| 1. |
- Andreen, Niklas, et al.
(författare)
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Mortality of COVID-19 is associated with comorbidity in patients with chronic obstructive pulmonary disease
- 2022
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Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 54:7, s. 508-513
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim of this study was to compare the outcome of coronavirus disease 2019 (COVID-19) in hospitalised patients with chronic obstructive pulmonary disease (COPD) with the outcome in matched COVID-19 patients without COPD. Methods Sixty-three COPD patients hospitalised for acute COVID-19 from March through August 2020 were retrospectively identified and 63 hospitalised COVID-19 patients without COPD were selected and matched for age, gender and month of hospital admission. Results COPD patients had a higher rate of comorbidities, especially cardiovascular disease, and a trend towards a higher 30-day mortality than control patients (35% vs. 22%). In the COPD group, high Charlson comorbidity index (p = 0.03) and previous cerebrovascular disease (p = 0.04) were associated with 30-day mortality in univariate analysis. Inhaled corticosteroids maintenance therapy was not associated with lower mortality. Conclusion COPD patients hospitalised for acute COVID-19 disease had significantly more comorbidities and a high risk of severe outcome and death within 30 days. Comorbidity, especially cardiovascular diseases, was associated with mortality among COPD patients.
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| 2. |
- Beck-Friis, Thomas, et al.
(författare)
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Outdoor Absolute Humidity Predicts the Start of Norovirus GII Epidemics
- 2023
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Ingår i: Microbiology Spectrum. - : American Society for Microbiology. - 2165-0497. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Seasonal variation of viral gastroenteritis is related to weather conditions, but the relationship with the incidence of viral gastroenteritis (GE) is not fully understood. This study examined the impact of outdoor climate factors on seasonal variation in detection rates of gastroenteritis viruses, with emphasis on norovirus. Weekly detection rates of norovirus genogroup I (GI) and II (GII), rotavirus, adenovirus, astrovirus, and sapovirus were analyzed in relation to average weekly means of meteorological parameters. Associations between rates of PCR detection of the viral GE pathogens and climate factors were investigated with generalized linear models. Low absolute humidity was correlated with increased detection of adenovirus (P = 0.007), astrovirus (P = 0.005), rotavirus (P = 0.004), norovirus GI (P = 0.001), and sapovirus (P = 0.002). In each investigated season, a drop in absolute humidity preceded the increase in norovirus GII detections. We found a correlation between declining absolute humidity and increasing norovirus GII detection rate. Absolute humidity was a better predictor of gastrointestinal virus seasonality compared to relative humidity.IMPORTANCE Viral gastroenteritis causes considerable morbidity, especially in vulnerable groups such as the elderly and chronically ill. Predicting the beginning of seasonal epidemics is important for the health care system to withstand increasing demands. In this paper we studied the association of outdoor climate factors on the detection rates of gastrointestinal viruses and the association between these factors and the onset of annual norovirus epidemics. Declining absolute humidity preceded the increase in diagnosed norovirus GII cases by approximately 1 week. These findings contribute to the understanding of norovirus epidemiology and allow health care services to install timely preventive measures and can help the public avoid transmission. Viral gastroenteritis causes considerable morbidity, especially in vulnerable groups such as the elderly and chronically ill. Predicting the beginning of seasonal epidemics is important for the health care system to withstand increasing demands.
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| 3. |
- Bergbrant, Susanna, et al.
(författare)
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Syndromic testing for respiratory pathogens but not National Early Warning Score can be used to identify viral cause in hospitalised adults with lower respiratory tract infections
- 2024
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Ingår i: INFECTIOUS DISEASES. - 2374-4235 .- 2374-4243. ; 56:7
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCommunity-acquired lower respiratory tract infection (LRTI) is a common reason for hospitalisation. Antibiotics are frequently used while diagnostic microbiological methods are underutilised in the acute setting.ObjectivesWe aimed to investigate the relative proportion of viral and bacterial infections in this patient group and explore methods for proper targeting of antimicrobial therapy.MethodsWe collected nasopharyngeal samples prospectively from adults hospitalised with LRTIs during three consecutive winter seasons (2016-2019). Syndromic nasopharyngeal testing was performed using a multiplex PCR panel including 16 viruses and four bacteria. Medical records were reviewed for clinical data.ResultsOut of 220 included patients, a viral pathogen was detected in 74 (34%), a bacterial pathogen in 63 (39%), both viral and bacterial pathogens in 49 (22%), while the aetiology remained unknown in 34 (15%) cases. The proportion of infections with an identified pathogen increased from 38% to 85% when syndromic testing was added to standard-of-care testing. Viral infections were associated with a low CRP level and absence of pulmonary infiltrates. A high National Early Warning Score did not predict bacterial infections.ConclusionsSyndromic testing by a multiplex PCR panel identified a viral infection or viral/bacterial coinfection in a majority of hospitalised adult patients with community-acquired LRTIs.
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| 4. |
- Olsson, Petter, et al.
(författare)
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HealthSWEDE : costs with sublingual immunotherapy - a Swedish questionnaire study
- 2021
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Ingår i: Allergy, Asthma & Clinical Immunology. - : BMC. - 1710-1484 .- 1710-1492. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim of this cross-sectional survey was to compare the health-economic consequences for allergic rhinitis (AR) patients treated with sublingual Immunotherapy (SLIT) in terms of direct and indirect costs with a reference population of patients receiving standard of care pharmacological therapy. Methods Primary objective was to analyse the health-economic consequences of SLIT for grass pollen allergy in Sweden vs reference group waiting for subcutaneous immunotherapy (SCIT). A questionnaire was mailed to two groups of AR patients. Results The questionnaire was distributed to 548 patients, 307 with SLIT and 241 in reference group (waiting for SCIT). Response rate was 53.8%. Mean annual costs were higher for reference patients than SLIT group; euro 3907 (SD 4268) vs euro 2084 (SD 1623) p < 0.001. Mean annual direct cost was higher for SLIT-patients, euro 1191 (SD 465) than for reference, euro 751 (SD 589) p < 0.001. Mean annual indirect costs for combined absenteeism and presenteeism were lower for patients treated with SLIT, euro 912 (SD 1530), than for reference, euro 3346 (SD 4120) p < 0.001, with presenteeism as main driver. Conclusions SLIT seems to be a cost-beneficial way to treat seasonal AR. This information might be used to guide future recommendations.
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| 5. |
- Sandberg Hanssen, Thor-Erik, et al.
(författare)
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Dissimilarities between the national cost/benefit models of road projects : Comparing appraisals in Nordic countries
- 2020
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Ingår i: Transportation research Interdisciplinary Perspectives. - : Elsevier. - 2590-1982. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- The Nordic Council has a vision to create the most integrated region globally by 2030. Nevertheless, Nordic cross-border infrastructure projects are generally developed by each nation individually. Joint Nordic infrastructure planning is thus fragmented. An example of this, as reported herein, is how road projects are assessed by the infrastructure planning authorities in Norway, Sweden, and Finland, the latter to which is included in the comparison for the first time. In each country, cost/benefit analyses (CBAs) are used. In each nation, the monetary values of changes in travel time, accidents, and environmental externalities are estimated. We then apply those values to the three national CBA models to assess an illustrative hypothetical road project. Theoretically, the models should provide similar outcomes when using a common set of parameters. Instead, we show that the choice of national model is crucial to the outcome. The Swedish model, for example, generates a higher cost of travel time than the other models irrespective of the nation from which we choose the parameters. Consequently, CBA-based assessments in the Nordic area depend strongly on the model applied and peculiarities in its coding. Finally, we discuss the policy implications of our findings for appraising national and Nordic projects.
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| 6. |
- Sansone, Martina, et al.
(författare)
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Extensive Hospital In-Ward Clustering Revealed By Molecular Characterization of Influenza A Virus Infection.
- 2020
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Ingår i: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 71:9
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Tidskriftsartikel (refereegranskat)abstract
- Nosocomial transmission of influenza A virus (InfA) infection is not fully recognized. The aim of this study was to describe the characteristics of hospitalized patients with InfA infections during an entire season and to investigate in-ward transmission at a large, acute-care hospital.During the 2016-17 season, all hospitalized patients≥18 years old with laboratory-verified (real-time polymerase chain reaction) InfA were identified. Cases were characterized according to age; sex; comorbidity; antiviral therapy; viral load, expressed as cycle threshold values; length of hospital stay; 30-day mortality; and whether the InfA infection met criteria for a health care-associated influenza A infection (HCAI). Respiratory samples positive for InfA that were collected at the same wards within 7 days were chosen for whole-genome sequencing (WGS) and a phylogenetic analysis was performed to detect clustering. For reference, concurrent InfA strains from patients with community-acquired infection were included.We identified a total of 435 InfA cases, of which 114 (26%) met the HCAI criteria. The overall 30-day mortality rate was higher among patients with HCAI (9.6% vs 4.6% among non-HCAI patients), although the difference was not statistically significant in a multivariable analysis, where age was the only independent risk factor for death (P<.05). We identified 8 closely related clusters (involving≥3 cases) and another 10 pairs of strains, supporting in-ward transmission.We found that the in-ward transmission of InfA occurs frequently and that HCAI may have severe outcomes. WGS may be used for outbreak investigations, as well as for evaluations of the effects of preventive measures.
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| 7. |
- Westin, Jonas, et al.
(författare)
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NÄRTRANS : hastighetsgränser och näringslivets nya transportflöden
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Trafikverket har under ett antal år arbetat med metoder för att studera konsekvenser av förändrade hastighetsgränser i vägnätet. I tidigare arbeten har fokus framför allt varit på effekter för personresor, såsom arbetspendling och tillgång till olika former av service. Mindre fokus har lagts på näringslivets transporter då de aktuella hastighetsjusteringarna till stor del inte bedömts ha samma påverkan på fordon med totalvikt som överstiger 3,5 ton.Samtidigt har under 2000-talet näringslivets transporter genomgått betydande förändringar. I en traditionell uppdelning av fordonsflottan antogs näringslivet använda medeltunga och tunga lastbilar medan hushåll och organisationer använde personbilar. Med en tung lastbil menas fordon som har en totalvikt som överstiger 3,5 ton. Dessa får köra högst 90 km/timmen på motorväg eller motortrafikled och 80 km/timmen på annan väg eller om lastbilen har släp. Baserat på dessa regler har konsekvenserna för näringslivet av sänkta hastighetsgränser ned till 80 km/h bedömts som små.Idag har ”en tredje kategori” av lätta lastbilar, budbilar, pickuper, servicebilar mm, med en vikt under 3,5 ton, vuxit fram, fordon som i allt större omfattning används av näringslivet och som därmed följer trafikföreskrifter, t.ex. hastighetsgränser, för personbilar. Denna kategori av fordon är bland annat vanliga hos företag och verksamheter inom t.ex. distribution, mindre bygg- och underhållsverksamhet, fastighetsskötsel, offentlig service, omsorg, hälsovård och handel.Syftet med denna rapport är att undersöka hur den växande ”tredje kategorin” av näringslivets fordon kan identifieras och urskiljas i statistiken samt hur dessa fordon hanteras i Trafikverkets nuvarande modellsystem. I rapporten undersöks och ges förslag på fortsatt metodutveckling för att analysera vilka effekter trafiksäkerhetshöjande hastighetssänkningar kan medföra för olika delar av näringslivet i en region.
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| 8. |
- Axelsson Linkowski, Weronika, et al.
(författare)
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Shifting Strategies between Generations in Sami Reindeer Husbandry : the Challenges of Maintaining Traditions while Adapting to a Changing Context
- 2020
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Ingår i: Human Ecology. - : Springer Science and Business Media LLC. - 0300-7839 .- 1572-9915. ; 48, s. 481-490
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Tidskriftsartikel (refereegranskat)abstract
- Many traditional pastoralist systems are greatly impacted by cumulative encroachments of other land users and by climate change. Understanding land degradation and the adaptive capacity of people who are dependent on the rangelands is an urgent priority for many areas in the world. In this research we explore how changing environmental conditions affect herding strategies on winter pastures and the role of indigenous and local traditional knowledge (ILK) in Sami reindeer husbandry. Our results indicate that traditional Sami reindeer herding strategies are still practiced, but that rapidly changing environmental circumstances are forcing herders into uncharted territories where these traditional strategies and the transmission of knowledge between generations may be of limited use. For example, rotational grazing is no longer possible as all pastures are being used, and changes in climate result in unpredictable weather patterns unknown to earlier generations.
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| 9. |
- Benavides, Raquel, et al.
(författare)
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The GenTree Leaf Collection : Inter- and intraspecific leaf variation in seven forest tree species in Europe
- 2021
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Ingår i: Global Ecology and Biogeography. - : John Wiley & Sons. - 1466-822X .- 1466-8238. ; 30:3, s. 590-597
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Tidskriftsartikel (refereegranskat)abstract
- Motivation Trait variation within species can reveal plastic and/or genetic responses to environmental gradients, and may indicate where local adaptation has occurred. Here, we present a dataset of rangewide variation in leaf traits from seven of the most ecologically and economically important tree species in Europe. Sample collection and trait assessment are embedded in the GenTree project (EU-Horizon 2020), which aims at characterizing the genetic and phenotypic variability of forest tree species to optimize the management and sustainable use of forest genetic resources. Our dataset captures substantial intra- and interspecific leaf phenotypic variability, and provides valuable information for studying the relationship between ecosystem functioning and trait variability of individuals, and the response and resilience of species to environmental changes. Main types of variable contained We chose morphological and chemical characters linked to trade-offs between acquisition and conservation of resources and water use, namely specific leaf area, leaf size, carbon and nitrogen content and their ratio, and the isotopic signature of stable isotope C-13 and N-15 in leaves. Spatial location and grain We surveyed between 18 and 22 populations per species, 141 in total, across Europe. Time period Leaf sampling took place between 2016 and 2017. Major taxa and level of measurement We sampled at least 25 individuals in each population, 3,569 trees in total, and measured traits in 35,755 leaves from seven European tree species, i.e. the conifers Picea abies, Pinus pinaster and Pinus sylvestris, and the broadleaves Betula pendula, Fagus sylvatica, Populus nigra and Quercus petraea. Software format The data files are in ASCII text, tab delimited, not compressed.
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| 10. |
- Ekström, Lars, 1959, et al.
(författare)
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A model for evaluation of the electric activity and oxygenation in the erector spinae muscle during isometric loading adapted for spine patients
- 2020
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Ingår i: Journal of Orthopaedic Surgery and Research. - : Springer Science and Business Media LLC. - 1749-799X. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Simultaneous measurement of electromyography (EMG) and local muscle oxygenation is proposed in an isometric loading model adjusted for patients that have undergone spinal surgery. Methods Twelve patients with degenerative lumbar spinal stenosis (DLSS) were included. They were subjected to a test protocol before and after surgery. The protocol consisted of two parts, a dynamic and an isometric Ito loading with a time frame of 60 s and accompanying rest of 120 s. The Ito test was repeated three times. EMG was measured bilaterally at the L4 level and L2 and was recorded using surface electrodes and collected (Biopac Systems Inc.). EMG signal was expressed as RMS and median frequency (MF). Muscle tissue oxygen saturation (MrSO(2)) was monitored using a near-infrared spectroscopy (NIRS) device (INVOS (R) 5100C Oxymeter). Two NIRS sensors were positioned bilaterally at the L4 level. The intensity of the leg and back pain and perceived exertion before, during, and after the test was evaluated with a visual analogue scale (VAS) and Borg RPE-scale, respectively. Results All patients were able to perform and complete the test protocol pre- and postoperatively. A consistency of lower median and range values was noted in the sensors of EMG1 (15.3 mu V, range 4.5-30.7 mu V) and EMG2 (13.6 mu V, range 4.0-46.5 mu V) that were positioned lateral to NIRS sensors at L4 compared with EMG3 (18.9 mu V, range 6.5-50.0 mu V) and EMG4 (20.4 mu V, range 7.5-49.0 mu V) at L2. Right and left side of the erector spinae exhibited a similar electrical activity behaviour over time during Ito test (60 s). Regional MrSO(2) decreased over time during loading and returned to the baseline level during recovery on both left and right side. Both low back and leg pain was significantly reduced postoperatively. Conclusion Simultaneous measurement of surface EMG and NIRS seems to be a promising tool for objective assessment of paraspinal muscle function in terms of muscular activity and local muscle oxygenation changes in response to isometric trunk extension in patients that have undergone laminectomy for spinal stenosis.
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