| 1. |
- Kehoe, Laura, et al.
(författare)
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Make EU trade with Brazil sustainable
- 2019
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 2. |
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| 3. |
- Kranaster, L., et al.
(författare)
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Biomarkers for Antidepressant Efficacy of Electroconvulsive Therapy: An Exploratory Cerebrospinal Fluid Study
- 2018
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Ingår i: Neuropsychobiology. - : S. Karger AG. - 0302-282X .- 1423-0224. ; 77:1, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- Background: No candidate biomarkers based on cerebrospinal fluid (CSF) have been identified as prognostic factors in patients with major depression treated with electroconvulsive therapy (ECT), yet. Method: Following different underlying hypotheses, we analysed baseline CSF levels of markers of neurodegeneration (tau proteins, -amyloids and neurogranin), elements of the innate immune system (interleukin [IL]-6, neopterin, soluble CD14, soluble CD163, migration inhibitory factor and monocyte chemotactic protein 1), endocannabinoids, sphingolipids and Klotho before ECT inpatients with depression (n = 12) to identify possible correlations with the clinical antidepressant response to ECT. Results: Correlation with the reduction of the depressive symptoms could be observed especially for markers of neurodegeneration and elements of the innate immune system. Differences for CSF levels of several markers were found between the groups of responders and non-responders at the trend level. Limitations: The sample size is small and the distribution of responders and non-responders is uneven. Conclusions: It is this first study on CSF biomarkers for antidepressant efficacy of ECT warrants further research regarding the mechanism of ECT and personalized antidepressant therapy.
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| 4. |
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| 5. |
- Holgerson, Meredith A., et al.
(författare)
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Classifying Mixing Regimes in Ponds and Shallow Lakes
- 2022
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Ingår i: Water resources research. - : John Wiley & Sons. - 0043-1397 .- 1944-7973. ; 58:7
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Tidskriftsartikel (refereegranskat)abstract
- Lakes are classified by thermal mixing regimes, with shallow waterbodies historically categorized as continuously mixing systems. Yet, recent studies demonstrate extended summertime stratification in ponds, underscoring the need to reassess thermal classifications for shallow waterbodies. In this study, we examined the summertime thermal dynamics of 34 ponds and shallow lakes across temperate North America and Europe to categorize and identify the drivers of different mixing regimes. We identified three mixing regimes: rarely (n = 18), intermittently (n = 10), and often (n = 6) mixed, where waterbodies mixed an average of 2%, 26%, and 75% of the study period, respectively. Waterbodies in the often mixed category were larger (≥4.17 ha) and stratification weakened with increased wind shear stress, characteristic of “shallow lakes.” In contrast, smaller waterbodies, or “ponds,” mixed less frequently, and stratification strengthened with increased shortwave radiation. Shallow ponds (<0.74 m) mixed intermittently, with daytime stratification often breaking down overnight due to convective cooling. Ponds ≥0.74 m deep were rarely or never mixed, likely due to limited wind energy relative to the larger density gradients associated with slightly deeper water columns. Precipitation events weakened stratification, even causing short-term mixing (hours to days) in some sites. By examining a broad set of shallow waterbodies, we show that mixing regimes are highly sensitive to very small differences in size and depth, with potential implications for ecological and biogeochemical processes. Ultimately, we propose a new framework to characterize the variable mixing regimes of ponds and shallow lakes.
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| 6. |
- Jahnke, T., et al.
(författare)
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Inner-Shell-Ionization-Induced Femtosecond Structural Dynamics of Water Molecules Imaged at an X-Ray Free-Electron Laser
- 2021
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Ingår i: Physical Review X. - : American Physical Society. - 2160-3308. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- The ultrafast structural dynamics of water following inner-shell ionization is a crucial issue in high-energy radiation chemistry. We have exposed isolated water molecules to a short x-ray pulse from a free-electron laser and detected momenta of all produced ions in coincidence. By combining experimental results and theoretical modeling, we can image dissociation dynamics of individual molecules in unprecedented detail. We reveal significant molecular structural dynamics in H2O2+, such as asymmetric deformation and bond-angle opening, leading to two-body or three-body fragmentation on a timescale of a few femtoseconds. We thus reconstruct several snapshots of structural dynamics at different time intervals, which highlight dynamical patterns that are relevant as initiating steps of subsequent radiation-damage processes.
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| 7. |
- Kutschera, Verena E., et al.
(författare)
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High genetic variability of vagrant polar bears illustrates importance of population connectivity in fragmented sea ice habitats
- 2016
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Ingår i: Animal Conservation. - : Wiley. - 1367-9430 .- 1469-1795. ; 19:4, s. 337-349
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Tidskriftsartikel (refereegranskat)abstract
- Projections by the Intergovernmental Panel on Climate Change (IPCC) and sea ice forecasts suggest that Arctic sea ice will decline markedly in coming decades. Expected effects on the entire ecosystem include a contraction of suitable polar bear habitat into one or few refugia. Such large-scale habitat decline and fragmentation could lead to reduced genetic diversity. Here we compare genetic variability of four vagrant polar bears that reached Iceland with that in recognized subpopulations from across the range, examining 23 autosomal microsatellites, mitochondrial control region sequences and Y-chromosomal markers. The vagrants' genotypes grouped with different genetic clusters and showed similar genetic variability at autosomal microsatellites (expected heterozygosity, allelic richness, and individual heterozygosity) as individuals in recognized subpopulations. Each vagrant carried a different mitochondrial haplotype. A likely route for polar bears to reach Iceland is via Fram Strait, a major gateway for the physical exportation of sea ice from the Arctic basin. Vagrant polar bears on Iceland likely originated from more than one recognized subpopulation, and may have been caught in sea ice export during long-distance movements to the East Greenland area. Although their potentially diverse geographic origins might suggest that these vagrants encompass much higher genetic variability than vagrants or dispersers in other regions, the four Icelandic vagrants encompassed similar genetic variability as any four randomly picked individuals from a single subpopulation or from the entire sample. We suggest that this is a consequence of the low overall genetic variability and weak range-wide genetic structuring of polar bears - few dispersers can represent a large portion of the species' gene pool. As predicted by theory and our demographic simulations, continued gene flow will be necessary to counteract loss of genetic variability in increasingly fragmented Arctic habitats. Similar considerations will be important in the management of other taxa that utilize sea ice habitats.
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| 8. |
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| 9. |
- Baillie, C. F., et al.
(författare)
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Scaling in Steiner random surfaces
- 1994
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Ingår i: Physics Letters. Section B: Nuclear, Elementary Particle and High-Energy Physics. - : Elsevier BV. - 0370-2693. ; 325:1-2, s. 45-50
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Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that the modified Steiner action functional has desirble properties for a random surface action. In this paper we investigate the scaling of the string tension and massgap in a variant of this action on dynamically triangulated random surfaces and compare the results with the gaussian plus extrinsic curvature actions that have been used previously.
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| 10. |
- Carvalho, A, et al.
(författare)
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First-principles study of the diffusion mechanisms of the self-interstitial in germanium
- 2008
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Ingår i: Journal of Physics. - : IOP Publishing. - 0953-8984 .- 1361-648X. ; 20:13
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Tidskriftsartikel (refereegranskat)abstract
- The self-interstitial in germanium can assume multiple configurations depending on the temperature and charge state. Here, we employ a first-principles density functional method to investigate the diffusion mechanisms of this defect. The energy barriers associated with the transformation between different structures are determined by the climbing nudged elastic band method, as a function of the charge state. The relation between the thermodynamic properties of the self-interstitial and the temperature evolution of electron radiation damage in germanium are discussed.
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| 11. |
- Carvalho, A., et al.
(författare)
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Primary defects in n-type irradiated germanium : a first-principles investigation
- 2008
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Ingår i: Solid State Phenomena. - 1012-0394 .- 1662-9779. ; 131-133, s. 253-258
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Tidskriftsartikel (refereegranskat)abstract
- The properties of point defects introduced by low temperature electron irradiation of germanium are investigated by first-principles modeling. Close Frenkel pairs, including the metastable fourfold coordinated defect, are modelled and their stability is discussed. It is found that damage evolution upon annealing below room temperature can be consistently explained with the formation of correlated interstitial-vacancy pairs if the charge-dependent properties of the vacancy and self-interstitial are taken into account. We propose that Frenkel pairs can trap up to two electrons and are responsible for conductivity loss in n-type Ge at low temperatures.
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| 12. |
- Carvalho, A., et al.
(författare)
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Self-interstitial in germanium
- 2007
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Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 99:17, s. 175502-
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Tidskriftsartikel (refereegranskat)abstract
- Low-temperature radiation damage in n- and p-type Ge is strikingly different, reflecting the charge-dependent properties of vacancies and self-interstitials. We find, using density functional theory, that in Ge the interstitial is bistable, preferring a split configuration when neutral and an open cage configuration when positively charged. The split configuration is inert while the cage configuration acts as a double donor. We evaluate the migration energies of the defects and show that the theory is able to explain the principal results of low-temperature electron-irradiation experiments.
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| 13. |
- Carvalho, A., et al.
(författare)
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Self-interstitials and Frenkel pairs in electron-irradiated germanium
- 2007
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Ingår i: Physica. B, Condensed matter. - : Elsevier BV. - 0921-4526 .- 1873-2135. ; 401-402, s. 495-498
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Tidskriftsartikel (refereegranskat)abstract
- First principles calculations were used to study the structures and electrical levels of the self-interstitial in Ge. We considered the possibility of structural changes consequent with change in charge state and show these have important implications in the mobility and electrical activity of the defect. The theoretical model is compared to the results of low temperature electron irradiation in germanium reported in the literature.
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| 14. |
- Coutinho, J., et al.
(författare)
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Limits to n-type doping in Ge : formation of donor-vacancy complexes
- 2008
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Ingår i: Diffusion and defect data, solid state data. Part A, Defect and diffusion forum. - 1012-0386 .- 1662-9507. ; 273-276, s. 93-98
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Tidskriftsartikel (refereegranskat)abstract
- Vacancies and interstitials in semiconductors play a fundamental role in both high temperature diffusion and low temperature radiation and implantation damage. In Ge, a serious contender material for high-speed electronics applications, vacancies have historically been believed to dominate most diffusion related phenomena such as self-diffusivity or impurity migration. This is to be contrasted with silicon, where self-interstitials also play decisive roles, despite the similarities in the chemical nature of both materials. We report on density functional calculations of the formation and properties of vacancy-donor complexes in germanium. We predict that most vacancy-donor aggregates are deep acceptors, and together with their high solubilities, we conclude that they strongly contribute for inhibiting donor activation levels in germanium.
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| 15. |
- Coutinho, J., et al.
(författare)
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Strong compensation of n-type Ge via formation of donor-vacancy complexes
- 2007
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Ingår i: Physica. B, Condensed matter. - : Elsevier BV. - 0921-4526 .- 1873-2135. ; 401-402, s. 179-183
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Tidskriftsartikel (refereegranskat)abstract
- Vacancies and interstitials in semiconductors play a fundamental role in both high-temperature diffusion and low-temperature radiation and implantation damage. In Ge, a serious contender material for high-speed electronics applications, vacancies have historically been believed to dominate most diffusion related phenomena such as self-diffusivity or impurity migration. This is to be contrasted with silicon, where self-interstitials also play decisive roles, despite the similarities in the chemical nature of both materials. We report on density functional calculations of the formation and properties of vacancy-donor complexes in germanium. We predict that most vacancy-donor aggregates are deep acceptors, and together with their high solubilities, we conclude that they strongly contribute for inhibiting donor activation levels in germanium
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| 16. |
- Janke, C., et al.
(författare)
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Ab initio investigation of boron diffusion paths in germanium
- 2008
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Ingår i: Physical Review B. Condensed Matter and Materials Physics. - 1098-0121 .- 1550-235X. ; 77:7
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Tidskriftsartikel (refereegranskat)abstract
- Experimental data indicate that boron diffuses very differently in Ge than in Si. To examine the kinetics of boron diffusion, density functional calculations were performed on a variety of boron diffusion mechanisms, including interstitial and vacancy-mediated paths, as well as a correlated exchange mechanism. It was found that although vacancy and correlated exchange mechanisms possess high diffusion barriers comparable with experiment, the barrier for interstitial-mediated diffusion lies around 3.8 eV and is similar to those found for boron diffusion in Si. This estimate is well below the experimental activation energy. The difference is attributed to the failure of the theory to include the effect of electronic excitations.
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| 17. |
- Janke, C., et al.
(författare)
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Ab initio investigation of boron diffusion paths in germanium
- 2007
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Ingår i: Journal of materials science. Materials in electronics. - : Springer Science and Business Media LLC. - 0957-4522 .- 1573-482X. ; 18:7, s. 775-780
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Tidskriftsartikel (refereegranskat)abstract
- Boron is observed to diffuse very slowly in germanium, as opposed to its behaviour in silicon where it exhibits Transient Enhanced Diffusion effects in implanted samples. As a result of this slow diffusion, boron is a very stable dopant, allowing devices to be created with very well-defined doping regions. To understand this superior performance, calculations were performed on a variety of boron diffusion paths, within vacancy and interstitial mediated methods. It was found that the vacancy mediated diffusion which is associated with the fast diffusion of many other species in germanium exhibits a total barrier of 5.8 eV. Interstitial-mediated diffusion had a total barrier for migration of 3.4 eV in the neutral and singly negative charge states, 3.2 eV for the positive charge state, but a formation barrier of 4.1 eV. Thus the barrier for interstitial-mediated diffusion is dominated by the formation energy of the self-interstitial.
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| 18. |
- Janke, C., et al.
(författare)
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Ab initio investigation of phosphorus and boron diffusion in germanium
- 2008
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Ingår i: Materials Science in Semiconductor Processing. - : Elsevier BV. - 1369-8001 .- 1873-4081. ; 11:5, s. 324-327
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Tidskriftsartikel (refereegranskat)abstract
- P and B diffusion has been modeled in Ge using ab initio methods along with the formation energies and electrical levels of various PV defects expected to be important in the deactivation of P in heavily n-doped Ge. The calculated activation barrier for B diffusion is found to be substantially lower than the measured barrier. However, the exceptionally large pre-exponential factor in the measured diffusivity points to a Meyer-Neldel rule operating and accounting for the discrepancy. The magnitude of the theoretical diffusivity is about a factor 10 lower than observed. For P diffusion, the experimental and theoretical results are in much closer agreement. The formation energy calculations show that all PV clusters are stable with respect to their component defects, and all but P V are predicted to introduce acceptor levels into the band gap. A simple analysis of possible formation mechanisms and Coulombic contributions suggests that as in Si, P V is the most important compensating center in heavily n-doped Ge.
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| 19. |
- Janke, C., et al.
(författare)
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Ab initio investigation of phosphorus diffusion paths in germanium
- 2008
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Ingår i: Physical Review B. Condensed Matter and Materials Physics. - 1098-0121 .- 1550-235X. ; 77:19
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Tidskriftsartikel (refereegranskat)abstract
- Ab initio calculations were performed to study phosphorus diffusion in germanium through vacancy and interstitial-mediated mechanisms as well as a correlated exchange mechanism without interaction with a mediating defect. It was found that the most favorable diffusion mechanism is sensitive to the position of the Fermi level within the band gap. For material with a midgap Fermi level, the neutral or singly positive phosphorus interstitial is the dominant diffusing species, while in n -type material, it is the doubly negative phosphorus-vacancy complex. For a Fermi level position of Ev +0.5 eV, a barrier for phosphorus diffusion via the doubly negative phosphorus-vacancy defect of ∼2.5 eV was calculated, which is roughly ∼1 eV below the equivalent process in Si.
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| 20. |
- Janke, C., et al.
(författare)
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Ab initio studies of arsenic and boron related defects in silicon mesa diodes
- 2007
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Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 90:15, s. 152103-
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Tidskriftsartikel (refereegranskat)abstract
- E centers are known to diffuse around 400 K in Si and may then form larger donor-vacancy defects such as As2V in heavily doped n-type Si doped with As or AsBV if they diffuse into p-type regions. Ab initio methods are used to explore these possibilities. The AsV defect possesses electrical levels in agreement with experiments. The AsBV defect is found to exhibit a charge-dependent structure, has a barrier to dissociation of ~1.4 eV, and possesses an acceptor level at 0.27 or 0.47 eV above the valence band top depending on the defect structure. The As2V defect possesses only an acceptor level at 0.22 eV below the conduction band. Comparison is made with recent experiments carried out on mesa diodes.
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| 21. |
- Janke, C., et al.
(författare)
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Supercell and cluster density functional calculations of the thermal stability of the divacancy in germanium
- 2006
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Ingår i: Materials Science in Semiconductor Processing. - : Elsevier BV. - 1369-8001 .- 1873-4081. ; 9:4-5, s. 484-488
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Tidskriftsartikel (refereegranskat)abstract
- Large vacancy clusters, or voids, formed during growth have been reported in Ge. The divacancy is a precursor to such clusters, and is believed to be stable up to 150 or 180 {ring operator} C. It is also believed to form in Ge irradiated at room temperature where single vacancies are mobile. Density functional theory calculations have been performed to calculate the energy barriers for migration and dissociation of the divacancy. We find the binding energy in the neutral charge state to lie in the range 1.1-1.5 eV, and this increases for more negative charge states. The migration energies were found to vary from 1.0 to 1.3 eV from the singly positive to the doubly negative state
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| 22. |
- Janke, C., et al.
(författare)
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Supercell and cluster density functional calculations of the thermal stability of the divacancy in germanium
- 2007
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Ingår i: Physical Review B. Condensed Matter and Materials Physics. - 1098-0121 .- 1550-235X. ; 75:19
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Tidskriftsartikel (refereegranskat)abstract
- Large vacancy clusters, or voids, formed during crystal growth have been reported in Ge. The divacancy is a precursor to such clusters, and is believed to be stable up to 150 or 180 °C. It is also believed to form in Ge irradiated at room temperature where single vacancies are mobile. Density functional theory (DFT) cluster calculations have been performed to calculate the energy barriers for migration and dissociation of the divacancy. We find that the binding energy in the neutral charge state is ~1.5 eV and increases for negatively charged states. The migration energies were found to vary from 1.0 to 1.3 eV from the singly positive to the doubly negative charge states. These results line up well with an estimate of a migration barrier of 1.0 eV for the divacancy from experimental data. Therefore, we conclude that the divacancy in germanium will anneal by migration to trapping centers.
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| 23. |
- Kitchener, A.C., et al.
(författare)
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Systematics, evolution and genetics of bears
- 2020
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Ingår i: <em>Bears of the World: Ecology, Conservation, and Management</em>. - Cambridge, UK : Cambridge University Press. ; , s. 3-20
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Bokkapitel (refereegranskat)
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| 24. |
- Nimptsch, Katharina, et al.
(författare)
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Plasma fetuin-A concentration, genetic variation in the AHSG gene and risk of colorectal cancer
- 2015
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 137:4, s. 911-920
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Tidskriftsartikel (refereegranskat)abstract
- Fetuin-A, also referred to as alpha 2-Heremans-Schmid glycoprotein (AHSG), is a liver protein known to inhibit insulin actions. Hyperinsulinemia is a possible risk factor for colorectal cancer; however, the role of fetuin-A in the development of colorectal cancer is unclear. We investigated the association between circulating fetuin-A and colorectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition. Fetuin-A concentrations were measured in prediagnostic plasma samples from 1,367 colorectal cancer cases and 1,367 matched controls. In conditional logistic regression models adjusted for potential confounders, the estimated relative risk (95% confidence interval) of colorectal cancer per 40 mg/mL higher fetuin-A concentrations (approximately one standard deviation) was 1.13 (1.02-1.24) overall, 1.21 (1.05-1.39) in men, 1.06 (0.93-1.22) in women, 1.13 (1.00-1.27) for colon cancer and 1.12 (0.94-1.32) for rectal cancer. To improve causal inference in a Mendelian Randomization approach, five tagging single nucleotide polymorphisms of the AHSG gene were genotyped in a subset of 456 case-control pairs. The AHSG allele-score explained 21% of the interindividual variation in plasma fetuin-A concentrations. In instrumental variable analysis, genetically raised fetuin-A was not associated with colorectal cancer risk (relative risk per 40 mg/mL genetically determined higher fetuin-A was 0.98, 95% confidence interval: 0.73-1.33). The findings of our study indicate a modest linear association between fetuin-A concentrations and risk of colorectal cancer but suggest that fetuin-A may not be causally related to colorectal cancer development.
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| 25. |
- Nimptsch, Katharina, et al.
(författare)
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Prospective and Mendelian randomization analyses on the association of circulating fatty acid binding protein 4 (FABP-4) and risk of colorectal cancer
- 2023
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Ingår i: BMC Medicine. - : BioMed Central (BMC). - 1741-7015. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fatty acid binding protein 4 (FABP-4) is a lipid-binding adipokine upregulated in obesity, which may facilitate fatty acid supply for tumor growth and promote insulin resistance and inflammation and may thus play a role in colorectal cancer (CRC) development. We aimed to investigate the association between circulating FABP-4 and CRC and to assess potential causality using a Mendelian randomization (MR) approach.Methods: The association between pre-diagnostic plasma measurements of FABP-4 and CRC risk was investigated in a nested case-control study in 1324 CRC cases and the same number of matched controls within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A two-sample Mendelian randomization study was conducted based on three genetic variants (1 cis, 2 trans) associated with circulating FABP-4 identified in a published genome-wide association study (discovery n = 20,436) and data from 58,131 CRC cases and 67,347 controls in the Genetics and Epidemiology of Colorectal Cancer Consortium, Colorectal Cancer Transdisciplinary Study, and Colon Cancer Family Registry.Results: In conditional logistic regression models adjusted for potential confounders including body size, the estimated relative risk, RR (95% confidence interval, CI) per one standard deviation, SD (8.9 ng/mL) higher FABP-4 concentration was 1.01 (0.92, 1.12) overall, 0.95 (0.80, 1.13) in men and 1.09 (0.95, 1.25) in women. Genetically determined higher FABP-4 was not associated with colorectal cancer risk (RR per FABP-4 SD was 1.10 (0.95, 1.27) overall, 1.03 (0.84, 1.26) in men and 1.21 (0.98, 1.48) in women). However, in a cis-MR approach, a statistically significant association was observed in women (RR 1.56, 1.09, 2.23) but not overall (RR 1.23, 0.97, 1.57) or in men (0.99, 0.71, 1.37).Conclusions: Taken together, these analyses provide no support for a causal role of circulating FABP-4 in the development of CRC, although the cis-MR provides some evidence for a positive association in women, which may deserve to be investigated further.
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| 26. |
- Pesut, B, et al.
(författare)
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Nursing and euthanasia: A narrative review of the nursing ethics literature
- 2020
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Ingår i: Nursing ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 27:1, s. 152-167
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Tidskriftsartikel (refereegranskat)abstract
- Medical Assistance in Dying, also known as euthanasia or assisted suicide, is expanding internationally. Canada is the first country to permit Nurse Practitioners to provide euthanasia. These developments highlight the need for nurses to reflect upon the moral and ethical issues that euthanasia presents for nursing practice. Purpose: The purpose of this article is to provide a narrative review of the ethical arguments surrounding euthanasia in relationship to nursing practice. Methods: Systematic search and narrative review. Nine electronic databases were searched using vocabulary developed from a stage 1 search of Medline and CINAHL. Articles that analysed a focused ethical question related to euthanasia in the context of nursing practice were included. Articles were synthesized to provide an overview of the literature of nursing ethics and euthanasia. Ethical Considerations: This review was conducted as per established scientific guidelines. We have tried to be fair and respectful to the authors discussed. Findings: Forty-three articles were identified and arranged inductively into four themes: arguments from the nature of nursing; arguments from ethical principles, concepts and theories; arguments for moral consistency; and arguments from the nature of the social good. Key considerations included nursing’s moral ontology, the nurse–patient relationship, potential impact on the profession, ethical principles and theories, moral culpability for acts versus omissions, the role of intention and the nature of the society in which euthanasia would be enacted. In many cases, the same assumptions, values, principles and theories were used to argue both for and against euthanasia. Discussion: The review identified a relative paucity of literature in light of the expansion of euthanasia internationally. However, the literature provided a fulsome range of positions for nurses to consider as they reflect on their own participation in euthanasia. Many of the arguments reviewed were not nursing-specific, but rather are relevant across healthcare disciplines. Arguments explicitly grounded within the nature of nursing and nurse–patient relationships warrant further exploration.
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| 27. |
- Screever, Elles M., et al.
(författare)
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Comorbidities complicating heart failure: changes over the last 15 years
- 2023
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Ingår i: Clinical Research in Cardiology. - : Springer Heidelberg. - 1861-0684 .- 1861-0692. ; 112:1, s. 123-133
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Tidskriftsartikel (refereegranskat)abstract
- Aims Management of comorbidities represents a critical step in optimal treatment of heart failure (HF) patients. However, minimal attention has been paid whether comorbidity burden and their prognostic value changes over time. Therefore, we examined the association between comorbidities and clinical outcomes in HF patients between 2002 and 2017. Methods and results The 2002-HF cohort consisted of patients from The Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) trial (n = 1,032). The 2017-HF cohort were outpatient HF patients enrolled after hospitalization for HF in a tertiary referral academic hospital (n = 382). Kaplan meier and cox regression analyses were used to assess the association of comorbidities with HF hospitalization and all-cause mortality. Patients from the 2017-cohort were more likely to be classified as HF with preserved ejection fraction (24 vs 15%, p < 0.001), compared to patients from the 2002-cohort. Comorbidity burden was comparable between both cohorts (mean of 3.9 comorbidities per patient) and substantially increased with age. Higher comorbidity burden was significantly associated with a comparable increased risk for HF hospitalization and all-cause mortality (HR 1.12 [1.02-1.22] and HR 1.18 [1.05-1.32]), in the 2002- and 2017-cohort respectively. When assessing individual comorbidities, obesity yielded a statistically higher prognostic effect on outcome in the 2017-cohort compared to the 2002-HF cohort (p for interaction 0.026). Conclusion Despite major advances in HF treatment over the past decades, comorbidity burden remains high in HF and influences outcome to a large extent. Obesity emerges as a prominent comorbidity, and efforts should be made for prevention and treatment. [GRAPHICS] .
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