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Background: Covid-19 infection caused by SARS-Cov-2 virus came to light at the end of 2019 and was declared as a pandemic by WHO in March 2020. Many comorbidities have shown to be associated with the severity of the viral infection with hypertension being one of the highest rated comorbidities since loss of the ACE2 receptor due to SARS-Cov-2 infection can lead to increased blood pressure. However, there is limited research on the prescribing of different antihypertensives in patients with covid-19. Aim: to study the initiation of different antihypertensive medicines for the patients whom had the Covid-19 infection. Materials and Method: Data were collected from a data base called SCIFI-PEARL based on linked data on covid-tests, diagnoses, dispensed prescription drugs and socioeconomic data from a number Swedish national registers. A cohort study was conducted for subjects between 20-80 years old with a Covid-19 positive tests compared to controls matched for age, sex and index point. Initiations of different antihypertensive drug classes were studied until October 2020 when the data were lastly collected. Results: A total of 224582 patients (both exposed and controls) were included in the study. After adjusting for comorbidities, ACEi was most commonly initiated to patients with covid-19 Hazard Ratio compared to controls being 1.83 [1.53, 2.19], followed by betablockers 1.74 [1.55, 1.95], CCBs 1.61 [1.41, 1.83], ARBs 1.61 [1.40, 1.86] and Diuretics 1.53 [1.32, 1.77]. There were no significant differences in initiations of ACEi and ARBs with fixed combination with Diuretics in Covid-19 infected patients compared to controls. Conclusion: All studied antihypertensive medicines were initiated more frequently to patients with Covid-19. This can either be associated with hypertension related to the Covid-19 infection or residual confounding factors not matched or adjusted for in the study.

The objective of this research work is to investigate the practicality of magnetic workholding of non-magnetic synthetic quartz during high-speed grinding. This research work is sponsored by Quartzdyne and will be used as the starting point to applying single-piece rounding of its quartz. Hypotheses were created that would permit the authors to conclude that magnets are in fact worthwhile workholders for non-magnetic materials. Designs of Experiments were used to reject or fail to reject the null hypotheses. Experiments were carried out using a custom HAAS lathe, modified into a grinding center with an NSK live spindle, and neodymium-iron-boron magnets used to obtain both the holding and shear forces. Lastly, purchased polyolefin foam bumpers were used to increase the shear force, values were obtained with the Starrett force measurement machine. Input variables for the Design of Experiments (DOE) comprised of the holding force, feed-rate, part rotation, and in-feed size of cuts. Sample rotation relative to the magnets was the singular output variable. Experimental results were fitted with the correct distribution and modeled. Once a statistically significant model was attained input settings that minimized quartz sample rotation were determined and used to create an optimized program. Two sets of experiments were needed before the data could be properly fitted with a model. Thirteen out of fifteen samples remained stationary during the optimized program, which was adequate in failing to reject the second null hypothesis; a static sample at 350 RPM will remain static when undergoing high-speed rounding of its outside perimeter. Comparison of cycle times was crucial in reaching this conclusion; in fact, the cycle time of 7 minutes and 58 seconds for the optimized program was substantially less than Quartzdyne's estimated batch flow per piece cycle time of around 15 minutes. Obtaining a model was not possible or needed for the first hypothesis due to all experiments having zero rotation, therefore the authors also failed to reject the first null hypothesis; a static sample sandwiched between two permanent magnets with adequate holding force will remain stationary during rotation (min 250 RPM) Larger in-feed size cuts are possible when the quartz is square in shape –interrupted cuts. As it becomes cylindrical, cuts were reduced to experimental levels. Also, due to the amount of material being removed, the resin bonded wheel required dressing, without it rotation is expected. Variation was noticed while quantifying the shear force; it is attributed to the polyolefin foam bumper with its inconsistent coefficient of friction. A more uniform material, which can provide repeatable shear force values, would lessen the variation. All optimized program samples turned out perfectly round- even the two that had slight rotation.

Over the last decade, linguistic relativity has seen a resurgence in research and discourse on thought, language, and culture. One particular facet of this research, multilingualism, has been relatively sparse in comparison to the wealth of research available focusing on individual languages and monolingual speakers. This study represents a preliminary investigation that enters this arena by focusing specifically on how speakers of English as a second language use English basic color terms in respect to monolingual speakers. This is done by using a modified methodology from the World Color Survey as a comparative model of a speaker’s division of colors. Participants in this study illicit responses for 160 color tiles taken from the Munsell color chart used as the basis of the World Color Survey. The results of this study show that three of the ten multilingual participants division of the color space per English color terms falls outside of the normal range of variation between the monolingual English speakers who participated in this study. Though future research is needed to definitively posit the reasons for those participants color maps, this study provides a new window and inquiry into an under-researched area of linguistic relativity.

On the basis of a strong body of data, the Institute of Medicine currently recommends at least 60 minutes of exercise per day to prevent body weight gain overtime. Previous studies have shown that there is no compensatory increase in food intake with this dose of exercise. Ultimately, the brain decides whether to alter food intake. Surprisingly, no published studies have assessed the impact of exercise on brain activation. Using functional magnetic resonance imaging (fMRI) and an appetite questionnaire, we investigated the effects of a single bout of aerobic exercise on brain responses to visual food cues and subjective appetite responses. After an overnight fast, 30 (17M, 13W), healthy, habitually active subjects (22.0±3.8 years, 23.6±2.4 kg/m2, 44.3±8.3 mL∙kg-1∙min-1) either rested or exercised for 60 minutes, in a counterbalanced crossover design. Immediately after each condition, blood oxygen dependent levels were determined in response to visual food cues of different energy value during an fMRI scan. Exercise showed significantly greater activation (P < .005, uncorrected) in regions implicated in food inhibition (superior frontal gyrus, medial surface), and visual attention (precuneus, superior temporal gyrus, middle temporal gyrus and fusiform gyrus) regions. However, exercise did show a greater activation in a food reward region (medial orbitofrontal cortex). The rest condition only showed greater activation in a visual center (fusiform gyrus) and the midbrain. In addition, relative to no-exercise, subjective appetite responses were suppressed following the exercise bout. Taken altogether, these data suggest exercise may impact the brain in a direction expected to suppress food intake and increase food attention, which is in line with previous behavioral, biological and fMRI data. These findings may explain, at least partially, why aerobic exercise does not lead to a compensatory increase in food intake.

Tillgång till ett brett sortiment av antibiotika är en nödvändighet för att bedriva en modern sjukvård och bromsa utvecklingen av antibiotikaresistensen. Den europeiska antibiotikamarknaden har sjunkit med ca 40% under perioden 2010-2021. Låga priser på antibiotikaförpackningar har bidragit till att antibiotikaföretagen inte anser det är lönsamt att ha antibiotikaprodukter registrerade i Sverige vilket leder till avregistrering. Läkemedelsverkets målsättning är att säkerställa en fortsatt tillgång till antibiotika och undvika att antibiotikaprodukter som Hälso- och sjukvården behöver avregistreras. Indikatorer som påvisar vilka antibiotikaprodukter som löper risk att avregistreras skulle kunna vara ett verktyg för Läkemedelsverket. Syftet med examensarbetet är att identifiera indikatorer som påvisar vilka antibiotikaprodukter som löper risk att avregistreras. Data har samlats in från olika myndigheters databaser såsom Tandvårds- och läkemedelsförmånsverket, E-hälsomyndigheten samt Läkemedelsverket. Resultatet från analysen påvisar att utträde ur läkemedelsförmånen, takpris, år takpriset sattes, antal Market Authorization Holder/produkt, antal tillverkare av Active Pharmaceutical Ingredient/Market Authorization Holder för en produkt, marknadsföring, försäljningsvärde, samt pris/förpackning påvisar trend för ökad risk av avregistrering. Upprepade restanmälningar, längd av restanmälningar samt försäljningsvolym påvisar inte ökad risk för avregistrering. Lokalisationen av tillverkare av Active Pharmaceutical Ingredient påvisar ökad risk för avregistrering med en viss tveksamhet.

ABSTRACT Background Pre-eclampsia is a condition that affects approximately 3-7% of pregnant women annually and is the most common cause of perinatal and maternal morbidity and mortality. For a long time, pre-eclampsia has been called "the disease of theories" because the etiology of the condition is not fully understood. More recent studies explain pre-eclampsia as a condition consisting of two stages. In the first stage, impaired trophoblast invasion occurs through the decidualized endometrium resulting in incomplete remodelling of the spiral artery which in turn leads to constricted vessels and placental ischaemia. Placental ischaemia causes, in the second stage, the release of immune cells, cytokines and anti-angiogenesis markers which in turn leads to the maternal endothelial dysfunction that occurs in pre-eclampsia.   Pre-eclampsia is divided into different classes depending on the week of pregnancy in which it develops. The subgroups are referred to as early, premature and term pre-eclampsia. Women who suffer from pre-eclampsia during pregnancy tend to develop cardiovascular diseases later in life and the baby born is at risk of developing chronic diseases.  Necessary symptoms for diagnosis of the disease are hypertension in normotensive women and/or proteinuria. In addition, the woman may suffer from renal insufficiency or hepatic insufficiency. Some of the risk factors that can lead to pre-eclampsia are chronic hypertension, multiple gestation and high maternal BMI.  The American College of Obstetricians and Gynecologists (ACOG) recommends acetylsalicylic acid for women who are at moderate to high risk of developing pre-eclampsia. Acetylsalicylic acid has several effects including inhibition of platelet aggregation via irreversible inhibition of cyclooxygenase (COX) acting on endothelial function.  Aim The study was performed to analyze whether pregnant women with moderate and high risk for pre-eclampsia routinely receive a prophylactic effect of low-dose acetylsalicylic acid and to investigate whether it can reduce the incidence of preterm delivery.   Methods and materials Relevant scientific clinical randomised trials were searched using the Pubmed medical database and search engine. Five studies between 2012-2022 were reviewed and selected.  Results The aspirin doses used in studies 1-4 ranged from 100-160 mg and were administered daily. The studies did not show any statistically significant difference on pre-eclampsia development between the group administered aspirin or placebo. Study 5, on the other hand, analysed whether aspirin had any effect on reducing the incidence of, among other things, preterm labour (&lt;37 weeks of gestation). The results of study 5 showed that preterm labour occurred in 11.6% of women treated with aspirin compared with 13.1% of cases in the placebo group, which was statistically significant. Discussion ACOG guidelines as well as the international recommendations seem to base their evidence on insufficient older studies. The studies that have been analysed show no prophylactic effect of aspirin. Although there were fewer pre-eclampsia cases in the aspirin groups compared to the placebo groups, the difference was not significant. However, the results of study 5 may be unreliable because the study was conducted in low- to middle-income countries where there is a higher risk of preterm birth and that a minimal treatment may play a major role. Therefore, several larger international studies conducted on relevant aspects are needed to demonstrate the effect of aspirin on pre-eclampsia.

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Malaria is one of the most devastating infectious diseases, with nearly half of the worlds population currently at risk of infection. Although mathematical models have made significant contributions towards the control and elimination of malaria, it continues to evade control. This thesis focuses on two aspects of malaria that complicate dynamics, helping it persist. The basic reproductive number is one of the most important epidemiological quantities as it provides a foundation for control and elimination. Recently, it has been suggested that R0 should be modified to account for the effects of finite host population on a single disease-generation. In chapter 2, we analytically calculate these finite-population reproductive numbers for both vector-borne and directly transmitted diseases with homogeneous transmission. We find simple, generalizable formula and show that when the population is small, control and elimination may be easier than predicted by R0. In chapter 3, we extend the results of chapter 2 and find expressions for the finite- population reproductive numbers for directly transmitted diseases with different types of heterogeneity in transmission. We also outline a framework for discussing the different types of heterogeneity in transmission. We show that although the effects of heterogeneity in a small population are complex, the implications for control are simple: when R0 is large relative to the size of the population, control or elimination is made easier by heterogeneity. Another basic question in malaria modeling is the effects of immunity on the population- level dynamics of malaria. In chapter 4, we explore the possibility that clinical immunity can cause bistable malaria dynamics. This has important implications for control: in areas with bistable malaria, if malaria could be eliminated until clinical immunity wanes, it would not be able to invade. We built a simple, analytically tractable model of malaria transmission and solved it to find a criterion for when we expect bistability to occur. Additionally, we review what is known about about the parameters underlying the model and highlighted key clinical immunity parameters for which little is known. Building on these results, in chapter 5, we fit the model developed in chapter 4 to incidence data from Kericho, Kenya and estimate key clinical immunity parameters to better understand the role clinical immunity plays in malaria transmission. Finally, in chapter 6, we summarize the key results and discuss the broader implications of these findings on future malaria control. / Thesis / Doctor of Philosophy (PhD)

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