| 1. |
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| 2. |
- de Niet, Julia, et al.
(författare)
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Benefits of Combining Satellite-Derived Snow Cover Data and Discharge Data to Calibrate a Glaciated Catchment in Sub-Arctic Iceland
- 2020
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Ingår i: Water. - : MDPI AG. - 2073-4441. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- The benefits of fractional snow cover area, as an additional dataset for calibration, were evaluated for an Icelandic catchment with a low degree of glaciation and limited data. For this purpose, a Hydrological Projections for the Environment (HYPE) model was calibrated for the Geithellnaa catchment in south-east Iceland using daily discharge (Q) data and satellite-retrieved MODIS snow cover (SC) images, in a multi-dataset calibration (MDC) approach. By comparing model results using only daily discharge data with results obtained using both datasets, the value of SC data for model calibration was identified. Including SC data improved the performance of daily discharge simulations by 7% and fractional snow cover area simulations by 11%, compared with using only the daily discharge dataset (SDC). These results indicate that MDC improves the overall performance of the HYPE model, confirming previous findings. Therefore, MDC could improve discharge simulations in areas with extra sources of uncertainty, such as glaciers and snow cover. Since the change in fractional snow cover area was more accurate when MDC was applied, it can be concluded that MDC would also provide more realistic projections when calibrated parameter sets are extrapolated to different situations.
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| 3. |
- Dejby, Ellen, et al.
(författare)
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Left-sided valvular heart disease and survival in out-of-hospital cardiac arrest: a nationwide registry-based study.
- 2023
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Ingår i: Scientific reports. - 2045-2322. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Survival in left-sided valvular heart disease (VHD; aortic stenosis [AS], aortic regurgitation [AR], mitral stenosis [MS], mitral regurgitation [MR]) in out-of-hospital cardiac arrest (OHCA) is unknown. We studied all cases of OHCA in the Swedish Registry for Cardiopulmonary Resuscitation. All degrees of VHD, diagnosed prior to OHCA, were included. Association between VHD and survival was studied using logistic regression, gradient boosting and Cox regression. We studied time to cardiac arrest, comorbidities, survival, and cerebral performance category (CPC) score. We included 55,615 patients; 1948 with AS (3,5%), 384 AR (0,7%), 17 MS (0,03%), and 704 with MR (1,3%). Patients with MS were not described due to low case number. Time from VHD diagnosis to cardiac arrest was 3.7years in AS, 4.5years in AR and 4.1years in MR. ROSC occurred in 28% with AS, 33% with AR, 36% with MR and 35% without VHD. Survival at 30days was 5.2%, 10.4%, 9.2%, 11.4% in AS, AR, MR and without VHD, respectively. There were no survivors in people with AS presenting with asystole or PEA. CPC scores did not differ in those with VHD compared with no VHD. Odds ratio (OR) for MR and AR showed no difference in survival, while AS displayed OR 0.58 (95% CI 0.46-0.72), vs no VHD. AS is associated with halved survival in OHCA, while AR and MR do not affect survival. Survivors with AS have neurological outcomes comparable to patients without VHD.
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| 4. |
- Envall, Ida, et al.
(författare)
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Existing evidence related to soil retention of phosphorus from on-site wastewater treatment systems in boreal and temperate climate zones : a systematic map
- 2023
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Ingår i: Environmental Evidence. - : Springer Nature. - 2047-2382. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden there are nearly one million soil-based on-site wastewater treatment systems (OWTSs). OWTSs may contribute to eutrophication of surface waters, due to the discharge of phosphorus (P). Hence, in certain cases, a high P removal rate (up to 90%) of OWTSs is required by Swedish authorities. Since these requirements may have costly consequences to property owners, it is debated whether they are too strict. In this debate, it is often claimed that the soil retention of P occurring in the natural environments may be underestimated by authorities. Soil retention is the inhibition of the transport of P through the ground, due to different chemical, physical and biological processes occurring there. These processes make the P transport slower, which may reduce the unwanted impact on receiving water bodies. However, the efficiency of soil retention of P remains unclear. The objective of this systematic map was to collect, code, organise and elucidate the relevant evidence related to the topic, to be able to guide stakeholders through the evidence base, and to support future research synthesising, commissioning, and funding. The systematic map was carried out in response to needs declared by the Swedish Agency for Marine and Water Management but the conclusions should be valid for a wider range of countries across boreo-temperate regions.Methods: Searches were made for peer-reviewed and grey literature using bibliographic databases, search engines, specialist websites, and stakeholder contacts. The references were screened for relevance according to a predefined set of eligibility criteria. A detailed database of the relevant studies was compiled. Data and metadata that enable evaluation and discussion of the character and quality of the evidence base were extracted and coded. Special focus was placed on assessing if existing evidence could contribute to policy and practice decision making. Descriptive information about the evidence base was presented in tables and figures. An interactive evidence atlas and a choropleth were created, displaying the locations of all studies.Review findings: 234 articles out of 10,797 screened records fulfilled the eligibility criteria. These articles contain 256 studies, performed in the field or in the laboratory. Six different study types were identified, based on where the measurements were conducted. Most studies, including laboratory studies, lack replicates. Most field studies are observational case studies.Conclusions: It is not possible to derive valid generic measures of the efficiency of soil retention of P occurring in the natural soil environment from available research. Neither does the evidence base allow for answering the question of the magnitude of the potential impact of OWTSs on the P concentration in recipients on a general basis, or under what conditions OWTSs generally have such an impact. A compilation of groundwater studies may provide examples of how far the P may reach in x years, but the number of groundwater studies is insufficient to draw any general conclusions, given the complexity and variability of the systems. Future research should strive for replicated study designs, more elaborate reporting, and the establishment of a reporting standard.
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| 5. |
- Envall, Ida, et al.
(författare)
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What evidence exists related to soil retention of phosphorus from on-site wastewater treatment systems in boreal and temperate climate zones? : A systematic map protocol
- 2020
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Ingår i: Environmental Evidence. - : BMC. - 2047-2382. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Soil-based on-site wastewater treatment systems (OWSs) are suspected to contribute to eutrophication of surface waters, due to the discharge of phosphorus (P). However, along the flow path between the facilities and surface waters, different processes contribute to delay the transport of phosphorus through the ground. This may reduce the unwanted impact on receiving water bodies. However, the strength and significance of this so-called soil retention remains unclear. In Sweden, there are nearly one million OWSs. To protect surface waters, a high P removal rate (up to 90%) is often required by the local municipalities. However, since these requirements may have costly consequences to property owners, it is debated as to whether they are too strict. In this debate, it is often claimed that the retention of P occurring in natural environments may be underestimated by authorities. Accordingly, there is a need for a scrutiny of the available evidence related to soil retention of phosphorus from OWSs. This is the objective of the planned systematic map. Focus will be on boreal and temperate climate zones. Methods Searches will be made for peer-reviewed articles and grey literature using bibliographic databases, search engines, specialist websites and stakeholder contacts. The references will be screened for relevance according to a predefined set of eligibility criteria. At stage one, after testing and clarifying the eligibility criteria, the references will be single-screened based on title and abstract. At stage two, potentially relevant references will be screened in full-text independently by two reviewers. We will compile a detailed database of the relevant studies. Moreover, a narrative report will be produced, describing the research landscape in general terms. This will be carried out with a conceptual model, describing the processes involved in P retention in natural environments, as a foundation. It will be discussed where the respective studies/study types fit into the conceptual model, and also evaluated how each study/study type can be related to the overarching question of eutrophication. Moreover, we will describe identified knowledge gaps that warrant further primary research effort, as well as identified knowledge clusters that could be suitable for systematic reviews.
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| 6. |
- Gustafsson, Arvid, et al.
(författare)
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Antibiotic prophylaxis and its effect on postprocedural adverse events in endoscopic retrograde cholangiopancreatography for primary sclerosing cholangitis
- 2023
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Ingår i: JGH Open. - : John Wiley & Sons. - 2397-9070. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aim: Primary sclerosing cholangitis (PSC) is characterized by multiple strictures of the biliary tree. Patients with PSC frequently require repeated endoscopic retrograde cholangiopancreatography (ERCP) procedures. These procedures are encumbered by an increased incidence of infectious adverse events such as cholangitis. Evidence regarding whether antibiotic prophylaxis (AP) should be administered is sparse; however, prophylaxis is recommended. We aimed to determine whether AP affects the rate of postprocedural infectious and overall adverse events.Methods: We conducted a retrospective cohort study and extracted all ERCP procedures with indicated PSC performed between 1 January 2006 and 31 December 2019, which were registered in the Swedish Registry for Gallstone Surgery and ERCP (GallRiks). The exclusion criteria were incomplete 30-day follow-up, non-index procedures, or ongoing antibiotics. The main outcomes were postprocedural infectious adverse events and overall adverse events at the 30-day follow-up.Results: A total of 2144 procedures with indication of PSC were eligible for inclusion. AP was administered in 1407 (66%) of these procedures. Patients receiving AP were slightly younger (44 vs 46 years, P = 0.005) and had more comorbidities (ASA ≥3, 19.8% vs 13.6%; P < 0.001). Procedures with AP demonstrated an infectious adverse event rate of 3.3% compared to 4.5% for non-AP procedures (P = 0.19). Postprocedural infectious adverse events (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.48–1.21) and overall adverse events (OR 0.79, 95% CI 0.60–1.04) did not differ between AP and non-AP.Conclusion: Patients with PSC who undergo ERCP have the same frequency of adverse events regardless of whether AP was used.
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| 7. |
- Gustafsson, Arvid, et al.
(författare)
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Antibiotic prophylaxis and post-procedure infectious complications in endoscopic retrograde cholangiopancreatography with peroral cholangioscopy.
- 2023
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Ingår i: Endoscopy international open. - : Georg Thieme Verlag KG. - 2364-3722. ; 11:12, s. E1177-E1183
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Tidskriftsartikel (refereegranskat)abstract
- Background and study aims: Single-operator peroral cholangioscopy (SOC) has gained increasing attention in modern biliary and pancreatic therapy and diagnosis. This procedure has shown higher rates of infectious complications than conventional endoscopic retrograde cholangiopancreatography (ERCP); therefore, many guidelines recommend antibiotic prophylaxis (AP). However, whether AP administration decreases infectious or overall adverse events (AEs) has been little studied. We aimed to study whether AP affects post-procedure infectious or overall AEs in ERCP with SOC.Patients and methods: We collected data from the Swedish Registry for Gallstone Surgery and ERCP (GallRiks). Of the 124,921 extracted ERCP procedures performed between 2008 and 2021, 1,605 included SOC and represented the study population. Exclusion criteria were incomplete 30-day follow-up, ongoing antibiotic use, and procedures with unspecified indication. Type and dose of antibiotics were not reported. Post-procedure infectious complications and AEs at 30-day follow-up were the main outcomes.Results: AP was administered to 1,307 patients (81.4%). In this group, 3.4% of the patients had infectious complications compared with 3.7% in the non-AP group. The overall AE rates in the AP and non-AP groups were 14.6% and 15.2%, respectively. The incidence of cholangitis was 3.1% in the AP group and 3.4% in the non-AP group. Using multivariable analysis, both infectious complications (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.54-1.57) and AEs (OR 0.87, 95% CI 0.65-1.16) remained unaffected by AP administration.Conclusions: No reduction in infectious complication rates and AEs was seen with AP administration for SOC. The continued need for AP in SOC remains uncertain.
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| 8. |
- Gustafsson, Arvid, et al.
(författare)
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Bile leakage and the number of metal clips on the cystic duct during laparoscopic cholecystectomy
- 2022
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Ingår i: Scandinavian Journal of Surgery. - : Sage Publications. - 1457-4969 .- 1799-7267. ; 111:2, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVE: The most common way of closing the cystic duct in laparoscopic cholecystectomy is by using metal clips (>80%). Nevertheless, bile leakage occurs in 0.4%-2.0% of cases, and thus causes significant morbidity. However, the optimal number of clips needed to avoid bile leakage has not been determined. The primary aim of this study was to evaluate bile leakage and post-procedural adverse events after laparoscopic cholecystectomy concerning whether two or three clips were used to seal the cystic duct.METHODS: Using a retrospective observational design, we gathered data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (ERCP) (GallRiks). From 2006 until 2019, 124,818 patients were eligible for inclusion. These were nested to cohorts of 75,322 (60.3%) for uncomplicated gallstone disease and 49,496 (39.7%) with complicated gallstone disease. The cohorts were grouped by the number (i.e. two or three) of metal clips applied to the proximal cystic duct. The main outcome was 30-day bile leakage and post-procedural adverse events.RESULTS: No significant differences surfaced in the rate of bile leakage (0.8% vs 0.8%; P = .87) or post-procedural adverse events (three clips, 5.7% vs two clips, 5.4%; P = .16) for uncomplicated gallstone disease. However, for complicated disease, bile leakage (1.4% vs 1.0%; P < .001) and post-procedural adverse events (10.2% vs 8.6%; P < .001) significantly increased when the cystic duct was sealed with three clips compared with two.CONCLUSIONS: Because no differences in the rates of bile leakage or adverse events emerged in uncomplicated gallstone disease when a third clip was applied, a third clip for additional safety is not recommended in such cases. On the contrary, bile leakage and adverse events increased when a third clip was used in patients with complicated gallstone disease. This finding probably indicates a more difficult cholecystectomy rather than being caused by the third clip itself.
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| 9. |
- Gustafsson, Camilla, et al.
(författare)
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Pasture is a risk factor for Toxoplasma gondii infection in fattening pigs
- 2016
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Ingår i: Veterinary Parasitology. - : Elsevier BV. - 0304-4017 .- 1873-2550. ; 224, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- As consumer awareness of animal welfare increases throughout Europe, housing of pigs in more animal-friendly systems is becoming more common. There is concern that these free-range and organic management systems increase the prevalence of zoonotic meat-borne pathogens, such as Toxoplasma gondii. In this study we compared the seroprevalence of T. gondii between commercial fattening pigs raised on conventional and on organic farms in Sweden. Furthermore, potential associations between presence of T. gondii antibodies and type of production, access to pasture, and geographical region were analysed. A significant difference in T. gondii seroprevalence was found between conventional (1%) and organic pigs (8%). The higher odds of seropositivity in organic production was attributed to pasture access specifically (OR=1.8 for a one-month increase in length of pasture exposure). This study shows that the prevalence of T. gondii in Swedish conventional pigs is low. However, as pigs with access to pasture are at higher risk of infection and because the demand for animal-friendly production systems is increasing, there is an obvious need to practically manage the higher T. gondii presence in products from pigs raised in organic systems with outdoor access.
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| 10. |
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| 11. |
- Gustafsson, Camilla, et al.
(författare)
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Toxoplasma gondii seroprevalence in wild boars (Sus scrofa) in Sweden and evaluation of ELISA test performance
- 2015
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 143, s. 1913-1921
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Tidskriftsartikel (refereegranskat)abstract
- Toxoplasma gondii is a zoonotic protozoan parasite, infecting a wide range of warm-blooded animals. The Swedish wild boar population is expanding and increased hunting provides its meat to a growing group of consumers. We performed a spatio-temporal investigation of T. gondii seroprevalence in Swedish wild boars. An ELISA was set up and evaluated against a commercial direct agglutination test, using Bayesian latent class analysis. The ELISA sensitivity and specificity were estimated to 79% and 85%, respectively. Of 1327 serum samples, 50% were positive. Thirty-four per cent of young wild boars and 55% of adults were positive (P<0·001). The total seroprevalence ranged from 72% in 2005 to 38% in 2011 (P<0·001), suggesting a declining trend. The highest seroprevalence, 65%, was recorded in South Sweden. In other regions it varied from 29% in Stockholm to 46% in East Middle Sweden.
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| 12. |
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| 13. |
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| 14. |
- Persson, Ing-Marie, 1946-
(författare)
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Krislärande – konfliktfylld anpassning : Pedagogik för samverkan inför samhällskriser
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A societal crisis is an emergency that affects many people and large parts of society, threatening life, health, safety and basic values. In a societal crisis, there is a need for coordination between various bodies in the society. Coordination in societal crises has previously been studied mainly from a management perspective. Learning perspectives have been studied to a lesser extent. The main purpose of this thesis is to increase knowledge about the conditions for developing consensus and establish a common understanding of synergy-effects, a surplus value, for knowledge meetings between individuals from different organizations when they cooperate in the emergency management system. The study seeks to understand to the following questions: 1) What images and ideas do participants bring into the coordination group about societal crisis, how have they developed and changed? 2) How do the participants act when they have different pictures and meet? 3) Can the basic ideas of the research circle be used for knowledge building at knowledge meetings in the emergency management-system? 4) Can the basic ideas of the research circle be used to develop consensus and establish a common understanding of synergy-effects before societal crises happen? The main study consists of three case studies in three different-sized municipalities. It is based on 36 semi-structured interviews with participants in local crisis management coordination groups, observations during exercises and meetings, document studies and an experiment with the so-called knowledge meeting. The results are compared with complementary studies from two knowledge meetings and two coordination exercises based on observation, questionnaires and evaluations. The individuals, organizations, and structures have been identified as frame factors for coordination groups. The results show that the participants have different images of societal crisis and that coordination is a time-consuming approach requiring cross-perspective learning, interaction, as well as dialogue and reflection skills. The participants eventually develop their crisis learning, i.e. conflict-filled adaptation. A system's opened nature is important for individual learning.
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| 15. |
- Sonderby, Ida E., et al.
(författare)
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Dose response of the 16p11.2 distal copy number variant on intracranial volume and basal ganglia
- 2020
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Ingår i: Molecular Psychiatry. - : Nature Publishing Group. - 1359-4184 .- 1476-5578. ; 25:3, s. 584-602
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Tidskriftsartikel (refereegranskat)abstract
- Carriers of large recurrent copy number variants (CNVs) have a higher risk of developing neurodevelopmental disorders. The 16p11.2 distal CNV predisposes carriers to e.g., autism spectrum disorder and schizophrenia. We compared subcortical brain volumes of 12 16p11.2 distal deletion and 12 duplication carriers to 6882 non-carriers from the large-scale brain Magnetic Resonance Imaging collaboration, ENIGMA-CNV. After stringent CNV calling procedures, and standardized FreeSurfer image analysis, we found negative dose-response associations with copy number on intracranial volume and on regional caudate, pallidum and putamen volumes (β = −0.71 to −1.37; P < 0.0005). In an independent sample, consistent results were obtained, with significant effects in the pallidum (β = −0.95, P = 0.0042). The two data sets combined showed significant negative dose-response for the accumbens, caudate, pallidum, putamen and ICV (P = 0.0032, 8.9 × 10−6, 1.7 × 10−9, 3.5 × 10−12 and 1.0 × 10−4, respectively). Full scale IQ was lower in both deletion and duplication carriers compared to non-carriers. This is the first brain MRI study of the impact of the 16p11.2 distal CNV, and we demonstrate a specific effect on subcortical brain structures, suggesting a neuropathological pattern underlying the neurodevelopmental syndromes.
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| 16. |
- Sønderby, Ida E., et al.
(författare)
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1q21.1 distal copy number variants are associated with cerebral and cognitive alterations in humans
- 2021
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Ingår i: Translational Psychiatry. - : Nature Publishing Group. - 2158-3188. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Low-frequency 1q21.1 distal deletion and duplication copy number variant (CNV) carriers are predisposed to multiple neurodevelopmental disorders, including schizophrenia, autism and intellectual disability. Human carriers display a high prevalence of micro- and macrocephaly in deletion and duplication carriers, respectively. The underlying brain structural diversity remains largely unknown. We systematically called CNVs in 38 cohorts from the large-scale ENIGMA-CNV collaboration and the UK Biobank and identified 28 1q21.1 distal deletion and 22 duplication carriers and 37,088 non-carriers (48% male) derived from 15 distinct magnetic resonance imaging scanner sites. With standardized methods, we compared subcortical and cortical brain measures (all) and cognitive performance (UK Biobank only) between carrier groups also testing for mediation of brain structure on cognition. We identified positive dosage effects of copy number on intracranial volume (ICV) and total cortical surface area, with the largest effects in frontal and cingulate cortices, and negative dosage effects on caudate and hippocampal volumes. The carriers displayed distinct cognitive deficit profiles in cognitive tasks from the UK Biobank with intermediate decreases in duplication carriers and somewhat larger in deletion carriers-the latter potentially mediated by ICV or cortical surface area. These results shed light on pathobiological mechanisms of neurodevelopmental disorders, by demonstrating gene dose effect on specific brain structures and effect on cognitive function.
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| 17. |
- van der Meer, Dennis, et al.
(författare)
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Association of Copy Number Variation of the 15q11.2 BP1-BP2 Region With Cortical and Subcortical Morphology and Cognition
- 2020
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Ingår i: JAMA psychiatry. - : American Medical Association (AMA). - 2168-6238 .- 2168-622X. ; 77:4, s. 420-430
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Recurrent microdeletions and duplications in the genomic region 15q11.2 between breakpoints 1 (BP1) and 2 (BP2) are associated with neurodevelopmental disorders. These structural variants are present in 0.5% to 1.0% of the population, making 15q11.2 BP1-BP2 the site of the most prevalent known pathogenic copy number variation (CNV). It is unknown to what extent this CNV influences brain structure and affects cognitive abilities.Objective: To determine the association of the 15q11.2 BP1-BP2 deletion and duplication CNVs with cortical and subcortical brain morphology and cognitive task performance.Design, Setting, and Participants: In this genetic association study, T1-weighted brain magnetic resonance imaging were combined with genetic data from the ENIGMA-CNV consortium and the UK Biobank, with a replication cohort from Iceland. In total, 203 deletion carriers, 45 247 noncarriers, and 306 duplication carriers were included. Data were collected from August 2015 to April 2019, and data were analyzed from September 2018 to September 2019.Main Outcomes and Measures: The associations of the CNV with global and regional measures of surface area and cortical thickness as well as subcortical volumes were investigated, correcting for age, age2, sex, scanner, and intracranial volume. Additionally, measures of cognitive ability were analyzed in the full UK Biobank cohort.Results: Of 45 756 included individuals, the mean (SD) age was 55.8 (18.3) years, and 23 754 (51.9%) were female. Compared with noncarriers, deletion carriers had a lower surface area (Cohen d = -0.41; SE, 0.08; P = 4.9 × 10-8), thicker cortex (Cohen d = 0.36; SE, 0.07; P = 1.3 × 10-7), and a smaller nucleus accumbens (Cohen d = -0.27; SE, 0.07; P = 7.3 × 10-5). There was also a significant negative dose response on cortical thickness (β = -0.24; SE, 0.05; P = 6.8 × 10-7). Regional cortical analyses showed a localization of the effects to the frontal, cingulate, and parietal lobes. Further, cognitive ability was lower for deletion carriers compared with noncarriers on 5 of 7 tasks.Conclusions and Relevance: These findings, from the largest CNV neuroimaging study to date, provide evidence that 15q11.2 BP1-BP2 structural variation is associated with brain morphology and cognition, with deletion carriers being particularly affected. The pattern of results fits with known molecular functions of genes in the 15q11.2 BP1-BP2 region and suggests involvement of these genes in neuronal plasticity. These neurobiological effects likely contribute to the association of this CNV with neurodevelopmental disorders.
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