| 1. |
- Akerstrom, Finn, et al.
(författare)
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Association between catheter ablation of atrial fibrillation and mortality or stroke
- 2024
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Ingår i: Heart. - : BMJ PUBLISHING GROUP. - 1355-6037 .- 1468-201X. ; 110, s. 163-169
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Tidskriftsartikel (refereegranskat)abstract
- Objective Catheter ablation of atrial fibrillation effectively reduces symptomatic burden. However, its long-term effect on mortality and stroke is unclear. We investigated if patients with atrial fibrillation who undergo catheter ablation have lower risk for all-cause mortality or stroke than patients who are managed medically. Methods We retrospectively included 5628 consecutive patients who underwent first-time catheter ablation for atrial fibrillation between 2008 and 2018 at three major Swedish electrophysiology units. Control individuals with an atrial fibrillation diagnosis but without previous stroke were selected from the Swedish National Patient Register, resulting in a control group of 48 676 patients. Propensity score matching was performed to produce two cohorts of equal size (n=3955) with similar baseline characteristics. The primary endpoint was a composite of all-cause mortality or stroke. Results Patients who underwent catheter ablation were healthier (mean CHA(2)DS(2)-VASc score 1.4 +/- 1.4 vs 1.6 +/- 1.5, p<0.001), had a higher median income (288 vs 212 1000 Swedish krona [KSEK]/year, p<0.001) and had more frequently received university education (45.1% vs 28.9%, p<0.001). Mean follow-up was 4.5 +/- 2.8 years. After propensity score matching, catheter ablation was associated with lower risk for the combined primary endpoint (HR 0.58, 95% CI 0.48 to 0.69). The result was mainly driven by a decrease in all-cause mortality (HR 0.51, 95% CI 0.41 to 0.63), with stroke reduction showing a trend in favour of catheter ablation (HR 0.75, 95% CI 0.53 to 1.07). Conclusions Catheter ablation of atrial fibrillation was associated with a reduction in the primary endpoint of all-cause mortality or stroke. This result was driven by a marked reduction in all-cause mortality.
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| 2. |
- Naucler, Pontus, et al.
(författare)
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HAI-Proactive : Development of an Automated Surveillance System for Healthcare-Associated Infections in Sweden
- 2020
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Ingår i: Infection control and hospital epidemiology. - : Cambridge University Press. - 0899-823X .- 1559-6834. ; 41, s. S39-S39
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Healthcare-associated infection (HAI) surveillance is essential for most infection prevention programs and continuous epidemiological data can be used to inform healthcare personal, allocate resources, and evaluate interventions to prevent HAIs. Many HAI surveillance systems today are based on time-consuming and resource-intensive manual reviews of patient records. The objective of HAI-proactive, a Swedish triple-helix innovation project, is to develop and implement a fully automated HAI surveillance system based on electronic health record data. Furthermore, the project aims to develop machine-learning–based screening algorithms for early prediction of HAI at the individual patient level. Methods: The project is performed with support from Sweden’s Innovation Agency in collaboration among academic, health, and industry partners. Development of rule-based and machine-learning algorithms is performed within a research database, which consists of all electronic health record data from patients admitted to the Karolinska University Hospital. Natural language processing is used for processing free-text medical notes. To validate algorithm performance, manual annotation was performed based on international HAI definitions from the European Center for Disease Prevention and Control, Centers for Disease Control and Prevention, and Sepsis-3 criteria. Currently, the project is building a platform for real-time data access to implement the algorithms within Region Stockholm. Results: The project has developed a rule-based surveillance algorithm for sepsis that continuously monitors patients admitted to the hospital, with a sensitivity of 0.89 (95% CI, 0.85–0.93), a specificity of 0.99 (0.98–0.99), a positive predictive value of 0.88 (0.83–0.93), and a negative predictive value of 0.99 (0.98–0.99). The healthcare-associated urinary tract infection surveillance algorithm, which is based on free-text analysis and negations to define symptoms, had a sensitivity of 0.73 (0.66–0.80) and a positive predictive value of 0.68 (0.61–0.75). The sensitivity and positive predictive value of an algorithm based on significant bacterial growth in urine culture only was 0.99 (0.97–1.00) and 0.39 (0.34–0.44), respectively. The surveillance system detected differences in incidences between hospital wards and over time. Development of surveillance algorithms for pneumonia, catheter-related infections and Clostridioides difficile infections, as well as machine-learning–based models for early prediction, is ongoing. We intend to present results from all algorithms. Conclusions: With access to electronic health record data, we have shown that it is feasible to develop a fully automated HAI surveillance system based on algorithms using both structured data and free text for the main healthcare-associated infections.Funding: Sweden’s Innovation Agency and Stockholm County CouncilDisclosures: None
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| 3. |
- Berhin, Johan, et al.
(författare)
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”Den svenska skogen är underutnyttjad”
- 2023
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Ingår i: Svenska Dagbladet Debatt. - 1101-2412.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Forskning och nya metoder för skogsbruk visar att svensk skog kan binda mycket mer koldioxid än i dag och samtidigt ge virke med högre värden. Vi menar att svensk skog är underutnyttjad, skriver flera debattörer.
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| 4. |
- Brown, Jamie Sutherland, et al.
(författare)
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Agreement Between Clinical Examination and Magnetic Resonance Imaging in Acute Knee Trauma With Hemarthrosis
- 2022
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Ingår i: Clinical Journal of Sport Medicine. - 1050-642X. ; 32:4, s. 401-406
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Tidskriftsartikel (refereegranskat)abstract
- Objective:Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner.Design:Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression.Setting:Helsingborg hospital.Patients:Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma.Interventions:Clinical examination and MRI.Main outcome measures:agreement between clinical examination and findings from MRI. We considered the radiologist's report as the gold standard.Results:Median time (25th, 75th percentile) from injury to clinical examination was 2 (1, 7) days, and from injury to imaging was 8 (5, 15) days. The overall sensitivity and specificity of clinical examination versus MRI for major ligament injury or lateral patella dislocation (LPD) were 70% [95% confidence interval 67-73) and 66% (61-72), respectively. Orthopedic subspecialist knee had the highest agreement with anterior cruciate ligament rupture (adjusted odds ratios were 1.7 (95% confidence interval 1.2-2.3), 1.9 (1.2-3.0) and 5.9 (3.7-9.5) for orthopedic trainees, orthopedic subspecialists other, and orthopedic subspecialist knee, respectively]. For other ligament injuries and LPD, we did not find statistically significant differences.Conclusions:Clinical diagnosis after acute knee injury is relatively unreliable versus MRI findings even when performed by orthopedic specialists. However, the agreement is improved when the examination is performed by an orthopedic knee subspecialist.
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| 5. |
- Brown, Jamie S., et al.
(författare)
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Clinical, patient-reported, radiographic and magnetic resonance imaging findings 11 years after acute posterior cruciate ligament injury treated non-surgically
- 2023
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Ingår i: BMC Musculoskeletal Disorders. - 1471-2474. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term consequences of posterior cruciate ligament (PCL) injury such as persistent posterior tibial translation and risk of osteoarthritis development are unclear. Additionally, little data is available describing the natural history of structural morphology of the ruptured PCL. The purpose of the study was to determine the long-term outcome after non-operatively treated PCL injury. Methods: Over 6-years, all acute knee injuries were documented by subacute MRI (median 8 days [5–15, 25th − 75th percentile] from injury to MRI). Twenty-six patients with acute PCL injury were identified of whom 18 (69%) participated in the long-term follow-up after 11 years. Follow-up included radiographic posterior tibial translation (RPTT) determined using the Puddu axial radiograph. weight-bearing knee radiographs, MRI and KOOS (Knee injury and Osteoarthritis Outcome Score). Results: On subacute MRI, 11 knees displayed total and 7 partial ruptures. At 11 (SD 1.9) years, the median RPTT was 3.7 mm (1.5–6.3, 25th − 75th percentile). Seven knees displayed radiographic osteoarthritis approximating Kellgren-Lawrence grade ≥ 2. All follow-up MRIs displayed continuity of the PCL. Patients with more severe RPTT (> 3.7 mm), had worse scores in the KOOS subscales for symptoms (mean difference 14.5, 95% CI 7–22), sport/recreation (30, 95% CI 0–65) and quality of life (25, 95% CI 13–57) than those with less severe RPTT (≤ 3.7 mm). This was also the case for the KOOS4 (22, 95% CI 9–34). Conclusion: Acute PCL injuries treated non-surgically display a high degree of PCL continuity on MR images 11 years after injury. However, there is a large variation of posterior tibial translation with higher values being associated with poorer patient-reported outcomes.
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| 6. |
- Brown, Jamie S., et al.
(författare)
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Clinical versus MRI grading of the medial collateral ligament in acute knee injury
- 2024
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Ingår i: Research in Sports Medicine. - : Informa UK Limited. - 1543-8627 .- 1543-8635. ; 32:1, s. 12-16
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Tidskriftsartikel (refereegranskat)abstract
- Sensitivity, specificity, and agreement between clinical and magnetic resonance imaging (MRI) gradings of the medial collateral ligament (MCL) after acute knee injury were evaluated in 362 patients. Ninety-seven per cent were injured during sports/recreation. Sensitivity and specificity of MRI for grade II or III MCL injury was 68% (95% CI 58–77%) and 90% (95% CI 86–93%), respectively. Weighted Kappa analysis showed moderate agreement between clinical and MRI grading (0.56 [95% CI 0.48–0.65]). Findings were similar for patients with and without concomitant cruciate ligament rupture (0.57 [95% CI 0.48–0.66] and 0.55 [95% CI 0.35–0.75], respectively) and for specialists in orthopaedics and knee sub-specialists (0.55 [95% CI 0.39–0.70] and 0.57 [95% CI 0.47–0.67], respectively). Agreement between clinical and MRI grading of MCL injuries by orthopaedic specialists in a general hospital is at least moderate regardless of the presence of cruciate ligament injury.
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| 7. |
- Côté, Marianne, et al.
(författare)
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Towards modeling data-poor lakes at the regional scale using parameters from data-rich lakes and relationships to lake characteristics
- 2023
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Ingår i: Inland Waters. - : Taylor & Francis. - 2044-2041 .- 2044-205X. ; 13:3, s. 388-401
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Tidskriftsartikel (refereegranskat)abstract
- Lakes pivotal for recreation and economically relevant activities are often remote and not well studied, which hinders the application of predictive lake models for their management. Here, we provide an approach to simulate—by means of the process-oriented model MyLake—water temperature, ice cover duration, dissolved oxygen, and light attenuation in 198 data-poor lakes based on parameters obtained for a subgroup of 12 data-rich lakes and morphometric data. Specifically, the model is first calibrated using a genetic algorithm on well-studied lakes. Simple relationships between the fitted parameters and lake-catchment morphometric properties are then derived, and the results of simulations using fitted and derived parameters are compared. The loss in goodness-of-fit, expressed as root mean square error (RMSE) incurred by using estimated rather than calibrated parameters, is 0.17 °C for water temperature and 0.82 mg L−1 for dissolved oxygen. These general relationships are then used to provide the model parameters for 198 data-poor lakes distributed throughout Sweden and to model these lakes. Overall, this proof of concept allows simulating lakes selected based on their relevance for lake management rather than based on the availability of extensive field datasets.
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| 8. |
- Curry, Amanda
(författare)
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Management Accounting Above and Under Ground : Field Studies of Operations Managers’ Everyday Work
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis concerns operations managers who are required to adhere to both management accounting and operational concerns in their everyday operational work. The question addressed in this thesis is how management accounting is implicated in the everyday operational work of operations managers and their team members in production environments. The purpose is to explore management accounting practices in the everyday work of operations managers and their team members in production environments, and to theorize about their practices at the intersection of management accounting and operations. The research process drew upon ethnographic ideas and included travels back and forth between theory and practice at a mining company. This thesis shows that operations managers use management accounting in an analytical manner when they draw upon management accounting frames of reference to organize and mobilize action in their everyday operational work. An analytical use of management accounting suggests that management accounting extends beyond accounting departments and meeting rooms at operational levels and reaches out to the shop-floor and the mines. In such settings, operations managers are found doing accounting when they alternate between management accounting and operational frames of reference to interpret, construct and talk accounting in their everyday operational work. Management accounting enables operations managers to make sense of operational situations, and to gain and exert agency in their operational work. The results indicate that management accounting becomes a ‘way of doing things’ in everyday operational work via mimetic mechanisms. At times, operations managers are required to abide by management accounting in their everyday operational work via coercive mechanisms. The first conclusion is that management accounting is implicated in the everyday operational work of operations managers and their team members through its presence as a frame of reference. Operations managers do not always need to rely on accounting artefacts to mobilize action. Rather, they can rely on their developed management accounting knowledge. The second conclusion is that management accounting is implicated in the everyday work of operations managers and their team members through its presence as a practice. Management accounting influences operational routines and activities, which enables operations managers and their team members to handle the intersection between management accounting and operations by developing ways of practicing management accounting in everyday operational work. One contribution to the accounting practice literature is presenting how operations managers are shown to engage in management accounting, thereby making it a practice in their everyday work. Another contribution to the literature on the intersection between management accounting and operations is showing that operations managers gain agency via management accounting in their everyday work, which helps them navigate between management accounting and operational concerns.
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| 9. |
- Englund, Göran, 1957-, et al.
(författare)
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Holocene extinctions of a top predator : effects of time, habitat area and habitat subdivision
- 2020
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Ingår i: Journal of Animal Ecology. - : John Wiley & Sons. - 0021-8790 .- 1365-2656. ; 89:5, s. 1202-1215
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Tidskriftsartikel (refereegranskat)abstract
- Loss of habitat and changes in the spatial configuration of habitats are major drivers of species extinctions, but the responses to these drivers differ between organisms. To advance theory on how extinction risk from different types of habitat alteration relates to species-specific traits, there is a need for studies of the long-term extinction dynamic of individual species. The goal of this study was to quantify how habitat area and the spatial configuration of habitats affect extinction rate of an aquatic top predator, the northern pike Esox lucius L. We recorded the presence/absence of northern pike in 398 isolated habitat fragments, each one consisting of a number of interconnected lakes. Time since isolation of the habitat fragments, caused by cut-off from the main dispersal source in the Baltic Sea, varied between 0 and 10,000 years. Using survival regression, we analysed how pike population survival was affected by time since isolation, habitat size and habitat subdivision. The approach builds on the assumptions that pike colonized all fragments before isolation and that current absences result from extinctions. We verified these assumptions by testing (a) if pike was present in the region throughout the entire time period when the lakes formed and (b) if pike typically colonize lakes that are formed today. We also addressed the likelihood that unrecorded anthropogenic introductions could bias our estimates of extinction rate. Our results supported the interpretation that current patterns of presence/absence in our study system are shaped by extinctions. Further, we found that time since isolation and fragment area had strong effects on pike population survival. In contrast, spatial habitat subdivision (i.e. if a fragment contained few large lakes or many small lakes) and other environmental covariates describing climate and productivity were unrelated to pike survival. Over all, extinction rate was high in young fragments and decreased sharply with increasing fragment age. Our study demonstrates how the link between extinction rate and habitat size and spatial structure can be quantified. More similar studies may help us find generalizations that can guide management of habitat size and connectivity.
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| 10. |
- Englund, Johanna, 1988, et al.
(författare)
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Deactivation of a Vanadium-Based SCR Catalyst Used in a Biogas-Powered Euro VI Heavy-Duty Engine Installation
- 2020
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Ingår i: Catalysts. - : MDPI AG. - 2073-4344. ; 10:5
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Tidskriftsartikel (refereegranskat)abstract
- We have investigated how the exhaust gases from a heavy-duty Euro VI engine, powered with biogas impact a vanadium-based selective catalytic reduction (SCR) catalyst in terms of performance. A full Euro VI emission control system was used and the accumulation of catalyst poisons from the combustion was investigated for the up-stream particulate filter as well as the SCR catalyst. The NO(x)reduction performance in terms of standard, fast and NO2-rich SCR was evaluated before and after exposure to exhaust from a biogas-powered engine for 900 h. The SCR catalyst retains a significant part of its activity towards NO(x)reduction after exposure to biogas exhaust, likely due to capture of catalyst poisons on the up-stream components where the deactivation of the oxidation catalyst is especially profound. At lower temperatures some deactivation of the first part of the SCR catalyst was observed which could be explained by a considerably higher surface V4+/V(5+)ratio for this sample compared to the other samples. The higher value indicates that the reoxidation of V(4+)to V(5+)is partially hindered, blocking the redox cycle for parts of the active sites.
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| 11. |
- Englund, Simon, et al.
(författare)
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Predictors of patient-reported fatigue symptom severity in a nationwide multiple sclerosis cohort
- 2023
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Ingår i: Multiple Sclerosis and Related Disorders. - : Elsevier. - 2211-0348 .- 2211-0356. ; 70
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fatigue is a debilitating symptom of multiple sclerosis (MS), but its relation to sociodemographic and disease-related characteristics has not been investigated in larger studies. The objectives of this study were to evaluate predictors of self-reported fatigue in a Swedish nationwide register-based MS cohort.METHODS: Using a repeated cross-sectional design, we included 2,165 persons with relapsing- remitting and secondary progressive MS with one or multiple Fatigue Scale for Motor and Cognitive Functions (FSMC) scores, which was modelled using multivariable linear regressions for multiple predictors.RESULTS: Only associations to expanded disability status scale (EDSS) and Symbol Digit Modalities Test (SDMT) were considered clinically meaningful among MS-associated characteristics in our main model; compared to mild disability (EDSS 0-2.5), those with severe disability (EDSS ≥6) scored 17.6 (95% CI 13.1-22.2) FSMC points higher, while the difference was 10.7 (95% CI 8.0-13.4) points for the highest and lowest quartiles of SDMT. Differences between highest and lowest quartiles of health-related quality of life (HRQoL) instruments were even greater and considered clinically meaningful; EuroQoL Visual Analogue Scale (EQ-VAS) 31.9 (95% CI 29.9-33.8), Multiple Sclerosis Impact Scale (MSIS-29) psychological component 35.6 (95% CI 33.8-37.4) and MSIS-29 physical component 45.5 (95% CI 43.7-47.4).CONCLUSION: Higher self-reported fatigue is associated with higher disability level and worse cognitive processing speed, while associations to other MS-associated characteristics including MS type, line of disease modifying therapy (DMT), MS duration, relapse and new cerebral lesions are weak. Furthermore, we found a strong correlation between high fatigue rating and lower ratings on health-related quality of life instruments.
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| 12. |
- Englund-Ögge, Linda, et al.
(författare)
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Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
- 2024
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Ingår i: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - 0001-6349 .- 1600-0412. ; 103:7, s. 1426-1436
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionWomen with type 1 diabetes have an increased risk of preeclampsia (PE), but it is not fully understood if degree of glycemic control is associated with this risk. The aim of this study was to assess glycemic control during pregnancy analyzed by continuous glucose monitoring (CGM) in women with and without PE and to investigate if glycemic control is associated with increased risk of PE.Material and MethodsA total of 120 pregnant Swedish women with type 1 diabetes using CGM were included. Background factors and pregnancy outcomes were collected from medical records. CGM data were collected via the internet-based platform Diasend. Mean glucose, standard deviation of mean glucose, percentage of time in target, time below target, and time above target were presented for each trimester in women who did or did not develop PE. Associations between CGM-derived metrics and PE were analyzed with logistic regression and adjusted for confounders.ResultsTwenty-two women (18.3%) developed PE. There were no significant differences in maternal characteristics between women with and without PE. Glycemic control improved in each trimester but was suboptimal in both groups. Time in target increased from 59% in the non-PE group and 54% in the PE group in the first trimester to 65% in both groups in the third trimester. There were no significant associations between glycemic control and PE after adjustment for confounders.ConclusionsDegree of glycemic control during pregnancy assessed by CGM was not associated with development of PE in women with type 1 diabetes. However, more research is needed to understand the role of glycemic control in relation to development of PE. This study showed that women with diabetes improved their glycemic control during pregnancy; however, there were no significant differences in glycemic control in women developing preeclampsia compared to women who did not develop preeclampsia. Larger studies are needed.image
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| 13. |
- Isacsson, Anders, et al.
(författare)
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Incidence and concomitant chondral injuries in a consecutive cohort of primary traumatic patellar dislocations examined with sub-acute MRI
- 2023
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 0341-2695 .- 1432-5195. ; 47:4, s. 973-981
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To present age- and sex-specific cumulative annual incidences of primary traumatic lateral patellar dislocation (LPD) and to detail patient characteristics and concomitant chondral injuries including osteochondral fractures, as visualized on magnetic resonance imaging (MRI), in a large consecutive cohort of knee-injured individuals. Methods: Data on primary traumatic lateral patellar dislocations were collected from a large consecutive cohort of knee injuries examined with sub-acute MRI in a single centre with a well-defined catchment area. Annual incidences for different age-groups in relation to gender were calculated together with the risk of concomitant chondral and osteochondral injury, during sports and in general. Results: A total of 184 primary patellar dislocations were identified in the cohort of 1145 acute knee injuries (n=175) and surgical records (n=9). Knee MRI was performed within a median of six days of injury. Median age of patients with primary LPD was 16 years (interquartile range, 14–21; range, 9–47) and 41% were females. Males were significantly older than females at the time of injury (median age 17 vs. 15, P = 0.021) and sustained their primary LPD during sports more often than females (65 vs. 40%, P < 0.001). Primary LPD occurred most frequently at the age of 13 to 15 years where the annual incidence was 125 (95% CI, 96–160) per 100,000 persons. The overall annual incidence of primary LPD was 14 (95% CI, 12–16) per 100,000 persons, with a predominance of males versus females (17 vs. 11, P = 0.01). Concomitant lesions to joint surfaces were displayed on MRI or during surgery in 75 (43%) knees. Osteochondral fractures were seen in 32 knees (18%). We found no statistically significant difference in the risk of osteochondral fracture between those injured during sports or during leisure activity (14 vs. 24%, P = 0.08). Conclusions: The annual incidence of first-time patellar dislocation was found to be 14 per 100,000 individuals with the highest incidence found among those aged 13–15 years. Primary LPD was more common among males and was sustained during sports activity in 55% of the cases. Associated injuries to the chondral surfaces should be expected in 43% of knees with primary LPD where 18% represent osteochondral fractures.
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| 14. |
- Juma, Ibrahim, et al.
(författare)
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Polyphenolic Content and Radical Scavenging Activities of the Peel, Pulp and Seed of Avocado (Persea americana Mill.) Grown in Tanzania
- 2023
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Ingår i: Tanzania Journal of Science. - 0856-1761 .- 2507-7961. ; 49, s. 230-239
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Tidskriftsartikel (refereegranskat)abstract
- Avocado is a healthy fruit and the consumption is continuously growing worldwide. The fruit contains polyphenolic compounds with antioxidant effects. Globally, research has been devoted to exploring the fruit quality, especially compounds with antioxidant effects, from different avocado-growing sites. However, the fruit quality of the Tanzanian avocado has so far not been investigated. In this study, the contents of polyphenols in peel, pulp and seed of avocados sampled in south-western Tanzania are described. The levels of total polyphenolic and flavonoid contents were measured, and antioxidant activity was evaluated using a 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. The total polyphenolic content was highest in the seed and lowest in the peel (424 and 200 mg GAE/100 g DW, respectively). As for the total flavonoid content, the pulp had the highest value of 36.98 mg RE/100 g DW, while the seed had the lowest value of 32.54 mg RE/100 g DW. The overall average half maximal effective concentration (EC50) values in decreasing order, corresponding to an increasing antiradical activity, were 4.90 (peel), 3.63 (seed) and 3.24 µg/mL (pulp). The seed and peel possessed high levels of total polyphenolic and flavonoid content, thus demonstrating substantial antioxidant capacity. Seed and peel can potentially be processed and included in the diet to provide inexpensive antioxidant ingredients of natural origin. Consumption of the seed will not only improve human health but also reduce the environmental pollution, as many thousand tonnes of avocado seeds are produced in Tanzania per year; a huge amount currently remains as waste.
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| 15. |
- Jönsson, Daniel, 1984-, et al.
(författare)
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Inviwo - A Visualization System with Usage Abstraction Levels
- 2020
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Ingår i: IEEE Transactions on Visualization and Computer Graphics. - : IEEE. - 1077-2626 .- 1941-0506. ; 26:11, s. 3241-3254
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Tidskriftsartikel (refereegranskat)abstract
- The complexity of todays visualization applications demands specific visualization systems tailored for the development of these applications. Frequently, such systems utilize levels of abstraction to improve the application development process, for insta
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| 16. |
- Kjölhede, Karin, et al.
(författare)
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Glycemic, maternal and neonatal outcomes in women with type 1 diabetes using continuous glucose monitoring during pregnancy – Pump vs multiple daily injections, a secondary analysis of an observational cohort study
- 2021
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 100:5, s. 927-933
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Continuous glucose monitoring (CGM) provides detailed information about glucose level fluctuations over time. The method is increasingly being used in pregnant women with type 1 diabetes. However, only one previous study compared CGM results related to pregnancy outcomes in women using insulin pumps with those administering multiple daily injections (MDI). We performed a secondary analysis of CGM metrics from an observational cohort of pregnant women with type 1 diabetes and compared insulin pump and MDI therapies in relation to maternal and neonatal outcomes. Material and methods: The study included 185 pregnant Swedish women with type 1 diabetes undergoing CGM throughout pregnancy. Women were divided according to insulin administration mode, ie MDI (n = 131) or pump (n = 54). A total of 91 women used real-time CGM and 94 women used intermittently viewed CGM. Maternal demographics and maternal and neonatal outcome data were collected from medical records. CGM data were analyzed according to predefined glycemic indices: mean glucose; standard deviation; percentage of time within, below and above glucose target range; mean amplitude of glycemic excursion; high and low glucose indices; and coefficient variation in percent. Associations between insulin administration mode and CGM data, on the one hand, and maternal and neonatal outcomes, on the other, were analyzed with analysis of covariance and logistic regression, respectively, adjusted for confounders. Results: There were no differences in maternal characteristics or glycemic indices between the MDI and pump groups, except for a longer duration of type 1 diabetes and higher frequencies of microangiopathy and real-time CGM among pump users. Despite improvement with each trimester, glucose levels remained suboptimal throughout pregnancy in both groups. There were no differences between the MDI and pump groups concerning the respective associations with any of the outcomes. The frequency of large for gestational age was high in both groups (MDI 49% vs pump 63%) and did not differ significantly. Conclusions: Pregnant women with type 1 diabetes did not differ in glycemic control or pregnancy outcome, related to MDI or pump administration of insulin. Glycemic control remained suboptimal throughout pregnancy, regardless of insulin administration mode.
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| 17. |
- Longinetti, Elisa, et al.
(författare)
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Trajectories of cognitive processing speed and physical disability over 11 years following initiation of a first multiple sclerosis disease-modulating therapy
- 2024
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ Publishing Group Ltd. - 0022-3050 .- 1468-330X. ; 95:2, s. 134-141
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We analysed the COMparison Between All immunoTherapies for Multiple Sclerosis (NCT03193866), a Swedish nationwide observational study in relapsing-remitting multiple sclerosis (RRMS), to identify trajectories of processing speed and physical disability after disease-modulating therapy (DMT) start.METHODS: Using a group-modelling approach, we assessed trajectories of processing speed with oral Symbol Digit Modalities Test (SDMT) and physical disability with Expanded Disability Status Scale, from first DMT start among 1645 patients with RRMS followed during 2011-2022. We investigated predictors of trajectories using group membership as a multinomial outcome and calculated conditional probabilities linking membership across the trajectories.RESULTS: We identified 5 stable trajectories of processing speed: low SDMT scores (mean starting values=29.9; 5.4% of population), low/medium (44.3; 25.3%), medium (52.6; 37.9%), medium/high (63.1; 25.8%) and high (72.4; 5.6%). We identified 3 physical disability trajectories: no disability/stable (0.8; 26.8%), minimal disability/stable (1.6; 58.1%) and moderate disability (3.2; 15.1%), which increased to severe disability. Older patients starting interferons were more likely than younger patients starting rituximab to be on low processing speed trajectories. Older patients starting teriflunomide, with more than one comorbidity, and a history of pain treatment were more likely to belong to the moderate/severe physical disability trajectory, relative to the no disability one. There was a strong association between processing speed and physical disability trajectories.CONCLUSIONS: In this cohort of actively treated RRMS, patients' processing speed remained stable over the years following DMT start, whereas patients with moderate physical disability deteriorated in physical function. Nevertheless, there was a strong link between processing speed and disability after DMT start.
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| 18. |
- Perrin, Sam Wenaas, et al.
(författare)
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Integrating dispersal along freshwater ecosystems into species distribution models
- 2020
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Ingår i: Diversity & distributions. - : John Wiley & Sons. - 1366-9516 .- 1472-4642. ; 26:11, s. 1598-1611
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Our ability to model species distributions and abundances is a valuable ecological tool in predicting future distributions of species. Effectively incorporating connectivity into these predictions is crucial; however, many connectivity measures utilize metrics which may not have a direct relation to the dispersal capacity of the species they are attempting to model. The identification of more relevant metrics is therefore a vital step forward in species distribution modelling.Location: 85 freshwater lakes across a latitudinal gradient in Sweden, and an additional 282 freshwater lakes in one drainage basin in northern Norway.Methods: To investigate the effect of different connectivity measures, we first record recolonization of fish into lakes previously treated with the piscicide rotenone. Two invasive fish species, the northern pike (Esox lucius) and the European perch (Perca fluviatilis), were used as focal study species. We model the distributions of these species in a drainage basin with snapshot data of present-day distributions to see how well the effects of the different connectivity measures correspond to the effects seen in our recolonization study. Connectivity is quantified using slope and distance along streams connecting lacustrine populations.Results: The effects of connectivity variables were similar in both the recolonization study and the species distribution modelling. Incorporation of connectivity improved species distribution models significantly. There was little evidence for the inclusion of distance between populations, while there was strong evidence for the inclusion of different slope parameters for both species.Main conclusions: Our study demonstrates the need to ensure the relevance of connectivity measures when accounting for dispersal limitation in distribution models. The correspondence of estimated connectivity measures from recolonization studies to those estimated from species distribution models demonstrates a link between species dispersal capacity and the connectivity measures employed, and is likely to improve our ability to predict species future distributions.
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| 19. |
- Piehl, Fredrik, et al.
(författare)
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COMBAT-MS : A Population-Based Observational Cohort Study Addressing the Benefit-Risk Balance of Multiple Sclerosis Therapies Compared with Rituximab
- 2024
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Ingår i: Annals of Neurology. - : John Wiley & Sons. - 0364-5134 .- 1531-8249.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess comparative effectiveness, safety, and tolerability of off-label rituximab, compared with frequently used therapies approved for multiple sclerosis (MS).METHODS: A Swedish cohort study of persons with relapsing-remitting MS, age 18 to 75 years at inclusion and with a first therapy start or a first therapy switch between 2011 and 2018. Low-dose rituximab was compared with MS-approved therapies. Primary outcomes were proportions with 12 months confirmed disability worsening and change in MS Impact Scale-29 (MSIS-29) scores, respectively. Secondary endpoints included relapses, therapy discontinuation, and serious adverse events. Analyses used an intention-to-treat approach and were adjusted for demographics, MS features, and health characteristics.RESULTS: We included 2,449 participants as first therapy start and 2,463 as first therapy switch. Proportions with disability worsening at 3 years were 9.1% for rituximab as first therapy and 5.1% after therapy switch, with no differences to MS-approved comparators. Worsening on rituximab was mostly independent of relapses. MSIS-29 with rituximab at 3 years improved by 1.3/8.4 points (physical/psychological) for first disease-modifying therapy (DMT) and 0.4/3.6 for DMT switch, and was mostly similar across therapies. Rituximab had lower relapse rates and higher therapy persistence in both groups. The rate of hospital-treated infections was higher with rituximab after a therapy switch, but not as a first therapy.INTERPRETATION: This population-based real-world cohort study found low rates of disability progression, mostly independent of relapses, and without significant differences between rituximab and MS-approved comparators. Rituximab led to lower rates of inflammatory activity and higher treatment persistence, but was associated with an increased rate of serious infections. ANN NEUROL 2024.
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| 20. |
- Rydén, Martin, et al.
(författare)
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A human meniscus explant model for studying early events in osteoarthritis development by proteomics
- 2023
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Ingår i: Journal of Orthopaedic Research. - 0736-0266. ; 41:12, s. 2765-2778
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Tidskriftsartikel (refereegranskat)abstract
- Degenerative meniscus lesions have been associated with both osteoarthritis etiology and its progression. We, therefore, sought to establish a human meniscus ex vivo model to study the meniscal response to cytokine treatment using a proteomics approach. Lateral menisci were obtained from five knee-healthy donors. The meniscal body was cut into vertical slices and further divided into an inner (avascular) and outer region. Explants were either left untreated (controls) or stimulated with cytokines. Medium changes were conducted every 3 days up to Day 21 and liquid chromatography–mass spectrometry was performed at all the time points for the identification and quantification of proteins. Mixed-effect linear regression models were used for statistical analysis to estimate the effect of treatments versus control on protein abundance. Treatment by IL1ß increased release of cytokines such as interleukins, chemokines, and matrix metalloproteinases but a limited catabolic effect in healthy human menisci explants. Further, we observed an increased release of matrix proteins (collagens, integrins, prolargin, tenascin) in response to oncostatin M (OSM) + tumor necrosis factor (TNF) and TNF+interleukin-6 (IL6) + sIL6R treatments, and analysis of semitryptic peptides provided additional evidence of increased catabolic effects in response to these treatments. The induced activation of catabolic processes may play a role in osteoarthritis development.
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| 21. |
- Stormlund, Sacha, et al.
(författare)
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The prevalence of late-follicular phase progesterone elevation and impact on the ongoing pregnancy rate after fresh and frozen blastocyst transfer. Sub-study of an RCT
- 2024
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Ingår i: HUMAN FERTILITY. - 1464-7273 .- 1742-8149. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- The effect of late-follicular phase progesterone elevation (LFPE) during ovarian stimulation on reproductive outcomes in ART treatment remains controversial, but recent studies indicate lower pregnancy rates with rising progesterone levels. This study aims to investigate the prevalence of late-follicular phase progesterone elevation (LFPE) and possible impact on ongoing pregnancy rate after fresh or frozen blastocyst transfer in a sub-study setting of a randomised controlled trial. A total of 288 women were included (n=137 and n=151 in the fresh transfer and freeze-all group, respectively). Among these 11(3.8%) had a progesterone level >= 1.5 ng/ml, and 20(6.9%) had a progesterone level >= 1.2 ng/ml on trigger day. Spline regression analysis showed no significant effect of late follicular phase progesterone levels on ongoing pregnancy. In the multivariate regression analysis (n = 312) only age, but not progesterone level on trigger day was significantly associated with ongoing pregnancy. In conclusion, in a clinical setting with moderate gonadotrophin stimulation and well-defined trigger and fresh transfer cancellation criteria, the prevalence of women with LFPE >= 1.5 ng/ml was low and did not indicate the clinical value of routine measurement of progesterone in the late follicular phase.
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| 22. |
- Wolski, Marcin, et al.
(författare)
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Early tibial subchondral bone texture changes after arthroscopic partial meniscectomy in knees without radiographic OA : A prospective cohort study
- 2020
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Ingår i: Journal of Orthopaedic Research. - : Wiley. - 0736-0266 .- 1554-527X. ; 38:8, s. 1819-1825
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Tidskriftsartikel (refereegranskat)abstract
- Arthroscopic partial meniscectomy (APM) may lead to changes in underlying trabecular bone (TB) structure potentially promoting the development of knee joint osteoarthritis. Our aim was to investigate if there are early changes occurring in tibial subchondral TB texture in the leg undergoing medial APM compared with the unoperated non-injured contra-lateral leg. The bone texture was measured as the medial-to-lateral ratio of fractal dimensions (FD) calculated for regions selected on weight-bearing anteroposterior tibiofemoral x-rays. Twenty-one subjects before and 12 months after APM were included from 374 patients scheduled for unilateral medial APM. The medial-to-lateral ratio was calculated for horizontal, vertical, and roughest FDs respectively. Higher FD means higher bone roughness. Each FD was calculated over a range of scales using a variance orientation transform method. Mean values of medial-to-lateral horizontal FD calculated for APM knees at follow-up were higher than those at baseline. For unoperated knees the values were lower. The difference in the horizontal FD change from baseline to follow-up between APM and contra-lateral legs was 0.028 (95% CI, 0.004-0.052). The bone roughness changes may reflect the increase in peak knee adduction moment (KAM) and KAM impulse during walking reported for the same cohort in a previous study. They may also reflect early signs of osteoarthritis development and thus, we speculate that individuals with increased bone texture roughness ratio after APM might be at higher risk of knee osteoarthritis development.
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