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  • Nilsson, Johan F., et al. (författare)
  • Predictability of food supply modulates nocturnal hypothermia in a small passerine : Food supply and nocturnal hypothermia
  • 2020
  • Ingår i: Biology letters. - : Royal Society Publishing. - 1744-9561 .- 1744-957X. ; 16:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The combination of short days and long cold winter nights, in temperate regions, presents a major challenge for small diurnal birds. Small birds regularly employ heterothermy and enter rest-phase hypothermia during winter nights to conserve energy. However, we know little about how environmental conditions, such as food availability, shape these strategies. We experimentally manipulated food availability in winter to free-living great tits Parus major. A 'predictable' and constant food supply was provided to birds in one area of a forest, while birds in another area did not have access to a reliable supplementary food source. We found that predictability of food affected the extent of nocturnal hypothermia, but the response differed between the sexes. Whereas male nocturnal body temperature was similar regardless of food availability, females exposed to a naturally 'unpredictable' food supply entered deeper hypothermia at night, compared with females that had access to predictable food and compared with males in both treatment groups. We suggest that this response is likely a consequence of dominance, and subdominant females subject to unpredictable food resources cannot maintain sufficient energy intake, resulting in a higher demand for energy conservation at night.
  • Cronholm, F., et al. (författare)
  • The fracture predictive ability of a musculoskeletal composite score in old men - data from the MrOs Sweden study
  • 2019
  • Ingår i: BMC Geriatr. - : BMC. - 1471-2318. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundDetection of high-risk individuals for fractures are needed. This study assessed whether level of physical activity (PA) and a musculoskeletal composite score could be used as fracture predictive tools, and if the score could predict fractures better than areal bone mineral density (aBMD).MethodsMrOs Sweden is a prospective population-based observational study that at baseline included 3014 men aged 69-81years. We assessed femoral neck bone mineral content (BMC), bone area, aBMD and total body lean mass by dual energy X-ray absorptiometry, calcaneal speed of sound by quantitative ultrasound and hand grip strength by a handheld dynamometer. PA was assessed by the Physical Activity Scale for the Elderly (PASE) questionnaire. We followed the participants until the date of first fracture, death or relocation (median 9.6years). A musculoskeletal composite score was calculated as mean Z-score of the five measured traits. A Cox proportional hazards model was used to analyze the association between the musculoskeletal traits, the composite score and incident fractures (yes/no) during the follow-up period. Data are presented as hazard ratios (HR) with 95% confidence intervals (95% CI) for fracture for a+1 standard deviation (SD) change (+1 Z-score) in the various musculoskeletal traits as well as the composite score. We used a linear regression model to estimate the association between level of PA, measured as PASE-score and the different musculoskeletal traits as well as the composite score.ResultsA+1 SD higher composite score was associated with an incident fracture HR of 0.61 (0.54, 0.69), however not being superior to aBMD in fracture prediction. A+1 SD higher PASE-score was associated with both a higher composite score and lower fracture incidence (HR 0.83 (0.76, 0.90)).ConclusionsThe composite score was similar to femoral neck aBMD in predicting fractures, and also low PA predicted fractures. This highlights the need of randomized controlled trials to evaluate if PA could be used as a fracture preventive strategy.
  • Ekberg, Marie, et al. (författare)
  • Hospital admission rates among men and women with symptoms of chronic bronchitis and airflow limitation corresponding to the GOLD stages of chronic obstructive pulmonary disease - A population-based study
  • 2008
  • Ingår i: Respiratory Medicine. - : Elsevier. - 1532-3064 .- 0954-6111. ; 102:1, s. 109-120
  • Tidskriftsartikel (refereegranskat)abstract
    • Chronic obstructive pulmonary disease is a major cause of increased morbidity and mortality. The aim of this study was to investigate hospital admission rates among individuals with symptoms of chronic bronchitis and among those with airflow limitation corresponding to GOLD stages 1-4. Method: Between 1974 and 1992, 22 044 middle-aged individuals participated in a health screening, which included spirometry (without broncho-dilation), as well as recording of respiratory symptoms and smoking habits. Information on hospital admissions until 31 December 2002 was obtained from local and national registers. The hospital admission rates due to all causes, obstructive Lung disease and cardiovascular disease were analysed among individuals with symptoms of chronic bronchitis and among those with airflow limitation corresponding to GOLD stages 1-4 using ordinal regression with adjustment for age and with individuals with normal lung function and without symptoms of chronic bronchitis as reference group. Results: Symptoms of chronic bronchitis and GOLD stages 1-4 showed increased hospital admission rates (hospital admission rates due to obstructive lung disease excluded) among smokers of both genders. Furthermore, symptoms of chronic bronchitis showed increased hospital admission rates due to obstructive lung disease among smoking women. There were also increased hospital admission rates due to obstructive lung disease among smokers of GOLD stages 1-4 and increased hospital admission rates due to cardiovascular disease among female smokers of GOLD stage 2. Conclusion: Among smokers, symptoms of chronic bronchitis as well airflow limitation corresponding to GOLD stages 1-4 conveyed a substantial morbidity with increased hospital admission rates due to all causes. The burden of disease is most likely underestimated among individuals with symptoms of chronic bronchitis and chronic obstructive pulmonary disease.
  • Ekberg, Marie, et al. (författare)
  • Mortality in GOLD stages of COPD and its dependence on symptoms of chronic bronchitis
  • 2005
  • Ingår i: Respiratory Research. - : BioMed Central (BMC). - 1465-9921. ; 6, s. 98-106
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The GOLD classification of COPD severity introduces a stage 0 ( at risk) comprising individuals with productive cough and normal lung function. The aims of this study were to investigate total mortality risks in GOLD stages 0 - 4 with special focus on stage 0, and furthermore to assess the influence of symptoms of chronic bronchitis on mortality risks in GOLD stages 1 - 4. Method: Between 1974 and 1992, a total of 22 044 middle-aged individuals participated in a health screening, which included a spirometry as well as recording of respiratory symptoms and smoking habits. Individuals with comorbidity at baseline ( diabetes, stroke, cancer, angina pectoris, or heart infarction) were excluded from the analyses. Hazard ratios (HR 95% CI) of total mortality were analyzed in GOLD stages 0 - 4 with individuals with normal lung function and without symptoms of chronic bronchitis as a reference group. HR: s in smoking individuals with symptoms of chronic bronchitis within the stages 1 - 4 were calculated with individuals with the same GOLD stage but without symptoms of chronic bronchitis as reference. Results: The number of deaths was 3674 for men and 832 for women based on 352 324 and 150 050 person-years respectively. The proportion of smokers among men was 50% and among women 40%. Self reported comorbidity was present in 4.6% of the men and 6.6% of the women. Among smoking men, Stage 0 was associated with an increased mortality risk, HR; 1.65 ( 1.32 - 2.08), of similar magnitude as in stage 2, HR; 1.41 ( 1.31 - 1.70). The hazard ratio in stage 0 was significantly higher than in stage 1 HR; 1.13 ( 0.98 - 1.29). Among male smokers with stage 1; HR: 2.04 ( 1.34 - 3.11), and among female smokers with stage 2 disease; HR: 3.16 ( 1.38 - 7.23), increased HR: s were found in individuals with symptoms of chronic bronchitis as compared to those without symptoms of chronic bronchitis. Conclusion: Symptoms fulfilling the definition of chronic bronchitis were associated with an increased mortality risk among male smokers with normal pulmonary function ( stage 0) and also with an increased risk of death among smoking individuals with mild to moderate COPD ( stage 1 and 2).
  • Moller, Anders Pape, et al. (författare)
  • Clutch-size variation in Western Palaearctic secondary hole-nesting passerine birds in relation to nest box design
  • 2014
  • Ingår i: Methods in Ecology and Evolution. - : John Wiley and Sons. - 2041-210X. ; 5:4, s. 353-362
  • Tidskriftsartikel (refereegranskat)abstract
    • Secondary hole-nesting birds that do not construct nest holes themselves and hence regularly breed in nest boxes constitute important model systems for field studies in many biological disciplines with hundreds of scientists and amateurs involved. Those research groups are spread over wide geographic areas that experience considerable variation in environmental conditions, and researchers provide nest boxes of varying designs that may inadvertently introduce spatial and temporal variation in reproductive parameters. We quantified the relationship between mean clutch size and nest box size and material after controlling for a range of environmental variables in four of the most widely used model species in the Western Palaearctic: great tit Parus major, blue tit Cyanistes caeruleus, pied flycatcher Ficedula hypoleuca and collared flycatcher F.albicollis from 365 populations and 79610 clutches. Nest floor area and nest box material varied non-randomly across latitudes and longitudes, showing that scientists did not adopt a random box design. Clutch size increased with nest floor area in great tits, but not in blue tits and flycatchers. Clutch size of blue tits was larger in wooden than in concrete nest boxes. These findings demonstrate that the size of nest boxes and material used to construct nest boxes can differentially affect clutch size in different species. The findings also suggest that the nest box design may affect not only focal species, but also indirectly other species through the effects of nest box design on productivity and therefore potentially population density and hence interspecific competition.
  • Moller, Anders P., et al. (författare)
  • Variation in clutch size in relation to nest size in birds
  • 2014
  • Ingår i: Ecology and Evolution. - : Wiley-Blackwell. - 2045-7758. ; 4:18, s. 3583-3595
  • Tidskriftsartikel (refereegranskat)abstract
    • Nests are structures built to support and protect eggs and/or offspring from predators, parasites, and adverse weather conditions. Nests are mainly constructed prior to egg laying, meaning that parent birds must make decisions about nest site choice and nest building behavior before the start of egg-laying. Parent birds should be selected to choose nest sites and to build optimally sized nests, yet our current understanding of clutch size-nest size relationships is limited to small-scale studies performed over short time periods. Here, we quantified the relationship between clutch size and nest size, using an exhaustive database of 116 slope estimates based on 17,472 nests of 21 species of hole and non-hole-nesting birds. There was a significant, positive relationship between clutch size and the base area of the nest box or the nest, and this relationship did not differ significantly between open nesting and hole-nesting species. The slope of the relationship showed significant intraspecific and interspecific heterogeneity among four species of secondary hole-nesting species, but also among all 116 slope estimates. The estimated relationship between clutch size and nest box base area in study sites with more than a single size of nest box was not significantly different from the relationship using studies with only a single size of nest box. The slope of the relationship between clutch size and nest base area in different species of birds was significantly negatively related to minimum base area, and less so to maximum base area in a given study. These findings are consistent with the hypothesis that bird species have a general reaction norm reflecting the relationship between nest size and clutch size. Further, they suggest that scientists may influence the clutch size decisions of hole-nesting birds through the provisioning of nest boxes of varying sizes.
  • Nilsson, Martin P., et al. (författare)
  • High patient satisfaction with a simplified BRCA1/2 testing procedure : long-term results of a prospective study
  • 2019
  • Ingår i: Breast Cancer Research and Treatment. - : Springer. - 0167-6806 .- 1573-7217. ; 173:2, s. 313-318
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: In the BRCAsearch study, unselected breast cancer patients were prospectively offered germline BRCA1/2 mutation testing through a simplified testing procedure. The purpose of the present study was to evaluate satisfaction with the BRCAsearch testing procedure and, furthermore, to report on uptake rates of prophylactic surgeries among mutation carriers. Methods: Pre-test information was provided by a standardized invitation letter instead of in-person genetic counseling. The patients were offered contact with a genetic counselor for telephone genetic counseling if they felt a need for that. Mutation carriers were telephoned and given a time for a face-to-face post-test genetic counseling appointment. Non-carriers were informed about the test result through a letter. One year after the test results were delivered, a study-specific questionnaire was mailed to the study participants who had consented to testing. The response rate was 83.1% (448 of 539). Results: A great majority (96.0%) of the responders were content with the method used for providing information within the study, and 98.7% were content with having pursued genetic testing. 11.1% answered that they would have liked to receive more oral information. In an adjusted logistic regression model, patients with somatic comorbidity (OR 2.56; P = 0.02) and patients born outside of Sweden (OR 3.54; P = 0.01) were more likely, and patients with occupations requiring at least 3 years of university or college education (OR 0.37; P = 0.06) were less likely to wanting to receive more oral information. All 11 mutation carriers attended post-test genetic counseling. At a median follow-up of 2 years, the uptake of prophylactic salpingo-oophorectomy was 100%, and the uptake of prophylactic mastectomy was 55%. Conclusions: Satisfaction with a simplified BRCA1/2 testing procedure was very high. Written pre-test information has now replaced in-person pre-test counseling for breast cancer patients in our health care region.
  • Cagnotto, G., et al. (författare)
  • Abatacept in rheumatoid arthritis: survival on drug, clinical outcomes, and their predictors-data from a large national quality register
  • 2020
  • Ingår i: Arthritis Research & Therapy. - : BioMed Central (BMC). - 1478-6362 .- 1478-6354. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background There are limited data regarding efficacy of abatacept treatment for rheumatoid arthritis (RA) outside clinical trials. Quality registers have been useful for observational studies on tumor necrosis factor inhibition in clinical practice. The aim of this study was to investigate clinical efficacy and tolerability of abatacept in RA, using a national register. Methods RA patients that started abatacept between 2006 and 2017 and were included in the Swedish Rheumatology Quality register (N = 2716) were investigated. Survival on drug was estimated using Kaplan-Meier analysis. The European League Against Rheumatism (EULAR) good response and Health Assessment Questionnaire (HAQ) response (improvement of >= 0.3) rates (LUNDEX corrected for drug survival) at 6 and at 12 months were assessed. Predictors of discontinuation were investigated by Cox regression analyses, and predictors of clinical response by logistic regression. Significance-based backward stepwise selection of variables was used for the final multivariate models. Results There was a significant difference in drug survival by previous biologic disease-modifying antirheumatic drug (bDMARD) exposure (p < 0.001), with longer survival in bionaive patients. Men (hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.74-0.98) and methotrexate users (HR 0.85, 95% CI 0.76-0.95) were less likely to discontinue abatacept, whereas a high pain score predicted discontinuation (HR 1.14 per standard deviation, 95% CI 1.07-1.20). The absence of previous bDMARD exposure, male sex, and a low HAQ score were independently associated with LUNDEX-corrected EULAR good response. The absence of previous bDMARD exposure also predicted LUNDEX-corrected HAQ response. Conclusions In this population-based study of RA, bDMARD naive patients and male patients were more likely to remain on abatacept with a major clinical response.
  • Kherad, Mehrsa, et al. (författare)
  • Risk factors for low back pain and sciatica in elderly men-the MrOS Sweden study
  • 2017
  • Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 46:1, s. 64-71
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: the aim of this study was to identify whether factors beyond anatomical abnormalities are associated with low back pain (LBP) and LBP with sciatica (SCI) in older men. Material and methods: Mister Osteoporosis Sweden includes 3,014 men aged 69-81 years. They answered questionnaires on lifestyle and whether they had experienced LBP and SCI during the preceding 12 months. About 3,007 men answered the back pain (BP) questions, 258 reported BP without specified region. We identified 1,388 with no BP, 1,361 with any LBP (regardless of SCI), 1,074 of those with LBP also indicated if they had experienced LBP (n = 615), LBP+SCI (n = 459).Results: about 49% of those with LBP and 54% of those with LBP+SCI rated their health as poor/very poor (P < 0.001). Men with any LBP to a greater extent than those without BP had poor self-estimated health, depressive symptoms, dizziness, fall tendency, serious comorbidity (diabetes, stroke, coronary heart disease, pulmonary disease and/or cancer) (all P < 0.001), foreign background, were smokers (all P < 0.01), had low physical activity and used walking aids (all P < 0.05). Men with LBP+SCI to a greater extent than those with LBP had lower education, lower self-estimated health, comorbidity, dizziness and used walking aids (all P < 0.001). Conclusions: in older men with LBP and SCI, anatomical abnormalities such as vertebral fractures, metastases, central or lateral spinal stenosis or degenerative conditions may only in part explain prevalent symptoms and disability. Social and lifestyle factors must also be evaluated since they are associated not only with unspecific LBP but also with LBP with SCI.
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