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- Hemmingsson, Eva-Stina, et al.
(författare)
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Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013
- 2018
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Ingår i: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 74:4, s. 483-488
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Many elderly people living in nursing homes experience pain and take analgesic medication. The aim of this study was to analyze the prevalence of pain and pharmacological pain treatment among people living in nursing homes in Sweden, in two large, comparable, samples from 2007 to 2013.Methods: Cross-sectional surveys were performed in 2007 and 2013, including all residents in nursing homes in the county of Västerbotten, Sweden. A total of 4933 residents (2814 and 2119 respectively) with a mean age of 84.6 and 85.0 years participated. Of these, 71.1 and 72.4% respectively were cognitively impaired. The survey was completed by the staff members who knew the residents best.Results: The prescription of opioids became significantly more common while the use of tramadol decreased significantly. The staff reported that 63.4% in 2007 and 62.3% in 2013 had experienced pain. Of those in pain, 20.2% in 2007 and 16.8% in 2013 received no treatment and 73.4 and 75.0% respectively of those with pain, but no pharmacological treatment, were incorrectly described by the staff as being treated for pain.Conclusions: There has been a change in the pharmacological analgesic treatment between 2007 and 2013 with less prescribing of tramadol and a greater proportion taking opioids. Nevertheless, undertreatment of pain still occurs and in many cases, staff members believed that the residents were prescribed analgesic treatment when this was not the case.
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2. |
- Mattsson, Niklas, 1979, et al.
(författare)
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BACE1 inhibition induces a specific cerebrospinal fluid β-amyloid pattern that identifies drug effects in the central nervous system.
- 2012
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- BACE1 is a key enzyme for amyloid-β (Aβ) production, and an attractive therapeutic target in Alzheimer's disease (AD). Here we report that BACE1 inhibitors have distinct effects on neuronal Aβ metabolism, inducing a unique pattern of secreted Aβ peptides, analyzed in cell media from amyloid precursor protein (APP) transfected cells and in cerebrospinal fluid (CSF) from dogs by immunoprecipitation-mass spectrometry, using several different BACE1 inhibitors. Besides the expected reductions in Aβ1-40 and Aβ1-42, treatment also changed the relative levels of several other Aβ isoforms. In particular Aβ1-34 decreased, while Aβ5-40 increased, and these changes were more sensitive to BACE1 inhibition than the changes in Aβ1-40 and Aβ1-42. The effects on Aβ5-40 indicate the presence of a BACE1 independent pathway of APP degradation. The described CSF Aβ pattern may be used as a pharmacodynamic fingerprint to detect biochemical effects of BACE1-therapies in clinical trials, which might accelerate development of novel therapies.
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4. |
- Aarnio, Riina, 1971-, et al.
(författare)
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Comparison of vaginal self-sampling and cervical sampling by medical professionals for the detection of HPV and CIN2+ : a randomized study
- 2021
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Ingår i: International Journal of Cancer. - : John Wiley & Sons. - 0020-7136 .- 1097-0215. ; 148:12, s. 3051-3059
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Tidskriftsartikel (refereegranskat)abstract
- Primary screening with human papillomavirus (HPV) test is more effective in reducing cervical cancer incidence than cytology and it also offers the opportunity to self-sample. We conducted a randomized study to compare vaginal self-sampling with cervical sampling by medical professionals for HPV testing concerning prevalence of HPV and detection of cervical intraepithelial neoplasia (CIN) of grade 2 or worse (CIN2+) or grade 3 or worse (CIN3+) in primary screening. In total, 11 951 women aged 30-60 years were randomized into two groups, 5961 for self-sampling (SS arm) and 5990 for sampling by medical professionals (SMP arm). Sampling was performed with a RoversViba-brush in the SS arm and a cytobrush in the SMP arm. All samples were applied to an indicating FTA elute card and analyzed for HPV using a clinically validated real-time PCR test (hpVIR). All HPV-positive women performed repeated sampling about 6 months later using the same procedure as used initially. All HPV-positive women in the second sampling were referred to colposcopy. The prevalence of HPV in the first test did not differ between the SS arm (6.8%, 167/2466) and the SMP arm (7.8%, 118/1519) (P = .255). The prevalence of CIN2+ per 1000 screened women was 17 (43/2466 × 1000) (95%CI 13-24) in the SS arm and 21 (32/1519 × 1000) (95%CI 15-30) in the SMP arm. For CIN3+, the prevalence per 1000 screened women was 14 (35/2466 × 1000) (95%CI 10-20) in the SS arm and 15 (23/1519 × 1000) (95%CI 10-23) in the SMP arm. In conclusion, self-sampling and sampling by medical professionals showed the same prevalence of HPV and detection rate of CIN2+ and CIN3+ in histology.
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5. |
- Aarnio, Riina, 1971-, et al.
(författare)
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Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized study
- 2020
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 20:1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundHuman papillomavirus (HPV) testing is recommended in primary cervical screening to improve cancer prevention. An advantage of HPV testing is that it can be performed on self-samples, which could increase population coverage and result in a more efficient strategy to identify women at risk of developing cervical cancer. Our objective was to assess whether repeated self-sampling for HPV testing is cost-effective in comparison with Pap smear cytology for detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) in increasing participation rate in primary cervical screening.MethodsA cost-effectiveness analysis (CEA) was performed on data from a previously published randomized clinical study including 36 390 women aged 30–49 years. Participants were randomized either to perform repeated self-sampling of vaginal fluid for HPV testing (n = 17 997, HPV self-sampling arm) or to midwife-collected Pap smears for cytological analysis (n = 18 393, Pap smear arm).ResultsSelf-sampling for HPV testing led to 1633 more screened women and 107 more histologically diagnosed CIN2+ at a lower cost vs. midwife-collected Pap smears (€ 228 642 vs. € 781 139). ConclusionsThis study projected that repeated self-sampling for HPV testing increased participation and detection of CIN2+ at a lower cost than midwife-collected Pap smears in primary cervical screening. Offering women a home-based self-sampling may therefore be a more cost-effective alternative than clinic-based screening.
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6. |
- Aarnio, Riina, et al.
(författare)
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Diagnostic excision of the cervix in women over 40 years with human papilloma virus persistency and normal cytology
- 2019
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Ingår i: European journal of obstetrics & gynecology and reproductive biology: X. - : Elsevier BV. - 2590-1613. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Persistent infection with human papillomavirus (HPV) is recognized as the main risk factor of cervical cancer. Investigation via cytology and colposcopy have lower sensitivity than HPV testing in the diagnosis of high-grade cervical intraepithelial neoplasia (CIN2+). Despite normal cytology and colposcopy findings women with persistent HPV infection have an increased risk of CIN2+. The aim of the study was to evaluate the proportion of histologically confirmed CIN2+ in women with persistent HPV infection and normal Pap smears.Study design: From April 2013 until March 2016 we prospectively recruited 91 women over 40 years with persistent HPV infection without any abnormalities in cytology. Of these, 40 women attended a gynecological examination including an HPV test, Pap smear, endocervical cytology, colposcopy with biopsies and diagnostic loop electrosurgical excision procedure (LEEP). Biopsy and LEEP samples were subjected to histological examination.Results: CIN2+ was verified by histological examination of the LEEP sample in 6/40 (15%) of the women. All the cytological samples were normal and none of the biopsies confirmed CIN2+. Only 19/40 women still had a persistent HPV infection at the study visit. None of the 21/40 women who had cleared their HPV infection at the study visit had CIN2+ in histology of the LEEP sample.Conclusions: A persistent HPV infection needs to be monitored despite normal Pap smears, since 6/40 (15%) women older than 40 years, was revealed to have an undiagnosed CIN2+ when LEEP was performed. Counseling women regarding the risk of cervical cancer and the expected effect of an eventual LEEP can help them to make an optimal informed choice.
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- Ahlin, Gustav, et al.
(författare)
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Structural requirements for drug inhibition of the liver specific human organic cation transport protein 1
- 2008
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Ingår i: Journal of Medicinal Chemistry. - : American Chemical Society (ACS). - 0022-2623 .- 1520-4804. ; 51:19, s. 5932-5942
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Tidskriftsartikel (refereegranskat)abstract
- The liver-specific organic cation transport protein (OCT1; SLC22A1) transports several cationic drugs including the antidiabetic drug metformin and the anticancer agents oxaliplatin and imatinib. In this study, we explored the chemical space of registered oral drugs with the aim of studying the inhibition pattern of OCT1 and of developing predictive computational models of OCT1 inhibition. In total, 191 structurally diverse compounds were examined in HEK293-OCT1 cells. The assay identified 47 novel inhibitors and confirmed 15 previously known inhibitors. The enrichment of OCT1 inhibitors was seen in several drug classes including antidepressants. High lipophilicity and a positive net charge were found to be the key physicochemical properties for OCT1 inhibition, whereas a high molecular dipole moment and many hydrogen bonds were negatively correlated to OCT1 inhibition. The data were used to generate OPLS-DA models for OCT1 inhibitors; the final model correctly predicted 82% of the inhibitors and 88% of the noninhibitors of the test set.
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8. |
- Amani, Navid, 1985, et al.
(författare)
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Array Configuration Effect on the Spatial Correlation of MU-MIMO Channels in NLoS Environments
- 2020
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Ingår i: 14th European Conference on Antennas and Propagation, EuCAP 2020. ; 2020:March
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Konferensbidrag (refereegranskat)abstract
- In this paper, three different base-station antenna (BSA) configurations are compared in terms of inter-user spatial correlation in a two dimensional (2D) non-line-of-sight (NLoS) environment. The three configurations are: (i) a regular uniform linear array (ULA); (ii) a periodic sparse array; and (iii) an aperiodic sparse array. Electromagnetic modeling of the NLoS channel is proposed where scatterers are considered as resonant dipoles confined in clusters of scatterers (CoSs). While the probability of facing highly correlated user-equipments (UEs) in a multi-user multiple-input multiple-output (MU-MIMO) system is decreasing as the richness of mutipath increases, the sparsity (increased inter-element spacing) is seen to be capable of reducing this probability as well. This is due to the larger spatial variations experienced by the sparse array. Moreover, the results show that further improvement can be achieved by deploying an aperiodic distribution of antenna elements into the sparse antenna aperture.
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9. |
- Ameur, Adam, et al.
(författare)
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Comprehensive profiling of the vaginal microbiome in HIV positive women using massive parallel semiconductor sequencing
- 2014
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 4, s. 4398-
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Tidskriftsartikel (refereegranskat)abstract
- Infections by HIV increase the risk of acquiring secondary viral and bacterial infections and methods are needed to determine the spectrum of co-infections for proper treatment. We used rolling circle amplification (RCA) and Ion Proton sequencing to investigate the vaginal microbiome of 20 HIV positive women from South Africa. A total of 46 different human papillomavirus (HPV) types were found, many of which are not detected by existing genotyping assays. Moreover, the complete genomes of two novel HPV types were determined. Abundance of HPV infections was highly correlated with real-time PCR estimates, indicating that the RCA-Proton method can be used for quantification of individual pathogens. We also identified a large number of other viral, bacterial and parasitic co-infections and the spectrum of these co-infections varied widely between individuals. Our method provides rapid detection of a broad range of pathogens and the ability to reconstruct complete genomes of novel infectious agents.
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10. |
- Amin, Shoaib Amin, 1985-
(författare)
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Characterization and Linearization of Multi-channel RF Power Amplifiers
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The demands for high data rates and broadband wireless access require the development of wireless systems that can support wide and multi-band signals. To deploy these signals, new radio frequency (RF) front-ends are required which impose new challenges in terms of power consumption efficiency and sources of distortion e.g., nonlinearity. These challenges are more pronounced in power amplifiers (PAs) that degrade the overall performance of the RF transmitter. Since it is difficult to optimize the linearity and efficiency characteristics of a PA simultaneously, a trade-off is needed. At high input power, a PA exhibits high efficiency at the expense of linearity. On the other hand, at low input power, a PA is linear at the expense of the efficiency. To achieve linearity and efficiency at the same time, digital pre-distortion (DPD) is often used to compensate for the PA nonlinearity at high input power. In case of multi-channel PAs, input and output signals of different channels interact with each other due to cross-talk. Therefore, these PAs exhibit different nonlinear behavior than the single-input single-output (SISO) PAs. The DPD techniques developed for SISO PAs do not result in adequate performance when used for multi-channel PAs. Hence, an accurate behavioral modeling is essential for the development of DPD for multi-channel RF PAs. In this thesis, we propose three novel behavioral models and DPD schemes for nonlinear multiple-input multiple-output (MIMO) transmitters in presence of cross-talk. A study of the source of cross-talk in MIMO transmitters have been investigated to derive simple and powerful modeling schemes. These models are extensions of a SISO generalized memory polynomial model. A comparative study with a previously published MIMO model is also presented. The effect of coherent and partially non-coherent signal generationon DPD performance is also highlighted. It is shown experimentally that with partially non-coherent signal generation, the performance of the DPD degrades compared to coherent signal generation. In context of multi-channel RF transmitters, PA behavioral models and DPD schemes suffer from a large number of model parameters with the increase in nonlinear order and memory depth. This growth leads to high complexity model identification and implementation. We have designed a DPD scheme for MIMO PAs using a sparse estimation technique for reducing model complexity. This technique also increases the numerical stability when linear least square estimation model identification is used. A method to characterize the memory effects in a nonlinear concurrent dual-band PAs is also presented. Compared to the SISO PAs, concurrent dual-band PAs are not only affected by intermodulation distortions but also by cross-modulation distortions. The characterization of memory effects inconcurrent dual-band transmitter is performed by injecting a two-tone test signal in each input channel of the transmitter. Asymmetric energy surfaces are introduced for the intermodulation and cross-modulation products, which can be used to identify the power and frequency regions where the memory effects are dominant.
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