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- Borgström, Fredrik, et al.
(författare)
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Fragility fractures in Europe: burden, management and opportunities.
- 2020
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Ingår i: Archives of osteoporosis. - : Springer Science and Business Media LLC. - 1862-3514 .- 1862-3522. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five countries of the European Union plus Sweden (EU6). In 2017, new fragility fractures in the EU6 are estimated at 2.7 million with an associated annual cost of €37.5 billion and a loss of 1.0 million quality-adjusted life years.Osteoporosis is characterized by reduced bone mass and strength, which increases the risk of fragility fractures, which in turn, represent the main consequence of the disease. This report provides an overview and a comparison of the burden and management of fragility fractures in the largest five EU countries and Sweden (designated the EU6).A series of metrics describing the burden and management of fragility fractures were defined by a scientific steering committee. A working group performed the data collection and analysis. Data were collected from current literature, available retrospective data and public sources. Different methods were applied (e.g. standard statistics and health economic modelling), where appropriate, to perform the analysis for each metric.Total fragility fractures in the EU6 are estimated to increase from 2.7 million in 2017 to 3.3 million in 2030; a 23% increase. The resulting annual fracture-related costs (€37.5 billion in 2017) are expected to increase by 27%. An estimated 1.0 million quality-adjusted life years (QALYs) were lost in 2017 due to fragility fractures. The current disability-adjusted life years (DALYs) per 1000 individuals age 50years or more were estimated at 21years, which is higher than the estimates for stroke or chronic obstructive pulmonary disease. The treatment gap (percentage of eligible individuals not receiving treatment with osteoporosis drugs) in the EU6 is estimated to be 73% for women and 63% for men; an increase of 17% since 2010. If all patients who fracture in the EU6 were enrolled into fracture liaison services, at least 19,000 fractures every year might be avoided.Fracture-related burden is expected to increase over the coming decades. Given the substantial treatment gap and proven cost-effectiveness of fracture prevention schemes such as fracture liaison services, urgent action is needed to ensure that all individuals at high risk of fragility fracture are appropriately assessed and treated.
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- Boxberg, Fredrik, et al.
(författare)
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Photovoltaics with piezoelectric core-shell nanowires
- 2011
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Ingår i: Physics of Semiconductors: 30th International Conference on the Physics of Semiconductors. - : AIP. - 1551-7616 .- 0094-243X. ; 1399, s. 469-470
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Konferensbidrag (refereegranskat)abstract
- We report on the discovery of a generic piezoelectric field in strained core-shell compound semiconductor nanowires. We present the lattice-mismatch induced strain in epitaxial core-shell nanowires and show that it gives, very generally, rise to an internal piezoelectric field along the axis of the nanowire. This field results predominantly from atomic displacements in polar bonds and microscopic polarizations along the nanowire axis within both the core and shell materials. The mechanism and internal piezoelectric field is particularly strong in < 111 > orientated zinc blende and [0001] orientated wurtzite crystalline core-shell nanowires. The effect can be employed to generate the potovoltaic effect in core-shell nanowires free of doping and thus offers a new device concept for solar cells and photodetectors.
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- Ekstrand, Eva-Maria, et al.
(författare)
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Methane potentials of the Swedish pulp and paper industry - A screening of wastewater effluents
- 2013
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Ingår i: Applied Energy. - : Elsevier. - 0306-2619 .- 1872-9118. ; 112, s. 507-517
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Tidskriftsartikel (refereegranskat)abstract
- With the final aim of reducing the energy consumption and increase the methane production at Swedish pulp and paper mills, the methane potential of 62 wastewater effluents from 10 processes at seven pulp and/or paper mills (A-G) was determined in anaerobic batch digestion assays. This mapping is a first step towards an energy efficient and more sustainable utilization of the effluents by anaerobic digestion, and will be followed up by tests in lab-scale and pilot-scale reactors. Five of the mills produce kraft pulp (KP), one thermo-mechanical pulp (TMP), two chemical thermo-mechanical pulp (CTMP) and two neutral sulfite semi-chemical (NSSC) pulp. Both elementary and total chlorine free (ECF and TCF, respectively) bleaching processes were included. The effluents included material from wood rooms, cooking and oxygen delignification, bleaching (often both acid- and alkali effluents), drying and paper/board machinery as well as total effluents before and after sedimentation. The results from the screening showed a large variation in methane yields (percent of theoretical methane potential assuming 940 NmL CH4 per g TOC) among the effluents. For the KP-mills, methane yields above 50% were obtained for the cooking effluents from mills D and F, paper machine wastewater from mill D, condensate streams from mills B, E and F and the composite pre-sedimentation effluent from mill D. The acidic ECF-effluents were shown to be the most toxic to the AD-flora and also seemed to have a negative effect on the yields of composite effluents downstream while three of the alkaline ECF-bleaching effluents gave positive methane yields. ECF bleaching streams gave higher methane yields when hardwood was processed. All TCF-bleaching effluents at the KP mills gave similar degradation patterns with final yields of 10-15% of the theoretical methane potential for four of the five effluents. The composite effluents from the two NSSC-processes gave methane yields of 60% of the theoretical potential. The TMP mill (A) gave the best average yield with all six effluents ranging 40-65% of the theoretical potential. The three samples from the CTMP process at mill B showed potentials around 40% while three of the six effluents at mill G (CTMP) yielded 45-50%.
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- Fritzell, Peter, et al.
(författare)
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Cost effectiveness of disc prosthesis versus lumbar fusion in patients with chronic low back pain: randomized controlled trial with 2-year follow-up :
- 2011
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 20:7, s. 1001-1011
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Tidskriftsartikel (refereegranskat)abstract
- When low back pain becomes chronic, surgery is sometimes performed. The gold standard today is lumbar fusion (FUS), using a variety of procedures. Total disc replacement (TDR) aimed at motion preservation is increasing in popularity. This randomized controlled health economic study assesses the cost-effectiveness of TDR (Charité/Prodisc/Maverick) compared with instrumented FUS (posterior lumbar fusion (PLF)/posterior lumbar interbody fusion (PLIF). Social and healthcare perspectives after two years are reported. In all, 152 patients were randomized to either TDR (n=80) or FUS (n=72). Cost to society, (total mean cost/patient, Swedish kronor=SEK, standard deviation) for TDR was SEK 599,560 (400,272), and for FUS SEK 685,919 (422,903) (ns). TDR was significantly less costly from a healthcare perspective, SEK 22,996 (43,055- -1,202). Number of days on sick leave among those who returned to work was 185 (146) in the TDR group, and 252 (189) in the FUS group (ns). Using EQ-5D, the total gain in quality adjusted life years (QALYs) over two years was 0.41 units for TDR and 0.40 units for FUS (ns). Based on EQ-5D, the incremental cost effectiveness ratio (ICER) of using TDR instead of FUS was difficult to analyze due to the “non-difference” in treatment outcome, which is why cost/QALY could not be defined. Using cost-effectiveness probabilistic analysis, the net benefit with CI) was found to be SEK 91,359 (-73,643 – 249,114) (ns). Conclusion: It is not possible to state whether TDR or FUS is more cost-effective after two years. Since disc replacement and lumbar fusion are based on different conceptual approaches, it is important to follow these results over time.
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- Haggren, Tuomas, et al.
(författare)
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InP nanowire p-type doping via Zinc indiffusion
- 2016
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Ingår i: Journal of Crystal Growth. - : Elsevier BV. - 0022-0248. ; 451, s. 18-26
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Tidskriftsartikel (refereegranskat)abstract
- We report an alternative pathway for p-type InP nanowire (NW) doping by diffusion of Zn species from the gas phase. The diffusion of Zn was performed in a MOVPE reactor at 350–500 °C for 5–20 min with either H2 environment or additional phosphorus in the atmosphere. In addition, Zn3P2 shells were studied as protective caps during post-diffusion annealing. This post-diffusion annealing was performed to outdiffuse and activate Zn in interstitial locations. The characterization methods included photoluminescence and single NW conductivity and carrier concentration measurements. The acquired carrier concentrations were in the order of >1017 cm−3 for NWs without post-annealing, and up to 1018 cm−3 for NWs annealed with the Zn3P2 shells. The diffused Zn caused redshift to the photoluminescence signal, and the degree of redshift depended on the diffusion process.
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- Jonsson, Emma, et al.
(författare)
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Cost and Health Outcomes Patterns in Patients Treated With Spinal Cord Stimulation Following Spine Surgery : A Register-Based Study
- 2020
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Ingår i: Neuromodulation. - : Elsevier BV. - 1094-7159 .- 1525-1403. ; 23:5, s. 626-633
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveSpinal cord stimulation (SCS), a minimally invasive treatment option for long‐term neuropathic pain, has been shown to be effective in patients with persisting neuropathic pain after spine surgery. However, little is known about the long‐term cost and quality‐of‐life (QoL) patterns in SCS‐treated patients. The aim is to describe the use of SCS, costs, pre‐spine‐surgery and post‐spine‐surgery QoL, and reported pain intensity, in patients who have undergone spine surgery and subsequent SCS implantation. The results will be related to outcome and cost in spine surgery patients in general.Materials and MethodsA research database comprised from six Swedish national and regional registers, and the spine surgery quality‐of‐care register Swespine was utilized. Two cohorts were identified: all patients who had spine surgery (N = 73,765) and patients who had spine surgery and subsequent SCS implantation (N = 239). Costs were analyzed before and after spine surgery for both cohorts, as well as before and after SCS implantation for the second cohort. QoL was explored by estimating patient‐reported outcome measures such as pain intensity, Oswestry Disability Index, and EuroQol‐5Dimensions from spine surgery up to five years post–spine surgery.ResultsIn spine surgery patients, mean QoL and pain intensity levels improved following surgery. Patients subsequently treated with SCS had lower reported QoL and higher costs before the initial spine surgery, and spine surgery did not lead to any substantial improvements, however, costs decreased following SCS implantation in these patients.
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