| 1. |
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| 2. |
- Ederle, Joerg, et al.
(author)
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Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
- 2010
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In: The Lancet. - 1474-547X. ; 375:9719, s. 985-997
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Journal article (peer-reviewed)abstract
- Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006), Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). Interpretation Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery.
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| 3. |
- Robinson, N. A., et al.
(author)
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Applying genetic technologies to combat infectious diseases in aquaculture
- 2022
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In: Reviews in Aquaculture. - : Wiley. - 1753-5123 .- 1753-5131. ; 15:2, s. 491-535
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Journal article (peer-reviewed)abstract
- Disease and parasitism cause major welfare, environmental and economic concerns for global aquaculture. In this review, we examine the status and potential of technologies that exploit genetic variation in host resistance to tackle this problem. We argue that there is an urgent need to improve understanding of the genetic mechanisms involved, leading to the development of tools that can be applied to boost host resistance and reduce the disease burden. We draw on two pressing global disease problems as case studies—sea lice infestations in salmonids and white spot syndrome in shrimp. We review how the latest genetic technologies can be capitalised upon to determine the mechanisms underlying inter- and intra-species variation in pathogen/parasite resistance, and how the derived knowledge could be applied to boost disease resistance using selective breeding, gene editing and/or with targeted feed treatments and vaccines. Gene editing brings novel opportunities, but also implementation and dissemination challenges, and necessitates new protocols to integrate the technology into aquaculture breeding programmes. There is also an ongoing need to minimise risks of disease agents evolving to overcome genetic improvements to host resistance, and insights from epidemiological and evolutionary models of pathogen infestation in wild and cultured host populations are explored. Ethical issues around the different approaches for achieving genetic resistance are discussed. Application of genetic technologies and approaches has potential to improve fundamental knowledge of mechanisms affecting genetic resistance and provide effective pathways for implementation that could lead to more resistant aquaculture stocks, transforming global aquaculture. © 2022 The Authors. Reviews in Aquaculture published by John Wiley & Sons Australia, Ltd.
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| 4. |
- D'Oria, Mario, et al.
(author)
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Outcomes of "Anterior Versus Posterior Divisional Branches of the Hypogastric Artery as Distal Landing Zone for Iliac Branch Devices" : The International Multicentric R3OYAL Registry
- 2024
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In: Journal of Endovascular Therapy. - : Sage Publications. - 1526-6028 .- 1545-1550. ; 31:2, s. 282-294
-
Journal article (peer-reviewed)abstract
- Objective: The aim of this multicentric registry was to assess the outcomes of "anteRior versus posteRior divisional bRanches Of the hYpogastric artery as distAl landing zone for iLiac branch devices (R3OYAL)."Methods: The main exposure of interest for the purpose of this study was the internal iliac artery (IIA) divisional branch (anterior vs posterior) that was used as distal landing zone. Early endpoints included technical success and adverse events. Late endpoints included survival, primary/secondary IIA patency, and IIA branch instability.Results: A total of 171 patients were included in the study, of which 50 received bilateral implantation of iliac branch devices (IBDs). This resulted in a total of 221 incorporated IIAs included in the final analysis, of which 40 were anterior divisional branches and 181 were posterior divisional branches. Technical success was high in both groups (anterior division: 98% vs posterior division: 100%, P = .18). Occurrence of any adverse event was noted in 14% of patients in both groups (P = 1.0). The overall rate of freedom from the composite IBD branch instability did not show significant differences between patients receiving distal landing in the anterior or posterior division of the IIA at 3 years (79% vs 87%, log-rank test = .215). The 3-year estimates of IBD patency were significantly lower in patients who received distal landing in the anterior divisional branch than those who received distal landing in the posterior divisional branch (primary patency: 81% vs 96%, log-rank test = .009; secondary patency: 81% vs 97%, log-rank test < .001).Conclusions: The use of the anterior or posterior divisional branches of the IIA as distal landing zone for IBD implantation shows comparable profiles in terms of immediate technical success, perioperative safety, and side-branch instability up to 3 years. However, IBD patency at 3 years was higher when the distal landing zone was achieved within the posterior divisional branch of the IIA.Clinical Impact: The results from this large multicentric registry confirm that use of the anterior or posterior divisional branches of the internal iliac artery (IIA) as distal landing zone for implantation of iliac branch devices (IBD) shows comparable profiles of safety and feasibility, thereby allowing to extend the indications for endovascular repair of aorto-iliac aneurysms to cases with unsuitable anatomy within the IIA main trunk. Although mid-term rates of device durability and branch instability seem to be similar, the rates of primary and secondary IBD patency at three years was favored when the distal landing zone was achieved in the posterior divisional branch of the IIA.
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| 5. |
- Hjorth, Stephan, 1953, et al.
(author)
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(3S)-3-(2,3-difluorophenyl)-3-methoxypyrrolidine (IRL752)-a Novel Cortical-Preferring Catecholamine Transmission- and Cognition-Promoting Agent
- 2020
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In: Journal of Pharmacology and Experimental Therapeutics. - : American Society for Pharmacology & Experimental Therapeutics (ASPET). - 0022-3565 .- 1521-0103. ; 374:3, s. 404-419
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Journal article (peer-reviewed)abstract
- Here we describe for the first time the distinctive pharmacological profile for (35)-3-(2,3-difluorophenyI)-3-nnethoxypyrrolidine (IRL752), a new phenyl-pyrrolidine derivative with regioselective central nervous system transmission-enhancing properties. IRL752 (3.7-150 mu mol/kg, s.c.) was characterized through extensive in vivo studies using behavioral, tissue neurochemical, and gene expression as well as microdialysis methods. Behaviorally, the compound normalized tetrabenazine-induced hypo-activity, whereas it was unable to stimulate basal locomotion in normal animals or either accentuate or reverse hyperactivity induced by amphetamine or MK-801. IRL752 induced but minor changes in monoaminergic tissue neurochemistry across noradrenaline (NA)- and dopamine (DA)-dominated brain regions. The expression of neuronal activity-, plasticity-, and cognition-related immediate early genes (IEGs), however, increased by 1.5-fold to 2-fold. Furthermore, IRL752 dose-dependently enhanced cortical catecholamine dialysate output to 600%-750% above baseline, whereas striatal DA remained unaltered, and NA rose to similar to 250%; cortical and hippocampal dialysate acetylcholine (ACh) increased to similar to 250% and 190% above corresponding baseline, respectively. In line with this cortically preferential transmission-promoting action, the drug was also procognitive in the novel object recognition and reversal learning tests. In vitro neurotarget affinity and functional data coupled to drug exposure support the hypothesis that 5-hydroxytryptannine 7 receptor and alpha 2(C)-adrenoceptor antagonism are key contributors to the in vivo efficacy and original profile of IRL752. The cortical-preferring facilitatory impact on cate-cholamine (and ACh) neurotransmission, along with effects on IEG expression and cognition-enhancing features, are in line with the potential clinical usefulness of IRL752 in conditions wherein these aspects may be dysregulated, such as in axial motor and cognitive deficits in Parkinson disease. SIGNIFICANCE STATEMENT This report describes the distinctive preclinical profile of (3S)3-(2,3-difluorophenyI)-3-nnethoxypyrrolidine (IRL752). Its in vivo neurochemical, behavioral, microdialysis, and gene expression properties are consistent with a cortically regioselective facilitatory impact on catecholaminergic and cholinergic neurotransmission accompanied by cognitive impairment-reversing features. The pharmacological characteristics of IRL752 are in line with the clinical usefulness of IRL752 in conditions wherein these aspects may be dysregulated, such as in axial motor and cognitive deficits in Parkinson disease.
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| 6. |
- Resch, Tim, et al.
(author)
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Development of Off-the-shelf Stent Grafts for Juxtarenal Abdominal Aortic Aneurysms.
- 2012
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In: European journal of vascular and endovascular surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 43:6, s. 655-660
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Journal article (peer-reviewed)abstract
- INTRODUCTION: The use of EVAR for more complex aneurysm anatomy has become more widespread over the past decade. Fenestrated and branched stent grafts for the visceral and iliac segment show promising short- and midterm outcome and these procedures have become routine in many vascular centers. However, at present, such grafts are customized to the individual patient and planning and manufacturing leads to significant treatment delay subjecting the patients to the risk of rupture during the waiting period. The purpose of this report is to describe the first experience in treating juxta/suprarenal aneurysms using the first version of a new fenestrated stent graft MATERIAL AND METHODS: A fenestrated device was designed with two renal fenestrations, an SMA fenestration and a scallop for the coeliac artery. The renal arteries were designed with an inner 6 mm fenestration and an outer 15 mm diameter creating a dome to allow renal artery catheterization for a range of renal artery distribution. Seven patients with complex visceral artery anatomy were treated with customized stent grafts containing these pivot renal fenestrations. RESULTS: Technical success was uniform with 100% target vessel catheterization and 0% 30-day mortality. In one case, the graft was displaced slightly during delivery resulting in a renal artery stent occlusion at 2 months postoperatively. CONCLUSIONS: The development of a modified fenestrated device has shown this to be feasible and it has the potential to reduce the need for extensive preoperative graft customization and establishing a true off the shelf platform for juxta- and suprarenal AAA.
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| 7. |
- Abdelhalim, Mohamed A., et al.
(author)
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Multicenter trans-Atlantic experience with fenestrated-branched endovascular aortic repair of chronic post-dissection thoracoabdominal aortic aneurysms
- 2023
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In: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 78:4, s. 854-862.e1
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: This multicenter international study aimed to describe outcomes of fenestrated-branched endovascular aortic repairs (FB-EVAR) in a cohort of patients treated for chronic post-dissection thoracoabdominal aortic aneurysms (PD-TAAAs).METHODS: We reviewed the clinical data of all consecutive patients treated by FB-EVAR for repair of extent I to III PD-TAAAs in 16 centers from the United States and Europe (2008-2021). Data were extracted from institutional prospectively maintained databases and electronic patient records. All patients received off-the-shelf or patient-specific manufactured fenestrated-branched stent grafts. Endpoints were any cause mortality and major adverse events at 30 days, technical success, target artery (TA) patency, freedom from TA instability, minor (endovascular with <12 Fr sheath) and major (open or ≥12 Fr sheath) secondary interventions, patient survival, and freedom from aortic-related mortality (ARM).RESULTS: A total of 246 patients (76% male; median age, 67 years [interquartile range, 61-73 years]) were treated for extent I (7%), extent II (55%), and extent III (35%) PD-TAAAs by FB-EVAR. The median aneurysm diameter was 65 mm (interquartile range, 59-73 mm). Eighteen patients (7%) were octogenarians, 212 (86%) were American Society of Anesthesiologists class ≥3, and 21 (9%) presented with contained ruptured or symptomatic aneurysms. There were 917 renal-mesenteric vessels targeted by 581 fenestrations (63%) and 336 directional branches (37%), with a mean of 3.7 vessels per patient. Technical success was 96%. Mortality and rate of major adverse events at 30 days was 3% and 28%, including disabling complications such as new onset dialysis in 1%, major stroke in 1%, and permanent paraplegia in 2%. Mean follow-up was 24 months. Kaplan-Meier (KM) estimated patient survival at 3 and 5 years was 79% ± 6% and 65% ± 10%. KM estimated freedom from ARM was 95% ± 3% and 93% ± 5% at the same intervals. Unplanned secondary interventions were needed in 94 patients (38%), including minor procedures in 64 (25%) and major procedures in 30 (12%). There was one conversion to open surgical repair (<1%). KM estimated freedom from any secondary intervention was 44% ± 9% at 5 years. KM estimated primary and secondary TA patency were 93% ± 2% and 96% ± 1% at 5 years, respectively.CONCLUSIONS: FB-EVAR for chronic PD-TAAAs was associated with high technical success and a low rate of mortality (3%) and disabling complications at 30 days. Although the procedure is effective in the prevention of ARM, patient survival was low at 5 years (65%), likely due to the significant comorbidities in this cohort of patients. Freedom from secondary interventions at 5 years was 44%, although most procedures were minor. The significant rate of reinterventions highlights the need for continued patient surveillance.
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| 8. |
- Abdulrasak, M., et al.
(author)
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The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm
- 2017
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884. ; 53:1, s. 69-76
-
Journal article (peer-reviewed)abstract
- Objective/Background The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. Methods This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months’ follow-up. Results In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15–72). Seven patients had late abdominal aortic aneurysm related deaths. There were 51 re-interventions (seven type Ia endoleak related). Five year crude primary, primary assisted, and secondary success rates were 55 ± 5%, 66 ± 5%, and 70 ± 5%, respectively. These crude rates were superior for elective patients (p = .008, p = .031, and p = .037, respectively), but the relative rates were not (p = .187, p = .640, p = .558, respectively). Primary and assisted freedom from type Ia endoleak 5 years post-operatively were 84 ± 4% and 89 ± 3%, respectively. These rates were superior in elective patients (p = .066 and p = .145, respectively), especially when relative rates were analysed (p = .025 and p = .063, respectively). The visceral aortic diameter increased significantly between the first and the last post-operative imaging in 15/91 (16%), 12/91 (13%), 34/91 (37%), and 30/91 (33%) patients at the levels of coeliac trunk, superior mesenteric artery, lowest renal artery, and 9 mm distal to lowest renal artery, respectively. Conclusion Intra-operatively placed Palmaz stents confer high long-term freedom from type Ia endoleak. Palmaz stents are an acceptable intra-operative bailout tool in the acute setting, but should not be used to extend elective infrarenal endovascular aneurysm repair to more demanding anatomies.
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| 9. |
- Alsterholm, Mikael, 1977, et al.
(author)
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Establishment and utility of SwedAD : a nationwide Swedish registry for patients with atopic dermatitis receiving systemic pharmacotherapy
- 2023
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 103
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Journal article (peer-reviewed)abstract
- SwedAD, a Swedish nationwide registry for patients with atopic dermatitis receiving systemic pharmacotherapy, was launched on 1 September 2019. We describe here the establishment of a user-friendly registry to the benefit of patients with atopic dermatitis. By 5 November 2022, 38 clinics had recorded 931 treatment episodes in 850 patients with an approximate national coverage rate of 40%. Characteristics at enrolment included median Eczema Area and Severity Index (EASI) 10.2 (interquartile range 4.0, 19.4), Patient-Oriented Eczema Measure (POEM) 18.0 (10.0, 24.0), Dermatology Life Quality Index (DLQI) 11.0 (5.0, 19.0) and Peak Itch Numerical Rating Scale-11 (NRS-11) 6.0 (3.0, 8.0). At 3 months, median EASI was 3.2 (1.0, 7.3) and POEM, DLQI, and NRS-11 were improved. Regional coverage varied, reflecting the distribution of dermatologists, the ratio of public to private healthcare, and difficulties in recruiting certain clinics. This study highlights the importance of a nationwide registry when managing systemic pharmacotherapy of atopic dermatitis.
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| 10. |
- Asciutto, G., et al.
(author)
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Endoconduits with “Pave and Crack” Technique Avoid Open Ilio-femoral Conduits with Sustainable Mid-term Results
- 2017
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884. ; 54:4, s. 472-479
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Journal article (peer-reviewed)abstract
- Objective/Background The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the “pave and crack” technique during endovascular aneurysm repair (EVAR) of varying complexity. Methods This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC. Secondary outcomes included EC patency and mortality. Results Nineteen patients underwent EVAR with EC (16 juxtarenal or thoraco-abdominal, two infrarenal and one thoracic; four were ruptured). Fourteen patients (73.7%) had TASC D lesions. In 10 cases (52.6%) adjunctive open/endovascular procedures to improve the femoral outflow were required. EC was technically successful in all cases and all EC were patent at EVAR completion. Thirty day mortality occurred in two cases (10.5%) One of these patients had been treated for rupture. One patient required two endovascular re-interventions at 1 and 5 years post-operatively to restore patency of the EC. No open re-interventions related to the EC were necessary. After a median follow-up period of 17 (interquartile range 5–37) months, the primary assisted patency of the EC was 88.9% (SE 10.5). No new onset of claudication or lower limb amputations occurred during the follow-up. Conclusion EC allows EVAR of varying complexity without the need for open surgical ilio-femoral conduits in patients with concomitant advanced iliac occlusive disease. Intra-operative haemodynamic instability was always avoided and mid-term patency was high.
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| 15. |
- Davies, Roy C, et al.
(author)
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A Practical Example Using VR in the Assessment of Brain Injury
- 1998
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In: The International Journal of Virtual Reality. - 1081-1451. ; 3:4, s. 1-7
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Journal article (peer-reviewed)abstract
- Virtual Reality (VR) as a complementary tool for medical practitioners in the assessment and rehabilitation of people who have suffered a traumatic brain injury (TBI) is discussed. A pilot-study has been undertaken on a prototype VR assessment tool. The design involved nine occupational therapists with expertise in the care of traumatic brain injured patients and one (computer experienced) patient. The aim was to begin a dialogue and to ascertain the potential of a VR system. A common method for occupational therapists to assess function and ability is to ask a patient to brew coffee. From the performance of such a task, an individual’s “functional signature” can be determined. The prototype was built using Superscape, a personal computer based VR system, to be close to the real coffee making task, including effects of making mistakes, realistic graphics and sound effects. The world was designed to be as easy to use and intuitive as possible, though problems of mental abstraction level, transfer of training and realistic interaction have yet to be resolved. The comments from the test participants have highlighted problem areas, given positive insight and pointed out other scenarios where VR may be of use in the rehabilitation of people with a traumatic brain injury.
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| 16. |
- Dias, Nuno, et al.
(author)
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Complicated Acute Type B Dissections-An 8-years Experience of Endovascular Stent-graft Repair in a Single Centre.
- 2006
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 31:5, s. 481-486
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Journal article (peer-reviewed)abstract
- Objective. To analyze the experience of a single centre using stent-grafts for treatment of complicated acute aortic type B-dissections (EVR-ABD). Design. Retrospective analysis of prospectively collected data from patients undergoing EVR-ABD between January 1997 and December 2004. Methods. EVR-ABD was performed in 31 patients (20 males, median age 74. years (IQR: 64-79)). Indications for treatment were aortic rupture (22 patients), intractable pain and hypertension (six patients), acute bowel ischemia (two patients) and transient paraplegia, lower limb and renal ischemia in one patient. Initially home-made devices (five patients) and subsequently commercially available thoracic stent-grafts were used. Results. Five patients (16%) died within 30 days of EVR-ABD. Postoperative complications occurred in 15 (48%) patients, including one paraplegia converted to paraparesis after cerebrospinal fluid drainage, five strokes, three lower limb ischemia, three myocardial infarction, two pneumonia and one colitis). Re-interventions were required in nine patients (29%). Six more deaths occurred during a median follow-up of 22 (IQR: 16-34) months, two related to the stent-graft and four due to cardiac disease. Conclusions. Stent-graft repair of complicated acute type B dissections seems to provide acceptable results and, therefore, it may be considered a valuable alternative to open surgery.
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| 19. |
- Graf, Wilhelm, et al.
(author)
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Results after sacral nerve stimulation for chronic constipation
- 2015
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In: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 27:5, s. 734-739
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Journal article (peer-reviewed)abstract
- BACKGROUND: Sacral nerve stimulation is an established treatment for fecal incontinence and initial reports describe successful results also in subjects with chronic constipation.METHODS: Consecutive patients with slow transit or outlet obstruction type constipation were offered external stimulation through a test electrode inserted in a sacral foramen during a 3-week period. The symptomatic evaluation was based on the number of bowel movements and a validated obstructed defecation score (ODS). A permanent implant was performed provided an overall 50% decrease in symptoms was observed.KEY RESULTS: In total, 44 patients with chronic constipation were treated with a 3-week test stimulation. Fifteen experienced a 50% reduction of symptoms and received a permanent implant. Four of the 15 with permanent implants were explanted during the course of the study. Five subjects (11% of original group) reported sustained symptom relief at final follow-up after a mean of 24 months (range 4-81). Mean ODS score did not change during the treatment. Patients with predominantly slow transit constipation or outlet obstruction did not differ concerning success rate.CONCLUSIONS & INFERENCES: Sacral nerve stimulation has limited efficacy in unselected patients with chronic constipation and cannot be recommended for treatment on routine basis.
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| 20. |
- Hallström, Elinor, et al.
(author)
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Dietary climate impact : Contribution of foods and dietary patterns by gender and age in a Swedish population
- 2021
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In: Journal of Cleaner Production. - : Elsevier BV. - 0959-6526 .- 1879-1786. ; 306
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Journal article (peer-reviewed)abstract
- Dietary climate impact in a Swedish population (56–95 years old) was estimated based on self-reported food intake from 50 000 men and women within two population-based cohorts and on climate data, covering emissions from farm to fork, for 600 foods representative for the Swedish market. Aims were to assess variation in dietary climate impact between population groups and between food categories. Mean dietary climate impact was 2.0 tons of CO2e/person/year, with about a threefold variation between high and low impact individuals. Food loss and waste accounted for 18%. Older individuals and women on average had lower total dietary climate impact per year, while differences between gender were smaller per 1000 kcal. Climate impact was greatly affected by dietary composition and especially by the content of animal-based and discretionary foods, responsible for 71% and 12% of total climate impact, respectively. Results indicate a large potential for reduced climate impact by adopting realistic dietary patterns. Suggested strategies to reach climate goals include reduction of red meat and prioritising lower impact foods within meat, dairy and seafood categories, limited consumption of discretionary foods and decreased over-consumption of total calories, combined with improvements in production including reduction of food loss and waste.
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| 21. |
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| 22. |
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| 23. |
- Lindén, Anita, et al.
(author)
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Special Considerations for Navigation and Interaction in Virtual Environments for People with Brain Injury
- 2000
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In: Proceedings of the 3rd International Conference on Disability, Virtual Reality & Associated Technologies. ; , s. 287-296
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Conference paper (peer-reviewed)abstract
- When a Virtual Environment (VE) is designed, decisions regarding the navigation of the viewpoint, interaction with objects, and the behavior of the VE itself are made. Each of these can affect the usability and the cognitive load on the user. A VE that had previously been constructed as a prototype tool for the assessment of brain injury has been studied to establish the consequences of such design decisions. Six people, two with brain injury, have used the VE to perform a specific task (brewing coffee) a total of ten times over two sessions separated by a week. These trials were video recorded and analysed. Results and implications are presented and discussed.
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| 24. |
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| 25. |
- Mangell, Peter, et al.
(author)
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Regional differences in mechanical properties between major arteries--an experimental study in sheep
- 1996
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In: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 12:2, s. 189-195
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Journal article (peer-reviewed)abstract
- PURPOSE: To study possible differences in mechanical properties between central (abdominal aorta) and more peripheral (common carotid and common femoral) arteries validating an earlier non-invasive study in children showing that central arteries are more distensible than peripheral ones. As invasive blood pressure was needed, but ethically impossible to obtain in children in an experimental setting, an animal model was chosen. DESIGN: Open experimental study. SETTING: Animal laboratory at university hospital. MATERIAL AND METHODS: The pulsatile vessel wall movements of the abdominal aorta (AA), common femoral (CFA) and common carotid (CCA) artery of nine sheep were examined using an ultrasound phase-locked echo-tracking technique. Intra-arterial blood pressure was measured and pressure-diameter relations, pressure strain elastic modulus (Ep) and stiffness (beta) calculated. Distensibility was defined as the inverse of Ep and stiffness. RESULTS: The AA showed lower values for Ep and stiffness (beta) than the CFA (p = 0.002) and CCA (p = 0.006), i.e. the latter two vessels were stiffer. The pressure-diameter relations confirmed these differences and showed a non-linearity for all three vessels with increased stiffness above 70-90 mm Hg. CONCLUSION: This study on young animals supports earlier findings of differences in mechanical properties between central and more peripheral arteries seen in healthy children. As pathologies between these vessels differ, with dilatation of the abdominal aorta and occlusive disease in the more peripheral vessels, part of the explanation might be found in the mechanical properties of the healthy vessels, characterised here with the echo-tracking technique.
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| 33. |
- Sigurdardottir, Gunnthorunn, et al.
(author)
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Cross-Cultural Validation of the RECAP of Atopic Eczema Question-naire in a Swedish Population
- 2024
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In: Acta Dermato-Venereologica. - : Medical Journals Sweden. - 0001-5555 .- 1651-2057. ; 104
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Journal article (peer-reviewed)abstract
- A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27-48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0-28) was 12 (IQR 5-19). The mean and median vIGA-ADTM scores (range 0-4) were 2 (standard deviation [SD] 2) and 3 (IQR 2-4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p < 0.001). There was no significant change in scores for participants who answered the questionnaire twice within 14 days. Over time, improved or worsened eczema, as evaluat-ed by vIGA-ADTM, affected RECAP scores significantly (p < 0.001). The study suggests that RECAP can assess AD control in a Swedish clinical setting and shows -acceptable reliability.
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| 34. |
- Sigurdardottir, Gunnthorunn, et al.
(author)
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Cross-Cultural Validation of the RECAP of Atopic Eczema Question-naire in a Swedish Population
- 2024
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In: Acta dermato-venereologica. - : Medical Journals Sweden. - 1651-2057 .- 0001-5555. ; 104
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Journal article (peer-reviewed)abstract
- A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27-48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0-28) was 12 (IQR 5-19). The mean and median vIGA-ADTM scores (range 0-4) were 2 (standard deviation [SD] 2) and 3 (IQR 2-4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p<0.001). There was no significant change in scores for participants who answered the questionnaire twice within 14 days. Over time, improved or worsened eczema, as evaluat-ed by vIGA-ADTM, affected RECAP scores significantly (p<0.001). The study suggests that RECAP can assess AD control in a Swedish clinical setting and shows -acceptable reliability.
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| 36. |
- Sonesson, B, et al.
(author)
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Outcome After Ruptured AAA Repair in Octo- and Nonagenarians in Sweden 1994-2014.
- 2017
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 53:5, s. 656-662
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To report the outcome after ruptured abdominal aortic aneurysm (rAAA) repair in octo- and nonagenarians from the Swedish Vascular Registry 1994-2014.MATERIAL AND METHODS: 2335 intact AAA (iAAA) and 1538 rAAA were identified in patients aged 80 years and older. Crude, long-term, and relative survival data were analysed using the Kaplan-Meier method. Crude survival was calculated including all deaths. Long-term survival was analysed excluding AAA repair related mortality, defined as death within 90 days of surgery. Relative survival was assessed by comparing the observed long-term survival after AAA repair with the expected survival of a Swedish population adjusted for age, gender, and operation year. Differences were compared using log-rank tests. The multivariate Cox model was used for adjusting for confounding factors between open repair (OR) and endovascular aneurysm repair (EVAR).RESULTS: Crude survival after rAAA repair was 30 days (55%), 90 days (50%), 1 year (45%), 5 years (26%), and 10 years (9%). Long-term survival was 1 year (90%), 5 years (53%), and 10 years (18%). When individuals with rAAA were categorized into males and females, crude and long-term survival showed no significant differences (p = .204 and p = .134). When rAAA patients were categorized into age groups (80-84 years, 85-89 years, 90+) crude survival diminished with increasing age, but long-term survival was not (p = .009 and p = .368). Compared with the general population, rAAA patients showed only a minor decrease in relative survival. Crude survival after rAAA was better for EVAR compared with OR (p = .007), hazard ratio 1.3 (95% CI 1.1-1.6, p < .012).CONCLUSIONS: There is a high (50%) peri-operative mortality after surgery for rAAA in octo- and nonagenarians, with no significant differences between the sexes and worse survival with increasing age. However, if a patient has survived the initial 90 days, long-term survival in this very old cohort is surprisingly good at more than 50% after 5 years, only slightly less than the general population.
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| 41. |
- Strid, Anna, et al.
(author)
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Climate impact from diet in relation to background and sociodemographic characteristics in the Vasterbotten Intervention Programme
- 2019
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In: Public Health Nutrition. - : Cambridge University Press (CUP). - 1368-9800 .- 1475-2727. ; 22:17, s. 3288-3297
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Journal article (peer-reviewed)abstract
- Objective: The objective of this study was to examine climate impact from diet across background and sociodemographic characteristics in a population-based cohort in northern Sweden. Design: A cross-sectional study within the Vasterbotten Intervention Programme. Dietary data from a 64-item food frequency questionnaire collected during 1996-2016 were used. Energy-adjusted greenhouse gas emissions (GHGE) for all participants, expressed as kg carbon dioxide equivalents/day and 4184 kJ (1000 kcal), were estimated using data from life cycle analyses. Differences in background and sociodemographic characteristics were examined between participants with low and high GHGE from diet, respectively. The variables evaluated were age, BMI, physical activity, marital status, level of education, smoking, and residence. Setting: Vasterbotten county in northern Sweden. Participants: In total, 46 893 women and 45 766 men aged 29-65 years. Results: Differences in GHGE from diet were found across the majority of examined variables. The strongest associations were found between GHGE from diet and age, BMI, education, and residence (all P < 0 center dot 001), with the highest GHGE from diet found among women and men who were younger, had a higher BMI, higher educational level, and lived in urban areas. Conclusions: This study is one of the first to examine climate impact from diet across background and sociodemographic characteristics. The results show that climate impact from diet is associated with age, BMI, residence and educational level amongst men and women in Vasterbotten, Sweden. These results define potential target populations where public health interventions addressing a move towards more climate-friendly food choices and reduced climate impact from diet could be most effective.
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| 44. |
- Åstrand, Håkan, et al.
(author)
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In vivo estimation of the contribution of elastin and collagen on the mechanical properties in the abdominal aorta of man : effect of age and gender
- 2011
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In: Journal of applied physiology. - : AMER PHYSIOLOGICAL SOC. - 8750-7587 .- 1522-1601. ; 110:1, s. 8750-8757
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Journal article (peer-reviewed)abstract
- The mechanical properties of the aorta affect cardiac function and are related to cardiovascular morbidity/mortality. This study was designed to evaluate the isotropic (mainly elastin, elastiniso) and anisotropic (mainly collagen, collagenani) material parameters within the human aorta in vivo. Thirty healthy men and women in three different age categories (23–30, 41–54, and 67–72 yr) were included. A novel mechanical model was used to identify the mechanical properties and the strain field with aid of simultaneously recorded pressure and radius in the abdominal aorta. The magnitudes of the material parameters relating to both the stiffness of elastiniso and collagenani were in agreement with earlier in vitro studies. The load-bearing fraction attributed to collagenani oscillated from 10 to 30% between diastolic and systolic pressures during the cardiac cycle. With age, stiffness of elastiniso increased in men, despite the decrease in elastin content that has been found due to elastolysis. Furthermore, an increase in stiffness of collagenani at high physiological pressure was found. This might be due to increased glycation, as well as changed isoforms of collagen in the aortic wall with age. A marked sex difference was observed, with a much less age-related effect, both on elastiniso and collagenani stiffness in women. Possible factors of importance could be the effect of sex hormones, as well as differing collagen isoforms, between the sexes.
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| 45. |
- Öhman, Annika, et al.
(author)
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Transplantation-free survival after Norwood surgery for hypoplastic left heart syndrome with aortic atresia: A Swedish national cohort study
- 2020
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In: Cardiology in the Young. - : Cambridge University Press (CUP). - 1047-9511 .- 1467-1107. ; 30:3
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Journal article (peer-reviewed)abstract
- Background: Norwood surgery has been available in Sweden since 1993. In this national cohort study, we analysed transplantation-free survival after Norwood surgery for hypoplastic left heart syndrome with aortic atresia. Methods: Patients were identified from the complete national cohort of live-born with hypoplastic left heart syndrome/aortic atresia 1993-2010. Analysis of survival after surgery was performed using Cox proportional hazards models for the total cohort and for birth period and gender separately. Thirty-day mortality and inter-stage mortality were analysed. Patients were followed until September 2016. Results: The 1993-2010 cohort consisted of 208 live-born infants. Norwood surgery was performed in 121/208 (58%). The overall transplantation-free survival was 61/121 (50%). The survival was higher in the late period (10-year survival 63%) than in the early period (10-year survival 40%) (p = 0.010) and lower for female (10-year survival 34%) than for male patients (10-year survival 59%) (p = 0.002). Inter-stage mortality between stages I and II decreased from 23 to 8% (p = 0.008). For male patients, low birthweight in relation to gestational age was a factor associated with poor outcome. Conclusion: The survival after Norwood surgery for hypoplastic left heart syndrome/aortic atresia improved by era of surgery, mainly explained by improved survival between stages I and II. Female gender was a significant risk factor for death or transplantation. For male patients, there was an increased risk of death when birthweight was lower than expected in relation to gestational age.
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