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  • 1.
    Belyaev, Yuri K
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    On consistency of maximum likelihood estimators based on resampled data2000Rapport (Övrigt vetenskapligt)
  • 2.
    Belyaev, Yuri K
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Parametric maximum likelihood estimators and resampling1997Rapport (Övrigt vetenskapligt)
  • 3.
    Bergdahl, Ingvar A
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Gerhardsson, Lars
    Liljelind, Ingrid E
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Skerfving, Staffan
    Plasma-lead concentration: investigations into its usefulness for biological monitoring of occupational lead exposure2006Ingår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 49, nr 2, s. 93-101Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The lead concentration in plasma is correlated to that in whole blood with a two to fourfold variation. It has never been investigated if this variation is inter-individual.

    Methods: Lead and hemoglobin were determined in blood and plasma from 13 lead workers with a history of relatively high blood-lead concentrations, sampled three times during 1 day. The variation in the distribution of lead between cells and plasma was studied, but not the variation in the lead concentrations as such.

    Results: Blood hemoglobin decreased with rising plasma lead (0.9–3.0 µg/L). Regarding the distribution of lead, no effect of current exposure during the day or of recent meals appeared. As much as 84% of the overall variance of the distribution of lead between cells and plasma could be attributed to individual factors. After adjustment for erythrocyte volume fraction this decreased to 67%. Plasma samples with elevated hemoglobin concentrations (due to in vitro hemolysis) had somewhat elevated lead concentrations.

    Conclusions: Plasma lead is not significantly altered by variation in a single day's exposure and, therefore, the choice of time of the day is not critical for sampling. However, plasma lead is negatively correlated to blood hemoglobin and mild hemolysis (not visible by the eye) in a sample may increase plasma lead with up to 30%. Finally, plasma provides lead exposure information that differs from whole blood, but it is not clear which one of these is the biomarker with the closest relation to exposure and/or effects.

  • 4.
    Brorsson, Camilla
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Dahlqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Naredi, Silvana
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Saliva stimulation with glycerine and citric acid does not affect salivary cortisol levels2014Ingår i: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 81, nr 2, s. 244-248Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    In critically ill patients with hypotension, who respond poorly to fluids and vasoactive drugs, cortisol insufficiency may be suspected. In serum over 90% of cortisol is protein-bound, thus routine measures of total serum cortisol may yield 'false lows' due to hypoproteinaemia. Thus, the occurrence of cortisol insufficiency could be overestimated in critically ill patients. Salivary cortisol can be used as a surrogate for free serum cortisol, but in critically ill patients saliva production is decreased, and insufficient volume of saliva for analysis is a common problem. The aim of this study was to investigate if a cotton-tipped applicator with glycerine and citric acid could be used for saliva stimulation without affecting salivary cortisol levels.

    DESIGN:

    Prospective, observational study.

    PARTICIPANTS:

    Thirty-six volunteers (six males, 30 females), age 49 ± 9 years, without known oral mucus membrane rupture in the mouth.

    MEASUREMENTS:

    Forty-two pairs of saliva samples (22 paired morning samples, 20 paired evening samples) were obtained before and after saliva stimulation with glycerine and citric acid. Salivary cortisol was analysed using Spectria Cortisol RIA (Orion Diagnostica, Finland).

    RESULTS:

    The paired samples correlated significantly (P < 0·0001) and there was no significant difference between un-stimulated and stimulated salivary cortisol levels.

    CONCLUSIONS:

    Saliva stimulation with a cotton-tipped applicator containing glycerine and citric acid did not significantly influence salivary cortisol levels in healthy volunteers. This indicates that salivary cortisol measurement after saliva stimulation may be a useful complement when evaluating cortisol status in critically ill patients.

  • 5.
    Brorsson, Camilla
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Dahlqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Thunberg, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Sylvan, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Naredi, Silvana
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Adrenal response after trauma is affected by time after trauma and sedative/analgesic drugs2014Ingår i: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 45, nr 8, s. 1149-1155Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The adrenal response in critically ill patients, including trauma victims, has been debated over the last decade. The aim of this study was to assess the early adrenal response after trauma. METHODS: Prospective, observational study of 50 trauma patients admitted to a level-1-trauma centre. Serum and saliva cortisol were followed from the accident site up to five days after trauma. Corticosteroid binding globulin (CBG), dehydroepiandrosterone (DHEA) and sulphated dehydroepiandrosterone (DHEAS) were obtained twice during the first five days after trauma. The effect of time and associations between cortisol levels and; severity of trauma, infusion of sedative/analgesic drugs, cardiovascular dysfunction and other adrenocorticotropic hormone (ACTH) dependent hormones (DHEA/DHEAS) were studied. RESULTS: There was a significant decrease over time in serum cortisol both during the initial 24 h, and from the 2nd to the 5th morning after trauma. A significant decrease over time was also observed in calculated free cortisol, DHEA, and DHEAS. No significant association was found between an injury severity score >/= 16 (severe injury) and a low (< 200 nmol/L) serum cortisol at any time during the study period. The odds for a serum cortisol < 200 nmol/L was eight times higher in patients with continuous infusion of sedative/analgesic drugs compared to patients with no continuous infusion of sedative/analgesic drugs. CONCLUSION: Total serum cortisol, calculated free cortisol, DHEA and DHEAS decreased significantly over time after trauma. Continuous infusion of sedative/analgesic drugs was independently associated with serum cortisol < 200 nmol/L.

  • 6.
    Lampa, Erik G.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Liljelind, Ingrid E.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Bergdahl, Ingvar A.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Optimizing occupational exposure measurement strategies when estimating the log-scale arithmetic mean value: An example from the reinforced plastics industry2006Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 50, nr 4, s. 371-377Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When assessing occupational exposures, repeated measurements are in most cases required. Repeated measurements are more resource intensive than a single measurement, so careful planning of the measurement strategy is necessary to assure that resources are spent wisely. The optimal strategy depends on the objectives of the measurements. Here, two different models of random effects analysis of variance (ANOVA) are proposed for the optimization of measurement strategies by the minimization of the variance of the estimated log-transformed arithmetic mean value of a worker group, i.e. the strategies are optimized for precise estimation of that value. The first model is a one-way random effects ANOVA model. For that model it is shown that the best precision in the estimated mean value is always obtained by including as many workers as possible in the sample while restricting the number of replicates to two or at most three regardless of the size of the variance components. The second model introduces the ‘shared temporal variation’ which accounts for those random temporal fluctuations of the exposure that the workers have in common. It is shown for that model that the optimal sample allocation depends on the relative sizes of the between-worker component and the shared temporal component, so that if the between-worker component is larger than the shared temporal component more workers should be included in the sample and vice versa. The results are illustrated graphically with an example from the reinforced plastics industry. If there exists a shared temporal variation at a workplace, that variability needs to be accounted for in the sampling design and the more complex model is recommended.

  • 7.
    Liljelind, Ingrid E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Eriksson, Kåre A
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif O
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Jonsson, I Birgitta M
    Burstrom, Ylva I
    A method for measuring the potential dermal exposure to methyl methacrylate during two different dental technical work tasks.2005Ingår i: Journal of Environmental Monitoring, ISSN 1464-0325, E-ISSN 1464-0333, Vol. 7, nr 5, s. 519-23Artikel i tidskrift (Refereegranskat)
  • 8.
    Liljelind, Ingrid E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagenbjörk-Gustafsson, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif O
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Potential dermal exposure to methyl methacrylate among dental technicians; variability and determinants in a field study.2009Ingår i: Journal of environmental monitoring : JEM, ISSN 1464-0333, Vol. 11, nr 1, s. 160-5Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Methyl methacrylate (MMA) is a commonly used chemical in dental work that can cause dermatitis. Nineteen dental technicians participated in a field study in which potential dermal exposure to MMA and exposure determinants, including glove use and MMA vapour in the breathing zone, were repeatedly monitored during three consecutive days. Using patches placed on various parts of their hands we observed that the fingers and palms of the dental technicians were exposed to MMA, and their forefingers were significantly more exposed than their ring fingers; this is based on pooled data for both left and right hands (p = 0.04). The exposure variability was greater between workers than within worker (i.e. day-to-day variability), but the between worker variability was to some extent explained by a model which included the tested determinants. Neither the amount of MMA vapours in the breathing zone nor glove use was consistently correlated with the dermal exposure. Thus, the effects of glove use and the distribution of exposure to MMA on the hands in working environments needs to be further investigated.

  • 9.
    Liljelind, Ingrid
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Toomingas, Allan
    Karolinska Institutet, Institute of Environmental Medicine, Unit of Occupational Medicine SE-171 76 Stockholm, Sweden.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Determinants Explaining the Variability of Hand-Transmitted Vibration Emissions From Two Different Work Tasks: Grinding and Cutting Using Angle Grinders2013Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 57, nr 8, s. 1065-1077Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There are numerous factors including physical, biomechanical, and individual that influence exposure to hand-transmitted vibration (HTV) and cause variability in the exposure measurements. Knowledge of exposure variability and determinants of exposure could be used to improve working conditions. We performed a quasi-experimental study, where operators performed routine work tasks in order to obtain estimates of the variance components and to evaluate the effect of determinants, such as machine–wheel combinations and individual operator characteristics.

    Methods: Two pre-defined simulated work tasks were performed by 11 operators: removal of a weld puddle of mild steel and cutting of a square steel pipe. In both tasks, four angle grinders were used, two running on compressed air and two electrically driven. Two brands of both grinding and cutting wheels were used. Each operator performed both tasks twice in a random order with each grinder and wheel and the time to complete each task was recorded. Vibration emission values were collected and the wheel wear was measured as loss of weight. Operators’ characteristics collected were as follows: age, body height and weight, length and volume of their hands, maximum hand grip force, and length of work experience with grinding machines (years). The tasks were also performed by one operator who used four machines of the same brand. Mixed and random effects models were used in the statistical evaluation.

    Results: The statistical evaluation was performed for grinding and cutting separately and we used a measure referring to the sum of the 1-s r.m.s. average frequency-weighted acceleration over time for completing the work task (a sa). Within each work task, there was a significant effect as a result of the determinants ‘the machine used’, ‘wheel wear’, and ‘time taken to complete the task’. For cutting, ‘the brand of wheel’ used also had a significant effect. More than 90% of the inherent variability in the data was explained by the determinants. The two electrically powered machines had a mean a sa that was 2.6 times higher than the two air-driven machines. For cutting, the effect of the brand of wheel on a sa was ~0.1 times. The a sa increased both with increasing wheel wear and with time taken to complete the work task. However, there were also a number of interaction effects which, to a minor extent, modified the a sa. Only a minor part (1%) of the total variability was attributed to the operator: for cutting, the volume of the hands, maximum grip force, and body weight were significant, while for grinding, it was the maximum grip force. There was no clear difference in a sa between the four copies of the same brand of each machine.

    Conclusions: By including determinants that were attributed to the brand of both machine and wheel used as well as the time taken to complete the work task, we were able to explain >90% of the variability. The dominating determinant was the brand of the machine. Little variability was found between operators, indicating that the overall effect as due to the operator was small.

  • 10.
    Liljelind, Ingrid
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, L
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Persson, M
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Can we explain the exposure variability found in hand-arm vibrations when using angle grinders?: A round robin laboratory study2010Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 83, nr 3, s. 283-290Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To quantify variance components of hand-arm vibration exposure from data collected in a laboratory study of four different angle grinders.

    METHODS: Four different angle grinders were sent to seven laboratories for grinding tests by three operators at each laboratory. Vibration in both the throttle and support handles was measured. For one grinder, the experimental set-up was repeated and two measurements were collected for that specific grinder.

    RESULTS: At least one-third of the estimated variability is attributable to the wheel and less than one-third to the operator. In repeated experiments, between-occasion, operator and wheel factors explained 4, 29 and 17% of the total variability, respectively.

    CONCLUSIONS: Since measured vibrations in the support and throttle handles are significantly differed, measurements should be taken at both locations. Factors influencing vibration variability include the presence/absence of an auto balance unit, wheel and operator, but other factors remain to be elucidated.

  • 11.
    Liljelind, Ingrid
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Toomingas, Allan
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Variability in Hand-Arm Vibration During Grinding Operations2011Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 55, nr 3, s. 296-304Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Measurements of exposure to vibrations from hand-held tools are often conducted on a single occasion. However, repeated measurements may be crucial for estimating the actual dose with good precision. In addition, knowledge of determinants of exposure could be used to improve working conditions. The aim of this study was to assess hand–arm vibration (HAV) exposure during different grinding operations, in order to obtain estimates of the variance components and to evaluate the effect of work postures.

    Methods: Ten experienced operators used two compressed air-driven angle grinders of the same make in a simulated work task at a workplace. One part of the study consisted of using a grinder while assuming two different working postures: at a standard work bench (low) and on a wall with arms elevated and the work area adjusted to each operator’s height (high). The workers repeated the task three times. In another part of the study, investigating the wheel wear, for each grinder, the operators used two new grinding wheels and with each wheel the operator performed two consecutive 1-min grinding tasks. Both grinding tasks were conducted on weld puddles of mild steel on a piece of mild steel. Measurements were taken according to ISO-standard 5349 [the equivalent hand–arm-weighted acceleration (m s−2) averaged over 1 min]. Mixed- and random-effects models were used to investigate the influence of the fixed variables and to estimate variance components.

    Results: The equivalent hand–arm-weighted acceleration assessed when the task was performed on the bench and at the wall was 3.2 and 3.3 m s−2, respectively. In the mixed-effects model, work posture was not a significant variable. The variables ‘operator’ and ‘grinder’ together explained only 12% of the exposure variability and ‘grinding wheel’ explained 47%; the residual variability of 41% remained unexplained. When the effect of grinding wheel wear was investigated in the random-effects model, 37% of the variability was associated with the wheel while minimal variability was associated with the operator or the grinder and 37% was unexplained. The interaction effect of grinder and operator explained 18% of the variability. In the wheel wear test, the equivalent hand–arm-weighted accelerations for Grinder 1 during the first and second grinding minutes were 3.4 and 2.9 m s−2, respectively, and for Grinder 2, they were 3.1 and 2.9 m s−2, respectively. For Grinder 1, the equivalent hand–arm-weighted acceleration during the first grinding minute was significantly higher (P = 0.04) than during the second minute.

    Conclusions: Work posture during grinding operations does not appear to affect the level of HAV. Grinding wheels explained much of the variability in this study, but almost 40% of the variance remained unexplained. The considerable variability in the equivalent hand–arm-weighted acceleration has an impact on the risk assessment at both the group and the individual level.

  • 12.
    Lindgren, Cecilia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Dahlqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Lindvall, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Koskinen, Lars-Owe
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Klinisk neurovetenskap.
    Naredi, Silvana
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Cortisol levels are influenced by sedation in the acute phase after subarachnoid haemorrhage2013Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 57, nr 4, s. 452-460Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Subarachnoid haemorrhage (SAH) is a life-threatening condition that may be aggravated by acute pituitary damage and cortisol insufficiency. Robust diagnostic criteria for critical illness-related corticosteroid insufficiency (CIRCI) are lacking. The aim of this study was to assess the frequency of CIRCI in the acute phase (0-240 h) after SAH and to evaluate associations between cortisol levels and clinical parameters (sedation, circulatory failure, gender, age, severity of disease, treatment). CIRCI was defined as a single morning serum cortisol (mSC) < 200 nmol/L. The lower limit for calculated free cortisol (cFC) was set at < 22 nmol/L, and for saliva cortisol at < 7.7 nmol/L.

    METHODS: Fifty patients were included. Serum/saliva cortisol and corticosteroid-binding globulin were obtained every second morning. A logistic regression model was used for multivariate analysis comparing cortisol levels with clinical parameters.

    RESULTS: Of the patients, 21/50 (42%) had an mSC < 200 nmol/L and 30/50 (60%) had a cFC < 22 nmol/L. In patients with continuous intravenous sedation, the odds ratio for a mSC to be < 200 nmol/L was 18 times higher (95% confidence interval 4.2-85.0, P < 0.001), and the odds ratio for a cFC to be < 22 nmol/L was 2.4 times higher (95% confidence interval 1.2-4.7, P < 0.05) compared with patients with no continuous intravenous sedation.

    CONCLUSIONS: Continuous intravenous sedation was significantly associated with cortisol values under defined limits (mSC < 200, cFC < 22 nmol/L). The possibility that sedating drugs per se may influence cortisol levels should be taken into consideration before CIRCI is diagnosed.

  • 13.
    Nilsson, Leif
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Belyaev, Yuri K.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Application of resampling to exponential and logistic regression1998Rapport (Övrigt vetenskapligt)
  • 14.
    Nordberg, Gunnar F
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lundström, Nils-Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagenbjörk-Gustafsson, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lagerkvist, Birgitta J-Son
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Svensson, Mona
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Blomberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin.
    Nilsson, Leif
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Bernard, Alfred
    Dumont, Xavier
    Bertilsson, Helen
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Eriksson, Kåre
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lung function in volunteers before and after exposure to trichloramine in indoor pool environments and asthma in a cohort of pool workers2012Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, nr 5, s. e000973-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Exposure to trichloramine (NCl(3)) in indoor swimming-pool environments is known to cause mucous membrane irritation, but if it gives rise to changes in lung function or asthma in adults is not known. (1) We determined lung function in volunteers before and after exposure to indoor pool environments. (2) We studied the occurrence of respiratory symptoms and asthma in a cohort of pool workers.

    DESIGN/METHODS/PARTICIPANTS: (1) We studied two groups of volunteers, 37 previously non-exposed healthy persons and 14 pool workers, who performed exercise for 2 h in an indoor pool environment. NCl(3) in air was measured during pool exposures and in 10 other pool environments. Filtered air exposures were used as controls. Lung function and biomarkers of pulmonary epithelial integrity were measured before and after exposure. (2) We mailed a questionnaire to 1741 persons who indicated in the Swedish census 1990 that they worked at indoor swimming-pools.

    RESULTS: (1) In previously non-exposed volunteers, statistically significant decreases in FEV(1) (forced expiratory volume) and FEV(%) (p=0.01 and 0.05, respectively) were found after exposure to pool air (0.23 mg/m(3) of NCl(3)). In pool workers, a statistically significant decrease in FEV(%) (p=0.003) was seen (but no significant change of FEV(1))(.) In the 10 other pool environments the median NCl(3) concentration was 0.18 mg/m(3). (2) Our nested case/control study in pool workers found an OR for asthma of 2.31 (95% CI 0.79 to 6.74) among those with the highest exposure. Exposure-related acute mucous membrane and respiratory symptoms were also found.

    CONCLUSIONS: This is the first study in adults showing statistically significant decreases in lung function after exposure to NCl(3). An increased OR for asthma among highly exposed pool workers did not reach statistical significance, but the combined evidence supports the notion that current workroom exposures may contribute to asthma development. Further research on sensitive groups is warranted.

  • 15.
    Persson, Mats
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Carlberg, Bo
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Weinehall, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Stegmayr, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Lindholm, Lars Hjalmar
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Risk stratification by guidelines compared to tisk assessment by risk equations applied to a MONICA sample2003Ingår i: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 21, nr 6, s. 1089-1095Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The World Health Organization/International Society of Hypertension (WHO/ISH) Hypertension Guidelines from 1999 propose a risk stratification scheme for estimating absolute risk for cardiovascular disease (CVD). Risk equations estimated by statistical methods are another way of predicting cardiovascular risk. Objective: We studied the differences between these two approaches when applied to the same set of individuals with high blood pressure. Design and methods: The two northernmost counties in Sweden (NSW) constitute one of the centres in the WHO MONICA (monitoring trends and determinants in cardiovascular disease) Project. Three population surveys have been carried out in 1986, 1990 and 1994, and were used to estimate a risk equation for predicting the 10-year risk of fatal/non-fatal stroke and myocardial infarction. Another MONICA sample from 1999, a total of 5997 subjects, was classified according to the recent WHO/ISH risk stratification scheme. A risk assessment was also performed, by using the risk equations from the NSW MONICA sample and Framingham risk equations. Results: The agreement between the two methods was good when the values obtained from the risk equation were averaged for each risk group obtained from the risk classification by guidelines. However, if the predicted risk for each individual was considered, the agreement was poor for the medium and high-risk groups. Although the average risk for all individuals is the same, many subjects have a higher risk or a lower risk than predicted by guidelines. Conclusions: Risk classification by the 1999 WHO/ISH Hypertension Guidelines is not accurate and detailed enough for medium- and high-risk patients, which could be of clinical importance in the medium risk group.

  • 16.
    Pya Arnqvist, Natalya
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Ngendangenzwa, Blaise
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Lindahl, Eric
    Volvo Group Trucks Operations.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    A statistical learning approach for defect detection and classification on specular carbody surfaces2019Konferensbidrag (Refereegranskat)
  • 17.
    Pya Arnqvist, Natalya
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Ngendangenzwa, Blaise
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Lindahl, Eric
    Volvo Group Trucks Operations.
    Yu, Jun
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Automated surface finish defect detection using statistical learning approach2018Konferensbidrag (Refereegranskat)
  • 18.
    Pya Arnqvist, Natalya
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Ngendangenzwa, Blaise
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Lindahl, Eric
    Volvo Group Trucks Operations.
    Yu, Jun
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Defect detection and classfiication: statistical learning approach - Part II2019Rapport (Övrigt vetenskapligt)
  • 19.
    Pya Arnqvist, Natalya
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Ngendangenzwa, Blaise
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Lindahl, Eric
    Volvo Group Trucks Operations.
    Yu, Jun
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Defect detection and classification: statistical learning approach2018Rapport (Övrigt vetenskapligt)
  • 20.
    Pya Arnqvist, Natalya
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Ngendangenzwa, Blaise
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Lindahl, Eric
    Volvo Group Trucks Operations.
    Yu, Jun
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Efficient surface finish defect detection using reduced rank spline smoothers2019Ingår i: CRoNoS & MDA 2019, 2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    One of the primary concerns of product quality control in the automotive industry is an automated detection of defects of small sizes on specular car body surfaces. A new statistical learning approach is presented for surface finish defect detection based on spline smoothing method for feature extraction and k-nearest neighbor probabilistic classifier. Rather than analyzing the natural images of the car body surfaces, the deflectometry technique is applied for image acquisition. Reduced rank cubic regression splines are used to smooth the pixel values while the effective degrees of freedom of the obtained smooths serve as components of the feature vector. A key advantage of the approach is that it allows us to reach near zero misclassification error when applying standard learning classifiers. We also propose the probability based performance evaluation metrics as alternatives to the conventional metrics. The usage of those provides the means for uncertainty estimation of the predictive performance of a classifier. Experimental classification results on the images obtained from the pilot system located at Volvo cab plant in Umea, Sweden, show that the proposed approach is much more efficient than compared methods.

  • 21.
    Rehn, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Matematisk statistik.
    Liljellind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Variation in exposure to whole-body vibration for operators of forwarder vehicles - aspects on measurement strategies and prevention2005Ingår i: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 35, nr 9, s. 831-842Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Exposure to whole-body vibration (WBV) may cause health problems, e.g. lumbago. The risk will depend on intensity and duration. Exposure to WBV in vehicles varies due to several factors as the vehicle type, the terrain condition, the driver, the speed etc. To estimate the health risk, the measurement strategy has to consider this variation. Furthermore, to understand the importance of different preventive strategies, the cause of the variation has to be known. The objective of this study was to describe variation in exposure to seated WBV during occupational operation of forwarder vehicles and to investigate sources for variation. WBV was measured in 10 various terrain types for seven forwarders operated by 11 drivers. For each driver there were between four and 35 measurements. The measurement periods varied between 0.2 and 34 min. The vibration total value (av) and total vibration dose value (VDVt) were determined. Results showed that WBV exposure varied considerably and that this variation could result in different conclusions regarding health risk assessments. The highest magnitudes were achieved during travelling activities. During travelling empty, variations in av were significantly dependent upon forwarder model and terrain type. No significant predictor for variation in VDVt was however found for travelling empty. During travelling loaded the forwarder model and operator were the most important predictors for variation in av. Variation in VDVt was also dependent on the forwarder model during travelling loaded.

  • 22.
    Sommar, Johan Nilsson
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hedmer, Maria
    Lundh, Thomas
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Skerfving, Staffan
    Bergdahl, Ingvar A
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Investigation of lead concentrations in whole blood, plasma and urine as biomarkers for biological monitoring of lead exposure2014Ingår i: Journal of Exposure Science and Environmental Epidemiology, ISSN 1559-0631, E-ISSN 1559-064X, Vol. 24, nr 1, s. 51-57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Lead in blood is a major concept in biomonitoring of exposure but investigations of its alternatives are scarce. The aim of the study was to describe different lead biomarkers' variances, day-to-day and between individuals, estimating their fraction of the total variance. Repeated sampling of whole blood, plasma and urine were conducted for 48 lead-exposed men and 20 individuals under normal environmental lead exposure, in total 603 measurements. For lead workers, the fraction of the total variance attributed to differences between individuals was 91% for whole-blood lead (geometric mean 227 μg/l; geometric standard deviation (GSD): 1.55 μg/l); plasma 78% (0.57 μg/l; GSD: 1.84 μg/l); density-adjusted urine 82%; and unadjusted urine 75% (23.7 μg/l; GSD: 2.48 μg/l). For the individuals under normal lead exposure, the corresponding fractions were 95% of the total variance for whole blood (20.7 μg/l; GSD: 8.6 μg/l), 15% for plasma (0.09 μg/l; GSD: 0.04 μg/l), 87% for creatinine-adjusted urine and 34% for unadjusted (10.8 μg/l; GSD: 6.7 μg/l). Lead concentration in whole blood is the biomarker with the best ability to discriminate between individuals with different mean concentration. Urinary and plasma lead also performed acceptably in lead workers, but at low exposures plasma lead was too imprecise. Urinary adjustments appear not to increase the between-individual fraction of the total variance among lead workers but among those with normal lead exposure.Journal of Exposure Science and Environmental Epidemiology advance online publication, 27 February 2013; doi:10.1038/jes.2013.4.

  • 23.
    Sonntag-Öström, Elisabet
    et al.
    Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum). Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordin, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Dolling, Ann
    Sveriges lantbruksuniversitet.
    Lundell, Ylva
    Sveriges lantbruksuniversitet.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Slunga Järvholm, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Can rehabilitation in boreal forests help recovery from exhaustion disorder?: the randomised clinical trial ForRest2015Ingår i: Scandinavian Journal of Forest Research, ISSN 0282-7581, E-ISSN 1651-1891, Vol. 30, nr 8, s. 732-748Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Modern society is faced with increasing incidence of mental and behavioural disorders. The objective of this study was to evaluate whether visits to boreal forests can be utilised for rehabilitation from exhaustion disorder (ED). This randomised controlled trial comprised of a forest rehabilitation group (n = 35) and a waiting list group (control group) (n = 43) with subsequent cognitive behavioural rehabilitation (CBR) for all participants in both groups. The recovery from ED was compared between the forest rehabilitation and the control group at baseline, after the forest rehabilitation (3 months), and at the end of the CBR (1 year). Both groups had enhanced recovery from ED after the 3-month intervention period and at the end of the CBR (1 year), and there were no significant differences between the groups in terms of psychological health measures. Mental state, attention capacity and preferences for different forest environments were studied during the forest visits. Mental state was improved, but it showed some seasonal differences. A significant effect on attention capacity was found for single forest visits, but there was no effect found for the rehabilitation period as a whole. The most popular forest environments contained easily accessible, open and bright settings with visible water and/or shelter. Forest rehabilitation did not enhance the recovery from ED compared to the control group, but the participants’ well-being was improved after single forest visits.

  • 24.
    Stenlund, Therese
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Ahlgren, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Lindahl, Bernt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burell, Gunilla
    Department of Public Health and Caring Sciences, University of Uppsala.
    Steinholtz, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Edlund, Curt
    Nilsson, Leif
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University.
    Slunga Birgander, Lisbeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST - a randomized clinical trial2009Ingår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 16, nr 3, s. 294-303Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered.

    Purpose

    Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on long-term sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only).

    Method

    In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 ± 7.4 years were allocated to one of the two rehabilitation programs.

    Results

    A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive–compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive–compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive–compulsive symptoms compared to patients in program B.

    Conclusion

    This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout.

  • 25.
    Stenlund, Therese
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Birgander, Lisbeth Slunga
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lindahl, Bernt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Ahlgren, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Effects of qigong in patients with burnout: a randomized controlled trial2009Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 9, s. 761-767Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate the efficacy of Qigong in rehabilitation for patients with burnout. DESIGN: Prospective, randomized controlled trial. SUBJECTS: Eighty-two patients (68 women and 14 men, mean age 44.3 (standard deviation 9.1) years) diagnosed with burnout.

    METHODS: Basic care was offered to both the intervention and the control group. Patients in the intervention group received basic care and, in addition, performed Qigong twice a week for 12 weeks. Psychological variables, health-related quality of life, perceived relaxation and physical measurements were assessed at baseline and after the intervention period.

    RESULTS: No significant difference in treatment efficacy between the groups was found by either intention-to-treat or per-protocol analyses. Both groups improved significantly over time, with reduced levels of burnout, fatigue, anxiety and depression, and increased dynamic balance and physical capacity. CONCLUSION: In this study, a Qigong intervention twice a week for 12 weeks had no additional effect beyond basic care for patients with burnout.

  • 26.
    van den Berg, Johannes
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Neely, Gregory
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Knutsson, Anders
    Landström, Ulf
    Electroencephalography and subjective ratings of sleep deprivation.2005Ingår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 6, nr 3, s. 231-240Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND PURPOSE: Sleep-related vehicle accidents account for many injuries and fatalities each year on monotonous motorways and roads. To effectively prevent such incidents requires greater knowledge of the mechanisms and development of the effects of sleep deprivation. Ten volunteers participated in a laboratory study aimed to analyze the way changes in wakefulness were described in terms of EEG changes and subjective ratings. PATIENTS AND METHODS: For each subject, the study consisted of four testing sessions that varied in length on different days: one session each of 60, 90, and 120 min when sleep-deprived, and one session of 120 min when rested. Changes in wakefulness were analyzed using electroencephalographic recordings and ratings on two different scales, the Karolinska Sleepiness Scale (KSS) and the Category-Ratio Scale (CR-10). RESULTS: The results indicate quite conclusively that significant changes in the perception of sleepiness occur during the first 60-90 min of sedentary, monotonous work. Beyond this time period, subjective and physiological changes remained constant throughout the rest of the 120-min period. CONCLUSION: In general, the subjective rating scales highly and significantly correlated with theta activity in both tired and rested states and with alpha activity in the rested state. Similar results were seen using both subjective rating scales.

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