544 research outputs found
The Role of Percutaneous Tibial Nerve Stimulation (PTNS) in Low Anterior Resection Syndrome (LARS): A Systematic Review and Meta-analysis
No full textPurpose: The aim of the present study was to evaluate the pooled efficacy of percutaneous tibial nerve stimulation (PTNS) in patients with low anterior resection syndrome (LARS). Material and Methods: This study was based on the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. The primary endpoint was the pooled effect size of PTNS in LARS score (LARSS). Secondary endpoints included incontinence (Fecal Incontinence Score—FIC, Obstructive Defecation Syndrome—ODS), sexual functionality and quality of life (QoL) questionnaires, and manometric evaluations. Continuous outcomes were reported as weighted mean difference (WMD), with the corresponding 95% confidence interval (95% CI). Quality evaluation was performed via the National Institutes of Health (NIH) quality assessment tool. Results: Overall, 5 studies were included. PTNS resulted to reduced LARSS values (WMD: − 5.68, 95%CI: − 7.73, − 3.63, p < 0.001). A similar effect was noted in St Mark’s FIC (p < 0.001) and ODS (p = 0.02) score. An improvement in several QoL scales was found. There was no effect in sexual functionality and manometric measurements. Compared to sham, PTNS significantly improved LARSS. Conclusions: The application of PTNS in patients with LARS results in an improvement in multiple clinical parameters, including defecation functionality and quality of life. Due to several study limitations, further high quality RCTs are required to delineate the exact efficacy of PTNS. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature
Accelerated Trajectories of Walking Capacity Across the Adult Life Span in Persons With Multiple Sclerosis: An Underrecognized Challenge
No full textBackground. In the general population, trajectories of walking capacity is accelerated and nonlinear with advanced age. Whether this is more pronounced in persons with multiple sclerosis (pwMS), along with the prevalence of dismobility (ie, slow gait speed), are currently unknown. Our objective was to investigate trajectories of walking capacity and prevalence of dismobility across the adult life span in pwMS versus healthy controls (HC). Methods. Data on maximal timed 25-foot walk test (T25FWT), 2-minute walk test (2MWT), and 6-minute walk test (6MWT) along with prevalence of dismobility were assembled from 2 RIMS multicenter studies (n = 502 pwMS; age range 21-77 years, 6 age groups: 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years). HC data were extracted from studies containing normative reference values (n = 1070-3780 HC). Results. Age trajectories of walking capacity was nonlinear and accelerated in pwMS versus HC. While measures of walking capacity in pwMS were suppressed already early in life, the gap between pwMS and HC significantly widened across the 6 age groups (pwMS performed 64%, 70%, 57%, 59%, 51%, and 37% of HC, respectively). This coincided with high prevalences of dismobility in pwMS across the 6 age groups when using usual gait speed cut-point values <1.0 m/s (corresponding to 33%, 32%, 51%, 59%, 75%, and 100%) and <0.6 m/s (corresponding to 19%, 12%, 26%, 23%, 33%, and 43%), markedly exceeding that observed in HC. Conclusion. The present data on walking capacity provide evidence for an accelerated deterioration in pwMS with advanced age, coinciding with high prevalences of dismobility (ie, slow gait speed).The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was partially funded via an unrestricted educational grant from Novartis Pharma AG to Rehabilitation in Multiple Sclerosis, the European network for best practice and research in MS rehabilitation (eurims.org).Hvid, LG (reprint author), Aarhus Univ, Sect Sport Sci, Dept Publ Hlth, Dalgas Ave 4, DK-8000 Aarhus C, Denmark.
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Author Correction: A new ape from Türkiye and the radiation of late Miocene hominines
No full textCorrection to: Communications Biology, published online 23 August 2023. In the original version of the Article, two authors and their affiliations were omitted. In the original version of the Article, author first names were not provided for all authors. The corrected author list and affiliations are provided below. This has now been corrected in the HTML and PDF versions of the article. Ayla Sevim-Erol1, David R. Begun2, Alper Yavuz3, Erhan Tarhan4, Çilem Sönmez Sözer1, Serdar Mayda5, Lars W. van den Hoek Ostende6, Robert M. G. Martin2 ; M. Cihat Alçiçek7 1 Ankara University, Faculty of Languages History and Geography, Department of Anthropology, Ankara, Türkiye 2 Department of Anthropology, University of Toronto, Toronto, ON, Canada 3 Mehmet Akif Ersoy University of Science and Letters, Department of Anthropology, Burdur, Türkiye 4 Hitit University Faculty of Science and Letters, Department of Anthropology, Çorum, Türkiye 5 Ege University Fakulty of Science, Department of Biology, İzmir, Türkiye 6 Naturalis Biodiversity Center, Leiden, The Netherlands 7 Pamukkale University, Department of Geology, 20070 Denizli, Türkiye The Author Contributions section should read “A.S.E. is the PR of the project, secured funding for excavations and lab analysis and directed excavations. A.S.E. and D.R.B. are responsible for data curation, acquired funding and supervised research. D.R.B. conceptualized the analysis, conducted the investigation, developed the methodology, prepared the original draft and all subsequent versions. C.S.S., S.M., L.W.vdH. and C.A. contributed their analysis of geological and paleontological results. R.M.G.M. was responsible for the segmentation and analysis of the scans of the mandible. A.Y and E.T. participated in the excavations.” This has now been corrected in the HTML and PDF versions of the article. © 2023, Springer Nature Limited
How are Green National Accounts Produced in Practice?
No full textDuring the last part of the twentieth century, the effect of human activity upon the environment became an important policy issue. There is now a growing concern about how economic activity affects the environment and it has become more and more recognised that economic growth is dependent upon the provision of environ-mental services. To be able to combine economic growth with a healthy environment in terms of a sustainable use of natural resources, a better understanding of the rela-tionships between economy and ecology needs to be developed.
The Role of High-Tech Capital Formation for Swedish Productivity Growth
No full textWhile using new data and standard growth-accounting techniques, this paper takes a closer look at the Swedish productivity revival in the second half of the 1990s. In particular, I find large total factor productivity growth in high-tech producing sectors and capital deepening associated with high-tech equipment elsewhere. In addition, for high-tech producers, high-tech capital deepening has as a rule contributed negatively to labor productivity growth - a result above all driven by large increases in hours worked in this sector. I also find that in the business sector, the contribution from high-tech capital deepening to labor productivity growth increased from about 1 percent 1994 to 9 percent 1999.
Future Waste Scenarios for Sweden based on a CGE-model
No full textOver the last decades, waste quantities have grown steadily in close relation to economic growth. To tackle the problem of continuing waste growth within the EU, waste prevention was listed among four top priorities in the EU Sixth environment Action Programme. A Computable General Equilibrium (CGE) model is here used for projecting future quantities of hazardous and non-hazardous waste in Sweden to 2030. The effects of driving forces behind waste generation are illustrated by comparing the results of waste projections for a Baseline scenario and four alternative scenarios. The scenarios differ mainly in GDP growth rates and in the assumptions about future waste intensities of the economic activities of firms and households. We use a high-resolution data set on waste flows of 18 various types of non-hazardous waste and 16 various types of hazardous waste attributed to six waste-generating sources for the base year 2006. Waste generated in the scenarios, thus, relate to firms’ material input, output, employees, capital scrapping and fuel combustion as well as households’ consumption. The impact of economic growth in increasing the generation of nonhazardous and hazardous waste is apparent when comparing the growth of waste from 2006 to 2030 in the five scenarios. On the contrary, technological change resulting in less waste intensive production processes and changed behaviour among households, making their activities less waste intensive, have a strong reducing effect, especially on generation of non-hazardous waste relating to firms’ material input.general equilibrium model; waste generation; decoupling; waste intensities waste scenarios.
The EMEC model: Version 2.0
No full textThe present paper introduces a new version of an applied general equilibrium model of the Swedish economy: Environmental Medium Term Economic Model (EMEC). The model is used at NIER for analysing economic implications for households and firms of the Swedish environmental policy. The economy and the environment interact in the model and thus, we can analyse the economic implica-tions of various environmental policy measures, such as a CO2-tax, a CO2-ceiling and CO2-trading. The model captures also ancillary benefits of climate policy for NOx, SO2, PM10 and PM20. This new version of EMEC, in addition, analyses the effects of road user charges and the economic impact of environmental policy measures on six types of households, as transport demand is represented in a much more detail and as households are distributed, by disposal income and residence. Furthermore, the model distinguishes 26 industries, 33 composite commodities, 26 consumer goods, two kinds of labour and eight pollutants. The model produces results for endogenous variables, which can be interpreted fully in terms of the model’s theory, data and the assumptions underlying the exogenous variables.CGE-model; Sectors; Pollutants; Factors of production; Substitution; Sweden
Antithrombotic treatment strategies after PCI – Authors' reply
No full textVranckx, P (reprint author), Hasselt Univ, Jessa Ziekenhuis, Fac Med & Life Sci, Dept Cardiol & Intens Care, B-3500 Hasselt, Belgium.
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Psychosocial stressors and depression at a Swedish primary health care centre. A gender perspective study
No full textAbstract Background Psychosocial stress may account for the higher prevalence of depression in women and in individuals with a low educational background. The aim of this study was to analyse the association between depression and socio-demographic data, psychosocial stressors and lifestyle circumstances from a gender perspective in a relatively affluent primary care setting. Methods Patients, aged 18- 75 years, visiting a drop-in clinic at a primary care health centre were screened with Beck's Depression Inventory (BDI). The physicians used also targeted screening with BDI. A questionnaire on socio-demographic data, psychosocial stressors and use of alcohol and tobacco was distributed. Among patients, who scored BDI ≥10, DSM-IV-criteria were used to diagnose depression. Of the 404 participants, 48 men and 76 women were diagnosed with depression. The reference group consisted of patients with BDI score Results The same three psychosocial stressors: feeling very stressed, perceived poor physical health and being dissatisfied with one's family situation were associated with depression equally in men and women. The negative predictive values of the main effect models in men and women were 90.7% and 76.5%, respectively. Being dissatisfied with one's work situation had high ORs in both men and women. Unemployment and smoking were associated with depression in men only. Conclusions Three questions, frequently asked by physicians, which involve patient's family and working situation as well as perceived stress and physical health, could be used as depression indicators in early detection of depression in men and women in primary health care.</p
Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study
No full textAbstract Background Survivers of stroke or transient ischaemic attacks (TIA) are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and patients' knowledge about risk factors, and patients' knowledge about their preventive treatment for stroke/TIA. Methods A questionnaire was distributed to 240 patients with stroke/TIA diagnoses, and 182 patients (76%) responded. We asked 13 questions about diseases/conditions and lifestyle factors known to be risk factors and four questions regarding other diseases/conditions ("distractors"). The patients were also asked whether they considered each disease/condition to be one of their own. Additional questions concerned the patients' social and functional status and their drug use. The t-test was used for continuous variables, chi-square test for categorical variables, and a regression model with variables influencing patient knowledge was created. Results Hypertension, hyperlipidemia and smoking were identified as risk factors by nearly 90% of patients, and atrial fibrillation and diabetes by less than 50%. Few patients considered the distractors as stroke/TIA risk factors (3-6%). Patients with a family history of cardiovascular disease, and patients diagnosed with carotid stenosis, atrial fibrillation or diabetes, knew these were stroke/TIA risk factors to a greater extent than patients without these conditions. Atrial fibrillation or a family history of cardiovascular disease was associated with better knowledge about risk factors, and higher age, cerebral haemorrhage and living alone with poorer knowledge. Only 56% of those taking anticoagulant drugs considered this as intended for prevention, while 48% of those taking platelet aggregation inhibitors thought this was for prevention. Conclusions Knowledge about hypertension, hyperlipidemia and smoking as risk factors was good, and patients who suffered from atrial fibrillation or carotid stenosis seemed to be well informed about these conditions as risk factors. However, the knowledge level was low regarding diabetes as a risk factor and regarding the use of anticoagulants and platelet aggregation inhibitors for stroke/TIA prevention. Better teaching strategies for stroke/TIA patients should be developed, with special attention focused on diabetic patients.</p
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