| 1. |
- Brännström, Andreas, et al.
(författare)
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Intermittent thoracic resuscitative endovascular balloon occlusion of the aorta improves renal function compared to 60 min continuous application after porcine class III hemorrhage
- 2023
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Ingår i: European Journal of Trauma and Emergency Surgery. - : Springer Berlin/Heidelberg. - 1863-9933 .- 1863-9941. ; 49:3, s. 1303-1313
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Tidskriftsartikel (refereegranskat)abstract
- Background Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may be considered for stabilization of patients with hemorrhage from below the diaphragm. Occluding the aorta is a powerful means of hemorrhagic control but is also associated with acute kidney injury, which increases mortality in trauma patients. Allowing for intermittent distal blood flow during REBOA application (iREBOA) could decrease this risk, but circulatory consequences have not been sufficiently elucidated. Therefore, we investigated circulatory effects and the renal artery blood flow (RBF) in iREBOA versus continuous, complete aortic occlusion (cREBOA).Methods In a porcine model of uncontrolled class III hemorrhage (34% estimated total blood volume, mean 1360 mL), swine (n = 12, mean weight 60.3 kg) were randomly assigned to iREBOA: 3-min full deflation every 10 min (n = 6), or cREBOA (n = 6), for 60 min of thoracic (zone I) application. The animals then underwent 60 min of reperfusion (critical care phase). Results Survival was 100% in iREBOA and 83% in cREBOA. The intermittent balloon deflation protocol was hemodynamically tolerable in 63% of reperfusion intervals. Systolic blood pressure decreased during the reperfusion intervals in iREBOA animals (mean 108 mm Hg versus 169 mm Hg; p < 0.005). No differences were detected in heart rate, cardiac output or stroke volume between methods. Troponin I increased in cREBOA after 60 min (mean 666-187 ng/L, p < 0.05). The norepinephrine requirement increased in cREBOA during reperfusion (mean infusion time 12.5-5.5 min; p < 0.05). Total ischemic time decreased in iREBOA (60.0-48.6 min; p < 0.001). RBF increased in iREBOA during balloon deflations and after 60 min reperfusion (61%-39% of baseline RBF; p < 0.05). Urine output increased in iREBOA (mean 135-17 mL; p < 0.001). Nephronal osteopontin, a marker of ischemic injury, increased in cREBOA (p < 0.05).Conclusion iREBOA was survivable, did not cause rebleeding, decreased the total ischemic time and increased the renal blood flow, urine output and decreased renal ischemic injury compared to cREBOA. Intermittent reperfusions during REBOA may be preferred to be continuous, complete occlusion in prolonged application to improve renal function.
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| 2. |
- Fredriksson, Sofie, 1983, et al.
(författare)
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The Impact of Occupational Noise Exposure on Hyperacusis: a Longitudinal Population Study of Female Workers in Sweden.
- 2021
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Ingår i: Ear and Hearing. - 1538-4667. ; 43:4, s. 1366-1377
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to assess the risk of hyperacusis in relation to occupational noise exposure among female workers in general, and among women working in preschool specifically.A retrospective longitudinal study was performed. Survey data were collected in 2013 and 2014 from two cohorts: randomly selected women from the population in region Västra Götaland, Sweden, and women selected based on having received a preschool teacher degree from universities in the same region. The final study sample included n = 8328 women born between 1948 and 1989. Occupational noise exposure was objectively assigned to all time periods from the first to the last reported occupation throughout working life, using the Swedish Job-Exposure Matrix (JEM) with three exposure intervals: <75 dB(A), 75 to 85 dB(A), and >85 dB(A). The JEM assigns preschool teachers to the 75 to 85 dB(A) exposure interval. The outcome hyperacusis was assessed by self-report using one question addressing discomfort or pain from everyday sounds. In the main analysis, a hyperacusis event was defined by the reported year of onset, if reported to occur at least a few times each week. Additional sensitivity analyses were performed using more strict definitions: (a) at least several times each week and (b) every day. The risk (hazard ratio, HR) of hyperacusis was analyzed in relation to years of occupational noise exposure, using survival analysis with frailty regression modeling accounting for individual variation in survival times which reflect, for example, noise exposure during years prior to onset. Occupational noise exposure was defined by the occupation held at year of hyperacusis onset, or the occupation held at the survey year if no event occurred. Models were adjusted for confounders including age, education, income, family history of hearing loss, and change of jobs due to noise.In total, n = 1966 hyperacusis events between 1960 and 2014 were analyzed in the main analysis. A significantly increased risk of hyperacusis was found among women working in any occupation assigned to the 75 to 85 dB(A) noise exposure group [HR: 2.6, 95% confidence interval (CI): 2.4-2.9], compared with the reference group <75 dB(A). The risk was tripled among preschool teachers specifically (HR: 3.4, 95% CI: 3.0-3.7), with the crude Kaplan-Meier curve showing a higher rate of onset early in the working life in preschool teachers compared with all the other exposure groups. The risk was increased, but not statistically significant in the main analysis, for the highest exposure group >85 dB(A), where only six hyperacusis events were identified (HR: 1.4, 95% CI: 0.6-3.1). In the sensitivity analysis, where hyperacusis was defined as occurring every day, the HR was significant also in the highest exposure group (HR: 3.8, 95% CI: 1.4-10.3), and generally slightly higher in the other exposure groups compared to the main analysis.This study indicates increased risk of hyperacusis already below the permissible occupational noise exposure limit in Sweden (85 dB LAeq,8h) among female workers in general, and in particular among preschool teachers. Prospective studies and less wide exposure intervals could confirm causal effects and assess dose-response relationships, respectively, although this study at present suggest a need for risk assessment, improved hearing prevention measures, and noise abatement measures in occupations with noise levels from 75 dB(A). The results could also have implications for management of occupational disability claims.
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| 3. |
- Grahn, Karin, et al.
(författare)
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Occupational exposure to particles and biomarkers of cardiovascular disease – during work and after vacation
- 2022
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 95, s. 1537-1548
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Tidskriftsartikel (refereegranskat)abstract
- Objective Ambient particle matter is a risk factor for cardiovascular disease (CVD). However, little is known about associations between particles in occupational settings and risk of CVD. We investigated associations between occupational dust exposure and biomarkers of CVD, and potential recovery effects after vacation.Methods Personal dust exposure measurements (respirable silica, respirable dust < 4 mu m, and particles of 0.1-10 mu m (PM 0.1-10) were conducted once, and biological sampling were performed twice on non-smoking, male construction workers in Stockholm county, Sweden; during work and immediately after summer vacation. Linear regressions with adjustments for confounders and covariates were performed evaluating associations between occupational dust exposure and biomarkers. Paired t tests were performed evaluating changes before and after vacation.Results Sixty-five workers participated. Homocysteine concentrations were significantly higher with increasing concentrations (mg/m(3)) of respirable silica, respirable dust, and PM 0.1-10, and pulse rate with higher levels of respirable dust and dust of PM 0.1-10. Homocysteine levels were also positively correlated to number of years of dust exposure, as were low-density lipoprotein (LDL) levels. A clear recovery effect was present for LDL after vacation, but not for homocysteine.Conclusions Occupational dust exposure was associated with some CVD risk markers, even at mean exposure concentrations below the Swedish occupational exposure limits for respirable silica and respirable dust, respectively. Vacation resulted in recovery for some risk markers. However, the change of the homocysteine and LDL levels suggest a long-term effect. Reduction of occupational exposure to dust may decrease the risk of CVD among exposed workers.
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| 4. |
- Grahn, Karin, et al.
(författare)
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Occupational noise exposure and acute effects on pulse rate and blood pressure
- 2022
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Ingår i: Proceedings of the International Congress on Acoustics.
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Konferensbidrag (refereegranskat)abstract
- Environmental exposure to noise and particle matter (PM) are risk factors for cardiovascular disease (CVD). Although there are often higher levels in occupational settings, little is known about noise and particle exposures at work and CVD risks. We investigated occupational noise and particle exposures and acute effects on pulse rate and blood pressure. 46 active, non-smoking, male construction workers were included in the study. Continuously logged personal exposure measurements of noise (LAmax, LCpeak) and dust of PM 0.1-10, continuously logged pulse rate and blood pressure measurements were performed for one working day on each participant. Significant associations were seen between these three exposures and acute changes in pulse rate. The effects were seen below the Swedish occupational exposure limits for LAmax and LCpeak, indicating that these limits may not protect from adverse cardiovascular effects. Also, an additive effect on pulse rate was seen if simultaneously exposed to noise and dust. No association were found between these exposures and blood pressure.
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| 5. |
- Gremyr, Ida, 1975, et al.
(författare)
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Exploring power shifts as an enabler for a strengthened patient role in quality improvements: A Swedish survey study
- 2021
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Ingår i: BMJ open quality. - : BMJ. - 2399-6641. ; 10:1
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Forskningsöversikt (refereegranskat)abstract
- Objectives This study examined the relationship between professionals' perceptions of a strengthened role for the patient and of patient involvement in quality improvement (QI) and whether professionals' experiences in improvement science were a moderator on such a relationship. Design From a predominantly close-ended, 44-item questionnaire, 4 questions specifically concerning professionals′ perception on patient involvement in QI were analysed. Setting Three Swedish regions. Participants 155 healthcare professionals who had previously participated in courses in improvement science. Results The covariate patient involvement was significantly related to a perceived strengthened patient role. There was also a significant interaction effect between degree of patient involvement and professionals' experience in the area of improvement science on a strengthened patient role. The result shows that there is a relationship between the perceived level of patient involvement in improvements and professionals' perceptions of a strengthened patient role. In this study, the covariate, perceived patient involvement, was significantly related to experiences of more equal relationships between patients and healthcare professionals. There was also a significant interaction effect between the degree of patient involvement and professionals' experience in the area of improvement science, for a more equal relationship between patients and healthcare professionals. Conclusion Increased patient involvement in QI is a means of strengthening the patient role and supporting a more equal relation between patients and healthcare professionals. Furthermore, empirical evidence shows that the healthcare professionals' experiences in the area of improvement science support a strengthened patient role and a more equal power relationship, but for this to happen, the mindset of professionals is key. Future research is needed to capture and investigate the experiences from patients and relatives about being involved in QI in healthcare, and to study the effects on quality in care processes.
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| 6. |
- Gustavsson, Cecilia, Dr, 1973-, et al.
(författare)
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Citizen science in radiation research
- 2020
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Ingår i: ND 2019. - : EDP Sciences. - 9782759891061
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Konferensbidrag (refereegranskat)abstract
- A growing trend in science is that research institutions reach out to members of the public for participating in research. The reasons for outreach are many, spanning from the desire to collect and/or analyse large sets of data efficiently, to the idea of including the general public on a very fundamental level in science-making and ultimately decision-making. The presented project is curriculum-based and carried out in 240 lower secondary school classes (pupils of age 13-16). The task, as designed by the participating universities, is to collect mushrooms, soil and animal droppings from different parts of Sweden, do preliminary sample preparation and analyses and send the samples to the university institutions for radioactivity measurement. Behind the project is a desire to compare today’s levels of 137Cs with those deposited right after the Chernobyl accident in 1986, but also to study the exchange of caesium between organisms as well as the impacts of biological and geological processes on uptake and retention. The scientific outcome is a geodatabase with the 137Cs activity (Bq/m2) present in the Swedish environment, where radioactivity data can be linked to the species (fungi, competing species, animals foraging), forest type, land type, land use and other environmental factors. The science question is of interest to the general public as foraging for mushrooms, as well as spending recreational time in forests is widely popular in Sweden. In this article, we will discuss the current status of the project and the observations we have made about how well the public can participate in scientific research. Focus will be on organization of the project, such as logistics, preparation of supportive material, feedback and communication between researchers and schools. We will present observations about the impact the project has had on the participants, based on quantitative and qualitative evaluations.
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| 7. |
- Gustavsson, Martha, et al.
(författare)
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Virtual reality gaming in rehabilitation after stroke - user experiences and perceptions
- 2022
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 44:22, s. 6759-6765
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The present study explored participants' experiences with and perceptions of using fully immersive head-mounted virtual reality (VR) gaming as rehabilitation after stroke. Methods Four men and three women (median age 64 years) with chronic stroke and varying motor impairment (mild to severe) were interviewed after 10 weeks of VR training on the commercial HTC Vive system, focusing on the upper extremities. Inductive qualitative thematic analysis was performed. Results The analysis revealed three main themes: playing the game, benefits and effects, and personalizing the game. Playing the game encompasses both the feeling of being immersed in the game and descriptions of the gaming being motivating and fun. Benefits and effects describe the participants' expectations of potential benefits, the importance of getting feed-back, and the impact in daily life. Personalizing the game includes finding the right game and level, and the participants' need for support to achieve full use of the training. Conclusions Participants with chronic stroke described the fully immersive VR gaming intervention as a fun and motivating way to improve their functioning in everyday life. Qualitative studies are needed to explore how people with stroke perceive VR gaming when it is implemented in real clinical environments.Clinical implications VR gaming was perceived as a positive and motivating rehabilitation after stroke. Getting feedback and perceiving benefits are essential parts of VR rehabilitation. Commercial fully immersive VR-games might be an option for stroke rehabilitation when the game can be personalized and support is available.
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| 8. |
- Gustavsson, Simon T., et al.
(författare)
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Nicotinamide prevents retinal vascular dropout in a rat model of ocular hypertension and supports ocular blood supply in glaucoma patients
- 2023
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Ingår i: Investigative Ophthalmology and Visual Science. - : Association for Research in Vision and Ophthalmology (ARVO). - 0146-0404 .- 1552-5783. ; 64
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. To investigate whether nicotinamide (NAM) modulates retinal vasculature in glaucoma.METHODS. This was a prospective controlled clinical trial investigating animal and human histopathology. Participants included normotensive and ocular hypertensive rats, postmortem human ocular tissue, glaucoma patients (n = 90), and healthy controls (n = 30). The study utilized histopathology, computer-assisted retinal vasculature analysis, optical coherence tomography angiography (OCTA), and NAM treatment. The main outcome measures included retinal vascular parameters in rats as assessed by AngioTool; retinal vasculature integrity in rats and humans as assessed by histopathology, antibody-staining, and ImageJ-based measurements; and retinal perfusion density (PD) and flux index in humans as assessed by OCTA.RESULTS. A number of vessel parameters were altered in ocular hypertension/glaucoma compared to healthy controls. NAM treatment improved the retinal vasculature in ocular hypertensive rats, with an increase in mean vessel area, percentage area covered by vessels, total vessel length, total junctions, and junction density as assessed by AngioTool (all P < 0.05); vessel wall integrity as assessed by VE-cadherin antibody staining was also improved (P < 0.01). In humans, as assessed by OCTA, increases in PD in the optic nerve head and macula complete image (0.7%, P = 0.04 and 1.0%, P = 0.002, respectively) in healthy controls, and an increase in the temporal quadrant of the macula (0.7%, P = 0.02) in glaucoma patients was seen after NAM treatment.CONCLUSIONS. NAM can prevent retinal vascular damage in an animal model of glaucoma. After NAM treatment, glaucoma patients and healthy controls demonstrated a small increase in retinal vessel parameters as assessed by OCTA.
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| 9. |
- Lantz, Mattias, 1971-, et al.
(författare)
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Gamma spectroscopy methodology for large amounts of environmental samples in Sweden 30 years after the Chernobyl accident
- 2020
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Ingår i: ND 2019. - : EDP Sciences. - 9782759891061
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Konferensbidrag (refereegranskat)abstract
- In a Swedish citizen science project, more than 200 elementary school classes participated in collecting fungi, soil samples, and droppings from deer and wild boar, from all over Sweden. The samples have been sent to a laboratory at Uppsala University where they are being analyzed through gamma spectroscopy with a shielded HPGe detector. The main objective is to scan the samples for 137Cs from the Chernobyl accident and compare the data with measurements from 1986, but uptake of naturally occuring radionuclides like 40K and radon daughters will also be determined. Together with the soil samples, transfer factors will be derived, and correlations for these factors will be sought for different species of fungi and soil types. The potential for correlating the results with different biological processes will also be investigated, in part through the collected animal droppings. This is a work in progress where the present status of the experimental setup and methodology are presented. Issues with the initial approach for corrections are discussed and preliminary results are presented.
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| 10. |
- Lundstrom, Dennis, et al.
(författare)
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Anisotropy in Thermal Transport Properties of Cast γ-TiAl Alloys
- 2022
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Ingår i: International Journal of Materials Research. - 1862-5282. ; 92:11, s. 1203-1212
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Tidskriftsartikel (refereegranskat)abstract
- The thermal transport properties have been determined for titanium aluminide with nominal composition Ti-48Al-2W-0.5Si (at.%), cast to cylindrical bars with different gamma/(gamma + alpha(2)) microstructures. The amount of phases and the orientation of the lamellar plates vary from the core to the rim in each of the bars. Differences in the thermal conductivity of the two phases lead to anisotropy in the thermal transport properties, but with cylindrical symmetry in the bars. A newly developed, high-precision technique, the so-called transient plane source (TPS) technique, was used to resolve the anisotropy in a wide temperature range. Typically, the conductivity increases monotonously from about 12- 14 W/m center dot K at room temperature up to about 20-22 W/m center dot K at 700 degrees C for the different materials. The anisotropy in both conductivity and diffusivity is about 15% at all temperatures, but with fundamental differences between the different materials. The anisotropy of the transport properties is explained in terms of amounts of phases and directionality of the lamellar plates.
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