har diskuterats länge i Kiruna. Kombination med ettenergilager och lägre framledningstemperatur skulle vara gynnsamt eftersomurladdningstemperaturen från energilagret inte skulle behöva höjas lika mycket.Skulle Kiruna i ett senare skede, efter att energilagret har uppförts, sänkatemperaturen i nätet skulle det för ett borrhålslager med värmepumpar innebära etteffektivare och lönsammare system. Framför allt skulle mindre el behövas tillvärmepumparna vilket är gynnsamt givet Kiruna Krafts ambitioner om att minskaandelen el som går åt till värmeförsörjningen.Det finns en stor outnyttjad restvärmepotential i Sverige och Europa. Genom enfallstudie av Kiruna har lärdomar för andra städer om effektiv integrering avrestvärme genererats. Framgångsfaktorerna i Kiruna och lösningar påförekommande hinder kan hjälpa andra städer att etablera ett effektivt ochlångvarigt samspel kring industriell restvärme. Att initialt fokusera på att bygga enrelation mellan parterna och etablera förtroende är en viktig nyckel för att kunnaidentifiera lösningar på andra förekommande barriärer. Flera ekonomiska barriärerhar haft stor påverkan och de har lösts genom transparens i kalkylerna, med ettgemensamt uppsatt mål att samarbetet inte ska påverka stadens invånareekonomiskt och genom statligt finansieringsstöd.En viktig framgångsfaktor har varit etablerandet av en strategisk samarbetsplattform som garanterat enkontinuerlig dialog. En kontinuerlig dialog krävs dels under etablerandet avsamarbetet men är lika viktig under pågående leverans för att inte riskera att tappabort relationen och förtroenden.För att identifiera vilka faktorer som kan påverka att innovativa energilösningarimplementeras för restvärmeåtervinning har projektet gjort en jämförande analys avbeslutsprocessen vid valet av fjärrvärmeteknik i Nya Kiruna Centrum ochBrunnshög i Lund. Beslutsprocessen resulterade i konventionell fjärrvärmeteknik tillNya Kiruna Centrum och ett lågtempererat fjärrvärmesystem i Brunnshög. Eninnovativ målsättning, särskilt i de externa direktiven, kunskap omrestvärmeåtervinning, antingen internt eller hos en långvarig samarbetspartner ochen holistisk syn på staden där många aktörer engageras för att man bättre ska kunnaförutse förändringar på lång sikt har identifierats som viktiga. För effektivenergiomställning av städer med restvärmeintegrering behöverrestvärmepotentialen kartläggas och inkluderas i stadens energiplanering i ett tidigtskede och i samverkan med relevanta aktörer. Energiplaneringen bör ske samtidigtsom, och i samråd med, andra större förändringar i staden för att undvikasuboptimala system där energieffektiviseringsprincipen inte tillämpas.
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34.
  • Fridolfsson, Jonatan, 1992, et al. (författare)
  • Accelerometer-measured absolute versus relative physical activity intensity : cross-sectional associations with cardiometabolic health in midlife.
  • 2023
  • Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Observational studies investigating the association between accelerometer-measured physical activity and health all use absolute measures of physical activity intensity. However, intervention studies suggest that the physical activity intensity required to improve health is relative to individual fitness. The aim of this study was to investigate the associations between accelerometer-measured absolute and relative physical activity intensity and cardiometabolic health, and what implications these associations may have on the interpretation of health-associated physical activity.METHODS: A sample of the cross-sectional Swedish CArdioPulmonary bioImage Study (SCAPIS) consisting of 4,234 men and women aged 55-64 years was studied. Physical activity intensity was measured by accelerometry and expressed as absolute (e.g., metabolic equivalents of task) or relative (percentage of maximal oxygen consumption). Fitness was estimated by the submaximal Ekblom-Bak test. A composite ('metabolic syndrome') score combined measures of waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides, and glycated hemoglobin. Associations of absolute and relative physical activity intensity with the health indicators (i.e., fitness and metabolic syndrome score) were studied by partial least squares regression. Analyses were stratified by fitness level.RESULTS: Both absolute and relative physical activity intensity associated with the health indicators. However, the strongest associations for absolute intensity varied depending on fitness levels, whereas the associations for relative intensity were more synchronized across fitness groups. The dose-response relationship between moderate-to-vigorous intensity and the health indicators was stronger for relative than for absolute intensity. The absolute and relative moderate-to-vigorous intensity cut-offs intersected at the 5th fitness percentile, indicating that the absolute intensity cut-off is too low for 95% of individuals in this sample. While 99% of individuals fulfilled the general physical activity recommendations based on absolute intensity measures, only 21% fulfilled the recommendations based on relative intensity measures. In relation to a "sufficient" fitness level, 9% fulfilled the recommendations.CONCLUSIONS: Accelerometer-measured relative physical activity intensity represents the intensity related to health benefits regardless of fitness level. Traditional absolute moderate intensity accelerometer cut-offs are too low for most individuals and should be adapted to the fitness level in the sample studied. Absolute and relative physical activity intensity cannot be used interchangeably.
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35.
  • Fridolfsson, Jonatan, 1992, et al. (författare)
  • One size does not fit all - translating absolute accelerometry to relative individual physical activity intensity for health
  • 2023
  • Ingår i: European Journal of Preventive Cardiology, Volume 30, Issue Supplement_1. - : Oxford University Press.
  • Konferensbidrag (refereegranskat)abstract
    • Funding AcknowledgementsType of funding sources: Foundation. Main funding source(s): The main funding body of The Swedish CArdioPulmonary bioImage Study (SCAPIS) is the Swedish Heart-Lung Foundation. The study is also funded by the Knut and Alice Wallenberg Foundation, the Swedish Research Council and VINNOVA (Sweden’s Innovation agency) the University of Gothenburg and Sahlgrenska University Hospital, Karolinska Institutet and Stockholm county council, Linköping University and University Hospital, Lund University and Skåne University Hospital, Umeå University and University Hospital, Uppsala University and University Hospital.IntroductionPhysical activity intensity can be expressed in either absolute (e.g. brisk walking or metabolic equivalents) or relative terms (e.g. proportion of maximal oxygen consumption or perceived exertion) (1). Although intervention studies typically use relative intensity for exercise prescription, large scale observational studies measuring physical activity with accelerometers always use absolute intensity. The association between relative physical activity intensity and cardiometabolic risk factors has not been studied using accelerometry previously.PurposeTo compare absolute and relative measures of physical activity intensity in terms of physical activity level and associations with cardiovascular risk factors among individuals with different fitness level.MethodsA subsample of the Swedish CArdioPulmonary bioImage Study (SCAPIS), in total 4234 men and women aged 50-64, was analysed (2). Physical activity was measured by accelerometers and the raw data processed with the 10 Hz frequency extended method (FEM) to get a more accurate measure of physical activity intensity compared to previous methods (3). Maximal oxygen consumption (fitness) was estimated by a submaximal ergometer test. Waist to hip ratio, systolic blood pressure, glycated haemoglobin (HBA1c) and high-density lipoprotein to total cholesterol ratio were combined into a composite cardiometabolic risk factor score. Partial least squares regression was used to investigate the associations of absolute and relative physical activity intensity with fitness as well as the composite score. The sample was divided into tertiles of fitness for stratified analyses.ResultsOverall, there was an association between physical activity at absolute moderate intensity and above, and the health outcomes. Yet, the main associations were found in the absolute moderate intensity range for the low fitness group and in the absolute vigorous intensity range for the high fitness group. When considering relative intensity however, all the main associations started in the upper part of the moderate intensity range and peaked in the vigorous intensity range (Figure 1). In addition, when comparing absolute and relative cut-offs for moderate intensity, absolute moderate intensity was too low for 95% of individuals in the sample (Figure 2). When using absolute intensity, 99% of individuals reached the general guidelines of 150 minutes of moderate-to-vigorous physical activity per week, while only 21% reached the guidelines based on relative intensity.ConclusionsHealth benefits of absolute intensity are misleading for most individuals in this sample and absolute measures of physical activity overestimate time spent at moderate intensity and above. Relative intensity should be used when interpreting accelerometer measured physical activity and when communicating health promoting physical activity.
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36.
  • Kasahara, K., et al. (författare)
  • Gut bacterial metabolism contributes to host global purine homeostasis
  • 2023
  • Ingår i: Cell Host & Microbe. - 1931-3128. ; 31:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The microbes and microbial pathways that influence host inflammatory disease progression remain largely undefined. Here, we show that variation in atherosclerosis burden is partially driven by gut microbiota and is associated with circulating levels of uric acid (UA) in mice and humans. We identify gut bacterial taxa spanning multiple phyla, including Bacillota, Fusobacteriota, and Pseudomonadota, that use multiple purines, including UA as carbon and energy sources anaerobically. We identify a gene cluster that encodes key steps of anaerobic purine degradation and that is widely distributed among gut-dwelling bacteria. Furthermore, we show that colonization of gnotobiotic mice with purine-degrading bacteria modulates levels of UA and other purines in the gut and systemically. Thus, gut microbes are important drivers of host global purine homeostasis and serum UA levels, and gut bacterial catabolism of purines may represent a mechanism by which gut bacteria influence health.
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37.
  • Molnar, David, et al. (författare)
  • Pre-diabetes is associated with attenuation rather than volume of epicardial adipose tissue on computed tomography
  • 2023
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The volume of epicardial adipose tissue (EATV) is increased in type-2 diabetes (T2D), while its attenuation (EATA) appears to be decreased. Similar patterns have been suggested in pre-diabetes, but data is scarce. In both pre-diabetes and T2D, any independent role of EATV and EATA in disease development remains to be proven, a task complicated by their substantial co-variation with other anthropometrics, e.g. BMI, waist circumference, and abdominal visceral adipose tissue (VAT). EATV and EATA was quantified in computed tomography (CT) images in a population study (n = 1948) using an automatic technique. Data was available on BMI, waist circumference, abdominal visceral adipose tissue (VAT) area, insulin resistance (IR) and glucose tolerance, the latter ranging from normal (NGT), over pre-diabetes (impaired fasting glucose [IFG, n = 414] impaired glucose tolerance [IGT, n = 321] and their combination [CGI, n = 128]), to T2D. EATV was increased in pre-diabetes, T2D and IR in univariable analyses and when adjusting for BMI, however not when adjusting for waist or VAT. EATA was reduced in pre-diabetes, T2D and IR in univariable analyses and when adjusting for BMI and waist, however not when adjusting for VAT. Adjustment for other co-variates had little influence on the results. In conclusion, EATV is increased and EATA reduced in pre-diabetes, T2D and IR, however, significant co-variation with other anthropometrics, especially VAT, obscures their function in disease development. The current results do not exclude a pathophysiological role of epicardial fat, but future studies need to adjust for anthropometrics, or focus on the microenvironment within the pericardial sac.
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38.
  •  
39.
  • Rawshani, Araz, 1986, et al. (författare)
  • Cardiac arrhythmias and conduction abnormalities in patients with type 2 diabetes
  • 2023
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The association between type 2 diabetes (T2D) and the development of cardiac arrhythmias and conduction disturbances has not been extensively studied. Arrhythmia was defined as atrial fibrillation and flutter (AF/AFl), ventricular tachycardia (VT) and ventricular fibrillation (VF), and conduction abnormality as sinus node disease (SND), atrioventricular (AV) block or pacemaker implantation, and intraventricular conduction blocks (IVCB). Incidence rates and Cox regression were used to compare outcomes, and to assess optimal levels for cardiometabolic risk factors and risk associated with multifactorial risk factor control (i.e., HbA1c, LDL-C, systolic blood pressure (SBP), BMI and eGFR), between patients with versus without T2D. The analyses included data from 617,000 patients with T2D and 2,303,391 matched controls. Patients with diabetes and the general population demonstrated a gradual increase in rates for cardiac conduction abnormalities and virtually all age-groups for AF/AFI showed increased incidence during follow-up. For patients with versus without T2D, risks for cardiac arrhythmias were higher, including for AF/AFl (HR 1.17, 95% CI 1.16-1.18), the composite of SND, AV-block or pacemaker implantation (HR 1.40, 95% CI 1.37-1.43), IVCB (HR 1.23, 95% CI 1.18-1.28) and VT/VF (HR 1.08, 95% CI 1.04-1.13). For patients with T2D who had selected cardiometabolic risk factors within target ranges, compared with controls, risk of arrythmia and conduction abnormalities for T2D vs not were: AF/AFl (HR 1.09, 95% CI 1.05-1.14), the composite of SND, AV-block or pacemaker implantation (HR 1.06, 95% CI 0.94-1.18), IVCB (HR 0.80, 95% CI 0.60-0.98), and for VT/VF (HR 0.97, 95% CI 0.80-1.17). Cox models showed a linear risk increase for SBP and BMI, while eGFR showed a U-shaped association. Individuals with T2D had a higher risk of arrhythmias and conduction abnormalities than controls, but excess risk associated with T2D was virtually not evident among patients with T2D with all risk factors within target range. BMI, SBP and eGFR displayed significant associations with outcomes among patients with T2D.
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40.
  • Sayols-Baixeras, Sergi, et al. (författare)
  • Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants From the SCAPIS Cohort
  • 2023
  • Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 148:6, s. 459-472
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Gut microbiota have been implicated in atherosclerotic disease, but their relation with subclinical coronary atherosclerosis is unclear. This study aimed to identify associations between the gut microbiome and computed tomography-based measures of coronary atherosclerosis and to explore relevant clinical correlates.Methods: We conducted a cross-sectional study of 8973 participants (50 to 65 years of age) without overt atherosclerotic disease from the population-based SCAPIS (Swedish Cardiopulmonary Bioimage Study). Coronary atherosclerosis was measured using coronary artery calcium score and coronary computed tomography angiography. Gut microbiota species abundance and functional potential were assessed with shotgun metagenomics sequencing of stool, and associations with coronary atherosclerosis were evaluated with multivariable regression models adjusted for cardiovascular risk factors. Associated species were evaluated for association with inflammatory markers, metabolites, and corresponding species in saliva.Results: The mean age of the study sample was 57.4 years, and 53.7% were female. Coronary artery calcification was detected in 40.3%, and 5.4% had at least 1 stenosis with >50% occlusion. Sixty-four species were associated with coronary artery calcium score independent of cardiovascular risk factors, with the strongest associations observed for Streptococcus anginosus and Streptococcus oralis subsp oralis (P<1×10-5). Associations were largely similar across coronary computed tomography angiography-based measurements. Out of the 64 species, 19 species, including streptococci and other species commonly found in the oral cavity, were associated with high-sensitivity C-reactive protein plasma concentrations, and 16 with neutrophil counts. Gut microbial species that are commonly found in the oral cavity were negatively associated with plasma indole propionate and positively associated with plasma secondary bile acids and imidazole propionate. Five species, including 3 streptococci, correlated with the same species in saliva and were associated with worse dental health in the Malmö Offspring Dental Study. Microbial functional potential of dissimilatory nitrate reduction, anaerobic fatty acid β-oxidation, and amino acid degradation were associated with coronary artery calcium score.Conclusions: This study provides evidence of an association of a gut microbiota composition characterized by increased abundance of Streptococcus spp and other species commonly found in the oral cavity with coronary atherosclerosis and systemic inflammation markers. Further longitudinal and experimental studies are warranted to explore the potential implications of a bacterial component in atherogenesis.
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41.
  • Sayols-Baixeras, Sergi, et al. (författare)
  • Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants From the SCAPIS Cohort
  • 2023
  • Ingår i: Circulation. - : American Heart Association. - 0009-7322 .- 1524-4539. ; 148:6, s. 459-472
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Gut microbiota have been implicated in atherosclerotic disease, but their relation with subclinical coronary atherosclerosis is unclear. This study aimed to identify associations between the gut microbiome and computed tomography–based measures of coronary atherosclerosis and to explore relevant clinical correlates.METHODS: We conducted a cross-sectional study of 8973 participants (50 to 65 years of age) without overt atherosclerotic disease from the population-based SCAPIS (Swedish Cardiopulmonary Bioimage Study). Coronary atherosclerosis was measured using coronary artery calcium score and coronary computed tomography angiography. Gut microbiota species abundance and functional potential were assessed with shotgun metagenomics sequencing of fecal samples, and associations with coronary atherosclerosis were evaluated with multivariable regression models adjusted for cardiovascular risk factors. Associated species were evaluated for association with inflammatory markers, metabolites, and corresponding species in saliva.RESULTS: The mean age of the study sample was 57.4 years, and 53.7% were female. Coronary artery calcification was detected in 40.3%, and 5.4% had at least 1 stenosis with >50% occlusion. Sixty-four species were associated with coronary artery calcium score independent of cardiovascular risk factors, with the strongest associations observed for Streptococcus anginosus and Streptococcus oralis subsp oralis (P<1×10–5). Associations were largely similar across coronary computed tomography angiography–based measurements. Out of the 64 species, 19 species, including streptococci and other species commonly found in the oral cavity, were associated with high-sensitivity C-reactive protein plasma concentrations, and 16 with neutrophil counts. Gut microbial species that are commonly found in the oral cavity were negatively associated with plasma indole propionate and positively associated with plasma secondary bile acids and imidazole propionate. Five species, including 3 streptococci, correlated with the same species in saliva and were associated with worse dental health in the Malmö Offspring Dental Study. Microbial functional potential of dissimilatory nitrate reduction, anaerobic fatty acid β-oxidation, and amino acid degradation were associated with coronary artery calcium score.CONCLUSIONS: This study provides evidence of an association of a gut microbiota composition characterized by increased abundance of Streptococcus spp and other species commonly found in the oral cavity with coronary atherosclerosis and systemic inflammation markers. Further longitudinal and experimental studies are warranted to explore the potential implications of a bacterial component in atherogenesis.
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42.
  • Schmidt, Caroline, 1966, et al. (författare)
  • Psychosocial work conditions and prediabetes risks: a cross-sectional study in middle-aged men and women.
  • 2023
  • Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Prediabetes is a condition between diabetes and normoglycemia, and is a state of major health concern, as a large proportion of people with prediabetes are likely to develop diabetes which is associated with high mortality and morbidity. The purpose of this study was to investigate whether adverse psychosocial work conditions, based on the Job Demand-Control-social support model, increases risk for early dysregulated glucose metabolism in 50-64-year-old men and women. Job conditions were measured with the Swedish Demand-Control-Support questionnaire. Impaired glucose metabolism was assessed by an oral glucose tolerance test. Differences between groups were analyzed with Chi-square test and one-way ANOVA with Bonferroni post-hoc test. Odds ratios (OR) and 95% confidence intervals (95% CI) between Job Demand-control-support and prediabetes outcome were calculated with multiple logistic regression. Results from an adjusted logistic regression model showed that in men and woman separately, an active work situation (high demands-high control) was associated with significantly lower prediabetes risk (OR 0.657, 95% CI 0.513-0.842). This finding is consistent through all logistic regression models with different levels of adjustments. Further, the current study does not lend support for the hypothesis that work conditions characterized by high demands-low control were associated with dysregulated glucose metabolism in men nor women despite accumulation of many life-style related risk factors in the high strain group. In conclusion, we could show that men and women assessing their work conditions as active, had lower risk for prediabetes.
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43.
  • Söderberg, Mia, 1977, et al. (författare)
  • Psychosocial job conditions and biomarkers of cardiovascular disease: A cross-sectional study in the Swedish CArdioPulmonary bioImage Study (SCAPIS).
  • 2023
  • Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 51:6, s. 843-852
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate associations between psychosocial work exposure and the presence of biological and imaging biomarkers of cardiovascular disease.This cross-sectional study was conducted in a sub-cohort of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Psychosocial exposure was evaluated with the job demand-control model, and analysed according to the standard categorization: high strain, active, passive and low strain (reference). Biomarkers (blood pressure, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, coronary artery calcification (CAC) and metabolic syndrome) were measured, or derived through measurements, from clinical examinations. Gender-specific prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated with regression models and adjusted for age, education, smoking, physical activity, general life stress and body mass index (BMI).The analyses included 3882 participants (52.5% women). High strain (high demands-low control) was linked to increased PR for low HDL cholesterol in women, adjusted for all covariates (PR 1.76; 95% CI 1.25-2.48). High strain was also related to moderately increased PR for metabolic syndrome in men, after adjustments for all covariates except BMI (PR 1.25; 95% CI 1.02-1.52). In addition, passive work (low demands-low control) was associated with diastolic hypertension in women (fully adjusted: PR 1.29; 95% CI 1.05-1.59). All relationships between psychosocial factors and LDL cholesterol or CAC (both genders), or hypertension (men), were non-significant.Poor psychosocial job conditions was associated with the presence of low HDL cholesterol and diastolic hypertension in women, and metabolic syndrome in men. These findings contribute to the knowledge of potential pathways between stressful work and coronary heart disease.
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44.
  • Tschiderer, L., et al. (författare)
  • Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies
  • 2023
  • Ingår i: Journal of the American Heart Association (JAHA). - 2047-9980. ; 12:12
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundThe association between common carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods and ResultsWe undertook an individual participant data meta-analysis of 20 prospective studies from the Proof-ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA-IMT and incident carotid plaque involving 21 494 individuals without a history of cardiovascular disease and without preexisting carotid plaque at baseline. Mean baseline age was 56 years (SD, 9 years), 55% were women, and mean baseline CCA-IMT was 0.71 mm (SD, 0.17 mm). Over a median follow-up of 5.9 years (5th-95th percentile, 1.9-19.0 years), 8278 individuals developed first-ever carotid plaque. We combined study-specific odds ratios (ORs) for incident carotid plaque using random-effects meta-analysis. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. The age-, sex-, and trial arm-adjusted OR for carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% CI, 1.31-1.50; I-2=63.9%). The corresponding OR that was further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low- and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication was 1.34 (95% CI, 1.24-1.45; I-2=59.4%; 14 studies; 16 297 participants; 6381 incident plaques). We observed no significant effect modification across clinically relevant subgroups. Sensitivity analysis restricted to studies defining plaque as focal thickening yielded a comparable OR (1.38 [95% CI, 1.29-1.47]; I-2=57.1%; 14 studies; 17 352 participants; 6991 incident plaques). ConclusionsOur large-scale individual participant data meta-analysis demonstrated that CCA-IMT is associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors.
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45.
  • Östgren, Carl Johan, et al. (författare)
  • Prevalence of atherosclerosis in individuals with prediabetes and diabetes compared to normoglycaemic individuals-a Swedish population-based study.
  • 2023
  • Ingår i: Cardiovascular diabetology. - : BioMed Central (BMC). - 1475-2840. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with type 2 diabetes have an increased risk of death and cardiovascular events and people with diabetes or prediabetes have been found to have increased atherosclerotic burden in the coronary and carotid arteries. This study will estimate the cross-sectional prevalence of atherosclerosis in the coronary and carotid arteries in individuals with prediabetes and diabetes, compared with normoglycaemic individuals in a large population-based cohort.The 30,154 study participants, 50-64years, were categorized according to their fasting glycaemic status or self-reported data as normoglycaemic, prediabetes, and previously undetected or known diabetes. Prevalence of affected coronary artery segments, severity of stenosis and coronary artery calcium score (CACS) were determined by coronary computed tomography angiography. Total atherosclerotic burden was assessed in the 11 clinically most relevant segments using the Segment Involvement Score and as the presence of any coronary atherosclerosis. The presence of atherosclerotic plaque in the carotid arteries was determined by ultrasound examination.Study participants with prediabetes (n=4804, 16.0%) or diabetes (n=2282, 7.6%) had greater coronary artery plaque burden, more coronary stenosis and higher CACS than normoglycaemic participants (all, p<0.01). Among male participants with diabetes 35.3% had CACS≥100 compared to 16.1% among normoglycaemic participants. For women, the corresponding figures were 8.9% vs 6.1%. The prevalence of atherosclerosis in the coronary arteries was higher in participants with previously undetected diabetes than prediabetes, but lower than in patients with known diabetes. The prevalence of any plaque in the carotid arteries was higher in participants with prediabetes or diabetes than in normoglycaemic participants.In this large population-based cohort of currently asymptomatic people, the atherosclerotic burden in the coronary and carotid arteries increased with increasing degree of dysglycaemia. The finding that the atherosclerotic burden in the coronary arteries in the undetected diabetes category was midway between the prediabetes category and patients with known diabetes may have implications for screening strategies and tailored prevention interventions for people with dysglycaemia in the future.
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46.
  • Bergfeldt, Lennart, 1950, et al. (författare)
  • Non-invasive electrophysiological differences between women and men:differences in body size not an explanation.
  • 2022
  • Ingår i: American journal of physiology. Heart and circulatory physiology. - : American Physiological Society. - 0363-6135 .- 1522-1539. ; 323:5
  • Tidskriftsartikel (refereegranskat)abstract
    • There are numerous sex-related differences in cardiac electrophysiology and arrhythmia propensity but very little knowledge about the reasons. Difference in body size has been proposed as one reason and was tested in this study of >20 cardiac electrophysiology parameters in 319 (158 women) apparently healthy 50-64 years old subjects from a randomly enrolled population sample, the SCAPIS pilot study (Swedish CArdio-Pulmonary bioImaging Study), using Frank vectorcardiography. We studied conventional conduction intervals, parameters reflecting electrical heterogeneity (dispersion) in the ventricles, QRS- and T-vector directions, spatial QRS-T angles, and T-vector loop morphology. Body surface area (BSA; two methods) and lean body mass (LBM), both estimated from body weight and height, were used as body size parameters. According to multivariable linear regression analysis adjusted for sex, there was no association between electrophysiological parameters and body size apart from QRS duration and QRSarea. In conclusion, most electrophysiological parameters assessed completely non-invasively and showing statistically significant differences between women and men on the group level show no association with BSA or LBM. Scaling (indexing) the electrophysiological parameters for body size parameters are therefore not an option. As a consequence, the explanation for the sex-related electrophysiological differences should be sought along other lines.
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47.
  • Bergström, Ulf, et al. (författare)
  • Kompensation för miljöpåverkan vid kustexploatering – dagens tillämpning av ekologisk kompensation och särskild fiskeavgift samt möjlig vidareutveckling
  • 2022
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Kustekosystemen är mycket viktiga för både biologisk mångfald och ekosystemtjänster, men påverkas samtidigt negativt av ett kontinuerligt ökat nyttjande av kustzonen för boende och olika verksamheter. Ekologisk kompensation är ett förvaltningsverktyg som syftar till att gottgöra oundviklig skada på naturmiljöer, exempelvis arter, naturtyper, ekosystemfunktioner och upplevelsevärden, i samband med mänsklig verksamhet. Verktyget har dock hittills använts i mycket begränsad omfattning i grunda kustmiljöer.Inom projektet ECOCOA, finansierat av Naturvårdsverket, har vi fokuserat på att utvärdera förutsättningarna för ökad användning av ekologisk kompensation i kustområden, som ett av flera verktyg som kan stöda miljövården. Projektets slutrapport (Bergström m.fl. 2021) ger en övergripande bild av samtliga resultat, medan vi i föreliggande rapport ger en fördjupning av de mer konkreta problem som kan uppstå vid handläggning av miljöärenden i förvaltningen, och möjliga lösningar på kort och lång sikt. Rapporten riktar sig i första hand till handläggare som vill utveckla tillämpningen av ekologisk kompensation vid vattenverksamhetsärenden, till tekniska råd vid markoch miljödomstolar, samt miljökonsulter och andra som kan behöva insyn i hur ekologisk kompensation kan användas och vidareutvecklas inom svensk kustmiljöförvaltning. I rapporten återger vi hur man hanterar ekologisk kompensation i svenska kustområden idag, till exempel hur handläggare arbetar med att mäta skada och bedöma omfattningen av kompensationsbehov. Vi beskriver även problematiken med småskaliga anmälningspliktiga ärenden, där den sammanlagda påverkan från många små exploateringar ger upphov till betydande förluster av biologisk mångfald och ekosystemtjänster. Slutligen beskriver vi hur den så kallade särskilda fiskeavgiften, som syftar till att tillvarata fiskeintresset i samband med vattenverksamhetsfrågor, tillämpas idag, samt analyserar hur beräkningsgrunderna skulle kunna utvecklas för att stärka användningen av ekologisk kompensationen som verktyg. Vår sammanställning och utvärdering utgår från ett generellt ramverk som utvecklats inom ECOCOA för att skatta skada och identifiera kompensationsbehov. Ramverket baseras på en kaskadmodell, som visar kopplingar mellan ekosystemets struktur, funktion, ekosystemtjänster och nyttigheter för människor. Modellen kan användas för att synliggöra hur verksamheter påverkar arter och livsmiljöer och vilka kostnader och förluster detta medför. Ramverket kan även användas för att bedöma i vilken omfattning en föreslagen åtgärd faktiskt kompenserar för de förluster som verksamheten innebär.Här följer en kort sammanfattning av resultaten som presenteras i rapporten: • En enkätundersökning riktad till aktörer inom kustförvaltningen visar att ekologisk kompensation i praktiken tillämpas mycket sällan inom kustmiljöförvaltningen idag, och att det finns ett stort behov av att ta fram riktlinjer för dess tillämpning, som stöd till handläggare, konsulter, domstolar och andra aktörer. På en mer generell nivå omfattar detta även ett behov av att förbättra kunskapen om restaureringsmetoder samt att ta fram metoder för värdering av skador på naturvärden. Det finns även ett behov av resurser för Sammanfattning 6 handläggare i form av tid och stöd för att tillämpa ekologisk kompensation i kustförvaltningen. • En utvärdering av befintliga domslut för ett antal tillståndspliktiga (dvs. storskaliga) vattenverksamhetsärenden visar att biologisk mångfald och ekosystemtjänster mycket sällan beaktas på ett sätt som är i linje med Sveriges åtaganden inom till exempel konventionen för biologisk mångfald och EU:s biodiversitetstrategi, där en bärande princip är att ingen nettoförlust ska ske. Det finns ett förbättringsutrymme som borde kunna mötas direkt genom en ökad kunskapsdelning mellan aktörer, och en förbättrad praxis gällande tillämpning av ekologisk kompensation. Samtidigt uppstår flera mer komplexa frågor som berör till exempel behovet av en gemensam fysisk planering och identifiering av lämpliga kompensationsåtgärder, där ett kunskapsbyggande behövs. • Småskalig kustexploatering, exempelvis bryggbyggen och små muddringar, är en särskilt utmanande fråga. Enskilda små ingrepp är anmälningspliktiga (dvs. sällan tillståndspliktiga), och trots att det vid handläggningen av dessa ärenden ställs krav på miljöhänsyn kan det ofta inte bedömas som skäligt att kräva att exploatören själv utför ekologisk kompensation. Den sammanlagda påverkan av dessa många små ingrepp är dock betydande, och det är angeläget att utforma ett system där även småskalig vattenverksamhet kompenserar för sina miljökostnader. Vi undersöker hur ett system för ekologisk kompensation som även omfattar småskalig exploatering skulle kunna se ut, i relation till konceptet habitatbanker eller kompensationspooler, där exploatören kan bidra ekonomiskt till habitatrestaureringar i stället för att själv utföra dem. • Den särskilda fiskeavgiften syftar till att kompensera för skador från vattenverksamheter på fisket och skulle kunna betraktas som ett förvaltningsverktyg för kompensation av en viss typ av förlust. I rapporten utvärderar vi hur det rådande fiskeavgiftssystemet fungerar och utforskar hur det kan fungera ur ett kompensationsperspektiv, samt ger förslag på hur beräkningsmodellen kan utvecklas.Sammantaget finns det ett stort behov av att utveckla ekologisk kompensation som ett av de verktyg som kan bidra till att motverka den allt snabbare förlusten av biologisk mångfald och ekosystemfunktioner. Parallellt behövs ytterligare åtgärder för att stärka skyddet av de känsligaste livsmiljöerna i kustzonen, eftersom bevarande av fungerande livsmiljöer är att föredra som ett mer kostnadseffektivt verktyg än restaurering av störda miljöer.
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48.
  • Bergström, Ulf, et al. (författare)
  • Long-term decline in northern pike (Esox lucius L.) populations in the Baltic Sea revealed by recreational angling data
  • 2022
  • Ingår i: Fisheries Research. - : Elsevier BV. - 0165-7836 .- 1872-6763. ; 251
  • Tidskriftsartikel (refereegranskat)abstract
    • In the Baltic Sea, the large predatory fish northern pike (Esox lucius L.) is important for both recreational fisheries and ecosystem functioning. As existing fishery-independent surveys do not adequately monitor pike populations, a general lack of knowledge on population status and trends poses challenges for management. Here we use recreational angling data as an alternative method to describe pike population development along the Swedish Baltic Sea coast from 1938 onwards and assess the change over time in potential mortality factors by estimating harvest by fisheries and consumption by large predators. Data from a Swedish national register on trophy-sized pike (>12 kg) showed that numbers and maximum sizes peaked in 1990-1995, after which declines in both metrics are evident. In logbooks from a sport fishing club in the Stockholm archipelago, a simultaneous decrease in maximum sizes of pike was observed, together with a decrease in the total number of pike caught per fishing day. Jointly, these data indicate a decline in the abundance of large pike since around 1990. While commercial pike fisheries in the Baltic Sea have decreased continuously since the 1950s, recreational fishing increased after 1985, when Swedish coastal waters were made open access to anglers. The declines in large pike starting in the 1990s could, thus, have been driven by an increase in mortality from recreational fisheries, which at the time primarily practiced catch and kill. Since the 2000s, bag and slot length limits, spawning closures, and a general increase in catch-and-release fishing has reduced the landings of pike in recreational fisheries. Despite these fisheries regulations and higher release rates the decline in catches of large pike has continued, indicating an effect of other mortality factors. The strong growth of grey seal (Halichoerus grypus) and great cormorant (Phalacrocorax carbo sinensis) populations suggest that predation pressure on pike has increased over time. In the Stockholm archipelago these two predators were estimated to remove 5-18 times (range based on different diet composition estimates) more pike biomass than total fisheries landings in 2014-2017. To improve the situation for northern pike in the Baltic Sea managers need to consider both fisheries restrictions and measures to decrease predation pressure and increase recruitment. Catch data from recreational fisheries may be used to evaluate such management efforts by providing information on the population development of this keystone species.
  •  
49.
  • Bonander, Carl, et al. (författare)
  • The value of combining individual and small area sociodemographic data for assessing and handling selective participation in cohort studies: Evidence from the Swedish CardioPulmonary bioImage Study
  • 2022
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives To study the value of combining individual- and neighborhood-level sociodemographic data to predict study participation and assess the effects of baseline selection on the distribution of metabolic risk factors and lifestyle factors in the Swedish CardioPulmonary bioImage Study (SCAPIS). Methods We linked sociodemographic register data to SCAPIS participants (n = 30,154, ages: 50-64 years) and a random sample of the study's target population (n = 59,909). We assessed the classification ability of participation models based on individual-level data, neighborhood-level data, and combinations of both. Standardized mean differences (SMD) were used to examine how reweighting the sample to match the population affected the averages of 32 cardiopulmonary risk factors at baseline. Absolute SMDs >0.10 were considered meaningful. Results Combining both individual-level and neighborhood-level data gave rise to a model with better classification ability (AUC: 71.3%) than models with only individual-level (AUC: 66.9%) or neighborhood-level data (AUC: 65.5%). We observed a greater change in the distribution of risk factors when we reweighted the participants using both individual and area data. The only meaningful change was related to the (self-reported) frequency of alcohol consumption, which appears to be higher in the SCAPIS sample than in the population. The remaining risk factors did not change meaningfully. Conclusions Both individual- and neighborhood-level characteristics are informative in assessing study selection effects. Future analyses of cardiopulmonary outcomes in the SCAPIS cohort can benefit from our study, though the average impact of selection on risk factor distributions at baseline appears small.
  •  
50.
  • Börjesson, Mats, 1965, et al. (författare)
  • Correlates of cardiorespiratory fitness in a population-based sample of middle-aged adults : cross-sectional analyses in the SCAPIS study
  • 2022
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: This study aimed to identify main sex-specific correlates of cardiorespiratory fitness (CRF) in a population-based, urban sample of Swedish adults.Design: Cross-sectional.Setting: Multi-site study at university hospitals, data from the Gothenburg site.Participants: A total of 5308 participants (51% women, aged 50-64 years) with a valid estimated VO2max, from submaximal cycle test, in the Swedish CArdioPulmonary bioImage Study (SCAPIS), were included.Primary and secondary outcomes: A wide range of correlates were examined including (a) sociodemographic and lifestyle behaviours, (b) perceived health, anthropometrics and chronic conditions and (c) self-reported as well as accelerometer-derived physical activity and sedentary behaviours. Both continuous levels of estimated VO2max as well as odds ratios (OR) and confidence intervals (CI)s of low VO2max (lowest sex-specific tertile) were reported.Results: In multivariable regression analyses, higher age, being born abroad, short education, high waist circumference, poor perceived health, high accelerometer-derived time in sedentary and low in vigorous physical activity, as well as being passive commuter, correlated independently and significantly with low VO2max in both men and women (OR range 1.31-9.58). Additionally in men, financial strain and being an ex-smoker are associated with higher odds for low VO2max (OR 2.15; 95% CI 1.33 to 3.48 and OR 1.40; 95% CI 1.09 to 1.80), while constant stress with lower odds (OR 0.61; 95% CI 0.43 to 0.85). Additionally in women, being a regular smoker is associated with lower odds for low VO2max (OR 0.64; 95% CI 0.45 to 0.92).Conclusions: The present study provides important reference material on CRF and correlates of CRF in a general middle-aged population, which can be valuable for future research, clinical practice and public health work. If relations are causal, increased knowledge about specific subgroups will aid in the development of appropriate, targeted interventions.
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