| 1. |
- Semb, Olof, et al.
(författare)
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Learning psychology as a challenging process towards development as well as "studies as usual" : a thematic analysis of medical students' reflective writing
- 2014
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Ingår i: Advances in Medical Education and Practice. - 1179-7258. ; 5, s. 491-498
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Tidskriftsartikel (refereegranskat)abstract
- Reflective writing in medical training has been shown to be most effective when combined with some form of personal meeting or dialog. During a course in medical psychology for medical students, reflective texts were followed up by an individual personal talk with a teacher from the course. Thematic analysis of the texts revealed four separate sub-themes: 1) the course has enabled me and the class to develop, which is good albeit arduous; 2) understanding myself is a resource in understanding people as well as knowing psychology; 3) the course provided me with new, purely intellectual skills as well as eye-openers; and 4) the receiving teacher is an integral part of my reflective writing. The main theme, capturing the students' writing process, concluded that students perceive the course as "Learning psychology as a challenging process towards development" as well as "studies as usual". Ethical, psychological, and pedagogical aspects are discussed in the paper.
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| 2. |
- Sundbom, Elisabet, et al.
(författare)
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Reflekterande skrivande och personligt samtal i läkarutbildningen: nya moment i psykologikurs bidrog till ökad självkännedom : [Reflective writing and personal talks in medical education: New segments in the medical psychology course helped to increase self-awarness]
- 2013
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Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 110:25-26
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Tidskriftsartikel (refereegranskat)abstract
- There is a national goal for medical students to gain self-awareness during their training. However, teaching methods and examination procedures supporting this goal are rarely discussed. Two new course segments – weekly newsletters and personal talks – aimed at stimulating self-reflection and self-awareness during the Medical Psychology course are presented, along with a student evaluation and the teachers’ experiences of the segments. The course evaluations and teachers’ comments support the perception that the new segments help to increase self-awareness. The teachers share the experience that the motivation, trust and openness shown by most of the students in their letters and talks are an impetus and important basis for increased self-reflection and self-awareness. For many students, personal talks have been important from a psychosocial point of view. It was possible to capture those in need of support and mediate further contacts when necessary.
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| 3. |
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| 4. |
- Andén, Annika, et al.
(författare)
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To make a difference - how GPs conceive consultation outcomes : A phenomenographic study
- 2009
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Ingår i: BMC Family Practice. - London : Springer Science and Business Media LLC. - 1471-2296. ; 10:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Outcomes from GPs consultations have been measured mainly with disease specific measures and with patient questionnaires about health, satisfaction, enablement and quality. The aim of this study was to explore GPs conceptions of consultation outcomes.Methods: Interviews with 17 GPs in groups and individually about consultation outcomes from recently performed consultations were analysed with a phenomenographic research approach.Results: The GPs conceived outcomes in four ways: patient outcomes, GPs self-evaluation, relationship building and change of surgery routines.Conclusion: Patient outcomes, as conceived by the GPs, were generally congruent with those that had been taken up in outcome studies. Relationship building and change of surgery routines were outcomes in preparation for consultations to come. GPs made self-assessments related to internalized norms, grounded on a perceived collegial professional consensus. Considerations of such different aspects of outcomes can inspire professional development.
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| 5. |
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| 6. |
- Andersson, Bert, 1952, et al.
(författare)
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Heart rate dependency of cardiac performance in heart failure patients treated with metoprolol.
- 1999
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Ingår i: European heart journal. - 0195-668X. ; 20:8, s. 575-83
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Tidskriftsartikel (refereegranskat)abstract
- To investigate whether a low heart rate is necessary to maintain improvement in myocardial function after long-term treatment with a beta-blocker in patients with heart failure.Forty-eight patients with congestive heart failure were investigated: 30 patients with dilated cardiomyopathy participating in a placebo-controlled trial (15 on placebo, 15 on metoprolol), and 18 patients treated by metoprolol in an open protocol. Investigations of spontaneous heart rate and of matched paced heart rates were performed at baseline and after 3, 6 and 12 months of follow-up by radionuclide angiography. There were significant signs of improvement in systolic indices of the spontaneous heart rate in the metoprolol-treated group (peak ejection rate: 0.98 to 1.32 end-diastolic volume.s-1, P = 0.015) as compared to placebo (1.14 to 1.19 end-diastolic volume.s-1, not significant). Similar effects were observed during the matched paced heart rate (peak ejection rate: metoprolol 0.91 to 1.38 end-diastolic volume.s-1, P = 0.037; placebo 1.22 to 1.12 end-diastolic volume.s-1, not significant). No effects were observed in the early peak filling rate. Left ventricular volumes decreased during metoprolol treatment, both for the spontaneous heart rate and during matched pacing.These data imply that beta-blocker treatment improves the force-frequency relationship of myocardial performance. A lower heart rate is not necessary to maintain cardiac function on a short-term basis, once myocardial recovery has occurred.
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| 7. |
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| 8. |
- Andersson, Linda, 1973, et al.
(författare)
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PLD1 and ERK2 regulate cytosolic lipid droplet formation
- 2006
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Ingår i: J Cell Sci. ; 119:Pt 11, s. 2246-57
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Tidskriftsartikel (refereegranskat)abstract
- We have previously uncovered roles for phospholipase D (PLD) and an unknown cytosolic protein in the formation of cytosolic lipid droplets using a cell-free system. In this report, PLD1 has been identified as the relevant isoform, and extracellular signal-regulated kinase 2 (ERK2) as the cytosolic protein. Increased expression of PLD1 increased lipid droplet formation whereas knockdown of PLD1 using siRNA was inhibitory. A role for ERK2 in basal lipid droplet formation was revealed by overexpression or microinjection, and ablation by siRNA knockdown or pharmacological inhibition. Similar manipulations of other Map kinases such as ERK1, JNK1 or JNK2 and p38alpha or p38beta were without effect. Insulin stimulated the formation of lipid droplets and this stimulation was inhibited by knockdown of PLD1 (by siRNA) and by inhibition or knockdown (by siRNA) of ERK2. Inhibition of ERK2 eliminated the effect of PLD1 on lipid droplet formation without affecting PLD1 activity, suggesting that PLD1 functions upstream of ERK2. ERK2 increased the phosphorylation of dynein which increased the amount of the protein on ADRP-containing lipid droplets. Microinjection of antibodies to dynein strongly inhibited the formation of lipid droplets, demonstrating that dynein has a central role in this formation. Thus dynein is a possible target for ERK2.
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| 9. |
- Andersson, Peter, et al.
(författare)
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Low symptomatic load in Crohn's disease with surgery and medicine as complementary treatments
- 1998
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa Healthcare. - 0036-5521 .- 1502-7708. ; 33:4, s. 423-429
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Tidskriftsartikel (refereegranskat)abstract
- Background: The treatment of Crohn's disease has changed owing to the recognition of its chronicity. Medical maintenance treatment and limited resections have evolved as major concepts of management, regarded as complementary, and both aim at reducing the symptoms.Methods: We investigated the symptomatic load in Crohn's disease as reflected in a cross-sectional study of the symptom index, physicians' assessment, and the patients' perception of health. A cohort of 212 patients from the primary catchment area and 125 referred patients were studied.Results: Of catchment area patients, 83% were receiving medication, and the annual rate of abdominal surgery was 5.7%. Corresponding figures for the referred patients were 82% and 10.3%. According to the symptom index, 87% of catchment area patients were in remission or had only mild symptoms; according to the physicians' assessment, 90% were. The patients' median perception of health was 90% of perfect health according to the visual analogue scale. The figures were similar for referred patients, except that referrals were considered more diseased by the physician.Conclusion: The great majority of patients with Crohn's disease are able to live in remission or experience only mild symptoms.
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| 10. |
- Andersson, Pernilla, et al.
(författare)
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Tools and drivers for chemical footprints : A mapping study of available tools and current policy drivers
- 2024
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The emission of hazardous substances occurs from the cradle to grave of products and services. Calculating a chemical footprint can help companies prioritize actions to reduce the potential impacts.This report is the result of a search for available tools for calculating chemical footprints and our attempt to identify regulatory drivers for such assessments. While tools and policy drivers for chemical footprints are available, there is still a need for development.
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| 11. |
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| 12. |
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| 13. |
- Andersson, Sven-Olof, et al.
(författare)
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Adverse Childhood Experiences are associated with choice of partner, both partners' relationship and psychosocial health as reported one year after birth of a common child : A cross-sectional study
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Adverse Childhood Experiences (ACEs) are common and known to have consequences for individuals' adult health, leading to a higher risk of illness. The aims of the study were to investigate the ACEs in couples, to examine the extent of assortative mating and to investigate the association between the relationship of the load of ACEs within couples and health outcomes, one year after the birth of a common child. At antenatal clinics in Sweden 818 couples were recruited and investigated one year after the birth of a common child answering a questionnaire including the exposure to ten ACE categories and several outcome variables. In total, 59% of both mothers and partners reported exposure to at least one of the ten ACE categories. Among the mothers 11% and among the partners 9% reported exposure to ≥4 ACE categories (p = 0.12). There was a correlation between the numbers of ACE categories reported by the mothers and their partners (Spearman's ρ = 0.18, p<0.001). This association pertained to six of the ten ACE categories. In multiple logistic regression analyses, there were associations between the ACE exposure load and unfavourable outcomes among the mothers, the partners and within the couples. Unfavourable outcomes concerning health were most prominent in couples where both members reported exposures to ≥4 ACE categories (self-rated bad health (OR 13.82; CI 2.75-69.49), anxiety (OR 91.97; CI 13.38-632.07), depression (OR 17.42; CI 2.14-141.78) and perceived stress (OR 11.04; CI 2.79-43.73)). Mothers exposed to ACEs tend to have partners also exposed to ACEs. Exposure to ACEs was associated with bad health and unfavourable life conditions within the couples, especially among couples where both members reported exposure to multiple ACEs. These results should stimulate incentives to find, to support and to treat individuals and couples where both members report multiple ACEs. The consequences for the children should be further studied as well as how these families should be treated in health care and society.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
- Andersson, Sven-Olof, 1943-
(författare)
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Time and general practice consultations : aspects of length, attendance and quality
- 1995
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The consultation is the GP’s form of work. How long a consultation should be, and what short/long consultations imply with regard to the satisfaction of patient and doctor has been much debated. The aim of this thesis was to study consultations with regard to content and time consumption in a short term and long term perspective. Three studies were carried out.1. Consultations with the members of a group of GPs were investigated, where patients and doctors separately assessed different aspects of the consultation, and their ratings were related to the real length of the consultations. The following questions were posed: Was there time enough? Could the patient tell the doctor about her/his problems? Were the problems physical or psychological? 2. Nurses at the primary care health centres were interviewed about their considerations in booking short or long appointments for the patients. 3. Patients who frequently attended one health centre during one year and consumed much time were studied. Quantitative and qualitative methods were used.The results of the first study (Papers I-III) show that the average length of the consultations was 21 minutes; there was considerable variation (ranging from 3 to 60 minutes). (About 600 consultations with 7 male doctors were registered in two batches). The doctors’ mean consultation length also varied widely, from 13-28 minutes. Consultations dealing with psychological problems were longer than those dealing with physical problems. Older patients had longer consultations than younger patients, and female patients had somewhat longer consultations than male patients. The patients were generally more satisfied with the consultations than the doctors were, and there were no clear affinities between long consultations and high satisfaction. Male patients and patients with physical problems mainly received short consultations, whereas patients with ”mixed" problems and older patients received long consultations.The single factors most decisive for the length of a consultation were ‘the doctor factor’, the character of the problem and the age of the patient. "Good” consultations (operational definition) were associated primarily with ‘the doctor factor’, and the real length of the consultations was less important.The interviews with ten experienced primary care nurses (Paper IV) showed that the nurses worked in two perspectives: in the ”immediate” perspective, appointments were booked according to rules which directly impacted the length of the visit, and in the "reflective" perspective, appointments were booked with a view to the quality of the work at the health centre and the long-term time consumption. Other factors of importance were the patient’s age and problem(s), the doctor’s experience and working style, and the current situation at the health centre.Frequent attenders (FAs) at one health centre (Paper V) were compared with a contrast group of matched patients (CPs). The FAs represented 1.7% of the population of the catchment area and made 15% of the visits. The FAs were a heterogeneous group where small boys, women of working age and pensioners of both sexes were overrepresented. The FAs had higher consultation frequency than the CPs during the year of investigation, but few remained FAs for longer periods. The FAs had more problems and more complex problems than the CPs. Complaints regarding the musculo-skeletal organs, and psychosocial problems were common among these patients, often in combination.The present work thus shows that longer consultations do not naturally imply higher patient satisfaction. Other factors than the time factor, in particular ‘the doctor factor’ seem to be more important. ‘The doctor factor’, the characteristics of the patients, the type of problem and the situation at the health centre also have a bearing on consultation length and time consumption in a short-term as well as long-term perspective. The implications of these factors and their relative importance are discussed, but further studies of certain issues, such as ‘the doctor factor’, are necessary.
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| 18. |
- Andersson, Thord, et al.
(författare)
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Consistent intensity inhomogeneity correction in water-fat MRI
- 2015
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley-Blackwell. - 1053-1807 .- 1522-2586. ; 42:2
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To quantitatively and qualitatively evaluate the water-signal performance of the consistent intensity inhomogeneity correction (CIIC) method to correct for intensity inhomogeneitiesMETHODS: Water-fat volumes were acquired using 1.5 Tesla (T) and 3.0T symmetrically sampled 2-point Dixon three-dimensional MRI. Two datasets: (i) 10 muscle tissue regions of interest (ROIs) from 10 subjects acquired with both 1.5T and 3.0T whole-body MRI. (ii) Seven liver tissue ROIs from 36 patients imaged using 1.5T MRI at six time points after Gd-EOB-DTPA injection. The performance of CIIC was evaluated quantitatively by analyzing its impact on the dispersion and bias of the water image ROI intensities, and qualitatively using side-by-side image comparisons.RESULTS: CIIC significantly ( P1.5T≤2.3×10-4,P3.0T≤1.0×10-6) decreased the nonphysiological intensity variance while preserving the average intensity levels. The side-by-side comparisons showed improved intensity consistency ( Pint≤10-6) while not introducing artifacts ( Part=0.024) nor changed appearances ( Papp≤10-6).CONCLUSION: CIIC improves the spatiotemporal intensity consistency in regions of a homogenous tissue type.
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| 19. |
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| 20. |
- Bill-Axelson, Anna, et al.
(författare)
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Radical prostatectomy versus watchful waiting in early prostate cancer
- 2005
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 352:19, s. 1977-1944
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:In 2002, we reported the initial results of a trial comparing radical prostatectomy with watchful waiting in the management of early prostate cancer. After three more years of follow-up, we report estimated 10-year results.METHODS:From October 1989 through February 1999, 695 men with early prostate cancer (mean age, 64.7 years) were randomly assigned to radical prostatectomy (347 men) or watchful waiting (348 men). The follow-up was complete through 2003, with blinded evaluation of the causes of death. The primary end point was death due to prostate cancer; the secondary end points were death from any cause, metastasis, and local progression.RESULTS:During a median of 8.2 years of follow-up, 83 men in the surgery group and 106 men in the watchful-waiting group died (P=0.04). In 30 of the 347 men assigned to surgery (8.6 percent) and 50 of the 348 men assigned to watchful waiting (14.4 percent), death was due to prostate cancer. The difference in the cumulative incidence of death due to prostate cancer increased from 2.0 percentage points after 5 years to 5.3 percentage points after 10 years, for a relative risk of 0.56 (95 percent confidence interval, 0.36 to 0.88; P=0.01 by Gray's test). For distant metastasis, the corresponding increase was from 1.7 to 10.2 percentage points, for a relative risk in the surgery group of 0.60 (95 percent confidence interval, 0.42 to 0.86; P=0.004 by Gray's test), and for local progression, the increase was from 19.1 to 25.1 percentage points, for a relative risk of 0.33 (95 percent confidence interval, 0.25 to 0.44; P<0.001 by Gray's test).CONCLUSIONS:Radical prostatectomy reduces disease-specific mortality, overall mortality, and the risks of metastasis and local progression. The absolute reduction in the risk of death after 10 years is small, but the reductions in the risks of metastasis and local tumor progression are substantial.
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| 21. |
- Boström, Pontus, 1982, et al.
(författare)
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Cytosolic lipid droplets increase in size by microtubule-dependent complex formation
- 2005
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Ingår i: Arterioscler Thromb Vasc Biol. - 1524-4636. ; 25:9, s. 1945-51
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Adipocyte differentiation-related protein (ADRP)-containing lipid droplets have an essential role in the development of insulin resistance and atherosclerosis. Such droplets form in a cell-free system with a diameter of 0.1 to 0.4 microm, while the droplets present in cells vary in size, from small to very large, suggesting that the droplets can increase in size after being assembled. We have addressed this possibility. METHODS AND RESULTS: Experiments in NIH 3T3 cells demonstrated that the lipid droplets could increase in size independently of triglyceride biosynthesis. NIH 3T3 cells were either microinjected with ADRP-GFP (green fluorescent protein) or stained with Nile Red and followed by confocal microscopy and time-lapse recordings. The results showed that lipid droplets formed complexes with each other, with a volume equal to the sum of the merging particles. The formation of complexes could be inhibited by the nocodazole-induced depolymerization of the microtubules; thus, the process is dependent on microtubules. The presence of dynein on ADRP-containing droplets supports a role for this motor protein. CONCLUSIONS: Lipid droplets can grow after they have been assembled. This increase in size is independent of triglyceride biosynthesis and involves formation of complexes, which requires intact microtubules.
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| 22. |
- Boström, Pontus, 1982, et al.
(författare)
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SNARE proteins mediate fusion between cytosolic lipid droplets and are implicated in insulin sensitivity.
- 2007
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Ingår i: Nature cell biology. - : Springer Science and Business Media LLC. - 1465-7392 .- 1476-4679. ; 9:11, s. 1286-93
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Tidskriftsartikel (refereegranskat)abstract
- The accumulation of cytosolic lipid droplets in muscle and liver cells has been linked to the development of insulin resistance and type 2 diabetes. Such droplets are formed as small structures that increase in size through fusion, a process that is dependent on intact microtubules and the motor protein dynein. Approximately 15% of all droplets are involved in fusion processes at a given time. Here, we show that lipid droplets are associated with proteins involved in fusion processes in the cell: NSF (N-ethylmaleimide-sensitive-factor), alpha-SNAP (soluble NSF attachment protein) and the SNAREs (SNAP receptors), SNAP23 (synaptosomal-associated protein of 23 kDa), syntaxin-5 and VAMP4 (vesicle-associated membrane protein 4). Knockdown of the genes for SNAP23, syntaxin-5 or VAMP4, or microinjection of a dominant-negative mutant of alpha-SNAP, decreases the rate of fusion and the size of the lipid droplets. Thus, the SNARE system seems to have an important role in lipid droplet fusion. We also show that oleic acid treatment decreases the insulin sensitivity of heart muscle cells, and this sensitivity is completely restored by transfection with SNAP23. Thus, SNAP23 might be a link between insulin sensitivity and the inflow of fatty acids to the cell.
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| 23. |
- Boström, Pontus, 1982, et al.
(författare)
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The assembly of lipid droplets and its relation to cellular insulin sensitivity.
- 2009
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Ingår i: Biochemical Society transactions. - 1470-8752. ; 37:Pt 5, s. 981-5
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Tidskriftsartikel (refereegranskat)abstract
- The assembly of lipid droplets is dependent on PtdIns(4,5)P(2) that activates PLD(1) (phospholipase D(1)), which is important for the assembly process. ERK2 (extracellular-signal-regulated kinase 2) phosphorylates the motor protein dynein and sorts it to lipid droplets, allowing them to be transported on microtubules. Lipid droplets grow in size by fusion, which is dependent on dynein and the transfer on microtubules, and is catalysed by the SNARE (soluble N-ethylmaleimide-sensitive fusion protein-attachment protein receptor) proteins SNAP-23 (23 kDa synaptosome-associated protein), syntaxin-5 and VAMP-4 (vesicle-associated protein 4). SNAP-23 is also involved in the insulin-dependent translocation of the glucose transporter GLUT4 to the plasma membrane. Fatty acids induce a missorting of SNAP-23, from the plasma membrane to the interior of the cell, resulting in cellular insulin resistance that can be overcome by increasing the levels of SNAP-23. The same missorting of SNAP-23 occurs in vivo in skeletal-muscle biopsies from patients with T2D (Type 2 diabetes). Moreover, there was a linear relation between the amount of SNAP-23 in the plasma membrane from human skeletal-muscles biopsies and the systemic insulin-sensitivity. Syntaxin-5 is low in T2D patients, which leads to a decrease in the insulin-dependent phosphorylation of Akt (also known as protein kinase B). Thus both SNAP-23 and syntaxin-5 are highly involved in the development of insulin resistance.
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| 24. |
- Boström, Pontus, 1982, et al.
(författare)
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The SNARE protein SNAP23 and the SNARE-interacting protein Munc18c in human skeletal muscle are implicated in insulin resistance/type 2 diabetes.
- 2010
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Ingår i: Diabetes. - : American Diabetes Association. - 1939-327X .- 0012-1797. ; 59:8, s. 1870-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Our previous studies suggest that the SNARE protein synaptosomal-associated protein of 23 kDa (SNAP23) is involved in the link between increased lipid levels and insulin resistance in cardiomyocytes. The objective was to determine whether SNAP23 may also be involved in the known association between lipid accumulation in skeletal muscle and insulin resistance/type 2 diabetes in humans, as well as to identify a potential regulator of SNAP23. RESEARCH DESIGN AND METHODS: We analyzed skeletal muscle biopsies from patients with type 2 diabetes and healthy, insulin-sensitive control subjects for expression (mRNA and protein) and intracellular localization (subcellular fractionation and immunohistochemistry) of SNAP23, and for expression of proteins known to interact with SNARE proteins. Insulin resistance was determined by a euglycemic hyperinsulinemic clamp. Potential mechanisms for regulation of SNAP23 were also investigated in the skeletal muscle cell line L6. RESULTS: We showed increased SNAP23 levels in skeletal muscle from patients with type 2 diabetes compared with that from lean control subjects. Moreover, SNAP23 was redistributed from the plasma membrane to the microsomal/cytosolic compartment in the patients with the type 2 diabetes. Expression of the SNARE-interacting protein Munc18c was higher in skeletal muscle from patients with type 2 diabetes. Studies in L6 cells showed that Munc18c promoted the expression of SNAP23. CONCLUSIONS: We have translated our previous in vitro results into humans by showing that there is a change in the distribution of SNAP23 to the interior of the cell in skeletal muscle from patients with type 2 diabetes. We also showed that Munc18c is a potential regulator of SNAP23.
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| 25. |
- Bygren, Lars Olov, 1936-, et al.
(författare)
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Cultural Participation and Health : A Randomized Controlled Trial Among Medical Care Staff
- 2009
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Ingår i: Psychosomatic Medicine. - : Wolters Kluwer. - 0033-3174 .- 1534-7796. ; 71:4, s. 469-473
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Population studies demonstrate that attending cultural events is conducive to improved health when baseline health, income, education, and health habits are taken into account. Animal experiments suggest possible mechanisms. We studied the link in humans between attending cultural events and health in a randomized controlled trial. Methods: Members of the local government officers' union in the health services in Umea, Sweden, were invited to the experiment and 101 people registered for fine arts visits once a week for 8 weeks. They chose films, concerts, or art exhibitions visits, or singing in a choir and were then randomized into 51 cases, starting at once, and 50 controls starting after the trial. Health was assessed before randomization and after the experimental period using the instrument for perceived health, short form (SF)-36, and tests of episodic memory, saliva-cortisol and immunoglobulin. The results were analyzed using a mixed design analysis of variance. Results: The SF-36 Composite Score called physical health improved in the intervention group and decreased among controls during the experiment (F(1,87) = 7.06, p = .009). The individual factor of the SF-36 called social functioning, improved more in the intervention group than among controls (F(1,98) = 8.11, p = .005) as well as the factor vitality (F(1,98) = 5.26, p = .024). The six other factors and the Mental Health Composite Score, episodic memory, cortisol and immunoglobulin levels did not change otherwise than among controls. Mechanisms are left to be identified. Conclusion: Fine arts stimulations improved perceived physical health, social functioning, and vitality.
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| 26. |
- Chapman, Henry N, et al.
(författare)
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Femtosecond X-ray protein nanocrystallography.
- 2011
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 470:7332, s. 73-7
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Tidskriftsartikel (refereegranskat)abstract
- X-ray crystallography provides the vast majority of macromolecular structures, but the success of the method relies on growing crystals of sufficient size. In conventional measurements, the necessary increase in X-ray dose to record data from crystals that are too small leads to extensive damage before a diffraction signal can be recorded. It is particularly challenging to obtain large, well-diffracting crystals of membrane proteins, for which fewer than 300 unique structures have been determined despite their importance in all living cells. Here we present a method for structure determination where single-crystal X-ray diffraction 'snapshots' are collected from a fully hydrated stream of nanocrystals using femtosecond pulses from a hard-X-ray free-electron laser, the Linac Coherent Light Source. We prove this concept with nanocrystals of photosystem I, one of the largest membrane protein complexes. More than 3,000,000 diffraction patterns were collected in this study, and a three-dimensional data set was assembled from individual photosystem I nanocrystals (∼200nm to 2μm in size). We mitigate the problem of radiation damage in crystallography by using pulses briefer than the timescale of most damage processes. This offers a new approach to structure determination of macromolecules that do not yield crystals of sufficient size for studies using conventional radiation sources or are particularly sensitive to radiation damage.
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| 27. |
- Collin, Sven-Olof, 1957-, et al.
(författare)
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Explaining the choice of accounting standards in municipal corporations
- 2004
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Positive accounting theory (PAT) tries to explain corporations’ choices of accounting standards. Empirical research in this field has been focused on the choices made by large, listed corporations. We challenge this grounding through extending the empirical domain by testing PAT on Swedish municipal corporations. In order to be able to explain the choice of accounting standards in municipal corporations, PAT has to be complemented by institutional factors that can consider the forces of coercive, mimetic and normative pressures presented by the environment. The sample of municipal corporations showed that the choice of standards was significantly explained by both PAT factors and institutional factors. The conclusion is that municipal corporations tend to be subject to institutional influence by accepting the practice of their auditing firm and by using specific standards order to legitimise themselves when they have reached a certain size. Additionally, they tend to act according to PAT predictions by using those standards that are able to reduce the profit to levels that society deems acceptable for municipal corporations. Accordingly, through extending the empirical domain to municipal corporations, this paper’s contribution is to show that PAT needs the complementary institutional factors in order to be capable of explaining choice of accounting standards in firms.
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| 28. |
- Collin, Sven-Olof, et al.
(författare)
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Explaining the choice of accounting standards in municipal corporations
- 2004
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Positive accounting theory (PAT) tries to explain corporations’ choices of accounting standards. Empirical research in this field has been focused on the choices made by large, listed corporations. We challenge this grounding through extending the empirical domain by testing PAT on Swedish municipal corporations. In order to be able to explain the choice of accounting standards in municipal corporations, PAT has to be complemented by institutional factors that can consider the forces of coercive, mimetic and normative pressures presented by the environment. The sample of municipal corporations showed that the choice of standards was significantly explained by both PAT factors and institutional factors. The conclusion is that municipal corporations tend to be subject to institutional influence by accepting the practice of their auditing firm and by using specific standards order to legitimise themselves when they have reached a certain size. Additionally, they tend to act according to PAT predictions by using those standards that are able to reduce the profit to levels that society deems acceptable for municipal corporations. Accordingly, through extending the empirical domain to municipal corporations, this paper’s contribution is to show that PAT needs the complementary institutional factors in order to be capable of explaining choice of accounting standards in firms.
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| 29. |
- Collin, Sven-Olof Yrjö, et al.
(författare)
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Explaining the choice of accounting standards in municipal corporations : Positive accounting theory and institutional theory as competitive or concurrent theories
- 2009
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Ingår i: Critical Perspectives on Accounting. - Camden : Academic Press. - 1045-2354 .- 1095-9955. ; 20:2, s. 141-174
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Tidskriftsartikel (refereegranskat)abstract
- Municipal corporations exist in an institutional twilight area, being both private and public, a characteristic, which presumably would be reflected in their choice of accounting standards. The literature of accounting choice does not, however, live in a twilight area, but is fragmented into two main divisions: positive accounting theory (PAT) and institutional theory (IT); only in a very few cases do the theories meet or cross-fertilize. We use both theories in this paper and derive hypotheses from them to explain accounting choices made by municipal corporations. Through testing the hypotheses on a sample of 545 Swedish municipal corporations, we indicate the empirical relevance of both PAT and IT. We conclude by suggesting an integrative approach of PAT and IT in an eclectic alternative. © 2008 Elsevier Ltd. All rights reserved.
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| 30. |
- Davidsson, Sabina, 1972-, et al.
(författare)
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Androgen deprivation therapy in men with prostate cancer is not associated with COVID-2019 infection
- 2023
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Ingår i: The Prostate. - : Alan R. Liss Inc.. - 0270-4137 .- 1097-0045. ; 83:6, s. 555-562
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Androgens may play a role in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and host responses as the virus is dependent on the androgen-regulated protein transmembrane serine protease 2 for cell entry. Studies have indicated that prostate cancer patients receiving androgen deprivation therapy (ADT) are at reduced risk of SARS-CoV-2 infection and serious complications compared with patients without ADT, but data are inconsistent.METHODS: A total of 655 prostate cancer patients who were under surveillance at two urology departments in Sweden on April 1, 2020 were included in the study as well as 240 patients with benign prostatic hyperplasia (BPH). At follow-up early in 2021, the participants completed a questionnaire containing information about symptoms compatible with coronavirus disease 2019 (COVID-19). Blood samples were also collected for the assessment of SARS-CoV-2 IgG antibodies (SARS-CoV-2 Total; Siemens). We used multivariable logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between ADT and the risk of SARS-CoV-2 infection.RESULTS: The cumulative incidence of SARS-CoV-2 seropositivity was 13.4% among patients receiving ADT and 10.4% among patients without ADT. After adjusting for potential confounders, we observed no differences in symptoms or risk of SARS-CoV-2 infection between patients with and without ADT (OR: 0.98; 95% CI: 0.52-1.85). Higher body mass index, Type 1 diabetes, and prostate cancer severity, defined by high Gleason score (8-10; OR: 2.06; 95% CI: 1.04-4.09) or elevated levels of prostate-specific antigen (>20 µg/l; OR: 2.15; 95% CI: 1.13-4.07) were associated with increased risk of SARS-CoV-2 infection. Overall, the risk of SARS-CoV-2 infection was not higher among men with prostate cancer than among men with BPH.CONCLUSIONS: Our results do not support the hypothesis that ADT use in prostate cancer patients reduces the risk or symptom severity of SARS-CoV-2 infection or that prostate cancer patients are at increased risk of COVID-19 compared with men without prostate cancer.
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| 31. |
- Ekeberg, Tomas, 1983-, et al.
(författare)
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Three-dimensional structure determination with an X-ray laser
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Three-dimensional structure determination of a non-crystalline virus has been achieved from a set of randomly oriented continuous diffraction patterns captured with an X-ray laser. Intense, ultra-short X-ray pulses intercepted a beam of single mimivirus particles, producing single particle X-ray diffraction patterns that are assembled into a three-dimensional amplitude distribution based on statistical consistency. Phases are directly retrieved from the assembled Fourier distribution to synthesize a three-dimensional image. The resulting electron density reveals a pseudo-icosahedral asymmetric virion structure with a compartmentalized interior, within which the DNA genome occupies only about a fifth of the volume enclosed by the capsid. Additional electron microscopy data indicate the genome has a chromatin-like fiber structure that has not previously been observed in a virus.
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| 32. |
- Erlandsson, Ann, 1968-, et al.
(författare)
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High inducible nitric oxide synthase in prostate tumor epithelium is associated with lethal prostate cancer
- 2018
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Ingår i: Scandinavian journal of urology. - : Informa Healthcare. - 2168-1805 .- 2168-1813. ; 52:2, s. 129-133
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to investigate the role of inducible nitric oxide synthase (iNOS) in lethal prostate cancer (PCa) by studying the iNOS immunoreactivity in tumor tissue from men diagnosed with localized PCa.MATERIALS AND METHODS: This study is nested within a cohort of men diagnosed with incidental PCa undergoing transurethral resection of the prostate (the Swedish Watchful Waiting Cohort). To investigate molecular determinants of lethal PCa, men who died from PCa (n = 132) were selected as cases; controls (n = 168) comprised men with PCa who survived for at least 10 years without dying from PCa during follow-up. The immunoreactivity of iNOS in prostate tumor epithelial cells and in cells of the surrounding stroma was scored as low/negative, moderate or high. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for lethal PCa according to iNOS category.RESULTS: There was no association between iNOS immunoreactivity in stroma and lethal disease. However, when comparing high versus low/negative iNOS immunoreactivity in epithelial cells, the OR for lethal PCa was 3.80 (95% CI 1.45-9.97).CONCLUSION: Patients with localized PCa have variable outcomes, especially those with moderately differentiated tumors. Identifying factors associated with long-term PCa outcomes can elucidate PCa tumor biology and identify new candidate prognostic markers. These findings support the hypothesis that high iNOS in tumor epithelium of the prostate is associated with lethal disease.
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| 33. |
- Erlandsson, Ann, 1968-, et al.
(författare)
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M2 macrophages and regulatory T cells in lethal prostate cancer.
- 2019
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Ingår i: The Prostate. - : John Wiley & Sons. - 0270-4137 .- 1097-0045. ; 79:4, s. 363-369
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Prostate cancer (PCa) is one of the most frequently diagnosed cancers in the world. Emerging evidence suggests that inflammatory cells such as M2 macrophages and regulatory T cells (Tregs ) can contribute to cancer progression by suppressing the anti-tumor immune response. This study investigated the number of CD163-positive M2 macrophages in PCa tissue. It also investigated the correlation and interaction of M2 macrophages and Tregs .METHODS: This nested case-control study included subjects from a cohort of men diagnosed with PCa as an incidental finding during transurethral resection of the prostate. The cases were 225 men who died from PCa, and the controls were 367 men who survived more than 10 years after PCa diagnosis without disease progression. Infiltrating CD163-positive M2 macrophages and FOXP3/CD4-positive Tregs in PCa tissue were identified using immunohistochemistry. The correlation and interaction of M2 macrophages and Tregs were assessed using Spearman's rank-order correlation and a likelihood test, respectively. Logistic regression was used to estimate odds ratios (ORs) for lethal PCa and macrophage counts.RESULTS: The number of M2 macrophages and Tregs showed a significant correlation (P < 0.001) but no interactions. The OR for lethal PCa was 1.93 (95%CI: 1.23-3.03) for men with high numbers of M2 macrophages. Also for cases with uncertain outcome (GS categories 3 + 4 and 4 + 3) high numbers of M2 macrophages does predict a poorer prognosis.CONCLUSIONS: Our data showed that men with high numbers of M2 macrophages in the prostate tumor environment had increased odds of dying of PCa. It is possible that M2 macrophages, together with other suppressor cells such as Tregs , promote an immunosuppressive environment.
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| 34. |
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| 35. |
- Garpenby, Peter, 1952-, et al.
(författare)
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Utvärdering av implementeringen av Nationella riktlinjer för hjärtsjukvård i fyra landsting och regioner : Rapport 1
- 2005
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport beskriver en mycket tidig (initial) fas av implementeringen av Nationella riktlinjer för hjärtsjukvård (NRH) inom fyra landsting och regioner. Undersökningen är utförd av PrioriteringsCentrum på uppdrag av Socialstyrelsen.Syftet är att genom en jämförande fallstudie beskriva förutsättningarna i fyra landsting/regioner för att implementera Nationella riktlinjer för hjärtsjukvård, och att analysera (förklara) skillnader och likheter bland dessa landsting/regioner i deras reaktion på riktlinjerna. De landsting och regioner som ingår i studien är Landstinget Sörmland, Landstinget Västernorrland, Region Skåne och Västra Götalandsregionen.Vi finner på det hela taget en positiv attityd till NRH i verksamheten och en vilja att agera med dokumentet som underlag. Inom verksamheten uppfattas NRH som ett stöd för prioriteringar och på många håll på verksamhetsnivån finns också ett stöd för öppna prioriteringar. Inom verksamheten liksom inom administrationen hittar vi en förhoppning om att NRH ska leda till ett arbete som ger en högre grad av systematisering av och överblick över hälso- och sjukvårdens innehåll. På många håll i verksamheten uppfattas NRH tillsammans med kvalitetsregister som viktiga verktyg för att följa upp och förbättra vården.Det är uppenbart att den professionella verksamheten och den politisktadministrativa delen inom de studerade landstingen/regionerna inte befinner i fas med avseende på kunskap om och förståelse för vad NRH innebär för huvudmannen. Vi tycker oss se tecken på att genomförandet av NRH inledningsvis sker i form av ”experimentell implementering.” Aktiviteter i anslutning till implementeringen sker huvudsakligen i den domän som domineras av professioner. Vi ser tecken på detta i främst Landstinget Sörmland och Region Skåne samt Västra Götalandsregionen. Eventuella konflikter får lösas på en låg nivå. I ett senare skede när tydliga alternativ finns och när resursanspråk knyts till väl definierade medel kan man föreställa sig att ansvaret flyttas högre upp i organisationen, och där engagerar politiska beslutsfattare. Vi bedömer dock att tjänstemän och politiker på landstings- och regionnivå förr eller senare tvingas ta ställning till NRH. Först måste dock verksamheten göra sin ”hemläxa” och erbjuda den politiskt-administrativa nivån en tolkning av vad riktlinjerna kan innebära för respektive landsting/region.Det är än så länge en öppen fråga om trycket underifrån i organisationen räcker för att aktivera den politiskt-administrativa nivån eller om nationella aktörer av olika slag måste stödja landstingen/regionerna för att detta ska bli möjligt.
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| 36. |
- Graae, Lisette, et al.
(författare)
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Miljöriskbedömning av läkemedelssubstanser
- 2022
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Rapport (refereegranskat)abstract
- Lokala utsläpp av läkemedelssubstanser från produktionen kan orsaka allvarliga miljöproblem. För närvarande finns det inga lagar, förordningar eller regler som kräver rapportering av utsläpp av läkemedelssubstanser från tillverkningen. Det finns dock flera frivilligt baserade initiativ för att övervaka och minska utsläppen av läkemedelssubstanser.Ett sådant initiativ är den modell för miljöriskbedömning av läkemedelsproduktion som utvecklades av IVL 2019 (rapport B2352, Pålsson et al). Föreliggande rapport beskriver vidareutveckling och testning av modellen i offentlig upphandling i Sverige. Studien omfattade även en kartläggning av andra liknande nationella och internationella initiativ samt en färdplan för vidareutveckling av modellen. Riskbedömning av antimikrobiella ämnen har utvecklats under projektet med beräkning av PNEC-R som specifikt tar upp den förutsedda koncentrationen utan effekt av resistens i motsats till det ordinarie PNEC-värdet som baseras på ekotoxikologiska effekter i recipienten. PNEC-R beräkningen bör återspegla koncentrationer i avloppsvattenströmmen som lämnar tillverkningsplatsen.För antimikrobiella ämnen bör både ett ekotoxikologiskt baserat PNEC och ett PNEC-R-värde bestämmas och det lägsta av de två ska användas i följande riskberäkning. Vidare bör PEC-beräkningen för antimikrobiella ämnen justeras så att den inte inkluderar avskiljningsgraden (%) för rening av avloppsvatten utanför anläggningen, eftersom blandningen av olika avloppsvattenströmmar i reningsverk utanför anläggningen snarare ökar än minskar utvecklingen av antimikrobiell resistens. Projektet omfattade en testning av modellen med verkliga data, testningen kunde inte genomföras pga. att företagen inte bidrog med data. Anledningen till detta var t.ex. konkurrerande prioriteringar i andra projekt och interna omorganisationer, konkurrerande prioriteringar i globala organisationer eller externa avtalspartner som inte var villiga att tillhandahålla den efterfrågade informationen. Den teoretiska utvärderingen och testningen visade dock att det är möjligt att använda den föreslagna modellen och de riskfraser den genererar i offentlig upphandling. Modellen skulle kunna införlivas i det redan befintliga utvärderingssystemet i Fass och därigenom förse upphandlingsorganisationen med nödvändiga riskfraser utan att avslöja konfidentiell data utanför tredjepartsgranskningsteamet. Detta borde vara ett viktigt tillägg till Upphandlingsmyndighetens föreslagna upphandlingskriterier. Att använda sig av de olika riskfraserna i offentlig upphandling kan vara ett mer distinkt sätt att utvärdera bidrag från anbudsgivare. Kartläggningen av de nationella och internationella initiativen visade att det finns många relevanta pågående projekt och initiativ som omfattar modeller för riskbedömning av läkemedelsproduktion och/eller miljöaspekter vid offentlig upphandling av läkemedel. Samarbete och anpassning av den utvecklade modellen till övriga initiativ behövs. Ytterligare behov av utveckling av modellen är följande: Fortsatt utveckling och anpassning av modellen till andra initiativ såsom EFPIA. I en komplex värdekedja representeras den slutliga riskfrasen av produkten av anläggningen med högst riskfras, oavsett de andra anläggningarnas riskfraser. Detta gör modellen något trubbig. I framtida versioner av modellen är det önskvärt att denna justeras för att bättre återspegla miljöprestandan i hela värdekedjan. Beräkningen av PEC-local för antimikrobiella ämnen bör uppdateras ytterligare för att bättre återspegla koncentrationerna i avloppsvatten som lämnar reningsanläggningen. PNEC-R borde användas istället för koncentrationen i recipienten.
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| 37. |
- Hadimeri, Henrik, et al.
(författare)
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A fixed protocol for outpatient clinic routines in the care of patients with severe renal failure
- 2013
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Ingår i: Renal failure. - : Informa Healthcare. - 0886-022X .- 1525-6049. ; 35:6, s. 845-854
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Tidskriftsartikel (refereegranskat)abstract
- Background: The primary aim of this study was to assess whether a fixed protocol, using a specially trained team, for intermediate follow-up to fulfillment of guideline targets is non-inferior to conventional follow-up in the care of uraemic patients. A secondary aim was to investigate possible impact on patient outcome.Methods: The cohort comprised 424 patients from seven centers. Inclusion criteria were either serum creatinine exceeding 200 mu mol/l or calculated clearance below 30 ml/min, representing CKD 4 or 5a. Six centers followed a standardized protocol (group 1). One center provided controls (group 2). The study design was prospective and interventional. The variables measured were blood hemoglobin, bicarbonate, calcium, phosphate, intact parathyroid hormone, albumin, renal function variables, blood pressure and RAAS blockade. The number of patients achieving the set goals was analyzed as a time trend to determine if the intervention resulted in an improvement.Results: At baseline, group 1 had significantly lower GFR and higher serum creatinine, calcium, phosphate, calcium x phosphate product and bicarbonate, lower mean arterial pressure (MAP), systolic blood pressures and less use of RAAS. During the intervention, group 1 improved in the direction of guidelines for blood hemoglobin, albumin, bicarbonate and MAP. Outcome of secondary endpoints gave a risk of death of 30% in both groups, while the risk of renal replacement therapy was higher in group 1.Conclusions: However, the time to renal replacement therapy was significantly shorter in the intervention group, indicating that other variables than guideline achievements are important for the patient.
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| 38. |
- Hong, Zhou, et al.
(författare)
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Measuring stiffness using acoustic tool for Scots pine breeding selection
- 2015
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Ingår i: Scandinavian Journal of Forest Research. - : Informa UK Limited. - 0282-7581 .- 1651-1891. ; 30:4, s. 363-372
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Tidskriftsartikel (refereegranskat)abstract
- Stiffness (modulus of elasticity, MOE) of conifer trees is the most important trait for structural wood products. Finding a fast, reliable and non-destructive way to measure MOE is a priority for screening large progeny trials in tree breeding programmes. For Scots pine, time-of-flight (TOF) velocity measured on standing trees accounted for 47% of the variation to the benchmark SilviScan-based clearwood MOE (MOEs), under the assumption of constant wood density. If wood density was included, 59% of the variation was accounted for. The TOF stiffness measurements on standing trees were, however, more related to the clearwood MOEs in the outerwood, and the prediction was the most reliable at breast height compared to the stem base and the top section. Microfibril angle (MFA) had higher correlation with acoustic velocity (VEL) of standing trees than wood density, and among the early, transition and latewood density, the latewood density had the highest correlation with stiffness measurements on standing trees. VEL measured at breast height in combination with wood density was the most reliable predictor of MOE of standing trees for selection and breeding in Scots pine.
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| 39. |
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| 40. |
- Koffert, J. P., et al.
(författare)
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Metformin treatment significantly enhances intestinal glucose uptake in patients with type 2 diabetes: Results from a randomized clinical trial
- 2017
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Ingår i: Diabetes Research and Clinical Practice. - : Elsevier BV. - 0168-8227 .- 1872-8227. ; 131, s. 208-216
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Tidskriftsartikel (refereegranskat)abstract
- Aims Metformin therapy is associated with diffuse intestinal 18F-fluoro-deoxyglucose (FDG) accumulation in clinical diagnostics using routine FDG-PET imaging. We aimed to study whether metformin induced glucose uptake in intestine is associated with the improved glycaemic control in patients with type 2 diabetes. Therefore, we compared the effects of metformin and rosiglitazone on intestinal glucose metabolism in patients with type 2 diabetes in a randomized placebo controlled clinical trial, and further, to understand the underlying mechanism, evaluated the effect of metformin in rats. Methods Forty-one patients with newly diagnosed type 2 diabetes were randomized to metformin (1g, b.i.d), rosiglitazone (4mg, b.i.d), or placebo in a 26-week double-blind trial. Tissue specific intestinal glucose uptake was measured before and after the treatment period using FDG-PET during euglycemic hyperinsulinemia. In addition, rats were treated with metformin or vehicle for 12weeks, and intestinal FDG uptake was measured in vivo and with autoradiography. Results Glucose uptake increased 2-fold in the small intestine and 3-fold in the colon for the metformin group and associated with improved glycemic control. Rosiglitazone increased only slightly intestinal glucose uptake. In rodents, metformin treatment enhanced intestinal FDG retention (P=0.002), which was localized in the mucosal enterocytes of the small intestine. Conclusions Metformin treatment significantly enhances intestinal glucose uptake from the circulation of patients with type 2 diabetes. This intestine-specific effect is associated with improved glycemic control and localized to mucosal layer. These human findings demonstrate directs effect of metformin on intestinal metabolism and elucidate the actions of metformin. Clinical trial number NCT02526615 © 2017 The Authors
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| 41. |
- Latz, Gunnar, 1984, et al.
(författare)
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Performance Analysis of a Reciprocating Piston Expander and a Plate Type Exhaust Gas Recirculation Boiler in a Water-Based Rankine Cycle for Heat Recovery from a Heavy Duty Diesel Engine
- 2016
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Ingår i: Energies. - : MDPI AG. - 1996-1073 .- 1996-1073. ; 9:7, s. 495-
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Tidskriftsartikel (refereegranskat)abstract
- The exhaust gas in an internal combustion engine provides favorable conditions for a waste-heat recovery (WHR) system. The highest potential is achieved by the Rankine cycle as a heat recovery technology. There are only few experimental studies that investigate full-scale systems using water-based working fluids and their effects on the performance and operation of a Rankine cycle heat recovery system. This paper discusses experimental results and practical challenges with a WHR system when utilizing heat from the exhaust gas recirculation system of a truck engine. The results showed that the boiler’s pinch point necessitated trade-offs between maintaining adequate boiling pressure while achieving acceptable cooling of the EGR and superheating of the water. The expander used in the system had a geometric compression ratio of 21 together with a steam outlet timing that caused high re-compression. Inlet pressures of up to 30 bar were therefore required for a stable expander power output. Such high pressures increased the pump power, and reduced the EGR cooling in the boiler because of pinch-point effects. Simulations indicated that reducing the expander’s compression ratio from 21 to 13 would allow 30% lower steam supply pressures without adversely affecting the expander’s power output.
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| 42. |
- Li, Lu, 1964, et al.
(författare)
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Epigallocatechin gallate increases the formation of cytosolic lipid droplets and decreases the secretion of apoB-100 VLDL
- 2006
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Ingår i: J Lipid Res. - 0022-2275. ; 47:1, s. 67-77
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Tidskriftsartikel (refereegranskat)abstract
- Epigallocatechin gallate (EGCG) increases the formation of cytosolic lipid droplets by a mechanism that is independent of the rate of triglyceride biosynthesis and involves an enhanced fusion between lipid droplets, a process that is crucial for their growth in size. EGCG treatment reduced the secretion of both triglycerides and apolipoprotein B-100 (apoB-100) VLDLs but not of transferrin, albumin, or total proteins, indicating that EGCG diverts triglycerides from VLDL assembly to storage in the cytosol. This is further supported by the observed increase in both intracellular degradation of apoB-100 and ubiquitination of the protein (indicative of increased proteasomal degradation) in EGCG-treated cells. EGCG did not interfere with the microsomal triglyceride transfer protein, and the effect of EGCG on the secretion of VLDLs was found to be independent of the LDL receptor. Thus, our results indicate that EGCG promotes the accumulation of triglycerides in cytosolic lipid droplets, thereby diverting lipids from the assembly of VLDL to storage in the cytosol. Our results also indicate that the accumulation of lipids in the cytosol is not always associated with increased secretion of VLDL.
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| 43. |
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| 44. |
- Mattsson, Bengt, 1941, et al.
(författare)
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["...always giving comfort". General practitioners and the everyday consolation] : "...och alltid trösta". Allmänläkaren och det dagliga tröstandet
- 2004
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Ingår i: Läkartidningen. - 0023-7205. ; 101:49
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Tidskriftsartikel (refereegranskat)abstract
- Since the time of Hippocrates" ... to always comfort" has been regarded as a part of every physician's profession. However, this daily phenomenon of medical practice has not been studied very much so far. Consolation is sometimes emphasized when care is more prominent than cure, as in palliative or intensive care or when seeing family members during these circumstances. Six general practitioners in a focus-group interview presented narratives about their experience of consolation in the consultation. They also described the last time they managed to comfort a patient. The narratives were analysed by an empirical psychological phenomenological method. Four themes emerged that gave a meaning to consolation: "presence", "be in contact", "confirmation" and "restoration". The consultations were characterized by acceptance, freedom, respect and absence of demand. However, consolation could also be associated with negative features such as instrumental and ritual behaviour and a "top-down" attitude that inhibited the healing process. Consolation as an important element of medical practice needs to be further studied.
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| 45. |
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| 46. |
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| 47. |
- Mucci, Lorelei A., et al.
(författare)
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Nine-gene molecular signature is not associated with prostate cancer death in a watchful waiting cohort
- 2008
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Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - Baltimore : Waverly Press. - 1055-9965 .- 1538-7755. ; 17:1, s. 249-251
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Tidskriftsartikel (refereegranskat)abstract
- Tumor molecular markers hold promise to distinguish potentially lethal from indolent prostate cancer and to guide treatment choices. A previous study identified a nine-gene molecular signature in tumors associated with prostate-specific antigen relapse after prostatectomy. We examined this molecular model in relation to prostate cancer death among 172 men with initially localized disease. We quantified protein expression of the nine genes in tumors to classify progression risk. Accounting for clinical prognostic factors, the nine-gene model did not provide discrimination to predict lethal and indolent prostate cancer.
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| 48. |
- Mucci, Lorelei A., et al.
(författare)
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Testing a multigene signature of prostate cancer death in the Swedish Watchful Waiting Cohort
- 2008
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Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - Philadelphia : American Association for Cancer Research. - 1055-9965 .- 1538-7755. ; 17:7, s. 1682-1688
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Tidskriftsartikel (refereegranskat)abstract
- Although prostate cancer is a leading cause of cancer death, most men die with and not from their disease, underscoring the urgency to distinguish potentially lethal from indolent prostate cancer. We tested the prognostic value of a previously identified multigene signature of prostate cancer progression to predict cancer-specific death. The Örebro Watchful Waiting Cohort included 172 men with localized prostate cancer of whom 40 died of prostate cancer. We quantified protein expression of the markers in tumor tissue by immunohistochemistry and stratified the cohort by quintiles according to risk classification. We accounted for clinical variables (age, Gleason, nuclear grade, and tumor volume) using Cox regression and calculated receiver operator curves to compare discriminatory ability. The hazard ratio of prostate cancer death increased with increasing risk classification by the multigene model, with a 16-fold greater risk comparing highest-risk versus lowest-risk strata, and predicted outcome independent of clinical factors (P = 0.002). The best discrimination came from combining information from the multigene markers and clinical data, which perfectly classified the lowest-risk stratum where no one developed lethal disease; using the two lowest-risk groups as reference, the hazard ratio (95% confidence interval) was 11.3 (4.0-32.8) for the highest-risk group and difference in mortality at 15 years was 60% (50-70%). The combined model provided greater discriminatory ability (area under the curve = 0.78) than the clinical model alone (area under the curve = 0.71; P = 0.04). Molecular tumor markers can add to clinical variables to help distinguish lethal and indolent prostate cancer and hold promise to guide treatment decisions.
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| 49. |
- Myrelid, Pär, et al.
(författare)
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Thiopurine Therapy Is Associated with Postoperative Intra-Abdominal Septic Complications in Abdominal Surgery for Crohns Disease
- 2009
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Ingår i: Diseases of the Colon & Rectum. - 0012-3706 .- 1530-0358. ; 52:8, s. 1387-1394
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Thiopurines are important as maintenance therapy in Crohns disease, but there have been concerns whether thiopurines increase the risk for anastomotic complications. The present study was performed to assess whether thiopurines alone, or together with other possible risk factors, are associated with postoperative intra-abdominal septic complications after abdominal surgery for Crohns disease. METHODS: Prospectively registered data regarding perioperative factors were collected at a single tertiary referral center from 1989 to 2002. Data from 343 consecutive abdominal operations on patients with Crohns disease were entered into a multivariate analysis to evaluate risk factors for intra-abdominal septic complications. All operations involved either anastomoses, strictureplasties, or both; no operations, however, involved proximal diversion. RESULTS: Intra-abdominal septic complications occurred in 26 of 343 operations (8%). Thiopurine therapy was associated with an increased risk of intra-abdominal septic complications (16% with therapy; 6% without therapy; P = 0.044). Together with established risk factors such as pre-operative intra-abdominal sepsis (18% with sepsis; 6% without sepsis; P = 0.024) and colocolonic anastomosis (16% with such anastomosis; 6% with other types of anastomosis; P = 0.031), thiopurine therapy was associated with intra-abdominal septic complications in 24% if any 2 or all 3 risk factors were present compared with 13% if any 1 factor was present, and only 4% in patients if none of these factors were present (P andlt; 0.0001). CONCLUSIONS: Thiopurine therapy is associated with postoperative intra-abdominal septic complications. The risk for intra-abdominal septic complications was related to the number of identified risk factors. This increased risk should be taken into consideration when planning surgery for Crohns disease.
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| 50. |
- Nordin, Elise, 1985, et al.
(författare)
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An inverse association between plasma benzoxazinoid metabolites and PSA after rye intake in men with prostate cancer revealed with a new method
- 2022
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322 .- 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Prostate cancer (PC) is a common cancer among men, and preventive strategies are warranted. Benzoxazinoids (BXs) in rye have shown potential against PC in vitro but human studies are lacking. The aim was to establish a quantitative method for analysis of BXs and investigate their plasma levels after a whole grain/bran rye vs refined wheat intervention, as well as exploring their association with PSA, in men with PC. A quantitative method for analysis of 22 BXs, including novel metabolites identified by mass spectrometry and NMR, was established, and applied to plasma samples from a randomized crossover study where patients with indolent PC (n = 17) consumed 485 g whole grain rye/rye bran or fiber supplemented refined wheat daily for 6 wk. Most BXs were significantly higher in plasma after rye (0.3–19.4 nmol/L in plasma) vs. refined wheat (0.05–2.9 nmol/L) intake. HBOA-glc, 2-HHPAA, HBOA-glcA, 2-HPAA-glcA were inversely correlated to PSA in plasma (p < 0.04). To conclude, BXs in plasma, including metabolites not previously analyzed, were quantified. BX metabolites were significantly higher after rye vs refined wheat consumption. Four BX-related metabolites were inversely associated with PSA, which merits further investigation.
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