| 1. |
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| 2. |
- Palmer, Nicholette D, et al.
(författare)
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A genome-wide association search for type 2 diabetes genes in African Americans.
- 2012
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Ingår i: PloS one. - San Francisco : Public Library of Science (PLoS). - 1932-6203. ; 7:1, s. e29202-
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Tidskriftsartikel (refereegranskat)abstract
- African Americans are disproportionately affected by type 2 diabetes (T2DM) yet few studies have examined T2DM using genome-wide association approaches in this ethnicity. The aim of this study was to identify genes associated with T2DM in the African American population. We performed a Genome Wide Association Study (GWAS) using the Affymetrix 6.0 array in 965 African-American cases with T2DM and end-stage renal disease (T2DM-ESRD) and 1029 population-based controls. The most significant SNPs (n = 550 independent loci) were genotyped in a replication cohort and 122 SNPs (n = 98 independent loci) were further tested through genotyping three additional validation cohorts followed by meta-analysis in all five cohorts totaling 3,132 cases and 3,317 controls. Twelve SNPs had evidence of association in the GWAS (P<0.0071), were directionally consistent in the Replication cohort and were associated with T2DM in subjects without nephropathy (P<0.05). Meta-analysis in all cases and controls revealed a single SNP reaching genome-wide significance (P<2.5×10(-8)). SNP rs7560163 (P = 7.0×10(-9), OR (95% CI) = 0.75 (0.67-0.84)) is located intergenically between RND3 and RBM43. Four additional loci (rs7542900, rs4659485, rs2722769 and rs7107217) were associated with T2DM (P<0.05) and reached more nominal levels of significance (P<2.5×10(-5)) in the overall analysis and may represent novel loci that contribute to T2DM. We have identified novel T2DM-susceptibility variants in the African-American population. Notably, T2DM risk was associated with the major allele and implies an interesting genetic architecture in this population. These results suggest that multiple loci underlie T2DM susceptibility in the African-American population and that these loci are distinct from those identified in other ethnic populations.
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| 3. |
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| 5. |
- Voight, Benjamin F., et al.
(författare)
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Twelve type 2 diabetes susceptibility loci identified through large-scale association analysis
- 2010
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 42:7, s. 579-589
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Tidskriftsartikel (refereegranskat)abstract
- By combining genome-wide association data from 8,130 individuals with type 2 diabetes (T2D) and 38,987 controls of European descent and following up previously unidentified meta-analysis signals in a further 34,412 cases and 59,925 controls, we identified 12 new T2D association signals with combined P < 5 x 10(-8). These include a second independent signal at the KCNQ1 locus; the first report, to our knowledge, of an X-chromosomal association (near DUSP9); and a further instance of overlap between loci implicated in monogenic and multifactorial forms of diabetes (at HNF1A). The identified loci affect both beta-cell function and insulin action, and, overall, T2D association signals show evidence of enrichment for genes involved in cell cycle regulation. We also show that a high proportion of T2D susceptibility loci harbor independent association signals influencing apparently unrelated complex traits.
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| 6. |
- Temmink, R. J. M., et al.
(författare)
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Mimicry of emergent traits amplifies coastal restoration success
- 2020
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Restoration is becoming a vital tool to counteract coastal ecosystem degradation. Modifying transplant designs of habitat-forming organisms from dispersed to clumped can amplify coastal restoration yields as it generates self-facilitation from emergent traits, i.e. traits not expressed by individuals or small clones, but that emerge in clumped individuals or large clones. Here, we advance restoration science by mimicking key emergent traits that locally suppress physical stress using biodegradable establishment structures. Experiments across (sub)tropical and temperate seagrass and salt marsh systems demonstrate greatly enhanced yields when individuals are transplanted within structures mimicking emergent traits that suppress waves or sediment mobility. Specifically, belowground mimics of dense root mats most facilitate seagrasses via sediment stabilization, while mimics of aboveground plant structures most facilitate marsh grasses by reducing stem movement. Mimicking key emergent traits may allow upscaling of restoration in many ecosystems that depend on self-facilitation for persistence, by constraining biological material requirements and implementation costs.
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| 7. |
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| 8. |
- Duffy, J. E., et al.
(författare)
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Biodiversity mediates top-down control in eelgrass ecosystems: a global comparative-experimental approach
- 2015
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Ingår i: Ecology Letters. - : Wiley. - 1461-023X .- 1461-0248. ; 18:7, s. 696-705
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Tidskriftsartikel (refereegranskat)abstract
- Nutrient pollution and reduced grazing each can stimulate algal blooms as shown by numerous experiments. But because experiments rarely incorporate natural variation in environmental factors and biodiversity, conditions determining the relative strength of bottom-up and top-down forcing remain unresolved. We factorially added nutrients and reduced grazing at 15 sites across the range of the marine foundation species eelgrass (Zostera marina) to quantify how top-down and bottom-up control interact with natural gradients in biodiversity and environmental forcing. Experiments confirmed modest top-down control of algae, whereas fertilisation had no general effect. Unexpectedly, grazer and algal biomass were better predicted by cross-site variation in grazer and eelgrass diversity than by global environmental gradients. Moreover, these large-scale patterns corresponded strikingly with prior small-scale experiments. Our results link global and local evidence that biodiversity and top-down control strongly influence functioning of threatened seagrass ecosystems, and suggest that biodiversity is comparably important to global change stressors.
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| 9. |
- Kaucka, M., et al.
(författare)
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Altered developmental programs and oriented cell divisions lead to bulky bones during salamander limb regeneration
- 2022
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- There are major differences in duration and scale at which limb development and regeneration proceed, raising the question to what extent regeneration is a recapitulation of development. We address this by analyzing skeletal elements using a combination of micro-CT imaging, molecular profiling and clonal cell tracing. We find that, in contrast to development, regenerative skeletal growth is accomplished based entirely on cartilage expansion prior to ossification, not limiting the transversal cartilage expansion and resulting in bulkier skeletal parts. The oriented extension of salamander cartilage and bone appear similar to the development of basicranial synchondroses in mammals, as we found no evidence for cartilage stem cell niches or growth plate-like structures during neither development nor regeneration. Both regenerative and developmental ossification in salamanders start from the cortical bone and proceeds inwards, showing the diversity of schemes for the synchrony of cortical and endochondral ossification among vertebrates. Normal limb development relies on synchronized formation of cartilage and bone. Here, the authors show that in salamander limb regeneration these processes are decoupled: ossification occurs after the final size of regenerating cartilage is reached, allowing fast regeneration and leading to bulky bones.
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| 10. |
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| 11. |
- Rosengren, Annika, 1951, et al.
(författare)
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Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study
- 2019
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Ingår i: Lancet Global Health. - : Elsevier BV. - 2214-109X. ; 7:6
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Tidskriftsartikel (refereegranskat)abstract
- Background Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status-wealth and education-differ among high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management. Methods In this large-scale prospective cohort study, we recruited adults aged between 35 years and 70 years from 367 urban and 302 rural communities in 20 countries. We collected data on families and households in two questionnaires, and data on cardiovascular risk factors in a third questionnaire, which was supplemented with physical examination. We assessed socioeconomic status using education and a household wealth index. Education was categorised as no or primary school education only, secondary school education, or higher education, defined as completion of trade school, college, or university. Household wealth, calculated at the household level and with household data, was defined by an index on the basis of ownership of assets and housing characteristics. Primary outcomes were major cardiovascular disease (a composite of cardiovascular deaths, strokes, myocardial infarction, and heart failure), cardiovascular mortality, and all-cause mortality. Information on specific events was obtained from participants or their family. Findings Recruitment to the study began on Jan 12, 2001, with most participants enrolled between Jan 6, 2005, and Dec 4, 2014. 160 299 (87.9%) of 182 375 participants with baseline data had available follow-up event data and were eligible for inclusion. After exclusion of 6130 (3.8%) participants without complete baseline or follow-up data, 154 169 individuals remained for analysis, from five low-income, 11 middle-income, and four high-income countries. Participants were followed-up for a mean of 7.5 years. Major cardiovascular events were more common among those with low levels of education in all types of country studied, but much more so in low-income countries. After adjustment for wealth and other factors, the HR (low level of education vs high level of education) was 1.23 (95% CI 0.96-1.58) for high-income countries, 1.59 (1.42-1.78) in middle-income countries, and 2.23 (1.79-2.77) in low-income countries (p(interaction)<0 .0001). We observed similar results for all-cause mortality, with HRs of 1.50 (1.14-1.98) for high-income countries, 1.80 (1.58-2.06) in middle-income countries, and 2.76 (2.29-3.31) in low-income countries (p(interaction)<0. 0001). By contrast, we found no or weak associations between wealth and these two outcomes. Differences in outcomes between educational groups were not explained by differences in risk factors, which decreased as the level of education increased in high-income countries, but increased as the level of education increased in low-income countries (p(interaction)<0.0001). Medical care (eg, management of hypertension, diabetes, and secondary prevention) seemed to play an important part in adverse cardiovascular disease outcomes because such care is likely to be poorer in people with the lowest levels of education compared to those with higher levels of education in low-income countries; however, we observed less marked differences in care based on level of education in middle-income countries and no or minor differences in high-income countries. Interpretation Although people with a lower level of education in low-income and middle-income countries have higher incidence of and mortality from cardiovascular disease, they have better overall risk factor profiles. However, these individuals have markedly poorer health care. Policies to reduce health inequities globally must include strategies to overcome barriers to care, especially for those with lower levels of education. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.
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| 12. |
- van Eijk-Hustings, Y, et al.
(författare)
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EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis
- 2012
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 71:1, s. 13-19
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Tidskriftsartikel (refereegranskat)abstract
- The authors aim to develop European League Against Rheumatism recommendations for the role of the nurse in the management of patients with chronic inflammatory arthritis, to identify a research agenda and to determine an educational agenda.MethodsA task force made up of a multidisciplinary expert panel including nurses, rheumatologists, occupational therapist, physiotherapist, psychologist, epidemiologist and patient representatives, representing 14 European countries, carried out the development of the recommendations, following the European League Against Rheumatism standardised operating procedures.The task force met twice. In the first meeting, the aims of the task force were defined, and eight research questions were developed. This was followed by a comprehensive, systematic literature search. In the second meeting, the results from the literature review were presented to the task force that subsequently formulated the recommendations, research agenda and educational agenda.ResultsIn total, 10 recommendations were formulated. Seven recommendations covered the contribution of nurses to care and management: education, satisfaction with care, access to care, disease management, psychosocial support, self-management and efficiency of care. Three recommendations focused on professional support for nurses: availability of guidelines or protocols, access to education and encouragement to undertake extended roles. The strength of the recommendations varied from A to C, dependent on the category of evidence (1A–3), and a high level of agreement was achieved. Additionally, the task force agreed upon 10 topics for future research and an educational agenda.Conclusion10 recommendations for the role of the nurse in the management of chronic inflammatory arthritis were developed using a combination of evidence-based and expert consensus approach.
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| 13. |
- Bech, B, et al.
(författare)
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2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis
- 2020
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 79:1, s. 61-68
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Tidskriftsartikel (refereegranskat)abstract
- To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse’s role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.
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| 14. |
- Blenckner, Thorsten, et al.
(författare)
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The Baltic Health Index (BHI): Assessing the social-ecological status of the Baltic Sea
- 2021
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Ingår i: People and Nature. - : Wiley. - 2575-8314. ; 3:2, s. 359-375
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Tidskriftsartikel (refereegranskat)abstract
- Improving the health of coastal and open sea marine ecosystems represents a substantial challenge for sustainable marine resource management, since it requires balancing human benefits and impacts on the ocean. This challenge is often exacerbated by incomplete knowledge and lack of tools that measure ocean and coastal ecosystem health in a way that allows consistent monitoring of progress towards predefined management targets. The lack of such tools often limits capabilities to enact and enforce effective governance. We introduce the Baltic Health Index (BHI) as a transparent, collaborative and repeatable assessment tool. The Index complements existing, more ecological-oriented, approaches by including a human dimension on the status of the Baltic Sea, an ecosystem impacted by multiple anthropogenic pressures and governed by a multitude of comprehensive national and international policies. Using a large amount of social-ecological data available, we assessed the health of the Baltic Sea for nine goals that represent the status towards set targets, for example, clean waters, biodiversity, food provision, natural products extraction and tourism. Our results indicate that the overall health of the Baltic Sea is suboptimal (a score of 76 out of 100), and a substantial effort is required to reach the management objectives and associated targets. Subregionally, the lowest BHI scores were measured for carbon storage, contaminants and lasting special places (i.e. marine protected areas), albeit with large spatial variation. Overall, the likely future status of all goals in the BHI averaged for the entire Baltic Sea is better than the present status, indicating a positive trend towards a healthier Baltic Sea. However, in some Baltic Sea basins, the trend for specific goals was decreasing, highlighting locations and issues that should be the focus of management priorities. The BHI outcomes can be used to identify both pan-Baltic and subregional scale management priorities and to illustrate the interconnectedness between goals linked by cumulative pressures. Hence, the information provided by the BHI tool and its further development will contribute towards the fulfilment of the UN Agenda 2030 and its Sustainability Development Goals. A free Plain Language Summary can be found within the Supporting Information of this article. A free Plain Language Summary can be found within the Supporting Information of this article.
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| 15. |
- Bosma, M, et al.
(författare)
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FNDC4 acts as an anti-inflammatory factor on macrophages and improves colitis in mice
- 2016
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Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 7, s. 11314-
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Tidskriftsartikel (refereegranskat)abstract
- FNDC4 is a secreted factor sharing high homology with the exercise-associated myokine irisin (FNDC5). Here we report that Fndc4 is robustly upregulated in several mouse models of inflammation as well as in human inflammatory conditions. Specifically, FNDC4 levels are increased locally at inflamed sites of the intestine of inflammatory bowel disease patients. Interestingly, administration of recombinant FNDC4 in the mouse model of induced colitis markedly reduces disease severity compared with mice injected with a control protein. Conversely, mice lacking Fndc4 develop more severe colitis. Analysis of binding of FNDC4 to different immune cell types reveals strong and specific binding to macrophages and monocytes. FNDC4 treatment of bone marrow-derived macrophages in vitro results in reduced phagocytosis, increased cell survival and reduced proinflammatory chemokine expression. Hence, treatment with FNDC4 results in a state of dampened macrophage activity, while enhancing their survival. Thus, we have characterized FNDC4 as a factor with direct therapeutic potential in inflammatory bowel disease and possibly other inflammatory diseases.
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| 17. |
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| 18. |
- Discepola, MN, et al.
(författare)
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Effects of non-pharmacological and non-surgical interventions on health outcomes in systemic sclerosis: protocol for a living systematic review
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:5, s. e047428-
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Tidskriftsartikel (refereegranskat)abstract
- Systemic sclerosis (SSc; scleroderma) is a rare, chronic, autoimmune disease with a high level of burden, a significant impact on the ability to carry out daily activities, and a considerable negative impact on health-related quality of life. Non-pharmacological interventions could be provided to potentially improve mental and physical health outcomes. However, the effectiveness of non-pharmacological interventions on health and well-being among individuals with SSc has not been well established. The proposed living systematic review aims to identify and evaluate randomised controlled trial (RCT) evidence on the effectiveness of non-pharmacological and non-surgical interventions on mental and physical health outcomes and on the delivery of such services in SSc.Methods and analysisEligible studies will be RCTs that examine non-pharmacological and non-surgical interventions aimed at improving health outcomes among individuals with SSc or the delivery of services intended to improve healthcare or support of people with SSc (eg, support groups). All RCTs included in a previous systematic review that sought studies published between 1990 and March 2014 will be evaluated for inclusion. Additional trials will be sought from January 2014 onwards using a similar, augmented search strategy developed by a health sciences librarian. We will search the MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library and Web of Science databases and will not restrict by language. Two independent reviewers will determine the eligibility of identified RCTs and will extract data using a prespecified standardised form in DistillerSR. Meta-analyses will be considered if ≥2 eligible RCTs report similar non-pharmacological interventions and comparable health outcomes. We will conduct a qualitative synthesis for interventions that cannot be synthesised via meta-analysis.Ethics and disseminationWe will post initial and ongoing results via a website, publish results periodically via peer-reviewed journal publication, and present results at patient-oriented events.PROSPERO registration numberCRD42020219914.
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| 19. |
- Kjellberg, A, et al.
(författare)
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Hyperbaric oxygen for treatment of long COVID-19 syndrome (HOT-LoCO): protocol for a randomised, placebo-controlled, double-blind, phase II clinical trial
- 2022
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 12:11, s. e061870-
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Tidskriftsartikel (refereegranskat)abstract
- Long COVID-19, where symptoms persist 12 weeks after the initial SARS-CoV-2-infection, is a substantial problem for individuals and society in the surge of the pandemic. Common symptoms are fatigue, postexertional malaise and cognitive dysfunction. There is currently no effective treatment and the underlying mechanisms are unknown, although several hypotheses exist, with chronic inflammation as a common denominator. In prospective studies, hyperbaric oxygen therapy (HBOT) has been suggested to be effective for the treatment of similar syndromes such as chronic fatigue syndrome and fibromyalgia. A case series has suggested positive effects of HBOT in long COVID-19. This randomised, placebo-controlled clinical trial will explore HBOT as a potential treatment for long COVID-19. The primary objective is to evaluate if HBOT improves health-related quality of life (HRQoL) for patients with long COVID-19 compared with placebo/sham. The main secondary objective is to evaluate whether HBOT improves endothelial function, objective physical performance and short-term HRQoL.Methods and analysisA randomised, placebo-controlled, double-blind, phase II clinical trial in 80 previously healthy subjects debilitated due to long COVID-19, with low HRQoL. Clinical data, HRQoL questionnaires, blood samples, objective tests and activity metre data will be collected at baseline. Subjects will be randomised to a maximum of 10 treatments with hyperbaric oxygen or sham treatment over 6 weeks. Assessments for safety and efficacy will be performed at 6, 13, 26 and 52 weeks, with the primary endpoint (physical domains in RAND 36-Item Health Survey) and main secondary endpoints defined at 13 weeks after baseline. Data will be reviewed by an independent data safety monitoring board.Ethics and disseminationThe trial is approved by the Swedish National Institutional Review Board (2021–02634) and the Swedish Medical Products Agency (5.1-2020-36673). Positive, negative and inconclusive results will be published in peer-reviewed scientific journals with open access.Trial registration numberNCT04842448.
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| 20. |
- Mattsson, M., et al.
(författare)
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Personal factors in systemic sclerosis and their coverage by patient-reported outcome measures
- 2015
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Ingår i: European Journal of Physical and Rehabilitation Medicine. - 1827-1804. ; 51:4, s. 405-421
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Tidskriftsartikel (refereegranskat)abstract
- Background. Systemic sclerosis (SSc) is an autoimmune disease where thickening of the skin can lead to reduced body function and limitations in activities. Severe forms can also affect and seriously damage inner organs. Patient-centred rehabilitation emphasises considerations of patients' background, experience and behavior which highlights the need to know if patient-reported outcome measures (PROMs) include such personal factors. Aim. To identify and describe personal factors in the experiences of functioning and health of persons with SSc and to examine if and to what extent PROMs in SSc research cover these factors. Design. Data from a qualitative study with focus group interviews were analysed. PROMs in SSc research were identified in a literature review between 2008-2013. Setting. Participants were recruited from outpatient clinics at rheumatology department. Population. Sixty-three patients with SSc from four European countries participated. Methods. Data from interviews were analysed using a structure of personal factors developed by Geyh et al. Identified PROMs were analysed and linked to main concepts, related to the personal factors, found in the interview data. Results. Nineteen main concepts were related to the area "patterns of experience and behaviour" in the personal factor structure, 16 to "thoughts and beliefs", nine to "feelings", one to "motives" and one to "personal history and biography", respectively. Among the 35 PROMs identified, 15 did not cover any of the identified concepts. Concepts within the area "feelings" were mostly covered by the PROMs. Five of the PROMs covered "patterns of experience and behaviour", while "motives" and "personal history and biography" were not covered at all. Four of the identified PROMs covered concepts within the areas "feelings", "thoughts and beliefs" and "patterns of experience and behaviour" in the same instrument. The Illness Cognition Questionnaire and Illness Behaviour Questionnaire were such PROMs. Conclusion. Patterns of experience and behaviour had the highest number of concepts related to personal factors, but few of the PROMs in SSc research covered these factors. Only a few PROMs covered several personal factors areas in the same instrument. Clinical Rehabilitation Impact. The results would be of value when developing core sets for outcome measurements in SSc.
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| 22. |
- Sperl, L, et al.
(författare)
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EDUCATIONAL NEEDS AMONG HEALTH PROFESSIONALS IN RHEUMATOLOGY: LOW AWARENESS OF EULAR OFFERINGS AND UNFAMILIARITY WITH COURSE CONTENT AS A MAJOR BARRIER - A EULAR FUNDED EUROPEAN SURVEY
- 2022
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 81, s. 139-140
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Health professionals in rheumatology (HPRs) should participate in post-graduate or continuous education to update and advance their knowledge and skills. This can improve patient outcomes and increase quality of care.1 EULAR aims to become a leading provider of postgraduate education for HPRs.ObjectivesThe aims of this study were to evaluate the current motivations for participating in postgraduate education of HPRs, identify barriers and facilitators for participation in postgraduate education, and evaluate participation in the current educational offerings of EULAR for HPRs across Europe.MethodsAn online survey was developed and distributed in collaboration with the EULAR Standing Committee of Education and Training (ESCET) and the Paediatric Rheumatology European Society (PReS). The questionnaire was translated by national HPR representatives in 24 languages to cover the 25 national member organisations. Barriers were assessed using 5-point Likert scales, higher scores representing higher barriers. Quantitative data were analysed using descriptive statistics. In addition, we ran the Latent Dirichlet Allocation (LDA) on the answers to the open questions. LDA is an unsupervised probabilistic topic modelling technique that extracts the meanings of a pre-defined number of topics. Design of the survey and reporting of results were done according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).ResultsThe online questionnaire was accessed 3,589 times but only 667 complete responses were recorded. HPRs from 34 European countries responded to the survey; 80% of whom were women. The highest-ranked educational need was prevention, including lifestyle interventions and professional development. Although EULAR was well known among HPRs, only 32.1% of HPRs in adult care and 18.6% of HPRs in paediatric care have ever heard of the EULAR School of Rheumatology (Table 1 A).Table 1.A: Feedback on EULAR. Data are presented separately for HPRs in adult and paediatric care; except for the filter questions, no mandatory questions were included in the survey. To clarify the number of responses per question, the number of valid answers for each question was reported.VariablesHPRs in adult careHPRs in paediatric careHave you ever heard of the EULAR School of Rheumatology?61443 I am not sure, n(%)62 (10.1%)7 (16.3%) No, n(%)355 (57.8%)28 (65.1%) Yes, n(%)197 (32.1%)8 (18.6%)Are you aware of courses offered by the EULAR School of Rheumatology? (sub question)1978 I am not sure, n(%)30 (15.2%)2 (25.0%) No, n(%)63 (32.0%)5 (62.5%) Yes, n(%)104 (52.8%)1 (12.5%)Have you ever attended one of the EULAR School of Rheumatology courses? (sub question)1031 I am not sure, n(%)1 (1.0%)0 No, n(%)47 (45.6%)0 Yes, n(%)55 (53.4%)1 (100%)Have you ever participated in a EULAR annual congress meeting?61843 I am not sure, n(%)11 (1.8%)0 No, n(%)457 (73.9%)39 (90.7%) Yes, n(%)150 (24.3%)4 (9.3%)The main barriers to participation in EULAR’s educational offerings were identified by HPRs in adult care and in paediatric care (respectively) as: the unfamiliarity with the course content (3.48 [±1.50]; 3.92 [±1.46]), the associated costs (3.44 [±1.35]; 3.69 [±1.28]) and English language (2.59 [±1.50]; 2.80 [±1.34]).ConclusionEULAR is well-known by HPRs in Europe, however, awareness of educational offerings is low and barriers to participation are numerous. To become the leading provider of postgraduate training by 2023, EULAR could use a “franchise” model that can be tailored to local conditions. This could be achieved by strengthening national organizations by actively involving them in the development of training programs and disseminating these programs and offerings through their networks.References[1]World Health Organization. Health workforce: Education and training: World Health Organization; 2019 [Available from: https://www.who.int/hrh/education/en/ accessed November, 2019 2019.Disclosure of InterestsLisa Sperl: None declared, Tanja Stamm Speakers bureau: AbbVie, Novartis, Roche, Sanofi, and Takeda, Consultant of: AbbVie and Sanofi Genzyme, Grant/research support from: AbbVie and Roche, Margaret Renn Andrews: None declared, Mathilda Bjork: None declared, Carina Boström: None declared, Jeannette Cappon: None declared, Jenny de la Torre-Aboki: None declared, Annette de Thurah: None declared, Andrea Domjan: None declared, Razvan Dragoi Speakers bureau: Received speaker fees last year from: Pfizer, Elly Lilly, Sandoz, Abbvie, Secom, EwoPharma, Fernando Estevez-Lopez: None declared, Ricardo J. O. Ferreira: None declared, George E. Fragoulis: None declared, Jolanta Grygielska: None declared, Katti Korve: None declared, Marja Leena Kukkurainen: None declared, Christel Madelaine-Bonjour: None declared, Andrea Marques: None declared, Jorit Meesters: None declared, Rikke Helene Moe: None declared, Ellen Moholt: None declared, Erika Mosor: None declared, Claudia Naimer-Stach: None declared, Mwidimi Ndosi: None declared, Polina Pchelnikova: None declared, Jette Primdahl: None declared, Polina Putrik: None declared, Anne-Kathrin Rausch Osthoff: None declared, Hana Smucrova: None declared, Sinisa Stefanac: None declared, Marco Testa: None declared, Leti van Bodegom-Vos: None declared, Wilfred Peter: None declared, Heidi A. Zangi: None declared, Olena Zimba: None declared, T.P.M. Vliet Vlieland: None declared, Valentin Ritschl: None declared
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| 23. |
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| 24. |
- Zangi, HA, et al.
(författare)
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EULAR recommendations for patient education for people with inflammatory arthritis
- 2015
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 74:6, s. 954-962
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Tidskriftsartikel (refereegranskat)abstract
- The task force aimed to: (1) develop evidence-based recommendations for patient education (PE) for people with inflammatory arthritis, (2) identify the need for further research on PE and (3) determine health professionals’ educational needs in order to provide evidence-based PE.MethodsA multidisciplinary task force, representing 10 European countries, formulated a definition for PE and 10 research questions that guided a systematic literature review (SLR). The results from the SLR were discussed and used as a basis for developing the recommendations, a research agenda and an educational agenda. The recommendations were categorised according to level and strength of evidence graded from A (highest) to D (lowest). Task force members rated their agreement with each recommendation from 0 (total disagreement) to 10 (total agreement).ResultsBased on the SLR and expert opinions, eight recommendations were developed, four with strength A evidence. The recommendations addressed when and by whom PE should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation. A high level of agreement was achieved for all recommendations (mean range 9.4–9.8). The task force proposed a research agenda and an educational agenda.ConclusionsThe eight evidence-based and expert opinion-based recommendations for PE for people with inflammatory arthritis are intended to provide a core framework for the delivery of PE and training for health professionals in delivering PE across Europe.
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| 26. |
- Anifanti, M, et al.
(författare)
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Right Ventricular Morphology and Function after Exercise Training in People with Systemic Sclerosis: A Randomized Controlled Pilot Study
- 2023
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Ingår i: Life (Basel, Switzerland). - : MDPI AG. - 2075-1729. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Vascular dysfunction and its concomitant multi-organ involvement, including cardiac involvement, affects prognosis in systemic sclerosis (SSc) patients. Regular exercise has demonstrated to be able to improve vascular function in SSc. However, the effects of an exercise program on the heart and specifically in right ventricular (RV) morphology and function in SSc have yet to be explored. The study aimed to examine whether a 3-month combined exercise program can affect RV morphology and function in SSc patients. Methods: Twenty-eight SSc patients were randomly allocated to either the exercise training (ET) or the control (CON) group. Baseline and follow-up assessments consisted of a cardiopulmonary exercise test along with both a conventional and a two-dimensional speckle tracking echocardiography (2DSTE) focused on RV morphology and function. Following the baseline assessments, Group ET participated in a supervised combined exercise program for 12 weeks, while group CON received their usual care. Results: The ET group demonstrated increases in peak oxygen consumption by 25.1% (p < 0.001), global RV free wall longitudinal systolic strain by 6.69% (p < 0.03), RV free wall longitudinal systolic strain of the basal segment by 13.5% (p < 0.001), and global RV four-chamber longitudinal systolic strain by 6.76% (p < 0.03) following the exercise program. No differences were observed in group CON. Conclusions: Combined exercise improved cardiorespiratory efficiency and indices of RV systolic function, as assessed by the 2DSTE, in SSc patients.
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| 27. |
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| 28. |
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| 29. |
- Astrom, M., et al.
(författare)
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Population health status based on the EQ-5D-Y-3L among adolescents in Sweden: Results by sociodemographic factors and self-reported comorbidity
- 2018
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 27:11, s. 2859-2871
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe EQ-5D-Y-3L is a generic health-related quality of life (HRQoL) measure developed for youth from 8years old. The aim of this study is to present population health status, based on the EQ-5D-Y-3L, among adolescents in Sweden, by sex, age, self-reported comorbidity and parents' occupational status.MethodsData were obtained from a cross-sectional total survey among students, aged 13-18 years, in a Swedish County year 2014. The survey included EQ-5D-Y-3L, questions regarding self-reported health, disease, functional impairment and mental distress. Parents' occupational status was used as a proxy for socio-economic status.ResultsA total of 6574 participants answered all the EQ-5D-Y-3L dimensions (mean age was 15.9years, same proportion of boys and girls). Girls reported more problems than boys in the dimensions doing usual activities', having pain or discomfort' and feeling worried, sad or unhappy', and lower mean VAS score. Respondents with one or both parents unemployed reported more problems with usual activities, pain/discomfort and in the mood dimension than those with both parents employed. Those with comorbidity had in general more problems in all dimensions and lower mean VAS score. The highest impact on VAS score was found for adolescents who reported that they always felt depressed.ConclusionsSex, age, self-reported comorbidity and parents' occupational status were associated with HRQoL determined by the EQ-5D-Y-3L in the general population of adolescents. The ability of EQ-5D-Y-3L to distinguish adolescents' health status based on these factors confirms the instrument's usefulness in assessment of HRQoL and as guidance for prioritization.
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| 30. |
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| 31. |
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| 32. |
- Bottner, F, et al.
(författare)
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Implant migration after early weightbearing in cementless hip replacement
- 2005
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Ingår i: Clinical Orthopaedics and Related Research. - 0009-921X .- 1528-1132. ; :436, s. 132-137
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-nine patients (five women and 24 men) with an average age of 47 years (range, 24-59 years) had 37 total hip arthroplasties using a hydroxyapatite-coated double-wedge press-fit femoral component. All patients had a Type A bone quality. Patients were either mobilized with weightbearing as tolerated or toe-touch weightbearing for 6 weeks postoperatively. After 6 weeks all patients were advanced to weightbearing as tolerated. Radiostereometric analysis radiographs were taken at 3 days, 6 weeks, and 6 months postoperatively to measure migration of the femoral component. Radiostereometric analysis revealed no difference in stem migration between the two groups as defined by maximal total point migration. There was a difference in the vertical (proximal-distal) migration within the first 6 weeks between groups (0.81 mm versus 0.13 mm), but not afterwards (0.17 mm versus 0.18 mm). Continuous migration after 6 weeks was observed in three patients from each group. There was no loosening in either group within a 2-year followup. Weightbearing as tolerated is recommended for young patients with excellent bone quality after cementless total hip arthroplasty with a double-wedge press-fit femoral component. Level of Evidence: Diagnostic study, Level I (testing of previously developed diagnostic criteria in series of consecutive patients-with previously applied reference gold standard). See the Guidelines for Authors for a complete description of levels of evidence.
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| 33. |
- Cetinic, I., et al.
(författare)
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Ultrasound Shear Wave Elastography, Shear Wave Dispersion and Attenuation Imaging of Pediatric Liver Disease with Histological Correlation
- 2022
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Ingår i: Children. - : MDPI AG. - 2227-9067. ; 9:5
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the feasibility of multiple ultrasound markers for the non-invasive characterization of fibrosis, inflammation and steatosis in the liver in pediatric patients. Materials and methods: The quantitative ultrasound measures shear wave elastography (SWE), shear wave dispersion (SWD) and attenuation imaging (ATI) were compared and correlated with percutaneous liver biopsies and corresponding measures in a control cohort. Results: The median age of the 32 patients was 12.1 years (range 0.1-17.9), and that of the 15 controls was 11.8 years (range: 2.6-16.6). Results: There was a significant difference in SWE values between histologic grades of fibrosis (p = 0.003), with a positive correlation according to the grade (r = 0.7; p < 0.0001). Overall, a difference in SWD values between grades of inflammation was found (p = 0.009) but with a lack of correlation (r = 0.1; p = 0.67). Comparing inflammation grades 0-1 (median:13.6 m/s kHz [min; max; 8.4; 17.5]) versus grades 2-3 (16.3 m/s kHz [14.6; 24.2]) showed significant differences between the groups (p = 0.003). In the 30 individuals with a steatosis score of 0, ATI was measured in 23 cases with a median value of 0.56 dB/cm/MHz. Conclusion: Comprehensive ultrasound analysis was feasible to apply in children and has the potential to reflect the various components of liver affection non-invasively. Larger studies are necessary to conclude to what extent these image-based markers can classify the grade of fibrosis, inflammation and steatosis.
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| 40. |
- Karlsson, M, et al.
(författare)
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Equilibrium and structural studies of silicon(IV) and aluminium(III) in aqueous solution. 34. A crystal structure determination of the Al(methylmalonate)(2)(CH3OH)(2)(-) complex with Na+ as counter-ion
- 1998
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Ingår i: Acta Chemica Scandinavica. - 0904-213X .- 1902-3103. ; 52:9, s. 1116-1121
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Tidskriftsartikel (refereegranskat)abstract
- The crystal structure of sodium bis(trans)-2-methylpropanedionatedimethanolaluminate(III), [Na+][Al(C4H4O4)(2)(CH3OH)(2)(-)], has been determined by single crystal X-ray diffraction. The compound crystallises in the trigonal space group R (3) over bar, with a = 12.046(2), c= 28.705(6) Angstrom and Z= 9. The refinement of 103 parameters on 946 reflections [1>2.0 sigma(I)] gave a final R-value of 0.064 (R-w= 0.066, S= 1.000). The structure consists of octahedral Al(C4H4O4)(2)(CH3OH)(2)(-) complexes and sodium ions. In these complexes, methylmalonate coordinates to Ak(3+) bidentately in the equatorial plane of the octahedron, while methanol coordinates at the apices. As such, it represents a rare single-crystal example of direct aluminium( III)-methanol coordination. The complexes, arranged in layers, are connected to each other by octahedrally coordinated sodium ions, in special position 6c, and hydrogen bonds. The layers, with the methyl group of methylmalonate pointing out from the layers, are stacked perpendicular to the [001] direction and are held together by other octahedrally coordinated sodium ions, in special position 3b.
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| 41. |
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| 42. |
- Knuuttila, M., et al.
(författare)
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Intratumoral androgen levels are linked to TMPRSS2-ERG fusion in prostate cancer
- 2018
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Ingår i: Endocrine-Related Cancer. - : Bioscientifica. - 1351-0088 .- 1479-6821. ; 25:9, s. 807-819
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Tidskriftsartikel (refereegranskat)abstract
- Intratumoral androgen biosynthesis is one of the mechanisms involved in the progression of prostate cancer, and an important target for novel prostate cancer therapies. Using gas chromatography-tandem mass spectrometry and genome-wide RNA sequencing, we have analyzed androgen concentrations and androgen-regulated gene expression in cancerous and morphologically benign prostate tissue specimens and serum samples obtained from 48 primary prostate cancer patients. Intratumoral dihydrotestosterone (DHT) concentrations were significantly higher in the cancerous tissues compared to benign prostate (P < 0.001). The tissue/serum ratios of androgens were highly variable between the patients, indicating individual patterns of androgen metabolism and/or uptake of androgens within the prostate tissue. An unsupervised hierarchical clustering analysis of intratissue androgen concentrations indicated that transmembrane protease, serine 2/ETS-related gene (TMPRSS2-ERG)-positive patients have different androgen profiles compared to TMPRSS2-ERG- negative patients. TMPRSS2-ERG gene fusion status was also associated with an enhanced androgen-regulated gene expression, along with altered intratumoral androgen metabolism, demonstrated by reduced testosterone concentrations and increased DHT/testosterone ratios in TMPRSS2-ERG-positive tumors. TMPRSS2-ERG-positive and - negative prostate cancer specimens have distinct intratumoral androgen profiles, possibly due to activation of testosterone-independent DHT biosynthesis via the alternative pathway in TMPRSS2-ERG-positive tumors. Thus, patients with TMPRSS2-ERG-positive prostate cancer may benefit from novel inhibitors targeting the alternative DHT biosynthesis.
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