| 1. |
- Ahlström, A., et al.
(författare)
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No major differences in perinatal and maternal outcomes between uninterrupted embryo culture in time-lapse system and conventional embryo culture
- 2023
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Ingår i: Human Reproduction. - : Oxford University Press. - 0268-1161 .- 1460-2350. ; 38:12, s. 2400-2411
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Tidskriftsartikel (refereegranskat)abstract
- STUDY QUESTION: Is embryo culture in a closed time-lapse system associated with any differences in perinatal and maternal outcomes in comparison to conventional culture and spontaneous conception?SUMMARY ANSWER: There were no significant differences between time-lapse and conventional embryo culture in preterm birth (PTB, <37 weeks), low birth weight (LBW, >2500 g) and hypertensive disorders of pregnancy for singleton deliveries, the primary outcomes of this study.WHAT IS KNOWN ALREADY: Evidence from prospective trials evaluating the safety of time-lapse incubation for clinical use show similar embryo development rates, implantation rates, and ongoing pregnancy and live birth rates when compared to conventional incubation. Few studies have investigated if uninterrupted culture can alter risks of adverse perinatal outcomes presently associated with IVF when compared to conventional culture and spontaneous conceptions.STUDY DESIGN, SIZE, DURATION: This study is a Swedish population-based retrospective registry study, including 7379 singleton deliveries after fresh embryo transfer between 2013 and 2018 from selected IVF clinics. Perinatal outcomes of singletons born from time-lapse-cultured embryos were compared to singletons from embryos cultured in conventional incubators and 71 300 singletons from spontaneous conceptions. Main perinatal outcomes included PTB and LBW. Main maternal outcomes included hypertensive disorders of pregnancy (pregnancy hypertension and preeclampsia).PARTICIPANTS/MATERIALS, SETTING, METHODS: From nine IVF clinics, 2683 singletons born after fresh embryo transfer in a time-lapse system were compared to 4696 singletons born after culture in a conventional incubator and 71 300 singletons born after spontaneous conception matched for year of birth, parity, and maternal age. Patient and treatment characteristics from IVF deliveries were cross-linked with the Swedish Medical Birth Register, Register of Birth Defects, National Patient Register and Statistics Sweden. Children born after sperm and oocyte donation cycles and after Preimplantation Genetic testing cycles were excluded. Odds ratio (OR) and adjusted OR were calculated, adjusting for relevant confounders.MAIN RESULTS AND THE ROLE OF CHANCE: In the adjusted analyses, no significant differences were found for risk of PTB (adjusted OR 1.11, 95% CI 0.87-1.41) and LBW (adjusted OR 0.86, 95% CI 0.66-1.14) or hypertensive disorders of pregnancy; preeclampsia and hypertension (adjusted OR 0.99, 95% CI 0.67-1.45 and adjusted OR 0.98, 95% CI 0.62-1.53, respectively) between time-lapse and conventional incubation systems. A significantly increased risk of PTB (adjusted OR 1.31, 95% CI 1.08-1.60) and LBW (adjusted OR 1.36, 95% CI 1.08-1.72) was found for singletons born after time-lapse incubation compared to singletons born after spontaneous conceptions. In addition, a lower risk for pregnancy hypertension (adjusted OR 0.72 95% CI 0.53-0.99) but no significant difference for preeclampsia (adjusted OR 0.87, 95% CI 0.68-1.12) was found compared to spontaneous conceptions. Subgroup analyses showed that some risks were related to the day of embryo transfer, with more adverse outcomes after blastocyst transfer in comparison to cleavage stage transfer.LIMITATIONS, REASONS FOR CAUTION: This study is retrospective in design and different clinical strategies may have been used to select specific patient groups for time-lapse versus conventional incubation. The number of patients is limited and larger datasets are required to obtain more precise estimates and adjust for possible effect of additional embryo culture variables.WIDER IMPLICATIONS OF THE FINDINGS: Embryo culture in time-lapse systems is not associated with major differences in perinatal and maternal outcomes, compared to conventional embryo culture, suggesting that this technology is an acceptable alternative for embryo incubation.
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| 2. |
- Punzi, Elisabeth, 1968, et al.
(författare)
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Relationships, Emotions, and Defenses Among Patients with Substance Use Disorders, Assessed with Karolinska Psychodynamic Profile: Possibilities to use Intensive Short-Term Dynamic Psychotherapy in Substance Abuse Treatment
- 2019
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Ingår i: Alcoholism Treatment Quarterly. - : Informa UK Limited. - 0734-7324 .- 1544-4538. ; 37:4, s. 481-496
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Tidskriftsartikel (refereegranskat)abstract
- Substance use disorders (SUDs) are connected to emotional and relational difficulties. Intensive Short-Term Dynamic Psychotherapy (ISTDP) aims at supporting emotion regulation and relational capacity through confronting the patient’s defenses. The authors assessed relational capacity, emotion regulation, and defenses in nine patients with severe SUD and a history of childhood maltreatment, using the semistructured method Karolinska Psychodynamic Profile. All participants had difficulties in handling interpersonal dependence and separations. Functioning in other areas varied. ISTDP could be useful in substance abuse treatment. Thorough assessment before starting ISTDP is however recommended so that treatment is planned according to the patients’ level of functioning.
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| 3. |
- Jour, Pia, et al.
(författare)
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Decreased water usage in a softwood ECF bleaching sequence : full mill simulations
- 2018
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Ingår i: TAPPI Journal. - : TAPPI. - 0734-1415. ; 17:6, s. 353-360
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Tidskriftsartikel (refereegranskat)abstract
- In this study, an elemental chlorine free (ECF) bleach plant with a D0(EOP)D1(EP)D2 sequence was studied with the aim of identifying options for significantly decreasing (fresh) water usage in the bleach plant and decreasing the effluent volume. A base-case simulation model for a softwood kraft market pulp mill was made based on a reference model representing the best available techniques as well as data produced in an extensive laboratory pulp bleaching study. This model was used to evaluate increased closure within the bleach plant and the recirculation of bleach plant effluent to the brownstock system and their effects on both the bleach plant and the recovery cycle. The results indicate that it is possible to reduce the fresh water consumption from 15 metric tons/a.d. metric ton in the base case to about 2 metric tons/a.d. metric ton, without increasing the carryover of chemical oxygen demand (COD) to the pulp machine. Nonprocess elements in wood contribute to the levels of metals found in the bleach plant and thus to the risk of precipitates such as calcium oxalate, barium sulfate, and calcium carbonate. The risk of precipitates forming is a key factor determining the possible degree of closure. In addition, chloride concentration in the black liquor is another important factor that is affected by recirculating bleach plant filtrate to the brownstock washer and by the grade of the sodium hydroxide used in the mill.
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| 4. |
- Lindgren, Anna Karin, et al.
(författare)
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Eradication of methicillin-resistant Staphylococcus aureus (MRSA) throat carriage : A randomised trial comparing topical treatment with rifampicin-based systemic therapy
- 2018
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Ingår i: International Journal of Antimicrobial Agents. - : Elsevier BV. - 0924-8579. ; 51:4, s. 642-645
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Tidskriftsartikel (refereegranskat)abstract
- Eradication of methicillin-resistant Staphylococcus aureus (MRSA) colonisation may prevent transmission of strains between patients and reduces the risk of clinical infection. Colonisation of the throat is associated with prolonged carriage and is more difficult to eradicate. An open randomised study was conducted to evaluate two eradication protocols. Patients with pharyngeal carriage of MRSA were enrolled at six Swedish centres during 4 years. One treatment group received oral rifampicin and either clindamycin or trimethoprim/sulfamethoxazole (SXT) for 7 days in combination with nasal mupirocin. Patients in the other group were treated with nasal mupirocin only. Patients in the same household were randomised together. Both groups followed a hygiene protocol including chlorhexidine washing. Cultures from the nares, perineum and throat were taken at baseline and then at 2 weeks, 2 months and 6 months after the end of treatment. A total of 28 patients received rifampicin-based systemic antibiotics and 24 subjects received mupirocin only. At follow-up 6 months after the end of treatment, 61% of patients and 50% of households in the systemic antibiotics group had culture results negative for MRSA. Significantly less patients (12%) and households (10%) became decolonised in the group receiving topical treatment only. A combination of rifampicin and either clindamycin or SXT was more effective in eliminating pharyngeal MRSA carriage compared with topical treatment with mupirocin only.
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| 5. |
- Lindgren, Karin Elvine, 1984-, et al.
(författare)
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Differences in secretome in culture media when comparing blastocysts and arrested embryos using multiplex proximity assay
- 2018
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Ingår i: Upsala Journal of Medical Sciences. - : TAYLOR & FRANCIS LTD. - 0300-9734 .- 2000-1967. ; 123:3, s. 143-152
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to assess different patterns of the human embryo secretome analysed as protein levels in culture media. Furthermore, analyses to correlate protein levels with quality and timing to development of human embryos were performed.Material and methods: Human day-2 cryopreserved embryos were cultured for four days in an EmbryoScope((R)) with a time-lapse camera, and embryo quality was evaluated retrospectively. After culture, the media were collected and relative levels of secreted proteins were analysed using Proseek Multiplex Assays. Protein levels were evaluated in relation to timing to development and the ability to form a blastocyst.Results: Specific patterns of timing of development of blastocysts were found, where a difference in time to start of cavitation was found between high- and low-quality blastocysts. There appeared to be a correlation between specific protein patterns and successful formation of morulae and blastocysts. Embryos developing into blastocysts had higher levels of EMMPRIN than arrested embryos, and levels of caspase-3 were lower in high- versus low-quality blastocysts. Also, higher levels of VEGF-A, IL-6, and EMMPRIN correlated with shorter times to morula formation.Conclusions: The secretome and timing to development differ in embryos forming blastocysts and those that become arrested, and in high- versus low-quality blastocysts. The levels of certain proteins also correlate to specific times to development.
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| 6. |
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| 7. |
- Lindgren, Karin, et al.
(författare)
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Soap separation : A new option for removal of NPEs
- 2018
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Ingår i: Pulping Engineering and Environmental Recycling Sustainability Conference, PEERS 2018. - : TAPPI Press. ; , s. 272-277
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Non-process elements (NPEs) are elements present in the process streams without taking part in the desired reaction. With increasing process closure and new NPE-rich input streams such as gasified bark in the lime kiln and the destruction of biosludge in the recovery boiler, the traditional purge points may prove insufficient. A new method to remove NPEs is suggested: Removal of NPEs from tall oil brine. The idea is based on the fact that many elements are enriched in the soap and separated from the black liquor but are later led back to the black liquor with the brine. The results showed strong enrichment of Ba, Ca, Mg, Mn, P and Zn in soap; an enrichment factor of 8 or higher was observed. Laboratory experiments where tall oil brine has been alkalized and subjected to a separation stage have been conducted. The laboratory experiments showed that more than 90% of Al, Ba, Mg, Mn and P precipitates and could be removed with the solid phase if alkalized to pH 11. The separation efficiency varied for Ca and Si from 70-85 %. To conclude, removal of non-process elements from tall oil brine is a promising new kidney, especially for P and Si.
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| 8. |
- Wallinder, Johan, et al.
(författare)
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Dynamic modelling of a kraft pulp mill producing softwood and hardwood pulp in campaigns
- 2018
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Ingår i: Pulping Engineering and Environmental Recycling Sustainability Conference, PEERS 2018: Technical Solutions for Today and Beyond. - 9781510874695 ; , s. 673-683
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Konferensbidrag (refereegranskat)abstract
- Pulp mills producing hardwood and softwood pulp in campaigns have constantly changing process stream compositions. There is aneed to know how these variations develop during the campaigns and that was the objective of this study. A dynamic model, built in the simulation program WinGEMS, has been created by including tanks and reactors with known residence times. A case with a mill producing softwood and hardwood pulp in campaigns has been designed and studied. Some of the studied parameters were white liquor concentration, recovery boiler load and composition of weak black liquor. The dynamic changes of these parameters were not unexpected; however, the time responses and magnitude of these changes were of bigger interest. For instance, it took a little more than 3 days, from the start of a new campaign, to totally replace the weak black liquor from one wood species with the other. In order to interpret results successfully, it was necessary to be aware of the residence time between certain positions in the pulp mill model.
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| 9. |
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| 10. |
- Jour, Pia, et al.
(författare)
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ECF bleaching of eucalyptus kraft pulp : simulation of a mill with a high degree of closure
- 2017
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Ingår i: International pulp bleaching conference. - : Suprema Grafica e Editora. - 9788581791340 ; , s. 106-110
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The composition of non-process elements (NPEs) in wood significantly affects the level of metals in the pulp in the bleach plant and contributes to the risk of forming precipitates. The possible degree of closure is often limited by calcium oxalate formation, mainly around the D0-stage, which can be prevented by increasing the temperature and/or decreasing the pH in this stage. This paper presents the effect of a decreased pH in the D0-stage when bleaching a eucalyptus kraft pulp as well as the influence it has on environmental parameters such as chemical oxygen demand (COD) and adsorbable organic halogens (AOX). The increased AOX measured when applying a low pH in the D0-stage was shown to be easily decomposed under process conditions. To be able to predict the effect on both the recovery cycle and the bleach plant itself as a consequence of increased closure of the bleach plant, a full mill simulation model (WinGEMS) was used based on a theoretical mill using the best available technology (BAT) in combination with data produced in laboratory trials. The model pulp mill was exclusively equipped with wash presses. According to the simulations, the effluent volume could be significantly decreased from 20.7 t/air dry tonne (ADt) pulp to 8.7 t/ADt in a D(EOP)DP sequence. Using a wood raw material with a calcium content of 520 mg/kg dry solids, no formation of calcium oxalate was predicted. However, for a wood raw material with a higher content, 800 mg/kg, calcium oxalate formation was likely to occur. By decreasing the final pH in the D0-stage from 3.0 to 2.5, formation of calcium oxalate could be avoided. At the effluent volume of 8.7 t/ADt, no fresh water was used in the bleach plant except for the water used for dilution of chemicals.
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