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- 2019
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Tidskriftsartikel (refereegranskat)
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- Ahmed, Abdulla, et al.
(författare)
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Evaluation of the European Society of Cardiology/European Respiratory Society derived three-and four-strata risk stratification models in pulmonary arterial hypertension : Introducing an internet-based risk stratification calculator
- 2023
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Ingår i: European Heart Journal Open. - : Oxford University Press (OUP). - 2752-4191. ; 3:2
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Estimation of prognosis in pulmonary arterial hypertension (PAH) has been influenced by that various risk stratification models use different numbers of prognostic parameters, as well as the lack of a comprehensive and time-saving risk assessment calculator. We therefore evaluated the various European Society of Cardiology (ESC)-/European Respiratory Society (ERS)-based three-and four-strata risk stratification models and established a comprehensive internet-based calculator to facilitate risk assessment. Methods and results: Between 1 January 2000 and 26 July 2021, 773 clinical assessments on 169 incident PAH patients were evaluated at diagnosis and follow-ups. Risk scores were calculated using the original Swedish Pulmonary Arterial Hypertension Registry (SPAHR)/Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA) three-strata model, the updated SPAHR three-strata model with divided intermediate risk, and the simplified three-parameter COMPERA 2.0 four-strata model. The original SPAHR/COMPERA and the updated SPAHR models were tested for both 3-6 and 7-11 available parameters, respectively. Prognostic accuracy [area under the receiver operating characteristic (ROC) curve (AUC)] and Uno's cumulative/time-dependent C-statistics (uAUC) were calculated for 1-, 3-, and 5-year mortality. At baseline, both the original SPAHR/COMPERA and the updated SPAHR models, using up to six parameters, provided the highest accuracy (uAUC = 0.73 for both models) in predicting 1-, 3-, and 5-year mortality. At follow-ups, the updated SPAHR model with divided intermediate risk (7-11 parameters) provided the highest accuracy for 1-, 3-, and 5-year mortality (uAUC = 0.90), followed by the original SPAHR/COMPERA model (7-11 parameters) (uAUC = 0.88) and the COMPERA 2.0 model (uAUC = 0.85). Conclusions: The present study facilitates risk assessment in PAH by introducing a comprehensive internet-based risk score calculator (https://www.svefph.se/risk-stratification). At baseline, utilizing the original or the updated SPAHR models using up to six parameters was favourable, the latter model additionally offering sub-characterization of the intermediate risk group. Our findings support the 2022 ESC/ERS pulmonary hypertension guidelines' strategy for risk stratification suggesting the utilization of a three-strata model at baseline and a simplified four-strata model at follow-ups. Our findings furthermore support the utility of the updated SPAHR model with divided intermediate risk, when a more comprehensive assessment is needed at follow-ups, complementing the three-parameter COMPERA 2.0 model. Larger multi-centre studies are encouraged to validate the utility of the updated SPAHR model. Take home message: By introducing an internet-based risk score calculator (https://www.svefph.se/risk-stratification), risk assessment is facilitated. Our results support the 2022 ESC/ERS pulmonary hypertension guidelines' risk stratification strategy, additionally suggesting the updated SPAHR three-strata model with divided intermediate risk, as a promising complement to the new simplified three-parameter COMPERA 2.0 four-strata strategy, when a more comprehensive overview is needed.
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- Altınışık, N. Ezgi, et al.
(författare)
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A genomic snapshot of demographic and cultural dynamism in Upper Mesopotamia during the Neolithic Transition
- 2022
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Ingår i: Science Advances. - : American Association for the Advancement of Science (AAAS). - 2375-2548. ; 8:44
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Tidskriftsartikel (refereegranskat)abstract
- Upper Mesopotamia played a key role in the Neolithic Transition in Southwest Asia through marked innovations in symbolism, technology, and diet. We present 13 ancient genomes (c. 8500 to 7500 cal BCE) from Pre-Pottery Neolithic Çayönü in the Tigris basin together with bioarchaeological and material culture data. Our findings reveal that Çayönü was a genetically diverse population, carrying mixed ancestry from western and eastern Fertile Crescent, and that the community received immigrants. Our results further suggest that the community was organized along biological family lines. We document bodily interventions such as head shaping and cauterization among the individuals examined, reflecting Çayönü’s cultural ingenuity. Last, we identify Upper Mesopotamia as the likely source of eastern gene flow into Neolithic Anatolia, in line with material culture evidence. We hypothesize that Upper Mesopotamia’s cultural dynamism during the Neolithic Transition was the product not only of its fertile lands but also of its interregional demographic connections.
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- Blåvarg, Ebba Christina, 1967-
(författare)
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Psykologi på schemat : Formeringen av ett skolämne, 1960–2015
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The school subject psychology in Sweden has undergone several extensive transformations during the period 1960–2015. Since the launch of Läroplan för gymnasiet 1965, psychology is a part of the national curriculum for upper secondary level as a standalone school subject in Sweden. However, it has been formulated differently within different discursive practices. This thesis focuses on the formation of the school subject psychology by analyzing texts on the subject from mainly three different practices where the subject is constructed. The first is a bureaucratic space that includes public policy texts developed through cooperation and regulation by way of bureaucratic processes. The second is a practice-oriented space and it includes teaching materials such as textbooks produced by publishers and individual authors. The third practice is a professional space and includes the discourse on the school subject psychology among teachers in the subject teacher’s association, teacher magazines and debate articles. Through a discursive perspective, the source material from these practices have been analyzed both by focusing on each space separately, and in parallel. Overall, the discourse on the school subject psychology has changed dynamically during the focused period, in the different spaces, which is depicted in detail with examples and excerpts. In addition, four overarching discourse orders are presented. First, the overarching empirical and scientific stance that permeated the subject at the beginning of the national curriculum in the 1960s. Later, in the 1990s and 2000s, an inward shift in subject focus, from being useful for understanding the world with a critical view, to critically examining and evaluating various psychological theories. However, perhaps the most unexpected finding are two major orders of discourse that can be seen in between these in time. Firstly, an overall vivid activity in all the practices and the major change that the subject underwent in the 1970s, in conjunction with the subject revision in 1979. And secondly, the extensive and almost absolute silence that followed in relation to the subject psychology. This thesis contributes to the research field by mapping the formation of psychology as a school subject in Sweden through different discursive practices, as well as highlighting various orders of discourse in relation to psychology as a school subject.
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- Choubey, Sandhya, et al.
(författare)
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Exploring invisible neutrino decay at ESSnuSB
- 2021
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Ingår i: Journal of High Energy Physics (JHEP). - : Springer Nature. - 1126-6708 .- 1029-8479. ; 2021:5
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Tidskriftsartikel (refereegranskat)abstract
- We explore invisible neutrino decay in which a heavy active neutrino state decays into a light sterile neutrino state and present a comparative analysis of two baseline options, 540 km and 360 km, for the ESSnuSB experimental setup. Our analysis shows that ESSnuSB can put a bound on the decay parameter tau (3)/m(3) = 2.64 (1.68) x 10(-11) s/eV for the baseline option of 360 (540) km at 3 sigma. The expected bound obtained for 360 km is slightly better than the corresponding one of DUNE for a charged current (CC) analysis. Furthermore, we show that the capability of ESSnuSB to discover decay, and to measure the decay parameter precisely, is better for the baseline option of 540 km than that of 360 km. Regarding effects of decay in delta (CP) measurements, we find that in general the CP violation discovery potential is better in the presence of decay. The change in CP precision is significant if one assumes decay in data but no decay in theory.
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- Kempe, Per, et al.
(författare)
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Immune profile in relation to sex steroid cyclicity in healthy women and women with multiple sclerosis
- 2018
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Ingår i: Journal of Reproductive Immunology. - : Elsevier. - 0165-0378 .- 1872-7603. ; 1:26, s. 53-59
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Tidskriftsartikel (refereegranskat)abstract
- To prospectively study systemic in vivo immunological effects of sex hormones, using different phases of oral combined hormonal contraceptives (CHC), and the natural menstrual cycles in both healthy women and in women with multiple sclerosis (MS), blood samples from sixty female MS patients and healthy controls with and without CHC were drawn in high and low estrogenic/progestogenic phases. Expression of Th-associated genes in blood cells was determined by qPCR and a panel of cytokines and chemokines was measured in plasma. High hormone level phases were associated with increases in Th1 (TBX21) and Th2 (GATA3) associated markers, as well as the B cell-associated chemokine CXCL13, while the inhibitory regulator CTLA-4 was decreased. These changes were not observed in MS patients, of whom most were treated with immunomodulatory drugs. Our data indicate immune activating properties in vivo of high steroid sex hormone levels during both CHC and normal menstrual cyclicity.
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| 8. |
- Kempe, Per, et al.
(författare)
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T cell subset-associated transcription factors, cytokines and chemokines in relation to the menstrual cycle and use of combined hormonal contraceptives in women with multiple sclerosis and healthy controls
- 2014
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Study question: Do peripheral blood levels of cytokines, chemokines, and transcription factors for different T helper (Th) cell subsets change in relation to high and low estrogen/progestogen states in women with multiple sclerosis (MS) and healthy controls with and without combined hormonal contraceptives (CHC)?Summary answer: Our findings indicate a general activation of peripheral blood T cells and B cells during high estrogen/progestogen phases with higher levels of transcription factors associated with both Th1 (TBX21) and Th2 (GATA3) subsets of T cells and the B cell-associated chemokine CXCL13.What is known already: There are some indications that sex steroids may positively affect MS clinically and immunologically.Study design, size, duration: A total of 60 women were included. Paired blood samples were drawn in high and low estrogen/progestogen phases during the same cycle in women using or not using CHC.Participants/materials, setting, methods: Participants were female MS patients and healthy controls with and without CHC. Concentrations of cytokines and chemokines were measured using multiplex bead technology and expression of transcription factors in blood cells was determined by qPCR. Owing to possible differences in cell composition, expression of Th-associated transcription factors were normalized to the T cell-specific transcription factor CD3E.Main results and the role of chance: Sixty women were included but 13 women dropped out, leaving 47 women to the statistical analyses. In healthy controls using CHC, both TBX21, and GATA3 expression was higher in the high estrogen/progestogen phase than in the low estrogen/progestogen phase. TBX21 expression in high estrogen/progestogen phase differed significantly between groups with the highest levels in healthy controls without CHC. In all MS patients as well as in healthy controls using CHC, the concentrations of CXCL13 was significantly higher in the high estrogen/progestogen phase compared to the low estrogen/progestogen phase.Limitations, reasons for caution: The low number of participants. A majority of the MS patients were using immunomodulatory drugs which may have interfered with the results. The study design makes it impossible to differ between estrogenic and progestogenic effects.Wider implications of the findings: Our findings show that high and low levels of estrogens and/or progestogens differently affect immune parameters related to Th cell subsets as well as B cells. The differences between high- and low estrogen/progestogen phases were most obvious in women using CHC indicating that CHC is more potent than 17β-Estradiol/progesterone in inducing immune changes in both MS patients and healthy women.Study funding/competing interest(s): This study was funded by the County Councils of Östergötland and Västernorrland, Sweden. No author have any conflicts of interest to declare.
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