| 1. |
- Andersson, Kennet, 1979-, et al.
(författare)
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Assessment of cerebrospinal fluid outflow conductance using an adaptive observer-experimental and clinical evaluation
- 2007
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Ingår i: Physiological Measurement. - : IOP Publishing. - 0967-3334 .- 1361-6579. ; 28:11, s. 1355-1368
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Tidskriftsartikel (refereegranskat)abstract
- Idiopathic normal pressure hydrocephalus (INPH) patients have a disturbance in the dynamics of the cerebrospinal fluid (CSF) system. The outflow conductance, C, of the CSF system has been suggested to be prognostic for positive outcome after treatment with a CSF shunt. All current methods for estimation of C have drawbacks; these include lack of information on the accuracy and relatively long investigation times. Thus, there is a need for improved methods. To accomplish this, the theoretical framework for a new adaptive observer (OBS) was developed which provides real-time estimation of C. The aim of this study was to evaluate the OBS method and to compare it with the constant pressure infusion (CPI) method. The OBS method was applied to data from infusion investigations performed with the CPI method. These consisted of repeated measurements on an experimental set-up and 30 patients with suspected INPH. There was no significant difference in C between the CPI and the OBS method for the experimental set-up. For the patients there was a significant difference, −0.84 ± 1.25 µl (s kPa)−1, mean ± SD (paired sample t-test, p < 0.05). However, such a difference is within clinically acceptable limits. This encourages further development of this new real-time approach for estimation of the outflow conductance.
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| 2. |
- Manchester, Ian, et al.
(författare)
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A nonlinear observer for on-line estimation of the cerebrospinal fluid outflow resistance.
- 2008
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Ingår i: Automatica. - : Elsevier. - 0005-1098 .- 1873-2836. ; 44:5, s. 1426-1430
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Tidskriftsartikel (refereegranskat)abstract
- Accurate estimates of the outflow resistance of the human cerebrospinal fluid system are important for the diagnosis of a medical condition known as hydrocephalus. In this paper we design a nonlinear observer which provides on-line estimates of the outflow resistance, to the best of our knowledge the first method to do so. The output of the observer is proven to globally converge to an unbiased estimate. Its performance is experimentally verified using the same apparatus used to perform actual patient diagnoses and a specially-designed physical model of the human cerebrospinal fluid system.
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| 3. |
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| 4. |
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| 5. |
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| 6. |
- Sjöquist, Emma S., et al.
(författare)
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Physical Activity Coaching of Patients with Rheumatoid Arthritis in Everyday Practice : A Long-term Follow-up
- 2011
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Ingår i: Musculoskeletal Care. - Chichester : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 9:2, s. 75-85
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the long-term effects on perceived general health, disease activity, pain, activity limitation and cognitive behavioural factors of a one-year coaching programme performed in ordinary physical therapy practice to promote the adoption of health-enhancing physical activity in patients with early rheumatoid arthritis (RA).METHODS: A total of 228 patients with early RA, from 10 rheumatology clinics in Sweden, were randomly assigned to an intervention group (IG; n = 94) or a control group (CG; n = 134). The IG was coached by physical therapists during the first year to adopt health-enhancing levels of physical activity (30 minutes/day, moderately intensive, ≥ 4 days/week). No coaching was given during the subsequent year between post-intervention and follow-up. Follow-up assessment consisted of a postal questionnaire on physical activity and of visual analogue scales for ratings of general health perception and pain. The Health Assessment Questionnaire Disability Index (HAQ) and the Disease Activity Score in 28 joints (DAS 28) were collected at regular medical check-ups.RESULTS: Sixty-five (69%) participants in the IG and 92 (69%) in the CG completed the entire study period by filling in the follow-up questionnaire on physical activity two years after baseline. The intervention seemed to lack any significant influence on long-term outcome. However, different patterns of change in physical activity behaviour were observed in the two groups.CONCLUSIONS: No long-term improvement in perceived general health or other outcomes were found in the follow-up. This may partly be because the intervention lacked several important behavioural elements for physical activity maintenance. Copyright © 2011 John Wiley & Sons, Ltd.
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| 7. |
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| 8. |
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| 9. |
- Wrede, Alexandra U. C., 1996-, et al.
(författare)
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Temporal trends in paediatric hydrocephalus : Rising prematurity and persistent ophthalmological challenges
- 2024
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 113:7, s. 1653-1663
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To study changes in aetiology, prematurity, comorbidity and ophthalmological outcomes in children with surgically treated hydrocephalus to provide information needed to maintain the best possible healthcare for a fragile and changing population.METHODS: Two population-based cohorts, born two decades apart in Region Västra Götaland Sweden, surgically treated for hydrocephalus at Sahlgrenska University Hospital in Gothenburg were recruited at approximately 10 years of age. The participants were examined according to an ophthalmological protocol, including history taking regarding perceptual visual dysfunction (PVD). Gestational age, aetiology and comorbidities were registered.RESULTS: The 1989-1993 group, comprised 52 children (48% girls; mean age 10, range 7.7-12.8 years), was compared with 24 children, born in 2007-2012 (29% girls; mean age 10, range 7.0-13.8 years). Extreme prematurity (gestational age ≤ 28 weeks) increased over time (p = 0.001). The vast majority of the children showed ophthalmological abnormalities, although motility defects and nystagmus decreased in the latter population. Subnormal visual acuity was associated with extreme prematurity (RR = 4.69; p = 0.030), and PVD with learning disability (RR = 2.44; p = 0.032).CONCLUSION: Paediatric hydrocephalus populations may change with improved healthcare. Since a high percentage shows ophthalmological abnormalities and more children are born extremely preterm, the entirety needs consideration both neurologically and ophthalmologically.
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| 10. |
- Adman, Per, et al.
(författare)
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171 forskare: ”Vi vuxna bör också klimatprotestera”
- 2019
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Ingår i: Dagens nyheter (DN debatt). - Stockholm. - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- DN DEBATT 26/9. Vuxna bör följa uppmaningen från ungdomarna i Fridays for future-rörelsen och protestera eftersom det politiska ledarskapet är otillräckligt. Omfattande och långvariga påtryckningar från hela samhället behövs för att få de politiskt ansvariga att utöva det ledarskap som klimatkrisen kräver, skriver 171 forskare i samhällsvetenskap och humaniora.
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| 11. |
- Ahlberg, Malin, 1986, et al.
(författare)
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A case study on supervised classification of Swedish pseudo-coordination
- 2015
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Ingår i: Proceedings of the 20th Nordic Conference of Computational Linguistics, NODALIDA 2015, May 11-13, 2015, Vilnius, Lithuania. - Linköpings universitet : Linköping University Electronic Press. - 1650-3686 .- 1650-3740. - 9789175190983
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Konferensbidrag (refereegranskat)abstract
- We present a case study on supervised classification of Swedish pseudo-coordination (SPC). The classification is attempted on the type-level with data collected from two data sets: a blog corpus and a fiction corpus. Two small experiments were designed to evaluate the feasability of this task. The first experiment explored a classifier’s ability to discriminate pseudo-coordinations from ordinary verb coordinations, given a small labeled data set created during the experiment. The second experiment evaluated how well the classifier performed at detecting and ranking SPCs in a set of unlabeled verb coordinations, to investigate if it could be used as a semi-automatic discovery procedure to find new SPCs.
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| 12. |
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| 13. |
- Akrap, Nina, et al.
(författare)
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Identification of Distinct Breast Cancer Stem Cell Populations Based on Single-Cell Analyses of Functionally Enriched Stem and Progenitor Pools
- 2016
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Ingår i: Stem Cell Reports. - : Elsevier BV. - 2213-6711. ; 6:1, s. 121-136
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Tidskriftsartikel (refereegranskat)abstract
- The identification of breast cancer cell subpopulations featuring truly malignant stem cell qualities is a challenge due to the complexity of the disease and lack of general markers. By combining extensive single-cell gene expression profiling with three functional strategies for cancer stem cell enrichment including anchorage-independent culture, hypoxia, and analyses of low-proliferative, label-retaining cells derived from mammospheres, we identified distinct stem cell clusters in breast cancer. Estrogen receptor (ER)alpha+ tumors featured a clear hierarchical organization with switch-like and gradual transitions between different clusters, illustrating how breast cancer cells transfer between discrete differentiation states in a sequential manner. ER alpha- breast cancer showed less prominent clustering but shared a quiescent cancer stem cell pool with ER alpha+ cancer. The cellular organization model was supported by single-cell data from primary tumors. The findings allow us to understand the organization of breast cancers at the single-cell level, thereby permitting better identification and targeting of cancer stem cells.
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| 14. |
- Almusaed, Amjad, 1967-, et al.
(författare)
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CDIO Initiative on Student Engagement by Effective Syncretic (Lectures – seminars)
- 2022. - 1
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Ingår i: Proceedings of IHSES 2022, International Conference on Humanities, Social and Education Sciences, Los Angeles, USA. - USA : ISTES Organization. - 9781952092336 ; , s. 249-261
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Konferensbidrag (refereegranskat)abstract
- New trends such as globalization, the knowledge economy, and the information technology revolution have become essential factors affecting the development of universities in the new era. These trends have profoundly impacted the survival and growth of universities. First, universities need to shoulder the knowledge creation work in many fields related to human survival and development in the era of the knowledge economy. Secondly, they must adapt to the influence of the technological revolution on human knowledge acquisition methods and change traditions. I will further explore the new requirements for talents in the new era and adjust our talent training concepts, values and models. How universities respond to challenges through operational changes and explore new models of higher education in line with social development in the new era is a topic that universities worldwide need to consider. The study aims to create an effective model to improve the interaction between the lectures and seminars objectives and activities based on CDIO standards 3 and 8. The integrated curriculum and active learning are crucial for improving future students' engineers' skills.Consequently, students will participate efficiently in the learning process. The study will focus on the concept of a "student-centered" learning environment based on the active learning model by using the research to create effective student engagement in the learning process. The work's positioning, goals, and learning model promotes the improvement of the student's engagement and learning mode in this context, pay attention to the course-student interaction in the process, stimulates students' learning initiative, and promote the teaching reform of participating colleges. The study aims to Increase the students' work and outcome towards creative results.
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| 15. |
- Andersson, Anderz, et al.
(författare)
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Juridik för lärare
- 2017. - 1
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Varje dag ställs förskollärare och lärare inför juridiska frågor. Det kan handla om tillsynsansvar, rätten att omhänderta en elevs mobil under en lektion eller vad som gäller för elevers inflytande över sin skolgång. Juridik för lärare ger tydliga och överskådliga svar på sådana frågor.Boken redogör för regler kopplade till förskollärarens och lärarens roll som tjänsteman, regler om handläggning samt offentlighet och sekretess. De centrala reglerna i skollagen, som handlar om skolplikt, barns och elevers utveckling mot målen, trygghet och studiero samt inflytande, presenteras ingående. Kränkande behandling och diskriminering har fått ett eget kapitel. Bokens avslutande del handlar om vårdnadshavares och föräldrars beslutanderätt och rätt till information.
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| 16. |
- Andersson, Anna-Lena, et al.
(författare)
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Inkludering och delaktighet i skolans arbete : perspektiv och betydelse
- 2023
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna artikel, i den sista delen av modulen, är att presentera perspektiv på delaktighet, integrering och inkludering avseende begreppens innebörd och konsekvenser. Fokus ligger på hur delaktighet och inkludering kan hanteras i det praktiska pedagogiska arbetet och på betydelsen av att skapa skolorganisatoriska förutsättningar för lärare, elevassistenter och personal som medverkar i undervisning och deras arbete med att stödja samtliga elevers kunskapsutveckling.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Andersson, C. David, et al.
(författare)
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Divergent Structure-Activity Relationships of Structurally Similar Acetylcholinesterase Inhibitors
- 2013
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Ingår i: Journal of Medicinal Chemistry. - : American Chemical Society (ACS). - 0022-2623 .- 1520-4804. ; 56:19, s. 7615-7624
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Tidskriftsartikel (refereegranskat)abstract
- The molecular interactions between the enzyme acetylcholinesterase (AChE) and two compound classes consisting of N-[2-(diethylamino)ethyl]benzenesulfonamides and N-[2-(diethylamino)ethyl]benzenemethanesulfonamides have been investigated using organic synthesis, enzymatic assays, X-ray crystallography, and thermodynamic profiling. The inhibitors' aromatic properties were varied to establish structure activity relationships (SAR) between the inhibitors and the peripheral anionic site (PAS) of AChE. The two structurally similar compound classes proved to have distinctly divergent SARs in terms of their inhibition capacity of AChE. Eight X-ray structures revealed that the two sets have different conformations in PAS. Furthermore, thermodynamic profiles of the binding between compounds and AChE revealed class-dependent differences of the entropy/enthalpy contributions to the free energy of binding. Further development of the entropy-favored compound class resulted in the synthesis of the most potent inhibitor and an extension beyond the established SARs. The divergent SARs will be utilized to develop reversible inhibitors of AChE into reactivators of nerve agent-inhibited AChE.
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| 21. |
- Andersson, C. David, 1978-, et al.
(författare)
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Physical Mechanisms Governing Substituent Effects on Arene-Arene Interactions in a Protein Milieu
- 2020
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Ingår i: Journal of Physical Chemistry B. - : American Chemical Society (ACS). - 1520-6106 .- 1520-5207. ; 124:30, s. 6529-6539
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Tidskriftsartikel (refereegranskat)abstract
- Arene-arene interactions play important roles in protein-ligand complex formation. Here, we investigate the characteristics of arene-arene interactions between small organic molecules and aromatic amino acids in protein interiors. The study is based on X-ray crystallographic data and quantum mechanical calculations using the enzyme acetylcholinesterase and selected inhibitory ligands as a model system. It is shown that the arene substituents of the inhibitors dictate the strength of the interaction and the geometry of the resulting complexes. Importantly, the calculated interaction energies correlate well with the measured inhibitor potency. Non-hydrogen substituents strengthened all interaction types in the protein milieu, in keeping with results for benzene dimer model systems. The interaction energies were dispersion-dominated, but substituents that induced local dipole moments increased the electrostatic contribution and thus yielded more strongly bound complexes. These findings provide fundamental insights into the physical mechanisms governing arene-arene interactions in the protein milieu and thus into molecular recognition between proteins and small molecules.
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| 22. |
- Andersson, Christian, et al.
(författare)
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Do you want your child to have a certified teacher?
- 2011
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Ingår i: Economics of Education Review. - : Elsevier BV. - 0272-7757 .- 1873-7382. ; 30:1, s. 65-78
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Tidskriftsartikel (refereegranskat)abstract
- This study examines how the teaching staff composition with respect to certification affects student achievement in compulsory Swedish schools. We apply an instrumental variable to estimate the effect of the share of non-certified teachers on student achievement (measured by grade point average, GPA). We find statistically significant negative effects on the GPA. The effect is stronger for students with highly educated parents. A one percentage point increase in the share of non-certified teachers is expected to decrease student's GPA by, on average, 1.8 standard deviations per year. This is a substantial effect considering the large differences in the shares of non-certified teachers across schools and municipalities.
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| 23. |
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| 24. |
- Andersson, Charlotta, et al.
(författare)
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Prognostic significance of specific anti-WT1 IgG antibody level in plasma in patients with ovarian carcinoma
- 2014
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Ingår i: Cancer Medicine. - : Wiley. - 2045-7634. ; 3:4, s. 909-918
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Tidskriftsartikel (refereegranskat)abstract
- Ovarian carcinoma (OC) has a poor prognosis and lack early effective screening markers. Wilm's tumor gene 1 (WT1) is overexpressed in OCs. Therefore, it is of great interest to investigate whether WT1-specific antibody (Ab) measurements in plasma can serve as a biomarker of anti-OC response, and is of importance in relation to patient prognosis. Peripheral blood samples were obtained from a total of 103 women with ovarian tumors with median being 1 day (range 0-48 days) before operation. WT1 IgG Ab levels were evaluated using enzyme-linked immunosorbent assay (ELISA). Immunohistochemical analysis of WT1 protein expression was performed on OC tissue samples. We found that low-WT1 Ab level in plasma was related to improved survival in patients diagnosed at stages III-IV and grade 3 carcinomas. Positive WT1 protein staining on OC tissue samples had a negative impact on survival in the entire cohort, both overall survival (OS) (P = 0.046) and progression-free survival (PFS) (P = 0.006), but not in the serous OC subtype. Combining WT1 IgG Ab levels and WT1 staining, patients with high-WT1 IgG Ab levels in plasma and positive WT1 protein staining in cancer tissues had shorter survival, with a significant association in PFS (P = 0.016). These results indicated that WT1 Ab measurements in plasma and WT1 staining in tissue specimens could be useful as biomarkers for patient outcome in the high-risk subtypes of OCs for postoperative individualized therapy.
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| 25. |
- Andersson, Daniel, 1979, et al.
(författare)
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Properties of targeted preamplification in DNA and cDNA quantification
- 2015
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Ingår i: Expert Review of Molecular Diagnostics. - : Informa UK Limited. - 1473-7159 .- 1744-8352. ; 15:8, s. 1085-1100
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Forskningsöversikt (refereegranskat)abstract
- Objective: Quantification of small molecule numbers often requires preamplification to generate enough copies for accurate downstream enumerations. Here, we studied experimental parameters in targeted preamplification and their effects on downstream quantitative real-time PCR (qPCR). Methods: To evaluate different strategies, we monitored the preamplification reaction in real-time using SYBR Green detection chemistry followed by melting curve analysis. Furthermore, individual targets were evaluated by qPCR. Result: The preamplification reaction performed best when a large number of primer pairs was included in the primer pool. In addition, preamplification efficiency, reproducibility and specificity were found to depend on the number of template molecules present, primer concentration, annealing time and annealing temperature. The amount of nonspecific PCR products could also be reduced about 1000-fold using bovine serum albumin, glycerol and formamide in the preamplification. Conclusion: On the basis of our findings, we provide recommendations how to perform robust and highly accurate targeted preamplification in combination with qPCR or next-generation sequencing.
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| 26. |
- Andersson, Emelie, et al.
(författare)
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Cerebral Aβ deposition precedes reduced cerebrospinal fluid and serum Aβ42/Aβ40 ratios in the App NL−F/NL−F knock-in mouse model of Alzheimer’s disease
- 2023
-
Ingår i: Alzheimer's Research and Therapy. - : Springer Science and Business Media LLC. - 1758-9193. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Aβ42/Aβ40 ratios in cerebrospinal fluid (CSF) and blood are reduced in preclinical Alzheimer’s disease (AD), but their temporal and correlative relationship with cerebral Aβ pathology at this early disease stage is not well understood. In the present study, we aim to investigate such relationships using App knock-in mouse models of preclinical AD. Methods: CSF, serum, and brain tissue were collected from 3- to 18-month-old AppNL−F/NL−F knock-in mice (n = 48) and 2–18-month-old AppNL/NL knock-in mice (n = 35). The concentrations of Aβ42 and Aβ40 in CSF and serum were measured using Single molecule array (Simoa) immunoassays. Cerebral Aβ plaque burden was assessed in brain tissue sections by immunohistochemistry and thioflavin S staining. Furthermore, the concentrations of Aβ42 in soluble and insoluble fractions prepared from cortical tissue homogenates were measured using an electrochemiluminescence immunoassay. Results: In AppNL−F/NL−F knock-in mice, Aβ42/Aβ40 ratios in CSF and serum were significantly reduced from 12 and 16 months of age, respectively. The initial reduction of these biomarkers coincided with cerebral Aβ pathology, in which a more widespread Aβ plaque burden and increased levels of Aβ42 in the brain were observed from approximately 12 months of age. Accordingly, in the whole study population, Aβ42/Aβ40 ratios in CSF and serum showed a negative hyperbolic association with cerebral Aβ plaque burden as well as the levels of both soluble and insoluble Aβ42 in the brain. These associations tended to be stronger for the measures in CSF compared with serum. In contrast, no alterations in the investigated fluid biomarkers or apparent cerebral Aβ plaque pathology were found in AppNL/NL knock-in mice during the observation time. Conclusions: Our findings suggest a temporal sequence of events in AppNL−F/NL−F knock-in mice, in which initial deposition of Aβ aggregates in the brain is followed by a decline of the Aβ42/Aβ40 ratio in CSF and serum once the cerebral Aβ pathology becomes significant. Our results also indicate that the investigated biomarkers were somewhat more strongly associated with measures of cerebral Aβ pathology when assessed in CSF compared with serum.
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| 27. |
- Andersson, Ing-Marie, et al.
(författare)
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A study visit to a vitual company
- 2012
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Ingår i: NGL 2012 Next Generation Learning Conference. - Falun : Högskolan Dalarna. - 9789185941476 ; , s. 69-74
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- To integrate study visits to different workplaces in higher education implies important benefits for the course quality. The study visit gives the students a better understanding for the real situations they will meet in working life. However for practical and economical reasons is that not always possible. The purpose of this project is to create a virtual company that shall replace the real one for study visits. The goal is to create a realistic picture and that intended use of it can come as close as possible to a real study visit. It is also important to facilitate linking theory and practice. The virtual company is built up by pictures, videos and text. All material is made available on a web page and when entering the students will meet a layout of the company. From that position is it possible to walk around and look at videos from different workstations. Besides that can they also listen to interviews with managers and representatives of staff as well as reading reports concerning productivity and the work environment. The focus of the study visit is work sciences, therefore the material also include some visualized information about work hazards. On the web page there are also a number of tasks for the students to carry out. Until the autumn 2011, 132 students at Dalarna University have visited and produced reports from the virtual company. They were studying in programs for mechanical engineering, production technicians and human resource management. An evaluation among some ten students showed that the study visit to the virtual company is flexible in time and effective, but that students wish to have even more detailed information about the company. Experiences from four years of use in a number of classes show that the concept is worth further development. Furthermore with production of new material the concept is likely to be applicable for other purposes.
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| 28. |
- Andersson, John, et al.
(författare)
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Equilibrium points of a singular cooperative system with free boundary
- 2015
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Ingår i: Advances in Mathematics. - : Elsevier BV. - 0001-8708 .- 1090-2082. ; 280, s. 743-771
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we initiate the study of maps minimising the energy integral(D)(vertical bar del u vertical bar(2) + 2 vertical bar u vertical bar) dx, which, due to Lipschitz character of the integrand, gives rise to the singular Euler equations Delta u = u / vertical bar u vertical bar chi({vertical bar u vertical bar >0}), u = (u(1,) ... ,u(m)) Our primary goal in this paper is to set up a road map for future developments of the theory related to such energy minimising maps. Our results here concern regularity of the solution as well as that of the free boundary. They are achieved by using monotonicity formulas and epiperimetric inequalities, in combination with geometric analysis.
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| 29. |
- Andersson, Kennet, et al.
(författare)
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Effect of resting pressure on the estimate of cerebrospinal fluid outflow conductance
- 2011
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Ingår i: Fluids and barriers of the CNS. - : Springer Science and Business Media LLC. - 2045-8118. ; 8:1, s. 15-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A lumbar infusion test is commonly used as a predictive test for patients with normal pressure hydrocephalus and for evaluation of cerebrospinal fluid (CSF) shunt function. Different infusion protocols can be used to estimate the outflow conductance (Cout) or its reciprocal the outflow resistance, (Rout) with or without using the baseline resting pressure, Pr. Both from a basic physiological research and a clinical perspective, it is important to understand the limitations of the model on which infusion tests are based. By estimating Cout using two different analyses, with or without Pr, the limitations could be explored. The aim of this study was to compare the Cout estimates, and investigate what effect Pr had on the results. METHODS: Sixty-three patients that underwent a constant pressure infusion protocol as part of their preoperative evaluation for normal pressure hydrocephalus, were included (age 70.3+/-10.8 years (mean +/-SD). The analysis was performed without (Cexcl Pr) and with (Cincl Pr) Pr. The estimates were compared using Bland-Altman plots and paired sample t-tests (p<0.05 considered significant). RESULTS: Mean Cout for the 63 patients was: Cexcl Pr = 7.0+/-4.0 (mean +/-SD) ul/(s kPa) and Cincl Pr = 9.1+/-4.3 ul/(s kPa) and Rout was 19.0+/-9.2 and 17.7+/-11.3 mmHg/ml/min, respectively. There was a positive correlation between methods (r=0.79, n=63, p<0.01). The difference, DeltaCout, -2.1+/-2.7 ul/(s kPa) between methods was significant (p<0.01) and DeltaRout was 1.2 +/- 8.8 mmHg/ml/min). The Bland-Altman plot visualized that the variation around the mean difference was similar all through the range of measured values and there was no correlation between DeltaCout and Cout. CONCLUSIONS: The difference between Cout estimates, obtained from analyses with or without Pr, needs to be taken into consideration when comparing results from studies using different infusion test protocols. The study suggests variation in CSF formation rate, variation in venous pressure or a pressure dependent Cout as possible causes for the deviation from the CSF absorption model seen in some patients.
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| 30. |
- Andersson, Linus, et al.
(författare)
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Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity
- 2016
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; 89:1, s. 79-88
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Multiple chemical sensitivity (MCS) is a prevalent medically unexplained symptom characterized by symptom reactions to everyday chemical exposure below hygienic thresholds. The aim of this study was to investigate the expressions of hyper-reactivity in MCS during whole-body exposure to low concentrations of the odorant n-butanol.Methods: We exposed 18 participants with MCS and 18 non-ill controls to a low concentration of the odorantn-butanol using an exposure chamber. The first 10 min constituted blank exposure, after which then-butanol concentration increased and reached a plateau at 11.5 mg/m3.Results: MCS participants, compared with controls, reported greater perceived odor intensities, more unpleasantness to the exposure and increasing symptoms over time. MCS participants also expressed higher pulse rate and lower pulse rate variability than controls did. No group differences were found for breathing rate or tonic electrodermal activity responses.Conclusions: We conclude that MCS sufferers differ from healthy controls in terms of autonomic responses, symptoms and chemosensory perception during chemical exposure.
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| 31. |
- Andersson, Marlene, et al.
(författare)
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Carbonic Anhydrase Generates CO2 and H+ That Drive Spider Silk Formation Via Opposite Effects on the Terminal Domains
- 2014
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Ingår i: PLoS biology. - : Public Library of Science (PLoS). - 1544-9173 .- 1545-7885. ; 12:8, s. e1001921-
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Tidskriftsartikel (refereegranskat)abstract
- Spider silk fibers are produced from soluble proteins (spidroins) under ambient conditions in a complex but poorly understood process. Spidroins are highly repetitive in sequence but capped by nonrepetitive N- and C-terminal domains (NT and CT) that are suggested to regulate fiber conversion in similar manners. By using ion selective microelectrodes we found that the pH gradient in the silk gland is much broader than previously known. Surprisingly, the terminal domains respond in opposite ways when pH is decreased from 7 to 5: Urea denaturation and temperature stability assays show that NT dimers get significantly stabilized and then lock the spidroins into multimers, whereas CT on the other hand is destabilized and unfolds into ThT-positive beta-sheet amyloid fibrils, which can trigger fiber formation. There is a high carbon dioxide pressure (pCO(2)) in distal parts of the gland, and a CO2 analogue interacts with buried regions in CT as determined by nuclear magnetic resonance (NMR) spectroscopy. Activity staining of histological sections and inhibition experiments reveal that the pH gradient is created by carbonic anhydrase. Carbonic anhydrase activity emerges in the same region of the gland as the opposite effects on NT and CT stability occur. These synchronous events suggest a novel CO2 and proton-dependent lock and trigger mechanism of spider silk formation.
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| 32. |
- Andersson, Morgan, 1965, et al.
(författare)
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Exploring the Function and Use of Common Spaces in Assisted Living for Older Persons
- 2014
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Ingår i: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 7:3, s. 98-119
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This exploratory study examines the function and use of common spaces in assisted living facilities (ALFs) from the residential and workplace perspectives.BACKGROUND: The impact of the physical environment on human activities in healthcare settings has been emphasized in many studies. Few studies, however, have explored the daily use of common spaces and theimpact on the usability of ALFs.METHODS: Four explorative methods–observation, group interviews, individual interviews, and questionnaires—were used to investigate 14 ALFs in Sweden. The study involves residents, staff, relatives, architects, and people responsible for planning and construction of eldercare.This research strategy combines quantitative and qualitative methods to enhance the validity of the results. Method triangulation and data triangulationwere used and the data were analyzed using Qualitative Content Analysis (QCA).RESULTS: The results show that residents and staff have different objectives for use and these differences affect usability, although explicit conflicts are rare. The residents, staff, and other stakeholders have differentviews about the demarcation of home and workplace and the role of common spaces as venues for social interaction.CONCLUSIONS: Both the residential and the workplace perspective must be considered when planning assisted living facilities. Otherwise, inherent conflicts between these perspectives will manifest as a result of thephysical design. Common spaces have diverse functions that are reflected in their spatial organization. Therefore, ALFs should be designed so the intended function of a specific space is apparent to all users.
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| 33. |
- Andersson, Nina, et al.
(författare)
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Adaptive method for assessment of cerebrospinal fluid outflow conductance.
- 2007
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Ingår i: Medical and Biological Engineering and Computing. - : Springer Science and Business Media LLC. - 0140-0118 .- 1741-0444. ; 45:4, s. 337-343
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Tidskriftsartikel (refereegranskat)abstract
- Outflow conductance (C out) is important for predicting shunt responsiveness in patients with suspected idiopathic adult hydrocephalus syndrome (IAHS). C out is determined by performing an infusion test into the cerebrospinal fluid system, and the reliability of the test is dependent on the measurement time. The objective of this study was to develop an adaptive signal analysis method to reduce the investigation time, by taking the individual intracranial pressure variations of the patient into consideration. The method was evaluated on 28 patients with suspected IAHS. The results from full time investigations (60 min) were compared to the results of the new algorithm. Applying the new adaptive method resulted in a reduction of mean investigation time by 14.3 ± 5.9 min (mean ± SD), p < 0.01. The reduction of reliability in the C out estimation was found clinically negligible. We thus recommend this adaptive method to be used when performing constant pressure infusion tests.
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| 34. |
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| 35. |
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| 36. |
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| 37. |
- Andersson, Nina, 1976-
(författare)
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Cerebrospinal fluid infusion methods : development and validation on patients with idiopathic normal pressure hydrocephalus
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cerebrospinal fluid (CSF) infusion tests can be used to estimate the dynamic properties of the CSF system. Idiopathic normal pressure hydrocephalus (INPH) is a syndrome signified by a disturbance to the CSF system, where the cause is unknown and the diagnosis is difficult to determine. As an aid in identifying patients with INPH who will improve after shunt surgery, infusion tests are commonly used to determine the outflow conductance (Cout), or outflow resistance (Rout=1/Cout), of the CSF system. The tests are also used to determine shunt function in vivo. The general aim of this thesis was to develop and validate CSF infusion methods, to investigate the dynamics of the CSF system. The methods should be applicable to patients with INPH, to aid in the quest to further improve the diagnosis and management of this syndrome.An existing mathematical model describing the dynamics of the CSF system was further developed. The characteristics of the model were verified and the effect of expanding intracranial air on the intracranial pressure (ICP) was simulated. The simulations supported the recommendation to maintain sea-level pressure during air ambulance transportation of patients with suspected intracranial air.A recently developed infusion apparatus was evaluated, on an experimental model as well as on a patient material. The repetitiveness in estimating Cout was found to be good. A statistically significant difference was found between the repeated Cout estimations in the patient group, indicating that there might have been a small physiological change introduced during the infusion test. A parameter, ∆Cout, was proposed and evaluated. It proved to reflect the reliability of individual Cout investigations in a clinically useful way, as well as to provide easily interpreted information.An adaptive algorithm for assessment of Cout was developed and evaluated on a patient group. The new algorithm was shown to reduce the investigation time, from 60 minutes, by 14.3 ± 5.9 minutes (mean ± SD), p<0.01, without reducing the reliability of the estimated Cout below clinically relevant levels.The relationship between ICP and CSF outflow was studied in a group of patients investigated for INPH. It was found that in the range of moderate increase from baseline pressure, the assumption of a pressure independent Rout was confirmed (p=0.5). However, at larger pressure increments, the relationship had a non-linear tendency (p<0.05). This indicates that the traditional view of a pressure independent Rout might have to be questioned in the region where ICP exceeds baseline pressure too much.Infusion tests can be performed in different ways, where three main categories may be distinguished. The bolus infusion method was compared to the constant pressure and constant flow infusion methods, on an experimental model as well as on a patient material. When physiological pressure fluctuations were added to the model, significant differences were found in the determination of Cout in the range of clinical importance, i.e. low Cout (p<0.05). The finding was supported by the patient investigations, the difference was however not significant.With the application of the new methods developed in this thesis, and the increased knowledge concerning relationships between CSF dynamic parameters, the CSF infusion test was further improved with the ability to increase measurement reliability in a reduced time. This constitutes a good basis to perform a large multi-centre study with the main goal to determine the predictive value of the parameter Cout.
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| 38. |
- Andersson, Nina, et al.
(författare)
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Combined Emulsion and Solvent Evaporation (ESE) Synthesis Route to Well-Ordered Mesoporous Materials
- 2007
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Ingår i: Langmuir. - : American Chemical Society (ACS). - 0743-7463 .- 1520-5827. ; 23:3, s. 1459-1464
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Tidskriftsartikel (refereegranskat)abstract
- Control over morphol. and internal mesostructure of surfactant templated silicas remains a challenge, esp. when considering scaling lab. syntheses up to industrial vols. Here we report a method combining emulsification with the evapn.-induced self-assembly (EISA) method for prepg. spherical, mesoporous silica particles. This emulsion and solvent evapn. (ESE) method has several potential advantages over classic pptn. routes: it is easily scaled while providing superior control over stoichiometric homogeneity of templating surfactants and inorg. precursors, and particle sizes and distributions are detd. by principles developed for manipulating droplet sizes within water-in-oil emulsions. To demonstrate the method, triblock copolymer P104 is used as a templating amphiphile, generating unusually well-ordered 2D hexagonal (P6mm) mesoporous silica, while particle sizes and morphologies were controlled by varying the type of emulsifier and the method for emulsification. [on SciFinder(R)]
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| 39. |
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| 40. |
- Andersson, Nina, et al.
(författare)
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Dependency of cerebrospinal fluid outflow resistance on intracranial pressure
- 2008
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Ingår i: Journal of Neurosurgery. - 0022-3085 .- 1933-0693. ; 109:5, s. 918-922
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Tidskriftsartikel (refereegranskat)abstract
- OBJECT: The outflow resistance (Rout) of the cerebrospinal fluid (CSF) system has generally been accepted by most investigators as independent of intracranial pressure (ICP), but there are also those claiming that it is not. The general belief is that this question has been investigated numerous times in the past, but few studies have actually been specifically aimed at looking at this relationship, and no study has been able to provide scientific evidence to elucidate fully this fundamental and important issue. The objective of this study was to investigate the relationship between ICP and CSF outflow in 30 patients investigated for idiopathic normal-pressure hydrocephalus. METHODS: Lumbar infusion tests with constant pressure levels were performed, and ICP and corresponding flow were measured on 6 pressure levels for each patient. All data were standardized for comparison. RESULTS: In the range of moderate increases from baseline pressure (approximately 5-12 mm Hg, mean baseline pressure 11.7 mm Hg), the assumption of a pressure-independent Rout was confirmed (p = 0.5). However, when the pressure increment from baseline pressure was larger (approximately 15-22 mm Hg), the relationship had a nonlinear tendency (p < 0.05). CONCLUSIONS: The results of this study support the classic textbook theory of a pressure-independent Rout in the normal ICP range, where the CSF system is commonly operating. However, the theory might have to be questioned in regions where ICP exceeds baseline pressure by too much.
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| 41. |
- Andersson, Nina, et al.
(författare)
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Differences in clinical reasoning among nurses working in highly specialised paediatric care
- 2012
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 21:5-6, s. 870-879
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. The aim of the study was to examine differences in clinical reasoning among novice, experienced and specialist paediatric nurses. Background. Highly specialised paediatric care requires specific knowledge and ongoing skill performance of the nurses employed. There is a lack of research in how paediatric nurses manage the daily care problems they encounter and how they acquire the skills required to give patients the best possible care. More knowledge is needed about how paediatric nurses with different experience and education reason and communicate about paediatric patient situations. Design. The study was based on six recorded group discussions of a fictitious, but realistic paediatric case. Three categories of nurses: novices (n = 7), experienced (n = 7) and specialists (n = 7) from a paediatric hospital participated. A qualitative content analysis approach was chosen to examine differences in clinical reasoning. Results. Several themes were uncovered: child's social situation, child abuse and the child's illness, qualitative differences emerged in how the nurses discussed the case. Three approaches were identified: a task-oriented approach (novices and experienced), an action-oriented approach (novices and experienced) and hypothesis-oriented approach (specialists) while discussing the case. Conclusion. When comparing nurses in three competence groups, it was established that the groups with extensive experience and specialist education reasoned differently than the other groups. Between the novice and experienced groups, no obvious differences were found. Thus, the importance of experience alone for the development of competence is still an open question. Experience combined with further education appears important for developing professional competence in paediatric care. Relevance to clinical practice. Nurses' reasoning in clinical paediatric care is related to experience and training.
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| 42. |
- Andersson, Nina, et al.
(författare)
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Lymphocyte antigen 6 superfamily member D is a marker of urothelial and squamous differentiation : Implications for risk stratification of bladder cancer
- 2020
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Ingår i: Biomarker research. - : Springer Science and Business Media LLC. - 2050-7771. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Screening across a multitude of normal and malignant tissues revealed an enhanced expression of lymphocyte antigen 6 superfamily member D (LY6D) in squamous epithelium and urothelium, as well as in malignancies derived therefrom. The aim of this study was to further delineate the protein expression of LY6D in urothelial bladder cancer, with particular attention to its relationship with clinicopathological characteristics and patient outcome. Methods: Immunohistochemical expression of LY6D was assessed in tissue microarrays with urothelial bladder cancer tumours from three independent patient cohorts; one with transurethral resection of the bladder (TURB) specimens of mixed tumour stages from 110 consecutive cases, one with tumours of mixed stages from 260 incident cases in a population-based cohort, and one with paired TURB specimens, resected tumours and a subset of lymph node metastases from 145 patients with muscle-invasive bladder cancer (MIBC). Chi-square and non-parametric tests were applied to examine associations of LY6D expression with clinicopathological characteristics. Kaplan-Meier and Cox regression analyses were applied to examine 5-year overall survival (OS) and recurrence free survival (RFS) in relation to LY6D expression. Results: In the two cohorts with mixed stages, positive LY6D expression was denoted in 63 and 64% of the cases, respectively, and found to be significantly higher in low-grade and less invasive tumours. Negative LY6D expression was significantly associated with a reduced 5-year OS, although not independently of established prognostic factors. In the population-based cohort, LY6D expression was higher in tumours with squamous differentiation and lower in other variant histologies compared to pure urothelial tumours, and the association of LY6D expression with survival was somewhat enhanced after exclusion of the former. LY6D expression was generally lower in the MIBC cohort, and even more reduced in resected tumours compared to TURB specimens in patients who had not received neoadjuvant chemotherapy. There were no significant associations between LY6D expression and RFS, neither allover nor in relation to neoadjuvant chemotherapy. Conclusion: LY6D is a marker of urothelial and squamous differentiation that may add useful diagnostic and prognostic information to better guide the clinical management of bladder cancer, given that the presence of variant histology is taken into account.
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| 43. |
- Andersson, Nina, 1976-
(författare)
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Mesostructured materials : Synthesis towards applications
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A new class of materials with well-defined structures on mesoscopic (2-50 nm) length scales has attracted considerable interest during the last decade. These mesostructured mataterials are formed from the self-assembly of amphiphillic molecules and inorganic precursors. The aim of this thesis has been to develop preparation methods that are scalable, and at the same time allow for efficient structural control coupled with possibility to incorporate different functionalities.Two different industrial processes for production of particles with spherical morphology were successfully tailored for synthesis of well-ordered mesostructured particles. An existing spray drying method for a fast and continuous production was further developed, and for the first time, an emulsion-based method was implemented. The latter method resulted in superior control of both particle size and internal mesostructure.Mesostructured photochromic pigments were synthesised by incorporating photochromic dyes in the organic domains of the surfactant templated inorganic/organic mesostructured silica particles. The pigments were produced using a one-pot synthesis method employing an aerosol reactor, allowing control over both the internal mesostructure and the dye content. We show that transparent photochromic films can be prepared using latex binders and conventional coating technology.Mesoporous magnetic carrier materials were prepared by adding iron oxide nanoparticles during either the emulsion- or aerosol processing. The surfactant templated silica matrix displayed well-ordered internal pore architecture with limited pore blocking caused by the incorporated iron oxide nanoparticles. The iron oxide content was precisely controlled, and the magnetic properties were preserved during the processing. Finally we demonstrate that these materials can be used to magnetically separate water-soluble dyes from solution.
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| 44. |
- Andersson, Nina, et al.
(författare)
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One-Pot Synthesis of Well-Ordered Mesoporous Magnetic Carriers
- 2007
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Ingår i: Journal of Materials Chemistry. - : Royal Society of Chemistry (RSC). - 0959-9428 .- 1364-5501. ; 17:26, s. 2700-2705
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Tidskriftsartikel (refereegranskat)abstract
- The facile preparation of a mesoporous magnetic carrier technology is demonstrated. The micron-sized spherical mesostructured particles are prepared using a newly-developed, one-step, combined emulsion and solvent evaporation (ESE) method. The surfactant-templated silica matrix display a well-ordered internal pore architecture. Very limited pore blocking, and only to a limited degree disordered- or worm-like structures are observed, induced by the iron oxide nanoparticles added to provide the superparamagnetic properties.The iron oxide content was precisely controlled, and the magnetic properties were well preserved during the process. Finally we demonstrate the applicability of the magnetically separable mesoporous material as an adsorbent for specific dissolved materials from dilute aqueous solutions.
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| 45. |
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| 46. |
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| 47. |
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| 48. |
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| 49. |
- Andersson-Papadogiannakis, Nina
(författare)
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Nurses in paediatric care : competence, professional identity and research utilization
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Paediatric health care is becoming highly specialized and there is a need of nurses with specialist knowledge in the field. A large turnover of personnel and shortage of specially trained paediatric nurses have resulted in employing newly graduated and inexperienced nurses which further contributes to a decrease in professional competence. Development of professional competence is thus a process that has to be present at all times and must be evaluated continuously. The aim of this thesis was to identify how competence levels can be shown by describing and analyzing how nurses employed in paediatric care describe their nursing role and how they evaluate their professional level and attitudes to research utilization. Furthermore, we wanted to analyze qualitative differences between nurses with diverse formal education and experiences. Study I: When eighteen newly graduated and newly employed nurses described what they included in the concepts of responsibility, management of daily and rapidly changing situations and reflection, the results, analysed with qualitative content analysis, showed that nurses seemed to be fully aware of their responsibility regarding patients' well-being. The moral responsibilities, i.e. to act as the patient's 'advocate' and protect patient's personal integrity, was also evident. The nurses emphasized the need of time and space for reflection, but also time to acquire the necessary knowledge for providing optimal nursing. Study II: Fifty-six newly graduated and newly employed nurses at two children's hospitals responded in written form to the two questionnaires; Professional Self Description Form (PSDF) 21 items in total including empathy, flexibility, ability to act etc.), and Barriers Scale 29 items in total concerning perceived barriers to research utilization). The results showed that in PSDF the nurses scored highest in compassion, ambition and sensitivity. The lowest scores were found in preparedness to act and problem-solving ability, leadership and discriminating capacity. In the Barriers Scale the nurses perceived the lowest barriers in the affirmations pertaining to themselves as nurses and the highest barriers within the areas concerning the organization. Study III: We have compared newly graduated nurses who had received 'traditional' introductory training and had worked for two years at a children's hospital (Controls, n=36) with nurses going through a one year trainee programme (Trainees, n=42) and with paediatric nurses with specialist education (Specialists, n=35), using the same questionnaire as in study II. The results showed that the control nurses rated themselves higher in the PSDF description of persistence compared to the other two groups. No other differences were found. In the Barriers Scale the specialists scored higher barrier in the affirmations pertaining to themselves as nurses, especially in that the nurse is unwilling to test new ideas, that there are not enough experienced colleagues with whom to discuss research results, and that the administration does not allow implementation of research results. Study IV: When comparing nurses with diverse formal education and experiences concerning qualitative differences when reasoning about a paediatric case the results showed some disparities. The study was based on six recorded group discussions of a fictive but realistic paediatric case and was analysed by a qualitative latent content analysis. Out of the themes found: child's social situation, child abuse and the child's illness, qualitative differences emerged in how the nurses discussed the case. Three separate approaches were identified: a task-oriented, an action-oriented and a hypothesis-oriented, the latter being evident in the two groups comprised of nurses with specialist education. Between the two other groups, novice and experienced nurses, no differences were shown in how they discussed the case. In conclusion: Newly graduated nurses are aware of their responsibility as nurses in general. Self-evaluation of 'professional self' and barriers to research utilization are quite similar and independent of professional experience and knowledge. Nurses with long experience and specialist education have a different approach in how they discuss a fictive but realistic case compared to nurses with lower educational level. Thus, the importance of experience per se for the development of competence is still an open question. Working experience in combination with further, specialist education seems to be of importance in the development of professional competence in paediatric care.
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| 50. |
- Andersson-Papadogiannakis, Nina
(författare)
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Professional identity and competence in practice : self-evaluation of nurses in paediatric care
- 2006
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Paediatric health care is becoming increasingly high-specialised and there is a need to employ, nurses with specialist knowledge in the field. A large turnover of personnel and shortage of specially training in paediatric nursing have led to the need for employment of newly graduated nurses. How to best support these nurses to be those competent nurses that is needed have therefore been discussed. Aim: The overall aim of the study was to describe and analyse how nurses employed in paediatric care, describe the nurse profession, evaluate their professional level and attitude towards to research utilization. Study I: 18, newly graduated and newly employed nurses have described what they included in the concepts of responsibility, management of daily and rapidly changing situations and reflection. The results, analysed with qualitative content analysis, showed that nurses seemed to be fully aware of their responsibility regarding patients' well-being. The moral responsibilities, i.e. to function as the patient's "advocate" and protect patient's personal integrity, was also evident. The nurses emphasized the need for time and space for reflection, but also time to acquire the necessary knowledge for providing optimal nursing. Study II: 56 newly graduated nurses, and newly employed at two children's hospitals, have responded to the two questionnaires; Professional Self Description Form (PSDF), where nurses evaluate themselves regarding empathy, flexibility, ability to act etc (21 items in total), and Barriers Scale, a questionnaire concerning perceived barriers to research utilization (29 items in total). In the PSDF the nurses rated themselves highest in items of In the newly graduated nurses' scorings at the time for their employment, the highest scores were found in consideration (mean 4.05), ambition (mean 3.91) and sensitivity (mean 3.84). The lowest scores were found in grasp of ideas (mean 2.69), leadership (mean 2.73) and discrimination (mean 2.89). Regarding Barriers Scale the nurses perceived the highest barriers in using research results in the health care mostly related to the organisation itself (Study II). Study III: is a comparison two years after graduation between 36 nurses who received "traditional" introductory training and had worked for two years at a children's hospital (Controls), and 42 nurses who went through a one year trainee programme (Trainee). These were also compared to 35 paediatric nurses with specialist education. (Specialists). They responded to the same questionnaire as in study II. The control nurses rated themselves higher in the PSDF description of persistence (p<0.024). No other differences were found. In the Barriers Scale the specialists scored higher barriers in the affirmations pertaining to themselves as nurses, especially in that nurse is unwilling to test new ideas, that there are not enough experienced colleagues with whom to discuss research results, and that the administration does not allow implementation of research results. In conclusion self-evaluation of professional self and barriers to research utilisation are quite similar and independent of professional experience and knowledge. How to best evaluate, support and further develop nurses in their professional role is still a question that needs an answer.
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