| 1. |
- Andersson, Lenastina, et al.
(författare)
-
Mälsåker Revisited: Museum och Iscensättning. : Kungl Konsthögskolan. Restaureringskonst 2015-2016
- 2016
-
Rapport (populärvet., debatt m.m.)abstract
- Rapporten redovisar arbeten från kursen Restaureringskonst på Konsthögskolan som under läsåret 2015-2016 har arbetat med tema Museum och Iscensättning. Hur kulturmiljöer påverkas när de blir museum, hur man restaurerar för museum, hur man bevarar och utvecklar en plats för kunskapsutbyte, bildning och upplevelser. Mälsåkers slott, utanför Mariefred, förvaltat av Statens Fastighetsverk, var studieobjekt för 20 studenter, (yrkesverksamma arkitekter, antikvarier, ingenjörer, konservatorer m fl) där utbildningens olika studiemoment som uppmätning, inventering, dokumentation har tillämpats. Fältarbetet har följts av studier i historik, kulturhistorisk värdering och analyser som gett visioner och gestaltningsförslag på ny verksamhet i slottet. Rapporten presenterar förslagen, med text, skisser, foton och ritningar. Fyra olika typer av museum med varierande grad av åtgärder, förändringar och utveckling av slottet. Restaureringsexperiment redovisas utifrån traditionella och digitala dokumentationsmetoder. Dessutom finns arbeten om barockens ljus, bladguld, brandskydd, pod-radio, kraftstation, engelska parken, dekorationsmålade tak, Gustavianum, Julius Kronbergs ateljé och barockträdgård m m. Förslagen visar att det är möjligt att transformera Mälsåkers barockslott till ett museum av idag med bibehållen historik och synliga tidslager.
|
|
| 2. |
- Byström, Emma, et al.
(författare)
-
Confidence in the National Immunization Program among parents in Sweden 2016 – A cross-sectional survey
- 2020
-
Ingår i: Vaccine. - : Elsevier BV. - 0264-410X. ; 38:22, s. 3909-3917
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Vaccination coverage for infant vaccinations in the Swedish National Immunization Program (NIP) has been high for more than a decade, with approximately 97% of 2-year-old children fully immunized. Vaccination coverage against Human Papilloma Virus (HPV) has been around 80% since introduction for girls in 2012. This indicates high parental confidence in the NIP, but as seen in other European countries rapid shifts in confidence may occur. This study examined vaccine confidence and attitudes towards vaccinations among parents in the Swedish population. Methods: A web-based survey was sent to 1046 parents with children aged 0–15 years, in a panel administrated by The Public Health Agency of Sweden. The survey included questions on vaccination awareness, safety and information channels. The response rate was 87%. Data were weighted to adjust for non-responders and for representativeness of the Swedish population. Results: Parents were categorized as acceptors (79%), questioning acceptors (19%) or selective refusers (2%). When excluding responses for HPV vaccination, the proportion of acceptors increased to 91%. The main reasons for questioning or refusing a vaccine were worry over adverse events, negative or lack of information. Along a spectrum of beliefs, acceptors and questioning acceptors were more similar compared to selective refusers. Nurses at child health clinics constituted the most used vaccination information source for acceptors, whereas selective refusers to a greater extent searched information online and in social media. Conclusions: The study demonstrates that parents in Sweden have confidence in and are positive towards vaccinations given within the NIP. One in five parents question vaccines, particularly regarding the HPV vaccine, but still concur to the NIP. Information on vaccines online and at vaccination appointments, including vaccine safety, is important for maintaining confidence in vaccination. Conducting recurring studies is valuable for monitoring vaccine confidence and changes in attitudes towards vaccination.
|
|
| 3. |
- Börjesson, Stefan, 1979-, et al.
(författare)
-
Limited Dissemination of Extended-Spectrum β-Lactamase- and Plasmid-Encoded AmpC-Producing Escherichia coli from Food and Farm Animals, Sweden
- 2016
-
Ingår i: Emerging Infectious Diseases. - : U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 22:4, s. 634-640
-
Tidskriftsartikel (refereegranskat)abstract
- Extended-spectrum β-lactamase (ESBL)- and plasmid-encoded ampC (pAmpC)-producing Enterobacteriaceae might spread from farm animals to humans through food. However, most studies have been limited in number of isolates tested and areas studied. We examined genetic relatedness of 716 isolates from 4,854 samples collected from humans, farm animals, and foods in Sweden to determine whether foods and farm animals might act as reservoirs and dissemination routes for ESBL/pAmpC-producing Escherichia coli. Results showed that clonal spread to humans appears unlikely. However, we found limited dissemination of genes encoding ESBL/pAmpC and plasmids carrying these genes from foods and farm animals to healthy humans and patients. Poultry and chicken meat might be a reservoir and dissemination route to humans. Although we found no evidence of clonal spread of ESBL/pAmpC-producing E. coli from farm animals or foods to humans, ESBL/pAmpC-producing E. coli with identical genes and plasmids were present in farm animals, foods, and humans.
|
|
| 4. |
- Domert, Jakob, et al.
(författare)
-
Aggregated Alpha-Synuclein Transfer Efficiently between Cultured Human Neuron-Like Cells and Localize to Lysosomes
- 2016
-
Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 11:12
-
Tidskriftsartikel (refereegranskat)abstract
- Parkinson's disease and other alpha-synucleinopathies are progressive neurodegenerative diseases characterized by aggregates of misfolded alpha-synuclein spreading throughout the brain. Recent evidence suggests that the pathological progression is likely due to neuron-to-neuron transfer of these aggregates between neuroanatomically connected areas of the brain. As the impact of this pathological spreading mechanism is currently debated, we aimed to investigate the transfer and subcellular location of alpha-synuclein species in a novel 3D co-culture human cell model based on highly differentiated SH-SY5Y cells. Fluorescently-labeled monomeric, oligomeric and fibrillar species of alpha-synuclein were introduced into a donor cell population and co-cultured with an EGFP-expressing acceptor-cell population of differentiated neuron-like cells. Subsequent transfer and colocalization of the different species were determined with confocal microscopy. We could confirm cell-to-cell transfer of all three alpha-synuclein species investigated. Interestingly the level of transferred oligomers and fibrils and oligomers were significantly higher than monomers, which could affect the probability of seeding and pathology in the recipient cells. Most alpha-synuclein colocalized with the lysosomal/endosomal system, both pre- and postsynaptically, suggesting its importance in the processing and spreading of alpha-synuclein.
|
|
| 5. |
- Edlund, Charlotta, et al.
(författare)
-
The clinical and microbiological efficacy of temocillin versus cefotaxime in adults with febrile urinary tract infection, and its effects on the intestinal microbiota : a randomised multicentre clinical trial in Sweden
- 2022
-
Ingår i: The Lancet - Infectious diseases. - : Elsevier. - 1473-3099 .- 1474-4457. ; 22:3, s. 390-400
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Use of third-generation cephalosporins, such as cefotaxime, is associated with an increased risk of selection for antimicrobial resistance, so alternative antibiotics need to be considered. The aim of the present study was to evaluate intestinal colonisation with third-generation cephalosporin-resistant pathogens following use of temocillin-an alternative antibiotic to cefotaxime that is potentially less prone to disturbing the intestinal microbiota-in empirical treatment of febrile urinary tract infection (UTI).METHODS: We did a randomised, multicentre, superiority, open-label phase 4 trial in patients who had been admitted to inpatient care in 12 Swedish hospitals with suspected or diagnosed febrile UTI (complicated or uncomplicated). To meet inclusion criteria, a patient was required to have at least one sign or symptom of pyelonephritis (ie, flank pain; costovertebral angle tenderness; and changes to urinary frequency or urgency or dysuria), a fever of 38·0°C or higher, and a positive urine dipstick (for nitrites, white blood cells, or both). Participants were also required to have an indication for intravenous antibiotic treatment. Participants were randomly assigned (1:1) to receive either 2 g temocillin or 1-2 g cefotaxime, by local investigators opening consecutive sealed randomisation envelopes that were generated centrally in advance. Both drugs were administered intravenously every 8 h. The trial was open label for investigators and patients, but those doing the microbiological analyses were masked to the groups. Participants were treated with antibiotics for 7-10 days (or up to 14 days if they had bacteraemia), at least 3 days of which were on the study drug; at day 4 and later, participants who were showing improvement could be given an oral antibiotic (ciprofloxacin, ceftibuten, cefixime, or co-trimoxazole). Patients not showing improvement were regarded as having treatment failures. Rectal swabs were collected at three timepoints: at baseline (before the first dose), after the last dose of study drug, and 7-10 days after treatment stopped. The composite primary outcome was colonisation with Enterobacterales with reduced susceptibility to third-generation cephalosporins, or colonisation with toxin-producing Clostridioides difficile, or both, to evaluate disturbance of the intestinal microbiota. The study is registered in the EU Clinical Trials Register (EudraCT 2015-003898-15).FINDINGS: Between May 20, 2016, and July 31, 2019, 207 patients were screened for eligibility, of whom 55 patients were excluded. 152 participants were randomly assigned to groups: 77 (51%) patients received temocillin, 75 (49%) patients received cefotaxime. The composite primary endpoint was met by 18 (26%) of 68 participants receiving temocillin versus 30 (48%) of 62 patients receiving cefotaxime (risk difference -22% [95% CI -42% to -3%]), showing superiority of temocillin versus cefotaxime (ie, less disturbance of the intestinal microbiota). 43 adverse events were reported in 40 (52%) of 77 patients in the temocillin group, versus 46 adverse events in 34 (45%) of 75 patients in the cefotaxime group. Most events were of mild to moderate severity. 21 (27%) patients in the temocillin and 17 (23%) patients in the cefotaxime group had an adverse event that was considered to be associated with the study drug.INTERPRETATION: Temocillin was found to be less selective than cefotaxime of Enterobacterales with reduced susceptibility to third-generation cephalosporins, and it could therefore be a favourable alternative in the empirical treatment of febrile UTI. Use of this antibiotic could reduce hospital transmission and health-care-associated infections by these pathogens.
|
|
| 6. |
- Ejhed, Helene, et al.
(författare)
-
Beräkning av kväve-och fosforbelastning på vatten och hav för uppföljning av miljökvalitetsmålet "Ingen övergödning"
- 2011
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- På uppdrag av Naturvårdverket har SMED genomfört beräkningar av kväve- och fosforbelastningar på vatten och hav i Sverige för år 2009. Beräkningarna har ge-nomförts med PLC5-metodik och underlag för att möjliggöra jämförelse med tidi-gare beräknad belastning år 1995, 2000 och 2006. Inom uppdraget har underlag och sammanställningar tagits fram till den nationella miljömålsuppföljningen av målet "Ingen övergödning" och uppföljning av utsläppsreduktion i förhållande till de Svenska betingen inom Baltic Sea Action Plan.Tidigare belastningsberäkningar (år 1995, 2000 och 2006) genomfördes baserat på långtidsmedelvärde av avrinning för att korttidsvariationer i klimatet inte skulle överskugga förändringar i källornas storlek. Beräkningarna genomfördes också av nettobelastningen på havet för kväve och fosfor, d.v.s. hur stor del som når havet efter avskiljning (retention) som sker vid transport genom mark, sjöar och vatten-drag. I detta projekt har samma metodik utnyttjats; samma avrinning och retent-ionsandel har använts för att resultaten från samtliga år ska kunna jämföras med varandra.Den totala bruttobelastningen av kväve från samtliga källor är 155 700 ton kväve år 2009 (utan bidrag från hygge), vilket motsvarar en minskning med totalt 11 % från år 1995. Den totala diffusa bruttobelastningen av kväve beräknades för år 2009 till 129 200 ton, d.v.s. ca 6 % minskning från 1995 års bruttobelastning av kväve från diffusa källor. Bruttobelastningen av kväve från jordbruksmark minskade med ca 10 % från 1995 års nivå och med ca 2 % från år 2006. Den minskade totala arean jordbruksmark står för i stort sett hela minskningen av belastningen från jord-bruksmark från år 2006 till 2009. Åtgärder i form av skyddszoner och fånggrödor har minskat under perioden och bidrar därmed inte till den lägre belastningen. Bruttobelastningen av kväve från reningsverk och industrier har minskat under perioden 1995 till 2009 med totalt 31 % respektive 34 %. Den största förändringen skedde mellan år 1995 och 2000 då kväverening infördes som reningssteg i många reningsverk och industrier. Från år 2000 till år 2009 har bruttobelastningen fortsatt att minska med 8 och 17 % från reningsverk respektive industrier. Belastningen från enskilda avlopp har däremot ökat något med 200 ton kväve sedan år 1995 på grund av ökat antal fastigheter med enskilda avlopp.Total nettobelastning av kväve år 2009 för hela Sverige var 115700 ton, vilket motsvarar en minskning från 1995 med 11 %. Regeringens havsmiljöplan (Rege-ringens skrivelse 2009/10:213 ) riktar in miljöarbetet bland annat för att klara ut-släppsreduktioner enligt Baltic Sea Action Plan (BSAP). Minskningen i nettobe-lastning av kväve från år 2000 till 2009 utgör endast 4700 ton kväve (Egentliga Östersjön, Öresund och Kattegatt) och mycket återstår om målet, 20780 ton kväve, ska uppnås.Den antropogena belastningen efter retention (netto) var 59000 ton kväve år 2009 för hela Sverige, totalt inklusive hyggen. Punktutsläpp av kväve år 2009 var 21800 ton och står för en betydande del av minskningen av den antropogena nettobelast-ningen med 30 % från 1995. De antropogena diffusa källorna har minskat med 12 % (netto) från år 1995 till 2009. Delmålet för kväve inom miljökvalitetsmålet "Ing-en övergödning" anger att senast år 2010 ska de svenska vattenburna utsläppen av kväveföreningar från mänsklig verksamhet till haven söder om Ålands hav ha minskat med minst 30 % från 1995 års nivå. Den totala antropogena nettobelast-ningen av kväve till haven söder om Ålands hav har beräknats till 42400 ton (utan hyggen för jämförelse med år 1995). Det innebär en minskning med ca 25 % från år 1995 till år 2009, vilket betyder att delmålet för kväve inte uppnåtts.Den totala bruttobelastningen av fosfor (diffusa källor och punktkällor) var sam-manlagt 4730 ton år 2009 (4750 ton med bidrag från hyggen inkluderat). Det mots-varar en minskning med 10 % sedan år 1995.Den totala diffusa bruttobelastningen av fosfor minskar med ca 4 % från år 1995. Bruttobelastningen av fosfor från jord-bruksmark minskade med ca 7 % från 1995 års nivå och med ca 2 % från år 2006. Orsaken till förändringen mellan 1995 och 2006 är införsel av åtgärder för minskat växtnäringsläckage, men från år 2006 till 2009 är det minskad total areal jord-bruksmark som står för i stort sett hela förändringen. Bruttobelastning av fosfor från punktkällor år 2009 beräknades till 880 ton, vilket motsvarar en minskning med ca 17 % från år 2006 och 30 % sedan år 1995. Kommunala avloppsrenings-verk står för den största förändringen, motsvarande ca 45 % lägre belastning år 2009 jämfört med år 1995. Den viktigaste orsaken till minskningen är att ny re-ningsteknik införts framför allt i de största reningsverken. Industrier står också för en betydande minskning, motsvarande 33 % från år 1995 till år 2009. De totala förändringarna i utsläpp innebär att enskilda avlopp, KARV respektive industrier står för ungefär lika stor belastning år 2009.Den antropogena bruttobelastningen av fosfor var sammanlagt 1930 ton år 2009, vilket motsvarar en minskning med ca 7 % från år 2006. Delmålet för fosfor inom miljökvalitetsmålet "Ingen övergödning" anger att till år 2010 ska de svenska vat-tenburna utsläppen av fosforföreningar från mänsklig verksamhet till sjöar, vatten-drag och kustvatten ha minskat med minst 20 % från 1995 års nivå. Den av mänsk-lig verksamhet orsakade vattenburna belastningen av fosfor har minskat med ca 18 % från år 1995 till år 2009 och miljömålet har därmed inte uppnåtts. Enligt dessa beräkningar återstår det att minska ca 50 ton fosfor för att miljömålet ska uppnås.Total nettobelastning av fosfor år 2009 för hela Sverige är 3360 ton, vilket motsva-rar en minskning från 1995 med 11 %. Den antropogena nettobelastningen av fos-for på havet har minskat med ca 22 % (380 ton) från år 1995 för hela Sverige. En-ligt Baltic Sea Action Plan (BSAP) är målet att minska belastningen av fosfor med 290 ton från land till Egentliga Östersjön. Minskningen i nettobelastning av fosfor från år 2000 till 2009 till Egentliga östersjön utgör endast 50 ton fosfor och mycket återstår om målet ska uppnås.
|
|
| 7. |
- Gustavsson, Catharina, et al.
(författare)
-
Predictive factors for disability outcome at 20 weeks and 2 years following a pain self-management group intervention in patients with persistent neck pain in primary health care
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Study design. An explorative, longitudinal, prospective study, with measurement at baseline, 20 weeks and 2 years. Objective. To explore plausible predictors associated with short-term (20 weeks) and long-term (2 years) treatment success in terms of pain-related disability for patients with persistent tension-type neck pain following a multi-component pain and stress self-management group intervention (PASS). Summary of Background Data. In previously reported short-term and long-term follow-up, PASS had better effect on pain control, pain-related self-efficacy, disability and catastrophizing than a control treatment; individually administered physical therapy (IAPT). Identification of patients who are likely to benefit from particular interventions is required. Methods. Data collected from 77 participants assigned to PASS in a randomized controlled trial were explored in order to identify plausible predictors of favorable outcome regarding pain-related disability as measured by the Neck Disability Index (NDI), by use of Pearson correlation analysis, factor analysis (FA) and partial least squares (PLS) and ordinary least squares (OLS) regression analyses. Data from self-assessment questionnaires completed by the participants before intervention, post-treatment (20 weeks) and at 2 years after the intervention, were used. The questionnaire comprised: the Self-Efficacy Scale (SES), the NDI, the Coping Strategies Questionnaire(CSQ), the Hospital Anxiety and Depression Scale (HADS) and questions regarding neck pain and analgesics. Results. Multivariate PLS regression analysis showed that baseline scores in NDI, SES and pain intensity explained only 31% of the variance in disability (NDI) immediately post-treatment (20-week follow-up). PLS regression analysis showed that post-treatment scores in NDI, SES and pain intensity explained 68% of the variance in disability (NDI) at 2 years. Univariate OLS linear regression analyses indicated that each variable contributed significantly to the latter PLS regression model (NDI p<0.001, SES p<0.001, pain intensity p<0.001). Conclusions. Treatment gains, as measured by immediate post-treatment scores at 20-week follow-up, in disability, self-efficacy and pain intensity were associated with long-term outcome in pain-related disability two years post-treatment, in patients with persistent neck pain participating in a self-management group intervention in PHC. Pre-treatment characteristics explained only a small proportion of variance in disability post-treatment. Thus, the intervention appears to be feasible for the majority of persons seeking PHC due to persistent tension-type neck pain.
|
|
| 8. |
- Hemmingsson, Erik, et al.
(författare)
-
Impact of social support intensity on walking in the severely obese : a randomized clinical trial
- 2008
-
Ingår i: Obesity. - : Wiley. - 1930-7381 .- 1930-739X. ; 16:6, s. 1308-1313
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: There are few established methods for promoting physical activity (PA) in the severely obese. Because social support is a potential method for promoting PA, we compared mean steps/day during 18 weeks in severely obese outpatients receiving either standard support (SS) or added support (AS). METHODS AND PROCEDURES: Eighty severely obese outpatients from an obesity clinic were invited; 66 provided written consent, 55 were randomized, and 42 were included in final analyses (9 men, 33 women; age 44.4 +/- 13.1 years; BMI 41.9 +/- 5.5 kg/m(2)). All participants received a pedometer and a walking promotion booklet. In addition to SS, the AS group received ten 2-h group counseling sessions aimed at increasing weekly accumulated steps, every second week during the study. Each participant was asked to complete a 7-day walking diary every second week (10 observations). RESULTS: Baseline steps/day was 6,912 for the AS group and 5,311 for the SS group (P = 0.023). Data at 18 weeks showed that the AS group recorded 10,136 steps/day and the SS group 6,118 steps/day (P = 0.024). There was no allocation x time interaction (P = 0.46). During the follow-up period as a whole, the AS group recorded 1,794 more steps/day than the SS group (P = 0.0074). DISCUSSION: The AS group recorded more steps/day than the SS group, reaching a mean level of approximately 10,000 steps/day. However, the nonsignificant interaction between allocation x time suggests that this difference was present already at baseline and did not increase during follow-up.
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
- Holmefur, Marie, 1968-, et al.
(författare)
-
Factors that predict and correlate with development of hand function in children with unilateral cerebral palsy
- 2012
-
Ingår i: 9th COTEC Congress of Occupational Therapy.
-
Konferensbidrag (refereegranskat)abstract
- Earlier studies of development of hand function showed large variation between individuals in course of development.Aim: To identify factors that predict or correlate with development of hand function in children with unilateral cerebral palsy (CP).Methods: Forty-five children with unilateral CP (inclusion age 18-64 months) were measured repeatedly with the Assisting Hand Assessment over on average 4,5 years. Data was collected on brain lesion (n=27), learning ability, sensibility in affected hand etc. A non-linear mixed models analysis was used.Results: Type, extent and location of brain lesion could predict development of hand function. Decreased learning ability was a predictor of slower development of hand function. Poor sensibility in the affected hand correlated with slower development and a lower ability level compared to children with good sensibility.Conclusion: Development of hand function can be predicted by brain lesion and is correlated to learning ability and sensibility in the affected hand.
|
|
| 12. |
- Holmefur, Marie, 1968-, et al.
(författare)
-
Longitudinal development of hand function in children with unilateral cerebral palsy
- 2009
-
Ingår i: Developmental Medicine & Child Neurology. - West Sussex, UK : Wiley-Blackwell. - 0012-1622 .- 1469-8749. ; 51:s5
-
Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives: Studies of longitudinal development of hand function in children with unilateral cerebral palsy (CP) are sparse. For children with unilateral CP the ability to use the affected hand as an effective assist to the dominant hand in bimanual tasks may be the most important aspect of hand function in daily life. This ability can be assessed with the assisting hand assessment (AHA). The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral CP between 18 months and 8 years of age.Design: This was a study of prognosis with a prospective longitudinal cohort design. Participants and Setting: Forty-three children with unilateral cerebral palsy participated (22 male, 21 female). They were recruited at local rehabilitation centres and constituted a convenience sample. Inclusion age was 18 months–5 years 4 months (mean 2 years 8 months). Manual ability classification system (MACS) levels: I [n=7], II [n=25], III [n=11].Materials/Methods: The children were assessed with the AHA over a period of at least 3 years (mean 4.5 years), with 3–11 assessments per child. Children entered the study at different ages allowing evaluation of development from ages 18 months to 8 years. Estimated average motor development curves were fitted with a non-linear mixed effects model.Results: Individual differences in development were considerable. Children with a high AHA score at 18 months (over 40 raw scores) reached a significantly higher ability level and at a higher progression rate than the children with a low 18-month AHA score. The children with high 18-month AHA score reached 90% of their limit at average age 3 years whereas the children with a low 18-month AHA score reached 90% of their maximum level at a mean age of 7. Similarly, the maximum level of development differed between children in MACS level I–III. The rate of change was similar in levels I and II and significantly slower, in level III.Conclusions/Significance: This study shows that children with different ability levels all develop their way of using their hemiplegic hand during the preschool years. The AHA can be used to follow development over time and the AHA score at 18 months can be used for approximate prediction of development of assisting hand use.
|
|
| 13. |
- Holmefur, Marie, 1968-, et al.
(författare)
-
Neuroradiology can predict the development of hand function in children with unilateral cerebral palsy
- 2013
-
Ingår i: Neurorehabilitation and Neural Repair. - : Sage Publications. - 1545-9683 .- 1552-6844. ; 27:1, s. 72-78
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Much variation is found in the development of hand function in children with unilateral cerebral palsy (CP).OBJECTIVE: To explore how anatomic brain abnormalities can be used to predict the development of hand function.METHODS: A total of 32 children with unilateral CP (16 boys and 16 girls) were evaluated at least once a year by the Assisting Hand Assessment (AHA). The data collection covered an age range from 18 months to 8 years (mean time in study, 4 years and 6 months). Computerized tomography or magnetic resonance imaging of the brain were assessed for patterns of brain damage, including the location of gray and extent of white-matter damage. The children were divided into groups according to lesion characteristics, and a series of univariate models were analyzed with a nonlinear mixed-effects model. The rate and maximum limit of development were calculated.RESULTS: The highest predictive power of better development of hand function was the absence of a concurrent lesion to the basal ganglia and thalamus, independent of the basic type of brain lesion. This model predicted both the rate of increasing ability and hand function at age 8 years. Hand function was also predicted by the basic pattern of damage and by the extent of white-matter damage. The presence of unilateral or bilateral damage had no predictive value.CONCLUSIONS: Neuroradiological findings can be used to make a crude prediction of the future development of the use of the affected hand in young children with unilateral CP.
|
|
| 14. |
|
|
| 15. |
- Limaye, Mukta, V, et al.
(författare)
-
Functionalization and patterning of nanocellulose films by surface-bound nanoparticles of hydrolyzable tannins and multivalent metal ions
- 2019
-
Ingår i: Nanoscale. - : Royal Society of Chemistry. - 2040-3364 .- 2040-3372. ; 11:41, s. 19278-19284
-
Tidskriftsartikel (refereegranskat)abstract
- Inspired by the Bogolanfini dyeing technique, we report how flexible nanofibrillated cellulose (CNF) films can be functionalized and patterned by surface-bound nanoparticles of hydrolyzable tannins and multivalent metal ions with tunable colors. Molecular dynamics simulations show that gallic acid (GA) and ellagic acid (EA) rapidly adsorb and assemble on the CNF surface, and atomic force microscopy confirms that nanosized GA assemblies cover the surface of the CNF. CNF films were patterned with tannin-metal ion nanoparticles by an in-fibre reaction between the pre-impregnated tannin and the metal ions in the printing ink. Spectroscopic studies show that the Fe-III/II ions interact with GA and form surface-bound, stable GA-Fe-III/II nanoparticles. The functionalization and patterning of CNF films with metal ion-hydrolyzable tannin nanoparticles is a versatile route to functionalize films based on renewable materials and of interest for biomedical and environmental applications.
|
|
| 16. |
- Mandrika, Ilona, et al.
(författare)
-
Improving the affinity of antigens for mutated antibodies by use of statistical molecular design
- 2008
-
Ingår i: Journal of Peptide Science. - : Wiley. - 1075-2617 .- 1099-1387. ; 14:7, s. 786-96
-
Tidskriftsartikel (refereegranskat)abstract
- We demonstrate the use of statistical molecular design (SMD) in the selection of peptide libraries aimed to systematically investigate antigen-antibody binding spaces. Earlier, we derived two novel antibodies by mutating the complementarity-determining region of the anti-p24 (HIV-1) single chain Fv antibody, CB4-1 that had lost their affinity for a p24 epitope-homologous peptide by 8- and 60-fold. The present study was devoted to explore how peptide libraries can be designed under experimental design criteria for effective screening of peptide antigens. Several small peptide-antigen libraries were selected using SMD principles and their activities were evaluated by their binding to SPOT-synthesized peptide membranes and by fluorescence polarization (FP). The approach was able to reveal the most critical residues required for antigen binding, and finally to increase the binding activity by proper modifications of amino acids in the peptide antigen. A model of the active peptide binding pocket formed by the mutated scFv and the antigen was compatible with the information gained from the experimental data. Our results suggest that SMD approaches can be used to explore peptide antigen features essential for their interactions with antibodies.
|
|
| 17. |
- Ny, Sofia, et al.
(författare)
-
Community carriage of ESBL-producing Escherichia coli is associated with strains of low pathogenicity : a Swedish nationwide study
- 2017
-
Ingår i: Journal of Antimicrobial Chemotherapy. - : Oxford University Press. - 0305-7453 .- 1460-2091. ; 72:2, s. 582-588
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Community carriage of ESBL-producing Escherichia coli (EPE) is common worldwide and there is a need to understand the connection between carriage and infection. We compared the molecular characteristics of EPE among Swedish community carriers with those of EPE causing invasive infections.METHODS: We collected 2134 faecal samples from randomly selected Swedish inhabitants and examined them for the presence of EPE. All participating volunteers answered a questionnaire about putative risk factors for EPE carriage. Suspected EPE isolates (n = 418) from patients with bloodstream infection (BSI) were collected from Swedish laboratories. Isolates were genotypically and phenotypically characterized.RESULTS: Our results show that the EPE population found in carriers generally had lower pathogenicity compared with the isolates from BSIs, since carriers had a lower proportion of E. coli belonging to phylogroup B2, ST131 and ST131 subclone H30-Rx. Isolates from carriers also had lower levels of multiresistance. The Swedish carriage rate of EPE was 4.7% (101/2134) among healthy volunteers. Risk factors associated with carriage were travel to countries in Asia (OR = 3.6, 95% CI = 1.4-9.2) and Africa (OR = 3.6, 95% CI = 1.7-7.7) and a diet without pork (OR = 0.5, 95% CI = 0.3-0.8 for pork eaters).CONCLUSIONS: E. coli host factors previously associated with higher pathogenicity were all more common in BSIs compared with carriers. This indicates that the risk of invasive infection with EPE may be relatively modest in many community carriers and that EPE carriage of high-risk strains should be the focus of attention for prevention.
|
|
| 18. |
- Petersson, Ingela, et al.
(författare)
-
Longitudinal changes in everyday life after home modifications for people aging with disabilities
- 2009
-
Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 16:2, s. 78-87
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate longitudinal impacts of home modifications on the difficulty of performing everyday life tasks for people aging with disabilities, and to investigate whether other factors had any additional impacts on difficulty in everyday life tasks for people receiving home modifications. Methods: The sample consisted of 103 persons aging with disabilities and in need of home modifications, divided into an intervention group and a comparison group. The data were first subjected to Rasch analysis and a random coefficient model was used. Results: Participants in the intervention group reported a significantly lower level of difficulty in everyday life tasks compared with those in the comparison group. One confounding factor, number of months waiting for home modification, had an impact on difficulty in everyday life. Conclusion: Home modifications are effective in decreasing difficulty in performing everyday life tasks up to six months after the installation. Furthermore, to be effective home modifications need to be installed in a timely fashion. For each consecutive month the person waited for their home modification the difficulty of performing everyday life tasks increased. Therefore, it is important that home modifications be installed as soon as possible after the need has been identified.
|
|
| 19. |
- Plum, Jakob, et al.
(författare)
-
Investigation of the Intra- and Interlaboratory Reproducibility of a Small Scale Standardized Supersaturation and Precipitation Method
- 2017
-
Ingår i: Molecular Pharmaceutics. - : American Chemical Society (ACS). - 1543-8384 .- 1543-8392. ; 14:12, s. 4161-4169
-
Tidskriftsartikel (refereegranskat)abstract
- The high number of poorly water-soluble compounds in drug development has increased the need for enabling formulations to improve oral bioavailability. One frequently applied approach is to induce supersaturation at the absorptive site, e.g., the small intestine, increasing the amount of dissolved compound available for absorption. However, due to the stochastic nature of nucleation, supersaturating drug delivery systems may lead to inter- and intrapersonal variability. The ability to define a feasible range with respect to the supersaturation level is a crucial factor for a successful formulation. Therefore, an in vitro method is needed, from where the ability of a compound to supersaturate can be defined in a reproducible way. Hence, this study investigates the reproducibility of an in vitro small scale standardized supersaturation and precipitation method (SSPM). First an intralaboratory reproducibility study of felodipine was conducted, after which seven partners contributed with data for three model compounds; aprepitant, felodipine, and fenofibrate, to determine the interlaboratory reproducibility of the SSPM. The first part of the SSPM determines the apparent degrees of supersaturation (aDS) to investigate for each compound. Each partner independently determined the maximum possible aDS and induced 100, 87.5, 75, and 50% of their determined maximum possible aDS in the SSPM. The concentration time profile of the supersaturation and following precipitation was obtained in order to determine the induction time (t(ind)) for detectable precipitation. The data showed that the absolute values of t(ind) and aDS were not directly comparable between partners, however, upon linearization of the data a reproducible rank ordering of the three model compounds was obtained based on the beta-value, which was defined as the slope of the In(t(ind)) versus In(aDS)(-2) plot. Linear regression of this plot showed that aprepitant had the highest beta-value, 15.1, while felodipine and fenofibrate had comparable beta-values, 4.0 and 4.3, respectively. Of the five partners contributing with full data sets, 80% could obtain the same rank order for the three model compounds using the SSPM (aprepitant > felodipine approximate to fenofibrate). The alpha-value is dependent on the experimental setup and can be used as a parameter to evaluate the uniformity of the data set. This study indicated that the SSPM was able to obtain the same rank order of the beta-value between partners and, thus, that the SSPM may be used to classify compounds depending on their supersaturation propensity.
|
|
| 20. |
- Svensson, Jakob, et al.
(författare)
-
Patterns of mortality risk among patients with substance use disorder: an opportunity for proactive patient safety?
- 2022
-
Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPatients with substance use disorder (SUD) suffer from excess mortality compared to the overall population. This study aims to identify patterns in death rates among patients with SUD visiting a SUD emergency ward and to explore whether this knowledge can be used as input to identify patients at risk and increase patient safety.MethodsHospital visit data to a SUD emergency ward were collected between 2010 and 2020 through medical records. Data included gender, age, SUD diagnosis, and the time of death. The Kruskal-Wallis rank sum test was used to test between ordinal variables, and risk ratio was used to quantify the difference in mortality risk. All statistical tests were two-sided, with a 95% confidence interval and a minimum significance level of 0.05.ResultsThe male patients in the study group had 1.41–1.59 higher mortality risk than the female patients. The study revealed an average death rate of 0.14 among all patients during the study period. Although patients with a diagnosed alcohol use disorder constituted 73.7% of the cohort, having an opioid use disorder or sedative hypnotics use disorder was associated with the highest death rates; 1.29–1.52 and 1.47–1.74 higher mortality risk than those without such diagnoses.ConclusionThis study demonstrates that data from visits to SUD emergency wards can be used to identify mortality risk factors, such as gender, type of diagnosis, number of diagnoses, and number of visits to the SUD emergency ward. Knowledge about patterns of patient visits and mortality risk could be used to increase patient safety through a decision support tool integrated with the electronic medical records. An improved system for early detection of increased mortality risk offers an opportunity for an adaptive patient safety system.
|
|
| 21. |
|
|
| 22. |
- Svensson, Jakob, et al.
(författare)
-
Visualizing healthcare system variability and resilience: a longitudinal study of patient movements following discharge from a Swedish psychiatric clinic
- 2020
-
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20
-
Tidskriftsartikel (refereegranskat)abstract
- Background: As healthcare becomes increasingly complex, new methods are needed to identify weaknesses in the system that could lead to increased risk. Traditionally, the focus for patient safety is to study incident reports and adverse events, but that starting point has been contested with a new era of safety investigations: the analysis of everyday clinical work, and the resilient healthcare. This study introduces a new approach of system monitoring as a way to strengthen patient safety and has focused on discharge in psychiatry as a risk for adverse outcomes. The aim was to analyse a psychiatric clinic’s everyday ‘normal’ performance variability of discharge from inpatient psychiatric care to outpatient care. Method: A retrospective longitudinal correlation study with a strategic selection. Data consist of 70,797 patient visits within one psychiatric clinic, and the visits were compared between 81 different wards in Stockholm County by using a model of time-lapse visualization. Results: The time-lapse visualization shows a discrepancy in types of visits and the proportion of cancelled visits to the outward units. 42% of all patients that were scheduled as an outward patient, did not complete this transition, but instead, they revisit the clinics’ emergency ward and did not receive the planned care treatment. The patients who visit the emergency ward instead of their planned outpatient visit did this within 20 days. Conclusions: The findings show a potential increased demand for emergency psychiatric care from 2010 to 2018 within the clinic. It also suggests that the healthcare system creates a space of temporal as well as functional variability, and that patients use this space to adapt to their changing conditions. This understanding can assist management in prioritising allocation of resources and thereby strengthen patient safety. Today’s incident reporting systems in healthcare are ineffective in monitoring patterns of more cancelled visits in outward units and sooner visit to the emergency ward. By using time-lapse visualization of patient interactions, stakeholders might analyse current-, and estimate future, stressors within the system to identify and understand potential system migration towards risk in healthcare. This could help healthcare management understand where resources should be prioritized.
|
|
| 23. |
- Taipale, Heidi, et al.
(författare)
-
Attention-Deficit/Hyperactivity Disorder Medications and Work Disability and Mental Health Outcomes
- 2024
-
Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 7:3
-
Tidskriftsartikel (refereegranskat)abstract
- Importance Individuals with attention-deficit/hyperactivity disorder (ADHD) often have comorbid psychiatric conditions. Relatively little is known about how specific ADHD medications are associated with overall treatment outcomes among these patients.Objective To investigate the association of the use of specific ADHD medications with hospitalization outcomes and work disability among adolescents and adults with ADHD.Design, Setting, and Participants This nationwide register-based cohort study identified individuals (aged 16-65 years) with ADHD from Swedish nationwide registers of inpatient health care, specialized outpatient health care, sickness absence, and disability pension during the years 2006 to 2021. Data analysis was performed from November 2022 to August 2023.Exposure Use of specific ADHD medications.Main Outcomes and Measures The main outcome measure was psychiatric hospitalization, and secondary outcomes were suicide attempt and/or death by suicide, nonpsychiatric hospitalization, and work disability (ie, sickness absence or disability pension). The risk of outcomes between use vs nonuse periods of ADHD medications was compared in a within-individual design, where a person acts as their own control, and was analyzed with stratified Cox models.Results A total of 221 714 persons with ADHD were included in the study cohort (mean [SD] age, 25.0 [11.2] years; 120 968 male individuals [54.6%]). Methylphenidate was the most commonly used ADHD medication (151 837 individuals [68.5%]), followed by lisdexamphetamine (78 106 individuals [35.2%]) during the follow-up (mean [SD], 7.0 [4.7] years). The following medications were associated with a decreased risk of psychiatric hospitalization: amphetamine (adjusted hazard ratio [aHR], 0.74; 95% CI, 0.61-0.90), lisdexamphetamine (aHR, 0.80; 95% CI, 0.78-0.82), ADHD drug polytherapy (aHR, 0.85; 95% CI, 0.82-0.88), dexamphetamine (aHR, 0.88; 95% CI, 0.83-0.94), and methylphenidate (aHR, 0.93; 95% CI, 0.92-0.95). No associations were found for modafinil, atomoxetine, clonidine, and guanfacine. Decreased risk of suicidal behavior was associated with the use of dexamphetamine (aHR, 0.69; 95% CI, 0.53-0.89), lisdexamphetamine (aHR, 0.76; 95% CI, 0.68-0.84), and methylphenidate (aHR, 0.92; 95% CI, 0.86-0.98). None of the medications was associated with increased risk of nonpsychiatric hospitalization; instead, use of amphetamine, lisdexamphetamine, polytherapy, dexamphetamine, methylphenidate, and atomoxetine were associated with decreased risk of nonpsychiatric hospitalization. The results regarding work disability were significant only for the use of atomoxetine (aHR, 0.89; 95% CI, 0.82-0.97), especially among adolescents and young adults aged 16 to 29 years, (aHR, 0.82; 95% CI, 0.73-0.92).Conclusions and Relevance In this nationwide cohort study of adolescents and adults with ADHD, the use of ADHD medication was associated with fewer hospitalizations for both psychiatric and nonpsychiatric morbidity and lower suicidal behavior.
|
|
| 24. |
- Tuiskunen, Anne, et al.
(författare)
-
Phenotypic characterization of patient dengue virus isolates in BALB/c mice differentiates dengue fever and dengue hemorrhagic fever from dengue shock syndrome
- 2011
-
Ingår i: Virology Journal. - : BioMed Central (BMC). - 1743-422X. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Dengue virus (DENV) infection is the most common arthropod-borne viral disease in man and there are approximately 100 million infections annually. Despite the global burden of DENV infections many important questions regarding DENV pathogenesis remain unaddressed due to the lack of appropriate animal models of infection and disease. A major problem is the fact that no non-human species naturally develop disease similar to human dengue fever (DF) or dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Apart from other risk factors for severe dengue such as host genetics and secondary infection with a heterologous DENV, virus virulence is a risk factor that is not well characterized.
|
|
| 25. |
- van der Valk, Ralf J P, et al.
(författare)
-
A novel common variant in DCST2 is associated with length in early life and height in adulthood.
- 2015
-
Ingår i: Human molecular genetics. - : Oxford University Press (OUP). - 1460-2083 .- 0964-6906. ; 24:4, s. 1155-68
-
Tidskriftsartikel (refereegranskat)abstract
- Common genetic variants have been identified for adult height, but not much is known about the genetics of skeletal growth in early life. To identify common genetic variants that influence fetal skeletal growth, we meta-analyzed 22 genome-wide association studies (Stage 1; N = 28 459). We identified seven independent top single nucleotide polymorphisms (SNPs) (P < 1 × 10(-6)) for birth length, of which three were novel and four were in or near loci known to be associated with adult height (LCORL, PTCH1, GPR126 and HMGA2). The three novel SNPs were followed-up in nine replication studies (Stage 2; N = 11 995), with rs905938 in DC-STAMP domain containing 2 (DCST2) genome-wide significantly associated with birth length in a joint analysis (Stages 1 + 2; β = 0.046, SE = 0.008, P = 2.46 × 10(-8), explained variance = 0.05%). Rs905938 was also associated with infant length (N = 28 228; P = 5.54 × 10(-4)) and adult height (N = 127 513; P = 1.45 × 10(-5)). DCST2 is a DC-STAMP-like protein family member and DC-STAMP is an osteoclast cell-fusion regulator. Polygenic scores based on 180 SNPs previously associated with human adult stature explained 0.13% of variance in birth length. The same SNPs explained 2.95% of the variance of infant length. Of the 180 known adult height loci, 11 were genome-wide significantly associated with infant length (SF3B4, LCORL, SPAG17, C6orf173, PTCH1, GDF5, ZNFX1, HHIP, ACAN, HLA locus and HMGA2). This study highlights that common variation in DCST2 influences variation in early growth and adult height.
|
|
