Central Sweden Research Articles

Ramming the parasites: Evaluation of quarantine procedures against Haemonchus contortus at sheep markets in Sweden

In Sweden, it is recommended to treat rams at sheep markets with ivermectin and then keep them in quarantine to minimise the risk of transmission of Haemonchus contortus between farms. The aim of this study was to evaluate the effectiveness of this practise. Accordingly the gastrointestinal parasite status of 50 rams purchased at two sheep markets in central Sweden in autumn 2019 was investigated using faecal samples collected on the day of sale (test 1), 12 ± 3 days after ivermectin injection (test 2, in quarantine) and a few months later before inclusion in the new flocks (test 3). We used both traditional diagnostic methods (i.e. identification of nematode eggs in faeces or larvae in cultures when H. contortus eggs could not be identified) and a molecular test based on the digital droplet PCR platform to further identify positive samples. In test 1, conducted in autumn, 40 % of rams were FEC-positive, but only 12 % (six rams) were infected with H. contortus according to conventional routine diagnostics. In test 2, 8 % (four rams) were FEC-positive, including one with 1050 eggs, 90 % of which were identified as H. contortus. This ram was therefore returned to the supplier. However, ivermectin was found to be effective when this animal and a group of lambs from the same farm were treated and tested again. Test 3 was performed on 44 of the same rams (in addition to the returned ram, two rams died in quarantine and the samples from three rams were never provided by the owners). The proportion of FEC-positive animals was 42 %, with an even higher proportion (27 %) of animals being H. contortus-positive than in test 1. The corresponding results for tests 1, 2 and 3 with the ddPCR assay were 18 %, 4 % and 76 %, respectively. This study demonstrates the superiority of DNA detection over microscopy, which is the mainstay in most diagnostic laboratories. Although the combined results confirm that H. contortus survived quarantine in two rams, in the other cases it is not clear whether the spring infection rates are due to re-emergence of persistent larvae from quarantine or reinfection on the new farm. These results suggest not only that we should recommend that sheep farmers use a more sensitive molecular test when purchasing and introducing new animals to their flock, but also that the reliability of injectable ivermectin as a quarantine treatment for removal of adult and larval stages needs further investigation.

Enhancing Mineral Exploration Programs Through Quantitative XRD: A Case Study from the Gumsberg Polymetallic Sulphide Deposits, Sweden

As challenges in precious and base metal exploration intensify due to the diminishing availability of high-grade ore deposits, rising demand, energy costs, and stricter regulations towards net-zero carbon activities, advanced techniques to enhance exploration efficiency are becoming increasingly critical. This study demonstrates the effectiveness of quantitative X-ray diffraction (QXRD) with Rietveld refinement, coupled with multivariate statistical analysis (including agglomerative hierarchical clustering, principal component analysis, and fuzzy analysis), in characterizing the complex mineralogy of strata-bound volcanic-associated limestone-skarn Zn-Pb-Ag-(Cu-Au)-type sulphide deposits (SVALS). Focusing on 113 coarse rejects from the Gumsberg project located in the Bergslagen mining district in central Sweden, the research identified five distinct mineralogical clusters corresponding to polymetallic base metal sulphide mineralization, its proximal alteration zones, and variably metamorphosed host rocks. The results reveal significant sulphide mineralization, ranging from disseminated to massive occurrences of sphalerite, pyrrhotite, pyrite, and galena, with trace amounts of secondary minerals like anglesite in certain samples indicating weathering processes. The study also identifies rare minerals such as armenite, often overlooked in traditional geological logging. These findings underscore the potential of QXRD to enhance resource estimation, optimize exploration strategies, and contribute to more efficient and sustainable mineral exploration programs. The accuracy of QXRD was cross-validated with geological logs and geochemical data, confirming its reliability as a mineralogical discrimination tool.

Gendered trends in unpaid labour by educational level in Sweden 2004-2022

Abstract Background Unpaid labour has recently been recognised as an important yet neglected social determinant of health. Our aim was to investigate the gendered trends in unpaid labour/domestic work by educational level in prime working-age Swedish adults (30-49 years) from 2004-2022. Methods The study is based on a postal survey sent to a random general population sample of adults from central Sweden in 2004, 2008, 2012, 2017 and 2022. The 30-49-year age group included between 5,500 and 12,200 respondents depending on the survey year. Trends in hours spent in domestic work and in experiencing domestic work as burdensome by gender and educational level were estimated by age-standardised proportions with corresponding 95% confidence intervals. Results Women reported spending more time in domestic work than men throughout every survey period from 2004 to 2022. For example, in 2022, 31% of women spent more than 20 hours per week in domestic work compared to 20% of men. Over time, hours spent in domestic work decreased in women whereas no trend was observed in men. Among women, educational level appeared to make no difference to prevalence of high domestic work time whereas, among men, it was consistently greater among those with higher educational levels. In general, women experienced domestic work as burdensome to a higher degree than men did. Conclusions As gender differences in unpaid labour/domestic work persist in Sweden, more effort is needed to implement social policies to increase men’s participation in domestic work, especially among men with low and middle educational levels, which has the potential to reduce gendered health inequities. Key messages • Amongst Swedish adults aged 30-49 years, the gender gap in unpaid labour has declined during the last two decades, but this is only due to women reducing their domestic work time. • For men, prevalence of high domestic work time was consistently greater among those with higher educational levels, whereas no difference was observed among women.

Assessment of genetic diversity, tissue tropism, and antigenic properties of Grimsö betacoronavirus in Swedish bank voles (Clethrionomys glareolus)

Zoonotic coronaviruses can transmit over species barriers and infect humans. To understand the zoonotic potential of a betacoronavirus, Grimsö virus (GRIV), we investigated the geographic distribution and tissue tropism of GRIV in Swedish bank voles (Clethrionomys glareolus), and the antigenicity of the nucleocapsid (N) protein. We screened the lung tissues from animals collected in the southern Sweden by RT-PCR with primers targeting the spike gene. Seven out of 74 animals were found to be positive. They are genetically close to GRIV from Grimsö, central Sweden. Positive rodents were studied for the tissue distribution of GRIV and GRIV RNA was mainly found in the respiratory tract. After three attempts of virus isolation were failed, we successfully established a Vero E6 cell line that stably expressed GRIV N protein, which has no cross-reactivity with patient serum containing antibodies against SARS-CoV-2, or with MERS-CoV. However, a low level of cross-reactivity to common cold coronaviruses was found, likely HCoV-OC43 or HCoV-HKU1, probably due to shared linear epitopes. With the high prevalence and the suggested respiratory transmission route, GRIV may have a high potential for spillover and cross-species transmission, and future serological screening of GRIV infections in domestic animals or humans will be needed.

Transit Safety of Women in Rural-Urban Contexts

Sexual harassment and other forms of transit crime are everyday occurrences for women and girls around the world. The absence of safety hampers the ability of numerous women to engage freely in school, employment, and public activities without being alert. This research explores women’s safety experiences, particularly focusing on young women in diverse rural and urban environments. We utilized chi-square analysis and regression models to analyze data obtained from a survey distributed to railway passengers in 2022 across neighboring municipalities in southern central Sweden. Findings show that being young makes women more likely to be victimized. Although rural women feel safer than their urban counterparts, they are more often willing to take precautionary measures before taking a trip (e.g., more often traveling with someone in the evening or avoiding certain stations). These findings call for gender-age-sensitive mobility policies, taking into account the intersectionality of transit safety, and reflecting women’s and girls’ safety needs in particular rural contexts.

Gastronomic ethnobiology of smelt, Osmerus eperlanus (L., 1758), a culturally significant but vanishing food item in Sweden

European smelt, Osmeras eperlanus L., was popular as food in central Sweden a century ago. During spring spawning, this fish could easily be caught in large quantities in rivers and streams with nets and wooden traps. While it is still appreciated as a delicious spring primer in several countries around the Baltic Sea, in Sweden its consumption is negligible. The fish has vanished from markets and restaurant menus, and it is fished only locally in Central Sweden. In Stockholm, smelt was fished commercially until 2016.Smelt is a small fish yet loaded with cultural symbolism, and it has attracted the attention of authors, designers, and visual artists for centuries. Attempts to relaunch smelt as a local speciality have had only marginal impact. It is far from endangered in Swedish waters, but as human food, this fish has gone from highly popular to neglected and ultimately ignored. This article discusses the significance of smelt as food and cultural symbol in historical times, causes and consequences of changing habits, and their influence on the consumption of smelt, the loss of knowledge regarding fish preparation, and the place of fish today in Swedish food traditions versus modern food preferences.

Tillage and land use management effects on soil organic matter and soil microbial biomass in a field network of practical farms in France, Romania, and Sweden

A reduction in tillage intensity, organic farming, and introduction of ley-grass periods into the crop rotation are means to improve the sustainable use of arable soils. The current study uses an on-farm approach to investigate soils from different practical farms in Northern France, Central Sweden, and Romania in comparison with previously published results from randomized field-experiments nearby. No-tillage generally increased the mean SOC and total N contents of arable fields in comparison with ploughing. However, this increase was only significant for the 70 % increase at 0–10 cm depth in France. No-tillage had no general effects on MBC or MBN and increased the ergosterol content at 0–10 cm depth in France and Sweden but not in Romania. Averaging depths and tillage systems, median MBC significantly increased in the order France (220 μg g−1 soil), Romania (324 μg g−1 soil), and Sweden (384 μg g−1 soil), whereas the median MB-C/N ratios followed the order France (5.6), Sweden (8.3), and Romania (10.4). The study region-specific changes in soil pH significantly affected covariate MBC and MBN in the regression equations for equal slopes ANCOVA models. In Northern France, organic farming and ley-grass implementation into the crop rotation increased SOC and total N contents to the level of the no-tillage fields. On-farm research gives similar results to long-term field experiments in France, Romania, and Sweden. For this reason, on-farm research on practical fields is an important, less expensive alternative to randomized field experiments, with a high potential for investigating actual and relevant research objectives. This will intensify exchange in knowledge between scientists and farmers.

Derivation of Predictive Layers Using Regional Till Geochemistry Data for Mineral Potential Mapping of the REE Line of Bergslagen, Central Sweden

With the increasing need for rare-earth elements (REEs) to reach the goals of the ongoing green energy transition, new and innovative methods are needed to identify new primary resources of these critical metals. This study explores the potential to use a non-biased, uniform till dataset to generate evidentiary layers that describe these critical factors and geochemical anomalies to aid mineral potential mapping (MPM) for REEs using machine-assisted methods. The till samples used in this study were collected from the “REE Line”, a sub-region within the Bergslagen lithotectonic province, Sweden, where numerous REE mineralizations occur. Multiple approaches were used in this study to isolate geochemical anomalies using multivariate methods, namely principal component analysis (PCA) and K-means clustering. Additional factors for classifying till samples were also tested, including alteration indices. Using known REE occurrences in Bergslagen as validation points, the results demonstrated the usefulness of multivariate methods applied to till geochemistry for predictive bedrock mapping, and to identify potential areas of REE mineralization within the REE line. The results of the alteration indices showed that the till geochemistry demonstrated similar levels of alteration when compared to the underlying bedrock, allowing for a regional alteration map to be generated. These results show that regional-scale till sampling can provide low-cost data for mineral exploration at the regional scale and generate usable evidentiary layers for GIS-based MPM.

Characterizing the distribution of extreme geoelectric field events in Sweden

Historically, Sweden has reported several impacts on transformers and transmission lines related to geomagnetically induced currents (GICs) that develop during strong space weather events. GICs are driven by the geoelectric field (E), and their intensity depends on various factors, including the lithology conductivity and the rate of change of the Earth's magnetic field. The purpose of this study is to perform an extreme value analysis (EVA) of the E magnitude at six different latitudes in Sweden and to express the maximum |E| that might be observed in 10, 50 and 100 years. We analyzed 10-second E data in Sweden, which was obtained from a 1-D model. This model incorporates 10-second geomagnetic measurements from the IMAGE network and the vertical Earth's ground electrical conductivity in Sweden, extracted from a 3-D conductance map for the Fennoscandian region. Extreme E events tend to occur in clusters around geomagnetic disturbances (substorms and geomagnetic storms). Therefore, we applied two different methods to decluster the data. After declustering, Generalized Pareto (GP) distributions were fitted to the remaining extreme events that exceed the 99.5th percentile. The EVA indicates that the shape parameter of the GP distribution depends on latitude. This implies that at higher geographic latitudes (64.52-68.02°N) the distribution decreases faster toward zero than at lower latitudes (58.26-62.25°N). As a result the expected maximum |E| in 100-years in central Sweden ranges between 4.0-8.5 V/km, while at higher latitudes, it ranges between 2.0-2.5 V/km similar to the modeled geoelectric field values during the Halloween event in October 2003. In particular, around 60.50°N the distribution of extreme events exhibits the heaviest tail. When we additionally consider the effect of conductivity, the region of west Sweden around 60.50°N exhibits the largest expected maximum in 100-years with a value around 8.5 V/km. This is three times larger the maximum modeled |E| at that latitude.

Data homogeneity impact in tree species classification based on Sentinel-2 multitemporal data case study in central Sweden

ABSTRACT Spatial information on forest composition is invaluable for achieving scientific, ecological, and management objectives and for monitoring multiple changes in forest ecosystems. The increased flow of optical satellite data provides new opportunities to improve tree species mapping. However, the accuracy of such maps is affected by training data, and in particular on the homogeneity of individual classes. Thus, we evaluated the effect of data homogeneity in tree species classification. We performed tree species classification by considering different ways to partition data into tree species classes. The class sets considered were (i) only mixed coniferous and mixed deciduous forest classes, (ii) single-species classes, (iii) single-species, mixed coniferous and mixed deciduous classes, and (iv) single-species, mixed coniferous and mixed deciduous classes and a true mixed class. Using data from the Swedish National Forest Inventory, we varied the threshold that defined dominating species. Tree species were classified for a study area in central Sweden using Sentinel-2 data and two classification approaches: Bayesian inference and random forest (RF). Images were selected by class separability and the most informative images based on variable selection with RF. The most informative images tended to be selected by both methods. However, in forests with tree species of similar spectral behaviour, image selection on the basis of class separability was found to be more reliable. More accurate classification results were achieved as the number of classes decreased and the threshold of plot purity increased. The Bayesian classification approach of only mixed coniferous and mixed deciduous classes gave the highest OA, always greater than 90%. When discriminating between pure plots of Birch (Betula spp.), Spruce (Picea abies), Scots pine (Pinus sylvestris) and Lodgepole pine (Pinus contorta), the best OA values were 84% for Bayesian and 80% for RF. In more complicated scenarios, RF resulted in higher overall accuracies (OA).

Influence of thermal intrusion on the Alum Shale from south central Sweden

This study investigates the geochemical and petrological characteristics of solid bitumen in the DBH15/73 core from the Furongian (upper Cambrian) and Miaolingian (middle Cambrian) Alum Shale in Billingen, south central Sweden. At Billingen a > 30 m thick Permian diabase (dolerite sill) intruded approximately 100 m above the Alum Shale that promoting the formation of solid bitumen in the uppermost half of the Alum Shale due to enhanced heat flow. The bitumen has been classified into bituminite/diagenetic solid bitumen (DSB), initial-oil solid bitumen (IOSB), and primary-oil solid bitumen (POSB) based on their genesis, morphology and random solid bitumen reflectance (BRo). The Miaolingian shale, constituting the lower part of the Alum Shale, is immature and contains solely bituminite and DSB, with measured BRo ranging from 0.40% to 0.48%. In contrast, the Furongian shale exhibits enrichment in IOSB and POSB and range from marginally mature to peak oil generation with towards the top of the section. Characteristics of uneven heating is seen in the IOSB (BRo: 0.97–1.08%) including oxidation rims and abnormally high maturity surrounding fractures. The POSB (BRo: 0.63–2.01%) is present not only in the Alum Shale but also in the overlying Ordovician Latorp limestone and the underlying Kakeled Limestone Bed, and shows flow structures which is further evidence for migration. The abundance of POSB and IOSB is determined through maceral point counting, revealing POSB as the dominant bitumen type (1.54–7.13 vol%), while IOSB constitutes the minority (0.05–0.31 vol%) within the Furongian shale. This distribution suggests rapid thermal evolution of organic matter within the oil generation window. Additionally, a reduction in free hydrocarbons (Rock-Eval S1), potential hydrocarbons (Rock-Eval S2), and unexpectedly low Tmax was observed in the Furongian shale. Results indicate that hydrocarbon generation resulting from thermal intrusion contributes to the relatively low S2. Migration of POSB and generated oil to adjacent layers leads to the loss of S1, while the reduced Tmax may be attributed to high uranium content which weakens carbon chain bond energy. These anomalies result in an underestimation when evaluating thermal maturity and kerogen type conversion based on Rock Eval data alone.

The meaning of being conscious during surgery with local or regional anesthesia–A phenomenological hermeneutic study

BackgroundWith increasing prevalence of surgery under local or regional anesthesia, which allows patients to remain conscious during the intraoperative phase, there is a growing need to comprehend the lived experiences associated with this practice. ObjectiveThis study aimed to illuminate the lived experiences of individuals who remained conscious during surgical intervention under local or regional anesthesia. DesignA qualitative design was chosen. Setting(s)Participants in the present study were recruited from three surgical wards located in central Sweden using a purposive sampling strategy. The surgical disciplines included ear, gynecological, hernioplasty, orthopedic, and vessel surgeries. ParticipantsFourteen narrative interviews were conducted with individuals who had undergone elective surgery while conscious. MethodsVerbatim transcribed text was analyzed using a phenomenological-hermeneutic method. ResultsThe lived experience of being conscious during surgery was marked by feelings of hope alongside a sense of losing one's identity and experiencing destabilization. Structural analysis revealed two themes. The first theme, 'being in the hands of others', encompassed subthemes such as 'entering an unfamiliar environment and procedure,' 'losing foothold and a sense of self-identity,' and 'enduring unexpected or anticipated discomfort.' The second theme, 'managing the inevitable for future health concerns,' involved subthemes such as 'pursuing self-acceptance of the situation,' 'entrusting the professionals while seeking signs of a smooth procedure,' and 'Enhancing own resilience through continuous support. ConclusionsBeyond the patient's physical well-being during surgery, the OR team should acknowledge the "person" component and focus on their emotional and social needs in this vulnerable situation. The four meta-paradigms of nursing—person, health, environment, and nursing—significantly influence the conscious patient's experience. Patient or Public ContributionNo patient or public contribution

Caesarean section on maternal request: a qualitative study of conflicts related to shared decision-making and person-centred care in Sweden

BackgroundToday, person-centred care is seen as a cornerstone of health policy and practice, but accommodating individual patient preferences can be challenging, for example involving caesarean section on maternal request (CSMR). The aim of this study was to explore Swedish health professionals’ perspectives on CSMR and analyse them with regard to potential conflicts that may arise from person-centred care, specifically in relation to shared decision-making.MethodsA qualitative study using both inductive and deductive content analysis was conducted based on semi-structured interviews. It was based on a purposeful sampling of 12 health professionals: seven obstetricians, three midwives and two neonatologists working at different hospitals in southern and central Sweden. The interviews were recorded either in a telephone call or in a video conference call, and audio files were deleted after transcription.ResultsIn the interviews, twelve types of expressions (sub-categories) of five types of conflicts (categories) between shared decision-making and CSMR emerged. Most health professionals agreed in principle that women have the right to decide over their own body, but did not believe this included the right to choose surgery without medical indications (patient autonomy). The health professionals also expressed that they had to consider not only the woman’s current preferences and health but also her future health, which could be negatively impacted by a CSMR (treatment quality and patient safety). Furthermore, the health professionals did not consider costs in the individual decision, but thought CSMR might lead to crowding-out effects (avoiding treatments that harm others). Although the health professionals emphasised that every CSMR request was addressed individually, they referred to different strategies for avoiding arbitrariness (equality and non-discrimination). Lastly, they described that CSMR entailed a multifaceted decision being individual yet collective, and the use of birth contracts in order to increase a woman’s sense of security (an uncomplicated decision-making process). ConclusionsThe complex landscape for handling CSMR in Sweden, arising from a restrictive approach centred on collective and standardised solutions alongside a simultaneous shift towards person-centred care and individual decision-making, was evident in the health professionals’ reasoning. Although most health professionals emphasised that the mode of delivery is ultimately a professional decision, they still strived towards shared decision-making through information and support. Given the different views on CSMR, it is of utmost importance for healthcare professionals and women to reach a consensus on how to address this issue and to discuss what patient autonomy and shared decision-making mean in this specific context.

Envisioning sustainable rural development: A narrative on accessibility and infrastructure from a Swedish region

Infrastructure developments depend on decision makers' perceptions of the particular policy issue and a preferred future state. The complex relationship between accessibility and rural development and the long periods from problem recognition to transport infrastructure realisations bring further uncertainty into regional planning. Therefore, government and public administration tend to rely on narratives to explain the policy issue and to transfer their perspectives into the policy process. However, oversimplified narratives unduly limit the understanding of the problem and so the choice of solutions. This paper aims therefore to contribute to an understanding of the recognition of accessibility and transport infrastructure as a policy problem for sustainable regional development in rural areas. It investigates the narrative that emerges from local officials' perceptions about a future society, reasons for sustainable growth and the collaboration at the local and regional levels in central Sweden. The analysis details the four key perspectives of the narrative: local people, work and leisure, an urban neighbourhood and public transport services. The findings stress the narrative's lack of oversight and inclusion that accounts for societies' heterogeneity. In particular, the analysis expounds a remarkable faceless story that conveys a prevalent lack of understanding of stakeholder needs and the role of critical infrastructure for societal development in rural areas.

Are we using more sugar substitutes? Wastewater analysis reveals differences and rising trends in artificial sweetener usage in Swedish urban catchments

The market for artificial sweeteners as substitutes for conventional sugar (sucrose) is growing, despite potential health risks associated with their intake. Estimating population usage of artificial sweeteners is therefore crucial, and wastewater analysis can serve as a complement to existing methods. This study evaluated spatial and temporal usage of artificial sweeteners in five Swedish communities based on wastewater analysis. We further compared their levels measured in wastewater with the restrictions during the COVID-19 pandemic in Sweden and assessed health risks to the Swedish population. Influent wastewater samples (n = 194) collected in March 2019-February 2022 from communities in central and southern Sweden were analyzed for acesulfame, saccharin, and sucralose using liquid-chromatography coupled with tandem mass spectrometry. Spatial differences in loads for individual artificial sweetener were observed, with sucralose being higher in Kalmar (southern Sweden), and acesulfame and saccharin in Enköping and Östhammar (central Sweden). Based on sucrose equivalent doses, all communities showed a consistent prevalence pattern of sucralose > acesulfame > saccharin. Four communities with relatively short monitoring periods showed no apparent temporal changes in usage, but the four-year monitoring in Uppsala revealed a significant (p < 0.05) annual increase of ∼19 % for sucralose, ∼9 % for acesulfame and ∼8 % for saccharin. This trend showed no instant or delayed effects from COVID-19 restrictions, reflecting positively on the studied population which retained similar exposure to the artificial sweeteners despite potential pandemic stresses. Among the three artificial sweeteners, only acesulfame’s levels were at the lower end of the health-related threshold for consumption of artificially sweetened beverages; yet, all were far below the acceptable daily intake, indicating no appreciable health risks. Our study provided valuable, pilot insights into the spatio-temporal usage of artificial sweeteners in Sweden and their associated health risks. This shows the usefulness of wastewater analysis for public health authorities wishing to assess future relevant interventions.

Bokningsstenar – betydande spår av de obetydliga

Ore grinding stones – A significant trace of the insignificants. In the summer of 2020, an archaeological excavation took place at Dammen’s blast furnace in Askersund, central Sweden. The site, active between 1642 and 1844, was a miner’s furnaceperiodically co-owned by Louis de Geer, a businessman who owned the nearby manor Godegård. Even though Dammen’s blast furnace was active for over 200 years, the traces of the iron production conducted here were sparce. Besides the large amount of slag and the foundations of two storage buildings, the main result of the excavation was the numerous ore grinding stones used in the process of refining the iron ore, identified by the smallish pits left on the stones’ surface after manually striking the ore with a hammer. In Sweden, this is a relatively unknown find category; few blast furnaceshave been investigated by archaeologists and when ore grinding stones have been identified, they have not received much attention. At larger blast furnace sites, the process of refining ore was often conducted mechanically with water-powered equipment but at smaller sites this was carried out by hand, usually by women, children and what was referred to as “inferior workers”.Thus, at Dammen’s blast furnace, the lowest ranking workers had left the clearest traces; 141 stones with slowly worn pits.

Mellan artefakt och geofakt. Glättstenar i samiska kontexter från 1700- och 1800-talen

Smoothing stones from Sami contexts in the 18th and 19th centuries. Smoothing stones of green stone/field stone are sometimes found in both Sámi and non-Sámi contexts from the Iron age and the Medieval period. Usually they are associated with leather or textile production. This paper discusses the findings of natural smoothing stones at three Sámi dwellings in Hälsingland and Gästrikland, central Sweden, dated from the end of the 18th to mid-19th centuries. The stones are interpreted as used in leather and textile production but also that they played a significant role for the maintaining, and development of Sámi traditions, in a time of forced sedentary habitation and assimilation.

#1802 Treatment with potassium binders in central Sweden—an observational study based on the DEMONSTRATE database

Abstract Background and Aims Hyperkalemia (HK), defined as a plasma potassium level (&amp;gt; 5.0 mmol/L), is associated with adverse outcomes, including cardiac arrhythmias and mortality. Until recently, HK was managed mainly with sodium polystyrene sulfonate (SPS) (first generation potassium binders) but concerns regarding the safety profile warranted new alternatives. The second-generation potassium binders, patiromer and sodium zirconium cyclosilicate (SZC) were introduced in Sweden in 2018 and 2019 respectively. The aim of this observational study was to understand the current use of new potassium binders, the related potassium values triggering treatment and to describe the clinical characteristics of patients treated with first- and second-generation potassium binders (SPS and patiromer/SZC respectively) in Sweden. Method An observational study based on laboratory data from six regions in central Sweden (18% of the Swedish population), linked to national health registry data, comprising information on clinical events and pharmacy drug dispensations. All treatment episodes of potassium binders between 01 July 2005 and 31 December 2022 were selected and restricted to patients with information on potassium values. A new treatment episode was defined as a gap of at least 120 days to the prior pharmacy dispensations of potassium binders. We analyzed potassium values (up to 60 days prior to initiation of potassium binders), demographics, comorbidities and treatments. Results are mainly presented by treatment episodes and strata of; (a) all, (b) first- and (c) second-generation potassium binders. Results In total, we identified 13 441 treatment episodes of which 13 218 episodes (n = 7086 individuals), were attributed to first generation potassium binders (throughout the study period) and 223 episodes (n = 151 individuals) to second-generation potassium binders (from 2018-2022) (Table 1). Baseline characteristics are presented by treatment episodes. Baseline potassium value prior to treatment was 5.6 (0.8) mmol/L for first and 5.6 (0.7) for second generation potassium binders. Mean eGFR prior to treatment was 22.3 (16.3) ml/min/1.73 m2 for first and 18.7 (16.0) for second-generation potassium binders. Compared to first generation, second-generation potassium binders were prescribed to patients with more comorbidities (41.7% vs 32.1% for heart failure, 88.3% vs 81.7% for hypertension, and 39.5% vs 28.9% for dialysis) and more frequently from cardiology/internal medicine units (41.7% vs 30.0%). Distribution of potassium levels at baseline is shown in Fig. 1. Conclusion Compared to first- generation potassium binder, we observed fewer treatment episodes with second generation potassium binders, of which majority had a more severe comorbidity profile. There was no difference in potassium values prior to treatment between first- and second-generation potassium-binders.

#1926 Persistence to first- and second- generation potassium binder treatment—an observational study based on the DEMONSTRATE database

Abstract Background and Aims Hyperkalemia (HK) is a common electrolyte abnormality mainly caused by reduced renal potassium excretion in patients with chronic kidney disease (CKD). Potassium binders, such as sodium polystyrene sulfonates (SPS) are widely used but may lead to adverse gastrointestinal (GI) symptoms, reducing their tolerability. Patiromer and sodium zirconium cyclosilicate (SZC) are newer ion exchange resins for treatment of HK which may cause fewer GI side-effects. This study aims to evaluate the persistence to first- (SPS) and second-generation potassium binder (patiromer and SZC) treatment and the related clinical characteristics. Method In this observational study based on the DEMONSTRATE database, a novel national and regional database comprising laboratory data from six regions in central Sweden (18% of the Swedish population), linked to the national health registry data, we selected all patients in Sweden having at least one pharmacy dispensation of either first (SPS) or second (patiromer or SZC) generation potassium binder between July 2005 and December 2022. By semi-automatically interpreting the prescribed dosages in combination with the amount of medical supply, duration for each dispensation was estimated and episodes of potassium binder treatments were established. For all potassium binder episodes, we described patient characteristics and persistence to treatment. Results are mainly presented by treatment episodes and by strata of (a) all, (b) first and (c) second generation potassium binders. Results Between July 2005 and December 2022, we identified 68 133 treatment episodes of potassium binders for 32 424 patients (Table 1). Of these, 31 730 individuals and 66 309 treatment episodes were attributed to first generation (throughout the study period), and 1,276 individuals and 1,824 treatment episodes to second-generation potassium binders (between 2018-2022) Mean (SD) age was slightly lower in patients initiating second compared to first generation potassium binders; 68.5 (15.6) vs 65.2 (16.6) years. Potassium binder treatment was more common in men compared to women (66.9% vs. 33.1%) with similar gender distribution between first- and second-generation potassium binders. Comorbidities were more common in patients initiating treatment with second than first generation potassium binders, notably for heart failure (40.0% vs. 29.7%) and dialysis (38.8% vs 29.2%). RAASi and MRA were more often prescribed to the second generation potassium binders vs first; 70.8% vs 62.9% for RAASi and 18.8% vs. 8.5% for MRA. Second generation potassium binders were more commonly initiated in cardiology/internal medicine units (41.7% vs. 34.8%) and dialysis (38.8% vs. 29.2%). Persistence was higher among patients treated with second generation potassium binders (Fig. 1). Conclusion Second generation potassium binders were more often prescribed to younger patients that had more co-morbidities being slightly more persistent to treatment when compared to patients on first generation potassium binders.

Synchronizing the Western Gotland Basin (Baltic Sea) and Lake Kälksjön (central Sweden) sediment records using common cosmogenic radionuclide production variations

Multi-archive studies of climate events and archive-specific response times require synchronous time scales. Aligning common variations in the cosmogenic radionuclide production rate via curve fitting methods provides a tool for the continuous synchronization of natural environmental archives down to decadal precision. Based on this approach, we synchronize 10Be records from Western Gotland Basin (WGB, Baltic Sea) and Lake Kälksjön (KKJ, central Sweden) sediments to the 14C production time series from the IntCal20 calibration curve during the Mid-Holocene period ~6400 to 5200 a BP. Before the synchronization, we assess and reduce non-production variability in the 10Be records by using 10Be/9Be ratios and removing common variability with the TOC record from KKJ sediments based on regression analysis. The synchronizations to the IntCal20 14C production time scale suggest decadal to multi-decadal refinements of the WGB and KKJ chronologies. These refinements reduce the previously centennial chronological uncertainties of both archives to about ± 20 (WGB) and ±40 (KKJ) years. Combining proxy time series from the synchronized archives enables us to interpret a period of ventilation in the deep central Baltic Sea basins from ~6250 to 6000 a BP as possibly caused by inter-annual cooling reducing vertical water temperature gradients allowing deep water formation during exceptionally cold winters.