| 1. |
- Gremyr, Andreas, et al.
(författare)
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How a Point-of-Care Dashboard Facilitates Co-production of Health Care and Health for and with Individuals with Psychotic Disorders : A Mixed-methods Case Study
- 2022
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIndividuals with psychotic disorders experience widespread treatment failures and risk early death. Sweden’s largest department specializing in psychotic disorders sought to improve patients’ health by developing a point-of-care dashboard to support joint planning and co-production of care. The dashboard was tested for 18 months and included more than 400 patients at two outpatient clinics.MethodsThis study evaluates the dashboard by addressing two questions:Can differences in health-related outcome measures be attributed to the use of the dashboard?How did the case managers experience the accessibility, use, and usefulness of the dashboard for co-producing care with individuals with psychotic disorders? This mixed-method case study used both Patient-Reported Outcome Measures (PROM) and data from a focus group interview with case managers. Data collection and analysis were framed by the Clinical Adoption Meta Model (CAMM) phases: i) accessibility, ii) system use, iii) behavior, and iv) clinical outcomes. The PROM used was the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0), which assesses functional impairment and disability. Patients at clinics using the dashboard were matched with patients at clinics not using the dashboard. PROM data were compared using non-parametric statistics due to skewness in distribution. The focus group included five case managers who had experience using the dashboard with patients.ResultsCompared to patients from clinics that did not use the dashboard, patients from clinics that did use the dashboard improved significantly overall (p = 0.045) and in the domain self-care (p = 0.041). Focus group participants reported that the dashboard supported data feedback-informed care and a proactive stance related to changes in patients’ health. The dashboard helped users identify critical changes and enabled joint planning and evaluation.ConclusionDashboard use was related to better patient health (WHODAS scores) when compared with matched patients from clinics that did not use the dashboard. In addition, case managers had a positive experience using the dashboard. Dashboard use might have lowered the risk for missing critical changes in patients’ health while increasing the ability to proactively address needs. Future studies should investigate how to enhance patient co-production through use of supportive technologies.
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| 2. |
- Gremyr, Andreas
(författare)
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Improving health with and for individuals with schizophrenia using a learning health system approach : From idea to daily practice
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psychotic disorders like schizophrenia have a typical onset in early adulthood with symptoms of hallucinations and disturbances of thought. Despite knowledge on what constitutes effective schizophrenia care, more than 70% of treatment attempts fail in Sweden, sometimes leading to early death. An appraisal of schizophrenia care shows a lack of ways to jointly plan and evaluate care, and an absence of a trustworthy theory-of-change. The Learning Health System (LHS) is a vision that has been translated into theories and models associated with improved outcomes for patients with other chronic conditions. The aim of this thesis is to enhance the understanding of the applicability of the LHS vision in the context of schizophrenia care, from the perspectives of both individuals and the health system in enabling coproduction of better health by addressing two research questions:i) How can improvement of health for individuals with schizophrenia and improvement of system performance be supported by coproduction in an LHS model?ii) Can an LHS-based intervention, i.e. the use of a point of care dashboard, contribute to better health for individuals with schizophrenia?Studying the existing published knowledge of LHS show that the concept has not yet been applied in mental healthcare settings but has potential to increase patient coproduction, continuous improvement and better health. Different forms of coproduction are supported in the most comprehensive LHS models and applications, ranging from dashboards at point of care to platforms that can help facilitate improvement initiatives.A case study, focused on studying the use and usefulness of a point-of-care dashboard at patient visits in outpatient care at the Department of Schizophrenia Spectrum Disorders at Sahlgrenska University Hospital in western Sweden. Use of the dashboard is associated with improved communication and health for patients. Assessment of the dashboard-project’s complexity using the Non-adoption, abandonment, scale-up, spread and sustainability complexity assessment tool (NASSS-CAT) was perceived as helpful in evaluating challenges and provided insight that can guide future development. An LHS model, that builds on both the reviewing of the literature and practical testing, is proposed.Further research is proposed in two areas, exploration of how dashboard initiatives can support coproduction and better health for individuals with complex chronic conditions and further development of LHS models by studying different LHS initiatives regarding system properties, forms of coproduction at play and effects on health outcomes for individuals and populations.
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| 3. |
- Gremyr, Andreas, et al.
(författare)
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Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study
- 2020
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 22:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health care is becoming more complex. For an increasing number of individuals, interacting with health care means addressing more than just one illness or disorder, engaging in more than one treatment, and interacting with more than one care provider. Individuals with severe mental illnesses such as schizophrenia are disproportionately affected by this complexity. Characteristic symptoms can make it harder to establish and maintain relationships. Treatment failure is common even where there is access to effective treatments, increasing suicide risk. Knowledge of complex adaptive systems has been increasingly recognized as useful in understanding and developing health care. A complex adaptive system is a collection of interconnected agents with the freedom to act based on their own internalized rules, affecting each other. In a complex health care system, relevant feedback is crucial in enabling continuous learning and improvement on all levels. New technology has potential, but the failure rate of technology projects in health care is high, arguably due to complexity. The Nonadoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability (NASSS) framework and complexity assessment tool (NASSS-CAT) have been developed specifically to help identify and manage complexity in technology-related development projects in health care. Objective: This study aimed to use a pilot version of the NASSS-CAT instrument to inform the development and deployment of a point-of-care dashboard supporting schizophrenia care in west Sweden. Specifically, we report on the complexity profile of the project, stakeholders' experiences with using NASSS-CAT, and practical implications. Methods: We used complexity assessment to structure data collection and feedback sessions with stakeholders, thereby informing an emergent approach to the development and deployment of the point-of-care dashboard. We also performed a thematic analysis, drawing on observations and documents related to stakeholders' use of the NASSS-CAT to describe their views on its usefulness. Results: Application of the NASSS framework revealed different types of complexity across multiple domains, including the condition, technology, value proposition, organizational tasks and pathways, and wider system. Stakeholders perceived the NASSS-CAT tool as useful in gaining perspective and new insights, covering areas that might otherwise have been neglected. Practical implications derived from feedback sessions with managers and developers are described. Conclusions: This case study shows how stakeholders can identify and plan to address complexities during the introduction of a technological solution. Our findings suggest that NASSS-CAT can bring participants a greater understanding of complexities in digitalization projects in general.
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| 4. |
- Gustavsson, Carolina, et al.
(författare)
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Cerebrospinal fluid levels of insulin, leptin, and agouti-related protein in relation to BMI in pregnant women
- 2016
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Ingår i: Obesity. - : Wiley. - 1930-7381. ; 24:6, s. 1299-1304
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveDuring pregnancy, metabolic interactions must be adapted, though neuroendocrine mechanisms for increased food intake are poorly understood. The objective of this study was to characterize differences in insulin, leptin, and agouti-related protein (AgRP) levels in serum and cerebrospinal fluid (CSF) in pregnant women with normal weight (NW) and pregnant women with overweight (OW) or obesity (OB). Placenta as a source for increased peripheral AgRP levels during pregnancy was also investigated. MethodsWomen were recruited at admission for elective cesarean section. Insulin, AgRP, and leptin were measured in serum and CSF from 30 NW, 25 OW, and 21 OB at term. Serum during pregnancy and placenta at term were collected for further AgRP analysis. ResultsImmunohistology showed placental production of AgRP and serum AgRP levels increased throughout pregnancy. CSF AgRP, leptin, and insulin levels were higher in OW and OB than NW. Serum leptin and insulin levels were higher and AgRP lower in OB than NW. ConclusionsHigh serum AgRP levels might protect from the suppressive effects of leptin during pregnancy. Pregnant women with OB and OW might further be protected from the suppressive effect of leptin by high CSF AgRP levels. Evidence was found, for the first time, of human placental AgRP production mirrored by levels in the circulation.
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| 5. |
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| 6. |
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| 7. |
- Sjöqvist, Axel S.L. 1990, et al.
(författare)
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Geochronology of the Norra Kärr alkaline complex, southern Sweden
- 2014
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Ingår i: 31st Nordic Geological Winter Meeting.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The Norra Kärr alkaline complex is a small intrusion of agpaitic nepheline syenite, located approximately 10 km north of Grän- na, southern Sweden, that is being explored for REE and Zr. Agpaitic nepheline syenites per definition do not contain simple Zr minerals like zircon and baddeleyite, despite generally high Zr contents (up to 1–2 wt.% ZrO2). Instead, Zr is mainly hosted in rock-forming complex Na-Ca-Zr silicate minerals such as members of the catapleiite, eudialyte, rosenbuschite, and wöhlerite groups. U-Pb zircon geochronology is thus highly impeded by the agpaitic nature. We established a new, reliable igneous age for the Norra Kärr alkaline complex at 1489±8 Ma (MSWD = 0.95) by dating zircons (U-Pb) in the country rocks that were affected by the magmatism-related alkaline alteration (fenitisation) by LA-MC-ICP-MS. Zircons from a satellite body of non-agpaitic syenite gave intercept ages within error of the age of fenitisation. This is an improvement upon an imprecise whole-rock Rb-Sr age of 1545±61 Ma (Blaxland 1977; Welin 1980). The non-fenitised country granite itself is dated at 1781±8 Ma (MSWD = 0.59), and thus belongs to the TIB1 (1.81–1.76 Ga) episode of the Transscandinavian Igneous Belt (TIB). Rare zircon xenocrysts extracted from the nepheline syenite show ages corresponding to 1.5 Ga lower crustal intrusives (rapakivi?), TIB, Svecofennian, and one Archaean zircon, which suggests the possibility for a remnant of Archaean basement below the TIB. There has historically been a vivid discussion about wheth- er or not Norra Kärr has been deformed and metamorphosed. New Ar-Ar step heating ages on sodic amphibole from Norra Kärr and muscovite and biotite from the country rocks give plateau ages at 1.1 Ga and 0.94 Ga, which correspond to ages derived for Sveconorwegian shear zones in the area. Together with textural and crystal chemical evidence, these ages make a compelling argument for some form of Sveconorwegian overprint of the Norra Kärr alkaline complex.
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| 8. |
- Andersson, Ulf, 1963-
(författare)
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Cognitive deafness : The deterioration of phonological representations in adults with an acquired severe hearing loss and its implications for speech understanding
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present thesis was to examine possible cognitive consequences of acquired hearing loss and the possible impact of these cognitive consequences on the ability to process spoken language presented through visual speechreading or through a cochlear implant.The main findings of the present thesis can be summarised in the following conclusions: (a) The phonological processing capabilities of individuals who have acquired a severe hearing loss or deafness deteriorate progressively as a function of number of years with a complete or partial auditory deprivation. (b) The observed phonological deterioration is restricted to certain aspects of the phonological system. Specifically, the phonological representations of words in the mental lexicon are of less good quality, whereas the phonological system in verbal working memory is preserved. (c) The deterioration of the phonological representations has a negative effect on the individual's ability to process speech, either presented visually (i.e., speechreading) or through a cochlear implant, as it may impair word recognition processes which involve activation of and discrimination between the phonological representations in the lexicon. (d) Thus, the present research describes an acquired cognitive disability not previously documented in the literature, and contributes to the context of other populations with phonological disabilities by showing that a complete or partial deprivation of auditory speech stimulation in adulthood can give rise to a phonological disability. (e) From a clinical point of view, the results from the present thesis suggest that early cochlear implantation after the onset of an acquired severe hearing loss is an important objective in order to reach a high level of speech understanding with the implant.
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| 9. |
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| 10. |
- Andersson, Ulf, 1963-, et al.
(författare)
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Number magnitude processing and basic cognitive functions in children with mathematical learning disabilities
- 2012
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Ingår i: Learning and individual differences. - : Elsevier. - 1041-6080 .- 1873-3425. ; 22:6, s. 701-714
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Tidskriftsartikel (refereegranskat)abstract
- The study sought out to extend our knowledge regarding the origin ofmathematical learning disabilities (MLD) in children by testing different hypotheses in the same samples of children. Different aspects of cognitive functions and number processing were assessed in fifth- and sixth-graders (11–13 years old) withMLD and compared to controls. The MLD group displayed weaknesses withmost aspects of number processing (e.g., subitizing, symbolic number comparison, number-line estimation) and two cognitive functions (e.g., visual–spatial working memory). These findings favor the defective approximate number system (ANS) hypothesis, but do not fit well with the access deficit hypothesis. Support is also provided for the defective object-tracking system (OTS) hypothesis, the domain general cognitive deficit hypothesis and to some extent the defective numerosity-coding hypothesis. The study suggests that MLD might be caused by multiple deficits and not a single core deficit.
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| 11. |
- Andersson, Ulf, 1963-, et al.
(författare)
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Pathways to arithmetic fact retrieval and percentage calculation in adolescents
- 2017
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Ingår i: British Journal of Educational Psychology. - : John Wiley & Sons. - 0007-0998 .- 2044-8279. ; 87:4, s. 647-663
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDeveloping sufficient mathematical skills is a prerequisite to function adequately in society today. Given this, an important task is to increase our understanding regarding the cognitive mechanisms underlying young people's acquisition of early number skills and formal mathematical knowledge.AimsThe purpose was to examine whether the pathways to mathematics model provides a valid account of the cognitive mechanisms underlying symbolic-number processing and mathematics in adolescents. The pathways model states that the three pathways should provide independent support to symbolic-number skill. Each pathway's unique contribution to formal mathematics varies depending on the complexity and demand of the tasks.SampleThe study used a sample of 114 adolescents (71 girls). Their mean age was 14.60 years (SD = 1.00).MethodsThe adolescents were assessed on tests tapping the three pathways and general cognitive abilities (e.g., working memory). A structural equation path analysis was computed.ResultsSymbolic-number comparison was predicted by the linguistic pathway, the quantitative pathway, and processing speed. The linguistic pathway, quantitative pathways, and symbolic-number comparison predicted arithmetic fact retrieval. The linguistic pathway, working memory, visual analogies, and symbolic-number comparison predicted percentage calculation.ConclusionsThere are both similarities and differences in the cognitive mechanisms underlying arithmetic fact retrieval and percentage calculation in adolescents. Adolescents’ symbolic-number processing, arithmetic fact retrieval, and percentage calculation continue to rely on the linguistic pathways, whereas the reliance upon the spatial pathway has ceased. The reliance upon the quantitative pathway varies depending on the task.
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| 12. |
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| 13. |
- Andersson, Ulf, 1963-
(författare)
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The contribution of working memory capacity to foreignlanguage comprehension in children
- 2010
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Ingår i: Memory. - London : Psychology Press. - 0965-8211 .- 1464-0686. ; 18:4, s. 458-472
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Tidskriftsartikel (refereegranskat)abstract
- The present study examined the contribution of working memory processes in children’s foreignlanguage processing of sentences and short stories. A total of 95 children were given measures of workingmemory when 9 10 years old. One to two years later at ages 11 12, tasks tapping foreign language literalcomprehension (English) and native language inferential comprehension (Swedish) were administered.Regression and correlation analyses demonstrated that both central executive and phonological loopprocesses predicted foreign language comprehension, whereas central executive processes but notphonological loop processes predicted native language reading comprehension. These findings show thatchildren’s foreign language processing is supported by their working memory capacity tested in theirnative language. Some of these working memory resources appear to be unique for foreign language. Thestrong association between native language and foreign language processing suggests that an importantfactor in becoming proficient in foreign language is the child’s general language aptitude. Possiblemechanisms for the contribution of working memory to children’s foreign language comprehension arediscussed.
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| 14. |
- Andersson, Ulf, 1963-
(författare)
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Working memory as a predictor of written arithmetical skills in children : The importance of central executive functions
- 2008
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Ingår i: British Journal of Educational Psychology. - 0007-0998 .- 2044-8279. ; 78:2, s. 181-203
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Tidskriftsartikel (refereegranskat)abstract
- Background. The study was conducted in an attempt to further our understanding of how working memory contributes to written arithmetical skills in children. Aim. The aim was to pinpoint the contribution of different central executive functions and to examine the contribution of the two subcomponents of children's written arithmetical skills. Sample and method. A total of 141 third- and fourth-graders were administered arithmetical tasks and measures of working memory, fluid IQ and reading. Regression analysis was used to examine the relationship between working memory and written arithmetical skills. Results. Three central executive measures (counting span, trail making and verbal fluency) and one phonological loop measure (Digit Span) were significant and predictors of arithmetical performance when the influence of reading, age and IQ was controlled for in the analysis. Conclusions. The present findings demonstrate that working memory, in general, and the central executive, in particular, contribute to children's arithmetical skills. It was hypothesized that monitoring and coordinating multiple processes, and accessing arithmetical knowledge from long-term memory, are important central executive functions during arithmetical performance. The contribution of the phonological loop and the central executive (concurrent processing and storage of numerical information) indicates that children aged 9-10 years primarily utilize verbal coding strategies during written arithmetical performance. © 2008 The British Psychological Society.
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| 15. |
- Balldin, Ulf, et al.
(författare)
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Color vision with rapid-onset acceleration
- 2003
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Ingår i: Aviation, Space and Environmental Medicine. - 0095-6562 .- 1943-4448. ; 74:1, s. 29-36
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Tidskriftsartikel (refereegranskat)
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| 16. |
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| 17. |
- Boström, Elisabeth Almer, 1983, et al.
(författare)
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Resistin and insulin/insulin-like growth factor signaling in rheumatoid arthritis.
- 2011
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Ingår i: Arthritis and rheumatism. - : Wiley. - 1529-0131 .- 0004-3591. ; 63:10, s. 2894-904
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Tidskriftsartikel (refereegranskat)abstract
- Human resistin has proinflammatory properties that activate NF-κB-dependent pathways, whereas its murine counterpart is associated with insulin resistance. The aim of this study was to examine potential cross-talk between resistin and insulin/insulin-like growth factor (IGF) signaling in rheumatoid arthritis (RA).
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| 18. |
- 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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| 19. |
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| 20. |
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| 21. |
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| 22. |
- Ergatoudes, Constantinos, et al.
(författare)
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Non-cardiac comorbidities and mortality in patients with heart failure with reduced vs. preserved ejection fraction: a study using the Swedish Heart Failure Registry
- 2019
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Ingår i: Clinical Research in Cardiology. - : Springer Science and Business Media LLC. - 1861-0684 .- 1861-0692. ; 108, s. 1025-33
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Tidskriftsartikel (refereegranskat)abstract
- Background: Heart failure (HF) and non-cardiac comorbidities often coexist and are known to have an adverse effect on outcome. However, the prevalence and prognostic impact of non-cardiac comorbidities in patients with HF with reduced ejection fraction (HFrEF) vs. those with preserved (HFpEF) remain inadequately studied. Methods and results: We used data from the Swedish Heart Failure Registry from 2000 to 2012. HFrEF was defined as EF < 50% and HFpEF as EF ≥ 50%. Of 31 344 patients available for analysis, 79.3% (n = 24 856) had HFrEF and 20.7% (n = 6 488) HFpEF. The outcome was all-cause mortality. We examined the association between ten non-cardiac comorbidities and mortality and its interaction with EF using adjusted hazard ratio (HR). Stroke, anemia, gout and cancer had a similar impact on mortality in both phenotypes, whereas diabetes (HR 1.57, 95% confidence interval [CI] [1.50–1.65] vs. HR 1.39 95% CI [1.27–1.51], p = 0.0002), renal failure (HR 1.65, 95% CI [1.57–1.73] vs. HR 1.44, 95% CI [1.32–1.57], p = 0.003) and liver disease (HR 2.13, 95% CI [1.83–2.47] vs. HR 1.42, 95% CI [1.09–1.85] p = 0.02) had a higher impact in the HFrEF patients. Moreover, pulmonary disease (HR 1.46, 95% CI [1.40–1.53] vs. HR 1.66 95% CI [1.54–1.80], p = 0.007) was more prominent in the HFpEF patients. Sleep apnea was not associated with worse prognosis in either group. No significant variation was found in the impact over the 12-year study period. Conclusions: Non-cardiac comorbidities contribute significantly but differently to mortality, both in HFrEF and HFpEF. No significant variation was found in the impact over the 12-year study period. These results emphasize the importance of including the management of comorbidities as a part of a standardized heart failure care in both HF phenotypes. © 2019, The Author(s).
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| 23. |
- Hall, Ulrika Andersson, et al.
(författare)
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Central and Peripheral Leptin and Agouti-Related Protein during and after Pregnancy in Relation to Weight Change.
- 2018
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Ingår i: Clinical endocrinology. - : Wiley. - 1365-2265 .- 0300-0664. ; 88:2, s. 263-271
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Tidskriftsartikel (refereegranskat)abstract
- To study changes of neuropeptides and adipokines in cerebrospinal fluid (CSF) and serum from pregnancy to post-pregnancy in relation to weight changes, fat mass and glucose metabolism.With high postpartum weight retention being a risk factor in future pregnancies and of life-long obesity we evaluated neuropeptide and adipokine changes in women who either gained weight or were weight stable.Women were followed for 5±1 years after pregnancy and divided into two groups, Weight-Stable and Weight-Gain, by weight change from start of pregnancy.Twenty-five women (BMI 27±5kg/m2 ) recruited at admission for elective caesarean section.CSF and serum levels of agouti-related protein (AgRP), leptin, and insulin, and serum levels of adiponectin and soluble leptin receptor were measured during and after pregnancy. These measurements were further related to fat mass and insulin sensitivity (HOMA-IR).S-AgRP levels during pregnancy were lower in the Weight-Stable group and a 1 unit increase in s-AgRP was associated with 24% higher odds of pertaining to the Weight-Gain group. After pregnancy, s-AgRP increased in the Weight-Stable group but decreased in the Weight-Gain group. Decreased transport of leptin into CSF during pregnancy was reversed by an increased CSF:serum leptin ratio after pregnancy. In women who returned to their pre-pregnancy weight, serum adiponectin increased after pregnancy and correlated negatively with HOMA-IR.S-AgRP concentration in late pregnancy may be one factor predicting weight change after pregnancy, and circulating AgRP may be physiologically important in the long-term regulation of body weight. This article is protected by copyright. All rights reserved.
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| 24. |
- Hjalmarsson, Clara, 1969, et al.
(författare)
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Risk of stroke in patients with heart failure and sinus rhythm: data from the Swedish Heart Failure Registry.
- 2021
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Ingår i: ESC heart failure. - : Wiley. - 2055-5822. ; 8:1, s. 85-94
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the 2year rate of ischaemic stroke/transient ischaemic attack (IS) in patients with heart failure (HF) who were in sinus rhythm (HF-SR) and aimed to develop a score for stratifying risk of IS in this population.A total of 15425 patients (mean age 71.5years, 39% women) with HF-SR enrolled in the Swedish Heart Failure Register were included; 28815 age-matched and sex-matched controls, without a registered diagnosis of HF, were selected from the Swedish Population Register. The 2year rate of IS was 3.0% in patients and 1.4% in controls. In the patient group, a risk score including age (1p for 65-74years; 2p for 75-84years; 3p for ≥85years), previous IS (2p), ischaemic heart disease, diabetes, hypertension, kidney dysfunction, and New York Heart Association III/IV class (1p each) was generated. Over a mean follow-up of 20.1 (SD 7.5)months, the cumulative incidences (per 1000 person-years) of IS in patients with score 0 to ≥7 were 2.2, 5.3, 8.9, 13.2, 15.7, 20.4, 26.4, and 33.0, with hazard ratios for score 1 to ≥7 (with 0 as reference): 2.4, 4.1, 6.1, 7.2, 9.4, 12.2, and 15.3. The risk score performed modestly (area under the curve 63.7%; P=0.4711 for lack of fit with a logistic model; P=0.7062 with Poisson, scaled by deviance).In terms of absolute risk, only 27.6% of patients had an annual IS incidence of ≤1%. To which extent this would be amenable to anticoagulant treatment remains conjectural. A score compiling age and specific co-morbidities identified HF-SR patients with increased risk of IS with modest discriminative ability.
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| 25. |
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| 26. |
- Holtstam, Dan, 1963-, et al.
(författare)
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Arrheniusite-(Ce), CaMg[(Ce7Y3)Ca5](SiO4)3(Si3B3O18)(AsO4)(BO3)F11, a new member of the vicanite group, from the Östanmossa mine, Norberg, Sweden
- 2021
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Ingår i: Canadian Mineralogist. - : Geological and Mineralogical Association of Canada. - 0008-4476 .- 1499-1276. ; 59, s. 177-189
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Tidskriftsartikel (refereegranskat)abstract
- Arrheniusite-(Ce) is a new mineral (IMA 2019-086) from the Östanmossa mine, one of the Bastnäs-type deposits in the Bergslagen ore region, Sweden. It occurs in a metasomatic F-rich skarn, associated with dolomite, tremolite, talc, magnetite, calcite, pyrite, dollaseite-(Ce), parisite-(Ce), bastnäsite-(Ce), fluorbritholite-(Ce) and gadolinite-(Nd). Arrheniusite-(Ce) forms anhedral, greenish-yellow translucent grains, up to 0.8 mm exceptionally. It is optically uniaxial (-), with ω = 1.750(5), ε = 1.725(5), and non-pleochroic in thin section. The calculated density is 4.78(1) g/cm3. Arrheniusite-(Ce) is trigonal, space group R3m, with unit-cell parameters a = 10.8082(3) Å, c = 27.5196(9) Å, and V = 2784.07(14) Å3 for Z = 3. The crystal structure was refined from X-ray diffraction data to R1 = 3.85 for 2286 observed reflections [Fo > 4σ(Fo)]. The empirical formula for the fragment used for the structural study, based on EPMA data and results from the structure refinement, is (Ca0.65As3+0.35)Σ1(Mg0.57Fe2+0.30As5+0.10Al0.03)Σ1[(Ce2.24Nd2.13La0.86Gd0.74Sm0.71Pr0.37)Σ7.05(Y2.76Dy0.26Er0.11Tb0.08Tm0.01Ho0.04Yb0.01)Σ3.27Ca4.14]Σ14.46(SiO4)3[(Si3.26B2.74)Σ6O17.31F0.69][(As5+0.65Si0.22P0.13)Σ1O4](B0.77O3)F11; the ideal formula obtained is CaMg[(Ce7Y3)Ca5](SiO4)3(Si3B3O18)(AsO4)(BO3)F11. Arrheniusite-(Ce) belongs to the vicanite group of minerals, and is distinct from other isostructural members mainly by having a Mg-dominant, octahedrally coordinated site (M6); it can be considered as a Mg-As analog to hundholmenite-(Y). The three-fold coordinated T5 site is partly occupied by B, like in laptevite-(Ce) and vicanite-(Ce). The mineral name honors C.A. Arrhenius (1757–1824), a Swedish officer and chemist, who first discovered gadolinite-(Y), from the famous Ytterby pegmatite quarry.
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| 27. |
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| 28. |
- Jungert, Tomas, 1973-, et al.
(författare)
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Self-efficacy Beliefs in Mathematics, Native Language Literacy and Foreign Language Amongst Boys and Girls with and without Mathematic Difficulties
- 2013
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Ingår i: Scandinavian Journal of Educational Research. - : Routledge. - 0031-3831 .- 1470-1170. ; 57:1, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to examine achievement and self-efficacy in mathematics and native and foreign language literacy in children with specific mathematic LD (MD-only), children with comorbid mathematic and reading difficulties (MD-RD), and compare them with children without LD (controls), as well as to explore gender differences. Participants were 143 fifth-graders in Sweden who completed National Tests and measures of self-efficacy in mathematics and literacy. The MD-RD children displayed lower self-efficacy in all subjects compared to the controls, even when controlling for achievement. The MD-only children displayed lower self-efficacy in mathematics, completely accounted for by their lower mathematic achievement. The lower self-efficacy for children with learning disabilities may primarily be explained by their history of low achievement interpreted as failures and their emphasis on negative appraisals.
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| 29. |
- Lagerstedt, Kristina, 1976, et al.
(författare)
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Genes with relevance for early to late progression of colon carcinoma based on combined genomic and transcriptomic information from the same patients.
- 2010
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Ingår i: Cancer informatics. - 1176-9351. ; 9, s. 79-91
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Genetic and epigenetic alterations in colorectal cancer are numerous. However, it is difficult to judge whether such changes are primary or secondary to the appearance and progression of tumors. Therefore, the aim of the present study was to identify altered DNA regions with significant covariation to transcription alterations along colon cancer progression. METHODS: Tumor and normal colon tissue were obtained at primary operations from 24 patients selected by chance. DNA, RNA and microRNAs were extracted from the same biopsy material in all individuals and analyzed by oligo-nucleotide array-based comparative genomic hybridization (CGH), mRNA- and microRNA oligo-arrays. Statistical analyses were performed to assess statistical interactions (correlations, co-variations) between DNA copy number changes and significant alterations in gene and microRNA expression using appropriate parametric and non-parametric statistics. RESULTS: Main DNA alterations were located on chromosome 7, 8, 13 and 20. Tumor DNA copy number gain increased with tumor progression, significantly related to increased gene expression. Copy number loss was not observed in Dukes A tumors. There was no significant relationship between expressed genes and tumor progression across Dukes A-D tumors; and no relationship between tumor stage and the number of microRNAs with significantly altered expression. Interaction analyses identified overall 41 genes, which discriminated early Dukes A plus B tumors from late Dukes C plus D tumor; 28 of these genes remained with correlations between genomic and transcriptomic alterations in Dukes C plus D tumors and 17 in Dukes D. One microRNA (microR-663) showed interactions with DNA alterations in all Dukes A-D tumors. CONCLUSIONS: Our modeling confirms that colon cancer progression is related to genomic instability and altered gene expression. However, early invasive tumor growth seemed rather related to transcriptomic alterations, where changes in microRNA may be an early phenomenon, and less to DNA copy number changes.
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| 30. |
- Lehmann, S, et al.
(författare)
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Targeting p53 in vivo : a first-in-man study with the p53-targeting compound APR-246 in refractory hematologic malignancies and prostate cancer
- 2012
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Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology. - 0732-183X .- 1527-7755. ; 30:29, s. 3633-3639
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: APR-246 (PRIMA-1MET) is a novel drug that restores transcriptional activity of unfolded wild-type or mutant p53. The main aims of this first-in-human trial were to determine maximum-tolerated dose (MTD), safety, dose-limiting toxicities (DLTs), and pharmacokinetics (PK) of APR-246.PATIENTS AND METHODS: APR-246 was administered as a 2-hour intravenous infusion once per day for 4 consecutive days in 22 patients with hematologic malignancies and prostate cancer. Acute myeloid leukemia (AML; n = 7) and prostate cancer (n = 7) were the most frequent diagnoses. Starting dose was 2 mg/kg with dose escalations up to 90 mg/kg.RESULTS: MTD was defined as 60 mg/kg. The drug was well tolerated, and the most common adverse effects were fatigue, dizziness, headache, and confusion. DLTs were increased ALT/AST (n = 1), dizziness, confusion, and sensory disturbances (n = 2). PK showed little interindividual variation and were neither dose nor time dependent; terminal half-life was 4 to 5 hours. Tumor cells showed cell cycle arrest, increased apoptosis, and upregulation of p53 target genes in several patients. Global gene expression analysis revealed changes in genes regulating proliferation and cell death. One patient with AML who had a p53 core domain mutation showed a reduction of blast percentage from 46% to 26% in the bone marrow, and one patient with non-Hodgkin's lymphoma with a p53 splice site mutation showed a minor response.CONCLUSION: We conclude that APR-246 is safe at predicted therapeutic plasma levels, shows a favorable pharmacokinetic profile, and can induce p53-dependent biologic effects in tumor cells in vivo.
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| 31. |
- Lyngfelt, Lovisa, et al.
(författare)
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Impact of the Uncoupling Protein 1 on Cardiovascular Risk in Patients with Rheumatoid Arthritis
- 2021
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Ingår i: Cells. - : MDPI AG. - 2073-4409. ; 10:5
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Tidskriftsartikel (refereegranskat)abstract
- Adiposity is strongly associated with cardiovascular (CV) morbidity. Uncoupling protein 1 (UCP1) increases energy expenditure in adipocytes and may counteract adiposity. Our objective was to investigate a connection between UCP1 expression and cardiovascular health in patients with rheumatoid arthritis (RA) in a longitudinal observational study. Transcription of UCP1 was measured by qPCR in the subcutaneous adipose tissue of 125 female RA patients and analyzed with respect to clinical parameters and the estimated CV risk. Development of new CV events and diabetes mellitus was followed for five years. Transcription of UCP1 was identified in 89 (71%) patients. UCP1 positive patients had often active RA disease (p = 0.017), high serum levels of IL6 (p = 0.0025) and were frequently overweight (p = 0.015). IL-6(hi)BMI(hi) patients and patients treated with IL6 receptor inhibitor tocilizumab had significantly higher levels of UCP1 compared to other RA patients (p < 0.0001, p = 0.032, respectively). Both UCP1(hi) groups displayed unfavorable metabolic profiles with high plasma glucose levels and high triglyceride-to-HDL ratios, which indicated insulin resistance. Prospective follow-up revealed no significant difference in the incidence of new CV and metabolic events in the UCP1(hi) groups and remaining RA patients. The study shows that high transcription of UCP1 in adipose tissue is related to IL6-driven processes and reflects primarily metabolic CV risk in female RA patients.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Lyxell, Björn, 1956-, et al.
(författare)
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Working memory and speech understanding.
- 1998
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Ingår i: Audio-visual speech processing.. - Sydney : Casual Publisher. ; , s. 133-137
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 37. |
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| 38. |
- Pullerits, Rille, 1969, et al.
(författare)
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High mobility group box chromosomal protein 1, a DNA binding cytokine, induces arthritis.
- 2003
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Ingår i: Arthritis and Rheumatism. - 1529-0131. ; 48:6, s. 1693-1700
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the potential role of high mobility group box chromosomal protein 1 (HMGB-1) in the pathogenesis of arthritis. METHODS: Mice were injected intraarticularly with 1 microg or 5 microg of HMGB-1. Joints were dissected on days 4, 7, and 28 after injection and were evaluated histopathologically and immunohistochemically. To investigate the importance of different white blood cell populations for the development of arthritis, in vivo cell depletion procedures were performed. In addition, spleen cells were cultured in the presence of HMGB-1, and nuclear factor kappaB (NF-kappaB) activation was detected by electrophoretic mobility shift assay. RESULTS: Injection of recombinant HMGB-1 (rHMGB-1) into different mouse strains resulted in an overall frequency of arthritis in 80% of the animals. The inflammation was characterized by mild to moderate synovitis and lasted for at least 28 days. The majority of cells found in the inflamed synovium were Mac-1+ macrophages, whereas only a few CD4+ lymphocytes were detected. Pannus formation was observed in some cases 7 and 28 days after HMGB-1 injection. No significant differences were found with respect to incidence and severity of arthritis between mice depleted of monocytes, granulocytes, or lacking T/B lymphocytes. However, combined removal of monocytes and neutrophils resulted in a 43% lower incidence of arthritis. Mice rendered deficient in the interleukin-1 (IL-1) receptor did not develop inflammation upon challenge with HMGB-1. In vitro data corroborate this finding, showing that rHMGB-1 activated NF-kappaB, a major pathway leading to IL-1 production. CONCLUSION: Our results indicate that HMGB-1 is not a mere expression of inflammatory responses, but on its own, it triggers joint inflammation by activating macrophages and inducing production of IL-1 via NF-kappaB activation.
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| 39. |
- Ragnarsson, Lars-Åke, 1968, et al.
(författare)
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Low temperature oxides deposited by remote plasma enhanced CVD
- 1994
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Ingår i: Proceedings of the Second International Symposium on Ultra-Clean Processing of Silicon Surfaces (UCPSS '94). ; , s. 117-
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Tidskriftsartikel (refereegranskat)abstract
- A remote plasma enhanced chemical vapor deposition (RPECVD) process was used to prepare SiO2-Si structures at ~300°C. The best midgap interface trap densities, Ditm, as obtained by C-V techniques are 6-8×1010 cm-2eV-1 for SiO2-Si(100) and 2-3×1011 cm-2eV-1 for SiO2-Si(111)
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| 40. |
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| 41. |
- Skagenholt, Mikael, 1992-, et al.
(författare)
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Neurodevelopmental differences in task-evoked number network connectivity : Comparing symbolic and nonsymbolic number discrimination in children and adults
- 2022
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Ingår i: Developmental Cognitive Neuroscience. - : Elsevier. - 1878-9293 .- 1878-9307. ; 58
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Tidskriftsartikel (refereegranskat)abstract
- Numerical cognition can take place in multiple representational formats, such as Arabic digits (e.g., 1), verbal number words (e.g., “two”), and nonsymbolic (e.g., •••) numerical magnitude. Basic numerical discrimination abilities are key factors underlying the development of arithmetic abilities, acting as an important developmental precursor of adult-level numeracy. While prior research has begun to detail the neural correlates associated with basic numerical discrimination skills in different representational formats, the interactions between functional neural circuits are less understood. A growing body of evidence suggests that the functional networks recruited by number discrimination tasks differ between children and adults, which may provide valuable insights into the development of numerical cognition. To this end, we posed two questions: how do the interactions between functional circuits associated with number processing differ in children and adults? Are differences in functional network connectivity modulated by numerical representational codes? A theoretically motivated 22 ROI analysis indicated significant functional connectivity differences between children and adults across all three codes. Adults demonstrated sparser and more consistent connectivity patterns across codes, indicative of developmental domain-specialization for number processing. Although neural activity in children and adults is similar, the functional connectivity supporting number processing appears subject to substantial developmental maturation effects.
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| 42. |
- Ståhle, Alexander, et al.
(författare)
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Designguide för Smarta gator
- 2022
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Designguiden för smarta gator konkretiserar hur de fyra megatrenderna urbanisering, digitalisering, samhällsförändringar och miljöförändringar leder till nya krav och utformningsprinciper för framtidens gator. Guiden är tänkt att fungera som en inspiration och ett underlag för att förnya svensk gatupolicy på nationell, regional och kommunal nivå.Guiden innehåller utöver en inledning följande kapitel: en historisk tillbakablick (gatans utveckling), gatans användning, gatans delar, gatans design, designprocessen, guidens genomförande.
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| 43. |
- Zamora, Juan Carlos, et al.
(författare)
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Considerations and consequences of allowing DNA sequence data as types of fungal taxa
- 2018
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Ingår i: IMA Fungus. - : INT MYCOLOGICAL ASSOC. - 2210-6340 .- 2210-6359. ; 9:1, s. 167-185
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Tidskriftsartikel (refereegranskat)abstract
- Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.
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