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- Dave, Nishi, et al.
(författare)
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Nosocomial SARS-CoV-2 infections and mortality during unique COVID-19 epidemic waves
- 2023
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 6:11
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Quantifying the burden of nosocomial SARS-CoV-2 infections and associated mortality is necessary to assess the need for infection prevention and control measures.Objective: To investigate the occurrence of nosocomial SARS-CoV-2 infections and associated 30-day mortality among patients admitted to hospitals in Region Stockholm, Sweden.Design, Setting, and Participants: A retrospective, matched cohort study divided the period from March 1, 2020, until September 15, 2022, into a prevaccination period, early vaccination and pre-Omicron (period 1), and late vaccination and Omicron (period 2). From among 303 898 patients 18 years or older living in Region Stockholm, 538 951 hospital admissions across all hospitals were included. Hospitalized admissions with nosocomial SARS-CoV-2 infections were matched to as many as 5 hospitalized admissions without nosocomial SARS-CoV-2 by age, sex, length of stay, admission time, and hospital unit.Exposure: Nosocomial SARS-CoV-2 infection defined as the first positive polymerase chain reaction test result at least 8 days after hospital admission or within 2 days after discharge.Main Outcomes and Measures: Primary outcome of 30-day mortality was analyzed using time-to-event analyses with a Cox proportional hazards regression model adjusted for age, sex, educational level, and comorbidities.Results: Among 2193 patients with SARS-CoV-2 infections or reinfections (1107 women [50.5%]; median age, 80 [IQR, 71-87] years), 2203 nosocomial SARS-CoV-2 infections were identified. The incidence rate of nosocomial SARS-CoV-2 infections was 1.57 (95% CI, 1.51-1.64) per 1000 patient-days. In the matched cohort, 1487 hospital admissions with nosocomial SARS-CoV-2 infections were matched to 5044 hospital admissions without nosocomial SARS-CoV-2 infections. Thirty-day mortality was higher in the prevaccination period (adjusted hazard ratio [AHR], 2.97 [95% CI, 2.50-3.53]) compared with period 1 (AHR, 2.08 [95% CI, 1.50-2.88]) or period 2 (AHR, 1.22 [95% CI, 0.92-1.60]). Among patients with nosocomial SARS-CoV-2 infections, 30-day AHR comparing those with 2 or more doses of SARS-CoV-2 vaccination and those with less than 2 doses was 0.64 (95% CI, 0.46-0.88).Conclusions and Relevance: In this matched cohort study, nosocomial SARS-CoV-2 infections were associated with higher 30-day mortality during the early phases of the pandemic and lower mortality during the Omicron variant wave and after the introduction of vaccinations. Mitigation of excess mortality risk from nosocomial transmission should be a strong focus when population immunity is low through implementation of adequate infection prevention and control measures.
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- Görg, Holger, et al.
(författare)
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Firm Size Distribution and Employment Fluctuations : Theory and Evidence
- 2016
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This paper studies the effect of the firm-size distribution on the relationship between employment and output. We construct a theoretical model, which predicts that changes in demand for industry output have larger effects on employment in industries characterised by a distribution that is more skewed towards smaller firms. Industry-specific shape parameters of the firm size distributions are estimated using firm-level data from Germany, Sweden and the UK, and used to augment a relationship between industry-level employment and output. Our empirical results align with the predictions of the theory and confirm that the size distribution of firms is an important determinant of the relationship between changes in output and employment.
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- Görg, Holger, et al.
(författare)
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Firm Size Distribution and Employment Fluctuations : Theory and Evidence
- 2017
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Ingår i: Research in Economics. - : Elsevier BV. - 1090-9443. ; 71:4, s. 690-703
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Tidskriftsartikel (refereegranskat)abstract
- We show that the firm-size distribution is an important determinant of the relationship between an industry's employment and output. A theoretical model predicts that changes in demand for an industry's output have larger effects on employment, resulting from adjustments at both the intensive and extensive margin, in industries characterised by a distribution that has a lower density of large firms. Industry-specific shape parameters of the firm size distributions are estimated using firm-level data from Germany, Sweden and the UK, and used to augment a relationship between industry-level employment and output. The empirical results align with the predictions of the theory.
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- Hård af Segerstad, Elin M., et al.
(författare)
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Daily intake of milk powder and risk of celiac disease in early childhood : A nested case-control study
- 2018
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 10:5
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Tidskriftsartikel (refereegranskat)abstract
- Milk powder and gluten are common components in Swedish infants’ diets. Whereas large intakes of gluten early in life increases the risk of celiac disease in genetically at-risk Swedish children, no study has yet evaluated if intake of milk powder by 2 years of age is associated with celiac disease. A 1-to-3 nested case-control study, comprised of 207 celiac disease children and 621 controls matched for sex, birth year, and HLA genotype, was performed on a birth cohort of HLA-DR3-DQ2 and/or DR4-DQ8-positive children. Subjects were screened annually for celiac disease using tissue transglutaminase autoantibodies (tTGA). Three-day food records estimated the mean intake of milk powder at ages 6 months, 9 months, 12 months, 18 months, and 24 months. Conditional logistic regression calculated odds ratios (OR) at last intake prior to seroconversion of tTGA positivity, and for each time-point respectively and adjusted for having a first-degree relative with celiac disease and gluten intake. Intake of milk powder prior to seroconversion of tTGA positivity was not associated with celiac disease (OR = 1.00; 95% CI = 0.99, 1.03; p = 0.763). In conclusion, intake of milk powder in early childhood is not associated with celiac disease in genetically susceptible children.
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- Phinney, Randi, et al.
(författare)
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Concentration of citrus fruit juices in membrane pouches with solar energy Part 2 : How solar drying setup and juice pretreatment determine the microbiological quality
- 2020
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Ingår i: Journal of Food Process Engineering. - : Wiley. - 0145-8876 .- 1745-4530. ; 43:4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate how solar drying setup and choice of juice pretreatment determine the microbiological quality in a fruit juice concentration process called solar assisted pervaporation (SAP). With this process, hygienic membrane pouches and solar energy are used to concentrate and preserve fruit juices. In this study, citrus (tangerine) marmalades were produced with SAP membrane pouches under realistic conditions in rural Mozambique with three solar drying setups and eight juice pretreatments. The results showed that the choice of solar drying setup had a negligible effect on the total aerobic plate count but a significant effect on the yeast plate count. Pasteurization as a juice pretreatment lowered the total aerobic count and the probability of fermentation, while lemon juice had no beneficial effect on the microbiological quality. The recommendations are to add sucrose and pasteurize the juice before drying and to use a direct active solar dryer. Practical Applications: Solar drying is a sustainable approach to food preservation for the future. However, there are food safety challenges with solar drying that make the process difficult to control. One challenge is the direct contact between the product and the surrounding air since the air may be contaminated with microorganisms. One approach to reduce the probability of contamination is by solar drying fruit juices with membrane pouches that provide a hygienic barrier between the product and the surrounding air. These types of pouches are especially suitable for juicy, citrus fruits that are difficult to preserve with traditional solar drying practices. The pouches can be used to concentrate citrus juices into marmalades in rural areas of tropical countries where established infrastructure is not available. This study investigated the hygienic nature of the approach in rural Mozambique with the help of small-scale producers to determine the optimal way to produce safe marmalades.
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| 9. |
- Tarai, Sambit, et al.
(författare)
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Improved automated tumor segmentation in whole-body 3D scans using multi-directional 2D projection-based priors
- 2024
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Ingår i: Heliyon. - : Elsevier. - 2405-8440. ; 10:4
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Tidskriftsartikel (refereegranskat)abstract
- Early cancer detection, guided by whole-body imaging, is important for the overall survival and well-being of the patients. While various computer-assisted systems have been developed to expedite and enhance cancer diagnostics and longitudinal monitoring, the detection and segmentation of tumors, especially from whole-body scans, remain challenging. To address this, we propose a novel end -to-end automated framework that first generates a tumor probability distribution map (TPDM), incorporating prior information about the tumor characteristics (e.g. size, shape, location). Subsequently, the TPDM is integrated with a state-of-the-art 3D segmentation network along with the original PET/CT or PET/MR images. This aims to produce more meaningful tumor segmentation masks compared to using the baseline 3D segmentation network alone. The proposed method was evaluated on three independent cohorts (autoPET, CAR-T, cHL) of images containing different cancer forms, obtained with different imaging modalities, and acquisition parameters and lesions annotated by different experts. The evaluation demonstrated the superiority of our proposed method over the baseline model by significant margins in terms of Dice coefficient, and lesion-wise sensitivity and precision. Many of the extremely small tumor lesions (i.e. the most difficult to segment) were missed by the baseline model but detected by the proposed model without additional false positives, resulting in clinically more relevant assessments. On average, an improvement of 0.0251 (autoPET), 0.144 (CAR-T), and 0.0528 (cHL) in overall Dice was observed. In conclusion, the proposed TPDM-based approach can be integrated with any state-of-the-art 3D UNET with potentially more accurate and robust segmentation results.
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