| 1. |
- Sparks, JA, et al.
(författare)
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Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: Results from the COVID-19 Global Rheumatology Alliance physician registry
- 2021
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 80:9, s. 1137-1146
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Tidskriftsartikel (refereegranskat)abstract
- To investigate baseline use of biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) and COVID-19 outcomes in rheumatoid arthritis (RA).MethodsWe analysed the COVID-19 Global Rheumatology Alliance physician registry (from 24 March 2020 to 12 April 2021). We investigated b/tsDMARD use for RA at the clinical onset of COVID-19 (baseline): abatacept (ABA), rituximab (RTX), Janus kinase inhibitors (JAKi), interleukin 6 inhibitors (IL-6i) or tumour necrosis factor inhibitors (TNFi, reference group). The ordinal COVID-19 severity outcome was (1) no hospitalisation, (2) hospitalisation without oxygen, (3) hospitalisation with oxygen/ventilation or (4) death. We used ordinal logistic regression to estimate the OR (odds of being one level higher on the ordinal outcome) for each drug class compared with TNFi, adjusting for potential baseline confounders.ResultsOf 2869 people with RA (mean age 56.7 years, 80.8% female) on b/tsDMARD at the onset of COVID-19, there were 237 on ABA, 364 on RTX, 317 on IL-6i, 563 on JAKi and 1388 on TNFi. Overall, 613 (21%) were hospitalised and 157 (5.5%) died. RTX (OR 4.15, 95% CI 3.16 to 5.44) and JAKi (OR 2.06, 95% CI 1.60 to 2.65) were each associated with worse COVID-19 severity compared with TNFi. There were no associations between ABA or IL6i and COVID-19 severity.ConclusionsPeople with RA treated with RTX or JAKi had worse COVID-19 severity than those on TNFi. The strong association of RTX and JAKi use with poor COVID-19 outcomes highlights prioritisation of risk mitigation strategies for these people.
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| 2. |
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| 5. |
- Ahlström, Johan, et al.
(författare)
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Influence of chloride and moisture content on steel rebar corrosion in concrete
- 2016
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Ingår i: Materials and corrosion - Werkstoffe und Korrosion. - : Wiley-VCH Verlag. - 0947-5117 .- 1521-4176. ; 67:10, s. 1049-1058
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Tidskriftsartikel (refereegranskat)abstract
- Reinforced mortar samples were exposed in humidity chambers with different relative humidity or exposed in cyclic moisture conditions. The rebars were in an “as received” condition meaning that the preexisting oxide scale were intact. The lowest chloride concentration that initiated corrosion was 1% Cl− by mass of cement, corrosion was then observed for samples exposed at 97% relative humidity. It is suggested that the corrosion rate decreases when samples are exposed to a relative humidity lower than 97%. The results indicate that threshold levels should be evaluated at rather humid conditions (97%) despite the fact that the maximum corrosion rate at higher chloride levels is observed in the interval 91–94%. For samples exposed to cyclic moisture conditions, a lower chloride concentration was needed to initiate corrosion compared to samples exposed in static moisture conditions.
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| 6. |
- Bender, R., et al.
(författare)
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Corrosion challenges towards a sustainable society
- 2022
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Ingår i: Materials and corrosion - Werkstoffe und Korrosion. - : Wiley. - 0947-5117 .- 1521-4176. ; 73:11, s. 1730-1751
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Tidskriftsartikel (refereegranskat)abstract
- A global transition towards more sustainable, affordable and reliable energy systems is being stimulated by the Paris Agreement and the United Nation's 2030 Agenda for Sustainable Development. This poses a challenge for the corrosion industry, as building climate-resilient energy systems and infrastructures brings with it a long-term direction, so as a result the long-term behaviour of structural materials (mainly metals and alloys) becomes a major prospect. With this in mind “Corrosion Challenges Towards a Sustainable Society” presents a series of cases showing the importance of corrosion protection of metals and alloys in the development of energy production to further understand the science of corrosion, and bring the need for research and the consequences of corrosion into public and political focus. This includes emphasis on the limitation of greenhouse gas emissions, on the lifetime of infrastructures, implants, cultural heritage artefacts, and a variety of other topics.
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| 7. |
- Ohlsson, Claes, 1965, et al.
(författare)
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Secular Trends in Pubertal Growth Acceleration in Swedish Boys Born from 1947 to 1996
- 2019
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Ingår i: JAMA Pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 173:9, s. 860-865
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Tidskriftsartikel (refereegranskat)abstract
- Importance: A secular trend for earlier menarcheal age has been established in girls but there are few studies of pubertal timing for boys. Objective: To determine if there is a secular trend for earlier pubertal timing among boys. Design, Setting, and Participants: For this population-based retrospective cohort study conducted in Gothenburg, Sweden, we collected heights and weights from school health records for boys born consecutively from January 1 and onwards in 1947 and every 5 years from 1951 to 1996 (n = 375 for each birth cohort from 1947-1991, n = 340 for the birth cohort in 1996, and n = 4090 for the total cohort). We estimated age at the peak height velocity (PHV), the maximum growth velocity during puberty, and childhood body mass index (BMI) at age 8 years for all study participants. The data were analyzed during 2018 and 2019. Boys were eligible if they had a complete personal identity number and data to calculate their age at PHV and childhood BMI. Approximately 2.4% of the original study population was excluded because they lacked a personal identity number, and in the remaining study population, 4090 (69%) had sufficient data to calculate childhood BMI and age at PHV. Exposures: The exposure was birth year and a potential confounding factor was childhood BMI. Main Outcomes and Measures: The outcome was age at PHV. Results: Of the 4090 participants, most were white and the mean (SD) age at PHV was 13.9 (1.1) years. A linear regression model revealed a significant association between year of birth and age at PHV. Age at PHV was 1.5 months earlier for every decade increase in birth year (95% CI, -1.72 to -1.19; P <.001). After adjusting for childhood BMI, age at PHV was 1.2 months earlier per decade increase in birth year (95% CI, -1.41 to -0.89). All analyses were repeated in the subgroup of boys born in Sweden and with parents born in Sweden with similar results, indicating that the secular trend was not explained by demographic changes in the population between 1947 and 1996. Conclusions and Relevance: We provide evidence of a secular trend for earlier pubertal timing in boys that is partially explained by an increased childhood BMI, but other factors that are unknown contribute. © 2019 Ohlsson C et al.
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| 8. |
- Owen, Rhodri E., et al.
(författare)
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Operando Ultrasonic Monitoring of Lithium-Ion Battery Temperature and Behaviour at Different Cycling Rates and under Drive Cycle Conditions
- 2022
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Ingår i: Journal of the Electrochemical Society. - : The Electrochemical Society. - 0013-4651 .- 1945-7111. ; 169:4
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Tidskriftsartikel (refereegranskat)abstract
- Effective diagnostic techniques for Li-ion batteries are vital to ensure that they operate in the required voltage and temperature window to prevent premature degradation and failure. Ultrasonic analysis has been gaining significant attention as a low cost, fast, non-destructive, operando technique for assessing the state-of-charge and state-of-health of Li-ion batteries. Thus far, the majority of studies have focused on a single C-rate at relatively low charge and discharge currents, and as such the relationship between the changing acoustic signal and C-rate is not well understood. In this work, the effect of cell temperature on the acoustic signal is studied and shown to have a strong correlation with the signal's time-of-flight. This correlation allows for the cell temperature to be inferred using ultrasound and to compensate for these effects to accurately predict the state-of-charge regardless of the C-rate at which the cell is being cycled. Ultrasonic state-of-charge monitoring of a cell during a drive cycle illustrates the suitability of this technique to be applied in real-world situations, an important step in the implementation of this technique in battery management systems with the potential to improve pack safety, performance, and efficiency:
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| 9. |
- Robinson, James B., et al.
(författare)
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Identifying Defects in Li-Ion Cells Using Ultrasound Acoustic Measurements
- 2020
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Ingår i: Journal of the Electrochemical Society. - : The Electrochemical Society. - 0013-4651 .- 1945-7111. ; 167:12
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Tidskriftsartikel (refereegranskat)abstract
- Identification of the state-of-health (SoH) of Li-ion cells is a vital tool to protect operating battery packs against accelerated degradation and failure. This is becoming increasingly important as the energy and power densities demanded by batteries and the economic costs of packs increase. Here, ultrasonic time-of-flight analysis is performed to demonstrate the technique as a tool for the identification of a range of defects and SoH in Li-ion cells. Analysis of large, purpose-built defects across multiple length scales is performed in pouch cells. The technique is then demonstrated to detect a microscale defect in a commercial cell, which is validated by examining the acoustic transmission signal through the cell. The location and scale of the defects are confirmed using X-ray computed tomography, which also provides information pertaining to the layered structure of the cells. The demonstration of this technique as a methodology for obtaining direct, non-destructive, depth-resolved measurements of the condition of electrode layers highlights the potential application of acoustic methods in real-time diagnostics for SoH monitoring and manufacturing processes.
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| 10. |
- Savendahl, L., et al.
(författare)
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Long-term mortality after childhood growth hormone treatment: the SAGhE cohort study
- 2020
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Ingår i: Lancet Diabetes & Endocrinology. - : Elsevier BV. - 2213-8587. ; 8:8, s. 683-692
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Tidskriftsartikel (refereegranskat)abstract
- Background Recombinant human growth hormone has been used for more than 30 years and its indications have increased worldwide. There is concern that this treatment might increase mortality, but published data are scarce. We present data from the entire dataset of all eight countries of the Safety and Appropriateness of Growth hormone treatments in Europe (SAGhE) consortium, with the aim of studying long-term overall and cause-specific mortality in young adult patients treated with recombinant human growth hormone during childhood and relating this to the underlying diagnosis. Methods This cohort study was done in eight European countries (Belgium, France, Germany, Italy, The Netherlands, Sweden, Switzerland, and the UK). Patients were classified a priori based on pre-treatment perceived mortality risk from their underlying disease and followed up for cause-specific mortality. Person-years at risk of mortality and expected rates from general population data were used to calculate standardised mortality ratios (SMRs). Findings The cohort comprised 24 232 patients treated with recombinant human growth hormone during childhood, with more than 400 000 patient-years of follow-up. In low-risk patients with isolated growth hormone deficiency or idiopathic short stature, all-cause mortality was not significantly increased (SMR 1.1, 95% CI 0.9-1.3). In children born small for gestational age, all-cause mortality was significantly increased when analysed for all countries (SMR 1.5, CI 1.1-1.9), but this result was driven by the French subcohort. In patients at moderate or high risk, mortality was increased (SMR 3.8, 3.3-4.4; and 17.1, 15.6-18.7, respectively). Mortality was not associated with mean daily or cumulative doses of recombinant human growth hormone for any of the risk groups. Cause-specific mortality from diseases of the circulatory and haematological systems was increased in all risk groups. Interpretation In this cohort, the largest, to our knowledge, with long-term follow-up of patients treated with recombinant human growth hormone during childhood, all-cause mortality was associated with underlying diagnosis. In patients with isolated growth hormone deficiency or idiopathic short stature, recombinant human growth hormone treatment was not associated with increased all-cause mortality. However, mortality from certain causes was increased, emphasising the need for further long-term surveillance. Copyright (C) 2020 Elsevier Ltd. All rights reserved.
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| 13. |
- Tidblad, A., et al.
(författare)
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Association of Childhood Growth Hormone Treatment With Long-term Cardiovascular Morbidity
- 2021
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Ingår i: JAMA Pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 175:2
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Tidskriftsartikel (refereegranskat)abstract
- Importance Concerns about the cardiovascular safety of recombinant human growth hormone (rhGH) treatment in childhood have recently been raised; however, long-term studies are limited. Objective To investigate the long-term risk of overall and severe cardiovascular events in patients previously treated with rhGH in childhood and whether there is an association with treatment duration or dose. Design, Setting, and Participants This nationwide population-based cohort study included patients treated with rhGH during childhood from January 1, 1985, to December 31, 2010, in Sweden, with follow-up through December 31, 2014. Included patients were treated with rhGH owing to isolated growth hormone deficiency (GHD), small for gestational age (SGA), and idiopathic short stature (ISS). For each patient, 15 age-, sex-, and region-based matched control individuals were randomly selected from the general population as a comparison group. Data on cardiovascular outcomes and covariates including gestational age, birth weight, birth length, socioeconomic status, and height were obtained through linkage with several health care and population-based registers. Data were analyzed from January 1, 1985, to December 31, 2014. Exposures Treatment with rhGH during childhood and adolescence (aged 0-18 years). Main Outcomes and Measures The primary outcome was the first cardiovascular event recorded after the start of follow-up, and the secondary outcome was the first severe cardiovascular event. Results A total of 53 444 individuals (3408 patients and 50 036 controls; 67.7% men; mean [SD] age at study end, 25.1 [8.2] years) were followed up for as long as 25 years (median follow-up, 14.9 [range, 0-25] years; total, 795 125 person-years). Among 1809 recorded cardiovascular events, the crude incidence rates were 25.6 events per 10 000 person-years for patients and 22.6 events per 10 000 person-years for controls. The adjusted hazard ratio (HR) for all cardiovascular events was higher in patients compared with controls (HR, 1.69; 95% CI, 1.30-2.19), especially for women (HR, 2.05; 95% CI, 1.31-3.20) compared with men (HR, 1.55; 95% CI, 1.12-2.13). All subgroups had increased HRs (SGA, 1.97 [95% CI, 1.28-3.04]; GHD, 1.66 [95% CI, 1.21-2.26]; and ISS, 1.55 [95% CI, 1.01-2.37]). Longer duration of rhGH treatment (HR, 2.08; 95% CI, 1.35-3.20) and total cumulative dose (HR, 2.05; 95% CI, 1.18-3.55) were associated with higher risk for overall cardiovascular disease. The adjusted HR for severe cardiovascular disease was 2.27 (95% CI, 1.01-5.12). Conclusions and Relevance In this cohort study, treatment with rhGH during childhood due to GHD, SGA, or ISS was associated with increased risks of cardiovascular events in early adulthood, particularly in women; however, conclusions of causality are still limited and the absolute risk remains low. Question Is childhood growth hormone treatment associated with an increased long-term risk of cardiovascular morbidity? Findings In this nationwide population-based cohort study of 3408 patients treated with growth hormone in childhood and followed up for 25 years, risk of cardiovascular events later in life was increased compared with 50 036 age-, sex-, and region-matched control individuals adjusted for possible confounders. Longer duration of treatment and higher cumulative dose further increased this risk. Meaning These findings suggest that childhood growth hormone treatment is associated with an increased risk of cardiovascular events in early adulthood, although conclusions of causality are limited and the absolute risks are low. This cohort study investigates the long-term risk of overall and severe cardiovascular events in patients previously treated with recombinant human growth hormone in childhood and assesses whether these events are associated with treatment duration or dose.
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| 17. |
- Tidblad, L, et al.
(författare)
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Comorbidities and treatment patterns in early rheumatoid arthritis: a nationwide Swedish study
- 2022
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Ingår i: RMD open. - : BMJ. - 2056-5933. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- To examine how comorbidities in patients with early rheumatoid arthritis (RA) associate with use of different disease-modifying antirheumatic drugs (DMARDs).MethodsWe used Swedish nationwide clinical and quality registers to collect comorbidity data for patients diagnosed with RA during 2006–2019 (n=13 505). We compared the use of DMARDs at diagnosis and after 1 year, in relation to comorbidity categories 5 years prior to RA diagnosis and overall comorbidity burden. For each comorbidity category, we also calculated adjusted ORs of being on treatment with other (or no) DMARDs compared with methotrexate (MTX) monotherapy 1 year after RA diagnosis.ResultsAt RA diagnosis, 68% (n=9178) of all patients were treated with MTX monotherapy, with the lowest proportion in patients with chronic kidney (CKD, 48%, n=50) and respiratory diseases (57%, n=413). At 1 year, most patients still received MTX monotherapy (<11% decrease, across all comorbidity categories). At 1 year, 13% received biological/targeted synthetic DMARDs, with the lowest proportion among patients with malignant diseases (OR=0.69, 95% CI=0.51 to 0.95). Being without DMARD at 1 year was more common among patients with CKD (OR=3.25, 95% CI=2.20 to 4.81), respiratory diseases (OR=1.83, 95% CI=1.32 to 2.53) or a history of hospitalisation due to infection (OR=1.47, 95% CI=1.23 to 1.75), and among patients with higher comorbidity burden and older age.ConclusionIn a nationwide setting with universal healthcare, most comorbid conditions do not limit the initiation or continuation of MTX or other DMARDs in early RA, although patients with certain comorbid conditions, higher comorbidity burden and higher age were somewhat less intensively treated.
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| 18. |
- Tidblad, L, et al.
(författare)
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COMORBIDITIES AT DIAGNOSIS OF RHEUMATOID ARTHRITIS
- 2020
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 79, s. 271-272
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Although many studies have reported an increased burden of comorbidities in patients with rheumatoid arthritis (RA), and their impact on RA outcomes, few studies have compared the pattern of comorbidities already at diagnosis of RA, in relation to the burden among matched control subjects. Only such a comparison can inform on which comorbidities are increased already before RA diagnosis, presumably due to overlapping causal factors, and which arise as a consequence of the RA disease or its treatment.Objectives:The aim of this study was to investigate the pattern of common chronic conditions in patients with RA, overall and stratified by serological status, at the time of diagnosis, compared to a matched control group reflective of the general population.Methods:This nationwide study included patients with a new-onset RA diagnosis, using data from the Swedish Rheumatology Quality register, from 2006 to 2015. We included 11,086 incident RA cases, of whom 62% were seropositive. From the Total Population Register, we identified 54,813 population controls, individually matched on age, sex and county of residence. Information about registered comorbidity diagnoses during the five years up until the RA diagnosis was retrieved from the Swedish National Patient Register. Information on dispersed drugs during the year up until the RA diagnosis was collected from the Prescribed Drug Register. Comorbidity diagnoses were grouped into 10 different categories (see table 1). Logistic regression was used to compare comorbidities between cases and controls, adjusted for the matching variables.Table 1.Relative risk of comorbidities at RA diagnosis, overall and by serological statusAll RASeropos RASeroneg RAComorbiditiesOR*95% CIOR*95% CIOR*95% CICardiovascular1.111.03–1.201.060.95–1.171.201.07–1.36Non-cardiac vascular1.030.98–1.091.030.96–1.101.060.97–1.16Respiratory1.581.44–1.741.741.54–1.961.351.15–1.59Gastrointestinal1.171.08–1.271.121.01–1.251.281.12–1.46Psychiatric0.870.82–0.920.870.80–0.930.960.87–1.06Nephrological0.900.71–1.150.890.63–1.250.960.68–1.36Infectious1.121.03–1.231.131.01–1.271.171.02–1.35Endocrine1.391.31–1.471.411.31–1.511.351.23–1.48Cancer0.880.79–0.970.810.71–0.930.930.80–1.10Neurological1.731.59–1.891.621.45–1.812.001.74–2.29*All ORs are adjusted for sex and age, and cases with RA are compared to their individually matched control subjects.Results:In seropositive as well as in seronegative RA, comorbidities within the respiratory (OR 1.58, 95% CI 1.44-1.74), gastrointestinal (OR 1.17, 95% CI 1.08-1.27), infectious (OR 1.12, 95% CI 1.03-1.23), endocrine (OR 1.39, 95% CI 1.31-1.47) and neurological (OR 1.73, 95% CI 1.59-1.89) categories were more common already at the time of RA diagnosis, compared to the matched population controls, as outlined in table 1. A history of cardiovascular disease was slightly increased among patients with seronegative RA (OR 1.20, 95% CI 1.07-1.36), and no increase was seen for non-cardiac vascular diseases. A history of psychiatric (OR 0.87, 95% CI 0.80-0.93) and cancer diagnoses (OR 0.81, 95% CI 0.71-0.93) was less common in seropositive RA vs. their matched controls. In terms of comorbidity burden, 15% of all RA patients had diagnoses from at least two of the ten comorbidity categories vs. 13% of the controls and 8% vs. 8% had diagnoses within three or more comorbidity categories.Conclusion:This large nationwide study demonstrates a marked increase in several comorbidities, in particular respiratory, endocrine and neurological diseases, already at, and before, the diagnosis of RA compared with age and sex matched controls, while psychiatric diagnoses are less common. These findings are important for the interpretation of comorbidity studies in established RA.Figure 1.Prevalence of comorbidities in Swedish patients with newly diagnosed RA compared to the matched controls * p < 0.05Disclosure of Interests:Liselotte Tidblad: None declared, Helga Westerlind: None declared, Johan Askling Grant/research support from: JA acts or has acted as PI for agreements between Karolinska Institutet and the following entities, mainly in the context of the ARTIS national safety monitoring programme of immunomodulators in rheumatology: Abbvie, BMS, Eli Lilly, Merck, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB Pharma, Saedis Saevarsdottir Employee of: Part-time at deCODE Genetics/Amgen Inc, working on genetic research unrelated to this project
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