| 4131. |
- Nadali, Mitra
(författare)
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Cardiovascular morbidity and metabolic signature in patients with rheumatoid arthritis
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and objectives: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease with excess risk for cardiovascular morbidity and mortality. The treatment of RA by anti-inflammatory drugs has dramatically been improved over the resent decades. Although, articular inflammation and disability burden has been reduced, cardiovascular disease (CVD) still accounts for more than half of all the death in RA population. This cannot entirely be explained by traditional cardiovascular risk factors and inflammatory activity. The general aims of this thesis were to study the role of essential metabolic pathways and their interplay with inflammation and cardiovascular morbidity in RA. Methods: A cohort of female RA patients was clinically studied and prospectively followed up under 5 years. Cardiovascular risk (CVR) in relation to metabolism regulating molecules in fat tissue and in the peripheral blood was investigated. Blood samples and white fat aspirations were used to study different cytokines and gene expressions. Quantitative PCR was used for transcriptional analysis of proteins. As receptor for insulin-like growth factor 1 (IGF1R) has a key role to connect inflammation and metabolism, the consequences of its inhibition on regulation of T cell balance in experimental RA were explored. Results: Low serum levels of IGF1 were associated with higher CVR, hypertension and metabolic signature such as adiposity and hyperlipidemia. The levels of IGF1 were constantly low independent to age in IGF1 low group and under 5 years follow-up, the frequency of hypertension and CV events were significantly higher in this group particularly, in younger patients compared to control group. RA patients with hypertension showed unfavorable metabolic profile including higher levels of plasma glucose and insulin followed consequently by higher inflammation and disease activity. Accumulation of signal transducer and activator of transcription 3 (STAT3) in white adipose tissue (WAT) promotes metabolic activity on leucocytes. Interleukin 6 (IL6) and leptin induce metabolic disorders and increased CVR by activating STAT3 in WAT, in RA. Low serum levels of soluble receptor for advanced glycation end products (sRAGE) were associated with both previous and new cardiometabolic events (CME). Younger patients with low sRAGE levels showed higher CVR and adverse metabolic factors. Inhibition of IGF1R on the levels of insulin receptor substrates (IRS1/2) in experimental model resolved the inflammation and arthritis followed by reduced production of IL6 and STAT3 by spleen T cells with consequent up-regulation of the regulatory T cells. Conclusion: A range of essential metabolic factors interplays with inflammatory pathways and CVR in RA. This underlines the need to apply biomarkers in clinical practice to improve CVD risk factors management in RA female patients. The patients would also benefit of monitoring for hyperglycemia, hypertension, and obesity.
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| 4132. |
- Naderehvandi, Khashayar, 1980
(författare)
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Vem vittnar för vittnet? - Det litterära verket som vittnesmål och översättning
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Two brothers are riding the subway in Toronto. They have been spending some time in the city as guests of their family – aunts and cousins. Everyone is originally from Iran, but the brothers have lived most of their lives in Sweden. As the train rushes through the greater metropolitan area, the exasperation they feel, augmented by the sticky summer heat, starts consuming them, until they start speaking with each other. The one brother is annoyed by the way the other speaks Persian with their family. Little by little, the conversation evolves into an argument, and finally into a full-blown verbal conflict. Suddenly, they notice the other passengers are staring at them, and with a flash of shame they realize that the curiosity of the perplexed faces staring at them is because their animated argument has been conducted in Swedish – a language that sounds nothing like what would have been expected from two Middle Eastern men. The point of departure for this inquiry is the brothers’ ability and inability to express intimacy and conflict in a language that can only exist as translation. The inquiry attempts to answer the question of how this event can be written, when the context that constitutes the receiving end of the account is shaped by the colonial history of the West – that is, when the potential reader is informed by a colonialist and racist epistemology. The study explores the possibility of decolonial practices embedded in literary and poetic writing. What is found at the heart of the inquiry is the literary construction of the event, not the event itself. By putting language into play, not only as a system of signs used for communication or critical thought but also as a poet and writer’s concrete working material, the study explores what is characteristically literary in texts that are the result of artistic practices, and how such texts operate not only to report an event but to change their readers from spectators of the events to witnesses. In effect, this is an inquiry into the possibility of poetic and literary language to challenge and shift epistemic systems by way of non-symbolic language.
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| 4133. |
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| 4134. |
- Nahal, Maha Sudki Hmeidan
(författare)
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Children with spina bifida and their mothers in Palestine. Lived experiences, self perceived health and sense of coherence
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ABSTRACT The overall aim in this thesis was to describe the lived experiences of children with spina bifida (SB) and their mothers while living under specific social and cultural conditions in West Bank, Palestine. A further aim was to gain knowledge about the impact of SB on self-perceived health and sense of coherence (SOC) among a group of children and adolescents with SB in comparison to their healthy peers. Study I and II involved narrative interviews with 20 mothers and 10 children, respectively, which were analysed with the phenomenological-hermeneutical method. Study III and IV involved self-reported questionnaires. The Pediatric Quality of Life Inventory (PedsQLTM 4.0) was used in Study III to assess self-perceived health in 50 children with SB in comparison with 150 healthy children. In Study IV, the PedsQLTM 4.0 and SOC scales were used to assess self-perceived health and SOC in 50 adolescents with SB in comparison with 150 healthy adolescents. The association between self-perceived health, SOC and levels of impairment in children and adolescents with SB was also investigated. The findings in this thesis show that children with SB, their mothers and other family members were struggling with negative sociocultural beliefs about the disability. Stigmatisation, political conflict and consequent poor health care services were shaping the daily life experiences of the children and their families. The lack of knowledge about health care needs of the child with SB had a true effect upon the mothers’ well-being, and increased their burden. Children with SB were struggling with social exclusion and seemed to possess a negative self-concept. Children and adolescents with SB perceived their health to be worse than the health of their peers. SOC was lower in adolescents with SB than it was in their healthy peers. Levels of impairment in mobility and hydrocephaly associated negatively with self-perceived health in children and adolescents with SB, while bladder dysfunction was negatively associated with SOC only among the adolescents. In conclusion, stakeholders, policy makers, health care providers and educators in Palestine must be aware of the extent of the burden and suffering experienced by children with SB and their families. Health promotion and social support for this group of children and their families can be achieved through the development and implementation of effective policies and strategies, such as a family-centred care (FCC) approach, within health care systems and rehabilitative practices in the Palestinian context. Keywords: Childhood, Disability, Experience, Family, Mother, Palestine, Perceived health, Phenomenological-hermeneutical, Spina bifida, Stigma, Sense of coherence
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| 4135. |
- Nahlbom, Katharina, 1968
(författare)
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Zur Absurdität und Relativität im Werk Reinhard Lettaus : "Das ist also das einzige, was bei allen unseren Überlegungen herauskommt: Dass wir irgendwann irgendwohin laufen." Zur Absurdität und Relativität im Werk Reinhard Lettaus
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study focuses on the thematic and narrative continuity of the literary prose work of the German writer Reinhard Lettau (1929-1996). Reinhard Lettau published six pieces of literary prose, including experimental short prose, a political, satirical play and a novel with autobiographic traits. The main argument of the study is, that in spite of the apparent disparity of the pieces there are certain themes and narrative structures, which appear constantly throughout Lettau’s work. A second argument is, that this thematic and narrative continuity consists on the one hand in a totally relative, instable and changeable world and on the other hand in the different ways the characters and narrators relate to this relativity and instability of their world. Each of the six analysis chapters addresses one of Lettau’s pieces Schwierigkeiten beim Häuserbauen (1962), Auftritt Manigs (1963), Feinde (1968), Frühstücksgespräche in Miami (1977), Zur Frage der Himmelsrichtungen (1988) and Flucht vor Gästen (1994) in terms of their thematic and narrative structure. Through a close reading, inspired by Gerard Génette’s narratological theory, the study shows that throughout the work the fictive world is relative and changeable and lacks given truths. Different world categories, for instance material reality and fantasies, merge and the characters do not have a stable identity, but play roles. There is no point of origin, from which the world appears in an absolute true way, but the worldview is always a matter of perspective. The relativity theme corresponds to the narrative openness of the texts, which often lack an omnipotent narrator as well as a given intention. To this relativity and instability the characters and narrators respond in two different manners. Some of them consider the world a joyful play, whereas others restlessly seek a stable ground, an absolute truth in form of a given identity or eternal values. This search always fails, which underlines the relative foundation of the narrated world. Mainly the last chapter places Lettau’s work in a literary tradition. The narrated relativity of the world and the search for an absolute truth bear a resemblance to the work of Franz Kafka, Jorge Luis Borges and Samuel Beckett among others. Furthermore the thematic and the narrative structure of Lettau’s work show a similarity to modern as well as to postmodern literature and philosophy, basically in that the two ways, in which the characters and narrators relate to the relativity of the world could be said to correspond to either a modern or a postmodern attitude. The study also questions the common opinion of Lettau’s work as merely ‘light’ and entertaining. It shows that beside the ‘light’ traits Lettau’s work also deals with philosophical questions like the existence of an absolute truth.
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| 4136. |
- Nair, Madhu K., 1966
(författare)
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Diagnostic Accuracy of Tuned Aperture Computed Tomography (TACT®)
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The diagnostic accuracy of Tuned Aperture Computed Tomography (TACT) was evaluated for a variety of diagnostic tasks. Drawbacks of 2D radiography, lack of accessibility and high cost associated with advanced imaging modalities prompted these studies. Mechanically induced vertical/oblique radicular fractures (VRF) on unrestored and endodontically treated teeth were imaged using 2D radiography, unprocessed and TACT-IR images. The effect of iterative restoration on diagnostic accuracy was studied in association with detection tasks such as VRF and mandibular fractures, as also with quantification efforts associated with osseous healing studied in vivo. Iterative restoration deblurring of TACT produced consistently higher diagnostic quality than the other two image types. The effect of observer training and previous experience with viewing TACT indicated that observers with prior experience performed better. It was also noted that fractures extending beyond the middle third of the roots were more accurately detected. The effect of the number of basis images on diagnostic accuracy of TACT radiographs for mandibular fractures showed that reconstructions using 16 basis images that had been iteratively restored performed significantly better. In the in vivo study, quantitative evaluation of healing of osseous defects subjected to different types of grafts using TACT indicates that the most optimal healing occurred with osteoblast-polymer matrix combination. TACT-IR correlated most with histomorphometric data. Increases in gray values corresponding to bone formation were notable during the early period following surgery. These studies indicate that there is enough justification for TACT to find applications in many clinical situations where an ordinary dental x-ray source and a digital sensor/film are currently being used.
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| 4137. |
- Nairat, Malik, 1973
(författare)
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Generative comics - A computational approach to creating comics material
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Digital storytelling can be employed as a tool that incorporates human creativity with technology. It synthesizes multimedia based elements to create engaging stories and compelling narratives. To this end, this research presents an approach that can be used as an assistant tool for comics artists. It focuses on generating comics-based narratives through a system that integrates three main components in the creation process, which are: agent-based system which generates raw narrative material based on the behavior of the system’s agents, an interactive evolution process where the author participate in the creation process, and comics generating engine that creates final comics as outputs. The general scope of the research is to construct a generative system that has the ability to create comics and fictional characters. The research utilizes the method of Research through Design (RtD) which favors evolution and iteration of the construction of the artifact based on trial and error to better solve complex design problems (Smith & Dean, 2014). Relevant aspects of computer science, visual arts, comics and storytelling have been combined together to form a unified research project that can answer the research questions: how can digital technology be employed in generating comics; how can it contribute to the creation of novel art forms; and how can it help artists in their creative practice. Through a review of generative comics researches, four categories are identified: Unified Comics Generators which investigate methods for generating both the story structure and its visual comics-based representation, Comics Elements Generators which explore various techniques for generating or employing particular comics elements such as panels, splashes, speech bubbles, and others, Visual Representation Generators which rely on importing the content from other narrative sources such as video games, video streaming, or chatting conversations through social media, and Generative Comics Installations which produce and present comic stories in a form of exhibited installations by capturing and manipulating live pictures of the audience. Research findings are discussed in terms of story characterization, the generated stories, and the comics visual representation. The constructed system showed high flexibility, scalability, competency, and capability that entitle it to be employed in various applications for different purposes.
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| 4138. |
- Najar, Hemen, 1979
(författare)
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Cardiometabolic risk indicators in bipolar disorders
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In addition to disabling mood episodes, bipolar disorders (BDs) predispose individuals to high cardiovascular disease (CVD) risk. This thesis explores the association between BDs and the metabolic risk indicators body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, and lipid profile. Study I showed no differences in weight gain or increase in BMI between individuals with BDs on mood stabilizer monotherapy compared with age- and sex-matched individuals with BDs who received treatment with a second-generation antipsychotic in addition to a mood stabilizer. Study II showed that individuals with BDs had higher mean levels of WHR, BMI, and atherogenic lipid profile compared with a control group. A sub-group of individuals with BDs and controls were followed-up after a period of 6–7 years. We found an increase in WHR and blood pressure in the patient group relative to the controls after the follow-up period. Study III partly replicated the findings of Study II using an independent cohort with a nearly identical study protocol and a follow-up of 7–8 years. Study IV compared the secular trends and the distribution of BMI between individuals with BDs and the general population in Sweden. The mean levels of BMI were higher in the patient group and increased more over time compared with the general population. Women with BDs and individuals with high BMI had the largest annual increase in BMI. In conclusion, individuals with BDs have a higher CVD risk-profile as measured by cardiometabolic risk indicators. It is important that clinicians adopt a proactive strategy, look at the overall picture, and observe minor changes in cardiometabolic status to prevent cardiometabolic disease generally and in individuals with BDs specifically.
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| 4139. |
- Najar, Jenna
(författare)
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Risk factors for dementia. Lifestyle, hormones, neurochemistry, and genetics
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The aim of this thesis was to expand the understanding about the effects of lifestyle factors, indicators of endogenous estrogens, and genetic factors on the risk of dementia and cerebrospinal fluid (CSF) markers for Alzheimer’s disease (AD). Method: We used population-based samples from the Gothenburg H70 Birth Cohort Studies (H70-studies), the Prospective Population Study of Women (PPSW), and the Mayo Clinic Study of Aging (MCSA 70+ study). Information on exposures (marital status [married vs not married], cognitive and physical activity [active vs inactive], indicators of endogenous estrogen [age at menarche and menopause, reproductive period, number of pregnancies, and months of breastfeeding], and genetic factors [polygenic risk scores for AD (AD-PRSs), and APOE genotype]) was obtained through interviews and examinations performed by experienced health personnel. Dementia was diagnosed according to established criteria based on information from the examinations. CSF levels of Aβ42, Aβ40, P-tau, and T-tau were measured with immunochemical methods. Results: In Project I (the H70-studies, n=913; the MCSA 70+ study, n=3,471), we found that married men had a reduced risk of dementia compared to unmarried men, while no association was observed in women. In Project II (PPSW and the H70-studies, n=784), we found that midlife cognitive and physical activity were independently associated with reduced risk of late-life dementia disorders. In Project III (PPSW and the H70-studies, n=1,364), we found that longer reproductive period and later age at menopause were associated with increased risk of dementia and AD. In Project IV (PPSW and the H70-studies, n=75), we found that longer reproductive period was associated with CSF biomarkers for AD (lower levels of Aβ42, lower ratio of Aβ42/Aβ40, and higher levels of P-tau). In Project V (the H70-studies, n=2,052), we found that AD-PRSs (including 39 and 57 genetic variants) and APOE genotype were associated with risk of dementia up to very old ages. Conclusion: The results from this thesis add knowledge about risk factors for dementia, and add further knowledge on the protective effects of cognitive and physical activity on different dementia disorders.
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| 4140. |
- Nakamura, Keisuke
(författare)
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Mechanical and Microstructural Properties of Monolithic Zirconia
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Zirconia has been widely used in dentistry to improve the strength of ceramic restorations maintaining aesthetics. In addition, zirconia is increasingly being used for monolithic crowns without veneering porcelain. However, there is a lack of scientific information regarding whether or not monolithic zirconia crowns can function with sufficient durability, especially in the molar regions. The overall aim of this thesis was to analyze factors that would affect mechanical and microstructural properties of monolithic zirconia crowns. Material testing was performed to evaluate the influence of sintering temperature, additional heat treatment, coloring procedure and autoclaving-induced low-temperature degradation (LTD) on the biaxial flexural strength of zirconia. Additional heat treatment did not reduce the strength, but the strength was found to decrease as the sintering temperature increased. The tooth-colored zirconia possessed equivalent strength to the non-colored zirconia. In addition, X-ray diffraction analysis and scanning electron microscopy showed that the tooth-colored zirconia had higher resistance to LTD. Crown fracture testing showed that the fracture resistance of the monolithic zirconia crowns with an occlusal thickness of 0.5 mm was significantly higher than that of lithium disilicate crowns with an occlusal thickness of 1.5 mm. The types of cements did not significantly affect the fracture resistance of monolithic zirconia crowns. When subjected to autoclaving-induced LTD, the fracture resistance of the monolithic zirconia crowns significantly decreased. By contrast, cyclic loading with a load of 300 N for 240,000 cycles did not significantly affect the fracture resistance of the crowns. The knowledge obtained by the laboratory studies performed suggests that monolithic zirconia crowns with a minimal thickness of 0.5 mm will have the capability of being applied to the molar region with sufficient durability, providing there is a properly controlled fabrication process to avoid unexpected degradation of the material.
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