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- Sperber, A. D., et al.
(författare)
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Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life
- 2022
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier BV. - 1542-3565. ; 20:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Conditions such as irritable bowel syndrome (IBS), functional dyspepsia, and functional constipation are among the prevalent gastrointestinal (GI) disorders classified as disorders of gutbrain interaction (DGBI), which can adversely affect the lives of sufferers. This study aimed to assess the degree and consequences of overlapping DGBI in a large population-based global scale. METHODS: Internet survey data from 54,127 adults (49.1% women) in 26 countries were analyzed by 4 GI anatomic regions (esophageal, gastroduodenal, bowel, and anorectal). The number of DGBIaffected GI regions was assessed, including associations with sex, age, disease severity, quality of life, psychosocial variables, and health care utilization. RESULTS: A total of 40.3% of surveyed individuals met Rome IV criteria for a DGBI. The percentages with 1-4 DGBI-affected GI regions were 68.3%, 22.3%, 7.1%, and 2.3%, respectively. The IBS symptom severity score increased significantly from 1 (207.6) to 4 (291.6) regions, as did nonGI symptom reporting (somatization), anxiety and depression, concerns and embarrassment about bowel function, doctor visits, medications, and abdominal surgeries (all P <.0001). Quality of life decreased with increasing number of DGBI regions (P <.0001). In a logistic mixed model, non-GI symptoms (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.08-1.10), being very vs not concerned (OR, 2.55; 95% CI, 2.27-2.90), being very vs not embarrassed about bowel function (OR, 1.20; 95% CI, 1.08-1.33), and mean number of doctor visits (OR, 1.23; 95% CI, 1.115-1.32) were most strongly associated with number of DGBI regions. CONCLUSIONS: DGBI in multiple anatomic GI regions is associated with increased psychological comorbidity, health care utilization, and IBS severity. Physician awareness of overlap could improve quality of care, prevent unnecessary interventions, and yield more positive health outcomes.
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| 3. |
- Freud, Lindsay R., et al.
(författare)
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Prenatal vs postnatal diagnosis of 22q11.2 deletion syndrome: cardiac and noncardiac outcomes through 1 year of age
- 2024
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Ingår i: American Journal of Obstetrics and Gynecology. - 0002-9378 .- 1097-6868. ; 230:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: The 22q11.2 deletion syndrome is the most common microdeletion syndrome and is frequently associated with congenital heart disease. Prenatal diagnosis of 22q11.2 deletion syndrome is increasingly offered. It is unknown whether there is a clinical benefit to prenatal detection as compared with postnatal diagnosis. Objective: This study aimed to determine differences in perinatal and infant outcomes between patients with prenatal and postnatal diagnosis of 22q11.2 deletion syndrome. Study Design: This was a retrospective cohort study across multiple international centers (30 sites, 4 continents) from 2006 to 2019. Participants were fetuses, neonates, or infants with a genetic diagnosis of 22q11.2 deletion syndrome by 1 year of age with or without congenital heart disease; those with prenatal diagnosis or suspicion (suggestive ultrasound findings and/or high-risk cell-free fetal DNA screen for 22q11.2 deletion syndrome with postnatal confirmation) were compared with those with postnatal diagnosis. Perinatal management, cardiac and noncardiac morbidity, and mortality by 1 year were assessed. Outcomes were adjusted for presence of critical congenital heart disease, gestational age at birth, and site. Results: A total of 625 fetuses, neonates, or infants with 22q11.2 deletion syndrome (53.4% male) were included: 259 fetuses were prenatally diagnosed (156 [60.2%] were live-born) and 122 neonates were prenatally suspected with postnatal confirmation, whereas 244 infants were postnatally diagnosed. In the live-born cohort (n=522), 1-year mortality was 5.9%, which did not differ between groups but differed by the presence of critical congenital heart disease (hazard ratio, 4.18; 95% confidence interval, 1.56–11.18; P<.001) and gestational age at birth (hazard ratio, 0.78 per week; 95% confidence interval, 0.69–0.89; P<.001). Adjusting for critical congenital heart disease and gestational age at birth, the prenatal cohort was less likely to deliver at a local community hospital (5.1% vs 38.2%; odds ratio, 0.11; 95% confidence interval, 0.06–0.23; P<.001), experience neonatal cardiac decompensation (1.3% vs 5.0%; odds ratio, 0.11; 95% confidence interval, 0.03–0.49; P=.004), or have failure to thrive by 1 year (43.4% vs 50.3%; odds ratio, 0.58; 95% confidence interval, 0.36–0.91; P=.019). Conclusion: Prenatal detection of 22q11.2 deletion syndrome was associated with improved delivery management and less cardiac and noncardiac morbidity, but not mortality, compared with postnatal detection.
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| 5. |
- Merkulova, Lena, et al.
(författare)
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Effect of Wind Speed on Moderate Resolution Imaging Spectroradiometer (MODIS) Aerosol Optical Depth over the North Pacific
- 2018
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Ingår i: Atmosphere. - : MDPI AG. - 2073-4433. ; 9:2
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Tidskriftsartikel (refereegranskat)abstract
- The surface-wind speed influences on aerosol optical depth (AOD), derived from the Moderate Resolution Imaging Spectroradiometer (MODIS) Aqua daily observations over the central North Pacific during the period 2003-2016, have been investigated in this study. The cloud coverage is relatively low over the present investigation area compared to other marine areas, which favors AOD derived from passive remote sensing from space. In this study, we have combined MODIS AOD with 2 m wind speed (U-2m) on a satellite-pixel basis, which has been interpolated from National Centers for Environmental Prediction (NCEP) reanalysis. In addition, daily averaged AOD derived from Aerosol Robotic Network (AERONET) measurements in the free-troposphere at the Mauna Loa Observatory (3397 m above sea level), Hawaii, was subtracted from the MODIS column AOD values. The latter was to reduce the contribution of aerosols above the planetary boundary layer. This study shows relatively strong power-law relationships between MODIS mean AOD and surface-wind speed for marine background conditions in summer, fall and winter of the current period. However, previous established relationships between AOD and surface-wind speed deviate substantially. Even so, for similar marine conditions the present relationship agrees reasonable well with a power-law relationship derived for north-east Atlantic conditions. The present MODIS retrievals of AOD in the marine atmosphere agree reasonably well with ground-based remote sensing of AOD.
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| 6. |
- Freud, E., et al.
(författare)
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Anthropogenic aerosol effects on convective cloud microphysical properties in southern Sweden
- 2008
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Ingår i: Tellus. Series B, Chemical and physical meteorology. - : Stockholm University Press. - 0280-6509 .- 1600-0889. ; 60:2, s. 286-297
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we look for anthropogenic aerosol effects in southern Scandinavia's clouds under the influence of moderate levels of pollution and relatively weak dynamic forcing. This was done by comparing surface aerosol measurements with convective cloud microphysical profiles produced from satellite image analyses. The results show that the clouds associated with the anthropogenic-affected air with high PM0.5, had to acquire a vertical development of similar to 3.5 km before forming precipitation-sized particles, compared to less than 1 km for the clouds associated with low PM0.5 air-masses. Additionally, a comparison of profiles with precipitation was done with regard to different potentially important parameters. For precipitating clouds the variability of the cloud thickness needed to produce the precipitation (Delta h(14)) is directly related to PM0.5 concentrations, even without considering atmospheric stability, the specific aerosol size distribution or the aerosols' chemical composition. Each additional 1 mu g m(-3) of PM0.5 was found to increase Delta h(14) by similar to 200-250 m. Our conclusion is that it is indeed possible to detect the effects of anthropogenic aerosol on the convective clouds in southern Scandinavia despite modest aerosol masses. It also emphasizes the importance of including aerosol processes in climate-radiation models and in numerical weather prediction models.
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| 7. |
- Freud, E., et al.
(författare)
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Robust relations between CCN and the vertical evolution of cloud drop size distribution in deep convective clouds
- 2008
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Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 8:6, s. 1661-1675
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Tidskriftsartikel (refereegranskat)abstract
- In-situ measurements in convective clouds (up to the freezing level) over the Amazon basin show that smoke from deforestation fires prevents clouds from precipitating until they acquire a vertical development of at least 4 km, compared to only 1-2 km in clean clouds. The average cloud depth required for the onset of warm rain increased by similar to 350 m for each additional 100 cloud condensation nuclei per cm(3) at a super-saturation of 0.5% (CCN0.5%). In polluted clouds, the diameter of modal liquid water content grows much slower with cloud depth (at least by a factor of similar to 2), due to the large number of droplets that compete for available water and to the suppressed coalescence processes. Contrary to what other studies have suggested, we did not observe this effect to reach saturation at 3000 or more accumulation mode particles per cm(3). The CCN0.5% concentration was found to be a very good predictor for the cloud depth required for the onset of warm precipitation and other microphysical factors, leaving only a secondary role for the updraft velocities in determining the cloud drop size distributions. The effective radius of the cloud droplets (r(e)) was found to be a quite robust parameter for a given environment and cloud depth, showing only a small effect of partial droplet evaporation from the cloud's mixing with its drier environment. This supports one of the basic assumptions of satellite analysis of cloud microphysical processes: the ability to look at different cloud top heights in the same region and regard their r(e) as if they had been measured inside one well developed cloud. The dependence of r(e) on the adiabatic fraction decreased higher in the clouds, especially for cleaner conditions, and disappeared at r(e)>=similar to 10 mu m. We propose that droplet coalescence, which is at its peak when warm rain is formed in the cloud at r(e)=similar to 10 mu m, continues to be significant during the cloud's mixing with the entrained air, cancelling out the decrease in r(e) due to evaporation.
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