| 1. |
- Dahlke, Helen E., et al.
(författare)
-
Contrasting trends in floods for two sub-arctic catchments in northern Sweden - does glacier presence matter?
- 2012
-
Ingår i: Hydrology and Earth System Sciences. - : Copernicus GmbH. - 1027-5606 .- 1607-7938. ; 16:7, s. 2123-2141
-
Tidskriftsartikel (refereegranskat)abstract
- Our understanding is limited to how transient changes in glacier response to climate warming will influence the catchment hydrology in the Arctic and Sub-Arctic. This understanding is particularly incomplete for flooding extremes because understanding the frequency of such unusual events requires long records of observation not often available for the Arctic and Sub-Arctic. This study presents a statistical analysis of trends in the magnitude and timing of flood extremes and the mean summer discharge in two sub-arctic catchments, Tarfala and Abisko, in northern Sweden. The catchments have different glacier covers (30% and 1%, respectively). Statistically significant trends (at the 5% level) were identified for both catchments on an annual and on a seasonal scale (3-months averages) using the Mann-Kendall trend test. Stationarity of flood records was tested by analyzing trends in the flood quantiles, using generalized least squares regression. Hydrologic trends were related to observed changes in the precipitation and air temperature, and were correlated with 3-months averaged climate pattern indices (e.g. North Atlantic oscillation). Both catchments showed a statistically significant increase in the annual mean air temperature over the comparison time period of 1985-2009 (Tarfala and Abisko p < 0.01), but did not show significant trends in the total precipitation (Tarfala p = 0.91, Abisko p = 0.44). Despite the similar climate evolution over the studied period in the two catchments, data showed contrasting trends in the magnitude and timing of flood peaks and the mean summer discharge. Hydrologic trends indicated an amplification of the streamflow and flood response in the highly glacierized catchment and a dampening of the response in the non-glacierized catchment. The glacierized mountain catchment showed a statistically significant increasing trend in the flood magnitudes (p = 0.04) that is clearly correlated to the occurrence of extreme precipitation events. It also showed a significant increase in mean summer discharge (p = 0.0002), which is significantly correlated to the decrease in glacier mass balance and the increase in air temperature (p = 0.08). Conversely, the non-glacierized catchment showed a significant decrease in the mean summer discharge (p = 0.01), the flood magnitudes (p = 0.07) and an insignificant trend towards earlier flood occurrences (p = 0.53). These trends are explained by a reduction of the winter snow pack due to higher temperatures in the winter and spring and an increasing soil water storage capacity or catchment storage due to progressively thawing permafrost.
|
|
| 2. |
- Dragsted, L., et al.
(författare)
-
Metabolomic response to Nordic foods
- 2015
-
Ingår i: Annals of Nutrition and Metabolism. - 0250-6807 .- 1421-9697. ; 67, s. 55-55
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 3. |
- Elmsjö, Albert, et al.
(författare)
-
NMR-based metabolic profiling in healthy individuals overfed different types of fat : links to changes in liver fat accumulation and lean tissue mass.
- 2015
-
Ingår i: Nutrition & Diabetes. - : Springer Science and Business Media LLC. - 2044-4052. ; 5:19, s. e182-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Overeating different dietary fatty acids influence the amount of liver fat stored during weight gain, however, the mechanisms responsible are unclear. We aimed to identify non-lipid metabolites that may differentiate between saturated (SFA) and polyunsaturated fatty acid (PUFA) overfeeding using a non-targeted metabolomic approach. We also investigated the possible relationships between plasma metabolites and body fat accumulation.METHODS: In a randomized study (LIPOGAIN study), n=39 healthy individuals were overfed with muffins containing SFA or PUFA. Plasma samples were precipitated with cold acetonitrile and analyzed by nuclear magnetic resonance (NMR) spectroscopy. Pattern recognition techniques were used to overview the data, identify variables contributing to group classification and to correlate metabolites with fat accumulation.RESULTS: We previously reported that SFA causes a greater accumulation of liver fat, visceral fat and total body fat, whereas lean tissue levels increases less compared with PUFA, despite comparable weight gain. In this study, lactate and acetate were identified as important contributors to group classification between SFA and PUFA (P<0.05). Furthermore, the fat depots (total body fat, visceral adipose tissue and liver fat) and lean tissue correlated (P(corr)>0.5) all with two or more metabolites (for example, branched amino acids, alanine, acetate and lactate). The metabolite composition differed in a manner that may indicate higher insulin sensitivity after a diet with PUFA compared with SFA, but this needs to be confirmed in future studies.CONCLUSION: A non-lipid metabolic profiling approach only identified a few metabolites that differentiated between SFA and PUFA overfeeding. Whether these metabolite changes are involved in depot-specific fat storage and increased lean tissue mass during overeating needs further investigation.
|
|
| 4. |
- Fischer, Sandra, et al.
(författare)
-
Disproportionate Water Quality Impacts from the Century-Old Nautanen Copper Mines, Northern Sweden
- 2020
-
Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 12:4
-
Tidskriftsartikel (refereegranskat)abstract
- Pollution from small historical mining sites is usually overlooked, in contrast to larger ones. Especially in the Arctic, knowledge gaps remain regarding the long-term mine waste impacts, such as metal leakage, on water quality. We study the small copper (Cu) mines of Nautanen, northern Sweden, which had been in operation for only six years when abandoned approximately 110 years ago in 1908. Measurements from field campaigns in 2017 are compared to synthesized historical measurement data from 1993 to 2014, and our results show that concentrations of Cu, Zn, and Cd on-site as well as downstream from the mining site are order(s) of magnitude higher than the local background values. This is despite the small scale of the Nautanen mining site, the short duration of operation, and the long time since closure. Considering the small amount of waste produced at Nautanen, the metal loads from Nautanen are still surprisingly high compared to the metal loads from larger mines. We argue that disproportionately large amounts of metals may be added to surface water systems from the numerous small abandoned mining sites. Such pollution loads need to be accounted for in sustainable assessments of total pollutant pressures in the relatively vulnerable Arctic environment.
|
|
| 5. |
- Fischer, Sandra, et al.
(författare)
-
Microbial Sulfate Reduction (MSR) as a Nature-Based Solution (NBS) to Mine Drainage : Contrasting Spatiotemporal Conditions in Northern Europe
- 2022
-
Ingår i: Water resources research. - 0043-1397 .- 1944-7973. ; 58:4
-
Tidskriftsartikel (refereegranskat)abstract
- An emerging solution in mine waste remediation is the use of biological processes, such as microbial sulfate reduction (MSR), to immobilize metals, reducing their bioavailability and buffering the pH of acid mine drainage. Apart from laboratory tests and local observations of natural MSR in, for example, single wetlands, little is known about spatiotemporal characteristics of freshwater MSR from multiple locations within entire hydrological catchments. We here applied an isotopic fractionation (δ34S values in SO42−) and a Monte Carlo-based mixing analysis scheme to detect MSR and its variation across two major mining regions (Imetjoki, Sweden and Khibiny, Russia) in the Arctic part of Europe under different seasonal conditions. Results indicate a range of catchment-scale MSR values in the Arctic of ∼5%–20% where the low end of the range was associated with the non-vegetated, mountainous terrain of the Khibiny catchment, having low levels of dissolved organic carbon (DOC). The high end of the range was related to vegetated conditions provided by the Imetjoki catchment that also contains wetlands, lakes, and local aquifers. These prolong hydrological residence times and support MSR hot spots reaching values of ∼40%. The present results additionally show evidence of MSR persistence over different seasons, indicating large potential, even under relatively cold conditions, of using MSR as part of nature-based solutions to mitigate adverse impacts of (acid) mine drainage. The results call for more detailed investigations regarding potential field-scale correlations between MSR and individual landscape and hydroclimatic characteristics, which, for example, can be supported by the isotopic fractionation and mixing scheme utilized here.
|
|
| 6. |
- Hommel, Adrianus L.A.J., et al.
(författare)
-
Optimizing Treatment in Undertreated Late-Stage Parkinsonism : A Pragmatic Randomized Trial
- 2020
-
Ingår i: Journal of Parkinson's Disease. - 1877-7171. ; 10:3, s. 1171-1184
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Treatment of patients with late-stage parkinsonism is often sub-optimal. Objective: To test the effectiveness of recommendations by a movement disorder specialist with expertise in late-stage parkinsonism. Methods: Ninety-one patients with late-stage parkinsonism considered undertreated were included in apragmatic a pragmatic multi-center randomized-controlled trial with six-month follow-up. The intervention group received a letter with treatment recommendations to their primary clinician based on an extensive clinical assessment. Controls received care as usual. The primary outcome was the Unified Parkinson Disease Rating Scale (UPDRS)part-II (Activities of Daily Living). Other outcomes included quality-of-life (PDQ-8), mental health (UPDRS-I), motor function (UPDRS-III), treatment complications (UPDRS-IV), cognition (Mini-mental-state-examination), non-motor symptoms (Non-Motor-Symptoms-scale), health status (EQ-5D-5L) and levodopa-equivalent-daily-dose (LEDD). We also assessed adherence to recommendations. In addition to intention-to-treat analyses, a per-protocol analysis was conducted. Results: Sample size calculation required 288 patients, but only 91 patients could be included. Treating physicians followed recommendations fully in 16 (28%) and partially in 21 (36%) patients. The intention-to-treat analysis showed no difference in primary outcome (between-group difference=-1.2, p=0.45), but there was greater improvement for PDQ-8 in the intervention group (between-group difference=-3.7, p=0.02). The per-protocol analysis confirmed these findings, and showed less deterioration in UPDRS-part I, greater improvement on UPDRS-total score and greater increase in LEDD in the intervention group. Conclusions: The findings suggest that therapeutic gains may be reached even in this vulnerable group of patients with late-stage parkinsonism, but also emphasize that specialist recommendations need to be accompanied by better strategies to implement these to further improve outcomes.
|
|
| 7. |
- Hommel, Adrianus L.A.J., et al.
(författare)
-
The Prevalence and Determinants of Neuropsychiatric Symptoms in Late-Stage Parkinsonism
- 2020
-
Ingår i: Movement Disorders Clinical Practice. - : Wiley. - 2330-1619. ; 7:5, s. 531-542
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Late-stage parkinsonism and Parkinson's disease (PD) are insufficiently studied population. Although neuropsychiatric symptoms (eg, psychosis, depression, anxiety, behavioral problems) are frequently present, their prevalence and clinical predictors remain unknown. Objective: To determine the prevalence and predictors of neuropsychiatric symptoms in late-stage PD. Methods: We conducted a multinational study of patients with PD with ≥7 years disease duration and either a Hoehn and Yahr stage ≥4 or a Schwab and England score ≤ 50% in the on stage. Neuropsychiatric symptoms were assessed through interviews with carers using the Neuropsychiatric Inventory, with a frequency × severity score ≥ 4, indicating clinically relevant symptoms. The determinants analyzed were demographic characteristics, medication, and motor and nonmotor symptoms. Univariate and multivariate logistic analyses were performed on predictors of clinically relevant neuropsychiatric symptoms. Results: A total of 625 patients were recruited in whom the Neuropsychiatric Inventory could be completed. In 92.2% (576/625) of the patients, at least 1 neuropsychiatric symptom was present, and 75.5% (472/625) had ≥1 clinically relevant symptom. The most common clinically relevant symptoms were apathy (n = 242; 38.9%), depression (n = 213; 34.5%), and anxiety (n = 148; 23.8%). The multivariate analysis revealed unique sets of predictors for each symptom, particularly the presence of other neuropsychiatric features, cognitive impairment, daytime sleepiness. Conclusion: Neuropsychiatric symptoms are common in late-stage PD. The strongest predictors are the presence of other neuropsychiatric symptoms. Clinicians involved in the care for patients with late-stage PD should be aware of these symptoms in this specific disease group and proactively explore other psychiatric comorbidities once a neuropsychiatric symptom is recognized.
|
|
| 8. |
|
|
| 9. |
- Kruse, Christopher, et al.
(författare)
-
Care of Late-Stage Parkinsonism : Resource Utilization of the Disease in Five European Countries
- 2024
-
Ingår i: Movement Disorders. - 0885-3185. ; 39:3, s. 571-584
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Parkinson's disease (PD) is a neurodegenerative disease that leads to progressive disability. Cost studies have mainly explored the early stages of the disease, whereas late-stage patients are underrepresented. Objective: The aim is to evaluate the resource utilization and costs of PD management in people with late-stage disease. Methods: The Care of Late-Stage Parkinsonism (CLaSP) study collected economic data from patients with late-stage PD and their caregivers in five European countries (France, Germany, the Netherlands, UK, Sweden) in a range of different settings. Patients were eligible to be included if they were in Hoehn and Yahr stage >3 in the on state or Schwab and England stage at 50% or less. In total, 592 patients met the inclusion criteria and provided information on their resource utilization. Costs were calculated from a societal perspective for a 3-month period. A least absolute shrinkage and selection operator approach was utilized to identify the most influential independent variables for explaining and predicting costs. Results: During the 3-month period, the costs were €20,573 (France), €19,959 (Germany), €18,319 (the Netherlands), €25,649 (Sweden), and €12,156 (UK). The main contributors across sites were formal care, hospitalization, and informal care. Gender, age, duration of the disease, Unified Parkinson's Disease Rating Scale 2, the EQ-5D-3L, and the Schwab and England Scale were identified as predictors of costs. Conclusion: Costs in this cohort of individuals with late-stage PD were substantially higher compared to previously published data on individuals living in earlier stages of the disease. Resource utilization in the individual sites differed in part considerably among these three parameters mentioned.
|
|
| 10. |
- Meinders, Marjan J., et al.
(författare)
-
Advance Care Planning and Care Coordination for People With Parkinson's Disease and Their Family Caregivers—Study Protocol for a Multicentre, Randomized Controlled Trial
- 2021
-
Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Parkinson's disease (PD) is a progressive neurodegenerative disease with motor- and non-motor symptoms. When the disease progresses, symptom burden increases. Consequently, additional care demands develop, the complexity of treatment increases, and the patient's quality of life is progressively threatened. To address these challenges, there is growing awareness of the potential benefits of palliative care for people with PD. This includes communication about end-of-life issues, such as Advance Care Planning (ACP), which helps to elicit patient's needs and preferences on issues related to future treatment and care. In this study, we will assess the impact and feasibility of a nurse-led palliative care intervention for people with PD across diverse European care settings. Methods: The intervention will be evaluated in a multicentre, open-label randomized controlled trial, with a parallel group design in seven European countries (Austria, Estonia, Germany, Greece, Italy, Sweden and United Kingdom). The “PD_Pal intervention” comprises (1) several consultations with a trained nurse who will perform ACP conversations and support care coordination and (2) use of a patient-directed “Parkinson Support Plan-workbook”. The primary endpoint is defined as the percentage of participants with documented ACP-decisions assessed at 6 months after baseline (t1). Secondary endpoints include patients' and family caregivers' quality of life, perceived care coordination, patients' symptom burden, and cost-effectiveness. In parallel, we will perform a process evaluation, to understand the feasibility of the intervention. Assessments are scheduled at baseline (t0), 6 months (t1), and 12 months (t2). Statistical analysis will be performed by means of Mantel–Haenszel methods and multilevel logistic regression models, correcting for multiple testing. Discussion: This study will contribute to the current knowledge gap on the application of palliative care interventions for people with Parkinson's disease aimed at ameliorating quality of life and managing end-of-life perspectives. Studying the impact and feasibility of the intervention in seven European countries, each with their own cultural and organisational characteristics, will allow us to create a broad perspective on palliative care interventions for people with Parkinson's disease across settings. Clinical Trial Registration: www.trialregister.nl, NL8180.
|
|
