| 1. |
|
|
| 2. |
- Ahlqvist, Emma, et al.
(författare)
-
Novel subgroups of adult-onset diabetes and their association with outcomes : a data-driven cluster analysis of six variables
- 2018
-
Ingår i: The Lancet Diabetes and Endocrinology. - 2213-8587 .- 2213-8595. ; 6:5, s. 361-369
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundDiabetes is presently classified into two main forms, type 1 and type 2 diabetes, but type 2 diabetes in particular is highly heterogeneous. A refined classification could provide a powerful tool to individualise treatment regimens and identify individuals with increased risk of complications at diagnosis.MethodsWe did data-driven cluster analysis (k-means and hierarchical clustering) in patients with newly diagnosed diabetes (n=8980) from the Swedish All New Diabetics in Scania cohort. Clusters were based on six variables (glutamate decarboxylase antibodies, age at diagnosis, BMI, HbA1c, and homoeostatic model assessment 2 estimates of β-cell function and insulin resistance), and were related to prospective data from patient records on development of complications and prescription of medication. Replication was done in three independent cohorts: the Scania Diabetes Registry (n=1466), All New Diabetics in Uppsala (n=844), and Diabetes Registry Vaasa (n=3485). Cox regression and logistic regression were used to compare time to medication, time to reaching the treatment goal, and risk of diabetic complications and genetic associations.FindingsWe identified five replicable clusters of patients with diabetes, which had significantly different patient characteristics and risk of diabetic complications. In particular, individuals in cluster 3 (most resistant to insulin) had significantly higher risk of diabetic kidney disease than individuals in clusters 4 and 5, but had been prescribed similar diabetes treatment. Cluster 2 (insulin deficient) had the highest risk of retinopathy. In support of the clustering, genetic associations in the clusters differed from those seen in traditional type 2 diabetes.InterpretationWe stratified patients into five subgroups with differing disease progression and risk of diabetic complications. This new substratification might eventually help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes.
|
|
| 3. |
- Asad, Samina, et al.
(författare)
-
HTR1A a Novel Type 1 Diabetes Susceptibility Gene on Chromosome 5p13-q13
- 2012
-
Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 7:5
-
Tidskriftsartikel (refereegranskat)abstract
- Background: We have previously performed a genome-wide linkage study in Scandinavian Type 1 diabetes (T1D) families. In the Swedish families, we detected suggestive linkage (LOD less than= 2.2) to the chromosome 5p13-q13 region. The aim of our study was to investigate the linked region in search for possible T1D susceptibility genes. Methodology/Principal Findings: Microsatellites were genotyped in the Scandinavian families to fine-map the previously linked region. Further, SNPs were genotyped in Swedish and Danish families as well as Swedish sporadic cases. In the Swedish families we detected genome-wide significant linkage to the 5-hydroxytryptamine receptor 1A (HTR1A) gene (LOD 3.98, pless than9.8x10(-6)). Markers tagging two separate genes; the ring finger protein 180 (RNF180) and HTR1A showed association to T1D in the Swedish and Danish families (pless than0.002, pless than0.001 respectively). The association was not confirmed in sporadic cases. Conditional analysis indicates that the primary association was to HTR1A. Quantitative PCR show that transcripts of both HTR1A and RNF180 are present in human islets of Langerhans. Moreover, immunohistochemical analysis confirmed the presence of the 5-HTR1A protein in isolated human islets of Langerhans as well as in sections of human pancreas. Conclusions: We have identified and confirmed the association of both HTR1A and RFN180, two genes in high linkage disequilibrium (LD) to T1D in two separate family materials. As both HTR1A and RFN180 were expressed at the mRNA level and HTR1A as protein in human islets of Langerhans, we suggest that HTR1A may affect T1D susceptibility by modulating the initial autoimmune attack or either islet regeneration, insulin release, or both.
|
|
| 4. |
- Barrueta Tenhunen, Annelie, et al.
(författare)
-
Does the antisecretory peptide AF-16 reduce lung oedema in experimental ARDS?
- 2019
-
Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 124:4, s. 246-253
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Acute respiratory distress syndrome (ARDS) is an acute inflammatory condition with pulmonary capillary leakage and lung oedema formation. There is currently no pharmacologic treatment for the condition. The antisecretory peptide AF-16 reduces oedema in experimental traumatic brain injury. In this study, we tested AF-16 in an experimental porcine model of ARDS. Methods: Under surgical anaesthesia 12 piglets were subjected to lung lavage followed by 2 hours of injurious ventilation. Every hour for 4 hours, measurements of extravascular lung water (EVLW), mechanics of the respiratory system, and hemodynamics were obtained. Results: There was a statistically significant (p = 0.006, two-way ANOVA) reduction of EVLW in the AF-16 group compared with controls. However, this was not mirrored in any improvement in the wet-to-dry ratio of lung tissue samples, histology, inflammatory markers, lung mechanics, or gas exchange. Conclusions: This pilot study suggests that AF-16 might improve oedema resolution as indicated by a reduction in EVLW in experimental ARDS.
|
|
| 5. |
- Barrueta Tenhunen, Annelie, et al.
(författare)
-
The antisecretory peptide AF-16 may modulate tissue edema but not inflammation in experimental peritonitis induced sepsis
- 2020
-
Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 15:8
-
Tidskriftsartikel (refereegranskat)abstract
- Sepsis is a life-threatening condition due to a dysregulated immunological response to infection. Apart from source control and broad-spectrum antibiotics, management is based on fluid resuscitation and vasoactive drugs. Fluid resuscitation implicates the risk of volume overload, which in turn is associated with longer stay in intensive care, prolonged use of mechanical ventilation and increased mortality. Antisecretory factor (AF), an endogenous protein, is detectable in most tissues and in plasma. The biologically active site of the protein is located in an 8-peptide sequence, contained in a synthetic 16-peptide fragment, named AF-16. The protein as well as the peptide AF-16 has multiple modulatory effects on abnormal fluid transport and edema formation/resolution as well as in a variety of inflammatory conditions. Apart from its' anti-secretory and anti-inflammatory characteristics, AF is an inhibitor of capillary leakage in intestine. It is not known whether the protein AF or the peptide AF-16 can ameliorate symptoms in sepsis. We hypothesized that AF-16 decreases the degree of hemodynamic instability, the need of fluid resuscitation, vasopressor dose and tissue edema in fecal peritonitis. To test the hypothesis, we induced peritonitis and sepsis by injecting autologous fecal solution into abdominal cavity of anesthetized pigs, and randomized (in a blind manner) the animals to intervention (AF-16, n = 8) or control (saline, n = 8) group. After the onset of hemodynamic instability (defined as mean arterial pressure < 60 mmHg maintained for > 5 minutes), intervention with AF-16 (20 mg/kg (50 mg/ml) in 0.9% saline) intravenously (only the vehicle in the control group) and a protocolized resuscitation was started. We recorded respiratory and hemodynamic parameters hourly for twenty hours or until the animal died and collected post mortem tissue samples at the end of the experiment. No differences between the groups were observed regarding hemodynamics, overall fluid balance, lung mechanics, gas exchange or histology. However, liver wet-to-dry ratio remained lower in AF-16 treated animals as compared to controls, 3.1 +/- 0.4, (2.7-3.5, 95% CI, n = 8) vs 4.0 +/- 0.6 (3.4-4.5, 95% CI, n = 8),p= 0.006, respectively. Bearing in mind the limited sample size, this experimental pilot study suggests that AF-16 may inhibit sepsis induced liver edema in peritonitis-sepsis.
|
|
| 6. |
- Dittrich, Yvonne, et al.
(författare)
-
Making e-Government Happen. Everyday co-development of services, citizenship and technology.
- 2003
-
Konferensbidrag (refereegranskat)abstract
- In a joint research project concerning the use and design of IT in public services, we are using a simple figure of on-going, design-oriented interactions to highlight shifting foci on relationships of codevelopment of services, citzenship and technology. We bring together a number of concrete examples of this on-going everyday co-development, presented from the different perspectives that we, as researchers from different disciplines and traditions, represent in the project. The article explores and discusses wokring relations of technology production and use that we see as central to what is actually making e-government happen - or not happen. The main challenge in this area, as we see it, concerns making visible, and developing supportive infrastructures for, the continuing local adaptation, development and design in use of integrated IT and public services.
|
|
| 7. |
- Ekelin, Annelie, et al.
(författare)
-
KomInDu : A Small Project about Big Issues
- 2004
-
Ingår i: The proceedings from the biennial Participatory Conferences (PDC)2004. - Toronto : CPSR. - 1581138512
-
Konferensbidrag (refereegranskat)abstract
- In this short paper, we present glimpses from an interdisciplinary research and development project aimed at enhancing local democracy by developing ICT support for the consultation process around the comprehensive plan of a municipality. For the participating researchers, the project offered the opportunity of combining and comparing approaches and methods from two different design traditions that share democratic ideals and ambitions of nurturing citizen/user participation in design processes. This proved to be more challenging than we had originally anticipated. Differences in perspective gave different interpretations of the design context as well as of how participatory the processes actually were.
|
|
| 8. |
|
|
| 9. |
- Ekvall-Hansson, Eva, et al.
(författare)
-
Multidisciplinary programme for stress-related disease in primary health care.
- 2009
-
Ingår i: Journal of Multidisciplinary Healthcare. - 1178-2390. ; 2, s. 61-65
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe a multidisciplinary program, given by an occupational therapist and a physiotherapist, for patients with stress-related disease in primary health care and to measure the effect of this program in terms of self-perceived health, degree of burnout, physical activity, symptoms, recreational activities, and psychological and physical well-being. Method: Retrospective study. Results: At measures after three months, the thirteen patients included in this study had improved in self-estimated health, measured with EuroQol-5D Visual Analogue Scale (p = 0.000), and in degree of burnout, measured with the Shirom–Melamed Burnout Questionnaire (p = 0.001). There was also a decrease in presence of headache, in physical activity and in satisfaction with leisure time, although not statistically significant. After six months, the improvements remained for all measures except physical activity. The patients were also satisfied with the program to a high degree, measured with Client Satisfaction Questionnaire (median 3.7). Conclusion: This descriptive study shows that a stress-management program, provided by a team including an occupational therapist and a physiotherapist in primary health care, is both feasible and effective in terms of self-estimated health, degree of burnout, and patient satisfaction.
|
|
| 10. |
- Elovaara, Pirjo, et al.
(författare)
-
Educational programs in e-government : An active, practice- and design-oriented network?
- 2004
-
Ingår i: 3rd International Conference on Electronic Government (EGOV 2004). - Zaragoza, SPAIN : SPRINGER-VERLAG BERLIN. ; , s. 457-459
-
Konferensbidrag (refereegranskat)abstract
- In the autumn of 2004, two higher educational programs in e-government will be starting up at Blekinge Institute of Technology in Southern Sweden. One of these is a Master’s level program, while the other is a more basic, two-year vocational education. Each will be the first of its kind in Scandinavia, and both will be offered as net-based distance education. The interdisciplinary group of researchers/teachers now developing the courses for these educational programs, in co-operation with several other research groups in Scandinavia, see this co-construction of distance education as the beginning of an active Scandinavian network of competence around higher education and ongoing research and development in the e-government area. We are currently exploring the possibilities of using distance education in this area as a way of networking around on-going e-government research and competence enhancement in Scandinavia. The Scandinavian tradition of Participatory Design, as well as ideas about e-government as constantly ongoing co-construction, have inspired us in our work with developing the new educational programs. A reference group consisting of representatives from a number of municipalities and various government agencies plays an important role in this work.
|
|
