11. |
- Aimo, Alberto, et al.
(författare)
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Revisiting the obesity paradox in heart failure : Per cent body fat as predictor of biomarkers and outcome
- 2019
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Ingår i: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 26:16, s. 1751-1759
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Tidskriftsartikel (refereegranskat)abstract
- Aims Obesity defined by body mass index (BMI) is characterized by better prognosis and lower plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in heart failure. We assessed whether another anthropometric measure, per cent body fat (PBF), reveals different associations with outcome and heart failure biomarkers (NT-proBNP, high-sensitivity troponin T (hs-TnT), soluble suppression of tumorigenesis-2 (sST2)). Methods In an individual patient dataset, BMI was calculated as weight (kg)/height (m) (2) , and PBF through the Jackson-Pollock and Gallagher equations. Results Out of 6468 patients (median 68 years, 78% men, 76% ischaemic heart failure, 90% reduced ejection fraction), 24% died over 2.2 years (1.5-2.9), 17% from cardiovascular death. Median PBF was 26.9% (22.4-33.0%) with the Jackson-Pollock equation, and 28.0% (23.8-33.5%) with the Gallagher equation, with an extremely strong correlation (r = 0.996, p < 0.001). Patients in the first PBF tertile had the worst prognosis, while patients in the second and third tertile had similar survival. The risks of all-cause and cardiovascular death decreased by up to 36% and 27%, respectively, per each doubling of PBF. Furthermore, prognosis was better in the second or third PBF tertiles than in the first tertile regardless of model variables. Both BMI and PBF were inverse predictors of NT-proBNP, but not hs-TnT. In obese patients (BMI >= 30 kg/m(2), third PBF tertile), hs-TnT and sST2, but not NT-proBNP, independently predicted outcome. Conclusion In parallel with increasing BMI or PBF there is an improvement in patient prognosis and a decrease in NT-proBNP, but not hs-TnT or sST2. hs-TnT or sST2 are stronger predictors of outcome than NT-proBNP among obese patients.
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12. |
- Andersson-Sköld, Yvonne, 1957, et al.
(författare)
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Microplastics from tyre and road wear: a literature review
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This literature review concerns microplastics from tyre and road wear caused by road traffic. As there is limited knowledge about microplastics in general, and microplastics from road traffic in particular, the Swedish Government commissioned the Swedish National Road and Transport Research Institute (VTI) to, during 2018-2020, develop and disseminate knowledge about microplastics from road traffic. The chapters in this report summarises existing knowledge about microplastics from road traffic with respect to the following aspects: sources, spread and presence; effects on and risk to the environment and human health; characteristics and chemical composition; tyre and road wear; sampling methods; analysis and sample preparation; and measures. The report also includes a chapter with overall conclusions, and a chapter about further research, development and investigation needs. The purpose of this report is to provide a basis for reducing the generation and spread of microplastics from road traffic. One aim of the report is to collate and disseminate knowledge about microplastics generated by tyre and road wear, and to review the current level of knowledge. A second aim is to identify knowledge gaps and research requirements in relation to microplastics from road traffic. This literature review is based on a review of scientific articles and reports, as well as technical literature and some information from experts and industry.
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13. |
- Andersson-Sköld, Yvonne, 1957-, et al.
(författare)
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Mikroplast från däck- och vägslitage : en kunskapssammanställning
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna kunskapssammanställning handlar om mikroplast från vägtrafikens däck- och vägslitage. Eftersom kunskapen om mikroplaster från vägtrafiken är begränsad samtidigt som däckslitage bedöms vara den största källan till utsläpp av mikroplast i Sverige, gav regeringen inom ramen för sitt arbete med plast och mikroplast Statens väg- och transportforskningsinstitut (VTI) i uppdrag att under 2018– 2020 ta fram och sprida kunskap om mikroplast från vägtrafiken. Varje kapitel i denna rapport sammanfattar befintlig kunskap om mikroplast från vägtrafiken avseende en eller flera aspekter. Dessa aspekter är: källor, spridning och förekomst; miljö- och hälsoeffekter samt risker; egenskaper och kemisk sammansättning; däck- och vägslitage; provtagningsmetoder; analys- och provberedningsmetoder samt åtgärder. Dessutom finns ett kapitel med sammanfattande slutsatser och allra sist ett kapitel om forsknings-, utvecklings- och utredningsbehov.Syftet med rapporten är att den ska utgöra ett underlag för att minska emissioner och spridning av mikroplast från vägtrafiken. Ett mål med rapporten är att sammanställa och sprida kunskap om mikroplast från däck- och vägslitage och att redogöra för nuvarande kunskapsläge. Ytterligare ett mål är att identifiera kunskaps- och forskningsbehov avseende mikroplast från vägtrafiken.Underlaget till denna kunskapssammanställning utgörs av vetenskapliga artiklar och rapporter samt facklitteratur och information från branschen och från experter.
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14. |
- Axelsson, Ida, et al.
(författare)
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Impact of storage time prior to cryopreservation on mechanical properties of aortic homografts
- 2024
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Ingår i: Cell and Tissue Banking. - : Springer Science and Business Media LLC. - 1389-9333 .- 1573-6814. ; 25:1, s. 27-37
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Tidskriftsartikel (refereegranskat)abstract
- Optimal time spans in homograft procurement are still debatable among tissue banks and needs to be further investigated. Cell viability decreases at longer preparation intervals, but the effect on collagen and elastic fibers has not been investigated to the same extent. These fibers are of importance to the homograft elasticity and strength. The objective of this study was to analyze the mechanical properties of homograft tissue at different time spans in the procurement process. Ten aortic homografts were collected at the Tissue Bank in Lund. Twelve samples were obtained from each homograft, cryopreserved in groups of three after 2–4 days, 7–9 days, 28–30 days, and 60–62 days in antibiotic decontamination. Mechanical testing was performed with uniaxial tensile tests, calculating elastic modulus, yield stress and energy at yield stress. Two randomly selected samples were assessed with light microscopy. Procurement generated a total of 120 samples, with 30 samples in each time group. Elastic modulus and yield stress was significantly higher in samples cryopreserved after 2–4 days (2.7 MPa (2.5-5.0) and 0.78 MPa (0.68-1.0)) compared to 7–9 days (2.2 MPa (2.0-2.6) and 0.53 MPa (0.46–0.69)), p = 0.008 and 0.011 respectively. Light microscopy did not show any difference in collagen and elastin at different time spans. There was a significant decrease in elastic modulus and yield stress after 7 days of decontamination at 4 °C compared to 2–4 days. This could indicate some deterioration of elastin and collagen at longer decontamination intervals. Clinical significance of these findings remains to be clarified.
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15. |
- Berndt, Sonja I., et al.
(författare)
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Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture
- 2013
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 45:5, s. 501-U69
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Tidskriftsartikel (refereegranskat)abstract
- Approaches exploiting trait distribution extremes may be used to identify loci associated with common traits, but it is unknown whether these loci are generalizable to the broader population. In a genome-wide search for loci associated with the upper versus the lower 5th percentiles of body mass index, height and waist-to-hip ratio, as well as clinical classes of obesity, including up to 263,407 individuals of European ancestry, we identified 4 new loci (IGFBP4, H6PD, RSRC1 and PPP2R2A) influencing height detected in the distribution tails and 7 new loci (HNF4G, RPTOR, GNAT2, MRPS33P4, ADCY9, HS6ST3 and ZZZ3) for clinical classes of obesity. Further, we find a large overlap in genetic structure and the distribution of variants between traits based on extremes and the general population and little etiological heterogeneity between obesity subgroups.
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16. |
- Björkman, Ida, et al.
(författare)
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Person-centred care on the move : An interview study with programme directors in Swedish higher education
- 2022
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is an increasing trend towards person-centred care (PCC) worldwide, suggesting that PCC should be mastered by future health care professionals. This study aims to explore programme directors' views on facilitators and barriers to implementing PCC in four of the largest national study programmes in Sweden training future health care professionals.METHODS: A qualitative design was applied and interviews were conducted with 19 programme directors of Swedish national study programmes in medicine, nursing, occupational therapy and physiotherapy. The interviews were analysed using qualitative content analysis. Themes were sorted according to the Consolidated Framework for Implementation Research (CFIR) in an abductive approach. COREQ guidelines were applied.RESULTS: The overarching theme, as interpreted from the programme directors' experiences, was 'Person-centred care is on the move at different paces.' The theme relates to the domains identified by the CFIR as outer setting, innovation, inner setting and process. PCC was understood as something familiar but yet new, and the higher education institutions were in a state of understanding and adapting PCC to their own contexts. The movement in the outer setting consists of numerous stakeholders advocating for increased patient influence, which has stirred a movement in the inner setting where the higher educational institutions are trying to accommodate these new demands. Different meanings and values are ascribed to PCC, and the concept is thus also 'on the move', being adapted to traditions at each educational setting.CONCLUSION: Implementation of PCC in Swedish higher education is ongoing but fragmented and driven by individuals with a specific interest. There is uncertainty and ambiguity around the meaning and value of PCC and how to implement it. More knowledge is needed about the core of PCC as a subject for teaching and learning and also didactic strategies suitable to support students in becoming person-centred practitioners.
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17. |
- Blomqvist, Göran, 1963-, et al.
(författare)
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Microplastics in snow in urban traffic environments
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Microplastics from road traffic, mainly from tyre wear, are globally considered to be one of the largest sources of microplastic contamination in the environment. Plastics can either be deposited in the road vicinity, at the roadside and in ditches or spread via stormwater and air to the environment and receiving water bodies. In cold climates, microplastics, as well as other traffic-related pollutants, can be temporarily stored in snow and ice on and around roads and streets. The location and concentration of these pollutants is influenced by winter operations, where ploughing and skid control contribute to redistribution, and by melting and compaction of ice and snow. This creates reservoirs of microplastics and other pollutants, which are released into stormwater or surrounding soil during thaws, but also provides an opportunity to reduce the spread of microplastics by managing snow and ice appropriately. In the present report, a case study of microplastics in snow has been carried out in the municipality of Karlstad in Sweden, to get an idea of the potential variation, both in terms of concentration and total amounts in relation to traffic and the location of the sampling in the street environment. Microplastics have been analysed by pyrolysis GC/MS to identify tyre-specific polymers in combination with eight commonly occurring plastic types. In addition, six municipalities in different parts of the country responded to a questionnaire on microplastics in snow and urban snowmelt management. The results show that microplastics related to tyre wear (rubber polymers) tend to be present in higher concentrations on and near the carriageway. Other plastics show a less clear link to traffic. Along a salted bicycle lane, an elevated level of polypropylene, from which the brush of the sweep-salting machine is made, could be detected in the surface layer of the snow. In general, knowledge about microplastics in urban snow is low in the municipalities that responded to the survey.
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18. |
- Eklund, Ida, et al.
(författare)
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Patients' Experiences of Pain and Postoperative Nausea and Vomiting in the Early Postoperative Period After an Elective Knee Arthroplasty
- 2020
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 35:4, s. 382-388
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of this study is to explore patients' experience of pain and postoperative nausea and vomiting (PONV) in the early postoperative period after knee arthroplasties.DesignThis is a retrospective cohort study with a quantitative approach. Data from patients registered in the Swedish Perioperative Registry were used. We used the Strenghtening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.MethodsData were collected from patients (N = 439) undergoing knee arthroplasties. The analysis was performed with descriptive and analytic statistics.FindingsThe findings indicate that women experienced significantly higher levels of pain than men and suffered significantly more often from PONV. However, the relationship of postoperative pain and PONV was not significant. There was also no significance for the relationship among postoperative pain, PONV, and age.ConclusionsCare needs to be sensitive to differences in experiencing pain and PONV depending on sex or gender bias, with a goal of increasing the equality in care.
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19. |
- Envall, Ida, et al.
(författare)
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Existing evidence related to soil retention of phosphorus from on-site wastewater treatment systems in boreal and temperate climate zones : a systematic map
- 2023
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Ingår i: Environmental Evidence. - : Springer Nature. - 2047-2382. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden there are nearly one million soil-based on-site wastewater treatment systems (OWTSs). OWTSs may contribute to eutrophication of surface waters, due to the discharge of phosphorus (P). Hence, in certain cases, a high P removal rate (up to 90%) of OWTSs is required by Swedish authorities. Since these requirements may have costly consequences to property owners, it is debated whether they are too strict. In this debate, it is often claimed that the soil retention of P occurring in the natural environments may be underestimated by authorities. Soil retention is the inhibition of the transport of P through the ground, due to different chemical, physical and biological processes occurring there. These processes make the P transport slower, which may reduce the unwanted impact on receiving water bodies. However, the efficiency of soil retention of P remains unclear. The objective of this systematic map was to collect, code, organise and elucidate the relevant evidence related to the topic, to be able to guide stakeholders through the evidence base, and to support future research synthesising, commissioning, and funding. The systematic map was carried out in response to needs declared by the Swedish Agency for Marine and Water Management but the conclusions should be valid for a wider range of countries across boreo-temperate regions.Methods: Searches were made for peer-reviewed and grey literature using bibliographic databases, search engines, specialist websites, and stakeholder contacts. The references were screened for relevance according to a predefined set of eligibility criteria. A detailed database of the relevant studies was compiled. Data and metadata that enable evaluation and discussion of the character and quality of the evidence base were extracted and coded. Special focus was placed on assessing if existing evidence could contribute to policy and practice decision making. Descriptive information about the evidence base was presented in tables and figures. An interactive evidence atlas and a choropleth were created, displaying the locations of all studies.Review findings: 234 articles out of 10,797 screened records fulfilled the eligibility criteria. These articles contain 256 studies, performed in the field or in the laboratory. Six different study types were identified, based on where the measurements were conducted. Most studies, including laboratory studies, lack replicates. Most field studies are observational case studies.Conclusions: It is not possible to derive valid generic measures of the efficiency of soil retention of P occurring in the natural soil environment from available research. Neither does the evidence base allow for answering the question of the magnitude of the potential impact of OWTSs on the P concentration in recipients on a general basis, or under what conditions OWTSs generally have such an impact. A compilation of groundwater studies may provide examples of how far the P may reach in x years, but the number of groundwater studies is insufficient to draw any general conclusions, given the complexity and variability of the systems. Future research should strive for replicated study designs, more elaborate reporting, and the establishment of a reporting standard.
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20. |
- Envall, Ida, et al.
(författare)
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What evidence exists related to soil retention of phosphorus from on-site wastewater treatment systems in boreal and temperate climate zones? : A systematic map protocol
- 2020
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Ingår i: Environmental Evidence. - : BMC. - 2047-2382. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Soil-based on-site wastewater treatment systems (OWSs) are suspected to contribute to eutrophication of surface waters, due to the discharge of phosphorus (P). However, along the flow path between the facilities and surface waters, different processes contribute to delay the transport of phosphorus through the ground. This may reduce the unwanted impact on receiving water bodies. However, the strength and significance of this so-called soil retention remains unclear. In Sweden, there are nearly one million OWSs. To protect surface waters, a high P removal rate (up to 90%) is often required by the local municipalities. However, since these requirements may have costly consequences to property owners, it is debated as to whether they are too strict. In this debate, it is often claimed that the retention of P occurring in natural environments may be underestimated by authorities. Accordingly, there is a need for a scrutiny of the available evidence related to soil retention of phosphorus from OWSs. This is the objective of the planned systematic map. Focus will be on boreal and temperate climate zones. Methods Searches will be made for peer-reviewed articles and grey literature using bibliographic databases, search engines, specialist websites and stakeholder contacts. The references will be screened for relevance according to a predefined set of eligibility criteria. At stage one, after testing and clarifying the eligibility criteria, the references will be single-screened based on title and abstract. At stage two, potentially relevant references will be screened in full-text independently by two reviewers. We will compile a detailed database of the relevant studies. Moreover, a narrative report will be produced, describing the research landscape in general terms. This will be carried out with a conceptual model, describing the processes involved in P retention in natural environments, as a foundation. It will be discussed where the respective studies/study types fit into the conceptual model, and also evaluated how each study/study type can be related to the overarching question of eutrophication. Moreover, we will describe identified knowledge gaps that warrant further primary research effort, as well as identified knowledge clusters that could be suitable for systematic reviews.
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