Air pollution is responsible for one in eight premature deaths worldwide, and thereby a major threat to human health. Health impact assessments of hypothetic changes in air pollution concentrations ...can be used as a mean of assessing the health impacts of policy, plans and projects, and support decision-makers in choices to prevent disease.
The aim of this study was to estimate health impacts attributable to a hypothetical decrease in air pollution concentrations in the city of Malmö in Southern Sweden corresponding to a policy on-road transportations without tail-pipe emissions in the municipality. We used air pollution data modelled for each of the 326,092 inhabitants in Malmö by a Gaussian dispersion model combined with an emission database with >40,000 sources. The dispersion model calculates Nitrogen Oxides (NOx) (later transformed into Nitrogen Dioxide (NO2)) and particulate matter with an aerodynamic diameter < 2.5 μg/m3 (PM2.5) with high spatial and temporal resolution (85 m and 1 h, respectively).
The average individual reduction was 5.1 (ranging from 0.6 to 11.8) μg/m3 in NO2, which would prevent 55 (2% of all deaths) to 93 (4%) deaths annually, depending on dose-response function used. Furthermore, we estimate that the NO2 reduction would result in 21 (6%) fewer cases of incident asthma in children, 95 (10%) fewer children with bronchitis every year, 30 (1%) fewer hospital admissions for respiratory disease, 87(4%) fewer dementia cases, and 11(11%) fewer cases of preeclampsia every year. The average reduction in PM2.5 of 0.6 (ranging from 0.1 till 1.7) μg/m3 would mean that 2729 (0.3%) work days would not be lost due to sick-days and that there would be 16,472 fewer restricted activity days (0.3%) that year had all on-road transportations been without tail-pipe emissions.
Even though the estimates are sensitive to the dose-response functions used and to exposure misclassification errors, even the most conservative estimate of the number of prevented deaths is 7 times larger than the annual traffic fatalities in Malmö, indicating a substantial possibility to reduce the health burden attributed to tail-pipe emissions in the study area.
•Health impact assessment of tail-pipe emissions.•Different exposure-response functions were used to highlight uncertainties in estimated results.•The results can assist informed decision making regarding tail-pipe emissions.•The number of traffic fatalities were few compared with the number of deaths due to tail-pipe emissions.
Background
CCR2 is involved in maintaining immune homeostasis and regulating immune function. This study aims to elucidate the mechanism by which CCR2 regulates B‐cell signalling.
Methods
In ...Ccr2‐knockout mice, the development and differentiation of B cells, BCR proximal signals, actin movement and B‐cell immune response were determined. Besides, the level of CCR2 in PBMC of SLE patients was analysed by bioinformatics.
Results
CCR2 deficiency reduces the proportion and number of follicular B cells, upregulates BCR proximal signalling and enhances the oxidative phosphorylation of B cells. Meanwhile, increased actin filaments aggregation and its associated early‐activation events of B cells are also induced by CCR2 deficiency. The MST1/mTORC1/STAT1 axis in B cells is responsible for the regulation of actin remodelling, metabolic activities and transcriptional signalling, specific MST1, mTORC1 or STAT1 inhibitor can rescue the upregulated BCR signalling. Glomerular IgG deposition is obvious in CCR2‐deficient mice, accompanied by increased anti‐dsDNA IgG level. Additionally, the CCR2 expression in peripheral B cells of SLE patients is decreased than that of healthy controls.
Conclusions
CCR2 can utilise MST1/mTORC1/STAT1 axis to regulate BCR signalling. The interaction between CCR2 and BCR may contribute to exploring the mechanism of autoimmune diseases.
CCR2 deficiency upregulates mouse B‐cell proximal signalling, enhances MST1, mTORC1 and STAT1 signalling to promote metabolic activity and actin remodelling. CCR2 deficiency attenuates the T cell dependent immune response in mice. CCR2 deficiency may cause glomerular IgG deposition and autoantibodies in mice. The expression of CCR2 in peripheral blood B cells of SLE patients is decreased.
•Surgical coaching programs are increasing in number in North America, but patient perspectives regarding these programs remain unknown.•Only a minority of patients were aware of the concept of ...surgical coaching.•Many patients were agreeable to the presence of a surgical coach during their care, and this number increased with further education about surgical coaching.•We suggest obtaining informed consent from patients in cases where surgical coaches are present.
Surgical coaching programs have been introduced as platforms for ongoing professional development amongst independently practicing surgeons. While there is a plethora of evidence regarding the effectiveness of surgical coaching for practicing staff surgeons, patients’ opinions regarding surgical coaching are largely unknown.
To determine patients’ baseline attitudes and opinions about the hypothetical situation of their treating surgeon having a surgical coach present during their upcoming operation, and to determine patients’ baseline knowledge and prior exposure to surgical coaching.
This study was conducted at a tertiary hospital in Vancouver, Canada. Patients on the surgical waitlist of 2 independently practicing Otolaryngologists within the subspeciality of Neurotology were invited to participate in the study. Participants engaged in a semi-structured interview to discuss their opinions and knowledge of physician coaches and to learn about surgical coaching. The interview was conducted based on a pre-set script.
Of the 100 patients approached, 70 consented to participate. Forty-three (61%) participants identified as female, and the mean age was 56±15 years. Initially, 84% of participants (n = 59) consented to the hypothetical presence of a surgical coach. Post-discussion, this number increased to 95.7% (n = 67, p = 0.04). Prior participant exposure to coaching related to employment, education, athletics, or music was high (90%, n = 63). Younger participants between 25 and 45 years of age were more amenable to the presence of a surgical coach compared to participants >66 years of age (p = 0.01). After the interview, 55 (79%) participants were interested in learning more about surgical coaching.
Many patients were unaware of the rationale and importance of surgical coaching programs for practicing staff surgeons. Most patients, especially younger patients, were amenable to the presence of a surgical coach during their surgery, and this number increased in all age categories with patient education about surgical coaching.
Abstract
In this longitudinal interview study, we have strived to advance the understanding of how organisational factors may hinder the emergence of transformational leadership among first line ...managers in social service organisations. By interviewing managers in a Swedish social service organisation during their first year of leadership, we first identified leadership ideals and then asked them to identify factors that hinder the performance of this leadership. Qualitative content analysis was used to analyse the data and the results revealed that the managers strived for a transformational leadership, but several factors in the organisation made it difficult to lead in the way they intended. Hindering factors were identified both at the organisational level, such as ‘top-down management’, ‘financial strain’ and ‘continuous change’, and in the managers’ own working environment in terms of ‘no support’, ‘high work-load’, ‘limited influence’, ‘administrative tasks’ and ‘distance to employees’. This study contributes to our understanding of organisational antecedents of transformational leadership as well as the premises of transformational leadership in social service organisations.
•Physical training was well tolerated and improved aerobic and muscle function.•Physical exercise of MG patients can be transferred to the community setting.•Well controlled MG patients can adhere to ...personal training regimens in a public gym.•This pragmatic case series supports individualized physical training in MG patients.
Although supervised aerobic and resistance training in a hospital setting was proven safe and beneficial for well-controlled myasthenia gravis (MG) patients, implementation of similar programs in the community has not been studied. We conducted a pragmatic open-label study at a large gym in Uppsala, Sweden. Seven patients with generalized MG were recruited to participate in an individualized, tailored exercise program, based on individual baseline status and personal goals, with a personal trainer. All patients completed the entire training period. The individually tailored exercise program was implemented safely and effectively, with all patients improving in aerobic capacity, muscle strength, and balance. Our pragmatic open-label case study suggests that well-controlled patients with generalized MG can extend their physical exercise to personal training in the gym. This is an essential step towards reducing the barriers to implementing exercise procols and increasing the availability of these interventions to MG patients.
Grease is commonly used to lubricate various machine components such as rolling bearings and seals. In this paper the flow of lubricating grease passing restrictions is described. Such flow occurs in ...rolling bearings during relubrication events where the grease is flowing in the transverse (axial) direction through the bearing and is hindered by guide rings, flanges etc, as well as in seals where transverse flow occurs, for example during so-called breathing caused by temperature fluctuations in the bearing. This study uses a 2D flow model geometry consisting of a wide channel with rectangular cross-section and two different types of restrictions to measure the grease velocity vector field, using the method of Micro Particle Image Velocimetry. In the case of a single restriction, the horizontal distance required for the velocity profile to fully develop is approximately the same as the height of the channel. In the corner before and after the restriction, the velocities are very low and part of the grease is stationary. For the channel with two flow restrictions, this effect is even more pronounced in the “pocket” between the restrictions. Clearly, a large part of the grease is not moving. This condition particularly applies to the cases with a low-pressure drop and where high consistency grease is used. In practice this means that grease is not replaced in such “corners” and that some aged/contaminated grease will remain in seal pockets.
► Grease flow is symmetric in the inlet and outlet zones. ► NLGI00 and NLGI 1 grease exhibit small circulation flow in the stagnant corner area. ► NLGI00 grease exhibits a parabolic velocity profile while higher NLGI number greases show plug flow. ► Higher the velocity of the grease, the deeper the flow depth.
European eels (Anguilla anguilla) migrate between the southwestern Sargasso Sea and the European and Mediterranean coasts. In a recent paper in Current Biology, Naisbett-Jones et al.1 claim to ...“provide the first evidence that they eels derive positional information from the Earth’s magnetic field” and that this information guides their migration. The evidence reported by Naisbett-Jones et al.1 in support of this conclusion was derived from eels collected in the Severn River (UK), approximately 50 km upstream of the estuary (i.e. not “in the Severn Estuary” as stated by the authors). Eels collected this far into rivers are benthic and fully adapted to freshwater; that is, they are late-stage glass eels (∼ 2 years old), not the pelagic leptocephalus (larval) life stage that actually undertakes the trans-Atlantic migration. The entire interpretive framework for the Naisbett-Jones et al.1 study rests on the assumption that the behaviour of these late-stage freshwater glass eels, and their responses to magnetic fields, can be used as a proxy for the responses of eel leptocephali. The authors present no evidence in support of this key assumption.
Durif et al. take issue with a recent Current Biology study on eel migration.
The increase of power generated by wind turbines has increased the stresses applied in all of its components, thereby causing premature failures. Particularly, pitch and yaw gears suffer from ...excessive wear mainly caused by inappropriate lubrication. This paper presents a novel method to automatically lubricate the wind turbine pitch gear during operation. A micro-nozzle to inject fresh grease continuously between the teeth in contact was designed, manufactured, and installed in a test bench of a 2 MW wind turbine pitch system. The test bench was used to characterize the fatigue behavior of the gear surface using conventional wind turbine greases under real cyclic loads. Measurements of wear evolution in a pitch gear with and without micro-nozzle show a decrease of 70 % of the wear coefficient after 2×10
4
cycles.
Background and purpose
The potentially increased risk of extrathymic cancers in myasthenia gravis (MG) remains uncertain. We present the occurrence of extrathymic cancer diagnoses in different MG ...subgroups.
Methods
We conducted a nationwide Swedish register‐based cohort study, including patients who had their first MG diagnosis or first prescription of acetylcholine esterase inhibitors between the years 2006 and 2018. Timing and subtypes of cancer diagnosis in relation to MG as well as corticosteroid‐sparing immunosuppressants (CSISs) were identified from national patient, cancer and drug registers.
Results
In the study population of 2812 MG patients, 92 had juvenile MG (3%), 632 had early‐onset MG (23%), 1968 had late‐onset MG (LOMG; 70%) and 120 patients had thymoma‐associated MG (TAMG; 4%). Extrathymic cancers were observed in 630 patients (22.4%). Skin cancer and cancer in the male genital organs were most common (N = 138, respectively), followed by cancers in the female genital organs (N = 103), digestive organs (N = 90) and breast (N = 80). Patients with TAMG (29.2%) and LOMG (28.4%) had the highest occurrence of extrathymic cancer. Cancer frequency was comparable between acetylcholine receptor antibody seropositive and seronegative patients. Two or more CSIS prescriptions significantly increased the frequency of cancer, especially cancers in the digestive organs (p = 0.0026), male genital organs (p = 0.0037) and skin (p < 0.0001).
Conclusions
Most extrathymic cancer types in MG were observed in TAMG and LOMG patients, and there was a clear correlation between CSIS exposure and cancer risk. This study sheds light on extrathymic cancers also in non‐thymoma MG.
We present the occurrence of extrathymic cancer diagnoses in different myasthenia gravis (MG) subgroups in a nationwide Swedish study. Extrathymic cancers were observed in 630 patients (22%). Most extrathymic cancer types in MG were observed in TAMG and LOMG patients.
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