| 1. |
- Bäckström, David C, et al.
(författare)
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Cerebrospinal Fluid Patterns and the Risk of Future Dementia in Early, Incident Parkinson Disease
- 2015
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Ingår i: JAMA Neurology. - : American Medical Association. - 2168-6149 .- 2168-6157. ; 72:10, s. 1175-1182
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: Alterations in cerebrospinal fluid (CSF) have been found in Parkinson disease (PD) and in PD dementia (PDD), but the prognostic importance of such changes is not well known. In vivo biomarkers for disease processes in PD are important for future development of disease-modifying therapies. OBJECTIVE: To assess the diagnostic and prognostic value of a panel of CSF biomarkers in patients with early PD and related disorders. DESIGN, SETTING, AND PARTICIPANTS: Regional population-based, prospective cohort study of idiopathic parkinsonism that included patients diagnosed between January 1, 2004, and April 30, 2009, by amovement disorder team at a university hospital that represented the only neurology clinic in the region. Participants were 128 nondemented patients with new-onset parkinsonism (104 with PD, 11 with multiple system atrophy, and 13 with progressive supranuclear palsy) who were followed up for 5 to 9 years. At baseline, CSF from 30 healthy control participants was obtained for comparison. MAIN OUTCOMES AND MEASURES: Cerebrospinal fluid concentrations of neurofilament light chain protein, Aβ1-42, total tau, phosphorylated tau, α-synuclein, and heart fatty acid-binding protein were quantified by 2 blinded measurements (at baseline and after 1 year). Follow-up included an extensive neuropsychological assessment. As PD outcome variables, mild cognitive impairment and incident PDD were diagnosed based on published criteria. RESULTS: Among the 128 study participants, the 104 patients with early PD had a different CSF pattern compared with the 13 patients with progressive supranuclear palsy (baseline area under the receiver operating characteristic curve, 0.87; P < .0001) and the 30 control participants (baseline area under the receiver operating characteristic curve, 0.69; P = .0021). A CSF biomarker pattern associated with the development of PDD was observed. In PD, high neurofilament light chain protein, low Aβ1-42, and high heart fatty acid-binding protein at baseline were related to future PDD as analyzed by Cox proportional hazards regression models. Combined, these early biomarkers predicted PDD with high accuracy (hazard ratio, 11.8; 95% CI, 3.3-42.1; P = .0001) after adjusting for possible confounders. CONCLUSIONS AND RELEVANCE: The analyzed CSF biomarkers have potential usefulness as a diagnostic tool in patients with parkinsonism. In PD, high neurofilament light chain protein, low Aβ1-42, and high heart fatty acid-binding protein were related to future PDD, providing new insights into the etiology of PDD.
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| 2. |
- Gyllenhammar, Daniel, 1994, et al.
(författare)
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Theory and practice of customer-related improvements: a systematic literature review
- 2023
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Ingår i: Total Quality Management and Business Excellence. - : Informa UK Limited. - 1478-3371 .- 1478-3363. ; 34:1-2, s. 201-219
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Tidskriftsartikel (refereegranskat)abstract
- Customers are vital to any organization and system, and must therefore be considered when seeking to improve. However, how to improve with regard to the customer, is not clear, and the knowledge is spread over several research fields, making it difficult for researchers and practitioners to comprehend. The purpose of this literature review is to show how customer-related improvements are described in the literature and how the research is performed. 666 articles were screened, resulting in 99 coded and analysed articles. The study concludes that there is a lack of understanding when it comes to the process of how to improve and that both practitioners and academics should focus more on the system level. It is also seen that by involving the customer in the improvement process, the improvement is more likely to succeed. The article concludes that there is a need for future research which are conceptual, longitudinal, and are addressing actual improvements, not just potential. From the practitioners' point of view, the article is proposing an increased focus on customer-related improvements which address aspects concerning people, such as employee competence and work environment, and reward systems, rather than strategy and processes to improve the potential benefits.
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| 3. |
- Kalm, Marie, 1981, et al.
(författare)
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Serum concentrations of the axonal injury marker neurofilament light protein are not influenced by blood-brain barrier permeability
- 2017
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Ingår i: Brain Research. - : Elsevier BV. - 0006-8993. ; 1668, s. 12-19
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Tidskriftsartikel (refereegranskat)abstract
- A blood biomarker to monitor individual susceptibility to neuronal injury from cranial radiotherapy could potentially help to individualize radiation treatment and thereby reduce the incidence and severity of late effects. An important feature of such a blood biomarker is that its concentration is not confounded by varying degrees of release from the brain into the blood across the blood-brain barrier (BBB). In this study, we investigated serum neurofilament light protein (NFL) concentrations in 21-day old mice following a single dose of cranial irradiation (8 Gy). Cranial irradiation resulted in acute cell injury measured as a 12.9-fold increase in caspase activity 6 h after irradiation; activation of inflammation measured by levels of CCL2 and increased BBB permeability measured by C-14-sucrose concentration ratios in brain and cerebrospinal fluid (CSF). Serum levels of NFL peaked at 6 h after both anesthesia and cranial irradiation, but no timely correlation of serum NFL concentration with BBB permeability was found. Further, three groups of patients with different degrees of BBB impairment (measured as the CSF/serum albumin ratio) were investigated. There was no correlation between serum NFL concentration and CSF/serum albumin ratio (r = 0.139, p = 0.3513), however a strong correlation was found for NFL concentration in serum and NFL concentration in CSF (r = 0.6303, p < 0.0001). In conclusion, serum NFL appears to be a reliable blood biomarker for neuronal injury, and its concentration is not confounded by BBB permeability. (C) 2017 Elsevier B.V. All rights reserved.
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| 4. |
- Melke, Jonas, 1971, et al.
(författare)
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A polymorphism in the serotonin receptor 3A (HTR3A) gene and its association with harm avoidance in women.
- 2003
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Ingår i: Archives of general psychiatry. - : American Medical Association (AMA). - 0003-990X. ; 60:10, s. 1017-23
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The brain neurotransmitter serotonin is known to affect various aspects of human behavior, including personality traits. Serotonin receptor type 3 is a ligand-gated channel encoded by 2 different subunit genes, HTR3A and HTR3B. A polymorphism (C178T) in the 5' region of the HTR3A gene has recently been identified and suggested to be of functional importance. OBJECTIVE: To elucidate the possible association between the C178T polymorphism in the HTR3A gene and personality traits in women. DESIGN: Two independent samples of 35- to 45-year-old Swedish women were recruited using the population register. Sample 1 (n = 195) was assessed via the Karolinska Scales of Personality and the Temperament and Character Inventory; sample 2 (n = 175) was assessed using the latter only. Both samples were genotyped with respect to the C178T polymorphism in the HTR3A gene. The A1596G polymorphism in the same gene was also investigated. RESULTS: A significant association between C178T genotype and the Temperament and Character Inventory factor harm avoidance was observed in sample 1 (corrected for multiple comparisons P =.04); this finding was subsequently replicated in sample 2 (P =.004) (pooled populations: P<.001). In the pooled sample, all harm avoidance subscales were found to be significantly associated with the C178T polymorphism: anticipatory worry (P =.001), fear of uncertainty (P<.001), shyness (P<.001), and fatigability and asthenia (P =.008). In addition, a significant association was found in sample 1 between the C178T polymorphism and the Karolinska Scales of Personality nonconformity factor (corrected P =.002), including the subscales of social desirability (P<.001), indirect aggression (P =.002), verbal aggression (P =.05), and irritability (P<.001). Participants homozygous for the less common T allele (<4%) differed from the remaining women by displaying lower ratings on harm avoidance and nonconformity. CONCLUSION: The C178T polymorphism in the HTR3A gene may affect the personality trait of harm avoidance in women.
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| 5. |
- Narbutaité Aflaki, Inga, 1973-, et al.
(författare)
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Utmaningar och framgångsfaktorer för att initiera, genomföra och anpassa ett idéburet-offentligt partnerskap : Ett kunskapsunerlag från följeforskning av IOP ensamkommande i Göteborg 2016-2017
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Antalet ensamkommande barn som kom till Sverige för att söka asyl ökade kraftigt under en period mellan 2014 och 2016, och speciellt många kom under hösten 2015. Flyktingvågen ställde nya krav på kommunerna men öppnade samtidigt möjligheter för innovativa angreppssätt. För att ta ett helhetsgrepp om mottagandet av ensamkommande barn och ungdomar inleddes en relativt ny form av samverkan, ett idéburet–offentligt partnerskap (IOP), mellan Göteborgs kommun (Social resursförvaltning) och sju (senare nio) idéburna verksamheter. Ett IOP utgör ett nytt sätt att tänka kring samverkan mellan staten och det civila samhället och kan ses som ett alternativ till upphandlingskontrakt och sedvanliga föreningsbidrag, framförallt inom sociala och integrationsfrågor. Det finns ännu begränsad kunskap kring implementeringen av IOP och implikationerna för båda sektorerna. Syftet med denna rapport är att ta fram kunskap om samverkansmodellen idéburet–offentligt partnerskap till nytta för framtida liknande arrangemang. Genom att samla in kunskap om IOP-samarbete i form av framgångsfaktorer och utmaningar ges bättre förutsättningar för tillämpningen av IOP-avtal inom andra välfärdsområden och inom andra kommuner och offentliga verksamheter. Projektet har genomförts i form av följeforskning på IOP Ensamkommande i Göteborg. Sammanfattningsvis, baserat på innehållet i detta kunskapsunderlag om IOP lyfter vi fram fyra rekommendationer för att öka användningen av IOP som samarbetsform: (1) Det behövs en ökad vilja och ett mod bland politiker och ledande tjänstemän inom den offentliga sektorn att våga initiera IOP-avtal trots juridiska oklarheter. Initierandet av IOP-samarbeten behöver stödjas av policyentreprenörer inom bägge sek-torerna och ha som utgångspunkt att olika organisationers identitet ska bevaras, och att klimatet ska vara präglat av tillit, öppna dialoger och en gemensam värdegrund. (2) För att framgångsrikt kunna genomföra ett IOP är det nödvändigt med en partnergemensam styrning, ledning och en aktiv samordning som bygger på vilja, tillit, ömsesidigt inflytande och kommunikation över organisationsgränserna. Något annat som är viktigt för att lyckas med ett IOP är att de idéburna aktörerna hittar sina unika roller i partnerskapet och förmedlar komplementära tjänster/insatser och därmed mervärden. (3) För att partnerskapet ska bli hållbart över tid och kunna anpassas efter nya förutsättningar krävs en fortsatt gemensam vilja, tillit och utvecklade relationer så att man hela tiden kan balansera mellan konflikt och konsensus, och mellan kontinuitet och förändring. (4) Det behövs en djupare och bredare kunskap om IOP generellt inom båda sektorerna, och i synnerhet om när och hur man kan initiera och driva ett IOP. Detta kan erhållas genom olika former av kunskapsutveckling och kunskapsspridning som utgår från flera praktiska exempel på IOP-samverkan.
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| 6. |
- Timpka, Toomas, et al.
(författare)
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A neighborhood susceptibility index for planning of local physical interventions in response to pandemic influenza outbreaks
- 2010
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Ingår i: AMIA Annual Symposium Proceedings. - 1942-597X. ; 2010, s. 792-796
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Tidskriftsartikel (refereegranskat)abstract
- The global spread of a novel A (H1N1) influenza virus in 2009 has highlighted the possibility of a devastating pandemic similar to the 'Spanish flu' of 1917-1918. Responding to such pandemics requires careful planning for the early phases where there is no availability of pandemic vaccine. We set out to compute a Neighborhood Influenza Susceptibility Index (NISI) describing the vulnerability of local communities of different geo-socio-physical structure to a pandemic influenza outbreak. We used a spatially explicit geo-physical model of Linköping municipality (pop. 136,240) in Sweden, and employed an ontology-modeling tool to define simulation models and transmission settings. We found considerable differences in NISI between neighborhoods corresponding to primary care areas with regard to early progress of the outbreak, as well as in terms of the total accumulated share of infected residents counted after the outbreak. The NISI can be used in local preparations of physical response measures during pandemics.
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| 7. |
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| 8. |
- Timpka, Toomas, et al.
(författare)
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Requirements and Design of the PROSPER Protocol for Implementation of Information Infrastructures Supporting Pandemic Response: A Nominal Group Study
- 2011
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:3, s. 0017941-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Advanced technical systems and analytic methods promise to provide policy makers with information to help them recognize the consequences of alternative courses of action during pandemics. Evaluations still show that response programs are insufficiently supported by information systems. This paper sets out to derive a protocol for implementation of integrated information infrastructures supporting regional and local pandemic response programs at the stage(s) when the outbreak no longer can be contained at its source. Methods: Nominal group methods for reaching consensus on complex problems were used to transform requirements data obtained from international experts into an implementation protocol. The analysis was performed in a cyclical process in which the experts first individually provided input to working documents and then discussed them in conferences calls. Argument-based representation in design patterns was used to define the protocol at technical, system, and pandemic evidence levels. Results: The Protocol for a Standardized information infrastructure for Pandemic and Emerging infectious disease Response (PROSPER) outlines the implementation of information infrastructure aligned with pandemic response programs. The protocol covers analyses of the community at risk, the response processes, and response impacts. For each of these, the protocol outlines the implementation of a supporting information infrastructure in hierarchical patterns ranging from technical components and system functions to pandemic evidence production. Conclusions: The PROSPER protocol provides guidelines for implementation of an information infrastructure for pandemic response programs both in settings where sophisticated health information systems already are used and in developing communities where there is limited access to financial and technical resources. The protocol is based on a generic health service model and its functions are adjusted for community-level analyses of outbreak detection and progress, and response program effectiveness. Scientifically grounded reporting principles need to be established for interpretation of information derived from outbreak detection algorithms and predictive modeling.
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| 9. |
- Westberg, Lars, 1973, et al.
(författare)
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Influence of androgen receptor repeat polymorphisms on personality traits in men
- 2009
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Ingår i: Journal of Psychiatry and Neuroscience. - 1488-2434 .- 1180-4882. ; 34:3, s. 205-213
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Tidskriftsartikel (refereegranskat)abstract
- Background Testosterone has been attributed importance for various aspects of behaviour. The aim of our study was to investigate the potential influence of 2 functional polymorphisms in the amino terminal of the androgen receptor on personality traits in men. Methods We assessed and genotyped 141 men born in 1944 recruited from the general population. We used 2 different instruments: the Karolinska Scales of Personality and the Temperament and Character Inventory. For replication, we similarly assessed 63 men recruited from a forensic psychiatry study group. Results In the population-recruited sample, the lengths of the androgen receptor repeats were associated with neuroticism, extraversion and self-transcendence. The association with extraversion was replicated in the independent sample. Limitations Our 2 samples differed in size; sample 1 was of moderate size and sample 2 was small. In addition, the homogeneity of sample 1 probably enhanced our ability to detect significant associations between genotype and phenotype. Conclusion Our results suggest that the repeat polymorphisms in the androgen receptor gene may influence personality traits in men.
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| 10. |
- Andersen, Henrik Rasmus, et al.
(författare)
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Estrogenic personal care products in a greywater reuse system
- 2007
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Ingår i: Water Science and Technology. - : IWA Publishing. - 0273-1223 .- 1996-9732. ; 56:12, s. 45-49
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Tidskriftsartikel (refereegranskat)abstract
- The occurrence and fate of parabens in a greywater system was assessed. The potential for removal of residual paraben concentrations in effluent greywater with chlorine dioxide was also investigated. The influent to the greywater plant was characterised by considerable variation, with concentrations from below the detection limit to 40 μg/L and the five commonly used parabens in consumer products were frequently detected. After the biological treatment only two paraben were detected with concentration from 65–120 ng/L. Chlorine dioxide treatment of the biologically treated effluent with dosages down to 0.75 mg/L resulted in more than 97% reduction of all parabens. Formation of the by-product chloroform was insignificant from the chlorine dioxide treatment.
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