Lund University Publications
Not a member yet
244244 research outputs found
Sort by
Managing coastal aquifer salinity risks : Strategies for balance, recharge, and crop adaptation
No full textThe aim of this study was to assess aquifer salinity risk by identifying high-risk land-use zones and proposing a new paradigm for groundwater resource management under salinization pressure. Salinity risk modeling was conducted with consideration of land-use patterns and agricultural production in the study region. The results revealed that approximately 26% of the aquifer lies within high-risk salinity zones. To mitigate this risk, three management strategies were evaluated: water balancing, crop pattern adaptation, and aquifer recharge. Implementation of these strategies reduced the extent of high and very high salinity risk areas by 6%, 9%, and 12.5%, respectively. Similarly, the maximum intensity of salinity risk decreased by 13%, 35%, and 52%, while the average intensity declined by 9%, 14%, and 55% under the balancing, adaptation, and recharge scenarios, respectively. These findings demonstrate that integrated groundwater management approaches, particularly recharge enhancement, can substantially reduce salinity risk and improve the resilience of coastal aquifers
Percutaneous and surgical management of aortic stenosis in the SWEDEHEART registry (2013–2023) : a nationwide observational study
No full textBackground: Management of severe aortic stenosis (AS) has evolved over the past decade, driven by the widespread adoption of transcatheter aortic valve implantation (TAVI). This study aims to assess trends in procedural volumes, patient characteristics, and outcomes for patients undergoing TAVI or surgical aortic valve replacement (SAVR) in Sweden. Methods: This was a descriptive, non-comparative, nationwide cohort study using the SWEDEHEART registry. We included 21,383 patients who underwent TAVI or SAVR between 2013 and 2023 (11,366 TAVI and 10,017 SAVR). Trends in patient characteristics, preoperative risk, complications and mortality were examined. Findings: TAVI procedures increased from 307 (26.1%, n = 307/1174) in 2013 to 1851 (71.2%, n = 1851/2601) in 2023, while SAVR volumes declined from ∼1000 annually before 2018 to roughly 750 procedures annually. Median age of TAVI patients were 81 (IQR 77, 85) years and 71 (IQR 65, 76) years for SAVR patients. The median EuroSCORE II for TAVI decreased from 5.6 (IQR 3.3, 10.2) to 2.7 (IQR 1.7, 4.6) (p = 0.002), and STS-PROM from 3.3 (IQR 1.9, 4.1) to 1.6 (IQR 1.1, 2.8) (p = 0.0021). Among SAVR patients, EuroSCORE II decreased from 1.5 (IQR 1.0, 2.3) to 1.3 (IQR 0.9, 2.1) (p = 0.022) and STS-PROM from 1.8 (IQR 1.2, 3.0) to 1.6 (IQR 1.1, 2.6) (p = 0.0082). Any in-hospital complications declined significantly for TAVI (29.2%, n = 210/719 to 13.2%, n = 244/1851), while SAVR complication rates increased slightly (18.4%, n = 354/1921 to 18.7%, n = 140/750). In-hospital mortality for TAVI declined from 3.6% (n = 26/719) to 1.0% (n = 18/1851), and 1-year mortality from 11.1% to 6.9% (p = 0.019). SAVR in-hospital all-cause death decreased from 1.6% to 0.4% (n = 3/750) and 5.0% to 2.2% for 1-year mortality (p = 0.013). Interpretation: TAVI has become the predominant treatment strategy for AS in Sweden expanding access within the treated cohort. Despite this, current 2023 SAVR results demonstrate similar in-hospital complication rates compared to TAVI (18.7% vs 13.2%), but lower in-hospital (0.4% vs 1.0%) and 1-year mortality rates (2.2% vs 6.9%). Funding: This study was supported by ALF and national research funding bodies
Giant branch planetary systems: Dynamical and radiative evolution
No full textIn seven billion years, the Sun will be dead. As stars like the Sun pass from their present state to that of a dead white dwarf star, they undergo two phases of extremely high luminosity and radius—the red giant branch and the asymptotic giant branch—during which they will lose half or more of their mass. These changes to the star have a significant impact on orbiting planets, asteroids, and comets. The large stellar radius (beyond the current orbit of the Earth) leads to the engulfment of bodies entering the stellar envelope, a process enhanced by strong tidal interactions. The high luminosity affects bodies’ orbits and physical properties, while mass loss can later trigger the destabilization of bodies around white dwarfs. It is necessary to understand these processes to understand the future of our Solar System and to interpret growing observations of planetary systems around evolved stars
Inequality in Ghana: Assessing the Impact of Government Tax and Expenditure Policies Over a Century
No full textAlthough rising inequality in sub-Saharan Africa has revived debates on the distributional effects of government tax and expenditure policies, there are relatively few long-term empirical studies on this issue. This chapter examines how government fiscal policies—both taxation and public spending—have evolved and shaped inequality trends in colonial and postcolonial Ghana. It finds that fiscal policy has generally had limited redistributive impact, due to the narrow tax base and a persistent bias in public spending toward the export sector. While calls for African governments to learn to tax more and spend better in order to reduce inequality are not misplaced, an understanding of the structural and political constraints that have historically limited the redistributive potential of fiscal policy is even more urgently needed
Phylogeny, systematics and evolution of mimicry patterns in Neotropical limenitidine butterflies
No full textThe Neotropical butterfly genus Adelpha Hübner exhibits remarkable species diversity and striking convergence in wing colour patterns potentially explained by mimicry, making it an exceptional model for exploring trait evolution and its relationship with speciation. To date, unresolved phylogenetic relationships hinder a comprehensive understanding of the evolutionary biology of the genus. Using a novel multi-marker dataset combining one mitochondrial and 15 nuclear gene fragments, we generate the most comprehensive phylogeny of the genus Adelpha to revisit its systematics and investigate the evolution of mimicry colour patterns. Our dataset encompasses 83 of the 87 known extant species and six Limenitis species that were recently excluded from Adelpha (134 of c. 160 subspecies in total), collectively displaying 14 distinct mimicry patterns. We provide conclusive evidence that corroborates previous work on the polyphyly of Adelpha as historically conceived and describe the genus Adelphina Páez & Willmott n. gen. to stabilise the nomenclature. The comprehensive phylogeny provided in this study lays a solid foundation for future research into the processes driving diversification within these species interacting through mimicry. Ancestral character state reconstruction reveals the gradual evolution of mimicry patterns. The more common mimicry pattern IPHICLUS (forewing with orange subapical spot and white band) is inferred as ancestral, but repeated convergent evolution is also recovered. Evolutionary convergence is also observed for the second most abundant mimicry pattern, COCALA (orange-white banded). Increased rates of mimicry pattern evolution are also found towards the equator. These results underscore the complexity of mimicry evolution in the Neotropical limenitidines, i.e., Adelpha and Adelphina n. gen., emphasising the need to explore its interplay with other biotic and abiotic factors
Targeting Antiviral Mechanisms in Asthma: Pharmacological Modulation of Epithelial Viral Sensing
No full textAsthma is a heterogeneous chronic respiratory disease affecting millions worldwide, and the prevalence is increasing. Although most patients achieve disease control using mainstay treatment with inhaled corticosteroids and bronchodilators, a subgroup of patients suffers from uncontrolled disease. Developing novel therapeutic strategies for these patients is therefore of great importance. When treatment is insufficient, patients may experience an acute worsening of symptoms, known as asthma exacerbations. These episodes are triggered by various environmental factors, with rhinovirus (RV) infections being the most common cause. RV primarily targets the bronchial epithelium, which functions both as a physical barrier and as an initiator of antiviral immune responses. In asthma, the bronchial epithelial function is dysregulated, characterized by barrier impairment, overproduction of epithelial alarmins and deficient production of antiviral interferons. This thesis aimed to investigate how pharmacological agents modulate altered immune mechanisms in the asthmatic bronchial epithelium. In addition, we aimed to assess pulmonary immune responses in commonly used inbred mouse strains in response to a viral mimic. We demonstrate that imiquimod, a TLR7 agonist, suppresses the poly(I:C) (a viral replication mimic)-induced pro-inflammatory and alarmin responses, while enhancing antiviral signaling in bronchial epithelial cells (BECs) from patients with asthma. We also demonstrate that following three days of intranasal poly(I:C) administration, BALB/c and C57Bl/6J, but not C57Bl/6N, mice show upregulation of general inflammatory markers in the lung, identifying them as suitable models for studying antiviral immune responses in the lung. Furthermore, we show that azithromycin, a macrolide antibiotic, enhances antiviral signaling in BECs from patients with asthma regardless of clinical asthma phenotype, via the TBK1/IKKε-IRF3/IRF7 axis. Interestingly, a macrolide with negligible antimicrobial activity showed similar effects, suggesting that the antiviral effects of azithromycin are independent of its antimicrobial activity. This thesis sheds light on different pharmacological approaches to normalizing altered immune mechanisms in the asthmatic bronchial epithelium and broadens our understanding of the immunomodulatory mechanisms of macrolide antibiotics
Caesarean section rates in public vs private hospitals in Europe : a systematic review and meta-analysis using the Robson ten group classification system
No full textINTRODUCTION: Since the last two decades, there has been a dramatic rise in caesarean sections (CS) throughout the world. This increase has been seen even in Europe, where rates vary significantly from 17% in Northern Europe to 56% in the South. Although, CS can be a lifesaving intervention when medically necessary, non-essential CS are associated with short- and long-term complications for both the mother and newborn. To curb this rising trend, it is important to understand underlying causes behind regional disparities, including differences between public and private hospitals.OBJECTIVE: To investigate variations in CS rates between public and private hospitals across European regions and at a country level using the Robson Ten Group Classification.METHODS: A systemic review of studies published between 1st January 2000 and 12th March 2025 was conducted using MEDLINE/PubMed, CINAHL, EMBASE, Global Index Medicus, Web of Science and Cochrane library, analysing CS rates in 25 European countries. All studies reporting births in Europe, Robson group, written in English or Swedish were included. The developed protocol was prospectively registered in PROSPERO (Registration number 513579). Meta-analysis using absolute numbers and percentages was conducted to compare the birth rates at country and regional levels. To assess the risk of bias, two reviewers independently evaluated the quality of the studies included using a modified Newcastle-Ottawa Scale adapted for cohort studies.RESULTS: Of 1385 articles, 46 were eligible for inclusion in the final analysis. A total of 12 505939 births were analysed, with 8 543803 (68.3%) occurring in public hospitals and 3 962136 (31.7%) in private hospitals. Overall, Southern Europe illustrated the highest CS rate (54.9% of all births) as compared to Northern Europe (16.9%). There was a lack of reporting from private hospitals, with data only for Southern Europe, where CS rates were significantly higher in private (73.1%) as compared to public (40.9%) hospitals. The largest differences were seen for low-risk women Robson Group 1, 2, 3 and 4 (private vs public: 67.8 vs 28%, 67.6 vs 39.7, 26.9 vs 9.1% and 38 vs 18% respectively).CONCLUSION: High CS rates were observed across Europe, with Southern Europe reporting the highest levels. Rates were consistently higher in private compared to public hospitals. In both settings, Group 5 (women with a previous CS) was the largest contributor to the overall CS rate. However, low-risk women in private hospitals (Groups 1 and 2) had twice the CS rates compared with public hospitals. These findings highlight that the excess CS burden in private hospitals is largely driven by unnecessary procedures in low-risk groups. There is an urgent need for interventions that promote evidence-based care and reduce unnecessary CS especially among low-risk women
Myeloid-Derived Suppressor Cells (MDSCs) Suppress T-Cell Proliferation Less Than Mature Neutrophils in Blood and Bone Marrow From Multiple Myeloma Patients
No full textMultiple myeloma (MM) is the second most common hematological malignancy, characterized by a clonal expansion of malignant plasma cells in bone marrow. Monoclonal gammopathy of undetermined significance (MGUS) is the premalignant condition of MM. The tumor microenvironment is thought to influence the progression from premalignant conditions. Myeloid-derived suppressor cells (MDSCs) are a heterogenous group of different cellular subsets with myeloid origin, characterized by their ability to inhibit T-cell responses. MDSC are thought to play an important immunoregulatory role in different diseases, and in many cancers their levels seem to correlate with a poor prognosis. There are three different subsets, the neutrophil-like polymorphonuclear (PMN)-MDSC, the monocyte-like (M)-MDSC, and the immature early (e)MDSC. In this study, we investigate the levels and functions of all MDSC subsets in the bone marrow of both MGUS and MM patients and compare it to blood MDSC. We found that MDSC levels are not increased in neither the blood nor bone marrow of MGUS or MM patients, and they lack strong T-cell suppressive abilities. Blood PMN-MDSC seems to have a small inhibitory effect, but mature neutrophils were more suppressive. Interestingly, eMDSC levels were decreased in the blood of MM patients. Our data indicate that MDSC are not key players in the pathogenesis of MM, but that mature neutrophils may be more important as they have a stronger immunoregulatory effect