Sleep duration and mortality, influence of age, retirement, and occupational group

SummaryPrevious work has shown that both long and short sleep duration is associated with increased mortality, with lowest risk around 7 hr. This has had widespread impact on views on the optimal sleep duration. However, age, being employed/retired, and blue‐/white‐collar status, may influence the time available for sleep and thus, confound the association. We investigated the role of these factors on the association between sleep duration and mortality. We used employed and retired participants (N = 25,430) from the Swedish National March Cohort and Cox proportional hazards regression to model the shape of the association. We found a significant U‐shaped association in a multivariable model with a hazard ratio (HR) of 1.24 (95% confidence interval [CI] 1.10, 1.39) for 60.3 years at baseline. The shape of the association did not differ between blue‐/white‐collar workers, nor between employed and retired groups. We conclude that the U‐shaped association between sleep duration and mortality is present only in older individuals

A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial

Background: Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. Objective: The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. Methods: HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. Results: Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. Conclusions: This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy

Från det imaginära till normala familjer : Analytiska konvergenser

I komplex analys finns det ett antal olika konvergenser varav vi tittar närmare på några här. Bland annat hur likformig konvergens medför punktvis konvergens men att det omvända ej gäller. Vi tittar också på vad de har för samband med lokal likformig konvergens och normal konvergens dvs. likformig konvergens på kompakta delmängder. Slutligen kommer vi att se på vad som gäller för familjer och kommer då in på lokalt begränsad, ekvikontinuitet, Arzela/Ascoli, Montels och Runges satser. Vi kommer här även se exempel på hur stort fel det egentligen kan bli för punktvisa konvergenta följder. De får normalt inte en gränsfunktion som är analytisk men vi ser både i Exempel 3.19 och Korollarium 3.23 att dessa ger resultat som är analytiska nästan överallt.This report will describe four different types of convergence. The types described are pointwise, local uniformly, uniformly and normal convergence. The different convergences are explored in a way of how they relate to each other. Finally this report will also investigate how this applies to normal families and the theories of Arzela/Ascoli, Montel and Runge. We will here see examples of how wrong it really can go for pointwise convergent sequences. They do usually not have a limit that is analytic but from both Example 3.19 and Corollary 3.23 we will see that they give functions that in fact are analytic almost everywhere

Regression då data utgörs av urval av ranger

För alpina skidåkare mäter man prestationer i så kallad FIS-ranking. Vi undersöker några metoder för hur man kan analysera data där responsen består av ranger som dessa. Vid situationer då responsdata utgörs av urval av ranger finns ingen självklar analysmetod. Det vi undersöker är skillnaderna vid användandet av olika regressionsanpassningar så som linjär, logistisk och ordinal logistisk regression för att analysera data av denna typ. Vidare används bootstrap för att bilda konfidensintervall. Det visar sig att för våra datamaterial ger metoderna liknande resultat när det gäller att hitta betydelsefulla förklarande variabler. Man kan därmed utgående från denna undersökning, inte se några skäl till varför man ska använda de mer avancerade modellerna.Alpine skiers measure their performance in FIS ranking. We will investigate some methods on how to analyze data where response data is based on ranks like this. In situations where response data is based on ranks there is no obvious method of analysis. Here, we examine differences in the use of linear, logistic and ordinal logistic regression to analyze data of this type. Bootstrap is used to make confidence intervals. For our data these methods give similar results when it comes to finding important explanatory variables. Based on this survey we cannot see any reason why one should use the more advanced models

Association between temperature, sunlight hours and alcohol consumption.

BACKGROUND:Alcohol is a major risk factor for liver cirrhosis. Recently, it was proposed that colder climate might causally lead to increased consumption of alcohol. METHODS:We performed an ecologic study, using monthly updated data on mean temperature, sunlight hours and alcohol consumption from ten regions in Sweden, using publicly available data. A generalised additive model, adjusted for region, was applied to examine the association between mean temperature and mean sunlight hours with mean alcohol consumption. RESULTS:We found a non-linear inverse association between mean monthly temperature and mean alcohol consumption, suggesting that warmer temperature was associated with increased alcohol consumption and colder temperature with a decreased consumption. We found no association between mean sunlight hours and alcohol consumption. Consumption was highest during public holidays. CONCLUSIONS:We found no association between a colder climate and increased alcohol consumption. Socio-economic factors are likely to explain the suggested association

Risk of cardiovascular disease and loss in life expectancy in NAFLD

Background and Aims Conflicting evidence exists on cardiovascular disease (CVD) risk in patients with NAFLD, and data are lacking on whether NAFLD increases mortality after a CVD event. Moreover, life expectancy in NAFLD has not been studied. We therefore examined CVD risk and life expectancy in patients with NAFLD compared with the general population. Approach and Results In this nationwide population-based cohort, all patients with NAFLD diagnosis and without baseline CVD (ascertaining from the Swedish National Patient Register from 1987 to 2016, n = 10,023) were matched 10:1 on age, sex, and municipality to individuals from the general population (controls, n = 96,313). CVD diagnosis and mortality were derived from national registers. Multistate models and flexible parametric survival models were used to estimate adjusted hazard ratios (aHRs) for CVD risk and loss in life expectancy due to NAFLD. We identified 1037 (10.3%) CVD events in patients with NAFLD and 4041 (4.2%) in controls. CVD risk was 2.6-fold higher in NAFLD compared with controls (aHR = 2.61, 95% CI = 2.36-2.88) and was strongest for nonfatal CVD (aHR = 3.71, 95% CI = 3.29-4.17). After a nonfatal CVD event, the risk for all-cause mortality was similar between patients with NAFLD and controls (aHR = 0.89, 95% CI = 0.64-1.25). Life expectancy in patients with NAFLD was, on average, 2.8 years lower than controls, with the highest loss of life-years when NAFLD was diagnosed in middle age (40-60 years). Conclusions NAFLD was associated with a higher risk of nonfatal CVD but did not affect post-CVD mortality risk. Patients diagnosed with NAFLD have a lower life expectancy than the general population.Funding Agencies|Region Stockholm</p

Three-fold Increased Risk of Death in Budd-Chiari Syndrome Compared to Matched Controls : A Population-based Cohort Study

Publisher Copyright: © 2022 AGA InstituteBackground & Aims: Patients with Budd-Chiari syndrome (BCS) have an elevated risk of overall and liver-specific mortality, but this has not been quantified on a population level nor compared against a matched general population cohort. Methods: We identified all patients in Sweden with a recorded diagnosis of BCS in the Swedish National Patient Register between 1987 and 2016. Patients with BCS were matched for age, sex, and municipality at baseline with up to 10 reference individuals from the general population. Data on cause-specific mortality were obtained from the Causes of Death Register. A Cox regression model was performed to investigate rates of all-cause and cause-specific mortality. Results: A total of 478 patients with BCS were matched with 4603 reference individuals. Of the patients with BCS, 43% were men, the median age was 58 years, 39% had a recorded diagnosis of a precipitating risk factor, and 13% had underlying liver disease. During a follow-up of up to 29 years, 243 (51%) of the patients with BCS died compared with 1346 (29%) of the reference individuals. Overall mortality was 70 per 1000 person-years in patients with BCS compared with 28 per 1000 person-years in reference individuals, translating into an adjusted hazard ratio (aHR) of 3.1 (95% confidence interval [CI], 2.6–3.6). Although liver-related mortality was particularly high (aHR, 47.6; 95% CI, 16.5–137.4), liver disease accounted for only 10% of deaths in BCS. The most common cause of death was cardiovascular disease (aHR, 2.2; 95% CI, 1.7–2.9). Conclusions: Patients with BCS in Sweden had a 3-fold higher risk of death compared with general population reference individuals. Although mortality from liver diseases was high in relative terms, most patients died from cardiovascular causes.Peer reviewe