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- Lindahl, Marcus, et al.
(author)
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Clinical Innovation Fellowship : an innovation / education initiative for medtech
- 2010
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Conference paper (other academic/artistic)abstract
- A new initiative of advanced multidisciplinary training in innovation, highly based on collaboration betweenstakeholders in health care, medical device industry and universities. Key areas of development are; overallprinciples of teaching innovation, accelerated problem based learning, the innovation process as educationand practice, needs in healthcare & medtech industry.This paper presents a Swedish initiative of advanced multidisciplinary training in innovation, which is highly based oncollaboration between stakeholders in health care, medical device industry and universities. The goal of this post-graduate education in clinic-centered innovation is to contribute to the development of a regional medical device cluster, toeducate the health care and medical device innovators and leaders for the future and to develop technical and organizational tools and solutions for the participating clinics.A few years ago some individuals at the Center for Technology, Medicine and Health, CTMH, got in contact with theStanford Biodesign Innovation program. Since the need for collaboration across boundaries and silos had been identified there was almost an instant initiative to try this model in Sweden. A dedicated effort to get funding and buildingresearch capacity started in parallel. A joint project for designing and developing a Swedish variation of the programwas set up.The paper presents examples of an existing innovation research education program at Stanford University and thenthe Swedish initiative that starts in the fall of 2010. Then issues and key areas of interest that have been identified indevelopment of the Swedish initiative are presented.These are; overall principles of teaching innovation, accelerated problem based learning, the innovation processas education and practive, and finally particular needs in Swedish health care and medical technology industry. Animportant difference between the programs at Stanford and Stockholm is the inclusion in the Swedish initiative of theorganizational issues faced by the clinics. These issues are exemplified with leadership and management theoriesidentifying health care as a technology intensive and safety critical socio-technical system. Finally these key areas of interest are then consolidated in designing the overall approach to the Swedish initiative and the curriculum in the fellowsspecialized training.The paper reports findings from an ongoing research project whose aim is to identify obstacles and success factorsfor initiating such an initiative within Swedish university and healthcare structures. The research project also aims toevaluate at least three cycles of the program.
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- Lundborg, Magnus, et al.
(author)
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Human skin barrier structure and function analyzed by cryo-EM and molecular dynamics simulation
- 2018
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In: Journal of Structural Biology. - : Academic Press. - 1047-8477 .- 1095-8657. ; 203:2, s. 149-161
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Journal article (peer-reviewed)abstract
- In the present study we have analyzed the molecular structure and function of the human skin's permeability barrier using molecular dynamics simulation validated against cryo-electron microscopy data from near native skin. The skin's barrier capacity is located to an intercellular lipid structure embedding the cells of the superficial most layer of skin - the stratum corneum. According to the splayed bilayer model (Iwai et al., 2012) the lipid structure is organized as stacked bilayers of ceramides in a splayed chain conformation with cholesterol associated with the ceramide sphingoid moiety and free fatty acids associated with the ceramide fatty acid moiety. However, knowledge about the lipid structure's detailed molecular organization, and the roles of its different lipid constituents, remains circumstantial. Starting from a molecular dynamics model based on the splayed bilayer model, we have, by stepwise structural and compositional modifications, arrived at a thermodynamically stable molecular dynamics model expressing simulated electron microscopy patterns matching original cryo-electron microscopy patterns from skin extremely closely. Strikingly, the closer the individual molecular dynamics models' lipid composition was to that reported in human stratum corneum, the better was the match between the models' simulated electron microscopy patterns and the original cryo-electron microscopy patterns. Moreover, the closest-matching model's calculated water permeability and thermotropic behaviour were found compatible with that of human skin. The new model may facilitate more advanced physics-based skin permeability predictions of drugs and toxicants. The proposed procedure for molecular dynamics based analysis of cellular cryo-electron microscopy data might be applied to other biomolecular systems.
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- Ryden, Lars, et al.
(author)
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Periodontitis Increases the Risk of a First Myocardial Infarction A Report From the PAROKRANK Study
- 2016
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In: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 133:6, s. 576-583
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Journal article (peer-reviewed)abstract
- Background The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study. Methods and Results Eight hundred five patients (<75 years of age) with a first myocardial infarction (MI) and 805 age- (mean 628), sex- (male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (80% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (<66%). Great efforts were made to collect information on possibly related confounders (approximate to 100 variables). Statistical comparisons included the Student pairwise t test and the McNemar test in 2x2 contingency tables. Contingency tables exceeding 2x2 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%; P<0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21-1.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03-1.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status). Conclusions In this large case-control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI.
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