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This study aimed to investigate economic self-sufficiency for immigrants, and how health status affected self-sufficiency. The proportion of self-sufficiency during years 1–10 after receiving a residence permit is presented for all non-European labour immigrants (n = 1259) and refugees (n = 23,859), aged 18–54, who immigrated to Sweden 2000–2006, and compared to a control group of Swedish-born (n = 144,745). The risk of not being self-sufficient in year 10 was analysed with Cox regression models, and the results are presented as hazard ratios (HRs) with 95% confidence intervals (CIs). Moreover, the impact on the self-sufficiency of having a diagnosis from specialised health care during the first five years in Sweden was analysed. The results showed that half of the refugees and three-quarters of the labour immigrants were self-sufficient 10 years after residency. The adjusted risk of not being self-sufficient at year 10 was 80% higher among labour immigrants (HR = 1.8; CI = 1.6–2.0) and more than two-fold among refugees (HR = 2.7; CI = 2.6–2.8) compared to the Swedish-born. Having a diagnosis from specialised health care during the first five years in Sweden had an impact on self-sufficiency in all groups; however, the impact of having a diagnosis did not differ between refugees and Swedish-born. Measures must be taken to increase immigrants’ work participation.

Two mathematical models of human thermal regulation include the rational Predicted Heat Strain (PHS) and the thermophysiological model by Fiala. The approaches of the models are different, however, they both aim at providing predictions of the thermophysiological responses to thermal environments of an average person. The aim of this study was to compare and analyze predictions of the two models against experimental data. The analysis also includes a gender comparison. The experimental data comprised of ten participants (5 males, 5 females, average anthropometric values were used as input) conducting an intermittent protocol of rotating tasks (cycling, stacking, stepping and arm crank) of moderate metabolic activities (134-291W/m2) with breaks in-between in a controlled environmental condition (34°C, 60% RH). The validation consisted of the predictions' comparison against experimental data from 2.5h of data of rectal temperature and mean skin temperature based on contact thermometry from four body locations. The PHS model over-predicted rectal temperatures during the first activity for males and the cooling effectiveness of sweat in the recovery periods, for both males and females. As a result, the PHS simulation underestimated the thermal strain in this context. The Fiala model accurately predicted the rectal temperature throughout the exposure. The fluctuation of the experimental mean skin temperature was not reflected in any of the models. However, the PHS simulation model showed better agreement than the Fiala model. As both models predicted responses more accurately for males than females, we suggest that in future development of the models it is important to take this result into account. The paper further discusses possible sources of the observed discrepancies and concludes with some suggestions for modifications.

Et arbeidsliv som prioriterer forebyggende arbeidsmiljoarbeid, er viktig for a sikre helse, sikkerhet og hoy arbeidsdeltakelse. Denne rapporten oppsummerer forskningslitteraturen som omhandler arbe ...

highlights abstract Objective: It is still not clarified whether spasticity contributes to impairments of gait function. Here we compared biomechanical measures of muscle weakness and stiffness of ankle muscles to impairments of gait function in adults with cerebral palsy (CP). Methods: Twenty-four adults with CP (mean age 34.3, range 18-57 years) and fifteen healthy age- matched controls were biomechanically measured for passive and reflex-mediated stiffness of the ankle plantarflexors at rest, maximal voluntary plantarflexion and dorsiflexion effort (MVCpf,df) and rate of force development (RFDpf,df). Kinematic analysis of the ankle joint during treadmill walking was obtained by 3- D motion analysis. Results: Passive stiffness was significantly increased in adults with CP compared to controls. Passive stiff- ness and RFDdf were correlated to reduced toe lift. RFDpf provided the best correlation to push-off velo- city, range of movement in the ankle joint and gait speed. Reflex-mediated stiffness was not correlated to any parameters of impaired gait. Conclusions: Impaired gait function in adults with CP is associated with reduced RFD and increased pas- sive stiffness of ankle muscles. Significance: These findings suggest that reduced rapid force generation and increased passive stiffness of ankle muscles rather than increased reflex-mediated stiffness (spasticity) likely contributes to impaired gait function in adults with CP.

Background A systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada. Methods We established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000–2016 and checked the reference lists of all included papers. Results Eighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited. Conclusion Some indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies. Electronic supplementary material The online version of this article (10.1186/s12889-018-5703-3) contains supplementary material, which is available to authorized users.

Background: Sickness absence with cash benefits from the sickness insurance gives an opportunity to be relieved from work without losing financial security. There are, however, downsides to taking sickness absence. Periods of sickness absence, even short ones, can increase the risk for future spells of sickness absence and unemployment. The sickness period may in itself have a detrimental effect on health. The aim of the study was to investigate if there is an association between exposure to sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income from work. Methods: Our cohort consisted of all immigrants aged 21-25 years in Sweden in 1993 (N=38 207) and a control group of native Swedes in the same age group (N=225 977). We measured exposure to sickness absence in 1993 with a follow-up period of 15 years. We conducted separate analyses for men and women, and for immigrants and native Swedes. Results: Exposure to >= 60 days of sickness absence in 1993 increased the risk of sickness absence [hazard ratio (HR) 1.6-11.4], unemployment (HR 1.1-1.2), disability pension (HR 1.2-5.3) and death (HR 1.2-3.5). The income from work, during the follow-up period, among individuals with spells of sick leave for >= 60 days in 1993 was around two-thirds of that of the working population who did not take sick leave. Conclusions: Individuals on sickness absence had an increased risk for work absence, death and lower future income.

Background and Method The aim was to investigate influence from variations in intensity of a painful conditioning stimulation (CS) on early (0–6 min) and prolonged (6–12 min) conditioned pain modulation (CPM) in volunteers during concurrent exposure to test stimuli (TS). CS was applied to either forearm using painful heat with an intensity of 2/10 and 5/10, respectively, rated on a 0–10 numerical pain rating scale. At a second session, CS with an intensity of 7/10 was applied to the arm using a tourniquet. Threshold and suprathreshold painful heat and pressure as well as painful repeated monofilament pricking (RMP) were assessed as TS. Results Regardless of TS, there was no significant difference in the magnitude of CPM within the same stimulus modality during the various intensities and phases of the CS. Significant modulation of heat pain thresholds (HPTs) was found during the early phase at 5/10 and 7/10, but not at 2/10. Only at 5/10 the prolonged CS resulted in a significant additional increase in HPT. During the early CS phase, CPM of suprathreshold heat pain was found at 2/10 and 5/10. The prolonged CS resulted in a significant additional temperature increase at 5/10. Only during the early phase significant CPM of pressure pain thresholds were found for all three pain intensities in conjunction with a significant CPM of suprathreshold pressure pain at 5/10. There was no CPM of RMP. Conclusion The CS intensity and the duration of CPM modulated pain sensitivity differentially across TS modalities.

Objective: Liquid-based cytology with supplementary human papillomavirus triage (LBC+HPV triage) of low-grade cytological abnormalities may improve the detection of cervical intraepithelial neoplasia (CIN) compared with conventional cytology. To investigate this subject, LBC+HPV triage and conventional cytology were alternated in a population-based screening setting. Cases with abnormal cytology were referred for colposcopy. Methods: We compared the performance of LBC+HPV triage [n=4059] and conventional cytology [n=4261] in detecting CIN2 or worse [CIN2+] and CIN3 or worse [CIN3+]. We used logistic regression to assess CIN detection rates and abnormal cytology rates, which yielded unadjusted odds ratios (OR) and corresponding 95% confidence intervals (CI). We computed adjusted ORs from a multivariate logistic regression model that included potential confounders such as age, screening centre and time period. Results: We found similar detection rates of CIN2+ by LBC+HPV triage and conventional cytology; the adjusted OR for the comparison of CIN detection rates was 0.87 (95% CI: 0.60-1.26) for CIN2+ and 1.00 (95% CI: 0.64-1.58) for CIN3+. We also found similar positive predictive values between methods. Thus, there was no advantage in using LBC+HPV triage as compared to conventional cytology in terms of sensitivity, specificity and positive and negative predictive value to detect histologically confirmed CIN2+ and CIN3+. Conclusions: LBC+HPV triage may lead to a reduction in unnecessary work-ups for women with abnormal cytological lesions who are negative for high-risk HPV. It is important to continuously monitor abnormal cytology rates, both when testing a new method, and after the new method has become routine.

BACKGROUND: Youth unemployment is an increasing problem for societies around the world. Research has revealed negative health effects of unemployment, and this longitudinal register-based cohort study examined the relationship between unemployment and later sickness absence, disability pension and death among youth in Sweden. METHOD: The study group of 199 623 individuals comprised all immigrants born between 1968 and 1972 who immigrated before 1990 (25 607) and a random sample of native Swedes in the same age-range (174 016). The baseline year was 1992, and the follow-up period was from 1993 to 2007. Subjects with unemployment benefit in 1990-91, disability pension in 1990-92, severe disorders leading to hospitalization in 1990-92 and subjects who emigrated during follow-up were excluded. RESULTS: Those who were unemployed in 1992 had elevated risk of ≥60 days of sickness absence (OR 1.02-1.49), disability pension (HR 1.08-1.62) and all except native Swedish women had elevated risk of death (HR 1.01-1.65) during follow-up compared with non-unemployed individuals. The risk of future sickness absence increased with the length of unemployment in 1992 (OR 1.06-1.54), and the risk of sickness absence increased over time. A larger part of the immigrant cohort was unemployed at baseline than native Swedes. Selection to unemployment by less healthy subjects may explain part of the association between unemployment and the studied outcomes. CONCLUSION: Unemployment at an early age may influence the future health of the individual. To a society it may lead to increased burdens on the welfare system and productivity loss for many years.

This article seeks to identify performance-enhancing strategies that could be used to improve and optimise human–technology collaboration in rock drilling ‘activity’ in deep mines. Results from the ...

The purpose of this article is to develop knowledge and learning on the best way to automate organisational activities in deep mines that could lead to the creation of harmony between the human, technical and the social system, towards increased productivity. The findings showed that though the introduction of high-level technological tools in the work environment disrupted the social relations developed over time amongst the employees in most situations, the technological tools themselves became substitute social collaborative partners to the employees. It is concluded that, in developing a digitised mining production system, knowledge of the social collaboration between the humans (miners) and the technology they use for their work must be developed. By implication, knowledge of the human's subject-oriented and object-oriented activities should be considered as an important integral resource for developing a better technological, organisational and human interactive subsystem when designing the intelligent automation and digitisation systems for deep mines. STATEMENT OF RELEVANCE: This study focused on understanding the social collaboration between humans and the technologies they use to work in underground mines. The learning provides an added knowledge in designing technologies and work organisations that could better enhance the human-technology interactive and collaborative system in the automation and digitisation of underground mines.

Recently we demonstrated brush-evoked allodynia to be a partially graded phenomenon since increased brushing length and number of strokes significantly increased the brush-evoked pain intensity. In this study the influence of stroking velocity and brushing force on dynamic mechanical allodynia was examined in 16 patients with peripheral neuropathy. Brush-evoked allodynia was induced by lightly stroking 60mm of the skin twice with a 16 mm wide brush while varying stroking velocity (10, 20, 30 mm/s) and brushing force (10, 20, 40 g). Intensity and duration of brush-evoked allodynia was recorded using a computerized visual analogue scale. The total brush-evoked pain intensity, including painful aftersensation was calculated as the area under the curve. Significantly increased total brush-evoked pain intensity was demonstrated with lower stroking velocity (P

Many construction work tasks are physically very strenuous and the incidence of work‐related musculoskeletal disorders (WMSDs) among construction workers is considerably higher than those in most other occupations. The aim of the study presented in this paper was to contribute to understanding a healthy construction site brought about by the best practices implemented by large construction sites to prevent WMSDs. A triangulation method made of interviews, site observations and studies on company's documents was used to identify the best practices in 13 several construction projects. A range of the best practices both in the pre‐construction and construction phases of the projects were identified in six different areas of the balance of the construction workplace system; however, there seems to be a significant need for good practices in the management of a systematic work environment. It is now established that Swedish construction industry has several best practices to protect work‐related musculoskeletal health. However, inadequate worker participation and the neglect of health and safety issues by designers in the planning process as well as the implications of some remuneration methods on the production schedule were perceived as detrimental to the musculoskeletal health of construction workers. Santrauka Daug statybos darbu yra fiziškai labai itempti, o su darbu susijusiu raumenu ir skeleto sistemos pažeidimu dažnis tarp statybininku yra kur kas aukštesnis negu tarp daugelio kitu profesiju. Šio tyrimo tikslas – pletoti supratima apie sveikatos būkle ir jos svarba dirbant statybu aikštelese, igyvendinant didelius statybos objektus, siekiant išvengti su darbu susijusiu raumenu ir skeleto sistemos pažeidimu. Tyrimams buvo taikytas interviu, pagristas trianguliacijos metodu, darbo procesu stebejimo statybos aikštelese metodas, buvo nagrineti statybos kompaniju dokumentai, siekiant identifikuoti 13 skirtingu statybos projektu. Geriausia praktika, prieš pradedant statybas ir jau statant, buvo nustatyta šešiuose skirtinguose statybu regionuose, tačiau tokia praktika yra svarbi darbo aplinkos vadyboje. Pripažinta, kad Švedijos statybos pramoneje taikomi keli būdai, kaip apsaugoti statybininkus nuo raumenu ir skeleto sistemos pažeidimu. Vis delto mažas darbininku domejimasis šia problema, sveikatos bei saugos problemu nepaisymas planavimo procese, kai kuriu atsilyginimo būdu itraukimas i gamybos veiksniu saraša buvo vertinti kaip faktoriai, žalingai veikiantys statybininku raumenu ir skeleto sistema. First Published Online: 10 Feb 2011 Reikšminiai žodžiai:statybos vadyba,sužalojimai,profesine sveikata,darbo salygos,su darbu susijes raumenu ir skeleto sistemos sutrikimas,nepatogi darbo poza

The present workforce in the mining industry is ageing, and mining companies have difficulties recruiting young people who are not particularly interested in working in the industry. Simultaneously, mining companies tend to rely on contractors that offer volume flexibility and expertise, often in a combination that is economically appealing. This makes recruitment and development of the whole of the mining workforce complex. To recruit the right workforce, mining companies and their contractors need to cooperate and improve their knowledge about both attractive and repelling work features so that they can make wiser strategic decisions based on facts. On the basis of a Swedish context, we discuss different aspects of attractive workplaces and summarise our 'lessons learned' in six recommendations dealing with general health and safety issues, work organisation, competence development, gender equality, social responsibility and outsourcing.

Swedish manufacturing industry has previous held a leading position regarding the development of attractive industrial work environments, but increasing market competition has changed the possibilities to maintain the position. The purpose of this literature study is therefore to describe and analyze how Swedish manufacturing industry manages work environment and production development in the new millennium. The description and analysis is based on recently reported Swedish research and development. The gathered picture of how production systems generally are developed in Sweden strongly contrasts against the idealized theoretical and legal view of how production systems should be developed. Even if some of the researchers' and authorities' ambitions and demands may seem unrealistically high today, there still is a very large potential for improving the processes and tools for designing production systems and work environment.

The vast majority of invasive cervical carcinomas harbor additional copies of the chromosome arm 3q, resulting in genomic amplification of the human telomerase gene TERC. Here, we evaluated TERC amplification in routinely collected liquid based cytology (LBC) samples with histologically confirmed diagnoses. A set of 78 LBC samples from a Swedish patient cohort were analyzed with a four-color fluorescence in situ hybridization probe panel that included TERC. Clinical follow-up included additional histological evaluation and Pap smears. Human papillomavirus status was available for all cases. The correlation of cytology, TERC amplification, human papillomavirus typing, and histological diagnosis showed that infection with high-risk human papillomavirus was detected in 64% of the LBC samples with normal histopathology, in 65% of the cervical intraepithelial neoplasia (CIN)1, 95% of the CIN2, 96% of the CIN3 lesions, and all carcinomas. Seven percent of the lesions with normal histopathology were positive for TERC amplification, 24% of the CIN1, 64% of the CIN2, 91% of the CIN3 lesions, and 100% of invasive carcinomas. This demonstrates that detection of genomic amplification of TERC in LBC samples can identify patients with histopathologically confirmed CIN3 or cancer. Indeed, the proportion of TERC-positive cases increases with the severity of dysplasia. Among the markers tested, detection of TERC amplification in cytological samples has the highest combined sensitivity and specificity for discernment of low-grade from high-grade dysplasia and cancer.

The relationship between immunological markers and histology according to the Kiel classification was studied in 40 adult non-Hodgkin lymphoma patients of Rappaport unfavourable histology. The membrane-associated and cytoplasmic Ig as well as receptors for sheep erythrocytes, Fc gamma and C3d receptors were analyzed on cryostate sections and in suspension. In some cases, a more precise immunophenotype was achieved by the use of monoclonal antibodies detecting different T and B cell antigens. Eighty-eight per cent of the lymphomas had B-cell, five per cent T cell and 7 per cent non-B/non-T cell phenotypes. All CBCC and CC lymphomas expressed monotypic Ig, but only 66 per cent of the CB lymphomas. Thus, morphology alone did not consistently predict immunophenotype in large-cell lymphomas. A simultaneous expression of multiple heavy chains and cytoplasmic Ig was found in some lymphomas, suggesting an intratumoral differentiation. The nodular or irregular tissue distribution patterns for Ig and C3d receptors found in histologically diffuse follicle derived lymphomas also suggest intratumoral variations in the marker expression, probably related to differentiation. The results suggest that lymphoma immunophenotype is important in obtaining a definite diagnosis in large-cell lymphomas and that it may lead to a better understanding of the differentiation of lymphomas of low-grade malignancy.

Research on the pathogenicity of human papillomaviruses (HPVs) during cervical carcinogenesis often relies on the study of homogenized tissue or cultured cells. This approach does not detect molecular heterogeneities within the infected tissue. It is desirable to understand molecular properties in specific histological contexts. We asked whether laser capture microdissection (LCM) of archival cervical tumors in combination with real-time polymerase chain reaction and bisulfite sequencing permits (i) sensitive DNA diagnosis of small clusters of formalin-fixed cells, (ii) quantification of HPV DNA in neoplastic and normal cells, and (iii) analysis of HPV DNA methylation, a marker of tumor progression. We analyzed 26 tumors containing HPV-16 or 18. We prepared DNA from LCM dissected thin sections of 100 to 2000 cells, and analyzed aliquots corresponding to between nine and 70 cells. We detected nine to 630 HPV-16 genome copies and one to 111 HPV-18 genome copies per tumor cell, respectively. In 17 of the 26 samples, HPV DNA existed in histologically normal cells distant from the margins of the tumors, but at much lower concentrations than in the tumor, suggesting that HPVs can infect at low levels without pathogenic changes. Methylation of HPV DNA, a biomarker of integration of the virus into cellular DNA, could be measured only in few samples due to limited sensitivity, and indicated heterogeneous methylation patterns in small clusters of cancerous and normal cells. LCM is powerful to study molecular parameters of cervical HPV infections like copy number, latency and epigenetics.

10 patients thymectomized about 20 years earlier were tested for delayed skin reactivity against mumps, streptokinase-streptodornase and PPD antigens. The T and B lymphocytes in peripheral blood were determined. 6 patients were surgically thymectomized and 2 of the received postoperative irradiation. 4 patients were treated with only high dose irradiation to the mediastinal compartment. None of the patients responded to all skin antigens, 1 was positive to two antigens and 3 to one antigen. The remaining patients were non-responders. The number of peripheral blood lymphocytes was slightly decreased in the patients. A significant decrease in the number of T-lymphocytes (p less than 0.005) was found in the whole patient group, and the depression was more pronounced in the surgically thymectomized patients (p less than 0.001). The number of B-lymphocytes was unaltered. It is concluded that the abnormalities in this patient group reflect a T-lymphocyte deficiency. The immunologic status of the patients before treatment is not known. However, in 3 patients with recently discovered untreated thymomas no abnormalities were found. Thus, adult thymectomy in man seem to lead to deficiency of cell mediated immunity, indicating an influence of the thymus in immunological functions during adult life.

An overdose of CCNU (600 mg over a 15-d period) was unintentionally ingested by a patient with advanced Hodgkin's disease subjected to combination chemotherapy. A severe bone marrow depression occurred 3 weeks after the start of the CCNU treatment. The nadir of the platelet count was reached after 4 weeks and that of the granulocyte count after 5 weeks. At the nadir of the white blood cell count, colony-forming cells (CFU-C) were found in significantly reduced numbers in the bone marrow, and were not found at all in the peripheral blood; the amount of colony-stimulating activity (CSA) produced by peripheral blood cells was reduced. However, the cells producing CSA recovered earlier than the CFU-C, and the CSA peak value was reached about 1 week before the peak value for CFU-C in the bone marrow. Thus, in vivo CSA-producing cells appeared to be more resistant to CCNU than were CFU-C, and their recovery appeared to be a prerequisite for the recovery of CFU-C and myelopoietic cells.

In a prospective study, sixty-five histologically verified Swedish cases of Hodgkin's disease were HL-A typed. The antigen frequencies in the patient group did not deviate from a group of normal controls. The frequency of HL-A8 was slightly increased in patients over 40 years (P less than 0.05). HL-A12 was markedly increased in patients below 40 years with a favourable histopathology (P less than 0.001). No association between sex or clinical stage and distribution of HL-A phenotypes was observed. The number of T-lymphocytes in blood and the spontaneous DNA synthesis and DNA synthesis induced by concanavalin A, pokeweed mitogen, phytohemagglutinin and PPD antigen in blood lymphocytes in vitro were determined in 60 patients. A significant increase of HL-A28 was noted in patients with advanced disease (P less than 0.01) and in patients responding poorly to PPD (P less than 0.001) and PWM (P less than 0.01). No correlation between HL-A antigen distribution and T-lymphocyte counts was observed.

Background Screening for cervical cancer based on testing for human papillomavirus (HPV) increases the sensitivity of detection of high-grade (grade 2 or 3) cervical intraepithelial neoplasia, but whether this gain represents overdiagnosis or protection against future high-grade cervical epithelial neoplasia or cervical cancer is unknown. Methods In a population-based screening program in Sweden, 12,527 women 32 to 38 years of age were randomly assigned at a 1:1 ratio to have an HPV test plus a Papanicolaou (Pap) test (intervention group) or a Pap test alone (control group). Women with a positive HPV test and a normal Pap test result were offered a second HPV test at least 1 year later, and those who were found to be persistently infected with the same high-risk type of HPV were then offered colposcopy with cervical biopsy. A similar number of double-blinded Pap smears and colposcopies with biopsy were performed in randomly selected women in the control group. Comprehensive registry data were used to follow the women for a mean of 4.1 years. The relative rates of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected at enrollment and at subsequent screening examinations were calculated. Results At enrollment, the proportion of women in the intervention group who were found to have lesions of grade 2 or 3 cervical intraepithelial neoplasia or cancer was 51% greater (95% confidence interval [CI], 13 to 102) than the proportion of women in the control group who were found to have such lesions. At subsequent screening examinations, the proportion of women in the intervention group who were found to have grade 2 or 3 lesions or cancer was 42% less (95% CI, 4 to 64) and the proportion with grade 3 lesions or cancer was 47% less (95% CI, 2 to 71) than the proportions of control women who were found to have such lesions. Women with persistent HPV infection remained at high risk for grade 2 or 3 lesions or cancer after referral for colposcopy. Conclusions The addition of an HPV test to the Pap test to screen women in their mid-30s for cervical cancer reduces the incidence of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected by subsequent screening examinations.

Using a semi-quantitative method the repeatability of brush-evoked allodynia was examined within and between days in nine patients with spontaneous ongoing pain and dynamic mechanical allodynia due to peripheral neuropathy. In addition, the relationship between the intensity of spontaneous ongoing pain and the total brush-evoked pain intensity was addressed. The brush stimulus was applied in the innervation territory of the lesioned nervous structure by lightly stroking 60 mm of the skin four times with an 8 mm wide brush. Using a computerized visual analogue scale the patients continuously rated the intensity and duration of brush-evoked allodynia and the total brush-evoked pain intensity was calculated as the area under the curve. The patients were examined 4 days during one month, i.e. at day 1, 3, 28 and 30 and each study day the stimulus was repeated four times with an inter-stimulus interval of 10 min. The variation between repeated assessments was analyzed using the intraclass correlation coefficient and the total brush-evoked pain intensity within days ranged from 0.89 to 0.95 ("very good repeatability") and between days from 0.77 to 0.97 ("very good repeatability"). A significant positive correlation was demonstrated between the mean intensity of spontaneous ongoing pain and the mean total brush-evoked pain intensity (r(s)=0.68, P0.042, "a moderate to good correlation").

Background: Prospective follow-up studies have recently suggested that persistent high-risk human papillomavirus (HPV) infections play a key role in the progression of CIN lesions and in the development of cervical cancer. However, data on type-specific persistence, viral integration, and the role of multiple infections are scanty. Materials and Methods: A cross-sectional/cohort study was conducted between 1998 and 2002 in three New Independent States of the former Soviet Union comprising a cohort of 3,187 women, of whom 854 women were followed up for a mean of 17 months (SD, 11.6). HPV genotyping was done with real-time PCR, detecting HPV types 16, 18/45, 31, 33/52/58, 35, and 39. The integration status of HPV16 was examined by using a novel Taqman-based PCR method. Results: The mean clearance time for the individual high– risk–type infection was 16.5 months (range = 0.9-34.9 months). HPV16 and HPV31 were the most persistent infections (clearance times = 18.1 and 16.2 months, respectively), whereas HPV39 infections cleared most rapidly. The mean copies per cell in HPV18/45, HPV31, HPV33/52/58, and HPV39 infections were higher in persisting HPV infections than in HPV infections that cleared, but the difference was not significant. Integration of HPV16 was not found to correlate with HPV persistence. Conclusions: A large proportion of women remained high-risk HPV positive after 18 months. Coinfection with multiple HPV types, viral load, or integration status did not correlate with persistence of high-risk HPV infections. (Cancer Epidemiol Biomarkers Prev 2007;16(1):17–22)

The aim of this register-based longitudinal study was to explore the relationship between exposure to unemployment and sick leave at a young age and later health and work related outcomes. A comparison was also made between immigrants and native Swedes. The study population consisted of all immigrants, born between 1968 and 1972, and a random sample of native Swedes in the same age range. The follow-up period was 15 years, divided into three 5-year periods. Unemployment in 1992 was associated with later ≥60 days of sickness absence, disability pension and, for all subjects except native Swedish women, also mortality during follow-up. The risk of future sickness absence was about the same in all three follow-up periods. There was an increased risk of ≥100 days of unemployment in all three follow-up periods, but the risk declined, however, until the last follow-up period. Higher level of education at baseline as well as education attained between 1993 and 1997 decreased the risk of future unemployment. Participating in active labour market programmes was associated with higher risk of future unemployment. The risk of both future unemployment and future sickness absence increased with the length of unemployment in 1992. Immigrants had a higher risk of unemployment both at baseline and at follow-up compared with native Swedes, but matched the pattern of native Swedes during follow-up. Exposure to ≥60 days of sickness absence in 1993 was associated with increased risk for ≥60 days of sickness absence, ≥100 days of unemployment, disability pension and mortality during follow-up compared with no sick leave at baseline. The income from work, during the follow-up period, among individuals with spells of sick leave ≥60 days in 1993 was around two-thirds of that of individuals not on >60 days of sick leave. There was a rapid increase in future work absence for the first 1–7 days of sick leave claimed. Thereafter there was a lower, but steady increase in days of future work absence for every increase in sick leave. This of course affects the individual in the first place and to a society it means substantial costs in the form of increased welfare payments, and loss of productivity and tax income.

A total of 91 cervical archival biopsy series were analysed for the presence and viral load of ‘high-risk’ types of human papillomavirus (HR-HPV), and p16 INK4a expression. The women had various degrees of CIN (cervical intraepithelial neoplasia). HPV 16 was the most prevalent type found, at 47% frequency. The frequency of HPV 16 increased with increasing immunoreactivity to p16 INK4a , from 39% to 44% at cases scored low to medium, to 65% at high reactivity. Thirty (33%) of the samples had negative p16 INK4a analysis results, but were positive for HR-HPV. There was no significant correlation between viral load and the level of p16 INK4a expression, while the grade of CIN correlated to such expressions. Thus, p16 INK4a expression analysis yielded information which is consistent with results from the histopathology and might complement the HPV analysis in a clinical prognostic procedure in order to find women at risk for cervical cancer.

Viruses of the tick-borne encephalitis (TBE) antigenic complex, within the family Flaviviridae, cause a variety of diseases including uncomplicated febrile illness, meningo-encephalitis and haemorrhagic fever. Different wildlife species act as reservoir hosts with ixodid tick species as vectors. TBE virus (TBEV) causes 40-130 cases confirmed serologically in Sweden each year. Characteristics of TBEV strains circulating in Sweden have not been investigated previously and no viral sequence data has been reported. In the present study, virus strains were isolated from serum of patients with clinical symptoms consistent with acute TBEV infection. Serologic characterisation, using a panel of E-specific monoclonal antibodies and cross-neutralisation tests, indicated that the Swedish strains of TBEV, isolated 1958-1994, all belonged to the Western TBEV subtype, which includes the Austrian vaccine strain Neudoerfl. Genetic analysis of a partial E-sequence confirmed this close relationship: all Swedish TBEV strains belonged to the European lineage of the Western TBEV subtype, which includes the previously characterised strains Neudoerfl, Hypr, and Kumlinge. Further, three Swedish strains showed partial E-sequences identical to that of the Finnish Kumlinge strain, ten Swedish strains formed a well-supported separate cluster, whereas four others did not show any real clustering. No apparent correlation was observed in comparison of clinical parameters with genetic data or geographic origin of the strains.

Alterations in gene expression represent key events in carcinogenesis. We have studied HPV-induced cervical carcinogenesis, using an HPV-33-positive cell line (UT-DEC-1) established from a low-grade vaginal dysplasia (VAIN-I). Early-passage cells contained HPV-33 in episomal form, but these were superseded at later passages by cells carrying only integrated virus. To gain insight into the biologic significance of HPV integration, we compared the level of gene expression in normal vaginal keratinocytes, early-passage and late-passage UT-DEC-1 cells, using cDNA microarrays. Total RNA was isolated from cells by CsCl-gradient centrifugation, reverse-transcribed with MMLV reverse transcriptase and labeled with alpha-(32)P ATP. A cDNA microarray expression profile analysis was performed with Clontech's Human Cancer 1.2 cDNA expression array kit. The 16 upregulated genes (cut-off 2-fold), identified by comparing both cell types to control keratinocytes, appeared to support cell-cycle progression or to be functional in mitosis. These included, e.g., MCM4 DNA replication licensing factor, cdc2p34 and chromatin assembly factor 1 p48 subunit. Downregulated genes (44 altogether) interfered with apoptosis and cell adhesion, including the apoptosis-inducing genes FRAP, Bik and caspase-9 precursor. The most significant differences between the late and early passages (29 and 46 constantly up- and downregulated genes without any fluctuation) were overexpression of the transcription factors E2F5 with its dimerization partner DP1, NF-kappa B and serine/threonine kinases and underexpression of enzymes of the MAPK pathway. Acquisition of a selective growth advantage after viral integration might be explained by a major shift from a MAPK pathway to cell-cycle dysregulation (G(2)/M).

To elucidate the structural requirements for intersubtype antigenicity of human immunodeficiency virus type 1 (HIV-1) third variable envelope region (V3), synthetic peptides were used in enzyme immunoassays (EIAs) with serum samples from persons with proven or probable subtype B and D infections. Mathematical analyses of results from EIAs with singly substituted V3 peptides revealed important residues determining overall N-terminal V3 peptide antigenicity. This information was used to design V3 immunogens, rabbit antiserum to which were tested in EIA and for in vitro neutralization of molecular clones of HIV-1(MN) and HIV-1(MAL). Intersubtype-reactive epitopes were distributed toward the N-terminal half of the V3 loop. Lysine at position 310, arginine at position 311, and isoleucine at position 314, all derived from the MN primary sequence, were major determinants of intersubtype V3 antigenicity. Combinations of residues that enhanced antigenicity often contained lysine at position 310. Threonine at position 308 was common in the least advantageous combinations. V3 immunogens modified to achieve optimal antigenicity induced antiserum with augmented cross-neutralization of virus from MAL and MN molecular clones, suggesting one approach to subunit vaccine development.

The modes of interaction between products of human endogenous retroviral (HERV) sequences and the immune system are largely unknown. In HIV infected persons, an exogenous retrovirus adds further complexity to the situation. Therefore, 14 synthetic peptides with sequences derived from conserved regions of various endogenous retroviruses (ERVs) and from related exogenous retroviruses were used to search for IgG and IgM antibodies that bind to such antigens in 15 HIV-1 seropositive and 17 seronegative immunosuppressed patients. IgG binding to three peptides, namely, the C-terminal half of murine leukemia virus (MLV) capsid protein, the conserved portion of HERV-H transmembrane protein, and the Pol region of human mouse mammary tumor virus (MMTV)-like (HML3) sequence, was observed in both groups. Binding was, however, more frequent and more firm in HIV-1 positive samples (P

IgG binding to V3 peptides and serum neutralising responses were studied in four HIV-1 infected individuals with progressive disease over a period of 31-70 months. The 18-20 mer peptides comprised residues 299-317 (numbering of HIV1 MN) in the N-terminal half of the V3 loop of the envelope glycoprotein gp120 and were derived from the sequences of autologous, as well as heterologous isolates. All four individuals studied lacked anti-V3 IgG binding to at least one autologous V3 sequence. V3 peptides to which autologous sera lacked binding IgG were all immunogenic in rabbits and induced antisera that were broadly cross-reactive by EIA and broadly cross-neutralising to primary HIV-1 isolates. This indicates that the peptides are immunogenic per se and that the respective human hosts have selective defects in recognising the corresponding V3 sequences. Despite the absence of antibody binding to autologous V3 peptides, the human sera had neutralising antibodies to autologous (three out of four cases), as well as heterologous isolates (all cases). Moreover, in vitro exposure of the patients' isolates to autologous neutralising serum or the homologous rabbit antiserum selected for variants with amino acid substitutions close to the crown of the V3 loop or in regions outside the sequence corresponding to peptides used for immunisation. The amino acid exchanges affected V3 positions known to be antigenic and which are also prone to change successively in infected persons. It is likely that neutralising antibodies recognise both linear and conformational epitopes in the V3 loop. Apparently, there are several, but restricted, numbers of ways for this structure to change its conformation and thereby give rise to neutralisation resistant viruses.

Von Frey filaments used for testing mechanical thresholds are mechanically unstable and their use is difficult to standardize. We have therefore constructed a hand-held electronic pressure algometer. The pressure algometer is connected to a computerized data collection system, allowing on-line display of the applied force as well as the application rate. Data stored on the computer can be replayed and further analyzed. Using this apparatus, we have measured the pressure-induced withdrawal thresholds in rats with surgically induced neuropathy. The probe, with a circular tip of 1.0 mm diameter, was applied manually with a pressure increasing by approximately 0.05 N/s. Presurgical thresholds were normally distributed with a mean of 0.415 N, showing no significant difference between paws. During 2 weeks after surgery, the thresholds of the operated side were significantly reduced (range, 0.209-0.318 N), while the thresholds of the non-operated side remained at higher values (range, 0.432-0.491 N). Thresholds of control rats without surgery were in the 0.380-0.520 N range, with no significant difference between paws. In an additional experiment it was shown that interobserver reliability was high, both between withdrawal threshold values obtained and between rates of application used. In conclusion, the electronic algometer allows standardization of testing, detailed documentation of each experiment and provides an objective and accurate method for measuring the reactions of test animals to mechanical stimuli.

The presence of human papillomaviruses (HPVs) in 38 oral and 16 laryngeal lesions (verrucous hyperplasia, carcinoma in situ and carcinomas) was investigated using the polymerase chain reaction (PCR) technique. All biopsies were fresh frozen and a set of consensus and type-specific primers was used for PCR detection and HPV typing. In oral biopsies a low proportion of HPV-positive cases was found, despite the sensitive techniques. Only one case out of 38, a carcinoma in situ was positive (2.6%). It is thought that this finding reflects a minimal presence of HPV in the oral lesions, but a transient role of virus in the induction of carcinomas cannot be ruled out. Differences in relation to other studies may be geographical and/or methodological. In laryngeal carcinomas (and dysplasias), 3 out of 16 cases were HPV positive. This frequency (19%) concurs with most other studies.