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The COVID-19 pandemic and associated measures implemented have rapidly changed how people move about and behave in society. Utilizing data on people’s mobility could provide unique and valuable insights to governments and institutions to better manage the crisis. These entities, however, have not traditionally had access to, nor the experience of applying, continuous anonymized and aggregated data on people mobility. This article aims to show how the Public Health Agency in Sweden successfully collaborated with a Nordic Telecoms operator to make use of such data during the COVID-19 pandemic. Specifically, it investigates how the collaboration started, approaches used to go from data to insight, outcomes and impact, and lessons learned on both sides. Telia, the largest telecom operator in the Nordics, had an existing product commercially available that provided anonymized and aggregated insights about people’s movement. Several challenges existed within Telia as it was the first time worldwide a collaboration with a Public Health Agency would take place and social benefits had to be weighed against commercial and reputational risks. The hypothesis at the beginning of the pandemic was that the solution could be adapted to fit the needs of policymakers and the internal challenges could be overcome, while providing a meaningful contribution to the fight against the virus. The results show that it is possible to both form a mutually beneficial collaboration between a telecom operator and a public institution, and to make use of mobility data in evidence-based policymaking without compromising applicable personal data protection laws.

Abstract Background In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s) and the potential for earlier detection using calls to a health advice line. Methods The investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas. Results Our analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant. Conclusions We conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

Structure and dynamics of voltage-gated ion channels, in particular the motion of the S4 helix, is a highly interesting and hotly debated topic in current membrane protein research. It has critical implications for insertion and stabilization of membrane proteins as well as for finding how transitions occur in membrane proteins-not to mention numerous applications in drug design. Here, we present a full 1 micros atomic-detail molecular dynamics simulation of an integral Kv1.2 ion channel, comprising 120,000 atoms. By applying 0.052 V/nm of hyperpolarization, we observe structural rearrangements, including up to 120 degrees rotation of the S4 segment, changes in hydrogen-bonding patterns, but only low amounts of translation. A smaller rotation ( approximately 35 degrees ) of the extracellular end of all S4 segments is present also in a reference 0.5 micros simulation without applied field, which indicates that the crystal structure might be slightly different from the natural state of the voltage sensor. The conformation change upon hyperpolarization is closely coupled to an increase in 3(10) helix contents in S4, starting from the intracellular side. This could support a model for transition from the crystal structure where the hyperpolarization destabilizes S4-lipid hydrogen bonds, which leads to the helix rotating to keep the arginine side chains away from the hydrophobic phase, and the driving force for final relaxation by downward translation is partly entropic, which would explain the slow process. The coordinates of the transmembrane part of the simulated channel actually stay closer to the recently determined higher-resolution Kv1.2 chimera channel than the starting structure for the entire second half of the simulation (0.5-1 micros). Together with lipids binding in matching positions and significant thinning of the membrane also observed in experiments, this provides additional support for the predictive power of microsecond-scale membrane protein simulations.

Tick-borne encephalitis (TBE) is a vaccine-preventable, high-priority disease in Sweden, with increasing incidence. However, surveillance is limited to case reports. We investigated relationships between reported TBE incidence and syndromic surveillance data to determine if these novel data sources could provide earlier indications of disease activity. We retrospectively compared national, weekly (2010−2017) reported TBE incidence to the percentage of TBE-related a) searches on the main Swedish healthcare information website and b) calls to its telehealth service using Spearman's ρ to determine the most strongly correlated lags. We conducted a sub-analysis (2012−2017) of TBE-related Google Trends queries and compared the number of TBE-related media stories to each novel surveillance dataset. Healthcare website searches for "tbe" and "vaccine" combined, "tbe", "tick", and "tick bite" led case data by 12, 8, 7, and 6 weeks, respectively (ρ = 0.87−0.89); telehealth calls led by 4 weeks (ρ = 0.92; all p < 0.001). Correlations and lags for Google Trends and healthcare website searches were fairly similar to each other. In comparison, correlation between the different syndromic surveillance datasets and the number of media stories was lower (ρ = 0.25−0.56). We observed volume discrepancies between TBE incidence and the novel surveillance datasets during some years, particularly for web searches. Syndromic surveillance data were strongly correlated with and preceded case data by 4–12 weeks. Syndromic data may provide advanced awareness and earlier indications of TBE activity, which can improve timing and specificity of public health communications. The use of these data as supplements to notifiable disease data for national planning and preparedness in real-time should be investigated. [ABSTRACT FROM AUTHOR]

Background: Limited language fluency can impede healthcare system navigation. In Sweden, the national telehealth line (Healthcare Guide 1177) offers interpretation in Arabic and Somali. We compared calls by language to identify differences in healthcare use for immigrant populations, focusing on three contact causes: pregnancy; vomiting or nausea in children; and worry/anxiety., Methods: We conducted a cross-sectional analysis of 3.9 million (n = 18 351 Arabic, n = 7199 Somali) telehealth calls (2014-18). Using multivariable logistic regression, we investigated associations between language of the call (Arabic, Somali, non-interpreted) and each contact cause. Potential confounders (age, region, year, and additionally for vomiting or nausea, month) and an interaction between age and language were considered., Results: Compared with non-interpreted calls, interpreted calls were associated with increased odds of being for pregnancy, especially for 19 to 29-year-olds [adjusted odds ratio (aOR) (95% CI) = 4.04 (3.66-4.46) and 4.60 (4.05-5.23), for Arabic and Somali calls, respectively]. Vomiting or nausea showed similar results, with aOR increasing with age: from 0.90 (0.75-1.07) (Arabic, <1 year) to 3.79 (2.86-5.01) (Somali, 5-9 years). In contrast, in unadjusted analyses, Arabic and Somali calls were associated with decreased odds of being for worry/anxiety [OR = 0.47 (0.38-0.58) and 0.34 (0.21-0.50)], respectively, compared with non-interpreted calls., Conclusion: Our results suggest callers to the interpreted lines may need additional assistance navigating the healthcare system for pregnancy and for vomiting or nausea among children. These findings can inform healthcare services planning for immigrants to Sweden and highlight a novel use of telehealth data as a way to uncover disparities in healthcare use within a multi-linguistic population., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.)

During the summer of 2018 large parts of Sweden experienced a record-breaking heatwave regarding temperatures and duration. Previous studies from Sweden with less extreme heat have shown that daily mortality is expected to increase during periods with high temperatures.  Between the 2nd of July and 5th of August, the period in 2018 with the highest temperatures, 635 more deaths were observed in Sweden compared to the same period in 2017. This corresponds to an 8,2% increase over the entire heatwave, and a 13,5% increase during the warmest week, the 16th to 22nd of July.  When using temperature data from four weather stations and relative risks from the models established for the Swedish heatwave early warning system, the heat episode in the summer of 2018 could be expected to result in 601-746 excess deaths, depending on model choice. Comparison with the observed mortality data therefore confirm the ability of the risk models to predict the expected increase in mortality also during longer periods with higher temperatures than ever studied before in Sweden.

Over a period of less than four weeks, 50 human cases of cryptosporidiosis were reported from a relatively small geographical area in Sweden. All cases were associated with visits to cattle spring pasture events at two farms (referred to as Farm A and B). Epidemiological and microbiological evidence show that contact with calves at the farms was the most likely source of Cryptosporidium infections. Gp60 sequences from human and calf isolates at Farm A were identical to each other, but differed from those at Farm B where, again, human and calf gp60 sequences were identical, proving that the two outbreaks had no common origin. As a direct consequence of these two outbreaks, and guided by knowledge gained from the outbreak investigations, the Swedish Board of Agriculture and all relevant farmer advisory organizations have updated their hygiene instructions for farm visits., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s) and the potential for earlier detection using calls to a health advice line., Methods: The investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas., Results: Our analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant., Conclusions: We conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

Motivation: Molecular simulation has historically been a low-throughput technique, but faster computers and increasing amounts of genomic and structural data are changing this by enabling large-scale automated simulation of, for instance, many conformers or mutants of biomolecules with or without a range of ligands. At the same time, advances in performance and scaling now make it possible to model complex biomolecular interaction and function in a manner directly testable by experiment. These applications share a need for fast and efficient software that can be deployed on massive scale in clusters, web servers, distributed computing or cloud resources., Results: Here, we present a range of new simulation algorithms and features developed during the past 4 years, leading up to the GROMACS 4.5 software package. The software now automatically handles wide classes of biomolecules, such as proteins, nucleic acids and lipids, and comes with all commonly used force fields for these molecules built-in. GROMACS supports several implicit solvent models, as well as new free-energy algorithms, and the software now uses multithreading for efficient parallelization even on low-end systems, including windows-based workstations. Together with hand-tuned assembly kernels and state-of-the-art parallelization, this provides extremely high performance and cost efficiency for high-throughput as well as massively parallel simulations., Availability: GROMACS is an open source and free software available from http://www.gromacs.org., Supplementary Information: Supplementary data are available at Bioinformatics online.

Voltage-gated ion channels open and close in response to changes in membrane potential, thereby enabling electrical signaling in excitable cells. The voltage sensitivity is conferred through four voltage-sensor domains (VSDs) where positively charged residues in the fourth transmembrane segment (S4) sense the potential. While an open state is known from the Kv1.2/2.1 X-ray structure, the conformational changes underlying voltage sensing have not been resolved. We present 20 additional interactions in one open and four different closed conformations based on metal-ion bridges between all four segments of the VSD in the voltage-gated Shaker K channel. A subset of the experimental constraints was used to generate Rosetta models of the conformations that were subjected to molecular simulation and tested against the remaining constraints. This achieves a detailed model of intermediate conformations during VSD gating. The results provide molecular insight into the transition, suggesting that S4 slides at least 12 Å along its axis to open the channel with a 3(10) helix region present that moves in sequence in S4 in order to occupy the same position in space opposite F290 from open through the three first closed states.

We describe how membrane proteins diffuse laterally in the membrane plane together with the lipids surrounding them. We find a number of intriguing phenomena. The lateral displacements of the protein and the lipids are strongly correlated, as the protein and the neighboring lipids form a dynamical protein-lipid complex, consisting of approximately 50-100 lipids. The diffusion of the lipids in the complex is much slower compared to the rest of the lipids. We also find a strong directional correlation between the movements of the protein and the lipids in its vicinity. The results imply that in crowded membrane environments there are no "free" lipids, as they are all influenced by the protein structure and dynamics. Our results indicate that, in studies of cell membranes, protein and lipid dynamics have to be considered together.

Structure and dynamics of voltage-gated ion channels, in particular the motion of the S4 helix, is a highly interesting and hotly debated topic in current membrane protein research. It has critical implications for insertion and stabilization of membrane proteins as well as for finding how transitions occur in membrane proteins-not to mention numerous applications in drug design. Here, we present a full 1 micros atomic-detail molecular dynamics simulation of an integral Kv1.2 ion channel, comprising 120,000 atoms. By applying 0.052 V/nm of hyperpolarization, we observe structural rearrangements, including up to 120 degrees rotation of the S4 segment, changes in hydrogen-bonding patterns, but only low amounts of translation. A smaller rotation ( approximately 35 degrees ) of the extracellular end of all S4 segments is present also in a reference 0.5 micros simulation without applied field, which indicates that the crystal structure might be slightly different from the natural state of the voltage sensor. The conformation change upon hyperpolarization is closely coupled to an increase in 3(10) helix contents in S4, starting from the intracellular side. This could support a model for transition from the crystal structure where the hyperpolarization destabilizes S4-lipid hydrogen bonds, which leads to the helix rotating to keep the arginine side chains away from the hydrophobic phase, and the driving force for final relaxation by downward translation is partly entropic, which would explain the slow process. The coordinates of the transmembrane part of the simulated channel actually stay closer to the recently determined higher-resolution Kv1.2 chimera channel than the starting structure for the entire second half of the simulation (0.5-1 micros). Together with lipids binding in matching positions and significant thinning of the membrane also observed in experiments, this provides additional support for the predictive power of microsecond-scale membrane protein simulations.