| 1. |
- Elden, Helen, 1959, et al.
(author)
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Study protocol of SWEPIS a Swedish multicentre register based randomised controlled trial to compare induction of labour at 41 completed gestational weeks versus expectant management and induction at 42 completed gestational weeks
- 2016
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In: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 16:49
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Journal article (peer-reviewed)abstract
- Background: Observational data shows that postterm pregnancy (>= 42 gestational weeks, GW) and late term pregnancy (>= 41 GW), as compared to term pregnancy, is associated with an increased risk for adverse outcome for the mother and infant. Standard care in many countries is induction of labour at 42 GW. There is insufficient scientific support that induction of labour at 41 GW, as compared with expectant management and induction at 42 GW will reduce perinatal mortality and morbidity without an increase in operative deliveries, negative delivery experiences or higher costs. Large randomised studies are needed since important outcomes; such as perinatal mortality and hypoxic ischaemic encephalopathy are rare events. Methods/Design: A total of 10 038 healthy women >= 18 years old with a normal live singleton pregnancy in cephalic presentation at 41 GW estimated with a first or second trimester ultrasound, who is able to understand oral and written information will be randomised to labour induction at 41 GW (early induction) or expectant management and induction at 42 GW (late induction). Women will be recruited at university clinics and county hospitals in Sweden comprising more than 65 000 deliveries per year. Primary outcome will be a composite of stillbirth, neonatal mortality and severe neonatal morbidity. Secondary outcomes will be other adverse neonatal and maternal outcomes, mode of delivery, women's experience, cost effectiveness and infant morbidity up to 3 months of age. Data on background variables, obstetric and neonatal outcomes will be obtained from the Swedish Pregnancy Register and the Swedish Neonatal Quality Register. Data on women's experiences will be collected by questionnaires after randomisation and 3 months after delivery. Primary analysis will be intention to treat. The statistician will be blinded to group and intervention. Discussion: It is important to investigate if an intervention at 41 GW is superior to standard care in order to reduce death and lifelong disability for the children. The pregnant population, >41 GW, constitutes 15-20 % of all pregnancies and the results of the study will thus have a great impact. The use of registries for randomisation and collection of outcome data represents a unique and new study design.
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| 2. |
- Fadl, Helena, 1965-, et al.
(author)
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Changing diagnostic criteria for gestational diabetes in Sweden-a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol
- 2019
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In: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
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Journal article (peer-reviewed)abstract
- Background The optimal criteria to diagnose gestational diabetes mellitus (GDM) remain contested. The Swedish National Board of Health introduced the 2013 WHO criteria in 2015 as a recommendation for initiation of treatment for hyperglycaemia during pregnancy. With variation in GDM screening and diagnostic practice across the country, it was agreed that the shift to new guidelines should be in a scientific and structured way. The aim of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) in Sweden () is to evaluate the clinical and health economic impacts of changing diagnostic criteria for GDM in Sweden and to create a prospective cohort to compare the many long-term outcomes in mother and baby under the old and new diagnostic approaches. Methods This is a stepped wedge cluster randomised controlled trial, comparing pregnancy outcomes before and after the switch in GDM criteria across 11 centres in a randomised manner. The trial includes all pregnant women screened for GDM across the participating centres during January-December 2018, approximately two thirds of all pregnancies in Sweden in a year. Women with pre-existing diabetes will be excluded. Data will be collected through the national Swedish Pregnancy register and for follow up studies other health registers will be included. Discussion The stepped wedge RCT was chosen to be the best study design for evaluating the shift from old to new diagnostic criteria of GDM in Sweden. The national quality registers provide data on the whole pregnant population and gives a possibility for follow up studies of both mother and child. The health economic analysis from the study will give a solid evidence base for future changes in order to improve immediate pregnancy, as well as long term, outcomes for mother and child.
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| 3. |
- Henrohn, Dan, et al.
(author)
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Effects of Oral Supplementation With Nitrate-Rich Beetroot Juice in Patients With Pulmonary Arterial Hypertension-Results From BEET-PAH, an Exploratory Randomized, Double-Blind, Placebo-Controlled, Crossover Study.
- 2018
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In: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 24:10, s. 640-653
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Journal article (peer-reviewed)abstract
- BACKGROUND: The nitrate-nitrite-nitric oxide (NO) pathway may represent a potential therapeutic target in patients with pulmonary arterial hypertension (PAH). We explored the effects of dietary nitrate supplementation, with the use of nitrate-rich beetroot juice (BRJ), in patients with PAH.METHODS AND RESULTS: We prospectively studied 15 patients with PAH in an exploratory randomized, double-blind, placebo-controlled, crossover trial. The patients received nitrate-rich beetroot juice (∼16 mmol nitrate per day) and placebo in 2 treatment periods of 7 days each. The assessments included; exhaled NO and NO flow-independent parameters (alveolar NO and bronchial NO flux), plasma and salivary nitrate and nitrite, biomarkers and metabolites of the NO-system, N-terminal pro-B-type natriuretic peptide, echocardiography, ergospirometry, diffusing capacity of the lung for carbon monoxide, and the 6-minute walk test. Compared with placebo ingestion of BRJ resulted in increases in; fractional exhaled NO at all flow-rates, alveolar NO concentrations and bronchial NO flux, and plasma and salivary levels of nitrate and nitrite. Plasma ornithine levels decreased and indices of relative arginine availability increased after BRJ compared to placebo. A decrease in breathing frequency was observed during ergospirometry after BRJ. A tendency for an improvement in right ventricular function was observed after ingestion of BRJ. In addition a tendency for an increase in the peak power output to peak oxygen consumption ratio (W peak/VO2 peak) was observed, which became significant in patients reaching an increase of plasma nitrite >30% (responders).CONCLUSIONS: BRJ administered for 1 week increases pulmonary NO production and the relative arginine bioavailability in patients with PAH, compared with placebo. An increase in the W peak/VO2 peak ratio was observed after BRJ ingestion in plasma nitrite responders. These findings indicate that supplementation with inorganic nitrate increase NO synthase-independent NO production from the nitrate-nitrite-NO pathway.
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| 4. |
- Lovvik, T. S., et al.
(author)
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Pregnancy and perinatal outcomes in women with polycystic ovary syndrome and twin births : a population-based cohort study
- 2015
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In: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 122:10, s. 1295-1302
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Journal article (peer-reviewed)abstract
- Objective:To investigate pregnancy and perinatal outcomes in twin births among women with and without polycystic ovary syndrome (PCOS) diagnosis. Design: Population-based cohort study. Setting: Sweden. Population: We identified 20965 women with twin births between 1995 and 2009 of whom 226 had a PCOS diagnosis through linkage between the Swedish Medical Birth Register and the Swedish National Patient Register. Methods: Calculating risk ratios (RR) with 95% confidence intervals (CI) using a log-binomial regression model and hazard ratios (HR) with 95% CI for preterm birth. Main outcome measures: Preterm birth, low birthweight, caesarean section, pre-eclampsia, Apgar score <7 at 5minutes and perinatal mortality. Results: PCOS diagnosis in twin pregnancy was associated with increased risk of preterm delivery (51% versus 43%, RR 1.18 [95% CI 1.03-1.37]), particularly spontaneous preterm delivery (37% versus 28%; RR 1.30 [95% CI 1.09-1.55]) and very preterm birth (<32weeks) (14% versus 8%, RR 1.62 [95% CI 1.10-2.37]). Twins of PCOS mothers had more often low birthweight (48% versus 39%, adjusted RR 1.40 [95% CI 1.09-1.80]). This difference disappeared when adjusting for gestational age. No risk difference was found for caesarean section, pre-eclampsia, low 5-minute Apgar score or perinatal mortality. Conclusions: The risk of preterm delivery in twin pregnancies is increased by having a PCOS diagnosis. This should be considered in risk estimation and antenatal follow-up of twin pregnancies.
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| 5. |
- Neupane, Suman, et al.
(author)
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The Hedyotis-Oldenlandia complex (Rubiaceae: Spermacoceae) in Asia and the Pacific : Phylogeny revisited with new generic delimitations
- 2015
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In: Taxon. - : Wiley. - 0040-0262 .- 1996-8175. ; 64:2, s. 299-322
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Journal article (peer-reviewed)abstract
- Hedyotis and related genera (here called the Hedyotis-Oldenlandia complex) are highly debated groups in the Rubiaceae family with no consensus to date on their generic delimitations. The present study focuses on Asian-Pacific taxa from these groups and aims at resolving taxonomic inconsistencies by describing monophyletic genera within the complex. The generic circumscriptions presented in our study are based on the phylogenetic trees of nuclear (ITS, ETS) and plastid (petD, rps16) sequence data inferred using Bayesian and maximum likelihood methods. Morphological key features of the group such as habit, fruit type, seed form, and pollen type are studied and compared with the phylogeny to characterize the clades. Based on these results, the Asian-Pacific members are placed in 14 monophyletic groups across the Hedyotis-Oldenlandia complex. Of these, we accept and circumscribe 13 monophyletic genera: Debia, Dentella, Dimetia, Edrastima, Exallage, Hedyotis, Involucrella, Kadua, Kohautia, Leptopetalum, Neanotis, Oldenlandia, and Scleromitrion. Two of these, Debia and Involucrella, are here described as new genera.
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| 6. |
- Stephansson, O., et al.
(author)
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Prolonged second stage of labour, maternal infectious disease, urinary retention and other complications in the early postpartum period
- 2016
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In: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 123:4, s. 608-616
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Journal article (peer-reviewed)abstract
- ObjectiveTo study the association between duration of second stage of labour and risks of maternal complications (infection, urinary retention, haematoma or ruptured sutures) in the early postpartum period. DesignPopulation-based cohort study. Setting and sampleWe included 72593 mothers with singleton vaginal deliveries at 37weeks of gestation in cephalic presentation, using the obstetric database from the Stockholm-Gotland region in Sweden, 2008-12. MethodsLogistic regression analysis. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated and adjustments were made for maternal age, body mass index, height, smoking, cohabitation, gestational age, labour induction, epidural analgesia and oxytocin augmentation. ResultsRates of any complication varied by parity from 7.3% in parous women with previous caesarean section, 4.8% in primiparas and 1.7% in parous women with no previous caesarean section. Compared with a second stage <1hour, the adjusted ORs for any complication (95% CI) in primiparas were for 1 to <2hours 1.28 (1.11-1.47); 2 to <3hours 1.54 (1.32-1.79), 3 to <4hours 1.63 (1.38-1.93) and 4hours 2.08 (1.74-2.49). The corresponding adjusted ORs for parous women without previous caesarean were 2.27 (1.78-2.90), 2.97 (2.09-4.22), 3.65 (2.25-5.94) and 3.16 (1.44-6.94), respectively. The adjusted ORs for women with previous caesarean were for 1 to <2hours 1.62 (1.13-2.32); 2 to <3hours 1.56 (1.00-2.43), 3 to <4hours 2.42 (1.52-3.87), and 4hours 2.31 (1.25-4.24). ConclusionsRisks of maternal complications in the postpartum period increase with duration of second stage of labour also after accounting for maternal, pregnancy and delivery characteristics. Special attention has to be given to parous women with previous caesarean deliveries.
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| 7. |
- Teyeb, O., et al.
(author)
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Evolving LTE future
- 2017
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In: Ericsson Technology Review. - : Telefonaktiebolaget L.M. Ericsson. - 0014-0171. ; 95:2, s. 8-22
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Journal article (peer-reviewed)abstract
- With 5G research progressing at a rapid pace, the standardization process has started in 3GPP. As the most prevalent mobile broadband communication technology worldwide, LTE constitutes an essential piece of the 5G puzzle. As such, its upcoming releases (Rel-14 and Rel-15) are intended to meet as many 5G requirements as possible and address the relevant use cases expected in the 5G era.
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| 8. |
- Valgeirsdóttir, Heiddis, et al.
(author)
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Prenatal exposures and birth indices, and subsequent risk of polycystic ovary syndrome : a national registry-based cohort study
- 2019
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In: British Journal of Obstetrics and Gynecology. - : WILEY. - 1470-0328 .- 1471-0528. ; 126:2, s. 244-251
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Journal article (peer-reviewed)abstract
- Objective: To study the associations between prenatal exposures and risk of developing polycystic ovary syndrome (PCOS).Design: National registry-based cohort study.Setting: Sweden.Population: Girls born in Sweden during the years 1982-1995 (n = 681 123).Methods: The girls were followed until the year 2010 for a diagnosis of PCOS. We estimated the associations between maternal body mass index (BMI), smoking, and size at birth with the risk of developing a PCOS diagnosis. Risks were calculated by adjusted hazard ratio (aHR) and 95% confidence intervals (95% CIs). Main outcome measures A diagnosis of PCOS at 15 years of age or later.Results: During the follow-up period 3738 girls were diagnosed with PCOS (0.54%). Girls with mothers who were overweight or obese had 1.5-2.0 times higher risk of PCOS (aHR 1.52, 95% CI 1.36-1.70; aHR 1.97, 95% CI 1.61-2.41, respectively), compared with girls born to mothers of normal weight. The risk of PCOS was increased if the mother smoked during pregnancy (1-9 cigarettes/day, aHR 1.31, 95% CI 1.18-1.47; >= 10 cigarettes/day, aHR 1.44, 95% CI 1.27-1.64). Being born small for gestational age (SGA) was associated with a later diagnosis of PCOS in crude estimates, but the association was not significant after adjusting for maternal factors.Conclusions: Maternal smoking and increased BMI appear to increase the risk of PCOS in offspring. The association between SGA and the development of PCOS appears to be mediated by maternal factors.
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| 9. |
- Wang, C., et al.
(author)
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Injecting different types of biomass products to the blast furnace and their impacts on the CO2 emission reduction
- 2015
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In: AISTech - Iron and Steel Technology Conference Proceedings. - : Association for Iron and Steel Technology, AISTECH. - 9781935117476 ; , s. 1525-1535
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Conference paper (peer-reviewed)abstract
- Recent years more research has been focusing on utilizing biomass in the blast furnaces (BFs). One driving force is linked to the climate change mitigation, i.e. to reduce CO2 emission from fossil reducing agents or fuels, by using biomass. The amounts of biomass that could be utilized in BF is limited by different parameters, such as metallurgical properties of reducing agents, fuel properties such as volatile content, fixed carbon and oxygen content, ash chemistry (S, Na2O, K2O, etc.). In this paper, different types of biomass products in the form of solid, liquid and gas are investigated as injectants to the blast furnace. The modelling work has been done for a BF from a Nordic country. The possible amounts of injected biomass products are presented. With the replacement ratios of pulverized coal (PC), the potential CO2emission reduction when injecting different biomass products is quantified. In addition, the strategy of using biomass at the studied iron-making plant is discussed. AISTech 2015 Proceedings
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