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Background: In Sweden, as in other countries, individuals with immigrant backgrounds are disproportionately represented within the incarcerated population. This study examined the association between immigrant background and future incarceration for individuals assessed for illicit substance use severity, while considering their prior incarceration history., Methods: Using data from Swedish Addiction Severity Index (ASI) assessments linked to register data from Statistics Sweden, we employed Zero-Inflated Negative Binomial (ZINB) regression models to analyse differences in incarceration histories within five years before and after ASI assessments based on immigrant backgrounds. Additionally, Cox proportional-hazard models were used to assess the likelihood of post-assessment incarceration among these groups., Results: Immigrant background was positively associated with pre- and post-assessment incarceration. First- and second-generation immigrants from the Global South had longer periods of incarceration in the five years before assessments compared to native Swedes. Post-assessment, first-generation immigrants showed longer periods of incarceration. Survival analyses supported these findings, indicating a higher risk of prolonged post-assessment incarceration among all immigrant groups, particularly first-generation immigrants from the Global South., Conclusion: Among individuals assessed for illicit drug use within Swedish municipalities, those with immigrant backgrounds faced higher incarceration risks, even after controlling for substance use severity and prior incarceration. Tailored interventions and support systems are vital to prevent re-entry into the criminal justice system. Timely actions can break re-offending cycles, redirecting paths away from reoffending and towards legal reintegration, thereby reducing incarceration and recidivism rates., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Laparoscopic distal pancreatectomy is being implemented worldwide. The aim of this study was to perform a cost-effectiveness analysis from a health care perspective., Methods: This cost-effectiveness analysis was based on the randomized controlled trial LAPOP, where 60 patients were randomized to open or laparoscopic distal pancreatectomy. For the follow-up of two years, resource use from a health care perspective was recorded, and health-related quality of life was assessed using the EQ-5D-5L. The per-patient mean cost and quality-adjusted life years (QALYs) were compared using nonparametric bootstrapping., Results: Fifty-six patients were included in the analysis. The mean health care costs were lower, €3863 (95% CI: -€8020 to €385), for the laparoscopic group. Postoperative quality of life improved with laparoscopic resection and resulted in a gain in QALYs of 0.08 (95% CI: -0.09 to 0.25). The laparoscopic group had lower costs and improved QALYs in 79% of bootstrap samples. With a cost-per-QALY threshold of €50 000, 95.4% of the bootstrap samples were in favour of laparoscopic resection., Conclusion: Laparoscopic distal pancreatectomy is associated with numerically lower health care costs and improvements in QALYs compared with the open approach. The results support the ongoing transition from open to laparoscopic distal pancreatectomies., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Total pancreatectomy (TP) is a major surgical procedure that involves lifelong exocrine and endocrine pancreatic insufficiency. Qualitative evidence is sparse regarding patients' experiences after the operation. The aim of this study was to explore patients' experiences of symptoms that occur after TP and how these symptoms affect their health and life situations., Methods: A qualitative design with prospective consecutive sampling and an inductive thematic analysis was used. Semistructured interviews were postoperatively performed at 6-9 months with 20 patients undergoing TP in two university hospitals in Sweden., Results: Two main themes emerged from the analysis: "Changes in everyday life" and "Psychological journey". Patients experienced symptoms related to diabetes as the major life change after the operation, and they were also limited by symptoms of exocrine insufficiency, difficulties with food intake and physical weakness. In the psychological journey that patients underwent, the support received from family, friends and the health care system was important. Moreover, patients experienced a general need for more extensive information, especially regarding diabetes., Conclusion: Patients experience a lack of sufficient support and education after TP, particularly concerning their diabetes. Further efforts should be undertaken to improve information and the organization of diabetes care for this patient group., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: With the poor prognosis of pancreatic cancer and the high rate of postoperative complications after pancreaticoduodenectomy, it is important to evaluate how the operation affects patients' quality of life., Methods: This single-centre study included all patients undergoing pancreaticoduodenectomy from 2006 to 2016. Quality of life was measured with two questionnaires preoperatively, and at 6 and 12 months postoperatively. Comparisons between groups were made using a linear mixed models analysis., Results: Of 279 patients planned for pancreaticoduodenectomy, 245 underwent the operation. The postoperative response rates were all 80% or more. Differences were found in one domain between the early and late time periods and three domains between patients receiving and not receiving adjuvant chemotherapy. No significant differences were found between patients with and without severe postoperative complications. However, the demographic variables of age group, sex, preoperative diabetes and smoking all exerted a significant impact on postoperative quality of life., Conclusion: While little or no impact was shown for the factors of postoperative complications, time period and adjuvant chemotherapy, demographic data, such as age, sex, preoperative diabetes and smoking, had considerable impacts on postoperative quality of life after pancreaticoduodenectomy., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Despite the ban of applying TBT coatings on leisure boats in the late 80s, recent studies show an ongoing spread of TBT from leisure boats, particularly during hull cleaning events. Therefore, countries in EU have adopted expensive measures to clean this wash water. A more cost-efficient measure is to focus directly on the source, i.e. identify leisure boats with high concentrations of TBT and prescribe boat owners to remove the paint. We have developed a new antifouling paint application for a handheld X-ray fluorescence (XRF) analyzer to be used for identifying boats with high area concentrations (µg/cm(2)) of Sn (indication that the hull contains TBT paint residues). Copper and zinc are also included in the application since these metals are used in the vast majority of today's paints. A blind test with up to four layers of TBT-, copper- and zinc-based paints showed good correlation between XRF-measured area concentrations and chemically analyzed concentrations. Future usage of the applications involves identification of boat hulls in particular with high Sn concentrations and also with high Cu and Zn concentrations. This method has the potential to become a useful tool in regulatory management of existence and use of toxic elements on boat hulls., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Sweden's compulsory addiction system treats individuals with severe alcohol and narcotics use disorders. Merging data from three national level register databases of those sentenced to compulsory care from 2001 to 2009 (n=4515), the aims of this study were to: (1) compute mortality rates to compare to the general Swedish population; (2) identify leading cause of mortality by alcohol or narcotics use; and (3) identify individual level characteristics associated with mortality among alcohol and narcotics users. In this population, 24% were deceased by 2011. The most common cause of death for alcohol users was physical ailments linked to alcohol use, while narcotics users commonly died of drug poisoning or suicide. Average age of death differed significantly between alcohol users (55.0) and narcotics users (32.5). Multivariable logistic regression analysis identified the same three factors predicting mortality: older age (alcohol users OR=1.28, narcotic users OR=1.16), gender [males were nearly 3 times more likely to die among narcotics users (p<.000) and 1.6 times more likely to die among alcohol users (p<.01)] and reporting serious health problems (for alcohol users p<.000, for narcotics users p<.05). Enhanced program and government efforts are needed to implement overdose-prevention efforts and different treatment modalities for both narcotic and alcohol users., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Unlabelled: Drop-out of addiction treatment is common, however, little is known about drop-out of compulsory care in Sweden. Data from two national register databases were merged to create a database of 4515 individuals sentenced to compulsory care 2001-2009. The study examined (1) characteristics associated with having dropped out from a first compulsory care episode, (2) the relationship between drop-out and returning to compulsory care through a new court sentence, and (3) the relationship between drop-out and mortality., Methods: Multivariable logistic regression analysis was used to address Aim 1 and Cox proportional hazards regression modeling was applied to respond to Aims 2 and 3., Findings: Age and previous history of crime were significant predictors for drop-out. Clients who dropped out were 1.67 times more likely to return to compulsory care and the hazard of dying was 16% higher than for those who dropped-out., Conclusion: This study finds that 59% of clients assigned to compulsory care drop-out. Younger individuals are significantly more likely to drop-out. Those who drop out are significantly more likely to experience negative outcomes (additional sentence to compulsory care and higher risk of mortality). Interventions need to be implemented that increase motivation of youth to remain in compulsory care., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Data from large-scale registers is often underutilized when evaluating addiction treatment programs. Since many programs collect register data regarding clients and interventions, there is a potential to make greater use of such records for program evaluation. The purpose of this article is to discuss the value of using large-scale registers in the evaluation and program planning of addiction treatment systems and programs. Sweden is used as an example of a country where register data is both available and is starting to be used in national evaluation and program planning efforts. The article focuses on possibilities, limitations and practicalities when using large-scale register data to conduct evaluations and program planning of addiction treatment programs. Main conclusions are that using register data for evaluation provides large amounts of data at low cost, limitations associated to the use of register data may be handled statistically, register data can answer important questions in planning of addiction treatment programs, and more accurate measures are needed to account for the diversity of client populations., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Purpose: This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT)., Methods: The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952)., Results: Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources., Discussion: EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Unlabelled: This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n=296) and clinical staff (n=518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical factors were associated with directors, and staff attitudes about the usefulness of science-based addiction treatment. For both directors and staff working in an organization that was affiliated with a research institution, working in an organization with better internet technology (measured through TCU-ORC scores) and having higher levels of education were all significantly associated with having more positive attitudes regarding science-based addiction treatment., Implications: government policy that promotes the hiring of addiction treatment clinical staff with professional degrees and encourages the development of linkages between addiction treatment researchers and treatment staff may positively impact attitudes and use of evidence-based addiction treatment practices (EBPs) in CBOs., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: This phase II study evaluated the safety and activity of ipilimumab, a fully human mAb that blocks cytotoxic T-lymphocyte antigen-4, in patients with advanced melanoma., Patients and Methods: Patients with previously treated, unresectable stage III/stage IV melanoma received 10 mg/kg ipilimumab every 3 weeks for four cycles (induction) followed by maintenance therapy every 3 months. The primary end point was best overall response rate (BORR) using modified World Health Organization (WHO) criteria. We also carried out an exploratory analysis of proposed immune-related response criteria (irRC)., Results: BORR was 5.8% with a disease control rate (DCR) of 27% (N = 155). One- and 2-year survival rates (95% confidence interval) were 47.2% (39.5% to 55.1%) and 32.8% (25.4% to 40.5%), respectively, with a median overall survival of 10.2 months (7.6-16.3). Of 43 patients with disease progression by modified WHO criteria, 12 had disease control by irRC (8% of all treated patients), resulting in a total DCR of 35%. Adverse events (AEs) were largely immune related, occurring mainly in the skin and gastrointestinal tract, with 19% grade 3 and 3.2% grade 4. Immune-related AEs were manageable and generally reversible with corticosteroids., Conclusion: Ipilimumab demonstrated clinical activity with encouraging long-term survival in a previously treated advanced melanoma population.

In this study, cell nuclei from aneuploid breast cancer samples were sorted with respect to DNA content into pure diploid and aneuploid fractions using flow cytometry. The nuclear proteins were then separated by one-dimensional gel electrophoresis (1D-PAGE) and differences in protein expression patterns, between diploid and aneuploid nuclei from the same tumours, were compared. Using a combination of peptide finger printing and peptide identification by MALDI-TOF mass spectrometry, we identified proteins and confirmed that the proteins were of nuclear origins. The results in this study add further information to the knowledge about the breast cancer disease complexity and heterogeneity at molecular level. For some of the tumours studied different nuclei protein patterns were obtained, in the diploid respective aneuploid nuclei populations, whilst other tumours did not show these differences., (Copyright 2009 Elsevier B.V. All rights reserved.)

A straight-chain oligomeric structure composed of five secoisolariciresinoldiglucoside (SDG) residues interconnected by four 3-hydroxy-3-methyl glutaric acid (HMGA) residues (molecular weight ca. 4000 Da) was assigned to the main lignan of flaxseed on the basis of nuclear magnetic resonance spectroscopy (NMR).

A novel compound, 4,4'-dihydroxy-3,3'-dimethoxy-beta-truxinic acid esterified to sucrose through the fructosyl 3-and 6-carbons (1), was isolated from oat grains (Avena sativa L.). Its structure was determined by a combination of mass spectrometry and 1-D and 2-D NMR. The amounts of 1 in groats of six different oat cultivars ranged from 101 to 150 microg g(-1) (dry wt). None was detected in the hulls. The free diacid, 4,4'-dihydroxy-3,3'-dimethoxy-beta-truxinic acid (2), could not be detected in groats nor in hulls.

Chromatographic separation of the liquid culture filtrate of the basidiomycete fungus Physisporinus sanguinolentus has yielded three new compounds viz., 2-methyl-4-pyrone, 2-methyl-5,6-dihydro-4-pyrone and the pyridone form of 4-hydroxy-2-methylpyridine, together with the known triacetic acid lactone, the sesquiterpene dialdehyde merulidial and a derivative of merulidial. Their structures were elucidated by spectroscopic analysis and by comparison to literature data and a synthetic sample. One of the compounds, merulidial, was shown to inhibit the germination of spores and the hyphal growth of the wood-rotting basidiomycete Heterobasidion annosum and the saprophytic mould Cladosporium cucumerinum.

Research suggests that African-American injection drug users, when compared with other ethnic and racial groups of injection drug users, are more likely to have no history of substance abuse treatment. The project evaluated was designed to attract African-American injection drug users to treatment by providing comprehensive pre-treatment services including street outreach, drop-in center services, case management, and motivational counseling. The overall program goal was to facilitate clients' acceptance of referral to treatment and readiness to utilize treatment. The evaluation described here examines whether, for this African-American population of hard-core drug users, utilization of pre-treatment services improved the intermediary treatment outcomes of entry into and completion of detoxification. Findings showed that high utilization of drop-in center services increased the frequency of entrance into detoxification programs. Entrance into detoxification has been shown to be significantly correlated with (a) entrance into further treatment, (b) reduced HIV/AIDS risk, and (c) successful linkage with health care and social services. Contrary to expectations, high utilization of pre-treatment services was not significantly correlated to increased completion of detoxification.

Three new saponins were isolated from a commercial bark extract of Quillaja saponaria Molina. These compounds were also obtained as degradation products from larger saponins in this extract when treated with strong alkali. The compounds were characterized, using mainly NMR spectroscopy, mass spectrometry and chemical methods, as quillaic acid 3-O-¿beta-D-galactopyranosyl-(1-->2)-beta-D-glucopyranosiduronic acid¿, 3-O-¿alpha-L-rhamnopyranosyl-(1-->3)-[beta-D-galactopyranosyl-(1-->2)] -beta-D-glucopyranosiduronic acid¿ and 3-O-¿beta-D-xylopyranosyl-(1-->3)-[beta-D-galactopyranosyl -(1-->2)]-beta-D-glucopyranosiduronic acid¿, respectively.

Five new compounds, viz. 3,4-dimethoxyphenyl 2-O-(3-O-methyl-alpha-L-rhamnopyranosyl)-beta-D-glucopyranoside, 4'-hydroxyphenacyl beta-D-glucopyranoside, (2R,3R)-2,3-dihydro-7-hydroxy-2-(4'- hydroxy-3'-methoxyphenyl)- 3-hydroxymethyl-5-benzofuranpropanol 4'-O-(3-O-methyl-alpha-L-rhamnopyranoside), 1-(4'-hydroxy-3'-methoxyphenyl)-2-[4"-(3-hydroxypropyl)-2"-methoxyphe noxy]-1,3-propanediol 4'-O-beta-D-xylopyranoside and 3'-O-methylcatechin 7-O-beta-D-glucopyranoside, together with several known compounds were isolated from the root bark of Picea abies. The structures were elucidated on the basis of chemical and spectroscopic evidence.

Persistence in soil of the two herbicides glyphosate and 2,4-D was investigated after application for brush control in conifer reforestation areas. Field experiments were carried out at five sites in southern Sweden and six in northern Sweden. Initially, glyphosate disappeared faster in northern soils than in southern soils. This was probably a result of the higher biological activity in the northern soils. However, small amounts of glyphosate were detected in the northern area long after all traces had disappeared in the south, presumably because of the long period during which the soil remained frozen in the northern area and because of the slow release of vegetation-bound herbicide. One metabolite of glyphosate, aminomethylphosphonic acid (AMPA), persisted longer than glyphosate itself. After 2 years, 8% of the theoretical amount was found in the northern area and, after 1 year, 1% in the southern area. 2,4-D disappeared rapidly from all sites, although minor amounts persisted for several years, probably because of slow release from vegetation-bound residues.