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Singh P, Lamine H, Sapkota S, Bahattab A, Eriksson A. Management of Mass-Casualty Incidents in Nepal: A Qualitative Case Study of Three District Hospitals in Nepal. Prehosp Disaster Med 2023; 38:606-611. [PMID: 37609893 PMCID: PMC10548016 DOI: 10.1017/s1049023x23006209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/22/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION The frequency of disasters world-wide has significantly increased in recent years, leading to an increase in the number of mass-casualty incidents (MCIs). These MCIs can overwhelm health care systems, requiring hospitals to respond quickly and effectively, often with limited resources. While numerous studies have identified the challenges in managing MCIs and have emphasized the importance of hospital disaster preparedness, there is a research gap in the preparedness level and response capacities of district hospitals in Nepal. STUDY OBJECTIVE This study attempts to fill this gap by understanding the perception of hospital staff in managing MCIs in district hospitals of Nepal. METHODS A qualitative case study was conducted in three district hospitals in Nepal. Semi-structured interviews were conducted with the hospital personnel, using an interview guide. An inductive thematic analysis was carried out to understand their perception on the most recent MCI management. RESULTS Three themes emerged from the data analysis: enablers in MCI management, barriers in MCI management, and recommendations for the future. Use of multiple communication channels, mobilization of entire hospital teams, mobilization of police in crowd control, presence of disaster store, and pre-identified triage areas were the major enablers that facilitated successful MCI management. Nonetheless, the study also revealed challenges such as a lack of knowledge on MCI response among new staff, disruptions caused by media and visitors, and challenges in implementing triage. CONCLUSION This study emphasized the importance of hospital disaster preparedness in managing MCIs and highlighted the significance of overcoming barriers and utilizing enablers for an efficient response. The findings of this study can provide the basis for the Ministry of Health and Population Nepal and district hospitals to plan initiatives for the effective management of MCIs in the future.
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Affiliation(s)
- Prinka Singh
- Department of Global Public Health, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Hamdi Lamine
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università Del Piemonte Orientale, 28100Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università Del Piemonte Orientale, 13100Vercelli, Italy
| | - Sujan Sapkota
- HERD International, Sainbu Awas Cr-10 Marga, Bhaisepati, Lalitpur, Nepal
| | - Awsan Bahattab
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università Del Piemonte Orientale, 28100Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università Del Piemonte Orientale, 13100Vercelli, Italy
| | - Anneli Eriksson
- Department of Global Public Health, Karolinska Institutet, Solna, Stockholm, Sweden
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Alhaffar MHDBA, Gomez MDMM, Sigua JA, Eriksson A. The cholera outbreak in Syria: a call for urgent actions. IJID Reg 2023; 8:71-74. [PMID: 37521106 PMCID: PMC10372181 DOI: 10.1016/j.ijregi.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023]
Abstract
The ongoing cholera outbreak in Syria poses a significant public health threat that requires immediate and comprehensive attention. The spread of the outbreak is attributed to a combination of factors, including displacement due to armed conflict, chronic water insecurity, inadequate water, sanitation, and hygiene infrastructure, climate change-induced droughts, weakened health system capacity, and political instability. The recent earthquake in the region has further complicated the situation, potentially leading to a surge in cholera cases. The limited capacity of the Syrian health system to handle the cholera outbreak, especially after the earthquake, highlights the urgent need for external support. The political instability in the country has hampered effective responses to the outbreak, contributing to the spread of the disease beyond Syria's borders. It is imperative to prioritize aid to address the fragmented response and provide the necessary resources for comprehensive and effective cholera prevention and control measures. The situation calls for an integrated, multi-sectoral approach that prioritizes economic development, universal access to sustainable safe drinking water, and adequate sanitation. Additionally, community engagement and education are essential for effective disease prevention and control. In conclusion, the ongoing cholera outbreak in Syria is a complex issue that requires urgent attention and action. The combination of armed conflict, water insecurity, climate change, and political instability have contributed to the spread of the disease, further compounded by the recent earthquake. To effectively address the outbreak and prevent its further spread, a comprehensive and integrated approach is needed, with support from the international community.
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Affiliation(s)
| | | | - Jemar Anne Sigua
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Anneli Eriksson
- Department of Global Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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Chen L, Eriksson A, Weström S, Pandzic T, Lehmann S, Cavelier L, Landegren U. 210P Ultra-sensitive monitoring of leukemia patients using superRCA mutation detection assays. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Chen L, Weström S, Eriksson A, Pandzic T, Lehmann S, Cavelier L, Landegren U. 107P Ultra-sensitive monitoring mutations in cancer patients using superRCA mutation detection assays. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Chen L, Eriksson A, Weström S, Pandzic T, Lehmann S, Cavelier L, Landegren U. 629P Ultra-sensitive monitoring of leukemia patients using superRCA mutation detection assays. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Stenberg K, Eriksson A, Odensten C, Darehed D. Mortality and complications after percutaneous endoscopic gastrostomy: a retrospective multicentre study. BMC Gastroenterol 2022; 22:361. [PMID: 35902805 PMCID: PMC9335963 DOI: 10.1186/s12876-022-02429-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Percutaneous endoscopic gastrostomy (PEG) is the method of choice for patients in need of long-term nutritional support or gastric decompression. Although it is considered safe, complications and relatively high mortality rates have been reported. We aimed to identify risk factors for complications and mortality after PEG in routine healthcare. Methods This retrospective study included all adult patients who received a PEG between 2013 and 2019 in Region Norrbotten, Sweden.
Results 389 patients were included. The median age was 72 years, 176 (45%) were women and 281 (72%) patients received their PEG due to neurological disease. All-cause mortality was 15% at 30 days and 28% at 90 days. Malignancy as the indication for PEG was associated with increased mortality at 90 days (OR 4.41, 95% CI 2.20–8.88). Other factors significantly associated with increased mortality were older age, female sex, diabetes mellitus, heart failure, lower body mass index and higher C-reactive protein levels. Minor and major complications within 30 days occurred in 11% and 15% of the patients, respectively. Diabetes increased the risk of minor complications (OR 2.61, 95% CI 1.04–6.55), while those aged 75 + years were at an increased risk of major complications, compared to those younger than 65 years (OR 2.23, 95% CI 1.02–4.85). Conclusions The increased risk of death among women and patients with malignancy indicate that these patients could benefit from earlier referral for PEG. Additionally, we found that age, diabetes, heart failure, C-reactive protein and body mass index all impact the risk of adverse outcomes.
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Affiliation(s)
- K Stenberg
- Department of Surgery, Sunderby Hospital, Kirurgkliniken, Sunderby sjukhus, Sjukhusvägen 10, 954 42, Södra Sunderbyn, Sweden.
| | - A Eriksson
- Department of Surgery, Sunderby Hospital, Kirurgkliniken, Sunderby sjukhus, Sjukhusvägen 10, 954 42, Södra Sunderbyn, Sweden
| | - C Odensten
- Department of Surgical and Preoperative Sciences, Surgery, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - D Darehed
- Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden
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Eriksson C, Andersen HM, Eriksson A, Johannessen A, Simonsen N, Thualagant N, Torp S, Haglund BJA. Health promotion research in the Nordic countries - a scoping review of PhD dissertations 2008-2018. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Nordic countries are welfare states that also have been claimed to be in the forefront in developing health promotion, in relation to theory, research, policy and practice. This scoping review was performed by members of the Nordic Health Promotion Research Network with the objectives to collect and identify the scope and theoretical basis of doctoral (PhD) dissertations on health promotion in a Nordic context.
Methods
Searches for dissertations, published 2008-2018, were performed in several databases in Denmark, Finland, Iceland, Norway, and Sweden. Those labelled “health promotion” present in titles, abstract or key words were included in the scoping review. Data was extracted based on a common template including title, aims, university, individual-national level, setting, type of study and collaboration.
Results
The search strategy had to be modified to include manual searches at university sites as no national data base was available. In total, 353 health promotion dissertations had been published at 41 different universities. Most dissertations were Swedish (193), while 56 came from Denmark, 53 from Norway and 51 from Finland, but non from Iceland. The main content was lifestyle (28%), mental or psychosocial health (14%), critical health promotion (8%), empowerment (7%) or refugee and immigrants (5%). The most common approach was settings (31%), including health care setting (14%), followed by societal (28%) and individual (28%) approaches. Mixed methods approach was most common research method (45%) followed by quantitative (32%) and qualitative methods (23%). Large country variations were seen in the health promotion.
Conclusions
Health promotion research in the Nordic countries can be characterised by focusing on lifestyle, settings approach, and primarily using a mixed methods approach. However, there are large variations between different health promotion PhDs, also including dissertations on critical health promotion and empowerment.
Key messages
Analysis of PhD dissertations can contribute to more comprehensive insight in disciplinary development. The research training will have implications for the future public health workforce. The Nordic collaboration enabled an extensive scoping review of PhD dissertations on health promotion research in the Nordic countries and shows what has characterized the field of research.
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Affiliation(s)
- C Eriksson
- Department of Public Health Science, Stockholm University, Stockholm, Sweden
| | - H M Andersen
- Center for Nursing, University College Absalon, Roskilde, Denmark
| | - A Eriksson
- School of Engineering Sciences, Royal Institute of Technology, Stockholm, Sweden
| | - A Johannessen
- Faculty of Health and Science, University of South-Eastern Norway, Vestfold, Norway
| | - N Simonsen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - N Thualagant
- Research Center for Health Promotion, University of Roskilde, Roskilde, Denmark
| | - S Torp
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway
| | - B J A Haglund
- Department of Global Health, Karolinska Institute, Stockholm, Sweden
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Meilia PDI, Herkutanto, Atmadja DS, Cordner S, Eriksson A, Kubat B, Kumar A, Payne-James JJ, Rubanzana WG, Uhrenholt L, Freeman MD, Zeegers MP. The PERFORM-P (Principles of Evidence-based Reporting in FORensic Medicine-Pathology version). Forensic Sci Int 2021; 327:110962. [PMID: 34474199 DOI: 10.1016/j.forsciint.2021.110962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/22/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Most findings of forensic pathology examinations are presented as written reports. There are currently no internationally accepted recommendations for writing forensic pathology reports. Existing recommendations are also varied and reflect the differences in the scope and role of forensic medical services and local settings in which they are to be implemented. The legal fact-finder thus faces wide variation in the quality of forensic pathology reports, which poses a threat to the reliability of legal decision-making. To address this issue, the development of the "PERFORM-P (Principles of Evidence-based Reporting in FORensic Medicine-Pathology version)" was undertaken. The goal of the PERFORM-P is to provide common practice recommendations adaptable to local requirements to promote evidence-based practice (EBP) in forensic pathology. METHODS An international consensus study was conducted in three phases by (1) developing a long-list of items to be considered in the reporting recommendations, (2) conducting a Delphi process (an iterative survey method to transform individual opinions into group consensus) with international forensic pathologists, and (3) designing the PERFORM-P prototype and its accompanying manual. RESULTS With assistance from 106 forensic pathologists/forensic medical practitioners from 41 countries, the PERFORM-P was developed. The PERFORM-P consists of a list of 61 items to be included in a forensic pathology report, which is accompanied by its Explanation and Elaboration (E&E) document. DISCUSSION To prepare forensic pathology (postmortem) reports that incorporate principles of evidence-based practice, internationally accepted recommendations might be helpful. The PERFORM-P identifies recommendations for necessary elements to include in a forensic pathology report. PERFORM-P can be applied to a wide range of matters requiring forensic pathological analysis, acceptable to forensic pathologists from a representative selection of jurisdictions and medico-legal systems.
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Affiliation(s)
- P D I Meilia
- Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, Maastricht, The Netherlands.
| | - Herkutanto
- Department of Forensic Medicine and Medicolegal Studies, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - D S Atmadja
- Department of Forensic Medicine and Medicolegal Studies, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - S Cordner
- The Victorian Institute of Forensic Medicine, Melbourne, Victoria, Australia
| | - A Eriksson
- Dept of Community Medicine and Rehabilitation/Forensic Medicine, Umeå University, Umeå, Sweden
| | - B Kubat
- Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, The Netherlands
| | - Adarsh Kumar
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
| | - J J Payne-James
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - W G Rubanzana
- Department of Epidemiology and Biostatistics, University of Rwanda College of Medicine and Health Sciences, School of Public Health, Kigali, Rwanda
| | - L Uhrenholt
- Department of Forensic Medicine, Section of Forensic Pathology, Aarhus University, Aarhus, Denmark
| | - M D Freeman
- Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M P Zeegers
- Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, Maastricht, The Netherlands
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Delaval M, Dauter U, Eriksson A, Kebede A, Isaxon C, Broberg K, Gliga A. Toxicity of combustion-derived particles from Ethiopian household solid fuels in human bronchial epithelial cells. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00707-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
CONTEXT Collisions between cometary neutrals in the inner coma of a comet and cometary ions that have been picked up into the solar wind flow and return to the coma lead to the formation of a broad inner boundary known as a collisionopause. This boundary is produced by a combination of charge transfer and chemical reactions, both of which are important at the location of the collisionopause boundary. Four spacecraft measured ion densities and velocities in the inner region of comets, exploring the part of the coma where an ion-neutral collisionopause boundary is expected to form. AIMS The aims are to determine the dominant physics behind the formation of the ion-neutral collisionopause and to evaluate where this boundary has been observed by spacecraft. METHODS We evaluated observations from three spacecraft at four different comets to determine if a collisionopause boundary was observed based on the reported ion velocities. We compared the measured location of the ion-neutral collisionopause with measurements of the collision cross sections to evaluate whether chemistry or charge exchange are more important at the location where the collisionopause is observed. RESULTS Based on measurements of the cross sections for charge transfer and for chemical reactions, the boundary observed by Rosetta appears to be the location where chemistry becomes the more probable result of a collision between H2O and H2O+ than charge exchange. Comparisons with ion observations made by Deep Space 1 at 19P/Borrelly and Giotto at 1P/Halley and 26P/Grigg-Skjellerup show that similar boundaries were observed at 19P/Borrelly and 1P/Halley. The ion composition measurements made by Giotto at Halley confirm that chemistry becomes more important inside of this boundary and that electron-ion dissociative recombination is a driver for the reported ion pileup boundary.
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Affiliation(s)
- K E Mandt
- Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Rd., Laurel, MD 20723
| | - A Eriksson
- Swedish Institute of Space Physics, POB 537, SE-751 21, Uppsala, Sweden
| | - A Beth
- Department of Physics, Imperial College London, Prince Consort Road, London SW7 2AZ, United Kingdom
| | - M Galand
- Department of Physics, Imperial College London, Prince Consort Road, London SW7 2AZ, United Kingdom
| | - E Vigren
- Swedish Institute of Space Physics, POB 537, SE-751 21, Uppsala, Sweden
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Marshall SK, Monárrez-Espino J, Eriksson A. Performance of mid-upper arm circumference to diagnose acute malnutrition in a cross-sectional community-based sample of children aged 6-24 months in Niger. Nutr Res Pract 2019; 13:247-255. [PMID: 31214293 PMCID: PMC6548705 DOI: 10.4162/nrp.2019.13.3.247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 04/30/2019] [Accepted: 05/09/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND/OBJECTIVES Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6–24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < −2, MUAC < 12.5 cm) and SAM (WHZ < −3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < −3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.
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Affiliation(s)
- Sarah K Marshall
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
| | - Joel Monárrez-Espino
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden.,Coordination for Health Research. Christus LatAm Hub - Center for Excellence and Innovation, 66260 Monterrey, Nuevo León, Mexico
| | - Anneli Eriksson
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
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Abstract
BACKGROUND Sweden's firearm legislation obligates physicians to report patients that are deemed unsuitable to possess a firearm. This study aimed to explore the involvement of firearm use in firearm fatalities and to evaluate physician reporting concerning cases of firearm deaths. METHODS Fatal firearm suicides and homicides in Sweden were studied for the years 2012-2013, accidental deaths and undetermined manner of deaths for the period 1987-2013. Police reports and autopsy protocols were collected from the National Board of Forensic Medicine, health care data in 1 year before the fatality from the National Board of Health, and information about physician reports and firearm licences from the Swedish Police. RESULTS A total of 291 firearm deaths (213 suicides, 52 accidental deaths, 23 solved homicides and 3 cases with undetermined manner of death) were identified. Firearm suicides were positively correlated with the number of licensed firearm owners. Legal firearm use predominated in firearm suicides and accidental deaths, illegal in homicides. No suicide victim or shooter in an accidental death was previously reported by a physician to the police according to the firearm law. The majority of the shooters in accidental deaths and suicides had no registered health care visits. Less than half (42%) of all suicide victims had a previous health care contact due to mental health problems. CONCLUSIONS Not one single suicide victim nor any shooter in accidental deaths in the present study had been reported according to the firearm law, bringing the evidence of a suboptimal framework.
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Affiliation(s)
- M Junuzovic
- Section of Forensic Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.,Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - A Rietz
- Section of Forensic Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - U Jakobsson
- Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - P Midlöv
- Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - A Eriksson
- Section of Forensic Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Affiliation(s)
- N Lynøe
- Learning, Informatics, Management and Ethics (LIME) Stockholm Centre for Healthcare Ethics Karolinska Institutet Stockholm, Sweden
| | - D Olsson
- Learning, Informatics, Management and Ethics (LIME) Medical Statistic Unit Karolinska Institutet Stockholm, Sweden
| | - A Eriksson
- Department of Community Medicine and Rehabilitation, Forensic Medicine Umeå University Umeå, Sweden
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Ågren S, Eriksson A, Fredrikson M, Hollman-Frisman G, Orwelius L. The health promoting conversations intervention for families with a critically ill relative: A pilot study. Intensive Crit Care Nurs 2018; 50:103-110. [PMID: 29731406 DOI: 10.1016/j.iccn.2018.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND After intensive care unit treatment, patients often have prolonged impairments that affect their physical, cognitive and mental health. Family members can face overwhelming and emotionally challenging situations and their concerns and needs must be addressed. OBJECTIVE We investigated the outcomes of pilot randomised control trial, a nurse-led family intervention, Health Promoting Conversations, which focused on family functioning and wellbeing in families with a critically ill member. STUDY DESIGN This randomised controlled pilot study used a pre-test, post-test design with intervention and control groups to investigate the outcomes of the nurse-led intervention in 17 families. OUTCOME MEASURES The Health Promoting Conversations intervention was evaluated using validated instruments that measure family functioning and family wellbeing: the General Functioning sub-scale from the McMaster Family Assessment Device; the Family Sense of Coherence, the Herth Hope Index, and the Medical Outcome Short-Form Health Survey. Descriptive and analytical statistical methods were used to analyse the data. RESULTS After 12 months, the intervention group reported better family functioning than the control group. The intervention group also had better social functioning and mental health after 12 months. CONCLUSION This intervention may improve family wellbeing by improving family function, reducing stress, and promoting better mental health.
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Affiliation(s)
- S Ågren
- Department of Cardiothoracic Surgery and Department of Medical and Health Sciences, Linköping University, Sweden.
| | - A Eriksson
- Department of Intensive Care, Linköping University, County Council of Östergötland, Linköping, Sweden.
| | - M Fredrikson
- Division of Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine and Forum Östergötland, Linköping University, Linköping, Sweden.
| | - G Hollman-Frisman
- Anesthetics, Operations and Speciality Surgery Center and Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden.
| | - L Orwelius
- Department of Intensive Care, Clinical and Experimental Medicine, Linköping University, County Council of Östergötland, Linköping, Sweden.
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Dellve L, Strömgren M, Williamsson A, Holden RJ, Eriksson A. Health care clinicians' engagement in organizational redesign of care processes: The importance of work and organizational conditions. Appl Ergon 2018; 68:249-257. [PMID: 29409641 DOI: 10.1016/j.apergo.2017.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 11/26/2017] [Accepted: 12/02/2017] [Indexed: 06/07/2023]
Abstract
The Swedish health care system is reorienting towards horizontal organization for care processes. A main challenge is to engage health care clinicians in the process. The aim of this study was to assess engagement (i.e. attitudes and beliefs, the cognitive state and clinical engagement behaviour) among health care clinicians, and to investigate how engagement was related to work resources and demands during organizational redesign. A cohort study was conducted, using a questionnaire distributed to clinicians at five hospitals working with care process improvement approaches, two of them having implemented Lean production. The results show that kinds of engagement are interlinked and contribute to clinical engagement behaviour in quality of care and patient safety. Increased work resources have importance for engagements in organizational improvements, especially in top-down implementations. An extended work engagement model during organizational improvements in health care was supported. The model contributes to knowledge about how and when clinicians are mobilized to engage in organizational changes.
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Affiliation(s)
- L Dellve
- KTH Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden; Department of Sociology and Work Science, Gothenburg University, Gothenburg, Sweden.
| | - M Strömgren
- KTH Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden
| | - A Williamsson
- KTH Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden
| | - R J Holden
- School of Informatics and Computing, Indiana University, Indianapolis, IN, USA
| | - A Eriksson
- KTH Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden
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Dall'Osto M, Beddows DCS, Asmi A, Poulain L, Hao L, Freney E, Allan JD, Canagaratna M, Crippa M, Bianchi F, de Leeuw G, Eriksson A, Swietlicki E, Hansson HC, Henzing JS, Granier C, Zemankova K, Laj P, Onasch T, Prevot A, Putaud JP, Sellegri K, Vidal M, Virtanen A, Simo R, Worsnop D, O'Dowd C, Kulmala M, Harrison RM. Novel insights on new particle formation derived from a pan-european observing system. Sci Rep 2018; 8:1482. [PMID: 29367716 PMCID: PMC5784154 DOI: 10.1038/s41598-017-17343-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/20/2017] [Indexed: 11/10/2022] Open
Abstract
The formation of new atmospheric particles involves an initial step forming stable clusters less than a nanometre in size (<~1 nm), followed by growth into quasi-stable aerosol particles a few nanometres (~1–10 nm) and larger (>~10 nm). Although at times, the same species can be responsible for both processes, it is thought that more generally each step comprises differing chemical contributors. Here, we present a novel analysis of measurements from a unique multi-station ground-based observing system which reveals new insights into continental-scale patterns associated with new particle formation. Statistical cluster analysis of this unique 2-year multi-station dataset comprising size distribution and chemical composition reveals that across Europe, there are different major seasonal trends depending on geographical location, concomitant with diversity in nucleating species while it seems that the growth phase is dominated by organic aerosol formation. The diversity and seasonality of these events requires an advanced observing system to elucidate the key processes and species driving particle formation, along with detecting continental scale changes in aerosol formation into the future.
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Affiliation(s)
- M Dall'Osto
- Institute of Marine Science, Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain. .,National Centre for Atmospheric Science Division of Environmental Health & Risk Management School of Geography, Earth & Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom. .,School of Physics, Centre for Climate & Air Pollution Studies, National University of Ireland Galway, University Road Galway, Galway, Ireland. .,Aerodyne Research, Inc., Billerica, MA, USA.
| | - D C S Beddows
- National Centre for Atmospheric Science Division of Environmental Health & Risk Management School of Geography, Earth & Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - A Asmi
- Department of Physics, University of Helsinki, P.O. Box 64, 00014, Helsinki, Finland
| | - L Poulain
- Leibniz Institute for Tropospheric Research, Permoserstr. 15, 04318, Leipzig, Germany
| | - L Hao
- University of Eastern Finland, Department of Applied Physics, P.O.Box 1627, FIN-70211, Kuopio, Finland
| | - E Freney
- Laboratoire de Météorologie Physique, CNRS-Université Blaise Pascal, UMR6016, 63117, Clermont, Ferrand, France
| | - J D Allan
- School of Earth, Atmospheric and Environmental Sciences, The University of Manchester, Manchester, UK
| | | | - M Crippa
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232, PSI, Villigen, Switzerland.,European Commission, Joint Research Centre (JRC), Directorate for Energy, Transport and Climate, Air and Climate Unit, Via E. Fermi 2749, I-21027, Ispra, (VA), Italy
| | - F Bianchi
- Department of Physics, University of Helsinki, P.O. Box 64, 00014, Helsinki, Finland.,Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232, PSI, Villigen, Switzerland
| | - G de Leeuw
- Finnish Meteorological Institute, Climate Change Unit, P.O. Box 503, 00101, Helsinki, Finland.,Netherlands Organisation for Applied Scientific Research TNO, Princetonlaan 6, 3508 TA, Utrecht, The Netherlands
| | - A Eriksson
- Division of Ergonomics and Aerosol Technology, Lund University, Box 118, SE-22100, Lund, Sweden
| | - E Swietlicki
- Division of Nuclear Physics, Lund University, Box 118, SE-22100, Lund, Sweden
| | - H C Hansson
- Department of Environmental Science and Analytical Chemistry, Stockholm University, 10691, Stockholm, Sweden
| | - J S Henzing
- Netherlands Organisation for Applied Scientific Research TNO, Princetonlaan 6, 3508 TA, Utrecht, The Netherlands
| | - C Granier
- Laboratoire d'Aérologie, Toulouse, France.,NOAA Earth System Laboratory and CIRES, University of Colorado, Boulder, USA
| | - K Zemankova
- Charles University, Faculty of Mathematics and Physics, Dept. of Atmospheric Physcis, Prague, Czechia
| | - P Laj
- Department of Physics, University of Helsinki, P.O. Box 64, 00014, Helsinki, Finland.,Univ. Grenoble-Alpes, CNRS, IRD, INPG, Institut des Géosciences de l'Environnement, Grenoble, France.,Univ. Grenoble-Alpes, CNRS, IRD, Observatoire des Sciences de l'Univers, Grenoble, France
| | - T Onasch
- Aerodyne Research, Inc., Billerica, MA, USA
| | - A Prevot
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232, PSI, Villigen, Switzerland
| | - J P Putaud
- European Commission, Joint Research Centre, Institute for Environment and Sustainability, 21027, (VA), Italy
| | - K Sellegri
- Laboratoire de Météorologie Physique, CNRS-Université Blaise Pascal, UMR6016, 63117, Clermont, Ferrand, France
| | - M Vidal
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Universitat de Barcelona, Av. Diagonal 643, 08028, Barcelona, Catalonia, Spain
| | - A Virtanen
- University of Eastern Finland, Department of Applied Physics, P.O.Box 1627, FIN-70211, Kuopio, Finland
| | - R Simo
- Institute of Marine Science, Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain
| | - D Worsnop
- Aerodyne Research, Inc., Billerica, MA, USA.,Department of Physics, University of Helsinki, P.O. Box 64, 00014, Helsinki, Finland
| | - C O'Dowd
- School of Physics, Centre for Climate & Air Pollution Studies, National University of Ireland Galway, University Road Galway, Galway, Ireland
| | - M Kulmala
- Department of Physics, University of Helsinki, P.O. Box 64, 00014, Helsinki, Finland
| | - Roy M Harrison
- National Centre for Atmospheric Science Division of Environmental Health & Risk Management School of Geography, Earth & Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.,Department of Environmental Sciences / Center of Excellence in Environmental Studies, King Abdulaziz University, PO Box 80203, 21589, Jeddah, Saudi Arabia
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17
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Abstract
Background: Low retention of humanitarian workers poses constraints on humanitarian organisations’ capacity to respond effectively to disasters. Research has focused on reasons for humanitarian workers leaving the sector, but little is known about the factors that can elucidate long-term commitment. Objective: To understand what motivates and supports experienced humanitarian health workers to remain in the sector. Methods: Semi-structured interviews were conducted with 10 experienced nurses who had been on at least three field missions with Médecins Sans Frontières Sweden. Interviews explored factors influencing the decision to go on missions, how nurses were supported and how they looked back on those experiences. Transcripts were analysed through content analysis informed by van Gennep’s concept of ‘Rite of Passage’, combined with elements of the self-determination theory. Results: The findings indicate that their motivations and how nurses thought of themselves, as individuals and professionals, changed over time. For initiation and continued engagement in humanitarian work, participants were motivated by several personal and professional ambitions, as well as altruistic principles of helping others. When starting their first humanitarian missions, nurses felt vulnerable and had low self-esteem. However, through experiencing feelings of autonomy, competence and relatedness during missions, they underwent a process of change and gradually adjusted to new roles as humanitarian health workers. Reintegration in their home community, while maintaining the new roles and skills from the missions, proved very challenging. They individually found their own ways of overcoming the lack of social support they experienced after missions in order to sustain their continuation in the sector. Conclusions: The findings highlight the importance of social environments that facilitate and support the adjustment of individuals during and after field missions. Learning from positive examples, such as nurses with several years of experience, can strengthen strategies of retention, which can ultimately improve the delivery of humanitarian assistance.
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Affiliation(s)
- Sara Albuquerque
- a Department of Public Health Sciences, Global Health , Karolinska Institutet , Stockholm , Sweden
| | - Anneli Eriksson
- a Department of Public Health Sciences, Global Health , Karolinska Institutet , Stockholm , Sweden
| | - Helle M Alvesson
- a Department of Public Health Sciences, Global Health , Karolinska Institutet , Stockholm , Sweden
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18
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Rosén M, Lynøe N, Elinder G, Hallberg B, Sundgren P, Eriksson A. Shaken baby syndrome and the risk of losing scientific scrutiny. Acta Paediatr 2017; 106:1905-1908. [PMID: 28871599 DOI: 10.1111/apa.14056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/02/2017] [Accepted: 08/29/2017] [Indexed: 12/01/2022]
Abstract
A systematic review of shaken baby syndrome by the Swedish Agency for Health Technology Assessment and Assessment of Social Services generated numerous reactions from professional organisations, even before the review was published. There was also a lively debate after a paper summarising its findings were published in Acta Paediatrica The various responses are worth debating further, as they raise several important issues with regard to research ethics, having an open debate and publishing scientific findings. CONCLUSION The responses to the shaken baby syndrome report indicate that scientific scrutiny risks being lost when researchers and organisations are not open to challenging established ideas.
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Affiliation(s)
- M Rosén
- Department of Learning, Informatics, Management and Ethics; Karolinska Institutet; Stockholm Sweden
| | - N Lynøe
- Stockholm Centre for Healthcare Ethics; Karolinska Institutet; Stockholm Sweden
| | - G Elinder
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
| | - B Hallberg
- Department of Clinical Science, Intervention and Technology; Karolinska University Hospital; Karolinska Institutet; Stockholm Sweden
| | - P Sundgren
- Department of Diagnostic Radiology; Clinical Sciences; Lund University; Lund Sweden
| | - A Eriksson
- Department of Community Medicine and Rehabilitation; Forensic Medicine; Umeå University; Umeå Sweden
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19
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Dellve L, Eriksson A. Development of health-promoting and sustainable leadership: follow-up of an intervention study. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Dellve
- Gothenburg University, Dept Sociology and Work Science, Gothenburg, Sweden
| | - A Eriksson
- Gothenburg University, Dept Sociology and Work Science, Gothenburg, Sweden
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20
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Ames MK, Atkins CE, Eriksson A, Hess AM. Aldosterone breakthrough in dogs with naturally occurring myxomatous mitral valve disease. J Vet Cardiol 2017; 19:218-227. [PMID: 28576479 DOI: 10.1016/j.jvc.2017.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 03/18/2017] [Accepted: 03/27/2017] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Aldosterone breakthrough (ABT) is the condition in which angiotensin converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers fail to effectively suppress the activity of the renin angiotensin aldosterone system. The objective of this study was to determine if ABT occurs in dogs with naturally occurring myxomatous mitral valve disease receiving an ACEI, using the urine aldosterone to creatinine ratio (UAldo:C) as a measure of renin angiotensin aldosterone system activation. ANIMALS, MATERIALS AND METHODS This study includes 39 dogs with myxomatous mitral valve disease. A UAldo:C cut-off definition (derived from a normal population of healthy, adult, and client-owned dogs) was used to determine the prevalence of ABT in this population. Spearman analysis and univariate logistic regression were used to evaluate the relationship between UAldo:C and ABT (yes/no) and eight variables (age, serum K+ concentration, serum creatinine concentration, ACEI therapy duration and ACEI dosage, furosemide therapy duration and furosemide dosage, and urine sample storage time). Finally, the UAldo:C in dogs receiving spironolactone, as part congestive heart failure (CHF) therapy, was compared to dogs with CHF that were not receiving spironolactone. RESULTS The prevalence of ABT was 32% in dogs with CHF and 30% in dogs without CHF. There was no relationship between either the UAldo:C or the likelihood of ABT and the eight variables. Therapy with spironolactone lead to a significant elevation of the UAldo:C. DISCUSSION Using the UAldo:C and a relatively stringent definition of ABT, it appears that incomplete RAAS blockade is common in dogs with MMVD receiving an ACEI. The prevalence of ABT in this canine population mirrors that reported in humans. While the mechanism of ABT is likely multifactorial and still poorly understood, the proven existence of ABT in dogs offers the potential to improve the prognosis for MMVD with the addition of a mineralocorticoid receptor blocker to current therapeutic regimens. CONCLUSIONS Approximately 30% of dogs being treated for heart disease and CHF satisfied the definition of ABT. Identifying patient subpopulations experiencing ABT may help guide future study design and clinical decision-making.
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Affiliation(s)
- M K Ames
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr. Raleigh, NC, 27607, USA.
| | - C E Atkins
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr. Raleigh, NC, 27607, USA
| | - A Eriksson
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr. Raleigh, NC, 27607, USA
| | - A M Hess
- Department of Statistics, Colorado State University, Ft. Collins, CO, USA
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21
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Eriksson A, Banks VA, Stanton NA. Transition to manual: Comparing simulator with on-road control transitions. Accid Anal Prev 2017; 102:227-234. [PMID: 28342410 DOI: 10.1016/j.aap.2017.03.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/07/2017] [Accepted: 03/11/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Whilst previous research has explored how driver behaviour in simulators may transfer to the open road, there has been relatively little research showing the same transfer within the field of driving automation. As a consequence, most research into human-automation interaction has primarily been carried out in a research laboratory or on closed-circuit test tracks. OBJECTIVE The aim of this study was to assess whether research into non-critical control transactions in highly automated vehicles performed in driving simulators correlate with road driving conditions. METHOD Twenty six drivers drove a highway scenario using an automated driving mode in the simulator and twelve drivers drove on a public motorway in a Tesla Model S with the Autopilot activated. Drivers were asked to relinquish, or resume control from the automation when prompted by the vehicle interface in both the simulator and on road condition. RESULTS Drivers were generally faster to resume control in the on-road driving condition. However, strong positive correlations were found between the simulator and on road driving conditions for drivers transferring control to and from automation. No significant differences were found with regard to workload, perceived usefulness and satisfaction between the simulator and on-road drives. CONCLUSION The results indicate high levels of relative validity of driving simulators as a research tool for automated driving research.
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Affiliation(s)
- A Eriksson
- Transportation Research Group, Faculty of Engineering and the Environment, University of Southampton, Boldrewood Campus, SO16 7QF, UK.
| | - V A Banks
- Human Factors Research Group, University of Nottingham, UK
| | - N A Stanton
- Transportation Research Group, Faculty of Engineering and the Environment, University of Southampton, Boldrewood Campus, SO16 7QF, UK
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22
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Gustafsson T, Eriksson A, Wingren C. Multivariate linear regression modelling of lung weight in 24,056 Swedish medico-legal autopsy cases. J Forensic Leg Med 2017; 46:20-22. [DOI: 10.1016/j.jflm.2016.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 10/22/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
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23
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Angelison L, Almer S, Eriksson A, Karling P, Fagerberg U, Halfvarson J, Thörn M, Björk J, Hindorf U, Löfberg R, Bajor A, Hjortswang H, Hammarlund P, Grip O, Torp J, Marsal J, Hertervig E. Long-term outcome of infliximab treatment in chronic active ulcerative colitis: a Swedish multicentre study of 250 patients. Aliment Pharmacol Ther 2017; 45:519-532. [PMID: 28025840 DOI: 10.1111/apt.13893] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 09/21/2016] [Accepted: 11/16/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Real-life long-term data on infliximab treatment in ulcerative colitis are limited. AIM To study the long-term efficacy and safety of infliximab in chronic active ulcerative colitis and possible predictors of colectomy and response were also examined. METHODS A retrospective multi-centre study of infliximab treatment in 250 patients with chronic active ulcerative colitis with inclusion criteria: age ≥18 years, ambulatory treated, steroid-dependent or intolerant and/or immunomodulator refractory or intolerant. RESULTS Steroid-free clinical remission was achieved by 123/250 patients (49.2%) at 12 months and in 126/250 patients at a median follow-up of 2.9 years (50.4%). Primary response at 3 months was achieved by 190/250 (76.0%) patients and associated with a high probability of response 168/190 (88.4%) at 12 months and 143/190 (75.3%) at follow-up. Long-term rate of colectomy in primary responders was 6/190 (3.2%) at 12 months and 27/190 (14.2%) at last follow-up. Failure to achieve response at 3 months was associated with a high risk of subsequent colectomy, 29/60 (48.3%) at 12 months and 41/60 (68.3%) at follow-up. Response at 12 months was associated with a low risk of subsequent colectomy, 14/181 (7.7%) compared with non-response 19/34 (55.9%) (P < 0.0001). Non-response at 3 months was an independent predictor of subsequent colectomy (HR = 9.40, 95% CI = 5.10-17.35, P < 0.001). Concomitant azathioprine therapy did not influence outcome in terms of colectomy. CONCLUSIONS Long-term efficacy of infliximab treatment in chronic active ulcerative colitis is excellent especially in patients who respond to induction treatment. Conversely, non-response at 3 months predicts a poor outcome, with a high risk of subsequent colectomy.
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24
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Forsell N, Holzmann M, Taki H, Eriksson A, Ruge T. Transport time from crash scene may influence survival. Trauma 2017. [DOI: 10.1177/1460408616665407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- N Forsell
- Department of Surgery, Umeå University, Umeå, Sweden
| | - M Holzmann
- Department of Internal Medicine, Solna, Karolinska Institute, Stockholm, Sweden
- Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - H Taki
- Department of Surgery, Umeå University, Umeå, Sweden
| | - A Eriksson
- Department of Community Medicine and Rehabilitation, Section of Forensic Medicine, Umeå University, Umeå, Sweden
| | - T Ruge
- Department of Surgery, Umeå University, Umeå, Sweden
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25
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Brolin Ribacke KJ, Saulnier DD, Eriksson A, von Schreeb J. Effects of the West Africa Ebola Virus Disease on Health-Care Utilization - A Systematic Review. Front Public Health 2016; 4:222. [PMID: 27777926 PMCID: PMC5056406 DOI: 10.3389/fpubh.2016.00222] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 09/26/2016] [Indexed: 11/21/2022] Open
Abstract
Significant efforts were invested in halting the recent Ebola virus disease outbreak in West Africa. Now, studies are emerging on the magnitude of the indirect health effects of the outbreak in the affected countries, and the aim of this study is to systematically assess the results of these publications. The methodology for this review adhered to the Prisma guidelines for systematic reviews. A total of 3354 articles were identified for screening, and while 117 articles were read in full, 22 studies were included in the final review. Utilization of maternal health services decreased during the outbreak. The number of cesarean sections and facility-based deliveries declined and followed a similar pattern in Guinea, Liberia, and Sierra Leone. A change in the utilization of antenatal and postnatal care and family planning services was also seen, as well as a drop in utilization of children’s health services, especially in terms of vaccination coverage. In addition, the uptake of HIV/AIDS and malaria services, general hospital admissions, and major surgeries decreased as well. Interestingly, it was the uptake of health service provision by the population that decreased, rather than the volume of health service provision. Estimates from the various studies suggest that non-Ebola morbidity and mortality have increased after the onset of the outbreak in Sierra Leone, Guinea, and Liberia. Reproductive, maternal, and child health services were especially affected, and the decrease in facility deliveries, cesarean sections, and volume of antenatal and postnatal care visits might have significant adverse effects on maternal and newborn health. The impact of Ebola stretches far beyond Ebola cases and deaths. This review indicates that indirect health service effects are substantial and both short and long term, and highlights the importance of support to maintain routine health service delivery and the maintenance of vaccination programs as well as preventative and curative malaria programs, both in general but especially in times of a disaster.
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Affiliation(s)
- Kim J Brolin Ribacke
- Health Systems and Policy Research Group, Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
| | - Dell D Saulnier
- Health Systems and Policy Research Group, Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
| | - Anneli Eriksson
- Health Systems and Policy Research Group, Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
| | - Johan von Schreeb
- Health Systems and Policy Research Group, Department of Public Health Sciences, Karolinska Institutet , Stockholm , Sweden
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Eriksson A, Strömgren M, Dellve L. ISQUA16-2687EXPERIENCES OF IMPLEMENTING OCCUPATIONAL HEALTH SERVICES DRIVEN INTERVENTION METHODS FOR SUSTAINABLE LEADERSHIP IN HEALTH CARE. Int J Qual Health Care 2016. [DOI: 10.1093/intqhc/mzw104.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Gallego-Llorente M, Connell S, Jones ER, Merrett DC, Jeon Y, Eriksson A, Siska V, Gamba C, Meiklejohn C, Beyer R, Jeon S, Cho YS, Hofreiter M, Bhak J, Manica A, Pinhasi R. The genetics of an early Neolithic pastoralist from the Zagros, Iran. Sci Rep 2016; 6:31326. [PMID: 27502179 PMCID: PMC4977546 DOI: 10.1038/srep31326] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 07/15/2016] [Indexed: 12/20/2022] Open
Abstract
The agricultural transition profoundly changed human societies. We sequenced and analysed the first genome (1.39x) of an early Neolithic woman from Ganj Dareh, in the Zagros Mountains of Iran, a site with early evidence for an economy based on goat herding, ca. 10,000 BP. We show that Western Iran was inhabited by a population genetically most similar to hunter-gatherers from the Caucasus, but distinct from the Neolithic Anatolian people who later brought food production into Europe. The inhabitants of Ganj Dareh made little direct genetic contribution to modern European populations, suggesting those of the Central Zagros were somewhat isolated from other populations of the Fertile Crescent. Runs of homozygosity are of a similar length to those from Neolithic farmers, and shorter than those of Caucasus and Western Hunter-Gatherers, suggesting that the inhabitants of Ganj Dareh did not undergo the large population bottleneck suffered by their northern neighbours. While some degree of cultural diffusion between Anatolia, Western Iran and other neighbouring regions is possible, the genetic dissimilarity between early Anatolian farmers and the inhabitants of Ganj Dareh supports a model in which Neolithic societies in these areas were distinct.
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Affiliation(s)
| | - S Connell
- School of Archaeology and Earth Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - E R Jones
- Department of Zoology, University of Cambridge, Cambridge, CB2 3EJ, UK
| | - D C Merrett
- Department of Archaeology, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Y Jeon
- The Genomics Institute, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea.,Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - A Eriksson
- Department of Zoology, University of Cambridge, Cambridge, CB2 3EJ, UK.,Integrative Systems Biology Laboratory, Division of Biological and Environmental Sciences &Engineering, King Abdullah University of Science and Technology, Thuwal 23955-6900, Kingdom of Saudi Arabia
| | - V Siska
- Department of Zoology, University of Cambridge, Cambridge, CB2 3EJ, UK
| | - C Gamba
- School of Archaeology and Earth Institute, University College Dublin, Belfield, Dublin 4, Ireland.,Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, Copenhagen 1350, Denmark
| | - C Meiklejohn
- Department of Anthropology, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada
| | - R Beyer
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge CB2 3ER, UK
| | - S Jeon
- The Genomics Institute, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea.,Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - Y S Cho
- The Genomics Institute, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea.,Department of Biomedical Engineering, School of Life Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - M Hofreiter
- Evolutionary Adaptive Genomics, Institute for Biochemistry and Biology, Department of Mathematics and Natural Sciences, University of Potsdam, Karl-Liebknechtstraße 24-25, Potsdam, 14476, Germany
| | - J Bhak
- The Genomics Institute, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Republic of Korea
| | - A Manica
- Department of Zoology, University of Cambridge, Cambridge, CB2 3EJ, UK
| | - R Pinhasi
- School of Archaeology and Earth Institute, University College Dublin, Belfield, Dublin 4, Ireland
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28
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Eriksson A, Gerdin M, Garfield R, Tylleskar T, von Schreeb J. How Bad Is It? Usefulness of the "7eed Model" for Scoring Severity and Level of Need in Complex Emergencies. PLoS Curr 2016; 8. [PMID: 28503357 PMCID: PMC5419815 DOI: 10.1371/currents.dis.d59e0fa39887031e1c3763851a6e5c2a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Humanitarian assistance is designated to save lives and alleviate suffering among people affected by disasters. In 2014, close to 25 billion USD was allocated to humanitarian assistance, more than 80% of it from governmental donors and EU institutions. Most of these funds are devoted to Complex Emergencies (CE). It is widely accepted that the needs of the affected population should be the main determinant for resource allocations of humanitarian funding. However, to date no common, systematic, and transparent system for needs-based allocations exists. In an earlier paper, an easy-to-use model, “the 7eed model”, based on readily available indicators that distinguished between levels of severity among disaster-affected countries was presented. The aim of this paper is to assess the usefulness of the 7eed model in regards to 1) data availability, 2) variations between CE effected countries and sensitivity to change over time, and 3) reliability in capturing severity and levels of need. Method: We applied the 7eed model to 25 countries with CE using data from 2013 to 2015. Data availability and indicator value variations were assessed using heat maps. To calculate a severity score and a needs score, we applied a standardised mathematical formula, based on the UTSTEIN template. We assessed the model for reliability on previous CEs with a “known” outcome in terms of excess mortality. Results: Most of the required data was available for nearly all countries and indicators, and availability increased over time. The 7eed model was able to discriminate between levels of severity and needs among countries. Comparison with historical complex disasters showed a correlation between excess mortality and severity score. Conclusion: Our study indicates that the proposed 7eed model can serve as a useful tool for setting funding levels for humanitarian assistance according to measurable levels of need. The 7eed model provides national level information but does not take into account local variations or specific contextual factors.
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Affiliation(s)
- Anneli Eriksson
- Department of Public Health Sciences, Health System and Policy, Karolinska Institute, Stockholm, Sweden
| | - Martin Gerdin
- Department of Public Health Sciences, Health System and Policy, Karolinska Institute, Stockholm, Sweden
| | | | | | - Johan von Schreeb
- Department of Public Health Sciences, Health System and Policy, Karolinska Institute, Stockholm, Sweden
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Jakosky BM, Grebowsky JM, Luhmann JG, Connerney J, Eparvier F, Ergun R, Halekas J, Larson D, Mahaffy P, McFadden J, Mitchell DF, Schneider N, Zurek R, Bougher S, Brain D, Ma YJ, Mazelle C, Andersson L, Andrews D, Baird D, Baker D, Bell JM, Benna M, Chaffin M, Chamberlin P, Chaufray YY, Clarke J, Collinson G, Combi M, Crary F, Cravens T, Crismani M, Curry S, Curtis D, Deighan J, Delory G, Dewey R, DiBraccio G, Dong C, Dong Y, Dunn P, Elrod M, England S, Eriksson A, Espley J, Evans S, Fang X, Fillingim M, Fortier K, Fowler CM, Fox J, Gröller H, Guzewich S, Hara T, Harada Y, Holsclaw G, Jain SK, Jolitz R, Leblanc F, Lee CO, Lee Y, Lefevre F, Lillis R, Livi R, Lo D, Mayyasi M, McClintock W, McEnulty T, Modolo R, Montmessin F, Morooka M, Nagy A, Olsen K, Peterson W, Rahmati A, Ruhunusiri S, Russell CT, Sakai S, Sauvaud JA, Seki K, Steckiewicz M, Stevens M, Stewart AIF, Stiepen A, Stone S, Tenishev V, Thiemann E, Tolson R, Toublanc D, Vogt M, Weber T, Withers P, Woods T, Yelle R. MAVEN observations of the response of Mars to an interplanetary coronal mass ejection. Science 2015; 350:aad0210. [PMID: 26542576 DOI: 10.1126/science.aad0210] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Coupling between the lower and upper atmosphere, combined with loss of gas from the upper atmosphere to space, likely contributed to the thin, cold, dry atmosphere of modern Mars. To help understand ongoing ion loss to space, the Mars Atmosphere and Volatile Evolution (MAVEN) spacecraft made comprehensive measurements of the Mars upper atmosphere, ionosphere, and interactions with the Sun and solar wind during an interplanetary coronal mass ejection impact in March 2015. Responses include changes in the bow shock and magnetosheath, formation of widespread diffuse aurora, and enhancement of pick-up ions. Observations and models both show an enhancement in escape rate of ions to space during the event. Ion loss during solar events early in Mars history may have been a major contributor to the long-term evolution of the Mars atmosphere.
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Affiliation(s)
| | - J M Grebowsky
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - J G Luhmann
- University of California at Berkeley, Berkeley, CA, USA
| | - J Connerney
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - F Eparvier
- University of Colorado, Boulder, CO, USA
| | - R Ergun
- University of Colorado, Boulder, CO, USA
| | - J Halekas
- University of Iowa, Iowa City, IA, USA
| | - D Larson
- University of California at Berkeley, Berkeley, CA, USA
| | - P Mahaffy
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - J McFadden
- University of California at Berkeley, Berkeley, CA, USA
| | - D F Mitchell
- University of California at Berkeley, Berkeley, CA, USA
| | | | - R Zurek
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - S Bougher
- University of Michigan, Ann Arbor, MI, USA
| | - D Brain
- University of Colorado, Boulder, CO, USA
| | - Y J Ma
- University of California at Los Angeles, Los Angeles, CA, USA
| | - C Mazelle
- CNRS-Institut de Recherche en Astrophysique et Planétologie (IRAP), Toulouse, France. University Paul Sabatier, Toulouse, France
| | | | - D Andrews
- Swedish Institute of Space Physics, Uppsala, Sweden
| | - D Baird
- NASA/Johnson Space Center, Houston, TX, USA
| | - D Baker
- University of Colorado, Boulder, CO, USA
| | - J M Bell
- National Institute of Aerospace, Hampton, VA, USA
| | - M Benna
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Chaffin
- University of Colorado, Boulder, CO, USA
| | - P Chamberlin
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - Y-Y Chaufray
- Laboratoire atmosphères, milieux et observations spatiales (LATMOS)-CNRS, Paris, France
| | - J Clarke
- Boston University, Boston, MA, USA
| | - G Collinson
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Combi
- University of Michigan, Ann Arbor, MI, USA
| | - F Crary
- University of Colorado, Boulder, CO, USA
| | - T Cravens
- University of Kansas, Lawrence, KS, USA
| | - M Crismani
- University of Colorado, Boulder, CO, USA
| | - S Curry
- University of California at Berkeley, Berkeley, CA, USA
| | - D Curtis
- University of California at Berkeley, Berkeley, CA, USA
| | - J Deighan
- University of Colorado, Boulder, CO, USA
| | - G Delory
- University of California at Berkeley, Berkeley, CA, USA
| | - R Dewey
- University of Colorado, Boulder, CO, USA
| | - G DiBraccio
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - C Dong
- University of Michigan, Ann Arbor, MI, USA
| | - Y Dong
- University of Colorado, Boulder, CO, USA
| | - P Dunn
- University of California at Berkeley, Berkeley, CA, USA
| | - M Elrod
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - S England
- University of California at Berkeley, Berkeley, CA, USA
| | - A Eriksson
- Swedish Institute of Space Physics, Uppsala, Sweden
| | - J Espley
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Evans
- Computational Physics, Inc., Boulder, CO, USA
| | - X Fang
- University of Colorado, Boulder, CO, USA
| | - M Fillingim
- University of California at Berkeley, Berkeley, CA, USA
| | - K Fortier
- University of Colorado, Boulder, CO, USA
| | - C M Fowler
- University of Colorado, Boulder, CO, USA
| | - J Fox
- Wright State University, Dayton, OH, USA
| | - H Gröller
- University of Arizona, Tucson, AZ, USA
| | - S Guzewich
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - T Hara
- University of California at Berkeley, Berkeley, CA, USA
| | - Y Harada
- University of California at Berkeley, Berkeley, CA, USA
| | - G Holsclaw
- University of Colorado, Boulder, CO, USA
| | - S K Jain
- University of Colorado, Boulder, CO, USA
| | - R Jolitz
- University of California at Berkeley, Berkeley, CA, USA
| | - F Leblanc
- Laboratoire atmosphères, milieux et observations spatiales (LATMOS)-CNRS, Paris, France
| | - C O Lee
- University of California at Berkeley, Berkeley, CA, USA
| | - Y Lee
- University of Michigan, Ann Arbor, MI, USA
| | - F Lefevre
- Laboratoire atmosphères, milieux et observations spatiales (LATMOS)-CNRS, Paris, France
| | - R Lillis
- University of California at Berkeley, Berkeley, CA, USA
| | - R Livi
- University of California at Berkeley, Berkeley, CA, USA
| | - D Lo
- University of Arizona, Tucson, AZ, USA
| | | | | | - T McEnulty
- University of Colorado, Boulder, CO, USA
| | - R Modolo
- Laboratoire atmosphères, milieux et observations spatiales (LATMOS)-CNRS, Paris, France
| | - F Montmessin
- Laboratoire atmosphères, milieux et observations spatiales (LATMOS)-CNRS, Paris, France
| | - M Morooka
- University of Colorado, Boulder, CO, USA
| | - A Nagy
- University of Michigan, Ann Arbor, MI, USA
| | - K Olsen
- University of Michigan, Ann Arbor, MI, USA
| | - W Peterson
- University of Colorado, Boulder, CO, USA
| | - A Rahmati
- University of Kansas, Lawrence, KS, USA
| | | | - C T Russell
- University of California at Los Angeles, Los Angeles, CA, USA
| | - S Sakai
- University of Kansas, Lawrence, KS, USA
| | - J-A Sauvaud
- CNRS-Institut de Recherche en Astrophysique et Planétologie (IRAP), Toulouse, France. University Paul Sabatier, Toulouse, France
| | - K Seki
- Nagoya University, Nagoya, Japan
| | - M Steckiewicz
- CNRS-Institut de Recherche en Astrophysique et Planétologie (IRAP), Toulouse, France. University Paul Sabatier, Toulouse, France
| | - M Stevens
- Naval Research Laboratory, Washington, DC, USA
| | | | - A Stiepen
- University of Colorado, Boulder, CO, USA
| | - S Stone
- University of Arizona, Tucson, AZ, USA
| | - V Tenishev
- University of Michigan, Ann Arbor, MI, USA
| | - E Thiemann
- University of Colorado, Boulder, CO, USA
| | - R Tolson
- North Carolina State University, Raleigh, NC, USA
| | - D Toublanc
- CNRS-Institut de Recherche en Astrophysique et Planétologie (IRAP), Toulouse, France. University Paul Sabatier, Toulouse, France
| | - M Vogt
- Boston University, Boston, MA, USA
| | - T Weber
- University of Colorado, Boulder, CO, USA
| | | | - T Woods
- University of Colorado, Boulder, CO, USA
| | - R Yelle
- University of Arizona, Tucson, AZ, USA
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30
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Bougher S, Jakosky B, Halekas J, Grebowsky J, Luhmann J, Mahaffy P, Connerney J, Eparvier F, Ergun R, Larson D, McFadden J, Mitchell D, Schneider N, Zurek R, Mazelle C, Andersson L, Andrews D, Baird D, Baker DN, Bell JM, Benna M, Brain D, Chaffin M, Chamberlin P, Chaufray JY, Clarke J, Collinson G, Combi M, Crary F, Cravens T, Crismani M, Curry S, Curtis D, Deighan J, Delory G, Dewey R, DiBraccio G, Dong C, Dong Y, Dunn P, Elrod M, England S, Eriksson A, Espley J, Evans S, Fang X, Fillingim M, Fortier K, Fowler CM, Fox J, Gröller H, Guzewich S, Hara T, Harada Y, Holsclaw G, Jain SK, Jolitz R, Leblanc F, Lee CO, Lee Y, Lefevre F, Lillis R, Livi R, Lo D, Ma Y, Mayyasi M, McClintock W, McEnulty T, Modolo R, Montmessin F, Morooka M, Nagy A, Olsen K, Peterson W, Rahmati A, Ruhunusiri S, Russell CT, Sakai S, Sauvaud JA, Seki K, Steckiewicz M, Stevens M, Stewart AIF, Stiepen A, Stone S, Tenishev V, Thiemann E, Tolson R, Toublanc D, Vogt M, Weber T, Withers P, Woods T, Yelle R. Early MAVEN Deep Dip campaign reveals thermosphere and ionosphere variability. Science 2015; 350:aad0459. [PMID: 26542579 DOI: 10.1126/science.aad0459] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The Mars Atmosphere and Volatile Evolution (MAVEN) mission, during the second of its Deep Dip campaigns, made comprehensive measurements of martian thermosphere and ionosphere composition, structure, and variability at altitudes down to ~130 kilometers in the subsolar region. This altitude range contains the diffusively separated upper atmosphere just above the well-mixed atmosphere, the layer of peak extreme ultraviolet heating and primary reservoir for atmospheric escape. In situ measurements of the upper atmosphere reveal previously unmeasured populations of neutral and charged particles, the homopause altitude at approximately 130 kilometers, and an unexpected level of variability both on an orbit-to-orbit basis and within individual orbits. These observations help constrain volatile escape processes controlled by thermosphere and ionosphere structure and variability.
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Affiliation(s)
- S Bougher
- CLaSP Department, University of Michigan, Ann Arbor, MI, USA.
| | - B Jakosky
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - J Halekas
- Department of Physics and Astronomy, University of Iowa, Iowa City, IA, USA
| | - J Grebowsky
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Luhmann
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - P Mahaffy
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - J Connerney
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - F Eparvier
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - R Ergun
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - D Larson
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - J McFadden
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - D Mitchell
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - N Schneider
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - R Zurek
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - C Mazelle
- CNRS/Institut de Recherche en Astrophysique et Planétologie, Toulouse, France. University Paul Sabatier, Toulouse, France
| | - L Andersson
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - D Andrews
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - D Baird
- NASA/Johnson Space Center, Houston, TX, USA
| | - D N Baker
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - J M Bell
- National Institute of Aerospace, Hampton, VA, USA
| | - M Benna
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - D Brain
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - M Chaffin
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - P Chamberlin
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - J-Y Chaufray
- Laboratoire Atmosphères, Milieux, Observations Spatiales /CNRS, Verrieres-le-Buisson, France
| | - J Clarke
- Department of Astronomy, Boston University, Boston, MA, USA
| | - G Collinson
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - M Combi
- CLaSP Department, University of Michigan, Ann Arbor, MI, USA
| | - F Crary
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - T Cravens
- Department of Physics and Astronomy, University of Kansas, Lawrence, KS, USA
| | - M Crismani
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - S Curry
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - D Curtis
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - J Deighan
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - G Delory
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - R Dewey
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - G DiBraccio
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - C Dong
- CLaSP Department, University of Michigan, Ann Arbor, MI, USA
| | - Y Dong
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - P Dunn
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - M Elrod
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - S England
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - A Eriksson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - J Espley
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Evans
- Computational Physics, Springfield, VA, USA
| | - X Fang
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - M Fillingim
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - K Fortier
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - C M Fowler
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - J Fox
- Department of Physics, Wright State University, Fairborn, OH, USA
| | - H Gröller
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - S Guzewich
- NASA/Goddard Space Flight Center, Greenbelt, MD, USA
| | - T Hara
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - Y Harada
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - G Holsclaw
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - S K Jain
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - R Jolitz
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - F Leblanc
- Laboratoire Atmosphères, Milieux, Observations Spatiales /CNRS, Verrieres-le-Buisson, France
| | - C O Lee
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - Y Lee
- CLaSP Department, University of Michigan, Ann Arbor, MI, USA
| | - F Lefevre
- Laboratoire Atmosphères, Milieux, Observations Spatiales /CNRS, Verrieres-le-Buisson, France
| | - R Lillis
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - R Livi
- Space Sciences Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - D Lo
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - Y Ma
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA, USA
| | - M Mayyasi
- Department of Astronomy, Boston University, Boston, MA, USA
| | - W McClintock
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - T McEnulty
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - R Modolo
- Laboratoire Atmosphères, Milieux, Observations Spatiales /CNRS, Verrieres-le-Buisson, France
| | - F Montmessin
- Laboratoire Atmosphères, Milieux, Observations Spatiales /CNRS, Verrieres-le-Buisson, France
| | - M Morooka
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - A Nagy
- CLaSP Department, University of Michigan, Ann Arbor, MI, USA
| | - K Olsen
- CLaSP Department, University of Michigan, Ann Arbor, MI, USA
| | - W Peterson
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - A Rahmati
- Department of Physics and Astronomy, University of Kansas, Lawrence, KS, USA
| | - S Ruhunusiri
- Department of Physics and Astronomy, University of Iowa, Iowa City, IA, USA
| | - C T Russell
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA, USA
| | - S Sakai
- Department of Physics and Astronomy, University of Kansas, Lawrence, KS, USA
| | - J-A Sauvaud
- CNRS/Institut de Recherche en Astrophysique et Planétologie, Toulouse, France. University Paul Sabatier, Toulouse, France
| | - K Seki
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya, Aichi, Japan
| | - M Steckiewicz
- CNRS/Institut de Recherche en Astrophysique et Planétologie, Toulouse, France. University Paul Sabatier, Toulouse, France
| | - M Stevens
- Naval Research Laboratory, Washington, DC, USA
| | - A I F Stewart
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - A Stiepen
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - S Stone
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
| | - V Tenishev
- CLaSP Department, University of Michigan, Ann Arbor, MI, USA
| | - E Thiemann
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - R Tolson
- National Institute of Aerospace, Hampton, VA, USA
| | - D Toublanc
- CNRS/Institut de Recherche en Astrophysique et Planétologie, Toulouse, France. University Paul Sabatier, Toulouse, France
| | - M Vogt
- Department of Astronomy, Boston University, Boston, MA, USA
| | - T Weber
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - P Withers
- Department of Astronomy, Boston University, Boston, MA, USA
| | - T Woods
- Laboratory for Atmospheric and Space Physics, University. of Colorado, Boulder, CO, USA
| | - R Yelle
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ, USA
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Eriksson A, Ohlsén YK, Garfield R, von Schreeb J. Who Is Worst Off? Developing a Severity-scoring Model of Complex Emergency Affected Countries in Order to Ensure Needs Based Funding. PLoS Curr 2015; 7:ecurrents.dis.8e7fb95c7df19c5a9ba56584d6aa2c59. [PMID: 26635996 PMCID: PMC4648580 DOI: 10.1371/currents.dis.8e7fb95c7df19c5a9ba56584d6aa2c59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Disasters affect close to 400 million people each year. Complex Emergencies (CE) are a category of disaster that affects nearly half of the 400 million and often last for several years. To support the people affected by CE, humanitarian assistance is provided with the aim of saving lives and alleviating suffering. It is widely agreed that funding for this assistance should be needs-based. However, to date, there is no model or set of indicators that quantify and compare needs from one CE to another. In an effort to support needs-based and transparent funding of humanitarian assistance, the aim of this study is to develop a model that distinguishes between levels of severity among countries affected by CE. METHODS In this study, severity serves as a predictor for level of need. The study focuses on two components of severity: vulnerability and exposure. In a literature and Internet search we identified indicators that characterize vulnerability and exposure to CE. Among the more than 100 indicators identified, a core set of six was selected in an expert ratings exercise. Selection was made based on indicator availability and their ability to characterize preexisting or underlying vulnerabilities (four indicators) or to quantify exposure to a CE (two indicators). CE from 50 countries were then scored using a 3-tiered score (Low-Moderate, High, Critical). RESULTS The developed model builds on the logic of the Utstein template. It scores severity based on the readily available value of four vulnerability and four exposure indicators. These are 1) GNI per capita, PPP, 2) Under-five mortality rate, per 1 000 live births, 3) Adult literacy rate, % of people ages 15 and above, 4) Underweight, % of population under 5 years, and 5) number of persons and proportion of population affected, and 6) number of uprooted persons and proportion of population uprooted. CONCLUSION The model can be used to derive support for transparent, needs-based funding of humanitarian assistance. Further research is needed to determine its validity, the robustness of indicators and to what extent levels of scoring relate to CE outcome.
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Affiliation(s)
- Anneli Eriksson
- Public Health Science, Centre for Research on HealthCare in Disasters, Health Systems and Policy Research Group, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Johan von Schreeb
- Department of Public Health Sciences, Health System and Policy, Karolinska Institute, Stockholm, Sweden
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Llorente MG, Jones ER, Eriksson A, Siska V, Arthur KW, Arthur JW, Curtis MC, Stock JT, Coltorti M, Pieruccini P, Stretton S, Brock F, Higham T, Park Y, Hofreiter M, Bradley DG, Bhak J, Pinhasi R, Manica A. Ancient Ethiopian genome reveals extensive Eurasian admixture in Eastern Africa. Science 2015; 350:820-2. [DOI: 10.1126/science.aad2879] [Citation(s) in RCA: 230] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 09/28/2015] [Indexed: 12/26/2022]
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Elías-Wolff F, Eriksson A, Manica A, Mehlig B. How Levins’ dynamics emerges from a Ricker metapopulation model. THEOR ECOL-NETH 2015. [DOI: 10.1007/s12080-015-0271-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Becker W, Eriksson A, Haglund M, Wretling S. Contents of total fat, fatty acids, starch, sugars and dietary fibre in Swedish market basket diets. Br J Nutr 2015; 113:1453-65. [PMID: 25989998 PMCID: PMC4462339 DOI: 10.1017/s0007114515000501] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/19/2014] [Accepted: 02/02/2015] [Indexed: 11/22/2022]
Abstract
The typical dietary supply of total fat, fatty acids, starch, sugars, polyols and dietary fibre in Sweden was assessed from analyses of market baskets (MB) purchased in 2005 and 2010. MB were based on food balance sheets, with each basket comprising about 130 foods, which represented more than 90% of annual dietary supply. Foods were divided into ten to twelve categories. In 2010, total fat contributed 34% of energy (E%), SFA 14.3 E%, MUFA 12.8 E%, PUFA 4.6 E%, n-6 fatty acids 3.6 E%, n-3 fatty acids 1.0 E% and trans-fatty acids (TFA) 0.5 E%. Glycaemic carbohydrates contributed 47 E%, monosaccharides 9 E%, sucrose 11 E%, disaccharides 15 E% and total sugars 24 E%. Added sugars contributed about 15 E%. Dietary fibre content was about 1.7 g/MJ in the 2010 MB. Compared with the 2005 MB, the dietary supply of TFA and dietary fibre was lower, otherwise differences were small. The present MB survey shows that the content of SFA and added sugars was higher than the current Nordic Nutrition Recommendations, while the content of PUFA and especially dietary fibre was lower. TFA levels decreased and dietary supply was well below the recommendations of the WHO. These results emphasise a focus on quality and food sources of fat and carbohydrates, limiting foods rich in SFA and added sugars and replacing them with foods rich in dietary fibre and cis-unsaturated fatty acids.
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Affiliation(s)
- W. Becker
- />National Food Agency, PO Box 622,
SE-75126Uppsala, Sweden
| | - A. Eriksson
- />National Food Agency, PO Box 622,
SE-75126Uppsala, Sweden
| | - M. Haglund
- />National Food Agency, PO Box 622,
SE-75126Uppsala, Sweden
| | - S. Wretling
- />National Food Agency, PO Box 622,
SE-75126Uppsala, Sweden
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Eriksson A, Österroos A, Hassan S, Gullbo J, Rickardson L, Jarvius M, Nygren P, Fryknäs M, Höglund M, Larsson R. Drug screen in patient cells suggests quinacrine to be repositioned for treatment of acute myeloid leukemia. Blood Cancer J 2015; 5:e307. [PMID: 25885427 PMCID: PMC4450329 DOI: 10.1038/bcj.2015.31] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 03/06/2015] [Indexed: 01/21/2023] Open
Abstract
To find drugs suitable for repositioning for use against leukemia, samples from patients with chronic lymphocytic, acute myeloid and lymphocytic leukemias as well as peripheral blood mononuclear cells (PBMC) were tested in response to 1266 compounds from the LOPAC1280 library (Sigma). Twenty-five compounds were defined as hits with activity in all leukemia subgroups (<50% cell survival compared with control) at 10 μM drug concentration. Only one of these compounds, quinacrine, showed low activity in normal PBMCs and was therefore selected for further preclinical evaluation. Mining the NCI-60 and the NextBio databases demonstrated leukemia sensitivity and the ability of quinacrine to reverse myeloid leukemia gene expression. Mechanistic exploration was performed using the NextBio bioinformatic software using gene expression analysis of drug exposed acute myeloid leukemia cultures (HL-60) in the database. Analysis of gene enrichment and drug correlations revealed strong connections to ribosomal biogenesis nucleoli and translation initiation. The highest drug–drug correlation was to ellipticine, a known RNA polymerase I inhibitor. These results were validated by additional gene expression analysis performed in-house. Quinacrine induced early inhibition of protein synthesis supporting these predictions. The results suggest that quinacrine have repositioning potential for treatment of acute myeloid leukemia by targeting of ribosomal biogenesis.
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Affiliation(s)
- A Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - A Österroos
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - S Hassan
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - J Gullbo
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - L Rickardson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - M Jarvius
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - P Nygren
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - M Fryknäs
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - M Höglund
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - R Larsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Akerblom O, de Verdier CH, Eriksson A, Garby L, Högman CF. Rapid freezing of erythrocytes using glycerol in low concentrations. Bibl Haematol 2015; 29:814-22. [PMID: 5728124 DOI: 10.1159/000384712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Rafajlović M, Klassmann A, Eriksson A, Wiehe T, Mehlig B. Demography-adjusted tests of neutrality based on genome-wide SNP data. Theor Popul Biol 2014; 95:1-12. [PMID: 24911258 DOI: 10.1016/j.tpb.2014.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 05/28/2014] [Accepted: 05/29/2014] [Indexed: 12/15/2022]
Abstract
Tests of the neutral evolution hypothesis are usually built on the standard null model which assumes that mutations are neutral and the population size remains constant over time. However, it is unclear how such tests are affected if the last assumption is dropped. Here, we extend the unifying framework for tests based on the site frequency spectrum, introduced by Achaz and Ferretti, to populations of varying size. Key ingredients are the first two moments of the site frequency spectrum. We show how these moments can be computed analytically if a population has experienced two instantaneous size changes in the past. We apply our method to data from ten human populations gathered in the 1000 genomes project, estimate their demographies and define demography-adjusted versions of Tajima's D, Fay & Wu's H, and Zeng's E. Our results show that demography-adjusted test statistics facilitate the direct comparison between populations and that most of the differences among populations seen in the original unadjusted tests can be explained by their underlying demographies. Upon carrying out whole-genome screens for deviations from neutrality, we identify candidate regions of recent positive selection. We provide track files with values of the adjusted and unadjusted tests for upload to the UCSC genome browser.
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Affiliation(s)
- M Rafajlović
- Department of Physics, University of Gothenburg, SE-412 96 Gothenburg, Sweden; The Linnaeus Centre for Marine Evolutionary Biology, University of Gothenburg, SE-405 30 Gothenburg, Sweden
| | - A Klassmann
- Institut für Genetik, Universität zu Köln, 50674 Köln, Germany
| | - A Eriksson
- Department of Zoology, University of Cambridge, CB2 3EJ Cambridge, UK; Integrative Systems Biology Lab, King Abdullah University of Science and Technology, Thuwal 23955-6900, Saudi Arabia
| | - T Wiehe
- Institut für Genetik, Universität zu Köln, 50674 Köln, Germany
| | - B Mehlig
- Department of Physics, University of Gothenburg, SE-412 96 Gothenburg, Sweden; The Linnaeus Centre for Marine Evolutionary Biology, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
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Eriksson A, Löfving S, Callaghan RC, Allebeck P. Alcohol use disorders and risk of Parkinson’s disease: findings from a Swedish national cohort study 1972-2008. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Häggström J, Boswood A, O'Grady M, Jöns O, Smith S, Swift S, Borgarelli M, Gavaghan B, Kresken JG, Patteson M, Åblad B, Bussadori CM, Glaus T, Kovačević A, Rapp M, Santilli RA, Tidholm A, Eriksson A, Belanger MC, Deinert M, Little CJL, Kvart C, French A, Rønn-Landbo M, Wess G, Eggertsdottir A, Lynne O'Sullivan M, Schneider M, Lombard CW, Dukes-McEwan J, Willis R, Louvet A, DiFruscia R. Longitudinal analysis of quality of life, clinical, radiographic, echocardiographic, and laboratory variables in dogs with myxomatous mitral valve disease receiving pimobendan or benazepril: the QUEST study. J Vet Intern Med 2013; 27:1441-51. [PMID: 24010489 DOI: 10.1111/jvim.12181] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 05/03/2013] [Accepted: 07/31/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Myxomatous mitral valve disease (MMVD) is an important cause of morbidity and mortality in dogs. OBJECTIVES To compare, throughout the period of follow-up of dogs that had not yet reached the primary endpoint, the longitudinal effects of pimobendan versus benazepril hydrochloride treatment on quality-of-life (QoL) variables, concomitant congestive heart failure (CHF) treatment, and other outcome variables in dogs suffering from CHF secondary to MMVD. ANIMALS A total of 260 dogs in CHF because of MMVD. METHODS A prospective single-blinded study with dogs randomized to receive pimobendan (0.4-0.6 mg/kg/day) or benazepril hydrochloride (0.25-1.0 mg/kg/day). Differences in outcome variables and time to intensification of CHF treatment were compared. RESULTS A total of 124 dogs were randomized to pimobendan and 128 to benazepril. No difference was found between groups in QoL variables during the trial. Time from inclusion to 1st intensification of CHF treatment was longer in the pimobendan group (pimobendan 98 days, IQR 30-276 days versus benazepril 59 days, IQR 11-121 days; P = .0005). Postinclusion, dogs in the pimobendan group had smaller heart size based on VHS score (P = .013) and left ventricular diastolic (P = .035) and systolic (P = .0044) dimensions, higher body temperature (P = .030), serum sodium (P = .0027), and total protein (P = .0003) concentrations, and packed cell volume (P = .030). Incidence of arrhythmias was similar in treatment groups. CONCLUSIONS AND CLINICAL IMPORTANCE Pimobendan versus benazepril resulted in similar QoL during the study, but conferred increased time before intensification of CHF treatment. Pimobendan treatment resulted in smaller heart size, higher body temperature, and less retention of free water.
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Affiliation(s)
- J Häggström
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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40
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Sjöberg M, Magnuson A, Björk J, Benoni C, Almer S, Friis-Liby I, Hertervig E, Olsson M, Karlén P, Eriksson A, Midhagen G, Carlson M, Lapidus A, Halfvarson J, Tysk C. Infliximab as rescue therapy in hospitalised patients with steroid-refractory acute ulcerative colitis: a long-term follow-up of 211 Swedish patients. Aliment Pharmacol Ther 2013; 38:377-87. [PMID: 23799948 DOI: 10.1111/apt.12387] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 05/15/2013] [Accepted: 06/05/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Rescue therapy with infliximab (IFX) has been proven effective in a steroid-refractory attack of ulcerative colitis (UC). The long-term efficacy is not well described. AIM To present a retrospective study of IFX as rescue therapy in UC. Primary end points were colectomy-free survival at 3 and 12 months. METHODS In this multicentre study, 211 adult patients hospitalised between 1999 and 2010 received IFX 5 mg/kg as rescue therapy due to a steroid-refractory, moderate-to-severe attack of UC. Exclusion criteria were duration of current flare for >12 weeks, corticosteroid treatment for >8 weeks before hospitalisation, previous IFX therapy or Crohn's disease. RESULTS Probability of colectomy-free survival at 3 months was 0.71 (95% CI, 0.64-0.77), at 12 months 0.64 (95% CI, 0.57-0.70), at 3 years 0.59 (95% CI, 0.52-0.66) and at 5 years 0.53 (95% CI, 0.44-0.61). Steroid-free, clinical remission was achieved in 105/211 (50%) and 112/209 (54%) patients at 3 and 12 months respectively. Of 75 colectomies during the first year, 48 (64%) were carried out during the first 14 days, 13 (17%) on days 15-90 and 14 (19%) between 3 and 12 months. There were three (1.4%) deaths during the first 3 months. CONCLUSIONS Infliximab is an effective rescue treatment, both short- and long-term, in a steroid-refractory attack of UC. Most IFX failures underwent surgery during the first 14 days, which calls for studies on how to optimise induction treatment with IFX. Serious complications, including mortality, were rare.
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Affiliation(s)
- M Sjöberg
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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Leander K, Berlin M, Eriksson A, Gadin KG, Hensing G, Krantz G, Swahnberg K, Danielsson M. Violence: Health in Sweden: The National Public Health Report 2012. Chapter 12. Scand J Public Health 2012; 40:229-54. [DOI: 10.1177/1403494812459609] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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42
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Garnier P, Wahlund JE, Holmberg MKG, Morooka M, Grimald S, Eriksson A, Schippers P, Gurnett DA, Krimigis SM, Krupp N, Coates A, Crary F, Gustafsson G. The detection of energetic electrons with the Cassini Langmuir probe at Saturn. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2011ja017298] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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43
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Freeman MD, Dobbertin K, Kohles SS, Uhrenholt L, Eriksson A. Serious head and neck injury as a predictor of occupant position in fatal rollover crashes. Forensic Sci Int 2012; 222:228-33. [PMID: 22742739 DOI: 10.1016/j.forsciint.2012.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 04/21/2012] [Accepted: 06/04/2012] [Indexed: 11/30/2022]
Affiliation(s)
- M D Freeman
- Department of Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR 97209, USA.
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44
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Eriksson A, Elías-Wolff F, Mehlig B. Metapopulation dynamics on the brink of extinction. Theor Popul Biol 2012; 83:101-22. [PMID: 23047064 DOI: 10.1016/j.tpb.2012.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 06/23/2012] [Accepted: 08/14/2012] [Indexed: 11/15/2022]
Abstract
We analyse metapopulation dynamics in terms of an individual-based, stochastic model of a finite metapopulation. We suggest a new approach, using the number of patches in the population as a large parameter. This approach does not require that the number of individuals per patch is large, neither is it necessary to assume a time-scale separation between local population dynamics and migration. Our approach makes it possible to accurately describe the dynamics of metapopulations consisting of many small patches. We focus on metapopulations on the brink of extinction. We estimate the time to extinction and describe the most likely path to extinction. We find that the logarithm of the time to extinction is proportional to the product of two vectors, a vector characterising the distribution of patch population sizes in the quasi-steady state, and a vector-related to Fisher's reproduction vector-that quantifies the sensitivity of the quasi-steady state distribution to demographic fluctuations. We compare our analytical results to stochastic simulations of the model, and discuss the range of validity of the analytical expressions. By identifying fast and slow degrees of freedom in the metapopulation dynamics, we show that the dynamics of large metapopulations close to extinction is approximately described by a deterministic equation originally proposed by Levins (1969). We were able to compute the rates in Levins' equation in terms of the parameters of our stochastic, individual-based model. It turns out, however, that the interpretation of the dynamical variable depends strongly on the intrinsic growth rate and carrying capacity of the patches. Only when the local growth rate and the carrying capacity are large does the slow variable correspond to the number of patches, as envisaged by Levins. Last but not least, we discuss how our findings relate to other, widely used metapopulation models.
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Affiliation(s)
- A Eriksson
- Department of Zoology, University of Cambridge, Cambridge, CB2 3EJ, UK
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Eriksson A, Hermanson M, Wickström M, Lindhagen E, Ekholm C, Jenmalm Jensen A, Löthgren A, Lehmann F, Larsson R, Parrow V, Höglund M. The novel tyrosine kinase inhibitor AKN-028 has significant antileukemic activity in cell lines and primary cultures of acute myeloid leukemia. Blood Cancer J 2012; 2:e81. [PMID: 22864397 PMCID: PMC3432483 DOI: 10.1038/bcj.2012.28] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aberrantly expressed tyrosine kinases have emerged as promising targets for drug development in acute myeloid leukemia (AML). We report that AKN-028, a novel tyrosine kinase inhibitor (TKI), is a potent FMS-like receptor tyrosine kinase 3 (FLT3) inhibitor (IC50=6 nℳ), causing dose-dependent inhibition of FLT3 autophosphorylation. Inhibition of KIT autophosphorylation was shown in a human megakaryoblastic leukemia cell line overexpressing KIT. In a panel of 17 cell lines, AKN-028 showed cytotoxic activity in all five AML cell lines included. AKN-028 triggered apoptosis in MV4-11 by activation of caspase 3. In primary AML samples (n=15), AKN-028 induced a clear dose-dependent cytotoxic response (mean IC50 1 μℳ). However, no correlation between antileukemic activity and FLT3 mutation status, or to the quantitative expression of FLT3, was observed. Combination studies showed synergistic activity when cytarabine or daunorubicin was added simultaneously or 24 h before AKN-028. In mice, AKN-028 demonstrated high oral bioavailability and antileukemic effect in primary AML and MV4-11 cells, with no major toxicity observed in the experiment. In conclusion, AKN-028 is a novel TKI with significant preclinical antileukemic activity in AML. Possible sequence-dependent synergy with standard AML drugs and good oral bioavailability has made it a candidate drug for clinical trials (ongoing).
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Affiliation(s)
- A Eriksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Eriksson A, Hansson K, Häggström J, Järvinen AK, Lord P. Pulmonary Blood Volume in Mitral Regurgitation in Cavalier King Charles Spaniels. J Vet Intern Med 2010; 24:1393-9. [DOI: 10.1111/j.1939-1676.2010.0619.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Dignass AU, Eriksson A, Kilander A, Pukitis A, Rhodes JM, Vavricka S. Clinical trial: five or ten cycles of granulocyte-monocyte apheresis show equivalent efficacy and safety in ulcerative colitis. Aliment Pharmacol Ther 2010; 31:1286-95. [PMID: 20331579 DOI: 10.1111/j.1365-2036.2010.04295.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Ulcerative colitis is characterized by leucocyte infiltration into the colonic mucosa. Granulocyte-monocyte apheresis depletes these cells. AIM To assess the non-inferiority of 5-10 apheresis treatments in patients with steroid-dependent or steroid-refractory ulcerative colitis. METHODS A total of 196 adults with moderate-severe ulcerative colitis were randomized 1:1 to 5 (n = 96) or 10 (n = 90) open label apheresis treatments. The primary endpoint was non-inferiority of clinical activity index score after 12 weeks. RESULTS The intent-to-treat population comprised 82 and 80 patients for the 5- and 10-treatment groups, respectively. The difference between the two groups in mean clinical activity index was 0.24 with an upper 95% confidence interval of 1.17, which was below a predefined non-inferiority threshold of 1.33. Clinical activity index score improved from baseline in both groups (from 8.7 to 5.6 with 5 treatments, and from 8.8 to 5.4 with 10), with no significant difference between the groups (P = 0.200). Outcomes for the 5- and 10-treatment groups were similar--clinical remission: 44% and 40%, respectively (P = 0.636); clinical response: 56% and 59%, respectively (P = 0.753). The treatment was well tolerated in both groups. CONCLUSIONS This prospective study comparing apheresis regimens in ulcerative colitis demonstrates that 5 treatments were not inferior to 10 treatments in steroid-refractory or -dependent ulcerative colitis.
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Affiliation(s)
- A U Dignass
- Department of Medicine I, Markus-Krankenhaus, Frankfurt/Main, Germany.
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Furmark T, Carlbring P, Hedman E, Sonnenstein A, Clevberger P, Bohman B, Eriksson A, Hållén A, Frykman M, Holmström A, Sparthan E, Tillfors M, Ihrfelt EN, Spak M, Eriksson A, Ekselius L, Andersson G. Guided and unguided self-help for social anxiety disorder: randomised controlled trial. Br J Psychiatry 2009; 195:440-7. [PMID: 19880935 DOI: 10.1192/bjp.bp.108.060996] [Citation(s) in RCA: 182] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder, but unguided self-help has been insufficiently studied. AIMS To evaluate the efficacy of guided and unguided self-help for social anxiety disorder. METHOD Participants followed a cognitive-behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n = 235) were randomised to one of three conditions in the first trial, or one of four conditions in the second. RESULTS Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later. CONCLUSIONS Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.
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Affiliation(s)
- Tomas Furmark
- Department of Psychology, Uppsala University, Box 1225, SE-751 42 Uppsala, Sweden.
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Carlsson C, Häggström J, Eriksson A, Järvinen AK, Kvart C, Lord P. Size and Shape of Right Heart Chambers in Mitral Valve Regurgitation in Small-Breed Dogs. J Vet Intern Med 2009; 23:1007-13. [DOI: 10.1111/j.1939-1676.2009.0359.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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