Familial Risks of Heart Failure in Sweden

Introduction: Despite major advances, the incidence rate and mortality of heart failure (HF) remains high, with a five-year survival of approximately 50%. At the time of inception of this thesis the familial risks of HF, including the aspects of mortality, were largely underdetermined. This thesis is composed of four papers with the main aims as follows:To determine the risk of hospitalization of HF associated with having affected siblings, and the ages at which this hypothesized risk apply (Paper I). To investigate the heritability (h2) of HF and the risk of HF in adoptees as determined by HF in biological and adoptive parents (Paper II). To determine if HF survival time is associated among affected siblings (Paper III). To investigate if mortality risks are increased in subjects with a sibling affected with HF (Paper IV).Methods All studies were based on Swedish nationwide interlinked registry data including the National Patient Register and the Multi-Generation Register to retrieve information of, e.g. family relationships, hospital discharge diagnoses and, in some instances, also hospital outpatient data. Adjustments were made for common HF comorbidities, age, sex and (with the exception of Paper III) aspects of socioeconomic data. Standardized incidence ratios (SIRs) of HF hospitalization were calculated for individuals with siblings hospitalized with HF compared with those whose siblings were not (Paper I). In a cohort study design using unconditional logistic regression, the odds ratios (ORs) of HF hospitalization were calculated in adoptees as determined by adoptive and biological parental hospitalization for HF, respectively. Heritability was estimated by using the Falconer regression method (Paper II). Using Cox regression, mortality hazard ratios (HRs) after first hospitalization for HF was calculated as determined by the survival of a sibling previously hospitalized first time for HF (Paper III). Mortality HRs were calculated for siblings of individuals who had been diagnosed with HF compared with siblings of individuals unaffected by HF as the reference group (Paper IV).Results: The SIR of HF hospitalization was 1.62 (95% CI 1.54–1.70) for subjects with one affected sibling and 15.46 (12.82–18.50) for subjects with two affected siblings. SIRs were highest among the youngest stratum of subjects under the age of 50 years and decreased with age (Paper I). The adoptee OR for HF hospitalization with an affected biological parent was 1.45 (95% CI, 1.04-2.03), whereas no significant association was found with an affected adoptive parent. Heritability of HF was 26% (SE, 14%) (Paper II).The mortality HR after first HF hospitalization for subjects having a sibling with corresponding survival < 5 years was 2.02 (95% CI, 1.32–3.09) (Paper III). Subjects with a sibling affected with HF had a mortality HR of 1.21 (95% CI 1.18–1.25). This risk remained (HR=1.19, 95% CI 1.15–1.23) also among subjects without HF themselves (Paper IV).Discussion: Family history, in the form of affected siblings or biological parents, is an important risk factor for HF. The moderate heritability level in relation to the magnitude of familial risk motivates further genetic studies. Sibling HF is also a risk factor for death. Familial factors may also be important for the prognosis of patients with HF. These results suggest the value of more studies to investigate the genomics influencing the risk of HF and the associated mortality risk. They also indicate that individuals with such a family history may be at increased risk and that clinical evaluation may be considered in select categories of patients

Neurophysiology of a left-edge boundary tone using natural and edited F0

The ERP effects of left-edge, sentence-medial boundary tones in East Swedish were examined using synthesized and non-synthesized F0. The perception of the boundary tone gave rise to an N100 effect, reflecting automated processing of the acoustic features of the stimuli, a broadly distributed P200 effect, similar to what has earlier been seen for sentence-initial pitch accents, and an expectancy negativity, previously observed in response to sentence-medial, expected pitch accents. The N100 effect was clear only for the synthesized stimuli, possibly due to their relatively greater salience. The P200 was only seen in the combined results. The expectancy negativity was present in the combined results as well as for the non-edited stimuli. The F0 synthesis in the environment of voiceless obstruents produced a difference in the F0 level before the disambiguation point of the H boundary tone, which led to an anterior negativity starting around 50 ms before the H

Interest contagion in violation-of-expectation-based false-belief tasks

In the debate about how to interpret Violation-of-Expectation (VoE) based false-belief experiments, it has been suggested that infants are predicting the actions of the agent based on more or less sophisticated cognitive means. We present an alternative, more parsimonious interpretation, exploring the possibility that the infants’ reactions are not governed by rational expectation but rather of memory strength due to differences in the allocation of cognitive resources earlier in the experiment. Specifically, it is argued that 1) infants’ have a tendency to find more interest in events that observed agents are attending to as opposed to unattended events (‘interest contagion’), 2) the object-location configurations that result from such interesting events are remembered more strongly by the infants, and 3) the VoE contrast arises as a consequence of the difference in memory strength between more and less interesting object-location configurations. We discuss two published experiments, one which we argue that our model can explain (Kovács, Téglás & Endress 2010), and one which we argue cannot be readily explained by our model (Onishi & Baillargeon 2005)

How can you reduce the energy consumption in milk production?

Lönsamheten i dagens mjölkproduktion är hårt pressad. Mjölkpriset har inte följt med kostnadsutvecklingen. Dagens högteknologiska mjölkproduktion förbrukar mycket energi. Ungefär 40 - 50 % av energiåtgången står mjölkningen för. De största förbrukarna av energin är, vakuumpump, kylaggregat, varmvattenberedare och automatiska disksystem. De står i nämnd ordning störst till minst. I denna studie har jag tagit upp olika åtgärder för att kunna reducera energiåtgången. Den största besparingen kan göras genom att installera frekvenstyrda vakuumpumpar ca 60 % av energiförbrukningen minskar i automatiska mjölkningssystem och i konventionella mjölkningssystem minskar energiförbrukningen bara 30 – 50 %. Den näst största besparingen är att minska energiåtgången vid kylning av mjölken, det kan göras på tre olika sätt med olika mycket besparing. Värmeåtervinning av värmen vid kylaggregatet, förkylning av mjölken och direktkylning. Vid diskningen har jag inte hittat något bra besparingsalternativ förutom vattenåtervinning. Det ger en miljöbesparing men ingen ekonomisk besparing. Så de viktigaste åtgärderna man kan göra är att installera en frekvenstyrd vakuumpump och minska energiförbrukningen vid kylningen av mjölken. Men hur mycket energi som kan sparas beror på besättningsstorleken och mjölkningsteknik. Slutsatsen jag kan göra av detta arbete är att investering i en frekvenstyrd vakuumpump ger störst besparing i ett automatiskt mjölkningssystem eller stora besättningar.The profitability in today’s milk production is very pressed. The milk price has not followed the cost for the operation. The farms is today equipped with more machines that use energy. About 40 - 50 % off the energy consumption on the farm is from the milking. The purpose with this study is to find new technology that can reduce the energy consumption. The greatest energy consumers are vacuum pump, compressor, water heater and automatic cleaning units. In this study I have take up ways to reduce the energy consumption. The greatest savings is to install a frequency controlled vacuum pump. In an automatic milking system you can save up to 60 % off the energy consumption. But in a conventional milking system you only can save 30 -50 % off the energy consumption. The second biggest savings is to reduce the energy needed for cooling off the milk. This you can do in three ways, heat recovery off the heat from the compressor, precooling, and instant cooling. For the water heater is the best savings to use heat recovery systems when you cooling the milk. For the washing I don’t have found any way to reduce the energy consumption. But you can use water recycling but it don’t gives any economics savings but it is good for the environment. So my conclusion is that you can save a lot of energy when you install a frequency controlled vacuum pump and one or combined systems to reduce the energy consumption for cooling of the milk. But how much energy you can save is depended off herd size and milking system. The conclusion I can make of this study is that investment in a frequency controlled vacuum pump gives biggest savings in automatic milking system or larger herds. In small herds it gives less savings because shorter running time

Urine separating toilets : clearing of blockages, collected volume and attitudes

It is important that the current urine separating systems are evaluated to allow improvements to be made and consequently increase their future propagation. In order to increase the knowledge about urine separating systems this study was made. It included, among other things, measurements of amounts of urine as well as of the composition of urine collected at Nytorgsgatan 4 in the city of Hallsberg. The study was increased after an inquiry that also included the district of Understenshöjden in the city of Stockholm. In the inquiry, the users were asked questions about odour, cleaning of toilets and occurrence of blockages in the urine water locks etc. It was shown that within two years from the installation of the toilets precipitation had accumulated that could block the flow completely. The last study in shis is on methods to clear the blockages. The collected urine solution from Nytorgsgatan contained 2.8 g of nitrogen, 0.22 g of phosphorus and 0.68 g of potassium per litre. These amounts correspond to 3.4 g of nitrogen, 0.27 g of phosphorus and 0.82 g of potassium per person per day and corresponded to 46, 40 and 49% respectively of the expected amounts, calculated from the average excretion per person with the urine as given by the Swedish Environmental Protection Agency. The amounts were adjusted after the time the average person at Nytorgsgatan spent at home per day. The concentrations of heavy metals in the urine were low. When using urine as a fertiliser, the amounts of heavy metals to arable land were much below the permitted ones when using sewage sludge as a pertiliser, except for copper where the amounts were slightly under the permitted level. The enquiry concentrated on the disadvantages with urine separating toilets, to find problems which could be solved. Odour, bad flushing and blockages in the water locks were three causes of dissatisfaction with urine separating toilets. Most of the problems with odour could have been avoided by careful installation of the toilet and better sealing of the joints. The persons in the enquiry found that the cleaning of the toilt Dubbletten was more difficult than that of conventional toilet, due to odour, precipitation and bad flushing of the urine bowl. The wnquiry showed that all inhabitants who had lived in the area for more than six months had had some kind of blockage in the urine water lock. All 98 of the examined water locks had reduced flow. In 77 of these the blockages were caused by hair and other such foreign bodies. Such blockages were easy to remedy. The other 21 blockages were dut to hard precipitation, which blocked up to 75% of the cross-section area. Hard precipitation, containing large proportions of metal phosphates, can be very hard to remove. It is always possible to remove them with mechanical aids, such as a cleaning wire but it can be very time consuming. Another problem with mechanical cleaning is that it can wear out the water locks. Chemical cleaning methods have been tested for that reason. The most efficient chemicals were sodium hydroxide, hydrochlorid acid and an industrial cleaning agent containing phosphoric acid. Sodium hydroxide was the most efficient of the studied chemicals. It reduced the precipitation by 80 to 100%, but it also rewuired large amounts of water afterwards to rinse out loose and softened precipitation. The other two chemicals reduces less of the precipitation but they also attacked the oxide that had been formed in the water locks and left a smooth copper surface. Those chemicals did not need any particular rinsing afterwards. The use of socium hydroxide can increase the urine solution's pH in the collection tank while acids can reduce the pH level. A high pH is preferable because of higher reduction in micro-organisms

Arbetsmaskiners bidrag till luftföroreningar i tätorter

The Swedish government has decided an action plan against particulate matter (PM10) within the county of Stockholm. Among other thing, the action plan stipulate that measures shall be taken in order to increase the knowledge about emissions of PM10 from non-road mobile machinery and their contribution to the air quality within densely populated areas. Non-road mobile machinery are characterised as mobile machinery not intended for the use of passenger- or goods-transport on the road, and equipped with an internal combustion engine as specified in directive 97/68/EC and directive 2000/25/EC, i.e. agricultural and forestry tractors and construction equipment such as wheel loaders, excavators, articulated haulers and mobile cranes. The purpose of this project, which was financed by the Swedish national road administration, was to update and summarise the current knowledge concerning fuel consumption and emissions from non-road mobile machinery and their contribution to the air quality in densely populated areas. A more specific aim of the project was to estimate the occurrence and age distribution and annual work hours of non-road mobile machinery within densely populated areas. Furthermore, annual fuel consumption and emissions amounts were also derived. Usually a single emission factor for each pollutant has been used when estimating emissions from the entire non-road mobile machinery sector, which has resulted in fairly uncertain results. Previous research has shown that it is not possible to develop one single set of emission factors that gives representative results for all types of non-road mobile machinery and operations (Hansson et al., 2001; Starr et al., 1999; Ullman et al., 1999). The latest research within the EMMA-projects in Sweden about the presence, use and emissions from non-road mobile machinery has resulted in better knowledge and data concerning emissions from non-road mobile machinery. Within the present project, emissions from non-road mobile machinery in two densely populated areas or population centres with different sizes have been studied. One large population centre represented by the city of Stockholm and one small represented by the town of Ljungby. The calculation of fuel consumption and emissions from non-road mobile machinery within the city of Stockholm has been conducted in accordance with the advanced approach presented by the emission inventory guidebook from the European Environement Agency (EEA, 2005). However, the methodology has been modified in order to thoroughly represent the actual assembly of non-road mobile machinery including the work performed by those machines annually. The same model that was used to derive fuel consumption has been employed for emissions as well. Compared with using average information, more reliable data were obtained through describing the number of machines, annual hour, engine power, load factor, specific fuel consumption and emissions amounts for each type of non-road mobile machinery and model year. All data were stored and used in different matrices, one for each variable. In total 31 different types of machines were defined for which data were collected for all model years from 1982 to 2006. Extensive inventories of non-road mobile machinery were carried out for both the city of Stockholm and Ljungby. For Stockholm the inventory contained both number of units and annual work hour as function of the age of the machinery. Reliable data could be obtained through the Swedish Machinery Testing Institute’s accredited inspection database in combination with statistics over both annual sale returns and registered machinery from the national vehicle database. The results from the inventory showed that about 2 800 non-road mobile machinery with both varying age and annual work hours operated within the city of Stockholm. In the city of Ljungby, less than 100 non-road mobile machinery were estimated to operate, thus called for an alternative method for the inventory. Based on data from local contractors that operated in the city of Ljungby, annual work hour for different types of non-road mobile machinery were collected. The result showed that about 48 000 hours of work with non-road mobile machinery were carried out within the city of Ljungby annually. Moreover, the majority of the work were performed with wheel loaders and different types of excavators. In table S1 annual emission- and fuel consumption amounts from the non-road mobile machinery sector in the cities of Stockholm and Ljungby year 2006 are shown

Pre-Hire Factors and Workplace Ethnic Segregation

In addition to neighbourhoods of residence, family and places of work play important roles in producing and reproducing ethnic segregation. Therefore, recent research on ethnic segregation and contact is increasingly turning its attention from residential areas towards other important domains of daily interethnic contact. The key innovation of this paper is to clarify the role of immigrants' pre-hire exposure to natives in the residence, workplace and family domains in immigrant exposure to natives in their current workplace. The study is based on Swedish population register data. The results show that at the macro level, workplace neighbourhood segregation is lower than residential neighbourhood segregation. Our micro-level analysis further shows that high levels of residential exposure of immigrants to natives help to reduce ethnic segregation at the level of workplace establishments as well.neighbourhood effects, residential segregation, workplace segregation, intermarriage, longitudinal analysis, Sweden

Experiencing the Future Car: Anticipatory UX as a Social and Digital Phenomenon

In order to be innovative and competitive, the automotive industry seeks to understand how to attract new customers, even before they have experienced the product. User Experience (UX) research often provides insights into situated uses of products, and reflections after their use, however tells us little about how products and services are experienced before use. We propose anticipation theory as a way to understand how shared experiences between people in an online discussion forum relate to UX of cars before they are actually experienced in real-life. We took an ethnographic approach to analyse the activities of members of a self-organised web-based discussion forum for Tesla car enthusiasts, to understand how product anticipation emerges in a digital-material setting. Our study identifies how anticipatory experiences create UX of car ownership which evolves through members’ engagement in a self-organised online community enabled through the digitalisation and connectivity of the car, and how such car experiences generate new forms of digital anticipation of the car. We conclude that the shift towards digitalisation of cars and subscription services creates a need for more interdisciplinary research into spatial and temporal aspects, where socially shared anticipatory experiences are increasingly important for the overall UX

Sociala rörelser, heterogenitet och enhet – en kommentar med nedslag i två sociala forum

Vilka utmaningar skapar den globala rättviserörelsen för äldre och nyare teorier om sociala rörelser? I denna text diskuteras dels traditionella teorier som Marx och Sombarts, dels teorierna om "nya sociala rörelser" (Touraine med flera). Denna diskussion kompletteras med presentationen av data från en enkätundersökning gjord vid lokala sociala forum i Sverige