| 1. |
- Bokhorst, Stef, et al.
(författare)
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Changing Arctic snow cover : A review of recent developments and assessment of future needs for observations, modelling, and impacts
- 2016
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 45:5, s. 516-537
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Forskningsöversikt (refereegranskat)abstract
- Snow is a critically important and rapidly changing feature of the Arctic. However, snow-cover and snowpack conditions change through time pose challenges for measuring and prediction of snow. Plausible scenarios of how Arctic snow cover will respond to changing Arctic climate are important for impact assessments and adaptation strategies. Although much progress has been made in understanding and predicting snow-cover changes and their multiple consequences, many uncertainties remain. In this paper, we review advances in snow monitoring and modelling, and the impact of snow changes on ecosystems and society in Arctic regions. Interdisciplinary activities are required to resolve the current limitations on measuring and modelling snow characteristics through the cold season and at different spatial scales to assure human well-being, economic stability, and improve the ability to predict manage and adapt to natural hazards in the Arctic region.
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| 2. |
- Callaghan, Terry, et al.
(författare)
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Multi-Decadal Changes in Tundra Environments and Ecosystems : Synthesis of the International Polar Year-Back to the Future Project (IPY-BTF)
- 2011
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 40:6, s. 705-716
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Tidskriftsartikel (refereegranskat)abstract
- Understanding the responses of tundra systemsto global change has global implications. Most tundraregions lack sustained environmental monitoring and oneof the only ways to document multi-decadal change is toresample historic research sites. The International PolarYear (IPY) provided a unique opportunity for such researchthrough the Back to the Future (BTF) project (IPY project#512). This article synthesizes the results from 13 paperswithin this Ambio Special Issue. Abiotic changes includeglacial recession in the Altai Mountains, Russia; increasedsnow depth and hardness, permafrost warming, andincreased growing season length in sub-arctic Sweden;drying of ponds in Greenland; increased nutrient availabilityin Alaskan tundra ponds, and warming at mostlocations studied. Biotic changes ranged from relativelyminor plant community change at two sites in Greenland tomoderate change in the Yukon, and to dramatic increasesin shrub and tree density on Herschel Island, and in subarcticSweden. The population of geese tripled at one sitein northeast Greenland where biomass in non-grazed plotsdoubled. A model parameterized using results from a BTFstudy forecasts substantial declines in all snowbeds andincreases in shrub tundra on Niwot Ridge, Colorado overthe next century. In general, results support and provideimproved capacities for validating experimental manipulation,remote sensing, and modeling studies.
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| 3. |
- Gonzalez Lindh, Margareta, 1965-, et al.
(författare)
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Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients
- 2017
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Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease. - 1176-9106 .- 1178-2005. ; 12, s. 331-337
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Tidskriftsartikel (refereegranskat)abstract
- Background: COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted). Methods: Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity,0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests). Results: Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients. Conclusion: Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both.
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| 4. |
- Gonzalez Lindh, Margareta, 1965-, et al.
(författare)
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Swallowing dysfunction in patients hospitalised due to a COPD exacerbation
- 2021
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Ingår i: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 7:2, s. 00173-2021-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This cross-sectional study aimed to investigate the prevalence of self-reported and clinically screened swallowing dysfunction (dysphagia) in COPD patients with severe exacerbations and to identify any associated factors. Findings were then compared to a control group.Methods: Participants included 30 patients hospitalised due to a COPD exacerbation. The control group consisted of 30 adults hospitalised with acute cardiac symptoms. Data were derived from spirometry, the 150 mL timed water swallow test, a cookie swallow test and a dyspnoea questionnaire (modified Medical Research Council (mMRC)). Scores from the 10-item Eating Assessment Tool (EAT-10) were calculated to assess patient perception of swallowing dysfunction.Results: Self-reported swallowing dysfunction and clinical signs thereof were more common in COPD patients than in the control group (67% versus 23% and 80% versus 37%, respectively; p <= 0.001). Clinical signs of swallowing dysfunction in the group with acute exacerbation of COPD were associated with self-reported swallowing dysfunction (p=0.02) and xerostomia (p=0.04). Dyspnoea (mMRC >= 2) was more common among the COPD patients (90% versus 47%, p<0.001). There was a significant negative correlation between lung function and self-reported dysphagia (r=-0.39, p=0.03), but not between lung function and clinically screened dysphagia (r=-0.23, p=0.21).Conclusion: COPD patients hospitalised with an acute exacerbation experienced significantly more self-reported and clinically screened swallowing dysfunction compared to a control group of patients with cardiac symptoms. Both patient groups experienced dyspnoea, but it was twice as common in the group with acute exacerbation of COPD. Both groups also experienced xerostomia.
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| 5. |
- Gonzalez Lindh, Margareta, 1965-
(författare)
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Swallowing Dysfunction in Respiratory Diseases : Prevalence and risk factors in COPD and COVID-19
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Swallowing dysfunction, dysphagia, is a common, sometimes dangerous, and often neglected problem that affects many people. The prevalence is estimated to be approximately 8% in the general population which makes it as common as e.g. diabetes or asthma. Dysphagia can cause serious complications like malnutrition, aspiration pneumonia and even death. The aims of this thesis were to gain further knowledge and a broader understanding of the prevalence, characteristics and risk factors of swallowing dysfunction in patients with respiratory diseases. Specifically Chronic Obstructive Pulmonary Disease, COPD, and COVID-19 after invasive mechanical ventilation.Study I is a prospective explorative study of 51 COPD patients in stable phase. Swallowing function was evaluated through a questionnaire and through two swallowing tests (water and a cookie) and lung function was measured through a spirometry. The prevalence of self- reported swallowing dysfunction was 65% and the screened prevalence was 49%. There was a negative correlation between lung function and both measurements of swallowing function, i.e. the poorer the lung function the more dysphagia symptoms.Study II is a cross-sectional multi-centre study where we examined the prevalence of self-reported swallowing dysfunction in 571 COPD patients. Additional tests were: spirometry, physical capacity, mMRC and CAT. Subjective swallowing symptoms were found in 33% of the patients. More prevalent in symptomatic patients and patients with lower physical capacity. A high score on the mMRC or CAT and a classification in GOLD groups B and D may be predictive of a swallowing dysfunction and should be addressed by the COPD nurse or physician.Study III is a cross-sectional study of 30 COPD patients hospitalized with a severe exacerbation. Their swallowing function was compared to a control group. The main results of this study were that the prevalence of swallowing dysfunction, both patient-reported and screened in patients hospitalised with a COPD exacerbation, was high. In addition, the AECOPD group was almost three times more likely to suffer from self-reported dysphagia compared to the control group.Study IV is a longitudinal cohort study of swallowing function in 28 COVID-19 patients post invasive mechanical ventilation. Dysphagia was found in 71% of the patients at baseline and it was associated with number of days in the hospital and in the ICU. At discharge from the hospital swallowing function and tolerance of oral intake had improved significantly.Conclusion: Swallowing dysfunction is prevalent both in COPD and in COVID-19 patients post invasive mechanical ventilation.
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| 6. |
- Micke, Patrick, et al.
(författare)
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The prognostic impact of the tumour stroma fraction : A machine learning-based analysis in 16 human solid tumour types
- 2021
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Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 65
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Tidskriftsartikel (refereegranskat)abstract
- Background: The development of a reactive tumour stroma is a hallmark of tumour progression and pronounced tumour stroma is generally considered to be associated with clinical aggressiveness. The variability between tumour types regarding stroma fraction, and its prognosis associations, have not been systematically analysed.Methods: Using an objective machine-learning method we quantified the tumour stroma in 16 solid cancer types from 2732 patients, representing retrospective tissue collections of surgically resected primary tumours. Image analysis performed tissue segmentation into stromal and epithelial compartment based on pan-cytokeratin staining and autofluorescence patterns.Findings: The stroma fraction was highly variable within and across the tumour types, with kidney cancer showing the lowest and pancreato-biliary type periampullary cancer showing the highest stroma proportion (median 19% and 73% respectively). Adjusted Cox regression models revealed both positive (pancreato-biliary type periampullary cancer and oestrogen negative breast cancer, HR(95%CI)=0.56(0.34-0.92) and HR (95%CI)=0.41(0.17-0.98) respectively) and negative (intestinal type periampullary cancer, HR(95%CI)=3.59 (1.49-8.62)) associations of the tumour stroma fraction with survival.Interpretation: Our study provides an objective quantification of the tumour stroma fraction across major types of solid cancer. Findings strongly argue against the commonly promoted view of a general associations between high stroma abundance and poor prognosis. The results also suggest that full exploitation of the prognostic potential of tumour stroma requires analyses that go beyond determination of stroma abundance.
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| 7. |
- Mollberg, Margareta, 1953, et al.
(författare)
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Comparison in obstetric management on infants with transient and persistent obstetric brachial plexus palsy.
- 2008
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Ingår i: Journal of child neurology. - : SAGE Publications. - 1708-8283 .- 0883-0738. ; 23:12, s. 1424-32
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Tidskriftsartikel (refereegranskat)abstract
- The outcome of obstetric brachial plexus palsy depends on the severity of the lesion of the nerve fibers. The aim of the prospective study is to evaluate if differences in force used in downward traction on the fetal head correlate to the number of nerve roots affected. At final neurological examination at 18 months of age, complete neurological recovery occurred in 80 of 98 children (82%). Downward traction of the fetal head was applied more often and with greater force in the group with persistent damage. There was a significant correlation between the force used to the number of nerve roots affected. The risk of persistent obstetric brachial plexus palsy at age 18 months depended on obstetric management and increased significantly with increasing force used in downward traction of the fetal head.
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| 8. |
- Pascual, Didac, et al.
(författare)
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The missing pieces for better future predictions in subarctic ecosystems: A Torneträsk case study
- 2021
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Ingår i: Ambio. - : Springer. - 0044-7447 .- 1654-7209. ; 50:2, s. 375-392
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Forskningsöversikt (refereegranskat)abstract
- Arctic and subarctic ecosystems are experiencing substantial changes in hydrology, vegetation, permafrost conditions, and carbon cycling, in response to climatic change and other anthropogenic drivers, and these changes are likely to continue over this century. The total magnitude of these changes results from multiple interactions among these drivers. Field measurements can address the overall responses to different changing drivers, but are less capable of quantifying the interactions among them. Currently, a comprehensive assessment of the drivers of ecosystem changes, and the magnitude of their direct and indirect impacts on subarctic ecosystems, is missing. The Torneträsk area, in the Swedish subarctic, has an unrivalled history of environmental observation over 100 years, and is one of the most studied sites in the Arctic. In this study, we summarize and rank the drivers of ecosystem change in the Torneträsk area, and propose research priorities identified, by expert assessment, to improve predictions of ecosystem changes. The research priorities identified include understanding impacts on ecosystems brought on by altered frequency and intensity of winter warming events, evapotranspiration rates, rainfall, duration of snow cover and lake-ice, changed soil moisture, and droughts. This case study can help us understand the ongoing ecosystem changes occurring in the Torneträsk area, and contribute to improve predictions of future ecosystem changes at a larger scale. This understanding will provide the basis for the future mitigation and adaptation plans needed in a changing climate.
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| 9. |
- Aasa, Ulrika, et al.
(författare)
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Normalisation of muscle strength for body size : The role of the function assessed
- 2004
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Ingår i: Journal of Human Movement Studies. - 0306-7297. ; 46:2, s. 105-116
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Tidskriftsartikel (refereegranskat)abstract
- The role of body size has often been neglected in routine tests of muscle strength and movement performance. The aim of the present study was to test the hypothesis that different types of functional movement performance require different normalisations in order to assess muscle strength. Twenty-one right-handed male university students were tested on the following functional movement tasks: vertical jump, standing soccer ball kick, seated medicine ball throw and standing maximal isometric lift. Isokinetic strength of active muscle \, groups was also recorded. The performance of the vertical jump and standing s9ccer ball kick demonstrated stronger relationship with the strength of active muscles normalised for body size, while the performance of the s~ated medicine ball throw and standing maximal Iisometric lift demonstrated stronger relationship with the non- normalised strength. It was concluded that the ability of performing functional movements based on overcoming gravitational and/or inertial resistance of subject's own body (such as keeping certain body postures, or various body movements) should be assessed by the tested muscle strength normalised for body size, while the functional performance based on muscle action performed against external objects (e.g. manual material handling, or lifting heavy objects) should be assessed by the non-normalised muscle strength. The obtained f"mdings proved to be in line with our recently proposed classification of muscle strength and functional movement tests based on the role of body size in the re~orded performance.
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| 10. |
- af Sandeberg, Margareta, et al.
(författare)
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Does school attendance during initial cancer treatment in childhood increase the risk of infection?
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 60:8, s. 1307-1312
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Tidskriftsartikel (refereegranskat)abstract
- Background The present study aimed to investigate the relationship between school attendance and infection requiring antimicrobial treatment in children undergoing treatment for cancer. Procedure A national cohort of children aged 7-16 years undergoing cancer treatment was assessed during two observation periods of 19 days each, 1 month (n=89) and 2.5 months (n=89) poststart of treatment. Children free from infection at start of each observation period were included. Multivariable logistic regression analyses were performed including factors potentially associated with start of antimicrobial treatment. Results Twenty-seven (30%) children started antimicrobial treatment during the first observation period. Factors associated with an increased risk of starting antimicrobial treatment were diagnosed with sarcoma (OR=24.37, P=0.002) or non-Hodgkin lymphoma (OR=17.57, P=0.025), having neutropenia (OR=5.92, P=0.020) and age less than 13 years (OR=8.54, P=0.014). During the second observation period, when 20 (22%) children started antimicrobial treatment, the probability of starting treatment was increased in children with neutropenia (OR=4.25, P=0.007). There was no statistically significant association between starting treatment for infection and school attendance. Conclusions In this study, children attending school while undergoing cancer treatment did not run a higher risk of starting antimicrobial treatment than children absent from school. However, there is a need for further studies evaluating risk of infections in children with ongoing cancer treatment.
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