| 1. |
- Venge, Per, et al.
(författare)
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HNL (Human Neutrophil Lipocalin) and a multimarker approach to the distinction between bacterial and viral infections
- 2019
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Ingår i: JIM - Journal of Immunological Methods. - : Elsevier. - 0022-1759 .- 1872-7905. ; 474
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The distinction between bacterial and viral causes of acute infections is a major clinical challenge. In this report we investigate the diagnostic performance in this regard of nine candidate biomarkers together with HNL (Human Neutrophil Lipocalin).METHODS: Blood was obtained from patients with symptoms of infectious (n = 581). HNL was measured in whole blood (B-HNL) after pre-activation with the neutrophil activator fMLP or in plasma (P-HNL). Azurocidin also known as heparin-binding protein (HBP), Calprotectin, PMN-CD64, CRP (C-reactive protein), IP-10 (Interferon γ-induced Protein 10 kDa), PCT (Procalcitonin), TK1 (Thymidine kinase 1), TRAIL (TNF-related apoptosis-inducing ligand) were measured in plasma/serum. Area under the ROC (receiver operating characteristics) curve (AuROC) was used for the evaluation of the clinical performance of the biomarkers.RESULTS: Side-by-side comparisons of the ten biomarkers showed large difference in the AuROC with B-HNL being the superior biomarker (0.91, 95% CI 0.86-0.95) and with the other nine biomarkers varying from AuROC of 0.63-0.79. The combination of B-HNL with IP-10 and/or TRAIL increased the diagnostic performance further to AuROCs of 0.94-0.97. The AuROCs of the combination of CRP with IP-10 and/or TRAIL were significantly lower than combinations with B-HNL 0.87 (95% CI 0.83-0.91).CONCLUSION: The diagnostic performance of whole blood activated HNL was superior in the distinction between bacterial or viral infections. The addition of IP-10 and/or TRAIL to the diagnostic algorithm increased the performance of B-HNL further. The rapid analysis of HNL, reflecting bacterial infections, together with biomarkers reflecting viral infections may be the ideal combination of diagnostic biomarkers of acute infections.
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| 2. |
- Bülow Anderberg, Sara, et al.
(författare)
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Systemic Human Neutrophil Lipocalin Associates with Severe Acute Kidney Injury in SARS-CoV-2 Pneumonia
- 2021
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 10:18
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Tidskriftsartikel (refereegranskat)abstract
- Neutrophils have been suggested mediators of organ dysfunction in COVID-19. The current study investigated if systemic neutrophil activity, estimated by human neutrophil lipocalin (HNL) concentration in peripheral blood, is associated with acute kidney injury (AKI) development. A total of 103 adult patients admitted to intensive care, with PCR-confirmed SARS-CoV-2 infection, were prospectively included (Clinical Trials ID: NCT04316884). HNL was analyzed in plasma (P-HNL Dimer) and in whole blood (B-HNL). The latter after ex vivo activation with N-formyl-methionine-leucine-phenylalanine. All patients developed respiratory dysfunction and 62 (60%) were treated with invasive ventilation. Sixty-seven patients (65%) developed AKI, 18 (17%) progressed to AKI stage 3, and 14 (14%) were treated with continuous renal replacement therapy (CRRT). P-HNL Dimer was higher in patients with invasive ventilation, vasopressors, AKI, AKI stage 3, dialysis, and 30-day mortality (p < 0.001-0.046). B-HNL performed similarly with the exception of mild AKI and mortality (p < 0.001-0.004). The cohort was dichotomized by ROC estimated cutoff concentrations of 13.2 mu g/L and 190 mu g/L for P-HNL Dimer and B-HNL respectively. Increased cumulative risks for AKI, AKI stage 3, and death were observed if above the P-HNL cutoff and for AKI stage 3 if above the B-HNL cutoff. The relative risk of developing AKI stage 3 was nine and 39 times greater if above the cutoffs in plasma and whole blood, respectively, for CRRT eight times greater for both. In conclusion, systemically elevated neutrophil lipocalin, interpreted as increased neutrophil activity, was shown to be associated with an increased risk of severe AKI, renal replacement therapy, and mortality in COVID-19 patients with respiratory failure.
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| 3. |
- Casswell, Stacey, et al.
(författare)
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COVID-19 Antibody Testing of Patients Admitted to the ICU by A Novel, Point-of-Care Assay, and the Relationship to Survival
- 2021
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Ingår i: Archives of Clinical and Biomedical Research. - : Fortune Journals. - 2572-5017. ; 05:06
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Tidskriftsartikel (refereegranskat)abstract
- Diagnosing persons infected by COVID-19 is key to the control of the pandemic. It has, however, become increasingly important to identify those who have had the infection by measurement of circulating antibodies against Sars-COV-2 of the IgM and IgG type. In this report we show the development of a rapid and sensitive point-of-care assay for the measurement of IgG antibodies against the two spike proteins, S1 and S2, of the Sars-COV-2 virus.Methods: The AgPlus electrochemical technology was applied and the S1 and S2 proteins were biotinylated and immobilized onto streptavidin coated magnetic particles as the capture component of the assay. The IgG antibodies bound to the particles were detected by anti-human IgG and the signal expressed as nC (nano Coulomb). Assay time was <10 min.Results: Plasma (n=211) from 117 SARS-Cov-2 PCR positive patients and from 78 persons with samples taken before the COVID-19 pandemic were analysed. The sensitivity and specificity of the assay were 91.9% and 100%, respectively. The assay was highly correlated to a predicate and FDA-approved IgG antibody ELISA (r=0.81). The IgG response was significantly lower in patients who died during their ICU stay.Conclusions: A poor IgG response after a COVID-19 infection is a serious risk factor as to death. A sensitive, rapid and accurate IgG antibody POC assay should be useful in the daily management and evaluation of COVID-19 infected patients.
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| 4. |
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| 5. |
- Eriksson, Anita, 1955-, et al.
(författare)
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Förskolechefens ansvar och uppdrag ur ett kommunalt förvaltningsperspektiv
- 2015
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Ingår i: Nordisk Barnehageforskning. - 1890-9167. ; 11:9, s. 1-17
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Tidskriftsartikel (refereegranskat)abstract
- The revision of the Swedish Education Act and of the Pre-School Curriculum of 2010 involved ademand for improved pedagogical quality and for an alteration and clarification of roles and responsibilitieswithin the pre-school sector. In the revision the responsibilities, authorizations and rights to make decisions ofthe Heads of Preschool were articulated and clarified. This article describes and discusses how the newresponsibilities and tasks of the Heads of Preschool have been interpreted and how the response to the revisionshas manifested itself within a framework of municipal public administration. The data used consists of aquestionnaire answered by 48 administrative officials with responsibility for education government in differentmunicipalities. The result shows that the Heads of Preschool in a majority of municipalities are faced withincreasing responsibilities and a new accountability structure. In order to meet the demands for improvedpedagogical quality they are also expected to provide competence development opportunities for preschool staff.
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| 6. |
- Eriksson, Anita, 1955-, et al.
(författare)
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Förskolepersonals tal om ansvar i relation till den förtydligade ansvarsstrukturen i svensk förskolepolicy.
- 2019
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Ingår i: Educare. - : Malmo University Library. - 1653-1868 .- 2004-5190. ; :3, s. 87-112
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Tidskriftsartikel (refereegranskat)abstract
- Based on interviews, field conversations and participant observation with head teachers and preschool teachers at four preschools in four different municipalities in Sweden, this article considers how preschool staff interpret and describe their workplace responsibilities four years after the revision of these in the 2010 Education Act and the preschool curriculum and how these descriptions may reflect increasing professionalization.The results demonstratethat the national curriculum discourse of increased preschool teacher professional responsibility was reproduced in general talk about work-duties and responsibilities, but that in more specific conversation related to concrete examples and tasks this was not as clearly the case. Instead, there was a re-contextualisation of the prevailing conditions in the actual preschool contexts. There was also a distinction between the two groups of participants. The head teachers expressed high expectations for preschool teachers to be responsible leaders in the pedagogical activities carried out by the team, but the preschool teachers did not represent themselves as leaders in the same sense. Finally, this study addresses whether the way of talking about the preschool teachers’ responsibilities can contribute to or limit their professionalisation.
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| 7. |
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| 8. |
- Eriksson, Anita, 1955-, et al.
(författare)
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Kommunal förvaltning som politisk aktör: Ett perspektiv på policy och förändring inom förskollärarprofessionen.
- 2019
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Ingår i: Pedagogisk forskning i Sverige. - : Linnaeus University. - 1401-6788 .- 2001-3345. ; 24:2, s. 5-28
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Tidskriftsartikel (refereegranskat)abstract
- Syftet med denna artikel är att bidra med kunskap om vad som sker på kommunal nivå i spåren av en nationell policyrevidering. I artikeln beskrivs hur förvaltningstjänstemän inom kommunala utbildningsförvaltningar har tolkat och arbetat med att implementera 2010 års skollags- och läroplansrevidering med fokus på förtydligandet av förskollärarens ansvar. Mer specifikt fokuseras förvaltningstjänstemäns bedömningar av förskollärares, och i viss mån förskolechefers och annan förskolepersonals, kompetensutvecklingsbehov och vilka utbildningsinsatser som har genomförts som en följd av policyrevideringarna. Av resultatet framgår att satsningar på kompetensutveckling rörande kvalitetssäkring genom pedagogisk dokumentation och utvärdering samt ämneskunskap har prioriterats högre än insatser för att stödja förskollärare i ansvaret för att leda det pedagogiska arbetet. Avslutningsvis diskuteras och problematiseras dels vad förvaltningstjänstemäns olika tolkningar och ageranden kan komma att betyda för förskolläraren som professionell aktör med ett förtydligat kvalitativt ansvar för den pedagogiska verksamhet som arbetslaget gemensamt ska genomföra och dels vad olika tolkningar och utbildningsinsatser kan innebära i ett professionsperspektiv.
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