| 1. |
- Axelsson, Kristian F., et al.
(author)
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Association Between Recurrent Fracture Risk and Implementation of Fracture Liaison Services in Four Swedish Hospitals: A Cohort Study
- 2020
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In: Journal of Bone and Mineral Research. - : Wiley. - 0884-0431 .- 1523-4681. ; 35:7, s. 1216-1223
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Journal article (peer-reviewed)abstract
- © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research Structured secondary preventions programs, called fracture liaison services (FLSs), increase the rate of evaluation with bone densitometry and use of osteoporosis medication after fracture. However, the evidence regarding the effect on the risk of recurrent fracture is insufficient. The aim of this study was to investigate if implementation of FLS was associated with reduced risk of recurrent fractures. In this retrospective cohort study, electronic health records during 2012 to 2017 were used to identify a total of 21,083 patients from four hospitals in Western Sweden, two with FLS (n = 15,449) and two without (n = 5634). All patients aged 50 years or older (mean age 73.9 [SD 12.4] years, 76% women) with a major osteoporotic index fracture (hip, clinical spine, humerus, radius, and pelvis) were included. The primary outcome was recurrent major osteoporotic fracture. All patients with an index fracture during the FLS period (n = 13,946) were compared with all patients in the period before FLS implementation (n = 7137) in an intention-to-treat analysis. Time periods corresponding to the FLS hospitals were used for the non-FLS hospitals. In the hospitals with FLSs, there were 1247 recurrent fractures during a median follow-up time of 2.2 years (range 0–6 years). In an unadjusted Cox model, the risk of recurrent fracture was 18% lower in the FLS period compared with the control period (hazard ratio = 0.82, 95% confidence interval [CI] 0.73–0.92, p = 0.001), corresponding to a 3-year number needed to screen of 61, and did not change after adjustment for clinical risk factors. In the hospitals without FLSs, no change in recurrent fracture rate was observed. Treatment decisions were made according to the Swedish treatment guidelines. In conclusion, implementation of FLS was associated with a reduced risk of recurrent fracture, indicating that FLSs should be included routinely at hospitals treating fracture patients. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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| 3. |
- Barregård, Lars, 1948, et al.
(author)
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Cadmium, mercury, and lead in kidney cortex of living kidney donors: Impact of different exposure sources.
- 2010
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In: Environmental research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 110:1, s. 47-54
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Journal article (peer-reviewed)abstract
- BACKGROUND: Most current knowledge on kidney concentrations of nephrotoxic metals like cadmium (Cd), mercury (Hg), or lead (Pb) comes from autopsy studies. Assessment of metal concentrations in kidney biopsies from living subjects can be combined with information about exposure sources like smoking, diet, and occupation supplied by the biopsied subjects themselves. OBJECTIVES: To determine kidney concentrations of Cd, Hg, and Pb in living kidney donors, and assess associations with common exposure sources and background factors. METHODS: Metal concentrations were determined in 109 living kidney donors aged 24-70 years (median 51), using inductively coupled plasma-mass spectrometry (Cd and Pb) and cold vapor atomic fluorescence spectrometry (Hg). Smoking habits, occupation, dental amalgam, fish consumption, and iron stores were evaluated. RESULTS: The median kidney concentrations were 12.9microg/g (wet weight) for cadmium, 0.21microg/g for mercury, and 0.08microg/g for lead. Kidney Cd increased by 3.9microg/g for a 10 year increase in age, and by 3.7microg/g for an extra 10 pack-years of smoking. Levels in non-smokers were similar to those found in the 1970s. Low iron stores (low serum ferritin) in women increased kidney Cd by 4.5microg/g. Kidney Hg increased by 6% for every additional amalgam surface, but was not associated with fish consumption. Lead was unaffected by the background factors surveyed. CONCLUSIONS: In Sweden, kidney Cd levels have decreased due to less smoking, while the impact of diet seems unchanged. Dental amalgam is the main determinant of kidney Hg. Kidney Pb levels are very low due to decreased exposure.
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| 4. |
- Bondesson, Johan, 1991, et al.
(author)
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Definition of Tubular Anatomic Structures from Arbitrary Stereo Lithographic Surface
- 2017
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In: Initiative Seminar Engineering Health, 8-9 November 2017, Chalmers.
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Conference paper (other academic/artistic)abstract
- An accurate description of anatomies and dynamics of vessels is crucial to understand their characteristics and improve surgical techniques, thus it is the basis, in addition to surgeon experience, on which stent design and operation procedures rely. The process of producing this description is user intensive, and recent improvement in image processing of medical3D imaging allows for a more automated workflow. However, there is a need to bridge the gap from a processed geometry to a robust mathematical computational grid. By sequentially segmenting a tubular anatomic structure, here defined by a stereo lithographic (STL) surface, an initial centerline is formed by connecting centroids of orthogonal cross-sectional contours along the length of the structure. Relying on the initial centerline, a set of non-overlapping 2D cross sectional contours are defined along the centerline, a centerline which is updated after the 2D contours are produced. After a second iteration of producing 2D contours and updating the centerline, a full description of the structure is created. Our method for describing vessel geometry shows good coherence to existing method. The main advantages of our method include the possibility of having arbitrary triangulated STL surface input, automated centerline definition, safety against intersecting cross-sectional contours and automatic clean-up of local kinks and wrinkles.
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| 6. |
- Bondesson, Johan, 1991, et al.
(author)
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Quantification of True Lumen Helical Morphology and Chirality in Type B Aortic Dissections
- 2021
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In: American Journal of Physiology - Heart and Circulatory Physiology. - : American Physiological Society. - 1522-1539 .- 0363-6135. ; 320:2, s. H901-H911
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Journal article (peer-reviewed)abstract
- Chirality is a fundamental property in many biologic systems. Motivated by previous observations of helical aortic blood flow, aortic tissue fibers, and propagation of aortic dissections, we introduce methods to characterize helical morphology of aortic dissections. After validation on computer generated phantoms, the methods were applied to patients with type B dissection. For this cohort, there was a distinct bimodal distribution of helical propagation of the dissection with either achiral or exclusively right-handed chirality, with no intermediate cases or left-handed cases. This clear grouping indicates that dissection propagation favors these two modes, potentially due to the right-handedness of helical aortic blood flow and cell orientation. The characterization of dissection chirality and quantification of helical morphology advances our understanding of dissection pathology and lays a foundation for applications in clinical research and treatment practice. For example, the chirality and magnitude of helical metrics of dissections may indicate risk of dissection progression, help define treatment and surveillance strategies, and enable development of novel devices that account for various helical morphologies.
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| 8. |
- Broberg, Karin, et al.
(author)
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Metodutveckling för blodprovstagning på filterpapper
- 2022
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Reports (other academic/artistic)abstract
- Blodprov för metallanalyser tas vanligtvis via prov av venblod från armvecket. Detta är dock eninvasiv metod och provtagningen måste utföras av medicinskt utbildad personal. Ett sätt att erhållablod med en mindre invasiv metod och som ger betydligt mindre blodvolym är att genom ett stick ifingret droppa kapillärblod på ett filterpapper som får torka. Ytterligare fördelar med dennaprovtagningsmetod är att det blir möjligt med ”självprovtagning” och att för en mindre kostnad kanblod samlas in från fler personer.Vi genomförde ett utvecklingsprojekt för att ta fram en metod för att samla in och mäta metallernakadmium, kvicksilver och bly i torkat blod (blodspottar på filterpapper) erhållet via självprovtagninggenom stick i fingret.Vi tog fram en sur tvättmetod för att tvätta bort metaller (bakgrundshalter) i filterpapper innan dekan användas för provtagning. Vi utvecklade en enkel men effektiv alkalisk urlakningsmetod avmetaller i blodspottarna. Vi tog fram ett självprovtagningskit för blodspottar samt instruktionsvideodesignat för att minimera kontaminering av metaller i omgivningsmiljön. Vi jämfördevenblodsprovtagning med självprovstagning för 17 försökspersoner och fann överensstämmelseframförallt för bly. Vi gjorde en inter-laboratoriejämförelse för mätning av metaller i blodspottar frånfem personer och fann överensstämmelse för kvicksilver och bly.Studien visar att det är möjligt att mäta toxiska metaller i små volymer från blodspottar erhållna viasjälvprovtagning. Emellertid skilde sig halterna i venblod och i blodspottar för vissa personer ochframförallt för kadmium. Det beror troligen på att blodspottarna kan kontamineras vid utstansningmed de stansverktyg som finns att köpa på marknaden. Ytterligare metodutveckling via framtagningav adekvat stansverktyg rekommenderas för att kunna mäta kadmium i blodspottar samt att däreftertesta metoden i HÄMI-projekt.
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| 9. |
- Gräns, Albin, 1979, et al.
(author)
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Stunning fish with CO2 or electricity: contradictory results on behavioural and physiological stress responses
- 2016
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In: Animal. - 1751-7311 .- 1751-732X. ; 10:2, s. 294-301
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Journal article (peer-reviewed)abstract
- Studies that address fi sh welfare before slaughter have concluded that many of the traditional systems used to stun fi sh including CO 2 narcosis are unacceptable as they cause avoidable stress before death. One system recommended as a better alternative is electrical stunning, however, the welfare aspects of this method are not yet fully understood. To assess welfare in aquaculture both behavioural and physiological measurements have been used, but few studies have examined the relationship between these variables. In an on-site study aversive behaviours and several physiological stress indicators, including plasma levels of cortisol and ions as well as blood physiological variables, were compared in Arctic char ( Salvelinus alpinus ) stunned with CO 2 or electricity. Exposure to water saturated with CO 2 triggered aversive struggling and escape responses for several minutes before immobilization, whereas in fi sh exposed to an electric current immobilization was close to instant. On average, it took 5 min for the fi sh to recover from electrical stunning, whereas fi sh stunned with CO 2 did not recover. Despite this, the electrically stunned fi sh had more than double the plasma levels of cortisol compared with fi sh stunned with CO 2 . This result is surprising considering that the behavioural reactions were much more pronounced following CO 2 exposure. These contradictory results are discussed with regard to animal welfare and stress physiological responses. The present results emphasise the importance of using an integrative and interdisciplinary approach and to include both behavioural and physiological stress indicators in order to make accurate welfare assessments of fish in aquaculture.
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| 10. |
- Guénot, Diego, et al.
(author)
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Distribution of Liquid Mass in Transient Sprays Measured Using Laser-Plasma-Driven X-Ray Tomography
- 2022
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In: Physical Review Applied. - 2331-7019. ; 17:6
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Journal article (peer-reviewed)abstract
- We report, the use of laser-plasma-driven x rays to reveal the three-dimensional (3D) structure of a highly atomizing water spray. Soft x rays approximately 5 keV are generated by means of a laser-plasma accelerator. Transmission radiography measurements are performed at different angles, by rotating a multihole injector. Using computer tomography, the local liquid volume distribution and its spatial variation are retrieved in 3D, showing up to 55% liquid fraction at the nozzle outlet, which decreases to below 7% within only 1 mm. The resolution of the liquid volume fraction is 0.5% while the spatial resolution of the radiographic images is 11.5μm. The x-ray source used here provides successful measurements of liquid mass distribution over a relatively large volume and is very promising for the analysis of a variety of challenging transient spray systems, e.g., the injection of liquid synthetic and biofuels used for future clean-combustion applications.
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