| 1. |
- Asp, Michaela, et al.
(author)
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Spatial detection of fetal marker genes expressed at low level in adult human heart tissue
- 2017
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In: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 7
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Journal article (peer-reviewed)abstract
- Heart failure is a major health problem linked to poor quality of life and high mortality rates. Hence, novel biomarkers, such as fetal marker genes with low expression levels, could potentially differentiate disease states in order to improve therapy. In many studies on heart failure, cardiac biopsies have been analyzed as uniform pieces of tissue with bulk techniques, but this homogenization approach can mask medically relevant phenotypes occurring only in isolated parts of the tissue. This study examines such spatial variations within and between regions of cardiac biopsies. In contrast to standard RNA sequencing, this approach provides a spatially resolved transcriptome- and tissue-wide perspective of the adult human heart, and enables detection of fetal marker genes expressed by minor subpopulations of cells within the tissue. Analysis of patients with heart failure, with preserved ejection fraction, demonstrated spatially divergent expression of fetal genes in cardiac biopsies.
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| 2. |
- Enhörning, Sofia, et al.
(author)
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Water Supplementation Reduces Copeptin and Plasma Glucose in Adults With High Copeptin : The H2O Metabolism Pilot Study
- 2019
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In: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 104:6, s. 1917-1925
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Because elevated copeptin, a marker of vasopressin, is linked to low water intake and high diabetes risk, we tested the effect of water supplementation on copeptin and fasting glucose.DESIGN, SETTING, AND PARTICIPANTS: Thirty-one healthy adults with high copeptin (>10.7 pmol · L-1 in men and >6.1 pmol·L-1 in women) identified in a population-based survey from 2013 to 2015 and with a current 24-hour urine osmolality of >600 mOsm · kg-1 were included.INTERVENTION: Addition of 1.5 L water daily on top of habitual fluid intake for 6 weeks.MAIN OUTCOME MEASURE: Pre- and postintervention fasting plasma copeptin concentrations.RESULTS: Reported mean water intake increased from 0.43 to 1.35 L · d-1 (P < 0.001), with no other observed changes in diet. Median (interquartile range) urine osmolality was reduced from 879 (705, 996) to 384 (319, 502) mOsm · kg-1 (P < 0.001); urine volume increased from 1.06 (0.90, 1.20) to 2.27 (1.52, 2.67) L · d-1 (P < 0.001); and baseline copeptin decreased from 12.9 (7.4, 21.9) pmol · L-1 to 7.8 (4.6;11.3) pmol · L-1 (P < 0.001). Water supplementation reduced fasting plasma glucose from a mean (SD) of 5.94 (0.44) to 5.74 (0.51) (P = 0.04). The water-associated reduction of both fasting copeptin and glucose concentration in plasma was most pronounced in participants in the top tertile of baseline copeptin.CONCLUSIONS: Water supplementation in persons with habitually low water consumption and high copeptin levels is effective in lowering copeptin. It appears a safe and promising intervention with the potential of lowering fasting plasma glucose and thus reducing diabetes risk. Further investigations are warranted to support these findings.
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| 3. |
- Gebert Persson, Sabine, et al.
(author)
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Public and private networks in tourism – : barriers to network identity construction and commitmen
- 2019
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Conference paper (peer-reviewed)abstract
- IntroductionDestinations all over the world encompass a broad range of stakeholders who all aspire to increase the tourism industry to accomplish regional development. At these destinations, there are many different stakeholders, who have mutual interest in a specific region, and there are different attempts to promote cooperation for joint efforts to attract visitors. Moreover, there is an increasing drive for municipalities to influence the tourism business as part of their regional development (Tillväxtverket, 2017).However, the aforementioned development of destinations has proven to involve competing interests between local, national and international stakeholders. Although private enterprises, the municipalities and on-governmental organizations, and residents have a common, or at least partly overlapping, interest in the development of a specific destination, competing interests will occasionally occur (c.f. Elbe et al., 2018). For instance, private businesses, like small local entrepreneurs, could be in direct competition with national or international corporations, despite the fact that they may have much to gain from joint marketing efforts (c.f. investment in a common brand). Similarly, public1organizations have a shared interest in the development of the tourism industry to increase tax revenues and job creation. However, municipalities have a greater responsibility for communities and its residents.As in many other sectors, public and private interactions are common within the tourism industry due to an overall reduction in public sector funding (Valente et al., 2015). Relationships between public and private actors are also set up to conjointly pool resources, share risks in the process of building, maintaining and developing public services (Keränen, 2017). Interactions between public-private actors have been acknowledged as important since these relationships enable firms to influence decisions within areas such as the public sector, rules and actions that can affect how the firm is perceived as legitimate or not (Hadjikhani, Lee, & Ghauri, 2008; Jansson, Saqib, & Sharma, 1995) but also as ways to develop new and existing resources. However, research has shown that uncertainty tends to be rather high in these relationships and the roles that the actors play are consequently dynamic and unclear. This in turn also affects how the actors perceive the cooperation between public and private actors (Keränen, 2017) and their commitment to these types of networks (Elbe et al., 2018). The sought after commitment would be enhanced if a mutual identity could be constituted; still the identity is established from how the stakeholders perceive their roles and relations to each other. So how could the identity of public actors merge with the identity of private actors to establish a mutual and common identity?Despite the apparent advantage to create a network to coordinate mutual, or at least overlapping, interests, it has proven to entail a number of difficult issues of which some will be addressed below. The combination of private and public stakeholders in one organization may have implications for its role and commitments (c.f. Elbe et al. 2009; 2018) i.e. it could influence the perceived identity construction of its constituents. The combination of public and private interests in the same organization could create tension; one perspective could have precedence over the other. For instance, if a publicly funded organization considers it to be its mission to only enhance businesses, there are stakeholder who could be overlooked, such as permanent residents, community services, and other lines of industry. Although the established networks are intended to work towards common goals, there may still be implicit and ambiguous goals, roles and identity formations.2The organizing of public and private interests in order to transform a place and its characteristics into a destination has proven to be a complex process. More research is needed in order to bring further clarity into factors affecting these types of relationships in terms of activities and resources (de Araujo and Bramwell, 2002) as well as how this affects the actors. Although there is a growing scholarly interest in public-private relationships, additional knowledge is needed on how the processes of these types of cooperation evolve (de Araujo and Bramwell, 2002). This is especially so in the context of created networks where the network is constructed rather than emerging and where the aim is to foster and manage activities, resource interactions and actor bonds.This paper sets out to further the understanding of interaction processes where public and private actors attempt to find ways to cooperate on a common issue. This is done by analyzing how the identity of a created network, consisting of public and private actors, develops over time. This paper focuses on explaining how a created network develops over time and why it evolves in the way it does. The purpose is to identify possible barriers to identity construction in a created network consisting of public and private actors. This is done through a case taking its point of departure in the decision of a major infrastructural investment in a destination in Sweden: the building of a new cruise quay on Gotland.Created public-private cooperation – previous research.Interactions between public-private actors have been acknowledged as important since these relationships enable firms to influence decisions within different areas such as the public sector, rules and actions (Keränen, 2017; Elbe et al., 2018) but also as ways to develop new and existing resources. These co-operations are encouraged by governments in many countries as interactions can facilitate the discussions and decisions related to how different activities evolve and are coordinated as well as how public resources are distributed. Moral responsibility and a way to recover citizens’ trust for politicians’ abilities to deliver on electoral pledge when resources are scarce has been emphasized as a reason for cooperation between public and private actors (Velotti, Botti & Vesci, 2012). In a tourism context, private-public cooperation can also increase the competitive advantage of destinations (Kotler et al., 1993).Over the last decades, a growing number of designated organizations for the coordination of tourist actors have been established using the concept of: Destination Management Organizations, DMO (c.f. Elbe et al. 2009). According to UNWTO (2018), the DMO’s3role should, “be to lead and coordinate activities under a coherent strategy in pursuit of this common goal.” The argument in research, and in practice, has been that these destination organizations can manage marketing and coordinate different actors from varying sectors in the society. Through this, it is assumed that the destination through facilitation of interactions among local actors and creation of networks can stimulate economic growth (Elbe et al., 2018). Hence, specific organizations are politically created to facilitate regional development. In addition, DMOs are proposed as a coalition of many organizations and interest although in practice, these organizations have proven to be composed in different ways, with varying performance (Tillväxtverket 2017). In order to understand the accomplishment the sought-after coordination of diverse stakeholder interests, a network approach has been suggested that encompasses inter-organizational relations (Elbe et al. 2018). The proposed network approach could take into account relations between organizations, not only limited to intra-organizational management models that do not encompass all stakeholders.Despite the numerous potential advantages of public-private interactions, they can be time- consuming and difficult as the participants come from different sectors and with deviating interests. Therefore, actors can perceive a risk that their power and influence may decrease. This can also lead to a lack of trust between the actors (de Araujo & Bramwell, 2002).Tensions and paradoxesInteraction between business actors are built around an economic rational. An assumption is that without economic incentives, interactions between business actors in networks will not come about (Håkansson, 1982; Finke et al., 2017). Different types of resources such as financial resources (capital), physical resources (time, technologies, people) and informational resources (knowledge) are exchanged and combined in new and unique ways through the interactions. Resources are through inherently dynamic and can always be used in new combinations within one relationship or in other relationships (Baraldi et al., 2012). An important condition and a factor influencing the interaction processes are the norms and perceptions of what constitutes the rules of the game. Through the interactions new norms for exchange can form and influence the continuation of the exchange. Whether to engage in the cooperation or not will be affected by previous experiences and expectations as expressed by Mousas and Ford (2009, p. 497): “Recurrent episodes are affected by the perceptions of the participants of their previous interactions and by their expectations of the future.” These exchange relationships, constitute the context in which interaction4processes between actors takes place (Easton & Håkansson, 1996; Håkansson & Ford, 2002; Håkansson & Waluszewski, 2002, 2007; Ritter, 2000).In tourist destinations, many of the resources used to attract tourists are public and common goods. The question of who owns these common goods is not always clear. Beaches, lakes, museums, culture heritage buildings are all resources that can attract tourists but that are public. Exchange relationships and agreement on how these public resources are exploited becomes essential for the survival of those organizations involved in developing act
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| 4. |
- Gustavsson, Carl Gunnar, et al.
(author)
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Blood viscosity in relation to blood haemoglobin concentration in healthy subjects and in patients with different cardiovascular diseases
- 1994
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In: Clinical Hemorheology. - New York, USA : Pergamon Press. - 0271-5198. ; 14:5, s. 677-683
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Journal article (peer-reviewed)abstract
- Abstract Blood viscosity was measured at different shear rates using a rotational viscometer, and the correlation between blood viscosity and blood haemoglobin concentration was studied. In 10 healthy controls correlation coefficients were: 0,966 at shear rate 40,0 s-1, 0,931 at 19,6 s-l, 0,817 at 2,3 s-1 and 0,816 at 0,8 s-l , p<0,01 to p < 0,001. The regression lines for these relationships were then applied to the patient groups to calculate what blood viscosity should be predicted solely from the individual haemoglobin concentration, "predicted blood viscosity". In 34 patients with cardiovascular diseases (20 patients with coronary artery disease (CAD), 8 patients with idiopathic dilated cardiomyopathy and 6 patients with primary pulmonary hypertension) the correlation between blood viscosity and haemoglobin concentration was less good, for the total patient material 0,748 to 0,613, p < 0,001 at all shear rates, and for the CAD patients 0,664 to 0,428, p < 0,05 at 3 out of 4 shear rates. Apparently the poorer correlation in the patients was due to a larger influence from factors unrelated to haemoglobin concentration/haematocrit, as the quotients between individually measured and predicted blood viscosity correlated with measured blood viscosity when the haematocrit factor had been eliminated by in vitro standardisation of sample haematocrits to 45%. Key words: Blood viscosity; Haemorheology; Haemoglobin concentration; Microcirculation.
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| 5. |
- Gustavsson, Carl Gunnar, et al.
(author)
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Changed blood rheology in patients with idiopathic dilated cardiomyopathy
- 1994
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In: Angiology. - New York, USA : Westminster Publications, Inc.. - 0003-3197 .- 1940-1574. ; 45:2, s. 107-111
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Journal article (peer-reviewed)abstract
- Abstract Rheologic properties of blood were studied in 8 patients with dilated cardiomyopathy (DCM) and in 10 healthy subjects. Whole-blood viscosity was measured at four different shear rates, by means of a computer-controlled rotational viscometer. The patients had significantly higher blood viscosity at all shear rates, both at their natural hematocrits and after an in vitro adjustment of sample hematocrits to 45%. Erythrocyte filterability (5 μm pore size) was significantly lower, fibrinogen concentration significantly higher, and HDLcholesterol concentration significantly lower in the patient group. No significant differences were found regarding hematocrit, mean corpuscular volume, haemoglobin concentration, leukocyte count and filterability (8 μm pore size), plasma viscosity, and total cholesterol concentration. The measured hemorheologic abnormalities may contribute to the previously reported reduction of coronary blood flow reserve in DCM patients and to myocardial microcirculatory disturbances, which have been suggested as a cause for DCM.
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| 6. |
- Gustavsson, Carl G, et al.
(author)
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Vein blood rheology alterations immediately after coronary angiography with iohexol, and one month later.
- 1996
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In: Clinical Hemorheology. - New York, USA : Pergamon Press. - 0271-5198. ; 16:6, s. 737-743
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Journal article (peer-reviewed)abstract
- Abstract The effects of coronary angiography with iohexol upon vein blood rheology were studied before, immediately after and one month after angiography. Haematocrit decreased from 40.5 % to 39.0 % immediately after angiography (p < 0.01). When this was compensated for by in vitro standardisation of sample haematocrits to 45% there was a blood viscosity increase by 10.9 - 15.0 %, at the four studied shear rates 0.8 s-1, 2.3 s-1, 19.6 s-1, and 40.0 s-1 (p < 0.05 - p < 0.01). In unadjusted samples, i.e. at the patients natural haematocrits, there was only a slight and statistically non-significant blood viscosity increase. Plasma viscosity decreased immediately after angiography, and was even lower 1 month after angiography. The haematocrit reduction correlated significantly with the iohexol doses (correlation coefficient -0.852, p < 0.001), whereas no significant correlation was found between the contrast volumes and the alterations of blood and plasma viscosity. Except for plasma viscosity, there were no significant differences when the values before angiography and one month later were compared. Key words: Blood viscosity; Contrast media; Iohexol; Coronary angiography; Haematocrit; Haemorheology
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| 7. |
- Linde, Cecilia, et al.
(author)
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Baseline characteristics of 547 new onset heart failure patients in the PREFERS heart failure study
- 2022
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In: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 9:4, s. 2125-2138
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Journal article (peer-reviewed)abstract
- Aim We present the baseline characteristics of the PREFERS Stockholm epidemiological study on the natural history and course of new onset heart failure (HF) aiming to improve phenotyping focusing on HF with preserved left ventricular ejection fraction (HFpEF) pathophysiology.Methods and results New onset HF patients diagnosed in hospital or at outpatient HF clinics were included at five Stockholm hospitals 2015-2018 and characterized by N-terminal pro brain natriuretic peptide (NT-proBNP), biomarkers, echocardiography, and cardiac magnetic resonance imaging (subset). HFpEF [left ventricular ejection fraction (LVEF) >= 50%) was compared with HF with mildly reduced LVEF (HFmrEF; LVEF 41-49%) and with HF with reduced LVEF (HFrEF; LVEF <= 40%). We included 547 patients whereof HFpEF (n = 137; 25%), HFmrEF (n = 61; 11%), and HFrEF (n = 349; 64%). HFpEF patients were older (76; 70-81 years; median; interquartile range) than HFrEF (67; 58-74; P < 0.001), more often women (49% vs. 30%; P < 0.001), and had significantly higher comorbidity burden. They more often had atrial fibrillation, hypertension, and renal dysfunction. NT-proBNP was lower in HFpEF (896; 462-1645 ng/L) than in HFrEF (1160; 563-2370; P = 0.005). In HFpEF, left ventricular (LV) diameters and volumes were smaller (P < 0.001) and septa! and posterior wall thickness and relative wall thickness higher (P < 0.001). E/e >= 14 was present in 26% of HFpEF vs. 32% of HFrEF (P = 0.017) and left atrial volume index > 34 mL/m(2) in 57% vs. 61% (P = 0.040). HFmrEF patients were intermediary between HFpEF and HFrEF for LV mass, LV volumes, and RV volumes but had the highest proportion of left ventricular hypertrophy and the lowest proportion of elevated E/e.Conclusions Phenotype data in new onset HF patients recruited in a broad clinical setting showed that 25% had HFpEF, were older, more often women, and had greater comorbidity burden. PREFERS is well suited to further explore biomarker and imaging components of HFpEF pathophysiology and may contribute to the emerging knowledge of HF epidemiology.
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| 8. |
- Matan, Dmitri, et al.
(author)
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Extracellular vesicles in heart failure : A study in patients with heart failure with preserved ejection fraction or heart failure with reduced ejection fraction characteristics undergoing elective coronary artery bypass grafting
- 2022
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In: Frontiers in Cardiovascular Medicine. - : Frontiers Media S.A.. - 2297-055X. ; 9
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Journal article (peer-reviewed)abstract
- AimsExtracellular vesicles (EVs) were investigated as potential biomarkers associated with heart failure (HF) pathophysiology in patients undergoing elective coronary artery bypass surgery characterized by HF phenotype. Materials and methodsPatients with preoperative proxy-diagnoses of HF types i.e., preserved (HFpEF; n = 19) or reduced ejection fraction (HFrEF; n = 20) were studied and compared to patients with normal left ventricular function (n = 42). EVs in plasma samples collected from the coronary sinus, an arterial line, and from the right atrium were analyzed by flow cytometry. We studied EVs of presumed cardiomyocyte origin [EVs exposing Connexin-43 + Caveolin-3 (Con43 + Cav3) and Connexin-43 + Troponin T (Con43 + TnT)], of endothelial origin [EVs exposing VE-Cadherin (VE-Cad)] and EVs exposing inflammatory markers [myeloperoxidase (MPO) or pentraxin3 (PTX3)]. ResultsMedian concentrations of EVs exposing Con43 + TnT and Con43 + Cav3 were approximately five to six times higher in coronary sinus compared to radial artery indicative of cardiac release. Patients with HFrEF had high trans-coronary gradients of both Con43 + TnT and Con43 + Cav3 EVs, whereas HFpEF had elevated gradients of Con43 + Cav3 EVs but lower gradients of Con43 + TnT. Coronary sinus concentrations of both Con43 + TnT and Con43 + Cav3 correlated significantly with echocardiographic and laboratory measures of HF. MPO-EV concentrations were around two times higher in the right atrium compared to the coronary sinus, and slightly higher in HFpEF than in HFrEF. EV concentrations of endothelial origin (VE-Cad) were similar in all three patient groups. ConclusionCon43 + TnT and Con43 + Cav3 EVs are released over the heart indicating cardiomyocyte origin. In HFrEF the EV release profile is indicative of myocardial injury and myocardial stress with elevated trans-coronary gradients of both Con43 + TnT and Con43 + Cav3 EVs, whereas in HFpEF the profile indicates myocardial stress with less myocardial injury.
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| 9. |
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| 10. |
- Persson, Sylvi Ulrika, et al.
(author)
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Studies on blood rheology in patients with primary pulmonary hypertension
- 1991
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In: Angiology. - New York, USA : Westminster Publications, Inc.. - 0003-3197 .- 1940-1574. ; 42:10, s. 836-842
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Journal article (peer-reviewed)abstract
- Abstract The rheologic properties of blood were studied in 6 patients with primary pulmonary hypertension (PPH) and compared with those of a control group of 10 healthy subjects. Blood viscosity was studied with a rotational viscometer and blood cell deformability with a filtrometer giving values for clogging particles (CP) and red cell transit time (RCTT). Blood viscosity at varying shear rates was found to be increased both at natural (p<0.025-0.005) and standardized hematocrit, 45% (p<0.05 at 40 s-1) in patients with PPH. Red cell deformability was reduced as indicated by a significant increase of RCTT (p<0.01). Increased values for hematocrit (p<0.001), hemoglobin concentration (p< 0.001), and erythrocyte count (p<0.005) were found and decreased values for mean corpuscular hemoglobin concentration (MCHC) (p< 0.025) and HDL cholesterol (p<0.005). Plasma viscosity, white cell deformability, white cell count, mean corpuscular volume (MCV), and plasma fibrinogen concentration did not significantly differ from the values found in the control group. It is concluded that patients with PPH have impaired blood rheology. The hemorheologic abnormalities in these patients may be of hemodynamic significance.
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