| 1. |
- Diarbakerli, E., et al.
(författare)
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Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010-2020
- 2022
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden. Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors. Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14% of the publications, 84% from secondary health care, and 2% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34%) and rehabilitation (15%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25%), fractures (16%), and joint, tendon, and muscle injuries (13%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8%, respectively). Pain disorder-related publications (10%) as well as bone health and osteoporosis-related publications (4%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3%, respectively). Conclusions: Swedish-affiliated MSK disorder research 2010-2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.
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| 2. |
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| 3. |
- Hygrell, T, et al.
(författare)
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An artificial intelligence-based model for prediction of atrial fibrillation from single-lead sinus rhythm electrocardiograms facilitating screening
- 2023
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Ingår i: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. - : Oxford University Press (OUP). - 1532-2092. ; 25:4, s. 1332-1338
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Tidskriftsartikel (refereegranskat)abstract
- AimsScreening for atrial fibrillation (AF) is recommended in the European Society of Cardiology guidelines. Yields of detection can be low due to the paroxysmal nature of the disease. Prolonged heart rhythm monitoring might be needed to increase yield but can be cumbersome and expensive. The aim of this study was to observe the accuracy of an artificial intelligence (AI)-based network to predict paroxysmal AF from a normal sinus rhythm single-lead ECG.Methods and resultsA convolutional neural network model was trained and evaluated using data from three AF screening studies. A total of 478 963 single-lead ECGs from 14 831 patients aged ≥65 years were included in the analysis. The training set included ECGs from 80% of participants in SAFER and STROKESTOP II. The remaining ECGs from 20% of participants in SAFER and STROKESTOP II together with all participants in STROKESTOP I were included in the test set. The accuracy was estimated using the area under the receiver operating characteristic curve (AUC). From a single timepoint ECG, the artificial intelligence–based algorithm predicted paroxysmal AF in the SAFER study with an AUC of 0.80 [confidence interval (CI) 0.78–0.83], which had a wide age range of 65–90+ years. Performance was lower in the age-homogenous groups in STROKESTOP I and STROKESTOP II (age range: 75–76 years), with AUCs of 0.62 (CI 0.61–0.64) and 0.62 (CI 0.58–0.65), respectively.ConclusionAn artificial intelligence–enabled network has the ability to predict AF from a sinus rhythm single-lead ECG. Performance improves with a wider age distribution.
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| 4. |
- Lembrechts, Jonas J., et al.
(författare)
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SoilTemp : A global database of near-surface temperature
- 2020
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 26:11, s. 6616-6629
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Tidskriftsartikel (refereegranskat)abstract
- Current analyses and predictions of spatially explicit patterns and processes in ecology most often rely on climate data interpolated from standardized weather stations. This interpolated climate data represents long-term average thermal conditions at coarse spatial resolutions only. Hence, many climate-forcing factors that operate at fine spatiotemporal resolutions are overlooked. This is particularly important in relation to effects of observation height (e.g. vegetation, snow and soil characteristics) and in habitats varying in their exposure to radiation, moisture and wind (e.g. topography, radiative forcing or cold-air pooling). Since organisms living close to the ground relate more strongly to these microclimatic conditions than to free-air temperatures, microclimatic ground and near-surface data are needed to provide realistic forecasts of the fate of such organisms under anthropogenic climate change, as well as of the functioning of the ecosystems they live in. To fill this critical gap, we highlight a call for temperature time series submissions to SoilTemp, a geospatial database initiative compiling soil and near-surface temperature data from all over the world. Currently, this database contains time series from 7,538 temperature sensors from 51 countries across all key biomes. The database will pave the way toward an improved global understanding of microclimate and bridge the gap between the available climate data and the climate at fine spatiotemporal resolutions relevant to most organisms and ecosystem processes.
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| 5. |
- Battista, Simone, et al.
(författare)
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Sex and age differences in the patient-reported outcome measures and adherence to an osteoarthritis digital self-management intervention
- 2024
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Ingår i: Osteoarthritis and Cartilage Open. - 2665-9131. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo explore sex and age differences in Patient-Reported Outcomes Measures (PROMs) and adherence to digital osteoarthritis (OA) self-management intervention.MethodsA register-based study with data from an OA digital self-management intervention. PROMs and adherence were collected at baseline and/or 3 month follow-up: ‘pain intensity’ in hip/knee (best/worst: 0–10), ‘activity impairments' (best/worst: 0–10), ‘overall health’ perception (worst/best: 0–10), ‘physical function’ (30-s chair stand test), ‘health-related quality of life’ (EQ-5D-5L index score; worst/best: 0.243–0.976), the subscales and total scores of the Knee Injury/Hip Disability and Osteoarthritis Outcome Score (KOOS/HOOS-12; worst/best: 0–100), ‘fear of movement’ (yes/no), ‘walking difficulties' (yes/no), ‘programme adherence’ (0–100 % and ≥80 % [yes/no]), ‘patient acceptable symptom state’ (PASS; yes/no), and ‘treatment failure’ (those who answered no to PASS question and thought the treatment failed [yes/no]). We used linear/logistic regression to calculate mean/risk differences in the PROMs and adherence levels among sex and age groups at 3-month follow-up. We employed entropy balancing to explore the contributions of baseline characteristics and different covariates to the sex/age differences.ResultsWe included 14,610 participants (mean (SD) age: 64.1 (9.1), 75.5 % females). Females generally reported better outcomes than males. Participants aged ≥70 had greater activity impairments, lower KOOS/HOOS-pain/function scores, more walking difficulties, less fear of movement and higher adherence than those <70. However, these differences were small and not likely clinically relevant.ConclusionNo clinically relevant differences in PROMs and adherence were found among sex/age groups in this digital OA programme, suggesting that sex/age seemed not to impact the outcomes of this intervention.
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| 6. |
- Bergkvist, Dan, et al.
(författare)
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Sick leave before and after arthroscopic partial meniscectomy due to traumatic meniscal tear
- 2020
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Ingår i: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 2:2
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Tidskriftsartikel (refereegranskat)abstract
- Summary Objective There is limited knowledge on sick leave associated with arthroscopic partial meniscectomy (APM) due to traumatic meniscal tear and its potential gender differences. Thus, our aim was to determine gender-specific sick leave before and after APM. Method In Skåne region, Sweden, we identified patients, aged 18–59 years diagnosed with traumatic meniscal tear without ligament injury, who had APM during 2004–2012. For each patient, we randomly sampled four age- and sex-matched reference subjects from the general population. We retrieved social insurance register data of all-cause sick leave exceeding two weeks. We analyzed the proportions and duration of sick leave with respect to days of sick leave, age, and gender. Results The cohort comprised 604 patients (29% women), mean (SD) age 40 (11) years, and 2254 reference subjects. Thirty-nine percent of women and 27% of men had a sick leave period longer than 14 days after APM. Still, we found that a new period of sick leave longer than 14 days, initiated on the day of APM (and not before), was relatively uncommon and equally distributed (15%) between women and men. Conclusion About one-third of the patients have more than 2 weeks of sick leave after APM for a traumatic meniscal tear and women are overrepresented in this category. Prolonged sick leave initiated on the day of APM was relatively uncommon. Other factors than surgery seem to explain the prolonged sick leave.
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| 7. |
- Carrick, Richard T., et al.
(författare)
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Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe
- 2024
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Ingår i: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645.
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC.Methods This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.Results One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.Conclusions North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs.
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| 8. |
- Cronström, Anna, et al.
(författare)
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Interpretation threshold values for patient-reported outcomes in patients participating in a digitally delivered first-line treatment program for hip or knee osteoarthritis
- 2023
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Ingår i: Osteoarthritis and Cartilage Open. - : Elsevier. - 2665-9131. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Establish proportions of patients reporting important improvement, acceptable symptoms and treatment failure and define interpretation threshold values for pain, patient-reported function and quality-of-life after participating in digital first-line treatment including education and exercise for hip and knee osteoarthritis (OA).Methods: Observational study. Responses to the pain Numeric Rating Scale (NRS, 0-10 best to worst), Knee injury and Osteoarthritis Outcome Score 12 (KOOS-12) and Hip disability and Osteoarthritis Outcome Score 12 (HOOS-12, both 0-100 worst to best) were obtained for 4383 (2987) and 20341 (1264) participants with knee (hip) OA at 3 and 12 months post intervention.. Threshold values for Minimal Important Change (MIC), Patient Acceptable Symptom State (PASS) and Treatment Failure (TF) were estimated using anchor-based predictive modeling.Results: 70–85% reported an important improvement in pain, function and quality of life after 3 and 12 months follow-up. 42% (3 months) and 51% (12 months) considered their current state as satisfactory, whereas 2-4% considered treatment failed. MIC values were -1 (NRS) and 0-4 (KOOS/HOOS-12) across follow-ups and joint affected. PASS threshold value for NRS was 3, and 53–73 for the KOOS/HOOS-12 subscales Corresponding values for TF were 5 (NRS) and 34–55 (KOOS/HOOS-12). Patients with more severe pain at baseline had higher MIC scores and accepted poorer outcomes at follow-ups.Conclusion: Threshold estimates aid in the interpretation of outcomes after first-line OA interventions assessed with NRS Pain and KOOS/HOOS-12. Baseline pain severity is important to consider when interpreting threshold values after first-line interventions in these patients.
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| 9. |
- Cronström, Anna, et al.
(författare)
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On the waiting list for joint replacement for knee osteoarthritis : are first-line treatment recommendations implemented?
- 2020
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Ingår i: Osteoarthritis and Cartilage Open. - : Elsevier. - 2665-9131. ; 2:2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate to what extent individuals participated in guideline-based first-line treatments before being assigned to a wait list for knee replacement for osteoarthritis (OA), and to what extent they were recommended such treatments once on the list. Factors associated with participation in first-line management were also investigated.Design: All patients on the waiting list ≥ three months for knee replacement due to knee OA (n = 229) at a public hospital in Sweden were invited to participate in this cross-sectional survey study. 136 individuals (mean age 70 ± 9 years, 59% women) answered self-reported questionnaires including demographics, physical activity level, knee function and treatments before and during their time on the waiting list.Results: Before being referred to the waiting list, 40% had participated in guideline-based OA management (Better management of patients with OsteoArthritis (BOA)), 53% in physiotherapy, 67% in either BOA or physiotherapy whilst 23% of those overweight (BMI≥25) had received weight-management advice. Women had participated in BOA and physiotherapy twice as often as men (51% vs. 25%, p = 0.002 and 66% vs. 34%, p < 0.001) prior to waiting list referral. During their time on the waiting list, only 10% were recommended BOA, 30% physiotherapy and 15% weight-management. 38% of the patients that had never participated in BOA indicated that they were interested in participating while waiting for their knee replacement.Conclusion: Our results suggest that recommended treatment guidelines for OA may not be adequately implemented in Swedish health-care. Further exploration of implementation barriers and lack of equality of care appears warranted.
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| 10. |
- Dahlberg, Hannes, et al.
(författare)
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Ferroelectric-Antiferroelectric Transition of Hf1- xZrxO2on Indium Arsenide with Enhanced Ferroelectric Characteristics for Hf0.2Zr0.8O2
- 2022
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Ingår i: ACS Applied Electronic Materials. - : American Chemical Society (ACS). - 2637-6113. ; 4:12, s. 6357-6363
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Tidskriftsartikel (refereegranskat)abstract
- The ferroelectric (FE)-antiferroelectric (AFE) transition in Hf1-xZrxO2 (HZO) is for the first time shown in a metal-ferroelectric-semiconductor (MFS) stack based on the III-V material InAs. As InAs displays excellent electron mobility and a narrow band gap, the integration of ferroelectric thin films for nonvolatile operations is highly relevant for future electronic devices and motivates further research on ferroelectric integration. When increasing the Zr fraction x from 0.5 to 1, the stack permittivity increases as expected, and the transition from FE to AFE-like behavior is observed by polarization and current-voltage characteristics. At x = 0.8 the polarization of the InAs-based stacks shows a larger FE-contribution as a more open hysteresis compared to both literature and reference metal-ferroelectric-metal (MFM) devices. By field-cycling the devices, the switching domains are studied as a function of the cycle number, showing that the difference in FE-AFE contributions for MFM and MFS devices is stable over switching and not an effect of wake-up. The FE contribution of the switching can be accessed by successively lowering the bias voltage in a proposed pulse train. The possibility of enhanced nonvolatility in Zr-rich HZO is relevant for device stacks that would benefit from an increase in permittivity and a lower operating voltage. Additionally, an interfacial layer (IL) is introduced between the HZO film and the InAs substrate. The interfacial quality is investigated as frequency-dependent capacitive dispersion, showing little change for varying ZrO2 concentrations and with or without included IL. This suggests material processing that is independently limiting the interfacial quality. Improved endurance of the InAs-Hf1-xZrxO2 devices with x = 0.8 was also observed compared to x = 0.5, with further improvement with the additional IL for Zr-rich HZO on InAs.
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