Arrival of rabbit haemorrhagic disease virus 2 to northern Europe: Emergence and outbreaks in wild and domestic rabbits (Oryctolagus cuniculus) in Sweden

Incursion of rabbit haemorrhagic disease virus (RHDV ) into Sweden was documented in 1990 and it is now considered endemic in wild rabbit (Oryctolagus cuniculus ) populations. Rabbit haemorrhagic disease virus 2 (RHDV 2), a new, related lagovirus was first detected in France in 2010, and has spread rapidly throughout Europe and beyond. However, knowledge of RHDV 2 in northern Europe is sporadic and incomplete, and in Sweden, routinely available diagnostic methods to detect rabbit haemorrhagic disease (RHD ) do not distinguish between types of virus causing disease. Using RHDV 2‐specific RT ‐qPCR , sequencing of the VP 60 gene and immunological virus typing of archived and prospective case material from the National Veterinary Institute's (SVA ) wildlife disease surveillance programme and diagnostic pathology service, we describe the emergence of RHDV 2 in Sweden in both wild and domestic rabbits. The earliest documented outbreak occurred on 22 May 2013, and from May 2013 to May 2016, 10 separate incidents of RHDV 2 were documented from six different municipalities in the southern half of Sweden. Phylogenetic analysis of the VP 60 gene shows clear clustering of Swedish isolates into three separate clusters within two different clades according to geographic location and time, suggesting viral evolution, multiple introduction events or both. Almost all cases of RHD examined by SVA from May 2013 to May 2016 were caused by RHDV 2, suggesting that RHDV 2 may be replacing RHDV as the predominant cause of RHD in Sweden.     

Risk of prostate cancer among Swedish‐born and foreign‐born men in Sweden, 1961–2004

To elucidate the importance of environmental and genetic factors in prostate cancer etiology, we compared the risk of prostate cancer among foreign‐born men to that of Swedish‐born men in Sweden and to that in the country of origin. We estimated rate ratios (RRs) with 95% confidence intervals (CIs) adjusted for age, calendar period of year and education using Poisson regression in a cohort of 3.8 million men aged 45 years and older between 1961 and 2004. During the 45 years of follow‐up, 8,244 and 187,675 cases of prostate cancer occurred among foreign‐born and Swedish‐born men, respectively. Overall, foreign‐born men had a significantly 40% decreased risk of prostate cancer compared to Swedish‐born men (RR = 0.62, 95% CI = 0.61–0.63). Men born in Middle Africa and in the Caribbean had an increased risk (RR = 1.89, 95% CI = 0.95–3.78 and RR = 1.24, 95% CI = 0.71–2.19, respectively). The overall risk in both strata of duration of residence or age at immigration was lower among immigrants compared to Swedish‐born men. After additional adjustment for birthplace and age at immigration, although the risk remained lower among immigrants compared to Swedish‐born, but it was increased among immigrants who stayed 35 years and longer compared to those who stayed shorter (RR = 1.33, 95% CI = 1.21–1.46). Both environmental and genetic factors seem to be involved in the etiology of prostate cancer. Duration of residence was an important factor affecting the risk among immigrants. Studies focusing on the etiology of prostate cancer specifically in African immigrants and their descendants and increasing preventive and diagnostic activities on old immigrants are recommended. © 2008 Wiley‐Liss, Inc.     

A coordinated cross‐disciplinary research initiative to address an increased incidence of narcolepsy following the 2009–2010 Pandemrix vaccination programme in Sweden

In response to the 2009–2010 influenza A(H1N1)pdm09 pandemic, a mass vaccination programme with the AS03‐adjuvanted influenza A(H1N1) vaccine Pandemrix was initiated in Sweden. Unexpectedly, there were a number of narcolepsy cases amongst vaccinated children and adolescents reported. In this review, we summarize the results of a joint cross‐disciplinary national research effort to investigate the adverse reaction signal from the spontaneous reporting system and to better understand possible causative mechanisms. A three‐ to fourfold increased risk of narcolepsy in vaccinated children and adolescents was verified by epidemiological studies. Of importance, no risk increase was observed for the other neurological and autoimmune diseases studied. Genetic studies confirmed the association with the allele HLA‐DQB1*06:02, which is known to be related to sporadic narcolepsy. Furthermore, a number of studies using cellular and molecular experimental models investigated possible links between influenza vaccination and narcolepsy. Serum analysis, using a peptide microarray platform, showed that individuals who received Pandemrix exhibited a different epitope reactivity pattern to neuraminidase and haemagglutinin, as compared to individuals who were infected with H1N1. Patients with narcolepsy were also found to have increased levels of interferon‐gamma production in response to streptococcus‐associated antigens. The chain of patient‐related events and the study results emerging over time were subjected to intense nationwide media attention. The importance of transparent communication and collaboration with patient representatives to maintain public trust in vaccination programmes is also discussed in the review. Organizational challenges due to this unexpected event delayed the initiation of some of the research projects, still the main objectives of this joint, cross‐disciplinary research effort were reached, and important insights were acquired for future, similar situations in which a fast and effective task force may be required to evaluate vaccination‐related adverse events.     

Ten-Week Follow-Up of Monkeypox Case-Patient,Sweden, 2022

A previously healthy male patient had detectable monkeypox virus DNA in saliva 76 days after laboratory confirmation of infection. A comprehensive characterization of viral kinetics and a detailed follow-up indicated a declining risk for transmission during the weeks after monkeypox symptoms appeared.     

A comparison of cost-effectiveness of computer-assisted 2-and 3-dimensional planning techniques in orthognathic surgery

The aim of this randomised controlled trial was to compare the costs and benefits of computer-based 2-dimensional and 3-dimensional predictions in orthognathic surgery.Subjects aged 18–30 years with severe class III malocclusion had their treatment planned with both 2- and 3-dimensional techniques. They were randomised in a 1:1 ratio for one or other planning technique. Costs (financial, time, and dose of radiation) were compared with benefits (accuracy and health-related quality of life (HRQoL)). In total, 57 subjects (27 women and 30 men, mean (range) age 21 (18–28) years) completed the study. Comparisons showed no significant difference in total time spent, but a large advantage for the 2-dimensional technique in financial costs (p < 0.001); it also required a significantly lower dose of radiation (p < 0.001). The cost-effectiveness analysis showed a reduction in time of 0.53 minutes/HRQoL-point gained, and an increased economic cost of US$15/HRQoL point gained for the 3-dimensional technique. It also showed that the two techniques consumed an equal amount of time, but that the 2-dimensional technique had lower financial costs, and the 3-dimensional technique a larger dose of radiation.     

A randomized controlled pilot study of the effects of 6-week high intensity hatha yoga protocol on health-related outcomes among students

ObjectiveModern hatha yoga exercises (YE) provide an alternative form of physical activity which may reduce stress, facilitate recovery and improve health. This study investigated the short-term effects of high intensity hatha yoga exercises (HIY) on health-related outcomes.MethodsA 6-week randomized controlled study was performed to compare HIY with a control group not changing their exercise behavior. Healthy students (N = 44; median age: 25 years, range 20–39 years; HIY: n = 21, including 3 men; control group: n = 23, including 3 men) novice to yoga participated in the intervention which included one weekly class and recommended home training. Participants provided self-reports in questionnaires before and after the intervention. Self-reports included anxiety and depression (Hospital Anxiety and Depression Scale), stress (Perceived Stress Scale), sleep quality (Pittsburgh Sleep Quality Index), insomnia (Insomnia Severity Index), subjective health complaints (Common Symptoms in General Practice Index) and self-rated health (single-item).ResultsAfter the 6-week intervention, there were no between-group differences in anxiety, depression, stress, sleep or self-rated health. However, when investigating associations within the HIY-group, a higher HIY-dose was related to less depression (r = 0.47; p = 0.03), improved sleep quality (r = 0.55; p = 0.01), and less insomnia (r = 0.49; p = 0.02).ConclusionsThere were no short-term between-group effects of HIY on mental distress, sleep or self-rated health. However, within the HIY-group, a higher dose was associated with improved mental health in terms of depression and with improved sleep. Although future studies with larger samples are needed, these preliminary findings suggest short-term positive effects of HIY on health-related outcomes among students.Trial registration numberNCT01305096.