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- Husby, A, et al.
(författare)
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Clinical outcomes of myocarditis after SARS-CoV-2 mRNA vaccination in four Nordic countries: population based cohort study
- 2023
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Ingår i: BMJ medicine. - : BMJ. - 2754-0413. ; 2:1, s. e000373-
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the clinical outcomes of myocarditis associated with mRNA vaccines against the SARS-CoV-2 virus compared with other types of myocarditis.DesignPopulation based cohort study.SettingNationwide register data from four Nordic countries (Denmark, Finland, Norway, and Sweden), from 1 January 2018 to the latest date of follow-up in 2022.ParticipantsThe Nordic myocarditis cohort; 7292 individuals aged ≥12 years who had an incident diagnosis of myocarditis as a main or secondary diagnosis, in a population of 23 million individuals in Denmark, Finland, Norway, and Sweden.Main outcome measuresHeart failure, or death from any cause within 90 days of admission to hospital for new onset myocarditis, and hospital readmission within 90 days of discharge to hospital for new onset myocarditis. Clinical outcomes of myocarditis associated with SARS-CoV-2 mRNA vaccination, covid-19 disease, and conventional myocarditis were compared.ResultsIn 2018-22, 7292 patients were admitted to hospital with new onset myocarditis, with 530 (7.3%) categorised as having myocarditis associated with SARS-CoV-2 mRNA vaccination, 109 (1.5%) with myocarditis associated with covid-19 disease, and 6653 (91.2%) with conventional myocarditis. At the 90 day follow-up, 62, nine, and 988 patients had been readmitted to hospital in each group (vaccination, covid-19, and conventional myocarditis groups, respectively), corresponding to a relative risk of readmission of 0.79 (95% confidence interval 0.62 to 1.00) and 0.55 (0.30 to 1.04) for the vaccination type and covid-19 type myocarditis groups, respectively, compared with the conventional myocarditis group. At the 90 day follow-up, 27, 18, and 616 patients had a diagnosis of heart failure or died in the vaccination type, covid-19 type, and conventional myocarditis groups, respectively. The relative risk of heart failure within 90 days was 0.56 (95% confidence interval 0.37 to 0.85) and 1.48 (0.86 to 2.54) for myocarditis associated with vaccination and covid-19 disease, respectively, compared with conventional myocarditis; the relative risk of death was 0.48 (0.21 to 1.09) and 2.35 (1.06 to 5.19), respectively. Among patients aged 12-39 years with no predisposing comorbidities, the relative risk of heart failure or death was markedly higher for myocarditis associated with covid-19 disease than for myocarditis associated with vaccination (relative risk 5.78, 1.84 to 18.20).ConclusionsCompared with myocarditis associated with covid-19 disease and conventional myocarditis, myocarditis after vaccination with SARS-CoV-2 mRNA vaccines was associated with better clinical outcomes within 90 days of admission to hospital.
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- Lie, S. O., et al.
(författare)
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Long-term results in children with AML: NOPHO-AML Study Group--report of three consecutive trials
- 2005
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Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 0887-6924 .- 1476-5551. ; 19:12, s. 2090-100
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Tidskriftsartikel (refereegranskat)abstract
- In all, 447 children with acute myeloid leukaemia (AML) have been treated on three consecutive NOPHO studies from July 1984 to December 2001. NOPHO-AML 84 was of moderate intensity with an induction of three courses of cytarabine, 6-thioguanine and doxorubicin followed by four consolidation courses with high-dose cytarabine. The 5-year event-free survival (EFS), disease free survival (DFS) and overall survival (OS) were 29, 37 and 38%. NOPHO-AML 88 was of high intensity with the addition of etoposide and mitoxantrone in selected courses during induction and consolidation. The interval between the induction courses should be as short as possible, that is, time intensity was introduced. The 5-year EFS, DFS and OS were 41, 48 and 46%. In NOPHO-AML 93, the treatment was stratified according to response to first induction course. The protocol utilised the same induction blocks as NOPHO-AML 88, but after the first block, children with a hypoplastic, nonleukaemic bone marrow were allowed to recover before the second block. Consolidation was identical with NOPHO-AML 88. The 5-year EFS, DFS and OS in NOPHO-AML 93 were 48, 52 and 65%. The new NOPHO-AML protocol has been based on experiences from previous protocols with stratification of patients with regard to in vivo response and specific cytogenetic aberrations.
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- Liimatainen, H., et al.
(författare)
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Driving forces of road freight CO2 in 2030
- 2015
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Ingår i: International Journal of Physical Distribution & Logistics Management. - : Emerald. - 0960-0035. ; 45:3, s. 260-285
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - Road freight carbon dioxide (CO2) emissions are determined by a complex interaction between shippers and hauliers within the boundaries set by regulations and economic factors. It is necessary to gain understanding about the various driving forces and trends affecting these to promote low carbon future. The purpose of this paper is to find out what factors affect the long-term future development of road freight CO2 emissions and whether the long-term emission targets will be achieved. Design/methodology/approach - An international comparison of similar Delphi surveys is carried out in Finland, Norway, and Sweden. Findings - The Delphi surveys indicate that the structural change of the economy, changes of consumer habits, concerns of energy and environment and changes in logistics practices and technology are the overarching trends shaping the future of the energy efficiency and CO2 emissions of road freight transport. The expert forecasts for Finland and Sweden highlight that reaching the carbon emission target of 30 per cent reduction for the year 2030 is possible. However, the CO2 emissions may also increase significantly even though the CO2 intensity would decrease, as the Norwegian forecast shows. Originality/value - This study combined quantitative and qualitative analysis. The results confirmed that similar factors are seen to affect the future in all three countries, but with some national differences in the likely effects of the factors. Future research using the same methodology would enable wider analysis of the global significance of these driving forces.
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- Liimatainen, H., et al.
(författare)
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Energy efficiency of road freight hauliers-A Nordic comparison
- 2014
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Ingår i: Energy Policy. - : Elsevier BV. - 0301-4215. ; 67, s. 378-387
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Tidskriftsartikel (refereegranskat)abstract
- In order to promote policy targets for decarbonising road freight, it is important to gain knowledge on the current energy efficiency practices of hauliers in various countries. This research aimed to provide such knowledge to enable international comparison of the energy efficiency practices of road freight hauliers. This was achieved by replicating the Finnish haulier survey in Denmark, Norway and Sweden. Energy efficiency index was developed to provide a simple metric for international comparison. The EEI covers various aspects of energy efficiency to provide a comprehensive outlook into the issue. The monitoring practices are fairly similar in all four countries, with typical monitoring done manually when filling the tank and data kept on a computer. Tonne-kilometre data is rarely monitored, but some other performance measures may be used. Current level of implementation of various energy efficiency actions is rather similar between the four countries. The simple and inexpensive actions, like choosing the lorry according to the cargo and idling avoidance, are most widely implemented. The energy efficiency index developed in this research proved to be a very useful tool for comparing the hauliers in the four countries. © 2013 Elsevier Ltd.
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- Melles, Martin, et al.
(författare)
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2.8 million years of arctic climate change from Lake El'gygytgyn, NE Russia
- 2012
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 337:6092, s. 315-320
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Tidskriftsartikel (refereegranskat)abstract
- The reliability of Arctic climate predictions is currently hampered by insufficient knowledge of natural climate variability in the past. A sediment core from Lake El'gygytgyn in northeastern (NE) Russia provides a continuous, high-resolution record from the Arctic, spanning the past 2.8 million years. This core reveals numerous "super interglacials" during the Quaternary; for marine benthic isotope stages (MIS) 11c and 31, maximum summer temperatures and annual precipitation values are similar to 4 degrees to 5 degrees C and similar to 300 millimeters higher than those of MIS 1 and 5e. Climate simulations show that these extreme warm conditions are difficult to explain with greenhouse gas and astronomical forcing alone, implying the importance of amplifying feedbacks and far field influences. The timing of Arctic warming relative to West Antarctic Ice Sheet retreats implies strong interhemispheric climate connectivity.
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