| 1. |
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| 2. |
- Baumeister, Hannah, et al.
(författare)
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A generalizable data-driven model of atrophy heterogeneity and progression in memory clinic settings
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Ingår i: Brain : a journal of neurology. - 1460-2156. ; 147:7, s. 2400-2413
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Tidskriftsartikel (refereegranskat)abstract
- Memory clinic patients are a heterogeneous population representing various aetiologies of pathological aging. It is unknown if divergent spatiotemporal progression patterns of brain atrophy, as previously described in Alzheimer's disease (AD) patients, are prevalent and clinically meaningful in this group of older adults. To uncover distinct atrophy subtypes, we applied the Subtype and Stage Inference (SuStaIn) algorithm to baseline structural MRI data from 813 participants enrolled in the DELCODE cohort (mean ± SD age = 70.67 ± 6.07 years, 52% females). Participants were cognitively unimpaired (CU; n = 285) or fulfilled diagnostic criteria for subjective cognitive decline (SCD; n = 342), mild cognitive impairment (MCI; n = 118), or dementia of the Alzheimer's type (n = 68). Atrophy subtypes were compared in baseline demographics, fluid AD biomarker levels, the Preclinical Alzheimer Cognitive Composite (PACC-5), as well as episodic memory and executive functioning. PACC-5 trajectories over up to 240 weeks were examined. To test if baseline atrophy subtype and stage predicted clinical trajectories before manifest cognitive impairment, we analysed PACC-5 trajectories and MCI conversion rates of CU and SCD participants. Limbic-predominant and hippocampal-sparing atrophy subtypes were identified. Limbic-predominant atrophy first affected the medial temporal lobes, followed by further temporal and, finally, the remaining cortical regions. At baseline, this subtype was related to older age, more pathological AD biomarker levels, APOE ε4 carriership, and an amnestic cognitive impairment. Hippocampal-sparing atrophy initially occurred outside the temporal lobe with the medial temporal lobe spared up to advanced atrophy stages. This atrophy pattern also affected individuals with positive AD biomarkers and was associated with more generalised cognitive impairment. Limbic-predominant atrophy, in all and in only unimpaired participants, was linked to more negative longitudinal PACC-5 slopes than observed in participants without or with hippocampal-sparing atrophy and increased the risk of MCI conversion. SuStaIn modelling was repeated in a sample from the Swedish BioFINDER-2 cohort. Highly similar atrophy progression patterns and associated cognitive profiles were identified. Cross-cohort model generalizability, both on the subject and group level, were excellent, indicating reliable performance in previously unseen data. The proposed model is a promising tool for capturing heterogeneity among older adults at early at-risk states for AD in applied settings. The implementation of atrophy subtype- and stage-specific end-points may increase the statistical power of pharmacological trials targeting early AD.
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| 3. |
- Bivall, Ann-Charlotte, et al.
(författare)
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Conditions for collaboration between higher education and healthcare providers organising clinical placements
- 2021
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Ingår i: Higher Education, Skills and Work-based Learning. - : Emerald Group Publishing Limited. - 2042-3896 .- 2042-390X. ; 11:4, s. 798-810
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Clinical placement is an important formalised student activity for linking healthcare education and healthcare practices. The purpose of this study is to investigate the organising of clinical placements by examining conditions for collaboration between higher education and healthcare organisations. Design/methodology/approach The study is based on interviews with central actors at a university and two healthcare organisations with official duties of organising clinical placements. Findings The findings indicate that collaboration in the organising of clinical placements is a complex matter of interconnected actors in different organisational positions, at both strategic and operative levels. The university and the healthcare organisations approached the clinical placement with a shared commitment. Practical implications The findings provide important guidance for improving collaboration in the organising of clinical placements. This may have an impact on how contextual conditions of the educational framing and daily healthcare practices are viewed and how the interdependency between the long-term strategic issues and the short-term needs of healthcare organisations is approached. Originality/value This research emphasises the need for careful consideration of the collaborative practices on an organisational level between higher education and healthcare organisations as different needs, motives and logics have to be considered.
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| 4. |
- Björkskog, Anni, et al.
(författare)
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Framtiden är redan byggd : 12 perspektiv
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- POST-ACCELERATION – framtiden är redan byggd har varit temat för kursen Byggnadskonst vid Kungl. Konsthögskolan 2022–2023. Att byggsektorn står för en betydande del av klimatpåverkan både gällande förbrukning av naturresurser och energi, är ingen nyhet, det är också den sektor som efterlämnar mest avfall. Att i större utsträckning återbruka hela byggnader, anläggningar och miljöer, vet vi skulle snabbt ge positiv effekt på klimatet. Att utgå ifrån det som redan finns, istället för att bygga nytt, innebär en kraftfull minskning av ytterligare miljöpåverkan. Majoriteten av den byggda miljön i Sverige är uppförd under senare delen av 1900-talet, en tid, som brukar kallas den stora accelerationen, starkt präglad av sin framtidstro, folkhemsbygge och välfärdsutveckling. Det är ofta i dessa vardagsmiljöer och nära relation till dess arkitektur som vi växer upp, lever våra liv och formas som människor. Livsviktiga miljöer, men känsliga, eftersom de ofta tas för givet, inte pekas ut som värdefulla och därför ofta lider av brist på omsorg och långsiktigt underhåll. Exploateringarna går så snabbt att det är svårt att få tillräcklig tidsdistans för att kunna förstå och värdera vidden av miljöernas idé, betydelse och storhet. Denna publikation redovisar studenternas enskilda arbeten. Materialet har tillkommit inom ramen för läsårets tema ”Post-acceleration - framtiden är redan byggd”, men varje studie utgår ifrån studenternas egna val av ämne. POST-ACCELERATION ingår i den utbildningssatsning som KKH Restaureringskonst sedan 2020 kallar Perspektiv. Utbildningen är forskningsinriktad, där studenterna kritiskt analyserar olika, och ibland motstridiga, perspektiv som idag finns i byggsektorn och samhällets strävan mot en mer hållbar riktning.
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| 5. |
- Cervantes-Madrid, Diana Lizeth, 1987, et al.
(författare)
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DNA alterations in Cd133+ and Cd133- tumour cells enriched from intra-operative human colon tumour biopsies.
- 2017
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Ingår i: BMC cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Tumour stem cells are considered important to promote disease progression, recurrence and treatment resistance following chemotherapy in colon cancer. However, genomic analyses of colorectal cancer have mainly been performed on integrated tumour tissue consisting of several different cell types in addition to differentiated tumour cells. The purpose of the present study was to compare genomic alterations in two cell fractions enriched of CD133+ and CD133-/EpCAM+ cells, respectively, obtained from fresh intraoperative human tumour biopsies.The tumour biopsies were fractionated into CD133+ and CD133-/EpCAM+ cells by immunomagnetic separation, confirmed by immunocytochemistry and Q-PCR. DNA were extracted and used for array comparative genome hybridization (aCGH) after whole genome amplification. Frozen tumour tissue biopsies were used for DNA/RNA extraction and Q-PCR analyses to check for DNA alterations detected in the cell fractions.The number and size of DNA alterations were equally distributed across the cell fractions; however, large deletions were detected on chromosome 1, 7 and 19 in CD133-/EpCAM+ cells. Deletions were frequent in both cell fractions and a deletion on chromosome 19p was confirmed in 90% of the patients.Isolation of enriched cells derived from tumour tissue revealed mainly genomic deletions, which were not observed in tumour tissue DNA analyses. CD133+ cells were genetically heterogeneous among patients without any defined profile compared to CD133-/EpCAM+ cells.
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| 6. |
- De Luca, Francesca, et al.
(författare)
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Elective one-minute full brain multi-contrast MRI versus brain CT in pediatric patients : a prospective feasibility study
- 2024
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Ingår i: BMC Medical Imaging. - 1471-2342. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Brain CT can be used to evaluate pediatric patients with suspicion of cerebral pathology when anesthetic and MRI resources are scarce. This study aimed to assess if pediatric patients referred for an elective brain CT could endure a diagnostic fast brain MRI without general anesthesia using a one-minute multi-contrast EPI-based sequence (EPIMix) with comparable diagnostic performance. Methods: Pediatric patients referred for an elective brain CT between March 2019 and March 2020 were prospectively included and underwent EPIMix without general anesthesia in addition to CT. Three readers (R1–3) independently evaluated EPIMix and CT images on two separate occasions. The two main study outcomes were the tolerance to undergo an EPIMix scan without general anesthesia and its performance to classify a scan as normal or abnormal. Secondary outcomes were assessment of disease category, incidental findings, diagnostic image quality, diagnostic confidence, and image artifacts. Further, a side-by-side evaluation of EPIMix and CT was performed. The signal-to-noise ratio (SNR) was calculated for EPIMix on T1-weighted, T2-weighted, and ADC images. Descriptive statistics, Fisher’s exact test, and Chi-squared test were used to compare the two imaging modalities. Results: EPIMix was well tolerated by all included patients (n = 15) aged 5–16 (mean 11, SD 3) years old. Thirteen cases on EPIMix and twelve cases on CT were classified as normal by all readers (R1–3), while two cases on EPIMix and three cases on CT were classified as abnormal by one reader (R1), (R1–3, p = 1.00). There was no evidence of a difference in diagnostic confidence, image quality, or the presence of motion artifacts between EPIMix and CT (R1–3, p ≥ 0.10). Side-by-side evaluation (R2 + R4 + R5) reviewed all scans as lacking significant pathological findings on EPIMix and CT images. Conclusions: Full brain MRI-based EPIMix sequence was well tolerated without general anesthesia with a diagnostic performance comparable to CT in elective pediatric patients. Trial registration: This study was approved by the Swedish Ethical Review Authority (ethical approval number/ID Ethical approval 2017/2424-31/1). This study was a clinical trial study, with study protocol published at ClinicalTrials.gov with Trial registration number NCT03847051, date of registration 18/02/2019.
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| 7. |
- Elfving, Kristina, et al.
(författare)
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Acute Uncomplicated Febrile Illness in Children Aged 2-59 months in Zanzibar : Aetiologies, Antibiotic Treatment and Outcome
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite the fact that a large proportion of children with fever in Africa present at primary health care facilities, few studies have been designed to specifically study the causes of uncomplicated childhood febrile illness at this level of care, especially in areas like Zanzibar that has recently undergone a dramatic change from high to low malaria transmission.METHODS: We prospectively studied the aetiology of febrile illness in 677 children aged 2-59 months with acute uncomplicated fever managed by IMCI (Integrated Management of Childhood Illness) guidelines in Zanzibar, using point-of-care tests, urine culture, blood-PCR, chest X-ray (CXR) of IMCI-pneumonia classified patients, and multiple quantitative (q)PCR investigations of nasopharyngeal (NPH) (all patients) and rectal (GE) swabs (diarrhoea patients). For comparison, we also performed NPH and GE qPCR analyses in 167 healthy community controls. Final fever diagnoses were retrospectively established based on all clinical and laboratory data. Clinical outcome was assessed during a 14-day follow-up. The utility of IMCI for identifying infections presumed to require antibiotics was evaluated.FINDINGS: NPH-qPCR and GE-qPCR detected ≥1 pathogen in 657/672 (98%) and 153/164 (93%) of patients and 158/166 (95%) and 144/165 (87%) of controls, respectively. Overall, 57% (387/677) had IMCI-pneumonia, but only 12% (42/342) had CXR-confirmed pneumonia. Two patients were positive for Plasmodium falciparum. Respiratory syncytial virus (24.5%), influenza A/B (22.3%), rhinovirus (10.5%) and group-A streptococci (6.4%), CXR-confirmed pneumonia (6.2%), Shigella (4.3%) were the most common viral and bacterial fever diagnoses, respectively. Blood-PCR conducted in a sub-group of patients (n = 83) without defined fever diagnosis was negative for rickettsiae, chikungunya, dengue, Rift Valley fever and West Nile viruses. Antibiotics were prescribed to 500 (74%) patients, but only 152 (22%) had an infection retrospectively considered to require antibiotics. Clinical outcome was generally good. However, two children died. Only 68 (11%) patients remained febrile on day 3 and three of them had verified fever on day 14. An additional 29 (4.5%) children had fever relapse on day 14. Regression analysis determined C-reactive Protein (CRP) as the only independent variable significantly associated with CXR-confirmed pneumonia.CONCLUSIONS: This is the first study on uncomplicated febrile illness in African children that both applied a comprehensive laboratory panel and a healthy control group. A majority of patients had viral respiratory tract infection. Pathogens were frequently detected by qPCR also in asymptomatic children, demonstrating the importance of incorporating controls in fever aetiology studies. The precision of IMCI for identifying infections requiring antibiotics was low.
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| 8. |
- Enbom, Malin, et al.
(författare)
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Detection of Epstein-Barr virus, but not human herpesvirus 8, DNA in cervical secretions from Swedish women by real-time polymerase chain reaction
- 2001
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Ingår i: Sexually Transmitted Diseases. - : Ovid Technologies (Wolters Kluwer Health). - 0148-5717 .- 1537-4521. ; 28:5, s. 300-306
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Epstein-Barr virus (EBV) and human herpesvirus 8 (HHV-8) are two related herpesviruses that may be sexually transmitted. GOAL: To examine the presence of HHV-8 and EBV DNA in the female genital tract. STUDY DESIGN: Real-time polymerase chain reaction systems for quantification of DNA from HHV-8, EBV, and herpes simplex virus type 2 were developed and used for examination of cervical secretions from 112 Swedish women. HHV-8, EBV, and herpes simplex virus type 2 serology was also performed on samples from all subjects. RESULTS: EBV DNA was found in 10 cervical secretion samples, sometimes in high amounts. No cervical secretion or leukocyte sample contained detectable HHV-8 DNA. Antibodies to HHV-8-latent and -lytic antigens were found in 2.7 % and 24% of serum samples, respectively. CONCLUSION: This study supports a possible sexual route of transmission for EBV but not for HHV-8. The new real-time polymerase chain reaction systems could be valuable in future studies of relations between virus load and disease
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| 9. |
- Ergatoudes, Constantinos, et al.
(författare)
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Long-term secondary prevention of acute myocardial infarction (SEPAT) - guidelines adherence and outcome
- 2016
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Ingår i: BMC cardiovascular disorders. - : Springer Science and Business Media LLC. - 1471-2261 .- 1471-2261. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. METHODS: Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden. All patients who agreed to participate in the study (16.2%) were invited for a structured interview, physical examinations and laboratory analysis 2 years after AMI. Guideline-directed secondary preventive goals were defined as optimally controlled blood pressure, serum cholesterol, glucose, regular physical activity, smoking cessation and pharmacological treatment. RESULTS: The mean age of the study cohort (n = 200) at the index AMI was 63.0 +/- 9.7 years, 79% were men. Only 3.5% of the cohort achieved all six guideline-directed secondary preventive goals 2 years after infarction. LDL < 1.8 mmol/L was achieved in 18.5% of the cohort, regular exercise in 45.5% and systolic blood pressure <140 mmHg in 57.0%. Anti-platelet therapy was used by 97% of the patients, beta-blockers by 83.0%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers by 76.5% and statins by 88.5%. During follow-up, non-fatal adverse cardiovascular events (cardiac hospitalization, recurrent acute coronary syndrome, angina pectoris, new percutaneous coronary intervention, new onset of atrial fibrillation, post-infarct heart failure, pacemaker implantation, stroke/transient ischemic attack (TIA), cardiac surgery and cardiac arrest) occurred in 47% of the cohort and readmission due to cardiac causes in 30%. CONCLUSIONS: Our data showed the failure of secondary prevention in our daily clinical practice and high rate of non-fatal adverse cardiovascular events 2 years after AMI.
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| 10. |
- Falk-Brynhildsen, Annika, et al.
(författare)
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Handledning av examensarbete
- 2023. - 3. uppl
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Ingår i: Vetenskaplig teori och metod. - Lund : Studentlitteratur AB. - 9789144161389 ; , s. 523-537
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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