| 1. |
- Muraro, Antonella, et al.
(author)
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Managing food allergy: GA2LEN guideline 2022.
- 2022
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In: The World Allergy Organization journal. - : Elsevier BV. - 1939-4551. ; 15:9
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Journal article (peer-reviewed)abstract
- Food allergy affects approximately 2-4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). A multidisciplinary international Task Force developed the guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We reviewed the latest available evidence as of April 2021 (161 studies) and created recommendations by balancing benefits, harms, feasibility, and patient and clinician experiences. We suggest that people diagnosed with food allergy avoid triggering allergens (low certainty evidence). We suggest that infants with cow's milk allergy who need a breastmilk alternative use either hypoallergenic extensively hydrolyzed cow's milk formula or an amino acid-based formula (moderate certainty). For selected children with peanut allergy, we recommend oral immunotherapy (high certainty), though epicutaneous immunotherapy might be considered depending on individual preferences and availability (moderate certainty). We suggest considering oral immunotherapy for children with persistent severe hen's egg or cow's milk allergy (moderate certainty). There are significant gaps in evidence about safety and effectiveness of the various strategies. Research is needed to determine the best approaches to education, how to predict the risk of severe reactions, whether immunotherapy is cost-effective and whether biological therapies are effective alone or combined with allergen immunotherapy.
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| 2. |
- Balakrishnan, Anita, et al.
(author)
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Delivery of hepato-pancreato-biliary surgery during the COVID-19 pandemic : an European-African Hepato-Pancreato-Biliary Association (E-AHPBA) cross-sectional survey
- 2020
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In: HPB. - : Elsevier BV. - 1365-182X. ; 22:8, s. 1128-1134
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Journal article (peer-reviewed)abstract
- Background: The extent of the COVID-19 pandemic and the resulting response has varied globally. The European and African Hepato-Pancreato-Biliary Association (E-AHPBA), the premier representative body for practicing HPB surgeons in Europe and Africa, conducted this survey to assess the impact of COVID-19 on HPB surgery. Methods: An online survey was disseminated to all E-AHPBA members to assess the effects of the pandemic on unit capacity, management of HPB cancers, use of COVID-19 screening and other aspects of service delivery. Results: Overall, 145 (25%) members responded. Most units, particularly in COVID-high countries (>100,000 cases) reported insufficient critical care capacity and reduced HPB operating sessions compared to COVID-low countries. Delayed access to cancer surgery necessitated alternatives including increased neoadjuvant chemotherapy for pancreatic cancer and colorectal liver metastases, and locoregional treatments for hepatocellular carcinoma. Other aspects of service delivery including COVID-19 screening and personal protective equipment varied between units and countries. Conclusion: This study demonstrates that the COVID-19 pandemic has had a profound adverse impact on the delivery of HPB cancer care across the continents of Europe and Africa. The findings illustrate the need for safe resumption of cancer surgery in a “new” normal world with screening of patients and staff for COVID-19.
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| 3. |
- Fanidi, Anouar, et al.
(author)
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Is high vitamin B12 status a cause of lung cancer?
- 2019
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In: International Journal of Cancer. - : John Wiley & Sons. - 0020-7136 .- 1097-0215. ; 145:6, s. 1499-1503
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Journal article (peer-reviewed)abstract
- Vitamin B supplementation can have side effects for human health, including cancer risk. We aimed to elucidate the role of vitamin B12 in lung cancer etiology via direct measurements of pre‐diagnostic circulating vitamin B12 concentrations in a nested case–control study, complemented with a Mendelian randomization (MR) approach in an independent case–control sample. We used pre‐diagnostic biomarker data from 5183 case–control pairs nested within 20 prospective cohorts, and genetic data from 29,266 cases and 56,450 controls. Exposures included directly measured circulating vitamin B12 in pre‐diagnostic blood samples from the nested case–control study, and 8 single nucleotide polymorphisms associated with vitamin B12 concentrations in the MR study. Our main outcome of interest was increased risk for lung cancer, overall and by histological subtype, per increase in circulating vitamin B12 concentrations. We found circulating vitamin B12 to be positively associated with overall lung cancer risk in a dose response fashion (odds ratio for a doubling in B12 [ORlog2B12] = 1.15, 95% confidence interval (95%CI) = 1.06–1.25). The MR analysis based on 8 genetic variants also indicated that genetically determined higher vitamin B12 concentrations were positively associated with overall lung cancer risk (OR per 150 pmol/L standard deviation increase in B12 [ORSD] = 1.08, 95%CI = 1.00–1.16). Considering the consistency of these two independent and complementary analyses, these findings support the hypothesis that high vitamin B12 status increases the risk of lung cancer.
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| 4. |
- Kanoni, Stavroula, et al.
(author)
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Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis.
- 2022
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In: Genome biology. - : Springer Science and Business Media LLC. - 1474-760X .- 1465-6906 .- 1474-7596. ; 23:1
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Journal article (peer-reviewed)abstract
- Genetic variants within nearly 1000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery.To expand our understanding of the underlying biological pathways and mechanisms controlling blood lipid levels, we leverage a large multi-ancestry meta-analysis (N=1,654,960) of blood lipids to prioritize putative causal genes for 2286 lipid associations using six gene prediction approaches. Using phenome-wide association (PheWAS) scans, we identify relationships of genetically predicted lipid levels to other diseases and conditions. We confirm known pleiotropic associations with cardiovascular phenotypes and determine novel associations, notably with cholelithiasis risk. We perform sex-stratified GWAS meta-analysis of lipid levels and show that 3-5% of autosomal lipid-associated loci demonstrate sex-biased effects. Finally, we report 21 novel lipid loci identified on the X chromosome. Many of the sex-biased autosomal and X chromosome lipid loci show pleiotropic associations with sex hormones, emphasizing the role of hormone regulation in lipid metabolism.Taken together, our findings provide insights into the biological mechanisms through which associated variants lead to altered lipid levels and potentially cardiovascular disease risk.
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| 5. |
- Muñoz, Nubia, et al.
(author)
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Impact of Human Papillomavirus (HPV)-6/11/16/18 Vaccine on All HPV-Associated Genital Diseases in Young Women.
- 2010
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In: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 102, s. 325-339
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Journal article (peer-reviewed)abstract
- Background The impact of the prophylactic vaccine against human papillomavirus (HPV) types 6, 11, 16, and 18 (HPV6/11/16/18) on all HPV-associated genital disease was investigated in a population that approximates sexually naive women in that they were "negative to 14 HPV types" and in a mixed population of HPV-exposed and -unexposed women (intention-to-treat group). Methods This analysis studied 17 622 women aged 15-26 years who were enrolled in one of two randomized, placebo-controlled, efficacy trials for the HPV6/11/16/18 vaccine (first patient on December 28, 2001, and studies completed July 31, 2007). Vaccine or placebo was given at day 1, month 2, and month 6. All women underwent cervicovaginal sampling and Papanicolaou (Pap) testing at day 1 and every 6-12 months thereafter. Outcomes were any cervical intraepithelial neoplasia; any external anogenital and vaginal lesions; Pap test abnormalities; and procedures such as colposcopy and definitive therapy. Absolute rates are expressed as women with endpoint per 100 person-years at risk. Results The average follow-up was 3.6 years (maximum of 4.9 years). In the population that was negative to 14 HPV types, vaccination was up to 100% effective in reducing the risk of HPV16/18-related high-grade cervical, vulvar, and vaginal lesions and of HPV6/11-related genital warts. In the intention-to-treat group, vaccination also statistically significantly reduced the risk of any high-grade cervical lesions (19.0% reduction; rate vaccine = 1.43, rate placebo = 1.76, difference = 0.33, 95% confidence interval [CI] = 0.13 to 0.54), vulvar and vaginal lesions (50.7% reduction; rate vaccine = 0.10, rate placebo = 0.20, difference = 0.10, 95% CI = 0.04 to 0.16), genital warts (62.0% reduction; rate vaccine = 0.44, rate placebo = 1.17, difference = 0.72, 95% CI = 0.58 to 0.87), Pap abnormalities (11.3% reduction; rate vaccine = 10.36, rate placebo = 11.68, difference = 1.32, 95% CI = 0.74 to 1.90), and cervical definitive therapy (23.0% reduction; rate vaccine = 1.97, rate placebo = 2.56, difference = 0.59, 95% CI = 0.35 to 0.83), irrespective of causal HPV type. Conclusions High-coverage HPV vaccination programs among adolescents and young women may result in a rapid reduction of genital warts, cervical cytological abnormalities, and diagnostic and therapeutic procedures. In the longer term, substantial reductions in the rates of cervical, vulvar, and vaginal cancers may follow.
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| 6. |
- Wallén Warner, Henriette, 1972-, et al.
(author)
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A behavioural study of quadbike drivers
- 2016
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Conference paper (peer-reviewed)abstract
- As quadbikes are becoming more and more common in Sweden the number of accidents also increases. The first aim of this study was therefore to increase our knowledge of how and where quadbikes are used, the mistakes and violations drivers make and what situations they consider as hazardous. The second aim was to increase our knowledge of the accidents. Seven injured and 22 non-injured quadbike drivers were interviewed. The results show that quadbikes are highly appreciated as tools, as vehicles for recreation and as means of transport. Inexperienced drivers’ lack of knowledge, alternatively experienced drivers’ stress and/or carelessness combined with the quadbikes special characteristics; underage drivers and passengers; quadbike-driving under the influence of alcohol and excessive speed are all factors that could contribute to accident involvement; and without a helmet the consequences of these accident might become more severe. To combat these problems, and to reduce the number of quadbike accidents, the authors suggest changes to the law for helmets, a short specialized course focusing on practical quadbike driving in combination with a theoretical education focusing on risk awareness as well as a national mobilization against quadbike driving under the influence of alcohol and underage drivers.
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| 7. |
- Wallén Warner, Henriette, 1972-, et al.
(author)
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Alkohol och cykling : en multidisciplinär studie
- 2017
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Reports (other academic/artistic)abstract
- Trots att tidigare studier visat att alkoholpåverkan kan vara en bidragande faktor vid cykelolyckor finns i dagsläget relativt lite kunskap om alkohol i samband med cykling. Det övergripande syftet med denna studie var därför att öka kunskapen om alkohol i samband med cykling. Studien är uppdelad i två olika delar; en analys av Trafikverkets djupstudiedata över omkomna cyklister samt en intervjustudie utifrån tre olika perspektiv; ett socialpsykologiskt, ett emotionssociologiskt och ett fenomenografiskt. Medan analysen av djupstudiedata resulterade i utförlig statistik över de olyckor där cyklister varit alkoholpåverkade resulterade intervjustudien i en djupare kunskap om cyklisters föreställningar, emotioner och uppfattningar rörande alkohol och cykling. Utifrån resultaten rekommenderas information och/eller kampanjer för att minska förekomsten av alkoholpåverkad cykling samt mängden alkohol i samband med cykling. Däremot rekommenderas inte införandet av promillegräns och vi är tveksamma till potentialen hos förbättrad kollektivtrafik för att minska antalet alkoholpåverkade cyklister och/eller förbättra säkerheten för dem som cyklar alkoholpåverkade.
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| 8. |
- Wallén Warner, Henriette, 1972-, et al.
(author)
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En modell för säker cykling
- 2018
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Reports (other academic/artistic)abstract
- Avsikten med det tvärvetenskapliga forskningsprogrammet En stark forskningsmiljö inom området hjulburna oskyddade trafikanter är att öka kunskapen om hjulburna oskyddade trafikanter och deras speciella förutsättningar i trafikmiljön för att på sikt kunna bidra till att nå det nationella hänsynsmålet med fokus på säkerhet. Syftet med denna modellrapport är att sammanfatta resultat och föreslagna åtgärder från de övriga åtta projekten inom ramen för forskningsprogrammet, men även från tidigare forskning och andra programövergripande aktiviteter, i en modell för säker cykling. Med modell avser vi i detta fall en lista över åtgärdsförslag som i enlighet med Haddons matris, utökad med förutsättningar, är riktade mot cyklisten, cykeln och trafikmiljön. För varje åtgärdsförslag finns även angivet var i händelseförloppet från förutsättningar till krasch som åtgärden bör sättas in samt vilka aktörer vi anser är lämpade att initiera och implementera åtgärdsförslagen. För att åstadkomma säker cykling visar resultaten att man måste titta på transportsystemet i sin helhet vilket i sin tur kräver samverkan mellan olika aktörer. Slutligen behövs fortsatt forskning för att kunna optimera utformningen av de olika åtgärderna och utvärdering för att säkerställa att de haft önskad effekt.
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| 9. |
- Wallén Warner, Henriette, 1972-, et al.
(author)
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Fyrhjulingsförares beteenden och felhandlingar
- 2015
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Reports (other academic/artistic)abstract
- I takt med att fyrhjulingarna blir allt fler ökar också antalet olyckor. Det första syftet med detta projekt var därför att öka kunskapen om de olyckor som inträffar medan det andra syftet var att öka kunskapen om var och hur fyrhjulingar framförs, vilka misstag och regelbrott som görs samt vilka situationer och beteenden som förarna anser är riskfyllda. Projektet var uppdelat i två delstudier där 51 vägtrafikolyckor registrerade i Strada-polis först analyserades, varefter sju skadade förare (inblandade i någon av de 51 vägtrafikolyckorna som registrerats i Strada) och 22 icke-skadade förare intervjuades. Resultaten visar att fyrhjulingen är ett uppskattat fordon som arbetsredskap, nöjesfordon så väl som transportmedel. Oerfarna förares bristande kunskap alternativt erfarna förares stress och/eller slarv i kombination med fyrhjulingens speciella egenskaper; minderåriga förare; fyrhjulingskörning under alkoholpåverkan samt för höga hastigheter, riskerar dock att leda till olyckor och utan hjälm kan konsekvenserna dessutom bli extra allvarliga. Med studiens resultat som grund rekommenderar författarna därför en rad åtgärder för att minska antalet allvarliga fyrhjulingsolyckor.
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| 10. |
- Warner, Henriette Wallén, et al.
(author)
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A comparison between Swedish and Nigerian taxi drivers
- 2007
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In: Proceedings of the International Cooperation on Theories and Concepts in Traffic Safety (ICTCT) Workshop. - Beijing, Kina.
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Book chapter (other academic/artistic)abstract
- In 2004 approximately 1.2 million people were killed in road traffic accidents and as many as 50 million were injured according to the World Health Organization. Vulnerable road users (e.g. pedestrians, bicyclists, motorcyclists, rickshaw- and cart-drivers) in low- and middle-income countries shoulder a large proportion of the global burden of road traffic deaths and serious injury. The elderly, children and disabled are especially vulnerable. While road traffic accident deaths in high-income countries are projected to decrease by 27% between 2000 and 2020, they are projected to increase by 83% in low- and middle-income countries. One of the World Health Organization’s concluding recommendations for the future was therefore to “enhance programmes of law enforcement with public information and education campaigns”. One problem with this is, however, that we know very little about how road users in low- and middle-income countries perceive the traffic environment and why they make the decisions they do. This is because much research focuses on European or American road users while, for example, African road users are hardly ever represented. Research findings from high-income countries can sometimes be successfully used even in low- and middle-income countries but this is far from always the case. One reason to why research findings in road safety are not always globally applicable is that the traffic environment is very different in different parts of the world, but also because of ideological bias in research. While most accident literature is based on “rational” approaches where accidents are seen as preventable many people in low-income countries have a completely different worldview where predestination plays an important role. In an attempt to further the knowledge about African road users a small pilot study was conducted comparing Nigerian and Swedish taxi drivers. The study was based on the theory of planned behaviour and addressed behaviours such as exceeding the speed limits and not using seat belts. This pilot study is the first in a series of studies. The results as well as their implications for the future studies will therefore be discussed.
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