| 1. |
- Claesson, Margareta, 1951, et al.
(författare)
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Astigmatism and the Impact of Relaxing Incisions After Penetrating Keratoplasty
- 2006
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Ingår i: Journal of Refractive Surgery. - 1081-597X. ; 23:3, s. 284-9
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Tidskriftsartikel (refereegranskat)abstract
- Astigmatism and the impact of relaxing incisions after penetrating keratoplasty.Claesson M, Armitage WJ. Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden. margareta.l.claesson@vgregion.se PURPOSE: To determine the impact of relaxing incisions for correcting postoperative astigmatism following penetrating keratoplasty. METHODS: Data were collected through the Swedish Corneal Transplant Register. Of the 1161 grafts with complete 2-year follow-up, 131 underwent relaxing incisions. Stepwise multiple regression was used to determine the factors that influenced the extent of astigmatism in diopters (D) (square root transformed). The change in astigmatism brought about by relaxing incisions was evaluated both by subtraction (ie, ignoring angle) and vector analysis. RESULTS: The overall mean astigmatism was 4.56 D (95% confidence interval [CI]: 4.40-4.73, n = 1161). The final regression model explained only a small proportion of the overall variability of the data (< 5%). There was a slight increase in postoperative astigmatism with recipient age (P = .025), and two of the seven participating clinics achieved lower levels of astigmatism (P = .001 and P = .036, respectively). In patients who underwent relaxing incisions, astigmatism was reduced from 8.40 D (95% CI: 8.0-9.0, n = 131) to 3.80 D (95% CI: 3.5-4.3). The mean difference by subtraction was 4.50 D (95% CI: 4.0-5.0, P < .001, paired t test). Vector analysis showed the overall reduction of astigmatism due to surgery to be 7.90 D (95% CI: 7.2-8.7). Compared with grafts with no refractive surgery, a trend was noted that suggested corrected visual acuity was improved following relaxing incisions. CONCLUSIONS: Relaxing incisions were found to be a safe and effective method for reducing postoperative astigmatism and may improve visual acuity. PMID: 17385295 [PubMed - indexed for MEDLINE]
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| 2. |
- Claesson, Margareta, 1951, et al.
(författare)
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Corneal oedema after cataract surgery: predisposing factors and corneal graft outcome.
- 2009
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 87:2, s. 154-9
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Pseudophakic bullous keratopathy (PBK) is one of the main indications for corneal transplantation. Graft survival and visual outcome in this group are often poorer than for other indications. The aim of this study was to find risk factors for developing corneal oedema after cataract surgery and factors that influence the subsequent survival of the graft and the visual outcome. METHODS: We carried out an observational, retrospective cohort study using data from the Swedish Cornea Transplant Register and patient medical records. A total of 273 patients whose indication for corneal transplantation was corneal oedema after cataract surgery were included in the study. Multiple logistic regression analysis and, where appropriate, univariate analyses were applied. RESULTS: A total of 43% of the patients developed persistent corneal oedema immediately after cataract surgery, the main risk factors for which were phacoemulsification and pre-existing endothelial disease. Almost a third (32%) of the transplants for PBK failed within 2 years, for which rejection and other postoperative complications increased the risk. Half (50%) the patients had visual acuity < or = 0.1 at 2 years after keratoplasty. Comorbidity, increasing duration of the bullous keratopathy and increasing age affected the visual outcome negatively. CONCLUSIONS: Phacoemulsification was a risk factor for immediate persistent corneal oedema after cataract surgery, although it did not increase the overall risk of developing PBK. However, transplants for immediate PBK had a better survival rate than those for later onset PBK. Shorter duration of PBK and intraocular lens exchange at the time of penetrating keratoplasty increased the likelihood of good visual acuity.
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| 3. |
- Claesson, Margareta, 1951
(författare)
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Corneal transplant outcome- a Swedish register
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim. The aim of this study was to present different aspects of the outcome after corneal transplantation based on data from the Swedish Cornea Register. Papers. The first paper describes the register and gives descriptive statistics and analysis of data from a two-year follow up, while the last paper presents data from a ten-year follow up. Papers two and three deal with two specific problems in corneal transplantation, astigmatism and corneal oedema after cataract surgery (bullous keratopathy, BK). Paper four and five compare the Swedish patients with a cohort from the Middle East. Results. The major indications were keratoconus (29%), BK (21%) and a mixed group of other diagnoses (32%), including regraft. The overall incidence of rejection at two years was 15%, and regrafting, which occurred in 10% of cases was related to rejection and other complications. Visual acuity (VA) after two years improved most in keratoconus and this was still the case after ten years. Most changes in visual outcome after PK in all indications occurred during the first two postoperative years. Graft survival and VA at ten years depended mainly on complications occurring before two years postoperative. The mean value of astigmatism at two years was 4.6 D (95% CI 4.4-4.7), independent of indication and preoperative astigmatism. In a group with high astigmatism (mean value 8.4 D) relaxing incisions reduced the astigmatism by 50%. At ten years there was a small increase in astigmatism in all indications. Bullous keratopathy was one of the indications with poorest outcome. The risk of developing BK at the time of cataract surgery was influenced by pre-existing endothelial disease and cataract surgery done by phaco-emulsification. In the Palestinian Territories the preponderance of keratoconus was higher than in Sweden. The patients came to surgery with a more advanced disease and more risk factors. They also developed more postoperative complication and the outcome was poorer, even though most gained some visual acuity. Conclusion. Through the data analysed from the register our knowledge of the outcome after corneal transplantation has increased. The register will also allow evaluation of new techniques of corneal transplantation.
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| 4. |
- Claesson, Margareta, et al.
(författare)
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Validation of Catquest-9SF-A Visual Disability Instrument to Evaluate Patient Function after Corneal Transplantation
- 2017
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Ingår i: Cornea. - 0277-3740 .- 1536-4798. ; 36:9, s. 1083-1088
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Catquest-9SF is a 9-item visual disability questionnaire developed for evaluating patient-reported outcome measures after cataract surgery. The aim of this study was to use Rasch analysis to determine the responsiveness of Catquest-9SF for corneal transplant patients. Methods: Patients who underwent corneal transplantation primarily to improve vision were included. One group (n = 199) completed the Catquest-9SF questionnaire before corneal transplantation and a second independent group (n = 199) completed the questionnaire 2 years after surgery. All patients were recorded in the Swedish Cornea Registry, which provided clinical and demographic data for the study. Winsteps software v.3.91.0 (Winsteps.com, Beaverton, OR) was used to assess the fit of the Catquest-9SF data to the Rasch model. Results: Rasch analysis showed that Catquest-9SF applied to corneal transplant patients was unidimensional (infit range, 0.73-1.32; outfit range, 0.81-1.35), and therefore, measured a single underlying construct (visual disability). The Rasch model explained 68.5% of raw variance. The response categories of the 9-item questionnaire were ordered, and the category thresholds were well defined. Item difficulty matched the level of patients' ability (0.36 logit difference between the means). Precision in terms of person separation (3.09) and person reliability (0.91) was good. Differential item functioning was notable for only 1 item (satisfaction with vision), which had a differential item functioning contrast of 1.08 logit. Conclusions: Rasch analysis showed that Catquest-9SF is a valid instrument for measuring visual disability in patients who have undergone corneal transplantation primarily to improve vision.
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| 5. |
- Claesson, Rolf, et al.
(författare)
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Actinomyces radicidentis and Actinomyces haliotis, coccoid Actinomyces species isolated from the human oral cavity
- 2017
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Ingår i: Anaerobe. - : Elsevier. - 1075-9964 .- 1095-8274. ; 48, s. 19-26
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Tidskriftsartikel (refereegranskat)abstract
- There are few reports on the bacterial species Actinomyces radicidentis in the literature. In this study, putative A. radicidentis isolates were collected from 16 root canal samples from 601 examined patients. The isolates were examined by biochemical tests, 16S rRNA gene sequencing, Arbitrarily-primed (AP-) PCR, antibiotic susceptibility testing, and MALDI-TOF analyses. In parallel, two A. radicidentis reference strains and two putative A. radicidentis isolates from United Kingdom were tested. Sixteen of the 18 isolates were confirmed as A. radicidentis. The remaining two isolates, both of which were isolated from root canals (one from Sweden and the other from the UK), but were identified as Actinomyces haliotis by sequencing ∼ 1300 base pairs of the 16S rRNA-gene. This isolates had a divergent, but between them similar, AP-PCR pattern, and a common distribution of sequence signatures in the 16S rRNA gene, but were not identified by MALDI-TOF. A. haliotis is a close relative to A. radicidentis, hitherto only been described from a sea-snail. The identity of A. haliotis was confirmed by a phylogenetic tree based on 16S rRNA gene sequences with species specific sequences included, and by additional biochemical tests. The examined bacteria exhibited similar antibiotic susceptibility patterns when tested for 10 separate antibiotic classes with E-tests (bioMérieux). The MIC90 for β-lactams (benzylpenicillin and cefuroxime) and vancomycin was 0.5 mg/L, for colistin and ciprofloxacin 8 mg/mL and for the other antibiotic classes ≤ 25 mg/mL The isolation of A. haliotis from infected dental root canals cast doubt on the accepted opinion that all Actinomyces infections have an endogenous source.
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| 6. |
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| 7. |
- Granlund, Margareta, et al.
(författare)
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Discrepancies in Antimicrobial Susceptibility between the JP2 and the Non-JP2 Genotype of Aggregatibacter actinomycetemcomitans
- 2022
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Ingår i: Antibiotics. - Basel : MDPI. - 2079-6382. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- The Aggregatibacter actinomycetemcomitans JP2 genotype is associated with high leukotoxin production and severe (aggressive) periodontitis. The aim of this study was to compare the antimicrobial susceptibility of JP2 and non-JP2 genotype strains. Minimal inhibitory concentrations (MICs) of 11 antimicrobials were determined for 160 A. actinomycetemcomitans of serotype a, b, or c, mostly isolated in Sweden or Ghana. MIC distributions for benzylpenicillin and fusidic acid revealed a more susceptible subpopulation for 38 serotype b strains, including the 32 of the JP2 genotype, with a benzylpenicillin MIC range of 0.125–0.5 mg/L. In contrast, benzylpenicillin MIC ≤ 16 mg/L was the estimated 99.5% epidemiological cutoff (ECOFF) of all strains. Beta-lactamase production was not detected. The fusidic acid MIC distribution of 11 strains of Aggregatibacter aphrophilus agreed with that found in non-JP2 strains. Cefotaxime, meropenem, levofloxacin, and trimethoprim–sulfamethoxazole MICs were all ≤0.25 mg/L, while MIC90 values for amoxicillin, azithromycin and tetracycline were 1 mg/L. Metronidazole MICs varied between 0.5 and >256 mg/L. The discrepant findings indicate that A. actinomycetemcomitans may be divided into two separate wild types, with a suggested intrinsic reduced susceptibility for benzylpenicillin in the majority of non-JP2 genotype strains. Possible implications for the treatment of A. actinomycetemcomitans infections are discussed.
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| 8. |
- Han, Hongya, et al.
(författare)
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Human 15-lipoxygenase-1 is a regulator of dendritic-cell spreading and podosome formation
- 2017
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Ingår i: The FASEB Journal. - : FEDERATION AMER SOC EXP BIOL. - 0892-6638 .- 1530-6860. ; 31:2, s. 491-504
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Tidskriftsartikel (refereegranskat)abstract
- Dendritic cells (DCs) involved in proinflammatory immune responses derive mainly from peripheral monocytes, and the cells subsequently mature and migrate into the inflammatory micromilieu. Here we report that suppressing of 15-lipoxygenase-1 led to a substantial reduction in DC spreading and podosome formation in vitro. The surface expression of CD83 was significantly lower in both sh-15-lipoxygenase-1 (15-LOX-1)-transduced cells and DCs cultivated in the presence of a novel specific 15-LOX-1 inhibitor. The T-cell response against tetanus-pulsed DCs was only affected to a minor extent on inhibition of 15-LOX-1. In contrast, endocytosis and migration ability of DCs were significantly suppressed on 15-LOX-1 inhibition. The expression of 15-LOX-1 in DCs was also demonstrated in affected human skin in atopic and contact dermatitis, showing that the enzyme is indeed expressed in inflammatory diseases in vivo. This study demonstrated that inhibiting 15-LOX-1 led to an impaired podosome formation in DCs, and consequently suppressed antigen uptake and migration capacity. These results indicated that 15-LOX-1 is a potential target for inhibiting the trafficking of DCs to lymphoid organs and inflamed tissues and decreasing the inflammatory response attenuating symptoms of certain immunologic and inflammatory disorders such as dermatitis.-Han, H., Liang, X., Ekberg, M., Kritikou, J. S., Brunnstro " m, angstrom., Pelcman, B., Matl, M., Miao, X., Andersson, M., Yuan, X., Schain, F., Parvin, S., Melin, E., Sjoberg, J., Xu, D., Westerberg, L. S., Bjorkholm, M., Claesson, H.- E. Human 15-lipoxygenase- 1 is a regulator of dendritic-cell spreading and podosome formation.
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| 9. |
- Hardarson, Thorir, 1967, et al.
(författare)
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Time-lapse recordings of human corneal epithelial healing
- 2004
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Ingår i: Acta Ophthalmologica Scandinavica. - 1395-3907. ; 82, s. 184-8
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Tidskriftsartikel (refereegranskat)abstract
- Time-lapse recordings of human corneal epithelial healing.Hardarson T, Hanson C, Claesson M, Stenevi U. Department of Obstetrics and Gynaecology, Gothenburg University, Gothenburg, Sweden. PURPOSE: The aim of this study was to design an experimental set-up for the study of human corneal epithelial wound healing in a controlled in vitro situation. METHODS: A time-lapse set-up was used. This allowed for pictures to be captured with a magnification ranging from x 80 to x 1800. Pictures were captured at 1-min intervals during the observation period, which lasted up to 4 days. Human corneal tissue was obtained from the Eye Bank or from surgery. A small, rounded lesion was produced in the corneal epithelium with a miniature drill. The specimens were placed in a mini-incubator; the camera focused on the epithelial lesion and continuously observed using the time-lapse set-up. RESULTS: The healing process of human corneal epithelium could be followed for several days. The initial healing response could be divided into a slow, a rapid and a consolidating phase. The first two phases lasted about 12 hours, and by then, epithelial cells covered the lesion. Depending on the origin of the tissue and the placement of the lesion, variations in the healing response could be seen. CONCLUSION: The time-lapse technique makes it possible to study epithelial wound healing over time at the cellular level. Data collected in this way can fill the gap between in vivo studies, where, by nature, human wound healing studies are restricted, and cell culture techniques, where cellular responses in many cases differ from the in vivo situation. PMID: 15043538 [PubMed - indexed for MEDLINE]
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| 10. |
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| 11. |
- Lagali, Neil, et al.
(författare)
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Donor and recipient endothelial cell population of the transplanted human cornea: a two-dimensional imaging study.
- 2010
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Ingår i: Investigative ophthalmology & visual science. - : Association for Research in Vision and Ophthalmology (ARVO). - 1552-5783 .- 0146-0404. ; 51:4, s. 1898-904
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To elucidate the pattern of donor and recipient endothelial cell populations in transplanted human corneas and determine the degree to which donor endothelial cells survive in the graft. Methods. Thirty-six corneal grafts were collected from recipients of opposite sex to the donor, at the time of retransplantation for various indications. Cells from the endothelial side of the grafts were harvested, preserving their relative location on the endothelium. Fluorescence in situ hybridization of the sex chromosomes enabled each cell to be identified as donor- or recipient-derived. Images of the graft endothelium were assembled, to depict the pattern of cell population of the graft, and the proportion of donor cells present was estimated. Results. Endothelial cells of donor origin were found in 26 of 36 grafts (72.2%)-in one case, up to 26 years after transplantation. The proportion of donor endothelium ranged from 2% to 99%; however, there was no significant correlation of this proportion with postoperative time (P = 0.19). The mean annual rate of donor cell loss correlated negatively with the time to graft failure by endothelial decompensation (P = 0.002). Endothelial images indicated a highly variable pattern of recipient cell repopulation of the graft. A tendency toward donor cell retention in transparent, successful grafts was noted; however, this feature alone was not a reliable indicator of long-term graft transparency. Conclusions. Two-dimensional imaging of the corneal graft endothelium revealed a variable pattern and extent of donor and recipient cell population, indicating the highly dynamic nature of the corneal endothelium after transplantation.
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| 12. |
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| 13. |
- Lagali, Neil, et al.
(författare)
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Survival of donor-derived cells in human corneal transplants.
- 2009
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Ingår i: Investigative ophthalmology & visual science. - : Association for Research in Vision and Ophthalmology (ARVO). - 1552-5783. ; 50:6, s. 2673-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine the fate of donor epithelial, stromal, and endothelial cells after corneal transplantation in humans. METHODS: Fifty-two transplanted corneal buttons were explanted over a 2-year period from patients who required regrafting and had received corneas from donors of opposite sex. Fluorescence in situ hybridization of the sex chromosomes of the epithelial, stromal, and endothelial cells was performed in histologic sections prepared from each freshly explanted graft. Fluorescence microscopy was subsequently used to determine the origin of cells in the graft (donor or recipient) and to quantify the relative proportion of donor and recipient cells of each corneal cell type. RESULTS: As early as 3 months after transplantation, donor epithelial cells were completely replaced by recipient epithelium in all corneal buttons examined. Donor stromal and endothelial cells, however, were found in all 52 buttons, with 4% to 95% of stromal cells and 6% to 95% of endothelial cells being of donor origin. No significant correlation between donor cell proportion and the age of the graft could be found. Donor-derived cells were found in significant numbers up to 32 years after transplantation. Eight corneas in this study were transparent, compensated grafts, and a similar long-term survival of donor stromal and endothelial cells was found in these cases. CONCLUSIONS: Although donor epithelial cells are promptly replaced, a high proportion of donor stromal and endothelial cells can survive within the corneal transplant in the long-term. The proportion of surviving donor cells is highly variable; however, the source of this variability remains unknown.
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| 14. |
- Li, Xiujuan, et al.
(författare)
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Suppressed Vascular Leakage and Myocardial Edema Improve Outcome From Myocardial Infarction
- 2020
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Ingår i: Frontiers in Physiology. - : Frontiers Media SA. - 1664-042X. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The acute phase of myocardial infarction (MI) is accompanied by edema contributing to tissue damage and disease outcome. Here, we aimed to identify the mechanism whereby vascular endothelial growth factor (VEGF)-A induces myocardial edema in the acute phase of MI to eventually promote development of therapeutics to specifically suppress VEGFA-regulated vascular permeability while preserving collateral vessel formation.Methods and Results: VEGFA regulates vascular permeability and edema by activation of VEGF receptor-2 (VEGFR2), leading to induction of several signaling pathways including the cytoplasmic tyrosine kinase c-Src. The activated c-Src in turn phosphorylates vascular endothelial (VE)-cadherin, leading to dissociation of endothelial adherens junctions. A particular tyrosine at position 949 in mouse VEGFR2 has been shown to be required for activation of c-Src. Wild-type mice and mice with phenylalanine replacing tyrosine (Y) 949 in VEGFR2 (Vegfr2Y949F/Y949F) were challenged with MI through permanent ligation of the left anterior descending coronary artery. The infarct size was similar in wild-type and mutant mice, but left ventricular wall edema and fibrinogen deposition, indicative of vascular leakage, were reduced in the Vegfr2Y949F/Y949F strain. When challenged with large infarcts, the Vegfr2Y949F/Y949F mice survived significantly better than the wild-type strain. Moreover, neutrophil infiltration and levels of myeloperoxidase were low in the infarcted Vegfr2Y949F/Y949F hearts, correlating with improved survival. In vivo tyrosine phosphorylation of VE-cadherin at Y685, implicated in regulation of vascular permeability, was induced by circulating VEGFA in the wild-type but remained at baseline levels in the Vegfr2Y949F/Y949F hearts.Conclusion: Suppression of VEGFA/VEGFR2-regulated vascular permeability leads to diminished edema without affecting vascular density correlating with improved myocardial parameters and survival after MI.
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| 15. |
- Maeso-Alonso, Laura, et al.
(författare)
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p73 is required for vessel integrity controlling endothelial junctional dynamics through Angiomotin
- 2022
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Ingår i: Cellular and Molecular Life Sciences (CMLS). - : Springer Nature. - 1420-682X .- 1420-9071. ; 79:10
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Tidskriftsartikel (refereegranskat)abstract
- Preservation of blood vessel integrity, which is critical for normal physiology and organ function, is controlled at multiple levels, including endothelial junctions. However, the mechanism that controls the adequate assembly of endothelial cell junctions is not fully defined. Here, we uncover TAp73 transcription factor as a vascular architect that orchestrates transcriptional programs involved in cell junction establishment and developmental blood vessel morphogenesis and identify Angiomotin (AMOT) as a TAp73 direct transcriptional target. Knockdown of p73 in endothelial cells not only results in decreased Angiomotin expression and localization at intercellular junctions, but also affects its downstream function regarding Yes-associated protein (YAP) cytoplasmic sequestration upon cell-cell contact. Analysis of adherens junctional morphology after p73-knockdown in human endothelial cells revealed striking alterations, particularly a sharp increase in serrated junctions and actin bundles appearing as stress fibers, both features associated with enhanced barrier permeability. In turn, stabilization of Angiomotin levels rescued those junctional defects, confirming that TAp73 controls endothelial junction dynamics, at least in part, through the regulation of Angiomotin. The observed defects in monolayer integrity were linked to hyperpermeability and reduced transendothelial electric resistance. Moreover, p73-knockout retinas showed a defective sprout morphology coupled with hemorrhages, highlighting the physiological relevance of p73 regulation in the maintenance of vessel integrity in vivo. We propose a new model in which TAp73 acts as a vascular architect integrating transcriptional programs that will impinge with Angiomotin/YAP signaling to maintain junctional dynamics and integrity, while balancing endothelial cell rearrangements in angiogenic vessels.
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| 16. |
- Potapenko, Ivan O., et al.
(författare)
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Donor Endothelial Cell Count Does Not Correlate With Descemet Stripping Automated Endothelial Keratoplasty Transplant Survival After 2 Years of Follow-up
- 2017
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Ingår i: Cornea. - : Lippincott Williams & Wilkins. - 0277-3740 .- 1536-4798. ; 36:6, s. 649-654
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To analyze the influence of low endothelial cell density (ECD) of donor cornea tissue, donor age, and sex on the transplant survival rate after Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: Graft ECD, age, and sex of donors used for DSAEK (n = 1789) during 7 years (2007-2014) in 4 Scandinavian hospitals were assessed for potential association with transplant survival at 2 years of follow-up using a Cox regression model correcting for confounding factors. The data were obtained from The Swedish Cornea Transplant Registry. Results: Transplant failure occurred in 196 patients, with 69 early failures during the first 3 postoperative months, and 127 late secondary failures. Twenty-five of the late secondary failures were due to rejection. Reversible rejections occurred in 67 patients. There was no significant impact of donor age [hazard ratio (HR) 1.0, 95% confidence interval (CI), 0.99-1.02, P = 0.32] or endothelial cell count (HR 1.00, 95% CI, 0.99-1.01, P = 0.3) on the survival rate of DSAEK transplants at 2 years of follow-up. The use of donor grafts with low ECD (, 2300 cells/mm(2)) did not influence the survival rate (HR 1.3, 95% CI, 0.76-2.35, P = 0.31). Male donor sex was associated with lower 2-year graft survival (HR 1.5, 95% CI, 1.042.28, P = 0.03), but not with rejection events (P = 0.26). Conclusions: Based on data from The Swedish Cornea Transplant Registry, low donor ECD was not detrimental to graft survival, whereas donor sex seemed to influence the outcome at the end of the 2-year follow-up.
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| 17. |
- Sjöblom, Yvonne, 1952-
(författare)
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På väg ut : När ungdomar rymmer och kastas ut hemifrån - ur socialtjänstens perspektiv
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to discover and understand how caseworkers in the social services view and present the phenomenon of young people who run away from and/or are thrown out of their homes. What images of these young people do they entertain and how do they articulate their work with this group?The data were collected through 20 qualitative group interviews with caseworkers who in 1997 were working with young people between the ages of 12 and 20 at Individual and Family Care sections in all the social districts of Stockholm Municipality. Simultaneously, a quantitative background study of 96 problem cases was also conducted. Following analysis of the initial group interviews, two of these were chosen for detailed case study. To provide a complementary perspective, the thesis also contains two case studies of accounts of running away/being thrown out from a runaway’s and a parents’ respective points of view.Leaving home in this way is seen to be more common among girls than among boys and the most usual cause a problematic family situation with elements of violence, assault, and substance abuse. A particularly vulnerable group is girls in immigrant families who are exposed to authoritarian upbringing and often suffer rough treatment. Dominant among these young people’s own individual problems is difficulty in school. Other problem areas mentioned are substance abuse, truant behaviour, staying out late and sexual promiscuity. A small number of runaways were able to return home after counselling; but the conditions leading to running away/being thrown out were described by the welfare workers as complex, and accounts of the same situation given by parents and runaways often differed widely.The caseworkers’ view of the phenomenon is informed by a relationship and family oriented perspective, where the paramount goal is “working home” the runaways/thrown outs and restoring them to the bosom of their families. When that avenue has failed, as often was the case, the alternative is to place them in family homes or institutions. Running away and being thrown out are seen as deviant attempts at accomplishing the process of separation from parents that is normal at this stage. In the case of girls of immigrant background who run away/get thrown out of their homes, the tendency is to explain the phenomenon as a ‘culture collision’ between incompatible value systems and traditions. When young people and even the parents come to the social services needing practical help with accommodation and economic support so that the children can leave home, the caseworkers described this as presenting a dilemma.The main technique relied upon by the caseworkers is counselling intended to lead to reconciliation between children and their parents. The thesis discusses the importance and consequences for these youth in their development towards adulthood of the lack of a young people’s perspective within the social services and the emphasis on the sanctity of the family. A clear contradiction lies in the fact that while the youth units have been established expressly for the purpose of helping young people, a social services dominated by a family perspective with the aim of reintegrating runaways into their often dysfunctional families takes on a mainly controlling and disciplinary role, where the young people’s individual survival strategies are not paid attention to or taken seriously.
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| 18. |
- Skelton, Alasdair, et al.
(författare)
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Hydrochemical Changes Before and After Earthquakes Based on Long-Term Measurements of Multiple Parameters at Two Sites in Northern IcelandA Review
- 2019
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Ingår i: Journal of Geophysical Research - Solid Earth. - 2169-9313 .- 2169-9356. ; 124:3, s. 2702-2720
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Forskningsöversikt (refereegranskat)abstract
- Hydrochemical changes before and after earthquakes have been reported for over 50years. However, few reports provide sufficient data for an association to be verified statistically. Also, no mechanism has been proposed to explain why hydrochemical changes are observed far from earthquake foci where associated strains are small (<10(-8)). Here we address these challenges based on time series of multiple hydrochemical parameters from two sites in northern Iceland. We report hydrochemical changes before and after M >5 earthquakes in 2002, 2012, and 2013. The longevity of the time series (10 and 16years) permits statistical verification of coupling between hydrochemical changes and earthquakes. We used a Student t test to find significant hydrochemical changes and a binomial test to confirm association with earthquakes. Probable association was confirmed for preseismic changes based on five parameters (Na, Si, K, O-18, and H-2) and postseismic changes based on eight parameters (Ca, Na, Si, Cl, F, SO4, O-18, and H-2). Using concentration ratios and stable isotope values, we showed that (1) gradual preseismic changes were caused by source mixing, which resulted in a shift from equilibrium and triggered water-rock interaction; (2) postseismic changes were caused by rapid source mixing; and (3) longer-term hydrochemical changes were caused by source mixing and mineral growth. Because hydrochemical changes occur at small earthquake-related strains, we attribute source mixing and water-rock interaction to microscale fracturing. Because fracture density and size scale inversely, we infer that mixing of nearby sources and water-rock interaction are feasible responses to small earthquake-related strains. Plain Language Summary Changes in groundwater chemistry before and after earthquakes have been reported for over 50years. However, few studies have been able to prove that the earthquakes caused these changes. Also, no study has explained why these changes are often reported far from where the earthquake occurred. Here we address these challenges based on measurements of groundwater chemistry made at two sites in northern Iceland over time periods of 10 and 16years. We used statistical methods to prove that the earthquakes caused changes of ground water chemistry both before and after the earthquakes. We showed that changes of groundwater chemistry before earthquakes were caused by slow mixing between different groundwaters, which triggered reactions with the wall rock that changed groundwater chemistry, and that changes of groundwater chemistry after earthquakes were causes by rapid mixing between different groundwaters. That these changes were detected far from where the earthquakes occurred suggests that cracking of the wall rock at a very small scale was all that was needed for mixing of different groundwaters and reactions with the wall rock to occur.
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| 19. |
- Viberg, Andreas, et al.
(författare)
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Incidence of corneal transplantation after phacoemulsification in patients with corneal guttata : a registry-based cohort study
- 2020
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Ingår i: Journal of cataract and refractive surgery. - : Lippincott Williams & Wilkins. - 0886-3350 .- 1873-4502. ; 46:7, s. 961-966
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the risk for corneal transplantation after phacoemulsification related to corneal guttata.Setting: Forty-nine Swedish cataract surgical units and 7 Swedish cornea transplantation units.Design: Registry-based cohort study.Methods: Patient data from the Swedish National Cataract Registry between 2010 and 2012 were linked with data from the Swedish Cornea Transplant Registry between 2010 and September 2017. Data from cataract patients were linked with data from patients who underwent corneal transplantation because of endothelial failure. Triple procedures and other surgical methods for cataract extraction other than phacoemulsification were excluded. If both eyes had surgery, 1 eye was randomly selected from the registry to obtain unrelated samples. The incidence was calculated per 10 000 person years, and Poisson regression analysis was used to investigate the risk for corneal transplantation because of endothelial failure after phacoemulsification.Results: Altogether, data from 276 362 cataract patients were linked with data from 2091 patients who underwent corneal transplantation. The incidence rate of corneal transplantation after phacoemulsification among patients with corneal guttata was 88 per 10 000 person years (95% CI, 74.5-103.1). The annual incidence rate was highest within the first year and diminished thereafter. The incidence rate of corneal transplantation among patients without corneal guttata was 1.4 per 10 000 person years (95% CI, 1.2-1.6). Phacoemulsification in patients with corneal guttata was associated with corneal transplantation with an adjusted relative risk of 68.2 (95% CI, 54.0-86.2).Conclusions: The relative risk for corneal transplantation after phacoemulsification was 68.2 times higher for patients with corneal guttata than that for those without. Still, most of the patients with corneal guttata did not undergo corneal transplantation during the study period.
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| 20. |
- Viberg, Andreas, et al.
(författare)
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Risk of corneal transplantation after phacoemulsification in patients with cornea guttata
- 2019
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Ingår i: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 97:S263
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: To investigate the risk of corneal transplantation after phacoemulsification related to cornea guttata.Methods: In this retrospective registry‐based cohort study, patient data from the Swedish National Cataract Register for years 2010‐2012 were linked with data from the Swedish Cornea Transplant Register for years 2010‐2017. Altogether, data from 276,354 cataract patients was linked with data from 2,091 patients with primary and secondary endothelial failure as indication for corneal transplantation. Other surgical methods for cataract extraction than phacoemulsification were excluded. If both eyes had surgery, one eye was randomly selected to obtain unrelated samples. A Kaplan‐Meier curve and Cox regression analysis were used to investigate the risk for corneal transplantation due to endothelial failure after phacoemulsification.Results: Out of the 3,346 phacoemulsification patients with cornea guttata, 153 underwent corneal transplantation within 6.2 years in median. The cumulative transplantation rate, 6 years after the phacoemulsification was 4.8% in the group with cornea guttata and 0.08% in the group without. The annual transplantation rate among the cornea guttata patients during the first year was 1.64% and diminished the following 5 years to 0.55% in average. The annual transplantation rate among the patients without cornea guttata was 0.01% in average after phacoemulsification during the same period of time. The transplantation hazard ratio for cornea guttata present at the phacoemulsification was 67.6 (95% CI: 53.6.0‐85.3, p < 0.001), when adjusting for potential confounders.Conclusions: The hazard of corneal transplantation after phacoemulsification was 67.6 times higher with cornea guttata than without. Still, the great majority of the patients with cornea guttata did not undergo corneal transplantation during the study period.
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| 21. |
- Wonneberger, Wolf, 1976, et al.
(författare)
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Genetic variants in the FOXO1 and ZNF469 genes are associated with keratoconus in Sweden: a case-control study
- 2024
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Ingår i: BMC OPHTHALMOLOGY. - 1471-2415. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Keratoconus (KC) is characterized by pathological thinning and bulging of the cornea that may lead to visual impairment. The etiology of sporadic KC remains enigmatic despite intensive research in recent decades. The purpose of this study was to examine the relationship between previously highlighted genetic variants associated with KC and sporadic KC in a Swedish cohort. Methods A total of 176 patients (age 16-70 years) with sporadic KC diagnosed by Scheimpflug-topography (Pentacam) were included. The control group (n = 418; age 70 years) was a subsample originating from the Gothenburg H70 Birth Cohort Studies of ageing. Extraction of DNA from blood samples was performed according to standard procedures, and genotyping was performed using competitive allele specific PCR (KASP) technology. A total of 11 single nucleotide polymorphisms (SNPs) were selected for analysis. Results Statistically significant associations (p = 0.005) were found between the SNPs rs2721051 and rs9938149 and sporadic KC. These results replicate earlier research that found associations between genetic variants in the FOXO1 and BANP-ZNF469 genes and sporadic KC in other populations. ConclusionGenetic variations in the FOXO1 and BANP-ZNF469 genes may be involved in the pathogenesis of sporadic KC.
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| 22. |
- Wonneberger, Wolf, 1976, et al.
(författare)
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Repeated Same-Day Versus Single Tomography Measurements of Keratoconic Eyes for Analysis of Disease Progression.
- 2018
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Ingår i: Cornea. - 1536-4798. ; 37:4, s. 474-479
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Tidskriftsartikel (refereegranskat)abstract
- Corneal tomography is used to assess progression of keratoconus and to direct clinical decisions regarding corneal cross-linking. The purpose of this study was to analyze the variability of repeated Scheimpflug-tomography (Pentacam Classic; Oculus, Wetzlar, Germany) measurements of keratoconic eyes in a clinical setting and to assess the validity of such measurements as a clinical decision-making tool.Eighty keratoconic eyes of 45 patients (age range 16-32 years) were examined at baseline and after follow-up periods of 3 to 6 months using 3 consecutive tomography measurements at each visit. Minimum corneal thickness and anterior sagittal curvature map parameters were studied [simulated keratometry (K) astigmatism (SimKast); maximum simulated K-reading (SimKmax); average SimK (SimKave); maximum K-readings on the 3-mm (Kmax3) and 5-mm (Kmax5) rings; and maximum K-reading (Kmax)].When comparing the first measurements at the first and second visits, respectively, 9% to 20% of eyes were classified as progressive depending on which parameter was chosen. Using the average of 3 consecutive measurements at each visit, 5% to 19% of eyes were classified as progressive. An increase in the SD of 3 consecutive measurements of SimKast (SD_SimKast) at the first visit of 1 diopter makes true progression of keratoconus 3.6 times more likely (odds ratio = 3.6; 95% confidence interval: 0.846-16.027; area under the curve = 0.70).The approach used to analyze progression in keratoconus, that is, single versus repeated measurements, may confer a great impact on the decision to perform corneal cross-linking treatment or not.
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| 23. |
- Wonneberger, Wolf, et al.
(författare)
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Repeated Same-Day Versus Single Tomography Measurements of Keratoconic Eyes for Analysis of Disease Progression
- 2018
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Ingår i: Cornea. - : Wolters Kluwer. - 0277-3740 .- 1536-4798. ; 37:4, s. 474-479
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:Corneal tomography is used to assess progression of keratoconus and to direct clinical decisions regarding corneal cross-linking. The purpose of this study was to analyze the variability of repeated Scheimpflug-tomography (Pentacam Classic; Oculus, Wetzlar, Germany) measurements of keratoconic eyes in a clinical setting and to assess the validity of such measurements as a clinical decision-making tool.Methods:Eighty keratoconic eyes of 45 patients (age range 16-32 years) were examined at baseline and after follow-up periods of 3 to 6 months using 3 consecutive tomography measurements at each visit. Minimum corneal thickness and anterior sagittal curvature map parameters were studied [simulated keratometry (K) astigmatism (SimKast); maximum simulated K-reading (SimKmax); average SimK (SimKave); maximum K-readings on the 3-mm (Kmax3) and 5-mm (Kmax5) rings; and maximum K-reading (Kmax)].Results:When comparing the first measurements at the first and second visits, respectively, 9% to 20% of eyes were classified as progressive depending on which parameter was chosen. Using the average of 3 consecutive measurements at each visit, 5% to 19% of eyes were classified as progressive. An increase in the SD of 3 consecutive measurements of SimKast (SD_SimKast) at the first visit of 1 diopter makes true progression of keratoconus 3.6 times more likely (odds ratio = 3.6; 95% confidence interval: 0.846-16.027; area under the curve = 0.70).Conclusions:The approach used to analyze progression in keratoconus, that is, single versus repeated measurements, may confer a great impact on the decision to perform corneal cross-linking treatment or not.
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| 24. |
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| 25. |
- Wästeby, N., et al.
(författare)
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Hydrochemical monitoring, petrological observation, and geochemical modeling of fault healing after an earthquake
- 2014
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Ingår i: Journal of Geophysical Research - Solid Earth. - 0148-0227 .- 2156-2202 .- 2169-9313 .- 2169-9356. ; 119:7, s. 5727-5740
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Tidskriftsartikel (refereegranskat)abstract
- Based on hydrochemical monitoring, petrological observations, and geochemical modeling, we identify a mechanism and estimate a time scale for fault healing after an earthquake. Hydrochemical monitoring of groundwater samples from an aquifer, which is at an approximate depth of 1200m, was conducted over a period of 10years. Groundwater samples have been taken from a borehole (HU-01) that crosses the Húsavík-Flatey Fault (HFF) near Húsavík town, northern Iceland. After 10weeks of sampling, on 16 September 2002, an M 5.8 earthquake occurred on the Grimsey Lineament, which is approximately parallel to the HFF. This earthquake caused rupturing of a hydrological barrier resulting in an influx of groundwater from a second aquifer, which was recorded by 15–20% concentration increases for some cations and anions. This was followed by hydrochemical recovery. Based on petrological observations of tectonically exhumed fault rocks, we conclude that hydrochemical recovery recorded fault healing by precipitation of secondary minerals along fractures. Because hydrochemical recovery accelerated with time, we conclude that the growth rate of these minerals was controlled by reaction rates at mineral-water interfaces. Geochemical modeling confirmed that the secondary minerals which formed along fractures were saturated in the sampled groundwater. Fault healing and therefore hydrochemical recovery was periodically interrupted by refracturing events. Supported by field and petrographic evidence, we conclude that these events were caused by changes of fluid pressure probably coupled with earthquakes. These events became successively smaller as groundwater flux decreased with time. Despite refracturing, hydrochemical recovery reached completion 8–10years after the earthquake.
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