| 1. |
- Alijagic, Andi, 1992-, et al.
(författare)
-
A Novel Nanosafety Approach Using Cell Painting, Metabolomics, and Lipidomics Captures the Cellular and Molecular Phenotypes Induced by the Unintentionally Formed Metal-Based (Nano)Particles
- 2023
-
Ingår i: Cells. - : MDPI. - 2073-4409. ; 12:2
-
Tidskriftsartikel (refereegranskat)abstract
- Additive manufacturing (AM) or industrial 3D printing uses cutting-edge technologies and materials to produce a variety of complex products. However, the effects of the unintentionally emitted AM (nano)particles (AMPs) on human cells following inhalation, require further investigations. The physicochemical characterization of the AMPs, extracted from the filter of a Laser Powder Bed Fusion (L-PBF) 3D printer of iron-based materials, disclosed their complexity, in terms of size, shape, and chemistry. Cell Painting, a high-content screening (HCS) assay, was used to detect the subtle morphological changes elicited by the AMPs at the single cell resolution. The profiling of the cell morphological phenotypes, disclosed prominent concentration-dependent effects on the cytoskeleton, mitochondria, and the membranous structures of the cell. Furthermore, lipidomics confirmed that the AMPs induced the extensive membrane remodeling in the lung epithelial and macrophage co-culture cell model. To further elucidate the biological mechanisms of action, the targeted metabolomics unveiled several inflammation-related metabolites regulating the cell response to the AMP exposure. Overall, the AMP exposure led to the internalization, oxidative stress, cytoskeleton disruption, mitochondrial activation, membrane remodeling, and metabolic reprogramming of the lung epithelial cells and macrophages. We propose the approach of integrating Cell Painting with metabolomics and lipidomics, as an advanced nanosafety methodology, increasing the ability to capture the cellular and molecular phenotypes and the relevant biological mechanisms to the (nano)particle exposure.
|
|
| 2. |
- Alijagic, Andi, 1992-, et al.
(författare)
-
Particle Safety Assessment in Additive Manufacturing : From Exposure Risks to Advanced Toxicology Testing.
- 2022
-
Ingår i: Frontiers in Toxicology. - : Frontiers Media S.A.. - 2673-3080. ; 4
-
Forskningsöversikt (refereegranskat)abstract
- Additive manufacturing (AM) or industrial three-dimensional (3D) printing drives a new spectrum of design and production possibilities; pushing the boundaries both in the application by production of sophisticated products as well as the development of next-generation materials. AM technologies apply a diversity of feedstocks, including plastic, metallic, and ceramic particle powders with distinct size, shape, and surface chemistry. In addition, powders are often reused, which may change the particles' physicochemical properties and by that alter their toxic potential. The AM production technology commonly relies on a laser or electron beam to selectively melt or sinter particle powders. Large energy input on feedstock powders generates several byproducts, including varying amounts of virgin microparticles, nanoparticles, spatter, and volatile chemicals that are emitted in the working environment; throughout the production and processing phases. The micro and nanoscale size may enable particles to interact with and to cross biological barriers, which could, in turn, give rise to unexpected adverse outcomes, including inflammation, oxidative stress, activation of signaling pathways, genotoxicity, and carcinogenicity. Another important aspect of AM-associated risks is emission/leakage of mono- and oligomers due to polymer breakdown and high temperature transformation of chemicals from polymeric particles, both during production, use, and in vivo, including in target cells. These chemicals are potential inducers of direct toxicity, genotoxicity, and endocrine disruption. Nevertheless, understanding whether AM particle powders and their byproducts may exert adverse effects in humans is largely lacking and urges comprehensive safety assessment across the entire AM lifecycle-spanning from virgin and reused to airborne particles. Therefore, this review will detail: 1) brief overview of the AM feedstock powders, impact of reuse on particle physicochemical properties, main exposure pathways and protective measures in AM industry, 2) role of particle biological identity and key toxicological endpoints in the particle safety assessment, and 3) next-generation toxicology approaches in nanosafety for safety assessment in AM. Altogether, the proposed testing approach will enable a deeper understanding of existing and emerging particle and chemical safety challenges and provide a strategy for the development of cutting-edge methodologies for hazard identification and risk assessment in the AM industry.
|
|
| 3. |
- Beck-Friis, Thomas, et al.
(författare)
-
Burden of rotavirus infection in hospitalized elderly individuals prior to the introduction of rotavirus vaccination in Sweden
- 2019
-
Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532. ; 119, s. 1-5
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Rotavirus gastroenteritis (GE) in the elderly has been much less studied than in children. Objectives: The aim of this study was to determine the morbidity and mortality for elderly hospitalized patients with rotavirus GE prior to the introduction of rotavirus vaccination in Sweden, and to investigate the epidemiology of rotavirus genotypes in these patients. Study design: All patients 60 years or older who were hospitalized at Sahlgrenska University Hospital, Gothenburg, Sweden, and were rotavirus positive in a clinical diagnostic test from 2009 to 2016, were included. Medical records were reviewed and rotavirus genotyping real-time PCR was performed. Results: One hundred and fifty-nine patients were included, corresponding to an annual incidence of hospitalization due to rotavirus GE of 16/100 000 inhabitants aged 60 years or older. G2P[4] was the most common genotype, followed by G1P[8] and G4P[8]. The majority of patients had community-onset of symptoms and no or few pre-existing health disorders. Four patients (2.5%) died within 30 days of sampling. Patients with hospital-onset rotavirus GE had a longer median length of stay following diagnosis compared with patients with community-onset of symptoms (19 vs. 5 days, p = 0.001) and higher 30-day mortality (8.6% (3/35) vs. < 1% (1/124), p = 0.03). Conclusions: Hospitalization due to rotavirus GE among the elderly seems to mainly affect otherwise healthy individuals and is associated with low 30-day mortality.
|
|
| 4. |
- Edén, Arvid, 1975, et al.
(författare)
-
Differential effects of efavirenz, lopinavir/r, and atazanavir/r on the initial viral decay rate in treatment naïve HIV-1-infected patients.
- 2010
-
Ingår i: AIDS research and human retroviruses. - : Mary Ann Liebert Inc. - 1931-8405 .- 0889-2229. ; 26:5, s. 533-40
-
Tidskriftsartikel (refereegranskat)abstract
- Initial viral decay rate may be useful when comparing the relative potency of antiretroviral regimens. Two hundred twenty-seven ART-naïve patients were randomized to receive efavirenz (EFV) (n = 74), lopinavir/ritonavir (LPV/r) (n = 77), or atazanavir/ritonavir (ATV/r) (n = 79) in combination with two NRTIs. The most frequently used NRTI combinations in the EFV and ATV/r groups were the nonthymidine analogues tenofovir and emtricitabine or lamivudine (70% and 68%, respectively) and, in the LPV/r group, lamivudine and the thymidine analogue zidovudine (89%). HIV-1 RNA was monitored during the first 28 days after treatment initiation. Phase 1 and 2 decay rate was estimated in a subset of 157 patients by RNA decrease from days 0 to 7, and days 14 to 28. One-way ANOVA and subsequent Tukey's post hoc tests were used for groupwise comparisons. Mean (95% CI) HIV-1 RNA reductions from days 0 to 28 were 2.59 (2.45-2.73), 2.42 (2.27-2.57), and 2.13 (2.01-2.25) log(10) copies/ml for the EFV-, LPV/r-, and ATV/r-based treatment groups, respectively, with a significantly larger decrease in the EFV-based group at all time points compared with ATV/r (p < 0.0001), and with LPV/r at days 7-21 (p < 0.0001-0.03). LPV/r gave a greater RNA decrease compared with ATV/r from day 14 (p = 0.02). Phase 1 decay rate was significantly higher in the EFV group compared with LPV/r (p = 0.003) or ATV/r (p < 0.0001). No difference was found in phase 2 decrease. EFV-based treatment gave a more rapid decline in HIV-1 RNA than did either of the boosted protease inhibitor-based regimens. The observed differences may reflect different inherent regimen potencies.
|
|
| 5. |
- Gustavsson, Lars, et al.
(författare)
-
Venous lactate levels can be used to identify patients with poor outcome following community-onset norovirus enteritis
- 2012
-
Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 44:10, s. 782-787
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Norovirus enteritis (NVE) can be fatal in frail patients. High blood lactate levels indicate hypoperfusion and predict mortality in many infectious diseases. The objective was to determine the frequency and association with mortality of elevated lactate levels in patients with community-onset NVE. Methods: A retrospective cohort study was performed. All hospitalized adult patients with community-onset NVE verified by polymerase chain reaction during the period August 2008 to June 2009 were included. Vital signs and venous lactate on arrival, co-morbid conditions, and time of death were registered. The outcome measure was 30-day all-cause mortality. Results: Eighty-two patients with a median age of 77 y (interquartile range (IQR) 53-86 y) were included, of whom 47 (57%) were female and 49 (60%) had at least 1 major co-morbid condition. Lactate levels were above the upper limit of normal (ULN; 1.6 mmol/l) in 45 patients (55%). The overall 30-day mortality rate was 7% (6/82). Mortality was 18% (5/28) with lactate >= 2.4 mmol/l (> 50% above the ULN) on admission compared to 2% (1/54) with lactate < 2.4 mmol/l (p < 0.05). Patients who died had a higher median lactate level compared to survivors: 4.5 (IQR 2.7-7.9) mmol/l vs 1.7 (IQR 1.3-2.5) mmol/l, respectively (p < 0.01). The adjusted odds ratio for death within 30 days for a 1 mmol/l increase in lactate was 2.5 (95% confidence interval 1.003-6.3, p = 0.049). Conclusions: We observed a high proportion of patients with elevated lactate levels in community-onset NVE. Lactate elevation could predict mortality. Measurement of blood lactate may be a valuable tool in the clinical management of patients with a suspected norovirus infection.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Sundell, Nicklas, et al.
(författare)
-
Measles outbreak in Gothenburg urban area, Sweden, 2017 to 2018: low viral load in breakthrough infections
- 2019
-
Ingår i: Eurosurveillance. - 1560-7917. ; 24:17, s. 2-12
-
Tidskriftsartikel (refereegranskat)abstract
- In an outbreak of measles in Gothenburg, Sweden, breakthrough infections (i.e. infections in individuals with a history of vaccination) were common. The objective of this study was to compare measles RNA levels between naive (i.e. primary) and breakthrough infections. We also propose a fast provisional classification of breakthrough infections. Medical records were reviewed and real-time PCR-positive samples geno-typed. Cases were classified as naive, break-through or vaccine infections. We compared clinical symptoms and measles RNA cycle threshold (Ct) values between breakthrough and naive infections. Sixteen of 28 confirmed cases of measles in this outbreak were breakthrough infections. A fast provisional classification, based on previous history of measles vaccination and detectable levels of measles IgG in acute serum, correctly identified 14 of the 16 breakthrough infections, confirmed by IgG avidity testing. Measles viral load was significantly lower in nasopharyngeal samples from individuals with breakthrough compared with naive infections (median Ct-values: 32 and 19, respectively, p < 0.0001). No onward transmission from break-through infections was identified. Our results indicate that a high risk of onward transmission is limited to naive infections. We propose a fast provisional classification of breakthrough measles that can guide contact tracing in outbreak settings.
|
|
| 9. |
- Sundell, Nicklas, et al.
(författare)
-
PCR detection of respiratory pathogens in asymptomatic and symptomatic adults.
- 2019
-
Ingår i: Journal of clinical microbiology. - 1098-660X. ; 57:1
-
Tidskriftsartikel (refereegranskat)abstract
- The frequency of viral respiratory pathogens in asymptomatic subjects is poorly defined. The aim of this study was to explore the prevalence of respiratory pathogens in the upper airways of asymptomatic adults, as compared with a reference population of symptomatic patients sampled in the same centres during the same period. Nasopharyngeal (NP) swab samples were prospectively collected from adults with and without ongoing symptoms of respiratory tract infection (RTI) during 12 consecutive months, in primary care centres as well as hospital emergency departments, and analysed for respiratory pathogens by a PCR panel detecting 16 viruses and four bacteria. Altogether, 444 asymptomatic and 75 symptomatic subjects completed sampling as well as follow-up (FU) at day 7. In the asymptomatic subjects the detection rate of viruses was low (4.3%) and the most common virus detected was rhinovirus (3.2%). Streptococcus pneumoniae was found in 5.6% of the asymptomatic subjects and Haemophilus influenzae in 1.4%. The only factor independently associated with low viral detection rate in asymptomatic subjects was age ≥65 (p=0.04). An increased detection rate of bacteria was seen in asymptomatic subjects who were currently smoking (p<0.01) and who had any chronical condition (p<0.01). We conclude that detection of respiratory viruses in asymptomatic adults is uncommon, suggesting that a positive PCR result from a symptomatic patient likely is relevant for ongoing respiratory symptoms. Age influences the likelihood of virus detection among asymptomatic adults and smoking as well as co-morbidity may increase the prevalence of bacterial pathogens in the upper airways.
|
|
| 10. |
- Zhang, Renyun, et al.
(författare)
-
Soap-film coating : High-speed deposition of multilayer nanofilms
- 2013
-
Ingår i: Scientific Reports. - Nature Publishing Group : Springer Science and Business Media LLC. - 2045-2322. ; 3, s. Art. no. 1477-
-
Tidskriftsartikel (refereegranskat)abstract
- The coating of thin films is applied in numerous fields and many methods are employed for the deposition of these films. Some coating techniques may deposit films at high speed; for example, ordinary printing paper is coated with micrometre-thick layers of clay at a speed of tens of meters per second. However, to coat nanometre thin films at high speed, vacuum techniques are typically required, which increases the complexity of the process. Here, we report a simple wet chemical method for the high-speed coating of films with thicknesses at the nanometre level. This soap-film coating technique is based on forcing a substrate through a soap film that contains nanomaterials. Molecules and nanomaterials can be deposited at a thickness ranging from less than a monolayer to several layers at speeds up to meters per second. We believe that the soap-film coating method is potentially important for industrial-scale nanotechnology.
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Andersson, Niklas, 1970, et al.
(författare)
-
A variant near the interleukin-6 gene is associated with fat mass in Caucasian men
- 2010
-
Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 34:6, s. 1011-9
-
Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Regulation of fat mass appears to be associated with immune functions. Studies of knockout mice show that endogenous interleukin (IL)-6 can suppress mature-onset obesity. OBJECTIVE: To systematically investigate associations of single nucleotide polymorphisms (SNPs) near the IL-6 (IL6) and IL-6 receptor (IL6R) genes with body fat mass, in support for our hypothesis that variants of these genes can be associated with obesity. DESIGN AND STUDY SUBJECTS: The Gothenburg Osteoporosis and Obesity Determinants (GOOD) study is a population-based cross-sectional study of 18- to 20-year-old men (n=1049), from the Gothenburg area (Sweden). Major findings were confirmed in two additional cohorts consisting of elderly men from the Osteoporotic Fractures in Men (MrOS) Sweden (n=2851) and MrOS US (n=5611) multicenter population-based studies. MAIN OUTCOME: The genotype distributions and their association with fat mass in different compartments, measured with dual-energy X-ray absorptiometry. RESULTS: Out of 18 evaluated tag SNPs near the IL6 and IL6R genes, a recently identified SNP rs10242595 G/A (minor allele frequency=29%) 3' of the IL6 gene was negatively associated with the primary outcome total body fat mass (effect size -0.11 standard deviation (s.d.) units per A allele, P=0.02). This negative association with fat mass was also confirmed in the combined MrOS Sweden and MrOS US cohorts (effect size -0.05 s.d. units per A allele, P=0.002). When all three cohorts were combined (n=8927, Caucasian subjects), rs10242595(*)A showed a negative association with total body fat mass (effect size -0.05 s.d. units per A allele, P<0.0002). Furthermore, the rs10242595(*)A was associated with low body mass index (effect size -0.03, P<0.001) and smaller regional fat masses. None of the other SNPs investigated in the GOOD study were reproducibly associated with body fat. CONCLUSIONS: The IL6 gene polymorphism rs10242595(*)A is associated with decreased fat mass in three combined cohorts of 8927 Caucasian men.
|
|
| 14. |
- Andersson, Urban, 1965, et al.
(författare)
-
Research.chalmers.se : building the next generation research information infrastructure at Chalmers University of Technology
- 2016
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- research.chalmers.se is the new research infrastructure - repository platform and CRIS - that is currently being developed by the library at Chalmers University of Technology, Sweden.With the aim of eventually becoming the place for all relevant research information at the university, and built in accordance with the principles of UX (User eXperience) and agile development (SCRUM) and with a steady focus on value and continuous deliveries, research.chalmers.se is set to replace most of the current research information infrastructure at the university. It will provide new services for collecting, curating and providing quality data, as well as tools for analysis, sharing and promotion of research output by new and up-to-date means.research.chalmers.se is (or will be)- creating and preserving values - research output and data repository with qualitativedata, researcher profiles, open access.- promoting open access publishing, by proving the value of knowledge sharing, visibilityand impact as a researcher.- collecting and curating all kinds of research information, including publications,research data and information about research projects and other research activities.- built with responsive design that is adapted to current user needs. - using current standards for validity and sustainability, such as ORCID, DOI andFundRef IDs.- providing new ways of exploring and analyzing data, such as altmetrics, open APIs andvisualization tools.In the first phase (starting in 2014) a complete system for handling research project and grant information has been developed, together with integration of the local HR system for persistent and structured data about staff and organisation.In the current phase (2016-) repository services are being developed, such as a new publication database and a new digital repository, along with services for sharing and collecting data.The next phase(s) will include handling of research data, research activities, learning objects and tools for bibliometric analysis.This poster will show some of the current and future features and the principles of UX and agile development, as well as the experiences of moving out of the comfort zone and dealing with new, non-publication related data, while sustaining and enhancing existing data and current services. It will discuss the challenges and possible solutions, when handling different kinds of research information for use and re-use, in the long run enabling the comprehension of the big picture of research at Chalmers University of Technology.
|
|
| 15. |
- Andreasson, Thomas, et al.
(författare)
-
Evaluation of anamnestic criteria for the identification of patients with acute community onset viral gastroenteritis in the emergency department-A prospective observational study.
- 2014
-
Ingår i: Scandinavian journal of infectious diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548. ; 46:8, s. 561-565
-
Tidskriftsartikel (refereegranskat)abstract
- Background: To our knowledge no clinical criteria for the identification of community onset viral gastroenteritis in individual patients have been evaluated systematically with modern PCR-based diagnostic assays as gold standard. Objective: The aim of this study was to identify factors independently associated with the detection of virus by PCR in rectal swab samples from patients with acute community onset gastroenteritis. Methods: A prospective observational study was conducted from December 2010 through March 2011 at the emergency department (ED) of a large teaching hospital. All patients who reported vomiting and/or diarrhoea up to 48 h prior to their visit to the ED were asked to participate. A rectal swab sample was obtained from each patient. Symptoms, date of onset, and epidemiological data were recorded. Samples were analysed with a multiple real-time PCR targeting 6 viral agents (astrovirus, adenovirus, rotavirus, sapovirus, and norovirus GI and GII). Results: Two hundred and five patients fulfilled the inclusion criteria, of whom 66 agreed to participate; their median (IQR) age was 65 (38-84) y and 43 (65%) were females. Thirty-one (47%) were positive by PCR for at least 1 of the agents examined (26 norovirus, 2 sapovirus, 2 rotavirus, and 1 adenovirus). Diarrhoea and a short duration of symptoms (≤ 2 days) were independently associated with a positive rectal swab sample, with odds ratios of 7.5 (95% confidence interval (CI) 2.0-28) and 10.4 (95% CI 1.9-56), respectively (p < 0.01 for both). A multivariate model including these 2 variables had a sensitivity of 81% (25/31) and a specificity of 69% (24/35). Conclusions: Diarrhoea and a short duration of symptoms were the only anamnestic criteria independently associated with acute community onset viral gastroenteritis confirmed by PCR.
|
|
| 16. |
- Beck-Friis, Thomas, et al.
(författare)
-
Outdoor Absolute Humidity Predicts the Start of Norovirus GII Epidemics
- 2023
-
Ingår i: Microbiology Spectrum. - : American Society for Microbiology. - 2165-0497. ; 11:2
-
Tidskriftsartikel (refereegranskat)abstract
- Seasonal variation of viral gastroenteritis is related to weather conditions, but the relationship with the incidence of viral gastroenteritis (GE) is not fully understood. This study examined the impact of outdoor climate factors on seasonal variation in detection rates of gastroenteritis viruses, with emphasis on norovirus. Weekly detection rates of norovirus genogroup I (GI) and II (GII), rotavirus, adenovirus, astrovirus, and sapovirus were analyzed in relation to average weekly means of meteorological parameters. Associations between rates of PCR detection of the viral GE pathogens and climate factors were investigated with generalized linear models. Low absolute humidity was correlated with increased detection of adenovirus (P = 0.007), astrovirus (P = 0.005), rotavirus (P = 0.004), norovirus GI (P = 0.001), and sapovirus (P = 0.002). In each investigated season, a drop in absolute humidity preceded the increase in norovirus GII detections. We found a correlation between declining absolute humidity and increasing norovirus GII detection rate. Absolute humidity was a better predictor of gastrointestinal virus seasonality compared to relative humidity.IMPORTANCE Viral gastroenteritis causes considerable morbidity, especially in vulnerable groups such as the elderly and chronically ill. Predicting the beginning of seasonal epidemics is important for the health care system to withstand increasing demands. In this paper we studied the association of outdoor climate factors on the detection rates of gastrointestinal viruses and the association between these factors and the onset of annual norovirus epidemics. Declining absolute humidity preceded the increase in diagnosed norovirus GII cases by approximately 1 week. These findings contribute to the understanding of norovirus epidemiology and allow health care services to install timely preventive measures and can help the public avoid transmission. Viral gastroenteritis causes considerable morbidity, especially in vulnerable groups such as the elderly and chronically ill. Predicting the beginning of seasonal epidemics is important for the health care system to withstand increasing demands.
|
|
| 17. |
- Bergbrant, Susanna, et al.
(författare)
-
Syndromic testing for respiratory pathogens but not National Early Warning Score can be used to identify viral cause in hospitalised adults with lower respiratory tract infections
- 2024
-
Ingår i: INFECTIOUS DISEASES. - 2374-4235 .- 2374-4243. ; 56:7
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundCommunity-acquired lower respiratory tract infection (LRTI) is a common reason for hospitalisation. Antibiotics are frequently used while diagnostic microbiological methods are underutilised in the acute setting.ObjectivesWe aimed to investigate the relative proportion of viral and bacterial infections in this patient group and explore methods for proper targeting of antimicrobial therapy.MethodsWe collected nasopharyngeal samples prospectively from adults hospitalised with LRTIs during three consecutive winter seasons (2016-2019). Syndromic nasopharyngeal testing was performed using a multiplex PCR panel including 16 viruses and four bacteria. Medical records were reviewed for clinical data.ResultsOut of 220 included patients, a viral pathogen was detected in 74 (34%), a bacterial pathogen in 63 (39%), both viral and bacterial pathogens in 49 (22%), while the aetiology remained unknown in 34 (15%) cases. The proportion of infections with an identified pathogen increased from 38% to 85% when syndromic testing was added to standard-of-care testing. Viral infections were associated with a low CRP level and absence of pulmonary infiltrates. A high National Early Warning Score did not predict bacterial infections.ConclusionsSyndromic testing by a multiplex PCR panel identified a viral infection or viral/bacterial coinfection in a majority of hospitalised adult patients with community-acquired LRTIs.
|
|
| 18. |
- Bjarnason, A., et al.
(författare)
-
Incidence, etiology, and outcomes of community-acquired pneumonia: A population-based study
- 2018
-
Ingår i: Open Forum Infectious Diseases. - : Oxford University Press (OUP). - 2328-8957. ; 5:2
-
Tidskriftsartikel (refereegranskat)abstract
- Background. The microbial etiology of community-acquired pneumonia (CAP) is often unclear in clinical practice, and previous studies have produced variable results. Population-based studies examining etiology and incidence are lacking. This study examined the incidence and etiology of CAP requiring hospitalization in a population-based cohort as well as risk factors and outcomes for specific etiologies. Methods. Consecutive admissions due to CAP in Reykjavik, Iceland were studied. Etiologic testing was performed with cultures, urine-antigen detection, and polymerase chain reaction analysis of airway samples. Outcomes were length of stay, intensive care unit admission, assisted ventilation, and mortality. Results. The inclusion rate was 95%. The incidence of CAP requiring hospitalization was 20.6 cases per 10 000 adults/year. A potential pathogen was detected in 52% (164 of 310) of admissions and in 74% (43 of 58) with complete sample sets. Streptococcus pneumoniae was the most common pathogen (61 of 310, 20%; incidence: 4.1/10 000). Viruses were identified in 15% (47 of 310; incidence: 3.1/10 000), Mycoplasma pneumoniae were identified in 12% (36 of 310; incidence: 2.4/10 000), and multiple pathogens were identified in 10% (30 of 310; incidence: 2.0/10 000). Recent antimicrobial therapy was associated with increased detection of M pneumoniae (P ≤ .001), whereas a lack of recent antimicrobial therapy was associated with increased detection of S pneumoniae (P = .02). Symptoms and outcomes were similar irrespective of microbial etiology. Conclusions. Pneumococci, M pneumoniae, and viruses are the most common pathogens associated with CAP requiring hospital admission, and they all have a similar incidence that increases with age. Symptoms do not correlate with specific agents, and outcomes are similar irrespective of pathogens identified. © The Author(s) 2018.
|
|
| 19. |
- Bjarnason, A, et al.
(författare)
-
Utility of oropharyngeal real-time PCR for S. pneumoniae and H. influenzae for diagnosis of pneumonia in adults.
- 2017
-
Ingår i: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. - : Springer Science and Business Media LLC. - 1435-4373. ; 36:3, s. 529-536
-
Tidskriftsartikel (refereegranskat)abstract
- A lack of sensitive tests and difficulties obtaining representative samples contribute to the challenge in identifying etiology in pneumonia. Upper respiratory tract swabs can be easily collected and analyzed with real-time PCR (rtPCR). Common pathogens such as S. pneumoniae and H. influenzae can both colonize and infect the respiratory tract, complicating the interpretation of positive results. Oropharyngeal swabs were collected (n=239) prospectively from adults admitted to hospital with pneumonia. Analysis with rtPCR targeting S. pneumoniae and H. influenzae was performed and results compared with sputum cultures, blood cultures, and urine antigen testing for S. pneumoniae. Different Ct cutoff values were applied to positive tests to discern colonization from infection. Comparing rtPCR with conventional testing for S. pneumoniae in patients with all tests available (n=57) resulted in: sensitivity 87%, specificity 79%, PPV 59% and NPV 94%, and for H. influenzae (n=67): sensitivity 75%, specificity 80%, PPV 45% and NPV 94%. When patients with prior antimicrobial exposure were excluded sensitivity improved: 92% for S. pneumoniae and 80% for H. influenzae. Receiver operating characteristic curve analysis demonstrated for S. pneumoniae: AUC=0.65 (95% CI 0.51-0.80) and for H. influenzae: AUC=0.86 (95% CI 0.72-1.00). Analysis of oropharyngeal swabs using rtPCR proved both reasonably sensitive and specific for diagnosing pneumonia caused by S. pneumoniae and H. influenzae. This method may be a useful diagnostic adjunct to other methods and of special value in patients unable to provide representative lower airway samples.
|
|
| 20. |
- Brittain-Long, Robin, 1969, et al.
(författare)
-
Access to a polymerase chain reaction assay method targeting 13 respiratory viruses can reduce antibiotics: a randomised, controlled trial.
- 2011
-
Ingår i: BMC medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Viral respiratory infections are common worldwide and range from completely benign disease to life-threatening illness. Symptoms can be unspecific, and an etiologic diagnosis is rarely established because of a lack of suitable diagnostic tools. Improper use of antibiotics is common in this setting, which is detrimental in light of the development of bacterial resistance. It has been suggested that the use of diagnostic tests could reduce antibiotic prescription rates. The objective of this study was to evaluate whether access to a multiplex polymerase chain reaction (PCR) assay panel for etiologic diagnosis of acute respiratory tract infections (ARTIs) would have an impact on antibiotic prescription rate in primary care clinical settings. METHODS: Adult patients with symptoms of ARTI were prospectively included. Nasopharyngeal and throat swabs were analysed by using a multiplex real-time PCR method targeting thirteen viruses and two bacteria. Patients were recruited at 12 outpatient units from October 2006 through April 2009, and samples were collected on the day of inclusion (initial visit) and after 10 days (follow-up visit). Patients were randomised in an open-label treatment protocol to receive a rapid or delayed result (on the following day or after eight to twelve days). The primary outcome measure was the antibiotic prescription rate at the initial visit, and the secondary outcome was the total antibiotic prescription rate during the study period. RESULTS: A total sample of 447 patients was randomised. Forty-one were excluded, leaving 406 patients for analysis. In the group of patients randomised for a rapid result, 4.5% (9 of 202) of patients received antibiotics at the initial visit, compared to 12.3% (25 of 204) (P = 0.005) of patients in the delayed result group. At follow-up, there was no significant difference between the groups: 13.9% (28 of 202) in the rapid result group and 17.2% (35 of 204) in the delayed result group (P = 0.359), respectively. CONCLUSIONS: Access to a rapid method for etiologic diagnosis of ARTIs may reduce antibiotic prescription rates at the initial visit in an outpatient setting. To sustain this effect, however, it seems necessary to better define how to follow and manage the patient according to the result of the test, which warrants further investigation. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01133782.
|
|
| 21. |
|
|
| 22. |
- Brittain-Long, Robin, 1969, et al.
(författare)
-
Seasonal variations of 15 respiratory agents illustrated by the application of a multiplex polymerase chain reaction assay.
- 2011
-
Ingår i: Scandinavian journal of infectious diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548.
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: Nucleic acid amplification tests are increasingly being used to diagnose viral and bacterial respiratory tract infections. The high sensitivity of these tests affects our understanding of the epidemiology of respiratory tract infections. We have assessed the detection rate of a multiplex real-time polymerase chain reaction (PCR) test, with emphasis on epidemiology and seasonal distribution of the most common respiratory tract infections. Methods: Seven thousand eight hundred and fifty-three nasopharyngeal samples from 7220 patients (age range 0-98 y, median 22 y) obtained during 36 consecutive months (November 2006-October 2009), were analyzed with a multiplex PCR panel including influenza A (IfA) and B (IfB) virus, parainfluenza virus (PIV) 1-3, respiratory syncytial virus (RSV), human rhinovirus (HRV), human coronavirus (CoV) OC43, NL63, and 229E, human metapneumovirus (HMPV), adenovirus (AdV), enterovirus (EV), and 2 bacteria - Mycoplasma pneumoniae and Chlamydophila pneumoniae. Results: Of the total samples, 44.5% (n = 3496) were positive for at least 1 agent, with HRV being the most common (n = 1482, 38.0%), followed by RSV (n = 526, 13.5%) and IfA (n = 403, 10.3%). The diagnostic yield was significantly higher during the winter and early spring compared to the summer (n = 2439 of 4458 samples, 54.7% and n = 1057 of 3395 samples, 31.1%, respectively; p < 0.001). Conclusions: The diagnostic yield was highly dependent on the month of sampling and the age of the patient. However, the overall detection rate per month was above 30%, apart for August and September. Our findings support the use of similar tests in routine clinical care all year round. HRV was the most common finding in the respiratory tract, independent of season.
|
|
| 23. |
- Broering Chaar, Ana Beatriz, 1990-, et al.
(författare)
-
The Effect of Cathodic Arc Guiding Magnetic Field on the Growth of (Ti0.36Al0.64)N Coatings
- 2019
-
Ingår i: Coatings. - : MDPI. - 2079-6412. ; 9:10
-
Tidskriftsartikel (refereegranskat)abstract
- We use a modified cathodic arc deposition technique, including an electromagnetic coil that introduces a magnetic field in the vicinity of the source, to study its influence on the growth of (Ti0.36Al0.64)N coatings. By increasing the strength of the magnetic field produced by the coil, the cathode arc spots are steered toward the edge of the cathode, and the electrons are guided to an annular anode surrounding the cathode. As a result, the plasma density between the cathode and substrate decreased, which was observed as a lateral spread of the plasma plume, and a reduction of the deposition rate. Optical emission spectroscopy shows reduced intensities of all recorded plasma species when the magnetic field is increased due to a lower number of collisions resulting in excitation. We note a charge-to-mass ratio decrease of 12% when the magnetic field is increased, which is likely caused by a reduced degree of gas phase ionization, mainly through a decrease in N2 ionization. (Ti0.36Al0.64)N coatings grown at different plasma densities show considerable variations in grain size and phase composition. Two growth modes were identified, resulting in coatings with (i) a fine-grained glassy cubic and wurtzite phase mixture when deposited with a weak magnetic field, and (ii) a coarse-grained columnar cubic phase with a strong magnetic field. The latter conditions result in lower energy flux to the coating’s growth front, which suppresses surface diffusion and favors the formation of c-(Ti,Al)N solid solutions over phase segregated c-TiN and w-AlN.
|
|
| 24. |
- Carlsson, Ylva, 1975, et al.
(författare)
-
COVID-19 in Pregnancy and Early Childhood (COPE): study protocol for a prospective, multicentre biobank, survey and database cohort study.
- 2021
-
Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:9
-
Tidskriftsartikel (refereegranskat)abstract
- There is limited knowledge on how the SARS-CoV-2 affects pregnancy outcomes. Studies investigating the impact of COVID-19 in early pregnancy are scarce and information on long-term follow-up is lacking.The purpose of this project is to study the impact of COVID-19 on pregnancy outcomes and long-term maternal and child health by: (1) establishing a database and biobank from pregnant women with COVID-19 and presumably non-infected women and their infants and (2) examining how women and their partners experience pregnancy, childbirth and early parenthood in the COVID-19 pandemic.This is a national, multicentre, prospective cohort study involving 27 Swedish maternity units accounting for over 86000 deliveries/year. Pregnant women are included when they: (1) test positive for SARS-CoV-2 (COVID-19 group) or (2) are non-infected and seek healthcare at one of their routine antenatal visits (screening group). Blood, as well as other biological samples, are collected at different time points during and after pregnancy. Child health up to 4years of age and parent experience of pregnancy, delivery, early parenthood, healthcare and society in general will be examined using web-based questionnaires based on validated instruments. Short- and long-term health outcomes will be collected from Swedish health registers and the parents' experiences will be studied by performing qualitative interviews.Confidentiality aspects such as data encryption and storage comply with the General Data Protection Regulation and with ethical committee requirements. This study has been granted national ethical approval by the Swedish Ethical Review Authority (dnr 2020-02189 and amendments 2020-02848, 2020-05016, 2020-06696 and 2021-00870) and national biobank approval by the Biobank Väst (dnr B2000526:970). Results from the project will be published in peer-reviewed journals.NCT04433364.
|
|
| 25. |
- Chen, Yu-Hsiang, et al.
(författare)
-
Enhanced thermal stability and fracture toughness of TiAlN coatings by Cr, Nb and V-alloying
- 2018
-
Ingår i: Surface & Coatings Technology. - : Elsevier. - 0257-8972 .- 1879-3347. ; 342, s. 85-93
-
Tidskriftsartikel (refereegranskat)abstract
- The effect of metal alloying on mechanical properties including hardness and fracture toughness were investigated in three alloys, Ti 0.33Al0.50(Me) 0.17N (Me = Cr, Nb and V), and compared to Ti0.50Al0.50N, in the as-deposited state and after annealing. All studied alloys display similar as-deposited hardness while the hardness evolution during annealing is found to be connected to phase transformations, related to the alloy’s thermal stability. The most pronounced hardening was observed in Ti0.50Al0.50N, while all the coatings with additional metal elements sustain their hardness better and they are harder than Ti0.50Al0.50N after annealing at 1100 °C. Fracture toughness properties were extracted from scratch tests. In all tested conditions, as-deposited and annealed at 900 and 1100 °C, Ti0.33Al0.50Nb0.17N show the least surface and sub-surface damage when scratched despite the differences in decomposition behavior and h-AlN formation. Theoretically estimated ductility of phases existing in the coatings correlates well with their crack resistance. In summary, Ti0.33Al0.50Nb0.17N is the toughest alloy in both as-deposited and post-annealed states.
|
|
| 26. |
- Ekström, Magnus, et al.
(författare)
-
Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women.
- 2024
-
Ingår i: Respiratory research. - : BioMed Central (BMC). - 1465-993X .- 1465-9921. ; 25:1
-
Tidskriftsartikel (refereegranskat)abstract
- Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population.Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50-64years. Breathlessness (modified Medical Research Council [mMRC]≥2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease.We included 25,948 people aged 57.5±[SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0-29.9), 21% obese (BMI≥30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6-66.0%), stress (31.6-76.8%), respiratory disease (20.1-37.1%), depression (17.1-26.6%), cardiac disease (6.3-12.7%), anemia (0.8-3.3%), and peripheral arterial disease (0.3-0.8%). Stress was the main factor in women and current smokers.Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting-supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.
|
|
| 27. |
- Gilles, Stefanie, et al.
(författare)
-
Pollen exposure weakens innate defense against respiratory viruses.
- 2020
-
Ingår i: Allergy. - : Wiley. - 1398-9995 .- 0105-4538. ; 75:3, s. 576-587
-
Tidskriftsartikel (refereegranskat)abstract
- Hundreds of plant species release their pollen into the air every year during early spring. During that period, pollen allergic as well as non-allergic patients frequently present to doctors with severe respiratory tract infections.To assess whether pollen may interfere with antiviral immunity.We combined data from real life human exposure cohorts, a mouse model and human cell culture to test our hypothesis.Pollen significantly diminished interferon-λ and pro-inflammatory chemokine responses of airway epithelia to rhinovirus and viral mimics and decreased nuclear translocation of interferon regulatory factors. In mice infected with respiratory syncytial virus, co-exposure to pollen caused attenuated antiviral gene expression and increased pulmonary viral titers. In non-allergic human volunteers, nasal symptoms were positively correlated with airborne birch pollen abundance, and nasal birch pollen challenge led to down-regulation of type I and -III interferons in nasal mucosa. In a large patient cohort, numbers of rhinovirus-positive cases were correlated with airborne birch pollen concentrations.The ability of pollen to suppress innate antiviral immunity, independent of allergy, suggests that high-risk population groups should avoid extensive outdoor activities when pollen and respiratory virus seasons coincide.
|
|
| 28. |
- Gustavsson, Lars, et al.
(författare)
-
Excess mortality following community-onset norovirus enteritis in the elderly.
- 2011
-
Ingår i: The Journal of hospital infection. - : Elsevier BV. - 1532-2939 .- 0195-6701. ; 79:1, s. 27-31
-
Tidskriftsartikel (refereegranskat)abstract
- Norovirus has been associated with excess deaths. A retrospective study of mortality following norovirus enteritis (NVE) was undertaken. All hospitalized adult patients with a stool sample positive for norovirus genogroup II on polymerase chain reaction, treated at Sahlgrenska University Hospital, Gothenburg, Sweden between August 2008 and June 2009, were included as cases (N=598, aged 18-101 years). Matched controls without enteritis (N=1196) were selected for comparison. Medical records were reviewed and deaths up to 90 days following positive sampling were noted, as well as comorbidities and length of hospital stay. Thirty- and 90-day survival rates were calculated. Total 30-day mortality was 7.6% and no deaths were recorded in cases aged 18-59 years. Thirty-day mortality was higher in cases with underlying medical conditions compared with those without these comorbidities (age 60-101 years: 89.5% vs 94.7% alive at Day 30, respectively; P<0.05). In cases aged >80 years, mortality was higher in those with community-onset NVE (N=64) compared with hospital-onset NVE (N=305) (81.2% vs 90.2% alive at Day 30, respectively; P<0.05), and compared with controls (N=128) (81.2% vs 91.4% alive at Day 30, respectively; P<0.05). Median length of hospital stay was 20 [interquartile range (IQR) 12-29] days for cases with hospital-onset NVE, and seven (IQR 2-13) days for controls (P<0.001). In conclusion, community-onset NVE requiring hospitalization was associated with higher mortality compared with hospital-onset NVE and matched controls in hospitalized elderly patients.
|
|
| 29. |
- Gustavsson, Lars, et al.
(författare)
-
Low serum levels of CCL5 are associated with longer duration of viral shedding in norovirus infection
- 2015
-
Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532. ; 69, s. 133-137
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The mechanisms that determine the duration of fecal shedding of norovirus in humans have not been described in detail. Objectives: We investigated serum inflammatory mediator levels in relation to the duration of viral shedding in norovirus infection. Study design: A prospective cohort study of patients hospitalized with acute norovirus genogroup II infection. Rectal swab samples were obtained at inclusion and day 7, 14, 21 and 28. Serum levels of 42 inflammatory mediators were determined with a Luminex-based cytokine assay. Sera from 20 healthy blood donors served as controls. Results: Altogether, 28 patients (54% women, median age 83 years, median duration of symptoms 3 days) were included. Twelve subjects cleared the virus within 14 days and 16 were norovirus-RNA positive for >21 days, constituting the two study groups ("rapid" vs. "slow" clearance). Individuals with norovirus infection had higher levels of IL-18, CXCL9, CXCL10, soluble IL-2 receptor and macrophage migration inhibitory factor (MIF), compared to controls (p < 0.05), with the highest median concentrations in the slow clearance group. In contrast, CCL5 levels were lower in the slow compared to the rapid clearance group (median 54 vs. 134 ng/mL, p < 0.05), and lower in norovirus-infected patients than in controls. Conclusion: Low levels of CCL5 were associated with longer duration of viral shedding, suggesting that CCL5 may influence the clearance of norovirus. (C) 2015 Elsevier B.V. All rights reserved.
|
|
| 30. |
- Gustavsson, Lars, et al.
(författare)
-
Rectal swabs can be used for diagnosis of viral gastroenteritis with a multiple real-time PCR assay.
- 2011
-
Ingår i: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. - : Elsevier BV. - 1873-5967. ; 51:4, s. 279-82
-
Tidskriftsartikel (refereegranskat)abstract
- Viral agents, especially norovirus, are the most common cause of nosocomial spread of epidemic gastroenteritis (GE). Rapid and reliable detection of these agents could reduce the risk of outbreaks.
|
|
| 31. |
- Gustavsson, Lars, et al.
(författare)
-
Rectal swabs can be used for diagnosis of viral gastroenteritis with a multiple real-time PCR assay
- 2011
-
Ingår i: Journal of Clinical Virology. - 1386-6532. ; 51, s. 275-278
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Viral agents, especially norovirus, are the most common cause of nosocomial spread of epidemic gastroenteritis (GE). Rapid and reliable detection of these agents could reduce the risk of outbreaks. Objective: To evaluate the diagnostic performance of rectal swab samples compared to standard stool samples for detection of agents causing viral GE by PCR. Study design: Complete pairs of rectal swab and stool samples, obtained simultaneously from patients with symptoms of acute onset GE, were analysed with a multiple real-time PCR targeting six different gastroenteritis agents (astro-, adeno-, rota-, sapo- and norovirus GI and II). Cycle threshold (Ct) values were registered for positive samples. A positive PCR result in either sample for any virus was considered gold standard. Results: 69 sample pairs were included of which 29 were negative in both sample types and 38 were positive in both sample types. One pair was positive in the stool sample only and another pair was positive in the rectal swab sample only. Sensitivity for both sample types was 97.5% (39/40). Conclusion: Rectal swab samples are as reliable as stool samples for PCR-based diagnosis of viral gastroenteritis in patients with a short duration of symptoms and may be used as a complement to stool samples, especially when immediate sampling is desirable.
|
|
| 32. |
- Gustavsson, Lars, et al.
(författare)
-
Slow Clearance of Norovirus following Infection with Emerging Variants of Genotype GII.4 Strains.
- 2017
-
Ingår i: Journal of clinical microbiology. - 1098-660X. ; 55:5, s. 1533-1539
-
Tidskriftsartikel (refereegranskat)abstract
- The emergence of new norovirus genotype GII.4 strains is associated with widespread norovirus epidemics. Extended periods of viral shedding can contribute to the epidemic potential of norovirus. To describe the duration of viral shedding in infections with novel emerging GII.4 strains versus infections with previously circulating strains, we performed a prospective cohort study of patients hospitalized with norovirus gastroenteritis during separate winter seasons. Rectal swab samples were obtained at the time of inclusion and weekly during follow-ups. The subgenotype strain was determined from capsid sequences. The outcome was defined by the detection of virus for >14 days (slow clearance) or by the detection of negative samples within 14 days (rapid clearance). Two major epidemic GII.4 strains emerged during the study period, GII.4 New Orleans 2009, in 2010, and GII.4 Sydney 2012, in 2012. From these two seasons, sequences were available from 24 cases where the duration of shedding could be determined. The median age of the patients was 83 years and 50% were women. The majority of patients were infected with virus that clustered with the respective season's epidemic strain (n = 19), whereas 5 patients had previously circulating strains (3 were Den Haag 2006b, in 2010, and 2 were New Orleans 2009, in 2012). Among the patients infected with an epidemic strain, the proportion who shed virus for >14 days was significantly higher (16/19 [84%] versus 1/5 [20%], P = 0.01). In summary, a slow clearance of norovirus from stool was more common in infections with novel epidemic GII.4 strains. This suggests that the average duration of shedding may be longer during seasons when new GII.4 strains have emerged.
|
|
| 33. |
- Hansen, Karin B., et al.
(författare)
-
Flocked nasal swab versus nasopharyngeal aspirate in adult emergency room patients: similar multiplex PCR respiratory pathogen results and patient discomfort
- 2016
-
Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 48:3, s. 246-250
-
Tidskriftsartikel (refereegranskat)abstract
- Fifty adult emergency room patients with symptoms of respiratory tract infections or acute onset of extreme fatigue were sampled by both nasopharyngeal aspirate (NPA) and flocked nasal swab (fNS). Respiratory agents were detected by a qualitative influenza PCR and an 18-valent multiplex PCR in 20 of 29 patients with a clinical diagnosis of respiratory tract infection, and in 3 of 21 without such a diagnosis. PCR detected influenza A and B in NPA samples from 11 patients and in fNS samples from 10 patients. Little or no discomfort was perceived by 60% of the patients when sampled by NPA and by 66% when sampled by fNS. We conclude that NPA and fNS were equally sensitive for detection of respiratory agents by multiplex PCR, and the two sampling methods did not differ significantly regarding discomfort perceived by patients (p=0.171, Wilcoxon signed rank test). Hence less invasive sampling by fNS might be preferable in certain settings and situations.
|
|
| 34. |
- Larsson, Johanna, et al.
(författare)
-
Säkerhetskultur och självkörande fordon och maskiner
- 2024
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Självkörande fordon inom transportsektorn befinner sig ännu i utvecklingsstadiet. Att införa självkörande fordon och maskiner i befintliga verksamheter innebär ofta förändringar både i organisationen och den fysiska miljön och kan även innebära nya risker. I detta sammanhang kan säkerhetskulturen, både hos utvecklare och hos användare, spela viktig roll för att självkörande fordon och maskiner ska fungera säkert och effektivt i olika verksamheter. Projektets mål har varit att utveckla metoder för att förbättra säkerhetskultur där människor och automatiserad teknik samverkar som agenter i ett gemensamt system, samt att utveckla mätverktyg där hållbarhet, jämställdhet och säkerhet utvärderas för införande av självkörande fordon och maskiner. Projektet har utgått ifrån fallstudier från två olika domäner – självkörande bussar och självkörande industritruckar. Intervjuer har genomförts med utvecklare, kunder och slutanvändare. En enkät har tagits fram att mäta säkerhetskultur, jämställdhetskultur och hållbarhetskultur i organisationer som utvecklar självkörande fordon. Utöver detta har data från incidentrapporter analyserats. Lärdomarna från resultaten och projektdeltagarnas tidigare erfarenheter har resulterat i ett första utkast av en processmodell där säkerhetskultur integreras i utvecklingen av självkörande fordon och maskiner. Intervjuerna med utvecklare och kunder av självkörande fordon visade att säkerhetskultur inte var ett etablerat begrepp vare sig hos utvecklarna eller hos kunderna och att det därför inte var en faktor som man medvetet beaktade. Lärdomar från enkäten var att det finns skillnader mellan produktföretag och som markant påverkar formuleringar av frågeställningar. Det gick inte att fastställa om det föreligger kopplingar mellan hållbarhets-, jämställdhets- och säkerhetskultur. Fallstudien med bussarna visade bland annat att kund och leverantör pratar om olika typer av säkerhet samt att säkerheten ofta, men inte alltid, är prioriterad över effektiviteten. Utifrån analyserna av incidentdata från självkörande bussar samt förarlösa industritruckar har en lista med förslag på nyckeltal för att kunna analysera incidenter med självkörande fordon tagits fram inom projektet.
|
|
| 35. |
- Magnusson, Jesper, et al.
(författare)
-
Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation
- 2018
-
Ingår i: Transplantation Direct. - : Ovid Technologies (Wolters Kluwer Health). - 2373-8731. ; 4:8
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Chronic lung allograft dysfunction (CLAD) is the major limiting factor for long-term survival in lung transplant recipients. Viral respiratory tract infection (VRTI) has been previously associated with CLAD development. The main purpose of this study was to evaluate the long-term effects of VRTI during the first year after lung transplantation in relation to CLAD development. Method. Ninety-eight patients undergoing lung transplantation were prospectively enrolled between 2009 and 2012. They were monitored for infections with predefined intervals and on extra visits during the first year, the total follow-up period ranged between 5 and 8 years. Nasopharyngeal swab and bronchoalveolar lavage samples were analyzed using a multiplex polymerase chain reaction panel for respiratory pathogens. Data regarding clinical characteristics and infectious events were recorded. Results. Viral respiratory tract infection during the first year was identified as a risk factor for long-term CLAD development (P = 0.041, hazard ratio 1.94 [1.03-3.66]) in a time-dependent multivariate Cox regression analysis. We also found that coronavirus in particular was associated with increased risk for CLAD development. Other identified risk factors were acute rejection and cyclosporine treatment. Conclusions. This study suggests that VRTI during the first year after lung transplantation is associated with long-term CLAD development and that coronavirus infections in particular might be a risk factor.
|
|
| 36. |
- Moreno, Maiara, et al.
(författare)
-
Adhesive wear of TiAlN coatings during low speed turning of stainless steel 316L
- 2023
-
Ingår i: Wear. - : Elsevier BV. - 0043-1648 .- 1873-2577. ; 524-525
-
Tidskriftsartikel (refereegranskat)abstract
- The wear behavior of TiAlN coatings during turning of stainless steel 316L at low cutting speeds (60–120 m/min) was investigated using scanning electron microscopy. In this speed range, the coatings fail by fracture due to an adhesive wear mechanism. The fracture of the coating is described in detail, including the strong influence of Al-content and cutting speed on the rate of wear. Low Al-content (x ≤ 0.23) coatings showed worse wear resistance than high Al-content (x ≥ 0.53) samples. Less substrate is exposed when the cutting speed is increased, because of reduced adhesive wear. The TiN and Ti0.77Al0.23N coatings are severely worn for all cutting speeds while Ti0.47Al0.53N and Ti0.38Al0.62N remain essentially unaffected at the highest speed. The difference in wear behavior is interpreted as a difference in the fracture toughness of the coatings.
|
|
| 37. |
- Moreno, Maiara, 1993-, et al.
(författare)
-
Strain and phase evolution in TiAlN coatings during high-speed metal cutting : An in operando high-energy x-ray diffraction study
- 2024
-
Ingår i: Acta Materialia. - : Elsevier. - 1359-6454 .- 1873-2453. ; 263
-
Tidskriftsartikel (refereegranskat)abstract
- We report on phase and strain changes in Ti1-xAlxN (0 ≤ x ≤ 0.61) coatings on cutting tools during turning recorded in operando by high-energy x-ray diffractometry. Orthogonal cutting of AISI 4140 steel was performed with cutting speeds of 360–370 m/min. Four positions along the tool rake face were investigated as a function of time in cut. Formation of γ-Fe in the chip reveals that the temperature exceeds 727 °C between the tool edge and the middle of the contact area when the feed rate is 0.06 mm/rev. Spinodal decomposition and formation of wurtzite AlN occurs at the positions of the tool with the highest temperature for the x ≥ 0.48 coatings. The strain evolution in the chip reveals that the mechanical stress is largest closest to the tool edge and that it decreases with time in cut for all analyzed positions on the rake face. The strain evolution in the coating varies between coatings and position on the rake face of the tool and is affected by thermal stress as well as the applied mechanical stress. Amongst others, the strain evolution is influenced by defect annihilation and, for the coatings with highest Al-content (x ≥ 0.48), phase changes.
|
|
| 38. |
- Nilsson, Anna, et al.
(författare)
-
Frequent detection of respiratory agents by multiplex PCR on oropharyngeal samples in Swedish school-attending adolescents
- 2012
-
Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 44, s. 393-397
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Respiratory agents may be detected in the oropharynx of healthy individuals. The extent of this condition and the reasons behind it are largely unknown. The objective of this study was to determine the factors associated with the presence of respiratory agents in the oropharynx of adolescents healthy enough to attend school activities. Methods: On a single day in December, samples from the posterior wall of the oropharynx of adolescents aged 1015 y were obtained using cotton-tipped swabs. The samples were analyzed by real-time polymerase chain reaction (PCR) for the presence of 13 respiratory viruses and 2 bacteria (Mycoplasma pneumoniae and Chlamydophila pneumoniae). Results: Out of the 232 adolescents sampled, 67 (29%) had any respiratory symptom. A positive PCR result was found in 50 individuals (22%). Human rhinovirus was the most commonly found agent. Respiratory agents were significantly more frequent in the younger age group (1013 y) than in the older age group (1415 y): 26% (38/148) vs 14% (12/84), respectively; p = 0.04. Cough was the only symptom that was more common among individuals with a positive PCR test than among those with a negative PCR test: 8/50 (16%) vs 11/182 (6%); p = 0.02. Family size and class size were not associated with the likelihood of a positive PCR test. Conclusions: The presence of respiratory agents in the oropharynx is a frequent finding among adolescents healthy enough to attend school activities. The high prevalence was found to be associated with young age, but not with the size of the family or class. © 2012 Informa Healthcare.
|
|
| 39. |
- Nordén, Rickard, 1977, et al.
(författare)
-
Quantification of torque teno virus and Epstein-Barr virus is of limited value for predicting the net state of immunosuppression after lung transplantation
- 2018
-
Ingår i: Open Forum Infectious Diseases. - : Oxford University Press (OUP). - 2328-8957. ; 5:4
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Major hurdles for survival after lung transplantation are rejections and infectious complications. Adequate methods for monitoring immune suppression status are lacking. Here, we evaluated quantification of torque teno virus (TTV) and Epstein-Barr virus (EBV) as biomarkers for defining the net state of immunosuppression in lung-transplanted patients. Methods. This prospective single-center study included 98 patients followed for 2 years after transplantation. Bacterial infections, fungal infections, viral respiratory infections (VRTI), cytomegalovirus (CMV) viremia, and acute rejections, as well as TTV and EBV levels, were monitored. Results. The levels of torque teno virus DNA increased rapidly after transplantation, likely due to immunosuppressive treatment. A modest increase in levels of Epstein-Barr virus DNA was also observed after transplantation. There were no associations between either TTV or EBV and infectious events or acute rejection, respectively, during follow-up. When Tacrolimus was the main immunosuppressive treatment, TTV DNA levels were significantly elevated 6-24 months after transplantation as compared with Cyclosporine treatment. Conclusions. Although replication of TTV, but not EBV, appears to reflect the functionality of the immune system, depending on the type of immunosuppressive treatment, quantification of TTV or EBV as biomarkers has limited potential for defining the net state of immune suppression.
|
|
| 40. |
|
|
| 41. |
- Olofsson, Sigvard, 1948, et al.
(författare)
-
PCR for detection of respiratory viruses: seasonal variations of virus infections
- 2011
-
Ingår i: EXPERT REVIEW OF ANTI-INFECTIVE THERAPY. - 1478-7210. ; 9:8, s. 615-626
-
Forskningsöversikt (refereegranskat)abstract
- Real-time PCR and related methods have revolutionized the laboratory diagnosis of viral respiratory infections because of their high detection sensitivity, rapidness and potential for simultaneous detection of 15 or more respiratory agents. Results from studies with this diagnostic modality have significantly expanded our knowledge about the seasonality of viral respiratory diseases, pinpointed the difficulties to make a reliable etiologic diagnosis without the aid of an unbiased multiplex molecular assay for respiratory viruses, and revealed previously unknown details as to possible infections with multiple agents as aggravating factors. The scope of this article is to review and discuss this new knowledge and its implications for diagnostic strategies and other measures essential for the clinical management of respiratory viral infections and for epidemiological surveillance of seasonal respiratory infections.
|
|
| 42. |
- Rogström, Lina, 1983-, et al.
(författare)
-
Structural changes in Ti1-xAlxN coatings during turning : A XANES and EXAFS study of worn tools
- 2023
-
Ingår i: Applied Surface Science. - : Elsevier. - 0169-4332 .- 1873-5584. ; 612
-
Tidskriftsartikel (refereegranskat)abstract
- Structural changes in Ti1-xAlxN coated tool inserts used for turning in 316L stainless steel were investigated by XANES, EXAFS, EDS, and STEM. For coarse-grained fcc-structured Ti1-xAlxN coatings, with 0 ≤ x ≤ 0.62, the XANES spectrum changes with Al-content. XANES Ti 1s line-scans across the rake face of the worn samples reveals that TiN-enriched domains have formed during turning in Ti0.47Al0.53N and Ti0.38Al0.62N samples as a result of spinodal decomposition. The XANES spectra reveal the locations on the tool in which the most TiN-rich domains have formed, indicating which part of the tool-chip contact area that experienced the highest temperature during turning. Changes in the pre-edge features in the XANES spectra reveal that structural changes occur also in the w-TiAlN phase in fine-grained Ti0.38Al0.62N during turning. EDS shows that Cr and Fe from the steel adhere to the tool rake face during machining. Cr 1s and Fe 1s XANES show that Cr is oxidized in the end of the contact length while the adhered Fe retains in the same fcc-structure as that of the 316L stainless steel.
|
|
| 43. |
- Sansone, Martina, et al.
(författare)
-
Extensive Hospital In-Ward Clustering Revealed By Molecular Characterization of Influenza A Virus Infection.
- 2020
-
Ingår i: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 71:9
-
Tidskriftsartikel (refereegranskat)abstract
- Nosocomial transmission of influenza A virus (InfA) infection is not fully recognized. The aim of this study was to describe the characteristics of hospitalized patients with InfA infections during an entire season and to investigate in-ward transmission at a large, acute-care hospital.During the 2016-17 season, all hospitalized patients≥18 years old with laboratory-verified (real-time polymerase chain reaction) InfA were identified. Cases were characterized according to age; sex; comorbidity; antiviral therapy; viral load, expressed as cycle threshold values; length of hospital stay; 30-day mortality; and whether the InfA infection met criteria for a health care-associated influenza A infection (HCAI). Respiratory samples positive for InfA that were collected at the same wards within 7 days were chosen for whole-genome sequencing (WGS) and a phylogenetic analysis was performed to detect clustering. For reference, concurrent InfA strains from patients with community-acquired infection were included.We identified a total of 435 InfA cases, of which 114 (26%) met the HCAI criteria. The overall 30-day mortality rate was higher among patients with HCAI (9.6% vs 4.6% among non-HCAI patients), although the difference was not statistically significant in a multivariable analysis, where age was the only independent risk factor for death (P<.05). We identified 8 closely related clusters (involving≥3 cases) and another 10 pairs of strains, supporting in-ward transmission.We found that the in-ward transmission of InfA occurs frequently and that HCAI may have severe outcomes. WGS may be used for outbreak investigations, as well as for evaluations of the effects of preventive measures.
|
|
| 44. |
- Sundell, Nicklas, et al.
(författare)
-
A four year seasonal survey of the relationship between outdoor climate and epidemiology of viral respiratory tract infections in a temperate climate
- 2016
-
Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532. ; 84, s. 59-63
-
Tidskriftsartikel (refereegranskat)abstract
- Background The relation between weather conditions, viral transmission and seasonal activity of respiratory viruses is not fully understood. Objectives To investigate the impact of outdoor weather in a temperate climate setting on the seasonal epidemiology of viruses causing respiratory tract infections, particularly influenza A (IFA). Study design In total, 20,062 clinical nasopharyngeal swab samples referred for detection of respiratory pathogens using a multiplex PCR panel, between October 2010 and July 2013, were included. Results of PCR detection were compared with local meteorological data for the same period. Results Low temperature and vapor pressure (VP) were associated with weekly incidence of IFA, respiratory syncytial virus, metapneumovirus, bocavirus and adenovirus but no association with relative humidity was found. The incidence of human rhinovirus and enterovirus was independent of temperature. During seasonal IFA outbreaks, the weekly drop of average temperature (compared with the week before) was strongly associated with the IFA incidence recorded the following week. Conclusion A sudden drop in outdoor temperature might activate the annual influenza epidemic in a temperate climate by facilitating aerosol spread in dry air. These conditions also seem to affect the incidence of other respiratory pathogens but not human rhino- or enterovirus, suggesting that routes of infection other than aerosol may be relevant for these agents. © 2016 Elsevier B.V.
|
|
| 45. |
|
|
| 46. |
- Thollander, Patrik, 1976-, et al.
(författare)
-
Energinyckeltal och växthusgasutsläpp baserade på industrins energianvändande processer
- 2021
-
Rapport (refereegranskat)abstract
- Svensk industri bör strategiskt arbeta mot ökad energi- och resurseffektivitet på en global marknad med knappare resurser. I detta sammanhang spelar beslutsunderlag och nyckeltal en central roll för att nå ökad effektivitet. Även för tillsynsmyndigheter är rättvisande nyckeltal avseende slutenergianvändning av mycket stor vikt för att kunna bedriva ett rättvist förebyggande och proaktivt arbete med svenska företag. De nyckeltal som finns på internationell och nationell nivå är baserade på tillförd energi och ofta relaterade till en ekonomisk output, till exempel förädlingsvärde. Det saknas emellertid nyckeltal kring slutenergianvändningen inom svensk industri fördelat på energibärare såsom el och olja och fördelat på slutenergiprocesser såsom ugnar, tryckluftskompressorer, etc. De siffror som ibland anges är baserade på grova uppskattningar. Projektets mål har därför varit att generera ett processträd avseende flera av de största, till slutenergianvändning räknat, svenska industribranscherna avseende hur slutenergianvändningen är fördelad på processnivå och olika energibärare, samt att allokera växthusgasutsläpp på dessa olika processer. Resultaten indikerar att nyckeltal baserade på energianvändning och indirekta växthusgasutsläpp på processnivå kan bidra till bättre kunskap om i vilka industriella energianvändande processer den största potentialen för energieffektivisering och minskning av växthusgasutsläpp finns. För att upprätthålla kunskap om var den största potentialen för förbättring finns krävs att energidata regelbundet samlas in efter en standardiserad kategorisering av energianvändande processer. Även om projektet har avgränsats till svensk industri kan resultatet vara till nytta också för andra medlemsstater inom EU liksom globalt.
|
|
| 47. |
- Vesterbacka, Jan, et al.
(författare)
-
Kinetics of microbial translocation markers in patients on efavirenz or lopinavir/r based antiretroviral therapy
- 2013
-
Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 8:1, s. e55038-
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We investigated whether there are differences in the effects on microbial translocation (MT) and enterocyte damage by different antiretroviral therapy (ART) regimens after 1.5 years and whether antibiotic use has impact on MT. In a randomized clinical trial (NCT01445223) on first line ART, patients started either lopinavir/r (LPV/r) (n = 34) or efavirenz (EFV) containing ART (n = 37). Lipopolysaccharide (LPS), sCD14, anti-flagellin antibodies and intestinal fatty acid binding protein (I-FABP) levels were determined in plasma at baseline (BL) and week 72 (w72).RESULTS: The levels of LPS and sCD14 were reduced from BL to w72 (157.5 pg/ml vs. 140.0 pg/ml, p = 0.0003; 3.13 ug/ml vs. 2.85 ug/ml, p = 0.005, respectively). The levels of anti-flagellin antibodies had decreased at w72 (0.35 vs 0.31 [OD]; p<0.0004), although significantly only in the LPV/r arm. I-FABP levels increased at w72 (2.26 ng/ml vs 3.13 ng/ml; p<0.0001), although significantly in EFV treated patients only. Patients given antibiotics at BL had lower sCD14 levels at w72 as revealed by ANCOVA compared to those who did not receive (Δ = -0.47 µg/ml; p = 0.015).CONCLUSIONS: Markers of MT and enterocyte damage are elevated in untreated HIV-1 infected patients. Long-term ART reduces the levels, except for I-FABP which role as a marker of MT is questionable in ART-experienced patients. Why the enterocyte damage seems to persist remains to be established. Also antibiotic usage may influence the kinetics of the markers of MT.TRIAL REGISTRATION: ClinicalTrials.gov NCT01445223.
|
|
| 48. |
- Westin, Johan, 1965, et al.
(författare)
-
Multiplex real-time PCR for detection of respiratory tract infections
- 2008
-
Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532. ; 41:1, s. 53-56
-
Tidskriftsartikel (refereegranskat)abstract
- Background Broad diagnostics of respiratoryinfection by molecular assays has not yet won acceptance due to technical difficulties and high costs. Objectives To evaluate clinical applicability of multiplexreal-timePCR. Study design An assay targeting influenza virus A (IfA) and B (IfB), parainfluenza 1-3 (PIV), human metapneumovirus (MPV), respiratory syncytial virus (RSV), rhinovirus (RV), enterovirus (EV), adenovirus (AdV), human coronaviruses (229E, OC43, NL63), M. pneumoniae and Ch. pneumoniae was developed and run daily on consecutive clinical nasopharyngeal swab samples. Results An etiology was identified in 48% of the 954 samples, with IfA in 25%, RV in 20%, MPV in 10% and M. pneumoniae in 10% of the positive. By a rational procedure costs could be reduced and the customer price set relatively low (€33 per sample). Conclusion Streamlined testing and cost limitation is achievable and probably critical for implementation of a broad molecular diagnostics of respiratoryinfections.
|
|
| 49. |
|
|
| 50. |
|
|
