| 1. |
- Eberhardson, Michael, et al.
(författare)
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Tumour necrosis factor inhibitors in Crohn's disease and the effect on surgery rates
- 2022
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Ingår i: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 24:4, s. 470-483
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Surgery is an important therapeutic option for Crohn's disease. The need for first bowel surgery seems to have decreased with the introduction of tumour necrosis factor inhibitors (TNFi; adalimumab or infliximab). However, the impact of TNFi on the need for intestinal surgery in Crohn's disease patients irrespective of prior bowel resection is not known. The aim of this work is to compare the incidence of bowel surgery in Crohn's disease patients who remain on TNFi treatment versus those who discontinue it. Method: We performed a nationwide register-based observational cohort study in Sweden of all incident and prevalent cases of Crohn's disease who started first-line TNFi treatment between 2006 and 2017. Patients were categorized according to TNFi treatment retention less than or beyond 1 year. The study cohort was evaluated with regard to incidence of bowel surgery from 12 months after the first ever TNFi dispensation. Results: We identified 5003 Crohn's disease patients with TNFi exposure: 3748 surgery naïve and 1255 with bowel surgery prior to TNFi initiation. Of these patients, 7% (n = 353) were subjected to abdominal surgery during the first 12 months after the start of TNFi and were subsequently excluded from the main analysis. A majority (62%) continued TNFi for 12 months or more. Treatment with TNFi for less than 12 months was associated with a significantly higher surgery rate compared with patients who continued on TNFi for 12 months or more (hazard ratio 1.26, 95% CI 1.09–1.46; p = 0.002). Conclusion: Treatment with TNFi for less than 12 months was associated with a higher risk of bowel surgery in Crohn's disease patients compared with those who continued TNFi for 12 months or more.
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| 2. |
- Mårild, Karl, 1982, et al.
(författare)
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Histologic activity in inflammatory bowel disease and risk of serious infections : A nationwide study
- 2024
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 22:4, s. 831-846
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Individuals with inflammatory bowel disease (IBD) are at increased risk of serious infections, but whether this risk varies by histological disease activity is unclear.METHODS: A national population-based study of 55,626 individuals diagnosed with IBD in 1990-2016 with longitudinal data on ileo-colorectal biopsies followed through 2016. Serious infections were defined as having an inpatient infectious disease diagnosis in the Swedish National Patient Register. We used Cox regression to estimate hazard ratios (HRs) for serious infections in the 12 months following documentation of histologic inflammation (vs. histological remission), adjusting for social and demographic factors, chronic comorbidities, prior IBD-related surgery and hospitalization. We also adjusted for IBD-related medications in sensitivity analyses.RESULTS: With histological inflammation vs. remission, there was 4.62 (95%CI=4.46-4.78) and 2.53 (95%CI=2.36-2.70) serious infections per 100 person-years of follow-up, respectively (adjusted [a]HR=1.59; 95%CI=1.48-1.72). Histological inflammation (vs. remission) were associated with an increased risk of serious infections in ulcerative colitis (UC, aHR=1.68; 95%CI=1.51-1.87) and Crohn's disease (CD, aHR=1.59; 95%CI=1.40-1.80). The aHRs of sepsis and opportunistic infections were 1.66 (95%CI=1.28-2.15) and 1.71 (95%CI=1.22-2.41), respectively. Overall, results were consistent across age groups, sex and education level and remained largely unchanged after adjustment for IBD-related medications (aHR=1.47; 95%CI=1.34-1.61).CONCLUSION: Histological inflammation of IBD was an independent risk factor of serious infections, including sepsis, suggesting that achieving histological remission may reduce infections in IBD.
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| 3. |
- Bröms, Gabriella, et al.
(författare)
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Capturing biologic treatment for IBD in the Swedish Prescribed Drug Register and the Swedish National Patient Register–a validation study
- 2021
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 56:4, s. 410-421
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is not known to what extent biologic treatment for IBD is captured in the Swedish Prescribed Drug Register (PDR) and the National Patient Register (NPR). Methods: A cross-sectional study from July 2005 until 2017, comparing data on biologic treatment in the PDR and the NPR with medical records. We assessed the proportion of started treatment episodes in the medical records that were found in the PDR/NPR ever, within +/− one year and within +/− three months; for any biologic drug, per specific drug (infliximab, adalimumab, golimumab, vedolizumab, ustekinumab), by calendar period (2005–2008, 2009–2012, and 2013–2017) and by study center. For adalimumab, we assessed the validity of end of treatment episodes. Results: Medical records of 1361 patients and 2323 treatment episodes with any biologic were reviewed and 80.1% (95% CI: 78.4–81.7) were ever captured in the PDR/NPR in. A time window of +/− one year or +/− three months reduced the sensitivity to 63.3% (95% CI: 61.3–65.3) and 52.6% (95% CI: 50.5–54.6), respectively. The sensitivity was high (>85%) for the prescribed injection drugs adalimumab, golimumab, and ustekinumab for all time windows and for adalimumab end of treatment, while considerably lower for the infusion drugs infliximab and vedolizumab. Conclusions: The PDR and the NPR are reliable data sources on treatment with injection biologics in patients with IBD in Sweden. Infliximab and vedolizumab are poorly captured, why PDR/NPR data should only be used after careful consideration of their limitations or complemented by other data sources, e.g., the disease-specific quality register SWIBREG.
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| 4. |
- Khalili, Hamed, et al.
(författare)
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Healthcare use, work loss and total costs in incident and prevalent Crohn's disease and ulcerative colitis : results from a nationwide study in Sweden
- 2020
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Ingår i: Alimentary Pharmacology and Therapeutics. - : John Wiley & Sons. - 0269-2813 .- 1365-2036. ; 52:4, s. 655-668
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are limited data on population-wide assessment of cost in Crohn's disease (CD) and ulcerative colitis (UC).Aim: To estimate the societal cost of actively treated CD and UC in Sweden.Methods: We identified 10 117 prevalent CD and 19 762 prevalent UC patients, aged ≥18 years on 1 January 2014 and 4028 adult incident CD cases and 8659 adult incident UC cases (2010-2013) from Swedish Patient Register. Each case was matched to five population comparators. Healthcare costs were calculated from medications, outpatient visits, hospitalisations and surgery. Cost of productivity losses was derived from disability pension and sick leave.Results: The mean annual societal costs per working-age patient (18-64 years) with CD and UC were $22 813 (vs $7533 per comparator) and $14 136 (vs $7351 per comparator) respectively. In patients aged ≥65 years, the mean annual costs of CD and UC were $9726 and $8072 vs $3875 and $4016 per comparator respectively. The majority of cost for both CD (56%) and UC (59%) patients originated from productivity losses. Higher societal cost of working-age CD patients as compared to UC patients was related to greater utilisation of anti-TNF (22.2% vs 7.4%) and increased annual disability pension (44 days vs 25 days). Among incident CD and UC patients, the mean total cost over the first year per patient was over three times higher than comparators.Conclusion: In Sweden, the societal cost of incident and prevalent CD and UC patients was consistently two to three times higher than the general population.
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| 5. |
- Lembrechts, Jonas J., et al.
(författare)
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SoilTemp : A global database of near-surface temperature
- 2020
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 26:11, s. 6616-6629
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Tidskriftsartikel (refereegranskat)abstract
- Current analyses and predictions of spatially explicit patterns and processes in ecology most often rely on climate data interpolated from standardized weather stations. This interpolated climate data represents long-term average thermal conditions at coarse spatial resolutions only. Hence, many climate-forcing factors that operate at fine spatiotemporal resolutions are overlooked. This is particularly important in relation to effects of observation height (e.g. vegetation, snow and soil characteristics) and in habitats varying in their exposure to radiation, moisture and wind (e.g. topography, radiative forcing or cold-air pooling). Since organisms living close to the ground relate more strongly to these microclimatic conditions than to free-air temperatures, microclimatic ground and near-surface data are needed to provide realistic forecasts of the fate of such organisms under anthropogenic climate change, as well as of the functioning of the ecosystems they live in. To fill this critical gap, we highlight a call for temperature time series submissions to SoilTemp, a geospatial database initiative compiling soil and near-surface temperature data from all over the world. Currently, this database contains time series from 7,538 temperature sensors from 51 countries across all key biomes. The database will pave the way toward an improved global understanding of microclimate and bridge the gap between the available climate data and the climate at fine spatiotemporal resolutions relevant to most organisms and ecosystem processes.
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| 6. |
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| 7. |
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| 8. |
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| 9. |
- Björk, Jonas, et al.
(författare)
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Recreational values of the natural environment in relation to neighbourhood satisfaction, physical activity, obesity and wellbeing.
- 2008
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 62:4, s. 2-2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this population-based study was to investigate associations between recreational values of the close natural environment and neighbourhood satisfaction, physical activity, obesity and wellbeing. METHODS: Data from a large public health survey distributed as a mailed questionnaire in suburban and rural areas of southern Sweden were used (N = 24,819; 59% participation rate). Geocoded residential addresses and the geographical information system technique were used to assess objectively five recreational values of the close natural environment: serene, wild, lush, spacious and culture. RESULTS: On average, a citizen of the Scania region, inner city areas excluded, only had access to 0.67 recreational values within 300 metres distance from their residence. The number of recreational values near the residence was strongly associated with neighbourhood satisfaction and physical activity. The effect on satisfaction was especially marked among tenants and the presence of recreational values was associated with low or normal body mass index in this group. A less marked positive association with vitality among women was observed. No evident effect on self-rated health was detectable. CONCLUSIONS: Immediate access to natural environments with high recreational values was rare in the study population and was distributed in an inequitable manner. Moreover, such access was associated with a positive assessment of neighbourhood satisfaction and time spent on physical activity, which can be expected to reduce obesity and increase vitality by having a buffering effect on stress.
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| 10. |
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| 11. |
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| 12. |
- Björk, Jonas, et al.
(författare)
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Skydda naturen nära oss
- 2007
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Ingår i: Skånska dagbladet. - 1103-9973. ; , s. 5-5
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 13. |
- Bodin, Theo, et al.
(författare)
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Annoyance, Sleep and Concentration Problems due to Combined Traffic Noise and the Benefit of Quiet Side.
- 2015
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 12:2, s. 1612-1628
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Tidskriftsartikel (refereegranskat)abstract
- Access to a quiet side in one's dwelling is thought to compensate for higher noise levels at the most exposed façade. It has also been indicated that noise from combined traffic sources causes more noise annoyance than equal average levels from either road traffic or railway noise separately.
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| 14. |
- Bodin, Theo, et al.
(författare)
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Road traffic noise and hypertension: results from a cross-sectional public health survey in southern Sweden.
- 2009
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Ingår i: Environmental Health. - 1476-069X. ; 8:38
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Results from studies of road traffic noise and hypertension are heterogeneous with respect to effect size, effects among males and females and with respect to effects across age groups. Our objective was to further explore these associations. METHODS: The study used cross-sectional public health survey data from southern Sweden, including 24,238 adults (18 - 80 years old). We used a geographic information system (GIS) to assess the average road noise (LAeq 24 hr) at the current residential address. Effects on self-reported hypertension were estimated by logistic regression with adjustment for age, sex, BMI, alcohol intake, exercise, education, smoking and socioeconomic status. RESULTS: Modest exposure effects (OR approximately 1.1) were generally noted in intermediate exposure categories (45 -64 dB(A)), and with no obvious trend. The effect was more pronounced at > 64 dB(A) (OR 1.45, 95% CI 1.04 - 2.02). Age modified the relative effect (p = 0.018). An effect was seen among middle-aged (40 - 59 years old) at noise levels 60 - 64 dB(A) (OR = 1.27, 95% CI 1.02 - 1.58)) and at > 64 dB(A) (OR = 1.91, 95% CI 1.19 - 3.06)). An effect was also indicated among younger adults but not among elderly. No apparent effect modification by gender, country of origin, disturbed sleep or strained economy was noted. CONCLUSION: The study supports an association between road traffic noise at high average levels and self-reported hypertension in middle-aged. Future studies should use age group -specific relative effect models to account for differences in prevalence.
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| 15. |
- Bodin, Theo, et al.
(författare)
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Survey context and question wording affects self reported annoyance due to road traffic noise: a comparison between two cross-sectional studies.
- 2012
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Ingår i: Environmental health : a global access science source. - 1476-069X. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Surveys are a common way to measure annoyance due to road traffic noise, but the method has some draw-backs. Survey context, question wording and answer alternatives could affect participation and answers and could have implications when comparing studies and/or performing pooled analyses. The aim of this study was to investigate the difference in annoyance reporting due to road traffic noise in two types of surveys of which one was introduced broadly and the other with the clearly stated aim of investigating noise and health METHODS: Data was collected from two surveys carried out in the municipality of Malmo, southern Sweden in 2007 and 2008 (n = 2612 and n = 3810). The first survey stated an aim of investigating residential environmental exposure, especially noise and health. The second survey was a broad public health survey stating a broader aim. The two surveys had comparable questions regarding noise annoyance, although one used a 5-point scale and the other a 4-point scale. We used geographic information systems (GIS) to assess the average road and railway noise (LAeq,24h) at the participants' residential address. Logistic regression was used to calculate odds ratios for annoyance in relation to noise exposure. RESULTS: Annoyance at least once a week due to road traffic noise was significantly more prevalent in the survey investigating environment and health compared to the public health survey at levels >45 dB(A), but not at lower exposure levels. However no differences in annoyance were found when comparing the extreme alternatives "never" and "every day". In the study investigating environment and health, "Noise sensitive" persons were more likely to readily respond to the survey and were more annoyed by road traffic noise compared to the other participants in that survey. CONCLUSIONS: The differences in annoyance reporting between the two surveys were mainly due to different scales, suggesting that extreme alternatives are to prefer before dichotomization when comparing results between the two. Although some findings suggested that noise-sensitive individuals were more likely to respond to the survey investigating noise and health, we could not find convincing evidence that contextual differences affected either answers or participation.
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| 16. |
- Boldis, Beata Vivien, 1993-, et al.
(författare)
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Comorbidities in women with polycystic ovary syndrome : a sibling study
- 2024
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Ingår i: BMC Women's Health. - 1472-6874. ; 24:1, s. 221-221
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Polycystic ovary syndrome (PCOS) has previously been associated with several comorbidities that may have shared genetic, epigenetic, developmental or environmental origins. PCOS may be influenced by prenatal androgen excess, poor intrauterine or childhood environmental factors, childhood obesity and learned health risk behaviors. We analyzed the association between PCOS and several relevant comorbidities while adjusting for early-life biological and socioeconomic conditions, also investigating the extent to which the association is affected by familial risk factors. METHODS: This total-population register-based cohort study included 333,999 full sisters, born between 1962 and 1980. PCOS and comorbidity diagnoses were measured at age 17-45 years through national hospital register data from 1997 to 2011, and complemented with information on the study subjects´ early-life and social characteristics. In the main analysis, sister fixed effects (FE) models were used to control for all time-invariant factors that are shared among sisters, thereby testing whether the association between PCOS and examined comorbidities is influenced by unobserved familial environmental, social or genetic factors. RESULTS: Three thousand five hundred seventy women in the Sister sample were diagnosed with PCOS, of whom 14% had obesity, 8% had depression, 7% had anxiety and 4% experienced sleeping, sexual and eating disorders (SSE). Having PCOS increased the odds of obesity nearly 6-fold (adjusted OR (aOR): 5.9 [95% CI:5.4-6.5]). This association was attenuated in models accounting for unobserved characteristics shared between full sisters, but remained considerable in size (Sister FE: aOR: 4.5 [95% CI: 3.6-5.6]). For depression (Sister FE: aOR: 1.4 [95% CI: 1.2-1.8]) and anxiety (Sister FE: aOR: 1.5 [95% CI: 1.2-1.8), there was a small decrease in the aORs when controlling for factors shared between sisters. Being diagnosed with SSE disorders yielded a 2.4 aOR (95% CI:2.0-2.6) when controlling for a comprehensive set of individual-level confounders, which only decreased slightly when controlling for factors at the family level such as shared genes or parenting style. Accounting for differences between sisters in observed early-life circumstances influenced the estimated associations marginally. CONCLUSION: Having been diagnosed with PCOS is associated with a markedly increased risk of obesity and sleeping, sexual and eating disorders, also after accounting for factors shared between sisters and early-life conditions.
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| 17. |
- Boldis, Beata Vivien, et al.
(författare)
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Early Life Factors and Polycystic Ovary Syndrome in a Swedish Birth Cohort
- 2023
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Ingår i: International Journal of Environmental Research and Public Health. - 1661-7827. ; 20:22
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Tidskriftsartikel (refereegranskat)abstract
- Polycystic ovary syndrome (PCOS) is a medical condition with important consequences for women’s well-being and reproductive outcomes. Although the etiology of PCOS is not fully understood, there is increasing evidence of both genetic and environmental determinants, including development in early life. We studied a population of 977,637 singleton women born in in Sweden between 1973 and 1995, followed sometime between the age 15 and 40. The incidence of PCOS was measured using hospital register data during 2001–2012, complemented with information about the women’s, parents’ and sisters’ health and social characteristics from population and health care registers. Cox regression was used to study how PCOS is associated with intergenerational factors, and a range of early life characteristics. 11,594 women in the study sample were diagnosed with PCOS during the follow-up period. The hazard rate for PCOS was increased 3-fold (HR 2.98, 95% CI 2.43–3.64) if the index woman’s mother had been diagnosed with PCOS, and with 1.5-fold (HR 1.51, 95% CI 1.39–1.63) if their mother had diabetes mellitus. We found associations of PCOS with lower (<7) one-minute Apgar score (HR 1.19, 95% CI 1.09–1.29) and with post-term birth (HR 1.19, 95% CI 1.13–1.26). Furthermore, heavy (10+ cigarettes/day) maternal smoking (HR 1.30, 95% CI 1.18–1.44) and maternal obesity (HR 1.90, 95% CI 1.62–2.36) were strongly associated with PCOS. This study finds support for the heritability and fetal origins of PCOS. Risk of PCOS could be reduced by further emphasizing the importance of maternal and early life health.
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| 18. |
- Eriksson, Carl, 1981-, et al.
(författare)
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Long-term effectiveness of vedolizumab in inflammatory bowel disease : a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
- 2017
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 52:6-7, s. 722-729
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw index<5 in Crohn's disease (CD) and Patient Simple Clinical Colitis Activity index<3 in ulcerative colitis (UC).Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (p<.0001 in both groups). Faecal-calprotectin decreased in CD (p<.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.
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| 19. |
- Hasselmann, Julien, et al.
(författare)
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Inguinal Vascular Surgical Wound Protection by Incisional Negative Pressure Wound Therapy : A Randomized Controlled Trial-INVIPS Trial
- 2020
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Ingår i: Annals of Surgery. - 1528-1140. ; 271:1, s. 48-53
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A randomized controlled trial (RCT) was undertaken to determine the effect of negative pressure wound therapy (NPWT) on closed incisions after inguinal vascular surgery regarding surgical site infections (SSIs) and other wound complications. BACKGROUND: SSIs are a major concern in open vascular procedures involving the inguinal region. Prophylactic NPWT on closed incisions has shown promising results, but the quality of evidence can be debated. This study aims to objectively evaluate whether NPWT on sutured inguinal incisions after elective vascular surgery can decrease the incidence of surgical site complications. METHODS: One hundred thirty-nine patients undergoing elective open vascular surgery with inguinal incisions received either NPWT or a standard dressing. Patients with bilateral incisions randomly received a dressing on one incision and the opposite dressing on the other. The primary endpoints were SSI or other wound complications at 3 months, assessed by wound care experts blinded to the treatment arm and using objective wound assessment criteria (ASEPSIS-score). Statistical analysis was performed on an intention-to-treat basis and obtained P values from analyses in the uni- and bilateral groups were combined to an overall P value using Fisher's method for combining P values. RESULTS: The incidence of SSI was reduced in the NPWT group compared with the control group [11.9% vs 29.5% in the unilateral group (n = 120), 5.3% vs 26.3% in the bilateral group (n = 19), respectively; combined P = 0.02]. No differences regarding other surgical site complications were observed between the groups. CONCLUSION: NPWT on closed inguinal vascular surgical incisions in elective patients reduces the incidence of SSI.
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| 20. |
- Hasselmann, Julien, et al.
(författare)
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Proposed Classification of Incision Complications: Analysis of a Prospective Study on Elective Open Lower - Limb Revascularization.
- 2020
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Ingår i: Surgical Infections. - : Mary Ann Liebert Inc. - 1557-8674 .- 1096-2964. ; 21:4, s. 384-390
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Tidskriftsartikel (refereegranskat)abstract
- Background: Incision complications (IC) have a significant impact on procedure-related morbidity after lower-limb revascularization. One of the most studied IC is surgical site infection (SSI). Reporting these complications in a uniform way is crucial to evaluate treatment approaches. The aim of this study was to propose a comprehensive classification of IC and apply it to compare SSI with other IC in a trial on elective open lower-limb revascularization procedures. Methods: Two hundred twenty-three eligible patients undergoing elective unilateral inguinal and infra-inguinal arterial vascular surgery were extracted from a randomized controlled trial on incisional negative-pressure wound therapy (NPWT) on inguinal vascular surgical incisions. The IC were classified by grades of severity (grade 0-6) that focused on IC-related consequences such as out-patient treatment (grade 1), prolonged in-patient treatment (grade 2), re-admission (grade 3), and re-operation (grade ≥4). An SSI was defined by the ASEPSIS score criteria. Results: An SSI was diagnosed in 63 patients (28.3%). Thirty-five of 160 patients (21.8%) not suffering from SSI underwent IC treatment. Treatment for IC was recorded for 25/144 patients (17.4%) with satisfactory site healing as judged by the ASEPSIS score. The median incision-related in-hospital stay in those with SSI (n = 79) and disturbed healing (n = 16) according to the ASEPSIS score was 13 days in both groups (p = 0.53). Five patients had peri-vascular SSI (IC grade 4 n = 4; grade 5 n = 1). The proposed classification of IC and the ASEPSIS score correlated highly (r = 0.77; p < 0.001). Inter-rater reliability for IC grading was substantial for three investigators with different levels of experience (k = 0.81, 0.71, and 0.70). Conclusions: The proposed incision classification suggests a comparable clinical significance of vascular IC in terms of IC-related in-patient stay, whether there was a surgical site infection or not. This classification system requires external validation.
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| 21. |
- Kristiansen, Jesper, et al.
(författare)
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Work stress, worries, and pain interact synergistically with modelled traffic noise on cross-sectional associations with self-reported sleep problems
- 2011
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 84:2, s. 211-224
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Tidskriftsartikel (refereegranskat)abstract
- To examine the risk of sleep problems associated with work stress (job strain, job demands, and decision authority), worries and pain and to investigate the synergistic interaction between these factors and traffic noise. Sleep problems and predictor variables were assessed in a cross-sectional public health survey with 12,093 respondents. Traffic noise levels were assessed using modelled A-weighted energy equivalent traffic sound levels at the residence. The risk of sleep problems was modelled using multiple logistic regression analysis. With regard to sleep problems not attributed to any external source (general sleep problems), independent main effects were found for traffic noise (women), decision authority (women), job strain, job demands, suffering from pain or other afflictions, worries about losing the job, experiencing bullying at work, having troubles paying the bills, and having a sick, disabled, or old relative to take care of (women). Significant synergistic effects were found for traffic noise and experiencing bullying at work in women. With regard to sleep problems attributed to traffic noise, strong synergistic interactions were found between traffic noise and, respectively, job demands (men), having pain or other afflictions, taking care of a sick, old, or disabled relative, and having troubles paying the bills. Main effects were found for worries about losing the job, experiencing bullying at work, job strain (men), and decision authority (men). Synergistic interactions could potentially contribute with 10-20% of the sleep problems attributed to traffic noise in the population. Work stress, pain, and different worries were independently associated with general sleep problems and showed in general no synergistic interaction with traffic noise. In contrast, synergistic effects between traffic noise and psychological factors were found with regard to sleep problems attributed to traffic noise. The synergy may contribute significantly to sleep problems attributed to traffic noise in the population.
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| 22. |
- Lembrechts, Jonas J., et al.
(författare)
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Global maps of soil temperature
- 2022
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 28:9, s. 3110-3144
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Tidskriftsartikel (refereegranskat)abstract
- Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0–5 and 5–15cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean=3.0±2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6±2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (−0.7±2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications.
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| 23. |
- Olén, Ola, et al.
(författare)
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Increasing Risk of Lymphoma Over Time in Crohn's Disease but Not in Ulcerative Colitis : A Scandinavian Cohort Study
- 2023
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 21:12, s. 3132-3142
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Earlier studies have provided varying risk estimates for lymphoma in patients with inflammatory bowel disease (IBD), but often have been limited by detection biases (especially during the first year of follow-up evaluation), misclassification, and small sample size; and rarely reflect modern-day management of IBD.Methods: We performed a binational register-based cohort study (Sweden and Denmark) from 1969 to 2019. We compared 164,716 patients with IBD with 1,639,027 matched general population reference individuals. Cox regression estimated hazard ratios (HRs) for incident lymphoma by lymphoma subtype, excluding the first year of follow-up evaluation.Results: From 1969 to 2019, 258 patients with Crohn's disease (CD), 479 patients with ulcerative colitis (UC), and 6675 matched reference individuals developed lymphoma. This corresponded to incidence rates of 35 (CD) and 34 (UC) per 100,000 person-years in IBD patients, compared with 28 and 33 per 100,000 person-years in their matched reference individuals. Although both CD (HR, 1.32; 95% CI, 1.16–1.50) and UC (HR, 1.09; 95% CI, 1.00–1.20) were associated with an increase in lymphoma, the 10-year cumulative incidence difference was low even in CD patients (0.08%; 95% CI, 0.02–0.13). HRs have increased in the past 2 decades, corresponding to increasing use of immunomodulators and biologics during the same time period. HRs were increased for aggressive B-cell non-Hodgkin lymphoma in CD and UC patients, and for T-cell non-Hodgkin lymphoma in CD patients. Although the highest HRs were observed in patients exposed to combination therapy (immunomodulators and biologics) or second-line biologics, we also found increased HRs in patients naïve to such drugs.Conclusions: During the past 20 years, the risk of lymphomas have increased in CD, but not in UC, and were driven mainly by T-cell lymphomas and aggressive B-cell lymphomas.
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| 24. |
- Persson, Roger, et al.
(författare)
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Trait anxiety and modeled exposure as determinants of Self-Reported Annoyance to Sound, Air Pollution and Other Environmental Factors in the home
- 2007
-
Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 81:2, s. 179-191
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Tidskriftsartikel (refereegranskat)abstract
- Objectives We examined to what degree annoyance ratings to noise, air pollution and other common environmental factors in the home environment could be considered to mirror personality disposition in terms of habitual anxiety level and, when appropriate, objectively modeled noise and nitrogen emission (NOx). Methods A trait anxiety scale was introduced in a cross-sectional public health survey with 2,856 respondents. Of these, 705 had self-reported asthma and the rest constituted gender-matched referents. Annoyance to ten specific factors in the residential environment, mainly focusing on source-specific noise and air pollution, was assessed on a six-point likert scale. A-weighted energy equivalent continuous sound pressure level during a full day (24 h; L (Aeq,24)) as well as annual average NOx levels (mu g/m(3)) at the residential address were modeled with high resolution, using a road data base and a detailed emission data base for NOx. Results The two most prevalent complaints were annoyance to traffic noise and sounds from neighbors, which was reported by about 8% of the participants. Unadjusted logistic regression analyses using the continuous trait anxiety score as a predictor showed positive associations with ratings of annoyance from total traffic noise, sounds from neighbors, sound from ventilation, exhaust fumes from traffic, sounds from other installations, and vibrations from traffic (ORs between 1.37 and 2.14). Modeled noise and NOx exposure were positively related with annoyance to traffic noise and exhaust fumes, respectively. Adjustment of the trait anxiety scores for other individual characteristics and potential determinants did not change the overall pattern of results. Conclusion Trait anxiety scores were often mirrored in ratings of annoyance, which suggests caution when using annoyance reports either as a surrogate measure for environmental exposure on the individual-level in epidemiologic studies or when studying the moderating effects of annoyance on health outcomes.
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| 25. |
- Shrestha, Sarita, 1991-, et al.
(författare)
-
The use of ICD codes to identify IBD subtypes and phenotypes of the Montreal classification in the Swedish National Patient Register
- 2020
-
Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 55:4, s. 430-435
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Whether data on International Classification of Diseases (ICD)-codes from the Swedish National Patient Register (NPR) correctly correspond to subtypes of inflammatory bowel disease (IBD) and phenotypes of the Montreal classification scheme among patients with prevalent disease is unknown. Materials and methods: We obtained information on IBD subtypes and phenotypes from the medical records of 1403 patients with known IBD who underwent biological treatment at ten Swedish hospitals and retrieved information on their IBD-associated diagnostic codes from the NPR. We used previously described algorithms to define IBD subtypes and phenotypes. Finally, we compared these register-generated subtypes and phenotypes with the corresponding information from the medical records and calculated positive predictive values (PPV) with 95% confidence intervals. Results: Among patients with clinically confirmed disease and diagnostic listings of IBD in the NPR (N = 1401), the PPV was 97 (96-99)% for Crohn's disease, 98 (97-100)% for ulcerative colitis, and 8 (4-11)% for IBD-unclassified. The overall accuracy for age at diagnosis was 95% (when defined as A1, A2, or A3). Examining the validity of codes representing disease phenotype, the PPV was 36 (32-40)% for colonic Crohn's disease (L2), 61 (56-65)% for non-stricturing/non-penetrating Crohn's disease behaviour (B1) and 83 (78-87)% for perianal disease. Correspondingly, the PPV was 80 (71-89)% for proctitis (E1)/left-sided colitis (E2) in ulcerative colitis. Conclusions: Among people with known IBD, the NPR is a reliable source of data to classify most subtypes of prevalent IBD, even though misclassification commonly occurred in Crohn's disease location and behaviour and also among IBD-unclassified patients.
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| 26. |
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| 27. |
- Stroh, Emilie, et al.
(författare)
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Measured and modeled personal and environmental NO2 exposure
- 2012
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Ingår i: Population Health Metrics. - : Springer Science and Business Media LLC. - 1478-7954. ; 10:10
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract in Undetermined Background: Measured or modeled levels of outdoor air pollution are being used as proxies for individual exposure in a growing number of epidemiological studies. We studied the accuracy of such approaches, in comparison with measured individual levels, and also combined modeled levels for each subject's workplace with the levels at their residence to investigate the influence of living and working in different places on individual exposure levels. Methods: A GIS-based dispersion model and an emissions database were used to model concentrations of NO2 at the subject's residence. Modeled levels were then compared with measured levels of NO2. Personal exposure was also modeled based on levels of NO2 at the subject's residence in combination with levels of NO2 at their workplace during working hours. Results: There was a good agreement between measured facade levels and modeled residential NO2 levels (r(s) = 0.8, p > 0.001); however, the agreement between measured and modeled outdoor levels and measured personal exposure was poor with overestimations at low levels and underestimation at high levels (r(s) = 0.5, p > 0.001 and r(s) = 0.4, p > 0.001) even when compensating for workplace location (r(s) = 0.4, p > 0.001). Conclusion: Modeling residential levels of NO2 proved to be a useful method of estimating facade concentrations. However, the agreement between outdoor levels (both modeled and measured) and personal exposure was, although significant, rather poor even when compensating for workplace location. These results indicate that personal exposure cannot be fully approximated by outdoor levels and that differences in personal activity patterns or household characteristics should be carefully considered when conducting exposure studies. This is an important finding that may help to correct substantial bias in epidemiological studies.
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| 28. |
- Sundén-Cullberg, Jonas, et al.
(författare)
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Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU
- 2017
-
Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 45:4, s. 591-599
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:: To study the prognostic value of fever in the emergency department in septic patients subsequently admitted to the ICU. DESIGN:: Observational cohort study from the Swedish national quality register for sepsis. SETTING:: Thirty ICU’s in Sweden. PATIENTS:: Two thousand two hundred twenty-five adults who were admitted to an ICU within 24 hours of hospital arrival with a diagnosis of severe sepsis or septic shock were included. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Body temperature was measured and classified according to four categories (< 37°C, 37–38.29°C, 38.3–39.5°C, ≥ 39.5°C). The main outcome was in-hospital mortality. Odds ratios for mortality according to body temperature were estimated using multivariable logistic regression. Subgroup analyses were conducted according to age, sex, underlying comorbidity, and time to given antibiotics. Overall mortality was 25%. More than half of patients had a body temperature below 38.3°C. Mortality was inversely correlated with temperature and decreased, on average, more than 5% points per °C increase, from 50% in those with the lowest temperatures to 9% in those with the highest. Increased body temperature in survivors was also associated with shorter hospital stays. Patients with fever received better quality of care, but the inverse association between body temperature and mortality was robust and remained consistent after adjustment for quality of care measures and other factors that could have confounded the association. Among vital signs, body temperature was best at predicting mortality. CONCLUSIONS:: Contrary to common perceptions and current guidelines for care of critically ill septic patients, increased body temperature in the emergency department was strongly associated with lower mortality and shorter hospital stays in patients with severe sepsis or septic shock subsequently admitted to the ICU.
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| 29. |
- Svensson Björk, Robert, et al.
(författare)
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Negative Pressure Wound Therapy for the Prevention of Surgical Site Infections Using Fascia Closure After EVAR-A Randomized Trial
- 2022
-
Ingår i: World Journal of Surgery. - : Springer. - 0364-2313 .- 1432-2323. ; 46:12, s. 3111-3120
-
Tidskriftsartikel (refereegranskat)abstract
- Background Surgical site infections (SSI) in the groin after vascular surgery are common. The aim of the study was to evaluate the effect of negative pressure wound therapy (NPWT) on SSI incidence when applied on closed inguinal incisions after endovascular aneurysm repair (EVAR). Methods A multicenter randomized controlled trial (RCT). Between November 2013 and December 2020, 377 incisions (336 bilateral and 41 unilateral) from elective EVAR procedures with the primary intent of fascia closure were randomized and included, receiving either NPWT or a standard dressing. In bilateral incisions, each incision randomly received the opposite dressing of the other side, thereby becoming each others control. The primary endpoint was SSI incidence at 90 days postoperatively, analyzed on an intention-to-treat basis. Uni and bilaterally operated incisions were analyzed separately, and their respective p-values combined using Fishers method for combining P-values. Study protocol (NCT01913132). Results The SSI incidence at 90 days postoperatively in bilateral incisions was 1.8% (n = 3/168) in the NPWT and 4.8% (n = 8/168) in the standard dressing group, and in unilateral incisions 13.3% (n = 2/15) and 11.5% (n = 3/26), respectively (combined p = 0.49). In all SSIs, bacteria were isolated from incisional wound cultures. No additional SSIs were diagnosed between 90 days and 1 year follow-up. Conclusions No evidence of difference in SSI incidence was seen in these low-risk inguinal incisions when comparing NPWT with standard dressings after EVAR with the primary intent of fascia closure.
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| 30. |
- Vikström, Linnea, et al.
(författare)
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Vaccine-induced correlate of protection against fatal COVID-19 in older and frail adults during waves of neutralization-resistant variants of concern : an observational study
- 2023
-
Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 30
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To inform future preventive measures including repeated vaccinations, we have searched for a clinically useful immune correlate of protection against fatal COVID-19 among nursing homes residents.METHODS: We performed repeated capillary blood sampling with analysis of S-binding IgG in an open cohort of nursing home residents in Sweden. We analyzed immunological and registry data from 16 September 2021 to 31 August 2022 with follow-up of deaths to 30 September 2022. The study period included implementation of the 3rd and 4th mRNA monovalent vaccine doses and Omicron virus waves.FINDINGS: A total of 3012 nursing home residents with median age 86 were enrolled. The 3rd mRNA dose elicited a 99-fold relative increase of S-binding IgG in blood and corresponding increase of neutralizing antibodies. The 4th mRNA vaccine dose boosted levels 3.8-fold. Half-life of S-binding IgG was 72 days. A total 528 residents acquired their first SARS-CoV-2 infection after the 3rd or the 4th vaccine dose and the associated 30-day mortality was 9.1%. We found no indication that levels of vaccine-induced antibodies protected against infection with Omicron VOCs. In contrast, the risk of death was inversely correlated to levels of S-directed IgG below the 20th percentile. The death risk plateaued at population average above the lower 35th percentile of S-binding IgG.INTERPRETATION: In the absence of neutralizing antibodies that protect from infection, quantification of S-binding IgG post vaccination may be useful to identify the most vulnerable for fatal COVID-19 among the oldest and frailest. This information is of importance for future strategies to protect vulnerable populations against neutralization resistant variants of concern.FUNDING: Swedish Research Council, SciLifeLab via Knut and Alice Wallenberg Foundation, VINNOVA. Swedish Healthcare Regions, and Erling Persson Foundation.
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| 31. |
- Ahlberg, Erik, et al.
(författare)
-
"Vi klimatforskare stödjer Greta och skolungdomarna"
- 2019
-
Ingår i: Dagens nyheter (DN debatt). - 1101-2447.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- DN DEBATT 15/3. Sedan industrialiseringens början har vi använt omkring fyra femtedelar av den mängd fossilt kol som får förbrännas för att vi ska klara Parisavtalet. Vi har bara en femtedel kvar och det är bråttom att kraftigt reducera utsläppen. Det har Greta Thunberg och de strejkande ungdomarna förstått. Därför stödjer vi deras krav, skriver 270 klimatforskare.
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| 32. |
- Ahsan, Aisha, et al.
(författare)
-
Phase Transitions in Confinements: Controlling Solid to Fluid Transitions of Xenon Atoms in an On-Surface Network
- 2019
-
Ingår i: Small. - : WILEY-V C H VERLAG GMBH. - 1613-6810 .- 1613-6829. ; 15:3
-
Tidskriftsartikel (refereegranskat)abstract
- This study reports on "phase" transitions of Xe condensates in on-surface confinements induced by temperature changes and local probe excitation. The pores of a metal-organic network occupied with 1 up to 9 Xe atoms are investigated in their propensity to undergo "condensed solid" to "confined fluid" transitions. Different transition temperatures are identified, which depend on the number of Xe atoms in the condensate and relate to the stability of the Xe clustering in the condensed "phase." This work reveals the feature-rich behavior of transitions of confined planar condensates, which provide a showcase toward future "phase-transition" storage media patterned by self-assembly. This work is also of fundamental interest as it paves the way to real space investigations of reversible solid to fluid transitions of magic cluster condensates in an array of extremely well-defined quantum confinements.
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| 33. |
- Ahsan, Aisha, et al.
(författare)
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Watching nanostructure growth: kinetically controlled diffusion and condensation of Xe in a surface metal organic network
- 2019
-
Ingår i: Nanoscale. - : ROYAL SOC CHEMISTRY. - 2040-3364 .- 2040-3372. ; 11:11, s. 4895-4903
-
Tidskriftsartikel (refereegranskat)abstract
- Diffusion, nucleation and growth provide the fundamental access to control nanostructure growth. In this study, the temperature activated diffusion of Xe at and between different compartments of an on-surface metal organic coordination network on Cu(111) has been visualized in real space. Xe atoms adsorbed at lower energy sites become mobile with increased temperature and gradually populate energetically more favourable binding sites or remain in a delocalized fluid form confined to diffusion along a topological subset of the on-surface network. These diffusion pathways can be studied individually under kinetic control via the chosen thermal energy kT of the sample and are determined by the network and sample architecture. The spatial distribution of Xe in its different modes of mobility and the time scales of the motion is revealed by Scanning Tunneling Microscopy (STM) at variable temperatures up to 40 K and subsequent cooling to 4 K. The system provides insight into the diffusion of a van der Waals gas on a complex structured surface and its nucleation and coarsening/growth into larger condensates at elevated temperature under thermodynamic conditions.
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| 34. |
- Al-Emrani, Faisal, et al.
(författare)
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Pattern of Five-Year Weight Change by Age and Birth Cohorts in a Swedish Adult Population
- 2013
-
Ingår i: The Open Public Health Journal. - : Bentham Science Publishers Ltd.. - 1874-9445. ; 6, s. 42-50
-
Tidskriftsartikel (refereegranskat)abstract
- The driving factors behind the global epidemic of obesity have not yet been fully elucidated. Investigating the effect of age and cohort on weight change might enable us to develop effective intervention strategies. Aims To analyse the pattern of BMI change by age and birth cohort over five-year follow-up in adult Swedish sample. Methods The data was drawn from the Scania Public Health Cohort. The baseline survey was conducted between 1999 and 2000, and the follow-up in 2005. A total of 10,373 individuals responded to both surveys; all were included in the present study. The data was stratified into three-year intervals according to a respondent’s birth year and age at baseline. This was done in order to allow for age and cohort effect analysis by means of fixed effects linear mixed models. Results We observed a significant increase in BMI between baseline and follow-up for males and females (p < 0.001), as well as significant age and cohort effects resulted from age
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| 35. |
- Alam, Assad, et al.
(författare)
-
Cooperative driving according to Scoop
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- KTH Royal Institute of Technology and Scania are entering the GCDC 2011 under the name Scoop –Stockholm Cooperative Driving. This paper is an introduction to their team and to the technical approach theyare using in their prototype system for GCDC 2011.
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| 36. |
- Albin, Maria, et al.
(författare)
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Acute myeloid leukemia and clonal chromosome aberrations in relation to past exposure to organic solvents
- 2000
-
Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 26:6, s. 482-491
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The effects of occupational and leisure-time exposures on the risk of acute myeloid leukemia (AML) were investigated with emphasis on clonal chromosome aberrations (CCA) and morphological subtypes. METHODS: Consecutively diagnosed cases of AML (N=333) and 1 population referent per case were retrospectively included in the study. Information on worktasks, companies, and leisure-time activities was obtained with telephone interviews. Exposure probability and intensity were assessed by occupational hygienists. Associations were evaluated with logistic regression. RESULTS: Exposure to organic solvents was associated with an increased risk of AML [low exposure: OR 1.5 (95% confidence interval (95% CI) 1.0-2.3, moderate-high exposure: OR 2.3 (95% CI 1.0-5.0)]. For exposure to solvents, but not to benzene, the OR was 1.2 (95% CI 0.69-2.0) for "low" and 2.7 (95% CI 1.0-7.3) for "moderate-high" exposure. The observed effects increased with intensity and duration of exposure. The estimated effects were higher for patients >60 years of age at the time of diagnosis. The effect of exposure to organic solvents was not differential with regard to morphology [except possibly erythroleukemia: OR 4.2, 95% CI 1.0-17 or the presence of CCA in general]. No increased risk for AML with complex CCA or with total or partial losses of chromosomes 5 or 7 were observed, but a higher risk was found for AML with trisomy 8 (OR 11, 95% CI 2.7-42) as the sole aberration. CONCLUSIONS: Exposure to organic solvents was associated with an increased risk of AML. This association was not due to benzene exposure alone and may be modified by age. Furthermore, specific associations with trisomy 8, and possibly also erythroleukemia, were suggested.
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| 37. |
- Albin, Maria; Björk, Jonas; Lövkvist, Håkan,
(författare)
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Exponering för omgivningsbuller i Skåne: Omfattning och miljömedicinsk bedömning
- 2003
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kartläggning av exponering för omgivningsbuller i Skåne och en miljömedicinsk bedömning av dess effekter har genomförts. Som underlag har använts trafik på statliga vägar, med beräkningar baserade på GIS-metodik, samt modeller för vägbullerbelastning i tätorter av olika storlek från såväl statliga som kommunala vägar. Uppgifter om störning och hälsotillstånd har hämtats från Folkhälsoenkät Skåne 2000. Den övervägande delen av befolkningen (3 av 4) bor i områden som inte är tysta (ekvivalentnivå över 40 dB(A). Nära var femte person i Skåne beräknas vara utsatt för omgivningsbuller från vägtrafik överskridande 55 dB(A) ekvivalentnivå över dygnet. I Malmö och Burlöv beräknas minst var fjärde invånare ha sådan exponering. För tåg- och flygtrafik saknas underlag för motsvarande beräkningar. Det fanns bland personer som beräknades vara exponerade över dessa nivåer en tendens till att oftare rapportera koncentrationsstörning. För personer som i större utsträckning kan antas vistas och arbeta hemma dagtid (hemarbetande, pensionärer, studerande, arbetslösa) var ökningen statistiskt signifikant (Oddskvot=3,5, 95% konfidensintervall 1,3-8.9), medan ingen effekt sågs hos de förvärvsarbetande. Inga statistiskt säkerställda samband sågs med sömnstörning eller blodtrycksmedicinering. Trafikbuller i bostaden upplevs som ganska mycket, eller mycket störande av var femtonde person i Skåne (7%). Flertalet av dessa, motsvarande 5% i hela befolkningen, anger att det är vägtrafiken som stör dem. Motsvarande 2-3% av befolkningen anger att trafikbullret ofta ger störd vila/avkoppling, insomning, respektive väckning. Kartläggningen visar att underlaget för hälsorelaterad miljöövervakning av exponering för trafikbuller är bristfälligt i flera avseenden. Trots detta visar kartläggningen att exponeringen för trafikbuller är ett betydande problem för befolkningen i Skåne. Problemet är särskilt uttalat i vissa kommuner där riktade insatser är befogade. Det är ur miljömedicinsk synpunkt angeläget att underlaget för fortsatt miljöövervakning av exponering för trafikbuller förbättras och därefter fortsatt uppdateras, med god tillgänglighet för olika samhällsinstanser.
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| 38. |
- Albin, Maria, et al.
(författare)
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Cytogenetic and morphologic subgroups of myelodysplastic syndromes in relation to occupational and hobby exposures.
- 2003
-
Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 29:5, s. 378-387
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study investigated the association between occupational and hobby exposure and the risk of myelodysplastic syndromes (MDS) while focusing on differential patterns of clonal chromosome aberrations and morphologic subgroups. METHODS: A case-referent study was conducted with 330 MDS patients investigated cytogenetically in 1976-1993 (cases) and matched referents. Telephone interviews with either the person or a next-of-kin were used. The participation rate of the cases and referents was 85% and 60%, respectively. Information was obtained from the next-of-kin more often for the cases (88%) than for the referents (26%). Occupational hygienists assessed the exposure using interview data on worktasks and hobbies. Associations with disease risk were evaluated for 10 exposures with a logistic regression analysis. RESULTS: The investigated exposures were generally not associated with cytogenetically abnormal MDS. Effect estimates for specific cytogenetic or morphologic subgroups were generally imprecise. Occupational exposure to extremely low-frequency magnetic fields (EMF) was associated with MDS with a normal karyotype [odds ratio (OR) 2.0, 95% confidence interval (95% CI) 1.0-4.0]. The exposure-response association was consistent for intensity but inconclusive for duration. A decreased risk was observed for MDS, irrespective of karyotypic pattern, among farmers and farmhands (OR 0.53, 95% CI 0.35-0.81). CONCLUSIONS: Cytogenetically abnormal MDS was generally not associated with occupational or hobby exposure to known or suspected genotoxic agents. However, exposure prevalences and intensities were low for several agents. An association was suggested between occupational exposure to EMF and MDS with a normal karyotype. Biases due to differential information quality and selective participation cannot be ruled out.
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| 39. |
- Almlof, Jonas, et al.
(författare)
-
Creating and detecting specious randomness
- 2023
-
Ingår i: EPJ QUANTUM TECHNOLOGY. - : Springer Nature. - 2662-4400 .- 2196-0763. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- We present a new test of non-randomness that tests both the lower and the upper critical limit of a chi 2-statistic. While checking the upper critical value has been employed by other tests, we argue that also the lower critical value should be examined for non-randomness. To this end, we prepare a binary sequence where all possible bit strings of a certain length occurs the same number of times and demonstrate that such sequences pass a well-known suite of tests for non-randomness. We show that such sequences can be compressed, and therefore are somewhat predictable and thus not fully random. The presented test can detect such non-randomness, and its novelty rests on analysing fixed-length bit string frequencies that lie closer to the a priori probabilities than could be expected by chance alone.
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| 40. |
- Almlöf, Jonas, et al.
(författare)
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A short and efficient error correcting code for polarization coded photonic qubits in a dissipative channel
- 2011
-
Ingår i: Optics Communications. - : Elsevier BV. - 0030-4018 .- 1873-0310. ; 284:1, s. 550-554
-
Tidskriftsartikel (refereegranskat)abstract
- We propose a short and efficient non-degenerate quantum error correcting code that is adapted for qubits encoded on two orthogonal, single-photon states (e.g., horizontally and vertically polarized) subject to a dissipative channel. The proposed code draws its strength from the fact that it is adapted to the physical characteristics of the information-carrying basis states under the action of the channel. The code combines different energy manifolds and consists of only 3 spatio-temporal modes and on average 2 photons per code word.
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| 41. |
|
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| 42. |
- Almlöf, Jonas, et al.
(författare)
-
Creating and detecting specious randomness
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- We present a new test of non-randomness that tests both the lower and the upper critical limit of aχ2-statistic. While checking the upper critical value has been employed by other tests, we argue that also the lower critical value should be examined for non-randomness. To this end, we prepare a binary sequence where all possible bit strings of a certain length occurs the same number of times and demonstrate that such sequences pass a well-known suite of tests for non-randomness. We show that such sequences can be compressed, and therefore are somewhat predictable and thus not fully random. The presented test can detect such non-randomness, and its novelty rests on analysing fixed-length bit string frequencies that lie closer to the a priori probabilities than could be expected by chance
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| 43. |
- Almlöf, Jonas, et al.
(författare)
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Fidelity as a figure of merit in quantum error correction
- 2013
-
Ingår i: Quantum information & computation. - 1533-7146. ; 13:1-2, s. 0009-0020
-
Tidskriftsartikel (refereegranskat)abstract
- We discuss the fidelity as a figure of merit in quantum error correction schemes. We show that when identifiable but uncorrectable errors occur as a result of the action of the channel, a common strategy that improves the fidelity actually decreases the transmitted mutual information. The conclusion is that while the fidelity is simple to calculate and therefore often used, it is perhaps not always a recommendable figure of merit for quantum error correction. The reason is that while it roughly speaking encourages optimisation of the "mean probability of success", it gives no incentive for a protocol to indicate exactly where the errors lurk. For small error probabilities, the latter information is more important for the integrity of the information than optimising the mean probability of success.
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| 44. |
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| 45. |
- Almlöf, Jonas
(författare)
-
Quantum error correction
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Quantum error correction is the art of protecting quantum states from the detrimental influence from the environment. To master this art, one must understand how the system interacts with the environment and gives rise to a full set of quantum phenomena, many of which have no correspondence in classical information theory. Such phenomena include decoherence, an effect that in general destroys superpositions of pure states as a consequence of entanglement with the environment. But decoherence can also be understood as “information leakage”, i.e., when knowledge of an encoded code block is transferred to the environment. In this event, the block’s information or entanglement content is typically lost.In a typical scenario, however, not all types of destructive events are likely to occur, but only those allowed by the information carrier, the type of interaction with the environment, and how the environment “picks up” information of the error events. These characteristics can be incorporated into a code, i.e., a channel-adapted quantum error-correcting code.Often, it is assumed that the environment’s ability to distinguish between error events is small, and I will denote such environments “memory-less”. But this assumption is not always valid, since the ability to distinguish error events is related to the temperature of the environment, and in the particular case of information coded onto photons, kBTR «ℏω typically holds, and one must then assume that the environment has a “memory”. In the thesis I describe a short quantum error-correction code adapted for photons interacting with a “cold” reservoir, i.e., a reservoir which continuously probes what error occurred in the coded state.I also study other types of environments, and show how to distill meaningful figures of merit from codes adapted for these channels, as it turns out that resource-based figures reflecting both information and entanglement can be calculated exactly for a well-studied class of channels: the Pauli channels. Starting from these resource-based figures, I establish the notion of efficiency and quality and show that there will be a trade-off between efficiency and quality for short codes. Finally I show how to incorporate, into these calculations, the choices one has to make when handling quantum states that have been detected as incorrect, but where no prospect of correcting them exists, i.e., so-called detection errors.
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| 46. |
- Almlöf, Jonas, 1973-
(författare)
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Quantum error correction
- 2012
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis intends to familiarise the reader with quantum error correction, and also show some relations to the well known concept of information - and the lesser known quantum information. Quantum information describes how information can be carried by quantum states, and how interaction with other systems give rise to a full set of quantum phenomena, many of which have no correspondence in classical information theory. These phenomena include decoherence, as a consequence of entanglement. Decoherence can also be understood as "information leakage", i.e., knowledge of an event is transferred to the reservoir - an effect that in general destroys superpositions of pure states.It is possible to protect quantum states (e.g., qubits) from interaction with the environment - but not by amplification or duplication, due to the "no-cloning" theorem. Instead, this is done using coding, non-demolition measurements, and recovery operations. In a typical scenario, however, not all types of destructive events are likely to occur, but only those allowed by the information carrier, the type of interaction with the environment, and how the environment "picks up" information of the error events. These characteristics can be incorporated into a code, i.e., a channel-adapted quantum error-correcting code. Often, it is assumed that the environment's ability to distinguish between error events is small, and I will denote such environments "memory-less". This assumption is not always valid, since the ability to distinguish error events is related to the \emph{temperature} of the environment, and in the particular case of information coded onto photons, typically holds, and one must then assume that the environment has a "memory". In this thesis, I describe a short quantum error-correcting code (QECC), adapted for photons interacting with a cold environment, i.e., this code protects from an environment that continuously records which error occurred in the coded quantum state.Also, it is of interest to compare the performance of different QECCs - But which yardstick should one use? We compare two such figures of merit, namely the quantum mutual information and the quantum fidelity, and show that they can not, in general, be simultaneously maximised in an error correcting procedure. To show this, we have used a five-qubit perfect code, but assumed a channel that only cause bit-flip errors. It appears that quantum mutual information is the better suited yardstick of the two, however more tedious to calculate than quantum fidelity - which is more commonly used.
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| 47. |
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| 48. |
- Alterbeck, Max, et al.
(författare)
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Designing and Implementing a Population-based Organised Prostate Cancer Testing Programme.
- 2022
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Ingår i: European urology focus. - : Elsevier BV. - 2405-4569. ; 8:6, s. 1568-1574
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Tidskriftsartikel (refereegranskat)abstract
- European guidelines recommend that well-informed men at elevated risk of having prostate cancer (PCa) should be offered prostate-specific antigen (PSA) testing with risk-stratified follow-up. The Swedish National Board of Health and Welfare recommends against screening for PCa but supports regional implementation of organised prostate cancer testing (OPT).To report the process for designing and implementing OPT programmes.Population-based OPT programmes in two Swedish regions, designed to include men aged between 50 and 74 yr, launched in September 2020 for 50-yr-old men.The number of men invited, the participation rate, and the numbers of magnetic resonance imaging (MRI) scans, urological visits, and biopsies from September 2020 to June 2021 were recorded.Two Swedish regions co-designed an OPT programme with a risk-stratified diagnostic algorithm based on prostate-specific antigen (PSA), PSA density, MRI findings, and age. An automated administrative system was developed on a nationwide web-based platform. Invitation letters and test results are automatically generated and sent out by post. Men with PSA ≥3ng/ml, a suspicious MRI lesion, and/or PSA density ≥0.15ng/ml/cm3 are referred for a prostate biopsy. Test results are registered for quality control and research. By June 2021, a total of 16515 men were invited, of whom 6309 (38%) participated; 147 had an MRI scan and 39 underwent prostate biopsy. The OPT framework, algorithm, and diagnostic pathways have been working well.We designed and implemented a framework for OPT with a high grade of automation. The framework and organisational experiences may be of value for others who plan a programme for early detection of PCa.We describe the implementation of an organised testing programme for early detection of prostate cancer in two Swedish regions. This model is the first of its kind and may serve as a template for similar programmes.
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| 49. |
- Amirahmadi, Ali, 1994-, et al.
(författare)
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A Masked Language Model for Multi-Source EHR Trajectories Contextual Representation Learning
- 2023
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Ingår i: Caring is Sharing - Exploiting the Value in Data for Health and Innovation - Proceedings of MIE 2023. - Amsterdam : IOS Press. - 1879-8365 .- 0926-9630. - 9781643683881 ; 302, s. 609-610, s. 609-610
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Konferensbidrag (refereegranskat)abstract
- Using electronic health records data and machine learning to guide future decisions needs to address challenges, including 1) long/short-term dependencies and 2) interactions between diseases and interventions. Bidirectional transformers have effectively addressed the first challenge. Here we tackled the latter challenge by masking one source (e.g., ICD10 codes) and training the transformer to predict it using other sources (e.g., ATC codes).
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| 50. |
- Andersson, Sven E, et al.
(författare)
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High NT-proBNP Is a Strong Predictor of Outcome in Elderly Heart Failure Patients.
- 2008
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Ingår i: American Journal of Geriatric Cardiology. - 1751-715X. ; 17:1, s. 13-20
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Tidskriftsartikel (refereegranskat)abstract
- All patients older than 65 years (184 men; mean age, 78+/-0.8 years/181 women; mean age, 82+/-0.6 years) seeking medical attention at the Lund University Hospital Emergency Clinic during a 2-year period who had an N-terminal prohormone brain natriuretic peptide (NT-proBNP) value >2000 pg/mL were followed up for survival. Mortality in the entire population was 21% after 3 months, 35% after 1 year, and 40% after 2 years. Multivariate analysis indicated that the NT-proBNP level and the New York Heart Association (NYHA) functional class were stronger predictors of mortality than were echocardiographic estimation of left ventricular ejection fraction or chest radiography. Patients who survived the first year were younger, had higher systolic blood pressure, had lower plasma creatinine, had lower inflammatory activity, and were treated with lower doses of furosemide. The results indicate that in this population, NT-proBNP level together with assessment of NYHA class gives the best prognostic information of 1-year mortality. (Am J Geriatr Cardiol. 2008;17:13-20).
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