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- Galozy, Alexander, 1991-, et al.
(författare)
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Pitfalls of medication adherence approximation through EHR and pharmacy records: Definitions, data and computation
- 2020
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Ingår i: International Journal of Medical Informatics. - Shannon : Elsevier BV. - 1386-5056 .- 1872-8243. ; 136
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Patients' adherence to medication is a complex, multidimensional phenomenon. Dispensation data and electronic health records are used to approximate medication-taking through refill adherence. In-depth discussions on the adverse effects of data quality and computational differences are rare. The purpose of this article is to evaluate the impact of common pitfalls when computing medication adherence using electronic health records. Procedures: We point out common pitfalls associated with the data and operationalization of adherence measures. We provide operational definitions of refill adherence and conduct experiments to determine the effect of the pitfalls on adherence estimations. We performed statistical significance testing on the impact of common pitfalls using a baseline scenario as reference. Findings: Slight changes in definition can significantly skew refill adherence estimates. Pickup patterns cause significant disagreement between measures and the commonly used proportion of days covered. Common data related issues had a small but statistically significant (p < 0.05) impact on population-level and significant effect on individual cases. Conclusion: Data-related issues encountered in real-world administrative databases, which affect various operational definitions of refill adherence differently, can significantly skew refill adherence values, leading to false conclusions about adherence, particularly when estimating adherence for individuals.
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| 2. |
- Eriksson, Martin, 1970, et al.
(författare)
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Community-Level Analysis of psbA Gene Sequences and Irgarol Tolerance in Marine Periphyton
- 2009
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Ingår i: Applied and Environmental Microbiology. - Washington, D.C. : American Society for Microbiology. - 0099-2240 .- 1098-5336. ; 75:4, s. 897-906
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Tidskriftsartikel (refereegranskat)abstract
- This study analyzes psbA gene sequences, predicted D1 protein sequences, species relative abundance, and pollution-induced community tolerance in marine periphyton communities exposed to the antifouling compound Irgarol 1051. The mechanism of action of Irgarol is the inhibition of photosynthetic electron transport at photosystem II by binding to the D1 protein. The metagenome of the communities was used to produce clone libraries containing fragments of the psbA gene encoding the D1 protein. Community tolerance was quantified with a short-term test for the inhibition of photosynthesis. The communities were established in a continuous flow of natural seawater through microcosms with or without added Irgarol. The selection pressure from Irgarol resulted in an altered species composition and an inducted community tolerance to Irgarol. Moreover, there was a very high diversity in the psbA gene sequences in the periphyton, and the composition of psbA and D1 fragments within the communities was dramatically altered by increased Irgarol exposure. Even though tolerance to this type of compound in land plants often depends on a single amino acid substitution (Ser(264)-> Gly) in the D1 protein, this was not the case for marine periphyton species. Instead, the tolerance mechanism likely involves increased degradation of D1. When we compared sequences from low and high Irgarol exposure, differences in nonconserved amino acids were found only in the so-called PEST region of D1, which is involved in regulating its degradation. Our results suggest that environmental contamination with Irgarol has led to selection for high-turnover D1 proteins in marine periphyton communities at the west coast of Sweden.
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| 3. |
- Holmqvist, Gärd, 1950-, et al.
(författare)
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Expressions of vitality affects and basic affects during art therapy and their meaning for inner change
- 2019
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Ingår i: International Journal of Art Therapy. - Abingdon : Taylor & Francis. - 1745-4832 .- 1745-4840. ; 24:1, s. 30-39
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the occurrence of vitality affects and basic affects and to shed light on their importance in terms of patients' inner change through art therapy. In an earlier study, where 17 women were interviewed about inner change through art therapy, a secondary deductive content analysis of images and statements was performed exploring the presence of vitality affects and basic affects. Nine of the 17 interviews contained clear descriptions of vitality affects and basic affects in the intersubjective communication between the patient and the therapist, these affects were also mirrored in the patients’ painted images.Three cases are used to illustrate the result and how affects were related to inner change. These three cases differ from each other in that they described vitality affects either arising from the art therapist’s empathetic verbal or non-verbal response, from a particular experience in nature, or from the interpreted symbolic language of the image. The common denominator uniting the three cases was the intersubjective communication with the therapist. This study indicates that image making in art therapy gives rise to vitality affects and basic affects that contributes to inner change. It also indicates the importance of having trust in both the method and the art therapist.
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| 4. |
- Selck, H., et al.
(författare)
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Assessing and managing multiple risks in a changing worldThe Roskilde recommendations
- 2017
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Ingår i: Environmental Toxicology and Chemistry. - Hoboken, NJ : Wiley. - 0730-7268 .- 1552-8618. ; 36:1, s. 7-16
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Tidskriftsartikel (refereegranskat)abstract
- Roskilde University (Denmark) hosted a November 2015 workshop, Environmental RiskAssessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological context for assessments in human-modified systems; 8) assess risks and benefits to humans and the ecosystem and consider unintended consequences of management actions; 9) avoid excessive conservatism or possible underprotection resulting from sole reliance on binary, numerical benchmarks; and 10) develop adaptive risk-management and regulatory goals based on ranges of uncertainty. Environ Toxicol Chem 2017;36:7-16. (c) 2016 SETAC
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| 5. |
- Teneberg, Susanne, et al.
(författare)
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Lactotetraosylceramide, a novel glycosphingolipid receptor for Helicobacter pylori, present in human gastric epithelium
- 2002
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Ingår i: Journal of Biological Chemistry. - Bethesda : American Society for Biochemistry and Molecular Biology. - 0021-9258 .- 1083-351X. ; 277:22, s. 19709-19719
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Tidskriftsartikel (refereegranskat)abstract
- The binding of Helicobacter pylori to glycosphingolipids was examined by binding of 35S-labeled bacteria to glycosphingolipids on thin-layer chromatograms. In addition to previously reported binding specificities, a selective binding to a non-acid tetraglycosylceramide of human meconium was found. This H. pylori binding glycosphingolipid was isolated and, on the basis of mass spectrometry, proton NMR spectroscopy, and degradation studies, were identified as Galβ3GlcNAcβ3-Galβ4Glcβ1Cer (lactotetraosylceramide). When using non-acid glycosphingolipid preparations from human gastric epithelial cells, an identical binding of H. pylori to the tetraglycosylceramide interval was obtained in one of seven samples. Evidence for the presence of lactotetraosylceramide in the binding-active interval was obtained by proton NMR spectroscopy of intact glycosphingolipids and by gas chromatography-electron ionization mass spectrometry of permethylated tetrasaccharides obtained by ceramide glycanase hydrolysis. The lactotetraosylceramide binding property was detected in 65 of 74 H. pylori isolates (88%) Binding of H. pylori to lactotetraosylceramide on thin-layer chromatograms was inhibited by preincubation with lactotetraose but not with lactose. Removal of the terminal galactose of lactotetraosylceramide by galactosidase hydrolysis abolished the binding as did hydrazinolysis of the acetamido group of the N-acetylglucosamine. Therefore, Galβ3GlcNAc is an essential part of the binding epitope.
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| 6. |
- Kutty Selva, Nandakumar, et al.
(författare)
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A recombinant vaccine effectively induces c5a-specific neutralizing antibodies and prevents arthritis.
- 2010
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Ingår i: PLoS ONE. - San Francisco, CA : Public Library of Science (PLoS). - 1932-6203. ; 5:10
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To develop and validate a recombinant vaccine to attenuate inflammation in arthritis by sustained neutralization of the anaphylatoxin C5a. METHODS: We constructed and expressed fusion protein of C5a and maltose binding protein. Efficacy of specific C5a neutralization was tested using the fusion protein as vaccine in three different arthritis mouse models: collagen induced arthritis (CIA), chronic relapsing CIA and collagen antibody induced arthritis (CAIA). Levels of anti-C5a antibodies and anti-collagen type II were measured by ELISA. C5a neutralization assay was done using a rat basophilic leukemia cell-line transfected with the human C5aR. Complement activity was determined using a hemolytic assay and joint morphology was assessed by histology. RESULTS: Vaccination of mice with MBP-C5a led to significant reduction of arthritis incidence and severity but not anti-collagen antibody synthesis. Histology of the MBP-C5a and control (MBP or PBS) vaccinated mice paws confirmed the vaccination effect. Sera from the vaccinated mice developed C5a-specific neutralizing antibodies, however C5 activation and formation of the membrane attack complex by C5b were not significantly altered. CONCLUSIONS: Exploitation of host immune response to generate sustained C5a neutralizing antibodies without significantly compromising C5/C5b activity is a useful strategy for developing an effective vaccine for antibody mediated and C5a dependent inflammatory diseases. Further developing of such a therapeutic vaccine would be more optimal and cost effective to attenuate inflammation without affecting host immunity.
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