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Kiwango G, Katopola D, Francis F, Möller J, Hasselberg M. A systematic review of risk factors associated with road traffic crashes and injuries among commercial motorcycle drivers. Int J Inj Contr Saf Promot 2024:1-14. [PMID: 38385344 DOI: 10.1080/17457300.2024.2319628] [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: 08/27/2023] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
To effectively reduce road traffic crashes (RTCs) and injuries interventions should be based on firm evidence regarding risk factors of RTCs and injuries in that specific population. Therefore, we undertook a systematic review to determine risk factors of RTCs and injuries among commercial motorcycle drivers. Searches were performed from inception to May 2022 in Medline, Embase, Cochrane Library, Web of Science Core Collection, PsycINFO and Cinahl, along with registers and reference lists. Inclusion criteria were commercial motorcycle drivers, quantitative observational studies, and RTCs and injuries. The search resulted in 1546 articles, of which 20 met the relevance and quality criteria. Of the 20 articles, 17 were cross-sectional, 2 were case-control studies, and one was a cohort study. Close to half of all articles (9) came from sub-Saharan Africa. Risk factors with consistent association with RTCs and injuries were young age, low education level, alcohol consumption, speeding, mobile phone use, non-helmet use, risky driving behaviours and long working hours. There was inconclusive evidence for driver's training, work schedules, motorcycle ownership, experience, dependents number, and marital status. More robust designs such as case-control or longitudinal studies are required to gain a comprehensive understanding of the antecedents of RTCs among commercial motorcycle drivers.
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Affiliation(s)
- George Kiwango
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Daudi Katopola
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Management Sciences, National Institute of Transport, Dar es Salaam, Tanzania
| | - Filbert Francis
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Statistics, National Institute of Medical Research, Tanga, Tanzania
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Marie Hasselberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Laflamme L, Lindholm E, Möller J. Repeated hospital admission for intentional poisonings among older adults - a Swedish national register-based study. BMC Geriatr 2024; 24:157. [PMID: 38360600 PMCID: PMC10870539 DOI: 10.1186/s12877-024-04717-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Poisoning injuries is an increasing concern among older people, and so is the repetition of intentional poisonings. To date, few studies have documented the pattern and individual risk factors for repeated poisonings. This national study aims to shed light on the burden, pattern, and health-related risk factors of repeated intentional poisoning leading to hospitalization or death among older Swedish adults (50 years and older), with a focus on the year following a first event. METHODS We conducted a nationwide register-based cohort study of people aged 50-100, hospitalized for intentional poisoning (ICD10: X60-69) during 2006-2016 (n = 15,219) and re-hospitalized by poisoning of any intent within a year (n = 1710), i.e., up to the end of 2017. We considered in turn, the distribution of the second poisoning in 30-day intervals stratified by intent; poisoning lethality within a month and a year; and the sex-specific association between health conditions and being re-hospitalized for intentional poisoning within one year as compared to being hospitalized only once using logistic regression (odds ratios (OR) with 95% confidence intervals (95% CI)). RESULTS Following an intentional poisoning, re-hospitalization within a year was predominantly for a new intentional poisoning (89.7%) and occurred most typically within a month (median 4 days). Death within 30 days occurred in similar proportion for the first and second poisoning (2.3% vs. 2.1% respectively). Among both men and women, comorbidity of psychiatric illness was strongly associated with re-hospitalization for intentional poisoning (adjusted ORs = 1.70; 95% CI = 1.45-2.01 and 1.89 (95% CI = 1.60-2.19) respectively). CONCLUSION Most re-hospitalizations within a year after intentional poisoning are also for intentional poisoning and occur most typically within days. Re-hospitalization is associated with several conditions that are characteristic of poor mental health and there are more similarities than differences between men and women in that respect.
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Affiliation(s)
- L Laflamme
- Department of Global Public Health , Karolinska Institutet, Widerströmska huset Tomtebodavägen 18A, 17177, Stockholm, Sweden
| | - E Lindholm
- Department of Global Public Health , Karolinska Institutet, Widerströmska huset Tomtebodavägen 18A, 17177, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health , Karolinska Institutet, Widerströmska huset Tomtebodavägen 18A, 17177, Stockholm, Sweden.
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Lundin A, Möller J, Forsell Y. The Major Depression Inventory for diagnosing according to DSM-5 and ICD-11: Psychometric properties and validity in a Swedish general population. Int J Methods Psychiatr Res 2023; 32:e1966. [PMID: 37042546 DOI: 10.1002/mpr.1966] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES The Major Depression Inventory (MDI) was constructed to assess DSM-IV and ICD-10 depression symptoms, and does not fully cover the symptoms listed in DSM-5 and ICD-11. This study aimed to augment the MDI to the new diagnostic standards by adding a new item, and to assess and compare the measurement performance of the MDI items and diagnostic algorithms for major depression according to DSM-IV, ICD-10, DSM-5 and ICD-11. METHODS Surveys collected 2001-2003 and 2021, including self-assessed MDI were used. A new hopelessness item was constructed and analyzed alongside the hopelessness item in the Symptom Checklist. The performance of items was compared using Rasch and Mokken analyses. Criterion validity was examined using equivalent diagnoses from psychiatric interview (Schedules for Clinical Assessments in Neuropsychiatry [SCAN]) as standard. RESULTS MDI information was provided by 8511 individuals in 2001-2003 (SCAN subsample n = 878), and 8863 in 2021. All items, including hopelessness had good psychometric properties. Sensitivity ranged between 56% and 70%, and specificity between 95% and 96%, indicating similar criterion validity. CONCLUSIONS Hopelessness and the MDI items had good psychometrics. MDI for DSM-5 and ICD-11 had similar validity as for DSM-IV and ICD-10. We recommend that MDI is updated to DSM-5 and ICD-11 by adding a hopelessness item.
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Affiliation(s)
- Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Mo M, Thiesmeier R, Kiwango G, Rausch C, Möller J, Liang Y. The Association between Birthweight and Use of Cardiovascular Medications: The Role of Health Behaviors. J Cardiovasc Dev Dis 2023; 10:426. [PMID: 37887873 PMCID: PMC10607150 DOI: 10.3390/jcdd10100426] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND There is limited evidence on the effect of low birthweight on the use of cardiovascular medications and the role of health behaviors. This study aims to determine the independent effect of low birthweight and its combination with adult health behaviors on the number of dispensed cardiovascular medications. METHODS We included 15618 participants with information on birthweight and self-reported health behaviors. Dispensed cardiovascular medications were identified from the Prescribed Drug Register based on a three-digit level Anatomical Therapeutic Chemical classification code (C01 to C10 and B01) and categorized into 0, 1, and ≥2 different types of medications. We applied multinomial logistic regression models estimating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Participants with low birthweight had a higher estimated OR of using ≥2 types of cardiovascular medications (OR = 1.46, 95% CI = 1.06, 2.01). Further, an increased risk for using ≥2 types of cardiovascular medications was found in participants with poor health behaviors for normal (OR = 2.17, 95% CI = 1.80, 2.62) and high (OR = 1.84, 95% CI = 1.29, 2.62) birthweight. The strongest effect on using ≥2 types of cardiovascular medications was found for low birthweight and poor health behaviors (OR = 3.14, 95% CI = 1.80, 5.50). CONCLUSION This cohort study provides evidence that low birthweight increases the risk of using more types of cardiovascular medications in adulthood. This study also suggests that ideal health behaviors reduce this risk.
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Affiliation(s)
- Minjia Mo
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Robert Thiesmeier
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - George Kiwango
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Physiology, Muhimbili University of Health and Allied Sciences, 17105 Dar es Salaam, Tanzania
| | - Christian Rausch
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
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Amado V, Trott S, Möller J, Couto MT, Wallis L, Laflamme L. Changing patterns in the burden of paediatric injuries during the COVID-19 pandemic: a study in Mozambique's central hospitals. BMC Health Serv Res 2023; 23:1071. [PMID: 37803444 PMCID: PMC10559493 DOI: 10.1186/s12913-023-10073-x] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
INTRODUCTION There is a substantial body of knowledge on the effects of the COVID-19 pandemic on injuries showing frequent but inconsistent reductions in both volume and pattern. Yet, studies specifically addressing children are less common, not least from low- and middle-income countries. This study investigated whether changes in the pattern and outcome of paediatric injury admissions to Mozambique's four regional referral hospitals during 2020. METHODS Clinical charts of paediatric patients presenting to the targeted hospitals with acute injuries were reviewed using a set of child, injury, and outcome characteristics during each of two consecutive restriction periods in 2020 using as a comparator the same periods in 2019, the year before the pandemic. Differences between 2020 and 2019 proportions for any characteristic were examined using the t-test (significance level 0.05). RESULTS During both restriction periods, compared with the previous year, reductions in the number of injuries were noticed in nearly all aspects investigated, albeit more remarkably during the first restriction period, in particular, greater proportions of injuries in the home setting and from burns (7.2% and 11.5% respectively) and a reduced one of discharged patients (by 2.5%). CONCLUSION During the restrictions implemented to contend the pandemic in Mozambique in 2020, although each restriction period saw a drop in the volume of injury admissions at central hospitals, the pattern of child, injury and outcome characteristics did not change much, except for an excess of home and burn injuries in the first, more restrictive period. Whether this reflects the nature of the restrictions only or, rather, other mechanisms that came into play, individual or health systems related, remains to be determined.
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Affiliation(s)
- Vanda Amado
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
- Maputo Central Hospital, Maputo, Mozambique.
| | - Sebastien Trott
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Maria Tereza Couto
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Medical Council Maputo, Maputo, Mozambique
| | - Lee Wallis
- Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
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Lageborn CT, Bjureberg J, Song J, Runeson B, Möller J, Ljung R, Dahlin M. Risk of suicide and self-harm in university students entering different university programs - a national register-based cohort study in Sweden. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1139-1149. [PMID: 37149517 PMCID: PMC10366015 DOI: 10.1007/s00127-023-02484-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/26/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE It is not known whether the elevated suicide risk in certain occupations, such as health care professionals, is partly attributable to a selection of individuals with prior vulnerability. We aimed to determine the risk of suicide and self-harm already in students entering different university programs. METHODS We used national registers to identify 621,218 Swedish residents aged 18-39 years with registration for a university program 1993-2013. Outcomes were suicide and self-harm within three years. We applied logistic regression analyses to calculate odds ratios (OR) and 95% confidence intervals (CI) of risk of suicide and self-harm, with the Education program category as a reference. Results were adjusted for sex, age, time period and for history of hospitalization due to mental disorder or self-harm, as a measure of previous vulnerability. In the second step, we stratified results by sex. RESULTS There was a higher risk of suicide (OR 2.4) in female nursing students and natural science students (OR 4.2) and of self-harm in female and male Nursing/Health care students (OR range 1.2 -1.7). Subcategorization into nursing students only strengthened the association with self-harm for both sexes. Prior vulnerability did not fully explain the increased risk. CONCLUSION The elevated risk of suicide in nursing and health care occupations partly has its onset in vulnerability factors present before or emerging during university studies. Increased efforts in identifying and treating mental disorders and preventing self-harm in university students could be an important step in preventing future suicides.
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Affiliation(s)
- Christine Takami Lageborn
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Johan Bjureberg
- Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Jie Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bo Runeson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Rickard Ljung
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Marie Dahlin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden
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Lageborn CT, Bjureberg J, Song J, Runeson B, Möller J, Ljung R, Dahlin M. Correction to: Risk of suicide and self-harm in university students entering different university programs - a national register-based cohort study in Sweden. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1151-1152. [PMID: 37277657 PMCID: PMC10366266 DOI: 10.1007/s00127-023-02512-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Christine Takami Lageborn
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Johan Bjureberg
- Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Jie Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bo Runeson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Rickard Ljung
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Marie Dahlin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Norra Stockholms Psykiatri, Vårdvägen 1, 112 81, Stockholm, Sweden
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Thiesmeier R, Skyving M, Möller J, Orsini N. A probabilistic bias analysis on the magnitude of unmeasured confounding: The impact of driving mileage on road traffic crashes. Accid Anal Prev 2023; 191:107144. [PMID: 37473524 DOI: 10.1016/j.aap.2023.107144] [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: 03/13/2023] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Unmeasured confounding can lead to biased interpretations of empirical findings. This paper aimed to assess the magnitude of suspected unmeasured confounding due to driving mileage and simulate the statistical power required to detect a discrepancy in the effect of polypharmacy on road traffic crashes (RTCs) among older adults. METHODS Based on Monte Carlo Simulation (MCS) approach, we estimated 1) the magnitude of confounding of driving mileage on the association of polypharmacy and RTCs and 2) the statistical power of to detect a discrepancy from no adjusted effect. A total of 1000 studies, each of 500000 observations, were simulated. RESULTS Under the assumption of a modest adjusted exposure-outcome odds ratio of 1.35, the magnitude of confounding bias by driving mileage was estimated to be 16% higher with a statistical power of 50%. Only an adjusted odds ratio of at least 1.60 would be associated with a statistical power of about 80% CONCLUSION: This applied probabilistic bias analysis showed that not adjusting for driving mileage as a confounder can lead to an overestimation of the effect of polypharmacy on RTCs in older adults. Even considering a large sample, small to moderate adjusted exposure effects were difficult to be detected.
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Affiliation(s)
- Robert Thiesmeier
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, SE-11365 Stockholm, Sweden.
| | - Marie Skyving
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, SE-11365 Stockholm, Sweden; Swedish Transport Agency, Department of Road and Rail, Isafjordsgatan 1, SE-16440 Kista, Sweden
| | - Jette Möller
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, SE-11365 Stockholm, Sweden
| | - Nicola Orsini
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, SE-11365 Stockholm, Sweden
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Jabri FF, Liang Y, Alhawassi TM, Johnell K, Möller J. Potentially Inappropriate Medications in Older Adults-Prevalence, Trends and Associated Factors: A Cross-Sectional Study in Saudi Arabia. Healthcare (Basel) 2023; 11:2003. [PMID: 37510444 PMCID: PMC10379671 DOI: 10.3390/healthcare11142003] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Potentially inappropriate medications (PIMs) in older adults are associated with drug-related problems, adverse health consequences, repeated hospital admissions and a higher risk of mortality. In Saudi Arabia and some Arab countries, studies of PIMs among large cohorts of older adults are limited. This study aimed to determine the prevalence of PIMs, trends and associated factors among outpatient older adults in Saudi Arabia. (2) Methods: A cross-sectional study was carried out. Over three years (2017-2019), data on 23,417 people (≥65 years) were retrieved from outpatient clinics in a tertiary hospital in Riyadh, Saudi Arabia. PIMs were assessed using the 2019 Beers Criteria. Covariates included sex, age, nationality, number of dispensed medications, and number of diagnoses. A generalized estimating equation model was used to assess trends and factors associated with PIMs. (3) Results: The prevalence of PIMs was high and varied between 57.2% and 63.6% over the study years. Compared with 2017, the prevalence of PIMs increased significantly, with adjusted odds ratios (OR) (95% confidence interval (95% CI)) of 1.23 (1.18-1.29) and 1.15 (1.10-1.21) for 2018 and 2019, respectively. Factors associated with being prescribed PIMs included ≥5 dispensed medications (OR_adjusted = 23.91, 95% CI = 21.47-26.64) and ≥5 diagnoses (OR_adjusted = 3.20, 95% CI = 2.88-3.56). Compared with females, males had a lower risk of being prescribed PIMs (OR_adjusted = 0.90, 95% CI = 0.85-0.94); (4) Conclusions: PIMs were common with an increasing trend among older adults in Saudi Arabia. A higher number of dispensed medications, increased number of diagnoses and female sex were associated with being prescribed PIMs. Recommendations on how to optimize prescriptions and implement de-prescribing strategies are urgently needed.
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Affiliation(s)
- Fouad F Jabri
- Department of Biostatistics, Epidemiology and Public Health, College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GPH, 171 77 Stockholm, Sweden
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GPH, 171 77 Stockholm, Sweden
| | - Tariq M Alhawassi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
- Medication Safety Research Chair, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, C8 Medicinsk Epidemiologi och Biostatistik, 171 77 Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GPH, 171 77 Stockholm, Sweden
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Skyving M, Möller J, Laflamme L. What triggers road traffic fatalities among older adult drivers? An investigation based on the Swedish register for in-depth studies of fatal crashes. Accid Anal Prev 2023; 190:107149. [PMID: 37364360 DOI: 10.1016/j.aap.2023.107149] [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: 11/21/2022] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Road traffic fatalities among drivers result not only from erroneous driving manoeuvres. They can also be triggered by poor mental or physical health like suicidal acts and acute disease attacks, the latter being more frequent with age. There are few studies comprising all the different triggers of fatal crashes among older drivers and on how these triggers evolve over time. This Swedish national study aims to investigate this, considering drivers 50+ years. METHOD For the period 2010-2019, data on non-commercial car drivers aged 50 and older were extracted from the Swedish Transport Administration's in-depth studies of fatal crashes, compiled in a register encompassing all road traffic fatalities. The crash triggers reported were classified as suicide, acute disease, own manoeuvre (single or other type of crash), external, and undetermined. Total and annual frequencies were presented by crash trigger, overall and stratified by sex and age groups. RESULTS In total, 762 fatalities were identified and with 709 of them, it was possible to classify the crash trigger: 12% resulting from suicide; 29% from acute disease; 49% from the driver's own manoeuvre; and 10% from an external crash trigger. Suicides increased from 9% in average 2010-2014 to 15% in 2015-2019 while acute disease decreased (from 32% to 27%). The overall male-to-female ratio was 4.5, and as high as 8.7 for acute disease. The relative importance of each trigger varied with age with, for instance, acute disease being more frequent in the two younger age groups; 31% for 50-64 and 52% for 65-79 years old drivers, while own manoeuvre was more prominent for drivers aged 80 and older (23%). CONCLUSION The distribution of the four different triggers of road traffic fatalities varies only slightly over time and, a majority are triggered by the driver's own manoeuvre. However, a substantial proportion, about four out of ten,are triggered by a health condition, of which some are suicide but the major part an acute disease, mainly cardiovascular. In some instances, such crashes can be harmful to other road users. Having in mind the need for safety and mobility of older drivers and the protection of all road users, there is a need for the promotion of road safety policies that encompass a wider range of measures to help reducing the likelihood of fatal and severe crashes to happen e.g., targeting incapacitated drivers.
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Affiliation(s)
- Marie Skyving
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, Stockholm SE-11365, Sweden; Swedish Transport Agency, Department of Road and Rail, Isafjordsgatan 1, Kista SE-16440, Sweden.
| | - Jette Möller
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, Stockholm SE-11365, Sweden
| | - Lucie Laflamme
- Karolinska Institutet, Department of Global Public Health, Tomtebodavägen 18A, Stockholm SE-17165, Sweden
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Sidorchuk A, Engström K, Möller J, Gémes K. Predictors of beverage-specific, alcohol consumption trajectories: A Swedish population-based cohort study. Nordisk Alkohol Nark 2023; 40:233-249. [PMID: 37255610 PMCID: PMC10225962 DOI: 10.1177/14550725221124386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/22/2022] [Indexed: 09/30/2023] Open
Abstract
Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups.
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Affiliation(s)
- Anna Sidorchuk
- Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
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Amado V, Couto MT, Filipe M, Möller J, Wallis L, Laflamme L. Assessment of critical resource gaps in pediatric injury care in Mozambique's four largest Hospitals. PLoS One 2023; 18:e0286288. [PMID: 37262032 DOI: 10.1371/journal.pone.0286288] [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] [Received: 02/01/2022] [Accepted: 05/14/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Hospitals from resource-scarce countries encounter significant barriers to the provision of injury care, particularly for children. Shortages in material and human resources are seldom documented, not least in African settings. This study analyzed pediatric injury care resources in Mozambique hospital settings. METHODS We undertook a cross-sectional study, encompassing the country's four largest hospitals. Data was collected in November 2020 at the pediatric emergency units. Assessment of the resources available was made with standardized WHO emergency equipment and medication checklists, and direct observation of premises and procedures. The potential impact of unavailable equipment and medications in pediatric wards was assessed considering the provisions of injury care. RESULTS There were significant amounts of not available equipment and medications in all hospitals (ranging from 20% to 49%) and two central hospitals stood out in that regard. The top categories of not available equipment pertained to diagnosis and monitoring, safety for health care personnel, and airway management. Medications to treat infections and poisonings were those most frequently not available. There were several noteworthy and life-threatening shortcomings in how well the facilities were equipped for treating pediatric patients. The staff regarded lack of equipment and skills as the main obstacles to delivering quality injury care. Further, they prioritized the implementation of trauma courses and the establishment of trauma centers to strengthen pediatric injury care. CONCLUSION The country's four largest hospitals had substantial quality-care threatening shortages due to lack of equipment and medications for pediatric injury care. All four hospitals face issues that put at risk staff safety and impede the implementation of essential care interventions for injured children. Staff wishes for better training, working environments adequately equipped and well-organized. The room for improvement is considerable, the study results may help to set priorities, to benefit better outcomes in child injuries.
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Affiliation(s)
- Vanda Amado
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of the Community Health, Eduardo Mondlane University, Maputo, Mozambique
- Department of Surgery, Maputo Central Hospital, Maputo, Mozambique
| | - Maria Tereza Couto
- Department of the Community Health, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Medical Council Maputo, Maputo, Mozambique
| | - Manuel Filipe
- Department of the Community Health, Eduardo Mondlane University, Maputo, Mozambique
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Lee Wallis
- Faculty of Health Sciences, Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
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13
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Möller J, Lindholm E, Fredlund P, Vaez M, Liang Y, Laflamme L. Trends in intentional and unintentional poisonings among older adults - A national register-based study in Sweden. BMC Geriatr 2023; 23:296. [PMID: 37189030 DOI: 10.1186/s12877-023-03973-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Among older people intentional poisoning outnumber unintentional ones. While there are indications that time trends differ by poisoning intent, studies are scarce. We assessed how the annual prevalence of intentional and unintentional poisoning changed over time, overall and by demographic groups. METHODS We conducted a national open cohort study of individuals aged 50-100 years, resident in Sweden during 2005-2016. Individuals were followed up in population-based registers for their demographic and health attributes from 2006-2016. Annual prevalence of hospitalization and death by poisoning intent (unintentional vs. intentional or undetermined; ICD-10 definitions) were compiled for the categories of four demographic attributes (age, sex, marital status, and birth cohort "baby boomers"). The time trends were assessed by multinomial logistic regression with year as an independent variable. RESULTS The annual overall prevalence of hospitalization and death by intentional poisonings consistently exceeded that of unintentional poisonings. There was a significant downward trend in intentional poisonings but not in unintentional ones. This difference in trends also applied when considering men and women separately, married and unmarried people, the young-old individuals (but not the older- or oldest-old ones), and the baby boomers and non-baby boomers. The largest demographic differences within intent were found between married and unmarried people, and the smallest one between men and women. CONCLUSION As expected, the annual prevalence of intentional poisonings considerably exceed that of unintentional ones among Swedish older people. The recent trends reveal a significant reduction of intentional poisonings, consistent across a range of demographic attributes. The scope for action regarding this preventable cause of mortality and morbidity remains considerable.
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Affiliation(s)
- J Möller
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GH, 171 77, Stockholm, Sweden
| | - E Lindholm
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GH, 171 77, Stockholm, Sweden.
| | - P Fredlund
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GH, 171 77, Stockholm, Sweden
| | - M Vaez
- Department of Living Conditions and Lifestyles, The Public Health Agency of Sweden, Stockholm, Sweden
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Y Liang
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GH, 171 77, Stockholm, Sweden
| | - L Laflamme
- Department of Global Public Health, Karolinska Institutet, K9 Global Folkhälsa, K9 GH, 171 77, Stockholm, Sweden
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Melendez P, Möller J, Arevalo A, Pinedo P. The effect of rumen-protected lysine and methionine on milk yield, milk components, and body weight in grazing Holstein cows during spring calving season in the southern hemisphere. Livest Sci 2023. [DOI: 10.1016/j.livsci.2023.105230] [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: 04/08/2023]
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15
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Sen A, Gémes K, Svensen C, Varmdal T, Jonsson M, Janszky I, Möller J. Risk of myocardial infarction after invasive outpatient procedures. Heart 2023; 109:839-845. [PMID: 36828624 DOI: 10.1136/heartjnl-2022-321780] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/02/2023] [Indexed: 02/26/2023] Open
Abstract
OBJECTIVE To assess the short-term risk of acute myocardial infarction (AMI) associated with procedures performed at outpatient specialised hospital clinics. METHODS In this case-crossover, population-based study, we identified first-time AMI cases aged ≥40 years via patient registries and linked them to their surgical intervention in Norway (2008-2016) and Sweden (2001-2014), respectively. The number of individuals with AMI who underwent procedures 0-7 days (hazard period) prior to the AMI diagnosis was compared with cases who were exposed 29-36 days (control period) before the AMI. A total of 6176 patients with AMI who underwent a procedure either during the defined hazard or control period contributed to the analyses. ORs with 95% CIs were computed using conditional logistic regression. RESULTS The mean age of the total population was 74.7 years and 64.6% were male. The relative risk was higher following procedures performed under general/regional anaesthesia for gastrointestinal endoscopy (ORsummary, 4.23, 95% CI 1.58 to 11.31), vascular (ORsummary, 3.12, 95% CI 1.10 to 8.90), urological/gynaecological (ORsummary, 2.30, 95% CI 1.50 to 3.53) and orthopaedic (ORsummary,1.78, 95% CI 1.30 to 2.44) procedures, and for ENT (ear, nose and throat) and mouth procedures (ORsummary, 1.53, 95% CI 1.19 to 1.99) performed under local anaesthesia. CONCLUSION This large population-based register study from two countries suggests that outpatient procedures are generally safe with regard to the postoperative risk of AMI. However, some procedures, such as gastrointestinal endoscopy, vascular procedures and urological/gynaecological procedures may increase the risk of AMI by twofold or threefold within the first 8 days after the procedures. Further studies are warranted to assess whether the effect is modified by cardiovascular medication or other clinical factors.
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Affiliation(s)
- Abhijit Sen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway .,Center for Oral Health Services and Research (TkMidt), Trondheim, Norway.,Clinic of Surgery, St. Olav's University Hospital, Trondheim, Norway
| | - Katalin Gémes
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Christer Svensen
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Torunn Varmdal
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Medical Quality Registries, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Magnus Jonsson
- Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Imre Janszky
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Regional Center for Health Care Improvement, St. Olav's University Hospital, Trondheim, Norway
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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16
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Mo M, Möller J, László KD, Liang Y. The joint effect between fetal growth and health behaviors on the risk of cardiovascular diseases in young adulthood. Ann Epidemiol 2023; 78:54-60. [PMID: 36596430 DOI: 10.1016/j.annepidem.2022.12.013] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/02/2023]
Abstract
PURPOSE To investigate the individual and the joint effect of impaired fetal growth and adult health behaviors on the risk of cardiovascular diseases (CVDs). METHODS A total of 15,618 individuals were included from three sub-cohorts of the Stockholm Public Health Cohort. Data on participants' birthweight and gestational age were retrieved from the Medical Birth Register. Data on the diagnoses of CVDs were extracted from the Swedish National Patient Register and the Cause of Death Register. Data on health behaviors were identified from self-reported questionnaires, and health behavioral profile was defined based on the recommendations of the American Health Association. The associations of fetal growth and health behaviors with the risk of CVDs were analyzed using Cox proportional hazard model. RESULTS Individuals born small for gestational age (SGA) had a higher risk of CVDs than those born appropriate for gestational age (AGA), and the adjusted hazard ratio (HR) and 95% confidence interval (CI) was 1.88 (1.44, 2.47). Participants born SGA and having poor health behavioral profile in adulthood had a higher risk of CVDs than those born AGA and having ideal health behaviors with adjusted HR (95% CI) being 3.58 (1.95, 6.56). CONCLUSIONS Impaired fetal growth was associated with an increased risk of CVDs in adulthood, and the risk was highest in individuals with both impaired fetal growth and poor health behaviors in adulthood.
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Affiliation(s)
- Minjia Mo
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Krisztina D László
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
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Möller J, Wolnicka-Glubisz A, Neesen F, Becker C, Raker V, Dreier R, Tulic M, Steinbrink K, öhm M, Kleszczynski K. 484 Melatonin induces melanoma cell death and synergizes with BRAF/MEK inhibitors by altering cell bioenergetics. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.498] [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: 11/19/2022]
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Abstract
OBJECTIVE In this study, we aimed to describe the effect of working from home on work conditions and private life by analyzing reported changes in different work-related factors. METHODS We used descriptive analyses on cross-sectional data of 4985 people aged 20 to 67 years from Stockholm, Sweden collected in 2021. The prevalence of reported changes for factors related to work and private life was analyzed by degree of work from home and stratified by age, sex, and educational level. RESULTS Participants who worked from home reported increased opportunities to structure the workday and combine work and private life, while at the same time experiencing increased isolation from the workplace. More females reported increased workload, whereas younger adults reported more changes overall. CONCLUSIONS Working from home was related to experiencing both positive and negative changes in work conditions and private life.
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19
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Laflamme L, Lindholm E, Airaksinen E, Vaez M, Möller J. 410 - Tendances des hospitalisations et décès par empoisonnement chez les personnes âgées. Étude nationale populationnelle en Suède. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.143] [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: 11/30/2022] Open
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20
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Sen A, Gémes K, Stålhammar G, Svensen C, Tornvall P, Jonsson M, Varmdal T, Endreseth BH, Janszky I, Möller J. Risk for Acute Myocardial Infarction After Ophthalmologic Procedures. Ann Intern Med 2022; 175:628-633. [PMID: 35313112 DOI: 10.7326/m20-6618] [Citation(s) in RCA: 7] [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] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Preoperative cardiovascular evaluations are frequently done before ambulatory ophthalmologic procedures. However, whether these procedures can trigger an acute myocardial infarction (AMI) is unknown. OBJECTIVE To assess the short-term risk for AMI associated with ophthalmologic procedures. DESIGN Case-crossover design. SETTING Population-based nationwide study from Norway and Sweden. PARTICIPANTS First-time patients with AMI, aged 40 years and older, identified via inpatient registries and linked to outpatient surgical procedures in Norway (2008 to 2014) and Sweden (2001 to 2014), respectively. MEASUREMENTS Using self-matching, for each participant, exposure to ophthalmologic procedures in the 0 to 7 days before AMI diagnosis (hazard period) was compared with an 8-day period 30 days earlier, that is, days 29 to 36 before AMI (control period) to estimate the relative risk for an AMI the week after an ophthalmologic procedure. The odds ratios (ORs) with 95% CIs were calculated, using conditional logistic regression. Only patients who had a procedure of interest during either the hazard or control period were included. RESULTS For the 806 patients with AMI included in this study, there was a lower likelihood of AMI in the week after an ophthalmologic procedure than during the control week (OR, 0.83; 95% CI, 0.75 to 0.91). Furthermore, there was no evidence of increased risk for AMI when analyses were stratified by surgery subtype, anesthesia (local or general), duration, invasiveness (low, intermediate, or high), patient's age (<65 years or ≥65 years), or comorbidity (none vs. any). LIMITATION Potential bias from time-varying confounders between the hazard and the control periods. CONCLUSION Ophthalmologic procedures done in an outpatient setting did not seem to be associated with an increased risk for AMI. PRIMARY FUNDING SOURCE Central Norway Regional Health Authority and the Swedish Research Council.
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Affiliation(s)
- Abhijit Sen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Center for Oral Health Services and Research (TkMidt), Trondheim, and Clinic of Surgery, St. Olav's University Hospital, Trondheim, Norway (A.S.)
| | - Katalin Gémes
- Department of Global Public Health, Institute of Environmental Medicine, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (K.G.)
| | - Gustav Stålhammar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, and St. Erik Eye Hospital, Stockholm, Sweden (G.S.)
| | - Christer Svensen
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden (C.S., P.T.)
| | - Per Tornvall
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden (C.S., P.T.)
| | - Magnus Jonsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, and Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden (M.J.)
| | - Torunn Varmdal
- Department of Research and Development, St. Olav's University Hospital, Trondheim, and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway (T.V.)
| | | | - Imre Janszky
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, and Clinic of Surgery and Regional Center for Health Care Improvement, St. Olav's University Hospital, Trondheim, Norway (I.J.)
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden (J.M.)
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Ljung R, Feychting M, Burström B, Möller J. Differences by region of birth in SARS-CoV-2 vaccine coverage and positive SARS-CoV-2 test among 400 000 healthcare workers and the general population in Sweden. Vaccine 2022; 40:2904-2909. [PMID: 35428499 PMCID: PMC8995201 DOI: 10.1016/j.vaccine.2022.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/21/2022] [Accepted: 04/04/2022] [Indexed: 11/25/2022]
Abstract
Background Globally SARS-CoV-2 vaccine coverage varies among healthcare workers. Methods Based on Swedish registers, data on vaccination status as of 31 October 2021 were analysed for all adults aged 35–64 years, 3 861 565 individuals, in Sweden by healthcare worker occupation group and region of birth. Results For both men and women vaccination coverage decreased in a graded manner by healthcare worker group with physicians having the highest coverage (96%), followed by registered nurses, licensed practical nurses, and nurse aides. Coverage also differed by region of birth for all groups of healthcare workers and non-healthcare workers with those born in Sweden with Sweden born parents having the highest coverage, and those born outside Sweden but within EU the lowest. Conclusion The difference in vaccine coverage by region of birth among healthcare workers, regardless of whether it results from socioeconomic inequalities or sociocultural beliefs, puts them at a great occupational hazard and increased risk of nosocomial transmission.
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22
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Petrov I, Boesenberg U, Bushuev VA, Hallmann J, Kazarian K, Lu W, Möller J, Reiser M, Rodriguez-Fernandez A, Samoylova L, Scholz M, Sinn H, Zozulya A, Madsen A. Performance of a cryo-cooled crystal monochromator illuminated by hard X-rays with MHz repetition rate at the European X-ray Free-Electron Laser. Opt Express 2022; 30:4978-4987. [PMID: 35209469 DOI: 10.1364/oe.451110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
Due to the high intensity and MHz repetition rate of photon pulses generated by the European X-ray Free-Electron Laser, the heat load on silicon crystal monochromators can become large and prevent ideal transmission in Bragg diffraction geometry due to crystal deformation. Here, we present experimental data illustrating how heat load affects the performance of a cryogenically cooled monochromator under such conditions. The measurements are in good agreement with a depth-uniform model of X-ray dynamical diffraction taking beam absorption and heat deformation of the crystals into account.
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23
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Skyving M, Forsman Å, Dukic Willstrand T, Laflamme L, Möller J. Medical impairment and road traffic crashes among older drivers in Sweden - A national, population-based, case-control study. Accid Anal Prev 2021; 163:106434. [PMID: 34700248 DOI: 10.1016/j.aap.2021.106434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/07/2021] [Revised: 09/23/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Several medical conditions are known to impair sensory, cognitive and motor functions and are associated with road traffic crashes (RTC). For the drivers of today, we lack updated knowledge on how driving-impairing conditions are associated with RTCs, across all driving-impairing conditions in a given population. We aim to determine this among older drivers in Sweden. METHODS A national, population register-based, matched case-control study comparing acknowledged driving-impairing health conditions among all older drivers (65 years or older) involved in an injurious RTC in the period 2011-2016 (n = 13,701) with those of controls: older drivers not involved in any RTC (n = 26,525) matched to the cases by age, sex and residential area. The medical conditions, extracted from the National Patient Register from 1997 up until date of RTC, were identified based on ICD-10 diagnosis codes and categorized into the 13 groups of medical conditions listed in the Swedish driver's license regulations. Conditional logistic regression was used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals. RESULTS Unadjusted ORs for RTC were increased for all conditions. After taking the other 12 medical conditions into account, the ORs remained significant in 11 out of the 13. A strong association was found for the group "ADHD and autism spectrum disorders" (OR 2.79, CI 1.47-5.30), although with very low prevalence among cases (0.2%). Moderate associations were found for three conditions with a case prevalence between 1.3% and 8.5%: epilepsy and seizure disorders (OR 1.53, CI 1.25-1.89), substance abuse and dependence (OR 1.45, CI 1.29-1.63), psychological diseases and mental disorders (OR 1.28, CI 1.18-1.39) and for one condition with a case prevalence of 14.7%, diabetes (OR 1.28, CI 1.20-1.36). CONCLUSIONS In Sweden, in the current generation of older drivers, acknowledged driving-impairing medical conditions at the national and European levels remain a concern. After adjustment for one another, all but 2 of the conditions are associated with RTCs albeit to varying degrees and more pronounced in the age group 65-79 compared to 80 or older. To promote and sustain older people's mobility, addressing this issue will require a blend of interventions where, hopefully, technological and infrastructural innovations may help counteracting individual health-related shortcomings.
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Affiliation(s)
- Marie Skyving
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, SE-11365 Stockholm, Sweden; Swedish Transport Agency, Department of Road and Rail, Isafjordsgatan 1, SE-16440 Kista, Sweden.
| | - Åsa Forsman
- The Swedish National Road and Transport Research Institute (VTI), Olaus Magnus väg 37, SE-58195 Linköping, Sweden.
| | | | - Lucie Laflamme
- Karolinska Institutet, Department of Global Public Health, Tomtebodavägen 18 A, SE-17165 Stockholm, Sweden.
| | - Jette Möller
- Karolinska Institutet, Department of Global Public Health, Solnavägen 1E, SE-11365 Stockholm, Sweden.
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Lampousi AM, Möller J, Liang Y, Berglind D, Forsell Y. Latent class growth modelling for the evaluation of intervention outcomes: example from a physical activity intervention. J Behav Med 2021; 44:622-629. [PMID: 33768391 PMCID: PMC8484241 DOI: 10.1007/s10865-021-00216-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/11/2021] [Indexed: 01/21/2023]
Abstract
Intervention studies often assume that changes in an outcome are homogenous across the population, however this assumption might not always hold. This article describes how latent class growth modelling (LCGM) can be performed in intervention studies, using an empirical example, and discusses the challenges and potential implications of this method. The analysis included 110 young adults with mobility disability that had participated in a parallel randomized controlled trial and received either a mobile app program (n = 55) or a supervised health program (n = 55) for 12 weeks. The primary outcome was accelerometer measured moderate to vigorous physical activity (MVPA) levels in min/day assessed at baseline, 6 weeks, 12 weeks, and 1-year post intervention. The mean change of MVPA from baseline to 1-year was estimated using paired t-test. LCGM was performed to determine the trajectories of MVPA. Logistic regression models were used to identify potential predictors of trajectories. There was no significant difference between baseline and 1-year MVPA levels (4.8 min/day, 95% CI: -1.4, 10.9). Four MVPA trajectories, 'Normal/Decrease', 'Normal/Increase', 'Normal/Rapid increase', and 'High/Increase', were identified through LCGM. Individuals with younger age and higher baseline MVPA were more likely to have increasing trajectories of MVPA. LCGM uncovered hidden trajectories of physical activity that were not represented by the average pattern. This approach could provide significant insights when included in intervention studies. For higher accuracy it is recommended to include larger sample sizes.
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Affiliation(s)
- Anna-Maria Lampousi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Kiwango G, Francis F, Moshiro C, Möller J, Hasselberg M. Association between alcohol consumption, marijuana use and road traffic injuries among commercial motorcycle riders: A population-based, case-control study in Dares Salaam, Tanzania. Accid Anal Prev 2021; 160:106325. [PMID: 34390892 DOI: 10.1016/j.aap.2021.106325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/30/2020] [Revised: 06/12/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Alcohol consumption and psychoactive drug use are well-recognised risk factors for road traffic injuries (RTIs). Both types of use may impair and affect drivers' performance. Yet, there is limited literature on their contribution to RTIs among commercial motorcycle riders, particularly in low- and middle-income settings. This study aimed to determine the association between alcohol consumption, marijuana use and RTIs among commercial motorcycle riders in the city of Dar es Salaam, Tanzania. METHODS We conducted a case-control study between July 2018 and March 2019. Cases (n = 164) were commercial motorcycle riders who had sustained an RTIs and attended at a hospital. Controls (n = 400) were commercial motorcycle riders who had not experienced an RTIs that led to hospital attendance during the past six months. Alcohol consumption was assessed using the Alcohol Use Disorder Identification (AUDIT) score, which classified participants as a non-drinker, normal drinker(1-7 scores) and risky drinker (scores ≥ 8). Marijuana use was assessed through self-reported use in the past year. We estimated odds ratios (ORs) using logistic regression adjusted for sociodemographic, driver-, and work-related factors. RESULTS Risky drinking was associated with close to six times the odds of RTIs compared to non-drinkers (OR = 5.98, 95% CI: 3.25 - 11.0). The association remained significant even after adjusting for sociodemographic, driving and work-related factors (OR = 2.41, 95% CI: 1.01 - 5.76). The crude odds ratios of RTIs were significantly higher among users of marijuana than non-users (OR = 2.33, 95% CI: 1.38 - 3.95). However, the association did not remain statistically significant after adjusting for confounders (OR = 1.11, 95% CI = 0.49-2.48). CONCLUSION Our findings confirm increased odds of RTIs among commercial motorcycle riders with risky drinking behaviour even after taking sociodemographic, driving and work-related factors into account. Unlike alcohol consumption the relationship between marijuana use and RTIs among commercial motorcycle riders was unclear. Since motorcycle riders are more susceptible to the effect of alcohol due to higher demands of balance and coordination and because commercial motorcyclist riders, in particular, they spend a considerable amount of time on the road, our results underscore the importance of addressing hazardous alcohol consumption and marijuana use in future prevention strategies to enhance road safety.
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Affiliation(s)
- George Kiwango
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Filbert Francis
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; National Institute of Medical Research, Tanga, Tanzania.
| | - Candida Moshiro
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Marie Hasselberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Duchesne J, Laflamme L, Lu L, Lagarde E, Möller J. Post-injury benzodiazepine and opioid use among older adults involved in road traffic crashes: A Swedish register-based longitudinal study. Br J Clin Pharmacol 2021; 88:764-772. [PMID: 34331716 DOI: 10.1111/bcp.15019] [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: 12/18/2020] [Revised: 06/15/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022] Open
Abstract
AIM Psychotropic drugs like opioids and benzodiazepines are prescribed for traumas resulting from road traffic crashes and the risk of developing an addiction deserves consideration. This study aims to shed light on how the consumption of those drugs evolves over time among older road traffic injury (RTI) victims. METHODS We conducted a nationwide Swedish register-based longitudinal study to identify trajectories of post-RTI psychotropic drug use. All individuals aged 50 years and older who had a hospital visit for an RTI from 2007 to 2015 were followed up during a 2-year period; those who used the drugs prior to the RTI were excluded. Trajectories were identified by performing latent class trajectory analysis on drug dispensation data for opioids and benzodiazepines separately (66 034 and 66 859 adults, respectively, in total). RESULTS Three trajectories were identified for opioids and four for benzodiazepines. The largest group in both instances included people with no-use/minimal use throughout the follow-up (81.3% and 92.8%). "Sporadic users" were more frequent among users of opioids (16.7%) than benzodiazepines (4.3%), whereas "chronic users" were found in similar proportions (2.0% and 1.8%). "Delayed chronic use" characterized the fourth group of benzodiazepine users (1.0%). CONCLUSION Several trajectories of psychotropic drug use were identified after RTI, from limited to chronic. Although chronic use was uncommon, a better understanding of the factors likely to increase that risk is warranted given the seriousness of the problem.
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Affiliation(s)
- Jeanne Duchesne
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux, Bordeaux, France.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Li Lu
- Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux, Bordeaux, France.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Emmanuel Lagarde
- Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux, Bordeaux, France.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Stratmann M, Forsell Y, Möller J, Liang Y. Informal care and the impact on depression and anxiety among Swedish adults: a population-based cohort study. BMC Public Health 2021; 21:1263. [PMID: 34187429 PMCID: PMC8243546 DOI: 10.1186/s12889-021-11246-1] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/08/2021] [Indexed: 12/05/2022] Open
Abstract
Background As the population is ageing, the need for informal caregivers increases, and thus we need to know more about the effects on caregivers. This study aims to determine both cross-sectional and longitudinal associations between perceived limitation of informal caregiving and mental health of caregivers. Methods This population-based cohort study was based on the Swedish Psykisk hälsa, Arbete och RelaTioner (PART) study, and 9346 individuals aged 18–65 were included. Data were collected through questionnaires, interviews and Swedish registers. Informal care was defined as care given to a family member. Self-reported and diagnosed depression and anxiety were included as outcomes. Covariates included sex, age, social support and socio-economic position. Ordinal logistic regression and Cox regression were performed to determine the associations between caregiving and anxiety or depression. Results Self-reported depression and anxiety was only increased among those experiencing limitations (adjusted odds ratios [aOR] 2.00, 95% confidence intervals [CI] 1.63–2.47 for depression; aOR 2.07, 95% CI 1.57–2.74 for anxiety) compared to those not giving care, respectively. The adjusted hazard ratio (aHR) were increased for diagnosed depression (aHR 1.97, 95% CI 1.27–3.05) and for diagnosed anxiety (aHR 1.86, 95% CI 1.06–3.25) among those giving care and experiencing limitations, compared to those not giving care. No significant associations were found in caregivers without limitations. Conclusion Caregivers experiencing limitations showed a significant association with short- and long-term anxiety and depression. This study implies the importance of exploring the degree to which informal caregiving can be provided without adding burden to caregivers. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11246-1.
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Affiliation(s)
- Marlene Stratmann
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
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28
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Vassholz M, Hoeppe HP, Hagemann J, Rosselló JM, Osterhoff M, Mettin R, Kurz T, Schropp A, Seiboth F, Schroer CG, Scholz M, Möller J, Hallmann J, Boesenberg U, Kim C, Zozulya A, Lu W, Shayduk R, Schaffer R, Madsen A, Salditt T. Pump-probe X-ray holographic imaging of laser-induced cavitation bubbles with femtosecond FEL pulses. Nat Commun 2021; 12:3468. [PMID: 34103498 PMCID: PMC8187368 DOI: 10.1038/s41467-021-23664-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/17/2020] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
Cavitation bubbles can be seeded from a plasma following optical breakdown, by focusing an intense laser in water. The fast dynamics are associated with extreme states of gas and liquid, especially in the nascent state. This offers a unique setting to probe water and water vapor far-from equilibrium. However, current optical techniques cannot quantify these early states due to contrast and resolution limitations. X-ray holography with single X-ray free-electron laser pulses has now enabled a quasi-instantaneous high resolution structural probe with contrast proportional to the electron density of the object. In this work, we demonstrate cone-beam holographic flash imaging of laser-induced cavitation bubbles in water with nanofocused X-ray free-electron laser pulses. We quantify the spatial and temporal pressure distribution of the shockwave surrounding the expanding cavitation bubble at time delays shortly after seeding and compare the results to numerical simulations.
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Affiliation(s)
- M Vassholz
- Institut für Röntgenphysik, Georg-August-Universität Göttingen, Göttingen, Germany
| | - H P Hoeppe
- Institut für Röntgenphysik, Georg-August-Universität Göttingen, Göttingen, Germany
| | - J Hagemann
- CXNS - Center for X-ray and Nano Science, Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - J M Rosselló
- Drittes Physikalisches Institut, Georg-August-Universität Göttingen, Göttingen, Germany
| | - M Osterhoff
- Institut für Röntgenphysik, Georg-August-Universität Göttingen, Göttingen, Germany
| | - R Mettin
- Drittes Physikalisches Institut, Georg-August-Universität Göttingen, Göttingen, Germany
| | - T Kurz
- Drittes Physikalisches Institut, Georg-August-Universität Göttingen, Göttingen, Germany
| | - A Schropp
- CXNS - Center for X-ray and Nano Science, Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - F Seiboth
- CXNS - Center for X-ray and Nano Science, Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - C G Schroer
- CXNS - Center for X-ray and Nano Science, Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
- Department Physik, Universität Hamburg, Hamburg, Germany
| | - M Scholz
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - J Möller
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - J Hallmann
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - U Boesenberg
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - C Kim
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - A Zozulya
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - W Lu
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - R Shayduk
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - R Schaffer
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - A Madsen
- European X-Ray Free-Electron Laser Facility, Schenefeld, Germany
| | - T Salditt
- Institut für Röntgenphysik, Georg-August-Universität Göttingen, Göttingen, Germany.
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Rausch C, van Zon SKR, Liang Y, Laflamme L, Möller J, de Rooij SE, Bültmann U. Geriatric Syndromes and Incident Chronic Health Conditions Among 9094 Older Community-Dwellers: Findings from the Lifelines Cohort Study. J Am Med Dir Assoc 2021; 23:54-59.e2. [PMID: 33798484 DOI: 10.1016/j.jamda.2021.02.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 08/10/2020] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To determine the association between geriatric syndromes and any specific incident chronic health conditions among older community-dwellers. DESIGN Population-based cohort study over a median follow-up period of 43 months. SETTING AND PARTICIPANTS Participants from the Lifelines Cohort Study aged 60 years and older without presence of the studied chronic health conditions at baseline (n = 9094). METHODS Baseline assessment took place between November 2006 and December 2013 and included information on socioeconomic (age, sex, level of education and income), social contact, and health-related factors [eg, self-rated health, body mass index, chronic health conditions, and health behavior (alcohol consumption and smoking)]. Participants also reported the presence of geriatric syndromes (ie, included falls, incontinence, vision impairment, hearing impairment, depressive symptoms, and frailty at baseline). Three follow-up questionnaires were used to examine the incidence of any and specific chronic health conditions (ie, pulmonary and cardiovascular diseases, diabetes, cancer, and neurological diseases). Cox regression was used to analyze the longitudinal associations between geriatric syndromes and incident chronic health conditions. RESULTS Older community-dwelling individuals with at least one geriatric syndrome (44.7%, n = 4038) had an increased risk of developing any new chronic health condition [hazard ratio (HR) 1.35; 95% confidence interval (CI) 1.21-1.51]. The association was attenuated but remained significant after adjustment for socioeconomic factors, social contact, health status, and health behavior (HR 1.27; 95% CI 1.12-1.43). Analyses for specific chronic health conditions showed that compared with older community-dwellers without geriatric syndromes, those with geriatric syndromes had an increased risk to develop a cardiovascular health condition (HR 1.42; 95% CI 1.13-1.79) or diabetes (HR 1.53; 95% CI 1.11-2.11). They had no increased risk to develop pulmonary conditions, cancer, or neurological conditions. CONCLUSION AND IMPLICATIONS The presence of geriatric syndromes is associated with incident chronic health conditions, specifically cardiovascular conditions and diabetes. Increased awareness is needed among older people with geriatric syndromes and their physicians. Comprehensive assessments of geriatric syndromes may help to prevent or at least delay the development of chronic health conditions.
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Affiliation(s)
- Christian Rausch
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Community and Occupational Medicine, Groningen, The Netherlands; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Sander K R van Zon
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Community and Occupational Medicine, Groningen, The Netherlands
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Sophia E de Rooij
- Medical School Twente, Medical Spectrum Twente, Enschede, The Netherlands; Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Center for Geriatric Medicine, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Community and Occupational Medicine, Groningen, The Netherlands
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Wirback T, Möller J, Larsson JO, Engström K. Social and sex differences in psychiatric comorbidity and psychosocial functioning among adolescents with depression. J Affect Disord 2021; 282:1132-1142. [PMID: 33601688 DOI: 10.1016/j.jad.2020.12.179] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 11/12/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND To determine social and sex differences in psychosocial functioning and psychiatric comorbidity among adolescents with depression. METHODS A cohort-based study in Stockholm, Sweden. Adolescents who turned 13 years during 2001-2007, were followed in registers until they turned 18 in 2005-2011, (n = 169,262). In the current study, those with depression at age 13-17 were included (n = 6,439). RESULTS Adolescents with parents with low (OR=1.5, CI 1.1-2.2) education were more likely to have low psychosocial functioning. Those with parents with low education and low household income were more likely to have comorbid internalizing (OR=1.3, CI 1.0-1.7/1.3, CI 1.0-1.7) and externalizing disorders (OR=2.5, CI 1.5-4.0/2.4, CI 1.4-4.2). Adolescents with parents born outside the Nordic countries were more likely to have comorbid externalizing disorders (OR=1.6, CI 1.1-2.4). No social differences were evident in relation to family receipt of unemployment benefits. Social differences were found for both girls and boys in relation to psychosocial functioning and comorbidity but the magnitude of social differences in depression with comorbidity was overall larger for boys than girls. LIMITATIONS The findings of the current study can only be generalized to adolescents that have sought care for and been diagnosed with depression, within a setting similar to this study, e.g. with free access to care. CONCLUSION Adolescents with depression and with more disadvantaged social circumstances in the childhood run a higher risk of psychiatric comorbidity and low psychosocial functioning, which can indicate a lengthy clinical course and poorer response to treatment. Both boys and girls follow this path but partly in different kinds of psychiatric comorbidity.
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Affiliation(s)
- Therese Wirback
- Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Jan-Olov Larsson
- Department of Women's and Children's Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Karin Engström
- Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
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31
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Madsen A, Hallmann J, Ansaldi G, Roth T, Lu W, Kim C, Boesenberg U, Zozulya A, Möller J, Shayduk R, Scholz M, Bartmann A, Schmidt A, Lobato I, Sukharnikov K, Reiser M, Kazarian K, Petrov I. Materials Imaging and Dynamics (MID) instrument at the European X-ray Free-Electron Laser Facility. J Synchrotron Radiat 2021; 28:637-649. [PMID: 33650576 PMCID: PMC7941285 DOI: 10.1107/s1600577521001302] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/04/2021] [Indexed: 05/27/2023]
Abstract
The Materials Imaging and Dynamics (MID) instrument at the European X-ray Free-Electron Laser (EuXFEL) facility is described. EuXFEL is the first hard X-ray free-electron laser operating in the MHz repetition range which provides novel science opportunities. The aim of MID is to enable studies of nano-structured materials, liquids, and soft- and hard-condensed matter using the bright X-ray beams generated by EuXFEL. Particular emphasis is on studies of structure and dynamics in materials by coherent scattering and imaging using hard X-rays. Commission of MID started at the end of 2018 and first experiments were performed in 2019.
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Affiliation(s)
- A. Madsen
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - J. Hallmann
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - G. Ansaldi
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - T. Roth
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - W. Lu
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - C. Kim
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - U. Boesenberg
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - A. Zozulya
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - J. Möller
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - R. Shayduk
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - M. Scholz
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - A. Bartmann
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - A. Schmidt
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - I. Lobato
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - K. Sukharnikov
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - M. Reiser
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - K. Kazarian
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
| | - I. Petrov
- European X-ray Free-Electron Laser Facility, Holzkoppel 4, 22869 Schenefeld, Germany
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Schmidt SC, Möller J, Bürgel N, Radke C, Beyer L, Marusch F. Minimally invasive accessory splenectomy for recurrent gastric variceal bleeding due to left-sided portal hypertension: report of the first case. J Surg Case Rep 2021; 2021:rjab008. [PMID: 33604020 PMCID: PMC7877905 DOI: 10.1093/jscr/rjab008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
Upper gastrointestinal bleeding from esophagogastric varices is a common scenario, especially in patients with portal hypertension induced by liver cirrhosis or other diseases with thrombosis of the splenic vein. However, accessory spleen as pathophysiological cause of a regional, left-sided portal hypertension and consecutive development of isolated gastric varices is rare. We report a case of recurrent gastric variceal bleeding resulting from sinistral portal hypertension associated with an accessory spleen in a patient who had traumatic splenectomy many decades before. The accessory spleen is an extremely rare cause for the development of regional, left-sided portal hypertension leading to isolated gastric varices. Minimally invasive splenectomy is a safe and efficient treatment option.
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Affiliation(s)
- S C Schmidt
- Department for Hepato-Pancreato-Biliary Surgery, Ernst von Bergmann Clinic, Potsdam, Germany
| | - J Möller
- Department for Hepato-Pancreato-Biliary Surgery, Ernst von Bergmann Clinic, Potsdam, Germany
| | - N Bürgel
- Department for Gastroenterology and Infectiology, Ernst von Bergmann Clinic, Potsdam, Germany
| | - C Radke
- Institute for Pathology, Ernst von Bergmann Clinic, Potsdam, Germany
| | - L Beyer
- Department for Radiology, Ernst von Bergmann Clinic, Potsdam, Germany
| | - F Marusch
- Clinic for General-, Visceral-, Vascular- and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam, Germany
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33
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Möller J, Rausch C, Laflamme L, Liang Y. Geriatric syndromes and subsequent health-care utilization among older community dwellers in Stockholm. Eur J Ageing 2021; 19:19-25. [PMID: 35241997 PMCID: PMC8881534 DOI: 10.1007/s10433-021-00600-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/26/2022] Open
Abstract
AbstractLittle is known about the long-term effect of geriatric syndromes on health-care utilization. This study aims to determine the association between geriatric syndromes and health-care utilization during a four-year period among older community dwellers. Based on the Stockholm Public Health Cohort study, a total number of 6700 community dwellers aged ≥65 years were included. From a baseline survey in 2006, geriatric syndromes were defined as having at least one of the following: insomnia, functional decline, urinary incontinence, depressive symptoms and vision impairment. Health-care utilization was identified by linkages at individual level with register data with a four-year follow-up. Cox regression was performed to estimate the associations. Compared to those without geriatric syndromes, participants with any geriatric syndromes had a higher prevalence of frequent hospitalizations, long hospital stays, frequent outpatient visits and polypharmacy in each of the follow-up years. After controlling for covariates, having any geriatric syndromes was associated with higher levels of utilization of inpatient and outpatient care as well as polypharmacy. The association was stable over time, and the fully adjusted hazard ratio (95% confidence interval) remained stable in frequent hospitalizations (from 1.89 [1.31, 2.73] in year 1 to 1.70 [1.23, 2.35] in year 4), long hospital stay (from 1.75 [1.41, 2.16] to 1.49 [1.24, 1.78]), frequent outpatient visits (from 1.40 [1.26, 1.54] to 1.33 [1.22, 1.46]) and polypharmacy (from 1.63 [1.46, 1.83] to 1.53 [1.37, 1.71]). Having any geriatric syndromes is associated with higher levels of health-care utilization among older community dwellers, and the impact of geriatric syndromes is stable over a four-year period.
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Affiliation(s)
- Jette Möller
- Department of Global Public Health, Karolinska Institutet, Widerströmska, 17177 Stockholm, Sweden
| | - Christian Rausch
- Department of Global Public Health, Karolinska Institutet, Widerströmska, 17177 Stockholm, Sweden
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institutet, Widerströmska, 17177 Stockholm, Sweden
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Widerströmska, 17177 Stockholm, Sweden
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Melendez P, Bartolome J, Roeschmann C, Soto B, Arevalo A, Möller J, Coarsey M. The association of prepartum urine pH, plasma total calcium concentration at calving and postpartum diseases in Holstein dairy cattle. Animal 2020; 15:100148. [PMID: 33573952 DOI: 10.1016/j.animal.2020.100148] [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: 03/22/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022] Open
Abstract
The use of anionic salts to prevent milk fever in dairy cattle has been an effective nutritional strategy; however, the degree of acidification that determines the most acceptable productive responses and well-being of the cow is still a controversial topic. The objective of this study was to assess urine pH in prepartum Holstein cows fed anionic diets and determine its association with plasma total Ca, Mg, P, β-hydroxyl-butyrate (BHB) concentrations at parturition and the occurrence of peripartum disorders. This investigation consisted of 2 studies. Study 1 was conducted on a grazing dairy. Between February and May 2019, 60 prepartum multiparous cows were tested for urine pH and plasma metabolite concentration at parturition. Total Ca, P, Mg and BHB at day 1 in milk (DIM) were assessed and statistically analyzed by ANOVA (models for polynomial regression). Study 2 was conducted on a drylot dairy farm. Between July 2018 and January 2019, 203 cows were evaluated for urine pH and followed-up for 30 DIM to obtain the incidence of dystocia, stillbirths, milk fever, retained fetal membranes, metritis, clinical mastitis and ketosis. Cows were categorized based on their last urine pH as group 1: pH > 7.0 (n = 135); group 2: pH between 6.0 and 7.0 (n = 46) and group 3: pH < 6.0 (n = 22). A logistic regression model for each health event was conducted considering urine pH group as the main effect. Urine sample was collected at 2.71 ± 2.84 days before parturition. In study 1, there was a quadratic effect of urine pH on total Ca. Total Ca concentration was higher between urine pH 6.0 and 7.0, while decreasing below pH 6.0 and above pH 7.0. There was a trend (P = 0.11) for a quadratic effect of urine pH on the concentration of plasma BHB at parturition. β-Hydroxyl-butyrate was lower approximately between urine pH 6.5 and 7.5. In study 2, the odds for a stillborn in cows with urine pH < 6.0 was 2.39 (95% CI = 1.06-5.40) times the odds for a stillborn in cows with urine pH ≥ 7.0. There was no association between urine pH and the other diseases. In conclusion, cows with prepartum urine pH < 6.0 and >7.0 had lower concentration of plasma total Ca and tended to have a higher concentration of BHB. Cows with urine pH < 6.0 had a higher incidence of stillbirths than cows with urine pH > 7.0.
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Affiliation(s)
- P Melendez
- Department of Population Health, College of Veterinary Medicine, University of Georgia, Tifton, GA 31793, USA.
| | - J Bartolome
- College of Veterinary Medicine, National University of La Pampa, Santa Rosa 6360, Argentina
| | - C Roeschmann
- College of Veterinary Medicine, University of Chile, Santiago 8820808, Chile
| | - B Soto
- College of Veterinary Medicine, National University of La Pampa, Santa Rosa 6360, Argentina
| | - A Arevalo
- Los Laureles Dairy Farm, Osorno 5390000, Chile
| | - J Möller
- Los Laureles Dairy Farm, Osorno 5390000, Chile
| | - M Coarsey
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Tifton, GA 31793, USA
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Xu Y, Möller J, Wang R, Liang Y. Life-course blood pressure trajectories and cardiovascular diseases: A population-based cohort study in China. PLoS One 2020; 15:e0240804. [PMID: 33085698 PMCID: PMC7577482 DOI: 10.1371/journal.pone.0240804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/02/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The patterns of blood pressure trajectory (i.e., change over time) over life-course remain to be explored. In this study, we aim to determine the trajectories of systolic blood pressure (SBP) from adulthood to late life and to assess its impact on the risk of cardiovascular diseases (CVDs). METHODS Based on the China Health and Nutrition Survey, a total of 3566 participants aged 20-50 years at baseline (1989) with at least three SBP measurements during 1989-2011 were included. SBP was measured through physical examination, and socio-demographic factors, lifestyles, medications, and CVDs were based on self-reported questionnaire. Latent class growth modeling was performed to examine SBP trajectory. Odds ratio (OR) and 95% confidence interval (CI) from logistic regression was used to determine the association between SBP trajectory and CVDs. RESULTS Five trajectory groups of SBP were identified: Class 1: rapid increase (n = 113, 3.2%); Class 2: slight increase (n = 1958, 54.9%); Class 3: stable (n = 614, 17.2%); Class 4: increase (n = 800, 22.4%); Class 5: fluctuant (n = 81, 2.3%). After adjustment of demographic factors, baseline SBP, and lifestyles, compared with the "slight increase" group, the OR (95% CI) of CVDs was 0.65 (0.32, 1.28) for "stable" group, 2.24 (1.40, 3.58) for "increase" group, 3.95 (1.81, 8.62) for "rapid increase" group, and 4.32 (1.76, 10.57) for "fluctuant" group. After stratified by use of antihypertensive drugs, the association was only significant for "rapid increase" group among those using antihypertensive drugs with OR (95% CI) of 2.81 (1.01, 7.77). CONCLUSIONS Having a rapidly increasing SBP over life-course is associated with a higher risk of CVDs. This implies the importance of monitoring lifetime change of blood pressure for the prevention of CVDs.
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Affiliation(s)
- Yongshi Xu
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Rui Wang
- The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Islam MT, Möller J, Zhou X, Liang Y. Life-course trajectories of body mass index and subsequent cardiovascular risk among Chinese population. PLoS One 2019; 14:e0223778. [PMID: 31600353 PMCID: PMC6786833 DOI: 10.1371/journal.pone.0223778] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 09/27/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Examining body mass index (BMI) change over life course is crucial for cardiovascular health promotion and prevention. So far, there is very few evidence on the long-term change of BMI from childhood to late life. This study aimed to examine the life-course trajectory patterns of BMI and then to link the trajectory patterns to cardiovascular risk factors in adulthood. METHODS Based on longitudinal data from the China Health and Nutrition Survey, 5276 participants (aged 6-60) at baseline (in 1989) with up to 7 measurements of BMI during 1989-2009 were selected in this study. Cardiovascular risk factors including high blood pressure, high blood glucose and high blood lipids were assessed in 2411 participants in 2009. Latent growth curve modelling was used to analyse the BMI trajectories, and logistic regression was used to examine the associations between trajectory patterns and cardiovascular risk factors. RESULTS Four trajectories patterns of BMI over life course (age 6-80) were identified: Normal-Stable (22.4% of the total participants), Low normal-Normal-Stable (44.1%), Low normal-Normal-Overweight (27.2%), and Overweight-Obese (4.3%). Compared to those with Normal-Stable pattern, those with Low normal-Normal-Stable pattern, Low normal-Normal-Overweight pattern and Overweight-Obese pattern had higher risk of high blood pressure (odds ratio range = 1.6-6.6), high blood glucose (1.7-9.1), dyslipidemia (2.6-5.9) and having at least two of the three cardiovascular risk factors (3.9-30.9). CONCLUSIONS Having a stable BMI within normal range over life course is associated with the lowest cardiovascular risk, whereas remaining overweight and obese over life course is associated with the highest cardiovascular risk.
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Affiliation(s)
- Md. Tauhidul Islam
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Initiative for Non-Communicable Diseases, Health System and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Xingwu Zhou
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Yajun Liang
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Monárrez-Espino J, Galanti MR, Hansson J, Janszky I, Söderberg-Löfdal K, Möller J. Treatment With Bupropion and Varenicline for Smoking Cessation and the Risk of Acute Cardiovascular Events and Injuries: a Swedish Case-Crossover Study. Nicotine Tob Res 2019; 20:606-613. [PMID: 28595356 DOI: 10.1093/ntr/ntx131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 06/07/2017] [Indexed: 11/12/2022]
Abstract
Introduction Bupropion and varenicline are non-nicotine medications used for smoking cessation that mitigate craving and withdrawal symptoms. We aim to investigate whether these drugs increase the risk of selected acute adverse outcomes when used in medical practice. Methods Population-based case-crossover design using data from Swedish health and administrative registers. Adult individuals diagnosed with acute myocardial infarction, stroke, suicide, suicide attempt, fall injury, or that suffered a road traffic crash from 01.10.2006 for bupropion, or from 01.03.2008 for varenicline, until 31.12.2013 were included. Different lengths of exposure periods were analyzed within the 12-week hazard period prior to the adverse outcome (1-14, 15-28, and 29-84 days). The control period was matched using the interval preceding the hazard period (85-168 days), and breaking it up into equivalent periods (85-98, 99-112, and 113-168 days). Conditional logistic regression with each case considered as one stratum was used to estimate adjusted odds ratios (OR) and confidence intervals (CI). Results Neither medication was associated with consistent higher risks for any of the adverse outcomes. For bupropion and varenicline, respectively, in the 1-14 days hazard period, OR (95% CI) were: myocardial infarction 1.14 (0.55 to 2.34) and 1.06 (0.70 to 1.62); stroke 1.16 (0.39 to 3.47) and 1.26 (0.72 to 2.17), and traffic crashes 0.85 (0.39 to 1.85) and 1.48 (0.90 to 2.41). In the other periods, ORs were similar or even lower. For falls and suicidal events ORs were generally below one for both drugs. Conclusion The available evidence suggests that if prescription guidelines are properly followed regarding potential contraindications both of these medications could be considered relatively safe. Implications The reliable exposure and diagnosis assessment used in this nationwide register-based study, along with the number of cases gathered makes this sample one of the largest of its type to assess potential side effects associated with the use of these drugs. Neither medication was associated with consistent higher risks for any of the adverse outcomes studied.
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Affiliation(s)
| | - Maria Rosaria Galanti
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Jenny Hansson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Imre Janszky
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology.,Regional center for health care improvement, St Olav Hospital, Trondheim, Norway
| | - Karin Söderberg-Löfdal
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden.,Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Deleskog A, Ljung R, Forsell Y, Nevriana A, Almas A, Möller J. Correction to: Severity of depression, anxious distress and the risk of type 2 diabetes - a population-based cohort study in Sweden. BMC Public Health 2019; 19:1268. [PMID: 31519164 PMCID: PMC6743110 DOI: 10.1186/s12889-019-7587-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Anna Deleskog
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, SE 171 77, Stockholm, Sweden.
| | - Rickard Ljung
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Alicia Nevriana
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Aysha Almas
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden.,Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden
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Deleskog A, Ljung R, Forsell Y, Nevriana A, Almas A, Möller J. Severity of depression, anxious distress and the risk of type 2 diabetes - a population-based cohort study in Sweden. BMC Public Health 2019; 19:1174. [PMID: 31455291 PMCID: PMC6712830 DOI: 10.1186/s12889-019-7322-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/15/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Previous studies assessing the relationship between depression and diabetes mellitus did not consider the severity of depression. In the present study we assessed the risk of developing type 2 diabetes mellitus (T2DM) among people with various severity of depression. METHODS This prospective longitudinal cohort study included 9,936 individuals residing in Stockholm County, Sweden who responded to the baseline questionnaire in 1998-2000. The participants were followed from 1 year after the baseline up to 2015 for the occurrence of T2DM, using the National Patient Register, Swedish Prescribed Drug Registers, and Cause of Death Register. Depression and anxious distress were assessed using psychiatric rating scales and defined according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). RESULTS Depression was associated with a statistically significant increased risk of T2DM after adjusting for potential confounders (OR 1.48, CI 1.10, 1.99). The strongest association was observed for severe depression (OR 1.72, CI 1.15, 2.59). Further, those with depression, regardless of severity, and with concurrent moderate/severe anxious distress had an increased risk of T2DM (OR 1.73, CI 1.13, 2.63) compared to those with neither depression nor anxious distress. CONCLUSIONS The study adds evidence that depression is associated with a higher risk for developing T2DM, and the association is stronger among people with severe depression.
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Affiliation(s)
- Anna Deleskog
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, SE 171 77, Stockholm, Sweden.
| | - Rickard Ljung
- Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Alicia Nevriana
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden
| | - Aysha Almas
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, SE 171 77, Stockholm, Sweden
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40
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Janszky I, Gémes K, Ahnve S, Asgeirsson H, Möller J. Invasive Procedures Associated With the Development of Infective Endocarditis. J Am Coll Cardiol 2019; 71:2744-2752. [PMID: 29903348 DOI: 10.1016/j.jacc.2018.03.532] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 02/14/2018] [Revised: 03/12/2018] [Accepted: 03/19/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Various invasive medical procedures might induce bacteremia and, hence, act as triggers for infective endocarditis. However, empirical data in humans on the potential dangers of invasive medical procedures in this regard are very sparse. Due to lack of sufficient data, it is currently debated whether the risk for endocarditis with medical procedures is substantial or rather negligible. OBJECTIVES The purpose of this nationwide case-crossover study was to quantify the excess risk for infective endocarditis in association with invasive medical and surgical procedures. METHODS The authors identified all adult patients treated for endocarditis in hospitals in Sweden between January 1, 1998, and December 31, 2011. The authors applied a case-crossover design and compared the occurrence of invasive medical procedures 12 weeks before endocarditis with a corresponding 12-week time period exactly 1 year earlier. The authors considered all invasive nondental medical procedures except for those that are likely to be undertaken due to endocarditis or sepsis or due to infections that could possibly lead to endocarditis. RESULTS The authors identified 7,013 cases of infective endocarditis during the study period. Among others, several cardiovascular procedures, especially coronary artery bypass grafting; procedures of the skin and management of wounds; transfusion; dialysis; bone marrow puncture; and some endoscopies, particularly bronchoscopy, were strongly associated with an increased risk for infective endocarditis. CONCLUSIONS This study suggests that several invasive nondental medical procedures are associated with a markedly increased risk for infective endocarditis.
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Affiliation(s)
- Imre Janszky
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Regional Center for Health Care Improvement, St. Olavs Hospital, Trondheim, Norway.
| | - Katalin Gémes
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Staffan Ahnve
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Hilmir Asgeirsson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Persson Å, Möller J, Engström K, Sundström ML, Nooijen CFJ. Is moving to a greener or less green area followed by changes in physical activity? Health Place 2019; 57:165-170. [PMID: 31055106 DOI: 10.1016/j.healthplace.2019.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/16/2018] [Revised: 03/04/2019] [Accepted: 04/22/2019] [Indexed: 11/16/2022]
Abstract
Green areas might provide an inviting setting and thereby promote physical activity. The objective of this study was to determine whether moving to different green area surroundings was followed by changes of physical activity. Data from a large population-based cohort of adults in Stockholm County responding to surveys in 2010 and 2014 were analysed (n = 42611). Information about walking/cycling and exercise were self-reported and living area greenness data were satellite-derived (NDVI, Normalized Difference Vegetation Index). Multinomial logistic regression analyses were performed separately for changes in levels of walking/cycling and exercise (decrease, stable, increase). Greenness was defined as a change in NDVI quartile to less green, same, or greener. Odds ratio's (OR) with 95% confidence intervals (CI) were presented adjusted for gender, age, education and area-based income. Contrary to what we hypothesized, those moving to a greener area were more likely to decrease their levels of walking/cycling (OR = 1.42, CI = 1.28-1.58), whereas those moving to a less green area were more likely to increase their walking/cycling (OR = 1.26, CI = 1.13-1.41). Exercise behaviour showed another pattern, with people being more likely to decrease exercise both when moving to a greener (OR = 1.25, CI = 1.22-1.38) and to a less green area (OR = 1.22, CI = 1.09-1.36). Studying subpopulations based on sociodemographic characteristics did not aid to clarify our results. This cohort study with repeated measurements did not support the currently available cross-sectional studies showing a strong positive relation between greenness and physical activity. Nevertheless, our findings have shown spatial patterns related to green areas and physical activity which imply a need for place-specific health policies.
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Affiliation(s)
- Åsa Persson
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden.
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Mare Lõhmus Sundström
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden.
| | - Carla F J Nooijen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden.
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Liang Y, Rausch C, Laflamme L, Möller J. Prevalence, trend and contributing factors of geriatric syndromes among older Swedes: results from the Stockholm County Council Public Health Surveys. BMC Geriatr 2018; 18:322. [PMID: 30594139 PMCID: PMC6311019 DOI: 10.1186/s12877-018-1018-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 12/17/2018] [Indexed: 11/25/2022] Open
Abstract
Background Evidence is scarce on the trend in prevalence of geriatric syndromes (GS). This study assesses how GS prevalence changes over time in Swedish older community-dwellers by socio-demography, and attempts to highlight factors that may contribute to explain the trend. Methods Data from Stockholm County Council Public Health Surveys in 2006, 2010 and 2014 were used. Old adults, aged 65–84 years, with measurements on GS items were identified. Thus, a total of 17,560 participants were selected in 2006 (n = 6295), 2010 (n = 6733) and 2014 (n = 4532). Data on socio-demographics, lifestyles and health status were collected through questionnaires. GS was defined as having at least one of the following: insomnia, urinary incontinence, severe hearing/vision problem, functional decline, fall and depressive disorder. Logistic regression was performed to assess the prevalence trend as well as the change in the associations of sociodemographic factors, health behaviors and chronic disease with GS. Results From 2006 to 2014, the prevalence of GS remained stable (Ptrend = 0.54). However, among old adults born outside Nordic countries, it increased significantly from 73.0% in 2006, 78.0% in 2010 to 83.0% in 2014 (Ptrend < 0.001). Furthermore, the association with GS became stronger for born outside Nordic counties (Ptrend < 0.001) and weaker for sedentary lifestyles (Ptrend = 0.004), whereas the association did not change for other sociodemographic factors, health behaviors and chronic disease (all Ptrend > 0.05). Conclusions At population level, GS prevalence remained stable at a high level among Swedish old community-dwellers. There are noteworthy differences in GS trend between population groups, in particular to the detriment of older adults born outside Nordic countries. Electronic supplementary material The online version of this article (10.1186/s12877-018-1018-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yajun Liang
- Department of Public Health Sciences, Karolinska Institutet, Widerströmska, 17177, Stockholm, Sweden.
| | - Christian Rausch
- Department of Public Health Sciences, Karolinska Institutet, Widerströmska, 17177, Stockholm, Sweden.,University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - Lucie Laflamme
- Department of Public Health Sciences, Karolinska Institutet, Widerströmska, 17177, Stockholm, Sweden
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Widerströmska, 17177, Stockholm, Sweden
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43
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Zinn T, Homs A, Sharpnack L, Tinti G, Fröjdh E, Douissard PA, Kocsis M, Möller J, Chushkin Y, Narayanan T. Ultra-small-angle X-ray photon correlation spectroscopy using the Eiger detector. J Synchrotron Radiat 2018; 25:1753-1759. [PMID: 30407186 PMCID: PMC6225738 DOI: 10.1107/s1600577518013899] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/01/2018] [Indexed: 05/10/2023]
Abstract
Successful implementation of the single-photon-counting Eiger 500k pixel array detector for sub-millisecond X-ray photon correlation spectroscopy (XPCS) measurements in the ultra-small-angle scattering region is reported. The performance is demonstrated by measuring the dynamics of dilute silica colloids in aqueous solvents when the detector is operated at different counter depths, 4, 8 and 12 bit. In the fastest mode involving 4 bit parallel readout, a stable frame rate of 22 kHz is obtained that enabled measurement of intensity-intensity autocorrelation functions with good statistics down to the 50 µs range for a sample with sufficient scattering power. The high frame rate and spatial resolution together with large number of pixels of the detector facilitate the investigation of sub-millisecond dynamics over a broad length scale by multispeckle XPCS. This is illustrated by an example involving phoretic motion of colloids during the phase separation of the solvent.
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Affiliation(s)
- T. Zinn
- ESRF – The European Synchrotron, 38043 Grenoble, France
| | - A. Homs
- ESRF – The European Synchrotron, 38043 Grenoble, France
| | - L. Sharpnack
- ESRF – The European Synchrotron, 38043 Grenoble, France
| | - G Tinti
- Paul Scherrer Institut, 5232 Villigen, Switzerland
| | - E Fröjdh
- Paul Scherrer Institut, 5232 Villigen, Switzerland
| | | | - M. Kocsis
- ESRF – The European Synchrotron, 38043 Grenoble, France
| | - J. Möller
- European X-ray Free-Electron Laser Facility, 22869 Schenefeld, Germany
| | - Y. Chushkin
- ESRF – The European Synchrotron, 38043 Grenoble, France
| | - T. Narayanan
- ESRF – The European Synchrotron, 38043 Grenoble, France
- Correspondence e-mail:
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Möller J, Pörtner R, Zeng AP, Jandt U. Population Dynamics in Antibody Producing CHO Cell Cultures. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855335] [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: 11/07/2022]
Affiliation(s)
- J. Möller
- Technische Universität Hamburg; Institut für Bioprozess- und Biosystemtechnik; Denickestraße 15 21073 Hamburg Germany
| | - R. Pörtner
- Technische Universität Hamburg; Institut für Bioprozess- und Biosystemtechnik; Denickestraße 15 21073 Hamburg Germany
| | - A.-P. Zeng
- Technische Universität Hamburg; Institut für Bioprozess- und Biosystemtechnik; Denickestraße 15 21073 Hamburg Germany
| | - U. Jandt
- Technische Universität Hamburg; Institut für Bioprozess- und Biosystemtechnik; Denickestraße 15 21073 Hamburg Germany
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Affiliation(s)
- J. Möller
- Technische Universität Hamburg; Institut für Bioprozess und Biosystemtechnik; Denickestraße 15 21073 Hamburg Germany
| | - K. Kuchemüller
- Technische Universität Hamburg; Institut für Bioprozess und Biosystemtechnik; Denickestraße 15 21073 Hamburg Germany
| | - R. Pörtner
- Technische Universität Hamburg; Institut für Bioprozess und Biosystemtechnik; Denickestraße 15 21073 Hamburg Germany
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Almas A, Forsell Y, Millischer V, Möller J, Lavebratt C. Association of Catechol-O-methyltransferase (COMT Val 158Met) with future risk of cardiovascular disease in depressed individuals - a Swedish population-based cohort study. BMC Med Genet 2018; 19:126. [PMID: 30045690 PMCID: PMC6060560 DOI: 10.1186/s12881-018-0645-2] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/12/2018] [Indexed: 12/19/2022]
Abstract
Background Catechol-O-methyltransferase (COMT Val158Met) has been implicated in both depression and cardiovascular disease. The purpose of this study was to assess if COMT Val158Met, which influences the COMT enzyme activity, has an effect on the risk of cardiovascular disease (CVD) in individuals with a history of depression and also to determine if the risk differs depending on gender. Methods Data from a longitudinal cohort study of mental health among Swedish adults was used. Depression was assessed twice 3 years apart for each participant, in 1998–2001 and 2001–2003. Saliva DNA was contributed by 4349 (41.7%) of the participants and 3525 was successfully genotyped for COMT Val158Met. Participants were followed up until December 2014 from the National Patient register with regard to cardiovascular outcomes (hypertensive or ischemic heart disease, and stroke). Results Those with depression and the high COMT enzyme activity genotype (Val/Val) had almost a three-fold increased risk of later CVD (OR 3.6; 95% CI: 2.0-6.6) compared to those non-depressed carrying the Val/Val allele. This effect on risk for CVD was higher in women compared to men (OR 7.0; 95% CI: 3.0-14.0 versus OR 2.1; 95% CI: 1.0-6.8). Both additive interaction (attributable proportion (AP) = 0.56; 95% CI: 0.24-0.90 and synergy index (SI) = 4.39; 1.0-18.7) and multiplicative interaction (log likelihood test p = 0.1) was present between depression and COMT Val158Met in predicting risk of later CVD. Conclusion High COMT activity genotype Val158Met increased the risk of CVD in depressed persons. The risk was higher in women compared to men.
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Affiliation(s)
- Aysha Almas
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden. .,Department of Medicine, Aga Khan University, Karachi, Pakistan.
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Neurogenetics Unit, Center for Molecular Medicine, Karolinska University Hospital, L8:00, 171 76, Stockholm, Sweden
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Neurogenetics Unit, Center for Molecular Medicine, Karolinska University Hospital, L8:00, 171 76, Stockholm, Sweden.
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Wirback T, Möller J, Larsson JO, Engström K. Social differences in diagnosed depression among adolescents in a Swedish population based cohort. BMC Psychiatry 2018; 18:216. [PMID: 29970041 PMCID: PMC6029410 DOI: 10.1186/s12888-018-1765-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Population based research regarding social differences in diagnosed depression in adolescence is sparse. In this study unique material containing in-and outpatient data was used to determine if low social position in childhood increases the risk of diagnosed depression in adolescence. To further examine this association, gender differences and interactions were explored. METHODS The study population was extracted from the Stockholm Youth Cohort (SYC), a register based cohort containing psychiatric care for all young people in Stockholm County and information about social position. For the purpose of this study, all in the SYC who turned 13 years old during 2001-2007, in total 169,262 adolescents, were followed up in 2005-2011 for diagnoses of depression until age 18. Associations were estimated with Cox regression models and presented as Hazard Ratios (HR). RESULTS The risk of diagnosed depression was higher for adolescents with parents with low education (HR = 1.1, CI = 1.0-1.2) and medium education (HR = 1.1, CI = 1.1-1.2) compared to high as well as for those with lower household income (for example, medium low, HR = 1.2, CI = 1.1-1.3) and for those with parents who received an unemployment benefit (HR = 1.3, CI = 1.2-1.4). No differences were found for those with the lowest household income compared to those with the highest level. Adolescents with parents born outside the Nordic countries had a lower risk of diagnosed depression (HR = 0.7, CI = 0.6-0.7). An interaction effect was found between gender and parental education. CONCLUSIONS Social differences were found but the magnitude was modest and gender differences small.
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Affiliation(s)
- Therese Wirback
- Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, 113 65, Stockholm, Sweden.
| | - Jette Möller
- 0000 0004 1937 0626grid.4714.6Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, 113 65 Stockholm, Sweden
| | - Jan-Olov Larsson
- 0000 0004 1937 0626grid.4714.6Department of Women’s and Children’s Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Karin Engström
- 0000 0004 1937 0626grid.4714.6Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, 113 65 Stockholm, Sweden
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Helgadóttir B, Forsell Y, Hallgren M, Möller J, Ekblom Ö. Long-term effects of exercise at different intensity levels on depression: A randomized controlled trial. Prev Med 2017; 105:37-46. [PMID: 28823684 DOI: 10.1016/j.ypmed.2017.08.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/13/2017] [Accepted: 08/14/2017] [Indexed: 12/25/2022]
Abstract
UNLABELLED Previous research has shown positive effects of exercise on depression but studies have mainly focused on the short-term effects; few have examined the long-term effect, especially with regard to differences in intensity. The aim of this study was to examine the long-term effects of prescribed exercise on depression, performed at three intensity levels. People aged 18-67years with mild to moderate depression (Patient Health Questionnaire-9 score of ≥10) participated in a single-blind, parallel randomized control trial lasting 12weeks (Sweden 2011-2013). Four arms were included: Treatment as usual (TAU, n=310), light (n=106), moderate (n=105) and vigorous exercise (n=99). Severity of depression was measured at baseline, post-treatment and 12-month follow-up using the Montgomery-Åsberg Depression Rating Scale (MADRS). Coefficients (β) and odds ratios were estimated using linear mixed models with time×group interactions. The results showed that at the 12month follow-up the light exercise group had significantly lower depression severity scores than the TAU (-1.9, 95% CI: -3.7, -0.04) and the moderate exercise group (-2.94 95% CI: -5.2, -0.7). The vigorous exercise group had significantly lower scores than the moderate exercise group only (-2.7, 95% CI: -4.9, -0.4). In conclusion, compared to usual care for depression, only light exercise resulted in significantly lower depression severity at 12-month follow-up. Both light and vigorous exercise was more effective than moderate exercise. TRIAL REGISTRATION The study was registered with the German Clinical Trial Register (DRKS study ID: DRKS00008745).
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Affiliation(s)
- Björg Helgadóttir
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Jette Möller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Örjan Ekblom
- The Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
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Nevriana A, Möller J, Laflamme L, Monárrez-Espino J. Road traffic crashes in Swedish older adults using zolpidem or zopiclone – population-based studies. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.325] [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: 11/15/2022] Open
Affiliation(s)
- A Nevriana
- Karolinska Institutet, Stockholm, Sweden
| | - J Möller
- Karolinska Institutet, Stockholm, Sweden
| | - L Laflamme
- Karolinska Institutet, Stockholm, Sweden
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Rausch C, Laflamme L, Liang Y, Bültmann U, de Rooij S, Johnell K, Möller J. Social inequalities in geriatric syndromes among community-dwelling older people. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.163] [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: 11/14/2022] Open
Affiliation(s)
- C Rausch
- University Medical Center Groningen, Stockholm, Sweden
| | - L Laflamme
- Karolinska Institutet, Stockholm, Sweden
| | - Y Liang
- Karolinska Institutet, Stockholm, Sweden
| | - U Bültmann
- University of Groningen, Groningen, Netherland
| | - S de Rooij
- University Medical Center Groningen, Stockholm, Sweden
| | - K Johnell
- Karolinska Institutet, Stockholm, Sweden
| | - J Möller
- Karolinska Institutet, Stockholm, Sweden
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