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- Barman, Linda, 1972-, et al.
(författare)
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Hardness or Resignation : How Emotional Challenges During Work‑Based Education Influence the Professional Becoming of Medical Students and Student Teachers
- 2023
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Ingår i: Vocations and Learning. - : Springer Nature. - 1874-785X .- 1874-7868.
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Tidskriftsartikel (refereegranskat)abstract
- This paper addresses how emotionally challenging experiences during work-basededucation may influence the professional becoming of student teachers and medicalstudents. We conducted a qualitative analysis of eight focus group interviewswith undergraduates from two universities in Sweden who studied to become eitherphysicians or teachers, and interpreted their experiences through Wenger’s theory ofcommunities of practice. The findings show that students’ ideal view of how to becaring in their aspiring professional role as physician or teacher collided with existingpractices, which affected them emotionally. In particular, the students found itchallenging when norms and practices differed from their values of professionalismand when the professional culture within practices reflected hardness (physicians) orresignation (teachers). Both medical students and student teachers experienced thatprofessional decision making and legitimacy challenged them emotionally, howeverin different ways and for different reasons. This study makes visible both generaland specific aspects of how students view their future role in the welfare sector andchallenging dimensions of professional practice. The findings bring into focus thequestion of how professional education can support students’ professional becomingin relation to their emotional challenges.
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- Goel, Suchi, et al.
(författare)
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RIFINs are adhesins implicated in severe Plasmodium falciparum malaria
- 2015
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Ingår i: Nature Medicine. - : Springer Science and Business Media LLC. - 1078-8956 .- 1546-170X. ; 21:4, s. 314-317
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Tidskriftsartikel (refereegranskat)abstract
- Rosetting is a virulent Plasmodium falciparum phenomenon associated with severe malaria. Here we demonstrate that P. falciparum-encoded repetitive interspersed families of polypeptides (RIFINs) are expressed on the surface of infected red blood cells (iRBCs), bind to RBCs-preferentially of blood group A-to form large rosettes and mediate microvascular binding of iRBCs. We suggest that RIFINs have a fundamental role in the development of severe malaria and thereby contribute to the varying global distribution of ABO blood groups in the human population.
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- Grigoriadis, Aristeidis, et al.
(författare)
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Development of a prognostic MRCP-score (DiStrict) for individuals with large-duct primary sclerosing cholangitis
- 2022
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Ingår i: JHEP Reports. - : Elsevier. - 2589-5559. ; 4:12
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Magnetic resonance cholangiopancreatography (MRCP) is used for the diagnosis and follow-up of individuals with primary sclerosing cholangitis (PSC). The aim of our study is to develop an MRCP-score based on chol-angiographic findings previously associated with outcomes and assess its reproducibility and prognostic value in PSC.Methods: The score (DiStrict score) was developed based on the extent and severity of cholangiographic changes of intra-hepatic and extrahepatic bile ducts (range 0-8) on 3D-MRCP. In this retrospective, multicentre study, three pairs of radiol-ogists with different levels of expertise from three tertiary centres applied the score independently. MRCP examinations of 220 consecutive individuals with PSC from a prospectively collected PSC-cohort, with median follow-up of 7.4 years, were reviewed. Inter-reader and intrareader agreements were assessed via intraclass correlation coefficient (ICC). After consensus, the prognostic value of the score was assessed using Cox-regression and outcome-free survival rates were assessed via Kaplan-Meier estimates. Harrell's C-statistic was calculated.Results: Forty patients developed outcomes (liver transplantation or liver-related death). Inter-reader agreement between experienced radiologists was good (ICC 0.82; 95% CI 0.74-0.87, and ICC 0.81; 95% CI 0.70-0.87, respectively) and better than the agreement for the pair of experienced/less-experienced radiologists (ICC 0.48; 95% CI 0.05-0.72). Agreement between radiologists from the three centres was good (ICC 0.76; 95% CI 0.57-0.89). Intrareader agreement was good to excellent (ICC 0.85-0.93). Harrell's C was 0.78. Patients with a DiStrict score of 5-8 had 8.2-fold higher risk (hazard ratio 8.2; 95% CI 2.97-22.65) of developing outcomes, and significantly worse survival (p <0.001), compared to those with a DiStrict score of 1-4.Conclusions: The novel DiStrict score is reproducible and strongly associated with outcomes, indicating its prognostic value for individuals with PSC in clinical practice.Impact and implications: The diagnosis of primary sclerosing cholangitis (PSC) is based on magnetic resonance chol-angiopancreatography (MRCP). However, the role of MRCP in the prognostication of PSC is still unclear. We developed a novel, simple, and reproducible risk-score, based on MRCP findings, that showed a strong association with prognosis in individuals with PSC (DiStrict score). This score can be easily used in clinical practice and thus has the potential to be useful in clinical trials and in patient counselling and management.
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| 6. |
- Grigoriadis, Aristeidis, et al.
(författare)
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Development of a prognostic MRCP score (DiStrict) for patients with large-duct primary sclerosing cholangitis
- 2022
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Ingår i: JHEP Reports. - : Elsevier BV. - 2589-5559. ; 4:12
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Tidskriftsartikel (refereegranskat)abstract
- Background and AimsMRCP is used for diagnosis and follow-up of patients with primary sclerosing cholangitis (PSC). Interest in the prognostic value of MRCP is increasing. The aim of our study is to develop an MRCP-score based on cholangiographic findings previously associated with outcomes and assess its reproducibility and prognostic value in PSC.MethodsThe score (DiStrict-score) was developed based on the extent and severity of cholangiographic changes of intrahepatic and extrahepatic bile ducts (range 0–8) on 3D-MRCP. In this retrospective, ethics review board approved, multicentre study, three pairs of radiologists with different levels of expertise from three tertiary centres applied the score independently. MRCP- examinations of 220 consecutive PSC-patients from a prospectively collected PSC-cohort, with median follow-up of 7.4 years, were reviewed. Interreader and intrareader agreements were assessed via intraclass correlation coefficient (ICC). After consensus, the prognostic value of the score was assessed using Cox-regression and outcome-free survival rates were assessed via Kaplan-Meier estimates. Harrell´s C-statistic was calculated.Results40 patients developed outcomes (liver transplantation or liver-related death). Interreader agreement between experienced radiologists was good (ICC=0.82; 95%CI:0.74–0.87, and ICC=0.81; 95%CI:0.70–0.87, respectively) and better than the agreement for the pair of experienced/less experienced radiologist (ICC=0.48; 95%CI:0.05–0.72). Agreement between radiologists from the three centres was good (ICC=0.76; 95%CI:0.57–0.89). Intrareader agreement was good to excellent (ICC=0.85–0.93). Harrell´s C was 0.78. Patients with DiStrict-score of 5 – 8 had 8.2 times higher risk (HR=8.2; 95%CI:2.97–22.65) for developing outcomes, and significantly worse survival (P ConclusionsThe novel DiStrict-score is reproducible and strongly associated with outcomes, indicating its value for PSC-patient prognoses in clinical practice.Lay summaryDiagnosis of primary sclerosing cholangitis (PSC) is based on magnetic resonance cholangiopancreatography (MRCP). However, the role of MRCP in the prognosis of PSC is still unclear. We developed a novel, simple, and reproducible risk-score, based on MRCP findings, that showed a strong association with PSC patient prognoses (DiStrict score). This score can be easily used in clinical practice and thus has the potential to be useful in clinical trials and in patient counselling and management.
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| 9. |
- Hult, Annika, et al.
(författare)
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Blood group genotype analysis for the quality improvement of reagent test red blood cells
- 2005
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Ingår i: Vox Sanguinis. - : Wiley. - 1423-0410 .- 0042-9007. ; 88:4, s. 265-270
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives Reagent red blood cells (RBCs) for antibody detection should express certain important antigens as a double dose, that is, the donors must be homozygous for the corresponding alleles. Traditionally, dose is determined by serological typing and known allele frequencies. However, RHD zygosity cannot be predicted serologically owing to the absence of an antithetical antigen, and FY zygosity is confounded by two variant haplotypes, FY*0 and FY*X. Furthermore, lack of reagents hampers our ability to type for some clinically important antigen pairs such as Do(a)/Do(b). Materials and Methods Genomic DNA was isolated from reagent RBC samples. Established, validated methods were used to determine the RHD, FY, and DO genotypes. Results Three of 52 D+ samples gave results that differed from the predicted genotype: two presumed (RR1)-R-1 samples and an (RR2)-R-2 sample were shown to be R(1)r" and R(2)r', respectively. Five of 59 samples that were from presumed homozygotes for either FY*A or FY*B were heterozygous, together with either FY*X (three samples) or FY*0 (two samples). Seventy-five samples tested for DO were DO*A/A (n = 14), DO*A/B (n = 39), or DO*B/B (n = 22). Conclusions The results show that serologically determined RhD and Duffy phenotypes of reagent RBCs are unreliable and that antigens we thought were represented as a double dose were single dose. The addition of Dombrock genotyping provides information which is useful in antibody identification. We conclude that selected genotype analyses are a valuable quality assurance measure to ensure that reagent RBCs comply with national and international recommendations for test sensitivity.
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