| 1. |
- Hagström, Hannes, et al.
(författare)
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Body mass index in early pregnancy and future risk of severe liver disease : a population-based cohort study
- 2019
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Ingår i: Alimentary Pharmacology and Therapeutics. - : Blackwell Science Ltd.. - 0269-2813 .- 1365-2036. ; 49:6, s. 789-796
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In young men, high body mass index (BMI) has been linked to liver disease later in life, but it is unclear if this also applies to women.AIM: To study the association between BMI early in life and development of liver disease later in life in women.METHODS: We obtained data on early pregnancy BMI from 1 139 458 Swedish women between 1992 and 2015. National registers were used to ascertain incident severe liver disease, defined as cirrhosis, decompensated liver disease (hepatocellular carcinoma, oesophageal varices, hepatorenal syndrome or hepatic encephalopathy) or liver failure. A Cox regression model was used to investigate associations of BMI with incident severe liver disease adjusting for maternal age, calendar year, country of birth, smoking, civil status and education.RESULTS: (95% CI 1.02-1.05). A diagnosis of diabetes was associated with an increased risk of severe liver disease independent of baseline BMI.CONCLUSION: A high BMI early in life in women is associated with a dose-dependent, increased risk for future severe liver disease.
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| 2. |
- Hagström, Hannes, et al.
(författare)
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Cardiovascular Outcomes in Patients With Biopsy-proven Alcohol-related Liver Disease
- 2023
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 21:7, s. 1841-1853.e12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Patients with alcohol-related liver disease (ALD) frequently have risk factors for cardiovascular disease (CVD), but their long-term risk of CVD is not well-known, especially considering the competing risk of death from liver-related causes. It is further unknown if any excess risk varies across histological subgroups.METHODS: We investigated the risk of CVD outcomes in 3488 persons with ALD and an available liver biopsy in Sweden between 1969 and 2016, compared with a matched reference population (n = 15,461). Administrative coding from national diagnostic and histopathology registers were used to define exposures and outcomes. Competing risk regression, taking non-CVD death into account and adjusting for potential confounders, was used to estimate subdistribution hazard ratios for incident CVD up until Dec 31, 2019.RESULTS: At baseline, patients with ALD had a median age of 58 years, 64% were men, and 2039 (58%) had cirrhosis on histology. The incidence rate of CVD was 35.6 per 1000 person-years in ALD compared with 19.0 per 1000 person-years in reference individuals. ALD was associated with a 2-fold increased short-term risk for CVD compared with matched reference individuals (subdistribution hazard ratio during the first year after diagnosis, 2.29; 95% confidence interval, 1.79-2.95), but this risk decreased with time. Incidence rates of CVD were comparable across histological subgroups (ranging from 27.4 CVD cases per 1000 person-years in those with normal histology to 39.2 cases per 1000 person-years in those with cirrhosis).CONCLUSIONS: Persons with biopsy-proven ALD have increased rates of CVD across histological subgroups compared with matched reference individuals, particularly just after ALD diagnosis. Active surveillance of modifiable CVD risk factors should be considered by clinicians treating patients with ALD.
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| 3. |
- Hagström, Hannes, et al.
(författare)
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Maternal obesity increases the risk and severity of NAFLD in offspring
- 2021
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Ingår i: Journal of Hepatology. - : Elsevier. - 0168-8278 .- 1600-0641. ; 75:5, s. 1042-1048
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Maternal obesity has been linked to the development of cardiovascular disease and diabetes in offspring, but its relationship to non-alcoholic fatty liver disease (NAFLD) is unclear.Methods: Through the nationwide ESPRESSO cohort study we identified all individuals <= 25 years of age in Sweden with biopsy verified NAFLD diagnosed between 1992 and 2016 (n = 165). These were matched by age, sex, and calendar year with up to 5 controls (n = 717). Through linkage with the nationwide Swedish Medical Birth Register (MBR) we retrieved data on maternal early-pregnancy BMI, and possible confounders, in order to calculate adjusted odds ratios (aORs) for NAFLD in offspring.Results: Maternal BMI was associated with NAFLD in offspring: underweight (aOR 0.84; 95% CI 0.14-5.15), normal weight (reference, aOR 1), overweight (aOR 1.51; 0.95-2.40), and obese (aOR 3.26; 1.72-6.19) women. Severe NAFLD (biopsy-proven fibrosis or cirrhosis) was also more common in offspring of overweight (aOR 1.94; 95% CI 0.96-3.90) and obese (aOR 3.67; 95% CI 1.61-8.38) mothers. Associations were similar after adjusting for maternal pre-eclampsia and gestational diabetes. Socio-economic parameters (smoking, mother born outside the Nordic countries and less than 10 years of basic education) were also associated with NAFLD in offspring but did not materially alter the effect size of maternal BMI in a multivariable model.Conclusions: This nationwide study found a strong association between maternal overweight/obesity and future NAFLD in offspring. Adjusting for socio-economic and metabolic parameters in the mother did not affect this finding, suggesting that maternal obesity is an independent risk factor for NAFLD in offspring.Lay summary: In a study of all young persons in Sweden with a liver biopsy consistent with fatty liver, the authors found that compared to matched controls, the risk of fatty liver was much higher in those with obese mothers. This was independent of available confounders and suggests that the high prevalence of obesity in younger persons might lead to a higher risk of fatty liver in their offspring.
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| 4. |
- Hagström, Hannes, et al.
(författare)
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Mortality in biopsy-proven alcohol-related liver disease : a population-based nationwide cohort study of 3453 patients
- 2021
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Ingår i: Gut. - : BMJ Publishing Group Ltd. - 0017-5749 .- 1468-3288. ; 70:1, s. 170-179
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Patients with alcohol-related liver disease (ALD) are at increased risk of death, but studies have rarely investigated the significance of histological severity or estimated relative risks compared with a general population. We examined mortality in a nationwide cohort of biopsy-proven ALD.Design: Population-based cohort study in Sweden comparing 3453 individuals with an International Classification of Disease (ICD) code for ALD and a liver biopsy from 1969 to 2017 with 16 535 matched general population individuals. Swedish national registers were used to ascertain overall and disease-specific mortality, starting follow-up at the latest of first ICD diagnosis or liver biopsy plus 3 months. Cox regression adjusted for relevant confounders was used to estimate HRs in ALD and histopathological subgroups.Results: Median age at diagnosis was 58 years, 65% were men and 52% had cirrhosis at baseline. Five-year cumulative mortality was 40.9% in patients with ALD compared with 5.8% in reference individuals. The risk for overall mortality was significantly increased (adjusted HR (aHR)=4.70, 95% CI 4.35 to 5.08). The risk of liver-related death was particularly high (43% of all deaths, aHR=167.6, 95% CI 101.7 to 276.3). Mortality was significantly increased also in patients with ALD without cirrhosis and was highest in the first year after baseline but persisted after >= 10 years of follow-up (aHR=2.74, 95% CI 2.37 to 3.16).Conclusion: Individuals with biopsy-proven ALD have a near fivefold increased risk of death compared with the general population. Individuals with ALD without cirrhosis were also at increased risk of death, reaffirming the need to increase vigilance in the management of these individuals.
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| 5. |
- Hagström, Hannes, et al.
(författare)
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Risk of Cancer in Biopsy-Proven Alcohol-Related Liver Disease : A Population-Based Cohort Study of 3410 Persons
- 2022
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 20:4, s. 918-929
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Persons with alcohol-related liver disease (ALD) are at an increased risk of death and liver-related endpoints, but the association with incident cancer is not well understood, and whether it differs across histopathological subgroups is undefined.METHODS: We investigated the risk of cancer in 3,410 persons with a diagnosis of ALD and an available liver biopsy in Sweden between 1969-2016, compared to a matched reference population. Administrative coding from national registers and liver biopsy data were used to define exposure and outcome status. Competing risk regression, adjusted for available confounders and using non-cancer mortality as the competing risk, was used to estimate subdistribution hazard ratios (sHRs) for incident cancer.RESULTS: At baseline, persons with ALD had a median age of 58.2 years, 67% were men, and 2,042 (60%) had cirrhosis. ALD was not associated with cancer in general (sHR = 1.01, 95%CI = 0.92-1.11), although the risk was increased in persons surviving >= 1 year (sHR = 1.19, 95% CI = 1.08-1.32). The risk of liver cancer was elevated sHR = 12.80, 95%CI = 9.38-17.45). HCC incidence among ALD persons with cirrhosis was 8.6 cases/1,000 person-years, corresponding to a cumulative incidence after 10 years of 5.0%.CONCLUSIONS: Persons with biopsy-proven ALD that survive the initial time after diagnosis are at an elevated risk for cancer, in particular HCC compared with the general population. Although the risk for HCC was elevated, data do not suggest that routine surveillance for HCC in ALD cirrhosis is cost-effective.
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| 6. |
- Hagström, Hannes, et al.
(författare)
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Risk of infections and their role on subsequent mortality in biopsy-proven alcohol-related liver disease
- 2022
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Ingår i: United European Gastroenterology journal. - : John Wiley & Sons. - 2050-6406 .- 2050-6414. ; 10:2, s. 198-211
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: The risk for infection in alcohol-related liver disease (ALD) has rarely been investigated at a population level, nor if the underlying liver histopathology is associated with infection risk. We examined the rate of hospital-based infections in a nationwide cohort of biopsy-proven ALD, and the subsequent risk of death.Methods: Population-based cohort study in Sweden comparing 4028 individuals with an international classification of disease (ICD) code for ALD and a liver biopsy from 1969 to 2017 with 19,296 matched general population individuals. Swedish national registers were used to ascertain incident infections in secondary or tertiary care and subsequent mortality until 2019. We used Cox regression, adjusted for sex, age, education, country of birth, diabetes, and number of hospitalizations in the year preceding liver biopsy date, to estimate hazard ratios (HRs) in ALD and histopathological subgroups compared to reference individuals.Results: Median age at ALD diagnosis was 59 years, 65% were men and 59% had cirrhosis at baseline. Infections were more common in patients with ALD (84 cases/1000 person-years [PY]) compared to reference individuals (29/1000 PYs; adjusted hazard ratio [aHR] 3.06, 95% CI = 2.85-3.29). This excess risk corresponded to one additional infection per 18 ALD patients each year. The rate of infections was particularly high in individuals with cirrhosis (aHR = 3.46) and in those with decompensation (aHR = 5.20). Restricting our data to those with an infection, ALD (aHR = 3.63, 95%CI = 3.36-3.93), and especially ALD cirrhosis (aHR = 4.31, 95%CI = 3.89-4.78) were linked to subsequent death.Conclusions: Individuals with biopsy-proven ALD have a three-fold increased rate of infections compared with the general population. The risk of death after an infection is also considerably higher in individuals with ALD.
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| 7. |
- Ludvigsson, Jonas F., 1969-, et al.
(författare)
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Pregnancy Outcome in Women Undergoing Liver Biopsy During Pregnancy: A Nationwide Population-Based Cohort Study.
- 2018
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Ingår i: Hepatology (Baltimore, Md.). - : Ovid Technologies (Wolters Kluwer Health). - 1527-3350 .- 0270-9139. ; 68:2, s. 625-633
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Tidskriftsartikel (refereegranskat)abstract
- Liver biopsy is an important procedure in the investigation of liver disease. We examined pregnancy outcomes in women who underwent liver biopsy during pregnancy. In a nationwide population-based cohort study we linked data from the Swedish Medical Birth Registry (for births between 1992 and 2011) with those from the Swedish Patient Registry. We identified 23 pregnancies exposed to liver biopsy. We calculated relative risks (RRs) for adverse pregnancy outcomes according to liver biopsy status using 1,953,887 unexposed pregnancies with and without a record of liver disease as reference. Our main outcome measures were stillbirth and preterm birth. There were no stillbirths in pregnancies exposed to liver biopsies compared with 0.3% stillbirths in unexposed pregnancies. 3/23 (13%) exposed pregnancies were preterm (RR=2.6; 95%CI=0.9-7.5). Compared with women with a record of liver disease, preterm birth was not increased in those exposed to liver biopsy (RR=0.9; 95%CI=0.1-6.0). Except for an increased risk of small for gestational age birth in pregnancies exposed to liver biopsy (RR=5.2; 95%CI=1.8-14.8), other adverse pregnancy outcomes were independent of liver biopsy status when the analysis was restricted to women with a diagnosis of liver disease. Compared with unexposed sibling pregnancies, pregnancies with a liver biopsy were 7 days shorter, but birth weights did not differ between the siblings (-67g; p>0.05).Apart from a moderately increased risk of preterm birth and small for gestational age, there was no association between liver biopsy during pregnancy and adverse pregnancy outcome. Potential excess risks should be weighed against the advantages of having a liver biopsy that may influence clinical management of the patient indirectly influencing fetal health. This article is protected by copyright. All rights reserved.
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| 8. |
- Lundgren, Ewa, et al.
(författare)
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Primary hyperparathyroidism revisited in menopausal women with serum calcium in upper normal range at population-based screening 8 years ago
- 2002
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 26:8, s. 931-936
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Tidskriftsartikel (refereegranskat)abstract
- Abstract. Population-based screening showed 2.1% prevalence of primaryhyperparathyroidism (pHPT) in postmenopausal women. Individualswith total serum (s)-calcium levels of 2.55 mmol/L or more at screeningwere diagnosed with pHPT when subsequent analysis supported inappropriatelyelevated intact parathormone (PTH) levels in relation to evennormal s-calcium levels. The arbitrary diagnostic criteria were validatedby parathyroidectomy. Herein we reinvestigated biochemical signs ofpHPT in women not diagnosed with pHPT due to s-calcium 2.50 to 2.54mmol/L (group A, n 160) at screening or due to appropriate PTH levelson two occasions after screening (group B, n 70). Altogether, 99 womenin group A and 47 in group B underwent reinvestigation 8.8 years afterscreening when they were 65 to 84 years old. The s-calcium levels averaged2.56 mmol/L and had increased in group A (mean 0.04 mmol/L) anddecreased in group B (mean 0.05 mmol/L). A total of 48 and 18 females(48%, 38%), respectively, met the previously validated criteria of pHPT.Altogether 21% of them were hypercalcemic (range 2.60 –3.12 mmol/L).Subgroup analysis showed that PTH had not increased with time (n 47)and that atherogenic blood lipids, but not glucose levels, were similar inpHPT patients and matched controls (n 37). Assuming the existence ofpHPT already at screening, the prevalence of pHPT could be adjusted to3.4%. Even the most liberal diagnostic criteria utilized at pHPT screeningseemed to underdiagnose the disease by inefficient cutoff limits for scalciumand PTH. Because one-fifth of the women with pHPT progressedto hypercalcemia, long-term follow-up is advocated for those with scalciumin the upper normal range.
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| 9. |
- Oldgren, Jonas, 1964-, et al.
(författare)
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Systematic Coronary Risk Evaluation estimated risk and prevalent subclinical atherosclerosis in coronary and carotid arteries: A population-based cohort analysis from the Swedish Cardiopulmonary Bioimage Study
- 2021
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 28:3, s. 250-259
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Tidskriftsartikel (refereegranskat)abstract
- Background It is not clear if the European Systematic Coronary Risk Evaluation algorithm is useful for identifying prevalent subclinical atherosclerosis in a population of apparently healthy individuals. Our aim was to explore the association between the risk estimates from Systematic Coronary Risk Evaluation and prevalent subclinical atherosclerosis. Design The design of this study was as a cross-sectional analysis from a population-based study cohort. Methods From the general population, the Swedish Cardiopulmonary Bioimage Study randomly invited individuals aged 50-64 years and enrolled 13,411 participants mean age 57 (standard deviation 4.3) years; 46% males between November 2013-December 2016. Associations between Systematic Coronary Risk Evaluation risk estimates and coronary artery calcification and plaques in the carotid arteries by using imaging data from a computed tomography of the heart and ultrasonography of the carotid arteries were examined. Results Coronary calcification was present in 39.5% and carotid plaque in 56.0%. In men, coronary artery calcium score >0 ranged from 40.7-65.9% and presence of carotid plaques from 54.5% to 72.8% in the age group 50-54 and 60-65 years, respectively. In women, the corresponding difference was from 17.1-38.9% and from 41.0-58.4%. A doubling of Systematic Coronary Risk Evaluation was associated with an increased probability to have coronary artery calcium score >0 (odds ratio: 2.18 (95% confidence interval 2.07-2.30)) and to have >1 carotid plaques (1.67 (1.61-1.74)). Conclusion Systematic Coronary Risk Evaluation estimated risk is associated with prevalent subclinical atherosclerosis in two major vascular beds in a general population sample without established cardiovascular disease or diabetes mellitus. Thus, the Systematic Coronary Risk Evaluation risk chart may be of use for estimating the risk of subclinical atherosclerosis.
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| 10. |
- Sharma, Rajani, et al.
(författare)
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Cancer Risk in Patients With Autoimmune Hepatitis : A Nationwide Population-Based Cohort Study With Histopathology
- 2022
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Ingår i: American Journal of Epidemiology. - : Oxford University Press. - 0002-9262 .- 1476-6256. ; 191:2, s. 298-319
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to determine the risk of incident cancer in autoimmune hepatitis (AIH) compared with the general population and siblings. AIH was defined by the presence of a medical diagnosis of AIH and results of examination of a liver biopsy specimen in a nationwide Swedish population-based cohort study. We identified 5,268 adults with AIH diagnosed during 1969-2016 and 22,996 matched, general population, reference individuals and 4,170 sibling comparators. Using Cox regression, hazard ratios were determined for any incident cancer, and subtypes were determined from the Swedish Cancer Register. During follow-up, a cancer diagnosis was made in 1,119 individuals with AIH (17.2 per 1,000 person-years) and 4,450 reference individuals (12.0 per 1,000 person-years). This corresponded to a hazard ratio of 1.53 (95% confidence interval: 1.42, 1.66). Cancer risk was highest in those with cirrhosis. There was a 29.18-fold increased risk of hepatocellular carcinoma (HCC) (95% confidence interval: 17.52, 48.61). The annual incidence risk of HCC in individuals with AIH who had cirrhosis was 1.1% per year. AIH was also linked to nonmelanoma skin cancer (hazard ratio (HR) = 2.69) and lymphoma (HR = 1.89). Sibling analyses yielded similar risk estimates for any cancer (HR = 1.84) and HCC (HR = 23.10). AIH is associated with an increased risk of any cancer, in particular, HCC and extrahepatic malignancies. The highest risk for cancer, especially HCC, is in patients with cirrhosis.
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| 11. |
- Sharma, Rajani, et al.
(författare)
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Increased Mortality Risk in Autoimmune Hepatitis : A Nationwide Population-based Cohort Study With Histopathology
- 2021
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 19:12, s. 2636-2647.e13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that may lead to cirrhosis and liver failure, but data on overall mortality in AIH are conflicting.METHODS: This was a nationwide population-based cohort study in Sweden from 1969-2017 of 6,016 adults with AIH and 28,146 matched general population reference individuals. AIH was defined by a combination of a medical diagnosis of AIH plus a liver biopsy from any of Sweden's 28 pathology departments. Through Cox regression, we estimated hazard ratios (HRs) for overall and cause-specific death. Liver transplant was included in our main outcome of death.RESULTS: During follow-up, 3,185 individuals with AIH died (41.4/1000 person-years) compared with 10,477 reference individuals (21.9/1000 person-years). The 10-year cumulative incidence of death was 32.3% (95%CI=31.1-33.6) for AIH individuals and 14.1% (95%CI=13.7-14.5) for reference individuals. This corresponded to an adjusted HR of 2.29 (95%CI=2.17-2.41), which remained elevated ≥20 years follow-up. AIH individuals with cirrhosis on biopsy had a high risk of death (HR=4.55; 95%CI=3.95-5.25), while mortality in patients with fibrosis, inflammation without fibrosis, or necrosis did not differ. Portal hypertension and overlap with cholestatic liver diseases were also associated with death. AIH was associated with an increased risk of death from cardiovascular disease (HR=1.27; 95%CI=1.15-1.40), liver disease (HR=66.24; 95%CI=48.19-91.03) and extrahepatic malignancy (HR=1.69; 95%CI=1.51-1.89). In a sibling comparison, AIH individuals remained at increased risk of death.CONCLUSION: AIH is associated with a 2-fold increased risk of death. Risks were particularly high in individuals with cirrhosis, portal hypertension, and overlap with cholestatic liver disease.
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| 12. |
- Simon, Tracey G., et al.
(författare)
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Risk of severe COVID-19 and mortality in patients with established chronic liver disease : a nationwide matched cohort study
- 2021
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Ingår i: BMC Gastroenterology. - : BioMed Central. - 1471-230X. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Some, but not all, prior studies have suggested that patients with chronic liver disease are at increased risk of contracting COVID-19 and developing more severe disease. However, nationwide data are lacking from well-phenotyped cohorts with liver histology and comparisons to matched general population controls.Methods: We conducted a nationwide cohort study of all Swedish adults with chronic liver disease (CLD) confirmed by liver biopsy between 1966 and 2017 (n = 42,320), who were alive on February 1, 2020. CLD cases were matched to <= 5 population comparators by age, sex, calendar year and county (n = 182,147). Using Cox regression, we estimated multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for COVID-19 hospitalization and severe COVID-19 (intensive care admission or death due to COVID-19).Results: Between February 1 and July 31, 2020, 161 (0.38%) CLD patients and 435 (0.24%) general population controls were hospitalized with COVID-19 (aHR = 1.36, 95% CI = 1.11-1.66), while 65 (0.15%) CLD patients and 191 (0.10%) controls developed severe COVID-19 (aHR = 1.08, 95% CI = 0.79-1.48). Results were similar in patients with CLD due to alcohol use, nonalcoholic fatty liver disease, viral hepatitis, autoimmune hepatitis, and other etiologies. Among patients with cirrhosis (n = 2549), the aHRs for COVID-19 hospitalization and for severe COVID-19 were 1.08 (95% CI 0.48-2.40) and 1.23 (95% CI = 0.37-4.04), respectively, compared to controls. Moreover, among all patients diagnosed with COVID-19, the presence of underlying CLD was not associated with increased mortality (aHR = 0.85, 95% CI = 0.61-1.19).Conclusions: In this nationwide cohort, patients with CLD had a higher risk of hospitalization for COVID-19 compared to the general population, but they did not have an increased risk of developing severe COVID-19.
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| 13. |
- ACOSTA HOSPITALECHE, Carolina, et al.
(författare)
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Historical perspective of Otto Nordenskjöld´s Antarctic fossil penguin collection and Carl Wiman’s contribution
- 2017
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Ingår i: Polar Record. - Cambridge. - 0032-2474 .- 1475-3057. ; 53:4, s. 364-375
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Tidskriftsartikel (refereegranskat)abstract
- The early explorer and scientist Otto Nordenskjöld, leader of the Swedish South Polar Expedition of 1901–1903, was the first to collect Antarctic penguin fossils. The site is situated in the northeastern region of Seymour Island and constitutes one of the most important localities in the study of fossilised penguins. The task of describing these specimens together with fossilised whale remains was given to Professor Carl Wiman (1867–1944) at Uppsala University, Sweden. Although the paradigm for the systematic study of penguins has changed considerably over recent years, Wiman's contributions are still remarkable. His establishment of grouping by size as a basis for classification was a novel approach that allowed them to deal with an unexpectedly high morphological diversity and limited knowledge of penguin skeletal anatomy. In the past, it was useful to provide a basic framework for the group that today could be used as ‘taxon free’ categories. First, it was important to define new species, and then to establish a classification based on size and robustness. This laid the foundation for the first attempts to use morphometric parameters for the classification of isolated penguin bones. The Nordenskjöld materials constitute an invaluable collection for comparative purposes, and every year researchers from different countries visit this collection.
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| 14. |
- Akner, Gunnar, 1953-, et al.
(författare)
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Vi står gärna bakom en utfallsbaserad vård
- 2017
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Ingår i: Dagens Samhälle. - 1652-6511.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Jörgen Nordenström försöker få det till att vår kritik av värdebaserad vård egentligen handlar om att vi vill ha mer resurser. Han har helt missuppfattat oss, skriver 26 specialistläkare i en replik.
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Bengtsson, Bonnie, et al.
(författare)
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Validity of administrative codes associated with cirrhosis in Sweden
- 2020
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 55:10, s. 1205-1210
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Although cirrhosisis a major cause of liver-related mortality globally, validation studies of the administrative coding for diagnoses associated with cirrhosis are scarce. We aimed to determine the validity of the International Classification of Diseases, 10th revision (ICD-10) codes corresponding to cirrhosis and its complications in the Swedish National Patient Register (NPR).Methods: We randomly selected 750 patients with ICD codes for either alcohol-related cirrhosis (K70.3), unspecified cirrhosis (K74.6) oesophageal varices (I85.0/I85.9), hepatocellular carcinoma (HCC, C22.0) or ascites (R18.9) registered in the NPR from 72 healthcare centres in 2000-2016. Hospitalisation events and outpatient visits in specialised care were included. Positive predictive values (PPVs) were calculated using the information in the patient charts as the gold standard.Results: Complete data were obtained for 630 (of 750) patients (84%). For alcohol-related cirrhosis, 126/136 cases were correctly coded, corresponding to a PPV of 93% (95% confidence interval, 95%CI: 87-96). The PPV for cirrhosis with unspecified aetiology was 91% (121/133, 95%CI: 85-95) and 96% for oesophageal varices (118/123, 95%CI: 91-99). The PPV was lower for HCC, 84% (91/109, 95%CI: 75-90). The PPV for liver-related ascites was low, 43% (56/129, 95%CI: 35-52), as this category often consisted of non-hepatic ascites. When combining the ascites code with a code for chronic liver disease, the PPV for liver-related ascites increased to 93% (50/54, 95%CI: 82-98).Conclusions: The validity of ICD-10 codes for cirrhosis, oesophageal varices and HCC is high. However, coding for ascites should be combined with a code of chronic liver disease to have an acceptable validity.
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| 19. |
- Bergman, David, et al.
(författare)
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Incidence of ICD-based diagnoses of alcohol-related disorders and diseases from swedish nationwide registers and suggestions for coding
- 2020
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Ingår i: Clinical Epidemiology. - Macclesfield, United Kingdom : Dove Medical Press Ltd.. - 1179-1349. ; 12, s. 1433-1442
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To improve consistency between register studies in Sweden and ensure valid comparisons of possible changes in alcohol-related disorders and diseases (ARDDs) over time, we propose a definition of ARDDs. Based on this definition, we examined Sweden’s incidence rates of ARDDs from 1970 to 2018 in non-primary healthcare settings (inpatient and outpatient). Methods: Swedish Society of Epidemiology members were invited to give feedback on the International Classification of Disease (ICD) codes with a potential link to alcohol use. We then calculated age-standardised and age-specific incidence of ARDDs over time according to the National Patient Register, and the lifetime prevalence of ARDDs diagnosed in adults alive in Sweden on Dec 31, 2018. Results: Sweden’s estimated incidence of ARDDs increased substantially after introducing the new ICD-9 codes in 1987. In the past 10 years (2009–2018), the incidence of ARDDs has been stable (males: 110/100,000 person-years, females: 49/100,000 person-years). Requiring at least two ICD records for diagnosed ARDDs led to a somewhat lower incidence of ARDDs (males: 71 per 100,000 person-years, females: 29 per 100,000 person-years). In Sweden, the lifetime prevalence of diagnosed ARDDs in adults on Dec 31, 2018, was 1.9% (95% CI=1.9–1.9). Conclusion: In this nationwide study, we found an incidence of ARDDs of 50–100/ 100,000 person-years. In 2018, 1 in 52 adults in Sweden had been diagnosed with ARDDs in the National Patient Register.
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| 20. |
- Bergström, Göran, et al.
(författare)
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Self-Report Tool for Identification of Individuals With Coronary Atherosclerosis : The Swedish CardioPulmonary BioImage Study
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Ingår i: Journal of the American Heart Association. - 2047-9980. ; , s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Coronary atherosclerosis detected by imaging is a marker of elevated cardiovascular risk. However, imaging involves large resources and exposure to radiation. The aim was, therefore, to test whether nonimaging data, specifically data that can be self-reported, could be used to identify individuals with moderate to severe coronary atherosclerosis.METHODS AND RESULTS: We used data from the population-based SCAPIS (Swedish CardioPulmonary BioImage Study) in individuals with coronary computed tomography angiography (n=25 182) and coronary artery calcification score (n=28 701), aged 50 to 64 years without previous ischemic heart disease. We developed a risk prediction tool using variables that could be assessed from home (self-report tool). For comparison, we also developed a tool using variables from laboratory tests, physical examinations, and self-report (clinical tool) and evaluated both models using receiver operating characteristic curve analysis, external validation, and benchmarked against factors in the pooled cohort equation. The self-report tool (n=14 variables) and the clinical tool (n=23 variables) showed high-to-excellent discriminative ability to identify a segment involvement score ≥4 (area under the curve 0.79 and 0.80, respectively) and significantly better than the pooled cohort equation (area under the curve 0.76, P<0.001). The tools showed a larger net benefit in clinical decision-making at relevant threshold probabilities. The self-report tool identified 65% of all individuals with a segment involvement score ≥4 in the top 30% of the highest-risk individuals. Tools developed for coronary artery calcification score ≥100 performed similarly. CONCLUSIONS: We have developed a self-report tool that effectively identifies individuals with moderate to severe coronary atherosclerosis. The self-report tool may serve as prescreening tool toward a cost-effective computed tomography-based screening program for high-risk individuals.
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| 21. |
- Bertonnier-Brouty, Ludivine, et al.
(författare)
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E2F transcription factors promote tumorigenicity in pancreatic ductal adenocarcinoma
- 2024
-
Ingår i: Cancer Medicine. - 2045-7634. ; 13:9
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with limited treatment options, illustrating an urgent need to identify new drugable targets in PDACs.OBJECTIVE: Using the similarities between tumor development and normal embryonic development, which is accompanied by rapid cell expansion, we aimed to identify and characterize embryonic signaling pathways that were reinitiated during tumor formation and expansion.METHODS AND RESULTS: Here, we report that the transcription factors E2F1 and E2F8 are potential key regulators in PDAC. E2F1 and E2F8 RNA expression is mainly localized in proliferating cells in the developing pancreas and in malignant ductal cells in PDAC. Silencing of E2F1 and E2F8 in PANC-1 pancreatic tumor cells inhibited cell proliferation and impaired cell spreading and migration. Moreover, loss of E2F1 also affected cell viability and apoptosis with E2F expression in PDAC tissues correlating with expression of apoptosis and mitosis pathway genes, suggesting that E2F factors promote cell cycle regulation and tumorigenesis in PDAC cells.CONCLUSION: Our findings illustrate that E2F1 and E2F8 transcription factors are expressed in pancreatic progenitor and PDAC cells, where they contribute to tumor cell expansion by regulation of cell proliferation, viability, and cell migration making these genes attractive therapeutic targets and potential prognostic markers for pancreatic cancer.
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| 22. |
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| 23. |
- Brinck, Jonas, et al.
(författare)
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E78.0A – en unik, ny ICD-10-kod för familjär hyperkolesterolemi [Sweden introduces a new specific ICD-10 code for the disease familial hypercholesterolemia]
- 2019
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Ingår i: Läkartidningen. - Stockholm, Sweden : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- At the turn of the year 2018/19, a new ICD-10 code (E78.0A) will be introduced in Sweden for the hereditary blood lipid disorder familial hypercholesterolemia (FH). Patients with FH have a significantly increased risk of developing atherosclerotic disease, such as myocardial infarction before the age of 50. However, early diagnosis and start of treatment of FH can ameliorate the diseases negative long term effects. The Swedish National Board of Health and Welfare gave in its guidelines from 2015 a high priority to the work of identifying and diagnosing individuals with FH in the general population. The introduction of the ICD-10 code E78.0A for FH may, when properly used, be an effective tool in this work.
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| 24. |
- Brinck, Jonas, et al.
(författare)
-
[Sweden introduces a new specific ICD-10 code for the disease familial hypercholesterolemia].
- 2019
-
Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 116
-
Tidskriftsartikel (refereegranskat)abstract
- At the turn of the year 2018/19, a new ICD-10 code (E78.0A) will be introduced in Sweden for the hereditary blood lipid disorder familial hypercholesterolemia (FH). Patients with FH have a significantly increased risk of developing atherosclerotic disease, such as myocardial infarction before the age of 50. However, early diagnosis and start of treatment of FH can ameliorate the disease's negative long term effects. The Swedish National Board of Health and Welfare gave in its guidelines from 2015 a high priority to the work of identifying and diagnosing individuals with FH in the general population. The introduction of the ICD-10 code E78.0A for FH may, when properly used, be an effective tool in this work.
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| 25. |
- Chapellier, Marion, et al.
(författare)
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Arrayed molecular barcoding identifies TNFSF13 as a positive regulator of acute myeloid leukemia-initiating cells
- 2019
-
Ingår i: Haematologica. - : Ferrata Storti Foundation (Haematologica). - 1592-8721 .- 0390-6078. ; 104:10, s. 2006-2016
-
Tidskriftsartikel (refereegranskat)abstract
- Dysregulation of cytokines in the bone marrow microenvironment promotes acute myeloid leukemia cell growth. Due to the complexity and low throughput of in vivo stem-cell based assays, studying the role of cytokines in the bone marrow niche in a screening setting is challenging. Herein, we developed an ex vivo cytokine screen using 11 arrayed molecular barcodes, allowing for a competitive in vivo readout of leukemia-initiating capacity. With this approach, we assessed the effect of 114 murine cytokines on MLL-AF9 acute myeloid leukemia mouse cells and identified the tumor necrosis factor ligand superfamily member 13 (TNFSF13) as a positive regulator of leukemia-initiating cells. By using Tnfsf13-/- recipient mice, we confirmed that TNFSF13 supports leukemia-initiation also under physiological conditions. TNFSF13 was secreted by normal myeloid cells but not by leukemia mouse cells, suggesting that mature myeloid bone marrow cells support leukemia cells by secreting TNFSF13. TNFSF13 supported leukemia cell proliferation in an NF-κB-dependent manner by binding TNFRSF17 and suppressed apoptosis. Moreover, TNFSF13 supported the growth and survival of several human myeloid leukemia cell lines, demonstrating that our findings translate to human disease. Taken together, using arrayed molecular barcoding, we identified a previously unrecognized role of TNFSF13 as a positive regulator of acute myeloid leukemia-initiating cells. The arrayed barcoded screening methodology is not limited to cytokines and leukemia, but can be extended to other types of ex vivo screens, where a multiplexed in vivo read-out of stem cell functionality is needed.
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Fagerlund, A. J., et al.
(författare)
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Experiences from patients in mental healthcare accessing their electronic health records : results from a cross-national survey in Estonia, Finland, Norway, and Sweden
- 2024
-
Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 24:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users' overall experiences with national PAEHR services.METHODS: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data.RESULTS: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information.CONCLUSIONS: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.
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| 30. |
- Fagerlund, Asbjørn Johansen, et al.
(författare)
-
Experiences from patients in mental healthcare accessing their electronic health records : results from a cross-national survey in Estonia, Finland, Norway, and Sweden
- 2024
-
Ingår i: BMC Psychiatry. - : BioMed Central Ltd. - 1471-244X. ; 24:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patients’ online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users’ overall experiences with national PAEHR services. Methods: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users’ experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. Results: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information. Conclusions: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.
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| 31. |
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| 32. |
- Hagenfeldt, Stefan, 1949-, et al.
(författare)
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The development of dark shales from the middle and late Cambrian to early Ordovician on the East European Platform – with focus on Gotland
- 2023
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Ingår i: GFF. - London : Taylor & Francis Group. - 1103-5897 .- 2000-0863.
-
Tidskriftsartikel (refereegranskat)abstract
- By compiling data from literature and unpublished reports a more detailed description is presented on the geographical and stratigraphic distribution of the Alum Shale Formation (ASF) and correlateable units on the East European Platform. In the northern part of Gotland, downfaulted patchy beds of the ASF indicate a former wider extension of the formation. Lower Ordovician (Tremadocian) examples of downfaulted patchy beds are the contemporaneous Sepopol and Nivenskaya formations in northeastern Poland and the Kaliningrad area, as well as the Salantai Formation in the east Baltic area. It is indicated that Furongian-Tremadocian beds, contemporaneous with the Kallavere, Türisalu, Tosna and Koporye formations, in the area of northern Estonia and the northwestern part of the Moscow Basin, extended to the Gotland and the South Bothnian Basin areas. South of Gotland, in the Swedish sector of the Baltic Basin, drill cores show evidence of tectonic movements through the presence of erosional surfaces indicating occasional subaerial exposure. In this region, variations in the areal extent and thickness of the ASF and coeval formations are suggested to be the result of epeirogenic and tectonic block movements. Tremadocian ASF is also indicated to be present south of Gotland. On Gotland, at least 5 m of the ASF is presumed to have been eroded. The Moscow Basin contains 19 m of dark shales (Koporye Formation) which is significantly thicker than in surrounding areas.
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| 33. |
- Hagström, Emil, et al.
(författare)
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Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening
- 2006
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Ingår i: European Journal of Endocrinology. - : Oxford University Press (OUP). - 0804-4643 .- 1479-683X. ; 155:1, s. 33-39
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Dyslipidemia, hypertension, diabetes mellitus and also primary hyperparathyroidism (pHPT)are associated with an increased risk of cardiovascular diseases. Metabolic abnormalities in mild pHPThave been reported, but never in cases with normal calcium and high parathyroid hormone (PTH)levels, i.e. suffering from ‘normocalcemic pHPT’. Our aim was to explore the occurrence of thesemetabolic abnormalities in individuals with normocalcemic pHPT identified in a population-basedscreening, and the effects of parathyroidectomy vs conservative treatment on metabolic variables.Design and methods: A population-based screening of 5202 post-menopausal women identified 30patients with normal calcium, inappropriately high PTH and normal creatinine. A 5-year follow-upincluded 15 parathyroidectomized (PTx) and nine conservatively followed cases, in a non-randomizedsetting, together with age-matched controls. Biochemical variables and body mass index (BMI) wereinvestigated.Results: At study entry, cases had higher calcium, PTH, glucose, low-density lipoprotein (LDL)/highdensitylipoprotein (HDL)-cholesterol, very low-density lipoprotein (VLDL)-cholesterol, total triglycerides,and BMI compared to controls (PZ!0.0001–0.035). The cases had a lower HDL-cholesterolvalue (PZ0.013) and one third of the cases had hypertriglyceridemia. During follow-up, the PTx casesdecreased in calcium, PTH, LDL/HDL-cholesterol, total and LDL-cholesterol (PZ0.0076–0.022).Investigated biochemical variables remained adverse in conservatively followed cases during follow-upexcept a decreased LDL-cholesterol value. All surgically treated patients had parathyroid adenoma.Conclusions: Cases with normocalcemic pHPT have increased proatherogenic lipoprotein levels, BMIand glucose levels compared to age-matched controls. Parathyroidectomy has positive effects on someof these variables and reverses them to the same level as the controls, while conservative treatmentfails to normalize the investigated metabolic variables.
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| 34. |
- Hagström, Emil, 1975-
(författare)
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Metabolic Disturbances in Relation to Serum Calcium and Primary Hyperparathyroidism
- 2006
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Primary hyperparathyroidism (pHPT), characterized by elevated serum levels of calcium and parathyroid hormone (PTH), is associated with a number of metabolic derangements causing secondary manifestations. These include osteoporosis and increased risk of fractures, but also risk factors for cardiovascular morbidity and mortality. These risk factors include impaired glucose tolerance (IGT), dyslipidemia, increased body mass index and hypertension. While the skeletal abnormalities are mainly due to elevated PTH, the latter disturbances are still unexplained. Non-insulin dependent diabetes mellitus (NIDDM), IGT, dyslipidemia and hypertension are all included in the metabolic syndrome, also associated with morbidity and mortality in cardiovascular diseases.In this thesis, decreased bone mineral density (BMD) and variables of the metabolic syndrome are explored in patients with mild and normocalcemic pHPT before and after parathyroidectomy. To further investigate the relationship between insulin sensitivity and calcium, a community-based cohort was investigated.In two different patient cohorts of pHPT, lipoprotein alterations with decreased levels of HDL-cholesterol and elevated triglycerides were found in association with a high frequency of IGT, NIDDM and decreased insulin sensitivity. Parathyroidectomy had effects on the dyslipidemia and in part on the glucose metabolism. The disturbed glucose metabolism in pHPT was substantiated by results from the general population by a negative association between insulin sensitivity, measured by hyperinsulinemic clamp, and serum calcium.In conclusion, normocalcemic, mild and overt pHPT are associated with a range of risk factors for cardiovascular diseases, development of NIDDM and decreased BMD in cortical as well as trabecular bone. These findings explain, at least in part, the elevated morbidity and mortality from cardiovascular disease as well as fractures, reported in pHPT patients. Moreover, in the general population, serum calcium is associated with decreased insulin sensitivity. Parathyroidectomy has positive effects on several, but not all, of the investigated metabolic parameters.
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Hagström, Josefin, et al.
(författare)
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Adolescents' and Young Adults' Experiences of Offense from Reading Their Health Records Online
- 2024
-
Ingår i: Studies in Health Technology and Informatics. - : IOS Press. - 0926-9630 .- 1879-8365. ; 310, s. 1422-1423
-
Tidskriftsartikel (refereegranskat)abstract
- Patients feeling offended by reading records online is a concern among healthcare professionals, however previously published work has focused on adult patients. Here, a survey was used to explore and compare experiences of offense among adolescents (15-19 years old) and young adults (20-24 years old). Findings indicated that while the ratio of those offended did not differ between adolescents and young adults, reasons for feeling offended did.
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| 39. |
- Hagström, Josefin, et al.
(författare)
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Adolescents' reasons for accessing their health records online, perceived usefulness and experienced provider encouragement : a national survey in Sweden
- 2024
-
Ingår i: BMJ Paediatrics Open. - : BMJ Publishing Group Ltd. - 2399-9772. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Having online access to electronic health records (EHRs) may help patients become engaged in their care at an early age. However, little is known about adolescents using patient portals. A national survey conducted within the Nordic eHealth project NORDeHEALTH provided an important opportunity to advance our understanding of adolescent users of patient portals. The present study explored reasons for reading the EHRs, the perceived usefulness of information and functions in a patient portal and the association between frequency of use and encouragement to read the EHR. Methods Data were collected in a survey using convenience sampling, available through the Swedish online health portal during 3 weeks in January and February 2022. This study included a subset of items and only respondents aged 15-19. Demographic factors and frequencies on Likert-style questions were reported with descriptive statistics, while Fisher's exact test was used to explore differences in use frequency based on having been encouraged to read by a healthcare professional (HCP). Results Of 13 008 users who completed the survey, 218 (1.7%) were unique users aged 15-19 (females: 77.1%). One-fifth (47/218, 21.6%) had been encouraged by HCPs to read their records, and having been encouraged by HCPs was related to higher use frequency (p=0.018). All types of information were rated high on usefulness, while some functions were rated low, such as blocking specific clinical notes from HCPs and managing services for family members. The main reason for reading their health records online was out of curiosity. Conclusions Adolescents who read their records online perceive it to be useful. Encouragement by HCPs can lead to increased use of patient portals among adolescents. Findings should be considered in the future design of patient portals for adolescents.
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| 40. |
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| 41. |
- Hagström, Jonas, 1959-, et al.
(författare)
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Late Jurassic–Early Cretaceous hydrocarbon seep boulders from NovayaZemlya and their faunas
- 2015
-
Ingår i: Palaeogeography, Palaeoclimatology, Palaeoecology. - : Elsevier. - 0031-0182 .- 1872-616X. ; 436, s. 231-244
-
Tidskriftsartikel (refereegranskat)abstract
- The paper describes Late Jurassic–Early Cretaceous seep carbonate boulders from the Russian Arctic island of Novaya Zemlya, collected in 1875 by A.E. Nordenskiöld during his expedition to Siberia. The carbonates are significantly depleted in heavy carbon isotopes (δ13C values as low as ca. − 40‰) and show textures typical for carbonates formed under the influence of hydrocarbons, such as fibrous carbonate cements and corrosion cavities. The rocks contain index fossils of Late Oxfordian–Early Kimmeridgian, Late Tithonian (Jurassic) and latest Berriasian–Early Valanginian (Cretaceous) age. The fossil fauna is species rich and dominated by molluscs, with subordinate brachiopods, echinoderms, foraminifera, serpulids and ostracods. Most of the species, including two chemosymbiotic bivalve species, likely belong to the ‘background’ fauna. Only a species of a hokkaidoconchid gastropod, and a possible abyssochrysoid gastropod, can be interpreted as restricted to the seep environment. Other seep faunas with similar taxonomic structure are suggestive of rather shallow water settings, but in case of Novaya Zemlya seep faunas such structure might result also from high northern latitude.
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| 42. |
- Hagström, Josefin, et al.
(författare)
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Minor and Parental Access to Electronic Health Records : Differences Across Four Countries
- 2022
-
Ingår i: Challenges of Trustable AI and Added-Value on Health. - : IOS Press. - 9781643682846 - 9781643682853 ; 294, s. 495-499
-
Konferensbidrag (refereegranskat)abstract
- An increasing number of countries are implementing patient access to electronic health records (EHR). However, EHR access for parents, children and adolescents presents ethical challenges of data integrity, and regulations vary across providers, regions, and countries. In the present study, we compare EHR access policy for parents, children and adolescents in four countries. Documentation from three areas: upper age limit of minors for which parents have access; age at which minors obtain access; and possibilities of access restriction and extension was collected from Sweden, Norway, Finland, and Estonia. Results showed that while all systems provided parents with automatic proxy access, age limits for its expiry differed. Furthermore, a lower minimum age than 18 for adolescent access was present in two of four countries. Differences between countries and potential implications for adolescents are discussed. We conclude that experiences of various approaches should be explored to promote the development of EHR regulations for parents, children and adolescents that increases safety, quality, and equality of care.
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| 43. |
- Hagström, Jonas, 1969-
(författare)
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Näringstillstånd och status hos sjöarna i Tyresåns avrinningsområde
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Halterna av näringsämnena fosfor och kväve är i stort sett oförändrade och fortsatt höga i de tätortspåverkade övergödda sjöarna i Tyresåns avrinningsområde visar en jämförelse mellan sexårsperioderna 2004-2009 och 2010-2015. Därför behövs fortsatta åtgärder mot övergödningsproblematiken i Tyresåns tätortspåverkade sjöar och vattendrag.
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| 44. |
- Hagström, Jonas, et al.
(författare)
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Näringstillståndet i Stockholms läns sjöar
- 2013
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Länsstyrelsen utför årligen egna vattenkemiska undersökningar och sammanställer även data från länets kommuner och recipientkontroll. Nedan presenteras kortfattat en sammanställning och klassning av näringstillståndet i Stockholms läns sjöar. Drygt hälften av sjöarna är näringsrika. Tillståndet i de östra delarna av Mälaren är avsevärt bättre än i sjöns övergödda västra delar.
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| 45. |
- Hagström, Jonas, et al.
(författare)
-
Näringstillståndet i Stockholms läns sjöar, vattendrag och havsområden : Ett underlag till uppföljningen av miljökvalitetsmålet ”Ingen övergödning”
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- (Förord:)Denna rapport presenterar en översikt av näringstillståndet i länets vattendrag och havsområden. Målsättningen har varit att ge en aktuell länstäckande bild över förhållandenai länet och en bedömning om dessa förändrats under senare år. I rapporten presenteras även en första sammanställning av resultaten från miljöövervakningsprogrammet ”Årliginventering och sammanställning av näringsförhållandena i tätortspåverkade sjöar”. Undersökningen är på sikt tänkt att ge en samlad länstäckande bild över utvecklingen iett urval av länets mest övergödda sjöar i tätortsmiljöer eller omvandlingsområden. Tillståndet i länets övriga sjöar presenteras endast översiktligt i denna rapport. En mer utförlig beskrivning återfinns dock i rapporten ”Hur mår sjöarna i länet” (Rapport 1999:15). En utvärdering av Riks- och länsinventeringen år 2000 kommer att publicerasav Länsstyrelsen under våren år 2004.Underlaget till rapporten baseras på ett flertal miljöundersökningar från framför allt länets recipientkontroll men även av Länsstyrelsens egna undersökningar. De sistnämnda är finansierade av Naturvårdsverket med medel för regional miljöövervakning.I bilaga 2 redovisas en förteckning över de olika undersökningarna och dess huvudmän.Det har även varit angeläget att beskriva utsläpp och förluster av näringsämnen från avloppsreningsverk och markanvändning. Rapporten innehåller även en uppslagsdel därresultaten från sammanlagt 23 vattendrag och 34 havsområden redovisas kortfattat. Det är Länsstyrelsens förhoppning att denna del är användbar som beslutsunderlag för regionaltmål- och åtgärdsarbete.Utredningen har gjorts som ett led i Länsstyrelsens regionala uppföljning av det nationella miljömålet ”Ingen övergödning”. Jonas Hagström och Joakim Pansar vidLänsstyrelsens miljöinformationsenhet har skrivit rapporten.
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| 46. |
- Hagström, Josefin, et al.
(författare)
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Security and Privacy of Online Record Access : A Survey of Adolescents' Views and Experiences in Sweden
- 2024
-
Ingår i: Journal of Adolescent Health. - : Elsevier. - 1054-139X .- 1879-1972.
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Ensuring security of online health records and patients' perceptions of security are concerns in adolescent healthcare. Little is known about adolescents' perceptions about healthcare's ability to protect online health records. This article explores adolescents' perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information. Methods: This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15–19 years. Gender and health status differences were calculated using the Kruskal-Wallis test. Results: Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%). Discussion: In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems.
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| 47. |
- Hagström, Jonas, et al.
(författare)
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Sjön Fysingens vattenkvalitet 1996-2014
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Vattenkemisk provtagning i sjön Fysingen sker i nationell regi på uppdrag av Naturvårdsverket sedan 1995/1996. En analys av data från nittonårsperioden 1996–2014 visar att sjöns vattenkvalitet ser ut att långsamt försämras med ökande halter av näringsämnet fosfor och brunare vatten kopplat till en haltökning av organiskt kol. Det är dock inga dramatiska förändringar som har skett. Haltökningen av organiskt kol kan kopplas till en samtidig minskning av vattnets elektriska ledningsförmåga och ökning av vattnets motståndskraft mot försurning. Detta kan sammantaget härledas till effekter av det minskade atmosfäriska nedfallet av försurande ämnen och möjliga effekter av ett förändrat klimat. De viktigaste förändringarna av vattenkemin i sjön Fysingen under perioden 1996–2014 omfattar: Ökande totalhalter av organiskt kol (TOC) Ökande vattenfärg (mätt som absorbans vid 420 nm för filtrerat prov) Ökning av alkaliniteten (vattnets motståndskraft mot försurning) Minskning av konduktiviteten (vattnets elektriska ledningsförmåga) Minskande halter av elektrolyterna sulfat (SO42-), kalcium (Ca2+), magnesium (Mg2+) och klorid (Cl-) Ökande halter av näringsämnet fosfor, både som totalfosfor (Tot-P) och fosfatfosfor (PO4-P)
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| 48. |
- Hagström, Jonas, et al.
(författare)
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The dawn of terrestrial ecosystems on Baltica: First report on land plant remains and arthropod coprolites from the Upper Silurian of Gotland, Sweden
- 2012
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Ingår i: Palaeogeography, Palaeoclimatology, Palaeoecology. - : Elsevier BV. - 1872-616X .- 0031-0182. ; 317-318, s. 162-170
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedSporangia, with their in situ cryptospores, spore masses, and a possible axis were identified in marginal marine Ludlovian deposits from Gotland. Sweden by means of light- and scanning electron microscopy.The sporangia identified are elongate, with fragments of the sporangia covering preserved, and contain well-preserved in situ embryophyte cryptospores identified as Laevolancis divellomedia (monad) and Dyadospora murusdensa (dyad). A single detached axis was identified possessing superficial longitudinal striations resembling epidermal cell patterning. The axis ends in a cup-shaped structure that possibly represents the basal part of a sporangium. masses of cryptospore monads shrouded in amorphous organic material, most probably representing coprolites of terrestrial arthropods, were found in the same beds. The spores in these masses are degraded in sharp contrast to the excellent preservation of the dispersed and sporangia-hosted spores. The monad, L divellomedia, a common local constituent of the dispersed microflora, was identified in the coprolites. This is the first report of undisputed Silurian land plant remains in Baltica and the study reveals one of the earliest examples of arthropod-plant interactions.
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| 49. |
- Hagström, Jonas, 1969-
(författare)
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Trender för näringstillståndet i tätortsnära tidsseriestationer i Tyresåns avrinningsområde
- 2016
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Rapport (populärvet., debatt m.m.)abstract
- Halterna av näringsämnena fosfor och kväve har generellt minskat i tätortspåverkade sjöar och vattendrag i Tyresåns avrinningsområde sedan slutet av 1990-talet. I sjöarna märks den förbättrade vattenkvaliteten även i form av en minskad mängd alger och förbättrat siktdjup. Detta är ett resultat av mer eller mindre framgångsrika åtgärder mot belastningen av närsalter i avrinningsområdet under de senaste årtiondena.Fortfarande kvarstår ett stort åtgärdsbehov för att ytterligare minska belastningen av näringsämnen i de delar av Tyresåns avrinningsområde som har stor urban påverkan. Även om halterna av fosfor och kväve minskat totalt sett under hela 18-årsperioden har ingen säkerställd haltminskning skett i någon av lokalerna under de senaste tio åren.
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| 50. |
- Hagström, Jonas, 1969-
(författare)
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Trender för näringstillståndet i tätortsnära tidsseriestationer i Tyresåns avrinningsområde
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Övergödning fortsätter att vara ett påtagligt miljöproblem i tätortspåverkade delar av Tyresåns avrinningsområde. Halterna av näringsämnena fosfor och kväve har överlag minskat i de tätortspåverkade mätstationerna sedan mätningarna inleddes i slutet av 1990-talet. Tyvärr har denna minskning avstannat och under den senaste 20-årsperioden finns inga säkerställda minskande trender för halterna av fosfor och kväve. Dock finns indikationer på en förbättring av vattenkvaliteten de senaste två åren i de dittills mest övergödda sjöarna Orlången och Trehörningen-Sjödalen efter nyligen genomförda åtgärder mot fosforbelastningen.
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