| 1. |
|
|
| 2. |
- Blume-Werry, Gesche, et al.
(författare)
-
Dwelling in the deep – permafrost thawing strongly increases plant root growth and root litter input
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Plant roots play a key role in ecosystem carbon and nutrient cycling. Climate warming induced thawing of permafrost exposes large amounts of carbon and nitrogen at greater soil depths that hitherto have been detached from plant influences. Whether plant roots can reach and interact with these carbon and nitrogen sources upon permafrost thaw remains unknown. Here, we use a long-term permafrost thaw experiment and a short-term deep fertilization experiment in northern Sweden to assess changes in vegetation composition and root dynamics (deep nitrogen uptake, root depth distribution, root growth and phenology, root mortality and litter input) related to permafrost thaw, both in active layer and in newly thawed permafrost. We show that Eriophorum vaginatum and Rubus chamaemorus, both relatively deep-rooting species, can take up nitrogen released at depth of permafrost thaw, despite the late release time in autumn when plant activity is expected to have ceased. Also, root dynamics changed drastically after a decade of experimental permafrost thaw. Total root length, root growth and root litter input all strongly increased, not only in the active layer but also in the newly thawed permafrost, and the timing of root growth was related to the seasonality of soil thaw. These responses were driven by Eriophorum vaginatum, which differed greatly in root dynamics compared to the other species and thus worked as an ecosystem engineer. This study demonstrates that soil organic matter currently locked-up at depth in permafrost is no longer detached from plant processes upon thaw. Given the pivotal role that roots have in the carbon cycle and the importance of the large carbon stocks in arctic soils, the changes observed here have the potential to feedback onto the global climate system.
|
|
| 3. |
|
|
| 4. |
- Hälleberg-Nyman, Maria, 1968-, et al.
(författare)
-
Intermittent versus indwelling urinary catheterisation in hip surgery patients : a randomised controlled trial with cost-effectiveness analysis
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Hip surgery is associated with a risk for postoperative urinary retention. To avoid urinary retention hip surgery patients undergo urinary catheterisation. Urinary catheterisation, however, is associated with increased risk for urinary tract infection (UTI). Presently, there is limited knowledge whether intermittent or indwelling urinary catheterisation is the preferred choice for short-term bladder drainage in patients undergoing hip surgery.Objectives: The aim of the study was to investigate differences between intermittent and indwelling urinary catheterisation in hip surgery patients in relation to nosocomial UTI and cost-effectiveness.Design: Randomised controlled trial with cost-effectiveness analysis. Setting: The study was carried out at an orthopaedic department at a Swedish university hospital.Method: One hundred seventy hip surgery patients (patients with fractures or with osteoarthritis) were randomly allocated to either intermittent or indwelling urinary catheterisation. Data collection took place at four time points: during stay in hospital, at discharge and at 4 weeks and 4 months after discharge. Results: Eighteen patients contracted nosocomial UTIs, 8 in the intermittent catheterisation group and 10 in the indwelling catheterisation group (p = 0.618). The patients in the intermittent catheterisation group were more often catheterised (p <0.001) and required more bladder scans (p <0.001) but regained normal bladder function sooner than the patients in the indwelling catheterisation group (p <0.001). Fourteen percent of the patients in the intermittent group did not need any catheterisation. Cost-effectiveness was similar between the indwelling and intermittent urinary catheterisation methods.Conclusions: In the perspective of cost-effectiveness both indwelling and intermittent methods could be appropriate in clinical praxis. Both methods have advantages and disadvantages but by not using indwelling catheterisation routinely in this patient group unnecessary catheterisations might be avoided.
|
|
| 5. |
- Jacobson, Sofie, et al.
(författare)
-
Leptin independently predicts development of future sepsis and determines survival in the acute phase
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To determine if levels of the adipocyte-derived hormones leptin and adiponectin (adipokines) predict sepsis development and if intra-individual changes in circulating levels from baseline to the acute phase affect outcome.Method: A nested case-referent study within the framework of the Northern Sweden Health and Disease Study (NSHDS) and the Northern Sweden Maternity Cohort (NSMC). Patients aged 18 years or more with documented sepsis within 24 hours after admission to the intensive care unit (ICU) were included if they had participated in a health survey and donated blood samples prior to the sepsis event, and if possible also had stored plasma from the acute phase. Two matched referents free of known sepsis were selected for each case. Baseline and acute phase plasma leptin and adiponectin levels were determined. The associations between adipokines and sepsis and its severity and outcome were determined.Results: We identified 57 men and 97 women with a first-time sepsis event 6.5 years (median with IQR 7.7) after participation in the health survey, and 83% of them had also samples from the acute septic phase. Hyperleptinemia associated with a future sepsis event (OR 1.77, 95% CI 1.04-3.00, P=0.03), with stronger associations with severe sepsis and septic shock than with sepsis. High leptin levels were also associated with hospital death in the fully adjusted model. Leptin remained associated with sepsis in men (P=0.02), but not in women (P=0.36), after stratification and adjustment for BMI. In the acute phase, leptin increased more in men than in women (P=0.001), and high leptin levels were associated with increased risk for in-hospital death in women (OR 4.18, 95%CI 1.17-15.00, P=0.03), while being protective in men (OR 0.05, 95% CI 0.01-0.48, P=0.01). Adiponectin did not associate with sepsis or outcome.Conclusions: Hyperleptinemia independently predicted the development of sepsis, and an unfavourable outcome in men. Adiponectin was not associated with sepsis development.
|
|
| 6. |
- Jacobson, Sofie, et al.
(författare)
-
Levels of mannose-binding lectin (MBL) predicts sepsis and associates with sepsis-related in-hospital mortality differentially in men and women
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To determine if levels of mannose-binding lectin (MBL) predict sepsis development and if intra-individual changes in circulating levels from baseline to the acute septic phase associate with in-hospital mortality.Method: A nested case-referent study within the framework of the Northern Sweden Health and Disease Study (NSHDS) and the Northern Sweden Maternity Cohort (NSMC). Patients aged 18 years or more with documented sepsis within 24 hours after admission to the intensive care unit were included if they had participated in a health survey and donated blood samples prior to the sepsis event. A subset of these patients had stored plasma also from the acute phase. Two matched referents free of known sepsis were selected for each case. Baseline and acute phase plasma MBL levels were determined. The association between MBL and sepsis, sepsis severity and in-hospital mortality were determined.Results: We identified 57 men and 95 women with a first-time sepsis event 6.5 years (median with IQR 7.7) after participation in a health survey, of which 127 also had samples from the acute septic phase. High baseline levels predicted future sepsis (OR 1.81, 95% CI 1.01-3.26), but were not associated with severity of sepsis or in-hospital fatality. Both high MBL levels in the acute phase (OR 4.94, 95% CI 1.44-16.89), and an increase from base line to the acute phase (OR 3.67, 95% CI 1.19-11.28) were associated with increased risk for in-hospital death in women, but not in men (OR 0.71, 95% CI 0.18-2.88). Low levels at baseline were not associated with future sepsis. Neither low levels at baseline, nor in the acute phase were associated with sepsis severity or in-hospital mortality.Conclusions: High pre-sepsis levels predicted a future sepsis event, and an increase from baseline to the acute phase as well as high levels in the acute phase associated with an unfavourable outcome in women.
|
|
| 7. |
- Johansson, Yvonne, et al.
(författare)
-
Self-perceived health among older men living in their own residence : a four year follow-up study
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This study characterize older men, who perceived themselves as healthy, with focus on demographical, social, medical and functional factors, and describe changes within the healthy group over time and find predictors of self-perceived health. The study has a prospective design and included 303 men, 75 and 80 years old, living in a municipality in the south of Sweden. Data collection took place 2001-2006 in a total of three – five examinations at an interval of one year. The examinations included questionnaires validated and tested for reliability, assessing the nutritional status, (Mini Nutritional Assessment), symptoms of depression (Geriatric Depression Scale-20), cognitive function (Mini Mental State Examination), health-related quality of life (Nottingham Health Profile), wellbeing (Philadelphia Geriatric Centre Multilevel Assessment Instrument), demographic factors, physical- and biochemical assessments. The men were divided into two groups according to their self-perceived health, 58% (n=175) perceived themselves as healthy and 42% n=128) as less healthy. Good physical health, the ability to walk a distance outdoors, an ability to maintain a social network and having energy were factors important to feeling healthy among men at baseline. Analyses at the follow-ups included men whom still perceived themselves as healthy and men who perceived their health as being impaired. Seventy five percent (n=132) of the healthy group at baseline still perceived themselves as healthy at the first follow-up. Important factors for a self perceived good health when growing older were feeling mentally well and being able to walk up and downstairs. These results indicated that areas representing the individuals own perception and ability are important to feel healthy.
|
|
| 8. |
- Johansson, Yvonne, et al.
(författare)
-
Self-reported energy and nutrient intake among older people : a two year follow-up study
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: The aim was to investigate older people’s energy intake regarding macro- and micronutrients, related to nutritional status, symptoms of depression, self-perceived health and demographical factors, and describe possible changes of energy intake during a period of two years. Method: The study included 115 individuals 80 years-old who performed a yearly 24h recallvof food intake, a total of three times. Energy requirement was estimated using weight, agevand gender and a Physical Activity Level of 1.6, and the Nordic Nutrition Recommendationsvwere used as a reference for nutrients. Nutritional status was assessed using the MinivNutritional Assessment and symptoms of depression using the Geriatric Depression Scale-20. Result: Three groups with different self-reported energy intakes appeared in the analysis, onev with <1500 kcal, a second with a fluctuating intake over time (±1500 kcal), and a third with ≥1500 kcal. Intake of vitamins A, D, E, folate and fibre were below the recommended levels in all groups. The same pattern of energy intake and micronutrients was found over time. No correlation between energy intake and MNA and GDS-20 was found. Conclusion: Reported energy intake and some micronutrients were low in relation to estimated energy requirement. This might be due to a combination of low energy intake, underreporting and the day on which the 24h recall was performed. Weight loss was found in women and men who reported a fluctuating energy intake and among men who reported an energy intake <1500 kcal. This might indicate an inadequate energy intake and an increased vulnerability to malnutrition.
|
|
| 9. |
- Ljungberg, Johan, et al.
(författare)
-
Arterial hypertension and elevated diastolic blood pressure is associated with developing aortic stenosis requiring surgery in persons less than 60 years of age
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Due to age-related differences in aortic valve structure, it is likely that the pathophysiology of aortic stenosis and associated risk factors differ between age groups. Here we prospectively studied the influence of traditional cardiovascular risk factors on aortic stenosis development among patients without concomitant coronary artery disease, and stratified for age. Methods: This study included 131 patients from previous population-based surveys, who underwent surgery for aortic stenosis and had no visible coronary arteriosclerosis upon preoperative coronary angiogram. The younger group included 49 patients of <60 years old at surgery: median age, 54.4 years; median follow-up, 8.7 years. The older group included 82 patients of ≥60 years old at surgery: median age, 71.3 years; median follow-up, 11.0 years. For each case, we selected four referents matched for age, gender, and geographic area. To identify predictors for surgery, we used multivariable conditional logistic regression with a model including arterial hypertension, cholesterol levels, diabetes, BMI, and smoking. Results: Future surgery for aortic stenosis was associated with arterial hypertension and elevated levels of diastolic blood pressure in the younger group (odds ratio, 3.40; 95% confidence interval, 1.45–7.93, and odds ratio 1,60; 95% confidence interval, 1.09–2.37, respectively), and with only impaired fasting glucose tolerance in the older group (odds ratio, 3.22; 95% confidence interval, 1.19–8.76). Conclusion: Arterial hypertension and elevated diastolic blood pressure are associated with a risk for aortic stenosis development in subjects below 60 years of age. Strict blood pressure control in this group are strongly advocated to avoid other cardiovascular diseases correlated to hypertension. If hypertension and elevated diastolic blood pressure are risk for developing aortic stenosis need further investigations. Notably, elevated fasting glucose levels were related to aortic stenosis in older adults without concomitant coronary artery disease.
|
|
