| 1. |
- Sepanlou, Sadaf G., et al.
(author)
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The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017
- 2020
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In: The Lancet Gastroenterology & Hepatology. - 2468-1253. ; 5:3, s. 245-266
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Journal article (peer-reviewed)abstract
- Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1.32 million (95% UI 1.27-1.45) deaths (440000 [416 000-518 000; 33.3%] in females and 883 000 [838 000-967 000; 66.7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2.4% (2.3-2.6) of total deaths globally in 2017 compared with 1.9% (1.8-2.0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21.0 (19.2-22.3) per 100 000 population in 1990 to 16.5 (15.8-18-1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32.2 [25.8-38.6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10.1 [9.8-10-5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3.7 [3.3-4.0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103.3 [64.4-133.4] per 100 000 in 2017). There were 10.6 million (10.3-10.9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33.2% for compensated cirrhosis and 54.8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases snore than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH.
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| 3. |
- Bader, Milad, et al.
(author)
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Modeling and inversion in acoustic-elastic coupled media using energy-stable summation-by-parts operators
- 2023
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In: Geophysics. - : SOC EXPLORATION GEOPHYSICISTS - SEG. - 0016-8033 .- 1942-2156. ; 88:3
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Journal article (peer-reviewed)abstract
- Seismic data acquired at the seafloor are valuable in charac-terizing the subsurface and monitoring producing hydrocarbon fields. To fully use such data, a stable, accurate, and efficient numerical scheme is needed that accounts for acoustic and elas-tic wave propagation, their interaction at the seafloor interface, and for sources and receivers placed on either side of that inter-face. Existing methods either make incorrect assumptions or have high implementation and computational costs. We have developed a high-order finite-difference summation-by-parts framework for the acoustic-elastic wave equations in second -or-der form (in terms of displacements in the solid and an extension of velocity potential in the fluid). Our modified discretization of the elastic operator overcomes the dispersion errors known to plague displacement-based schemes in the high VP/VS limit. We weakly impose boundary and interface conditions using simulta-neous approximation terms, leading to an energy-stable numeri-cal scheme that rigorously handles point injection and extraction. The fully discrete system is self-adjoint after a time reversal and a sign flip and is furthermore a high-order accurate discretization of the continuous problem. The self-adjointness ensures that for-ward and adjoint wavefields are computed with similar accuracy and simplifies gradient computation for inversion purposes. We find that our numerical scheme achieves accuracy comparable to a more computationally expensive spectral-element method and demonstrate its application to full-waveform inversion using the Marmousi2 model.
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| 4. |
- Flores, Wilfredo C., et al.
(author)
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Energy System Observatory of Honduras
- 2021
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In: 2021 IEEE Electrical Power and Energy Conference (EPEC). - : Institute of Electrical and Electronics Engineers (IEEE). ; , s. 536-540
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Conference paper (peer-reviewed)abstract
- Data management is strategically necessary to make decisions, planning and monitoring within the energy sector. Recently, the Engineering Faculty of the Universidad Tecnológica Centroamericana (UNITEC), Honduras launched a tool called the Energy Observatory of Honduras. This tool fills the gap that exists in the access to energy data within the country. This tool provides data from the demand and generation of electricity in a free and easy way. Also, the information relating to the consumption of fossil fuels and firewood as well as the access to real-time data and energy indexes are shown.
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| 5. |
- Khorram-Manesh, Amir, 1958, et al.
(author)
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Current Perspectives and Concerns Facing Hospital Evacuation: The Results of a Pilot Study and Literature Review.
- 2022
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In: Disaster medicine and public health preparedness. - : Cambridge University Press (CUP). - 1938-744X .- 1935-7893. ; 16:2, s. 650-658
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Journal article (peer-reviewed)abstract
- To analyze the evacuation preparedness of hospitals within the European Union (EU).This study consisted of 2 steps. In the first step, a systematic review of the subject matter, according to the PRISMA flow diagram, was performed. Using Scopus (Elsevier, Amsterdam, Netherlands), PubMed (National Library of Medicine, Bethesda, MD), and Gothenburg University´s search engine, 11 questions were extracted from the review and were sent to representatives from 15 European Union (EU)- and non-EU countries.The findings indicate that there is neither a full preparedness nor a standard guideline for evacuation within the EU or other non-EU countries in this study. A major shortcoming revealed by this study is the lack of awareness of the untoward consequences of medical decision-making during an evacuation. Some countries did not respond to the questions due to the lack of relevant guidelines, instructions, or time.Hospitals are exposed to internal and external incidents and require an adequate evacuation plan. Despite many publications, reports, and conclusions on successful and unsuccessful evacuation, there is still no common guide for evacuation, and many hospitals lack the proper preparedness. There is a need for a multinational collaboration, specifically within the EU, to establish such an evacuation planning or guideline to be used mutually within the union and the international community.
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| 6. |
- Khorram-Manesh, Amir, 1958, et al.
(author)
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The Development of Swedish Military Healthcare System: Part II-Re-evaluating the Military and Civilian Healthcare Systems in Crises Through a Dialogue and Study Among Practitioners.
- 2021
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In: Military medicine. - : Oxford University Press (OUP). - 1930-613X .- 0026-4075. ; 186:3-4
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Journal article (peer-reviewed)abstract
- Historical changes have transformed Sweden from being an offensive to a defensive and collaborative nation with national and international engagement, allowing it to finally achieve the ground for the civilian-military collaboration and the concept of a total defense healthcare. At the same time, with the decreasing number of international and interstate conflicts, and the military's involvement in national emergencies and humanitarian disaster relief, both the need and the role of the military healthcare system within the civilian society have been challenged. The recent impact of the COVID-19 in the USA and the necessity of military involvement have led health practitioners to anticipate and re-evaluate conditions that might exceed the civilian capacity of their own countries and the need to have collaboration with the military healthcare. This study investigated both these challenges and views from practitioners regarding the benefits of such collaboration and the manner in which it would be initiated.A primary study was conducted among responsive countries using a questionnaire created using the Nominal Group Technique. Relevant search subjects and keywords were extracted for a systematic review of the literature, according to the PRISMA model.The 14 countries responding to the questionnaire had either a well-developed military healthcare system or units created in collaboration with the civilian healthcare. The results from the questionnaire and the literature review indicated a need for transfer of military medical knowledge and resources in emergencies to the civilian health components, which in return, facilitated training opportunities for the military staff to maintain their skills and competencies.As the world witnesses a rapid change in the etiology of disasters and various crises, neither the military nor the civilian healthcare systems can address or manage the outcomes independently. There is an opportunity for both systems to develop future healthcare in collaboration. Rethinking education and training in war and conflict is indisputable. Collaborative educational initiatives in disaster medicine, public health and complex humanitarian emergencies, international humanitarian law, and the Geneva Convention, along with advanced training in competency-based skill sets, should be included in the undergraduate education of health professionals for the benefit of humanity.
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| 7. |
- Lorente, Almudena, et al.
(author)
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Microwave radiation-assisted synthesis of levulinic acid from microcrystalline cellulose : Application to a melon rind residue
- 2023
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In: International Journal of Biological Macromolecules. - : Elsevier BV. - 0141-8130 .- 1879-0003. ; 237
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Journal article (peer-reviewed)abstract
- The circular economy considers waste to be a new raw material for the development of value-added products. In this context, agroindustrial lignocellulosic waste represents an outstanding source of new materials and platform chemicals, such as levulinic acid (LA). Herein we study the microwave (MW)-assisted acidic conversion of microcrystalline cellulose (MCC) into LA. The influence of acidic catalysts, inorganic salt addition and ball -milling pre-treatment of MCC on LA yield was assessed. Depolymerization and disruption of cellulose was monitored by FTIR, TGA and SEM, whereas the products formed were analyzed by HPLC and NMR spectroscopy. The parameters that afforded the highest LA yield (48 %, 100 % selectivity) were: ball-milling pre-treatment of MCC for 16 min at 600 rpm, followed by MW-assisted thermochemical treatment for 20 min at 190 degrees C, aqueous p-toluenesulfonic acid (p-TSA) 0.25 M as catalyst and saturation with KBr. These optimal conditions were further applied to a lignocellulosic feedstock, namely melon rind, to afford a 51 % yield of LA. These results corroborate the suitability of this method to obtain LA from agroindustrial wastes, in line with a circular economy-based approach.
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| 8. |
- Mohammadi, M Rezaa, et al.
(author)
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Isolation and characterization of microvesicles from mesenchymal stem cells.
- 2020
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In: Methods. - : Elsevier BV. - 1095-9130 .- 1046-2023. ; 177, s. 50-57
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Journal article (peer-reviewed)abstract
- Mesenchymal stem or stromal cells are currently under clinical investigation for multiple diseases. While their mechanism of action is still not fully elucidated, vesicles secreted by MSCs are believed to recapitulate their therapeutic potentials to some extent. Microvesicles (MVs), also called as microparticles or ectosome, are among secreted vesicles that could transfer cytoplasmic cargo, including RNA and proteins, from emitting (source) cells to recipient cells. Given the importance of MVs, we here attempted to establish a method to isolate and characterize MVs secreted from unmodified human bone marrow derived MSCs (referred to as native MSCs, and their microvesicles as Native-MVs) and IFNγ stimulated MSCs (referred to as IFNγ-MSCs, and their microvesicles as IFNγ-MVs). We first describe an ultracentrifugation technique to isolate MVs from the conditioned cell culture media of MSCs. Next, we describe characterization and quality control steps to analyze the protein and RNA content of MVs. Finally, we examined the potential of MVs to exert immunomodulatory effects through induction of regulatory T cells (Tregs). Secretory vesicles from MSCs are promising alternatives for cell therapy with applications in drug delivery, regenerative medicine, and immunotherapy.
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| 9. |
- Nyberg, Andre, Docent, 1984-, et al.
(author)
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Effects of low-load/high-repetition resistance training on exercise capacity, health status and limb muscle adaptation in patients with severe COPD : a randomized controlled trial
- 2021
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In: Chest. - : Elsevier. - 0012-3692 .- 1931-3543. ; 159:5, s. 1821-1832
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Journal article (peer-reviewed)abstract
- Background: Training volume is paramount in the magnitude of physiological adaptations following resistance training. However, patients with severe COPD are limited by dyspnea during traditional two-limb low-load/high-repetition resistance training (LLHR-RT), resulting in suboptimal training volumes. During a single exercise session, single-limb LLHR-RT decreases the ventilatory load and enables higher localized training volumes compared with two-limb LLHR-RT.Research Question: Does single-limb LLHR-RT lead to more profound effects compared with two-limb LLHR-RT on exercise capacity (6-min walk distance [6MWD]), health status, muscle function, and limb adaptations in patients with severe COPD?Study Design and Methods: Thirty-three patients (mean age 66 ± 7 years; FEV1 39 ± 10% predicted) were randomized to 8 weeks of single- or two-limb LLHR-RT. Exercise capacity (6MWD), health status, and muscle function were compared between groups. Quadriceps muscle biopsy specimens were collected to examine physiological responses.Results: Single-limb LLHR-RT did not further enhance 6MWD compared with two-limb LLHR-RT (difference, 14 [–12 to 39 m]. However, 73% in the single-limb group exceeded the known minimal clinically important difference of 30 m compared with 25% in the two-limb group (P = .02). Health status and muscle function improved to a similar extent in both groups. During training, single-limb LLHR-RT resulted in a clinically relevant reduction in dyspnea during training compared with two-limb LLHR-RT (–1.75; P = .01), but training volume was not significantly increased (23%; P = .179). Quadriceps muscle citrate synthase activity (19%; P = .03), hydroxyacyl-coenzyme A dehydrogenase protein levels (32%; P < .01), and capillary-to-fiber ratio (41%; P < .01) were increased compared with baseline after pooling muscle biopsy data from all participants.Interpretation: Single-limb LLHR-RT did not further increase mean 6MWD compared with two-limb LLHR-RT, but it reduced exertional dyspnea and enabled more people to reach clinically relevant improvements in 6MWD. Independent of execution strategy, LLHR-RT improved exercise capacity, health status, muscle endurance, and enabled several physiological muscle adaptations, reducing the negative consequences of limb muscle dysfunction in COPD.
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| 10. |
- Shoaee, Mohammad Javad, et al.
(author)
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Defining paleoclimatic routes and opportunities for hominin dispersals across Iran
- 2023
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:3
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Journal article (peer-reviewed)abstract
- Fossil and archaeological evidence indicates that hominin dispersals into Southwest Asia occurred throughout the Pleistocene, including the expansion of Homo sapiens populations out of Africa. While there is evidence for hominin occupations in the Pleistocene in Iran, as evidenced by the presence of Lower to Upper Paleolithic archaeological sites, the extent to which humid periods facilitated population expansions into western Asia has remained unclear. To test the role of humid periods on hominin dispersals here we assess Paleolithic site distributions and paleoenvironmental records across Iran. We developed the first spatially comprehensive, high-resolution paleohydrological model for Iran in order to assess water availability and its influence on hominin dispersals. We highlight environmentally mediated routes which likely played a key role in Late Pleistocene hominin dispersals, including the expansion of H. sapiens and Neanderthals eastwards into Asia. Our combined analyses indicate that, during MIS 5, there were opportunities for hominins to traverse a northern route through the Alborz and Kopet Dagh Mountains and the Dasht-I Kavir desert owing to the presence of activated fresh water sources. We recognize a new southern route along the Zagros Mountains and extending eastwards towards Pakistan and Afghanistan. We find evidence for a potential northern route during MIS 3, which would have permitted hominin movements and species interactions in Southwest Asia. Between humid periods, these interconnections would have waned, isolating populations in the Zagros and Alborz Mountains, where hominins may have continued to have had access to water.
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