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1.	Aad, G., et al. (författare) The ATLAS Experiment at the CERN Large Hadron Collider 2008 Ingår i: Journal of Instrumentation. - 1748-0221. ; 3:S08003 Forskningsöversikt (refereegranskat)abstract The ATLAS detector as installed in its experimental cavern at point 1 at CERN is described in this paper. A brief overview of the expected performance of the detector when the Large Hadron Collider begins operation is also presented.
2.	Hörnqvist, Magnus, et al. (författare) En öppen stad, en ej befästad 2005 Ingår i: Fronesis. - 1404-2614. ; :18, s. 8-19 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Vår tid är urbanitetens epok. Människor vill komma till staden. Utflyttningen från landsbygd till stad tycks vara en social omvandlingsprocess utan ände. I dagens Sverige bor 84 procent av befolkningen i städer. På tvåhundra år har förhållandet mellan stad och landsbygd nästan vänts i sin motsats. Någon gång under 1930-talets början passerade antalet stadsboende landsbygdens befolkning. Det som hände i Sverige för 70 år sedan händer i dag på global nivå. Under 2005 beräknas antalet människor som bor i en stad någonstans i världen passera det antal som bor på landsbygden. Och det är inte i Nord som den största tillväxten av stadsbefolkningar sker, utan i Syd. Bilden av Syd som det rurala, jordbrukshushållande och efterblivna – i kontrast till bilden av Nord som det urbana, industriella och i utveckling stadda – känns allt mer förfelad. Det är i Syd som de verkligt stora städerna formligen exploderar fram. Men denna omkastning innebär inte en utvecklingsväg som följer det sätt på vilket storstäder i Nord växte fram. Det paradoxala för storstäderna i Syd är att det inte alltid är industrialiseringen som driver fram urbaniseringen. Stor- eller megastäderna i Syd närs av en bräcklig informell sektor. Denna utveckling av en "informaliserad" sektor på arbetsmarknaden – med lågbetalda och osäkra tjänstearbeten – är inte något som enbart sker i Syd. Det som tycks karaktärisera västvärldens metropoler är just framväxten av denna typ av arbeten, samtidigt som industrijobben är på tillbakagång. Samtidigt blir storstäderna allt viktigare för de globala ekonomiska flödena – och självmedvetenheten om detta faktum hos städernas makthavare växer i samma utsträckning. Städer konkurrerar med andra städer om att attrahera kapital och arbetskraft. Staden blir ett varumärke som ska säljas in på städernas marknad, med hjälp av stadsmiljöer som passar en framväxande kreativ klass.
3.	Lund Hansen, Anders, et al. (författare) Introduction - David Harveys återpolitisering av staden 2011 Ingår i: Ojämlikhetens nya geografi. Texter om stadens och rummets förändringar under den globala kapitalismen. - 9789173899291 Bokkapitel (refereegranskat)
4.	Abarkan, Abdellah, et al. (författare) Corona hotar förvärra svenska bostadskrisen. 108 forskare: Sveriges regering och kommuner måste förhindra en katastrof. 2020 Ingår i: Aftonbladet. - 1103-9000. Tidskriftsartikel (populärvet., debatt m.m.)abstract Debattartikel och Öppet brev publicerad i tidningen Aftonbladet. 29.3. 2020.
5.	Abata, E., et al. (författare) Study of energy response and resolution of the ATLAS barrel calorimeter to hadrons of energies from 20 to 350 GeV 2010 Ingår i: Nuclear Instruments and Methods in Physics Research Section A. - : Elsevier. - 0168-9002 .- 1872-9576 .- 0167-5087. ; 621:1-3, s. 134-150 Tidskriftsartikel (refereegranskat)abstract A fully instrumented slice of the ATLAS detector was exposed to test beams from the SPS (Super Proton Synchrotron) at CERN in 2004. In this paper, the results of the measurements of the response of the barrel calorimeter to hadrons with energies in the range 20-350 GeV and beam impact points and angles corresponding to pseudo-rapidity values in the range 0.2-0.65 are reported. The results are compared to the predictions of a simulation program using the Geant 4 toolkit. (C) 2010 Published by Elsevier B.V.
6.	Abdalla, M., et al. (författare) Simulation of CO2 and Attribution Analysis at Six European Peatland Sites Using the ECOSSE Model 2014 Ingår i: Water, Air and Soil Pollution. - : Springer Science and Business Media LLC. - 1573-2932 .- 0049-6979. ; 225:11, s. 2182-2182 Tidskriftsartikel (refereegranskat)abstract In this study, we simulated heterotrophic CO2 (Rh) fluxes at six European peatland sites using the ECOSSE model and compared them to estimates of Rh made from eddy covariance (EC) measurements. The sites are spread over four countries with different climates, vegetation and management. Annual Rh from the different sites ranged from 110 to 540 g C m(-2). The maximum annual Rh occurred when the water table (WT) level was between -10 and -25 cm and the air temperature was above 6.2 degrees C. The model successfully simulated seasonal trends for the majority of the sites. Regression relationships (r(2)) between the EC-derived and simulated Rh ranged from 0.28 to 0.76, and the root mean square error and relative error were small, revealing an acceptable fit. The overall relative deviation value between annual EC-derived and simulated Rh was small (-1 %) and model efficiency ranges across sites from -0.25 to +0.41. Sensitivity analysis highlighted that increasing temperature, decreasing precipitation and lowering WT depth could significantly increase Rh from soils. Thus, management which lowers the WT could significantly increase anthropogenic CO2, so from a carbon emissions perspective, it should be avoided. The results presented here demonstrate a robust basis for further application of the ECOSSE model to assess the impacts of future land management interventions on peatland carbon emissions and to help guide best practice land management decisions.
7.	Alehagen, Urban, et al. (författare) Association Between Use of Statins and Mortality in Patients With Heart Failure and Ejection Fraction of greater than= 50% 2015 Ingår i: Circulation Heart Failure. - : LIPPINCOTT WILLIAMS and WILKINS. - 1941-3289 .- 1941-3297. ; 8:5, s. 862-870 Tidskriftsartikel (refereegranskat)abstract Background The pathophysiology of heart failure with preserved ejection fraction is poorly understood, but may involve a systemic proinflammatory state. Therefore, statins might improve outcomes in patients with heart failure with preserved ejection fraction defined as 50%. Methods and Results Of 46 959 unique patients in the prospective Swedish Heart Failure Registry, 9140 patients had heart failure and ejection fraction 50% (age 7711 years, 54.0% women), and of these, 3427 (37.5%) were treated with statins. Propensity scores for statin treatment were derived from 40 baseline variables. The association between statin use and primary (all-cause mortality) and secondary (separately, cardiovascular mortality, and combined all-cause mortality or cardiovascular hospitalization) end points was assessed with Cox regressions in a population matched 1:1 based on age and propensity score. In the matched population, 1-year survival was 85.1% for statin-treated versus 80.9% for untreated patients (hazard ratio, 0.80; 95% confidence interval, 0.72-0.89; Pless than0.001). Statins were also associated with reduced cardiovascular death (hazard ratio, 0.86; 95% confidence interval, 0.75-0.98; P=0.026) and composite all-cause mortality or cardiovascular hospitalization (hazard ratio, 0.89; 95% confidence interval, 0.82-0.96; P=0.003). Conclusions In heart failure with ejection fraction 50%, the use of statins was associated with improved outcomes. The mechanisms should be evaluated and the effects tested in a randomized trial.
8.	Alehagen, Urban, et al. (författare) Association Between Use of Statins and Outcomes in Heart Failure With Reduced Ejection Fraction Prospective Propensity Score Matched Cohort Study of 21 864 Patients in the Swedish Heart Failure Registry 2015 Ingår i: Circulation Heart Failure. - : American Heart Association. - 1941-3289 .- 1941-3297. ; 8:2, s. 252-260 Tidskriftsartikel (refereegranskat)abstract Background-In heart failure (HF) with reduced ejection fraction, randomized trials of statins did not demonstrate improved outcomes. However, randomized trials may not always be generalizable. The aim was to determine whether statins are associated with improved outcomes in an unselected nationwide population of patients with HF with reduced ejection fraction overall and in relation to ischemic heart disease (IHD). Methods and Results-In the Swedish Heart Failure Registry, 21 864 patients with HF with reduced ejection fraction (age +/- SD, 72+/-12 years; 29% women), of whom 10 345 (47%) were treated with statins, were studied. Propensity scores for statin use were derived from 42 baseline variables. The associations between statin use and outcomes were assessed with Cox regressions in a population matched 1: 1 based on propensity score and age and in the overall population with adjustment for propensity score and age. The primary outcome was all-cause mortality; secondary outcomes were cardiovascular mortality; HF hospitalization; and combined all-cause mortality or cardiovascular hospitalization. Survival at 1 year in the matched population was 83% for statin-treated versus 79% for untreated patients (hazard ratio, 0.81; 95% confidence interval, 0.76-0.86; Pless than0.001). In the unmatched population, 1-year survival was 85% for statin-treated versus 79% for untreated patients, hazard ratio after adjustment for propensity score and age was 0.84 (95% confidence interval, 0.80-0.89; Pless than0.001). No examined baseline variables interacted with statin use except for IHD (P=0.001), with a hazard ratio of 0.76 (95% confidence interval, 0.70-0.82, Pless than0.001) with IHD and 0.95 (95% confidence interval, 0.85-1.07; P=0.430 without IHD. Statin use was also associated with reduced risk for all 3 secondary outcomes. Conclusions-In an unselected nationwide population of patients with HF with reduced ejection fraction, statins were associated with improved outcomes, specifically in the presence of IHD. This contrasts with previous randomized controlled trials. Additional randomized controlled trials with more generalized inclusion or focused on IHD may be warranted.
9.	Borgerlighet 2007 Ingår i: Fronesis. - 1404-2614. ; :24 Annan publikation (refereegranskat)abstract Lyxkonsumtion, Stureplansbrats, medelklass och överklass diskuteras allt mer. Samtidigt har den partipolitiska borgerligheten tagit över regeringsmakten. Men vad innebär det att tala om borgerlighet i dagens Sverige? Vilka tillhör denna sociala kategori och vad utmärker den? I Fronesis nr 24 dissekeras gårdagens såväl som dagens borgerlighet.
10.	Box, Jason E., et al. (författare) Key indicators of Arctic climate change: 1971–2017 2019 Ingår i: Environmental Research Letters. - : IOP Publishing. - 1748-9326. ; 14:4 Tidskriftsartikel (refereegranskat)abstract Key observational indicators of climate change in the Arctic, most spanning a 47 year period (1971–2017) demonstrate fundamental changes among nine key elements of the Arctic system. We find that, coherent with increasing air temperature, there is an intensification of the hydrological cycle, evident from increases in humidity, precipitation, river discharge, glacier equilibrium line altitude and land ice wastage. Downward trends continue in sea ice thickness (and extent) and spring snow cover extent and duration, while near-surface permafrost continues to warm. Several of the climate indicators exhibit a significant statistical correlation with air temperature or precipitation, reinforcing the notion that increasing air temperatures and precipitation are drivers of major changes in various components of the Arctic system. To progress beyond a presentation of the Arctic physical climate changes, we find a correspondence between air temperature and biophysical indicators such as tundra biomass and identify numerous biophysical disruptions with cascading effects throughout the trophic levels. These include: increased delivery of organic matter and nutrients to Arctic near‐coastal zones; condensed flowering and pollination plant species periods; timing mismatch between plant flowering and pollinators; increased plant vulnerability to insect disturbance; increased shrub biomass; increased ignition of wildfires; increased growing season CO2 uptake, with counterbalancing increases in shoulder season and winter CO2 emissions; increased carbon cycling, regulated by local hydrology and permafrost thaw; conversion between terrestrial and aquatic ecosystems; and shifting animal distribution and demographics. The Arctic biophysical system is now clearly trending away from its 20th Century state and into an unprecedented state, with implications not only within but beyond the Arctic. The indicator time series of this study are freely downloadable at AMAP.no.
11.	Carter, M. S., et al. (författare) Synthesizing greenhouse gas fluxes across nine European peatlands and shrublands - responses to climatic and environmental changes 2012 Ingår i: Biogeosciences. - : Copernicus GmbH. - 1726-4189. ; 9:10, s. 3739-3755 Tidskriftsartikel (refereegranskat)abstract In this study, we compare annual fluxes of methane (CH4), nitrous oxide (N2O) and soil respiratory carbon dioxide (CO2) measured at nine European peatlands (n = 4) and shrublands (n = 5). The sites range from northern Sweden to Spain, covering a span in mean annual air temperature from 0 to 16 degrees C, and in annual precipitation from 300 to 1300 mm yr(-1). The effects of climate change, including temperature increase and prolonged drought, were tested at five shrubland sites. At one peatland site, the long-term (> 30 yr) effect of drainage was assessed, while increased nitrogen deposition was investigated at three peatland sites. The shrublands were generally sinks for atmospheric CH4, whereas the peatlands were CH4 sources, with fluxes ranging from -519 to + 6890 mg CH4-Cm-2 yr(-1) across the studied ecosystems. At the peatland sites, annual CH4 emission increased with mean annual air temperature, while a negative relationship was found between net CH4 uptake and the soil carbon stock at the shrubland sites. Annual N2O fluxes were generally small ranging from -14 to 42 mg N2O-Nm(-2) yr(-1). Highest N2O emission occurred at the sites that had highest nitrate (NO3-) concentration in the soil water. Furthermore, experimentally increased NO3- deposition led to increased N2O efflux, whereas prolonged drought and long-term drainage reduced the N2O efflux. Soil CO2 emissions in control plots ranged from 310 to 732 g CO2-C m(-2) yr(-1). Drought and long-term drainage from -519 to + 6890 mg CH4-C m(-2) yr(-1) across the studied ecosystems. At the peatland sites, annual CH4 emission increased with mean annual air temperature, while a negative relationship was found between net CH4 uptake and the soil carbon stock at the shrubland sites. Annual N2O fluxes were generally small ranging from -14 to 42 mg N2O-N m(-2) yr(-1). Highest N2O emission occurred at the sites that had highest nitrate (NO3-) concentration in the soil water. Furthermore, experimentally increased NO3- deposition led to increased N2O efflux, whereas prolonged drought and long-term drainage reduced the N2O efflux. Soil CO2 emissions in control plots ranged from 310 to 732 g CO2-Cm-2 yr(-1). Drought and long-term drainage generally reduced the soil CO2 efflux, except at a hydric shrubland where drought tended to increase soil respiration. In terms of fractional importance of each greenhouse gas to the total numerical global warming response, the change in CO2 efflux dominated the response in all treatments (ranging 71-96%), except for NO3- addition where 89% was due to change in CH4 emissions. Thus, in European peatlands and shrublands the effect on global warming induced by the investigated anthropogenic disturbances will be dominated by variations in soil CO2 fluxes.
12.	Chadalavada, Sucharitha, et al. (författare) Diabetes and heart failure associations in women and men : Results from the MORGAM consortium 2023 Ingår i: Frontiers in Cardiovascular Medicine. - 2297-055X. ; 10 Tidskriftsartikel (refereegranskat)abstract Background: Diabetes and its cardiovascular complications are a growing concern worldwide. Recently, some studies have demonstrated that relative risk of heart failure (HF) is higher in women with type 1 diabetes (T1DM) than in men. This study aims to validate these findings in cohorts representing five countries across Europe.Methods: This study includes 88,559 (51.8% women) participants, 3,281 (46.3% women) of whom had diabetes at baseline. Survival analysis was performed with the outcomes of interest being death and HF with a follow-up time of 12 years. Sub-group analysis according to sex and type of diabetes was also performed for the HF outcome.Results: 6,460 deaths were recorded, of which 567 were amongst those with diabetes. Additionally, HF was diagnosed in 2,772 individuals (446 with diabetes). A multivariable Cox proportional hazard analysis showed that there was an increased risk of death and HF (hazard ratio (HR) of 1.73 [1.58–1.89] and 2.12 [1.91–2.36], respectively) when comparing those with diabetes and those without. The HR for HF was 6.72 [2.75–16.41] for women with T1DM vs. 5.80 [2.72–12.37] for men with T1DM, but the interaction term for sex differences was insignificant (p for interaction 0.45). There was no significant difference in the relative risk of HF between men and women when both types of diabetes were combined (HR 2.22 [1.93–2.54] vs. 1.99 [1.67–2.38] respectively, p for interaction 0.80).Conclusion: Diabetes is associated with increased risks of death and heart failure, and there was no difference in relative risk according to sex.
13.	Chadburn, Sarah E., et al. (författare) Carbon stocks and fluxes in the high latitudes : using site-level data to evaluate Earth system models 2017 Ingår i: Biogeosciences. - : Copernicus GmbH. - 1726-4170 .- 1726-4189. ; 14:22, s. 5143-5169 Tidskriftsartikel (refereegranskat)abstract It is important that climate models can accurately simulate the terrestrial carbon cycle in the Arctic due to the large and potentially labile carbon stocks found in permafrost-affected environments, which can lead to a positive climate feedback, along with the possibility of future carbon sinks from northward expansion of vegetation under climate warming. Here we evaluate the simulation of tundra carbon stocks and fluxes in three land surface schemes that each form part of major Earth system models (JSBACH, Germany; JULES, UK; ORCHIDEE, France). We use a site-level approach in which comprehensive, high-frequency datasets allow us to disentangle the importance of different processes. The models have improved physical permafrost processes and there is a reasonable correspondence between the simulated and measured physical variables, including soil temperature, soil moisture and snow. We show that if the models simulate the correct leaf area index (LAI), the standard C3 photosynthesis schemes produce the correct order of magnitude of carbon fluxes. Therefore, simulating the correct LAI is one of the first priorities. LAI depends quite strongly on climatic variables alone, as we see by the fact that the dynamic vegetation model can simulate most of the differences in LAI between sites, based almost entirely on climate inputs. However, we also identify an influence from nutrient limitation as the LAI becomes too large at some of the more nutrient-limited sites. We conclude that including moss as well as vascular plants is of primary importance to the carbon budget, as moss contributes a large fraction to the seasonal CO2 flux in nutrient-limited conditions. Moss photosynthetic activity can be strongly influenced by the moisture content of moss, and the carbon uptake can be significantly different from vascular plants with a similar LAI. The soil carbon stocks depend strongly on the rate of input of carbon from the vegetation to the soil, and our analysis suggests that an improved simulation of photosynthesis would also lead to an improved simulation of soil carbon stocks. However, the stocks are also influenced by soil carbon burial (e.g. through cryoturbation) and the rate of heterotrophic respiration, which depends on the soil physical state. More detailed below-ground measurements are needed to fully evaluate biological and physical soil processes. Furthermore, even if these processes are well modelled, the soil carbon profiles cannot resemble peat layers as peat accumulation processes are not represented in the models. Thus, we identify three priority areas for model development: (1) dynamic vegetation including (a) climate and (b) nutrient limitation effects; (2) adding moss as a plant functional type; and an (3) improved vertical profile of soil carbon including peat processes.
14.	Edner, Magnus, et al. (författare) Association between renin-angiotensin system antagonist use and mortality in heart failure with severe renal insufficiency: a prospective propensity score-matched cohort study 2015 Ingår i: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645. ; 36:34, s. 2318-2326 Tidskriftsartikel (refereegranskat)abstract Aims In heart failure (HF) with reduced ejection fraction (EF), renin-angiotensin receptor (RAS) antagonists reduce mortality. However, severe renal insufficiency was an exclusion criterion in trials. We tested the hypothesis that RAS antagonists are associated with reduced mortality also in HF with severe renal insufficiency. Methods and results We studied patients with EF less than= 39% registered in the prospective Swedish Heart Failure Registry. In patients with creatinine greater than221 mu mol/L or creatinine clearance less than30 mL/min, propensity scores for RAS-antagonist use were derived from 36 variables. The association between RAS antagonist use and all-cause mortality was assessed with Cox regression in a cohort matched 1:1 based on age and propensity score. To assess consistency, we performed the same analysis as a positive control in patients without severe renal insufficiency. Between 2000 and 2013, there were 24 283 patients of which 2410 [age, mean (SD), 82 (9), 45% women] had creatinine greater than221 mu mol/L or creatinine clearance less than30 mL/min and were treated (n = 1602) or not treated (n = 808) with RAS antagonists. In the matched cohort of 602 vs. 602 patients [age 83 (8), 42% women], RAS antagonist use was associated with 55% [95% confidence interval (CI) 51-59] vs. 45% (41-49) 1-year survival, P less than 0.001, with a hazard ratio (HR) for mortality of 0.76 (95% CI 0.67-0.86, P less than 0.001). In positive control patients without severe renal insufficiency [n = 21 873; age 71 (12), 27% women], the matched HR was 0.79 (95% CI 0.72-0.86, P less than 0.001). Conclusion In HF with severe renal insufficiency, the use of RAS antagonists was associated with lower all-cause mortality. Prospective randomized trials are needed before these findings can be applied to clinical practice.
15.	Eklind-Cervenka, Maria, et al. (författare) Association of Candesartan vs Losartan With All-Cause Mortality in Patients With Heart Failure 2011 Ingår i: JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. - : Ama American Medical Association. - 0098-7484 .- 1538-3598. ; 305:2, s. 175-182 Tidskriftsartikel (refereegranskat)abstract Context Angiotensin II receptor blockers (ARBs) reduce combined mortality and hospitalization in patients with heart failure (HF) with reduced left ventricular ejection fraction. Different agents have different affinity for the AT(1) receptor and may have different clinical effects, but have not been tested against each other in HF. Objective To assess the association of candesartan vs losartan with all-cause mortality in patients with HF. Design, Setting, and Patients An HF registry (the Swedish Heart Failure Registry) of 30 254 unique patients registered from 62 hospitals and 60 outpatient clinics between 2000 and 2009. A total of 5139 patients (mean [SD] age, 74 [11] years; 39% women) were treated with candesartan (n=2639) or losartan (n=2500). Survival as of December 14, 2009, by ARB agent was analyzed by Kaplan-Meier method and predictors of survival determined by univariate and multivariate proportional hazard regression models, with and without adjustment for propensity scores and interactions. Stratified analyses and quantification of residual confounding were also performed. Main Outcome Measures All-cause mortality at 1 and 5 years. Results One-year survival was 90% (95% confidence interval [CI], 89%-91%) for patients receiving candesartan and 83% (95% CI, 81%-84%) for patients receiving losartan, and 5-year survival was 61% (95% CI, 54%-68%) and 44% (95% CI, 41%-48%), respectively (log-rank Pandlt;.001). In multivariate analysis with adjustment for propensity scores, the hazard ratio for mortality for losartan compared with candesartan was 1.43 (95% CI, 1.23-1.65; Pandlt;.001). The results persisted in stratified analyses. Conclusion In this registry of patients with HF, the use of candesartan compared with losartan was associated with a lower mortality risk.
16.	Eriksson, Bjorn, et al. (författare) Limited value of NT-proBNP as a prognostic marker of all-cause mortality in patients with heart failure with preserved and mid-range ejection fraction in primary care : A report from the swedish heart failure register 2019 Ingår i: Scandinavian Journal of Primary Health Care. - : TAYLOR & FRANCIS LTD. - 0281-3432 .- 1502-7724. ; 37:4, s. 434-443 Tidskriftsartikel (refereegranskat)abstract Aim: The prognostic value of natriuretic peptides in the management of heart failure (HF) patients with ejection fraction (EF) <40% is well established, but is less known for those with EF >= 40% managed in primary care (PC). Therefore, the aim of this study is to describe the prognostic significance of plasma NT-proBNP in such patients managed in PC. Subjects: We included 924 HF patients (48% women) with EF >= 40% and NT-proBNP registered in the Swedish Heart Failure Registry. Follow-up was 1100 +/- 687 days. Results: One-, three- and five-year mortality rates were 8.1%, 23.9% and 44.7% in patients with EF 40-50% (HFmrEF) and 7.3%, 23.6% and 37.2% in patients with EF >= 50% (HFpEF) (p = 0.26). Patients with the highest mean values of NT-proBNP had the highest all-cause mortality but wide standard deviations (SDs). In univariate regression analysis, there was an association only between NT-proBNP quartiles and all-cause mortality. In HFmrEF patients, hazard ratio (HR) was 1.96 (95% CI 1.60-2.39) p < 0.0001) and in HFpEF patients, HR was 1.72 (95% CI 1.49-1.98) p < 0.0001). In a multivariate Cox proportional hazard regression analysis, adjusted for age, NYHA class, atrial fibrillation and GFR class, this association remained regarding NT-proBNP quartiles [HR 1.83 (95% CI 1.38-2.44), p < 0.0001] and [HR 1.48 (95% CI 1.16-1.90), p = 0.0001], HFmrEF and HFpEF, respectively. Conclusion: NT-proBNP has a prognostic value in patients with HF and EF >= 40% managed in PC. However, its clinical utility is limited due to high SDs and the fact that it is not independent in this population which is characterized by high age and much comorbidity.
17.	Faxneld, Suzanne, et al. (författare) Differences in physiological response to increased seawater temperature in nearshore and offshore corals in northern Vietnam 2011 Ingår i: Marine Environmental Research. - : Elsevier BV. - 0141-1136 .- 1879-0291. ; 71:3, s. 225-233 Tidskriftsartikel (refereegranskat)abstract Effects of elevated seawater temperature show high spatial heterogeneity and variation within and among coral species. The objective of this study was to investigate how two coral species, Porites lutea and Galaxea fascicularis, from two high latitude reefs differently exposed to chronic disturbance, respond to elevated seawater temperatures. Corals were collected from reefs nearshore (i.e. subjected to high sediment load, higher chlorophyll α concentrations, turbidity etc.) and offshore (i.e. less exposed). The corals were exposed in the lab to gradually increasing temperatures (25.5–33.5 °C) for 72 h after which they were allowed to recover to ambient temperature (25.5 °C) for 24 h. Production and respiration were measured after 24, 48, 72 and 96 h. The results show that P. lutea from nearshore reefs suffered an initial decrease in gross primary production/respiration (GP/R) ratio after 24 h, after only a moderate temperature increase (+2 °C, from 25.5 to 27.5 °C), while there was no difference in GP/R ratio between heat-exposed and controls the other days, indicating that the chronic disturbance in the nearshore reef had no effect on their thermotolerance. Furthermore, P. lutea from the offshore reef showed a decrease in GP/R ratio both after 24 h and 72 h (33.5 °C) of exposure.In comparison, G. fascicularis showed a decrease in GP/R ratio after 48 h, 72 h and 96 h of exposure for the nearshore corals. Also, after 72 h these corals had withdrawn their polyps. There were no differences between heat-treated and controls for the offshore G. fascicularis. This implies that the chronically disturbed G. fascicularis had lower thermotolerance when exposed to a temperature increase.This study, hence, shows that the response of corals to elevated seawater temperature varies with species and environmental background history.
18.	Ferry, Magnus, et al. (författare) In the crossing of the fields of education and sport : Social selection among pupils in school sports 2015 Konferensbidrag (refereegranskat)abstract IntroductionWith reference to Bourideu’s theoretical framework, the fields of education and sport can be seen as social fields in which choice and social selection are influenced partly by the possession of capital and habitus and partly by the organisational and structural circumstances. This paper sets out to investigate those pupils who, in the crossing of the fields of education and sports, choose and have been selected to participate in school sports in Sweden. From a cultural sociological perspective, the main purpose of this paper is to identify and analyse how organisational conditions and pupils’ social characteristics interact with the different selection processes underlying upper secondary pupils’ participation in school sports.MethodsFor the analysis of the selection of pupils on a national level, we use registry data on upper secondary school pupils in Sweden. For the analysis of the selection process on an individual level, data were derived from two questionnaire surveys completed by pupils participating in school sports at 18 strategically selected upper secondary school during 2008 and 2009. In total, the survey data consist of answers from 677 pupils (386 boys and 291 girls). For this paper, the conforming parts of the questionnaires were merged, and include information about the pupils’ social background, choice of education, athletic level and parental involvement in sport. Characteristics that can be seen as indications of the possession of an educational capital and sporting capital.ResultsSwedish school sports are organised primarily in combination with academic study programmes and team sport, and this results in that in comparison the nationwide population pupils who participate in school sports are: to a higher degree boys, attending academic study programs, have Swedish background and whose parents have a higher education level (p<0.05). Furthermore, the result show that the choice between different school sports programmes is related to the pupils’ possession of educational capital and sporting capital. School sports programmes with higher demands on athletic ability require larger possessions of capital among the pupils (p<0.05).DiscussionWe argue that school sports, through the crossing of the two fields of education and sports, increase the social selection among the pupil. The organisational condition for school sports makes participation neither reasonable nor possible for all pupils. Instead, the supply of school sport appeals to a narrow or rather specific taste for sport and education. In this sense school sport is generally organized in a way to attract boys with highly educated parents and with an interest in sports.
19.	Ferry, Magnus, et al. (författare) Pupils in upper secondary school sports : Choices based on what? 2018 Ingår i: Sport, Education and Society. - London : Routledge. - 1357-3322 .- 1470-1243. ; 23:3, s. 270-282 Tidskriftsartikel (refereegranskat)abstract In the fields of both education and sport, the possession of capital and habitus influences an individual’s lifestyles and choices, which in turn affects the social selection within these fields. In this article, we will study the Swedish system of school sports as an overlap between the fields of education and sport, and thus viewed as a double dominated field. From a cultural sociological perspective, the purpose of this article is to analyse and explain how the organisational conditions and pupils’ social characteristics interact with upper secondary pupils’ choices of different school sports programmes in Sweden. Based on registry data on secondary school sports pupils, the results show that the supply of school sports requires specific forms of social dispositions that have an impact on which categories of pupils choose to participate. Among the students participating in school sports, there is a higher proportion of pupils who: are of Swedish origin (p < 0.05), are boys (p < 0.05), attend academic study programmes (p < 0.05), and have parents with high educational capital (p < 0.05). Furthermore, based on 677 pupils’ questionnaire responses, collected through two studies on school sports in Sweden, the results show that the choice between different types of school sports programmes is related to the intersection between pupils’ sex and possession of educational and sporting capital. One important conclusion is that the overlap between the fields of education and sports exacerbates gender and class biases, and that the supply of school sports in Sweden appeals to a narrow or rather specific taste for sport and education, particularly favouring boys with highly educated parents and an interest in team sports.
20.	Ferry, Magnus, 1972-, et al. (författare) School sports pupils in Swedish upper secondary schools : selection based on what? 2014 Annan publikation (övrigt vetenskapligt/konstnärligt)abstract In both the fields of education and the field of sport, an individual’s possession of capital and his or her habitus influence lifestyle and choices that in turn affect the selection of pupils on a collective level. In this article, we will study school sports and the crossing of these two fields. From a cultural sociological perspective, the main purpose of this article is to identify and analyse how organisational conditions and pupils’ social characteristics interact with the different selection processes that underlie upper secondary pupils’ participation in school sports in Sweden. The results show that the selection of pupils to school sports is ultimately a question of how school sports is organised and the pupils’ social characteristics. Upper secondary schools generally organise school sports through academic programmes, and with team sports, this seems to be better adapted to the interests and sports habits of middle-class boys. Furthermore, on the basis of 677 pupils’ questionnaire responses, the results of this study show that choice between different types of school sports programmes depends on the possession of educational capital and sporting capital.
21.	Fjellstrom, Sanna, et al. (författare) Web-based training intervention to increase physical activity level and improve health for adults with intellectual disability 2022 Ingår i: Journal of Intellectual Disability Research. - : John Wiley & Sons. - 0964-2633 .- 1365-2788. ; 66:12, s. 967-977 Tidskriftsartikel (refereegranskat)abstract Background: Individuals with intellectual disability (ID) are less physically active, have a higher body mass index (BMI) and are at greater risk for cardiovascular diseases (CVDs) than people without ID. The purpose of the study was to explore the effectiveness of a web-based training programme, consisting of 150 min of activity per week, on the health of people with ID.Method: Participants with ID living in supported accommodation (n = 28, 48% female, age = 36.4 ± 9.56 years) participated in a web-based training programme, consisting of a combination of exercises (endurance, strength balance and flexibility) of moderate intensity, 50 min, three times per week for 12 weeks. The body composition and waist circumference (WC) were measured, and questionnaires were used to assess enjoyment, quality of life (QoL) and physical activity (PA) level. Descriptive statistics and pairwise comparison pre and post intervention were carried out.Results: A total of 22 out of 28 participants completed the 12-week training intervention with 83% mean attendance of training sessions. The intensity of the PA level increased and a decrease in fat mass of 1.9 ± 2.4 kg, P < 0.001 and WC of 3 ± 5 cm, P = 0.009 were observed. Enjoyment of training sessions was 3.9 out of 5, and no differences in QoL were found.Conclusion: A web-based training programme is an effective tool for improving health parameters of people with ID and offers a new way for caregivers to enhance the PA for the target group.
22.	Hansen, Henning Gram, et al. (författare) Versatile microscale screening platform for improving recombinant protein productivity in Chinese hamster ovary cells 2015 Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 5 Tidskriftsartikel (refereegranskat)abstract Chinese hamster ovary (CHO) cells are widely used as cell factories for the production of biopharmaceuticals. In contrast to the highly optimized production processes for monoclonal antibody (mAb)-based biopharmaceuticals, improving productivity of non-mAb therapeutic glycoproteins is more likely to reduce production costs significantly. The aim of this study was to establish a versatile target gene screening platform for improving productivity for primarily non-mAb glycoproteins with complete interchangeability of model proteins and target genes using transient expression. The platform consists of four techniques compatible with 96-well microplates: lipid-based transient transfection, cell cultivation in microplates, cell counting and antibody-independent product titer determination based on split-GFP complementation. We were able to demonstrate growth profiles and volumetric productivity of CHO cells in 96-half-deepwell microplates comparable with those obtained in shake flasks. In addition, we demonstrate that split-GFP complementation can be used to accurately measure relative titers of therapeutic glycoproteins. Using this platform, we were able to detect target gene-specific increase in titer and specific productivity of two non-mAb glycoproteins. In conclusion, the platform provides a novel miniaturized and parallelisable solution for screening target genes and holds the potential to unravel genes that can enhance the secretory capacity of CHO cells.
23.	Heitor Colombelli Manfrão-Netto, João, et al. (författare) Metabolic engineering of Pseudomonas putida for production of vanillylamine from lignin-derived substrates 2021 Ingår i: Microbial Biotechnology. - : Wiley. - 1751-7907 .- 1751-7915. ; 14:6, s. 2448-2462 Tidskriftsartikel (refereegranskat)abstract Whole-cell bioconversion of technical lignins using Pseudomonas putida strains overexpressing amine transaminases (ATAs) has the potential to become an eco-efficient route to produce phenolic amines. Here, a novel cell growth-based screening method to evaluate the in vivo activity of recombinant ATAs towards vanillylamine in P. putida KT2440 was developed. It allowed the identification of the native enzyme Pp-SpuC-II and ATA from Chromobacterium violaceum (Cv-ATA) as highly active towards vanillylamine in vivo. Overexpression of Pp-SpuC-II and Cv-ATA in the strain GN442ΔPP_2426, previously engineered for reduced vanillin assimilation, resulted in 94- and 92-fold increased specific transaminase activity, respectively. Whole-cell bioconversion of vanillin yielded 0.70 ± 0.20 mM and 0.92 ± 0.30 mM vanillylamine, for Pp-SpuC-II and Cv-ATA, respectively. Still, amine production was limited by a substantial re-assimilation of the product and formation of the by-products vanillic acid and vanillyl alcohol. Concomitant overexpression of Cv-ATA and alanine dehydrogenase from Bacillus subtilis increased the production of vanillylamine with ammonium as the only nitrogen source and a reduction in the amount of amine product re-assimilation. Identification and deletion of additional native genes encoding oxidoreductases acting on vanillin are crucial engineering targets for further improvement.
24.	Hellström, Ann, 1959, et al. (författare) Effect of Enteral Lipid Supplement on Severe Retinopathy of Prematurity A Randomized Clinical Trial 2021 Ingår i: JAMA Pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 175:4, s. 359-367 Tidskriftsartikel (refereegranskat)abstract IMPORTANCE Lack of arachidonic acid (AA) and docosahexaenoic acid (DHA) after extremely preterm birth may contribute to preterm morbidity, including retinopathy of prematurity (ROP). OBJECTIVE To determine whether enteral supplementation with fatty acids from birth to 40 weeks' postmenstrual age reduces ROP in extremely preterm infants. DESIGN, SETTING, AND PARTICIPANTS The Mega Donna Mega trial, a randomized clinical trial, was a multicenter study performed at 3 university hospitals in Sweden from December 15, 2016, to December 15, 2019. The screening pediatric ophthalmologists were masked to patient groupings. A total of 209 infants born at less than 27 weeks' gestation were tested for eligibility, and 206 infants were included. Efficacy analyses were performed on as-randomized groups on the intention-to-treat population and on the per-protocol population using as-treated groups. Statistical analyses were performed from February to April 2020. INTERVENTIONS Infants received either supplementation with an enteral oil providing AA (100mg/kg/d) and DHA (50mg/kg/d) (AA:DHA group) or no supplementation within 3 days after birth until 40 weeks' postmenstrual age. MAIN OUTCOMES AND MEASURES The primary outcomewas severe ROP (stage 3 and/or type 1). The secondary outcomes were AA and DHA serum levels and rates of other complications of preterm birth. RESULTS A total of 101 infants (58 boys [57.4%]; mean [SD] gestational age, 25.5 [1.5] weeks) were included in the AA:DHA group, and 105 infants (59 boys [56.2%]; mean [SD] gestational age, 25.5 [1.4] weeks) were included in the control group. Treatment with AA and DHA reduced severe ROP compared with the standard of care (16 of 101 [15.8%] in the AA:DHA group vs 35 of 105 [33.3%] in the control group; adjusted relative risk, 0.50 [95% CI, 0.28-0.91]; P =.02). The AA:DHA group had significantly higher fractions of AA and DHA in serum phospholipids compared with controls (overall mean difference in AA:DHA group, 0.82 mol% [95% CI, 0.46-1.18 mol%]; P <.001; overall mean difference in control group, 0.13 mol% [95% CI, 0.01-0.24 mol%]; P =.03). There were no significant differences between the AA:DHA group and the control group in the rates of bronchopulmonary dysplasia (48 of 101 [47.5%] vs 48 of 105 [45.7%]) and of any grade of intraventricular hemorrhage (43 of 101 [42.6%] vs 42 of 105 [40.0%]). In the AA:DHA group and control group, respectively, sepsis occurred in 42 of 101 infants (41.6%) and 53 of 105 infants (50.5%), serious adverse events occurred in 26 of 101 infants (25.7%) and 26 of 105 infants (24.8%), and 16 of 101 infants (15.8%) and 13 of 106 infants (12.3%) died. CONCLUSIONS AND RELEVANCE This study found that, compared with standard of care, enteral AA:DHA supplementation lowered the risk of severe ROP by 50% and showed overall higher serum levels of both AA and DHA. Enteral lipid supplementation with AA:DHA is a novel preventive strategy to decrease severe ROP in extremely preterm infants.
25.	Håkansson, H., et al. (författare) In vivo and in vitro toxicity of fractionated fish lipids, with particular regard to their content of chlorinated organic compounds 1991 Ingår i: Pharmacology and Toxicology. - : Wiley. - 0901-9928 .- 1600-0773. ; 69:6, s. 459-471 Tidskriftsartikel (refereegranskat)abstract Six different lipid matrices (the intact lipid (IL), four lipid fractions with different polarity, and the free fatty acids (FFAs) obtained by hydrolysis of the triacylglycerol (TAG) containing fraction) were obtained from salmon (Salmo salar) and eel (Anguilla anguilla), each collected at a contaminated and a comparatively uncontaminated catch site along the coast of Scandinavia. The lipid matrices were studied in toxicological test systems representing various biological functions of different organ systems from several species and trophic levels. The results were evaluated with particular respect to the concentrations of extractable organically bound chlorine (EOCl) in the matrices tested. In some test systems, the specimens with a higher EOCl concentration appeared to be more toxic. For example, the TAG containing fraction (F2) from Idefjord eel, having a higher EOCl content than F2 from Oslofjord eel, reduced the number and hatchability of eggs laid by zebrafish. Both IL and F2 of Idefjord eel increased mortality and reduced the oxygen/nitrogen-ratio in blue mussels. Non-polar compounds (F1) from Bothnian Sea salmon induced 7-ethoxyresurofin O-deethylase (EROD) activity in rainbow trout hepatocytes, whereas F1 from Senja salmon did not. F1 from Bothnian Sea salmon also reduced the number of T-cells in foetal mouse thymus anlagen in vitro compared with the cell number in anlagen exposed to F1 from Senja salmon. A positive correlation between EOCl concentration and test response was found for EROD activity in rainbow trout hepatocytes and for ATP-leakage in Erlich ascites tumour cells when testing the phospolipid containing fraction (F4). However, in most test systems the fish oils, irrespective of EOCl content, were of low toxicity, and the observed effects need to be verified in future studies.
26.	Jackson, Alice M., et al. (författare) Sacubitril-valsartan as a treatment for apparent resistant hypertension in patients with heart failure and preserved ejection fraction 2021 Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 42:36, s. 3741-3752 Tidskriftsartikel (refereegranskat)abstract Aims: Patients with heart failure and preserved ejection fraction (HFpEF) frequently have difficult-to-control hypertension. We examined the effect of neprilysin inhibition on apparent resistant hypertension in patients with HFpEF in the PARAGON-HF trial, which compared the effect of sacubitril-valsartan with valsartan.Methods and results: In this post hoc analysis, patients were categorized according to systolic blood pressure at the end of the valsartan run-in (n=4795). Apparent resistant hypertension was defined as systolic blood pressure >= 14 0mmHg (>= 135 mmHg if diabetes) despite treatment with valsartan, a calcium channel blocker, and a diuretic. Apparent mineralocorticoid receptor antagonist (MRA)-resistant hypertension was defined as systolic blood pressure >= 140 mmHg (>= 135 mmHg if diabetes) despite the above treatments and an MRA. The primary outcome in the PARAGON-HF trial was a composite of total hospitalizations for heart failure and death from cardiovascular causes. We examined clinical endpoints and the safety of sacubitril-valsartan according to the hypertension category. We also examined reductions in blood pressure from the end of valsartan run-in to Weeks 4 and 16 after randomization. Overall, 731 patients (15.2%) had apparent resistant hypertension and 135 (2.8%) had apparent MRA-resistant hypertension. The rate of the primary outcome was higher in patients with apparent resistant hypertension [17.3; 95% confidence interval (CI) 15.6-19.1 per 100 person-years] compared to those with a controlled systolic blood pressure (13.4; 12.7-14.3 per 100 person-years), with an adjusted rate ratio of 1.28 (95% CI 1.05-1.57). The reduction in systolic blood pressure at Weeks 4 and 16, respectively, was greater with sacubitril-valsartan vs. valsartan in patients with apparent resistant hypertension [-4.8 (-7.0 to -2.5) and 3.9 (-6.6 to -1.3) mmHg] and apparent MRA-resistant hypertension [-8.8 (-14.0 to -3.5) and -6.3 (-12.5 to -0.1) mmHg]. The proportion of patients with apparent resistant hypertension achieving a controlled systolic blood pressure by Week 16 was 47.9% in the sacubitril-valsartan group and 34.3% in the valsartan group [adjusted odds ratio (OR) 1.78, 95% CI 1.30-2.43]. In patients with apparent MRA-resistant hypertension, the respective proportions were 43.6% vs. 28.4% (adjusted OR 2.63, 95% CI 1.18-5.89).Conclusion: Sacubitril-valsartan may be useful in treating apparent resistant hypertension in patients with HFpEF, even in those who continue to have an elevated blood pressure despite treatment with at least four antihypertensive drug classes, including an MRA.
27.	Johanen, Astera, et al. (författare) Trabecular bone pattern assessment in dental radiographs for prediction of bone fracture risk 2019 Rapport (övrigt vetenskapligt/konstnärligt)
28.	Johanen, Astera, et al. (författare) Trabecular bone patterns as a fracture risk predictor: a systematic review 2021 Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 79:7, s. 482-491 Tidskriftsartikel (refereegranskat)abstract The aim of this systematic review was to evaluate the assessment of trabecular bone patterns in dental radiographs, for fracture risk prediction, compared with the current diagnostic methods.The PRISMA guidelines were followed. According to predefined inclusion criteria (PICO), literature searches were focussed on published studies with analyses of trabecular bone patterns on intraoral and/or in panoramic radiographs, compared with Dual X-ray Absorptiometry (DXA) and/or Fracture Risk Assessment Tool (FRAX), with the outcomes; fracture and/or sensitivity and specificity for osteoporosis prediction. The included studies were quality-assessed using the QUADAS-2 tool and the certainties of evidence was assessed using the GRADE approach.The literature searches identified 2913 articles, whereas three were found to meet the inclusion criteria. Two longitudinal cohort studies evaluated the use of trabecular bone patterns to predict bone fractures. In one of the studies, the relative risk of fracture was significantly higher for women with sparse bone pattern, identified by visual assessment of dental radiographs, and in the other study by digital software assessment. Visual assessment in the second study did not show significant results. The cross-sectional study of digital analyses of trabecular bone patterns in relation to osteoporosis reported a sensitivity of 0.70 and a specificity of 0.69.Based on low certainty of evidence, trabecular bone evaluation on dental radiographs may predict fractures in adults without a prior diagnosis of osteoporosis, and based on very low certainty of evidence, it is uncertain whether digital image analyses of trabecular bone can predict osteoporosis.
29.	Jonsdottir, Gudbjörg, et al. (författare) Survival in multiple myeloma patients who develop second malignancies : a population-based cohort study 2016 Ingår i: Haematologica. - : Ferrata Storti Foundation. - 0390-6078 .- 1592-8721. ; 101:4, s. e145-e148 Tidskriftsartikel (refereegranskat)
30.	Jonsson, Åsa, et al. (författare) A comprehensive assessment of the association between anemia, clinical covariates and outcomes in a population-wide heart failure registry 2016 Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 211, s. 124-131 Tidskriftsartikel (refereegranskat)abstract Background: The aim was to investigate the prevalence of, predictors of, and association with mortality and morbidity of anemia in a large unselected cohort of patients with heart failure (HF) and reduced ejection fraction (HFrEF) and to explore if there were specific subgroups of high risk. Methods: In patients with HFrEF in the Swedish Heart Failure Registry, we assessed hemoglobin levels and associations between baseline characteristics and anemia with logistic regression. Using propensity scores for anemia, we assessed the association between anemia and outcomes with Cox regression, and performed interaction and sub-group analyses. Results: There were 24 511 patients with HFrEF (8303 with anemia). Most important independent predictors of anemia were higher age, male gender and renal dysfunction. One-year survival was 75% with anemia vs. 81% without (p < 0.001). In the matched cohort after propensity score the hazard ratio associated with anemia was for all-cause death 1.34 (1.28-1.40; p < 0.0001), CV mortality 1.28 (1.20-1.36; p < 0.0001), and combined CV mortality or HF hospitalization 1.24 (1.18-1.30; p < 0.0001). In interaction analyses, anemia was associated with greater risk with lower age, male gender, EF 30-39%, and NYHA-class I-II. Conclusion: In HFrEF, anemia is associated with higher age, male gender and renal dysfunction and increased risk of mortality and morbidity. The influence of anemia on mortality was significantly greater in younger patients, in men, and in those with more stable HF. The clinical implication of these findings might be in the future to perform targeted treatment studies. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
31.	Jonsson, Åsa, 1969- (författare) How to create and analyze a Heart Failure Registry with emphasis on Anemia and Quality of Life 2017 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Background and aimsHeart failure (HF) is a major cause of serious morbidity and death in the population and one of the leading medical causes of hospitalization among people older than 60 years. The aim of this thesis was to describe how to create and how to analyze a Heart Failure Registry with emphasis on Anemia and Quality of Life. (Paper I) We described the creation of the Swedish Heart Failure Registry (SwedeHF) as an instrument, which may help to optimize the handling of HF patients and show how the registry can be used to improve the management of patients with HF. (Paper II) In order to show how to analyze a HF registry we investigated the prevalence of anemia, its predictors, and its association with mortality and morbidity in a large cohort of unselected patients with HFrEF included in the SwedeHF, and to explore if there are subgroups of HF patients identifying high--‐risk patients in need of treatment. (Paper III) In order to show another way of analyzing a HF registry we assessed the prevalence of, associations with, and prognostic impact of anemia in patients with HFmrEF and HFpEF. (Paper IV) Finally we examined the usefulness of EQ--‐ 5D as a measure of patient--‐reported outcomes among HF patients using different analytical models and data from the SwedeHF, and comparing results about HRQoL for patients with HFpEF and HFrEF.Methods An observational study based on the SwedeHF database, consisting of about 70 variables, was undertaken to describe how a registry is created and can be used (Paper I). One comorbidity (anemia) was applied to different types of HF patients, HFrEF (EF <40%) (II) and HFmrEF (EF 40--‐49% ) or HFpEF (> 50%) (III) analyzing the data with different statistical methods. The usefulness of EQ--‐5D as measure of patient--‐ reported outcomes was studied and the results about HRQoL were compared for patients with HFpEF and HFrEF (IV).ResultsIn the first paper (Paper I) we showed how to create a HF registry and presented some characteristics of the patients included, however not adjusted since this was not the purpose of the study. In the second paper (Paper II) we studied anemia in patients with HFrEF and found that the prevalence of anemia in HFrEF were 34 % and the most important independent predictors were higher age, male gender and renal dysfunction. One--‐year survival was 75 % with anemia vs. 81 % without (p<0,001). In the matched cohort after propensity score the hazard ratio associated with anemia was for all--‐cause death 1.34. Anemia was associated with greater risk with lower age, male gender, EF 30--‐39%, and NYHA--‐class I--‐II. In the third paper (Paper III) we studied anemia in other types of HF patients and found that the prevalence in the overall cohort in patients with EF > 40% was 42 %, in HFmrEF 38 % and in HFpEF (45%). Independent associations with anemia were HFpEF, male sex, higher age, worse New York Heart Association class and renal function, systolic blood pressure <100 mmHg, heart rate ≥70 bpm, diabetes, and absence of atrial fibrillation. One--‐year survival with vs. without anemia was 74% vs. 89% in HFmrEF and 71% vs. 84% in HFpEF (p<0.001 for all). Thus very similar results in paper II and III but in different types of HF patients. In the fourth paper (Paper IV) we studied the usefulness of EQ--‐5D in two groups of patients with HF (HFpEF and HFrEF)) and found that the mean EQ--‐5D index showed small reductions in both groups at follow--‐up. The patients in the HFpEF group reported worsening in all five dimensions, while those in the HFrEF group reported worsening in only three. The Paretian classification showed that 24% of the patients in the HFpEF group and 34% of those in the HFrEF group reported overall improvement while 43% and 39% reported overall worsening. Multiple logistic regressions showed that treatment in a cardiology clinic affected outcome in the HFrEF group but not in the HFpEF group (Paper IV).Conclusions The SwedeHF is a valuable tool for improving the management of patients with HF, since it enables participating centers to focus on their own potential for improving diagnoses and medical treatment, through the online reports (Paper I). Anemia is associated with higher age, male gender and renal dysfunction and increased risk of mortality and morbidity (II, III). The influence of anemia on mortality was significantly greater in younger patients in men and in those with more stable HF (Paper II, III). The usefulness of EQ--‐5D is dependent on the analytical method used. While the index showed minor differences between groups, analyses of specific dimensions showed different patterns of change in the two groups of patients (HFpEF and HFrEF). The Paretian classification identified subgroups that improved or worsened, and can therefore help to identify needs for improvement in health services (Paper IV).
32.	Kasurinen, Ville, et al. (författare) Latent heat exchange in the boreal and arctic biomes 2014 Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 20:11, s. 3439-3456 Forskningsöversikt (refereegranskat)abstract In this study latent heat flux (E) measurements made at 65 boreal and arctic eddy-covariance (EC) sites were analyses by using the Penman-Monteith equation. Sites were stratified into nine different ecosystem types: harvested and burnt forest areas, pine forests, spruce or fir forests, Douglas-fir forests, broadleaf deciduous forests, larch forests, wetlands, tundra and natural grasslands. The Penman-Monteith equation was calibrated with variable surface resistances against half-hourly eddy-covariance data and clear differences between ecosystem types were observed. Based on the modeled behavior of surface and aerodynamic resistances, surface resistance tightly control E in most mature forests, while it had less importance in ecosystems having shorter vegetation like young or recently harvested forests, grasslands, wetlands and tundra. The parameters of the Penman-Monteith equation were clearly different for winter and summer conditions, indicating that phenological effects on surface resistance are important. We also compared the simulated E of different ecosystem types under meteorological conditions at one site. Values of E varied between 15% and 38% of the net radiation in the simulations with mean ecosystem parameters. In general, the simulations suggest that E is higher from forested ecosystems than from grasslands, wetlands or tundra-type ecosystems. Forests showed usually a tighter stomatal control of E as indicated by a pronounced sensitivity of surface resistance to atmospheric vapor pressure deficit. Nevertheless, the surface resistance of forests was lower than for open vegetation types including wetlands. Tundra and wetlands had higher surface resistances, which were less sensitive to vapor pressure deficits. The results indicate that the variation in surface resistance within and between different vegetation types might play a significant role in energy exchange between terrestrial ecosystems and atmosphere. These results suggest the need to take into account vegetation type and phenology in energy exchange modeling.
33.	Koebsch, Franziska, et al. (författare) Refining the role of phenology in regulating gross ecosystem productivity across European peatlands 2020 Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 26:2, s. 876-887 Tidskriftsartikel (refereegranskat)abstract The role of plant phenology as a regulator for gross ecosystem productivity (GEP) in peatlands is empirically not well constrained. This is because proxies to track vegetation development with daily coverage at the ecosystem scale have only recently become available and the lack of such data has hampered the disentangling of biotic and abiotic effects. This study aimed at unraveling the mechanisms that regulate the seasonal variation in GEP across a network of eight European peatlands. Therefore, we described phenology with canopy greenness derived from digital repeat photography and disentangled the effects of radiation, temperature and phenology on GEP with commonality analysis and structural equation modeling. The resulting relational network could not only delineate direct effects but also accounted for possible effect combinations such as interdependencies (mediation) and interactions (moderation). We found that peatland GEP was controlled by the same mechanisms across all sites: phenology constituted a key predictor for the seasonal variation in GEP and further acted as a distinct mediator for temperature and radiation effects on GEP. In particular, the effect of air temperature on GEP was fully mediated through phenology, implying that direct temperature effects representing the thermoregulation of photosynthesis were negligible. The tight coupling between temperature, phenology and GEP applied especially to high latitude and high altitude peatlands and during phenological transition phases. Our study highlights the importance of phenological effects when evaluating the future response of peatland GEP to climate change. Climate change will affect peatland GEP especially through changing temperature patterns during plant phenologically sensitive phases in high latitude and high altitude regions.
34.	Komaguchi, Kenji, et al. (författare) ESR and theoretical studies of trimer radical cations of coronene 2006 Ingår i: Spectrochimica Acta A. ; 63, s. 76- Tidskriftsartikel (refereegranskat)
35.	Kropp, Heather, et al. (författare) Shallow soils are warmer under trees and tall shrubs across Arctic and Boreal ecosystems 2021 Ingår i: Environmental Research Letters. - : IOP Publishing. - 1748-9326. ; 16:1 Tidskriftsartikel (refereegranskat)abstract Soils are warming as air temperatures rise across the Arctic and Boreal region concurrent with the expansion of tall-statured shrubs and trees in the tundra. Changes in vegetation structure and function are expected to alter soil thermal regimes, thereby modifying climate feedbacks related to permafrost thaw and carbon cycling. However, current understanding of vegetation impacts on soil temperature is limited to local or regional scales and lacks the generality necessary to predict soil warming and permafrost stability on a pan-Arctic scale. Here we synthesize shallow soil and air temperature observations with broad spatial and temporal coverage collected across 106 sites representing nine different vegetation types in the permafrost region. We showed ecosystems with tall-statured shrubs and trees (>40 cm) have warmer shallow soils than those with short-statured tundra vegetation when normalized to a constant air temperature. In tree and tall shrub vegetation types, cooler temperatures in the warm season do not lead to cooler mean annual soil temperature indicating that ground thermal regimes in the cold-season rather than the warm-season are most critical for predicting soil warming in ecosystems underlain by permafrost. Our results suggest that the expansion of tall shrubs and trees into tundra regions can amplify shallow soil warming, and could increase the potential for increased seasonal thaw depth and increase soil carbon cycling rates and lead to increased carbon dioxide loss and further permafrost thaw.
36.	Lilja-Lund, Otto, 1981- (författare) A population-based study on neuropsychological and morphological signs of idiopathic normal pressure hydrocephalus 2022 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is typically manifested in people over 65 years. The condition of gait disturbances, incontinence, and cognitive dysfunction can be reversed in up to 80% of the cases by ventricular shunting. Neuropsychological testing and standardized brain imaging of signs of iNPH are essential to detect and define the progression. The aims of this thesis were to develop a radiological iNPH scale, examine how morphological features relate to symptoms of iNPH, investigate if dual-task testing (e.g., walking and talking) is helpful in detecting iNPH, and monitor developing symptoms over two years.METHOD: The studies include 168 participants (median [range] age 73 [66–92]) at baseline (2014/2015) and 104 participants (age 75 [68–91]) at follow-up (2016/2017) from the general population. Neuropsychological tests of executive functions, memory, and motor performance, and computed tomography (CT) for brain imaging were used.RESULTS: Seven morphological features were combined into a scoring scale for iNPH. The total score correlated with clinical symptoms (r = -0.40, p <.001). All core symptoms were associated to wider temporal horns (TH) (p <.01). Participants with iNPH stopped walking to talk more frequently (p = .044). Participants who developed iNPH during the study worsened more on declarative memory (ES -0.37).DISCUSSION: The Radscale was related to symptoms of iNPH and the TH to all main clinical features. Difficulties walking while recalling a previous event, worsened declarative memory, and expanding ventricular space surrounding the hippocampus were noticeable signs of iNPH. Memory functions are important to recognize in iNPH.
37.	Lindberg, Felix, et al. (författare) Patient profile and outcomes associated with follow-up in specialty vs. primary care in heart failure 2022 Ingår i: ESC Heart Failure. - : Wiley Periodicals Inc. - 2055-5822. ; 9:2, s. 822-833 Tidskriftsartikel (refereegranskat)abstract Aims Factors influencing follow-up referral decisions and their prognostic implications are poorly investigated in patients with heart failure (HF) with reduced (HFrEF), mildly reduced (HFmrEF), and preserved (HFpEF) ejection fraction (EF). We assessed (i) the proportion of, (ii) independent predictors of, and (iii) outcomes associated with follow-up in specialty vs. primary care across the EF spectrum. Methods and results We analysed 75 518 patients from the large and nationwide Swedish HF registry between 2000-2018. Multivariable logistic regression models were fitted to identify the independent predictors of planned follow-up in specialty vs. primary care, and multivariable Cox models to assess the association between follow-up type and outcomes. In this nationwide registry, 48 115 (64%) patients were planned for follow-up in specialty and 27 403 (36%) in primary care. The median age was 76 [interquartile range (IQR) 67-83] years and 27 546 (36.5%) patients were female. Key independent predictors of planned follow-up in specialty care included optimized HF care, that is follow-up in a nurse-led HF clinic [odds ratio (OR) 4.60, 95% confidence interval (95% CI) 4.41-4.79], use of HF devices (OR 3.99, 95% CI 3.62-4.40), beta-blockers (OR 1.39, 95% CI 1.32-1.47), renin-angiotensin system/angiotensin-receptor-neprilysin inhibitors (OR 1.21, 95% CI 1.15-1.27), and mineralocorticoid receptor antagonists (OR 1.31, 95% CI 1.26-1.37); and more severe HF, that is higher NT-proBNP (OR 1.13, 95% CI 1.06-1.20) and NYHA class (OR 1.13, 95% CI 1.08-1.19). Factors associated with lower likelihood of follow-up in specialty care included older age (OR 0.29, 95% CI 0.28-0.30), female sex (OR 0.89, 95% CI 0.86-0.93), lower income (OR 0.79, 95% CI 0.76-0.82) and educational level (OR 0.77, 95% CI 0.73-0.81), higher EF [HFmrEF (OR 0.65, 95% CI 0.62-0.68) and HFpEF (OR 0.56, 95% CI 0.53-0.58) vs. HFrEF], and higher comorbidity burden, such as presence of kidney disease (OR 0.91, 95% CI 0.87-0.95), atrial fibrillation (OR 0.85, 95% CI 0.81-0.89), and diabetes mellitus (OR 0.92, 95% CI 0.88-0.96). A planned follow-up in specialty care was independently associated with lower risk of all-cause [hazard ratio (HR) 0.78, 95% CI 0.76-0.80] and cardiovascular death (HR 0.76, 95% CI 0.73-0.78) across the EF spectrum, but not of HF hospitalization (HR 1.06, 95% CI 1.03-1.10). Conclusions In a large nationwide HF population, referral to specialty care was linked with male sex, younger age, lower EF, lower comorbidity burden, better socioeconomic environment and optimized HF care, and associated with better survival across the EF spectrum. Our findings highlight the need for greater and more equal access to HF specialty care and improved quality of primary care.
38.	Linde, Cecilia, et al. (författare) Gender, underutilization of cardiac resynchronization therapy, and prognostic impact of QRS prolongation and left bundle branch block in heart failure. 2015 Ingår i: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 17:3, s. 424-431 Tidskriftsartikel (refereegranskat)abstract AIMS: It has been suggested that cardiac resynchronization therapy (CRT) is less utilized, dyssynchrony occurs at narrower QRS, and CRT is more beneficial in women compared with men. We tested the hypotheses that (i) CRT is more underutilized and (ii) QRS prolongation and left bundle branch block (LBBB) are more harmful in women.METHODS AND RESULTS: We studied 14 713 patients (28% women) with left ventricular ejection fraction (LVEF) <40% in the Swedish Heart Failure Registry. In women vs. men, CRT was present in 4 vs. 7% (P < 0.001) and was absent but with indication in 30 vs. 31% (P = 0.826). Next, among 13 782 patients (28% women) without CRT, 9% of women and 17% of men had non-specific intraventricular conduction delay (IVCD) and 27% of women and 24% of men had LBBB. One-year survival with narrow QRS was 85% in women and 88% in men, with IVCD 74 and 78%, and with LBBB 84 and 82%, respectively. Compared with narrow QRS, IVCD had a multivariable hazard ratio of 1.24 (95% CI 1.05-1.46, P = 0.011) in women and 1.30 (95% CI 1.19-1.42, P < 0.001) in men, and LBBB 1.03 (95% CI 0.91-1.16, P = 0.651) in women and 1.16 (95% CI 1.07-1.26, P < 0.001) in men, P for interaction between gender and QRS morphology, 0.241.CONCLUSIONS: While the proportion with CRT was lower in women, CRT was equally underutilized in both genders. QRS prolongation with or without LBBB was not more harmful in women than in men. Efforts to improve CRT implementation should be directed equally towards women and men.
39.	Lindroth, Anders, et al. (författare) Environmental controls on the CO2 exchange in north Europea mires 2007 Ingår i: Tellus. Series B: Chemical and Physical Meteorology. - : Stockholm University Press. - 0280-6509 .- 1600-0889. ; 59, s. 812-825 Tidskriftsartikel (refereegranskat)
40.	Liwing, Johan, et al. (författare) Improved survival in myeloma patients : starting to close in on the gap between elderly patients and a matched normal population 2014 Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 164:5, s. 684-693 Tidskriftsartikel (refereegranskat)abstract The outcome for multiple myeloma patients has improved since the introduction of bortezomib, thalidomide and lenalidomide. However, studies comparing new and conventional treatment include selected patient groups. We investigated consecutive patients (n = 1638) diagnosed in a defined period and compared survival with a gender- and age-matched cohort Swedish population (n = 9 340 682). Median overall survival for non-high-dose treated patients was 2.8 years. The use of bortezomib, thalidomide or lenalidomide in first line therapy predicted a significantly longer overall survival (median 4.9 years) compared to conventional treatment (2.3 years). Among non-high-dose treated patients receiving at least 2 lines with bortezomib, thalidomide or lenalidomide, 69% and 63% have survived at 3 and 5 years as compared to 48% and 22% with conventional drugs and 88% and 79% in the matched cohort populations, respectively. The median overall survival in high-dose treated patients was 6.9 years. Of these patients, 84% survived at 3 years and 70% at 5 years as compared to 98% and 95% in the matched cohort population. Overall survival in the best non-high-dose treated outcome group is closing the gap with the matched cohort. Upfront use of new drugs is clearly better than waiting until later lines of treatment.
41.	López-Blanco, Efrén, et al. (författare) Evaluation of terrestrial pan-Arctic carbon cycling using a data-assimilation system 2019 Ingår i: Earth System Dynamics. - : Copernicus GmbH. - 2190-4979 .- 2190-4987. ; 10:2, s. 233-255 Tidskriftsartikel (refereegranskat)abstract There is a significant knowledge gap in the current state of the terrestrial carbon (C) budget. Recent studies have highlighted a poor understanding particularly of C pool transit times and of whether productivity or biomass dominate these biases. The Arctic, accounting for approximately 50 % of the global soil organic C stocks, has an important role in the global C cycle. Here, we use the CARbon DAta MOdel (CARDAMOM) data-assimilation system to produce pan-Arctic terrestrial C cycle analyses for 2000-2015. This approach avoids using traditional plant functional type or steady-state assumptions. We integrate a range of data (soil organic C, leaf area index, biomass, and climate) to determine the most likely state of the high-latitude C cycle at a 1 degrees x 1 degrees resolution and also to provide general guidance about the controlling biases in transit times. On average, CARDAMOM estimates regional mean rates of photosynthesis of 565 g C m(-2) yr (-1) (90 % confidence interval between the 5th and 95th percentiles: 428, 741), autotrophic respiration of 270 g Cm-2 yr(-1) (182, 397) and heterotrophic respiration of 219 g Cm-2 yr(-1) (31, 1458), suggesting a pan-Arctic sink of -67 (-287, 1160) g Cm-2 yr(-1), weaker in tundra and stronger in taiga. However, our confidence intervals remain large (and so the region could be a source of C), reflecting uncertainty assigned to the regional data products. We show a clear spatial and temporal agreement between CARDAMOM analyses and different sources of assimilated and independent data at both pan-Arctic and local scales but also identify consistent biases between CARDAMOM and validation data. The assimilation process requires clearer error quantification for leaf area index (LAI) and biomass products to resolve these biases. Mapping of vegetation C stocks and change over time and soil C ages linked to soil C stocks is required for better analytical constraint. Comparing CARDAMOM analyses to global vegetation models (GVMs) for the same period, we conclude that transit times of vegetation C are inconsistently simulated in GVMs due to a combination of uncertainties from productivity and biomass calculations. Our findings highlight that GVMs need to focus on constraining both current vegetation C stocks and net primary production to improve a process-based understanding of C cycle dynamics in the Arctic.
42.	López-Blanco, Efrén, et al. (författare) Exchange of CO2 in Arctic tundra : Impacts of meteorological variations and biological disturbance 2017 Ingår i: Biogeosciences. - : Copernicus GmbH. - 1726-4170 .- 1726-4189. ; 14:19, s. 4467-4483 Tidskriftsartikel (refereegranskat)abstract An improvement in our process-based understanding of carbon (C) exchange in the Arctic and its climate sensitivity is critically needed for understanding the response of tundra ecosystems to a changing climate. In this context, we analysed the net ecosystem exchange (NEE) of CO2 in West Greenland tundra (64°N) across eight snow-free periods in 8 consecutive years, and characterized the key processes of net ecosystem exchange and its two main modulating components: gross primary production (GPP) and ecosystem respiration (Reco). Overall, the ecosystem acted as a consistent sink of CO2, accumulating g'30g dagger;Cg'2 on average (range of g'17 to g'41gdagger;Cg'2) during the years 2008-2015, except 2011 (source of 41gdagger;Cg'2), which was associated with a major pest outbreak. The results do not reveal a marked meteorological effect on the net CO2 uptake despite the high interannual variability in the timing of snowmelt and the start and duration of the growing season. The ranges in annual GPP (g'182 to g'316gdagger;Cg'2) and Reco (144 to 279gdagger;Cg'2) were > 5 fold larger than the range in NEE. Gross fluxes were also more variable (coefficients of variation are 3.6 and 4.1% respectively) than for NEE (0.7%). GPP and Reco were sensitive to insolation and temperature, and there was a tendency towards larger GPP and Reco during warmer and wetter years. The relative lack of sensitivity of NEE to meteorology was a result of the correlated response of GPP and Reco. During the snow-free season of the anomalous year of 2011, a biological disturbance related to a larvae outbreak reduced GPP more strongly than Reco. With continued warming temperatures and longer growing seasons, tundra systems will increase rates of C cycling. However, shifts in sink strength will likely be triggered by factors such as biological disturbances, events that will challenge our forecasting of C states.
43.	López-Blanco, Efrén, et al. (författare) Plant Traits are Key Determinants in Buffering the Meteorological Sensitivity of Net Carbon Exchanges of Arctic Tundra 2018 Ingår i: Journal of Geophysical Research - Biogeosciences. - 2169-8953. Tidskriftsartikel (refereegranskat)abstract The climate sensitivity of carbon (C) cycling in Arctic terrestrial ecosystems is a major unknown in the Earth system. There is a lack of knowledge about the mechanisms that drive the interactions between photosynthesis, respiration, and changes in C stocks across full annual cycles in Arctic tundra. We use a calibrated and validated model (soil-plant-atmosphere; SPA) to estimate net ecosystem exchange (NEE), gross primary production (GPP), ecosystem respiration (Reco), and internal C processing across eight full years. SPA's carbon flux estimates are validated with observational data obtained from the Greenland Ecosystem Monitoring program in West Greenland tundra. Overall, the model explained 73%, 73%, and 50% of the variance in NEE, GPP, and Reco, respectively, and 85% of the plant greenness variation. Flux data highlighted the insensitivity of growing season NEE to interannual meteorological variability, due to compensatory responses of photosynthesis and ecosystem respiration. In this modelling study, we show that this NEE buffering is the case also for full annual cycles. We show through a sensitivity analysis that plant traits related to nitrogen are likely key determinants in the compensatory response, through simulated links to photosynthesis and plant respiration. Interestingly, we found a similar temperature sensitivity of the trait-flux couplings for GPP and Reco, suggesting that plant traits drive the stabilization of NEE. Further, model analysis indicated that wintertime periods decreased the C sink by 60%, mostly driven by litter heterotrophic respiration. This result emphasizes the importance of wintertime periods and allows a more comprehensive understanding of full annual C dynamics.
44.	Lund, Anna My, et al. (författare) Mother's Own Milk and Its Relationship to Growth and Morbidity in a Population-based Cohort of Extremely Preterm Infants 2022 Ingår i: Journal of Pediatric Gastroenterology and Nutrition. - : Wolters Kluwer. - 0277-2116 .- 1536-4801. ; 74:2, s. 292-300 Tidskriftsartikel (refereegranskat)abstract Objectives:The aim of the study was to evaluate the relationships between intake of mother's own milk (MOM), compared with intake of pasteurized donor milk (DM), and postnatal growth, incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD), in extremely preterm infants.Methods:Swedish population-based cohort of surviving extremely preterm infants born 2004 to 2007. Exposure to MOM and DM was investigated from birth until 32 weeks postmenstrual age (PMA) in 453 infants. Primary outcome variables were change in z-score (Δ) from birth to 32 weeks PMA for weight, length, and head circumference (HC). Secondary outcomes were incidence of ROP and BPD. Mixed models adjusting for confounders were used to investigate the association between exposures and outcomes.Results:Infants' mean gestational age (GA) was 25.4 weeks. Unadjusted, MOM (per 10 mL · kg-1 · day-1) was associated with Δweight and ΔHC with beta estimates of 0.03 z-score units (95% CI, 0.02-0.04, P < 0.001) and 0.03 z-score units (95% CI, 0.01-0.05, P = 0.003), respectively. After adjustment for predefined confounders, the association remained significant for Δweight and ΔHC. A similar pattern was found between Δweight and each 10% increase of MOM. Unadjusted, a higher intake of MOM (mL · kg-1 · day-1) was significantly associated to a lower probability of any ROP and severe ROP; however, these associations did not remain in the adjusted analyses. No associations were found between MOM (mL · kg-1 · day-1) and BPD. Moreover, no associations were found between DM and growth or morbidity outcomes.Conclusions:An increased intake of MOM, as opposed to DM (and not formula feeding), was associated with improved postnatal weight gain and HC growth from birth until 32 weeks PMA in extremely preterm infants. Interventions aiming at increasing early intake of unpasteurized MOM for extremely preterm infants should be encouraged.
45.	Lund, Lars H., et al. (författare) Age, prognostic impact of QRS prolongation and left bundle branch block, and utilization of cardiac resynchronization therapy: findings from 14713 patients in the Swedish Heart Failure Registry 2014 Ingår i: European Journal of Heart Failure. - : Oxford University Press (OUP): Policy B / Wiley. - 1388-9842 .- 1879-0844. ; 16:10, s. 1073-1081 Tidskriftsartikel (refereegranskat)abstract AimsAge is not a contraindication to cardiac resynchronization therapy (CRT), but the prevalence and prognostic impact of QRS prolongation with intraventricular conduction delay (IVCD) and left bundle branch block (LBBB), as well as CRT utilization, may differ with age. We tested the hypotheses that in the elderly: (i) IVCD and LBBB are more prevalent, (ii) IVCD and LBBB are more harmful, and (iii) CRT is underutilized. Methods and resultsWe studied 14713 patients with ejection fraction 39% in the Swedish Heart Failure Registry and divided into age groups 65years, 66-80years and greater than80years. Among 13782 patients without CRT, IVCD was present in the three age groups in 11% vs. 15% vs. 19% and LBBB was present in 20% vs. 27% vs. 28%, respectively, (Pless than0.001). The multivariable hazard ratio (HR) for all-cause mortality over a median (interquartile range) follow-up of 29 (12-53) months for IVCD vs. narrow QRS was 1.31 (1.06-1.63, P=0.013) in the 65year group, 1.32 (1.17-1.47, Pless than0.001) in the 66-80year group, and 1.26 (1.21-1.41, pless than0.001) in the greater than80year group. For LBBB vs. narrow QRS it was 1.29 (1.07-1.56, P=0.009), 1.17 (1.06-1.30, P=0.002), and 1.10 (0.99-1.22, P=0.091), respectively. The adjusted P for interaction between age and QRS morphology was 0.664. In the three age groups, CRT was present in 6% vs. 8% vs. 4% and absent but with indication in 23% vs. 32% vs. 37%, respectively (Pless than0.001). ConclusionsBoth IVCD and LBBB were more common with increasing age and were similarly strong independent predictors of mortality and in all ages. The underutilization of CRT was worse with increasing age.
46.	Lund, Lars H., et al. (författare) Association Between Use of beta-Blockers and Outcomes in Patients With Heart Failure and Preserved Ejection Fraction 2014 Ingår i: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA): JAMA. - 0098-7484 .- 1538-3598. ; 312:19, s. 2008-2018 Tidskriftsartikel (refereegranskat)abstract IMPORTANCE Heart failure with preserved ejection fraction (HFPEF) may be as common and may have similar mortality as heart failure with reduced ejection fraction (HFREF). beta-Blockers reduce mortality in HFREF but are inadequately studied in HFPEF. OBJECTIVE To test the hypothesis that beta-blockers are associated with reduced all-cause mortality in HFPEF. DESIGN Propensity score-matched cohort study using the Swedish Heart Failure Registry. Propensity scores for beta-blacker use were derived from 52 baseline clinical and socioeconomic variables. SETTING Nationwide registry of 67 hospitals with inpatient and outpatient units and 95 outpatient primary care clinics in Sweden with patients entered into the registry between July 1, 2005, and December 30, 2012, and followed up until December 31, 2012. PARTICIPANTS From a consecutive sample of 41 976 patients, 19 083 patients with HFPEF (mean [SD] age, 76 [12] years; 46% women). Of these, 8244 were matched 2:1 based on age and propensity score for beta-blocker use, yielding 5496 treated and 2748 untreated patients with HFPEF. Also we conducted a positive-control consistency analysis involving 22 893 patients with HFREF, of whom 6081 were matched yielding 4054 treated and 2027 untreated patients. EXPOSURES beta-Blockers prescribed at discharge from the hospital or during an outpatient visit, analyzed 2 ways: without consideration of crossover and per-protocol analysis with censoring at crossover, if applicable. MAIN OUTCOMES AND MEASURES The prespecified primary outcome was all-cause mortality and the secondary outcome was combined all-cause mortality or heart failure hospitalization. RESULTS Median follow-up in HFPEF was 755 days, overall; 709 days in the matched cohort; no patients were lost to follow-up. In the matched HFPEF cohort, 1-year survival was 80% vs 79% for treated vs untreated patients, and 5-year survival was 45% vs 42%, with 2279(41%) vs 1244(45%) total deaths and 177 vs 191 deaths per 1000 patient-years (hazard ratio [HR], 0.93; 95% Cl, 0.86-0.996; P =.04). beta-Blockers were not associated with reduced combined mortality or heart failure hospitalizations: 3368(61%) vs 1753(64%) total for first events, with 371 vs 378 first events per 1000 patient-years (HR, 0.98; 95% Cl, 0.92-1.04; P = .46). In the matched HFREF cohort, beta-blockers were associated with reduced mortality (HR, 0.89; 95% Cl, 0.82-0.97, P=.005) and also with reduced combined mortality or heart failure hospitalization (HR, 0.89; 95% Cl, 0.84-0.95; P =.001). CONCLUSIONS AND RELEVANCE In patients with HFPEF, use of beta-blockers was associated with lower all-cause mortality but not with combined all-cause mortality or heart failure hospitalization. beta-Blockers in HFPEF should be examined in a large randomized clinical trial.
47.	Lund, Lars H, et al. (författare) Association Between Use of Renin-Angiotensin System Antagonists and Mortality in Patients With Heart Failure and Preserved Ejection Fraction 2012 Ingår i: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA): JAMA. - 0098-7484 .- 1538-3598. ; 308:20, s. 2108-2117 Tidskriftsartikel (refereegranskat)abstract CONTEXT:Heart failure with preserved ejection fraction (HFPEF) may be as common and as lethal as heart failure with reduced ejection fraction (HFREF). Three randomized trials of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ie, renin-angiotensin system [RAS] antagonists) did not reach primary end points but may have had selection bias or been underpowered.OBJECTIVE:To test the hypothesis that use of RAS antagonists is associated with reduced all-cause mortality in an unselected population with HFPEF.DESIGN, SETTING, AND PATIENTS:Prospective study using the Swedish Heart Failure Registry of 41,791 unique patients registered from 64 hospitals and 84 outpatient clinics between 2000 and 2011. Of these, 16,216 patients with HFPEF (ejection fraction ≥40%; mean [SD] age, 75 [11] years; 46% women) were either treated (n = 12,543) or not treated (n = 3673) with RAS antagonists. Propensity scores for RAS antagonist use were derived from 43 variables. The association between use of RAS antagonists and all-cause mortality was assessed in a cohort matched 1:1 based on age and propensity score and in the overall cohort with adjustment for propensity score as a continuous covariate. To assess consistency, separate age and propensity score-matched analyses were performed according to RAS antagonist dose in patients with HFPEF and in 20,111 patients with HFREF (ejection fraction <40%) in the same registry.MAIN OUTCOME MEASURE:All-cause mortality.RESULTS:In the matched HFPEF cohort, 1-year survival was 77% (95% CI, 75%-78%) for treated patients vs 72% (95% CI, 70%-73%) for untreated patients, with a hazard ratio (HR) of 0.91 (95% CI, 0.85-0.98; P = .008). In the overall HFPEF cohort, crude 1-year survival was 86% (95% CI, 86%-87%) for treated patients vs 69% (95% CI, 68%-71%) for untreated patients, with a propensity score-adjusted HR of 0.90 (95% CI, 0.85-0.96; P = .001). In the HFPEF dose analysis, the HR was 0.85 (95% CI, 0.78-0.83) for 50% or greater of target dose vs no treatment (P < .001) and 0.94 (95% CI, 0.87-1.02) for less than 50% of target dose vs no treatment (P = .14). In the age and propensity score-matched HFREF analysis, the HR was 0.80 (95% CI, 0.74-0.86; P < .001).CONCLUSION:Among patients with heart failure and preserved ejection fraction, the use of RAS antagonists was associated with lower all-cause mortality.
48.	Lund, Lars H., et al. (författare) Association of Spironolactone Use With All-Cause Mortality in Heart Failure A Propensity Scored Cohort Study 2013 Ingår i: Circulation Heart Failure. - : Lippincott Williams & Wilkins. - 1941-3289 .- 1941-3297. ; 6:2, s. 174-183 Tidskriftsartikel (refereegranskat)abstract Background-In 3 randomized controlled trials in heart failure (HF), mineralocorticoid receptor antagonists reduced mortality. The net benefit from randomized controlled trials may not be generalizable, and eplerenone was, but spironolactone was not, studied in mild HF. We tested the hypothesis that spironolactone is associated with reduced mortality also in a broad unselected contemporary population with HF and reduced ejection fraction, in particular New York Heart Association (NYHA) I-II. Methods and Results-We prospectively studied 18 852 patients (age 71+/-12 years; 28% women) with NYHA I-IV and ejection fraction <40% who were registered in the Swedish Heart Failure Registry between 2000 and 2012 and who were (n=6551) or were not (n=12 301) treated with spironolactone. We derived propensity scores for spironolactone treatment based on 41 covariates. We assessed survival by Cox regression with adjustment for propensity scores and with matching based on propensity score. We performed sensitivity and residual confounding analyses and analyzed the NYHA I-II and III-IV subgroups separately. One-year survival was 83% versus 84% in treated versus untreated patients (log rank P<0.001). After adjustment for propensity scores, the hazard ratio for spironolactone was 1.05 (95% confidence interval, 1.00-1.11; P=0.054). Spironolactone interacted with NYHA (P<0.001). In the NYHA I-II subgroup, after adjustment for propensity scores, the hazard ratio for spironolactone was 1.11 (95% confidence interval, 1.02-1.21; P=0.019). Conclusions-In an unselected contemporary population of HF with reduced ejection fraction, spironolactone was not associated with reduced mortality. The net benefits of spironolactone may be lower outside the clinical trial setting and in milder HF.
49.	Lund, Larrs H., et al. (författare) Prevalence, correlates, and prognostic significance of QRS prolongation in heart failure with reduced and preserved ejection fraction 2013 Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 34:7, s. 529-539 Tidskriftsartikel (refereegranskat)abstract AimsThe independent clinical correlates and prognostic impact of QRS prolongation in heart failure (HF) with reduced and preserved ejection fraction (EF) are poorly understood. The rationale for cardiac resynchronization therapy (CRT) in preserved EF is unknown. The aim was to determine the prevalence of, correlates with, and prognostic impact of QRS prolongation in HF with reduced and preserved EF.Methods and resultsWe studied 25 171 patients (age 74.6 ± 12.0 years, 39.9% women) in the Swedish Heart Failure Registry. We assessed QRS width and 40 other clinically relevant variables. Correlates with QRS width were assessed with multivariable logistic regression, and the association between QRS width and all-cause mortality with multivariable Cox regression. Pre-specified subgroup analyses by EF were performed. Thirty-one per cent had QRS ≥120 ms. Strong predictors of QRS ≥120 ms were higher age, male gender, dilated cardiomyopathy, longer duration of HF, and lower EF. One-year survival was 77% in QRS ≥120 vs. 82% in QRS <120 ms, and 5-year survival was 42 vs. 51%, respectively (P < 0.001). The adjusted hazard ratio for all-cause mortality was 1.11 (95% confidence interval 1.04-1.18, P = 0.001) for QRS ≥120 vs. <120 ms. There was no interaction between QRS width and EF.ConclusionQRS prolongation is associated with other markers of severity in HF but is also an independent risk factor for all-cause mortality. The risk associated with QRS prolongation may be similar regardless of EF. This provides a rationale for trials of CRT in HF with preserved EF.
50.	Lund, Lars, et al. (författare) Use of venous-thrombotic-embolic prophylaxis in patients undergoing surgery for renal tumors : a questionnaire survey in the Nordic countries (The NORENCA-2 study) 2018 Ingår i: Research and Reports in Urology. - : DOVE Medical Press Ltd.. - 2253-2447. ; 10, s. 181-187 Tidskriftsartikel (refereegranskat)abstract Purpose: To examine the variation in venous thromboembolism prophylactic treatment (VTEP) among renal cancer patients undergoing surgery.Materials and methods: An Internet-based questionnaire on renal tumor management before and after surgery was mailed to all Nordic departments of urology. The questions focused on the use of VTEP and were subdivided into different surgical modalities.Results: Questionnaires were mailed to 91 institutions (response rate 53%). None of the centers used VTEP before surgery, unless the patient had a vena caval tumor thrombus. Overall, the VTEP utilized during hospitalization for patients undergoing renal surgery included early mobilization (45%), compression stockings (52%) and low-molecular-weight heparin (89%). In patients undergoing open radical Nx, 80% of institutions used VTEP during their hospitalization (23% compression stockings and 94% low-molecular-weight heparin). After leaving the hospital, the proportion and type of VTEP received varied considerably across institutions. The most common interval, used in 60% of the institutions, was for a period of 4 weeks. The restriction to the Nordic countries was a limitation and, therefore, may not reflect the practice patterns elsewhere. It is a survey study and, therefore, cannot measure the behaviors of those institutions that did not participate.Conclusion: We found variation in the type and duration of VTEP use for each type of local intervention for renal cancer. These widely disparate variations in care strongly argue for the establishment of national and international guidelines regarding VTEP in renal surgery.

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