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  1. Article ; Online: Use of Cl and C isotopic fractionation to identify degradation and sources of polychlorinated phenols: mechanistic study and field application.

    Aeppli, Christoph / Tysklind, Mats / Holmstrand, Henry / Gustafsson, Örjan

    Environmental science & technology

    2013  Volume 47, Issue 2, Page(s) 790–797

    Abstract: ... We evaluated the use of compound-specific chlorine and carbon isotope analysis (Cl- and C-CSIA) to assess CP ... dechlorination by representative soil enzymes (C. fumago chloroperoxidase, horseradish peroxidase, and laccase ... For carbon, a slight inverse isotope effect was observed (C-AKIE = 0.9945 ± 0.0019). This fractionation ...

    Abstract The widespread use of chlorinated phenols (CPs) as a wood preservative has led to numerous contaminated sawmill sites. However, it remains challenging to assess the extent of in situ degradation of CPs. We evaluated the use of compound-specific chlorine and carbon isotope analysis (Cl- and C-CSIA) to assess CP biotransformation. In a laboratory system, we measured isotopic fractionation during oxidative 2,4,6-trichlorophenol dechlorination by representative soil enzymes (C. fumago chloroperoxidase, horseradish peroxidase, and laccase from T. versicolor). Using a mathematical model, the validity of the Rayleigh approach to evaluate apparent kinetic isotope effects (AKIE) was confirmed. A small but significant Cl-AKIE of 1.0022 ± 0.0006 was observed for all three enzymes, consistent with a reaction pathway via a cationic radical species. For carbon, a slight inverse isotope effect was observed (C-AKIE = 0.9945 ± 0.0019). This fractionation behavior is clearly distinguishable from reported reductive dechlorination mechanisms. Based on these results we then assessed degradation and apportioned different types of technical CP mixtures used at two former sawmill sites. To our knowledge, this is the first study that makes use of two-element CSIA to study sources and transformation of CPs in the environment.
    MeSH term(s) Armoracia/enzymology ; Ascomycota/enzymology ; Basidiomycota/enzymology ; Biodegradation, Environmental ; Carbon Isotopes/isolation & purification ; Carbon Isotopes/metabolism ; Chemical Fractionation/methods ; Chloride Peroxidase/metabolism ; Chlorine/isolation & purification ; Chlorine/metabolism ; Chlorophenols/metabolism ; Environmental Monitoring/methods ; Environmental Pollutants/metabolism ; Fungicides, Industrial/metabolism ; Halogenation ; Horseradish Peroxidase/metabolism ; Isotopes/isolation & purification ; Isotopes/metabolism ; Laccase/metabolism ; Models, Biological ; Oxidation-Reduction
    Chemical Substances Carbon Isotopes ; Chlorophenols ; Environmental Pollutants ; Fungicides, Industrial ; Isotopes ; Chlorine (4R7X1O2820) ; Laccase (EC 1.10.3.2) ; Horseradish Peroxidase (EC 1.11.1.-) ; Chloride Peroxidase (EC 1.11.1.10) ; 2,4,6-trichlorophenol (MHS8C5BAUZ)
    Language English
    Publishing date 2013-01-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1520-5851
    ISSN (online) 1520-5851
    DOI 10.1021/es303343u
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Use of Cl and C Isotopic Fractionation to Identify Degradation and Sources of Polychlorinated Phenols: Mechanistic Study and Field Application

    Aeppli, Christoph / Gustafsson Örjan / Holmstrand Henry / Tysklind Mats

    Environmental Science & Technology. 2013 Jan. 15, v. 47, no. 2

    2013  

    Abstract: ... 6-trichlorophenol dechlorination by representative soil enzymes (C. fumago chloroperoxidase ... a cationic radical species. For carbon, a slight inverse isotope effect was observed (C-AKIE = 0.9945 ± 0 ...

    Abstract The widespread use of chlorinated phenols (CPs) as a wood preservative has led to numerous contaminated sawmill sites. However, it remains challenging to assess the extent of in situ degradation of CPs. We evaluated the use of compound-specific chlorine and carbon isotope analysis (Cl– and C–CSIA) to assess CP biotransformation. In a laboratory system, we measured isotopic fractionation during oxidative 2,4,6-trichlorophenol dechlorination by representative soil enzymes (C. fumago chloroperoxidase, horseradish peroxidase, and laccase from T. versicolor). Using a mathematical model, the validity of the Rayleigh approach to evaluate apparent kinetic isotope effects (AKIE) was confirmed. A small but significant Cl-AKIE of 1.0022 ± 0.0006 was observed for all three enzymes, consistent with a reaction pathway via a cationic radical species. For carbon, a slight inverse isotope effect was observed (C-AKIE = 0.9945 ± 0.0019). This fractionation behavior is clearly distinguishable from reported reductive dechlorination mechanisms. Based on these results we then assessed degradation and apportioned different types of technical CP mixtures used at two former sawmill sites. To our knowledge, this is the first study that makes use of two-element CSIA to study sources and transformation of CPs in the environment.
    Keywords biotransformation ; carbon ; chloride peroxidase ; chlorides ; chlorine ; dechlorination ; isotope fractionation ; isotopes ; laccase ; mathematical models ; peroxidase ; phenols ; sawmills ; soil enzymes
    Language English
    Dates of publication 2013-0115
    Size p. 790-797.
    Publishing place American Chemical Society
    Document type Article
    ISSN 1520-5851
    DOI 10.1021%2Fes303343u
    Database NAL-Catalogue (AGRICOLA)

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  3. Article ; Online: Cost Analysis of Remote Cardiac Rehabilitation Compared With Facility-Based Cardiac Rehabilitation for Coronary Artery Disease.

    Oehler, Andrew C / Holmstrand, Ericka C / Zhou, Lulu / Harzand, Arash / Vathsangam, Harshvardhan / Kendall, Kellee / Gabriel, George / Murali, Srinivas

    The American journal of cardiology

    2023  Volume 210, Page(s) 266–272

    Abstract: Remote cardiac rehabilitation (RCR) represents a promising, noninferior alternative to facility-based cardiac rehabilitation (FBCR). The comparable cost of RCR in US populations has yet to be extensively studied. The purpose of this prospective, patient- ... ...

    Abstract Remote cardiac rehabilitation (RCR) represents a promising, noninferior alternative to facility-based cardiac rehabilitation (FBCR). The comparable cost of RCR in US populations has yet to be extensively studied. The purpose of this prospective, patient-selected study of traditional FBCR versus a third-party asynchronous RCR platform was to assess whether RCR can be administered at a comparable cost and clinical efficacy to FBCR. Adult insured patients were eligible for enrollment after an admission for a coronary heart disease event. Patients selected either FBCR or Movn RCR, a 12-week telehealth intervention using an app-based platform and internet-capable medical devices. Clinical demographics, intervention adherence, cost-effectiveness, and hospitalizations at 1-year after enrollment were assessed from the Highmark claims database after propensity matching between groups. A total of 260 patients were included and 171 of those eligible (65.8%) received at least 1 cardiac rehabilitation session and half of the patients chose Movn RCR. The propensity matching produced a sample of 41 matched pairs. Movn RCR led to a faster enrollment and higher completion rates (80% vs 50%). The total medical costs were similar between Movn RCR and FBCR, although tended toward cost savings with Movn RCR ($10,574/patient). The cost of cardiac rehabilitation was lower in those enrolled in Movn RCR ($1,377/patient, p = 0.002). The all-cause and cardiovascular-related hospitalizations or emergency department visits in the year after enrollment in both groups were similar. In conclusion, this pragmatic study of patients after a coronary heart disease event led to equivalent total medical costs and lower intervention costs for an asynchronous RCR platform than traditional FBCR while maintaining similar clinically important outcomes.
    MeSH term(s) Adult ; Humans ; Coronary Artery Disease/rehabilitation ; Cardiac Rehabilitation ; Prospective Studies ; Costs and Cost Analysis ; Telemedicine
    Language English
    Publishing date 2023-11-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2023.08.061
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Digital hypertension management: clinical and cost outcomes of a pilot implementation of the OMRON hypertension management platform.

    Holmstrand, Ericka C / Sato, Hironori / Li, Jim / Mukherjee, Abhishek / Fitzpatrick, Nicole E / Rayl, Kenneth R / Colangelo, Francis R

    Frontiers in digital health

    2023  Volume 5, Page(s) 1128553

    Abstract: Importance: Home monitoring of blood pressure (BP) in hypertensive patients can improve outcomes, but challenges to both patient compliance and the effective transmission of home BP readings to physicians can limit the extent to which physicians can use ...

    Abstract Importance: Home monitoring of blood pressure (BP) in hypertensive patients can improve outcomes, but challenges to both patient compliance and the effective transmission of home BP readings to physicians can limit the extent to which physicians can use this information to improve care. The OMRON Hypertension Management Platform (OMRON HMP) pairs a home BP cuff with a digital product that tracks data, provides reminders to improve patient compliance, and provides a streamlined source of information to physicians.
    Objective: The primary objective of the quality improvement (QI) project was to test the hypothesis that use of the OMRON HMP could reduce the number and cost of hypertension related claims, relative to a retrospectively matched cohort of insured members. A secondary objective was to demonstrate improvement in control of BP among patients.
    Design: Eligible members were recruited to the QI project between December 1, 2018 and December 30, 2020 and data collected for six months following recruitment. All members received the OMRON HMP intervention.
    Setting: Enrollment and data collection were coordinated on-site at selected PCP partner providers in Western Pennsylvania. Eligible members were identified from insurance claims data as those receiving care for primary hypertension from participating primary care physicians and/or cardiologists.
    Participants: Eligible members were between the ages of 35 and 85, with a diagnosis of primary hypertension. The retrospective cohort was selected from electronic medical records of Highmark-insured patients with hypertension who received care at Allegheny Health Network (AHN), a subsidiary of Highmark Health. Members were matched on baseline BP and lipid measures, age, smoking status, diabetes status, race and sex.
    Intervention: Daily home BP readings were recorded by the OMRON HMP app. Patient data was reviewed by clinical staff on a weekly basis and treatment plans could be adjusted in response to this data.
    Results: OMRON HMP users showed a significant increase in the number and cost of hypertension-related claims, contrary to the hypothesis, but did display improvements in control of BP.
    Conclusions and relevance: The use of a digital platform to facilitate at-home BP monitoring appeared to improve BP control but led to increased hypertension-related costs in the short-term.
    Language English
    Publishing date 2023-09-20
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-253X
    ISSN (online) 2673-253X
    DOI 10.3389/fdgth.2023.1128553
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Hospital-Care Utilization and Medical Cost Patterns Among Patients With Insulin-Dependent Diabetes.

    Alkhaddo, Jamil / Zhou, Lulu / Rossi, Caitlan / Moheet, Amir / Sonon, Kristen E / Rayl, Kenneth / Holmstrand, Ericka C

    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

    2022  Volume 28, Issue 11, Page(s) 1132–1139

    Abstract: Objective: Using claims data from an integrated payer-provider, we compared costs incurred by patients with insulin-dependent diabetes mellitus (IDDM) who received Hospital Inpatient/Observation/EmeRgency Department care (HIghER care) for diabetes- ... ...

    Abstract Objective: Using claims data from an integrated payer-provider, we compared costs incurred by patients with insulin-dependent diabetes mellitus (IDDM) who received Hospital Inpatient/Observation/EmeRgency Department care (HIghER care) for diabetes-related events with those who did not receive such care to identify a target population for interventions in future studies.
    Methods: A retrospective study pooled real-world claims data for IDDM (type 1 or type 2) between July 1, 2018, and June 30, 2019. Medical claims were used to calculate the total and diabetes-related allowed medical costs to the enterprise and per member per month costs.
    Results: Medical and prescription drug coverage from 19 378 members was analyzed. Only 8.4% of the IDDM population received HIghER care but incurred 20% of medical expenses and nearly 40% of diabetes-related medical costs. For HIghER care patients, medical spending was higher in every inpatient and outpatient category (Wilcoxon 2-sample tests, all P < .0001). Non-diabetes-related prescription drug costs were greater in this group (Wilcoxon test, Z = 2.2879, P = .0221), whereas diabetes-related prescription drug costs were higher for non-HIghER care (Wilcoxon test, Z = -9.5918, P < .0001). In a longitudinal study of 29 602 patients over 24 months, previous-year receipt of HIghER care was a significant predictor of HIghER care the subsequent year (odds ratio, 3.28).
    Conclusion: Medical spending for patients receiving HIghER care was disproportionately high and greater in every inpatient and outpatient category. HIghER care receipt the previous year was highly predictive of HIghER care episodes the following year.
    MeSH term(s) Humans ; Diabetes Mellitus, Type 1/drug therapy ; Retrospective Studies ; Prescription Drugs ; Longitudinal Studies ; Hospitals ; Insulins ; Health Care Costs
    Chemical Substances Prescription Drugs ; Insulins
    Language English
    Publishing date 2022-09-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1473503-9
    ISSN 1530-891X
    ISSN 1530-891X
    DOI 10.1016/j.eprac.2022.08.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: First and Subsequent Lifetime Alcoholism and Mental Disorders in Suicide Victims With Reference to a Community Sample-the Lundby Study 1947-1997.

    Holmstrand, Cecilia / Bogren, Mats / Mattisson, Cecilia / Brådvik, Louise

    Frontiers in psychiatry

    2018  Volume 9, Page(s) 173

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2018-05-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2018.00173
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Book: Flexible Processes and Improved Technologies for Urban Infrastructure Construction Sites (PANTURA)

    Holmstrand, Magnus

    Abstract: ... of public funds by saving a significant amount of time and money, c) use new materials to increase off-site ...

    Institution University of Technology Goeteborg, Mottagarens namn, 412 96, Goeteborg, SE
    Abstract Objective: More than 50% of bridges in European cities are older than 40 years and bridges are a vital part of the infrastructure. Bridge managers are currently dealing with a large number of structurally deficient, obsolete bridges. The need to maintain, renew, strengthen and upgrade this part of the infrastructure will increase dramatically in the near future. PANTURA has bridges as its focal point. It is, however, important to stress that the approach proposed here can be applied to all infrastructure projects. The aims are to improve highly flexible off-site production processes, create resource-efficient construction sites, improve technologies and tools for bridge construction in densely populated areas and enhance communication between local authorities and construction companies. The main benefits of PANTURA are relevant to the Work Programme and are as follows: a) equip authorities, stakeholders and experts with a comprehensive instrument (methods, tools and techniques) to prepare and perform bridge construction, maintenance, repair and renovation processes in the most effective and efficient way, in the shortest possible time, with the most efficient, sustainable use of resources and with zero disturbance and disruption for the urban environment and urban life of the inhabitants, b) reduce lifecycle costs, i.e. the more efficient use of public funds by saving a significant amount of time and money, c) use new materials to increase off-site industrial production, technical innovations and new markets for SMEs and d) improve benchmarking systems to promote a performance-based, innovative, creative construction industry. PANTURA applies research based on a multidisciplinary, holistic approach and promotes innovative yet practical solutions, while covering the entire lifecycle process. PANTURA aims to realise these objectives by taking current research on construction processes, ICT tools and infrastructure technologies one step further.
    Keywords Bruecke ; Stadt ; Infrastruktur ; Bedarf ; Vermehrung ; Stress ; Off-Site ; Werkzeug ; Ballungsgebiet ; Verkehr ; Gemeindeverwaltung ; Arbeit ; Muskelarbeit ; Behoerde ; Interessengruppe ; Technik ; Instandhaltung ; Stoerfall ; Umwelt ; Kosten ; Gemeingebrauch ; Finanzierung ; Material (Ausgangsstoff) ; Innovation ; Markt ; Industrie ; Forschung ; Abdeckung ; Staedtische Infrastruktur ; Produktionstechnik ; Ressourceneffizienz ; Nachhaltige Ressourcennutzung ; Innenstadt ; Einwohner
    Language English
    Document type Book
    Remark project start: 01/01/2011 project end: 12/31/2013 grant ID: 265172
    Database Environmental research database (UFORDAT) of the German Federal Environment Agency (UBA)

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  8. Article ; Online: Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party Payer Environment.

    Harzand, Arash / Weidman, Aaron C / Rayl, Kenneth R / Adesanya, Adelanwa / Holmstrand, Ericka / Fitzpatrick, Nicole / Vathsangam, Harshvardhan / Murali, Srinivas

    Frontiers in digital health

    2021  Volume 3, Page(s) 678009

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-11-24
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-253X
    ISSN (online) 2673-253X
    DOI 10.3389/fdgth.2021.678009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Gender differences in subtypes of depression by first incidence and age of onset: a follow-up of the Lundby population.

    Bogren, Mats / Brådvik, L / Holmstrand, C / Nöbbelin, L / Mattisson, C

    European archives of psychiatry and clinical neuroscience

    2017  Volume 268, Issue 2, Page(s) 179–189

    Abstract: The Lundby Study is a prospective mental health survey in a community population (N = 3563), in which data were collected in 4 waves of field-work between 1947 and 1997. We investigated gender differences during the follow-up in overall first incidence ... ...

    Abstract The Lundby Study is a prospective mental health survey in a community population (N = 3563), in which data were collected in 4 waves of field-work between 1947 and 1997. We investigated gender differences during the follow-up in overall first incidence rates, ages of onset, and incidence by age of onset patterns, in different subtypes of depression. The overall incidence rate in females was higher than males for most subtypes of depression. However, for depression with melancholic and/or psychotic features, the overall first incidence rate did not differ significantly between the genders. The mean age of onset did not differ significantly between females and males in any of the depressive subtypes. Nevertheless, females and males had different first incidence rates by age of onset patterns for unipolar non-melancholic DSM-IV mood disorder and major depressive disorder (MDD), with a consistent gender incidence gap across all ages, but with the most conspicuous gender gap in middle age. The first incidence rates by age of onset patterns for DSM-IV MDD with melancholic and/or psychotic features did not differ significantly between the genders. The findings support that females are more prone than males to develop depression with medium severity, but no gender differences were found in melancholic and/or psychotic depression. The findings may support that unipolar non-melancholic depression and melancholic and/or psychotic depression represents different disorders. Tentative explanations for this are discussed.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Age of Onset ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Depression/classification ; Depression/diagnosis ; Depression/epidemiology ; Female ; Follow-Up Studies ; Health Surveys ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Psychiatric Status Rating Scales ; Sex Characteristics ; Young Adult
    Language English
    Publishing date 2017-03-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1045583-8
    ISSN 1433-8491 ; 0175-758X ; 0940-1334
    ISSN (online) 1433-8491
    ISSN 0175-758X ; 0940-1334
    DOI 10.1007/s00406-017-0778-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Long-term suicide risk in no, one or more mental disorders: the Lundby Study 1947-1997.

    Holmstrand, C / Bogren, M / Mattisson, C / Brådvik, L

    Acta psychiatrica Scandinavica

    2015  Volume 132, Issue 6, Page(s) 459–469

    Abstract: Objective: To investigate long-term suicide risk in individuals with no, one or more mental disorders.: Method: In the Lundby Study, involving a total population of 3563 subjects, mental health and suicide risk were monitored over 54-64 years.: ... ...

    Abstract Objective: To investigate long-term suicide risk in individuals with no, one or more mental disorders.
    Method: In the Lundby Study, involving a total population of 3563 subjects, mental health and suicide risk were monitored over 54-64 years.
    Results: The long-term suicide risk in subjects with no, one, or more mental disorders was 0.3%, 3.4% and 6.2% respectively. For individuals with only depression, the risk was 6.0%, only alcohol use disorder 4.7%, and only psychosis 3.1%. However, when individuals had additional disorders, the suicide risks were 6.6%, 9.4% and 10.4% respectively. Each diagnosis per se was significantly related to increased risk of suicide. Men had a higher suicide risk in depression than women. Men who had alcohol use disorder in addition to depression showed a very high risk of suicide, 16.2%.
    Conclusion: Long-term suicide risk was increased for depression, alcohol use disorder, and psychosis per se. For the latter two the diagnosis alone there may be a lower risk than previously estimated when there is no additional diagnosis. In men, depression in addition to alcohol use disorder should be treated vigorously in the work to prevent suicide.
    MeSH term(s) Aged ; Aged, 80 and over ; Comorbidity ; Female ; Humans ; Male ; Mental Disorders/epidemiology ; Middle Aged ; Registries/statistics & numerical data ; Suicide/statistics & numerical data ; Sweden/epidemiology
    Language English
    Publishing date 2015-09-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 103-x
    ISSN 1600-0447 ; 0001-690X
    ISSN (online) 1600-0447
    ISSN 0001-690X
    DOI 10.1111/acps.12506
    Database MEDical Literature Analysis and Retrieval System OnLINE

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