Obstructive sleep apnea (OSA) is common in patients with coronary artery disease (CAD), many of whom do not report daytime sleepiness. First-line treatment for symptomatic OSA is continuous positive ...airway pressure (CPAP), but its value in patients without daytime sleepiness is uncertain.
To determine the effects of CPAP on long-term adverse cardiovascular outcome risk in patients with CAD with nonsleepy OSA.
This single-center, prospective, randomized, controlled, open-label, blinded evaluation trial was conducted between December 2005 and November 2010. Consecutive patients with newly revascularized CAD and OSA (apnea-hypopnea index ≥15/h) without daytime sleepiness (Epworth Sleepiness Scale score <10) were randomized to auto-titrating CPAP (n = 122) or no positive airway pressure (n = 122).
The primary endpoint was the first event of repeat revascularization, myocardial infarction, stroke, or cardiovascular mortality. Median follow-up was 57 months. The incidence of the primary endpoint did not differ significantly in patients who did versus did not receive CPAP (18.1% vs. 22.1%; hazard ratio, 0.80; 95% confidence interval, 0.46-1.41; P = 0.449). Adjusted on-treatment analysis showed a significant cardiovascular risk reduction in those who used CPAP for ≥4 versus <4 hours per night or did not receive treatment (hazard ratio, 0.29; 95% confidence interval, 0.10-0.86; P = 0.026).
Routine prescription of CPAP to patients with CAD with nonsleepy OSA did not significantly reduce long-term adverse cardiovascular outcomes in the intention-to-treat population. There was a significant reduction after adjustment for baseline comorbidities and compliance with the treatment. Clinical trial registered with www.clinicaltrials.gov (NCT 00519597).
Swedish crime fiction became an international phenomenon in the first decade of the 21st century, starting first with novels but then percolating through Swedish-language television serials and films ...and onto English-language BBC productions and Hollywood remakes. This book looks at the rich history of 'Scandinavian noir', examines the appeal of this particular genre and attempts to reveal why it is distinct from the plethora of other crime fictions.
Farmers in some parts of Sweden have problems achieving quality assurance certification for their products due to frequently excessive cadmium (Cd) concentrations in wheat grain. Such problems are ...most frequent in areas where soils are affected by sedimentary rock containing alum shale. In this study we used aerial and ground-based gamma radiometry to assess Cd risk in food production at regional and field scale in one such area. A regional risk map for Cd in arable soils in the south-eastern tip of Sweden was created using aerial gamma-ray spectrometry measurements (238U, 232Th, and 40K) combined with maps on bedrock geology and Quaternary soil deposits. The map had 5 hypothetical risk categories. Category 1 areas (highest risk) had >5ppm 238U, category 2 had 3–5ppm 238U, category 3 till on Cambrian sandstone, category 4 fluvial deposits downstream from risk categories 1–3, and category 5 other arable soils (low risk). The high uranium (U) levels were caused by inclusion of alum shale fragments, which may also contain high amounts of Cd. The Cambrian sandstone is a possible source of high soil Cd concentrations (but low in U) since it in this area contains sphalerite (ZnS), which is high in Cd. Directed sampling revealed very high Cd concentrations in both soil and winter wheat grain in the higher risk categories. The R2 value for the positive correlation between Cd and estimated 238U in topsoil was 0.59. The risk categories based on soil properties were also useful in predicting Cd concentration in wheat but there were no differences between categories 2, 3 and 4, so for wheat three risk classes appeared more relevant. The spatial variation in Cd in the study area is considerable according to the risk classification and many farms include both high and low Cd areas. Use of a ground-based gamma-ray sensor for detailed mapping of fields at two farms in high Cd risk areas gave a fairly strong correlation between 238U and soil Cd (R2=0.68). When 232Th/238U ratio was used instead the relationship was even stronger (R2=0.75). The Th/U ratio can remove some of the noise in gamma recordings and may be useful in depicting high U areas. Airborne gamma-ray scanning also outlined the Cd risk areas fairly well (R2=0.39) at the field level. The results show that geological maps and gamma radiation mapping, calibrated with a few analyses of Cd concentrations in soils and crops, can be used for risk classification of soils at the regional scale in this type of landscape. Using gamma-ray data, many areas that would have been overlooked when using geological maps alone were classified as high risk. Ground-based gamma-ray scanning could be useful for farmers to identify fields and parts of fields where special consideration is needed to reduce the risk of high Cd in crops.
► Cadmium in crops is a food safety factor. ► A regional risk map was created for Cd in arable soils. ► High risk was correlated to gamma radiation and bedrock geology. ► The spatial variation in Cd in the study area was considerable. ► The risk map pin-points parts of the farm needing special attention regarding crop Cd.
Adenosine deaminases acting on RNA (ADAR) are RNA-editing enzymes that may restrict viral infection. We have utilized deep sequencing to determine adenosine to guanine (A→G) mutations, signifying ...ADAR activity, in clinical samples retrieved from 93 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients in the early phase of the COVID-19 pandemic. A→G mutations were detected in 0.035% (median) of RNA residues and were predominantly nonsynonymous. These mutations were rarely detected in the major viral population but were abundant in minor viral populations in which A→G was more prevalent than any other mutation (
< 0.001). The A→G substitutions accumulated in the spike protein gene at positions corresponding to amino acids 505 to 510 in the receptor binding motif and at amino acids 650 to 655. The frequency of A→G mutations in minor viral populations was significantly associated with low viral load (
< 0.001). We additionally analyzed A→G mutations in 288,247 SARS-CoV-2 major (consensus) sequences representing the dominant viral population. The A→G mutations observed in minor viral populations in the initial patient cohort were increasingly detected in European consensus sequences between March and June 2020 (
< 0.001) followed by a decline of these mutations in autumn and early winter (
< 0.001). We propose that ADAR-induced deamination of RNA is a significant source of mutated SARS-CoV-2 and hypothesize that the degree of RNA deamination may determine or reflect viral fitness and infectivity.
Abstract This study investigates two concurrent trends across Europe and North America: the increasing instability of parental unions and men’s rising contributions to household work. Because ...children have almost universally resided with their mothers and it is difficult for non-residential fathers to maintain any levels of care work, union dissolutions have potentially slowed societal increases in gender equality. A new family form—50/50 living arrangements—has begun to challenge our understanding of the consequences of union dissolution. Since 50/50 residence requires fathers to take full care responsibility for the child half of the time—something few partnered fathers do—it may even push parents into a more egalitarian division of care work. We have studied care work using Swedish administrative data on parents’ leave from work to care for a sick child. We have created a panel of leave-sharing for children aged 2–11, and use an event-study design to estimate the causal effect of dissolution on the sharing of sick-child leave. The results show that in parental unions dissolving today, the dissolution leads to an increase in fathers’ share of sick-child leave. Whereas union dissolutions have for decades been slowing the gender revolution in Sweden, they are now accelerating it.
As atopic eczema is triggered by environmental factors, such as temperature, differences in disease burden between and within countries are possible. One method to study this phenomenon is to perform ...web-search analysis, since the internet is commonly used to retrieve health-related information. This study, investigating the Google search volume regarding eczema in Swedish counties between April 2017 and March 2021, revealed a continuous increase in number of searches and that the search volume was higher in Northern than Southern Sweden. Gotland had the most searches per 100,000 inhabitants. In general, there was a negative correlation between search volume and temperature (r=-0.315, p < 0.001) and hours of sunshine (r=-0.213, p < 0.001), whereas there was a positive association between search volume and wind (r=0.229, p < 0.001). Search engine analysis is a rapid and cost-effective method of examining search behaviour regarding disease among the general population within a country and, thus, can enable the identification of regions with specific interests and needs.
Premature mortality in autism spectrum disorder Hirvikoski, Tatja; Mittendorfer-Rutz, Ellenor; Boman, Marcus ...
British journal of psychiatry,
03/2016, Volume:
208, Issue:
3
Journal Article
Peer reviewed
Open access
Mortality has been suggested to be increased in autism spectrum disorder (ASD).
To examine both all-cause and cause-specific mortality in ASD, as well as investigate moderating role of gender and ...intellectual ability.
Odds ratios (ORs) were calculated for a population-based cohort of ASD probands (n = 27,122, diagnosed between 1987 and 2009) compared with gender-, age- and county of residence-matched controls (n = 2,672,185).
During the observed period, 24,358 (0.91%) individuals in the general population died, whereas the corresponding figure for individuals with ASD was 706 (2.60%; OR = 2.56; 95% CI 2.38-2.76). Cause-specific analyses showed elevated mortality in ASD for almost all analysed diagnostic categories. Mortality and patterns for cause-specific mortality were partly moderated by gender and general intellectual ability.
Premature mortality was markedly increased in ASD owing to a multitude of medical conditions.
The Sveconorwegian orogeny in SW Baltica comprised a series of geographically and tectonically discrete events between 1140 and 920Ma. Thrusting and high-grade metamorphism at 1140–1080Ma in central ...parts of the orogen were followed by arc magmatism and ultra-high-temperature metamorphism at 1060–920Ma in the westernmost part of the orogen. In the eastern part of the orogen, crustal thickening and high-pressure metamorphism took place at 1050 in one terrane and at 980Ma in another. These discrete tectonothermal events are incompatible with an evolution resulting from collision with another major, continental landmass, and better explained as accretion and re-amalgamation of fragmented and attenuated crustal blocks of the SW Baltica margin behind an evolving continental-margin arc. In contrast, the coeval, along-strike Grenvillian orogeny is typically ascribed to long-lived collision with Amazonia. Here we argue that coeval, but tectonically different events in the Sveconorwegian and Grenville orogens may be linked through the behavior of the Amazonia plate. Subduction of Amazonian oceanic crust, and consequent slab pull, beneath the Sveconorwegian may have driven long-lived collision in the Grenville. Conversely, the development of a major orogenic plateau in the Grenville may have slowed convergence, thereby affecting the rate of oceanic subduction and thus orogenic evolution in the Sveconorwegian. Convergence ceased in the Grenville at ca. 980Ma, in contrast to the Sveconorwegian where convergence continued until ca. 920Ma, and must have been accommodated elsewhere along the Grenville–Amazonia segment of the margin, for example in the Goiás Magmatic Arc which had been established along the eastern Amazonian margin by 930Ma. Our model shows how contrasting but coeval orogenic behavior can be linked through geodynamic coupling along and across tectonic plates.
Display omitted
•The Sveconorwegian orogeny involved crustal accretion along an active margin.•Discrete Grenvillian/Sveconorwegian tectonic events were geodynamically linked.•Amazonia and SW Baltica were not juxtaposed during Sveconorwegian orogeny.
This article tests the claim that government cooperation between mainstream parties and radical right parties can be explained by coalition theory. It does so by analysing three Swedish cases of ...coalition formation where the radical right Sweden Democrats (SD) have remained excluded despite holding a pivotal position in the parliament. It argues that, with the right analytical tools, this exclusion can be explained by coalition theory: cooperation with the SD has been unattractive in terms of policy, and unnecessary because the mainstream parties have been able to form viable minority governments. This argument requires three things: first, that we consider the two-dimensional nature of Swedish politics; second, that we shift the focus from majority government to viable government; and third, that we acknowledge strategic time horizons that extend well into the future. The findings contribute to our understanding of coalition formation and of how mainstream parties respond strategically to the radical right.
To explain single-mother poverty, existing research has either emphasized individualistic, or contextual explanations. Building on the prevalences and penalties framework (Brady et al. 2017), we ...advance the literature on single-mother poverty in three aspects: First, we extend the framework to incorporate heterogeneity among single mothers across countries and over time. Second, we apply this extended framework to Germany, the United Kingdom and Sweden, whose trends in single-mother poverty (1990–2014) challenge ideal-typical examples of welfare state regimes. Third, using decomposition analyses, we demonstrate variation across countries in the relative importance of prevalences and penalties to explain time trends in single-mother poverty. Our findings support critiques of static welfare regime typologies, which are unable to account for policy change and poverty trends of single mothers. We conclude that we need to understand the combinations of changes in single mothers’ social compositions and social policy contexts, if we want to explain time trends in single-mother poverty.
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