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- Grip, Helena, et al.
(författare)
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Cervical helical axis characteristics and its center of rotation during active head and upper arm movements-comparisons of whiplash-associated disorders, non-specific neck pain and asymptomatic individuals.
- 2008
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Ingår i: Journal of Biomechanics. - : Springer. - 0021-9290 .- 1873-2380. ; 41:13, s. 2799-2805
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Tidskriftsartikel (refereegranskat)abstract
- The helical axis model can be used to describe translation and rotation of spine segments. The aim of this study was to investigate the cervical helical axis and its center of rotation during fast head movements (side rotation and flexion/extension) and ball catching in patients with non-specific neck pain or pain due to whiplash injury as compared with matched controls. The aim was also to investigate correlations with neck pain intensity. A finite helical axis model with a time-varying window was used. The intersection point of the axis during different movement conditions was calculated. A repeated-measures ANOVA model was used to investigate the cervical helical axis and its rotation center for consecutive levels of 15 degrees during head movement. Irregularities in axis movement were derived using a zero-crossing approach. In addition, head, arm and upper body range of motion and velocity were observed. A general increase of axis irregularity that correlated to pain intensity was observed in the whiplash group. The rotation center was superiorly displaced in the non-specific neck pain group during side rotation, with the same tendency for the whiplash group. During ball catching, an anterior displacement (and a tendency to an inferior displacement) of the center of rotation and slower and more restricted upper body movements implied a changed movement strategy in neck pain patients, possibly as an attempt to stabilize the cervical spine during head movement.
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| 4. |
- Grip, Helena, et al.
(författare)
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Cervical helical axis characteristics and its centre of rotation during active head movements : comparisons of whiplash-associated disorders, non-specific neck pain and asymptomatic individuals
- 2008
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Ingår i: Journal of Biomechanics. - : Elsevier. - 0021-9290 .- 1873-2380. ; 41:13, s. 2799-2805
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Tidskriftsartikel (refereegranskat)abstract
- The helical axis model can be used to describe translation and rotation of spine segments. The aim of this study was to investigate the cervical helical axis and its center of rotation during fast head movements (side rotation and flexion/extension) and ball catching in patients with non-specific neck pain or pain due to whiplash injury as compared with matched controls. The aim was also to investigate correlations with neck pain intensity. A finite helical axis model with a time-varying window was used. The intersection point of the axis during different movement conditions was calculated. A repeated-measures ANOVA model was used to investigate the cervical helical axis and its rotation center for consecutive levels of 15° during head movement. Irregularities in axis movement were derived using a zero-crossing approach. In addition, head, arm and upper body range of motion and velocity were observed. A general increase of axis irregularity that correlated to pain intensity was observed in the whiplash group. The rotation center was superiorly displaced in the non-specific neck pain group during side rotation, with the same tendency for the whiplash group. During ball catching, an anterior displacement (and a tendency to an inferior displacement) of the center of rotation and slower and more restricted upper body movements implied a changed movement strategy in neck pain patients, possibly as an attempt to stabilize the cervical spine during head movement.
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- Gunnarsson, Iva, et al.
(författare)
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Histopathologic and clinical outcome of rituximab treatment in patients with cyclophosphamide-resistant proliferative lupus nephritis
- 2007
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Ingår i: Arthritis and Rheumatism. - : John Wiley & Sons. - 0004-3591 .- 1529-0131. ; 56:4, s. 1263-1272
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Rituximab is a monoclonal antibody directed against the CD20 marker of B cells. Because of its ability to deplete B lymphocytes, it has been suggested that the drug could be of benefit in B cell-dependent diseases, including systemic lupus erythematosus (SLE). The purpose of this study was to investigate the histopathologic and clinical effects of combination treatment with rituximab and cyclophosphamide (CYC) in patients with CYC-resistant proliferative lupus nephritis.METHODS: Seven female patients with proliferative lupus nephritis were treated with rituximab in combination with CYC. Renal biopsies were performed before treatment and during followup. SLE activity was evaluated by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the British Isles Lupus Assessment Group index. In 6 of the 7 patients, immunostaining of lymphocyte subpopulations in the renal tissue was performed before treatment and during followup.RESULTS: At 6 months of followup, significant clinical improvement was noted, with a reduction in SLEDAI scores (from a mean of 15 to 3), anti-double-stranded DNA antibody levels (from a mean of 174 IU/ml to 56 IU/ml), and anti-C1q antibody levels (from a mean of 35 units/ml to 22 units/ml). On repeat renal biopsy, improvement in the histopathologic class of nephritis occurred in a majority of patients, and a decrease in the renal activity index was noted (from 6 to 3). A reduction in the number of CD3, CD4, and CD20 cells in the renal interstitium was noted in 50% of the patients on repeat biopsy.CONCLUSION: At 6 months of followup, all patients had responded both clinically and histopathologically to combination therapy. For patients with proliferative lupus nephritis who fail to respond to conventional immunosuppressive therapy including CYC, combined treatment with rituximab and CYC may constitute a new treatment option.
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- Ludvigsson, Jonas F., 1969-, et al.
(författare)
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Adaptation of the Charlson Comorbidity Index for Register-Based Research in Sweden
- 2021
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Ingår i: Clinical Epidemiology. - : Dove Medical Press Ltd.. - 1179-1349. ; 13, s. 21-41
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Comorbidity indices are often used to measure comorbidities in register-based research. We aimed to adapt the Charlson comorbidity index (CCI) to a Swedish setting.Methods: Four versions of the CCI were compared and evaluated by disease-specific experts.Results: We created a cohesive coding system for CCI to 1) harmonize the content between different international classification of disease codes (ICD-7,8,9,10), 2) delete incorrect codes, 3) enhance the distinction between mild, moderate or severe disease (and between diabetes with and without end-organ damage), 4) minimize duplication of codes, and 5) briefly explain the meaning of individual codes in writing.Conclusion: This work may provide an integrated and efficient coding algorithm for CCI to be used in medical register-based research in Sweden.
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- Sundelin, Håkan, et al.
(författare)
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Business case for electric road
- 2018
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Konferensbidrag (refereegranskat)abstract
- Electrified roads have the potential to reduce carbon dioxide emissions from the transport sector. Where long-distance heavy traffic is concerned, there is actually no cheaper alternative which is equally energy-efficient, has such low carbon dioxide emissions and for which the energy supply is assured in Sweden and the rest of Europe. Many questions nevertheless remain.In this preliminary study we have focussed on the business ecosystem likely to be built up alongside an electrified road. This has been done by means of interviewing interested parties and a thorough review of previous publications. On the basis of this background information, a computation model has been developed to be able to analyse the influence of various parameters. The stretch of 120 kilometre long road between Gävle and Borlänge has been used as a case study but an attempt to find other applicable stretches has also been undertaken. The model has a solid footing with the parties involved in the project and with people who have good insight into financial computations previously undertaken in relation to electrified roads.The computation model that has been developed is primarily thought of as a model for overall surpluses or deficits for all stakeholders in the business ecosystem. It is not, therefore, a complete socio-economic model, which would include considerably more consequences for society at large, such as the influence on local and national businesses, increased employment and so forth. The model has been developed on the assumption that all prices and values are given for a point in time when the solution is in an ’early commercialisation phase’.In comparison with diesel routes, it generally applies for electrified roads that every kilometre of road and every vehicle adds extra costs and that every kilometre driven creates savings. Thus for an electrified road system to be profitable, the stretch of electrified road must comprise a significant percentage of the overall distance driven by a truck. Nor must the stretch of road be too short, for then too much time is spent loading/unloading and too few kilometres (where the savings occur) are driven. Following familiarisation with various scenarios, a coherent, highly qualitative judgment, based on the electrified road computation model, would suggest that the suitable characteristics for such roads would be:A distance of at least twenty kilometresAnnual average daily traffic (AADT) for electrified road trucks should be around two times as many as the number of electrified kilometresThe electrified stretch should comprise 60% percent or more of the trucks’ overall distance driven each year.For the case of Gävle-Borlänge (120 km), it appears that the stretch will be able to pay for itself, for example, when 190 electrified trucks complete the stretch an average of 4 times per day throughout the year (back and forth twice a day 365 days a year), amounting to 92% of the vehicles’ overall distance being driven on electrified road.
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- Sundelin, Håkan, et al.
(författare)
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Förstudie av affärsekosystem för elvägar
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Elvägar har potential att minska koldioxidutsläppen från transportsektorn. För långväga tungtrafik finns egentligen inga rimliga alternativ som både är energieffektiva, har lågtkoldioxidutsläpp och där energiförsörjningen är säkrad såväl i Sverige som i övriga Europa,men det återstår ännu många frågor.I denna förstudie har vi fokuserat på det affärsekosystem som kommer att byggas upp kringen elväg. Detta har gjorts genom intressentintervjuer och en grundlig genomgång av tidigarepublikationer. Utifrån denna bakgrundsinformation har en kalkyl skapats för att kunnaanalysera olika parametrars påverkan. Sträckan Gävle-Borlänge har använts som fallstudie,men ett första försök att finna andra lämpliga sträckor har även genomförts. Kalkylen harförankrats med projektets parter och personer med god insikt i tidigare genomfördaekonomiska kalkyler av elvägar.För att undersöka förutsättningar för ett framtida samarbete har projektet fört dialog medEU projektet FABRIC, organisationerna CEDR och ERTRAC, samt även amerikanskaintressenter. I de fall då det inneburit deltagande på konferenser så har kunskapen från dessaförmedlats genom nyhetsbrevet OMEV.Den kalkyl som skapats är i första hand tänkt som en kalkyl över totalt över- eller underskottför alla inblandade aktörer i affärsekosystemet. Det är alltså inte en komplettsamhällsekonomisk kalkyl som skulle inkludera betydligt fler konsekvenser för samhället istort, såsom påverkan på lokalt och nationellt näringsliv, ökad sysselsättning etc. Kalkylen ärgjord med antagandet att alla priser och värden anges för en punkt i tiden då lösningenbefinner sig i en ”tidig kommersialiseringsfas”.För elvägar i jämförelse med dieselvägar gäller generellt att varje vägkilometer och varjefordon skapar extra kostnader, och varje körd kilometer skapar besparingar. Därför vill manför lönsamma elvägssystem att sträckan på elväg utgör en avsevärd andel av lastbilarnastotala körda distans. Dock får sträckan inte vara för kort för då ägnas för mycket tid åtlastning och för få kilometrar (där besparingen sker) blir körda. En samlad och i hög gradkvalitativ bedömning efter att ha bekantat sig med olika scenarier, baserade påelvägskalkylen, är att lämpliga egenskaper för öppna vägsträckor är:• Minst ett par mils distans,• Årsdygnstrafik (ÅDT) för elvägslastbilar bör, i bägge riktningarna, vara ungefärdubbelt så många som sträckans antal kilometer i en riktning.• Elsträckan utgör en avsevärd andel av lastbilarnas totala körda distans varje år,åtminstone 40 %, och gärna en bit över 60 %.Ingående värden i kalkylen baseras på en kartläggning av tidigare genomfördakostnadsanalyser. Med hjälp av experter har vi sedan valt en sannolik nivå. Andelen (60 %)av den totala sträckan som elektrifieras baseras på preliminära resultat av en analys avsträckan Gävle-Borlänge från forskningsprojektet ERSET.Slutna elvägsystem har en del fördelar i termer av att de har förmodat färrediffusionsbarriärer. Det krävs dock stora volymer för att nå lönsamhet. För områden som har stora volymer kan det dock fungera enligt den här modellen. Tänkbara fall skulle kunna varahamnar, gruvor och andra typer av storskaliga industriskyttlar.I ett slutet system längs en 30 km lång sträcka med 50 lastbilar behöver varje lastbil körafram och tillbaka 8 gånger per dag 365 dagar om året för att nå break-even. Vidmedelhastigheten 50 km/h blir det 9,6 timmar – exklusive på och avlastning. Om vi antar attvarje på- respektive avlastning tar 15 minuter tillkommer 4 timmar. En framtida fråga är dåvilka produktionsanläggningar som kan sysselsätta 50 lastbilar 13,5 timmar om dagen 365dagar om året.För fallet Gävle-Borlänge framgår det att sträckan kan betala sig exempelvis då 190elvägslastbilar passerar sträckan i snitt 4 gånger varje dag hela året (t.ex. två gånger fram ochtillbaka 365 gånger per år), vilket utgör 92 % elvägsandel av fordonets totala distans.Sträckan Göteborg – Stockholm har diskuterats i flertalet rapporter och analysen visar attden kan bli lönsam. Det krävs dock en avsevärd investering, men en storskalig utbyggnad ärsamtidigt det scenario som kräver lägst andel elvägsfordon. ÅDT för tunga lastbilar påsträckan varierar längs sträckan mellan 1000 och 2000. Analysen visar att elvägssystemetskulle betala av sig om 700 elvägslastbilar trafikerade sträckan en gång varje dag året omvilket ger en elvägslastbils-ÅDT på 854, d.v.s. mellan 43 % och 86 % av totala flödet.
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