The impact of estimation methods for alcoholattributable mortality on long-term trends for the general population and by educational level in Finland and Italy (Turin)

Background and aims This paper assesses the impact of estimation methods for general and education-specific trends in alcohol-attributable mortality (AAM), and develops an alternative method that can be used when the data available for study is limited. Methods We calculated yearly adult (30+) age-standardised and age-specific AAM rates by sex for the general population and by educational level (low, middle, high) in Finland and Turin (Italy) from 1972 to 2017. Furthermore the slope index of inequality and relative inequality index were computed by country and sex. We compared trends, levels, age distributions, and educational inequalities in AAM according to three existing estimation methods: (1) Underlying COD (UCOD), (2) Multiple COD (MCOD) method, and (3) the population attributable fractions (PAF)-method. An alternative method is developed based on the pros and cons of these methods and the outcomes of the comparison. Results The UCOD and MCOD approaches revealed mainly increasing trends in AAM compared to the declining trends according to the PAF approach. These differences are more pronounced when examining AAM trends by educational groups, particularly for Finnish men. Until age 65, age patterns are similar for all methods, and levels nearly identical for MCOD and PAF in Finland. Our novel method assumes a similar trend and age pattern as observed in UCOD, but adjusts its level upwards so that it matches the level of the PAF approach for ages 30-64. Our new method yields levels in-between UCOD and PAF for Turin (Italy), and resembles the MCOD rates in Finland for females. Relative inequalities deviate for the PAFmethod (lower levels) compared to other methods, whereas absolute inequalities are generally lower for UCOD than all three methods that combine wholly and partly AAM. Conclusions The choice of method to estimate AAM affects not only levels, but also general and education- specific trends and inequalities. Our newly developed method constitutes a better alternative for multiple-country studies by educational level than the currently used UCODmethod when the data available for study is limited to underlying causes of death.</p

Structural batteries in electric road vehicles -When is it a good idea?

Structural batteries, SBs, are composites that can be used as structural elements in electrical vehicles to store energy while also decreasing their weight and, consequently, their energy consumption. However, research has shown that a transition to SBs does not automatically provide environmental benefits (Hermansson et al., 2021), and that efforts need to be made to assess when the use of SBs will in fact decrease the environmental impact of electrical vehicles. This presentation will include early prospective LCA results of SBs in vehicles and discuss when their use is a good idea, as well as potential improvement opportunities.\ua0ReferencesHermansson, F., Berg, I., Sandberg, K., Asp, L. E., Janssen, M., &amp; Svanstr\uf6m, M. (2021). The environmental benefits and challenges of a composite car with structural battery materials. Paper presented at the Resource Efficient Vehicles Conference, Stockholm

The impact of estimation methods for alcoholattributable mortality on long-term trends for the general population and by educational level in Finland and Italy (Turin)

Background and aims This paper assesses the impact of estimation methods for general and education-specific trends in alcohol-attributable mortality (AAM), and develops an alternative method that can be used when the data available for study is limited. Methods We calculated yearly adult (30+) age-standardised and age-specific AAM rates by sex for the general population and by educational level (low, middle, high) in Finland and Turin (Italy) from 1972 to 2017. Furthermore the slope index of inequality and relative inequality index were computed by country and sex. We compared trends, levels, age distributions, and educational inequalities in AAM according to three existing estimation methods: (1) Underlying COD (UCOD), (2) Multiple COD (MCOD) method, and (3) the population attributable fractions (PAF)-method. An alternative method is developed based on the pros and cons of these methods and the outcomes of the comparison. Results The UCOD and MCOD approaches revealed mainly increasing trends in AAM compared to the declining trends according to the PAF approach. These differences are more pronounced when examining AAM trends by educational groups, particularly for Finnish men. Until age 65, age patterns are similar for all methods, and levels nearly identical for MCOD and PAF in Finland. Our novel method assumes a similar trend and age pattern as observed in UCOD, but adjusts its level upwards so that it matches the level of the PAF approach for ages 30-64. Our new method yields levels in-between UCOD and PAF for Turin (Italy), and resembles the MCOD rates in Finland for females. Relative inequalities deviate for the PAFmethod (lower levels) compared to other methods, whereas absolute inequalities are generally lower for UCOD than all three methods that combine wholly and partly AAM. Conclusions The choice of method to estimate AAM affects not only levels, but also general and education- specific trends and inequalities. Our newly developed method constitutes a better alternative for multiple-country studies by educational level than the currently used UCODmethod when the data available for study is limited to underlying causes of death.</p

Climate impact and energy use of structural battery composites in electrical vehicles—a comparative prospective life cycle assessment

Purpose: Structural battery composites (SBCs) are multifunctional carbon fibre composites that can be used as structural elements in battery electric vehicles to store energy. By decreasing the weight of the vehicle, energy consumption in the use phase can be reduced, something that could be counteracted by the energy-intensive carbon fibre production. The purpose of this study is to shed light on such life-cycle considerations.Method: Prospective life cycle assessment is used to compare the future cradle-to-grave climate impact and energy use of SBCs in battery electric vehicles to conventional metals and lithium-ion batteries. Additionally, the influences from differ- ent technology development routes, primarily related to the carbon fibre production, are assessed. The functional unit is the roof, hood, and doors of a battery electric vehicle with maintained flexural stiffness used for 200,000 km. To capture the multifunctionality of the material, the lithium-ion battery is also included in the functional unit.Results and discussion: Results show that SBCs have a large potential to decrease the life cycle climate impact and energy use of battery electric vehicles, especially following routes focusing on decreasing the use of fossil resources, both for raw materials and as energy sources. The comparative assessment of multifunctional or recycled materials to conventional mate- rials introduces several methodological challenges, such as defining the functional unit and choice of allocation approach for distributing burdens and benefits between life cycles in recycling. This study illustrates the importance of using both the cut-off and end-of-life recycling allocation approaches to capture extremes and to not provide biased results. This study also highlights the importance of considering the ease of repairability in comparative studies, as damages to car parts made from SBCs are likely more difficult to repair than those made from conventional materials.Conclusions: SBCs have the potential to reduce the life cycle climate impact and energy use for most scenarios compared to conventional materials. Three main methodological challenges were found: the comparison to a material with a well- established recycling system throughout its life cycle, the need for expanding the system boundaries to include the lithium-ion battery, and the difference in repairability of SBCs compared to the conventional material

The impact of estimation methods for alcoholattributable mortality on long-term trends for the general population and by educational level in Finland and Italy (Turin)

Background and aims This paper assesses the impact of estimation methods for general and education-specific trends in alcohol-attributable mortality (AAM), and develops an alternative method that can be used when the data available for study is limited. Methods We calculated yearly adult (30+) age-standardised and age-specific AAM rates by sex for the general population and by educational level (low, middle, high) in Finland and Turin (Italy) from 1972 to 2017. Furthermore the slope index of inequality and relative inequality index were computed by country and sex. We compared trends, levels, age distributions, and educational inequalities in AAM according to three existing estimation methods: (1) Underlying COD (UCOD), (2) Multiple COD (MCOD) method, and (3) the population attributable fractions (PAF)-method. An alternative method is developed based on the pros and cons of these methods and the outcomes of the comparison. Results The UCOD and MCOD approaches revealed mainly increasing trends in AAM compared to the declining trends according to the PAF approach. These differences are more pronounced when examining AAM trends by educational groups, particularly for Finnish men. Until age 65, age patterns are similar for all methods, and levels nearly identical for MCOD and PAF in Finland. Our novel method assumes a similar trend and age pattern as observed in UCOD, but adjusts its level upwards so that it matches the level of the PAF approach for ages 30-64. Our new method yields levels in-between UCOD and PAF for Turin (Italy), and resembles the MCOD rates in Finland for females. Relative inequalities deviate for the PAFmethod (lower levels) compared to other methods, whereas absolute inequalities are generally lower for UCOD than all three methods that combine wholly and partly AAM. Conclusions The choice of method to estimate AAM affects not only levels, but also general and education- specific trends and inequalities. Our newly developed method constitutes a better alternative for multiple-country studies by educational level than the currently used UCODmethod when the data available for study is limited to underlying causes of death.</p

Lessons to be learned from periodontitis

Purpose of reviewThis article reviews the link between periodontitis and rheumatoid arthritis (RA) with regard to similarities in genetic risk factors and immunopathogenesis. Emphasis is paid to the potential role of the periodontal pathogen Porphyromonas gingivalis in the etiopathogenesis of both periodontitis and RA, in particular by post-translational modification of arginine into citrulline.Recent findingsP. gingivalis, a major periodontal pathogen, is presently known as the only bacterium in the oral flora which contains a peptidyl arginine deiminase enzyme (PAD). This enzyme is necessary for citrullination. As a result, citrullinated proteins and P. gingivalis PAD, PAD2 and PAD4 (expressed by infiltrating neutrophils) are found in periodontal tissues. Autoantibodies directed to citrullinated proteins, so-called anticitrullinated protein antibodies (ACPAs), are found to be present in gingival crevicular fluid originating from inflamed gingival tissue. Furthermore, treatment studies have revealed that nonsurgical periodontal treatment, that is removal of sub-gingival calculus and biofilm deposits, is accompanied by a reduction in the severity of RA.SummaryIn this study the similarities in immune response and tissue degradation between RA and periodontitis are reviewed. It is shown that the two diseases share the same environmental and genetic risk factors, apart from the fact that there is a link between both diseases via citrullination of proteins by human PAD and P. gingivalis PAD.</p

Levels of Anti-Citrullinated Protein Antibodies and Rheumatoid Factor, Including IgA Isotypes, and Articular Manifestations in Ulcerative Colitis and Crohn's Disease

Systemic presence of arthritis autoantibodies (AAb) is specific for rheumatoid arthritis (RA). AAb initiation might be triggered by chronic mucosal inflammation, such as in inflammatory bowel disease (IBD). We assessed the prevalence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF) in ulcerative colitis (UC) and Crohn&rsquo;s disease (CD) patients, with regard to the prevalence of joint complaints in AAb+ versus AAb&minus; IBD patients. RA patients and healthy subjects (HC) served as controls. Serum was collected from 226 UC, 165 CD and 86 RA patients, and 36 HCs. One-hundred-and-ten UC (48.7%) and 76 CD (46.1%) patients were seropositive for at least one autoantibody, compared to 4 (13.9%) HCs and 81 (94.2%) RA patients. Eighty-three (37%) UC and 52 (32%) CD patients were seropositive for the anti-cyclic citrullinated protein antibody (anti-CCP2) of the immunoglobulin A type (IgA anti-CCP2), compared to 1 (2.8%) HC and 64 (74%) RA patients. RF of the immunoglobulin G type (IgG RF) and IgA RF seropositivity in UC and CD patients was comparable to HCs and low compared to RA patients. Arthralgia was reported by 34 (18.7%) UC and 50 (33.1%) CD patients, but presence of arthralgia was not increased in AAb+ patients. AAbs are frequently present in IBD patients, supporting the hypothesis that inflammation of intestinal mucosa induces low systemic levels of ACPA