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Plastic pollution is one of the major global environmental challenges and is therefore attracting increased societal attention. This has resulted in the adoption of a long array of national and international policies, targeting plastic pollution. Whereas early plastic pollution regulation focused mainly on banning specific plastic products such as plastic bags, more recent focus has been devoted to the full plastic value chain. The aim of this focus is to facilitate a transition towards a circular plastic economy. This review first describes the historical development of policy initiatives targeting plastic pollution, followed by a review of key legislations at each step of the plastic value chain. Finally, the review introduces policy measures most often used since 2018 to target plastic pollution and discuss the importance of regulation that facilitate the transition towards a circular plastic economy.

BACKGROUND: Ischaemia-reperfusion injury in kidney transplantation leads to delayed graft function (DGF), which is associated with reduced long term graft function. Remote ischaemic conditioning (RIC) improved early kidney graft function in a porcine model of donation after brain death and was associated with improved long-term cardiac outcome after myocardial ischaemia. This randomised, double-blinded trial evaluated the effect of RIC on kidney graft outcome in the first year, and examined the predictive value of a new measure of initial kidney graft function, i.e. the estimated time to a 50% reduction in plasma creatinine post-transplantation (tCr50). METHODS: A total of 225 patients undergoing deceased donor kidney transplantation were randomised to RIC or a sham procedure performed prior to kidney reperfusion. Up to four repetitive cycles of five minutes of leg ischaemia and five minutes of reperfusion were given. GFR, plasma creatinine, cystatin C and neutrophil gelatinase associated lipocalin (NGAL) were measured at three and twelve months and estimated GFR was calculated using four different equations. Other secondary outcomes were identified from patient files. RESULTS: RIC did not affect GFR or other outcomes when compared to the sham procedure at three or twelve months. tCr50 correlated with one year graft function (p<0.0001 for both mGFR and eGFR estimates). In contrast, DGF i.e. "need of dialysis the first week" did not correlate significantly with one year GFR. CONCLUSION: RIC during deceased donor kidney transplantation did not improve one year outcome. However, tC

Contains fulltext : 200674.pdf (publisher's version ) (Open Access)

Contains fulltext : 200674.pdf (publisher's version ) (Open Access)

Contains fulltext : 200674.pdf (publisher's version ) (Open Access)

Contains fulltext : 176266.pdf (publisher's version ) (Open Access)

Contains fulltext : 176266.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 176266.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 134827.pdf (preprint version ) (Open Access)

Contains fulltext : 134827.pdf (preprint version ) (Open Access)

Background Salmonella Typhimurium is an important pathogen of human and animals. It shows a broad growth range and survives in harsh conditions. The aim of this study was to analyze transcriptional responses to a number of growth and stress conditions as well as the relationship of metabolic pathways and/or cell functions at the genome-scale-level by network analysis, and further to explore whether highly connected genes (hubs) in these networks were essential for growth, stress adaptation and virulence. Results De novo generated as well as published transcriptional data for 425 selected genes under a number of growth and stress conditions were used to construct a bipartite network connecting culture conditions and significantly regulated genes (transcriptional network). Also, a genome scale network was constructed for strain LT2. The latter connected genes with metabolic pathways and cellular functions. Both networks were shown to belong to the family of scale-free networks characterized by the presence of highly connected nodes or hubs which are genes whose transcription is regulated when responding to many of the assayed culture conditions or genes encoding products involved in a high number of metabolic pathways and cell functions. The five genes with most connections in the transcriptional network (wraB, ygaU, uspA, cbpA and osmC) and in the genome scale network (ychN, siiF (STM4262), yajD, ybeB and dcoC) were selected for mutations, however mutagenesis of ygaU and ybeB proved unsuccessful. No difference between mutants and the wild type strain was observed during growth at unfavorable temperatures, pH values, NaCl concentrations and in the presence of H2O2. Eight mutants were evaluated for virulence in C57/BL6 mice and none differed from the wild type strain. Notably, however, deviations of phenotypes with respect to the wild type were observed when combinations of these genes were deleted. Conclusion Network analysis revealed the presence of hubs in both tran

PURPOSE: This study was designed to evaluate the interobserver and intraobserver agreement of two-dimensional (2-D) and three-dimensional (3-D) anal endosonography for the detection of local recurrence anal carcinoma. METHODS: Thirty-six patients were treated for anal carcinoma, and seven had recurrent disease. They were investigated by using 3-D endosonography at Rigshospitalet from July 2001 to January 2005 because of suspected local recurrence. The 3-D endosonographic examinations were reviewed from the hard disc by two observers who twice reviewed all 2-D examinations (the axial projection) as well as all 3-D examinations (the axial, as well as the reconstructed coronal and sagittal projections). The observers scored each examination according to the following scale regarding presence of local recurrence: 1 = no finding/benign findings; 2 = properly benign findings; 3 = suspicious findings/malignant findings. Kappa statistic-statistic was used to evaluate interobserver and intraobserver variation. RESULTS: Three-dimensional endosonography achieved better interobserver agreement than 2-D endosonography: kappa 3-D 0.34-047 vs. kappa 2-D 0.15-0.28 and better intraobserver agreement: kappa 3-D 0.34-0.62 vs. kappa 2-D 0.22-0.28. These differences showed P < 0.05. CONCLUSIONS: Three-dimensional endosonography proved to have significantly better interobserver and intraobserver agreement than 2-D endosonography concerning detection of recurrent anal cancer. Three-dimensional endosonography seems to be less dependent of the individual examiner than 2-D endosonography Udgivelsesdato: 2009/3

Noninvasive evaluation of the coronary arteries by multi-detector row computed tomography is a promising new alternative to conventional invasive coronary angiography. This article describes the technical background, methods, limitations and clinical applications and reviews current literature that compares the diagnostic accuracy of multi-detector row computed tomography with that of coronary angiography Udgivelsesdato: 2009/4/6

Udgivelsesdato: 2009/3/23

Conventional Doppler methods for blood velocity estimation only estimate the velocity component along the ultrasound beam direction. This implies that a Doppler angle under examination close to 90 degrees results in unreliable information about the true blood direction and blood velocity. The novel method transverse oscillation (TO), which combines estimates of the axial and the transverse velocity components in the scan plane, makes it possible to estimate the vector velocity of the blood regardless of the Doppler angle. The present study evaluates the TO method with magnetic resonance phase contrast angiography (MRA) by comparing in vivo measurements of stroke volume. Eleven healthy volunteers were included in this prospective study. From the obtained data sets recorded with the 2 modalities, vector velocity sequences were constructed and stroke volume calculated. Angle of insonation was approximately 90 degrees for TO measurements. The correlation between the stroke volume estimated by TO and MRA was 0.91 (p < 0.01) with the equation for the line of regression: MRA = 1.1.TO-0.4. A Bland-Altman plot was additionally constructed where the mean difference was 0.2 ml with limits of agreement at -1.4 ml and 1.9 ml. The results indicate that reliable vector velocity estimates can be obtained in vivo using the presented angle-independent 2-D vector velocity method. The TO method can be a useful alternative to conventional Doppler systems by avoiding the angle artifact, thus giving quantitative velocity information Udgivelsesdato: 2009/1

Udgivelsesdato: 2009

Udgivelsesdato: 2009/3/23

Udgivelsesdato: 2009

Conventional Doppler methods for blood velocity estimation only estimate the velocity component along the ultrasound beam direction. This implies that a Doppler angle under examination close to 90 degrees results in unreliable information about the true blood direction and blood velocity. The novel method transverse oscillation (TO), which combines estimates of the axial and the transverse velocity components in the scan plane, makes it possible to estimate the vector velocity of the blood regardless of the Doppler angle. The present study evaluates the TO method with magnetic resonance phase contrast angiography (MRA) by comparing in vivo measurements of stroke volume. Eleven healthy volunteers were included in this prospective study. From the obtained data sets recorded with the 2 modalities, vector velocity sequences were constructed and stroke volume calculated. Angle of insonation was approximately 90 degrees for TO measurements. The correlation between the stroke volume estimated by TO and MRA was 0.91 (p < 0.01) with the equation for the line of regression: MRA = 1.1.TO-0.4. A Bland-Altman plot was additionally constructed where the mean difference was 0.2 ml with limits of agreement at -1.4 ml and 1.9 ml. The results indicate that reliable vector velocity estimates can be obtained in vivo using the presented angle-independent 2-D vector velocity method. The TO method can be a useful alternative to conventional Doppler systems by avoiding the angle artifact, thus giving quantitative velocity information Udgivelsesdato: 2009/1

PURPOSE: This study was designed to evaluate the interobserver and intraobserver agreement of two-dimensional (2-D) and three-dimensional (3-D) anal endosonography for the detection of local recurrence anal carcinoma. METHODS: Thirty-six patients were treated for anal carcinoma, and seven had recurrent disease. They were investigated by using 3-D endosonography at Rigshospitalet from July 2001 to January 2005 because of suspected local recurrence. The 3-D endosonographic examinations were reviewed from the hard disc by two observers who twice reviewed all 2-D examinations (the axial projection) as well as all 3-D examinations (the axial, as well as the reconstructed coronal and sagittal projections). The observers scored each examination according to the following scale regarding presence of local recurrence: 1 = no finding/benign findings; 2 = properly benign findings; 3 = suspicious findings/malignant findings. Kappa statistic-statistic was used to evaluate interobserver and intraobserver variation. RESULTS: Three-dimensional endosonography achieved better interobserver agreement than 2-D endosonography: kappa 3-D 0.34-047 vs. kappa 2-D 0.15-0.28 and better intraobserver agreement: kappa 3-D 0.34-0.62 vs. kappa 2-D 0.22-0.28. These differences showed P < 0.05. CONCLUSIONS: Three-dimensional endosonography proved to have significantly better interobserver and intraobserver agreement than 2-D endosonography concerning detection of recurrent anal cancer. Three-dimensional endosonography seems to be less dependent of the individual examiner than 2-D endosonography Udgivelsesdato: 2009/3

Noninvasive evaluation of the coronary arteries by multi-detector row computed tomography is a promising new alternative to conventional invasive coronary angiography. This article describes the technical background, methods, limitations and clinical applications and reviews current literature that compares the diagnostic accuracy of multi-detector row computed tomography with that of coronary angiography Udgivelsesdato: 2009/4/6

Conventional ultrasound methods for acquiring color images of blood velocity are limited by a relatively low frame-rate and are restricted to give velocity estimates along the ultrasound beam direction only. To circumvent these limitations, the method presented in this paper uses 3 techniques: 1) The ultrasound is not focused during the transmissions of the ultrasound signals; 2) A 13-bit Barker code is transmitted simultaneously from each transducer element; and 3) The 2-D vector velocity of the blood is estimated using 2-D cross-correlation. A parameter study was performed using the Field II program, and performance of the method was investigated when a virtual blood vessel was scanned by a linear array transducer. An improved parameter set for the method was identified from the parameter study, and a flow rig measurement was performed using the same improved setup as in the simulations. Finally, the common carotid artery of a healthy male was scanned with a scan sequence that satisfies the limits set by the Food and Drug Administration. Vector velocity images were obtained with a frame-rate of 100 Hz where 40 speckle images are used for each vector velocity image. It was found that the blood flow approximately followed the vessel wall, and that maximum velocity was approximately 1 m/s, which is a normal value for a healthy person. To further evaluate the method, the test person was scanned with magnetic resonance (MR) angiography. The volume flow derived from the MR scanning was compared with that from the ultrasound scanning. A deviation of 9% between the 2 volume flow estimates was found Udgivelsesdato: 2008/8

OBJECTIVE: Ultrasonography (US) performed by clinicians might shorten workout time and diminish the workload of simple diagnostic procedures for physicians specialized in US. The purpose of this follow-up study was to evaluate the effect of an introductory course in US on participants' clinical behaviour and course compliance. MATERIAL AND METHODS: The course consisted of a combined didactic, hands-on, one-day course including a skills test and a review of 20 still-pictures of pathological findings for final authorization. A questionnaire focusing on pre- and post-course activity and its impact on clinical behaviour was sent to 162 participants. RESULTS: The response rate was 64% (103). Forty-eight (47%) participants changed their clinical approach, 45 (44%) their workout programme and 25 (24%) the pattern of referral. Eleven (10%) sent in the required pathological findings for final authorization. Thirty-four (33%) participants did not carry out US after the course; 19 did not have access to US apparatus, 7 claimed that they lacked the time, 6 lacked supervision and 1 participant cited insufficiency of the course. Clinical approach was changed by 48 (47%), acute workout by 45 (44%) and pattern of referral by 24 (23%). CONCLUSIONS: Clinicians appear to be ready to change the patterns of their workout programmes and clinical approach after a combined didactic and hands-on introduction to US, but only 10% produced the recommended documentation for authorization. National guidelines need to be introduced for gastroenterologists and surgeons or the European Federation of Societies for Ultrasound in Medicine and Biology Guidelines should be implemented Udgivelsesdato: 2008

Background: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. Hypothesis: A preventive training program based on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 1020 soldiers aged 20.9 years ( range, 19-26 years) undergoing 3 months of basic military training consecutively enrolled from December 2004 to December 2005. The prevention program consisted of an exercise program of 15 minutes' duration 3 times a week, including 5 exercises for strength, flexibility, and coordination; the placebo program consisted of 5 exercises for the upper body. Results: During the observation period, 223 subjects sustained an injury, with 50 and 48 of these fulfilling the study criteria for overuse knee injuries or medial tibial stress syndrome, respectively. There were no significant differences in incidence of injury between the prevention group and the placebo group ( incidence, 0.22 vs 0.19; P = .162; relative risk = 1.05 [ range, 0.98-1.11]). The soldiers in the prevention group had the greater improvement in running distance in 12-minute run tests ( 82 vs 43 m; P = .037). Conclusion: An exercise program with an emphasis on muscular strengthening, coordination, and flexibility based on intrinsic risk factors identified through a literature review did not influence the risk of developing overuse knee injuries or medial tibial stress syndrome in subjects undergoing an increase in physical activity. The program increased maximal running distance in a 12-minute test Udgivelsesdato: 2008/4

Udgivelsesdato: 2008/3/17

Objective: To investigate acute anterior knee pain caused by overuse in terms of pain location, aggravating activities, findings on clinical examination and ultrasound/MRI examination. To determine if acute anterior knee pain caused by overuse should be classified as a subgroup of patellofemoral pain syndrome (PFPS). Methods: In a observational study design 30 army recruits with anterior knee pain (mean duration of pain 4 weeks) were examined using the PFPS pain severity scale (PSS), knee pain diagrams, standardised clinical examination, ultrasound and MRI examinations. Results: On PSS typical knee loading activities were the most painful, while sitting with knee bend for prolonged time caused surprisingly little pain. Pain was most commonly perceived in the peripatellar area (25 patients (83%)). The most common site of pain on clinical examination was the peripatellar area (25 patients (83%)), but other synovial covered structures including the fat pad of Hoffa (12 patients (40%)), the medial plica and the joint line (12 patients (40%)) were also involved. Only eight patients (27%) experienced pain on the patellofemoral compression test. Only discrete changes was detected on MRI/ultrasound. Conclusions: Acute anterior knee pain should be regarded as a subgroup of PFPS as both symptoms and clinical examination suggests this. The clinical examination with disseminated pain in all synovial covered structures is consistent with ideas of the importance of synovium in the genesis of pain Udgivelsesdato: 2008/1

Conventional ultrasound methods for acquiring color images of blood velocity are limited by a relatively low frame-rate and are restricted to give velocity estimates along the ultrasound beam direction only. To circumvent these limitations, the method presented in this paper uses 3 techniques: 1) The ultrasound is not focused during the transmissions of the ultrasound signals; 2) A 13-bit Barker code is transmitted simultaneously from each transducer element; and 3) The 2-D vector velocity of the blood is estimated using 2-D cross-correlation. A parameter study was performed using the Field II program, and performance of the method was investigated when a virtual blood vessel was scanned by a linear array transducer. An improved parameter set for the method was identified from the parameter study, and a flow rig measurement was performed using the same improved setup as in the simulations. Finally, the common carotid artery of a healthy male was scanned with a scan sequence that satisfies the limits set by the Food and Drug Administration. Vector velocity images were obtained with a frame-rate of 100 Hz where 40 speckle images are used for each vector velocity image. It was found that the blood flow approximately followed the vessel wall, and that maximum velocity was approximately 1 m/s, which is a normal value for a healthy person. To further evaluate the method, the test person was scanned with magnetic resonance (MR) angiography. The volume flow derived from the MR scanning was compared with that from the ultrasound scanning. A deviation of 9% between the 2 volume flow estimates was found Udgivelsesdato: 2008/8

OBJECTIVE: Ultrasonography (US) performed by clinicians might shorten workout time and diminish the workload of simple diagnostic procedures for physicians specialized in US. The purpose of this follow-up study was to evaluate the effect of an introductory course in US on participants' clinical behaviour and course compliance. MATERIAL AND METHODS: The course consisted of a combined didactic, hands-on, one-day course including a skills test and a review of 20 still-pictures of pathological findings for final authorization. A questionnaire focusing on pre- and post-course activity and its impact on clinical behaviour was sent to 162 participants. RESULTS: The response rate was 64% (103). Forty-eight (47%) participants changed their clinical approach, 45 (44%) their workout programme and 25 (24%) the pattern of referral. Eleven (10%) sent in the required pathological findings for final authorization. Thirty-four (33%) participants did not carry out US after the course; 19 did not have access to US apparatus, 7 claimed that they lacked the time, 6 lacked supervision and 1 participant cited insufficiency of the course. Clinical approach was changed by 48 (47%), acute workout by 45 (44%) and pattern of referral by 24 (23%). CONCLUSIONS: Clinicians appear to be ready to change the patterns of their workout programmes and clinical approach after a combined didactic and hands-on introduction to US, but only 10% produced the recommended documentation for authorization. National guidelines need to be introduced for gastroenterologists and surgeons or the European Federation of Societies for Ultrasound in Medicine and Biology Guidelines should be implemented Udgivelsesdato: 2008

Background: It is unknown whether an exercise program can prevent overuse injuries in the lower extremity. An often encountered and important risk factor for the development of lower extremity overuse injuries is an abrupt increase in activity level. Hypothesis: A preventive training program based on a literature review of intrinsic risk factors, and performed concurrent with an increase in physical activity, can reduce the incidence of overuse knee injuries and medial tibial stress syndrome, as well as increase running distance. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 1020 soldiers aged 20.9 years ( range, 19-26 years) undergoing 3 months of basic military training consecutively enrolled from December 2004 to December 2005. The prevention program consisted of an exercise program of 15 minutes' duration 3 times a week, including 5 exercises for strength, flexibility, and coordination; the placebo program consisted of 5 exercises for the upper body. Results: During the observation period, 223 subjects sustained an injury, with 50 and 48 of these fulfilling the study criteria for overuse knee injuries or medial tibial stress syndrome, respectively. There were no significant differences in incidence of injury between the prevention group and the placebo group ( incidence, 0.22 vs 0.19; P = .162; relative risk = 1.05 [ range, 0.98-1.11]). The soldiers in the prevention group had the greater improvement in running distance in 12-minute run tests ( 82 vs 43 m; P = .037). Conclusion: An exercise program with an emphasis on muscular strengthening, coordination, and flexibility based on intrinsic risk factors identified through a literature review did not influence the risk of developing overuse knee injuries or medial tibial stress syndrome in subjects undergoing an increase in physical activity. The program increased maximal running distance in a 12-minute test Udgivelsesdato: 2008/4

Objective: To investigate acute anterior knee pain caused by overuse in terms of pain location, aggravating activities, findings on clinical examination and ultrasound/MRI examination. To determine if acute anterior knee pain caused by overuse should be classified as a subgroup of patellofemoral pain syndrome (PFPS). Methods: In a observational study design 30 army recruits with anterior knee pain (mean duration of pain 4 weeks) were examined using the PFPS pain severity scale (PSS), knee pain diagrams, standardised clinical examination, ultrasound and MRI examinations. Results: On PSS typical knee loading activities were the most painful, while sitting with knee bend for prolonged time caused surprisingly little pain. Pain was most commonly perceived in the peripatellar area (25 patients (83%)). The most common site of pain on clinical examination was the peripatellar area (25 patients (83%)), but other synovial covered structures including the fat pad of Hoffa (12 patients (40%)), the medial plica and the joint line (12 patients (40%)) were also involved. Only eight patients (27%) experienced pain on the patellofemoral compression test. Only discrete changes was detected on MRI/ultrasound. Conclusions: Acute anterior knee pain should be regarded as a subgroup of PFPS as both symptoms and clinical examination suggests this. The clinical examination with disseminated pain in all synovial covered structures is consistent with ideas of the importance of synovium in the genesis of pain Udgivelsesdato: 2008/1

Udgivelsesdato: 2008/3/17

Level set methods [Osher and Sethian. Fronts propagating with curvature-dependent speed: algorithms based on Hamilton-Jacobi formulations. J. Comput. Phys. 79 (1988) 12] have proved very successful for interface tracking in many different areas of computational science. However, current level set methods are limited by a poor balance between computational efficiency and storage requirements. Tree-based methods have relatively slow access times, whereas narrow band schemes lead to very large memory footprints for high resolution interfaces. In this paper we present a level set scheme for which both computational complexity and storage requirements scale with the size of the interface. Our novel level set data structure and algorithms are fast, cache efficient and allow for a very low memory footprint when representing high resolution level sets. We use a time-dependent and interface adapting grid dubbed the "Dynamic Tubular Grid" or DT-Grid. Additionally, it has been optimized for advanced finite difference schemes currently employed in accurate level set computations. As a key feature of the DT-Grid, the associated interface propagations are not limited to any computational box and can expand freely. We present several numerical evaluations, including a level set simulation on a grid with an effective resolution of 10243. © 2006 Springer Science+Business Media, Inc.