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- Algera, Joost, 1993, et al.
(författare)
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Managing pain in irritable bowel syndrome: current perspectives and best practice
- 2023
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Ingår i: Expert Review of Gastroenterology & Hepatology. - 1747-4124. ; 17:9, s. 871-881
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Forskningsöversikt (refereegranskat)abstract
- IntroductionIrritable bowel syndrome (IBS) is characterized by chronic symptoms (>6 months) of abdominal pain in combination with a disturbed bowel habit. There is an association between the intensity of abdominal pain and the need for health care utilization. A bidirectionally disordered gut-brain interaction is central in the pathophysiology of IBS where a number of factors, gastrointestinal and non-gastrointestinal, can contribute to the illness experience. In order to treat abdominal pain in IBS, mapping these factors in a multidimensional clinical profile is helpful.Areas coveredThis review covers basic epidemiology and pathophysiology of abdominal pain in IBS, the diagnostic approach, and a multidimensional treatment model where the management of abdominal pain is in focus.Expert opinionA personalized treatment of abdominal pain in IBS is possible in patients who understand the diagnosis, the potential of therapies used, and where a good continuity in the patient-doctor relationship is established.
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| 2. |
- Bergström, Sara, et al.
(författare)
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Miljöbedömning och miljöbeskrivning i väg- och järnvägsprojekt : Vägledning
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna vägledning förmedlar Trafikverkets syn på hur de båda processerna miljöbedömning och miljöbeskrivning bör tillämpas i planläggning och projektering av väg- och järnvägsprojekt, med utgångspunkt från lagkrav, praxis och Trafikverkets erfarenheter. Den tar även upp innehållet i de båda dokumenten miljökonsekvensbeskrivning och miljöbeskrivning som kommer ut av de båda processerna. Vägledningen syftar till att bidra till integrering av miljöaspekter i planläggning och projektering av vägar och järnvägar samt till en god kvalitet på genomförande och redovisning. Den syftar även till att miljöbedömningar och miljöbeskrivningar ska genomföras på ett likartat sätt i hela Trafikverket och få en jämn kvalitet. Vägledningen riktar sig främst till Trafikverkets konsulter och egna miljöspecialister som gör miljöbedömningar och miljöbeskrivningar i Trafikverkets väg- och järnvägsprojekt. Vägledningen ersätter Trafikverkets Handbok om metodik för miljökonsekvensbeskrivning för vägar och järnvägar (Trafikverket 2011:090). Den ersätter också texter om MKB och miljöbeskrivning i Trafikverkets Rapport planläggning av vägar och järnvägar. Vägledningen innehåller bland annat:relevant lagstiftning och målbeskrivning om hur miljö integreras samt miljöbedömningens roll och moment i planläggningens olika skedensamråd, samrådsunderlag, utredning om betydande miljöpåverkan och miljökonsekvensbeskrivningens (MKB) innehåll Trafikverkets syn på hantering av miljöaspekter, behov av att koppla dessa till miljöintressen för vilka konsekvenser beskrivs
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| 5. |
- Gard Timmerfors, Jessica, et al.
(författare)
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New drum-chipping technology for a more uniform size distribution of wood chips
- 2019
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Ingår i: Holzforschung. - : De Gruyter. - 0018-3830 .- 1437-434X.
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Tidskriftsartikel (refereegranskat)abstract
- Wood chips from a novel type of drum chipper were compared to wood chips from a conventional disc chipper in an evaluation based on demonstration-scale and industrial-scale machinery. The evaluation was performed as the wood chippers were used as production machines in a kraft pulp mill using softwood. The average bulk density of the wood chips from the disc chipper and the drum chipper was similar and within the range of 138-140 kg/m 3 . The size distribution of the wood chips was investigated using a conventional screening method, and by using an automatized image-analysis system based on laser scanning. The average length was set to be the same, but the wood chips from the drum chipper had a more uniform length. The average thickness was similar, but the drum chipper generated slightly more thinner wood chips. Compared to the disc chipper and using the screening method, the drum chipper generated a similar fraction of oversized and overthick wood chips, 51% more large accept chips, 11% more total accept chips, and 74% less pin chips and fines. Image analysis resulted in similar data. The results indicate that drum chippers warrant further attention as an alternative to conventional industrial-scale disc chippers. ©2019 Jessica Gard Timmerfors et al.
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| 6. |
- Gard Timmerfors, Jessica, 1989-, et al.
(författare)
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The impact of using different wood qualities and wood species on chips produced using a novel type of pilot drum chipper
- 2021
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Ingår i: Nordic Pulp & Paper Research Journal. - : De Gruyter Open. - 0283-2631 .- 2000-0669. ; 36:2, s. 214-226
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Tidskriftsartikel (refereegranskat)abstract
- Resource-efficient wood chipping for forest-industrial processes demands large fractions of accept chips and small fractions of small-sized material, such as pin chips and fines. In Kraft pulping, a narrow distribution of wood chip thickness is important for even impregnation and for making high-quality pulp. Using newly developed forest-industrial drum-chipping technology, the investigation covered wood of varying moisture content, frozen versus unfrozen wood, and the use of different wood species. Using conventional techniques for analyzing wood chip dimensions, fast-grown spruce wood with high moisture content gave 4.2 % pin chips and fines, which was less than half of the fractions obtained with spruce wood with lower moisture content. A comparison between frozen and unfrozen pine resulted in slightly thinner and shorter chips for the frozen wood, but in both cases accept yields of up to ∼85 % were achieved. A comparison of different tree species (aspen, birch, pine, and spruce) resulted in larger accept fractions (∼90 %) for the hardwood species, even though the average length of these wood chips was as low as 17 mm. The results provide a first indication of how basic wood log properties affect the yields of accept chips and small-sized material when using modern industrial drum-chipping technology.
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| 7. |
- Miloff, Alexander, et al.
(författare)
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Automated virtual reality exposure therapy for spider phobia vs. in-vivo one-session treatment : A randomized non-inferiority trial
- 2019
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 118, s. 130-140
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Tidskriftsartikel (refereegranskat)abstract
- This study compared the efficacy of a technician-assisted single-session virtual reality exposure therapy (VRET) for the treatment of spider phobia featuring low-cost consumer-available hardware and novel automated software to gold-standard in-vivo one-session treatment (OST), using a parallel group randomized non-inferiority design. Method Participants (N = 100) were randomized to VRET and OST arms. Assessors blinded to treatment allocation evaluated participants at pre- and post-treatment as well follow-up (3 and 12 months) using a behavioral approach test (BAT) and self-rated fear of spider, anxiety, depression and quality-of-life scales. A maximum post-treatment difference of 2-points on the BAT qualified as non-inferiority margin. Results Linear mixed models noted large, significant reductions in behavioral avoidance and self-reported fear in both groups at post-treatment, with VRET approaching the strong treatment benefits of OST over time. Non-inferiority was identified at 3- and 12- months follow-up but was significantly worse until 12-months. There was no significant difference on a questionnaire measuring negative effects. Conclusions Automated VRET efficaciously reduced spider phobia symptoms in the short-term and was non-inferior to in-vivo exposure therapy in the long-term. VRET effectiveness trials are warranted to evaluate real-world benefits and non-specific therapeutic factors accruing from the presence of a technician during treatment. ClinicalTrials.gov (NCT02533310).
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| 8. |
- Reid, Steven E, et al.
(författare)
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Cancer-associated fibroblasts rewire the estrogen receptor response in luminal breast cancer, enabling estrogen independence
- 2024
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Ingår i: Oncogene. - 1476-5594.
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Tidskriftsartikel (refereegranskat)abstract
- Advanced breast cancers represent a major therapeutic challenge due to their refractoriness to treatment. Cancer-associated fibroblasts (CAFs) are the most abundant constituents of the tumor microenvironment and have been linked to most hallmarks of cancer. However, the influence of CAFs on therapeutic outcome remains largely unchartered. Here, we reveal that spatial coincidence of abundant CAF infiltration with malignant cells was associated with reduced estrogen receptor (ER)-α expression and activity in luminal breast tumors. Notably, CAFs mediated estrogen-independent tumor growth by selectively regulating ER-α signaling. Whereas most prototypical estrogen-responsive genes were suppressed, CAFs maintained gene expression related to therapeutic resistance, basal-like differentiation, and invasion. A functional drug screen in co-cultures identified effector pathways involved in the CAF-induced regulation of ER-α signaling. Among these, the Transforming Growth Factor-β and the Janus kinase signaling cascades were validated as actionable targets to counteract the CAF-induced modulation of ER-α activity. Finally, genes that were downregulated in cancer cells by CAFs were predictive of poor response to endocrine treatment. In conclusion, our work reveals that CAFs directly control the luminal breast cancer phenotype by selectively modulating ER-α expression and transcriptional function, and further proposes novel targets to disrupt the crosstalk between CAFs and tumor cells to reinstate treatment response to endocrine therapy in patients.
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| 9. |
- Sjölund, Jessica, 1988, et al.
(författare)
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Allergy-related diseases in childhood and risk for abdominal pain-related functional gastrointestinal disorders at 16 years-a birth cohort study
- 2021
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Ingår i: Bmc Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Studies on allergy-related diseases in relation to abdominal pain-related functional gastrointestinal disorders (AP-FGIDs) in children are few and results are contradictory. We examined the associations between childhood allergy-related diseases and adolescent AP-FGIDs in general and irritable bowel syndrome (IBS) in particular. Method Prospective population-based birth cohort study of 4089 children born in Sweden 1994-1996. We analysed data from 2949 children with complete follow-up at 16 years (y) and no diagnosis of inflammatory bowel disease or coeliac disease at 12y or 16y. Asthma, rhinitis, eczema, and food hypersensitivity (FH) were assessed through questionnaires at 1-2y, 4y, 8y, 12y, and 16y. AP-FGIDs and IBS were assessed through questionnaires at 16y and defined according to the Rome III criteria. Associations between childhood allergy-related diseases and any AP-FGID and IBS and 16y respectively were examined using binomial generalized linear models with a log link function and described as relative risk with 95% confidence intervals. Results The prevalence of any AP-FGID and IBS at 16y were 12.0% and 6.0% respectively. Eczema at 1-2y, 4y, and 8y, and FH at 12y and 16y were associated with an increased risk for any AP-FGID at 16y. Asthma and FH at 12y and 16y were associated with an increased risk for IBS at 16y. The relative risk for IBS at 16y increased with increasing number of concurrent allergy-related diseases at 16y, but linear trend for relative risk was only borderline statistically significant (P for trend = 0.05). Conclusions This prospective population-based study demonstrated positive associations between childhood allergy-related diseases and adolescent AP-FGIDs, including IBS, implicating shared pathophysiology among these disorders.
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| 10. |
- Sjölund, Jessica, 1988, et al.
(författare)
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Diuretics, Limited Ultrafiltration, and Residual Renal Function in Incident Hemodialysis Patients: A Case Series
- 2016
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Ingår i: Seminars in dialysis. - : Wiley. - 0894-0959. ; 29:5, s. 410-415
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Tidskriftsartikel (refereegranskat)abstract
- The effect of diuretics on residual renal function expressed as residual GFR (rGFR) and urine volume (rUV) using 24-hour urine collections has not been well examined in hemodialysis (HD) patients. We present a small (seven patient) but provocative case series describing a strikingly low rate of decline in rUV and rGFR (average of creatinine and urea clearances, 24-hour urine collections) in patients treated with increasing doses of furosemide (up to 360 mg/day) during the first 2 years after initiation of HD. Between 6 and 12 months, the mean rUV fell by 1 ml/month, whereas rGFR declined by 0.03 ml/min/1.73 m2/month. The mean rate of decline from 12 to 24 months for rUV (33 ml/month) and rGFR (0.02 ml/min/1.73 m2/month) were also low. While data are clearly limited and the observation retrospective, they are consistent with the better documented benefit of diuretics observed in end-stage renal disease patients treated with peritoneal dialysis. © 2016 Wiley Periodicals, Inc.
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