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- Blennow Nordström, Erik, et al.
(författare)
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Neuropsychological outcome after cardiac arrest : results from a sub-study of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial
- 2023
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Ingår i: Critical Care. - : BioMed Central (BMC). - 1364-8535 .- 1466-609X. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cognitive impairment is common following out-of-hospital cardiac arrest (OHCA), but the nature of the impairment is poorly understood. Our objective was to describe cognitive impairment in OHCA survivors, with the hypothesis that OHCA survivors would perform significantly worse on neuropsychological tests of cognition than controls with acute myocardial infarction (MI). Another aim was to investigate the relationship between cognitive performance and the associated factors of emotional problems, fatigue, insomnia, and cardiovascular risk factors following OHCA.METHODS: This was a prospective case-control sub-study of The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Eight of 61 TTM2-sites in Sweden, Denmark, and the United Kingdom included adults with OHCA of presumed cardiac or unknown cause. A matched non-arrest control group with acute MI was recruited. At approximately 7 months post-event, we administered an extensive neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes.RESULTS: Of 184 eligible OHCA survivors, 108 were included, with 92 MI controls enrolled. Amongst OHCA survivors, 29% performed z-score ≤ - 1 (at least borderline-mild impairment) in ≥ 2 cognitive domains, 14% performed z-score ≤ - 2 (major impairment) in ≥ 1 cognitive domain while 54% performed without impairment in any domain. Impairment was most pronounced in episodic memory, executive functions, and processing speed. OHCA survivors performed significantly worse than MI controls in episodic memory (mean difference, MD = - 0.37, 95% confidence intervals [- 0.61, - 0.12]), verbal (MD = - 0.34 [- 0.62, - 0.07]), and visual/constructive functions (MD = - 0.26 [- 0.47, - 0.04]) on linear regressions adjusted for educational attainment and sex. When additionally adjusting for anxiety, depression, fatigue, insomnia, hypertension, and diabetes, executive functions (MD = - 0.44 [- 0.82, - 0.06]) were also worse following OHCA. Diabetes, symptoms of anxiety, depression, and fatigue were significantly associated with worse cognitive performance.CONCLUSIONS: In our study population, cognitive impairment was generally mild following OHCA. OHCA survivors performed worse than MI controls in 3 of 6 domains. These results support current guidelines that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue.TRIAL REGISTRATION: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018.
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- Blennow Nordström, Erik, et al.
(författare)
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Neuropsychological outcome after cardiac arrest : A prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2)
- 2020
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA. Methods: This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses. Discussion: In this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA. Trial registration: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018
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- Clausen, Henning, et al.
(författare)
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Newborn Screening for High-Risk Congenital Heart Disease by Dried Blood Spot Biomarker Analysis.
- 2024
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Ingår i: JAMA Network Open. - 2574-3805. ; 7:6
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Tidskriftsartikel (refereegranskat)abstract
- Importance Congenital heart disease (CHD) is the most common human organ malformation, affecting approximately 1 of 125 newborns globally.Objectives Assessing the performance of 2 diagnostic tests using minimal amounts of dried blood spots (DBS) to identify high-risk CHD compared with controls in a Swedish cohort of neonates.Design, Setting, and Participants This diagnostic study took place in Sweden between 2019 and 2023 and enrolled full-term babies born between 2005 and 2023. All cases were identified through centralized pediatric cardiothoracic surgical services in Lund and Gothenburg, Sweden. Controls were followed up for 1 year to ensure no late presentations of high-risk CHD occurred. Cases were verified through surgical records and echocardiography.Exposure High-risk CHD, defined as cases requiring cardiac surgical management during infancy due to evolving signs of heart failure or types in which the postnatal circulation depends on patency of the arterial duct. Using 3-μL DBS samples, automated quantitative tests for NT-proBNP and interleukin 1 receptor-like 1 (IL-1 RL1; formerly known as soluble ST2) were compared against established CHD screening methods.Main Outcomes and Measures Performance of DBS tests to detect high-risk CHD using receiver operating characteristic curves; Bland-Altman and Pearson correlation analyses to compare IL-1 RL1 DBS with plasma blood levels.Results A total of 313 newborns were included (mean [SD] gestational age, 39.4 [1.3] weeks; 181 [57.8%] male). Mean (SD) birthweight was 3495 (483) grams. Analyzed DBS samples included 217 CHD cases and 96 controls. Among the CHD cases, 188 participants (89.3%) were high-risk types, of which 73 (38.8%) were suspected prenatally. Of the 188 high-risk cases, 94 (50.0%) passed pulse oximetry screening and 36 (19.1%) were initially discharged after birth without diagnoses. Combining NT-proBNP and IL-1 RL1 tests performed well in comparison with existing screening methods and enabled additional identification of asymptomatic babies with receiver operating characteristic area under the curve 0.95 (95% CI, 0.93-0.98).Conclusions and relevance In this diagnostic study, NT-proBNP and IL-1 RL1 DBS assays identified high-risk CHD in a timely manner, including in asymptomatic newborns, and improved overall screening performance in this cohort from Sweden. Prospective evaluation of this novel approach is warranted.
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- Friberg, Hanna, et al.
(författare)
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Effect of earthworms and incorporation of grass on Plasmodiophora brassicae
- 2008
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Ingår i: Pedobiologia. - : Elsevier BV. - 1873-1511 .- 0031-4056. ; 52:1, s. 29-39
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Tidskriftsartikel (refereegranskat)abstract
- The resting spores of Plasmodiophora brassicae, causal agent of clubroot disease of crucifers, are tolerant structures with the abitity to survive for at least 15 years in soil waiting for a host. The influence of incorporation of cut grass (Lolium perenne) and presence of the earthworm Aporrectodea caliginosa on R brassicae resting spores was investigated in a microcosm experiment, and measured as disease development in susceptible bait plants (Brassica rapa var. pekinensis). Grass material was incorporated every other month during 498 days of experiment, and soil samples for P brassicae bioassay were collected nine times, just before each incorporation of grass. The grass treatment, irrespective of earthworm presence, resutted in a tower soil pH, increased the proportion of large soil. aggregates and increased the abundance of mites, collembolans and nematodes. The microbial biomass (SIR) was increased by grass incorporation, as a result of an increase in growing microbial biomass. When earthworms were present, the response of the microbial community was more pronounced, and the organic material. was mineralised more efficiently, leading to a higher percentage ash content of the soil. In contrary to these changes, clubroot disease severity did not differ among the treatments at any specific sampling. Across all samplings, however, disease severity was higher in the grass treatment without earthworms compared with the control treatment. The result contradicts earlier studies on earthworm effects on P brassicae. The importance of different earthworm species on the interaction is discussed. (c) 2008 Elsevier GmbH. All rights reserved.
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- Friberg, Katarina, 1974-
(författare)
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A Co-operative Take on Free Trade : International Ambitions and Regional Initiatives in International Co-operative Trade
- 2017
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Ingår i: A Global History of Consumer Co-operation since 1850. - Leiden : Brill Academic Publishers. - 9789004336544 ; , s. 201-225
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Bokkapitel (refereegranskat)abstract
- This chapter deals with co-operative ambitions to create institutions that would establish international co-operative trade. This implied stimulating trade between the national co-operative wholesales, or more ambitiously, the creation of an international co-operative business organization. Free trade as a trade policy and as an approach to internationalism was a condition for the realization of international co-operative trade. Protectionism was not an option. But the very notion of free trade, and the ways in which co-operators have related to it, has been subject to subtle shifts and changes. In the chapter, we follow the endeavours of co-operators to agree on institutions for co-operative international trade and thereby also their discussion regarding free trade policy. The period covered is the first half of the twentieth century but focus is on the inter-war period.
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- Friberg, Katarina
(författare)
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Accounts along the aid chain : Administering a moral economy
- 2015
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Ingår i: Journal of Global Ethics. - : Informa UK Limited. - 1744-9626 .- 1744-9634. ; 11:2, s. 246-256
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is threefold. First, it aims to delineate the flow of resources and the claims on those resources within the humanitarian aid system by locating task structures and functional units across the aid chain. Second, it draws on this account to highlight tensions in the system. Different stations in the organisational process are conditioned by the tasks assigned to them, how those tasks are anchored in a moral economy, and their historical interrelations. Third, it explores how aid organisations are perceived by experts in different parts of the aid chain. Four key agents were invited to recount their work experiences. We then consider how the outlook of the interviewees was shaped by their place in the aid chain. The interviews are an inventory of experiences, a preliminary corroboration of the organisational analysis that preceded them, and a source of future hypotheses. © 2015 The Author(s). Published by Taylor & Francis.
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