| 1. |
- Sederholm Lawesson, Sofia, 1973-, et al.
(författare)
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Association Between History of Adverse Pregnancy Outcomes and Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography.
- 2023
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Ingår i: JAMA. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 329:5, s. 393-404
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Tidskriftsartikel (refereegranskat)abstract
- Adverse pregnancy outcomes are recognized risk enhancers for cardiovascular disease, but the prevalence of subclinical coronary atherosclerosis after these conditions is unknown.To assess associations between history of adverse pregnancy outcomes and coronary artery disease assessed by coronary computed tomography angiography screening.Cross-sectional study of a population-based cohort of women in Sweden (n=10528) with 1 or more deliveries in 1973 or later, ascertained via the Swedish National Medical Birth Register, who subsequently participated in the Swedish Cardiopulmonary Bioimage Study at age 50 to 65 (median, 57.3) years in 2013-2018. Delivery data were prospectively collected.Adverse pregnancy outcomes, including preeclampsia, gestational hypertension, preterm delivery, small-for-gestational-age infant, and gestational diabetes. The reference category included women with no history of these exposures.Coronary computed tomography angiography indexes, including any coronary atherosclerosis, significant stenosis, noncalcified plaque, segment involvement score of 4 or greater, and coronary artery calcium score greater than 100.A median 29.6 (IQR, 25.0-34.9) years after first registered delivery, 18.9% of women had a history of adverse pregnancy outcomes, with specific pregnancy histories ranging from 1.4% (gestational diabetes) to 9.5% (preterm delivery). The prevalence of any coronary atherosclerosis in women with a history of any adverse pregnancy outcome was 32.1% (95% CI, 30.0%-34.2%), which was significantly higher (prevalence difference, 3.8% [95% CI, 1.6%-6.1%]; prevalence ratio, 1.14 [95% CI, 1.06-1.22]) compared with reference women. History of gestational hypertension and preeclampsia were both significantly associated with higher and similar prevalence of all outcome indexes. For preeclampsia, the highest prevalence difference was observed for any coronary atherosclerosis (prevalence difference, 8.0% [95% CI, 3.7%-12.3%]; prevalence ratio, 1.28 [95% CI, 1.14-1.45]), and the highest prevalence ratio was observed for significant stenosis (prevalence difference, 3.1% [95% CI, 1.1%-5.1%]; prevalence ratio, 2.46 [95% CI, 1.65-3.67]). In adjusted models, odds ratios for preeclampsia ranged from 1.31 (95% CI, 1.07-1.61) for any coronary atherosclerosis to 2.21 (95% CI, 1.42-3.44) for significant stenosis. Similar associations were observed for history of preeclampsia or gestational hypertension among women with low predicted cardiovascular risk.Among Swedish women undergoing coronary computed tomography angiography screening, there was a statistically significant association between history of adverse pregnancy outcomes and image-identified coronary artery disease, including among women estimated to be at low cardiovascular disease risk. Further research is needed to understand the clinical importance of these associations.
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| 2. |
- Svenungsson, Elisabet, et al.
(författare)
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Antiphospholipid antibodies in patients with myocardial infarction with and without obstructive coronary arteries
- 2022
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 291:3, s. 327-337
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent studies demonstrate that prothrombotic antiphospholipid antibodies (aPL) are overrepresented in patients with myocardial infarction (MI) due to coronary artery disease (MICAD). However, it is not known whether aPL differ between the two subsets of MI: MICAD and MI with nonobstructive coronary arteries (MINOCA). Objectives: To determine whether aPL are associated with MINOCA or MICAD, or with hypercoagulability as assessed by activated protein C–protein C inhibitor (APC–PCI) complex. Methods: Well-characterized patients with MINOCA (n = 98), age- and gender-matched patients with MICAD (n = 99), and healthy controls (n = 100) were included in a cross-sectional case–control study. Autoantibodies (IgA/G/M) targeting cardiolipin and β2glycoprotein-I and specific nuclear antigens were analyzed by multiplexed bead technology. The concentration of APC–PCI was determined as a measure of hypercoagulability by an immunofluorometric sandwich assay. Results: Both prevalence and titers of aPL of the IgG isotype (anti-cardiolipin and/or anti-β2glycoprotein-I) were higher in patients with MINOCA and MICAD than in controls. aPL IgG positivity was twice as frequent among patients with MICAD than MINOCA (11% vs. 6%, nonsignificant). We observed no group differences regarding aPL IgA/M or antibodies targeting specific nuclear antigens. Levels of APC–PCI were elevated in aPL IgG-positive compared to aPL IgG-negative MICAD patients. Conclusions: aPL IgG, but not IgA/M, are enriched particularly in patients with MICAD but also in patients with MINOCA, as compared to controls. Interestingly, signs of hypercoagulability—measured by increased levels of the APC–PCI complex—were present in aPL IgG-positive MICAD patients, indicating an association with functional disturbances of the coagulation system.
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| 3. |
- Antona, Jacobo, 1981, et al.
(författare)
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Correlation of Global Head and Brain Tissue Injury Criteria to Experimental Concussion derived from Monkey Head Trauma Experiments
- 2013
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Ingår i: IRCOBI Conference. - 2235-3151. ; :IRC-13-55, s. 509-522
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Konferensbidrag (refereegranskat)abstract
- A series of 24 frontal head traumatic impacts on macaques carried out in the past were simulatedwith a validated finite element model of the specimens. From these simulations, brain tissue response and headaccelerations were extracted. Based on the accelerations, global head injury criteria were calculated.Correlation between the brain tissue mechanical parameters, the global head injury criteria and the concussionscored in the experiments were analyzed. Based on this analysis, global head injury criteria that best correlatewith concussion score for frontal impacts were identified and injury risk functions for brain tissue that can beused for human FE models are proposed. In addition, the new results were compared to a previous study basedon simulations of 19 occipital head impacts from the same data source.
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| 4. |
- Anund, Anna, 1964-, et al.
(författare)
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Hantverkares och omsorgspersonals resor i tjänsten : Fokus på arbetsmiljö och säkerhet
- 2024
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med föreliggande studie var att öka kunskapen om arbetsmiljö, hälsa och trafiksäkerhet för hantverkare och personal inom omsorgen (hemtjänst och hemsjukvård) i samband med resor till och från uppdrag inom tjänsten.I studien har den dagliga verksamheten kartlagts dels med objektiva mätningar av körsträckor, tid på dygnet, körtider, hastigheter, lastsäkring etcetera (delstudie A), dels utifrån subjektiva upplevelser (enkäter och djupintervjuer; delstudie B respektive C).Resultaten visar på att hantverkare och omsorgspersonal hade olika förutsättningar avseende säkra resor i samband med uppdrag inom tjänsten.Hantverkare reste längre, men hade färre resor per dag och överskred hastighetsgränserna oftare jämfört med omsorgspersonalen. Omsorgspersonalen hade högre subjektiv sömnighet och stress vid uppvaknandet än hantverkarna. Det var dock ingen skillnad i antal personer som rapporterade höga värden på sömnighet och stress under arbetsdagen. Av hantverkarna var det 30 procent som rapporterade att de led av måttliga eller stora besvär av värk och muskelspänningar, det var 30 procent som hade ont i nedre delen av ryggen. Bland omsorgspersonalen var det 49 procent som led av värk och muskelspänningar och 46 procent som led av värk i nedre delen av ryggen. Vidare var det 37 procent av hantverkarna som rapporterade att de fick otillräckligt med sömn, motsvarande siffra för omsorgen var 58 procent. Av hantverkarnas bilar var det totalt 64 procent som hade förutsättningar för säker förankring. De cyklar som användes i omsorgen hade brister avseende reflexer, bromsar etcetera. Det var endast 30 procent av de som cyklade som instämde i att de ganska eller mycket ofta använder hjälm.Med en utgångspunkt i resultaten från de tre delstudierna har vi formulerat ett antal rekommendationer. Dessa omfattar områden: Stärkt kompetens, Cyklar/el-cyklar; inköp och underhåll, Motorfordon; inköp och utrustning, Lastning/förankring samt Förtydligat arbetsmiljöansvar. Dessutom har några ytterligare områden för fortsatt forskning identifierats.
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| 5. |
- Arbogast, Kristy B, et al.
(författare)
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Child Occupant Protection: Latest Knowledge and Future Opportunities – Results of a 2015 Workshop in Gothenburg, Sweden
- 2015
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Ingår i: 13th International Conference on Protection of children in cars, December 3 – 4, Munich, Germany.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Child occupant protection research remains a critical need for industry, academia, government and safety advocacy organizations. While reductions in fatalities and serious injuries have been achieved, motor vehicle crashes remain a leading cause of death and disability for children and adolescents and as a result, represent a public health priority.To facilitate international coordination and sharing of knowledge around this topic, the fourth biennial international workshop on Child Occupant Protection was convened in September 2015, bringing together worldwide leaders in the fields of child occupant protection, biomechanics, and auto safety to critically review the state-of-knowledge in the field and identify high-priority research topics and strategize toward their implementation.Summaries of previous workshops were presented at the 2011 and 2013 Protection of Children in Cars Conferences. The following describes the recommendations that emanated from the 2015 meeting.
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| 6. |
- Brindefalk, B., et al.
(författare)
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Bacterial composition in Swedish raw drinking water reveals three major interacting ubiquitous metacommunities
- 2022
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Ingår i: Microbiologyopen. - : Wiley. - 2045-8827. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- Background Surface raw water used as a source for drinking water production is a critical resource, sensitive to contamination. We conducted a study on Swedish raw water sources, aiming to identify mutually co-occurring metacommunities of bacteria, and environmental factors driving such patterns. Methods The water sources were different regarding nutrient composition, water quality, and climate characteristics, and displayed various degrees of anthropogenic impact. Water inlet samples were collected at six drinking water treatment plants over 3 years, totaling 230 samples. The bacterial communities of DNA sequenced samples (n = 175), obtained by 16S metabarcoding, were analyzed using a joint model for taxa abundance. Results Two major groups of well-defined metacommunities of microorganisms were identified, in addition to a third, less distinct, and taxonomically more diverse group. These three metacommunities showed various associations to the measured environmental data. Predictions for the well-defined metacommunities revealed differing sets of favored metabolic pathways and life strategies. In one community, taxa with methanogenic metabolism were common, while a second community was dominated by taxa with carbohydrate and lipid-focused metabolism. Conclusion The identification of ubiquitous persistent co-occurring bacterial metacommunities in freshwater habitats could potentially facilitate microbial source tracking analysis of contamination issues in freshwater sources.
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| 7. |
- Brolin, Karin, 1974, et al.
(författare)
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A prestudy of the potential of using finite element analysis for understanding horse accidents
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This prestudy is an investigation into the potential of using the THUMS [5] model and LS-Dyna [6] simulations to understand the risk of thorax injury in horse related accidents such as horse kicks, tramples, falls from horse backs or rotational falls. A simple model of a security vest was also developed for the THUMS model, to facilitate injury risk comparisons with and without the vest. The severity of thorax injuries was quantified by measuring local stresses and strains in the cortical bone of the ribs, as well as the total deformation of the thorax, measured with Dmax and DcTHOR [2]. This prestudy attempt to answer five questions:•What is the worst location on the chest to be trampled by a horse with respect to rib fractures?•How does the stiffness of the ground compound affect the risk of rib fractures when trampled by a horse?•How does the risk of thorax injuries vary when falling off a horseback in different angles?•How does the momentum of a horse kick affect the risk of thorax injury on the THUMS model with and without a protective vest?•How can a rotational fall be modelled and how severe is the injury outcome?Simulations were set up in LS-Dyna with the THUMS model representing the human body with different environments built up around it representing the scenarios in the five questions. The structure of the report follows the five questions through both the method and results sections.
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| 8. |
- Brolin, Karin, 1974, et al.
(författare)
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Active Child Models for Traffic Safety Research Interim Report 2, October 2013
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The project Active Child Models for Traffic Safety Research is funded by Folksams Forskningsstiftelse. The overall project aim is to increase the safety of child car occupants and thereby reduce the number of traffic induced injuries in 3 to 12 year-old children. The specific aim is to create a computer model of a child that includes active musculature. Based on literature review of child numerical models it was decided to proceed with child multi body models in the MADYMO code (TASS, Rijswijk, the Netherlands). The 6 and 10 year-old child facet models, the Q6, Q10 and Hybrid III 6 year-old ATD models were compared regarding kinematics to experimental data with child volunteers in 1 g braking and steering events. The ATD models did not represent the experimental ATD response. The child facet models represented the child volunteers for about 3-400 ms of the events, and after that behaved cadaver like with much larger head and sternum displacement compared to the volunteers. Then, the child facet model representing the 6 year-old child was chosen to implement muscle activity. Muscle activity was represented by an active spine that applied torques at each vertebral joint in response to joint angle changes in two directions: flexion-extension motions and lateral bending. A partial, integrative and derivative controller governed with input from angular sensors controlled torque actuators. The controller gains were based on adult data and scaled by 50% for a first version of the active child model. Then, an optimization approach was adopted to tune the control gains in the lumbar, thoracic and cervical spine such that head and sternum kinematics would correlate to the mean values from the volunteer braking and steering experiments. The first version of the active child model had a significantly improved biofidelity compared to the original facet model, with shape and magnitude of head and sternum displacements similar to the volunteer data. The optimization created non biofidelic gain combinations, although providing important input to future work. It is necessary to perform a reanalyses of the experimental data in order to have data for powerful performance criteria in future optimizations. Future work is needed to improve the optimization and provide controller gains based on child volunteer data, rather than scaled adult data. Then, the tuned active child model has to be validated to new experimental data sets. A new steering and braking experiment with approximately 1 g acceleration loading was performed during 2013 and will provide a good validation data set. Also, there is a data set with child volunteers in sled test of approximately 4 g that can be used. Then, the active model is suitable to perform parameters studies of how child restraints design, emergency manoeuver characteristics and child posture influences the safety of children in the rear seat.
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| 9. |
- Brolin, Karin, 1974, et al.
(författare)
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Active Spine Modeling Representing a 6 Year-Old Child
- 2014
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Ingår i: 7th World Congress of Biomechanics.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In a car crash, properly restrained forward facing children may sustain head injuries due to contact with the car interior. Emergency events such as braking and steering will influence the kinematics of the child, thereby affecting the child’s interaction with the restraint systems. Volunteer experiments (Stockman et al. 2013) have shown that children around six years of age, properly restrained on a booster cushion, may slip out of the shoulder belt during a 1g emergency event, while older children can maintain their posture better. A numerical human body model of the 6 year-old would be a valuable tool to study and improve the performance of restraint systems in the pre-crash phase. Compared to a crash, an emergency event typically has low g and long duration loading; hence, the muscle activity will influence the kinematics of the child. Therefore, the aim of this work is to develop an active 6 year-old human body model.The 6 year-old facet occupant multi body model in the MADYMO code (TASS, Rijswijk, the Netherlands) was selected. The spine is composed of rigid vertebral bodies connected with spherical joints. Muscle activity was implemented by applying torques at each vertebral joint for flexion-extension and lateral bending. The torque actuators were controlled by proportional, integrative and derivative controllers comparing the current joint angles to an initial posture reference value. The controller gains were based on adult data and scaled by 50% for a first version of the active child model. The resulting active 6 year-old model was used to simulate the volunteer experiments by Stockman et al. 2013. The model was seated on a booster cushion and loaded with the average experimental pulse. The first version of the active child model had a significantly improved biofidelity compared to the original facet model, with shape and magnitude of displacements similar to the volunteer data, see Figure.It is concluded that the first version active 6 year-old model can reproduce this specific emergency event. Future work should focus on controller gain optimization and further validation.
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| 10. |
- Brolin, Karin, 1974, et al.
(författare)
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Aiming for an average female virtual human body model for seat performance assessment in rear-end impacts
- 2015
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Ingår i: The 24th ESV Conference Proceedings.
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Konferensbidrag (refereegranskat)abstract
- The female part of the population suffers more Whiplash Associated Disorders (WAD) in car crashes than males. Several studies have illustrated the need to consider the female population when developing and assessing the WAD prevention performance of advanced restraint systems in rear-end collisions. Presently only one crash test dummy is available, the average sized male BioRID. Recently a virtual dummy model of an average female, EvaRID, was developed and used in rear impact simulations. The results stressed the need for models representing the female part of the population, as well. Virtual crash simulations have become essential in traffic safety and with models of both an average male and female, further steps in addressing improved assessment of WAD prevention can be taken. The present paper presents a starting point of research aiming to develop an open-source average female Finite Element (FE) model with an anatomically detailed cervical spine. This paper provides a review of the literature to identify gender specific neck biomechanics and anatomical differences, followed by a review of published FE models of the cervical spine. Data on vertebral body dimensions (height, width, depth, spinal canal diameter, facet joint angles) have been compiled from biomechanical literature. Significant gender differences exist for the vertebral body depth and width, the spinal curvature in the seated posture, and the spinal stiffness and range of motion. All have the potential to influence the outcome of an impact and should be accounted for in the development of WAD prevention. The review of FE models of the cervical spine presented 17 models based on male geometry but only one model scaled to represent a female. An overview of the models are given with respect to the solver, geometry source, number of elements, and implementation of the facet joints, ligaments, and muscles. It is recommended that an average female model is developed with focus on; 1) the shape of the female vertebral body, especially the depth and width that provides less support area than for males,2) defining the spinal curvature representative of seated female volunteers who generally display less lordosis than males, 3) the dimensions of the spinal ligaments, rather than the material properties, to capture the larger range of motion and less spinal stiffness of female subjects compared to males, and validation to female volunteers and PMHS tests for range of motion, while failure prediction seem less gender sensitive.
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