| 1. |
- Arthur, Cecilia, et al.
(författare)
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Simultaneous Ultra-Sensitive Detection of Structural and Single Nucleotide Variants Using Multiplex Droplet Digital PCR in Liquid Biopsies from Children with Medulloblastoma
- 2023
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Ingår i: Cancers. - : MDPI. - 2072-6694. ; 15:7
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Tidskriftsartikel (refereegranskat)abstract
- Medulloblastoma is one of the most common types of brain tumors in children. During and after treatment with surgery, chemotherapy, and/or radiotherapy, children with this disease are monitored with imaging and cerebrospinal fluid analysis for the detection of tumor cells. These methods are not always sensitive or specific enough to confirm or rule out residual disease. Here, we develop a laboratory test based on the genetic makeup of medulloblastomas in 12 children. We analyze liquid biopsies (cerebrospinal fluid and blood plasma) for specific genetic fragments leaking from the individual tumors and find molecular traces of disease in 75% (9/12) of children overall. None of the children had malignant cells in the cerebrospinal fluid. We propose that this test could open up new technical possibilities to track measurable residual disease in children with medulloblastoma in order to further risk-adapt treatment, but first, larger studies of the approach at standardized time points are warranted.Medulloblastoma is a malignant embryonal tumor of the central nervous system (CNS) that mainly affects infants and children. Prognosis is highly variable, and molecular biomarkers for measurable residual disease (MRD) detection are lacking. Analysis of cell-free DNA (cfDNA) in cerebrospinal fluid (CSF) using broad genomic approaches, such as low-coverage whole-genome sequencing, has shown promising prognostic value. However, more sensitive methods are needed for MRD analysis. Here, we show the technical feasibility of capturing medulloblastoma-associated structural variants and point mutations simultaneously in cfDNA using multiplexed droplet digital PCR (ddPCR). Assay sensitivity was assessed with a dilution series of tumor in normal genomic DNA, and the limit of detection was below 100 pg of input DNA for all assays. False positive rates were zero for structural variant assays. Liquid biopsies (CSF and plasma, n = 47) were analyzed from 12 children with medulloblastoma, all with negative CSF cytology. MRD was detected in 75% (9/12) of patients overall. In CSF samples taken before or within 21 days of surgery, MRD was detected in 88% (7/8) of patients with localized disease and in one patient with the metastasized disease. Our results suggest that this approach could expand the utility of ddPCR and complement broader analyses of cfDNA for MRD detection.
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| 2. |
- Bylund-Grenklo, Tove, et al.
(författare)
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Dignity in life and care : The perspectives of Swedish patients in a palliative care context
- 2019
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Ingår i: International Journal of Palliative Nursing. - : MA Healthcare Ltd. - 1357-6321 .- 2052-286X. ; 25:4, s. 193-201
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Tidskriftsartikel (refereegranskat)abstract
- Background: How patients preserve their sense of dignity in life is an important area of palliative care that remains to be explored. Aims: To describe patients' perspectives of what constitutes a dignified life within a palliative care context. Methods: Twelve palliative care patients were interviewed about their views on living with dignity. Data were analysed using qualitative content analysis. Results: What constitutes a dignified life during end-of-life care was captured by the theme 'I may be ill but I am still a human being' and presented under the categories 'preserving my everyday life and personhood', 'having my human value maintained by others through 'coherence' and 'being supported by society at large'. Conclusion: Patients' sense of dignity can be preserved by their own attitudes and behaviours, by others and through public support. Health professionals need to adopt a dignity-conserving approach, for which awareness of their own attitudes and behaviours is crucial.
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| 3. |
- Englund-Ögge, Linda, et al.
(författare)
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Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
- 2024
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Ingår i: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - 0001-6349 .- 1600-0412. ; 103:7, s. 1426-1436
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionWomen with type 1 diabetes have an increased risk of preeclampsia (PE), but it is not fully understood if degree of glycemic control is associated with this risk. The aim of this study was to assess glycemic control during pregnancy analyzed by continuous glucose monitoring (CGM) in women with and without PE and to investigate if glycemic control is associated with increased risk of PE.Material and MethodsA total of 120 pregnant Swedish women with type 1 diabetes using CGM were included. Background factors and pregnancy outcomes were collected from medical records. CGM data were collected via the internet-based platform Diasend. Mean glucose, standard deviation of mean glucose, percentage of time in target, time below target, and time above target were presented for each trimester in women who did or did not develop PE. Associations between CGM-derived metrics and PE were analyzed with logistic regression and adjusted for confounders.ResultsTwenty-two women (18.3%) developed PE. There were no significant differences in maternal characteristics between women with and without PE. Glycemic control improved in each trimester but was suboptimal in both groups. Time in target increased from 59% in the non-PE group and 54% in the PE group in the first trimester to 65% in both groups in the third trimester. There were no significant associations between glycemic control and PE after adjustment for confounders.ConclusionsDegree of glycemic control during pregnancy assessed by CGM was not associated with development of PE in women with type 1 diabetes. However, more research is needed to understand the role of glycemic control in relation to development of PE. This study showed that women with diabetes improved their glycemic control during pregnancy; however, there were no significant differences in glycemic control in women developing preeclampsia compared to women who did not develop preeclampsia. Larger studies are needed.image
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| 4. |
- Karnaouri, Anthi C, et al.
(författare)
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Recombinant expression of thermostable processive MtEG5 endoglucanase and its synergism with MtLPMO from Myceliophthora thermophila during the hydrolysis of lignocellulosic substrates
- 2017
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Ingår i: Biotechnology for Biofuels. - : BioMed Central (BMC). - 1754-6834. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundFilamentous fungi are among the most powerful cellulolytic organisms in terrestrial ecosystems. To perform the degradation of lignocellulosic substrates, these microorganisms employ both hydrolytic and oxidative mechanisms that involve the secretion and synergism of a wide variety of enzymes. Interactions between these enzymes occur on the level of saccharification, i.e., the release of neutral and oxidized products, but sometimes also reflected in the substrate liquefaction. Although the synergism regarding the yield of neutral sugars has been extensively studied, further studies should focus on the oxidized sugars, as well as the effect of enzyme combinations on the viscosity properties of the substrates.ResultsIn the present study, the heterologous expression of an endoglucanase (EG) and its combined activity together with a lytic polysaccharide monooxygenase (LPMO), both from the thermophilic fungus Myceliophthora thermophila, are described. The EG gene, belonging to the glycoside hydrolase family 5, was functionally expressed in the methylotrophic yeast Pichia pastoris. The produced MtEG5A (75 kDa) featured remarkable thermal stability and showed high specific activity on microcrystalline cellulose compared to CMC, which is indicative of its processivity properties. The enzyme was capable of releasing high amounts of cellobiose from wheat straw, birch, and spruce biomass. Addition of MtLPMO9 together with MtEG5A showed enhanced enzymatic hydrolysis yields against regenerated amorphous cellulose (PASC) by improving the release not only of the neutral but also of the oxidized sugars. Assessment of activity of MtEG5A on the reduction of viscosity of PASC and pretreated wheat straw using dynamic viscosity measurements revealed that the enzyme is able to perform liquefaction of the model substrate and the natural lignocellulosic material, while when added together with MtLPMO9, no further synergistic effect was observed.ConclusionsThe endoglucanase MtEG5A from the thermophilic fungus M. thermophila exhibited excellent properties that render it a suitable candidate for use in biotechnological applications. Its strong synergism with LPMO was reflected in sugars release, but not in substrate viscosity reduction. Based on the level of oxidative sugar formation, this is the first indication of synergy between LPMO and EG reported.
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| 5. |
- Kjölhede, Karin, et al.
(författare)
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Glycemic, maternal and neonatal outcomes in women with type 1 diabetes using continuous glucose monitoring during pregnancy – Pump vs multiple daily injections, a secondary analysis of an observational cohort study
- 2021
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 100:5, s. 927-933
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Continuous glucose monitoring (CGM) provides detailed information about glucose level fluctuations over time. The method is increasingly being used in pregnant women with type 1 diabetes. However, only one previous study compared CGM results related to pregnancy outcomes in women using insulin pumps with those administering multiple daily injections (MDI). We performed a secondary analysis of CGM metrics from an observational cohort of pregnant women with type 1 diabetes and compared insulin pump and MDI therapies in relation to maternal and neonatal outcomes. Material and methods: The study included 185 pregnant Swedish women with type 1 diabetes undergoing CGM throughout pregnancy. Women were divided according to insulin administration mode, ie MDI (n = 131) or pump (n = 54). A total of 91 women used real-time CGM and 94 women used intermittently viewed CGM. Maternal demographics and maternal and neonatal outcome data were collected from medical records. CGM data were analyzed according to predefined glycemic indices: mean glucose; standard deviation; percentage of time within, below and above glucose target range; mean amplitude of glycemic excursion; high and low glucose indices; and coefficient variation in percent. Associations between insulin administration mode and CGM data, on the one hand, and maternal and neonatal outcomes, on the other, were analyzed with analysis of covariance and logistic regression, respectively, adjusted for confounders. Results: There were no differences in maternal characteristics or glycemic indices between the MDI and pump groups, except for a longer duration of type 1 diabetes and higher frequencies of microangiopathy and real-time CGM among pump users. Despite improvement with each trimester, glucose levels remained suboptimal throughout pregnancy in both groups. There were no differences between the MDI and pump groups concerning the respective associations with any of the outcomes. The frequency of large for gestational age was high in both groups (MDI 49% vs pump 63%) and did not differ significantly. Conclusions: Pregnant women with type 1 diabetes did not differ in glycemic control or pregnancy outcome, related to MDI or pump administration of insulin. Glycemic control remained suboptimal throughout pregnancy, regardless of insulin administration mode.
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| 6. |
- Krynina, Olha, et al.
(författare)
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The potential of liquid biopsy for detection of the KIAA1549-BRAF fusion in circulating tumor DNA from children with pilocytic astrocytoma
- 2024
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Ingår i: Neuro-Oncology Advances. - : Oxford University Press. - 2632-2498. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLow-grade gliomas (LGGs) represent children’s most prevalent central nervous system tumor, necessitating molecular profiling to diagnose and determine the most suitable treatment. Developing highly sensitive screening techniques for liquid biopsy samples is particularly beneficial, as it enables the early detection and molecular characterization of tumors with minimally invasive samples.MethodsWe examined CSF and plasma samples from patients with pilocytic astrocytoma (PA) using custom multiplexed droplet digital polymerase chain reaction (ddPCR) assays based on whole genome sequencing data. These assays included a screening test to analyze BRAF duplication and a targeted assay for the detection of patient-specific KIAA1549::BRAF fusion junction sequences or single nucleotide variants.ResultsOur findings revealed that 5 out of 13 individual cerebrospinal fluid (CSF) samples tested positive for circulating tumor DNA (ctDNA). Among these cases, 3 exhibited the KIAA1549::BRAF fusion, which was detected through copy number variation (CNV) analysis (n = 1) or a fusion-specific probe (n = 2), while 1 case each displayed the BRAF V600E mutation and the FGFR1 N577K mutation. Additionally, a quantitative analysis of cell-free DNA (cfDNA) concentrations in PA CSF samples showed that most cases had low cfDNA levels, below the limit of detection of our assay (<1.9 ng).ConclusionsWhile CNV analysis of CSF samples from LGGs still has some limitations, it has the potential to serve as a valuable complementary tool. Furthermore, it can also be multiplexed with other aberrations, for example, to the BRAF V600 test, to provide important insights into the molecular characteristics of LGGs.
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| 7. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review
- 2019
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 6:3, s. 664-675
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To continuing the quest of the concept of transition in nursing research and toexplore how the concept of transition is used in occupational therapy, oral health andsocial work as well as in interdisciplinary studies in health and welfare, between2003–2013.Design: An integrative literature review.Methods: PubMed, CINAHL, PsycINFO, DOSS, SocIndex, Social Science Citation Indexand AMED databases from 2003–2013 were used. Identification of 350 articles includingthe concept of transition in relation to disciplines included. Assessment of articlesare in accordance to Meleis’ typologies of transition by experts in each discipline.Chosen key factors were entered into Statistical Package for the Social Sciences (SPSS).Results: Meleis’ four typologies were found in all studied disciplines, except developmentin oral health. The health‐illness type was the most commonly explored,whereas in social work and in occupation therapy, situational transitions dominated.
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| 8. |
- Muraleedharan, Madhu Nair
(författare)
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Depolymerization of Lignocellulose by Lytic Polysaccharide MonoOxygenases
- 2018
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Lignocellulose biomass is considered as one of the most potential and sustainable sources for the production of value-added chemicals and fuels while replacing the traditional petroleum resources. In a biorefinery, by employing biochemical conversion processes,cellulose present in the biomass is broken down into monomeric sugars which can belater converted into fuels or chemicals. This process is done with the help of different cellulose digesting enzymes (cellulases), isolated from natural cellulolytic organisms suchas saprophytic fungi.Lytic polysaccharide monooxygenases (LPMOs) are considered as one of the vital classesof enzymes in the bio-conversion of lignocellulose. They are copper active enzymes present naturally in cellulose degrading fungi. Unlike the traditional cellulases, they havea unique way of breaking cellulose using molecular oxygen or hydrogen peroxide as cosubstratein the presence of a reducing agent. Their ability to enhance the action of other cellulases in depolymerizing the cellulose, make them an integral part of today’s commercial cellulase cocktails.This thesis comprises the study about the action of lytic polysaccharide monooxygenaseson various cellulose substrates, both model and natural. The first part of the thesis focuses on the ability of an LPMO (MtLPMO9) and a traditional cellulase (MtEG5A), to act insynergism. The evaluation was done based on the release of oxidized and non-oxidized sugars and also on the ability to liquefy the substrates. It was observed that together, these two enzymes resulted in enhanced release of oxidized and non-oxidized sugars. Both were able to reduce viscosity of the substrates but no further synergistic effect was observed when added together.The second part focuses on the ability of LPMOs to accept electrons from lignins for their action of breaking cellulose chains. Three LPMOs, MtLPMO9, PcLPMO9D and NcLPMO9C, lignins from agricultural and forest biomass pretreated by various pretreatment methods were selected. It was demonstrated that lignins, both in isolatedand substrate bound form were able to act indirectly as reducing agents, by releasingsoluble low-molecular-weight molecules that act as mediators between enzyme and bulklignins. The structural and compositional properties of lignins also affected their ability toact as electron donors. In addition, the effect of biomass pretreatment methods on the lignin properties was also studied. The lignins from acid catalyzed organosolv pretreatment were found as the best candidates in supplying electrons to the enzymes.Interestingly, NcLPMO9C was not able to utilize lignins as electron donors requiring further investigation on their mechanism both in vivo and in vitro.
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| 9. |
- Muraleedharan, Madhu Nair, et al.
(författare)
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Effect of lignin fractions isolated from different biomass sources on cellulose oxidation by fungal lytic polysaccharide monooxygenases
- 2018
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Ingår i: Biotechnology for Biofuels. - London : BMC. - 1754-6834. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLytic polysaccharide monooxygenases (LPMOs) are copper-dependent enzymes that oxidatively cleave recalcitrant lignocellulose in the presence of oxygen or hydrogen peroxide as co-substrate and a reducing agent as electron donor. One of the possible systems that provide electrons to the LPMOs active site and promote the polysaccharide degradation involves the mediation of phenolic agents, such as lignin, low-molecular-weight lignin-derived compounds and other plant phenols. In the present work, the interaction of the bulk insoluble lignin fraction extracted from pretreated biomass with LPMOs and the ability to provide electrons to the active site of the enzymes is studied.ResultsThe catalytic efficiency of three LPMOs, namely MtLPMO9 with C1/C4 regioselectivity, PcLPMO9D which is a C1 active LPMO and NcLPMO9C which is a C4 LPMO, was evaluated in the presence of different lignins. It was correlated with the physicochemical and structural properties of lignins, such as the molecular weight and the composition of aromatic and aliphatic hydroxyl groups. Moreover, the redox potential of lignins was determined with the use of large amplitude Fourier Transform alternating current cyclic voltammetry method and compared to the formal potential of the Cu (II) center in the active site of the LPMOs, providing more information about the lignin-LPMO interaction. The results demonstrated the existence of low-molecular weight lignin-derived compounds that are diffused in the reaction medium, which are able to reduce the enzyme active site and subsequently utilize additional electrons from the insoluble lignin fraction to promote the LPMO oxidative activity. Regarding the bulk lignin fractions, those isolated from the organosolv pretreated materials served as the best candidates in supplying electrons to the soluble compounds and, finally, to the enzymes. This difference, based on biomass pretreatment, was also demonstrated by the activity of LPMOs on natural substrates in the presence and absence of ascorbic acid as additional reducing agent.ConclusionsLignins can support the action of LPMOs and serve indirectly as electron donors through low-molecular-weight soluble compounds. This ability depends on their physicochemical and structural properties and is related to the biomass source and pretreatment method.
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| 10. |
- Nair, Madhu Muraleedharan
(författare)
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Lytic Polysaccharide MonoOxygenases; their role for lignocellulose depolymerization and production of (functional) biobased compounds
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Increased environmental concerns over petroleum-based products triggered the quest to find a sustainable alternative for fuels, chemicals etc. Lignocellulose biomass, due to its abundance, is considered as one of the most promising sustainable sources for the production of fuels and chemicals, while replacing the traditional petroleum resources. In a biorefinery, by choosing a greener biochemical conversion process with cellulolytic enzymes, cellulose from biomass is depolymerized into monomeric sugars and residual fibers; which can be later converted into a spectra of value added products.Lytic polysaccharide monooxygenases (LPMOs) are one of the essential groups of enzymes in the bioconversion of lignocellulose. They are copper active enzymes that are produced by different polysaccharide degrading organisms in nature, such as lignocellulolytic fungi. In lignocellulose degradation, they are different from the traditional hydrolytic cellulolytic enzymes with their unique way of oxidative breakage of cellulose, in the presence of a co-substrate such as oxygen, and a reducing agent like lignin in the biomass. Their ability to enhance the action of traditional cellulases in cellulose depolymerization make them an integral part of today’s commercial cellulosic cocktails.Primary goals of biorefinery research include efficient liquefaction of lignocellulose in order to increase the release of monomeric sugars towards the production of various chemicals and fuels, together with the potential use of residual fibers for the production of value-added products; all by minimizing the release of undesired by-products and the environmental impact of the process. LPMOs, along with other cellulases, have been shown to be very much beneficial in this.This thesis comprises the study of LPMOs from different fungal origin, in their depolymerization ability on various substrates, including both model substrates and natural biomass samples. The evaluation was done based on their ability to release neutral and oxidized sugars, as well as their capability to promote liquefaction. Effect of various pretreatment methods of lignocellulose on the action of LPMOs was studied, together with their capability to use lignin present in the wood as a reducing agent, which gives a better understanding about their function in nature. Lastly, their role in producing value added materials such as nanocellulose, the prebiotic disaccharide cellobiose, from lignocellulose was also evaluated.
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