| 1. |
- Allhorn, Maria, et al.
(författare)
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Heme-Scavenging Role of alpha1-Microglobulin in Chronic Ulcers.
- 2003
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Ingår i: Journal of Investigative Dermatology. - : Elsevier BV. - 1523-1747 .- 0022-202X. ; 121:3, s. 640-646
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Tidskriftsartikel (refereegranskat)abstract
- Chronic venous ulcers are characterized by chronic inflammation. Heme and iron, originating from blood cell hemolysis as well as extravascular necrosis, have been implicated as important pathogenic factors due to their promotion of oxidative stress. It was recently reported that the plasma and tissue protein alpha1-microglobulin is involved in heme metabolism. The protein binds heme, and a carboxy-terminally processed form, truncated alpha1-microglobulin, also degrades heme. Here, we show the presence of micromolar levels of heme and free iron in chronic leg ulcer fluids. Micromolar amounts of alpha1-microglobulin was also present in the ulcer fluids and bound to added radiolabeled heme. Truncated alpha1-microglobulin was found in the ulcer fluids and exogenously added alpha1-microglobulin was processed into the truncated alpha1-microglobulin form. Histochemical analysis of chronic wound tissue showed the presence of iron deposits, heme/porphyrins in infiltrating cells basement membranes and fibrin cuffs around vessels, and alpha1-microglobulin ubiquitously distributed but especially abundant in basement membranes around vessels and at fibrin cuffs. Our results suggest that alpha1-microglobulin constitutes a previously unknown defense mechanism against high heme and iron levels during skin wound healing. Excessive heme and iron, which are not buffered by alpha1-microglobulin, may underlie the chronic inflammation in chronic ulcers.
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| 2. |
- Andersson, Tilde, et al.
(författare)
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Common skin bacteria protect their host from oxidative stress through secreted antioxidant RoxP
- 2019
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Cutibacterium acnes is an abundant skin commensal with several proposed mutualistic functions. A protein with strong antioxidant activity was recently identified from the C. acnes secretome. This protein, termed RoxP, facilitated aerobic bacterial growth in vitro and ex vivo. As reducing events naturally occurred outside of the bacterial cell, it was further hypothesized that RoxP could also serve to modulate redox status of human skin. The biological function of RoxP was here assessed in vitro and in vivo, through oxidatively stressed cell cultures and through protein quantification from skin affected by oxidative disease (actinic keratosis and basal cell carcinoma), respectively. 16S rDNA amplicon deep sequencing and single locus sequence typing was used to correlate bacterial prevalence to cutaneous RoxP abundances. We show that RoxP positively influence the viability of monocytes and keratinocytes exposed to oxidative stress, and that a congruent concentration decline of RoxP can be observed in skin affected by oxidative disease. Basal cell carcinoma was moreover associated with microbial dysbiosis, characterized by reduced C. acnes prevalence. C. acnes's secretion of RoxP, an exogenous but naturally occurring antioxidant on human skin, is likely to positively influence the human host. Results furthermore attest to its prospective usability as a biopharmaceutical.
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| 3. |
- Bernhardsson, Susanne, 1958, et al.
(författare)
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Implementation of physical activity on prescription for children with obesity in paediatric health care (IMPA): protocol for a feasibility and evaluation study using quantitative and qualitative methods
- 2022
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Ingår i: Pilot and Feasibility Studies. - : Springer Science and Business Media LLC. - 2055-5784. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical inactivity is a main cause of childhood obesity which tracks into adulthood obesity, making it important to address early in life. Physical activity on prescription (PAP) is an evidence-based intervention that has shown good effect on physical activity levels in adults, but has not been evaluated in children with obesity. This project aims to evaluate the prerequisites, determinants, and feasibility of implementing PAP adapted to children with obesity and to explore children's, parents', and healthcare providers' experiences of PAP. Methods: In the first phase of the project, healthcare providers and managers from 26 paediatric clinics in Region Vastra Gotaland, Sweden, will be invited to participate in a web-based survey and a subset of this sample for a focus group study. Findings from these two data collections will form the basis for adaptation of PAP to the target group and context. In a second phase, this adapted PAP intervention will be evaluated in a clinical study in a sample of approximately 60 children with obesity (ISO-BMI > 30) between 6 and 12 years of age and one of their parents/legal guardians. Implementation process and clinical outcomes will be assessed pre- and post-intervention and at 8 and 12 months' follow-up. Implementation outcomes are the four core constructs of the Normalization Process Theory; coherence, cognitive participation, collective action, and reflexive monitoring; and appropriateness, acceptability, and feasibility of the PAP intervention. Additional implementation process outcomes are recruitment and attrition rates, intervention fidelity, dose, and adherence. Clinical outcomes are physical activity pattern, BMI, metabolic risk factors, health-related quality of life, sleep, and self-efficacy and motivation for physical activity. Lastly, we will explore the perspectives of children and parents in semi-structured interviews. Design and analysis of the included studies are guided by the Normalization Process Theory. Discussion: This project will provide new knowledge regarding the feasibility of PAP for children with obesity and about whether and how an evidence-based intervention can be fitted and adapted to new contexts and populations. The results may inform a larger scale trial and future implementation and may enhance the role of PAP in the management of obesity in paediatric health care in Sweden.
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| 4. |
- Boman, Charlotte, et al.
(författare)
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Physical activity on prescription for children with obesity: a focus group study exploring experiences in paediatric healthcare
- 2024
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Ingår i: Frontiers in Health Services. - 2813-0146. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Insufficient physical activity is a growing public health concern and is closely linked to obesity in both adults and children. Swedish physical activity on prescription (PAP) is effective in increasing physical activity levels in adults, but knowledge about how PAP is used in paediatric healthcare is lacking. Therefore, this study aimed to explore experiences of working with PAP for children with obesity amongst paediatric staff and managers. Methods: Seven focus group discussions with 26 participants from paediatric outpatient clinics in western Sweden were conducted. Data were analysed both inductively and deductively, framed by the Normalization Process Theory's four core constructs: coherence, cognitive participation, collective action, and reflexive monitoring. Results: The PAP work for children with obesity was experienced to be about helping children to become physically active, and less about losing weight. Identified barriers for using PAP were the non-uniform nature of the work and a perceived lack of guidelines. Collaboration with physiotherapists and physical activity organisers outside the organisation was identified as an important facilitator. An important contextual factor for implementing PAP is the collaboration between paediatric clinics and physical activity organisers. In the transition between these stakeholders, maintaining a family-centred approach when working with PAP was experienced as challenging. Conclusions: PAP is a well-known intervention that is inconsistently used for children with obesity. The intervention should include a family-centred approach for this patient group. It also needs to align better with existing collaborations with other healthcare units as well as with new forms of collaboration with physical activity organisers in the community.
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| 5. |
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| 6. |
- Boman, Charlotte, et al.
(författare)
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Prerequisites for implementing physical activity on prescription for children with obesity in paediatric health care: A cross-sectional survey.
- 2023
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Ingår i: Frontiers in Health Services. - : Frontiers Media SA. - 2813-0146. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Physical inactivity is a main driver of childhood obesity that tracks into adulthood, making it crucial to address early in life. Swedish physical activity on prescription (PAP) is an effective intervention for increasing physical activity levels in adults and is being implemented in primary care in Sweden. Before implementing PAP for children, both intervention effectiveness and implementation prerequisites need to be examined. Framed by the Normalization Process Theory (NPT) domains, this study aimed to investigate perceptions of PAP amongst paediatric staff and managers working with children with obesity, as well as acceptability, appropriateness, feasibility, and barriers and facilitators for implementing PAP in paediatric health care.Staff and managers in 28 paediatric outpatient clinics in western Sweden were surveyed using validated implementation instruments and open-ended questions. Data were analysed using Mann-Whitney U tests and Kruskal-Wallis tests. Qualitative data were categorised into NPT domains.The survey response rate was 54% (125/229). Most respondents (82%) reported PAP to be familiar and many (56%) perceived it as a normal part of work; nurses and physiotherapists to a greater extent (p<0.001). This was anticipated to increase in the future (82%), especially amongst those with the longest work experience (p=0.012). Respondents reported seeing the potential value in their work with PAP (77%), being open to working in new ways to use PAP (94%), and having confidence in their colleagues' ability to use PAP (77%). Barriers and facilitators were found in all the NPT domains, mainly collective action and reflexive monitoring, where, for example, inadequacies of education, resources, and research on PAP for children were reported as barriers. Most respondents agreed that PAP was acceptable, appropriate, and feasible (71% to 88%).PAP is familiar and perceived as an acceptable, appropriate, and feasible intervention, and by many viewed as a normal part of clinical routines in paediatric outpatient clinics in western Sweden, especially by physiotherapists and nurses. Barriers and faciliators are mainly related to collective action and reflexive monitoring. The wide acceptance demonstrates receptiveness to PAP as an intervention to promote an active lifestyle for children with obesity.
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| 7. |
- Bäcklund, Katarina, 1982-, et al.
(författare)
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Building Occupants, Their Behavior and the Resulting Impact on Energy Use in Campus Buildings : A Literature Review with Focus on Smart Building Systems
- 2023
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Ingår i: Energies. - : MDPI AG. - 1996-1073. ; 16:17, s. 6104-6104
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Tidskriftsartikel (refereegranskat)abstract
- In the light of global climate change and the current energy crisis, it is crucial to target sustainable energy use in all sectors. Buildings still remain one of the most energy-demanding sectors. Campus buildings and higher educational buildings are important to target due to their high and increasing energy demand. This building segment also represents a research gap, as mostly office or domestic buildings have been studied previously. In the quest for thermal comfort, a key stakeholder in building energy demand is the building occupant. It is therefore crucial to promote energy-aware behaviors. The building systems are another key factor to consider. As conventional building systems are replaced with smart building systems, the entire scenario is redrawn for how building occupants interact with the building and its systems. This study argues that behavior is evolving with the smartness of building systems. By means of a semi-systematic literature review, this study presents key findings from peer-reviewed research that deal with building occupant behavior, building systems and energy use in campus buildings. The literature review was an iterative process based on six predefined research questions. Two key results are presented: a graph of reported energy-saving potentials and a conceptual framework to evaluate building occupants impact on building energy use. Furthermore, based on the identified research gaps in the selected literature, areas for future research are proposed.
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| 8. |
- Bäcklund, Katarina, 1982-
(författare)
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Human-Centric Operations of Smarter Higher Educational Buildings in Sweden
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This PhD thesis is based on four articles, each focused on distinct research areas: building occupants, smarter higher educational buildings, smart building systems and the digital transformation of real estate organizations. Rather than concentrating on one specific research area, the objective was to provide a comprehensive view of the broader system and delve into these four key research areas. Thus, they are all interdependent and require equal attention to facilitate the digital transformation within the commercial real estate industry. This transformation aims to create a more climate neutral built environment while ensuring good quality indoor comfort. The findings reveal a paradox within smart building systems, where building occupants are often treated as passive agents and interactions are intentionally reduced. However, it can be argued that some interactions will be beneficial, as building occupants considered as active agents could contribute to a more sustainable building operation. This study also concludes that current smart buildings are not yet smart enough and that all data is not smart data. Furthermore, the investigation into what constitutes a smart building has led to the identification of key features of smarter higher educational buildings. Finally, the concluding part of this study delved into the organizational challenges associated with digital transformation, proposing potential solutions to enhance innovation processes. Based on these findings, a framework for human-centric digital transformation was proposed.
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| 9. |
- Bäcklund, Katarina, 1982-, et al.
(författare)
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In Search for Untapped Energy-Saving Potential in Green and Smart Higher Educational Buildings—An Empirical Case Study Involving the Building Occupants
- 2023
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Ingår i: Buildings. - : MDPI AG. - 2075-5309. ; 13:12
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Tidskriftsartikel (refereegranskat)abstract
- Energy-intense activities and the unpredictable and complex behavior of building occupants lead to an increase in building energy demand. It is, therefore, crucial to study underlying factors for building energy demand related to the users. Higher educational buildings are relevant to study for several reasons: they host the future workforce and citizens, they are predicted to increase in numbers, and they represent a building type less studied. Furthermore, green-rated buildings equipped with smart building systems also represent a research gap that is relevant to address since such a building design involves IoT-functionalities and digital features for the building occupants to interact with. There is also a conceivable risk that if the users know that the building is green-rated and technologically advanced, this may alter their perception of the building operation and thus their behavior. To study the relationship between building occupants and such green and smart educational structure, a survey was conducted in a Swedish higher educational building; as a result, 300 responses were collected and analyzed. The responses revealed that the building occupants act with energy awareness, and they are conscious about energy-saving behaviors. One building feature in particular was studied: the Digital Room Panels (DRPs). The DRP allows the building occupants to modify the indoor temperature and is, therefore, essential for thermal comfort. One key finding from the survey revealed that 70% of the building occupants did not know how the DRPs operate. This study argues that this result can be explained with a lack of communication and user friendliness. Inadequate interactions with building systems could also result in opportunities for energy saving might not be realized. The findings of this case study led to valuable recommendations and suggestions for future research endeavors.
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| 10. |
- Bäcklund, Katarina, 1982-, et al.
(författare)
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Showcasing a Digital Twin for Higher Educational Buildings : Developing the Concept Towards Human Centricity
- 2024
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Ingår i: Frontiers in Built Environment. - : Frontiers Media SA. - 2297-3362. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Digital twin technology is an emerging technology within the built environment. There are yet many unexplored opportunities to utilize digital twins for facilitating the transformation towards a climate neutral building stock while also meeting the expectations from the building occupants. This article presents a case study of a digital twin, developed for an existing commercial building stock of campus areas in Sweden. The overarching purpose of the digital twin is to support both building occupants and building operators. This twofold human-centric approach represents a novel approach for building digital twins. The digital twin is based on 3D scanning and together with geospatial data, a real-like navigational indoor environment is created. Three innovative features are presented; the building analysis module, the digital twin mobile application and the building operations module. The results show that the digital twin improves the building occupant’s experience by supporting navigation and providing access to room booking system via this dedicated interface. Building management is also benefited by the digital twin through easier access to building data aggregated into one platform and a state-of-the-art analysis tool for optimizing the use of indoor space. The digital twin holds future potential to achieve operational excellence by incorporating feedback mechanisms and utilizing Artificial Intelligence to enable intelligent fault detection and prevention. Keywords:
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