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- Backman, Helena, et al.
(author)
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Decreased COPD prevalence in Sweden after decades of decrease in smoking
- 2020
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In: Respiratory Research. - : Springer Nature. - 1465-9921 .- 1465-993X. ; 21
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Journal article (peer-reviewed)abstract
- BackgroundCOPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantial and ongoing decrease in smoking prevalence has been observed in several European countries including Sweden. The aim of the current study was to estimate the prevalence, characteristics and risk factors for COPD in the Swedish general population. A further aim was to estimate the prevalence trend of COPD in Northern Sweden from 1994 to 2009.MethodsTwo large random population samples were invited to spirometry with bronchodilator testing and structured interviews in 2009–2012, one in south-western and one in northern Sweden, n = 1839 participants in total. The results from northern Sweden were compared to a study performed 15 years earlier in the same area and age-span. The diagnosis of COPD required both chronic airway obstruction (CAO) and the presence of respiratory symptoms, in line with the GOLD documents since 2017. CAO was defined as post-bronchodilator FEV1/FVC < 0.70, with sensitivity analyses based on the FEV1/FVC < lower limit of normal (LLN) criterion.ResultsBased on the fixed ratio definition, the prevalence of COPD was 7.0% (men 8.3%; women 5.8%) in 2009–2012. The prevalence of moderate to severe (GOLD ≥ 2) COPD was 3.5%. The LLN based results were about 30% lower. Smoking, occupational exposures, and older age were risk factors for COPD, whereof smoking was the most dominating risk factor. In northern Sweden the prevalence of COPD, particularly moderate to severe COPD, decreased significantly from 1994 to 2009, and the decrease followed a decrease in smoking.ConclusionsThe prevalence of COPD has decreased in Sweden, and the prevalence of moderate to severe COPD was particularly low. The decrease follows a major decrease in smoking prevalence over several decades, but smoking remained the dominating risk factor for COPD.
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| 4. |
- Eriksson, Kaja, et al.
(author)
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Periodontal Health and Oral Microbiota in Patients with Rheumatoid Arthritis
- 2019
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In: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 8:5
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Journal article (peer-reviewed)abstract
- This study aimed to investigate the periodontal health of patients with established rheumatoid arthritis (RA) in relation to oral microbiota, systemic and oral inflammatory mediators, and RA disease activity. Forty patients underwent full-mouth dental/periodontal and rheumatological examination, including collection of blood, saliva, gingival crevicular fluid (GCF) and subgingival plaque. Composition of plaque and saliva microbiota were analysed using 16S rRNA sequencing and levels of inflammatory mediators by multiplex-immunoassay. The majority of the patients (75%) had moderate or severe periodontitis and the rest had no/mild periodontitis. Anti-citrullinated protein antibody (ACPA) positivity was significantly more frequent in the moderate/severe periodontitis (86%) compared to the no/mild group (50%). No significance between groups was observed for RA disease duration or activity, or type of medication. Levels of sCD30/TNFRSF8, IFN-2, IL-19, IL-26, MMP-1, gp130/sIL-6R ss, and sTNF-R1 were significantly higher in serum or GCF, and April/TNFSF13 was significantly higher in serum and saliva samples in moderate/severe periodontitis. The microbial composition in plaque also differed significantly between the two groups. In conclusion, the majority of RA patients had moderate/severe periodontitis and that this severe form of the disease was significantly associated with ACPA positivity, an altered subgingival microbial profile, and increased levels of systemic and oral inflammatory mediators.
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- Holzapfel, Damian M., et al.
(author)
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Enhanced thermal stability of (Ti,Al)N coatings by oxygen incorporation
- 2021
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In: Acta Materialia. - : Elsevier. - 1359-6454 .- 1873-2453. ; 218
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Journal article (peer-reviewed)abstract
- Thermal stability of protective coatings is one of the performance-defining properties for advanced cutting and forming applications as well as for energy conversion. To investigate the effect of oxygen incorporation on the high-temperature behavior of (Ti,Al)N, metastable cubic (Ti,Al)N and (Ti,Al)(OxN1-x) coatings are synthesized using reactive arc evaporation. X-ray diffraction of (Ti,Al)N and (Ti,Al)(OxN1-x) coatings reveals that spinodal decomposition is initiated at approximately 800 degrees C, while the subsequent formation of wurtzite solid solution is clearly delayed from 1000 degrees C to 1300 degrees C for (Ti,Al)(OxN1-x) compared to (Ti,Al)N. This thermal stability enhancement can be rationalized based on calculated vacancy formation energies in combination with spatially-resolved composition analysis and calorimetric data: Energy dispersive X-ray spectroscopy and atom probe tomography data indicate a lower O solubility in wurtzite solid solution compared to cubic (Ti,Al)(O,N). Hence, it is evident that for the growth of the wurtzite, AlN-rich phase in (Ti,Al)N, only mobility of Ti and Al is required, while for (Ti,Al)(O,N), in addition to mobile metal atoms, also non-metal mobility is required. Prerequisite for mobility on the non-metal sublattice is the formation of non-metal vacancies which require larger temperatures than for the metal sublattice due to significantly larger magnitudes of formation energies for the non-metal vacancies compared to the metal vacancies. This notion is consistent with calorimetry data which indicate that the combined energy necessary to form and grow the wurtzite phase is larger by a factor of approximately two in (Ti,Al)(O,N) than in (Ti,Al)N, causing the here reported thermal stability increase. (C) 2021 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
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| 7. |
- Holzapfel, Damian M., et al.
(author)
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Influence of ion irradiation-induced defects on phase formation and thermal stability of Ti0.27Al0.21N0.52 coatings
- 2022
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In: Acta Materialia. - : Elsevier. - 1359-6454 .- 1873-2453. ; 237
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Journal article (peer-reviewed)abstract
- The influence of changes induced by ion irradiation on structure and thermal stability of metastable cubic (Ti,Al)N coatings deposited by cathodic arc evaporation is systematically investigated by correlating experiments and theory. Decreasing the nitrogen deposition pressure from 5.0 to 0.5 Pa results in an ion flux-enhancement by a factor of three and an increase of the average ion energy from 15 to 30 eV, causing the stress-free lattice parameter to expand from 4.170 to 4.206 Å, while the chemical composition of Ti0.27Al0.21N0.52 remains unchanged. The 0.9% lattice parameter increase is a consequence of formation of Frenkel pairs induced by ion bombardment, as revealed by density functional theory (DFT) simulations. The influence of the presence of Frenkel pairs on the thermal stability of metastable Ti0.27Al0.21N0.52 is investigated by scanning transmission electron microscopy, differential scanning calorimetry, atom probe tomography and in-situ synchrotron X-ray powder diffraction. It is demonstrated that the ion flux and ion energy induced formation of Frenkel pairs increases the thermal stability as the Al diffusion enabled crystallization of the wurtzite solid solution is retarded. This can be rationalized by DFT predictions since the presence of Frenkel pairs increases the activation energy for Al diffusion by up to 142%. Hence, the thermal stability enhancement is caused by a hitherto unreported mechanism - the Frenkel pair impeded Al mobility and thereby retarded formation of wurtzite solid solution.
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- Margot-Cattin, Isabel, et al.
(author)
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Visiting Out-of-Home Places when Living with Dementia
- 2021
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In: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie. - : Sage Publications. - 0008-4174. ; 88:2, s. 131-141
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Journal article (peer-reviewed)abstract
- Background. Persons living with dementia face a reduction of their life space outside home and disengagement from participation, linked to places visited. Purpose. This study explored stability and change in perceived participation in places visited outside home and its relationship with occupational gaps among older adults. Method. Older adults living with (n = 35) or without (n = 35) dementia were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire and the Occupational Gaps Questionnaire (OGQ). Data analysis used descriptive and inferential statistics. Findings. The group of people living with dementia reported significantly fewer places (p < .001) visited than the comparison group and having abandoned more places visited (p < .001) than the comparison group. The number of occupational gaps was significantly different between groups (p < .001). Implications. Participation outside home is not influenced in a uniform and straightforward way for persons living with dementia; the shrinking world effect appears differently in relation to types of places.
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| 9. |
- Patomella, Ann-Helen, et al.
(author)
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Primary prevention of stroke : randomised controlled pilot trial protocol on engaging everyday activities promoting health
- 2019
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:11
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Journal article (peer-reviewed)abstract
- IntroductionStroke is a globally common disease that has detrimental effects on the individual and, more broadly, on society. Lifestyle change can contribute to reducing risk factors for stroke. Although a healthy lifestyle has direct benefits, sustaining and incorporating healthy activities into everyday life is a challenge. Engaging everyday activities have the potential to support lifestyle change and to promote sustainable activity patterns. Current healthcare is failing to reduce modifiable risk factors in people at risk, and in addition to current practice, there is a need for systematic and efficient non-pharmacological and non-surgical stroke-prevention strategies. The aim of the pilot study was to increase knowledge about the effects of a prevention programme and its feasibility to promote sustainable and healthy activity patterns among persons at risk of stroke.Methods and analysisThe proposed pilot study will be a two-armed randomised, assessor-blinded, parallel pilot trial. The study will include feasibility data, investigating acceptability and delivery of the intervention. Persons at risk of stroke (n=60) will be included in a mobile phone-supported prevention programme. The 10-week programme will be conducted at primary healthcare clinics, combining group meetings and online resources to support self-management of lifestyle change. Main outcomes are stroke risk, lifestyle habits and healthy activity patterns. Assessments will be performed at baseline and at follow-up (immediately following the end of the programme and at 6 and 12 months). Effects of the programme will be analysed using inferential statistics. Feasibility will be analysed using both qualitative and quantitative methods.Ethics and disseminationThe study has been approved by the Regional Ethical Review Board in Stockholm, Sweden, being granted reference numbers 2015/834-31, 2016/2203-32 and 2019/01444. Study results will be disseminated through peer-review journals and presentations to mixed audiences at regional and international conferences. Trial registration number NCT03730701.
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