| 1. |
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| 2. |
- Glimelius, Bengt, et al.
(author)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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In: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Journal article (peer-reviewed)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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| 3. |
- Hansson, Jonny, et al.
(author)
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An optimisation strategy in a digital environment applied to neonatal chest imaging.
- 2005
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In: Radiation protection dosimetry. - : Oxford University Press (OUP). - 0144-8420 .- 1742-3406. ; 114:1-3, s. 278-85
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Journal article (peer-reviewed)abstract
- The aim of this study was to find the optimum tube voltage for neonatal chest imaging in computed radiography. The study was designed to take full advantage of the benefits of digital imaging, for example, by comparing the tube voltages at constant effective dose. A phantom study using a living rabbit was first conducted. Images were collected at tube voltages ranging from 40 to 90 kV(p). The reproduction of four structures (central vessels, peripheral vessels, carina and thoracic vertebrae) was rated by 10 radiologists. The reproduction of both central and peripheral vessels was relatively independent of tube voltage. The carina was better reproduced at higher tube voltages whereas the opposite was true for the thoracic vertebrae. Based on the higher importance of the reproduction of the carina it was decided that 90 kV(p) was the optimal tube voltage. To validate the result from the phantom study, a follow-up study was conducted in which images of neonates collected at the tube voltage regularly used at Sahlgrenska University Hospital (70 kV(p)) were compared with images collected at the tube voltage proposed by the phantom study. The follow-up study confirmed the results from the phantom study that the reproduction of the carina was better at 90 than at 70 kV(p). In conclusion, for neonatal chest imaging-given the same effective dose-90 kVp gives better reproduction of important structures than the regularly used 70 kV(p).
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| 4. |
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| 5. |
- Jonsson, Sarah, 1982-
(author)
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Pelvic inflammatory disease and epithelial ovarian tumors
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Background: Epithelial ovarian cancer and borderline ovarian tumors consist of several histotypes in which high-grade serous carcinoma is the most common. The majority of epithelial ovarian tumors are considered to originate in the fimbriated end of the fallopian tubes. What initiates these tumors is far from completely understood. Pelvic inflammatory disease has been proposed as a modifiable risk factor for epithelial ovarian tumors. A major cause of pelvic inflammatory disease is Chlamydia trachomatis which has been shown to have cancer-causing potential. The overall purpose of this thesis was to study associations of pelvic inflammatory disease and C. trachomatis with risk of epithelial ovarian tumors.Methods: In a cross-sectional study (Paper I) we collected ovarian tissue and corresponding blood samples from 69 women undergoing surgery due to suspected ovarian pathology. C. trachomatis specific protein (immunohistochemistry) and C. trachomatis DNA (qPCR) in ovarian tissue were analyzed (Paper I). In a nested case-control study (Paper II) prospective blood samples from 92 women diagnosed with high-grade serous ovarian cancer were matched to four controls each for age and date of plasma sampling. C. trachomatis specific plasma antibodies were analyzed by commercial Enzyme-Linked ImmunoSorbent Assay (ELISA) and Micro-ImmunoFluorescence (MIF) (Paper I and Paper II). We performed a nationwide register-based case-control study where we included 15 072 women diagnosed with epithelial ovarian cancer (Paper III), 4782 women diagnosed with borderline ovarian tumors (Paper IV), and ten controls each matched for age and residential district. Using national Swedish registers, we retrieved data on historyof pelvic inflammatory disease and the potential confounding factors parity, educational level, previous gynecological surgery, and hormonal therapy.Results: We found C. trachomatis DNA in ovarian tissue of eight women with ovarian carcinoma, but not in ovarian tissue from women with borderline ovarian tumors or benign disease (Paper I). The prevalence of the C. trachomatis specific protein did not differ in benign and malignant tissue (Paper I). Prevalence of C. trachomatis specific plasma antibodies was similar in cases and controls at diagnosis (Paper I) and prospectively (Paper II). A history of clinically verified pelvic inflammatory disease was associated with an increased risk of epithelial ovarian cancer overall (Paper III) and borderline ovarian tumors overall (Paper IV). Histotype-specific analyses showed an increased risk of serous carcinoma (Paper III), high-grade serous carcinoma (Paper III), clear cell carcinoma (Paper III), and serous borderline ovarian tumors (Paper IV) but not significantly with other histotypes. A dose-response relationship was seen between an increased number of pelvic inflammatory disease episodes and epithelial ovarian cancer (Paper III), as well as borderline ovarian tumors (Paper IV).Conclusions: This thesis contributes to an improved understanding of the association between pelvic inflammatory disease and epithelial ovarian tumors. The results regarding C. trachomatis are inconclusive and suggests that the association of pelvic inflammatory disease with epithelial ovarian tumors acts through mechanisms other than Chlamydia alone.
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| 6. |
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| 7. |
- Jonsson, Sarah, et al.
(author)
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Pelvic inflammatory disease and risk of epithelial ovarian cancer : a national population-based case-control study in Sweden
- 2024
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In: American Journal of Obstetrics and Gynecology. - : Elsevier. - 0002-9378 .- 1097-6868. ; 230:1, s. 75.e1-75.e15
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Journal article (peer-reviewed)abstract
- Background: Epithelial ovarian cancer is an insidious disease, and women are often diagnosed when the disease is beyond curative treatment. Accordingly, identifying modifiable risk factors is of paramount importance. Inflammation predisposes an individual to cancer in various organs, but whether pelvic inflammatory disease is associated with an increased risk of epithelial ovarian cancer has not been fully determined.Objective: This study aimed to investigate a possible association between clinically verified pelvic inflammatory disease and the risk of epithelial ovarian cancer.Study Design: In this national population-based case-control study, all women in Sweden diagnosed with epithelial ovarian cancer between 1999 and 2020 and 10 controls for each were identified, matched for age and residential district. Using several Swedish nationwide registers, data on previous pelvic inflammatory disease and potential confounding factors (age, parity, educational level, and previous gynecologic surgery) were retrieved. Adjusted odds ratios and 95% confidence intervals were estimated using conditional logistic regression. Histotype-specific analyses were performed for the subgroup of women diagnosed with epithelial ovarian cancer between 2015 and 2020. Moreover, hormonal contraceptives and menopausal hormone therapy were adjusted in addition to the aforementioned confounders.Results: This study included 15,072 women with epithelial ovarian cancer and 141,322 controls. Most women (9102 [60.4%]) had serous carcinoma. In a subgroup of cases diagnosed between 2015 and 2020, high-grade serous carcinoma (2319 [60.0%]) was identified. A total of 168 cases (1.1%) and 1270 controls (0.9%) were diagnosed with pelvic inflammatory disease. Previous pelvic inflammatory disease was associated with an increased risk of epithelial ovarian cancer (adjusted odds ratio, 1.39; 95% confidence interval, 1.17–1.66) and serous carcinoma (adjusted odds ratio, 1.46; 95% confidence interval, 1.18–1.80) for the entire study population. For the subgroup of women diagnosed in 2015–2020, pelvic inflammatory disease was associated with high-grade serous carcinoma (adjusted odds ratio, 1.43; 95% confidence interval, 1.01–2.04). The odds ratios of the other histotypes were as follows: endometrioid (adjusted odds ratio, 0.13; 95% confidence interval, 0.02–1.06), mucinous (adjusted odds ratio, 1.55; 95% confidence interval, 0.56–4.29), and clear cell carcinoma (adjusted odds ratio, 2.30; 95% confidence interval, 0.90–5.86). A dose-response relationship was observed between the number of pelvic inflammatory disease episodes and the risk of epithelial ovarian cancer (Ptrend<.001).Conclusion: A history of pelvic inflammatory disease is associated with an increased risk of epithelial ovarian cancer and a dose-response relationship is evident. Histotype-specific analyses show an association with increased risk of serous epithelial ovarian cancer and high-grade serous carcinoma and potentially also with clear cell carcinoma, but there is no significant association with other histotypes. Infection and inflammation of the upper reproductive tract might have serious long-term consequences, including epithelial ovarian cancer.
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| 8. |
- Morian, Hanna, et al.
(author)
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Reliability and validity testing of team emergency assessment measure in a distributed team context
- 2023
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In: Frontiers in Psychology. - 1664-1078. ; 14
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Journal article (peer-reviewed)abstract
- Medical multi-professional teams are increasingly collaborating via telemedicine. In distributed team settings, members are geographically separated and collaborate through technology. Developing improved training strategies for distributed teams and finding appropriate instruments to assess team performance is necessary. The Team Emergency Assessment Measure (TEAM), an instrument validated in traditional collocated acute-care settings, was tested for validity and reliability in this study when used for distributed teams. Three raters assessed video recordings of simulated team training scenarios (n = 18) among teams with varying levels of proficiency working with a remotely located physician via telemedicine. Inter-rater reliability, determined by intraclass correlation, was 0.74-0.92 on the TEAM instrument's three domains of leadership, teamwork, and task management. Internal consistency (Cronbach's alpha) ranged between 0.89-0.97 for the various domains. Predictive validity was established by comparing scores with proficiency levels. Finally, concurrent validity was established by high correlations, >0.92, between scores in the three TEAM domains and the teams' overall performance. Our results indicate that TEAM can be used in distributed acute-care team settings and consequently applied in future-directed learning and research on distributed healthcare teams.
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| 9. |
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| 10. |
- Ahlbeck Bergendahl, Ida, et al.
(author)
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Fisk- och skaldjursbestånd i hav och sötvatten 2016 : Resursöversikt
- 2016
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Reports (other academic/artistic)abstract
- I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES).De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.Rapporten omfattar 41 fiskarter uppdelade i olika bestånd, samt sju skal- och blötdjursarter.Nytt för årets upplaga är kapitlet om ekosystemtjänster. Avsnittet beskriver de fördelar människan får genom ekosystemen, till exempel hur fisk och skaldjur kommer till nytta för människan genom föda, rekreation och biologisk mångfald. Nytt för i år är också att rapportens diagram och figurer anpassats för läsare med defekt färgseende.Översikten är utarbetad av SLU Aqua på uppdrag av Havs- och vattenmyndigheten.
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| 11. |
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| 12. |
- Alce, Günter, et al.
(author)
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VENTURI - immersiVe ENhancemenT of User-woRld Interactions
- 2012
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Reports (other academic/artistic)abstract
- The Augmented Reality (AR) concept has excited visionaries and researchers for decades, and finally its enabling technologies are beginning to materialize on consumer-grade mobile devices. The availability of powerful mobile computing platforms combined with fast mobile Internet access, opens the door to ‘solid’ visual/auditory augmentation of the world with geo-spatial knowledge, distilled from our personal digital lifestyles in social networks and the cloud. However, convincing AR has to date only been demonstrated on small mock-ups in controlled spaces. We have not yet seen key conditions being met to make AR a booming technology: seamless persistence and pervasiveness. This paper introduces the FP7 funded VENTURI project and its technologies, which aims to create a pervasive AR paradigm. The goal is to create an AR experience that is always present whilst never obstructing, delivering pertinent information in a ‘user’ rather than a ‘device’ centric way. This requires a change in how we think of and develop user interaction interfaces, making ‘context’ the starting point of all interactions. VENTURI addresses such issues, creating a user appropriate, contextually aware AR system, through a seamless integration of core technologies and applications on a state-of-the-art mobile platform.
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| 13. |
- Alfredson, Håkan, et al.
(author)
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Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis
- 1998
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In: American Journal of Sports Medicine. - : Sage. - 0363-5465 .- 1552-3365. ; 26:3, s. 360-366
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Journal article (peer-reviewed)abstract
- We prospectively studied the effect of heavy-load eccentric calf muscle training in 15 recreational athletes (12 men and 3 women; mean age, 44.3 +/- 7.0 years) who had the diagnosis of chronic Achilles tendinosis (degenerative changes) with a long duration of symptoms despite conventional nonsurgical treatment. Calf muscle strength and the amount of pain during activity (recorded on a visual analog scale) were measured before onset of training and after 12 weeks of eccentric training. At week 0, all patients had Achilles tendon pain not allowing running activity, and there was significantly lower eccentric and concentric calf muscle strength on the injured compared with the noninjured side. After the 12-week training period, all 15 patients were back at their preinjury levels with full running activity. There was a significant decrease in pain during activity, and the calf muscle strength on the injured side had increased significantly and did not differ significantly from that of the noninjured side. A comparison group of 15 recreational athletes with the same diagnosis and a long duration of symptoms had been treated conventionally, i.e., rest, nonsteroidal antiinflammatory drugs, changes of shoes or orthoses, physical therapy, and in all cases also with ordinary training programs. In no case was the conventional treatment successful, and all patients were ultimately treated surgically. Our treatment model with heavy-load eccentric calf muscle training has a very good short-term effect on athletes in their early forties.
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| 14. |
- Almquist, Martin, et al.
(author)
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Metabolic factors and risk of thyroid cancer in the Metabolic syndrome and Cancer project (Me-Can)
- 2011
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In: Cancer Causes and Control. - : Springer. - 0957-5243 .- 1573-7225. ; 22:5, s. 743-751
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Journal article (peer-reviewed)abstract
- Objective To investigate metabolic factors and their possible impact on risk of thyroid cancer. Methods A prospective cohort study was conducted based on seven population-based cohorts in Norway, Austria, and Sweden, in the Metabolic syndrome and Cancer project (Me-Can). Altogether 578,700 men and women with a mean age of 44.0 years at baseline were followed for on average 12.0 years. Relative risk of incident thyroid cancer was assessed by levels of BMI, blood pressure, and blood levels of glucose, cholesterol, triglycerides, and by a combined metabolic syndrome (MetS) score. Risk estimates were investigated for quintiles, and a z score distribution of exposures was analyzed using Cox proportional hazards regression. Results During follow-up, 255 women and 133 men were diagnosed with thyroid cancer. In women, there was an inverse association between glucose and thyroid cancer risk, with adjusted RR: 95% CI was 0.61 (0.41–0.90), p trend = 0.02 in the fifth versus the first quintile, and a positive association between BMI and thyroid cancer risk with a significant trend over quintiles. There was no association between the other metabolic factors, single or combined (Met-S), and thyroid cancer. Conclusion In women, BMI was positively, while blood glucose levels were inversely, associated with thyroid cancer.
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| 15. |
- Ancelle-Park, R., et al.
(author)
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Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet
- 2012
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In: Journal of Medical Screening. - : SAGE Publications. - 0969-1413 .- 1475-5793. ; 19, s. 5-13
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Journal article (peer-reviewed)abstract
- Objectives To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women. Methods From the studies reviewed, the primary benefit of screening, breast cancer mortality reduction, was compared with the main harms, over-diagnosis and false-positive screening results (FPRs). Results Pooled estimates of breast cancer mortality reduction among invited women were 25% in incidence-based mortality studies and 31% in case-control studies (38% and 48% among women actually screened). Estimates of over-diagnosis ranged from 1% to 10% of the expected incidence in the absence of screening. The combined estimate of over-diagnosis for screened women, from European studies correctly adjusted for lead time and underlying trend, was 6.5%. For women undergoing 10 biennial screening tests, the estimated cumulative risk of a FPR followed by non-invasive assessment was 17%, and 3% having an invasive assessment. For every 1000 women screened biennially from age 50-51 until age 68-69 and followed up to age 79, an estimated seven to nine lives are saved, four cases are over-diagnosed, 170 women have at least one recall followed by non-invasive assessment with a negative result and 30 women have at least one recall followed by invasive procedures yielding a negative result. Conclusions The chance of saving a woman's life by population-based mammographic screening of appropriate quality is greater than that of over-diagnosis. Service screening in Europe achieves a mortality benefit at least as great as the randomized controlled trials. These outcomes should be communicated to women offered service screening in Europe.
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| 16. |
- Andersson, Mattias, et al.
(author)
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Editor's Choice – Structured Computed Tomography Analysis can Identify the Majority of Patients at Risk of Post-Endovascular Aortic Repair Rupture
- 2022
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 64, s. 166-174
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Journal article (peer-reviewed)abstract
- Objective: The main objective was to report mechanisms and precursors for post-endovascular aneurysm repair (EVAR) rupture. The second was to apply a structured protocol to explore whether these factors were identifiable on follow up computed tomography (CT) prior to rupture. The third objective was to study the incidence, treatment, and outcome of post-EVAR rupture. Methods: This was a multicentre, retrospective study of patients treated with standard EVAR at five Swedish hospitals from 2008 to 2018. Patients were identified from the Swedvasc registry. Medical records were reviewed up to 2020. Index EVAR and follow up data were recorded. The primary endpoint was post-EVAR rupture. CT at follow up and at post-EVAR rupture were studied, using a structured protocol, to determine rupture mechanisms and identifiable precursors. Results: In 1 805 patients treated by EVAR, 45 post-EVAR ruptures occurred in 43 patients. The cumulative incidence was 2.5% over a mean follow up of 5.2 years. The incidence rate was 4.5/1 000 person years. Median time to post-EVAR rupture was 4.1 years. A further six cases of post-EVAR rupture in five patients found outside the main cohort were included in the analysis of rupture mechanisms only. The rupture mechanism was type IA in 20 of 51 cases (39%), IB in 20 of 51 (39%) and IIIA/B in 11 of 51 (22%). One of these had type IA + IB combined. One patient had an aortoduodenal fistula without another mechanism being identified. Precursors had been noted on CT follow up prior to post-EVAR rupture in 16 of 51 (31%). Retrospectively, using the structured protocol, precursors could be identified in 43 of 51 (84%). In 17 of 27 (63%) cases missed on follow up but retrospectively identifiable, the mechanisms were type IB/III. Overall, the 30 day mortality rate after post-EVAR rupture was 47% (n = 24/51) and the post-operative mortality rate was 21% (n = 7/33). Conclusions: Most precursors of post-EVAR rupture are underdiagnosed but identifiable before rupture using a structured follow up CT protocol. Precursors of type IB and III failures caused the majority of post-EVAR ruptures.
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| 17. |
- Andreou, Dimitrios, et al.
(author)
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d-amino acid oxidase activator gene (DAOA) variation affects cerebrospinal fluid homovanillic acid concentrations in healthy Caucasians
- 2012
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In: European Archives of Psychiatry and Clinical Neuroscience. - : Springer Science and Business Media LLC. - 0940-1334 .- 1433-8491. ; 262:7, s. 549-556
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Journal article (peer-reviewed)abstract
- The d-amino acid oxidase activator (DAOA) protein regulates the function of d-amino oxidase (DAO), an enzyme that catalyzes the oxidative deamination of d-3,4-dihydroxyphenylalanine (D-DOPA) and d-serine. D-DOPA is converted to l-3,4-DOPA, a precursor of dopamine, whereas d-serine participates in glutamatergic transmission. We hypothesized that DAOA polymorphisms are associated with dopamine, serotonin and noradrenaline turnover in the human brain. Four single-nucleotide polymorphisms, previously reported to be associated with schizophrenia, were genotyped. Cerebrospinal fluid (CSF) samples were drawn by lumbar puncture, and the concentrations of the major dopamine metabolite homovanillic acid (HVA), the major serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) and the major noradrenaline metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) were measured. Two of the investigated polymorphisms, rs3918342 and rs1421292, were significantly associated with CSF HVA concentrations. Rs3918342 was found to be nominally associated with CSF 5-HIAA concentrations. None of the polymorphisms were significantly associated with MHPG concentrations. Our results indicate that DAOA gene variation affects dopamine turnover in healthy individuals, suggesting that disturbed dopamine turnover is a possible mechanism behind the observed associations between genetic variation in DAOA and behavioral phenotypes in humans.
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| 18. |
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| 19. |
- Anyatonwu, Obinna Princewill, et al.
(author)
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The determinants of postpartum contraceptive use in Nigeria
- 2023
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In: Frontiers in Global Women's Health. - : Frontiers Media S.A.. - 2673-5059. ; 4
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Journal article (peer-reviewed)abstract
- Introduction: Postpartum contraception is vital for maternal and child health, and reduces the risk of infant mortality. The Health Belief Model (HBM) is a widely accepted framework for exploring health behaviors, such as contraceptive use. Therefore, this study aimed to investigate the factors influencing postpartum contraceptive use in Nigeria and to contextualize the findings within the framework of the HBM.Methods: This study was a secondary analysis of cross-sectional data collected from the Demographic Health Survey conducted in Nigeria (NDHS). In total, 28,041 women were included in this study. Self-reported contraceptive use was the outcome, while the explanatory variables included maternal age, place of residence, region of residence, religion, marital status, educational level, household wealth quintiles, knowledge of the ovulatory cycle, decision-maker for health care, and distance to health care facilities. Descriptive statistics and multivariate logistic regression were used to summarize and identify factors influencing postpartum contraceptive use. The HBM was used to discuss the main findings.Results: The prevalence of postpartum contraceptive use in Nigeria is 27%. Our findings showed that the odds of using contraceptives during the postpartum period were higher among women who knew their ovulation cycles, lived in urban areas in the southern region, had no distance barriers to health care, and were 25–49 years old. Education, wealth, and marital status also increase the odds of contraceptive use. However, women who lived in the northeast and northwest regions or shared decision-making with their partners had lower odds.Conclusion: This study highlights the need for region-specific and age-focused interventions to increase contraceptive use in Nigeria. Additionally, increasing accessibility and affordability of contraceptives for younger and economically disadvantaged women, along with promoting women's autonomy in decision-making, can further enhance contraceptive use across Nigeria.
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| 20. |
- Arrskog, Tobias, et al.
(author)
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Hyperlocal event extraction of future events
- 2012
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In: DeRiVE 2012: Detection, Representation, and Exploitation of Events in the Semantic Web (CEUR Workshop Proceedings). - 1613-0073. ; 902, s. 11-21
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Conference paper (peer-reviewed)abstract
- From metropolitan areas to tiny villages, there is a wide variety of organizers of cultural, business, entertainment, and social events. These organizers publish such information to an equally wide variety of sources. Every source of published events uses its own document structure and provides dierent sets of information. This raises signicant customization issues. This paper explores the possibilities of extracting future events from a wide range of web sources, to determine if the document structure and content can be exploited for time-ecient hyperlocal event scraping. We report on two experimental knowledge-driven, pattern-based programs that scrape events from web pages using both their content and structure.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Bergdahl, Ingvar A, et al.
(author)
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Lung cancer and exposure to quartz and diesel exhaust in Swedish iron ore miners with concurrent exposure to radon
- 2010
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In: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 67:8, s. 513-518
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Studies of underground miners have documented an increased risk of lung cancer mainly linked to radon exposure but possibly influenced by other concurrent exposures. METHODS: A cohort study was carried out in 8321 iron ore miners with low exposure to radon, employed in 1923-1998 and followed up for lung cancer in 1958-2000. Historical exposures to radon, crystalline silica and diesel exhaust were assessed. Data including exposure to radon, quartz and diesel exhaust from another mine with higher exposure to radon were reanalysed. RESULTS: Miners had increased risk for lung cancer (SIR 1.48 (95% CI 1.22 to 1.78), based on 112 cases during 227,000 person-years). The increased risk could not be explained by exposure to radon or diesel exhaust but was associated with exposure to crystalline silica: SIR 0.96 (0.53 to 1.62), 1.45 (1.10 to 1.87), 1.99 (1.31 to 2.90) and 1.77 (0.92 to 3.10) in groups with exposure to 0, 0-2, 2-5 and >5 mg years/m3, respectively. Reanalysis of data from the other mine indicated that quartz was a possible confounder in the analysis of relationship between radon and lung cancer. In the highest radon exposed group, the point estimate for the RR decreased from 5.65 to 3.90 when adjusting for concurrent exposure to quartz. CONCLUSIONS: Crystalline silica, a known carcinogen, probably affects lung cancer risk in iron ore miners. The main implication of the results is for interpretation of the dose-response curve for radon and lung cancer in underground iron ore miners. Since exposure to radon and quartz is often correlated, quartz exposure can be an important confounder.
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| 25. |
- Berglund, Håkan, et al.
(author)
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Assessing the extinction vulnerability of wood-inhabiting fungal species in fragmented northern Swedish boreal forests
- 2008
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In: Biological Conservation. - : Elsevier BV. - 0006-3207 .- 1873-2917. ; 141:12, s. 3029-3039
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Journal article (peer-reviewed)abstract
- Fragmentation of old-growth forests and greatly reduced amounts of coarse dead wood in managed forests threat the persistence of many saproxylic species in boreal Fennoscandia. Individual old-growth forest remnants may lose species over time as they pay off their extinction debt. We tested this by comparing the observed site occupancy of individual wood-inhabiting fungal species in isolated old-growth stands (i.e. woodland key habitats; WKHs) with statistical predictions of their occupancy assuming potential extinction debt had already been paid off. The occupancy of species was analysed in two sets of WKHs differing in time since isolation (i.e. recent and old isolates).Few species occurred more frequently than expected in WKHs. However, patterns across species and across all WKHs masked important differences among species in their risk of facing future extinction. The site occupancy decreased significantly between recent and old isolates for a group of annual, red-listed specialist fungal species, suggesting that an extinction debt in WKHs may exist among specific species confined to coarse dead wood and old-growth forest habitat. Generalist species that also occur in the surrounding matrix showed no negative trends, or actually increased in site occupancy, making future extinctions less likely. Thus, continuing loss of threatened species are likely if not preservation of WKHs are combined with other conservation efforts in managed forest landscapes. Natural forest landscapes may serve as important references when aiming to identify species in risk of future extinction but more detailed knowledge about the biology of the most vulnerable species is also required.
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| 26. |
- Berglund, Håkan, 1967-
(author)
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Biodiversity in fragmented boreal forests : assessing the past, the present and the future
- 2004
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Doctoral thesis (other academic/artistic)abstract
- The aims of this thesis are to (1) analyze the predictability (indicators) of plant and fungal species diversity in old-growth forests, and (2) assess the history and biodiversity of woodland key habitats (WKHs) and their potential to maintain species diversity in fragmented boreal forest landscapes. Predictability was explored in Granlandet nature reserve, an unexploited landscape composed of discrete old-growth Picea forest patches of varying size isolated by wetland, reflecting conditions of insular biota at stochastic equilibrium. Data from 46 patches (0.2-12 ha) showed that most species were rare. However, species richness and composition patterns exhibited a high degree of predictability, which strengthen the possibility to apply biodiversity indicators in old-growth forest stands. Area was a key factor. The increase in species richness starts to level out at 2-3 ha. Large patches host more Red-list species in their interiors than do small ones, i.e. stand size is an important qualitative aspect of old-growth habitat. Nestedness emerged in relation to area but also in equal-sized plots. Structural complexity and habitat quality were important for species richness and compositional patterns, and small habitats of high quality could harbor many rare species. Monitoring of wood-fungi on downed logs showed that species diversity on downed logs changed over periods of 5-10 years and that the occurrences of annual species were unpredictable. It is suggested that monitoring of species with durable fruit bodies (mainly polypores) is likely to be a feasible approach to obtain comparable data over time.Assessments of biodiversity of WKHs were performed in two areas with contrasting histories of forest exploitation, namely in south boreal and north boreal Sweden. Analyses of the history of 15 south boreal WKHs showed that fire-suppression, selective logging until mid-20th century and abandonment by modern forestry has shaped their forest structure. These WKHs are not untouched forests, they lack key structural components and harbor few Red-list species. Artificial interventions to restore natural processes and patterns are needed to further increase their suitability for threatned species. Modeling analyses of species richness in 32 WKHs in north boreal Sweden, some of which have not been isolated by modern forestry until recently, indicated an excess of crustose lichen species, i.e. WKHs may face delayed species extinctions. By contrast, the results indicate that wood-fungi have tracked the environmental changes. Differences in substrate dynamics between epiphytes on living trees and species growing on decaying logs may explain the diffeence between species groups. The results indicate that population densities of Red-list species were low, which may result in further depletion of species diversity.Continuing species declines and extinctions are likely if not conservation of WKHs are combined with other considerations in th managed forest landscape. Both WKHs and their surroundings must be managed and designed to maintain biodiversity over time. For a successful future conservation of boreal forest biodiversity monitoring of WKHs must be combined with monitoring of refeence areas.
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| 27. |
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| 28. |
- Berglund, Håkan, et al.
(author)
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Nested plant and fungal communities : the importance of area and habitat quality in maximizing species capture in boreal old-growth forests
- 2003
-
In: Biological conservation. - 0006-3207. ; 112:3, s. 319-328
-
Journal article (peer-reviewed)abstract
- Knowledge of the distribution of rare species is crucial for species conservation in fragmented habitats. Species communities often exhibit nestedness, i.e. species in species-poor sites comprise a subset of richer ones. Thus, rare species are confined to species-rich sites. We evaluate whether plant and fungal communities in 46 old-growth spruce forest patches (0.17–12 ha) exhibit nestedness. The question whether a single large patch or several small patches capture most species (i.e. the SLOSS-issue) is evaluated in combination with species saturation analyses. All species groups exhibited significant nestedness. Area was generally related to nestedness, i.e. rare species were over-represented in the largest patches. Species saturation analysis indicated that large patches accumulated more Red-list species in patch interiors than small patches. Thus, rare and Red-list species were best captured in large patches. However, nestedness also emerged in equal sized sample plots, i.e. rare species were over-represented in high quality habitats. Thus, small habitats of high quality should not be neglected in a conservation perspective.
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| 29. |
- Berglund, Håkan, et al.
(author)
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Predictability of plant and fungal species richness of old-growth boreal forest islands
- 2001
-
In: Journal of Vegetation Science. - 1100-9233 .- 1654-1103. ; 12:6, s. 857-866
-
Journal article (peer-reviewed)abstract
- The fragmentation and deterioration of old-growth forest habitat by modern forestry have become a major threat to species diversity in Fennoscandia. In order to develop a conservation strategy for the remaining diversity it is essential to identify the existing diversity and to develop appropriate conservation and monitoring programs. For these purposes indicators of conservation value for administrative prioritization are required. This study examines the predictability of plant and fungal species richness on two spatial scales on 46 isolated old-growth forest islands (0.17-12 ha) in a forest-wetland mosaic. We explore (1) to what extent area, isolation and stand structure variables can explain the variation in species richness and (2) if richness patterns of individual species groups correlate. Isolation showed no relation to species richness. Area explained 50-70% of the variation in total species richness and was positively related to the density of crustose lichens and Red-list species in island interiors. Stand structure variables explained 28-66% of the residual variation in total species richness after controlling for island size, and 15-73% of the variation in density of species in island interiors. The highest predictability of species richness was found among substrate-specific fungi and Red-list species. Different stand structure variables were found to explain richness in the different species groups, and only among a few species groups species richness correlated. Thus, species richness of one single species group is unlikely to be a good indicator for total biodiversity. The results show that measurements of stand size and stand structure variables may be a strong complementary tool. and sometimes a substitute to extensive species inventories when one aims to estimate and monitor plant and fungal species diversity in old-growth Picea abies forests.
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| 30. |
- Berglund, Håkan, et al.
(author)
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Quantifying habitat requirements of tree-living species in fragmented boreal forests with Bayesian methods
- 2009
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In: Conservation Biology. - : Wiley. - 0888-8892 .- 1523-1739. ; 23:5, s. 1127-1137
-
Journal article (peer-reviewed)abstract
- Quantitative conservation objectives require detailed consideration of the habitat requirements of target species. Tree-living bryophytes, lichens, and fungi are a critical and declining biodiversity component of boreal forests. To understand their requirements, Bayesian methods were used to analyze the relationships between the occurrence of individual species and habitat factors at the tree and the stand scale in a naturally fragmented boreal forest landscape. The importance of unexplained between-stand variation in occurrence of species was estimated, and the ability of derived models to predict species' occurrence was tested. The occurrence of species was affected by quality of individual trees. Furthermore, the relationships between occurrence of species at the tree level and size and shape of stands indicated edge effects, implying that some species were restricted to interior habitats of large, regular stands. Yet for the habitat factors studied, requirements of many species appeared similar. Species occurrence also varied between stands; most of the seemingly suitable trees in some stands were unoccupied. The models captured most variation in species occurrence at tree level. They also successfully accounted for between-stand variation in species occurrence, thus providing realistic simulations of stand-level occupancy of species. Important unexplained between-stand variation in species occurrence warns against a simplified view that only local habitat factors influence species' occurrence. Apparently, similar stands will host populations of different sizes due to historical, spatial, and stochastic factors. Thus, habitat suitability cannot be assessed simply by population sizes, and stands lacking a species may still provide suitable habitat and merit protection.
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| 31. |
- Berglund, Håkan, et al.
(author)
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Verifying an extinction debt in north Swedish boreal forests
- 2005
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In: Conservation biology. - : Wiley. - 0888-8892 .- 1523-1739. ; 19:2, s. 338-348
-
Journal article (peer-reviewed)abstract
- Destruction and fragmentation of natural habitats results in small species populations that face increased risk of extinction. A time delay may be involved in the regional extinction of species, and the number of species that eventually may go extinct in the future is called the "extinction debt." In boreal Sweden, we examined whether the number of epiphytic crustose lichens and wood-inhabiting fungi in old-growth forest remnants diverges from species richness levels in forest patches that have been naturally isolated for millennia. An excess of species in forest remnants could indicate the presence of an extinction debt. Observed species richness in 32 old-growth forest remnants (also called woodland key habitats [WKHs]) was compared with predicted species richness. To predict species richness we used regression models based on data from 46 isolated old-growth forest patches in a forest-wetland matrix. The reference landscape is ancient and assumed to reflect the conditions of insular floras in dynamic equilibrium. Stand factors constituted predictive variables in the models. The observed number of lichen species was higher than expected (i.e., an extinction debt among lichens may exist). By contrast, there was no significant difference between observed and expected species richness among wood-inhabiting fungi. The species richness of wood-inhabiting fungi has adjusted to the changes in forest and landscape structure more rapidly than the species richness of lichens. Differences in substrate dynamics between epiphytes on living trees and species growing on decaying logs might explain the difference between species groups. The results also indicate that population densities of red-listed species were low, which may result in continuing extinctions of red-listed species. The importance of WKHs might be overvalued because species may be lost if conservation efforts consider only protection and preservation of WKHs.
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| 32. |
- Berglund, Tomas, et al.
(author)
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An obstacle-avoiding minimum variation B-spline problem
- 2003
-
In: Proceedings. - Los Alamitos, Calif : IEEE Communications Society. - 0769519857 ; , s. 156-161
-
Conference paper (peer-reviewed)abstract
- We study the problem of computing a planar curve, restricted to lie between two given polygonal chains, such that the integral of the square of arc-length derivative of curvature along the curve is minimized. We introduce the minimum variation B-spline problem, which is a linearly constrained optimization problem over curves, defined by B-spline functions only. An empirical investigation indicates that this problem has one unique solution among all uniform quartic B-spline functions. Furthermore, we prove that, for any B-spline function, the convexity properties of the problem are preserved subject to a scaling and translation of the knot sequence defining the B-spline.
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| 33. |
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| 34. |
- Berglund, Tomas, et al.
(author)
-
Epi-convergence of minimum curvature variation B-splines
- 2003
-
Reports (other academic/artistic)abstract
- We study the curvature variation functional, i.e., the integral over the square of arc-length derivative of curvature, along a planar curve. With no other constraints than prescribed position, slope angle, and curvature at the endpoints of the curve, the minimizer of this functional is known as a cubic spiral. It remains a challenge to effectively compute minimizers or approximations to minimizers of this functional subject to additional constraints such as, for example, for the curve to avoid obstacles such as other curves. In this paper, we consider the set of smooth curves that can be written as graphs of three times continuously differentiable functions on an interval, and, in particular, we consider approximations using quartic uniform B- spline functions. We show that if quartic uniform B-spline minimizers of the curvature variation functional converge to a curve, as the number of B-spline basis functions tends to infinity, then this curve is in fact a minimizer of the curvature variation functional. In order to illustrate this result, we present an example of sequences of B-spline minimizers that converge to a cubic spiral.
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| 35. |
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| 36. |
- Berglund, Tomas, et al.
(author)
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Planning smooth and obstacle-avoiding b-spline paths for autonomous mining vehicles
- 2010
-
In: IEEE Transactions on Automation Science and Engineering. - 1545-5955 .- 1558-3783. ; 7:1, s. 167-172
-
Journal article (peer-reviewed)abstract
- We study the problem of automatic generation of smooth and obstacle-avoiding planar paths for efficient guidance of autonomous mining vehicles. Fast traversal of a path is of special interest. We consider four-wheel four-gear articulated vehicles and assume that we have an a priori knowledge of the mine wall environment in the form of polygonal chains. Computing quartic uniform B-spline curves, minimizing curvature variation, staying at least at a proposed safety margin distance from the mine walls, we plan high speed paths.
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| 37. |
- Berglund, Tomas, et al.
(author)
-
The problem of computing an obstacle-avoiding minimum variation B-spline
- 2003
-
Reports (other academic/artistic)abstract
- We study the problem of computing a planar curve restricted to lie between two given polygonal chains such that the integral of the square of arc- length derivative of curvature along the curve is minimized. We introduce the Minimum Variation B-spline problem which is a linearly constrained optimization problem over curves defined by B-spline functions only. An empirical investigation indicates that this problem has one unique solution among all uniform quartic B-spline functions. Furthermore, we prove that, for any B-spline function, the convexity properties of the problem are preserved subject to a scaling and translation of the knot sequence defining the B-spline.
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| 38. |
- Bergström, Ulrica, 1970-, et al.
(author)
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Fracture mechanisms and fracture pattern in men and women aged 50 years and older : a study of a 12-year population-based injury register, Umeå, Sweden
- 2008
-
In: Osteoporosis International. - London : Springer International. - 0937-941X .- 1433-2965. ; 19:9, s. 1267-1273
-
Journal article (peer-reviewed)abstract
- Summary: In a study of a 12-year population-based injury register, Umeå, Sweden, we analyzed the fracture mechanisms and fracture pattern in men and women 50 years and older. Low-energy trauma was responsible for the major and costliest part of the fracture panorama, but the pattern differs between age groups. Introduction: Osteoporosis-related fracture is a major health problem: the number of hip fractures is expected to double to 2030. While osteoporosis is one of many risk factors, trauma is almost always involved. Therefore, we analyzed injury mechanisms in patients aged over 50. Methods: We registered injury mechanism, cause, diagnosis in all trauma patients at Umeå University hospital, Sweden. This population-based register (1993–2004) comprises a total of 113,668 injuries (29,189 fractures). Patients ≥50 years contributed to 13,279 fractures. Results: Low-energy trauma (fall <1 m) caused 53% of all fractures ≥50 years and older. In those over 75 low-energy trauma caused >80%. The seasonal variation of fractures was maximally 25%. With increasing age, proximal fractures became more common, in both upper and lower extremities. Proximal locations predominate in older age groups. Conclusions: Low-energy trauma was responsible for the largest and costliest part of the fracture panorama. In fact, almost all fractures in middle-aged and old people were caused by low-energy mechanisms; thus, most fractures in these patients have a fragility component, and the contribution of osteoporosis-related fractures is more important than previously thought. A better understanding of injury mechanisms also in low-energy trauma is a prerequisite for preventive interventions.
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| 39. |
- Bergström, Ulrica, 1970-
(author)
-
Fragility fractures in fragile people : epidemiology of the age quake
- 2009
-
Doctoral thesis (other academic/artistic)abstract
- Osteoporosis-related fracture is already today a major public health problem and the number of hip fractures is expected to double to 2030. Sweden has one of the highest hip fracture incidences worldwide. This may be explained by several factors: e.g. age, genetic, climatologic, geographic and a relative vitamin D deficiency, secondary to the limited sunlight exposure especially during winter months. Intrinsic and extrinsic factors contribute to a fracture, although a prior low energy fracture is one of the strongest predictors for a subsequent one and this should be a target for secondary fracture prevention in an orthopaedic setting. Since 1993 all injured patients admitted to the emergency floor and all in-hospital fractures at Umeå University Hospital, Sweden, were registered according to the Injury Data Base, former EHLASS. There were 31,173 fracture events (one or more fractures at the same time), of which 13,931 were in patients’ ≥ 50 years old. The fracture database was co analyzed with the Northern Sweden Health and Disease Study cohort in a nested case-control study for investigations of associations between osteoporotic fracture and serum markers, lifestyle data, nutrition etc. We found that there were differences in fracture pattern depending on age and sex. Both injury mechanism and fracture site were strongly dependent of age. The most severe fragility fracture, hip fracture, had a decreasing incidence. However, the incidence curve was right-shifting leading to an increase, both in numbers and in incidence of hip fractures among the oldest female. To identify people at high risk for fractures, re-fracture patients are useful. No less than 21% of the fracture patients had suffered more than one fracture event, accounting for 38% of all fracture events. The total risk ratio for a subsequent fracture was 2.2 (2.1-2.3 95% CI). In males the highest risk for re fracture was in the age cohort 70-79 years (RR 2.7, 2.3-3.2 95% CI), in females > 90 years (RR 3.9, 3.2-4.8 95% CI). Another possible risk factor in this subarctic population is the lack of sunlight, leading to a vitamin D deficit. The overall adjusted risk of sustaining a hip fracture in this population was 2.7 (95%CI:1.3-5.4) in subjects with a serum 25 hydroxyvitamin D below 50 nmol/l. The association was, however, different according to age at baseline. Thus in subjects aged 60 years and above at baseline, the adjusted odds ratio of sustaining a hip fracture was 6.2 (1.2-32.5 95%CI) for the group of individuals with a serum 25OHD below 50 nmol/l, whereas no significant association was found in the youngest age group. In the next 30 years the ongoing demographic changes will accelerate. The World War II baby boomers will cause an age quake. We can already see signs heralding a new fracture pattern: an increasing cohort of mobile but fragile elderly, with considerable co-morbidity is now at risk for fragility fractures. In fracture patients, clinical information is sufficient to pinpoint patients with a high risk for re-fractures. It is therefore clinically important to use the information provided by the fracture event. We suggest that trauma units and primary care units should screen for risk factors and inform patients about the treatment options, and to organize fracture liaison services. This seems to be especially cost-efficient for our oldest and frailest patients. Secondary prophylaxis and follow-up treatment after cardiovascular disorders are now a matter of course worldwide, but the screening for risk factors, in order to prevent a second fracture, is often neglected. This is one of the most important issues of fracture care in the future in order to improve general health.
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| 40. |
- Bergström, Ulrica, 1970-, et al.
(author)
-
The hip fracture incidence curve is shifting to the right : a forecast of the age-quake
- 2009
-
In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 80:5, s. 520-524
-
Journal article (peer-reviewed)abstract
- Background The number of hip fractures has doubled in the last 30–40 years in many countries. Age-adjusted incidence has been reported to be decreasing in Europe and North America, but is there a decreasing trend in all age groups? Patients and methods This population-based study included all hip-fracture patients over 50 years of age (a total of 2,919 individuals, 31% of whom were men) admitted to Umeå University Hospital, Sweden, from 1993 through 2005. Results The incidence of hip fracture declined between the periods 1993–1996 and 2001–2005: from 706 to 625 hip fractures per 105 women and from 390 to 317 hip fractures per 105 men. However, there was a 114% increase in the number of fractures in women aged 90 or older (12 and 25 hip fractures/year, respectively, in the two time periods). For the period 2001–05, women ≥ 90 years of age accounted for almost the same numbers of hip fractures as women aged 75–79 (27 fractures/year). The rate increased during this period, from 2,700 per 105 women to 3,900 per 105 women > 90 years. In men there were declining trends for both relative and absolute numbers. Interpretation Although age-adjusted incidence declined in the population > 50 years of age, absolute fracture rate and incidence increased in the very old. Women over 90 now have the same absolute number of hip fractures every year as women aged 75–79 years. There was a right-shift in hip fracture distribution towards the oldest old, probably due to an increased number of octo/nonagenarians, a new population of particularly frail old people that hardly existed earlier. Better health among septuagenarians may also have delayed the age at which fractures occurred. This changing pattern will strain orthopedic and geriatric resources even more.
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| 41. |
- Bjarnason, Elizabeth, et al.
(author)
-
A Proposal for Improving Project Coordination using Data Mining and Proximity Tracking
- 2016
-
In: CEUR Workshop Proceedings. ; 1564
-
Conference paper (peer-reviewed)abstract
- Coordination is an important success factor for a development project. Communication gaps, e.g. between product owners shaping the requirements and testers verifying the developed software can result in wasted effort and unsuccessful products. We propose improving the communication between project members with recommendations of whom to interact with and what to discuss based on link prediction in multi-layered proximity-based social graphs based on data mined from project repositories. We plan to explore and validate these ideas through prototyping and by applying a design-science approach in collaboration with an industrial partner.
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| 42. |
- Björ, Bodil, et al.
(author)
-
Fifty-year-follow-up of mortality among a cohort of iron-ore miners in Sweden, with specific reference to myocardial infarction mortality
- 2009
-
In: Occupational and Environmental Medicine. - London : BMJ Publishing Group. - 1351-0711 .- 1470-7926. ; 66:4, s. 264-268
-
Journal article (peer-reviewed)abstract
- Objectives: This study investigates both general mortality and mortality from myocardial infarction among men employed in iron-ore mines in Sweden.Methods: The mortality of employees (surface and underground workers) at the iron-ore mines in Malmberget and Kiruna, Sweden was investigated. The study cohort comprised men who had been employed for at least 1 year between 1923 and 1996. The causes of death were obtained from the national cause of death register from 1952 to 2001. Indirect standardised mortality ratios (SMR) were calculated for four main causes. Mortality specifically from myocardial infarction was also analysed.Results: 4504 deaths in the cohort gave an SMR for total mortality of 1.05 (95% CI 1.02 to 1.09). Mortality was significantly higher for lung cancer (SMR 1.73, 95% CI 1.52 to 1.97). There was an increased risk of injuries and poisonings (SMR 1.34, 95% CI 1.24 to 1.46) and respiratory diseases (SMR 1.14, 95% CI 1.00 to 1.28). There were 1477 cases of myocardial infarction, resulting in an SMR of 1.12 (95% CI 1.07 to 1.18). SMR was higher (1.35, 95% CI 1.22 to 1.50) for men aged ≤60 years than for those >60 years of age (1.06, 95% CI 1.00 to 1.13).Conclusions: Mortality from myocardial infarction was higher than expected. There was also an increased risk of death from injuries and poisonings, lung cancer and respiratory diseases, as well as higher general mortality. Our findings support the results of previous studies that there is an association between working in the mining industry and adverse health outcomes.
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| 43. |
- Björ, Bodil M, et al.
(author)
-
Mortality from myocardial infarction in relation to exposure to vibration and dust among a cohort of iron-ore miners in Sweden
- 2010
-
In: Occupational and Environmental Medicine. - : BMJ Publishing Group. - 1351-0711 .- 1470-7926. ; 67:3, s. 154-158
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of this study was to investigate myocardial infarction mortality in relation to exposure to hand-arm vibration (HAV) and whole-body vibration (WBW) as well as exposure to dust among men employed in two Swedish iron-ore mines. METHODS: This study comprised employed men at two iron-ore mines in Sweden who had been employed for at least one year from 1923 up to 1996. The causes of death were obtained from the national cause of death register from 1952 to 2001. Myocardial infarction mortality was obtained by linking personal identification numbers to the national cause of death register. Poisson regression was used for risk estimations on exposure-response relation, and analyses were made on the two age groups 60 years. RESULTS: Relative risks for myocardial infarction mortality in relation to exposure were significantly increased for exposure (0/>0) to WBV (RR: 1.18, 95% CI 1.06-1.31) and dust (RR: 1.15, 95% CI 1.02-1.31), and the results indicated an exposure-response relation for WBV and dust separately. For 60 years and younger, exposure to HAV (0/>0) (RR: 1.34, 95% CI 1.03-1.74) and WBV (0/>0) (RR: 1.39, 95% CI 1.13-1.72) increased the risk of MI mortality. An exposure-response was found for HAV and WBV, as the medium and high exposed categories showed significantly increased risk estimates. None of the exposures significantly increased the risk in the group above 60 years. The increased risk estimates for exposure to WBV remained when adjusting for exposure to dust. CONCLUSIONS: The results for the working-age (
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| 44. |
- Björ, Ove, 1967-, et al.
(author)
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A comparison between standard methods and structural nested modelling when bias from a healthy worker survivor effect is suspected : an iron-ore mining cohort study
- 2015
-
In: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 72:7, s. 536-542
-
Journal article (peer-reviewed)abstract
- Objectives Iron-ore miners are exposed to extremely dusty and physically arduous work environments. The demanding activities of mining select healthier workers with longer work histories (ie, the Healthy Worker Survivor Effect (HWSE)), and could have a reversing effect on the exposure-response association. The objective of this study was to evaluate an iron-ore mining cohort to determine whether the effect of respirable dust was confounded by the presence of an HWSE. Methods When an HWSE exists, standard modelling methods, such as Cox regression analysis, produce biased results. We compared results from g-estimation of accelerated failure-time modelling adjusted for HWSE with corresponding unadjusted Cox regression modelling results. Results For all-cause mortality when adjusting for the HWSE, cumulative exposure from respirable dust was associated with a 6% decrease of life expectancy if exposed >= 15 years, compared with never being exposed. Respirable dust continued to be associated with mortality after censoring outcomes known to be associated with dust when adjusting for the HWSE. In contrast, results based on Cox regression analysis did not support that an association was present. Conclusions The adjustment for the HWSE made a difference when estimating the risk of mortality from respirable dust. The results of this study, therefore, support the recommendation that standard methods of analysis should be complemented with structural modelling analysis techniques, such as g-estimation of accelerated failure-time modelling, to adjust for the HWSE.
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| 45. |
- Björ, Ove, 1967-, et al.
(author)
-
Do physical workload or temperature characteristics in an outdoor workingenvironment explain deviating rates of mortality and incidental cancer? A cohort study based on iron-ore mining.
-
Other publication (other academic/artistic)abstract
- Background A cohort study that examined iron ore mining found negative associations between cumulative working time employed underground and several severe outcomes. In this cohort study, and using the same group of miners, we examined whether heavy physical workload or the temperature characteristics represented by an outdoor working environment could explain these lower rates.Method This study was based on a Swedish iron ore mining cohort consisting of 13000 workers employed between 1923 and 1998. Exposure was defined as cumulative employment time in heavy physical workload or outdoor work. Poisson regression models were used to generate smoothed estimates of standardized morbidity ratios and adjusted rate ratios, both models by cumulative exposure time. SMRs for different cohort subgroups were used to compare the occurrence of cerebrovascular disease mortality to the reference population.Results The adjusted rate ratio between employment classified as outdoor work ≥25 years and short term outdoor work was 1.62 (95% CI 1.07–2.42). The subgroup underground work ≥15 years deviated most in occurrence of cerebrovascular disease mortality compared with the reference population: SMR (0.70 (95% CI 0.56–0.85)). No elevated rates were associated with cumulative employment time representing heavy physical workloads.Conclusion Employment in temperature shifting outdoor environments was associated with elevated rates of cerebrovascular disease mortality. In contrast, work in tempered underground employment was associated with a protecting effect. Based on selected groups of mortalities, physically heavy workloads did not protect for mortality later in life.
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| 46. |
- Björ, Ove, et al.
(author)
-
Is outdoor work associated with elevated rates of cerebrovascular disease mortality? : a cohort study based on iron-ore mining
- 2016
-
In: Journal of Occupational Medicine and Toxicology. - : Springer Science and Business Media LLC. - 1745-6673. ; 11
-
Journal article (peer-reviewed)abstract
- BACKGROUND: A cohort study that examined iron ore mining found negative associations between cumulative working time employed underground and several outcomes, including mortality of cerebrovascular diseases. In this cohort study, and using the same group of miners, we examined whether work in an outdoor environment could explain elevated cerebrovascular disease rates.METHODS: This study was based on a Swedish iron ore mining cohort consisting of 13,000 workers. Poisson regression models were used to generate smoothed estimates of standardized mortality ratios and adjusted rate ratios, both models by cumulative exposure time in outdoor work.RESULTS: The adjusted rate ratio between employment classified as outdoor work ≥25 years and outdoor work 0-4 years was 1.62 (95 % CI 1.07-2.42). The subgroup underground work ≥15 years deviated most in occurrence of cerebrovascular disease mortality compared with the external reference population: SMR (0.70 (95 % CI 0.56-0.85)).CONCLUSIONS: Employment in outdoor environments was associated with elevated rates of cerebrovascular disease mortality. In contrast, work in tempered underground employment was associated with a protecting effect.
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| 47. |
- Björ, Ove, et al.
(author)
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Reduced mortality rates in a cohort of long-term underground iron-ore miners
- 2013
-
In: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 56:5, s. 531-540
-
Journal article (peer-reviewed)abstract
- Background Historically, working in iron-ore mines has been associated with an increased risk of lung cancer and silicosis. However, studies on other causes of mortality are inconsistent and in the case of cancer incidence, sparse. The aim of this study was to examine the association between iron-ore mining, mortality and cancer incidence.Methods A 54-year cohort study on iron-ore miners from mines in northern Sweden was carried out comprising 13,000 workers. Standardized rate ratios were calculated comparing the disease frequency, mortality, and cancer incidence with that of the general population of northern Sweden. Poisson regression was used to evaluate the association between the durations of employment and underground work, and outcome.Results Underground mining was associated with a significant decrease in adjusted mortality rate ratios for cerebrovascular and digestive system diseases, and stroke. For several outcomes, elevated standardized rate ratios were observed among blue-collar workers relative to the reference population. However, only the incidence of lung cancer increased with employment time underground (P<0.001).Conclusions Long-term iron-ore mining underground was associated with lower rates regarding several health outcomes. This is possibly explained by factors related to actual job activities, environmental exposure, or the selection of healthier workers for long-term underground employment.Am. J. Ind. Med. 56:531540, 2013. (c) 2013 Wiley Periodicals, Inc.
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| 48. |
- Björ, Ove, 1967-
(author)
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Strategies for assessing health risks from two occupational cohorts within the domain of northern Sweden
- 2013
-
Doctoral thesis (other academic/artistic)abstract
- Background: Studies based on a cohort design requires access to both subject-specific and period-specific information. In order to conduct an occupational cohort study, access to exposure information and the possibility and permission to link information on outcomes from other registers are generally necessary. The analysis phase is also aggravated by its added complexity because of the longitudinal dimension of the cohort’s data.This thesis aims at increasing the knowledge on hazards from work on fatalities and cancer within the domain of cohort studies on miners and metal refiners and to study the complexity of the analysis by discussing and suggesting analytical strategies.Methods: The study population for this thesis consisted of a cohort of 2264 blue-collar aluminium smelter workers (paper I) and a cohort of 13000 blue-collar iron-ore miners (papers II-IV), both followed for over 50 years. The outcomes were collected from the Swedish Cause of Death Register and the Swedish Cancer Register. The primary methods of analysis were either Standardized Morbidity Ratios (SMR) or internal comparisons based on Cox or Poisson regression modeling. In paper IV, a g-estimation based on an accelerated failure-time model was performed to estimate the survival ratio.Results: The results from paper I suggested that working as a blue-collar worker metal refiner was associated with increased rates of incidental lung cancer. Elevated rates among short term workers were observed for several outcomes. Paper I also showed that the choice of reference population when calculating SMR could influence the conclusions of the results. In paper II, several outcomes were elevated among the miners compared to the reference population from northern Sweden. However, no outcome except lung cancer was associated with cumulative employment time. The most recurrent pattern of the results was the negative association between cumulative employment time underground and several outcomes. The results from paper III showed that cumulative employment time working outdoors was associated with increased rates of cerebrovascular disease mortality. However, employment with heavy physical workloads did not explain the previously observed decreasing rates in the selected groups of outcomes. The adjustment for the healthy worker survivor effect by g-estimation in paper IV suggested that exposure from respirable dust was associated with elevated mortality risks that could not be observed with standard analytical methods.Conclusion: Our studies found several rates from the cohorts that were elevated compared to external refererence populations but also that long term employments generally were associated with decreasing rates. Furthermore, incidental lung cancer rates was found elevated for the metal refiners. Among the miners, mortality rates of cerebrovascular diseases depended on if work was performed outdoor (higher rates) or underground (lower rates). Methodologically, this thesis has discussed different analytical strategies for handling confounding in occupational cohort studies. Paper IV showed that the healthy worker survivor effect could be adjusted for by performing g-estimation.
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| 49. |
- Bjørge, Tone, et al.
(author)
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Metabolic risk factors and ovarian cancer in the metabolic syndrome and cancer project
- 2011
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In: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 40:6, s. 1667-1677
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Journal article (peer-reviewed)abstract
- BACKGROUND: No studies have so far evaluated the impact of the metabolic syndrome (MetS) as an entity on ovarian cancer risk. The authors aimed to examine the association between factors in the MetS, individually and combined, and risk of ovarian cancer incidence and mortality. METHODS: Altogether, 290 000 women from Austria, Norway and Sweden were enrolled during 1974-2005, with measurements taken of height, weight, blood pressure and levels of glucose, cholesterol and triglycerides. Relative risks (RRs) of ovarian cancer were estimated using Cox regression for each MetS factor in quintiles and for standardized levels (z-scores), and for a composite z-score for the MetS. RRs were corrected for random error in measurements. RESULTS: During follow-up, 644 epithelial ovarian cancers and 388 deaths from ovarian cancer were identified. There was no overall association between MetS and ovarian cancer risk. Increasing levels of cholesterol [RR 1.52, 95% confidence interval (95% CI) 1.01-2.29, per 1-U increment of z-score] and blood pressure (RR 1.79, 95% CI 1.12-2.86) conferred, however, increased risks of mucinous and endometrioid tumours, respectively. In women below the age of 50 years, there was increased risk of ovarian cancer mortality for MetS (RR 1.52, 95% CI 1.00-2.30). Increasing levels of BMI (RR 1.17, 95% CI 1.01-1.37) conferred increased risk of ovarian cancer mortality in women above the age of 50 years. CONCLUSION: There was no overall association between MetS and ovarian cancer risk. However, increasing levels of cholesterol and blood pressure increased the risks of mucinous and endometrioid tumours, respectively. Increasing levels of BMI conferred an increased risk of ovarian cancer mortality in women above the age of 50 years.
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- Bjørge, Tone, et al.
(author)
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Metabolic syndrome and breast cancer in the me-can (metabolic syndrome and cancer) project.
- 2010
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In: Cancer Epidemiology, Biomarkers and Prevention. - 1055-9965 .- 1538-7755. ; 19:7, s. 1737-1745
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Journal article (peer-reviewed)abstract
- BACKGROUND: Few studies have assessed the metabolic syndrome (MetS) as an entity in relation to breast cancer risk, and results have been inconsistent. We aimed to examine the association between MetS factors (individually and combined) and risk of breast cancer incidence and mortality. METHODS: Two hundred ninety thousand women from Austria, Norway, and Sweden were enrolled during 1974-2005, with measurements of height, weight, blood pressure, and levels of glucose, cholesterol, and triglycerides. Relative risks (RR) of breast cancer were estimated using Cox proportional hazards regression for each MetS factor in quintiles and for standardized levels (z-scores) and for a composite z-score for the MetS. RESULTS: There were 4,862 incident cases of breast cancer and 633 deaths from breast cancer identified. In women below age 50, there was a decreased risk of incident cancer for the MetS (per 1-unit increment of z-score; RR, 0.83; 95% confidence interval, 0.76-0.90) as well as for the individual factors (except for glucose). The lowest risks were seen among the heaviest women. In women above age 60, there was an increased risk of breast cancer mortality for the MetS (RR, 1.23; 95% confidence interval, 1.04-1.45) and for blood pressure and glucose. The strongest association with mortality was seen for increased glucose concentrations. CONCLUSIONS: The MetS was associated with a decreased risk of incident breast cancer in women below age 50 with high body mass index, and with an increased risk of breast cancer mortality in women above 60. IMPACT: Lifestyle interventions as recommended for cardiovascular disease prevention may be of value to prevent breast cancer mortality in postmenopausal women.
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