| 1. |
- Andersen, Hans Estrup, et al.
(författare)
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Identifying Hot Spots of Agricultural Nitrogen Loss Within the Baltic Sea Drainage Basin
- 2016
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Ingår i: Water, Air and Soil Pollution. - : Springer Science and Business Media LLC. - 0049-6979 .- 1573-2932. ; 227:1
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Tidskriftsartikel (refereegranskat)abstract
- Agricultural management practices are among the major drivers of agricultural nitrogen (N) loss. Legislation and management incentives for measures to mitigate N loss should eventually be carried out at the individual farm level. Consequently, an appropriate scale to simulate N loss from a scientific perspective should be at the farm scale. A data set of more than 4000 agricultural fields with combinations of climate, soils and agricultural management which overall describes the variations found in the Baltic Sea drainage basin was constructed. The soil-vegetation-atmosphere model Daisy (Hansen et al. 2012) was used to simulate N loss from the root zone of all agricultural fields in the data set. From the data set of Daisy simulations, we identified the most important drivers for N loss by multiple regression statistics and developed a statistical N loss model. By applying this model to a basin-wide data set on climate, soils and agricultural management at a 10 x 10 km scale, we were able to calculate root-zone N losses from the entire Baltic Sea drainage basin and identify N loss hot spots in a consistent way and at a level of detail not hitherto seen for this area. Further, the root-zone N loss model was coupled to estimates of nitrogen retention in catchments separated into retention in groundwater and retention in surface waters allowing calculation of the coastal N loading.
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| 2. |
- Blauenfeldt, Rolf Ankerlund, et al.
(författare)
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Remote Ischemic Conditioning for Acute Stroke : The RESIST Randomized Clinical Trial
- 2023
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Ingår i: JAMA. - 0098-7484. ; 330:13, s. 1236-1246
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke. Objective: To evaluate the effect of RIC when initiated in the prehospital setting and continued in the hospital on functional outcome in patients with acute stroke. Design, Setting, and Participants: This was a randomized clinical trial conducted at 4 stroke centers in Denmark that included 1500 patients with prehospital stroke symptoms for less than 4 hours (enrolled March 16, 2018, to November 11, 2022; final follow-up, February 3, 2023). Intervention: The intervention was delivered using an inflatable cuff on 1 upper extremity (RIC cuff pressure, ≤200 mm Hg [n = 749] and sham cuff pressure, 20 mm Hg [n = 751]). Each treatment application consisted of 5 cycles of 5 minutes of cuff inflation followed by 5 minutes of cuff deflation. Treatment was started in the ambulance and repeated at least once in the hospital and then twice daily for 7 days among a subset of participants. Main Outcomes and Measures: The primary end point was improvement in functional outcome measured as a shift across the modified Rankin Scale (mRS) score (range, 0 [no symptoms] to 6 [death]) at 90 days in the target population with a final diagnosis of ischemic or hemorrhagic stroke. Results: Among 1500 patients who were randomized (median age, 71 years; 591 women [41%]), 1433 (96%) completed the trial. Of these, 149 patients (10%) were diagnosed with transient ischemic attack and 382 (27%) with a stroke mimic. In the remaining 902 patients with a target diagnosis of stroke (737 [82%] with ischemic stroke and 165 [18%] with intracerebral hemorrhage), 436 underwent RIC and 466 sham treatment. The median mRS score at 90 days was 2 (IQR, 1-3) in the RIC group and 1 (IQR, 1-3) in the sham group. RIC treatment was not significantly associated with improved functional outcome at 90 days (odds ratio [OR], 0.95; 95% CI, 0.75 to 1.20, P =.67; absolute difference in median mRS score, -1; -1.7 to -0.25). In all randomized patients, there were no significant differences in the number of serious adverse events: 169 patients (23.7%) in the RIC group with 1 or more serious adverse events vs 175 patients (24.3%) in the sham group (OR, 0.97; 95% CI, 0.85 to 1.11; P =.68). Upper extremity pain during treatment and/or skin petechia occurred in 54 (7.2%) in the RIC group and 11 (1.5%) in the sham group. Conclusions and Relevance: RIC initiated in the prehospital setting and continued in the hospital did not significantly improve functional outcome at 90 days in patients with acute stroke. Trial Registration: ClinicalTrials.gov Identifier: NCT03481777.
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| 3. |
- Semb, Gunvor, et al.
(författare)
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A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.
- 2017
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 2-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.TRIAL REGISTRATION: ISRCTN29932826.
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| 4. |
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| 5. |
- Andersen, Christen L., et al.
(författare)
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A phase II study of vorinostat (MK-0683) in patients with polycythaemia vera and essential thrombocythaemia
- 2013
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Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 162:4, s. 498-508
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Tidskriftsartikel (refereegranskat)abstract
- Inhibition of histone deacetylases may be an important target in patients with myeloproliferative neoplasms. This investigator-initiated, non-randomized, open-label phase II multi-centre study included 63 patients (19 essential thrombocythaemia, 44 polycythaemia vera) from 15 centres. The primary objective was to evaluate if vorinostat was followed by a decline in clonal myeloproliferation as defined by European Leukaemia Net. Thirty patients (48%) completed the intervention period (24 weeks of therapy). An intention-to-treat response rate of 35% was identified. Pruritus was resolved [19% to 0% (P=0.06)] and the prevalence of splenomegaly was lowered from 50% to 27% (P=0.03). Sixty-five per cent of the patients experienced a decrease in JAK2 V617F allele burden (P=0.006). Thirty-three patients (52% of patients) discontinued study drug before end of intervention due to adverse events (28 patients) or lack of response (5 patients). In conclusion, vorinostat showed effectiveness by normalizing elevated leucocyte and platelet counts, resolving pruritus and significantly reducing splenomegaly. However, vorinostat was associated with significant side effects resulting in a high discontinuation rate. A lower dose of vorinostat in combination with conventional and/or novel targeted therapies may be warranted in future studies.
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| 6. |
- Andersen, Christen Lykkegaard, et al.
(författare)
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Circulating YKL-40 in patients with essential thrombocythemia and polycythemia vera treated with the novel histone deacetylase inhibitor vorinostat
- 2014
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Ingår i: Leukemia Research. - : Elsevier. - 0145-2126 .- 1873-5835. ; 38:7, s. 816-821
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Tidskriftsartikel (refereegranskat)abstract
- YKL-40 regulates vascular endothelial growth factors and induces tumor proliferation. We investigated YKL-40 before and after treatment with vorinostat in 31 polycythemia vera (PV) and 16 essential thrombocythemia (ET) patients. Baseline PV patient levels were 2 times higher than in healthy controls (P<0.0001) and 1.7 times higher than in ET (P = 0.02). A significant correlation between YKL-40 at baseline and neutrophils, CRP, LDH, JAK2V617F and platelets in PV patients was observed, as well as a significantly greater reduction of YKL-40 levels in PV patients responding to therapy. YKL-40 might be a novel marker of disease burden and progression in myeloproliferative neoplasms.
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| 7. |
- Czajkowski, Mikołaj, et al.
(författare)
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Increasing the cost-effectiveness of nutrient reduction targets using different spatial scales
- 2021
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 790
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we investigate the potential gains in cost-effectiveness from changing the spatial scale at which nutrient reduction targets are set for the Baltic Sea, with particular focus on nutrient loadings from agriculture. The costs of achieving loading reductions are compared across five levels of spatial scale, namely the entire Baltic Sea; the marine basin level; the country level; the watershed level; and the grid square level. A novel highly-disaggregated model, which represents decreases in agricultural profits, changes in root zone N concentrations and transport to the Baltic Sea is used. The model includes 14 Baltic Sea marine basins, 14 countries, 117 watersheds and 19,023 10-by-10 km grid squares. The main result which emerges is that there is a large variation in the total cost of the program depending on the spatial scale of targeting: for example, for a 40% reduction in loads, the costs of a Baltic Sea-wide target is nearly three times lower than targets set at the smallest level of spatial scale (grid square). These results have important implications for both domestic and international policy design for achieving water quality improvements where non-point pollution is a key stressor of water quality.
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| 8. |
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| 9. |
- Saarela, Svetlana, et al.
(författare)
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Comparing frameworks for biomass prediction for the Global Ecosystem Dynamics Investigation
- 2022
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Ingår i: Remote Sensing of Environment. - : Elsevier. - 0034-4257 .- 1879-0704. ; 278
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Tidskriftsartikel (refereegranskat)abstract
- NASA's Global Ecosystem Dynamics Investigation (GEDI) mission offers data for temperate and pan-tropical estimates of aboveground forest biomass (AGB). The spaceborne, full-waveform LiDAR from GEDI provides sample footprints of canopy structure, expected to cover about 4% of the land area following two years of operation. Several options are available for estimating AGB at different geographical scales. Using GEDI sample data alone, gridded biomass predictions are based on hybrid inference which correctly propagates errors due to the modeling and accounts for sampling variability, but this method requires at least two GEDI tracks in the area of interest. However, there are significant gaps in GEDI coverage and in some areas of interest GEDI data may need to be combined with other wall-to-wall remotely sensed (RS) data, such as those from multispectral or SAR sensors. In these cases, we may employ hierarchical model-based (HMB) inference that correctly considers the additional model errors that result from relating GEDI data to the wall-to-wall data. Where predictions are possible from both hybrid and HMB inference the question arises which framework to choose, and under what circumstances? In this paper, we make progress towards answering these questions by comparing the performance of the two prediction frameworks under conditions relevant for the GEDI mission. Conventional model-based (MB) inference with wall-to-wall TanDEM-X data was applied as a baseline prediction framework, which does not involve GEDI data at all. An important feature of the study was the comparison of AGB predictors in terms of both standard deviation (SD: the square root of variance) and root mean square error (RMSE: the square root of mean square error – MSE). Since, in model-based inference, the true AGB in an area of interest is a random variable, comparisons of the performance of prediction frameworks should preferably be made in terms of their RMSEs. However, in practice only the SD can be estimated based on empirical survey data, and thus it is important also to study whether or not the difference between the two uncertainty measures is small or large under conditions relevant for the GEDI mission. Our main findings were that: (i) hybrid and HMB prediction typically resulted in smaller RMSEs than conventional MB prediction although the difference between the three frameworks in terms of SD often was small; (ii) in most cases the difference between hybrid and HMB inference was small in terms of both RMSE and SD; (iii) the RMSEs for all frameworks was substantially larger than the SDs in small study areas whereas the two uncertainty measures were similar in large study areas, and; (iv) spatial autocorrelation of model residual errors had a large effect on the RMSEs of AGB predictors, especially in small study areas. We conclude that hybrid inference is suitable in most GEDI applications for AGB assessment, due to its simplicity compared to HMB inference. However, where GEDI data are sparse HMB inference should be preferred.
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| 10. |
- Wulff, Fredrik, et al.
(författare)
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Reduction of Baltic Sea Nutrient Inputs and Allocation of Abatement Costs Within the Baltic Sea Catchment
- 2014
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 43:1, s. 11-25
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Tidskriftsartikel (refereegranskat)abstract
- The Baltic Sea Action Plan (BSAP) requires tools to simulate effects and costs of various nutrient abatement strategies. Hierarchically connected databases and models of the entire catchment have been created to allow decision makers to view scenarios via the decision support system NEST. Increased intensity in agriculture in transient countries would result in increased nutrient loads to the Baltic Sea, particularly from Poland, the Baltic States, and Russia. Nutrient retentions are high, which means that the nutrient reduction goals of 135 000 tons N and 15 000 tons P, as formulated in the BSAP from 2007, correspond to a reduction in nutrient loadings to watersheds by 675 000 tons N and 158 000 tons P. A cost-minimization model was used to allocate nutrient reductions to measures and countries where the costs for reducing loads are low. The minimum annual cost to meet BSAP basin targets is estimated to 4.7 billion a,not sign.
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