Swedish Case Research Articles

COVID-19 in the neighbourhood: the socio-spatial selectivity of severe COVID-19 cases in Sweden, March 2020–June 2021

AbstractIn this paper we analyse spatial and temporal variation in the risk of intensive care unit (ICU) admission for COVID-19 in Sweden. The analysis is based on geocoded and time-stamped data from the Swedish Intensive Care Registry (SIR). We merge this data with a classification of Swedish neighbourhood cluster types constructed from multi-scalar measures of socio-economic and country of birth segregation (Kawalerowicz and Malmberg in Multiscalar typology of residential areas in Sweden, 2021 available from https://doi.org/10.17045/sthlmuni.14753826.v1). We examine 1) if residence in more socio-economically deprived or diverse neighbourhood cluster types was associated with a higher risk of ICU admission for COVID-19, 2) if residence in more affluent neighbourhoods was associated with a lower risk of ICU admission for COVID-19, and 3) how these patterns changed over time during the three first waves of the pandemic. While the highest overall risk was associated with residence in urban disadvantage coupled with diversity, models where neighbourhood cluster types were interacted with waves reveal that the highest risk was associated with living in a neighbourhood cluster type characterised by rural town disadvantage coupled with diversity under the 3rd wave (February 2021–June 2021). Residence in such a neighbourhood cluster type was associated with a four times higher risk of ICU admission, compared to the reference category of living in a homogeneous rural neighbourhood cluster type with average levels of deprivation under wave 1. Looking at disparities within each wave we found that residence in most affluent urban areas was at first associated with a slightly higher risk of ICU admission for COVID-19 as compared with the reference category of living in a homogeneous rural neighbourhood cluster type, but under waves 2 and 3 this risk was no longer statistically significant. The largest inequalities between different neighbourhood cluster types could be seen during the 1st wave. Over time, the risks converged between different neighbourhood cluster types.

Early detection of the emerging SARS-CoV-2 BA.2.86 lineage through integrated genomic surveillance of wastewater and COVID-19 cases in Sweden, weeks 31 to 38 2023.

The SARS-CoV-2 BA.2.86 Omicron subvariant was first detected in wastewater in Sweden in week 31 2023, using 21 highly specific markers from the 50 investigated. We report BA.2.86's introduction and subsequent spread to all 14 regions performing wastewater sampling, and on 70 confirmed COVID-19 cases, along with the emergence of sublineages JN.1 and JN.2. Further, we investigated two novel mutations defining the unique BA.2.86 branching in Sweden. Our integrated approach enabled variant tracking, offering evidence for well-informed public health interventions.

Sound insulation in multi-family houses: Proposal of single number limits for acoustical protection and comfort

In this paper, the acoustical quality in apartment housing is studied. The purpose is to find out to what extent occupants are annoyed by indoor noise and to compare the annoyance with measured airborne and impact sound insulation. The occupants in 38 building cases in Sweden, grouped into different construction categories, were asked in a questionnaire to rate their annoyance for a variety of potentially disturbing sound sources. In total, 1230 individual responses were used for the statistical analyses. The result shows that on average, the occupants are quite satisfied and reported low annoyance. This is taken as an indication that the present National legislation for sound insulation, airborne sound insulation included, works well. However, annoyance from footstep of walking neighbours is an exception, causing significantly greater annoyance compared to any other source, especially among occupants in lightweight buildings. The commonly used impact sound insulation descriptors are unable to match subjective experience. In combination with the sensitivity of lightweight floors to low-frequency sounds, improper building designs are likely to result in poor noise protection for the occupants. To overcome this issue, a new single number quantity taking frequencies as low as 25 Hz into account is suggested.

Re-inventing housing finance with blockchain. The case of Sweden

This article examines the ongoing transformation of mortgage markets induced by blockchain applications for property transactions. It argues that their adoption can reshape housing finance by re-inventing the qualities of products circulating therein. This process was evident in Sweden, where a public–private consortium pioneered the use of blockchain to orchestrate the conveyance and mortgaging of residential across the entire country. Drawing from several distinct fields and building on the analysis of 24 semi-structured interviews, this article follows the interdisciplinary cultural economy literature on marketization. It demonstrates that by integrating technology with the legacy Land Administration System (LAS), the experiment offered a way to “fix” the Swedish mortgage market, through re-engineering conveyance workflow and supplying mortgages with a transparent audit trail. Circulating such radically new products could reconcile contradictions between Swedish mortgage market liquidity and risk-taking on the one hand and longstanding concerns about its financial safety for consumers on the other. This created unanticipated risks, however, which shaped the outcome of the experiment. This research contends that, at this early stage of the technology adoption, taking a step back to better understand the role of LAS in structuring concrete configurations of housing and mortgage markets opens the door to considering the mechanisms that shape the outcomes of such experiments – a reintroduction of existing and profoundly uneven socioeconomic relations.

How demand uncertainty influences electricity network prices under revenue-cap regulation: The case of Sweden

The amount of electricity end-users demand from the distribution grid is going to be more uncertain in the future. In this paper, we empirically investigate how variation in demand (which we refer to as demand uncertainty) influence the pricing behavior of distribution system operators (DSOs) that are subject to an ex-ante revenue cap and a penalty scheme that is activated when the cap is violated. Using data from 162 Swedish electricity DSOs observed over 13 years, our econometric investigations shows that demand uncertainty leads to lower electricity distribution prices under the current ex-ante revenue cap regime, but not under the previous ex-post rate-of-return regime. We also find that DSOs react more strongly to uncertainty when they have a relatively higher debt ratio. While lower network prices may sound like a good outcome for customers, it also leads to reduced revenue and a slowdown in investments. Thus, when society benefits from distribution network expansions and the DSOs are regulated by ex-ante revenue caps, the regulator should consider regulating the debt ratio.

Uncontrolled Donation after Circulatory Death Only Lung Program: An Urgent Opportunity.

Uncontrolled donation after circulatory death (uDCD) represents a potential source of lungs, and since Steen's 2001 landmark case in Sweden, lungs have been recovered from uDCD donors and transplanted to patients in other European countries (France, the Netherlands, Spain and Italy) with promising results. Disparities still exist among European countries and among regions in Italy due to logistical and organizational factors. The present manuscript focuses on the clinical experiences pertaining to uDCD lungs in North America and European countries and on different lung maintenance methods. Existing experiences (and protocols) are not uniform, especially with respect to the type of lung maintenance, the definition of warm ischemic time (WIT) and, finally, the use of ex vivo perfusion (available in the last several years in most centers). In situ lung cooling may be superior to protective ventilation, but this process may be difficult to perform in the uDCD setting and is also time-consuming. On the other hand, the "protective ventilation technique" is simpler and feasible in every hospital. It may lead to a broader use of uDCD lung donors. To date, the results of lung transplants performed after protective ventilation as a preservation technique are scarce but promising. All the protocols comprise, among the inclusion criteria, a witnessed cardiac arrest. The detectable differences included preservation time (240 vs. 180 min) and donor age (<55 years in Spanish protocols and <65 years in Toronto protocols). Overall, independently of the differences in protocols, lungs from uDCD donors show promising results, and the possibility of optimizing ex vivo lung perfusion may broaden the use of these organs.

Cardiac Enlargement in a Medicolegal Autopsy Setting.

A key element for diagnosing cardiac enlargement in an autopsy setting is relevant heart weight references. However, most available references are to a large extent not representative of a medicolegal autopsy population, implying that reference weights are likely lower than those in the relevant population.To establish more applicable heart weight references in a medicolegal autopsy population, we designed a heart weight model that accounts for undiagnosed cardiac enlargement using data from 11,897 nontraumatic Swedish medicolegal autopsy cases autopsied between 2010 and 2019. The model was validated in 296 nonobese young adult suicidal hanging cases.For a decedent of average height (174 cm), the evidence that a heart weight was enlarged reached weak support at approximately 430 g, substantial support at approximately 480 g, and strong support at 520 g. The modeled prevalence of cardiac enlargement was very high among elderly and obese decedents.We believe that our model is more applicable in a medicolegal setting than those previously published. The presented quantification of the degree of uncertainty regarding diagnosis can help the pathologist in diagnosing cardiac enlargement. To facilitate the use of this model, we also made it available through a simple online tool ( https://formedum.shinyapps.io/HeartWeightCalc/ ).

Treatment utilization and effectiveness of neoadjuvant chemotherapy comparing men and women diagnosed with breast cancer: a Swedish retrospective cohort study

PurposeEvidence supporting the use of neoadjuvant chemotherapy (NAC) in early breast cancer is based on studies mainly including women, whereas the utilization and effectiveness of NAC in men is less studied. The present study aimed to investigate the utilization and effectiveness of NAC in men and women with early breast cancer.MethodsEligible patients were identified through the Swedish National Breast Cancer Quality Register, that includes all newly diagnosed breast cancer cases in Sweden from 2008 and onwards. For the treatment utilization analysis, all patients with stage I–III between 2008 and 2020 were included (n = 82,888), whereas for the effectiveness analysis the cohort was restricted to patients receiving NAC (n = 6487). For both analyses, multivariate logistic regression models were applied to investigate potential sex disparities in NAC utilization and effectiveness, adjusted for patient- and tumor characteristics.ResultsIn the NAC utilization analysis, 487 men and 82,401 women with stage I–III were included. No statistically significant difference between sexes in terms of NAC utilization was observed (adjusted Odds Ratio (adjOR): 1.135; 95% Confidence Interval (CI) 0.606–2.128) with an overall utilization rate of 4.9% in men compared to 7.8% in women. Among the 24 men and 6463 women who received NAC, the pathologic complete response (pCR) rates were 16.7% and 21.2%, respectively (adjOR: 1.141; 95% CI 0.141–9.238).ConclusionThe present study did not find any sex disparities in NAC utilization or effectiveness in terms of pCR. This supports the current recommendations of treating men with breast cancer with the same indications for NAC as women.

Flowing Capital‐Disrupted Homes: Financialisation and Maintenance of Rental Housing in Sweden

AbstractStudies on rental housing financialisation have blossomed over the last decade. Studies are often concerned with issues around affordability and displacement, while less focus has been on how financialisation reconfigures the materials of housing, home, and the residential environment by subordinating maintenance to aggressive and unsustainable renovation strategies. We look at the case of Sweden and zoom in on a working‐class Stockholm suburb where part of the housing stock is owned by the German, publicly listed real estate company Vonovia. We discuss how national and international regulations remain insufficient in ensuring that every day and structural maintenance is conducted properly by financialised landlords, leaving tenants stuck with delayed and poor‐quality repair and replacement work as well as insufficient communication, severely affecting their quality of life. We propose to discuss the concepts of “housing as infrastructure” to account for these complex consequences.

The Noise of the News: Spectral Analysis of Early Swedish Television News 1958 - 1978.

Looking back on the very first year of television in Sweden, the head of programming Henrik Hahr celebrated having brought the world into “the living room of the viewer”. From the emergence of Swedish public service television in 1956 and onwards, the medium would be lauded as a window to the world. Yet, what noises came through this window? Shifting focus away from the visual content of television, this article explores and emphasizes the sonic dimensions of early Swedish news broadcasting. In the middle of the 20th century, the look, and the sound of the news were taking shape across television stations around the world. In Sweden, public service broadcasting was partly influenced by the backdrop of the cold war, and demands were formulated on a style of television that would be distinctive from the American and Soviet alternatives. This was a matter of images and audio in equal proportions. Deciding what kind of sound was added to the previously mute newsreels was at the heart of televised journalism. With a media monopoly running two competing news shows, the Swedish case offers insight into the establishment and differentiation of public service television aesthetics in the post-war era. Prior research has investigated the institutions, infrastructures, and ideas which shaped early Swedish television, but the very signals remain unexplored. This article introduces new methods for studying aural aesthetics in audiovisual media. By conducting various types of spectral visualization on recorded television news from 1958 until 1978, this analysis traces the sonic profile of the Swedish public service. The aim is to provide historical knowledge of how the news sounded and which aural experiences were promoted within the realm of the welfare state media monopoly. However, by drawing attention to the prospect of audio signal processing as a method for cultural-historical research, the purpose is also to make a methodological contribution to television studies at large.

Accelerated learning for wood supply managers – the next generation of on-line training tools

ABSTRACT The Virtual Wood Supply Arena is an on-line training environment for managing roundwood purchase, production and transport in cut-to-length supply systems. The purpose of its development was accelerated training for coordination of these functions under realistic operating conditions. It offers 8- and 12-week scenarios for supplying five mills. Weekly planning is done for 10 harvesting teams and 10 trucks in a Swedish case geography while tracking mill delivery fulfillment under weekly trafficability restrictions. The purpose of this paper is to introduce the training environment and report the progression of student performance after 2 years of use in university-level training. Student teams reached full delivery fulfillment within three training runs. After familiarization during an introductory run, a complete 12-week scenario took four effective hours to complete. Delivery fulfillment increased from 82 to 95 and 100% between the first, second and third training runs. The progression of team performance included a 36% reduction of relocation distances for harvesting teams and 11% reduction of transport distances for hauling from forest to mill. By the third training run these performance levels were attained with less than 2 weeks of inventory for both the purchase bank and roadside stocks.

Association of childhood infections and perinatal factors with ankylosing spondylitis: a Swedish nationwide case–control and sibling study

ObjectivesTo identify perinatal and early-life risk factors for ankylosing spondylitis (AS), controlling for family-shared confounding with a sibling comparison design.MethodsIn this nationwide, register-based case–control study, we identified 5612 AS cases...

Evaluation of TSO–DSO Coordination Schemes for meshed-to-meshed configurations: Lessons learned from a realistic Swedish case study

Evaluation of TSO–DSO Coordination Schemes for meshed-to-meshed configurations: Lessons learned from a realistic Swedish case study

Freight modal shift: A means or an objective in achieving lower emission targets? The case of Sweden

For several decades, modal shift within the freight transport sector has been promoted by policy makers as an important basis for achieving lower transport emission targets. Even though the literature on mode choice is well established, there is less consensus about the volume of freight with the potential to shift and, more importantly, the actual contribution of freight modal shift to achieving less climate and air pollution impacts. The climate contribution of freight modal shift can be increasingly questioned, as decarbonization is taking place at increasing rates within road freight transport. In this paper, the role of modal shift policies in realizing climate objectives is scrutinized by focusing on the case of Sweden, which serves to illustrate some general insights. We highlight how modal shift is often analyzed and discussed in isolation, even though it forms an important part of a policy mix in which it may contribute to achieving climate objectives. Treating modal shift as an objective in its own right may render less effective and cost-efficient policy instruments.

Genotypic characterization of Staphylococcus chromogenes and Staphylococcus simulans from Swedish cases of bovine subclinical mastitis

Staphylococcus chromogenes and Staphylococcus simulans are commonly found in intramammary infections (IMI) associated with bovine subclinical mastitis, but little is known about genotypic variation and relatedness within species. This includes knowledge about genes encoding antimicrobial resistance (AMR) and potential virulence factors (pVF). The aim of this study was therefore to investigate these aspects by whole-genome sequencing of milk isolates from Swedish dairy cows with subclinical mastitis in an observational study. We also wanted to study if specific genotypes were associated with persistent IMI and the inflammatory response at udder quarter level. In total, 105 and 118 isolates of S. chromogenes and S. simulans, respectively, were included. Isolates were characterized using a 7-locus multilocus sequence typing (7-MLST), core genome analysis and in-silico analysis of AMR and pVF genes. Forty-seven sequence types (ST) and 7 core genome clusters of S. chromogenes were identified, and the most common ST were ST-6 and ST-109, both belonging to cluster VII. A 7-locus MLST scheme for S. simulans was not available, but 3 core genome clusters and 5 subclusters were described. Overall, substantial variation in ST and clusters among cows and herds were found in both species. Some ST of S. chromogenes were found in several herds, indicating spread between herds. Moreover, within-herd spread of the same genotype was observed for both species. Only a few AMR genes (blaZ, strpS194, vga(A)) were detected in a limited number of isolates, with the exception of blaZ coding for β-lactamase, which was identified in 22% of the isolates of S. chromogenes with ST-19, ST-102, and ST-103 more commonly carrying this gene compared with other STs. However, the blaZ gene was not identified in S. simulans. The average total number of pVF detected per isolate was similar in S. chromogenes (n = 30) and S. simulans (n = 33), but some variation in total numbers and presence of specific pVF or functional groups of pVF, was shown between ST/clusters within species. Differences in inflammatory response and potentially in persistent IMI at udder quarter level were found between S. chromogenes subtypes but not between S. simulans subtypes. In conclusion, the results from the present study generates new insight into the epidemiology of bovine S. chromogenes and S. simulans IMI, which can have implications for future prevention and antimicrobial treatment of infections related to these species.

Cerebral venous sinus thrombosis cases detected in on-call CT venographies in Sweden, 2019-2022.

No well-established criteria exist for assessing the risk of cerebral venous sinus thrombosis (CVST). Here, we sought to gain an understanding of CVST cases and associated risk factors, based on the rates of emergency CT venographies (CTVs) performed after hours. Furthermore, we aimed to assess possible correlations between CVST rates and COVID-19, including at the start of the COVID-19 vaccination campaign. We collected reports of emergency CTVs performed after hours at 56 Swedish hospitals between 1/1/2019 and 12/31/2022, and divided them into five groups: (I) from 1/1/2019 to 1/31/2020, before the emergence of COVID-19 cases in Sweden; (II) from 2/1/2020 to 12/26/2020, after the emergence of COVID-19 but before vaccination rollout; (III) from 12/27/2020 to 7/28/2021, from the start of the COVID-19 vaccination campaign until 50% of the adult population in Sweden had been vaccinated; (IV) from 7/29/2021 to 2/1/2022, from when 50% of the adult population was vaccinated until restrictions were lifted; and (V) from 2/2/2022 to 12/31/2022, after restriction measures were suspended. For all included patients, we collected information on demographics and clinical history, including pregnancy, recent partum, and use of oral contraceptives or post-menopausal hormone replacement therapy. In total, we collected 430 reports (92% female, 8% male). The CVST positivity rate was 22.2% in men vs. 2.3% in women. None of the pregnant (n = 49) or postpartum (n = 12) women had CVST positivity. The frequency of CTV examinations was lowest in group 2; during this period, the average time between patients being imaged was 7days. The frequency of CTV examinations was highest in group IV; during this period, a patient underwent this type of scan every 1.5days, on average. The frequency of CVST-positive scans was lowest in group II; during this period, a positive case was found every 66days, on average. The frequency of CVST-positive scans was highest in group IV; during this period, a positive case was found every 62days, on average, and no statistical difference with respect to group II was observed. Pregnancy and recent partum were not significant risk factors for CVST. The elevated CVST positivity rate observed during the height of the COVID-19 pandemic suggested that patients with less likelihood for positive CVST had fewer emergency visits. The positivity rate did not increase with the start of the COVID-19 pandemic or the rollout of COVID-19 vaccination.

Developing welfare technology to increase children’s participation in child welfare assessments: an empirical case in Sweden

ABSTRACT The purpose of the article is to describe and problematise the practice-initiated idea of developing a digital tool for children in child welfare investigations and whether and how this welfare technology is useful for social workers. The results include interview data and descriptions of the research process. The social workers are of the opinion that the digital application increases the possibilities for children’s participation in child investigations, even though their main focus is to create an alliance with the parents. During the research process the digital tool has developed from an empirical idea to a conversation tool and been tested with different user groups. However, the law on procurement limits the possibilities for data storage if the digital tool is to be used in the future. In sum, in order to develop child protection work further, more practice-based research needs to be conducted so that researchers can develop the practice’s ideas and identify the obstacles, opportunities, organisational conditions and development needs. The social workers in this study believe that the digital tool is useful for accessing children's perspectives and experiences, even though relational work with children is not their main task in child welfare investigations.

Application of Artificial Intelligence for Predicting CO2 Emission Using Weighted Multi-Task Learning

Carbon emissions significantly contribute to global warming, amplifying the occurrence of extreme weather events and negatively impacting the overall environmental transformation. In line with the global commitment to combat climate change through the Paris Agreement (COP21), the European Union (EU) has formulated strategies aimed at achieving climate neutrality by 2050. To achieve this goal, EU member states focus on developing long-term national strategies (NLTSs) and implementing local plans to reduce greenhouse gas (GHG) emissions in alignment with EU objectives. This study focuses on the case of Sweden and aims to introduce a comprehensive data-driven framework that predicts CO2 emissions by using a diverse range of input features. Considering the scarcity of data points, we present a refined variation of multi-task learning (MTL) called weighted multi-task learning (WMTL). The findings demonstrate the superior performance of the WMTL model in terms of accuracy, robustness, and computation cost of training compared to both the basic model and MTL model. The WMTL model achieved an average mean squared error (MSE) of 0.12 across folds, thus outperforming the MTL model’s 0.15 MSE and the basic model’s 0.21 MSE. Furthermore, the computational cost of training the new model is only 20% of the cost required by the other two models. The findings from the interpretation of the WMTL model indicate that it is a promising tool for developing data-driven decision-support tools to identify strategic actions with substantial impacts on the mitigation of CO2 emissions.

Interstitial emergence of national defence entrepreneurial firms and re-configuration of the state as a defence actor: the case of Sweden’s Vesper Group

ABSTRACT Does growing reliance on private military and security companies (PMSCs) lead to the re-configuration of the state as a security and defence actor in Europe? Building on the multiple-networks-approach in organisation theory (Padgett and Powell), the current paper develops an analytical approach for studying the rise of new organizational forms in interstitial spaces via mechanisms including extension and differentiation; fusion and hybridity; transposition and refunctionality; and multivocality. The empirical analysis focuses on the rules and practices of Vesper Group - a PMSC working closely with the Swedish government. Several findings are reported. First, a new organizational form seems to be emerging as a result of the ongoing multiple network dynamics – national defence entrepreneurial firm. This is a type of a firm different from mainstream PMSCs in that it is owned by venture capital companies from their home state and also in that it is closely associated with its respective state in terms of its personnel policies, expertise and operational goals and scope. Second, the case of Sweden’s Vesper Group and its cooperation with the Swedish government indicates that some EU member states may also be in the process of structural and institutional mutation as providers of defence and crisis management capabilities.

Academic teachers’ experiences of technology enhanced learning (TEL) in higher education – A Swedish case

Academic teachers’ experiences of technology enhanced learning (TEL) in higher education – A Swedish case