Tiltaksrettet overvåking av Glomma ved Borregaard 2022

Prosjektleder: Maia Røst KileRapporten presenterer resultater fra undersøkelser av heterotrof begroing og fisk i Glomma ved Borregaard i 2022. Hensikten har vært å vurdere effekter av bedriftens utslipp på økologiske forhold i vassdraget, identifisere mulige tidstrender og undersøke rekruttering av laks. Prøver av heterotrof begroing antyder at bedriftens utslipp påvirker nedre Glomma, men da klassifiseringen ikke kunne utføres iht. veilederen, vurderes 2022-resultatene som usikre. Trenden fra tidligere år, der tilstanden er god oppstrøms Borregaards utslipp og hovedsakelig dårlig nedstrøms Borregaards utslipp, gjenspeiles likevel i årets resultater. Det ble fanget færre laks under el-fisket i 2022 enn i 2021. Estimerte tettheter var hhv. 17 og 23 ungfisk av laks pr. 100 m2 på nedre og øvre grusøre. Tettheten ved nedre grusøre var blant de høyeste observert i perioden 2013-2022, mens tettheten ved øvre grusøre var under medianen for perioden. Undersøkelse av fargemerking i et utvalg individer viste overtall av villfisk i 2022. Vi anbefaler å opprettholde overvåkingen på alle stasjonene i Glomma ved Borregaard, også på stasjonene lengst nede i vassdraget, for å få et mer presist bilde av vassdragets selvrensingsevne på den aktuelle strekningen.Borregaard AS, SarpsborgpublishedVersio

Active conventional treatment and three different biological treatments in early rheumatoid arthritis : phase IV investigator initiated, randomised, observer blinded clinical trial

OBJECTIVE To evaluate and compare benefits and harms of three biological treatments with different modes of action versus active conventional treatment in patients with early rheumatoid arthritis. DESIGN Investigator initiated, randomised, open label, blinded assessor, multiarm, phase IV study. SETTING Twenty nine rheumatology departments in Sweden, Denmark, Norway, Finland, the Netherlands, and Iceland between 2012 and 2018. PARTICIPANTS Patients aged 18 years and older with treatment naive rheumatoid arthritis, symptom duration less than 24 months, moderate to severe disease activity, and rheumatoid factor or anti-citrullinated protein antibody positivity, or increased C reactive protein. INTERVENTIONS Randomised 1:1:1:1, stratified by country, sex, and anti-citrullinated protein antibody status. All participants started methotrexate combined with (a) active conventional treatment (either prednisolone tapered to 5 mg/day, or sulfasalazine combined with hydroxychloroquine and intraarticular corticosteroids), (b) certolizumab pegol, (c) abatacept, or (d) tocilizumab. MAIN OUTCOME MEASURES The primary outcome was adjusted clinical disease activity index remission (CDAI RESULTS 812 patients underwent randomisation. The mean age was 54.3 years (standard deviation 14.7) and 68.8% were women. Baseline disease activity score of 28 joints was 5.0 (standard deviation 1.1). Adjusted 24 week CDAI remission rates were 42.7% (95% confidence interval 36.1% to 49.3%) for active conventional treatment, 46.5% (39.9% to 53.1%) for certolizumab pegol, 52.0% (45.5% to 58.6%) for abatacept, and 42.1% (35.3% to 48.8%) for tocilizumab. Corresponding absolute differences were 3.9% (95% confidence interval -5.5% to 13.2%) for certolizumab pegol, 9.4% (0.1% to 18.7%) for abatacept, and -0.6% (-10.1% to 8.9%) for tocilizumab. Key secondary outcomes showed no major differences among the four treatments. Differences in CDAI remission rates for active conventional treatment versus certolizumab pegol and tocilizumab, but not abatacept, remained within the prespecified non-inferiority margin of 15% (per protocol population). The total number of serious adverse events was 13 (percentage of patients who experienced at least one event 5.6%) for active conventional treatment, 20 (8.4%) for certolizumab pegol, 10 (4.9%) for abatacept, and 10 (4.9%) for tocilizumab. Eleven patients treated with abatacept stopped treatment early compared with 20-23 patients in the other arms. CONCLUSIONS All four treatments achieved high remission rates. Higher CDAI remission rate was observed for abatacept versus active conventional treatment, but not for certolizumab pegol or tocilizumab versus active conventional treatment. Other remission rates were similar across treatments. Non-inferiority analysis indicated that active conventional treatment was non-inferior to certolizumab pegol and tocilizumab, but not to abatacept. The results highlight the efficacy and safety of active conventional treatment based on methotrexate combined with corticosteroids, with nominally better results for abatacept, in treatment naive early rheumatoid arthritis.Peer reviewe

Tålegrenser for forsuring og overskridelser for Høyangervassdraget i Vestland fylke

Prosjektleder: Cathrine Brecke GundersenDet har blitt beregnet tålegrenser for forsuring og overskridelse av disse for Høyangervassdraget og separat for delnedbørfeltene Håland, Gautingsdal og Eiriksdal. Overskridelser er beregnet for dagens (årene 2017-2021) og framtidige (år 2030 og 2050) avsetninger av svovel og nitrogen. Både SSWC- og FAB-modellene ble benyttet. Resultatene viser ingen overskridelse i nedbørfeltene for alle tidsperiodene. På grunn av forsinkelser i systemene kan det være forsuring selv om tålegrensene ikke er overskredet. Men så lenge det ikke er overskridelse, vil forsuringen gradvis avta, og de sure episodene vil bli mindre hyppigere og alvorlige.Statsforvalteren i VestlandpublishedVersio

EWAS of post-COVID-19 patients shows methylation differences in the immune-response associated gene, IFI44L, three months after COVID-19 infection

Although substantial progress has been made in managing COVID-19, it is still difficult to predict a patient’s prognosis. We explored the epigenetic signatures of COVID-19 in peripheral blood using data from an ongoing prospective observational study of COVID-19 called the Norwegian Corona Cohort Study. A series of EWASs were performed to compare the DNA methylation profiles between COVID-19 cases and controls three months post-infection. We also investigated differences associated with severity and long-COVID. Three CpGs—cg22399236, cg03607951, and cg09829636—were significantly hypomethylated (FDR < 0.05) in COVID-19 positive individuals. cg03607951 is located in IFI44L which is involved in innate response to viral infection and several systemic autoimmune diseases. cg09829636 is located in ANKRD9, a gene implicated in a wide variety of cellular processes, including the degradation of IMPDH2. The link between ANKRD9 and IMPDH2 is striking given that IMPDHs are considered therapeutic targets for COVID-19. Furthermore, gene ontology analyses revealed pathways involved in response to viruses. The lack of significant differences associated with severity and long-COVID may be real or reflect limitations in sample size. Our findings support the involvement of interferon responsive genes in the pathophysiology of COVID-19 and indicate a possible link to systemic autoimmune diseases.publishedVersio

Miljøundersøkelse i Aulivassdraget, oppfølging i 2015

Det rapporteres her fra en oppfølgende miljøundersøkelse i Aulivassdraget, Tønsberg, etter brannen i utendørs lager av plast iblandet fraksjoner av EE-avfall, på gjenvinningsbedriften Revac AS på Linnestad industriområde i Vestfold i 2014. Etter brannen forårsaket forurenset slukkevann fiskedød i vassdraget. Konsentrasjonene av undersøkte tungmetaller og organiske miljøgifter i sedimentprøver fra vassdraget (2014) og i blåskjell og sedimenter fra Ilene/Tønsbergfjorden (2014/2015) var lavere enn miljøkvalitetsstandarden til vannforskriften (EQS-verdiene) og oppfylte således kravene til god kjemisk tilstand for EUs prioriterte miljøgifter og god økologisk tilstand for de vannregionspesifikke stoffene. Konsentrasjonene av de undersøkte miljøgifter i en jordprøve fra utløpsområdet for slukkevannet (2014) kvalifiserte for Klasse 1 «Meget god» til Klasse 3 «Moderat» vurdert i forhold til tilstandsklasser for forurenset grunn, med unntak for krom hvor klassifiseringen er mer uviss avhengig av tilstandsformen til krom. Undersøkelser høsten 2015 viser at bunndyrsamfunnene i vassdraget har fortsatt å restituere seg etter utslippet i 2014. I nedre deler av vassdraget er økologisk tilstand vesentlig dårligere enn forventet naturtilstand, noe som i større grad antas å være forårsaket av andre lokale påvirkninger enn utslippet fra Revac AS. Etter utslippet og fiskedøden i 2014 har det nå skjedd en rekolonisering av fisk i vassdraget. Det ble i august 2015 fanget ørret på alle undersøkte strekninger i vassdraget, fra referanseområdet ovenfor utslippet i Bjunebekken og ned mot utløpsområdet til Aulielva.Revac A

Prophylactic anticoagulation with low molecular weight heparin in COVID-19: cohort studies in Denmark and Sweden

OBJECTIVES: To evaluate safety and effectiveness of prophylactic anticoagulation with low molecular weight heparin (LMWH) in individuals hospitalised for COVID-19. METHODS: Using healthcare records from the capital region of Denmark (March 2020-February 2021) and Karolinska University Hospital in Sweden (February 2020-September 2021), we conducted an observational cohort study comparing clinical outcomes 30 days after admission among individuals hospitalised for COVID-19 starting prophylactic LMWH during the first 48 hours of hospitalisation with outcomes among those not receiving prophylactic anticoagulation. We used inverse probability weighting to adjust for confounders and bias due to missing information. Risk ratios, risk differences and robust 95% confidence intervals (CI) were estimated using binomial regression. Country-specific risk ratios were pooled using random-effects meta-analysis. RESULTS: We included 1692 and 1868 individuals in the Danish and Swedish cohorts. Of these, 771 (46%) and 1167 (62%) received prophylactic LMWH up to 48 hours after admission. The combined mortality in Denmark and Sweden was 12% (N=432) and the pooled risk ratio was 0.89 (CI 0.61-1.29) comparing individuals who received LMWH to those who did not. The relative risk of ICU admission was 1.12 (CI 0.85-1.48), while we observed no increased risk of bleeding (RR 0.60, 0.14-2.59). The relative risk of venous thromboembolism was 0.68 (CI: 0.33-1.38) in Sweden. Less than 5 VTE events were observed among individuals receiving LMWH in Denmark, preventing a meaningful analysis. CONCLUSION: We found no benefit on mortality with prophylactic LMWH and no increased risk of bleeding among COVID-19 patients receiving prophylactic LMWH

Contaminants in coastal waters of Norway 2016

Revised version of 7200-2017 / M-856This programme examines the levels, trends and effects of contaminants in biota along the coast of Norway. The 2016- investigation included analyses of 104 different contaminants or biological effect parameters in five types of samples (blue mussel, dog whelk, common periwinkle and cod). The contaminants include metals (Hg, Cd, Pb, Cu, Zn, Ag, As, Ni, Cr and Co), tributyltin (TBT), organochlorines (e.g. PCBs, DDT), PAHs, polybrominated diphenyl ethers (PBDEs), perfluorinated alkylated substances (PFAS) as well as contaminants that have recently received much attention such as hexabromocyclododecane (HBCDs), chlorinated paraffins (SCCP, MCCP), phosphorus flame retardants (PFRs), bisphenol A (BPA), tetrabrombisphenol A (TBBPA) and alkyphenols. Biological effects parameters included VDSI, OH-pyrene metabolites, ALA-D and EROD. In the report, 30 representative substances or parameters were chosen for analyses of 800 time series (last 10 years). Of these there were statistically significant trends in 135 cases: 107 were downwards and 28 upwards. The dominance of downward trends indicated that contamination is decreasing for the measured substances. The downwards trends for TBT-concentrations and effect parameter (VDSI) confirmed that the legislation banning the use of TBT has been effective. Of the 2016-medians for all 800 time series, there were 403 cases that could be classified against EQS, of which 254 (63 %) were below the EQS and 149 (37 %) were above the EQS. All of the 2016-medians from the 800 time series could be classified using a new concept denoted provisional high reference concentrations (PROREF). Of these 594 were below PROREF and 206 exceeded PROREF: 124 by a factor of less than two, 59 by a factor between two and five, 11 by a factor between five and 10, six by a factor between 10 and 20, and six by a factor greater than 20. Some cases warrant special concern, such as high concentrations of several organic pollutants in cod liver from the Inner Oslofjord. High concentrations of DDE in mussels from the Sørfjord were related to earlier use of DDT as pesticide in orchards along the fjord. The influence of fish length on contaminant concentration was examined. Results of analyses of stable isotopes of carbon and nitrogen are presented to investigate the role of food origin and trophic levels for observed contaminant concentrations.Norwegian Environment AgencypublishedVersio