| 1. |
- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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| 2. |
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| 3. |
- Drake, TM, et al.
(author)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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In: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Journal article (peer-reviewed)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
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| 4. |
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| 5. |
- Abdo, A. A., et al.
(author)
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FERMI/LARGE AREA TELESCOPE BRIGHT GAMMA-RAY SOURCE LIST
- 2009
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In: Astrophysical Journal Supplement Series. - : American Astronomical Society. - 0067-0049 .- 1538-4365. ; 183:1, s. 46-66
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Journal article (peer-reviewed)abstract
- Following its launch in 2008 June, the Fermi Gamma-ray Space Telescope (Fermi) began a sky survey in August. The Large Area Telescope (LAT) on Fermi in three months produced a deeper and better resolved map of the gamma-ray sky than any previous space mission. We present here initial results for energies above 100 MeV for the 205 most significant (statistical significance greater than similar to 10 sigma) gamma-ray sources in these data. These are the best characterized and best localized point-like (i.e., spatially unresolved) gamma-ray sources in the early mission data.
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| 6. |
- Abdo, A. A., et al.
(author)
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A limit on the variation of the speed of light arising from quantum gravity effects
- 2009
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 462:7271, s. 331-334
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Journal article (peer-reviewed)abstract
- A cornerstone of Einstein’s special relativity is Lorentz invariance—the postulate that all observers measure exactly the same speed of light in vacuum, independent of photon-energy. While special relativity assumes that there is no fundamental length-scale associated with such invariance, there is a fundamental scale (the Planck scale, lPlanck~1.62×10-33cm or EPlanck = MPlanckc2~1.22×1019GeV), at which quantum effects are expected to strongly affect the nature of space–time. There is great interest in the (not yet validated) idea that Lorentz invariance might break near the Planck scale. A key test of such violation of Lorentz invariance is a possible variation of photon speed with energy. Even a tiny variation in photon speed, when accumulated over cosmological light-travel times, may be revealed by observing sharp features in γ-ray burst (GRB) light-curves. Here we report the detection of emission up to ~31GeV from the distant and short GRB090510. We find no evidence for the violation of Lorentz invariance, and place a lower limit of 1.2EPlanck on the scale of a linear energy dependence (or an inverse wavelength dependence), subject to reasonable assumptions about the emission (equivalently we have an upper limit of lPlanck/1.2 on the length scale of the effect). Our results disfavour quantum-gravity theories in which the quantum nature of space–time on a very small scale linearly alters the speed of light.
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| 18. |
- Horne, B D, et al.
(author)
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Pharmacogenetic warfarin dose refinements remain significantly influenced by genetic factors after one week of therapy
- 2012
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In: Thrombosis and Haemostasis. - 0340-6245 .- 2567-689X. ; 107:2, s. 232-240
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Journal article (peer-reviewed)abstract
- By guiding initial warfarin dose, pharmacogenetic (PGx) algorithms may improve the safety of warfarin initiation. However, once international normalised ratio (INR) response is known, the contribution of PGx to dose refinements is uncertain. This study sought to develop and validate clinical and PGx dosing algorithms for warfarin dose refinement on days 6-11 after therapy initiation. An international sample of 2,022 patients at 13 medical centres on three continents provided clinical, INR, and genetic data at treatment days 6-11 to predict therapeutic warfarin dose. Independent derivation and retrospective validation samples were composed by randomly dividing the population (80%/20%). Prior warfarin doses were weighted by their expected effect on S-warfarin concentrations using an exponential-decay pharmacokinetic model. The INR divided by that "effective" dose constituted a treatment response index . Treatment response index, age, amiodarone, body surface area, warfarin indication, and target INR were associated with dose in the derivation sample. A clinical algorithm based on these factors was remarkably accurate: in the retrospective validation cohort its R2 was 61.2% and median absolute error (MAE) was 5.0 mg/week. Accuracy and safety was confirmed in a prospective cohort (N=43). CYP2C9 variants and VKORC1-1639 G→A were significant dose predictors in both the derivation and validation samples. In the retrospective validation cohort, the PGx algorithm had: R2= 69.1% (p<0.05 vs. clinical algorithm), MAE= 4.7 mg/week. In conclusion, a pharmacogenetic warfarin dose-refinement algorithm based on clinical, INR, and genetic factors can explain at least 69.1% of therapeutic warfarin dose variability after about one week of therapy.
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| 19. |
- Abdo, A. A., et al.
(author)
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FERMI/LARGE AREA TELESCOPE DISCOVERY OF GAMMA-RAY EMISSION FROM THE FLAT-SPECTRUM RADIO QUASAR PKS 1454-354
- 2009
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In: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 697:1, s. 934-941
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Journal article (peer-reviewed)abstract
- We report the discovery by the Large Area Telescope (LAT) onboard the Fermi Gamma-Ray Space Telescope of high-energy gamma-ray (GeV) emission from the flat-spectrum radio quasar PKS 1454-354 (z = 1.424). On 2008 September 4, the source rose to a peak flux of (3.5 +/- 0.7) x 10(-6) ph cm(-2) s(-1) (E > 100 MeV) on a timescale of hours and then slowly dropped over the following 2 days. No significant spectral changes occurred during the flare. Fermi/LAT observations also showed that PKS 1454-354 is the most probable counterpart of the unidentified EGRET source 3EG J1500-3509. Multiwavelength measurements performed during the following days (7 September with Swift; 6-7 September with the ground-based optical telescope Automated Telescope for Optical Monitoring; 13 September with the Australia Telescope Compact Array) resulted in radio, optical, UV, and X-ray fluxes greater than archival data, confirming the activity of PKS 1454-354.
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| 20. |
- Abdo, A. A., et al.
(author)
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MULTIWAVELENGTH MONITORING OF THE ENIGMATIC NARROW-LINE SEYFERT 1 PMN J0948+0022 IN 2009 MARCH-JULY
- 2009
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In: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 707:1, s. 727-737
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Journal article (peer-reviewed)abstract
- Following the recent discovery of gamma rays from the radio-loud narrow-line Seyfert 1 galaxy PMN J0948+0022 (z = 0.5846), we started a multiwavelength campaign from radio to gamma rays, which was carried out between the end of 2009 March and the beginning of July. The source displayed activity at all the observed wavelengths: a general decreasing trend from optical to gamma-ray frequencies was followed by an increase of radio emission after less than two months from the peak of the gamma-ray emission. The largest flux change, about a factor of about 4, occurred in the X-ray band. The smallest was at ultraviolet and near-infrared frequencies, where the rate of the detected photons dropped by a factor 1.6-1.9. At optical wavelengths, where the sampling rate was the highest, it was possible to observe day scale variability, with flux variations up to a factor of about 3. The behavior of PMN J0948+0022 observed in this campaign and the calculated power carried out by its jet in the form of protons, electrons, radiation, and magnetic field are quite similar to that of blazars, specifically of flat-spectrum radio quasars. These results confirm the idea that radio-loud narrow-line Seyfert 1 galaxies host relativistic jets with power similar to that of average blazars.
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| 28. |
- Hedelin, Beatrice, 1974-, et al.
(author)
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What's left before participatory modeling can fully support real-world environmental planning processes : A case study review
- 2021
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In: Environmental Modelling & Software. - : Elsevier BV. - 1364-8152 .- 1873-6726. ; 143
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Journal article (peer-reviewed)abstract
- In environmental participatory modeling (PM), both computer and non-computer-based modeling techniques are used to aid participatory problem description, solution, and decision-making actions in environmental contexts. Although many PM case studies have been published, few efforts have sought to systematically describe and understand dominant PM processes or establish best practices for PM. As a first step, we have reviewed a random sample of environmental PM case study articles (n = 60) using a novel PM process evaluation instrument. We found that significant work likely remains for PM to fully support participatory and integrated planning processes. While PM reports systematically address knowledge integration and learning, they often neglect the facilitation of a multi-value perspective within a democratic process, and the integration across organizations within a governance system. If not reported, we suspect these aspects are also neglected in practice. We conclude with key research and practice issues for improving PM as an approach for real-world participatory planning and governance.
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| 34. |
- Abdo, A. A., et al.
(author)
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FERMI LARGE AREA TELESCOPE OBSERVATIONS OF THE VELA PULSAR
- 2009
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In: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 696:2, s. 1084-1093
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Journal article (peer-reviewed)abstract
- The Vela pulsar is the brightest persistent source in the GeV sky and thus is the traditional first target for new gamma-ray observatories. We report here on initial Fermi Large Area Telescope observations during verification phase pointed exposure and early sky survey scanning. We have used the Vela signal to verify Fermi timing and angular resolution. The high-quality pulse profile, with some 32,400 pulsed photons at E >= 0.03 GeV, shows new features, including pulse structure as fine as 0.3 ms and a distinct third peak, which shifts in phase with energy. We examine the high-energy behavior of the pulsed emission; initial spectra suggest a phase-averaged power-law index of Gamma = 1.51(-0.04)(+0.05) with an exponential cutoff at E-c = 2.9 +/- 0.1 GeV. Spectral fits with generalized cutoffs of the form e(-(E/Ec)b) require b <= 1, which is inconsistent with magnetic pair attenuation, and thus favor outer-magnetosphere emission models. Finally, we report on upper limits to any unpulsed component, as might be associated with a surrounding pulsar wind nebula.
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| 35. |
- Abdo, A. A., et al.
(author)
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FERMI OBSERVATIONS OF HIGH-ENERGY GAMMA-RAY EMISSION FROM GRB 080825C
- 2009
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In: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 707:1, s. 580-592
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Journal article (peer-reviewed)abstract
- The Fermi Gamma-ray Space Telescope has opened a new high-energy window in the study of gamma-ray bursts (GRBs). Here we present a thorough analysis of GRB 080825C, which triggered the Fermi Gamma-ray Burst Monitor (GBM), and was the first firm detection of a GRB by the Fermi Large Area Telescope (LAT). We discuss the LAT event selections, background estimation, significance calculations, and localization for Fermi GRBs in general and GRB 080825C in particular. We show the results of temporal and time-resolved spectral analysis of the GBM and LAT data. We also present some theoretical interpretation of GRB 080825C observations as well as some common features observed in other LAT GRBs.
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| 36. |
- Aoun, M. -C, et al.
(author)
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Gas Security of Supply in the European Union
- 2017
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In: Europe's Energy Transition. - : Elsevier. - 9780128098066 - 9780128099032 ; , s. 67-78
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Book chapter (peer-reviewed)abstract
- The EU remains widely dependent on external gas supplies, with imports representing 70% of its consumption in 2013. Member States have different import profiles with divergent levels of dependency on Russian imports. Several European Member States rely heavily on Russian supplies, which shows that the EU gas supply security needs to be examined both from an internal and international perspective. Since the 2009 crisis between Russia and Ukraine, the EU has adopted several legislative tools to strengthen EU gas security of supply. The third legislative package, the security of supply Regulation (EU) 994/2010 and the Energy Infrastructure package identifying Projects of Common Interest have significantly improved the ability of the EU to face import disruptions. However, several countries remain particularly vulnerable to the occurrence of disruption. When considering national production, storage, and the diversity of suppliers, Bulgaria, Czech Republic, Estonia, Finland, Latvia, and Lithuania seem to be at risk. Romania, Poland, and Hungary also import the bulk of their gas from Russia, but have either domestic production or significant storage capacity.
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| 37. |
- Bergkvist, C., et al.
(author)
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Dietary exposure to polychlorinated biphenyls is associated with increased risk of stroke in women
- 2014
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In: Journal of Internal Medicine. - : WILEY. - 0954-6820 .- 1365-2796. ; 276:3, s. 248-259
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Journal article (peer-reviewed)abstract
- Objective. The potentially beneficial effects of fish consumption on stroke may be modified by major food contaminants in fish. Polychlorinated biphenyls (PCBs) in particular are proposed to play a role in the aetiology of stroke. The aim of this study was to assess the association between dietary PCB exposure and stroke risk with the intake of long-chain omega-3 fish fatty acids and fish consumption. Design. The prospective population-based Swedish Mammography Cohort was examined. It was comprised of 34 591 women free of cardiovascular diseases and cancer at baseline in 1997 and followed up for 12 years. Validated estimates of dietary PCB exposure were obtained via a food frequency questionnaire at baseline. Incident cases of stroke were ascertained through register linkage. Results. During 12 years of follow-up (397 309 person-years), there were 2015 incident cases of total stroke (1532 ischaemic strokes, 216 intracerebral haemorrhages, 94 subarachnoid haemorrhages and 173 unspecified strokes). Multivariable-adjusted relative risks (RR), controlled for known stroke risk factors and fish consumption, were 1.67 [95% confidence interval (CI), 1.29-2.17] for total stroke, 1.61 (95% CI, 1.19-2.17) for ischaemic stroke and 2.80 (95% CI, 1.42-5.55) for haemorrhagic stroke for women in the highest quartile of dietary PCB exposure (median 288 ng day(-1)) compared with women in the lowest quartile (median 101 ng day(-1)). Conclusion. Dietary exposure to PCBs was associated with an increased stroke risk in women, especially haemorrhagic stroke. The results provide important information regarding the risk-benefit analysis of fish consumption, particularly for cerebrovascular disease prevention.
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| 41. |
- Darnerud, P O, et al.
(author)
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Dietary intake estimations of organohalogen contaminants (dioxins, PCB, PBDE and chlorinated pesticides, e.g. DDT) based on Swedish market basket data
- 2006
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In: Food and Chemical Toxicology. - : Elsevier BV. - 0278-6915 .- 1873-6351. ; 44:9, s. 1597-1606
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Journal article (peer-reviewed)abstract
- By use of a Swedish Market basket study from 1999, in which foods were sampled from four regions, the dietary intake of persistent organic pollutants (POPs) was assessed. Based on earlier data, six food groups (fish, meat, dairy products, egg, fats/oils, and pastries; comprising 52 food items) were selected for POP analyses. Homogenates from these six groups were subjected to POP analyses and levels presented on dioxins (PCDD/PCDFs), dioxin-like PCBs, PCB-153, summation operatorPCBs, BDE-47, summation operatorPBDEs, DDE, summation operatorDDTs, HCB, summation operatorHCHs, and summation operatorchlordanes, after adjusting non-quantified levels to 1/2 LOQ. For all compounds, the fish homogenate contained the comparatively highest levels, on a fresh weight basis. Intake calculations based on the six food groups showed that summation operatorPCBs and summation operatorDDTs gave per capita intakes of 615 and 523 ng/day, respectively, that the estimated summation operatorPBDE intake was 51 ng/day and that of dioxins and dioxin-like PCBs was 96 pg WHO-TEQ/day. The estimated mean intakes were below (total-TEQ: 1.3 pg/kgbw/day) or well below (summation operatorDDTs: 8.9 ng/kgbw/day) internationally agreed intake limits (total-TEQ: 2 pg/kgbw/day; summation operatorDDTs: 10,000 ng/kgbw/day). A number of uncertainty factors, including analytical limitations due to low POP levels in food, give reason for caution in the use of the presented intake data. However, the intake estimations of dioxins, summation operatorPCBs and summation operatorPBDEs are well in accordance to calculations of POP intakes in Sweden made by alternate methods.
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| 42. |
- Darnerud, P. O., et al.
(author)
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POP levels in breast milk and maternal serum and thyroid hormone levels in mother-child pairs from Uppsala, Sweden
- 2010
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In: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 36:2, s. 180-187
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Journal article (peer-reviewed)abstract
- In experimental studies, it has frequently been observed that the homeostasis of thyroid hormones (THs) is affected by exposure to persistent organic pollutants (POPs), such as dioxins and PCBs. In man, similar effects have been indicated in several epidemiological studies. In order to investigate the possible effect on THs at low background exposures found among the Swedish population the following study was performed. Primiparous women (n=395) in the Uppsala region were recruited between 1996 and 1999. Of these, 325 mothers agreed to donate a serum sample in late pregnancy and breast milk was obtained from 211 women 3 weeks after delivery. Babies were sampled for blood at 3 weeks (n=150) and 3 months (n=115) after birth. In connection to the sampling, questions on personal characteristics were asked. Levels of low (tri- to penta-) chlorinated PCB, di-ortho PCB, p,p'-DDE, (mono-ortho) PCB TEQ and PCDD/DF TEQ were monitored in breast milk and in mother's blood (not PCDD/DF). The results showed that the measured TH levels (thyroid-stimulating hormone - TSH, total tri-iodothyronine - TT3, free thyroxine - FT4) in mothers and children were within the reference range. Some significant associations were seen between POP exposures and TH levels in mother or child after simple regression analysis. Following adjustment for important confounding factors, the significant associations mostly disappeared. However, significantly decreasing TT3 levels with increasing prenatal low-chlorinated PCB exposure were still seen in 3 week old children, and on TT3 in mothers exposed to PCDD/DF. In conclusion, the study clearly shows the importance of adjustment for important confounding factors in the analysis of possible associations between POP exposure and hormonal effects. The remaining associations are weak in both children and mothers and the clinical consequences of these alterations are uncertain. When comparing studies that investigate associations between TH levels and POP levels during the perinatal stage, no obvious between-study concordance was seen regarding the critical dose for hormonal effects to occur.
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| 43. |
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| 44. |
- Fisher, Robert S., et al.
(author)
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ILAE official report : a practical clinical definition of epilepsy
- 2014
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In: Epilepsia. - : Wiley-Blackwell. - 0013-9580 .- 1528-1167. ; 55:4, s. 475-482
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Journal article (peer-reviewed)abstract
- Epilepsy was defined conceptually in 2005 as a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures. This definition is usually practically applied as having two unprovoked seizures >24h apart. The International League Against Epilepsy (ILAE) accepted recommendations of a task force altering the practical definition for special circumstances that do not meet the two unprovoked seizures criteria. The task force proposed that epilepsy be considered to be a disease of the brain defined by any of the following conditions: (1) At least two unprovoked (or reflex) seizures occurring >24h apart; (2) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10years; (3) diagnosis of an epilepsy syndrome. Epilepsy is considered to be resolved for individuals who either had an age-dependent epilepsy syndrome but are now past the applicable age or who have remained seizure-free for the last 10years and off antiseizure medicines for at least the last 5years. "Resolved" is not necessarily identical to the conventional view of "remission or "cure." Different practical definitions may be formed and used for various specific purposes. This revised definition of epilepsy brings the term in concordance with common use. A PowerPoint slide summarizing this article is available for download in the Supporting Information section.
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| 46. |
- Glynn, A., et al.
(author)
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Determinants of serum concentrations of perfluoroalkyl acids (PFAAs) in school children and the contribution of low-level PFAA-contaminated drinking water
- 2020
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In: Environmental Science-Processes & Impacts. - : Royal Society of Chemistry (RSC). - 2050-7887 .- 2050-7895. ; 22:4, s. 930-944
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Journal article (peer-reviewed)abstract
- Little is known about the demographic/life-style/physiological determinants explaining the variation of serum perfluoroalkyl acid (PFAA) concentrations in children. We identified significant determinants in children and investigated the influence of low-level PFAA-contaminated drinking water (DW) (<10 ng L(-1)of single PFAAs) on serum concentrations. Four perfluorosulfonic acids (PFSAs) and 11 perfluorocarboxylic acids (PFCAs) were analyzed in serum from 5(th)grade children from 11 Swedish schools (N= 200; average age: 12 years) using liquid chromatography-tandem-mass-spectrometry. Data on demography and life-style/physiological factors were obtained by questionnaires. PFAA concentrations in raw and drinking water (DW) were obtained from the water works supplying DW to the schools. In multiple regression analyses school was the determinant contributing most to the variation in PFAA concentrations, with the lowest contribution for PFHpA (10%) and the highest for PFHxS (81%). Girls had lower adjusted mean concentrations of PFHxS, PFOS, PFNA and PFDA than boys, but a higher concentration of PFHxA. Girls reporting onset of menstruation had lower PFHxS and PFOA concentrations than other girls, suggesting menstrual bleeding elimination. Children born by mothers from less industrialized countries had lower mean concentrations of both PFSAs and PFCAs than children with mothers from highly industrialized countries, suggesting differences in early-life exposure. Life-style factors associated with paternal education levels appeared to influence PFAA concentrations differently than maternal education level. Already at an average DW PFHxS concentration of 2 ng L-1, children had a significantly higher adjusted mean serum PFHxS concentration than at an average DW concentration of <1.6 ng PFHxS L-1. Similar results were observed for PFOS and PFOA. The DW variable explained 16% (PFOA) to 78% (PFHxS) of the variation in serum PFAA concentrations, suggesting that low-level-contaminated DW is a significant source of exposure for children in Sweden. Although some of the associations, especially those with menstruation and maternal birth country, should be interpreted with extra caution due to the small size of the study, the results contribute to future work on identifying populations of children at risk of elevated PFAA exposures.
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| 47. |
- Glynn, A. Wicklund, et al.
(author)
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Organochlorines and bone mineral density in Swedish men from the general population
- 2000
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In: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 11:12, s. 1036-1042
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Journal article (peer-reviewed)abstract
- Persistent organochlorines (POCs), such as polychlorinated biphenyls (PCBs) and DDT, are present at relatively high concentrations in food and show estrogenic, anti-estrogenic or anti-androgenic activity in biological test systems. Because bone mineral density (BMD) in men is influenced by sex hormones, we looked for associations between BMD and serum concentrations of POCs in 115 men (mean age 63 years, range 40-75 years) from the general Swedish population. Ten PCB congeners, five DDT isomers, hexachlorobenzene, three hexachlorocyclohexane isomers, trans-nonachlor and oxychlordane were analyzed by gas chromatography. Quantitative bone measurements were performed by dual-energy X-ray absorptiometry at three sites: whole body, the L2-L4 region of the lumbar spine, and the neck region of the proximal femur, as well as by quantitative ultrasound on the left os calcis (broadband ultrasound attenuation (BUA) and speed of sound (SOS)). After adjustment for confounding factors in linear regression analyses we found no strong association between serum concentrations of single POCs and the five BMD and ultrasound variables. When POCs were grouped according to hormonal activity (estrogenic, anti-estrogenic, anti-androgenic) and the study subjects were divided into organochlorine concentration quartiles, a weak association was indicated between increased serum concentrations of p,p'-DDE (antiandrogenic) and decreased BMD, BUA and SOS. This may suggest that p,p'-DDE could cause negative effects on bone density, but the findings might also be due to chance since multiple comparisons were made in the statistical analysis. Overall our results do not suggest that the studied POCs caused major effects on bone density in our study group.
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