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- Holmqvist, Jacob, et al.
(författare)
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Patterns and determinants of blood transfusion in intensive care in Sweden between 2010 and 2018: A nationwide, retrospective cohort study
- 2022
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 62:6, s. 1188-1198
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Tidskriftsartikel (refereegranskat)abstract
- Background Intensive care unit (ICU) patients are transfused with blood products for a number of reasons, from massive ongoing hemorrhage, to mild anemia following blood sampling, combined with bone marrow depression due to critical illness. There's a paucity of data on transfusions in ICUs and most studies are based on audits or surveys. The aim of this study was to provide a complete picture of ICU-related transfusions in Sweden. Methods We conducted a register based retrospective cohort study with data on all adult patient admissions from 82 of 84 Swedish ICUs between 2010 and 2018, as recorded in the Swedish Intensive Care Register. Transfusions were obtained from the SCANDAT-3 database. Descriptive statistics were computed, characterizing transfused and nontransfused patients. The distribution of blood use comparing different ICUs was investigated by computing the observed proportion of ICU stays with a transfusion, as well as the expected proportion. Results In 330,938 ICU episodes analyzed, at least one transfusion was administered for 106,062 (32%). For both red-cell units and plasma, the fraction of patients who were transfused decreased during the study period from 31.3% in 2010 to 24.6% in 2018 for red-cells, and from 16.6% in 2010 to 9.4% in 2018 for plasma. After adjusting for a range of factors, substantial variation in transfusion frequency remained, especially for plasma units. Conclusion Despite continuous decreases in utilization, transfusions remain common among Swedish ICU patients. There is considerable unexplained variation in transfusion rates. More research is needed to establish stronger critiera for when to transfuse ICU patients.
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- Hansson, Julia, 1978, et al.
(författare)
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Fuel choices for different transport modes when decarbonizing the scandinavian energy system
- 2021
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Ingår i: European Biomass Conference and Exhibition Proceedings. - 2282-5819. ; , s. 1068-1073
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Konferensbidrag (refereegranskat)abstract
- To meet future climate targets, shipping, aviation, and road transport need to reduce their carbon dioxide emissions. This partly by the introduction of alternative transportation fuels and a range of fuel options exist. This study provides an initial assessment of cost-effective future fuel choices for shipping, aviation and road transport in Scandinavia considering carbon reduction requirements and the entire energy system. The cost minimizing energy systems model TIMES Nordic covering Sweden, Norway and Denmark is used. For passenger and freight road transport a considerable electrification seems cost-effective. However, biofuels are needed too, not least in shipping and aviation. The findings indicate that biomass-based marine fuels and bio-jet fuels represent cost-effective mitigation measures in the shipping and aviation sector for 2030 and 2050 in all studied scenario cases. Electrofuels in the aviation and shipping sector is to some extent also a cost-effective option but only when carbon capture and storage is not deployed in large-scale. In general, the development of carbon capture and storage for biomass-based technologies and how these negative emissions will be considered in policy making is important for the development also in the transport sector and particularly for the role of biofuels.
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- Lindgren, Fredrik, 1979, et al.
(författare)
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The natural environment and human impacts
- 2016
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Ingår i: Shipping and the Environment: Improving Environmental Performance in Marine Transportation. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 9783662490457 ; , s. 29-74
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- To comprehend the implications of the various environmental issues that man is inducing on the Earth (with a focus on the shipping industry), an understanding of the Earth's major systems is necessary. The natural environment, which consists of air, water, land and living organisms, is a dynamic system in which material and energy are exchanged within and between the individual components. The system is divided into four spheres (atmosphere, hydrosphere, geosphere, and biosphère), and fluxes of energy and material are exchanged amongst these spheres. The spheres also largely govern the fate of various environmental problems originating from the shipping industry. Therefore, background information related to these spheres is provided, and their major properties and implications are explained. Regarding the atmosphere, radiation and energy budgets are explained in conjunction with the weather and climate. Concerning the hydrosphere, oceanography is introduced together with marine ecology. Addressing the geosphere, the elements in the Earth's crust and mineral commodities are discussed. Regarding the biosphere, energy is transferred through food chains; the differences between life in water and life on land are examined. Energy flows through and is stored in these spheres; this stored energy is essential to the natural environment and human society. The different primary energy sources are described and divided into non-renewable and renewable sources. Finally, an introduction to human impacts on the natural environment and to major environmental issues is provided.
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- Salo, Kent, 1967, et al.
(författare)
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Emissions to the air
- 2016
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Ingår i: Shipping and the Environment: Improving Environmental Performance in Marine Transportation. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 9783662490457 ; , s. 169-227
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Seeing the black smoke coming out of the funnel of a manoeuvring ship makes it easy to understand that the ship's propulsion contributes to the emission of air pollutants. However, there is more than meets the eye going up in smoke. A vast majority of ships use fossil fuels, increasing a positive net contribution of carbon dioxide to the atmosphere when they are combusted. Because the fuels that are used are often of low quality and possess a high sulphur content, a number of other air pollutants are also emitted. Emissions to the air from ships include greenhouse gases (such as carbon dioxide, methane and nitrous oxide), sulphur and nitrogen oxides, with both acidifying and eutrophication effects, and different forms of particles, with impacts on health and climate. However, not all emissions to the atmosphere from ships originate from the combustion of fuels for propulsion and energy production. The handling of crude oil as cargo and compounds used in refrigeration systems cause emissions of volatile organic compounds and ozone-depleting substances. The sources of the most important emissions and relevant regulations are described in this chapter.
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- Wilewska-Bien, Magda, 1977, et al.
(författare)
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Measures to reduce discharges and emissions
- 2016
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Ingår i: Shipping and the Environment: Improving Environmental Performance in Marine Transportation. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 9783662490457 ; , s. 341-396
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Discharges and émissions from shipping can be reduced through different technical measures, many of which apply similar principies, e.g., filtration or absorption. Ballast water treatment systems can be used to limit the spread of invasive species. Selective catalytic reduction units and exhaust gas recirculation can be used to reduce nitrogen oxide emissions, and scrubbers and diesel particulate filters can be used to reduce sulphur dioxide and particle emissions. The restoration or remediation of natural environments may also be required after large oil spills. Possible remediation methods include booms, mechanical techniques and dispersant chemicals. These and several additional technical measures to reduce discharges and emissions are described in this chapter, including measures to reduce the impact of the infrastructure related to the shipping industry.
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