Extremvärme ett ökande problem för globala folkhälsan : Klimatförändringarnas negativa hälsoeffekter drabbar även Sverige

High temperatures have a direct impact on body functions. Heat waves increase mortality risks due to myocardial infarction, stroke, and pulmonary disease. Cold temperatures also increase mortality, but with a longer latency. A recent study found only a small difference between the minimal mortality temperature (MMT) and the temperatures at which mortality rose steeply, although the majority of deaths occurred at temperatures below MMT. Global climate change with increasing temperatures seriously threatens health, work capacity, and generation of household incomes, particularly among poor people in hot countries. In Sweden, heat waves increase mortality in vulnerable groups of elderly people and patients with chronic heart and lung diseases, as well as those performing intensive physical work in hot environments. The medical profession can play an important role not only in prevention of climate change, but also in adaptation to climate change with the goal of minimizing health risks

Doubtful outcome of the validation of the Rome II questionnaire: validation of a symptom based diagnostic tool

<p>Abstract</p> <p>Background</p> <p>Questionnaires are used in research and clinical practice. For gastrointestinal complaints the Rome II questionnaire is internationally known but not validated. The aim of this study was to validate a printed and a computerized version of Rome II, translated into Swedish. Results from various analyses are reported.</p> <p>Methods</p> <p>Volunteers from a population based colonoscopy study were included (n = 1011), together with patients seeking general practice (n = 45) and patients visiting a gastrointestinal specialists' clinic (n = 67). The questionnaire consists of 38 questions concerning gastrointestinal symptoms and complaints. Diagnoses are made after a special code. Our validation included analyses of the translation, feasibility, predictability, reproducibility and reliability. Kappa values and overall agreement were measured. The factor structures were confirmed using a principal component analysis and Cronbach's alpha was used to test the internal consistency.</p> <p>Results and Discussion</p> <p>Translation and back translation showed good agreement. The questionnaire was easy to understand and use. The reproducibility test showed kappa values of 0.60 for GERS, 0.52 for FD, and 0.47 for IBS. Kappa values and overall agreement for the predictability when the diagnoses by the questionnaire were compared to the diagnoses by the clinician were 0.26 and 90% for GERS, 0.18 and 85% for FD, and 0.49 and 86% for IBS. Corresponding figures for the agreement between the printed and the digital version were 0.50 and 92% for GERS, 0.64 and 95% for FD, and 0.76 and 95% for IBS. Cronbach's alpha coefficient for GERS was 0.75 with a span per item of 0.71 to 0.76. For FD the figures were 0.68 and 0.54 to 0.70 and for IBS 0.61 and 0.56 to 0.66. The Rome II questionnaire has never been thoroughly validated before even if diagnoses made by the Rome criteria have been compared to diagnoses made in clinical practice.</p> <p>Conclusion</p> <p>The accuracy of the Swedish version of the Rome II is of doubtful value for clinical practice and research. The results for reproducibility and reliability were acceptable but the outcome of the predictability test was poor with IBS as an exception. The agreement between the digital and the paper questionnaire was good.</p

Use of expert elicitation to assign weights to climate and hydrological models in climate impact studies

Various methods are available for assessing uncertainties in climate impact studies. Among such methods, model weighting by expert elicitation is a practical way to provide a weighted ensemble of models for specific real-world impacts. The aim is to decrease the influence of improbable models in the results and easing the decision-making process. In this study both climate and hydrological models are analysed, and the result of a research experiment is presented using model weighting with the participation of six climate model experts and six hydrological model experts. For the experiment, seven climate models are a priori selected from a larger EURO-CORDEX (Coordinated Regional Downscaling Experiment - European Domain) ensemble of climate models, and three different hydrological models are chosen for each of the three European river basins. The model weighting is based on qualitative evaluation by the experts for each of the selected models based on a training material that describes the overall model structure and literature about climate models and the performance of hydrological models for the present period. The expert elicitation process follows a three-stage approach, with two individual rounds of elicitation of probabilities and a final group consensus, where the experts are separated into two different community groups: a climate and a hydrological modeller group. The dialogue reveals that under the conditions of the study, most climate modellers prefer the equal weighting of ensemble members, whereas hydrological-impact modellers in general are more open for assigning weights to different models in a multi-model ensemble, based on model performance and model structure. Climate experts are more open to exclude models, if obviously flawed, than to put weights on selected models in a relatively small ensemble. The study shows that expert elicitation can be an efficient way to assign weights to different hydrological models and thereby reduce the uncertainty in climate impact. However, for the climate model ensemble, comprising seven models, the elicitation in the format of this study could only re-establish a uniform weight between climate models.This work was funded by the project AQUA-CLEW, which is part of ERA4CS (European Research Area for Climate Services), an ERANET (European Research Area Net-work) initiated by JPI Climate (Joint Programming Initiative) andfunded by Formas (Sweden); German Aerospace Center (DLR, Germany); Ministry of Education, Science and Research (BMBWF,Austria); Innovation Fund Denmark; Ministry of Economic Affairs and Digital Transformation (MINECO, Spain); and French National Research Agency with co-funding by the European Commission (grant no. 69046). The contribution of Philippe Lucas-Picher was supported by the French National Research Agency (future investment programme no. ANR-18-MPGA-0005). Rafael Pimentel acknowledges funding by the Modality 5.2 of the Programa Propio 2018 of the University of Córdoba and the Juan de la Cierva Incorporación programme of the Ministry of Science and Innovation (grant no. IJC2018-038093-I). Rafael Pimentel and María J. Polo are members of DAUCO (Unit of Excellence reference no. CEX2019-000968-M), with financial support from the Spanish Ministry of Science and Innovation and the Spanish State Research Agency, through the Severo Ochoa Centre of Excellence and María de Maeztu Unit of Excellence in research and development (R&D)

The genetic history of Scandinavia from the Roman Iron Age to the present

The authors acknowledge support from the National Genomics Infrastructure in Stockholm funded by Science for Life Laboratory, the Knut and Alice Wallenberg Foundation and the Swedish Research Council, and SNIC/Uppsala Multidisciplinary Center for Advanced Computational Science for assistance with massively parallel sequencing and access to the UPPMAX computational infrastructure. We used resources from projects SNIC 2022/23-132, SNIC 2022/22-117, SNIC 2022/23-163, SNIC 2022/22-299, and SNIC 2021-2-17. This research was supported by the Swedish Research Council project ID 2019-00849_VR and ATLAS (Riksbankens Jubileumsfond). Part of the modern dataset was supported by a research grant from Science Foundation Ireland (SFI), grant number 16/RC/3948, and co-funded under the European Regional Development Fund and by FutureNeuro industry partners.Peer reviewedPublisher PD

High Temperature Triggers Latent Variation among Individuals: Oviposition Rate and Probability for Outbreaks

It is anticipated that extreme population events, such as extinctions and outbreaks, will become more frequent as a consequence of climate change. To evaluate the increased probability of such events, it is crucial to understand the mechanisms involved. Variation between individuals in their response to climatic factors is an important consideration, especially if microevolution is expected to change the composition of populations.Here we present data of a willow leaf beetle species, showing high variation among individuals in oviposition rate at a high temperature (20 °C). It is particularly noteworthy that not all individuals responded to changes in temperature; individuals laying few eggs at 20 °C continued to do so when transferred to 12 °C, whereas individuals that laid many eggs at 20 °C reduced their oviposition and laid the same number of eggs as the others when transferred to 12 °C. When transferred back to 20 °C most individuals reverted to their original oviposition rate. Thus, high variation among individuals was only observed at the higher temperature. Using a simple population model and based on regional climate change scenarios we show that the probability of outbreaks increases if there is a realistic increase in the number of warm summers. The probability of outbreaks also increased with increasing heritability of the ability to respond to increased temperature.If climate becomes warmer and there is latent variation among individuals in their temperature response, the probability for outbreaks may increase. However, the likelihood for microevolution to play a role may be low. This conclusion is based on the fact that it has been difficult to show that microevolution affect the probability for extinctions. Our results highlight the urge for cautiousness when predicting the future concerning probabilities for extreme population events

Lean Construction : effektivisering av byggprocessen genom användning av rullarmering och självkompakterande betong

Validerat; 20101217 (root

Reduced drug accumulation is more important in acquired resistance against oxaliplatin than against cisplatin in isogenic colon cancer cells.

Preclinical studies have indicated that there is only partial cross-resistance between cisplatin and oxaliplatin. The molecular background for this is incompletely known. To investigate the differences in resistance, we rendered a colon cancer cell line (S1) resistant against cisplatin and oxaliplatin and characterized the subclones with regard to cross-resistance, platinum uptake, and gene expression profiles. Four oxaliplatin and four cisplatin-resistant cell lines were produced from S1 by step-wise increasing the concentrations of the drugs in the growth medium. Cytotoxicity was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and platinum accumulation in cell lysates and DNA preparations by inductively coupled plasma mass spectroscopy. Gene expression was investigated by cDNA microarrays. The protein expression of the ATP-binding cassette B1 (ABCB1) was measured by immunohistochemistry. The cisplatin-resistant cell lines were 1.5-6.2-fold resistant against cisplatin and the oxaliplatin-resistant sublines 2.6-17-fold resistant against oxaliplatin. There was a limited degree of cross-resistance. Oxaliplatin resistance could be explained to a larger degree by reduced drug accumulation whereas mechanisms for increased tolerance against platinum incorporation in DNA seemed to be of higher importance for resistance against cisplatin. A greater number of ABC transporters were upregulated in the oxaliplatin-resistant cell lines compared with those selected for cisplatin resistance. ABCB1 was highly overexpressed in the three most oxaliplatin-resistant sublines, but significantly underexpressed in the two most cisplatin-resistant cell lines. This was also confirmed by immunohistochemistry. However, functional tests did not show any increase in ABCB1 transport activity in the oxaliplatin-resistant sub-lines compared with S1