| 21. |
- Schmidtke, A, et al.
(author)
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Attempted suicide in Europe : rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide.
- 1996
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In: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 93:5, s. 327-38
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Journal article (peer-reviewed)abstract
- The World Health Organization/EURO Multicentre Project on Parasuicide is part of the action to implement target 12 of the WHO programme, "Health for All by the Year 2000', for the European region. Sixteen centres in 13 European countries are participating in the monitoring aspect of the project, in which trends in the epidemiology of suicide attempts are assessed. The highest average male age-standardized rate of suicide attempts was found for Helsinki, Finland (314/100,000), and the lowest rate (45/100,000) was for Guipuzcoa, Spain, representing a sevenfold difference. The highest average female age-standardized rate was found for Cergy-Pontoise, France (462/100,000), and the lowest (69/100,000) again for Guipuzcoa, Spain. With only one exception (Helsinki), the person-based suicide attempt rates were higher among women than among men. In the majority of centres, the highest person-based rates were found in the younger age groups. The rates among people aged 55 years or over were generally the lowest. For the majority of the centres, the rates for individuals aged 15 years or over decreased between 1989 and 1992. The methods used were primarily "soft' (poisoning) or cutting. More than 50% of the suicide attempters made more than one attempt, and nearly 20% of the second attempts were made within 12 months after the first attempt. Compared with the general population, suicide attempters more often belong to the social categories associated with social destabilization and poverty.
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| 22. |
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| 23. |
- Achtert, Peggy, 1982-, et al.
(author)
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Investigation of polar stratospheric clouds in January 2008 by means of ground-based and spaceborne lidar measurements and microphysical box model simulations
- 2011
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In: Journal of Geophysical Research. - 0148-0227 .- 2156-2202. ; 116, s. D07201-
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Journal article (peer-reviewed)abstract
- Polar stratospheric clouds (PSCs) play a key role in heterogeneous chemistry and ozone depletion in the lower stratosphere. The type of PSC as well as their temporal and spatial extent are important for the occurrence of heterogeneous reactions and, thus, ozone depletion. In this study a combination of ground-based and spaceborne lidar measurements were used together with microphysical box model simulations along back trajectories to investigate the formation and alteration of Arctic PSCs. The measurements were made by the Rayleigh/Mie/Raman lidar system at Esrange and by the Cloud-Aerosol Lidar with Orthogonal Polarization aboard the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) satellite. Between 20 and 23 January 2008 PSCs composed of liquid particles were observed by CALIPSO between Greenland and the western side of the Scandinavian Mountains. Between 21 and 23 January 2008 the Esrange lidar observed a PSC composed of distinct layers of liquid and solid particles on the eastern side of the mountain range. Microphysical box model simulations along air parcel back trajectories indicate that liquid particles had formed at least 40 h before the observation at Esrange. Furthermore, the model indicates a high HNO(3) uptake into the liquid layer between 10 and 20 h before the observation. The PSC was formed when the air mass was over Greenland. On two occasions during these 20 h, CALIPSO observed PSCs when its measurement tracks crossed the air parcel back trajectory ending at the location of the Esrange lidar. Backscatter ratios calculated from the output of the box model simulation indicate good agreement with the values observed with the Esrange lidar and by CALIPSO. The box model simulations along the back trajectories from Esrange to the CALIPSO ground track and beyond provide us with the unique opportunity to relate ground-based and spaceborne lidar measurements that were not performed at the same spatial location and time. Furthermore, possible differences in the observations from ground and space can be traced to temporal and/or geographically induced changes in particle microphysics within the measured PSCs.
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| 24. |
- Biselli, P. J. C., et al.
(author)
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Nasal high-flow therapy reduces work of breathing compared with oxygen during sleep in COPD and smoking controls: a prospective observational study
- 2017
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In: Journal of Applied Physiology. - : American Physiological Society. - 8750-7587 .- 1522-1601. ; 122:1, s. 82-88
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Journal article (peer-reviewed)abstract
- Patients with chronic obstructive pulmonary disease (COPD) endure excessive resistive and elastic loads leading to chronic respiratory failure. Oxygen supplementation corrects hypoxemia but is not expected to reduce mechanical loads. Nasal high-flow (NHF) therapy supports breathing by reducing dead space, but it is unclear how it affects mechanical loads of patients with COPD. The objective of this study was to compare the effects of low-flow oxygen and NHF therapy on ventilation and work of breathing (WOB) in patients with COPD and controls during sleep. Patients with COPD (n = 12) and controls (n = 6) were recruited and submitted to polysomnography to measure sleep parameters and ventilation in response to administration of oxygen and NHF. A subset of six patients also had an esophageal catheter inserted for the purpose of measuring WOB. Patients with COPD had similar minute ventilation (V-E) but lower tidal volumes than matched controls. With oxygen, SaO(2) was increased and V-E was reduced in both controls and patients with COPD, but there was an increase in transcutaneous CO2 levels. NHF produced a greater reduction in V-E and was associated with a reduction in CO2 levels. Although NHF halved WOB, oxygen produced only a minor reduction in this parameter. We conclude that oxygen produced little change in WOB, which was associated with CO2 elevations. On the other hand, NHF produced a large reduction in V-E and WOB with a concomitant decrease in CO2 levels. Our data indicate that NHF improves alveolar ventilation during sleep compared with oxygen and room air in patients with COPD and therefore can decrease their cost of breathing. NEW & NOTEWORTHY Nasal high-flow (NHF) therapy can support ventilation in patients with chronic obstructive pulmonary disease during sleep by decreasing the work of breathing and improving CO2 levels. On the other hand, oxygen supplementation corrects hypoxemia, but it produces only a minimal reduction in work of breathing and is associated with increased CO2 levels. Therefore, NHF can be a useful method to assist ventilation in patients with increased respiratory mechanical loads.
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| 25. |
- Biselli, P., et al.
(author)
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Reductions in dead space ventilation with nasal high flow depend on physiological dead space volume: metabolic hood measurements during sleep in patients with COPD and controls
- 2018
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In: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 51:5
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Journal article (peer-reviewed)abstract
- Nasal high flow (NHF) reduces minute ventilation and ventilatory loads during sleep but the mechanisms are not clear. We hypothesised NHF reduces ventilation in proportion to physiological but not anatomical dead space. 11 subjects (five controls and six chronic obstructive pulmonary disease (COPD) patients) underwent polysomnography with transcutaneous carbon dioxide (CO2) monitoring under a metabolic hood. During stable non-rapid eye movement stage 2 sleep, subjects received NHF (20 L center dot min(-1)) intermittently for periods of 5-10 min. We measured CO2 production and calculated dead space ventilation. Controls and COPD patients responded similarly to NHF. NHF reduced minute ventilation (from 5.6 +/- 0.4 to 4.8 +/- 0.4 L center dot min(-1); p< 0.05) and tidal volume (from 0.34 +/- 0.03 to 0.3 +/- 0.03 L; p< 0.05) without a change in energy expenditure, transcutaneous CO2 or alveolar ventilation. There was a significant decrease in dead space ventilation (from 2.5 +/- 0.4 to 1.6 +/- 0.4 L center dot min(-1); p< 0.05), but not in respiratory rate. The reduction in dead space ventilation correlated with baseline physiological dead space fraction (r(2)=0.36; p< 0.05), but not with respiratory rate or anatomical dead space volume. During sleep, NHF decreases minute ventilation due to an overall reduction in dead space ventilation in proportion to the extent of baseline physiological dead space fraction.
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| 26. |
- Blum, Ulrich, et al.
(author)
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Simultaneous lidar observations of a polar stratospheric cloud on the east and west side of the Scandinavian mountains and microphysical box model simulations
- 2006
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In: Annales Geophysicae. ; 24, s. 3267-3277
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Journal article (peer-reviewed)abstract
- The importance of polar stratospheric clouds (PSC) for polar ozone depletion is well established. Lidar experiments are well suited to observe and classify polar stratospheric clouds. On 5 January 2005 a PSC was observed simultaneously on the east and west sides of the Scandinavian mountains by ground-based lidars. This cloud was composed of liquid particles with a mixture of solid particles in the upper part of the cloud. Multi-colour measurements revealed that the liquid particles had a mode radius of r~300 nm, a distribution width of ~1.04 and an altitude dependent number density of N~2–20 cm−3. Simulations with a microphysical box model show that the cloud had formed about 20 h before observation. High HNO3 concentrations in the PSC of 40–50 weight percent were simulated in the altitude regions where the liquid particles were observed, while this concentration was reduced to about 10 weight percent in that part of the cloud where a mixture between solid and liquid particles was observed by the lidar. The model simulations also revealed a very narrow particle size distribution with values similar to the lidar observations. Below and above the cloud almost no HNO3 uptake was simulated. Although the PSC shows distinct wave signatures, no gravity wave activity was observed in the temperature profiles measured by the lidars and meteorological analyses support this observation. The observed cloud must have formed in a wave field above Iceland about 20 h prior to the measurements and the cloud wave pattern was advected by the background wind to Scandinavia. In this wave field above Iceland temperatures potentially dropped below the ice formation temperature, so that ice clouds may have formed which can act as condensation nuclei for the nitric acid trihydrate (NAT) particles observed at the cloud top above Esrange.
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| 27. |
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| 28. |
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| 29. |
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| 30. |
- Fricke, K., et al.
(author)
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Nasal high flow, but not supplemental O-2, reduces peripheral vascular sympathetic activity during sleep in COPD patients
- 2018
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In: International Journal of Chronic Obstructive Pulmonary Disease. - 1178-2005. ; 13, s. 3635-3643
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Journal article (peer-reviewed)abstract
- Introduction: Patients with COPD have increased respiratory loads and altered blood gases, both of which affect vascular function and sympathetic activity. Sleep, particularly rapid eye movement (REM) sleep, is known to exacerbate hypoxia and respiratory loads. Therefore, we hypothesize that nasal high flow (NHF), which lowers ventilatory loads, reduces sympathetic activity during sleep and that this effect depends on COPD severity. Methods: We performed full polysomnography in COPD patients (n=17; FEV1, 1.6 +/- 0.6 L) and in matched controls (n=8). Participants received room air (RA) at baseline and single night treatment with O-2 (2 L/min) and NHF (20 L/min) in a random order. Finger pulse wave amplitude (PWA), a measure of vascular sympathetic tone, was assessed by photoplethysmography. Autonomic activation (AA) events were defined as PWA attenuation >= 30% and indexed per hour for sleep stages (AA index [AAI]) at RA, NHF, and O-2). Results: In COPD, sleep apnea improved following O-2 (REM-apnea hypopnea index [AHI] with RA, O-2, and NHF: 18.6 +/- 20.9, 12.7 +/- 18.1, and 14.4 +/- 19.8, respectively; P=0.04 for O-2 and P=0.06 for NHF). REM-AAI was reduced only following NHF in COPD patients (AAI-RA, 21.5 +/- 18.4 n/h and AAI-NHF, 9.9 +/- 6.8 n/h, P=0.02) without changes following O-2 (NFIF-O-2 difference, P=0.01). REM-AAI reduction was associated with lung function expressed as FEV1 and FVC (FEV1: r=-0.59, P=0.001; FEV1/FVC: r=-0.52 and P=0.007). Conclusion: NHF but not elevated oxygenation reduces peripheral vascular sympathetic activity in COPD patients during REM sleep. Sympathetic off-loading by NHF, possibly related to improved breathing mechanics, showed a strong association with COPD severity.
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