| 1. |
- Rodríguez-Varela, Ricardo, et al.
(author)
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The genetic history of Scandinavia from the Roman Iron Age to the present
- 2023
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In: Cell. - : Elsevier. - 0092-8674 .- 1097-4172. ; 186:1, s. 32-46
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Journal article (peer-reviewed)abstract
- We investigate a 2,000-year genetic transect through Scandinavia spanning the Iron Age to the present, based on 48 new and 249 published ancient genomes and genotypes from 16,638 modern individuals. We find regional variation in the timing and magnitude of gene flow from three sources: the eastern Baltic, the British-Irish Isles, and southern Europe. British-Irish ancestry was widespread in Scandinavia from the Viking period, whereas eastern Baltic ancestry is more localized to Gotland and central Sweden. In some regions, a drop in current levels of external ancestry suggests that ancient immigrants contributed proportionately less to the modern Scandinavian gene pool than indicated by the ancestry of genomes from the Viking and Medieval periods. Finally, we show that a north-south genetic cline that characterizes modern Scandinavians is mainly due to the differential levels of Uralic ancestry and that this cline existed in the Viking Age and possibly earlier.
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| 2. |
- Alping, Peter, et al.
(author)
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Cancer Risk for Fingolimod, Natalizumab, and Rituximab in Multiple Sclerosis Patients
- 2020
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In: Annals of Neurology. - : John Wiley & Sons. - 0364-5134 .- 1531-8249. ; 87:5, s. 688-699
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Novel, highly effective disease-modifying therapies have revolutionized multiple sclerosis (MS) care. However, evidence from large comparative studies on important safety outcomes, such as cancer, is still lacking.METHODS: In this nationwide register-based cohort study, we linked data from the Swedish MS register to the Swedish Cancer Register and other national health care and census registers. We included 4,187 first-ever initiations of rituximab, 1,620 of fingolimod, and 1,670 of natalizumab in 6,136 MS patients matched for age, sex, and location to 37,801 non-MS general population subjects. Primary outcome was time to first invasive cancer.RESULTS: We identified 78 invasive cancers among treated patients: rituximab 33 (incidence rate [IR] per 10,000 person-years = 34.4, 95% confidence interval [CI] = 23.7-48.3), fingolimod 28 (IR = 44.0, 95% CI = 29.2-63.5), and natalizumab 17 (IR = 26.0, 95% CI = 15.1-41.6). The general population IR was 31.0 (95% CI = 27.8-34.4). Adjusting for baseline characteristics, we found no difference in risk of invasive cancer between rituximab, natalizumab, and the general population but a possibly higher risk with fingolimod compared to the general population (hazard ratio [HR] = 1.53, 95% CI = 0.98-2.38) and rituximab (HR = 1.68, 95% CI = 1.00-2.84).INTERPRETATION: In this first large comparative study of 3 highly effective MS disease-modifying therapies, no increased risk of invasive cancer was seen with rituximab and natalizumab, compared to the general population. However, there was a borderline-significant increased risk with fingolimod, compared to both the general population and rituximab. It was not possible to attribute this increased risk to any specific type of cancer, and further studies are warranted to validate these findings.
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| 3. |
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| 4. |
- Draper, Teri, et al.
(author)
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A comparison of industrial-scale (471 MWe) radiometer heat flux measurements between pulverized-coal and 85% coal/15% biomass co-firing combustion
- 2021
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Conference paper (other academic/artistic)abstract
- This work evaluates and compares radiative heat transfer measurements conducted at the 471 MWe Hunter Powerplant Unit 3 utility boiler in Utah, USA, during commercial operation with coal and during tests with co-firing of coal and biomass. The coal used was a Utah sourced bituminous coal, which was mixed with 15 wt% of torrefied wood in the co-firing test. The measurements were gathered using two different narrow angle radiometers and one ellipsoidal radiometer to measure the radiative heat flux. Data were gathered at several floors through port openings in the boiler wall and the samplings were spread out over several hours. Additionally, the gas temperature was measured at positions close to the inner walls of the different floors. Overall, the measured heat fluxes decreased with increasing boiler floor level, and while the measurement data spread is rather high for each measurement, the data spreads for both fuel conditions significantly overlap each other, indicating that it is likely the heat flux profile remains unchanged when running either type of fuel.
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| 5. |
- Englund, Simon, et al.
(author)
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Predictors of patient-reported fatigue symptom severity in a nationwide multiple sclerosis cohort
- 2023
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In: Multiple Sclerosis and Related Disorders. - : Elsevier. - 2211-0348 .- 2211-0356. ; 70
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Journal article (peer-reviewed)abstract
- BACKGROUND: Fatigue is a debilitating symptom of multiple sclerosis (MS), but its relation to sociodemographic and disease-related characteristics has not been investigated in larger studies. The objectives of this study were to evaluate predictors of self-reported fatigue in a Swedish nationwide register-based MS cohort.METHODS: Using a repeated cross-sectional design, we included 2,165 persons with relapsing- remitting and secondary progressive MS with one or multiple Fatigue Scale for Motor and Cognitive Functions (FSMC) scores, which was modelled using multivariable linear regressions for multiple predictors.RESULTS: Only associations to expanded disability status scale (EDSS) and Symbol Digit Modalities Test (SDMT) were considered clinically meaningful among MS-associated characteristics in our main model; compared to mild disability (EDSS 0-2.5), those with severe disability (EDSS ≥6) scored 17.6 (95% CI 13.1-22.2) FSMC points higher, while the difference was 10.7 (95% CI 8.0-13.4) points for the highest and lowest quartiles of SDMT. Differences between highest and lowest quartiles of health-related quality of life (HRQoL) instruments were even greater and considered clinically meaningful; EuroQoL Visual Analogue Scale (EQ-VAS) 31.9 (95% CI 29.9-33.8), Multiple Sclerosis Impact Scale (MSIS-29) psychological component 35.6 (95% CI 33.8-37.4) and MSIS-29 physical component 45.5 (95% CI 43.7-47.4).CONCLUSION: Higher self-reported fatigue is associated with higher disability level and worse cognitive processing speed, while associations to other MS-associated characteristics including MS type, line of disease modifying therapy (DMT), MS duration, relapse and new cerebral lesions are weak. Furthermore, we found a strong correlation between high fatigue rating and lower ratings on health-related quality of life instruments.
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| 6. |
- Gall, Dan, 1981, et al.
(author)
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Recirculation of NO x and SO x Scrubber Effluent to an Industrial Grate Fired MSW Boiler-Influence on Combustion Performance, Deposition Behavior, and Flue Gas Composition
- 2022
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In: Energy & Fuels. - : American Chemical Society (ACS). - 1520-5029 .- 0887-0624. ; 36:11, s. 5868-5877
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Journal article (peer-reviewed)abstract
- The concept of scrubber effluent recirculation has recently received attention in connection to NOxemission control. Here, we present data from an industrial-scale MSW-fired plant, where effluent from a combined NOxand SOxscrubber was recirculated and injected into a grate-fired boiler. The combustion characteristics were carefully studied during the injections to observe the potential effects on burnout and flue gas composition. In addition, deposition measurements were performed to observe effects on growth rate and chemical composition of deposits, which are critical factors for any solid fuel-fired heat and power plant. The recirculation of the nitrogen-rich waste streams was performed via pre-existing liquid injection equipment, and the results show that the N-containing compounds in the scrubber effluent were efficaciously reduced to inert nitrogen gas. Furthermore, the recirculation of the scrubber effluent may reduce ammonia demand for selective non-catalytic reduction systems by inhibiting the formation of ammonium chloride. Sulfur and alkali components in the effluent increased the deposition growth rate and also changed the chemical composition of the deposits. Understanding how the local conditions at the injection point influence the distribution and speciation of the injected compounds is essential for a successful recirculation strategy.
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| 7. |
- Granqvist, Mathias, et al.
(author)
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Comparative effectiveness of dimethyl fumarate as the initial and secondary treatment for MS
- 2020
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In: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 26:12, s. 1532-1539
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Journal article (peer-reviewed)abstract
- BACKGROUND: Population-based real-world evidence studies of the effectiveness and tolerability of dimethyl fumarate in relation to common treatment alternatives are still limited.OBJECTIVE: To evaluate the clinical effectiveness and tolerability of dimethyl fumarate (DMF) as the initial and secondary treatment for relapsing-remitting multiple sclerosis (RRMS) patients compared with common treatment alternatives in Sweden.METHODS: We conducted a nationwide retrospective observational cohort study of all RRMS patients identified through the Swedish MS registry initiating DMF (n = 641) or interferons/glatiramer acetate (IFN/GA; n = 555) as the initial therapy, or DMF (n = 703) or fingolimod (FGL; n = 194) after switch from IFN/GA between 1 January 2014 and 31 December 2016.RESULTS: The discontinuation rate was lower with DMF as the initial treatment than IFN/GA (adjusted hazard rate (HR): 0.46, 95% confidence interval (CI): 0.37-0.58, p < 0.001), but higher than FGL as the secondary treatment (HR: 1.51, CI: 1.08-2.09, p < 0.05). Annualized relapse rate (ARR) was lower with DMF compared to IFN/GA (0.04, CI: 0.03-0.06 vs 0.10, CI: 0.07-0.13; p < 0.05), but not FGL (0.03, CI: 0.02-0.05 vs 0.02, CI: 0.01-0.04; p = 0.41). Finally, time to first relapse (TTFR) was longer with DMF as the initial, but not secondary, therapy (p < 0.05 and p = 0.20, respectively).CONCLUSION: Our findings indicate that DMF performs better than IFN/GA as the initial treatment for RRMS. Compared to FGL, DMF displayed a lower tolerability, but largely similar effectiveness outcomes.
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| 8. |
- Gunnarsson, Niklas, et al.
(author)
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Learning a Deformable Registration Pyramid
- 2021
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In: Segmentation, Classification, and Registration of Multi-modality Medical Imaging Data. - Cham : Springer Nature. - 9783030718268 - 9783030718275 ; , s. 80-86
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Conference paper (peer-reviewed)abstract
- We introduce an end-to-end unsupervised (or weakly supervised) image registration method that blends conventional medical image registration with contemporary deep learning techniques from computer vision. Our method downsamples both the fixed and the moving images into multiple feature map levels where a displacement field is estimated at each level and then further refined throughout the network. We train and test our model on three different datasets. In comparison with the initial registrations we find an improved performance using our model, yet we expect it would improve further if the model was fine-tuned for each task. The implementation is publicly available (https://github.com/ngunnar/learning-a-deformable-registration-pyramid).
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| 9. |
- Gunnarsson, Niklas, et al.
(author)
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Unsupervised dynamic modeling of medical image transformations
- 2022
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In: 2022 25th International Conference on Information Fusion (FUSION 2022). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781737749721 - 9781665489416 ; , s. 1-7
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Conference paper (peer-reviewed)abstract
- Spatiotemporal imaging has applications in e.g. cardiac diagnostics, surgical guidance, and radiotherapy monitoring, In this paper, we explain the temporal motion by identifying the underlying dynamics, only based on the sequential images. Our dynamical model maps the inputs of observed high-dimensional sequential images to a low-dimensional latent space wherein a linear relationship between a hidden state process and the lower-dimensional representation of the inputs holds. For this, we use a conditional variational auto-encoder (CVAE) to nonlinearly map the higher dimensional image to a lower-dimensional space, wherein we model the dynamics with a linear Gaussian state-space model (LG-SSM). The model, a modified version of the Kalman variational auto-encoder, is end-to-end trainable, and the weights, both in the CVAE and LG-SSM, are simultaneously updated by maximizing the evidence lower bound of the marginal likelihood. In contrast to the original model, we explain the motion with a spatial transformation from one image to another. This results in sharper reconstructions and the possibility of transferring auxiliary information, such as segmentation, through the image sequence. Our experiments, on cardiac ultrasound time series, show that the dynamic model outperforms traditional image registration in execution time, to a similar performance. Further, our model offers the possibility to impute and extrapolate for missing samples.
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| 10. |
- Gunnarsson, Thordur, et al.
(author)
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Eight-year outcome after invasive treatment of infrainguinal intermittent claudication : A population-based analysis from the Swedish vascular register (Swedvasc)
- 2020
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In: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 8
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Journal article (peer-reviewed)abstract
- Objectives: Invasive treatment of infrainguinal intermittent claudication is controversial, and long-term outcomes are scarce. The study aim was to evaluate 8 years results regarding new vascular interventions on index and contralateral limb, hospitalization, mortality, and amputation in 775 patients revascularized for infrainguinal intermittent claudication in 2009. Methods: Data on new vascular interventions retrieved from the Swedish vascular register (Swedvasc) were linked to the Inpatient Register and Cause of Death Register with information on hospitalizations, primary discharge diagnoses according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), deaths, causes of death, and amputations. Results: During 8 years of follow-up, 486 new vascular interventions were performed. Patients were admitted for a total of 4662 hospitalizations and spent 25,970 days in hospital. Between 79% and 99% of surviving subjects were hospitalized each year. During follow-up, 311 (40.1%) patients died. The most common causes of hospitalization and death were cerebrovascular disease, ischemic heart disease, or other diseases of the circulatory system, causing 47.5% of hospitalizations and 42.4% of deaths. Seventy-seven major lower limb amputations were performed in 52 patients. Conclusion: As patients undergoing invasive treatment of infrainguinal intermittent claudication have high morbidity and mortality, during 8 years of follow-up, the indication for invasive treatment should be carefully weighed against concomitant comorbidities and the timing of this treatment optimized with regard to the patient’s possibilities to enjoy positive treatment effects on quality of life.
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