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1.	Dabhilkar, Mandar, et al. (author) Supplier selection or collaboration? : Determining factors of performance improvement when outsourcing manufacturing 2009 In: Journal of Purchasing and Supply Management. - : Elsevier BV. - 1478-4092 .- 1873-6505. ; 15:3, s. 143-153 Journal article (peer-reviewed)abstract An empirical study was designed to determine factors of performance improvement when outsourcing manufacturing. Findings from a survey of 136 manufacturing plants in Sweden show that most of them achieve their outsourcing motives, but not without trade-offs. Factors of performance improvements such as economies of scale or operations in low-cost countries can improve one performance dimension, such as product cost, yet negatively impact volume flexibility, speed or product innovation. The results show part characteristics and supplier operating capabilities are more important than supplier relationship strategies when outsourcing manufacturing, meaning that supplier selection trumps supplier collaboration in the make-or-buy decision.
2.	Adrian, Maria, et al. (author) Minimal guidewire length for central venous catheterization of the right subclavian vein : A CT-based consecutive case series 2022 In: Journal of Vascular Access. - : SAGE Publications. - 1129-7298 .- 1724-6032. ; 23:3, s. 375-382 Journal article (peer-reviewed)abstract BACKGROUND: Central venous catheter (CVC) misplacement occurs frequently after right subclavian vein catheterization. It can be avoided by using ultrasound to confirm correct guidewire tip position in the lower superior vena cava prior to CVC insertion. However, retraction of the guidewire during the CVC insertion may dislocate the guidewire tip from its desired and confirmed position, thereby resulting in CVC misplacement. The aim of this study was to determine the minimal guidewire length required to maintain correct guidewire tip position in the lower superior vena cava throughout an ultrasound-guided CVC placement in the right subclavian vein.METHODS: One hundred adult patients with a computed tomography scan of the chest were included. By using multiplanar reconstructions from thin-sliced images, the distance from the most plausible distal puncture site of the right subclavian vein to the optimal guidewire tip position in the lower superior vena cava was measured (vessel length). In addition, measurements of equipment in common commercial over-the-wire percutaneous 15-16 cm CVC kits were performed. The 95th percentile of the vessel length was used to calculate the required minimal guidewire length for each CVC kit.RESULTS: The 95th percentile of the vessel length was 153 mm. When compared to the calculated minimal guidewire length, the guidewires were up to 108 mm too short in eight of eleven CVC kits.CONCLUSION: After confirmation of a correct guidewire position, retraction of the guidewire tip above the junction of the brachiocephalic veins should be avoided prior to CVC insertion in order to preclude dislocation of the catheter tip towards the right internal jugular vein or the left subclavian vein. This study shows that many commercial over-the-wire percutaneous 15-16 cm CVC kits contain guidewires that are too short for right subclavian vein catheterization, i.e., guidewire retraction is needed prior to CVC insertion.
3.	Alinasab, Babak, et al. (author) The Supratarsal Approach for Correction of Anterior Frontal Bone Fractures 2018 In: The Journal of Craniofacial Surgery. - Philadelphia, PA : Lippincott Williams & Wilkins. - 1049-2275 .- 1536-3732. ; 29:7, s. 1906-1909 Journal article (peer-reviewed)abstract Background: To approach isolated anterior frontal bone fracture, coronal incision is the common surgical access of choice. This approach has complications such as aesthetically undesirable scarring and alopecia along the incision line. An alternative approach to these fractures is through a supratarsal incision. The aim of the present study was to correct the frontal bone fracture, through supratarsal approach.Methods: Six consecutive patients with frontal bone fracture were operated through supratarsal incision and evaluated regarding: patient cosmetic satisfaction, forehead contour, scarring, sensibility and motility in forehead and upper eyelids.Results: Seven months (6–12) postoperatively, all the patients had normal mobility in the forehead and the upper eyelids and 17% (n = 1) had hypoesthesia of superior orbital nerve. The forehead contour was excellent in all patients. About 83% (n = 5) of the patients were very satisfied and 17% (n = 1) were satisfied with the surgical result.Conclusion: Correction of anterior frontal bone fracture through a supratarsal approach appears to be safe and offers a sufficient exposure to the frontal bone fracture correction with excellent contouring results and no noticeable scarring.
4.	Bengtsson, Daniel, et al. (author) Movements, Home-Range Size and Habitat Selection of Mallards during Autumn Migration 2014 In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:6 Journal article (peer-reviewed)abstract The mallard (Anas platyrhynchos) is a focal species in game management, epidemiology and ornithology, but comparably little research has focused on the ecology of the migration seasons. We studied habitat use, time-budgets, home-range sizes, habitat selection, and movements based on spatial data collected with GPS devices attached to wild mallards trapped at an autumn stopover site in the Northwest European flyway. Sixteen individuals (13 males, 3 females) were followed for 15-38 days in October to December 2010. Forty-nine percent (SD = 8.4%) of the ducks' total time, and 85% of the day-time (SD = 28.3%), was spent at sheltered reefs and bays on the coast. Two ducks used ponds, rather than coast, as day-roosts instead. Mallards spent most of the night (76% of total time, SD = 15.8%) on wetlands, mainly on alvar steppe, or in various flooded areas (e.g. coastal meadows). Crop fields with maize were also selectively utilized. Movements between roosting and foraging areas mainly took place at dawn and dusk, and the home-ranges observed in our study are among the largest ever documented for mallards (mean = 6,859 ha; SD = 5,872 ha). This study provides insights into relatively unknown aspects of mallard ecology. The fact that autumn-staging migratory mallards have a well-developed diel activity pattern tightly linked to the use of specific habitats has implications for wetland management, hunting and conservation, as well as for the epidemiology of diseases shared between wildlife and domestic animals.
5.	Bengtsson, D, et al. (author) Previously unknown thyroid dysfunction in patients with acute ischemic stroke. 2012 In: Acta Neurologica Scandinavica. - : Wiley-Blackwell. - 0001-6314 .- 1600-0404. ; 126:2, s. 98-102 Journal article (peer-reviewed)abstract OBJECTIVES: Opinions differ regarding the clinical significance of subclinical thyroid disorders. The aim of the present study was to evaluate the prevalence and influence of previously unknown overt or subclinical thyroid dysfunction in patients with acute ischemic stroke and to look for differences between cardio-embolic and non-embolic ischemic stroke.MATERIAL AND METHODS: A total of 153 Swedish patients diagnosed with first-time acute ischemic stroke were included in the study and categorized for suspected cardio-embolic (n = 30) or non-embolic (n = 123) ischemic stroke depending on the presence of atrial fibrillation (AF). Blood samples were taken 48 h or earlier after onset of stroke symptoms.RESULTS: Previously, unknown overt or subclinical thyroid dysfunction was found in 12%. Previously, unknown overt or subclinical hyperthyroidism was more common in the AF group (13%) compared to the non-AF group (3%), P = 0.048. Patients with AF had slightly higher concentrations of free T4 (15 vs 14 pm; P < 0.001), but there was no significant difference in concentrations of S-TSH or prevalence of thyroperoxidase (TPO) antibodies between the groups.CONCLUSIONS: In patients with first-time acute ischemic stroke, unknown thyroid dysfunction is common, and unknown overt or subclinical hyperthyroidism is associated with cardio-embolic stroke.
6.	Bengtsson, Fredrik, et al. (author) Extinction of conditioned blink responses by cerebello-olivary pathway stimulation 2007 In: NeuroReport. - 1473-558X. ; 18:14, s. 1479-1482 Journal article (peer-reviewed)abstract Learning of classically conditioned eyeblink responses depends on mechanisms within the cerebellum. It has been suggested that climbing fibres from the inferior olive transmit the unconditioned stimulus signal to the cerebellum. We have previously shown that the pathway from the deep cerebellar nuclei to the inferior olive inhibits olivary activity. It is known that repeated presentation of the conditioned stimulus on its own leads to extinction of the conditioned response. If the unconditioned stimulus signal is transmitted to the cerebellum via the inferior olive - climbing fibre system then stimulation of the nucleo-olivary pathway just before the unconditioned stimulus in a trained animal should lead to extinction. The results from this investigation confirm this.
7.	Bengtsson, Fredrik, et al. (author) Feedback control of Purkinje cell activity by the cerebello-olivary pathway. 2004 In: European Journal of Neuroscience. - : Wiley. - 1460-9568 .- 0953-816X. ; 20:11, s. 2999-3005 Journal article (peer-reviewed)abstract The pathway from the deep cerebellar nuclei to the inferior olive, the source of the climbing fibre input to the cerebellum, inhibits olivary transmission. As climbing fibre activity can depress the background firing of the Purkinje cells, it was suggested that nucleo-olivary (N–O) inhibition is a negative feedback mechanism for regulating Purkinje cell excitability. This suggestion was investigated, in a set-up with decerebrate ferrets, both by blocking and by stimulating cerebellar output while recording Purkinje cell activity. Blocking the N–O pathway was followed by an increased climbing fibre activity and a dramatic reduction in simple spike firing. Stimulation of the N–O fibres depressed climbing fibre responses and caused an increase in simple spike firing. These results are taken as support for the feedback hypothesis.
8.	Bengtsson, Fredrik, et al. (author) Information technology as a change actant in sustainability innovation : Insights from Uppsala 2011 In: Journal of strategic information systems. - : Elsevier BV. - 0963-8687 .- 1873-1198. ; 20:1, s. 96-112 Journal article (peer-reviewed)abstract This study investigates the effects of a sustainability initiative in a Swedish municipality viewed through the lens of actor network theory. The focus is on the consequences of committing to the implementation of a reporting and analysis system for IT-supported sustainability. This commitment involves several actor networks, both internal and external to the municipality. The study shows that, to implement successfully a sustainability initiative, a thorough understanding of organizational routines and standards is required to enrol the affected stakeholders. Information systems can play a central role as tools for improving sustainability indicators and routines, thereby constituting important change actants.
9.	Bengtsson, Fredrik, et al. (author) Sustaining Sustainability : Investigating the Long-Term Effects of a Sustainability Initiative 2016 In: Nordic Contributions in IS Research. - Switzerland : Springer International Publishing. - 9783319435961 - 9783319435978 ; , s. 86-99 Book chapter (peer-reviewed)abstract This study investigates to what extent holistic sustainability values persist when a sustainability innovation initiative is transformed to standard mode of operation in a Swedish municipality through the lens of actor-network theory. The focus is on the effect of change in sustainability routines, inscribed in IT systems, when governance shifts from a dedicated initiative management to regular management. This longitudinal study shows that information systems can play a central role to enrol stakeholders in sustainable practices, but that sustainability outcomes are closely related to the view of sustainability inscribed in routines and supportive IT systems.
10.	Bengtsson, Patrik, et al. (author) Lokala och regionala utvecklingsprojekt i träförädling : Local and regional development projects in wood manufacturing 2000 Reports (other academic/artistic)
11.	Cedergren, Alexander, et al. (author) Understanding practical challenges to risk and vulnerability assessments : the case of Swedish municipalities 2019 In: Journal of Risk Research. - : Informa UK Limited. - 1366-9877 .- 1466-4461. ; 22:6, s. 782-795 Journal article (peer-reviewed)abstract Assessing risks and vulnerabilities in the multifaceted context of a municipality is challenging. There is a plethora of methods and tools to support this task. However, to achieve successful outcomes from Risk and Vulnerability Assessments (RVAs), merely applying theoretically and technically rigorous methods is far from enough; the question of how a method is implemented in a practical context is crucial for reaching intended outcomes. In this paper, we broaden the scope, from a strict consideration of technical and methodological matters, to a presentation of the more elusive challenges in accomplishing RVAs that are actually useful in a local context. We conduct and contrast two independent studies that were aimed at identifying general challenges in achieving a successful RVA process in Swedish municipalities. Based on the findings, we argue that there is a need for a considerably increased focus on municipal practices and on the implementation of methods in the practical context. Knowledge and understanding of such practical challenges are pivotal for efforts aimed at both developing methods for RVA and improving the entire RVA process.
12.	Eberhardson, Michael, et al. (author) Tumour necrosis factor inhibitors in Crohn's disease and the effect on surgery rates 2022 In: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 24:4, s. 470-483 Journal article (peer-reviewed)abstract Aim: Surgery is an important therapeutic option for Crohn's disease. The need for first bowel surgery seems to have decreased with the introduction of tumour necrosis factor inhibitors (TNFi; adalimumab or infliximab). However, the impact of TNFi on the need for intestinal surgery in Crohn's disease patients irrespective of prior bowel resection is not known. The aim of this work is to compare the incidence of bowel surgery in Crohn's disease patients who remain on TNFi treatment versus those who discontinue it. Method: We performed a nationwide register-based observational cohort study in Sweden of all incident and prevalent cases of Crohn's disease who started first-line TNFi treatment between 2006 and 2017. Patients were categorized according to TNFi treatment retention less than or beyond 1 year. The study cohort was evaluated with regard to incidence of bowel surgery from 12 months after the first ever TNFi dispensation. Results: We identified 5003 Crohn's disease patients with TNFi exposure: 3748 surgery naïve and 1255 with bowel surgery prior to TNFi initiation. Of these patients, 7% (n = 353) were subjected to abdominal surgery during the first 12 months after the start of TNFi and were subsequently excluded from the main analysis. A majority (62%) continued TNFi for 12 months or more. Treatment with TNFi for less than 12 months was associated with a significantly higher surgery rate compared with patients who continued on TNFi for 12 months or more (hazard ratio 1.26, 95% CI 1.09–1.46; p = 0.002). Conclusion: Treatment with TNFi for less than 12 months was associated with a higher risk of bowel surgery in Crohn's disease patients compared with those who continued TNFi for 12 months or more.
13.	Fridman-Bengtsson, Ola, et al. (author) Evaluation of different hydrocortisone treatment strategies in transsphenoidal pituitary surgery 2019 In: Acta Neurochirurgica. - : Springer Nature. - 0001-6268 .- 0942-0940. ; 161:8, s. 1715-1721 Journal article (peer-reviewed)abstract BackgroundHydrocortisone treatment in transsphenoidal pituitary surgery has been debated. Although several publications advocate restrictive treatment, centers around the world administer stress doses of hydrocortisone in patients with presumed intact cortisol production. Our aim with this analysis was to compare postoperative hypocortisolism in patients who received three different protocols of hydrocortisone therapy during and after surgery.MethodThis was a retrospective observational study. Based on perioperative hydrocortisone dose given, patients were divided in three groups: high dose (HD), intermediate dose (ID), and low dose (LD). Postoperative evaluation of the pituitary function was performed using S-cortisol at day 4 and short Synacthen test (SST) at 6–8 weeks. Patients with ACTH-producing adenomas or preoperative hydrocortisone treatment were excluded.ResultThere was no difference between the groups regarding failure rate of SST. The rate of failed SST (all groups) was 51/186 (27%), 24/74 (32%) in the HD group and 26/74 (35%) and 11/38 (29%) in the ID and LD groups respectively. There was no significant difference between the ID and LD groups regarding S-cortisol at postoperative day 4 regarding serum cortisol level below 200 nmol/L. There was a significant but weak correlation, rs 0.330 (P < 0.01) between S-cortisol day 4 and SST at 4–6 weeks.ConclusionsPeri and postoperative hydrocortisone treatment did not affect SST response 6–8 weeks postoperatively, whereas the rate of patients with S-cortisol below 200 nmol/L at postoperative day 4 did. LD hydrocortisone therapy seems to favor a better endogenous production in the early postoperative phase.
14.	Khalili, Hamed, et al. (author) Healthcare use, work loss and total costs in incident and prevalent Crohn's disease and ulcerative colitis : results from a nationwide study in Sweden 2020 In: Alimentary Pharmacology and Therapeutics. - : John Wiley & Sons. - 0269-2813 .- 1365-2036. ; 52:4, s. 655-668 Journal article (peer-reviewed)abstract Background: There are limited data on population-wide assessment of cost in Crohn's disease (CD) and ulcerative colitis (UC).Aim: To estimate the societal cost of actively treated CD and UC in Sweden.Methods: We identified 10 117 prevalent CD and 19 762 prevalent UC patients, aged ≥18 years on 1 January 2014 and 4028 adult incident CD cases and 8659 adult incident UC cases (2010-2013) from Swedish Patient Register. Each case was matched to five population comparators. Healthcare costs were calculated from medications, outpatient visits, hospitalisations and surgery. Cost of productivity losses was derived from disability pension and sick leave.Results: The mean annual societal costs per working-age patient (18-64 years) with CD and UC were $22 813 (vs $7533 per comparator) and $14 136 (vs $7351 per comparator) respectively. In patients aged ≥65 years, the mean annual costs of CD and UC were $9726 and $8072 vs $3875 and $4016 per comparator respectively. The majority of cost for both CD (56%) and UC (59%) patients originated from productivity losses. Higher societal cost of working-age CD patients as compared to UC patients was related to greater utilisation of anti-TNF (22.2% vs 7.4%) and increased annual disability pension (44 days vs 25 days). Among incident CD and UC patients, the mean total cost over the first year per patient was over three times higher than comparators.Conclusion: In Sweden, the societal cost of incident and prevalent CD and UC patients was consistently two to three times higher than the general population.
15.	Kochar, Bharati, et al. (author) Prevalence and Implications of Frailty in Older Adults With Incident Inflammatory Bowel Diseases : A Nationwide Cohort Study 2022 In: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 20:10, s. 2358-2365 Journal article (peer-reviewed)abstract Background and Aims: We aimed to compare the risk of frailty in older adults with incident inflammatory bowel disease (IBD) and matched non-IBD comparators and assess the association between frailty and future hospitalizations and mortality.Methods: In a cohort of patients with incident IBD ≥60 years of age from 2007 to 2016 in Sweden identified using nationwide registers, we defined frailty using Hospital Frailty Risk Score. We compared prevalence of frailty in patients with IBD with age, sex, place of residency– and calendar year–matched population comparators. In the IBD cohort, we used Cox proportional hazards modeling to examine the associations between frailty risk and hospitalizations or mortality.Results: We identified 10,590 patients with IBD, 52% female with a mean age of 71 years of age, matched to 103,398 population-based comparators. Among patients with IBD, 39% had no risk for frailty, 49% had low risk for frailty, and 12% had higher risk for frailty. Mean Hospital Frailty Risk Score was 1.9 in IBD and 0.9 in matched comparators (P < .01). Older adults with IBD at higher risk for frailty had a 20% greater risk for mortality at 3 years compared with those who were not frail. Compared with nonfrail older patients with IBD, patients at higher risk for frailty had increased mortality (hazard ratio [HR], 3.22, 95% confidence interval [CI], 2.86–3.61), all-cause hospitalization (HR, 2.42; 95% CI, 2.24–2.61), and IBD-related hospitalization (HR, 1.50; 95% CI, 1.35–1.66). These associations were not attenuated after adjusting for comorbidities.Conclusions: Frailty is more prevalent in older adults with IBD than in matched comparators. Among older patients with IBD, frailty is associated with increased risk for hospitalizations and mortality.
16.	Ludvigsson, Jonas F., 1969-, et al. (author) Swedish Inflammatory Bowel Disease Register (SWIBREG) : a nationwide quality register 2019 In: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 54:9, s. 1089-1101 Research review (peer-reviewed)abstract Background: Inflammatory bowel disease (IBD) is a chronic, inflammatory relapsing disease with increasing incidence. IBD research and long-term follow-up of patients have, however, been hampered by lack of detailed data on disease phenotype, patient-reported outcome measures, Physician Global Assessment, disease activity, and hospital-administered drugs.Aim: To review the Swedish IBD quality register (SWIBREG).Methods: Review of SWIBREG including questionnaire data from users and patients.Results: SWIBREG was launched in 2005, and as of April 2019, contains 46,400 patients with IBD (Crohn's disease: n = 15,705, ulcerative colitis: n = 21,540, IBD unclassified and other colitis (including e.g., microscopic colitis): n = 9155). Of these IBD patients, 7778 had been diagnosed in childhood (16.8%). Earlier research has shown that combining SWIBREG and the Swedish National Patient Register (NPR) yields a positive predictive value of 100% (95%CI = 95-100%) for having a diagnosis of IBD. Moreover, out of all patients in the NPR with a diagnosis of IBD plus either IBD-related surgery or immunomodulatory/biological treatment during the past 18 months, SWIBREG covers 59.0%. SWIBREG records not only information on conventional therapies but also on biological treatment, surgery, smoking, disease activity, patient-reported outcome measures (PROMs), and patient-experienced measures (PREMs). Data are presented through a graphical decision support system.Conclusion: SWIBREG benefits patients with IBD, and offers an ideal opportunity for healthcare personnel and researchers to examine disease phenotype and activity, PROMs/PREMs, and hospital-administered drugs in patients with IBD.
17.	Mellander, Helena, et al. (author) Virtual monoenergetic images by spectral detector computed tomography may improve image quality and diagnostic ability for ischemic lesions in acute ischemic stroke 2023 In: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 64:4, s. 1631-1640 Journal article (peer-reviewed)abstract Background: Acute ischemic lesions are challenging to detect by conventional computed tomography (CT). Virtual monoenergetic images may improve detection rates by increased tissue contrast. Purpose: To compare the ability to detect ischemic lesions of virtual monoenergetic with conventional images in patients with acute stroke. Material and Methods: We included consecutive patients at our center that underwent brain CT in a spectral scanner for suspicion of acute stroke, onset <12 h, with or without (negative controls) a confirmed cortical ischemic lesion in the initial scan or a follow-up CT or magnetic resonance imaging. Attenuation was measured in predefined areas in ischemic gray (guided by follow-up exams), normal gray, and white matter in conventional images and retrieved in spectral diagrams for the same locations in monoenergetic series at 40–200 keV. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Visual assessment of diagnostic measures was performed by independent review by two neuroradiologists blinded to reconstruction details. Results: In total, 29 patients were included (January 2018 to July 2019). SNR was higher in virtual monoenergetic compared to conventional images, significantly at 60–150 keV. CNR between ischemic gray and normal white matter was higher in monoenergetic images at 40–70 keV compared to conventional images. Virtual monoenergetic images received higher scores in overall image quality. The sensitivity for diagnosing acute ischemia was 93% and 97%, respectively, for the reviewers, compared to 55% of the original report based on conventional images. Conclusion: Virtual monoenergetic reconstructions of spectral CIs may improve image quality and diagnostic ability in stroke assessment.
18.	Mårild, Karl, 1982, et al. (author) Histologic activity in inflammatory bowel disease and risk of serious infections : A nationwide study 2024 In: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 22:4, s. 831-846 Journal article (peer-reviewed)abstract BACKGROUND AND AIMS: Individuals with inflammatory bowel disease (IBD) are at increased risk of serious infections, but whether this risk varies by histological disease activity is unclear.METHODS: A national population-based study of 55,626 individuals diagnosed with IBD in 1990-2016 with longitudinal data on ileo-colorectal biopsies followed through 2016. Serious infections were defined as having an inpatient infectious disease diagnosis in the Swedish National Patient Register. We used Cox regression to estimate hazard ratios (HRs) for serious infections in the 12 months following documentation of histologic inflammation (vs. histological remission), adjusting for social and demographic factors, chronic comorbidities, prior IBD-related surgery and hospitalization. We also adjusted for IBD-related medications in sensitivity analyses.RESULTS: With histological inflammation vs. remission, there was 4.62 (95%CI=4.46-4.78) and 2.53 (95%CI=2.36-2.70) serious infections per 100 person-years of follow-up, respectively (adjusted [a]HR=1.59; 95%CI=1.48-1.72). Histological inflammation (vs. remission) were associated with an increased risk of serious infections in ulcerative colitis (UC, aHR=1.68; 95%CI=1.51-1.87) and Crohn's disease (CD, aHR=1.59; 95%CI=1.40-1.80). The aHRs of sepsis and opportunistic infections were 1.66 (95%CI=1.28-2.15) and 1.71 (95%CI=1.22-2.41), respectively. Overall, results were consistent across age groups, sex and education level and remained largely unchanged after adjustment for IBD-related medications (aHR=1.47; 95%CI=1.34-1.61).CONCLUSION: Histological inflammation of IBD was an independent risk factor of serious infections, including sepsis, suggesting that achieving histological remission may reduce infections in IBD.
19.	Olén, Ola, et al. (author) Increasing Risk of Lymphoma Over Time in Crohn's Disease but Not in Ulcerative Colitis : A Scandinavian Cohort Study 2023 In: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 21:12, s. 3132-3142 Journal article (peer-reviewed)abstract Background & Aims: Earlier studies have provided varying risk estimates for lymphoma in patients with inflammatory bowel disease (IBD), but often have been limited by detection biases (especially during the first year of follow-up evaluation), misclassification, and small sample size; and rarely reflect modern-day management of IBD.Methods: We performed a binational register-based cohort study (Sweden and Denmark) from 1969 to 2019. We compared 164,716 patients with IBD with 1,639,027 matched general population reference individuals. Cox regression estimated hazard ratios (HRs) for incident lymphoma by lymphoma subtype, excluding the first year of follow-up evaluation.Results: From 1969 to 2019, 258 patients with Crohn's disease (CD), 479 patients with ulcerative colitis (UC), and 6675 matched reference individuals developed lymphoma. This corresponded to incidence rates of 35 (CD) and 34 (UC) per 100,000 person-years in IBD patients, compared with 28 and 33 per 100,000 person-years in their matched reference individuals. Although both CD (HR, 1.32; 95% CI, 1.16–1.50) and UC (HR, 1.09; 95% CI, 1.00–1.20) were associated with an increase in lymphoma, the 10-year cumulative incidence difference was low even in CD patients (0.08%; 95% CI, 0.02–0.13). HRs have increased in the past 2 decades, corresponding to increasing use of immunomodulators and biologics during the same time period. HRs were increased for aggressive B-cell non-Hodgkin lymphoma in CD and UC patients, and for T-cell non-Hodgkin lymphoma in CD patients. Although the highest HRs were observed in patients exposed to combination therapy (immunomodulators and biologics) or second-line biologics, we also found increased HRs in patients naïve to such drugs.Conclusions: During the past 20 years, the risk of lymphomas have increased in CD, but not in UC, and were driven mainly by T-cell lymphomas and aggressive B-cell lymphomas.
20.	Risto, Anton, et al. (author) Reoperations and Long-term Survival of Kock’s Continent Ileostomy in Inflammatory Bowel Disease Patients: A Population Based National Cohort Study from Sweden 2023 In: Diseases of the Colon & Rectum. - : Wolters Kluwer. - 0012-3706 .- 1530-0358. ; 66:11, s. 1492-1499 Journal article (peer-reviewed)abstract BACKGROUND: Kock’s continent ileostomy is an option after proctocolectomy for patients not suitable for ileal pouch anal anastomosis or ileorectal anastomosis. Ulcerative colitis is the most common indication for continent ileostomy.OBJECTIVE: The aim of this study was to evaluate the long-term outcome of continent ileostomy.DESIGN: Retrospective cohort register study.SETTINGS: Data were obtained from the Swedish National Patient Registry.PATIENTS: All patients with inflammatory bowel disease and a continent ileostomy were identified. Data on demographics, diagnosis, reoperations, and excisions of the continent ileostomy was obtained. Patients with inconsistent diagnostic coding were classified as inflammatory bowel disease-unclassified.MAIN OUTCOME MEASURES: The main outcome measures was number of reoperations, time to reoperations and time to excision of continent ileostomy.RESULTS: We identified 727 patients, 428 (59%) with ulcerative colitis, 45 (6%) with Crohn’s disease and 254 (35%) with inflammatory bowel disease-unclassified. After a median follow-up time of 27 (IQR, 21-31) years 191 (26%) patients had never had revisional surgery. Some 1,484 reoperations were performed on 536 (74%) patients, the median number of reoperations was 1 (IQR, 0-3) per patient. The continent ileostomy was excised in 77 (11%) patients. Reoperation within the first year after reconstruction was associated with higher rate of revisions (IRR, 2.90 p < 0.001) and shorter time to excision (HR 2.38 p < 0.001). Constructing the continent ileostomy after year 2000 was associated with increased revision and excision rates (IRR, 2.7 p < 0.001 and HR 2.74 p = 0.013). Inflammatory bowel disese-unclassified was associated with increased revisions (IRR, 1.3 p < 0.001) and the proportion of IBD-unclassified patients almost doubled from the 1980s (32%) to after 2000 (50%).LIMITATIONS: Retrospective design, data from register. No data on quality of life available.CONCLUSION: Continent ileostomy is associated with substantial need for revisional surgery, but most patients get to keep their reconstruction for a long time. See Video Abstract at https://links.lww.com/DCR/C122.
21.	Strömwall, Leif, 1967, et al. (author) Assessing children's statements: The impact of a repeated experience on CBCA and RM ratings 2004 In: APPLIED COGNITIVE PSYCHOLOGY. - : Wiley. - 0888-4080 .- 1099-0720. ; 18:6, s. 653-668:18, s. 653-668 Journal article (peer-reviewed)abstract This study examined the extent to which the Criteria-based Content Analysis (CBCA) technique and the Reality Monitoring (RM) technique were affected by the number of times children had experienced or imagined an event. Children (age 10-13, N =87 ) participated in an experiment where half the sample experienced a health examination (either one or four times), and the other half imagined (either one or four times) that they took part in a health examination. One week after the final occasion, the children were interviewed. The results showed that RM was sensitive to both the authenticity of the statements (increased presence of the criteria for real events) and whether the event had been repeatedly experienced/imagined (increased presence of the criteria for the repeated actions). The CBCA did not successfully distinguish the real from the imagined.
22.	Svensson, Pär, et al. (author) Cerebellar inhibition of inferior olivary transmission in the decerebrate ferret. 2006 In: Experimental Brain Research. - : Springer Science and Business Media LLC. - 0014-4819 .- 1432-1106. ; 168, s. 241-253 Journal article (peer-reviewed)abstract Stimulation around the superior cerebellar peduncle or within the deep cerebellar nuclei is known to inhibit the inferior olive with a very long latency. It has been suggested that this inhibition is mediated by the GABA-ergic nucleo-olivary pathway, but alternative explanations such as activation of an indirect excitatory pathway or a pathway via the red nucleus are possible. A long-latency inhibition via the nucleo-olivary pathway would have profound implications for cerebellar function and the present study was performed to test alternative explanations and to characterize the nucleo-olivary inhibition. Climbing fibre responses (CFRs), evoked by periorbital stimulation and recorded from the cerebellar cortex, could be inhibited by stimulation of two distinct mesencephalic areas. One was located within the superior cerebellar peduncle and the other about 1 mm further ventrally. Inhibition evoked from either area occurred in the inferior olive and was independent of a red nucleus relay. Single Purkinje cell recordings revealed that inhibition from the ventral area was not secondary to olivary activation. It is concluded that stimulation of the ventral area activated nucleo-olivary fibres. The inhibition elicited by stimulation within the peduncle probably resulted from indirect activation on the nucleo-olivary fibres via antidromic activation of the interpositus nucleus. The time courses of the inhibition from the two areas were indistinguishable. The duration of the strongest inhibition was short and had a sharp peak at about 30 ms. It is suggested that the time course of the inhibition is important for temporal regulation of learned responses.
23.	Svensson, Pär, et al. (author) Effect of conditioned stimulus parameters on timing of conditioned purkinje cell responses 2010 In: Journal of Neurophysiology. - : American Physiological Society. - 0022-3077 .- 1522-1598. ; 103:3, s. 1329-1336 Journal article (peer-reviewed)abstract Pavlovian eyeblink conditioning is a useful experimental model for studying adaptive timing, an important aspect of skilled movements. The conditioned response (CR) is precisely timed to occur just before the onset of the expected unconditioned stimulus (US). The timing can be changed immediately, however, by varying parameters of the conditioned stimulus (CS). It has previously been shown that increasing the intensity of a peripheral CS or the frequency of a CS consisting of a train of stimuli to the mossy fibers shortens the latency of the CR. The adaptive timing of behavioral CRs probably reflects the timing of an underlying learned inhibitory response in cerebellar Purkinje cells. It is not known how the latency of this Purkinje cell CR is controlled. We have recorded form Purkinje cells in conditioned decerebrate ferrets while increasing the intensity of a peripheral CS or the frequency of a mossy fiber CS. We observe changes in the timing of the Purkinje cell CR that match the behavioral effects. The results are consistent with the effect of CS parameters on behavioral CR latency being caused by corresponding changes in Purkinje cell CRs. They suggest that synaptic temporal summation may be one of several mechanisms underlying adaptive timing of movements.
24.	Ternstedt, PAtrik, 1979-, et al. (author) Using an AOD simulator workbench to support process control development 2011 In: METEC InSteelCon 2011, Düsseldorf, Germany, 27 June - 1 July, 2011. Conference paper (other academic/artistic)abstract The AOD (Argon Oxygen Decarburization) process is simulated with a model developed within the RFCS project OPCONSTAINLESS. The focus on the project has been on the influence of slag on the decarburization process. Here, a slag property is usually a parameter that is not used for process control, often due to the complexity of the slag system. The workbench, TimeAOD2, has been coupled with the Thermo-Calc software [1], giving the ratios of different slag phases and amount of liquid slag throughout the operation. The workbench gives the process manager an opportunity to see the outcome of different process layouts, control paradigms and raw material choices under different production conditions. A number of scenarios are outlined and different solutions evaluated. The simulation data is for some cases compared to operational data from AOD plants in Sweden.
25.	Wadelius, Mia, et al. (author) Sulfasalazine-Induced Agranulocytosis Is Associated With the Human Leukocyte Antigen Locus. 2018 In: Clinical Pharmacology and Therapeutics. - : Wiley. - 0009-9236 .- 1532-6535. ; 103:5, s. 843-853 Journal article (peer-reviewed)abstract Agranulocytosis is a serious, although rare, adverse reaction to sulfasalazine, which is used to treat inflammatory joint and bowel disease. We performed a genome‐wide association study comprising 9,380,034 polymorphisms and 180 HLA alleles in 36 cases of sulfasalazine‐induced agranulocytosis and 5,170 population controls. Sulfasalazine‐induced agranulocytosis was significantly associated with the HLA region on chromosome 6. The top hit (rs9266634) was located close to HLA‐B, odds ratio (OR) 5.36 (95% confidence interval (CI) (2.97, 9.69) P = 2.55 × 10−8). We HLA‐sequenced a second cohort consisting of 40 cases and 142 treated controls, and confirmed significant associations with HLA‐B08:01, OR = 2.25 (95% CI (1.02, 4.97) P = 0.0439), in particular the HLA‐B08:01 haplotype HLA‐DQB102:01‐DRB103:01‐B08:01‐C07:01, OR = 3.79 (95% CI (1.63, 8.80) P = 0.0019), and with HLA‐A31:01, OR = 4.81 (95% CI (1.52, 15.26) P = 0.0077). The number needed to test for HLA‐B08:01 and HLA‐A31:01 to avoid one case was estimated to be 1,500. We suggest that intensified monitoring or alternative treatment should be considered for known carriers of HLA‐B08:01 or HLA‐A*31:01.
26.	Westberg, Karin, et al. (author) Primary Versus Staged Reconstruction and Risk of Surgical Failure in Patients With Ulcerative Colitis : a Nation-wide Cohort Study 2022 In: Inflammatory Bowel Diseases. - : Oxford University Press. - 1078-0998 .- 1536-4844. ; 28:9, s. 1301-1308 Journal article (peer-reviewed)abstract Lay Summary: This population-based study of 2172 patients treated with colectomy for ulcerative colitis shows that a colectomy and restorative IRA/IPAA surgery performed simultaneously entails a higher risk of failure than when reconstruction is performed later.Background: Restorative surgery after colectomy due to ulcerative colitis (UC) may be performed simultaneously with colectomy (primary) or as a staged procedure. Risk factors for failure after restorative surgery are not fully explored. This study aimed to compare the risk of failure after primary and staged reconstruction.Methods: This is a national register-based cohort study of all patients 15 to 69 years old in Sweden treated with colectomy due to UC and who received an ileorectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA) between 1997 and 2017. Failure was defined as a reoperation with new ileostomy after restorative surgery or a remaining defunctioning ileostomy after 2 years. Risk of failure was calculated using the Kaplan-Meier method and Cox regression adjusted for sex, age, calendar period, primary sclerosing cholangitis, and duration of UC.Results: Of 2172 included patients, 843 (38.8%) underwent primary reconstruction, and 1329 (61.2%) staged reconstruction. Staged reconstruction was associated with a decreased risk of failure compared with primary reconstruction (hazard ratio, 0.73; 95% CI, 0.58-0.91). The 10-year cumulative risk of failure was 15% vs 20% after staged and primary reconstruction, respectively. In all, 1141 patients (52.5%) received an IPAA and 1031 (47.5%) an IRA. In stratified multivariable models, staged reconstruction was more successful than primary reconstruction in both IRA (hazard ratio, 0.75; 95% CI, 0.54-1.04) and IPAA (hazard ratio, 0.73; 95% CI, 0.52-1.01), although risk estimates failed to attain statistical significance.Conclusions: In UC patients undergoing colectomy, postponing restorative surgery may decrease the risk of failure.

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