| 1. |
- Hagberg, Linus, et al.
(författare)
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LCA calculations on Swedish wood pellet production chains - according to the Renewable Energy Directive
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The study includes calculations of typical life cycle emissions of greenhouse gases for representative Swedish pellet production chains in accordance with the calculation rules in RED (Directive 2009/28/EC). The study also intends to analyse how the directive is applicable on solid biofuels in general and on wood pellet production in particular, and to identify such aspects of the methodology in RED that are associated with obscurities, problems or lead to misleading results compared to other life cycle analysis principles. The report includes a large number of alternative calculations to show how different facts, assumptions and methodological choices affect the results. This includes the effect of what fuels are used for drying, different transport distances, assumed fuel mix for purchased electricity, the variance in efficiency between the investigated plants as well as the effect of different interpretations of the RED methodology for greenhouse gas calculations.
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| 2. |
- Abdul-Sattar Aljabery, Firas, et al.
(författare)
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Management and outcome of muscle-invasive bladder cancer with clinical lymph node metastases. A nationwide population-based study in the bladder cancer data base Sweden (BladderBaSe)
- 2019
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Ingår i: Scandinavian journal of urology. - : Informa Healthcare. - 2168-1805 .- 2168-1813. ; 53:5, s. 332-338
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the clinical management and outcome of patients with muscle-invasive bladder cancer with clinical lymph node involvement, using longitudinal nationwide population-based data.Methods: In the Bladder Cancer Data Base Sweden (BladderBaSe), treatment and survival in patients with urinary bladder cancer clinical stage T2-T4 N + M0 diagnosed between 1997 and 2014 was investigated. Patients´ characteristics were studied in relation to TNM classification, curative or palliative treatment, cancer-specific (CSS) and overall survival (OS). Age at diagnosis was categorised as ≤60, 61-70, 71-80 and >80 years, and time periods were stratified as follows: 1997-2001, 2002-2005, 2006-2010 and 2011-2014.Results: There were 786 patients (72% males) with a median age of 71 years (interquartile range = 64-79 years). The proportion of patients with high comorbidity increased over time. Despite similar low comorbidity, curative treatment was given to 44% and to 70% of those in older (>70 years) and younger age groups, respectively. Curative treatment decreased over time, but chemotherapy and cystectomy increased to 25% during the last time period. Patients with curative treatment had better survival compared to those with palliative treatment, both regarding CSS and OS in the whole cohort and in all age groups.Conclusions: The low proportion of older patients undergoing treatment with curative intent, despite no or limited comorbidity, indicates missed chances of treatment with curative intent. The reasons for an overall decrease in curative treatment over time need to be analysed and the challenge of coping with an increasing proportion of node-positive patients with clinically significant comorbidity needs to be met.
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| 3. |
- Aljabery, Firas, et al.
(författare)
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Treatment and prognosis of bladder cancer patients with other primary cancers : A nationwide population-based study in the Bladder Cancer Data Base Sweden (BladderBaSe)
- 2020
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Ingår i: BJU International. - : Blackwell Publishing. - 1464-4096 .- 1464-410X. ; 126:5, s. 625-632
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study how patients with urinary bladder cancer (UBC) with previous or concomitant other primary cancers (OPCs) were treated, and to investigate their prognosis.Patients And Methods: Using nationwide population-based data in the Bladder Cancer Data Base Sweden (BladderBaSe), we analysed the probability of treatment with curative intent, and UBC-specific and overall survival (OS) in patients with UBC diagnosed in the period 1997-2014 with or without OPC. The analyses considered the patient's characteristics, UBC tumour stage at diagnosis, and site of OPC.Results: There were 38 689 patients, of which 9804 (25%) had OPCs. Those with synchronous OPCs more often had T2 and T3 tumours and clinically distant disease at diagnosis than those with UBC only. Patients with synchronous prostate cancer, female genital cancer and lower gastro-intestinal cancer were more often treated with curative intent than patients with UBC only. When models of survival were adjusted for age at diagnosis, marital status, education, year of diagnosis, Charlson Comorbidity Index and T-stage, UBC-specific survival was similar to patients with UBC only, but OS was lower for patients with synchronous OPC, explained mainly by deaths in OPC primaries with a bad prognosis.Conclusions: OPC is common in patients with UBC. Treatment for UBC, after or in conjunction with an OPC, should not be neglected and carries just as high a probability of success as treatment in patients with UBC only. The needs of patients with UBC and OPC, and optimisation of their treatment considering their complicated disease trajectory are important areas of research.
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| 4. |
- Bergengren, Oskar, et al.
(författare)
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Short term outcomes after robot assisted and open cystectomy- A nation-wide population-based study
- 2023
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Ingår i: Ejso. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 49:4, s. 868-874
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: We aimed to compare short term outcomes after robot assisted radical cystectomy (RARC) and open radical cystectomy (ORC) for urinary bladder cancer in a large population.Materials and methods: We included all patients without distant metastases who underwent either RARC or ORC with ileal conduit between 2011 and 2019 registered in the Bladder cancer data Base Sweden (BladderBaSe) 2.0. Primary outcome was unplanned readmissions within 90 days, and secondary out-comes within 90 days of surgery were reoperations, Clavien 3-5 complications, total days alive and out of hospital, and mortality. The analysis was carried out using multivariate regression models.Results: Out of 2905 patients, 832 were operated with RARC and 2073 with ORC. Robotic procedures were to a larger extent performed during later years, at high volume centers (47% vs 17%), more often for organ-confined disease (82% vs. 72%) and more frequently in patients with high socioeconomic status (26% vs. 21%). Patients operated with RARC were more commonly readmitted (29% vs. 25%). In multi -variable analysis RARC was associated with decreased risk of Clavien 3-5 complications (OR 0.58, 95% CI 0.47-0.72), reoperations (OR 0.53, 95% CI 0.39-0.71) and had more days alive and out of hospital (mean difference 3.7 days, 95% CI 2.4-5.0).Conclusion: This study illustrates the "real-world" effects of a gradual and nation-wide introduction of RARC. Patients operated with RARC had fewer major complications and reoperations but were more frequently readmitted compared to ORC. The observed differences were largely due to more wound related complications among patients treated with ORC.(c) 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 5. |
- Bergström, Gunnar, et al.
(författare)
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Does sickness presenteeism have an impact on future general health?
- 2009
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Ingår i: International Archives of Occupational and Environmental Health. - Berlin : Springer. - 0340-0131 .- 1432-1246. ; 82:10, s. 1179-1190
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The primary aim of this prospective study was to investigate whether working despite illness, so called "sickness presenteeism", has an impact on the future general health of two different working populations during a follow-up period of 3 years.METHODS: The study was based on two bodies of data collected at a number of Swedish workplaces from 1999 to 2003. The first material comprised 6,901 employees from the public sector and the second 2,862 subjects from the private sector. A comprehensive survey was issued three times: at baseline, after 18 months and after 3 years. Apart from the explanatory variable sickness presenteeism, several potential confounders were considered. The outcome variable was good/excellent versus fair/poor self-reported health.RESULTS: Sickness presenteeism at baseline was consistently found to heighten the risk of fair/poor health at both the 18-month and 3-year follow ups even after adjusting for the detected confounders.CONCLUSIONS: To the best of the authors' knowledge, this study is the first to show that sickness presenteeism appears to be an independent risk factor for future fair/poor general health.
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| 6. |
- Bobjer, Johannes, et al.
(författare)
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A population-based study on the effect of a routine second-look resection on survival in primary stage T1 bladder cancer
- 2021
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 55:2, s. 108-115
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Tidskriftsartikel (refereegranskat)abstract
- Objective To assess the value of second-look resection (SLR) in stage T1 bladder cancer (BCa) with respect to progression-free survival (PFS), and also the secondary outcomes recurrence-free survival (RFS), bladder-cancer-specific survival (CSS), and cystectomy-free survival (CFS). Patients and methods The study included 2456 patients diagnosed with stage T1 BCa 2004-2009 with 5-yr follow-up registration in the nationwide Bladder Cancer Data Base Sweden (BladderBaSe). PFS, RFS, CSS, and CFS were evaluated in stage T1 BCa patients with or without routine SLR, using univariate and multivariable Cox regression with adjustment for multiple confounders (age, gender, tumour grade, intravesical treatment, hospital volume, comorbidity, and educational level). Results SLR was performed in 642 (26%) individuals, and more frequently on patients who were aged < 75 yr, had grade 3 tumours, and had less comorbidity. There was no association between SLR and PFS (hazard ratio [HR] 1.1, confidence interval [CI] 0.85-1.3), RFS (HR 1.0, CI 0.90-1.2), CFS (HR 1.2, CI 0.95-1.5) or CSS (HR 1.1, CI 0.89-1.4). Conclusions We found similar survival outcomes in patients with and patients without SLR, but our study is likely affected by selection mechanisms. A randomised study defining the role of SLR in stage T1 BCa would be highly relevant to guide current praxis.
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| 7. |
- Bobjer, Johannes, et al.
(författare)
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Bladder cancer recurrence in papillary urothelial neoplasm of low malignant potential (PUNLMP) compared to G1 WHO 1999: a population-based study
- 2022
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 56:1, s. 14-18
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Tidskriftsartikel (refereegranskat)abstract
- Objective Papillary urothelial neoplasm of low malignant potential (PUNLMP) and stage TaG1 non-muscle invasive bladder cancer (NMIBC) represent separate categories in current WHO 1999 grade definitions. Similarly, PUNLMP and Ta low-grade are separate entities in the WHO 2004/2016 grading system. However, this classification is currently questioned by reports showing a similar risk of recurrence and progression for both categories. Patients and methods In this population-based study, risk estimates were evaluated in patients diagnosed with PUNLMP (n = 135) or stage TaG1 (n = 2176) NMIBC 2004-2008 with 5-year follow-up registration in the nation-wide Bladder Cancer Data Base Sweden (BladderBaSe). The risk of recurrence was assessed using multivariable Cox regression with adjustment for multiple confounders (age, gender, marital status, comorbidity, educational level, and health care region). Results At five years, 28/135 (21%) patients with PUNLMP and 922/2176 (42%) with TaG1 had local recurrence. The corresponding progression rates were 0.7% (1/135) and 4.0% (86/2176), respectively. A higher relative risk of recurrence was detected in patients with TaG1 tumours compared to PUNLMP (Hazard Ratio 1.6, 95% CI 1.2-2.0) at 5-year follow-up, while progression events were too few to compare. Conclusions The difference in risk of recurrence between primary stage TaG1 and PUNLMP stands in contrast to the recently adapted notion that treatment and follow-up strategies can be merged into one low-risk group of NMIBC.
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| 8. |
- Hagberg, Daniel P., et al.
(författare)
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A novel organic chromophore for dye-sensitized nanostructured solar cells
- 2006
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Ingår i: Chemical Communications. - : Royal Society of Chemistry (RSC). - 1359-7345 .- 1364-548X. ; :21, s. 2245-2247
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Tidskriftsartikel (refereegranskat)abstract
- A novel and efficient polyene-diphenylaniline dye for dye-sensitized solar cells has been synthesized. The dye has a short synthesis route and is readily adsorbed on TiO2 under a variety of dye-bath conditions. The overall solar-to-energy conversion efficiency is over 5% in the preliminary tests, in comparison with the conventional N719 dye which gives 6% under the same conditions. The dye is designed for future use also in solid state devices, with triarylamine based hole conductors.
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| 9. |
- Hagberg, Martin, et al.
(författare)
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Miljövärdering av energilösningar i byggnader (etapp 2)
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det ställs allt högre krav på byggnaders energiprestanda och i takt med detta ökar efterfrågan på miljövärdering av byggnader och deras energilösningar. I detta projekt vidareutvecklas en metodik för värdering av byggnaders energianvändning ur miljösynpunkt (metodens grundversion utvecklades i ”etapp 1” av projektet). Vi benämner metoden ”Tidstegsmetoden”. Tidstegsmetoden avser att analysera miljökonsekvenserna av byggnaders energilösningar. Metoden ska visa på effekterna av olika val och kunna ge underlag till beslut vid planering av renovering och nybyggnation. Därför är utgångspunkten att analysera systemkonsekvenser av förändrad energianvändning. Produktion av el-, fjärrvärme-, och fjärrkyla kan vara förknippade med stora skillnader i miljöpåverkan beroende på vilken tid som avses; t.ex., om det är sommar eller vinter, om det är nutid eller framtid. För att på ett representativt sätt kunna bedöma miljökonsekvensen av en förändrad energianvändning i en byggnad är därför tidsaspekten central. Den presenterade metoden hanterar därför två olika tidsdimensioner. Den ena avser den framtida utvecklingen av energisystemet – från nu och ca 20 år framåt i tiden. Den andra dimensionen är tidsupplösning över året, som avser att fånga variationer över säsonger, månader, dygn och timmar. Med konsekvens- och tidsperspektivet i fokus, inkluderar tillvägagångssättet: beräkning av byggnadens energianvändning för aktuella energiåtgärder; bestämning av miljövärdesfaktorer för en förändrad användning av bränslen, fjärrvärme, fjärrkyla och el; och beräkning miljöpåverkan av de aktuella energiåtgärderna baserat på de beräknade förändringarna i energianvändning och de fastställda miljövärdesfaktorerna. För att bättre täcka in de många osäkerheter som är förknippade med en framåtblickande analys kopplas beräkningarna till ett antal kontrasterande scenarioförutsättningar. Detta ger ett resultatspann för miljöpåverkan av de studerade energilösningarna. För att exemplifiera metoden presenteras i rapporten ett antal kvantitativa exempel. I dessa beräknas klimatpåverkan (utsläpp av CO2e) av olika energieffektiviseringsåtgärder i ett flerfamiljshus byggt under miljonprogrammet. Den principiella beräkningsgången går också att applicera på andra miljöaspekter såväl som för andra typer av byggnader och energiåtgärder. I rapporten görs beräkningarna för tre olika typer av fjärrvärmenät, samt för olika kontrasterande scenarier, bland annat kopplat till elsystemets utveckling. Sammantaget har projektet resulterat i en metod som länkar ihop tidsupplöst miljövärdering för fjärrvärme, fjärrkyla, och el med ett framåtblickande konsekvensperspektiv. Scenarioangreppssättet bidrar till att hantera in en del av de osäkerheter som är förknippade med framtidsstudier. Den utvecklade metoden kan i fortsatt tillämpning bidra till miljömässigt mer välgrundade beslut vid renovering och nybyggnation av fastigheter.
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| 10. |
- Hellström, Vivan, et al.
(författare)
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Malignancies in transplanted patients : Multidisciplinary evaluation and switch to mTOR inhibitors after kidney transplantation - experiences from a prospective, clinical, observational study
- 2016
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Ingår i: Acta Oncologica. - Uppsala : Acta Universitatis Upsaliensis. - 0284-186X .- 1651-226X. ; 55:6, s. 774-781
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Tidskriftsartikel (refereegranskat)abstract
- Background Solid organ transplant recipients are at increased risk of developing malignancies. The objective of this prospective, observational, one-armed study was to study the feasibility to add a mammalian target of rapamycin (mTOR) inhibitor to the immunosuppressive regimen in transplanted patients with post-transplant malignancies. During the trial the need to improve identification of post-transplant malignancies and to reassure adequate oncological treatment of these patients became evident. Multidisciplinary team (MDT) evaluation of oncological and immunosuppressive treatments was implemented for all patients with malignancies after renal or combined renal and pancreas transplantation because of the trial.Material and methods At Uppsala University Hospital, Sweden, a MDT consisting of transplant surgeons, nephrologists, oncologists and dermatologists evaluated 120 renal or combined renal and pancreas-transplanted recipients diagnosed with malignancies from September 2006 to July 2012. To identify all malignancies, the population was linked to the Regional Tumor Registry (RTR). We recorded to which extent a switch to mTOR inhibitors was possible and how often the originally planned oncological managements were adjusted. All patients were followed for three years. (ClinicalTrials.gov: NCT02241564).Results In 76 of 120 patients (63%) a switch to mTOR inhibitors was possible. Immunosuppression was interrupted in seven patients (6%), reduced in three patients (2%) and remained unchanged in 34 of 120 patients (28%). Identification of post-transplant malignancies increased significantly after linkage to RTR (p=0.015). The initially recommended oncological treatment was adjusted in 23 of 44 patients (52%) with solid or hematological malignancies; 36 of these patients (82%) were treated according to national guidelines.Conclusion In two thirds of the patients the immunosuppressive treatment could be changed to an mTOR inhibitor with anti-tumor effects in transplanted patients with post-transplant malignancies. The use of regional tumor registers considerably improved the identification of patients with post-transplant malignancies indicating that post-transplant malignancies might be timely underreported in transplant registers.
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