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Novel ambient-pressure CCUM concept based on nitrate-salt-catalyzed magnesite formation
No full textAbstract
Nitrate salt-mediated carbonation of MgO has been investigated for CO2 absorbers applications but has not been systematically assessed as a potential carbon capture and utilization via mineralization (CCUM) route to produce anhydrous magnesium carbonate (magnesite, MgCO3) at ambient pressures. To this end, we introduce a conceptual CCUM process, and present preliminary data on how process variables affect product purity and morphology. We demonstrate that nitrate-salts-catalyzed CCUM concept shows initial viability and optimize the process for maximal CO2 uptake, employing brucite and periclase as precursors. Data reveals strong morphological changes according to the precursor’s type and catalysts concentration, showing the potential for morphological tuning of the product according to the application requirements. The basic concept is presented and further research needs discussed as well as the main aspects affecting the gate-to-gate boundaries of the approach.Abstract
Nitrate salt-mediated carbonation of MgO has been investigated for CO2 absorbers applications but has not been systematically assessed as a potential carbon capture and utilization via mineralization (CCUM) route to produce anhydrous magnesium carbonate (magnesite, MgCO3) at ambient pressures. To this end, we introduce a conceptual CCUM process, and present preliminary data on how process variables affect product purity and morphology. We demonstrate that nitrate-salts-catalyzed CCUM concept shows initial viability and optimize the process for maximal CO2 uptake, employing brucite and periclase as precursors. Data reveals strong morphological changes according to the precursor’s type and catalysts concentration, showing the potential for morphological tuning of the product according to the application requirements. The basic concept is presented and further research needs discussed as well as the main aspects affecting the gate-to-gate boundaries of the approach
Outage, Symbol Error Probability, and Rate of RIS-Assisted MIMO Systems with Phase Errors
No full textAbstract
This work provides a comprehensive performance analysis of a reconfigurable intelligent surface (RIS)-assisted multiple-input multiple-output (MIMO) communication system in the presence of phase errors. We first derive the exact expressions for the first and second moments of the maximum signal-to-noise ratio at the receiver. We then use these moments to obtain highly accurate and insightful expressions for the outage probability, average symbol error probability (SEP), and ergodic rate (ER) for various phase error distributions, leveraging the moment-matching approach. Furthermore, we present closed-form asymptotic expressions for these performance metrics. The derived expressions are then leveraged to gain important insights into the impact of phase errors on the scaling laws of diversity order, coding gain, and ER. The numerical results show that the presence of phase errors can significantly degrade the system’s diversity order and coding gain. Specifically, we show that, in the absence of phase errors, the diversity order scales linearly with the number of RIS elements, while the diversity order reduces to unity in the presence of uniformly distributed phase errors. Finally, the analytical findings are demonstrated through extensive simulation results.Abstract
This work provides a comprehensive performance analysis of a reconfigurable intelligent surface (RIS)-assisted multiple-input multiple-output (MIMO) communication system in the presence of phase errors. We first derive the exact expressions for the first and second moments of the maximum signal-to-noise ratio at the receiver. We then use these moments to obtain highly accurate and insightful expressions for the outage probability, average symbol error probability (SEP), and ergodic rate (ER) for various phase error distributions, leveraging the moment-matching approach. Furthermore, we present closed-form asymptotic expressions for these performance metrics. The derived expressions are then leveraged to gain important insights into the impact of phase errors on the scaling laws of diversity order, coding gain, and ER. The numerical results show that the presence of phase errors can significantly degrade the system’s diversity order and coding gain. Specifically, we show that, in the absence of phase errors, the diversity order scales linearly with the number of RIS elements, while the diversity order reduces to unity in the presence of uniformly distributed phase errors. Finally, the analytical findings are demonstrated through extensive simulation results
Automodification of N-terminal serine residues facilitates PARP2 release from DNA
No full textAbstract
ADP-ribosyltransferases PARP1 and PARP2 are involved in DNA repair mechanisms and play a major role in detecting DNA damage. PARP1/2 enzymes transfer the ADP-ribosyl moiety from NAD+ to DNA damage response proteins, histones and to itself, activating the DNA repair cascade. Recent studies have shown that histone PARylation factor 1 (HPF1) forms a joint active site with the catalytic domain of PARP1/2 and alters their target modification site from glutamate/aspartate to serine. In this work, we identified key serine residues within the N-terminus of full-length human PARP2 that are the main targets of automodification. We demonstrated this using site-directed mutagenesis, gel-based PARylation assays of automodification reactions, and by measuring the release of PARP2 from the DNA damage site using a fluorescence polarization assay. We show that, in the presence of HPF1, PARP2 serine 8 and serine 73 are predominantly ADP-ribosylated and serine 8, which is present in the two human PARP2 isoforms, is the major site for PARP2 automodification. Our results provide insight into the mechanistic role of the N-terminus of PARP2 in the PARylation-dependent release of PARP2 from DNA damage sites.Abstract
ADP-ribosyltransferases PARP1 and PARP2 are involved in DNA repair mechanisms and play a major role in detecting DNA damage. PARP1/2 enzymes transfer the ADP-ribosyl moiety from NAD+ to DNA damage response proteins, histones and to itself, activating the DNA repair cascade. Recent studies have shown that histone PARylation factor 1 (HPF1) forms a joint active site with the catalytic domain of PARP1/2 and alters their target modification site from glutamate/aspartate to serine. In this work, we identified key serine residues within the N-terminus of full-length human PARP2 that are the main targets of automodification. We demonstrated this using site-directed mutagenesis, gel-based PARylation assays of automodification reactions, and by measuring the release of PARP2 from the DNA damage site using a fluorescence polarization assay. We show that, in the presence of HPF1, PARP2 serine 8 and serine 73 are predominantly ADP-ribosylated and serine 8, which is present in the two human PARP2 isoforms, is the major site for PARP2 automodification. Our results provide insight into the mechanistic role of the N-terminus of PARP2 in the PARylation-dependent release of PARP2 from DNA damage sites
Utilization of artificial intelligence in geotechnical engineering
No full textRakentaminen edellyttää pohjaolosuhteiden tuntemista. Siihen erikoistunutta tekniikan suuntausta kutsutaan geotekniikaksi ja tähän liittyvää suunnittelua geotekniseksi suunnitteluksi. Geoteknisessä suunnittelussa pyritään tunnistamaan ja hallitsemaan maa-alueen pohjaolosuhteita, jotta maa-alue voitaisiin valjastaa haluttuun käyttöön.
Teknologian kehityksestä syntyneiden ohjelmien ja sovelluksien käyttöä on pyritty jalkauttamaan suunnittelutyöhön tehokkuuden kasvattamiseksi. Tällä hetkellä suurimmat trendit ovat tekoälyn ympärillä. Tätä teknologiaa kehiteltäessä syntyneitä sovelluksia on pyritty tuomaan osaksi geoteknistä suunnittelutyötä.
Tässä kandidaatin työssä perehdytään tekoälyyn sekä tekoälysovellusten käyttöön geoteknisessä suunnittelutyössä. Tutkimusmenetelminä on käytetty kirjallisuuskatsausta, jonka tueksi toteutettiin ja dokumentoitiin asiantuntijahaastatteluita, joiden avulla pyrittiin saamaan tarkempaa kuvaa tekoälyn hyödyntämisestä geoteknisessä suunnittelutyössä. Työ on toteutettu yhteistyössä Ramboll Finlandin kanssa, jonka työntekijöitä on haastateltu. Toteutettujen haastatteluiden vastauksista kävi ilmi, että tekoäly on otettu käyttöön niin suunnittelutyössä kuin projektin muissakin työvaiheissa. Tekoälyn käyttö on sidonnainen käytettyihin suunnittelusovelluksiin sekä tämän käyttäjän yksilölliseen osaamiseen. Tuloksista voidaan päätellä, että tekoälyn käytön kasvattamiseksi geoteknisessä suunnittelussa olisi parasta, että suunnittelusovelluksia kehitettäisiin niin että tekoäly olisi yhtenä sisäisenä osana näissä sovelluksissa.Construction requires knowledge of the ground conditions. The technical field which specializes in this topic is called geotechnical engineering and the related design is called geotechnical engineering. Geotechnical engineering aims to identify and control the ground conditions of the land in order to harness the land as it has planned.
Efforts have been made to introduce the use of programs and applications created by technological developments to the design work in order to increase efficiency. Currently, the biggest trends are around artificial intelligence. Efforts have been made to integrate the applications created in the development of this technology into geotechnical engineering.
This Bachelor's thesis focuses on artificial intelligence and the use of artificial intelligence applications in geotechnical design work. A literature review has been used as research methods, and expert interviews were carried out and documented to provide a more accurate picture of the use of artificial intelligence in geotechnical design work. The work has been carried out in cooperation with Ramboll Finland, whose employees have been interviewed. The responses to the interviews carried out showed that artificial intelligence is already included in the design work and in all the other work phases of the project. The use of artificial intelligence is tied to the design applications used as well as to the individual competence of the user. The results suggest that in order to increase the use of AI in geotechnical engineering, it would be best to develop design applications so that AI would be an internal part of these applications
Comorbidities at MS Diagnosis and Their Association With Treatment Persistence: Real‐World Clinical Data
No full textAbstract
Objectives:
The objectives were to evaluate the prevalence of comorbidities at the time of multiple sclerosis (MS) diagnosis in a Finnish cross-sectional cohort and to analyze whether comorbidities at diagnosis associate with clinical characteristics, treatment delays, initial disease-modifying treatment (DMT) choice, DMT persistence, and disease activity.
Methods:
Patients with relapsing-remitting MS (RRMS) were recruited during their appointments at the neurology outpatient clinic of the Oulu University Hospital, Finland, between the years 2018 and 2022. The data was gathered from the hospital medical records.
Results:
The study cohort consisted of 421 Finnish RRMS patients, of whom 51.8% had at least one or more comorbidity at the time of MS diagnosis. Depression (16.2%) and migraine (11.6%) were the most common comorbidities. Medium-efficacy injectable DMTs (interferon-β and glatiramer acetate) were associated with lower treatment persistence in patients with any comorbidity or psychiatric comorbidity during the 4-year follow-up. Among patients with psychiatric comorbidity, the rate of DMT discontinuation was high shortly after the DMT initiation, and the annualized relapse rate at the start of the DMT was higher compared with those without psychiatric comorbidity (1.3 [SD 0.78] vs. 1.1 [SD 0.74], p = 0.026).
Conclusion:
Comorbidities, especially psychiatric diseases, are associated with lower persistence on injectable DMTs. As comorbidities complicate the treatment of RRMS, it is crucial to identify their role from early on.Abstract
Objectives:
The objectives were to evaluate the prevalence of comorbidities at the time of multiple sclerosis (MS) diagnosis in a Finnish cross-sectional cohort and to analyze whether comorbidities at diagnosis associate with clinical characteristics, treatment delays, initial disease-modifying treatment (DMT) choice, DMT persistence, and disease activity.
Methods:
Patients with relapsing-remitting MS (RRMS) were recruited during their appointments at the neurology outpatient clinic of the Oulu University Hospital, Finland, between the years 2018 and 2022. The data was gathered from the hospital medical records.
Results:
The study cohort consisted of 421 Finnish RRMS patients, of whom 51.8% had at least one or more comorbidity at the time of MS diagnosis. Depression (16.2%) and migraine (11.6%) were the most common comorbidities. Medium-efficacy injectable DMTs (interferon-β and glatiramer acetate) were associated with lower treatment persistence in patients with any comorbidity or psychiatric comorbidity during the 4-year follow-up. Among patients with psychiatric comorbidity, the rate of DMT discontinuation was high shortly after the DMT initiation, and the annualized relapse rate at the start of the DMT was higher compared with those without psychiatric comorbidity (1.3 [SD 0.78] vs. 1.1 [SD 0.74], p = 0.026).
Conclusion:
Comorbidities, especially psychiatric diseases, are associated with lower persistence on injectable DMTs. As comorbidities complicate the treatment of RRMS, it is crucial to identify their role from early on
The carbon footprint of a student at Oulu Business School
No full textIlmastonmuutoksen hillintään liittyvät tavoitteet ovat laajentaneet laskentatoimen tarkastelualuetta ympäristövaikutusten mittaamiseen, analysointiin ja raportointiin. Hiilijalanjälkilaskenta on vakiintunut keskeiseksi välineeksi kasvihuonekaasupäästöjen arvioinnissa, mutta korkeakoulujen kontekstissa tarkastelu on painottunut pääosin organisaatiotasolle. Opiskelijan opiskeluarkeen liittyvää hiilijalanjälkeä on tutkittu suomalaisessa korkeakoulukontekstissa vain rajallisesti.
Tämän tutkimuksen tavoitteena on laskea Oulun yliopiston kauppakorkeakoulun opiskelijan vuotuinen hiilijalanjälki ja tunnistaa keskeisimmät opiskeluun liittyvät päästölähteet. Tutkimus toteutetaan määrällisenä tapaustutkimuksena, jossa yhdistetään elinkaariperusteinen laskenta ja kulutuspohjaisiin panos–tuotosmalleihin perustuvat päästökertoimet opiskelijan hiilijalanjäljen arvioimiseksi. Keskiarvoinen hiilijalanjälki esitetään kilogrammoina hiilidioksidiekvivalenttia (kg CO₂e) opiskelijaa kohden yhden lukuvuoden ajalta.
Laskenta perustuu kuuteen pääkategoriaan: opiskeluun liittyvään liikkumiseen, ruokailuun, kansainväliseen opiskeluliikkuvuuteen, opiskeluun liittyvään kulutukseen, digitaalisten laitteiden hankintaan sekä kampuksen energiankäyttöön, vedenkulutukseen ja jätehuoltoon. Tutkimuksen tulokset osoittavat, että opiskelijan hiilijalanjälki muodostuu pääosin epäsuorista päästölähteistä, ja merkittäviä päästöosuuksia aiheuttavat erityisesti liikkuminen, ruokailu ja kansainvälinen opiskelijaliikkuvuus.
Tutkimus täydentää korkeakoulujen hiilijalanjälkilaskentaa tarjoamalla opiskelijakohtaisen näkökulman, joka mahdollistaa päästöjen tarkemman kohdentamisen ja tukee yliopistojen vastuullisuustyötä. Tuloksia voidaan hyödyntää kestävän kehityksen toimenpiteiden suunnittelussa sekä opiskelijoiden ilmastotietoisuuden lisäämisessä. Lisäksi tutkimus tuottaa vertailukelpoista tietoa, jota voidaan hyödyntää jatkotutkimuksessa ja korkeakoulujen ilmastovaikutusten arvioinnissa
Marketing management during growth : a multiple case study among Finnish software companies in B2B market
No full textThe rapid pace of digitalization and change in operational environment affect currently B2B businesses regardless of their branch. Thus, software companies operating in B2B market act as remarkable enablers for other businesses and their functions. It can be said that partnerships with software companies can determine company’s success nowadays more than ever.
Software business itself is highly growth orientated and competitive branch, where fast-paced technological development and changes in economic conditions influence business significantly. Barriers for entry to new businesses are relatively low compared to the more traditional branches, but the rate of failure is remarkable and competition for the best employees is really intense.
Based on this prevalent state of B2B software industry and increasing demand for their offerings, the aim of this study is to explore marketing management in different stages of growth among enterprises in B2B software business in Finland. The special focus is on how marketing activities and operations evolve as companies grow and how various marketing approaches are applied. This way startup entrepreneurs and companies that are already operating in the industry can utilize the collected information for their successful and well-controlled growth, which also aligns with the core values and research themes of the principal of this thesis, MicroENTRE. It is also important to recognize how presented stages of growth models can act as road maps for B2B software companies to prepare them better for managerial decision-making related to marketing during their path of growth.
This study’s empirical part was conducted as a qualitative multiple case study through semi-structured theme interviews of experts in Finnish B2B software industry. They worked for the four case companies presented in this study. Theory guided qualitative content analysis method was used in analyzing the interview data; in order to keep in mind, the theoretical synthesis formed from the prior research. Theoretical synthesis was formed from earlier research about marketing management related dimensions, company growth and software industry related empirical knowledge.
The findings of this study support and strengthen the earlier research on stages of growth models in technology intensive companies and marketing management in software and technology business. The key findings of this study include growth stage related marketing and other business management recommendations for B2B software companies to boost their growth and valuable guidelines for their branding and brand management. The most important finding of this study is that entrepreneurial marketing approach can be seen as a significant success factor in B2B software business and mastering it can lead companies to profitable growth
Consultation-liaison psychiatry in Finland today and challenges for the future
No full textAbstract
The ongoing health and social services reform in Finland will restructure the organization of public healthcare and social welfare to 21 wellbeing services counties. Organizational models within wellbeing services counties will differ from each other and psychiatric services are going to be placed differently. Reform has raised concerns about the role of CL psychiatry (consultation-liaison psychiatry) in the future. In this article we will discuss the challenges of collaboration and consultation between psychiatric services and somatic specialties in changing operating environment. As background information some statistics from medical units of two Finnish hospitals where somatically ill patients have been referred to CL psychiatric services is explored. Also, as a description of key patient groups in CL psychiatric services the statistics of the main ICD-10 diagnoses in CL psychiatric services is presented. Medical conditions are associated significantly with increased psychological symptoms and psychiatric disorders. Therefore, different medical specialties widely use CL psychiatric services. The patients referred from somatic units form an important psychiatric patient group, which differs from the patients in psychiatric services generally. The vast majority of these patients are of working age. Continual cooperation between psychiatry and medical services should be guaranteed in the current reform of the organization of public healthcare. High-level treatment of medically ill should be ensured by maintaining general hospital psychiatry units and also transferring their skills more widely to outpatient settings.Abstract
The ongoing health and social services reform in Finland will restructure the organization of public healthcare and social welfare to 21 wellbeing services counties. Organizational models within wellbeing services counties will differ from each other and psychiatric services are going to be placed differently. Reform has raised concerns about the role of CL psychiatry (consultation-liaison psychiatry) in the future. In this article we will discuss the challenges of collaboration and consultation between psychiatric services and somatic specialties in changing operating environment. As background information some statistics from medical units of two Finnish hospitals where somatically ill patients have been referred to CL psychiatric services is explored. Also, as a description of key patient groups in CL psychiatric services the statistics of the main ICD-10 diagnoses in CL psychiatric services is presented. Medical conditions are associated significantly with increased psychological symptoms and psychiatric disorders. Therefore, different medical specialties widely use CL psychiatric services. The patients referred from somatic units form an important psychiatric patient group, which differs from the patients in psychiatric services generally. The vast majority of these patients are of working age. Continual cooperation between psychiatry and medical services should be guaranteed in the current reform of the organization of public healthcare. High-level treatment of medically ill should be ensured by maintaining general hospital psychiatry units and also transferring their skills more widely to outpatient settings
Knowledge management, operational resilience and export performance: moderating roles of strategic flexibility and maturity of digital transformation in emerging markets
No full textAbstract
Purpose:
This paper develops and tests a model centered on the critical role of operational resilience in driving export performance in an emerging market within a global, volatile, uncertain, complex and ambiguous environment. We investigate how knowledge management capability can reinforce operational resilience to improve export performance and explore how strategic flexibility and digital transformation maturity shape these effects.
Design/methodology/approach:
We tested the model using data from 400 manufacturing firms from Bangladesh, collected through a multi-wave survey with responses from two mid-level managers per firm. Through a structural path analysis, we explored the intricate connections between KMC-based strategy, operational resilience and export performance. The direct and mediation effects were analyzed using Mplus 8 and Python packages. Specifically, the moderation effects and the Johnson–Neyman (J–N) plot were tested using the Python PyProcess package.
Findings:
The findings confirmed the robustness of our conceptual model. Further analysis revealed that strategic flexibility has a stronger moderated mediation effect than the firms' maturity of the digital transformation.
Originality/value:
The study advances a unique integration of the information processing view with the knowledge-based view of the firm in exploring key factors underlying the export performance in emerging market firms. By establishing how pre-shock capabilities, such as strategic flexibility and maturity of digital transformation, serve as essential components for improving a firm's operational resilience we add to the export managers' toolkit for improving export performance.Abstract
Purpose:
This paper develops and tests a model centered on the critical role of operational resilience in driving export performance in an emerging market within a global, volatile, uncertain, complex and ambiguous environment. We investigate how knowledge management capability can reinforce operational resilience to improve export performance and explore how strategic flexibility and digital transformation maturity shape these effects.
Design/methodology/approach:
We tested the model using data from 400 manufacturing firms from Bangladesh, collected through a multi-wave survey with responses from two mid-level managers per firm. Through a structural path analysis, we explored the intricate connections between KMC-based strategy, operational resilience and export performance. The direct and mediation effects were analyzed using Mplus 8 and Python packages. Specifically, the moderation effects and the Johnson–Neyman (J–N) plot were tested using the Python PyProcess package.
Findings:
The findings confirmed the robustness of our conceptual model. Further analysis revealed that strategic flexibility has a stronger moderated mediation effect than the firms' maturity of the digital transformation.
Originality/value:
The study advances a unique integration of the information processing view with the knowledge-based view of the firm in exploring key factors underlying the export performance in emerging market firms. By establishing how pre-shock capabilities, such as strategic flexibility and maturity of digital transformation, serve as essential components for improving a firm's operational resilience we add to the export managers' toolkit for improving export performance
Adult obesity and risk of severe infections: a multicohort study with global burden estimates
No full textSummary
Background:
Adult obesity has been linked to specific infections, but evidence across the full spectrum of infectious diseases remains scarce. In this multicohort study with impact modelling, we examined the association between this preventable risk factor and the incidence, hospitalisations, and mortality of 925 bacterial, viral, parasitic, and fungal infectious diseases, and estimated their global and regional attributable impact.
Methods:
We used pooled data from two Finnish cohort studies and repeated analyses in an independent population from the UK Biobank. BMI was assessed at baseline (1998–2002 in the Finnish studies; 2006–10 in UK Biobank), and participants were categorised as having healthy weight (18·5–24·9 kg/m2), overweight (25·0–29·9 kg/m2) or obesity, classified as class I (30·0–34·9 kg/m2), class II (35·0–39·9 kg/m2), or class III (≥40·0 kg/m2). Participants were followed up through national hospitalisation and mortality registries for hospital admissions and deaths due to infectious diseases. Using hazard ratios derived from the Finnish cohorts and UK Biobank, along with obesity prevalence estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study database, we estimated the proportion of fatal infections attributable to obesity globally, regionally, and by country for the years 2018 (before), 2021 (during), and 2023 (after the COVID-19 pandemic).
Findings:
The analysis included 67 766 adults (mean age 42·1 [SD 10·8] years; 49 516 [73·1%] females, 18 250 [26·9%] males) from the Finnish cohorts and 479 498 adults (mean age 57·0 [SD 8·1] years; 261 084 [54·4%] females, 218 414 [45·6%] males) from UK Biobank. Participants had no recent history of infection-related hospitalisations at baseline. During follow-up, there were 8230 incident infection cases in the Finnish cohorts and 81 945 in UK Biobank. Compared with individuals of healthy weight, those with class III obesity had a three-times higher risk of infection-related hospital admissions (Finnish cohorts 2·75 [95% CI 2·24–3·37], UK Biobank 3·07 [2·95–3·19]), death (Finnish cohorts 3·06 [1·25–7·49], UK Biobank 3·54 [3·15–3·98]), or either outcome (Finnish cohorts 2·69 [2·19–3·30], UK Biobank 3·07 [2·95–3·19]). The corresponding pooled hazard ratio for either fatal or non-fatal severe infection among individuals with any obesity (classes I–III) was 1·7 (1·7–1·8). This association was consistent across different indicators of obesity (BMI, waist circumference, and waist-to-height ratio), demographic and clinical subgroups, and a wide range of infections (non-fatal and fatal, acute and chronic, bacterial and viral [including subtypes], and parasitic and fungal). Applying these risk estimates to global burden of disease data, the population attributable fractions of infection-related deaths due to obesity were estimated at 8·6% (6·6–11·1) in 2018, 15·0% (12·8–17·4) in 2021, and 10·8% (8·6–13·6) in 2023.
Interpretation:
Adult obesity is a risk factor for infection-related hospitalisations and mortality across diverse pathogen types, populations, and baseline clinical profiles, with evidence suggesting that approximately one in ten infection-related deaths worldwide might be attributable to obesity.
Funding:
Wellcome Trust, Medical Research Council, and Research Council of Finland.Summary
Background:
Adult obesity has been linked to specific infections, but evidence across the full spectrum of infectious diseases remains scarce. In this multicohort study with impact modelling, we examined the association between this preventable risk factor and the incidence, hospitalisations, and mortality of 925 bacterial, viral, parasitic, and fungal infectious diseases, and estimated their global and regional attributable impact.
Methods:
We used pooled data from two Finnish cohort studies and repeated analyses in an independent population from the UK Biobank. BMI was assessed at baseline (1998–2002 in the Finnish studies; 2006–10 in UK Biobank), and participants were categorised as having healthy weight (18·5–24·9 kg/m2), overweight (25·0–29·9 kg/m2) or obesity, classified as class I (30·0–34·9 kg/m2), class II (35·0–39·9 kg/m2), or class III (≥40·0 kg/m2). Participants were followed up through national hospitalisation and mortality registries for hospital admissions and deaths due to infectious diseases. Using hazard ratios derived from the Finnish cohorts and UK Biobank, along with obesity prevalence estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study database, we estimated the proportion of fatal infections attributable to obesity globally, regionally, and by country for the years 2018 (before), 2021 (during), and 2023 (after the COVID-19 pandemic).
Findings:
The analysis included 67 766 adults (mean age 42·1 [SD 10·8] years; 49 516 [73·1%] females, 18 250 [26·9%] males) from the Finnish cohorts and 479 498 adults (mean age 57·0 [SD 8·1] years; 261 084 [54·4%] females, 218 414 [45·6%] males) from UK Biobank. Participants had no recent history of infection-related hospitalisations at baseline. During follow-up, there were 8230 incident infection cases in the Finnish cohorts and 81 945 in UK Biobank. Compared with individuals of healthy weight, those with class III obesity had a three-times higher risk of infection-related hospital admissions (Finnish cohorts 2·75 [95% CI 2·24–3·37], UK Biobank 3·07 [2·95–3·19]), death (Finnish cohorts 3·06 [1·25–7·49], UK Biobank 3·54 [3·15–3·98]), or either outcome (Finnish cohorts 2·69 [2·19–3·30], UK Biobank 3·07 [2·95–3·19]). The corresponding pooled hazard ratio for either fatal or non-fatal severe infection among individuals with any obesity (classes I–III) was 1·7 (1·7–1·8). This association was consistent across different indicators of obesity (BMI, waist circumference, and waist-to-height ratio), demographic and clinical subgroups, and a wide range of infections (non-fatal and fatal, acute and chronic, bacterial and viral [including subtypes], and parasitic and fungal). Applying these risk estimates to global burden of disease data, the population attributable fractions of infection-related deaths due to obesity were estimated at 8·6% (6·6–11·1) in 2018, 15·0% (12·8–17·4) in 2021, and 10·8% (8·6–13·6) in 2023.
Interpretation:
Adult obesity is a risk factor for infection-related hospitalisations and mortality across diverse pathogen types, populations, and baseline clinical profiles, with evidence suggesting that approximately one in ten infection-related deaths worldwide might be attributable to obesity.
Funding:
Wellcome Trust, Medical Research Council, and Research Council of Finland