| 431. |
- Robba, Chiara, et al.
(författare)
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Oxygen targets and 6-month outcome after out of hospital cardiac arrest : a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial
- 2022
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO2) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO2 with patients’ outcome. Methods: Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO2 < 60 mmHg and severe hyperoxemia as PaO2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results: 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO2-AUC), for hyperoxemia was significantly associated with mortality (p = 0.003). Conclusions: In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration: clinicaltrials.gov NCT02908308, Registered September 20, 2016.
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| 432. |
- Rotter Sopasakis, Victoria, 1972, et al.
(författare)
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Toll-like receptor-mediated inflammation markers are strongly induced in heart tissue in patients with cardiac disease under both ischemic and non-ischemic conditions.
- 2019
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Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 293, s. 238-247
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Tidskriftsartikel (refereegranskat)abstract
- A sustained low grade inflammatory state is a recognized feature of various diseases, including cardiovascular disease. This state of chronic inflammation involves activation of Toll-like receptor (TLR) signaling. However, little is known regarding the genetic profile of TLR components in cardiac tissue from patients with cardiac disease.In this study we investigated the genetic profile of 84 TLR markers in a unique set of cardiac tissue from patients that had undergone either coronary artery bypass grafting (CABG) or aortic valve replacement (AVR). In addition, we compared the gene data from the cardiac tissue with the same gene profile in blood as well as circulating cytokines to elucidate possible targets in blood that could be used to estimate the inflammatory state of the heart in cardiac disease.We found a marked upregulation of TLR-induced inflammation in cardiac tissue from both patient groups compared to healthy controls. The inflammation appeared to be primarily mediated through TLR1, 3, 7, 8 and 10, resulting in a marked induction of mediators of the innate immune response. Furthermore, the gene expression data in combination with unbiased multivariate analysis suggested a difference in inflammatory response in ischemic cardiac tissue compared to non-ischemic cardiac tissue. Serum levels of IL-13 were significantly elevated in both CABG and AVR patients compared to controls, whereas other cytokines did not appear to coincide with cardiac TLR-induced inflammation.We propose that cardiac disease in humans may be mediated by local cardiac TLR signaling under both ischemic and non-ischemic conditions.
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| 433. |
- Royer, Patrick, et al.
(författare)
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Plasma proteomics for prediction of subclinical coronary artery calcifications in primary prevention
- 2024
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 271, s. 55-67
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Recent developments in high-throughput proteomic technologies enable the discovery of novel biomarkers of coronary atherosclerosis. The aims of this study were to test if plasma protein subsets could detect coronary artery calcifications (CAC) in asymptomatic individuals and if they add predictive value beyond traditional risk factors. Methods: Using proximity extension assays, 1,342 plasma proteins were measured in 1,827 individuals from the Impaired Glucose Tolerance and Microbiota (IGTM) study and 883 individuals from the Swedish Cardiopulmonary BioImage Study (SCAPIS) aged 50-64 years without history of ischaemic heart disease and with CAC assessed by computed tomography. After data-driven feature selection, extreme gradient boosting machine learning models were trained on the IGTM cohort to predict the presence of CAC using combinations of proteins and traditional risk factors. The trained models were validated in SCAPIS. Results: The best plasma protein subset (44 proteins) predicted CAC with an area under the curve (AUC) of 0.691 in the validation cohort. However, this was not better than prediction by traditional risk factors alone (AUC = 0.710, P = .17). Adding proteins to traditional risk factors did not improve the predictions (AUC = 0.705, P = .6). Most of these 44 proteins were highly correlated with traditional risk factors. Conclusions: A plasma protein subset that could predict the presence of subclinical CAC was identified but it did not outperform nor improve a model based on traditional risk factors. Thus, support for this targeted proteomics platform to predict subclinical CAC beyond traditional risk factors was not found.
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| 434. |
- Rylander, Thomas, 1972, et al.
(författare)
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FEM algorithms for Maxwell's equations
- 1998
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Ingår i: EMB 98 - Electromagnetic Computations for Analysis and Design of Complex Systems.
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Konferensbidrag (refereegranskat)
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| 435. |
- Rönnbäck, Annica, et al.
(författare)
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Diurnal effects of enriched environment in immediate early gene expression in the rat brain
- 2005
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Ingår i: Brain research. - : Elsevier BV. - 0006-8993. ; 1046:1-2, s. 137-144
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Tidskriftsartikel (refereegranskat)abstract
- Rodents housed in an enriched environment (EE) show increased neuronal plasticity with enhanced long-term potentiation and memory performance. We report an EE-induced increase in NGFI-A and Krox-20 mRNA expression exclusively during the dark period of the day. In addition, EE-housed rats showed considerable diurnal variation in NGFI-A, Krox-20, and NGFI-B mRNA expression which was absent in single-housed rats. Thus, EE-induced molecular changes are more evident during the dark phase when the rats have higher motor and exploratory activity. This is important to take into account in future studies of molecular mediators of experience-dependent neuronal plasticity.
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| 436. |
- Salinas, Francisco, et al.
(författare)
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The Genetic Basis of Natural Variation in Oenological Traits in Saccharomyces cerevisiae.
- 2012
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 7:11
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Tidskriftsartikel (refereegranskat)abstract
- Saccharomyces cerevisiae is the main microorganism responsible for wine alcoholic fermentation. The oenological phenotypes resulting from fermentation, such as the production of acetic acid, glycerol, and residual sugar concentration are regulated by multiple genes and vary quantitatively between different strain backgrounds. With the aim of identifying the quantitative trait loci (QTLs) that regulate oenological phenotypes, we performed linkage analysis using three crosses between highly diverged S. cerevisiae strains. Segregants from each cross were used as starter cultures for 20-day fermentations, in synthetic wine must, to simulate actual winemaking conditions. Linkage analysis on phenotypes of primary industrial importance resulted in the mapping of 18 QTLs. We tested 18 candidate genes, by reciprocal hemizygosity, for their contribution to the observed phenotypic variation, and validated five genes and the chromosome II right subtelomeric region. We observed that genes involved in mitochondrial metabolism, sugar transport, nitrogen metabolism, and the uncharacterized ORF YJR030W explained most of the phenotypic variation in oenological traits. Furthermore, we experimentally validated an exceptionally strong epistatic interaction resulting in high level of succinic acid between the Sake FLX1 allele and the Wine/European MDH2 allele. Overall, our work demonstrates the complex genetic basis underlying wine traits, including natural allelic variation, antagonistic linked QTLs and complex epistatic interactions between alleles from strains with different evolutionary histories.
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| 437. |
- Samuelsson, Oscar, et al.
(författare)
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Pilotförsök med membranbioreaktor för avloppsvattenrening
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det finns ett växande intresse för kommunal avloppsvattenrening med membranteknik i Sverige. Fördelarna med membranteknik är att låga utsläpps- och partikelhalter kan uppnås på en liten anläggningsyta. Den största nackdelen är en ökad energi-förbrukning, på grund av den ökade luftning för rengöring av membranen och stora recirkulationsflöden som innebär ökad pumpenergi. Stockholm Vatten har beslutat att införa membranteknik i befintliga volymer på Henriksdal avloppsreningsverk. Detta för att klara både framtida skärpta utsläppskrav och en ökad belastning (fördubblad till år 2040, jämfört med dagens belastning). Ökningen orsakas av avvecklingen av Bromma reningsverk i kombination med en allmän befolkningstillväxt. Försök med en MembranBioReaktor (MBR) har under ett år genomförts på Hammarby Sjöstadsverk där en skalenlig pilotanläggning med membranteknik, Sjöstadsverkets Linje 1, har jämförts med en konventionell reningsanläggning, Henriksdal. Flödena under försöket motsvarade prognosticerade flöden för Henriksdal år 2040. Fyra olika driftsfall studerades i pilotförsöken där inflödet av avloppsvattnet varierade mellan: konstant medelflöde, dynamiskt medelflöde och maximalt flöde (förväntad maximal veckobelastning år 2040). Följande slutsatser kunde dras: Förväntade utsläppskrav, <0,2 mg/L Tot-P och <6 mg/L Tot-N, var möjliga att uppnå under minst en månad för samtliga driftsfall. Vid maximalt flöde tilläts en högre dos av både järnsulfat och kolkälla. Vid normal dosering av järnsulfat noterades ingen negativ effekt med fouling på membranen. Det fanns inte heller några indikationer på att förbrukningen av järnsulfat, vid normal dosering, skilde sig i MBR-systemet jämfört med Henriksdal. Vid maximala belastningsfallet doserades en högre halt järnsulfat vilket resulterade i låg utgående fosfathalt kring 0,1 mg/L. Det fanns dock en indikation på att förhållandet mellan avskild mängd fosfor per doserad mängd järn försämrades vid den högre dosen. Membranen hade en hög medelpermeabilitet och robust avskiljning av partikulärt material under hela försöksåret. Slammets filtrerbarhet analyserades med två mätmetoder inom ett examensarbete. Filtrerbarheten förbättrades under tiden som försöket pågick, och var god enligt mätmetodernas referensvärden. Membranen rengjordes med kemikalier, oxalsyra och natriumhypoklorit, vid fem tillfällen. Vid ett av dessa tillfällen analyserades halten klororganiska föreningar, AOX, i utgående vatten. AOX ökade under det dygn som rengöringen genomfördes från 0,03 till 0,6 mg/L i utgående vatten. Efterföljande dygn var halterna åter 0,03 mg/L. Det var möjligt att hålla en hög slamhalt i Sjöstadsverket Linje 1, 4000 -10 000 mg/L, genom hela försöket. Även den totala slamåldern var hög jämfört med traditionella system; 15-50 dygn. En jämförelse mellan slammets aktivitet; nitrifikations- och denitrifikationshastighet, visade dock att aktiviteten var lägre i MBR-systemet än i Henriksdal. Nitrifikation noterades i MBR-reaktoren vid belastningstoppar av ammonium. Detta gjorde att nitrifikationen, från systemet i sin helhet, var fullständig under hela försöksåret.
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| 438. |
- Sandholm, Kerstin, et al.
(författare)
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Early Immune Responses to Borrelia garinii and Borrelia afzeliiin Lyme Borreliosis : Local Complement Activation in Erythema Migrans and in vitro Studies ofComplement Activation, Phagocytosis and Cytokine Profile
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- An optimal eradication of spirochetes in Lyme borreliosis depends on the early immune response, including the potent actions of the complement system. We here assessed possible differences between two Borrelia burgdorferi genospecies in their ability to activate complement, and the consequences of complement activation in terms of phagocytosis and induction of cytokines.Early local complement activation was assessed immunohistochemically in skin biopsies from patients with erythema migrans (EM) caused by B. afzelii or B. garinii. Complement activation, phagocytosis and early cytokine and chemokine release were studied in vitro by incubating clinical isolates of B. afzelii (K78 from a human skin biopsy) and B. garinii (LU59 from human cerebrospinal fluid) in human whole blood.B. afzelii and B. garinii were detected in skin biopsies from EM and deposition of C3-fragments and IgG was found adjacent to the spirochetes. In vitro, B. garinii LU59 induced higher complement activation (measured as the generation of C3a and C5b-9), while B. afzelii K78 recruited more factor H. Phagocytosis by granulocytes and monocytes was demonstrated to be largely dependent on complement activation since phagocytosis was substantially reduced by addition of the C3 inhibitor compstatin or a C5a receptor antagonist. The early cytokine and chemokine release in human blood in response to live spirochetes revealed a rapid and pronounced pro-inflammatory response, mainly associated with the Th1- and Th17-types.We conclude that complement is activated locally in the skin in EM, and that B. garinii LU59 activates complement more than B. afzelii K78. Complement activation is pivotal for efficient phagocytosis of Borrelia spirochetes, especially in early infection before specific antibodies are produced. Both B. garinii LU59 and B. afzelii K78 induce proinflammatory cytokines rapidly, but no clear differences were seen between the two genospecies in this respect.
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| 439. |
- Sandstedt, Mikael, 1990, et al.
(författare)
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Wide QRS-T angles are associated with markers of increased inflammatory activity independently of hypertension and diabetes.
- 2020
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Ingår i: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. - : Wiley. - 1542-474X. ; 25:6
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Tidskriftsartikel (refereegranskat)abstract
- Wide QRS-T angles and inflammatory activity are markers of future cardiovascular events including sudden cardiac death (SCD). The association between wide QRS-T angles and inflammatory activation is however not fully understood.1,094 study participants of both sexes, 50-64 years old, were included from a randomly selected population-based cohort as a part of the Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot study. Serum samples were analyzed for markers of inflammation, cardiac wall stress/injury, and the metabolic syndrome. Wide QRS-T angles were defined using Frank vectorcardiography. Variables were analyzed through unsupervised principal component analysis (PCA) as well as Orthogonal Projections to Latent Structures (OPLS) modeling. In addition, a subset of study participants was analyzed in a post hoc matched group design.Wide QRS-T angles correlated positively with markers of inflammation, cardiac wall stress/injury, the metabolic syndrome, and male sex in both PCA and OPLS models. In the matched post hoc analysis, participants with wide QRS-T angles had significantly higher counts of white blood cells (WBC) and neutrophils in comparison with matched controls. WBC as well as the number of neutrophils, monocytes, basophils, eosinophils and levels of C-reactive protein, IL-1, IL-4, IL-6, TNF-α, and NT-pro-BNP were also significantly higher in comparison with healthy controls.Markers of inflammatory activation and cardiac injury/wall stress were significantly higher in the presence of wide QRS-T angles. These results corroborate an association between abnormal electrophysiological function and inflammatory activation and may have implications for the prediction of SCD.
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| 440. |
- Sannerstedt, Anders, et al.
(författare)
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Hur extrema är Sverigedemokraterna?
- 2015
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Ingår i: Fragment : SOM-undersökningen 2014 - SOM-undersökningen 2014. - 9789189673328 ; , s. 399-414
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Bokkapitel (refereegranskat)
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