Food waste is a problem with economic, environmental and social implications, making it both important and complex. Previous studies have addressed food waste management options at the less ...prioritised end of the waste hierarchy, but information on more prioritised levels is also needed when selecting the best available waste management options. Investigating the global warming potential of different waste management options offers a limited perspective, but is still important for validating generations from the waste hierarchy in a local context. This study compared the effect on greenhouse gas emissions of different food waste management scenarios representing different levels in the waste hierarchy in the city of Uppsala, Sweden. A life cycle assessment was performed for six waste management scenarios (landfill, incineration, composting, anaerobic digestion, animal feed and donations), using five food products (bananas, grilled chicken, lettuce, beef and bread) as examples when treated as individual waste streams. For all five waste streams, the established waste hierarchy was a useful, but approximate, tool for prioritising the various options, since landfill proved to be the worst option and donation, anaerobic digestion and incineration with energy recovery the best options, for easily handle products, wet products and dry products, respectively, taking into account the GHG emissions. The greatest potential for reducing greenhouse gas emissions was in the bread waste stream, since bread is an energy-rich product with a relatively low carbon footprint, increasing the possibilities for replacing fossil energy carriers. Lettuce, with its high water content, had the least potential to reduce greenhouse gas emissions when the waste management method was changed. Waste valorisation measures should therefore focus on food products with the potential to replace production of goods and services, rather than on food products that are wasted in large quantities or have a high carbon footprint.
•Five individual waste streams from supermarkets in Uppsala, Sweden, were analysed.•Six scenarios representing different levels in the waste hierarchy were investigated.•Emissions of greenhouse gases were calculated using the life cycle assessment method.•The waste hierarchy was found to be useful, but approximate, for waste management.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Polyelectrolyte gels have the capacity to absorb large amounts of multivalent species of opposite charge from aqueous solutions of low ionic strength, and release them at elevated ionic strengths. ...The reversibility offers the possibility to switch between “storage” and “release” modes, useful in applications such as drug delivery. The review focuses on systems where so-called volume phase transitions (VPT) of the gel network take place upon the absorption and release of proteins and self-assembling amphiphiles. We discuss the background in terms of thermodynamic driving forces behind complex formation in oppositely charged mixtures, the role played by cross-links in covalent gels, and general aspects of phase coexistence in networks in relation to Gibbs’ phase rule. We also briefly discuss a gel model frequently used in papers covered by the review. After that, we review papers dealing with collapse and swelling transitions of gels in contact with solution reservoirs of macroions and surfactants. Here we describe recent progress in our understanding of the conditions required for VPT, competing mechanisms, and hysteresis effects. We then review papers addressing equilibrium aspects of core–shell phase coexistence in gels in equilibrium. Here we first discuss early observations of phase separated gels and results showing how the phases affect each other. Then follows a review of recent theoretical and experimental studies providing evidence of thermodynamically stable core–shell phase separated states, and detailed analyses of the conditions under which they exist. Finally, we describe the results from investigations of mechanisms and kinetics of the collapse/swelling transitions induced by the loading/release of proteins, surfactants, and amphiphilic drug molecules.
Summary Background New drug treatments, clinical trials, and standards of quality for assessment of evidence justify an update of evidence-based recommendations for the pharmacological treatment of ...neuropathic pain. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), we revised the Special Interest Group on Neuropathic Pain (NeuPSIG) recommendations for the pharmacotherapy of neuropathic pain based on the results of a systematic review and meta-analysis. Methods Between April, 2013, and January, 2014, NeuPSIG of the International Association for the Study of Pain did a systematic review and meta-analysis of randomised, double-blind studies of oral and topical pharmacotherapy for neuropathic pain, including studies published in peer-reviewed journals since January, 1966, and unpublished trials retrieved from ClinicalTrials.gov and websites of pharmaceutical companies. We used number needed to treat (NNT) for 50% pain relief as a primary measure and assessed publication bias; NNT was calculated with the fixed-effects Mantel-Haenszel method. Findings 229 studies were included in the meta-analysis. Analysis of publication bias suggested a 10% overstatement of treatment effects. Studies published in peer-reviewed journals reported greater effects than did unpublished studies ( r2 9·3%, p=0·009). Trial outcomes were generally modest: in particular, combined NNTs were 6·4 (95% CI 5·2–8·4) for serotonin-noradrenaline reuptake inhibitors, mainly including duloxetine (nine of 14 studies); 7·7 (6·5–9·4) for pregabalin; 7·2 (5·9–9·21) for gabapentin, including gabapentin extended release and enacarbil; and 10·6 (7·4–19·0) for capsaicin high-concentration patches. NNTs were lower for tricyclic antidepressants, strong opioids, tramadol, and botulinum toxin A, and undetermined for lidocaine patches. Based on GRADE, final quality of evidence was moderate or high for all treatments apart from lidocaine patches; tolerability and safety, and values and preferences were higher for topical drugs; and cost was lower for tricyclic antidepressants and tramadol. These findings permitted a strong recommendation for use and proposal as first-line treatment in neuropathic pain for tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, pregabalin, and gabapentin; a weak recommendation for use and proposal as second line for lidocaine patches, capsaicin high-concentration patches, and tramadol; and a weak recommendation for use and proposal as third line for strong opioids and botulinum toxin A. Topical agents and botulinum toxin A are recommended for peripheral neuropathic pain only. Interpretation Our results support a revision of the NeuPSIG recommendations for the pharmacotherapy of neuropathic pain. Inadequate response to drug treatments constitutes a substantial unmet need in patients with neuropathic pain. Modest efficacy, large placebo responses, heterogeneous diagnostic criteria, and poor phenotypic profiling probably account for moderate trial outcomes and should be taken into account in future studies. Funding NeuPSIG of the International Association for the Study of Pain.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
•Reduced storage temperature reduced food waste for all perishable products investigated.•The most cost-efficient waste reduction was found for meat products.•For dairy and cheese products, the costs ...of waste reduction exceeded the potential savings.
Food waste is a major problem and therefore measures are needed to reduce it. Since expired best-before date is a frequently cited cause of food waste in supermarkets, prolonging shelf life could reduce food waste. Longer shelf life could be achieved in different ways, e.g. reduced storage temperature. However, there is limited knowledge regarding the extent to which longer shelf life actually leads to reduced food waste, and whether the benefits of reduced waste exceed the increased energy costs of maintaining reduced storage temperature. Therefore this study calculated the net effect of reducing food waste in supermarkets by reducing the storage temperature through simulating the relationships between food waste reduction, longer shelf life, reduced storage temperature and increased energy costs.
A case study was performed using three years of data on cheese, dairy, deli and meat product waste in six Swedish supermarkets, together with published data on microbiological growth at different temperatures and on the energy requirement for cold storage at different temperatures. Food waste was found to be reduced with lower storage temperature for all food products tested. This measure gave increasing net savings in terms of money and greenhouse gas emissions for meat products with decreasing storage temperature. Deli products had net savings close to zero, while for dairy and cheese products there were net losses, since the costs of reducing storage temperature exceeded the potential savings. Therefore, reducing storage temperature has the potential to reduce waste, but at a total net cost. However, a net benefit can be achieved if the measure is only introduced for products with high relative waste, low turnover and high value per unit mass.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
We aimed to identify determinants in acute stroke that are associated with falls during the stroke unit stay. In order to enable individualized preventive actions, this knowledge is fundamental. ...Based on local and national quality register data on an unselected sample of 5065 stroke patients admitted to a stroke unit at a Swedish university hospital, univariable and multivariable logistic regression analyses were performed. The dependent variable was any fall during stroke unit stay. The independent variables related to function, activity, personal factors, time to assessment, comorbidities and treatments. Determinants of falls were: being male (odds ratio (OR) 2.25, 95% confidence interval (95% CI) 1.79-2.84), haemorrhagic stroke (OR 1.39, 95% CI 1.05-1.86), moderate stroke symptoms according to the National Institutes of Health Stroke Scale (NIHSS score 2-5 vs. NIHSS score 0-1) (OR 1.43, 95% CI 1.08-1.90), smoking (OR 1.70, 95% CI 1.29-2.25), impaired postural control in walking (OR 4.61, 95% CI 3.29-6.46), impaired postural control in standing (OR 1.60, 95% CI 1.25-2.05), stroke-related arm- and hand problems, OR 1.45, 95% CI 1.11-1.91), impaired cognition (OR 1.43, 95% CI 1.04-1.95), and urinary tract infection (OR 1.91, 95% CI 1.43-2.56). The findings from this study are useful in clinical practice and might help to improve patient safety after stroke.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Abstract
Background
Safety data for different anticoagulant medications in venous thromboembolism (VTE) are scarce, in particular for extended treatment.
Objectives
To compare major bleeding rates ...depending on the choice of anticoagulation during initial (first 6 months) and extended treatment (6 months up to 5 years).
Methods
A nationwide register‐based study including cancer‐free patients with a first‐time VTE between 2014 and 2020. Cox proportional hazards models were used to compare bleeding rates.
Results
We included 6558 patients on warfarin, 18,196 on rivaroxaban, and 19,498 on apixaban. At 6 months, 4750 (72.4%) remained on warfarin, 11,366 (62.5%) on rivaroxaban, and 11,940 (61.2%) on apixaban. During initial treatment, major bleeding rates were 3.86 (95% CI 3.14–4.58), 2.93 (2.55–3.31), and 1.95 (1.65–2.25) per 100 patient‐years for warfarin, rivaroxaban, and apixaban, respectively, yielding adjusted hazard ratios (aHRs) of 0.89 (95% CI 0.71–1.12) for rivaroxaban versus warfarin, 0.55 (0.43–0.71) for apixaban versus warfarin, and 0.62 (0.50–0.76) for apixaban versus rivaroxaban. During extended treatment, major bleeding rates were 1.55 (1.19–1.91), 1.05 (0.85–1.26), and 0.96 (0.78–1.15) per 100 patient‐years for warfarin, rivaroxaban, and apixaban, respectively, with aHRs of 0.72 (0.53–0.99) for rivaroxaban versus warfarin, 0.60 (0.44–0.82) for apixaban versus warfarin, and 0.85 (0.64–1.12) for apixaban versus rivaroxaban. Previous bleeding and increasing age were risk factors for bleeding both during initial and extended treatment.
Conclusion
Apixaban had a lower bleeding risk than warfarin or rivaroxaban during initial treatment. During extended treatment, bleeding risk was similar for apixaban and rivaroxaban, and higher with warfarin.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
► We quantified the wastage of fruits and vegetables in six Swedish low price stores. ► A majority of the wasted fruits and vegetables was due to reclamations. ► The waste was categorised in ...pre-store waste and in-store waste. ► The unrecorded part of the wastage was categorised as unrecorded in-store waste.
To prevent retail food wastage, better understanding of waste patterns is necessary. Flows of fruit and vegetables at six Swedish retail stores were analysed in this study, both by analysing recorded data and by performing physical measurements. Total wasted fresh fruits and vegetables were 4.3% of delivered quantity. The largest category was pre-store waste (goods rejected at delivery; 3.01%), followed by recorded in-store waste (0.99%) and unrecorded in-store waste (0.3%). A positive correlation between unrecorded in-store waste and total waste was found, indicating that a thorough recording of waste could be an effective way to reduce retail waste of fresh fruits and vegetables. The praxis allowing large amounts of reclamations of delivered goods was recognised as the main reason for waste, since pre-store waste contributed with the majority of the waste flow. Initiatives to reduce fresh fruit and vegetable waste in the studied retail chain thus need to focus on the pre-store waste to be efficient.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The redefinition of neuropathic pain as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system," which was suggested by the International Association for the ...Study of Pain (IASP) Special Interest Group on Neuropathic Pain (NeuPSIG) in 2008, has been widely accepted. In contrast, the proposed grading system of possible, probable, and definite neuropathic pain from 2008 has been used to a lesser extent. Here, we report a citation analysis of the original NeuPSIG grading paper of 2008, followed by an analysis of its use by an expert panel and recommendations for an improved grading system. As of February, 2015, 608 eligible articles in Scopus cited the paper, 414 of which cited the neuropathic pain definition. Of 220 clinical studies citing the paper, 56 had used the grading system. The percentage using the grading system increased from 5% in 2009 to 30% in 2014. Obstacles to a wider use of the grading system were identified, including (1) questions about the relative significance of confirmatory tests, (2) the role of screening tools, and (3) uncertainties about what is considered a neuroanatomically plausible pain distribution. Here, we present a revised grading system with an adjusted order, better reflecting clinical practice, improvements in the specifications, and a word of caution that even the "definite" level of neuropathic pain does not always indicate causality. In addition, we add a table illustrating the area of pain and sensory abnormalities in common neuropathic pain conditions and propose areas for further research.
Objectives
The prevalence of dementia is growing rapidly worldwide. The early identification and treatment of cognitive decline could reduce the burden on the health care system. Our objective was to ...investigate whether factors measured at an examination at age 50 predict cognitive impairment (CI) 23 years later.
Materials & Methods
In 1993 we enrolled a randomly selected sample of 798 men, 50 years of age, from the general population. They all underwent a physical examination, provided blood samples and filled out questionnaires addressing lifestyle and psychosocial factors. Cognitive testing was offered to all participants still alive in 2016, at age 73.
Results
A total of 333 men participated in the cognitive study, of which 80 (24.0%) performed at a level corresponding to mild cognitive impairment, and four (1.2%) at a level consistent with severe cognitive impairment. After the first step in the multivariable analysis, hypertension, heavy smoking, high intake of alcohol, financial stress, difficulty falling asleep, and cogwheel rigidity were associated with cognitive impairment. After further adjustment, only wide waist circumference measured in cm (OR 1.04, 95% CI 1.00–1.08, p = .04), leg pendulousness (OR 41.97, 95% CI 3.27–538.62, p = .004) and self‐assessed hidden irritability (OR 2.18, 95% CI 1.10–4.32, p = .03) at baseline, remained as being associated with cognitive impairment 23 years later.
Conclusions
Extrapyramidal symptoms such as leg pendulousness, at the age of 50, may be an indicator for very early identification of future cognitive decline.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Cover crop cultivation can be a vital strategy for mitigating climate change in agriculture, by increasing soil carbon stocks and resource efficiency within the cropping system. Another mitigation ...option is to harvest the cover crop and use the biomass to replace greenhouse gas-intensive products, such as fossil fuels. Harvesting cover crop biomass could also reduce the risk of elevated N2O emissions associated with cover crop cultivation under certain conditions, which would offset much of the mitigation potential. However, harvesting cover crops also reduces soil carbon sequestration potential, as biomass is removed from the field, and cultivation of cover crops requires additional field operations that generate greenhouse gas emissions. To explore these synergies and trade-offs, this study investigated the life cycle climate effect of cultivating an oilseed radish cover crop under different management strategies in southern Scandinavia. Three alternative scenarios (Incorporation of biomass into soil; Mowing and harvesting aboveground biomass; Uprooting and harvesting above- and belowground biomass) were compared with a reference scenario with no cover crop. Harvested biomass in the Mowing and Uprooting scenarios was assumed to be transported to a biogas plant for conversion to upgraded biogas, with the digestate returned to the field as an organic fertiliser for the subsequent crop. The climate change mitigation potential of cover crop cultivation was found to be 0.056, 0.58 and 0.93 Mg CO2-eq ha−1 in the Incorporation, Mowing and Uprooting scenario, respectively. The Incorporation scenario resulted in the highest soil carbon sequestration, but also the greatest soil N2O emissions. Substitution of fossil diesel showed considerable mitigation potential, especially in the Uprooting scenario, where biogas production was highest. Sensitivity analysis revealed a strong impact of time of cover crop establishment, with earlier establishment leading to greater biomass production and thus greater mitigation potential.
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•The life cycle climate impact of cover crop cultivation was quantified.•Trade-off between soil carbon sequestration and N2O emissions was investigated.•N2O emission factor for oilseed radish cover crop was estimated.•Harvesting the cover crop for biogas production increased the mitigation potential.•Results showed high sensitivity to the timing of cover crop establishment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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