| 1. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Bergström, Göran, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 3. |
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| 4. |
- Leksell, Eva, et al.
(författare)
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Perceived Oral Health and Care of Children with Juvenile Idiopathic Arthritis : A Qualitative Study
- 2015
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 29:3, s. 223-230
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To increase knowledge about how children diagnosed with juvenile idiopathic arthritis (JIA) perceive their oral health and dental care. Methods: Fifteen interviews with children diagnosed with JIA, aged 6 to 16 years, were analyzed according to classical grounded theory. Results: The children's main concern about their oral health was identified as creating a positive identity after being diagnosed with JIA and learning to live with oral health problems. While attempting to cope with this concern, the children often endured in silence, the core category in the analysis. A variety of aspects were found of this core coping strategy, which were categorized as differentiating from the disease, working on personal caretaking and positive attitude, fighting fears and sadness, control of professional aid, and building supportive relationships. The results emphasize the importance for caregivers to show empathy and interest in the child as a person, to ask precise questions when taking case histories so the child does not remain silent, to provide psychosocial support and suggest positive coping strategies, to describe and administer treatments, and to give hope for the future. Conclusion: Awareness of the social interaction between a child diagnosed with JIA and health professionals as well as awareness of how to approach a child with longstanding illness are crucial for disclosing and treating the child's orofacial symptoms.
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| 5. |
- Locke, Adam E, et al.
(författare)
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Genetic studies of body mass index yield new insights for obesity biology.
- 2015
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 518:7538, s. 197-401
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Tidskriftsartikel (refereegranskat)abstract
- Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.
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| 6. |
- Magnusson, Petra, 1963-, et al.
(författare)
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Texts, information and multimodality in the digital age : towards sustained and composite MIL in education
- 2019
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- For this presentation, we have compiled seven studies from primary to higher education. Thepurpose is to illuminate affordances the digital and multimodal text landscape impose onteachers and students. The Swedish curriculum (revised 2017) aims to strengthen students’digital competences towards understanding effects on society, using and understanding digitaltools and media, applying a critical and responsible approach and solving problems andapplying ideas creatively. This recent curricular revision puts emphasis on work withinteractive texts, texts created in collaboration with others, texts where words, images andsound interact, democracy and public opinion in social media, responsible use of language indigital media, understanding how information can be controlled by underlying algorithms,distinguishing between sources of information and interests behind them, boundary betweenfreedom of expression and social media violations, impact of digitalization on labor market,attitudes and values. Obviously, the technology brings new opportunities to the classroomfostering responsible and equitable access to information and knowledge and with thatrequirements to develop MIL skills to understand information and multimodal texts andnavigate safely in an increasingly complex society. As future citizens, students need to be ableto design texts, read to find and evaluate multimodal information. Consequently, students needinstructions and strategies to develop MIL and relevant digital text competences. How doteachers and students meet these expectations and requirements on MIL?A crucial feature, which has been shown in several studies including ours, displays that bothteachers and students need to develop knowledge of and a language for the phenomena that arecurrently outside what is traditionally covered by the school subjects. Further, teachers needtools attuned to new grading and assessment criteria, in order to support students in evaluatingand interpreting information and designing multimodal texts. Students, in turn, need strategiesand instructions on how to evaluate and interpret information to avoid superficial, misguidedor mechanical processing of information. They need to develop a broad understanding of visual,auditory and other modal representations and develop strategies for navigating and interpretingmultimodal text design. We have also found that teachers, regardless of grade or subject,experience difficulties to relate students’ digital text competences to the knowledgerequirements in curricula that to a large extent emphasize verbal language (i.e. speech andwriting). This may explain some of our results showing that other ways of expressing meaning(i.e. images and sound) tend to be overlooked or downplayed in assessment of students’ texts.Without teachers valuing non-verbal language, students will not access and engage incontemporary media and texts which implies lack of opportunities to develop MIL needed asfuture, critical and engaging citizens. We contend that the competence to design digital texts isthe other side of the coin of evaluating and reading information. We want especially highlightthe value of understanding the multimodal aspects of digital texts for teachers’ and students’critical access, use, and participation in the flow of information as a means to realize rights tofreedom of information and expression.
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| 7. |
- Magnusson, Petra, et al.
(författare)
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Texts, information and multimodality in the digital age : towards sustained and composite MIL in education
- 2019
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- For this presentation, we have compiled seven studies from primary to higher education. Thepurpose is to illuminate affordances the digital and multimodal text landscape impose onteachers and students. The Swedish curriculum (revised 2017) aims to strengthen students’digital competences towards understanding effects on society, using and understanding digitaltools and media, applying a critical and responsible approach and solving problems andapplying ideas creatively. This recent curricular revision puts emphasis on work withinteractive texts, texts created in collaboration with others, texts where words, images andsound interact, democracy and public opinion in social media, responsible use of language indigital media, understanding how information can be controlled by underlying algorithms,distinguishing between sources of information and interests behind them, boundary betweenfreedom of expression and social media violations, impact of digitalization on labor market,attitudes and values. Obviously, the technology brings new opportunities to the classroomfostering responsible and equitable access to information and knowledge and with thatrequirements to develop MIL skills to understand information and multimodal texts andnavigate safely in an increasingly complex society. As future citizens, students need to be ableto design texts, read to find and evaluate multimodal information. Consequently, students needinstructions and strategies to develop MIL and relevant digital text competences. How doteachers and students meet these expectations and requirements on MIL?A crucial feature, which has been shown in several studies including ours, displays that bothteachers and students need to develop knowledge of and a language for the phenomena that arecurrently outside what is traditionally covered by the school subjects. Further, teachers needtools attuned to new grading and assessment criteria, in order to support students in evaluatingand interpreting information and designing multimodal texts. Students, in turn, need strategiesand instructions on how to evaluate and interpret information to avoid superficial, misguidedor mechanical processing of information. They need to develop a broad understanding of visual,auditory and other modal representations and develop strategies for navigating and interpretingmultimodal text design. We have also found that teachers, regardless of grade or subject,experience difficulties to relate students’ digital text competences to the knowledgerequirements in curricula that to a large extent emphasize verbal language (i.e. speech andwriting). This may explain some of our results showing that other ways of expressing meaning(i.e. images and sound) tend to be overlooked or downplayed in assessment of students’ texts.Without teachers valuing non-verbal language, students will not access and engage incontemporary media and texts which implies lack of opportunities to develop MIL needed asfuture, critical and engaging citizens. We contend that the competence to design digital texts isthe other side of the coin of evaluating and reading information. We want especially highlightthe value of understanding the multimodal aspects of digital texts for teachers’ and students’critical access, use, and participation in the flow of information as a means to realize rights tofreedom of information and expression.
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| 8. |
- Malmström, Eva Maj, et al.
(författare)
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Co-morbidities to Vestibular Impairments—Some Concomitant Disorders in Young and Older Adults
- 2021
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Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dizziness and pain are common complaints that often appear concomitantly, with or without a causal relationship. However, these symptoms might maintain and exacerbate each other and other co-morbidities. Therefore, adequate rehabilitation may have to include an expanded focus on other deficits and preconditions, especially in older adults and in patients. Objective: To understand how frequently vestibular dysfunction coincided with medical conditions and aging, we studied two categories: Study 1: patients referred to a vestibular unit and Study 2: senior members in a fitness association. Method: Study 1: 49 patients [34 females/15 males; mean age 52 years (SEM 2.0)] seeking health care for balance disorders and vestibular deficits were asked in questionnaires about their perception of dizziness and pain, and emotional and functional strains. Study 2: 101 senior members in a fitness association [91 females/10 males; mean age 75 years (SEM 0.6)], were assessed for vestibular and balance deficits and for any co-morbidities. The participants were monitored for falls for 12 months after the initial assessments. Result: Study 1: Co-morbidity often existed between dizziness and pain (65%). The patients reported high emotional and functional strain related to their dizziness and pain. Patients older than 60 years reported longer durations of pain (p ≤ 0.028) but less emotional strain (p = 0.036), compared to younger patients. Study 2: 84% of the participants had a vestibular impairment, often without noticing any symptoms. Furthermore, 40% reported cardiovascular illnesses, 12% musculoskeletal disorders, and 63% reported other medical conditions. Forty-two percent experienced falls within 1 year after the initial assessments (thereof 42% in the group with vestibular deficits and 38% in the group without vestibular deficits). Conclusion: To enhance and preserve postural control, both in patients with vestibular deficits and in older adults, we suggest an expanded clinical perspective. Hence, we recommend detailed examinations of the vestibular system but simultaneously probing for possible co-morbidities. Since aging often entails deterioration of multimodal processes related to maintained mobility and postural stability, our results add focus on the importance of addressing balance disorders together with additional medical conditions.
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| 9. |
- Malmström, Eva-Maj, et al.
(författare)
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Influence of prolonged unilateral cervical muscle contraction on head repositioning - Decreased overshoot after a 5-min static muscle contraction task.
- 2010
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X. ; 15, s. 229-234
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Tidskriftsartikel (refereegranskat)abstract
- The ability to reproduce a specified head-on-trunk position can be an indirect test of cervical proprioception. This ability is affected in subjects with neck pain, but it is unclear whether and how much pain or continuous muscle contraction factors contribute to this effect. We studied the influence of a static unilateral neck muscle contraction task (5 min of lateral flexion at 30% of maximal voluntary contraction) on head repositioning ability in 20 subjects (10 women, 10 men; mean age 37 years) with healthy necks. Head repositioning ability was tested in the horizontal plane with 30 degrees target and neutral head position tests; head position was recorded by Zebris((R)), an ultrasound-based motion analyser. Head repositioning ability was analysed for accuracy (mean of signed differences between introduced and reproduced positions) and precision (standard deviation of the differences). Accuracy of head repositioning ability increased significantly after the muscle contraction task, as the normal overshoot was reduced. An average overshoot of 7.1 degrees decreased to 4.6 degrees after the muscle contraction task for the 30 degrees target and from 2.2 degrees to 1.4 degrees for neutral head position. The increased accuracy was most pronounced for movements directed towards the activated side. Hence, prolonged unilateral neck muscle contraction may increase the sensitivity of cervical proprioceptors.
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| 10. |
- Masoumi, Zahra, et al.
(författare)
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Hypoxia-induced alpha-globin expression in syncytiotrophoblasts mimics the pattern observed in preeclamptic placentas
- 2021
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Ingår i: International Journal of Molecular Sciences. - : MDPI AG. - 1661-6596 .- 1422-0067. ; 22:7
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Tidskriftsartikel (refereegranskat)abstract
- Preeclampsia (PE) is a pregnancy disorder associated with placental dysfunction and elevated fetal hemoglobin (HbF). Early in pregnancy the placenta harbors hematopoietic stem and progenitor cells (HSPCs) and is an extramedullary source of erythropoiesis. However, globin expression is not unique to erythroid cells and can be triggered by hypoxia. To investigate the role of the placenta in increasing globin levels previously reported in PE, flow cytometry, histological and immunostaining and in situ analyses were used on placenta samples and ex vivo explant cultures. Our results indicated that in PE pregnancies, placental HSPC homing and erythropoiesis were not affected. Non-erythroid alpha-globin mRNA and protein, but not gamma-globin, were detected in syncytiotrophoblasts and stroma of PE placenta samples. Similarly, alpha-globin protein and mRNA were upregulated in normal placenta explants cultured in hypoxia. The upregulation was inde-pendent of HIF1 and NRF2, the two main candidates of globin transcription in non-erythroid cells. Our study is the first to demonstrate alpha-globin mRNA expression in syncytiotrophoblasts in PE, induced by hypoxia. However, gamma-globin was only expressed in erythrocytes. We conclude that alpha-globin, but not HbF, is expressed in placental syncytiotrophoblasts in PE and may contribute to the pathology of the disease.
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