| 1. |
- Batra, Gorav, et al.
(författare)
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Atrial fibrillation in patients undergoing coronary artery surgery is associated with adverse outcome
- 2019
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Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis. - 0300-9734 .- 2000-1967. ; :1, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim was to determine the association between atrial fibrillation (AF) and outcome in patients undergoing coronary artery bypass grafting (CABG).METHODS: All patients undergoing CABG between January 2010 and June 2013 were identified in the Swedish Heart Surgery Registry. Outcomes studied were all-cause mortality, cardiovascular mortality, myocardial infarction, congestive heart failure, ischemic stroke, and recurrent AF. Patients with history of AF prior to surgery (preoperative AF) and patients without history of AF but with AF episodes post-surgery (postoperative AF) were compared to patients with no AF using adjusted Cox regression models.RESULTS: Among 9,107 identified patients, 8.1% (n = 737) had preoperative AF, and 25.1% (n = 2,290) had postoperative AF. Median follow-up was 2.2 years. Compared to no AF, preoperative AF was associated with higher risk of all-cause mortality, adjusted hazard ratio with 95% confidence interval (HR) 1.76 (1.33-2.33); cardiovascular mortality, HR 2.43 (1.68-3.50); and congestive heart failure, HR 2.21 (1.72-2.84). Postoperative AF was associated with risk of all-cause mortality, HR 1.27 (1.01-1.60); cardiovascular mortality, HR 1.52 (1.10-2.11); congestive heart failure, HR 1.47 (1.18-1.83); and recurrent AF, HR 4.38 (2.46-7.78). No significant association was observed between pre- or postoperative AF and risk for myocardial infarction and ischemic stroke.CONCLUSIONS: Approximately 1 in 3 patients undergoing CABG had pre- or postoperative AF. Patients with pre- or postoperative AF were at higher risk of all-cause mortality, cardiovascular mortality, and congestive heart failure, but not of myocardial infarction or ischemic stroke. Postoperative AF was associated with higher risk of recurrent AF.
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| 2. |
- Brännström, Kristoffer, et al.
(författare)
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Ca2+ enhances Aβ polymerization rate and fibrillar stability in a dynamic manner
- 2013
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Ingår i: Biochemical Journal. - : Portland Press. - 0264-6021 .- 1470-8728. ; 450, s. 189-197
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Tidskriftsartikel (refereegranskat)abstract
- Identifying factors that affect the self-assembly of the amyloid-β peptide (Aβ) is of utmost importance in the quest to understand the molecular mechanisms causing Alzheimer's disease (AD). Ca2+ has previously been shown to accelerate both Aβ fibril nucleation and maturation, and a dysregulated Ca2+ homeostasis frequently correlates with development of AD. The mechanisms regarding Ca2+ binding as well as its effect on fibril kinetics are not fully understood. Using a polymerization assay we show that Ca2+ in a dynamic and reversible manner enhances both the elongation rate and fibrillar stability, where specifically the "dock and lock" phase mechanism is enhanced. Through NMR analysis we found that Ca2+ affects the fibrillar architecture. In addition, and unexpectedly, we found that Ca2+ does not bind the free Aβ monomer. This implies that Ca2+ binding requires an architecture adopted by assembled peptides, and consequently is mediated through intermolecular interactions between adjacent peptides. This gives a mechanistic explanation to the enhancing effect on fibril maturation and indicates structural similarities between prefibrillar structures and mature amyloid. Taken together we expose how Ca2+ levels affect the delicate equilibrium between the monomeric and assembled Aβ and how fluctuations in vivo may contribute to development and progression of the disease.
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| 3. |
- Christersson, Christina, et al.
(författare)
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Comparison of warfarin versus antiplatelet therapy after surgical bioprosthetic aortic valve replacement
- 2020
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 106:11, s. 838-844
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To compare effectiveness of warfarin and antiplatelet exposure regarding both thrombotic and bleeding events, following surgical aortic valve replacement with a biological prosthesis(bioSAVR).METHODS: The study included all patients in Sweden undergoing a bioSAVR during 2008-2014 who were alive at discharge from the index hospital stay. Exposure was analysed and defined as postdischarge dispension of any antithrombotic pharmaceutical, updated at each following dispensions and categorised as single antiplatelet (SAPT), warfarin, warfarin combined with SAPT, dual antiplatelet (DAPT) or no antithrombotic treatment. Exposure to SAPT was used as comparator. Outcome events were all-cause mortality, ischaemic stroke, haemorrhagic stroke, any thromboembolism and major bleedings. We continuously updated adjustments for comorbidities with any indication for antithrombotic treatment by Cox regression analysis.RESULTS: We identified 9539 patients with bioSAVR (36.8% women) at median age of 73 years with a mean follow-up of 3.13 years. As compared with SAPT, warfarin alone was associated with a lower incidence of ischaemic stroke (HR 0.49, 95% CI 0.35 to 0.70) and any thromboembolism (HR 0.75, 95% CI 0.60 to 0.94) but with no difference in mortality (HR 0.94, 95% CI 0.78 to 1.13). The incidence of haemorrhagic stroke (HR 1.94, 95% CI 1.07 to 3.51) and major bleeding (HR 1.67, 95% CI 1.30 to 2.15) was higher during warfarin exposure. As compared with SAPT, DAPT was not associated with any difference in ischaemic stroke or any thromboembolism. Risk-benefit analyses demonstrated that 2.7 (95% CI 1.0 to 11.9) of the ischaemic stroke cases could potentially be avoided per every haemorrhagic stroke caused by warfarin exposure instead of SAPT during the first year.CONCLUSION: In patients discharged after bioSAVR, warfarin exposure as compared with SAPT exposure was associated with lower long-term risk of ischaemic stroke and thromboembolic events, and with a higher incidence of bleeding events but with similar mortality.
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| 4. |
- Olofsson, Anders, et al.
(författare)
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Amide solvent protection analysis demonstrates that amyloid-beta(1-40) and amyloid-beta(1-42) form different fibrillar structures under identical conditions.
- 2007
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Ingår i: Biochem J. - 1470-8728. ; 404:1, s. 63-70
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Tidskriftsartikel (refereegranskat)abstract
- AD (Alzheimer's disease) is a neurodegenerative disorder characterized by self-assembly and amyloid formation of the 39–43 residue long Ab (amyloid-b)-peptide. The most abundant species, Ab(1–40) and Ab(1–42), are both present within senile plaques, but Ab(1–42) peptides are considerably more prone to self-aggregation and are also essential for the development of AD. To understand the molecular and pathological mechanisms behind AD, a detailed knowledge of the amyloid structures of Ab-peptides is vital. In the present study we have used quenched hydrogen/deuterium-exchange NMR experiments to probe the structure of Ab(1–40) fibrils. The fibrils were prepared and analysed identically as in our previous study on Ab(1–42) fibrils, allowing a direct comparison of the two fibrillar structures. The solvent protection pattern of Ab(1–40) fibrils revealed two well-protected regions, consistent with a structural arrangement of two b-strands connected with a bend. This protection pattern partly resembles the pattern found in Ab(1–42) fibrils, but the Ab(1–40) fibrils display a significantly increased protection for the N-terminal residues Phe4–His14, suggesting that additional secondary structure is formed in this region. In contrast, the C-terminal residues Gly37–Val40 show a reduced protection that suggests a loss of secondary structure in this region and an altered filament assembly. The differences between the present study and other similar investigations suggest that subtle variations in fibril-preparation conditions may significantly affect the fibrillar architecture.
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| 5. |
- Olofsson, Anders, et al.
(författare)
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Quenched hydrogen/deuterium exchange NMR characterization of amyloid-β peptide aggregates formed in the presence of Cu2+ or Zn2
- 2009
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Ingår i: The FEBS Journal. - : Wiley InterScience. - 1742-464X .- 1742-4658. ; 276:15, s. 4051-4060
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Tidskriftsartikel (refereegranskat)abstract
- Alzheimer's disease, a neurodegenerative disorder causing synaptic impairment and neuronal cell death, is strongly correlated with aggregation of the amyloid-β peptide (Aβ). Divalent metal ions such as Cu2+ and Zn2+ are known to significantly affect the rate of aggregation and morphology of Aβ assemblies in vitro and are also found at elevated levels within cerebral plaques in vivo. The present investigation characterized the architecture of the aggregated forms of Aβ(1–40) and Aβ(1–42) in the presence or absence of either Cu2+ or Zn2+ using quenched hydrogen/deuterium exchange combined with solution NMR spectroscopy. The NMR analyses provide a quantitative and residue-specific structural characterization of metal-induced Aβ aggregates, showing that both the peptide sequence and the type of metal ion exert an impact on the final architecture. Common features among the metal-complexed peptide aggregates are two solvent-protected regions with an intervening minimum centered at Asn27, and a solvent-accessible N-terminal region, Asp1–Lys16. Our results suggest that Aβ in complex with either Cu2+ or Zn2+ can attain an aggregation-prone β-strand–turn–β-strand motif, similar to the motif found in fibrils, but where the metal binding to the N-terminal region guides the peptide into an assembly distinctly different from the fibril form.
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| 6. |
- Roos, Anders, et al.
(författare)
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Using von Thünen rings and service-dominant logic in balancing forest ecosystem services
- 2018
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Ingår i: Land Use Policy. - : Elsevier BV. - 0264-8377 .- 1873-5754. ; 79, s. 622-632
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Tidskriftsartikel (refereegranskat)abstract
- The allocation of forest land to different uses for ecosystem services (ES) is a complex task which is increasingly influenced by current urbanisation trends and the growth of the service-oriented economy. With the focus on cultural ES, this paper examines the principles that are intended to ensure the best cultural ES value in forest land use allocation. The analysis considers the co-creation process of cultural ES value and the trade-off between cultural and other categories of ES in an urban rural context. A literature review of applied studies on forest land use allocation and ES is presented and research gaps are identified. Based on the findings of the review, two theoretical frameworks for an improved analysis of cultural ES value and land use allocation are suggested: the von Thiinen location theory and service-dominant logic (SDL). Von Thiinen showed that optimal land use is determined by the land rents for different alternative uses, which vary depending on distance from population centres. SDL, a theory from the field of marketing research, focuses on the role of skills and services in addition to the traditional goods-related attributes for the creation of customer value. This paper argues that a combination of the two frameworks can inspire future research and policymaking concerning forest land use allocation. The von Thiinen framework highlights the role of local forest landscapes in proximity to population centres for creating cultural ES value. The SDL theory emphasises the co-creation of forest based cultural ES value that involves the forest ecosystem; beneficiaries of cultural ES value; and actors, who also are resource integrators (e.g. forest owners, planners, associations and other actors). Examples of applications of the two frameworks are given and both practical implications and limitations are discussed.
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| 7. |
- Ankre, Rosemarie, 1975-, et al.
(författare)
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Att mäta friluftsliv
- 2014. - 1
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Ingår i: Friluftsliv i Förändring. - Stockholm : Carlsson Bokförlag. - 9789173316323 ; , s. 102-118
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Bokkapitel (refereegranskat)
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| 8. |
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| 9. |
- Ankre, Rosemarie, 1975-, et al.
(författare)
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Managers' experiences of visitor monitoring in Swedish outdoor recreational areas
- 2016
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Ingår i: Journal of Outdoor Recreation and Tourism. - : Elsevier. - 2213-0780 .- 2213-0799. ; 14, s. 35-40
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Tidskriftsartikel (refereegranskat)abstract
- Systematically collected information on outdoor recreation participation, motives and behaviors can improve recreation opportunities and reduce the risk of user conflicts. There are many uses of this type of information for managers of recreational areas including analyses of environmental, social and economic impacts, development of infrastructure, and marketing to appropriate audiences. One key component in building this knowledge is the application of visitor monitoring. This study takes an exploratory approach by analyzing managers' experiences on different on-site monitoring methods at 12 recreational areas in Sweden. Results show that knowledge of these methods and their use are strongly linked to individual managers' skills and competence. Contemporary changes in recreation behavior calls for more innovative monitoring approaches, but managers included in this study primarily work with rather traditional methods, which is likely representative of the overall situation in Sweden. Networking, educational programs and closer collaborations with universities could facilitate some of the challenges identified.Management implications● The study showed the relevance of improved visitor monitoring practices, and tailor-made monitoring guidelines, based on actual use and experience-based data.● Adequate visitor monitoring practices:- help to better incorporate recreation activities and values in natural resource management decisions,● increase the awareness of possible conflicts between recreational and other resource users,● show the possible need for increased management capacity, additional training or new ways of visitor management and provide a better foundation for decision making.
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| 10. |
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