| 1. |
- Santangelo, James S., et al.
(författare)
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Global urban environmental change drives adaptation in white clover
- 2022
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 375
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Tidskriftsartikel (refereegranskat)abstract
- Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural dines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale.
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| 2. |
- Su, Zhan, et al.
(författare)
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Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus.
- 2012
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 44:10
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Tidskriftsartikel (refereegranskat)abstract
- Barrett's esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia, and it strongly predisposes to esophageal adenocarcinoma (EAC), a tumor with a very poor prognosis. We report the first genome-wide association study on Barrett's esophagus, comprising 1,852 UK cases and 5,172 UK controls in the discovery stage and 5,986 cases and 12,825 controls in the replication stage. Variants at two loci were associated with disease risk: chromosome 6p21, rs9257809 (Pcombined=4.09×10(-9); odds ratio (OR)=1.21, 95% confidence interval (CI)=1.13-1.28), within the major histocompatibility complex locus, and chromosome 16q24, rs9936833 (Pcombined=2.74×10(-10); OR=1.14, 95% CI=1.10-1.19), for which the closest protein-coding gene is FOXF1, which is implicated in esophageal development and structure. We found evidence that many common variants of small effect contribute to genetic susceptibility to Barrett's esophagus and that SNP alleles predisposing to obesity also increase risk for Barrett's esophagus.
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| 3. |
- Tesi, Bianca, et al.
(författare)
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Diagnostic yield and clinical impact of germline sequencing in children with CNS and extracranial solid tumors : a nationwide, prospective Swedish study
- 2024
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChildhood cancer predisposition (ChiCaP) syndromes are increasingly recognized as contributing factors to childhood cancer development. Yet, due to variable availability of germline testing, many children with ChiCaP might go undetected today. We report results from the nationwide and prospective ChiCaP study that investigated diagnostic yield and clinical impact of integrating germline whole-genome sequencing (gWGS) with tumor sequencing and systematic phenotyping in children with solid tumors.MethodsgWGS was performed in 309 children at diagnosis of CNS (n = 123, 40%) or extracranial (n = 186, 60%) solid tumors and analyzed for disease-causing variants in 189 known cancer predisposing genes. Tumor sequencing data were available for 74% (227/309) of patients. In addition, a standardized clinical assessment for underlying predisposition was performed in 95% (293/309) of patients.FindingsThe prevalence of ChiCaP diagnoses was 11% (35/309), of which 69% (24/35) were unknown at inclusion (diagnostic yield 8%, 24/298). A second-hit and/or relevant mutational signature was observed in 19/21 (90%) tumors with informative data. ChiCaP diagnoses were more prevalent among patients with retinoblastomas (50%, 6/12) and high-grade astrocytomas (37%, 6/16), and in those with non-cancer related features (23%, 20/88), and ≥2 positive ChiCaP criteria (28%, 22/79). ChiCaP diagnoses were autosomal dominant in 80% (28/35) of patients, yet confirmed de novo in 64% (18/28). The 35 ChiCaP findings resulted in tailored surveillance (86%, 30/35) and treatment recommendations (31%, 11/35).InterpretationOverall, our results demonstrate that systematic phenotyping, combined with genomics-based diagnostics of ChiCaP in children with solid tumors is feasible in large-scale clinical practice and critically guides personalized care in a sizable proportion of patients.
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| 4. |
- Tesi, Bianca, et al.
(författare)
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Diagnostic yield and clinical impact of germline sequencing in children with CNS and extracranial solid tumors : a nationwide, prospective Swedish study
- 2024
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer predisposition (ChiCaP) syndromes are increasingly recognized as contributing factors to childhood cancer development. Yet, due to variable availability of germline testing, many children with ChiCaP might go undetected today. We report results from the nationwide and prospective ChiCaP study that investigated diagnostic yield and clinical impact of integrating germline whole-genome sequencing (gWGS) with tumor sequencing and systematic phenotyping in children with solid tumors.Methods: gWGS was performed in 309 children at diagnosis of CNS (n = 123, 40%) or extracranial (n = 186, 60%) solid tumors and analyzed for disease-causing variants in 189 known cancer predisposing genes. Tumor sequencing data were available for 74% (227/309) of patients. In addition, a standardized clinical assessment for underlying predisposition was performed in 95% (293/309) of patients.Findings: The prevalence of ChiCaP diagnoses was 11% (35/309), of which 69% (24/35) were unknown at inclusion (diagnostic yield 8%, 24/298). A second-hit and/or relevant mutational signature was observed in 19/21 (90%) tumors with informative data. ChiCaP diagnoses were more prevalent among patients with retinoblastomas (50%, 6/12) and high-grade astrocytomas (37%, 6/16), and in those with non-cancer related features (23%, 20/88), and ≥2 positive ChiCaP criteria (28%, 22/79). ChiCaP diagnoses were autosomal dominant in 80% (28/35) of patients, yet confirmed de novo in 64% (18/28). The 35 ChiCaP findings resulted in tailored surveillance (86%, 30/35) and treatment recommendations (31%, 11/35).Interpretation: Overall, our results demonstrate that systematic phenotyping, combined with genomics-based diagnostics of ChiCaP in children with solid tumors is feasible in large-scale clinical practice and critically guides personalized care in a sizable proportion of patients.Funding: The study was supported by the Swedish Childhood Cancer Fund and the Ministry of Health and Social Affairs.
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| 5. |
- Artigas Soler, María, et al.
(författare)
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Genome-wide association and large-scale follow up identifies 16 new loci influencing lung function.
- 2011
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Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 43:11, s. 1082-90
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary function measures reflect respiratory health and are used in the diagnosis of chronic obstructive pulmonary disease. We tested genome-wide association with forced expiratory volume in 1 second and the ratio of forced expiratory volume in 1 second to forced vital capacity in 48,201 individuals of European ancestry with follow up of the top associations in up to an additional 46,411 individuals. We identified new regions showing association (combined P < 5 × 10(-8)) with pulmonary function in or near MFAP2, TGFB2, HDAC4, RARB, MECOM (also known as EVI1), SPATA9, ARMC2, NCR3, ZKSCAN3, CDC123, C10orf11, LRP1, CCDC38, MMP15, CFDP1 and KCNE2. Identification of these 16 new loci may provide insight into the molecular mechanisms regulating pulmonary function and into molecular targets for future therapy to alleviate reduced lung function.
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| 6. |
- Conesa-Boj, Sonia, et al.
(författare)
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Vertical "III-V" V-Shaped Nanomembranes Epitaxially Grown on a Patterned Si[001] Substrate and Their Enhanced Light Scattering
- 2012
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Ingår i: ACS Nano. - : American Chemical Society (ACS). - 1936-086X .- 1936-0851. ; 6:12, s. 10982-10991
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Tidskriftsartikel (refereegranskat)abstract
- We report on a new form of III-IV compound semiconductor nanostructures growing epitaxially as vertical V-shaped nanomembranes on Si(001) and study their light-scattering properties. Precise position control of the InAs nanostructures in regular arrays is demonstrated by bottom-up synthesis using molecular beam epitaxy in nanoscale apertures on a SiO2 mask. The InAs V-shaped nanomembranes are found to originate from the two opposite facets of a rectangular pyramidal island nucleus and extend along two opposite < 111 > B directions, forming flat {110} walls. Dark-field scattering experiments, in combination with light-scattering theory, show the presence of distinctive shape-dependent optical resonances significantly enhancing the local intensity of incident electromagnetic fields over tunable spectral regions. These new nanostructures could have interesting potential in nanosensors, infrared light emitters, and nonlinear optical elements.
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| 7. |
- Ek, Anna, et al.
(författare)
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Physical Activity and Mobile Phone Apps in the Preschool Age: Perceptions of Teachers and Parents
- 2019
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Physical activity (PA) is already beneficial at the preschool age. In many countries, young children spend most of their days in the preschool setting, making it a common arena for PA interventions. Mobile health tools are becoming increasingly popular to promote PA in different populations; however, little is known about the interest for and how the preschool setting could incorporate such a tool.OBJECTIVE:This study aimed to examine how teachers and parents perceive PA in preschool-aged children in general and their perceptions of how a mobile phone app could be used to promote PA in the preschool setting.METHODS:Semistructured interviews were conducted with 15 teachers (93%, [14/15] women, mean age 43.5 years, 47%, [7/15] with a university degree and 10 parents [91%, 9/10] women, mean age 38.9 years, all with a university degree) recruited from 2 urban preschools in central Sweden. The interviews were recorded, fully transcribed, coded, and analyzed using thematic analysis by means of an inductive approach.RESULTS:The analysis revealed 4 themes: (1) children are physically active by nature, (2) the environment as a facilitator or a barrier, (3) prerequisites of the adult world, and (4) an app in the preschool setting-challenges and possibilities. Parents and teachers perceived preschoolers as being spontaneously physically active; however, high-intensity PA was perceived as low. The PA was specifically performed during the day in the preschool. Identified facilitators of PA were access to safe and engaging outdoor environments such as forests, spacious indoor areas, and adult involvement. Adult involvement was considered especially important for children preferring sedentary activities. Identified barriers for PA were restricted indoor and outdoor space, rules for indoor activities, and lack of adult involvement because of time constraints. The teachers perceived that they had limited skills and experiences using apps in general, although they also acknowledged the increasing role of technological tools in the curriculum. Thus, the teachers expressed an interest for an app designed as a support tool for them, especially for situations when PA was limited because of perceived barriers. They suggested the app to include accessible information regarding the health benefits of PA in children linked to a library of activities for different settings and seasons. Parents suggested interactive app features including problem-solving tasks and music and dance, but not video clips as they made children passive.CONCLUSIONS:Vigorous PA was perceived as low in preschool-aged children. Future tailoring of interventions in the preschool setting should work around barriers and support facilitators to PA, especially PA of high intensity. In such work, an app could serve as a source of inspiration for PA in different ages, settings, and seasons and thus reduce environmental and structural inequalities in the preschool setting.
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| 8. |
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| 9. |
- Gronholm-Nyman, Petra, et al.
(författare)
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Limited Effects of Set Shifting Training in Healthy Older Adults
- 2017
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Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media S.A.. - 1663-4365. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Our ability to flexibly shift between tasks or task sets declines in older age. As this decline may have adverse effects on everyday life of elderly people, it is of interest to study whether set shifting ability can be trained, and if training effects generalize to other cognitive tasks. Here, we report a randomized controlled trial where healthy older adults trained set shifting with three different set shifting tasks. The training group (n = 17) performed adaptive set shifting training for 5 weeks with three training sessions a week (45 min/session), while the active control group (n = 16) played three different computer games for the same period. Both groups underwent extensive pre-and post-testing and a 1-year follow-up. Compared to the controls, the training group showed significant improvements on the trained tasks. Evidence for near transfer in the training group was very limited, as it was seen only on overall accuracy on an untrained computerized set shifting task. No far transfer to other cognitive functions was observed. One year later, the training group was still better on the trained tasks but the single near transfer effect had vanished. The results suggest that computerized set shifting training in the elderly shows long-lasting effects on the trained tasks but very little benefit in terms of generalization.
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| 10. |
- Lindqvist, Anna-Karin, et al.
(författare)
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Active School Transportation in Winter Conditions: Biking Together Is Warmer
- 2019
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:2
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Tidskriftsartikel (refereegranskat)abstract
- There has been a decline in children’s use of active school transportation (AST) while there is also limited research concerning AST in winter conditions. This study aimed to explore the prerequisites and experiences of schoolchildren and parents participating in an empowerment- and gamification-inspired intervention to promote students’ AST in winter conditions. Methods: Thirty-five students, who were aged 12–13 years, and 34 parents from the north of Sweden participated in the study. Data were collected using photovoice and open questions in a questionnaire and analyzed using qualitative content analysis. Results: The results show that involvement and togetherness motivated the students to use AST. In addition, during the project, the parents changed to have more positive attitudes towards their children’s use of AST. The students reported that using AST during wintertime is strenuous but rewarding and imparts a sense of pride. Conclusion: Interventions for increasing students’ AST in winter conditions should focus on the motivational aspects for both children and parents. For overcoming parental hesitation with regards to AST during winter, addressing their concerns and empowering the students are key factors. To increase the use of AST all year around, targeting the challenges perceived during the winter is especially beneficial.
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| 11. |
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| 12. |
- Lindqvist, Anna-Karin, et al.
(författare)
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User Perception of a Smartphone App to Promote Physical Activity through Active Transportation : An Inductive Qualitative Content Analysis within the Smart City Active Mobile Phone Intervention (SCAMPI) Study
- 2020
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 8:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical inactivity is globally recognized as a major risk factor for morbidity, particularly the incidence of non-communicable diseases, and mortality. Engaging in active transportation (AT) is a viable approach toward increasing physical activity (PA) on a daily basis. Mobile (mHealth) interventions enable promoting AT to a larger population. The Smart City Active Mobile Phone Intervention (SCAMPI) study is a randomized controlled trial designed to evaluate a smartphone application (app)’s ability to motivate participants to increase their PA by engaging in AT.Objective: This qualitative study examines the acceptance and usability of the SCAMPI app from the participants’ perspectives.Methods: Seventeen residents of Stockholm county (13 women; age range 25-61 years), who had completed the three-month, app-based behavioral change program in the SCAMPI randomized controlled trial during 2018 agreed to participate in a semi-structured telephone-based interview. These 17 participants were well representative of the whole intervention group (n = 127) in terms of baseline characteristics such as age, sex, and area of residence. The interviews were audio-recorded, transcribed verbatim, and analyzed using inductive qualitative content analysis.Results: The content analysis revealed two themes and four subcategories. The first theme “Main motivators: monitoring and messages” highlighted that monitoring AT and being able to set weekly goals using the app were the primary motivators reported among study participants. The second theme “Acceptable but modifiable” reflects that the app was well accepted and effectively encouraged many participants to use more AT. Nevertheless, there were functions in the app that require modification. For example, while the automated travel tracking feature was appreciated, participants found it time-consuming and unreliable at times.Conclusions: This study contributes novel insight into healthy adults’ experiences of using a mobile app to promote the use of AT. The results showed that the app was well-accepted and that self-monitoring and goal setting were the main motivators to engage in more AT. The automated tracking of AT was appreciated; however, it was also reported to be energy- and time-consuming when it failed to work. Thus, this feature should be improved going forward.
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| 13. |
- Lindstrand, Anna, et al.
(författare)
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Genome sequencing is a sensitive first-line test to diagnose individuals with intellectual disability
- 2022
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Ingår i: Genetics in Medicine. - : ELSEVIER SCIENCE INC. - 1098-3600 .- 1530-0366. ; 24:11, s. 2296-2307
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Individuals with intellectual disability (ID) and/or neurodevelopment disorders (NDDs) are currently investigated with several different approaches in clinical genetic diagnostics. Methods: We compared the results from 3 diagnostic pipelines in patients with ID/NDD: genome sequencing (GS) first (N = 100), GS as a secondary test (N = 129), or chromosomal microarray (CMA) with or without FMR1 analysis (N = 421). Results: The diagnostic yield was 35% (GS -first), 26% (GS as a secondary test), and 11% (CMA/FMR1). Notably, the age of diagnosis was delayed by 1 year when GS was performed as a secondary test and the cost per diagnosed individual was 36% lower with GS first than with CMA/FMR1. Furthermore, 91% of those with a negative result after CMA/FMR1 analysis (338 individuals) have not yet been referred for additional genetic testing and remain undiagnosed. Conclusion: Our findings strongly suggest that genome analysis outperforms other testing strategies and should replace traditional CMA and FMR1 analysis as a first-line genetic test in individuals with ID/NDD. GS is a sensitive, time-and cost-effective method that results in a confirmed molecular diagnosis in 35% of all referred patients. (c) 2022 The Authors. Published by Elsevier Inc. on behalf of American College of Medical Genetics and Genomics. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 14. |
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| 15. |
- Neuman, Nicklas, 1987-, et al.
(författare)
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Children's experiences of meals after obesity treatment : a qualitative follow-up four years after a randomized controlled trial
- 2022
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Ingår i: BMC Pediatrics. - : BioMed Central (BMC). - 1471-2431. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The practice of eating together, commensality, is rarely explored in the context of childhood obesity treatment. This is noteworthy given long-standing debates about the physical, psychosocial, and societal benefits of meals, especially family meals. Moreover, as children with obesity experience weight bias and stigma both within and outside the home, it is important to examine meals as a locus of social exchange around food and the body. Our study is based on the premises that eating together (i) matters and (ii) occurs in different environments with diverse social organization, where food-related interactions create varying arrangements of individuals, groups, their statuses, and their actions.Method: The study explores children’s experiences of meals in different social contexts. Thirty-two children (age 8–10 years) living in Sweden were interviewed, 4 years after they entered an obesity intervention trial. Thematic analysis was applied to the data.Results: We thematized three meal types, with each meal type having two subthemes: (i) “The family meal”, with “Shared routines, rituals, and rules” and “Individual solutions and choices”; (ii) “The school meal”, with “Rules and norms of the school” and “Strategies of the child”; and (iii) “The friend meal”, with “Handling food that was disliked” and “Enjoyment of food”. These three different meal types carried different experiences of and knowledge about how they were socially organized.Conclusions: While the children spoke about the family and school meals as meaningful, the friend meal stood out as particularly positive. Contrary to our expectations, the children did not express experiences of weight bias or obesity stigma around meals, nor did they speak negatively about parental control of their food intake. Our findings, especially regarding the friend meal, have implications for further research into commensality and social influences on eating among children with obesity, from early childhood into adolescence.
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| 16. |
- Nikkarinen, Anna, et al.
(författare)
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Soluble CD163 predicts outcome in both chemoimmunotherapy and targeted therapy-treated mantle cell lymphoma
- 2023
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Ingår i: Blood Advances. - : American Society of Hematology. - 2473-9529 .- 2473-9537. ; 7:18, s. 5304-5313
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Tidskriftsartikel (refereegranskat)abstract
- The outcome for patients with mantle cell lymphoma (MCL) has drastically improved with new treatments directed toward the tumor immune microenvironment, where macrophages play an important role. In MCL, the presence of M2 macrophages defined by CD163 expression in diagnostic biopsies has been associated with a worse prognosis. An alternative way to assess the abundance of M2 macrophages is by measuring the level of soluble CD163 in serum (sCD163). We aimed to investigate the prognostic value of sCD163 in 131 patients with MCL. We found that high sCD163 at diagnosis was associated with shorter progression-free survival (PFS) and shorter overall survival (OS) in 81 patients who were newly diagnosed and subsequently treated with chemoimmunotherapy. The same was seen in a cohort of 50 patients with relapsed MCL that were mainly treated within the phase 2 Philemon-trial with rituximab, ibrutinib, and lenalidomide. In patients who were newly diagnosed and had low levels of sCD163, 5-year survival was 97%. There was a moderate correlation between sCD163 and tissue CD163. The association with a poor prognosis was independent of MCL international prognostic index, Ki67, p53 status, and blastoid morphology, as assessed in a multivariable Cox proportional hazards model. In this study, high sCD163 was associated with both shorter PFS and shorter OS, showing that high levels of the M2 macrophage marker sCD163 is an independent negative prognostic factor in MCL, both in the chemoimmunotherapy and ibrutinib/lenalidomide era. In addition, low sCD163 levels identify patients with MCL with a very good prognosis.
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| 17. |
- Olsson, Jens, et al.
(författare)
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Miljön i Hanöbukten 2015-2017 : finns det ett samband mellan tillståndet för fisken, dess hälsa och belastningen av miljöfarliga ämnen?
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under slutet av 2000-talet inkom flertalet rapporter från allmänheten och fiskare i de västra delarna av Hanöbukten om låga förekomster av fisk, förekomst av sårskadad fisk och illaluktande vatten i området. Den här rapporten sammanfattar resultaten och slutsatserna från undersökningar i Västra Hanöbukten utförda under 2015-2017 med syfte att undersöka eventuella samband mellan miljöfarliga ämnen och fiskhälsa, samt orsakerna till uppkomsten av sårskadad fisk i området. Därtill presenteras resultaten från provfisken utförda i syfte att kartlägga bestånden av kustfisk i området. Följande fyra frågeställningar besvaras:Vilka eventuella samband mellan miljöfarliga ämnen och fiskhälsa har framkommit?Vilka orsaker till uppkomst av sårskadad fisk har dokumenterats?Vilka resultat har kartläggningen av kustfiskbestånd, miljöfarliga ämnen respektive fiskhälsa lett till?Vilka slutsatser kan dras gällande vilka arter och storleksklasser som påverkas mest av miljöfarliga ämnen? Resultaten från analyserna av miljöfarliga ämnen i skrubbskädda och torsk visar inte på några generellt förhöjda halter av miljöfarliga ämnen i Västra Hanöbukten under 2015-2016 i jämförelse med referensstationerna Kvädöfjärden och Torhamn (Östra Hanöbukten, skrubbskädda) och sydöstra Gotland (torsk). För några miljögifter såsom DDE och PFOS var halterna hos skrubbskädda något högre i Västra Hanöbukten än i Kvädöfjärden, men halterna ligger under gränsvärden för båda dessa ämnen och inom den naturliga variation som är förväntad med hänsyn till inom- och mellanårsvariation i referensstationer. För torsk visade resultaten att sårskador som antas vara orsakade av nejonöga från Hanöbukten hade högre halter av PCB:er, DDT och dess metaboliter, bromerade flamskyddsmedel och PFAS (poly- och perfluorerade ämnen) jämfört med fiskar utan sårskador i området. Om de högre halterna av miljögifter i sårskadad fisk är ett resultat av lägre kondition och fettvikt hos fisken till följd av sårskadorna eller om gifterna i sig påverkar fisken negativt är idag oklart. För torsk med okända sårskador från Hanöbukten kunde ingen koppling göras mellan uppkomst av sårskador och de analyserade miljögifterna. Undersökningarna av skrubbskäddans hälsa i Västra Hanöbukten visade på tydliga fysiologiska skillnader mellan skrubbskädda som fångats i området jämfört med referenslokalen Kvädöfjärden under 2015. Dessa skillnader kan tyda på påverkan av miljögifter. Men de undersökningar som genomfördes under 2016 och 2017 kunde emellertid inte belägga dessa tydliga skillnader när fisk från Västra Hanöbukten jämfördes med den från referensområdet Torhamn i östra Blekinge. Histopatologiska undersökningar på fisk insamlade 2017 visade även att fiskarna i Västra Hanöbukten är relativt friska. Orsaken till de möjligen episodiskt förekommande förändringarna av fiskens hälsotillstånd i Västra Hanöbukten under 2015 är inte känd, men kan vara ett resultat av variation mellan områden i olika omgivningsfaktorer som födotillgång och/eller vattentemperatur. Det kan dock inte uteslutas att de förändringarna i skrubbskädda som observerats kan vara orsakade av ett eller flera miljöfarliga ämnen som inte ingått i undersökningarna som presenteras i denna rapport. Resultaten från provfiskena visar att fisksamhällets struktur och funktion i de västra delarna av Hanöbukten under 2015-2017 inte avviker i jämförelse med tidigare undersökningar i området och andra kustområden i södra Östersjön. Torsk och skrubbskädda är vanliga arter i fisksamhället i Västra Hanöbukten. Även om fångsterna av arterna generellt var låga i provfiskena under 2015-2017, avviker de inte tydligt från tidigare undersökningar i området och i andra kustområden i södra Östersjön utan speglar sannolikt förändringar under senare år i beståndssituationen för arterna i Östersjön. Emellertid var också konditionen hos torsk och skrubbskädda låg i de västra delarna av Hanöbukten under 2015-2017, och det finns en antydan till lägre kondition hos båda arterna jämfört med andra kustområden i södra Östersjön som möjligen kan tyda på låg födotillgång i området. Frekvensen av fisk (framförallt torsk och skrubbskädda) med yttre fysiska avvikelser såsom bett, sårskador och deformationer verkar vara något förhöjd i Västra Hanöbukten jämfört med andra områden längs den svenska kusten. De typiska frätskador som allmänheten rapporterat i området kunde inte påvisas i provfiskena, och hudsår delvis sannolikt orsakade av andra djur som säl och nejonöga dominerade de yttre fysiska avvikelserna som noterades. Vad som orsakar övriga avvikelser är idag inte klarlagt, men skulle möjligen kunna kopplas till att fiskens låga kondition gör den mer känslig för yttre påverkan. Med grund i de utförda undersökningar och erhållna resultat under 2015-2017 har inte några tydliga samband mellan miljöfarliga ämnen, fiskens hälsotillstånd och bestånd dokumenterats i Västra Hanöbukten. Det är därför inte heller möjligt att uttala sig om vilka storleksklasser av fisk som är känsligast för miljöfarliga ämnen. Förutom angrepp av andra djur som säl och nejonöga, har inte orsaken till de okända skador som observerats på fisken kunnat fastställas. Med utgångspunkt i de resultat som idag finns tillgängliga, kan det dock inte uteslutas att den avvikande hälsan hos skrubbskäddan i Västra Hanöbukten under 2015 och vissa av de yttre fysiska avvikelserna som noterades hos fisken under provfiskena kan ha orsakats av miljöfarliga ämnen. Undersökningarna i Västra Hanöbukten under 2015-2017 har bidragit till en ökad kunskap om tillståndet för fisken i området gällande miljögiftsbelastning, hälsa, samhälle och bestånd, och huruvida det nuvarande tillståndet avviker från andra delar av Östersjön. Systemet i de västra delarna av Hanöbukten är relativt unikt i Sverige, med en öppen kust mot södra Östersjön, och informationen som presenteras i denna rapport bör utgöra en grund för en långsiktig miljöövervakning av fisken i området. En långsiktig miljöövervakning i Västra Hanöbukten medger även en framtida bedömning av miljötillståndet i området, och möjliggör samtidigt upptäckt och dokumentation av episodiska fenomen som påverkar fisksamhällets struktur och funktion, samt fiskens individuella hälsa och belastning av miljöfarliga ämnen.
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| 18. |
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| 19. |
- Rodrigues, Joana M., et al.
(författare)
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Infiltration of CD163-, PD-L1-and FoxP3-positive cells adversely affects outcome in patients with mantle cell lymphoma independent of established risk factors
- 2021
-
Ingår i: British Journal of Haematology. - : John Wiley & Sons. - 0007-1048 .- 1365-2141. ; 193:3, s. 520-531
-
Tidskriftsartikel (refereegranskat)abstract
- We characterised patients with mantle cell lymphoma (MCL) with poor prognosis based on differences in immune infiltration. Different expressions of the tumour cell markers Cyclin D1 and sex-determining region Y-box transcription factor 11 (SOX11), and the immune markers cluster of differentiation 3 (CD3), CD4, CD8, CD25, forkhead box protein P3 (FoxP3), T-box transcription factor TBX21 (T-bet), programmed cell death protein 1 (PD-1), programmed-death ligand 1 (PD-L1) and CD163 were investigated for all-cause mortality in 282 patients with MCL and time-to-progression (TTP) in 106 clinical trial patients. With increasing age, a significantly lower infiltration of CD3(+) T lymphocytes was seen. T-cell infiltration was independent of cellular tumour antigen p53 (p53) expression, Ki-67, morphology and frequency of tumour cells. The all-cause mortality was higher in patients with PD-L1-expression above cut-off [hazard ratio (HR) 1 center dot 97, 95% confidence interval (CI) 1 center dot 18-3 center dot 25, adjusted for sex and MCL International Prognostic Index (MIPI)] and a higher frequency of CD163(+) cells (continuously, HR 1 center dot 51, 95% CI 1 center dot 03-2 center dot 23, adjusting for age, sex, morphology, Ki-67 and p53). In patients treated within the Nordic Lymphoma Group MCL2/3 trials, TTP was shorter in patients with a higher frequency of FoxP3(+) cells (HR 3 center dot 22, 95% CI 1 center dot 40-7 center dot 43) and CD163(+) cells (HR 6 center dot 09, 95% CI 1 center dot 84-20 center dot 21), independent of sex and MIPI. When combined a higher frequency of CD163(+) macrophages and PD-L1(+) cells or high CD163(+) macrophages and FoxP3(+) regulatory T cells indicated worse outcome independent of established risk factors. The T-cell infiltrate was in turn independent of molecular characteristics of the malignant cells and decreased with age.
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| 20. |
- Rodrigues, Joana M., et al.
(författare)
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p53 is associated with high-risk and pinpoints TP53 missense mutations in mantle cell lymphoma
- 2020
-
Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 191:5, s. 796-805
-
Tidskriftsartikel (refereegranskat)abstract
- Survival for patients diagnosed with mantle cell lymphoma (MCL) has improved drastically in recent years. However, patients carrying mutations in tumour protein p53 (TP53) do not benefit from modern chemotherapy-based treatments and have poor prognosis. Thus, there is a clinical need to identify missense mutations through routine analysis to enable patient stratification. Sequencing is not widely implemented in clinical practice for MCL, and immunohistochemistry (IHC) is a feasible alternative to identify high-risk patients. The aim of the present study was to investigate the accuracy of p53 as a tool to identify patients with TP53 missense mutations and the prognostic impact of overexpression and mutations in a Swedish population-based cohort. In total, 317 cases were investigated using IHC and 255 cases were sequenced, enabling analysis of p53 and TP53 status among 137 cases divided over the two-cohort investigated. The accuracy of predicting missense mutations from protein expression was 82%, with sensitivity at 82% and specificity at 100% in paired samples. We further show the impact of p53 expression and TP53 mutations on survival (hazard ratio of 3·1 in univariate analysis for both), and the association to risk factors, such as high MCL International Prognostic Index, blastoid morphology and proliferation, in a population-based setting.
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| 21. |
- Rodrigues, Joana M., et al.
(författare)
-
p53 is associated with high-risk and pinpointsTP53missense mutations in mantle cell lymphoma
- 2020
-
Ingår i: British Journal of Haematology. - : WILEY. - 0007-1048 .- 1365-2141. ; 191:5, s. 796-805
-
Tidskriftsartikel (refereegranskat)abstract
- Survival for patients diagnosed with mantle cell lymphoma (MCL) has improved drastically in recent years. However, patients carrying mutations in tumour protein p53 (TP53) do not benefit from modern chemotherapy-based treatments and have poor prognosis. Thus, there is a clinical need to identify missense mutations through routine analysis to enable patient stratification. Sequencing is not widely implemented in clinical practice for MCL, and immunohistochemistry (IHC) is a feasible alternative to identify high-risk patients. The aim of the present study was to investigate the accuracy of p53 as a tool to identify patients withTP53missense mutations and the prognostic impact of overexpression and mutations in a Swedish population-based cohort. In total, 317 cases were investigated using IHC and 255 cases were sequenced, enabling analysis of p53 andTP53status among 137 cases divided over the two-cohort investigated. The accuracy of predicting missense mutations from protein expression was 82%, with sensitivity at 82% and specificity at 100% in paired samples. We further show the impact of p53 expression andTP53mutations on survival (hazard ratio of 3 center dot 1 in univariate analysis for both), and the association to risk factors, such as high MCL International Prognostic Index, blastoid morphology and proliferation, in a population-based setting.
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| 22. |
- Sandström Gerdtsson, Anna, et al.
(författare)
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Overexpression of the key metabolic protein CPT1A defines mantle cell lymphoma patients with poor response to standard high dose chemotherapy independent of MIPI and complement established high-risk factors
- 2023
-
Ingår i: Haematologica. - : Ferrata Storti Foundation (Haematologica). - 0390-6078 .- 1592-8721. ; 108:4, s. 1092-1104
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Tidskriftsartikel (refereegranskat)abstract
- The variable outcome to standard immunochemotherapy for mantle cell lymphoma (MCL) patients is a clinical challenge. Established risk factors, including high MCL international prognostic index (MIPI), high proliferation (Ki-67), non-classic (blastoid/pleomorphic) morphology, and mutated TP53, only partly identify patients in need of alternative treatment. Deepened understanding of biological factors that influence time to progression and relapse would allow for an improved stratification, and identification of novel targets for high-risk patients. We performed gene expression analyses to identify pathways and genes associated with outcome in a cohort of homogeneously treated patients. In addition to deregulated proliferation, we show that thermogenesis, fatty acid degradation and oxidative phosphorylation are altered in patients with poor survival, and that high expression of carnitine palmitoyltransferase 1A (CPT1A), an enzyme involved in fatty acid degradation, can specifically identify high-risk patients independent of the established high-risk factors. We suggest that complementary investigations of metabolism may increase the accuracy of patient stratification and that immunohistochemistry-based assessment of CPT1A can contribute to defining high-risk MCL.
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| 23. |
- Wireklint Sundström, Birgitta, et al.
(författare)
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”Nationella riktlinjer behövs för ambulanspersonal”
- 2017
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Ingår i: Svenska Dagbladet. - 1101-2412. ; :2017-06-29
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Det är förödande att sänka kraven på ambulanspersonal. Därför efterlyser vi nationella riktlinjer och beslut som tydligt anger en lägsta utbildningsnivå för anställning inom ambulanssjukvården, skriver Nätverket för utbildning av ambulanssjuksköterskor i en slutreplik.
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| 24. |
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| 25. |
- Alehagen, Siw, et al.
(författare)
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Perceptions of family planning among low-income men in Western Kenya : Original Article
- 2009
-
Ingår i: International Nursing Review. - : Wiley. - 0020-8132 .- 1466-7657. ; 56:3, s. 340-345
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Tidskriftsartikel (refereegranskat)abstract
- Background: Men have rarely been involved in either receiving or providing information on sexuality, reproductive health or birth spacing. They have also been ignored or excluded in one way or the other from participating in many family planning programmes as family planning is viewed as a womans affair. Aim: To describe the perceptions of family planning among low-income men in Western Kenya. Methods: A qualitative study using focus group interviews and content analysis was conducted, with 64 men aged 15-54 years participating actively. Findings: Perceptions of family planning were manifold. For example, some perceived it as meaning having the number of children one is able to provide for. Most men knew about traditional and modern methods of birth control, although their knowledge was poor and misconceived. Modern methods were thought to give side effects, discouraging family planning. Low instances of family planning were also because of the fact that culturally, children are considered wealth. A law advocating family size limitation was regarded as necessary for the future. Conclusion: Mens perceptions of family planning are manifold. Their knowledge about contraception is poor and sometimes misconceived. Preferences regarding a childs gender are strong, thus attitudes and cultural beliefs that might hinder family planning have to be considered. A policy on male contraception and contraceptive services is seen as necessary.
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| 26. |
- Alexandridis, Vasileios, et al.
(författare)
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Retropubic slings are more efficient than transobturator at 10-year follow-up : a Swedish register-based study
- 2023
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Ingår i: International Urogynecology Journal. - : Springer Science and Business Media LLC. - 0937-3462 .- 1433-3023. ; 34:6, s. 1307-1315
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and hypothesis: Long-term performance of mid-urethral slings (MUS) and potential differences between the retropubic and the transobturator technique for insertion are scarcely studied. This study aims to evaluate the efficacy and safety 10 years after surgery and compare the two main surgical techniques used. Methods: Women who underwent surgery with a MUS between 2006 and 2010 were identified using the Swedish National Quality Register of Gynecological Surgery and were invited 10 years after the operation to answer questionnaires regarding urinary incontinence and its impact on quality-of-life parameters (UDI-6, IIQ-7) and impression of improvement, as well as questions regarding possible sling-related complications and reoperation. Results: The subjective cure rate reported by 2421 participating women was 63.3%. Improvement was reported by 79.2% of the participants. Women in the retropubic group reported higher cure rates, lower urgency urinary incontinence rates and lower UDI-6 scores. No difference was shown between the two methods regarding complications, reoperation due to complications or IIQ-7 scores. Persisting sling-related symptoms were reported by 17.7% of the participants, most commonly urinary retention. Mesh exposure was reported by 2.0%, reoperation because of the tape by 5.6% and repeated operation for incontinence by 6.9%, significantly more in the transobturator group (9.1% vs. 5.6%). Preoperative urinary retention was a strong predictor for impaired efficacy and safety at 10 years. Conclusions: Mid-urethral slings demonstrate good results for the treatment of stress urinary incontinence and tolerable complication profiles in a 10-year perspective. The retropubic approach displays higher efficacy than the transobturator, with no difference regarding safety.
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| 27. |
- Amer-Wåhlin, Isis, et al.
(författare)
-
Slutrapport för EVIDIGVO
- 2024
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den här texten presenterar resultat från tre aktiviteter för kunskapsinsamling om implementering av digitala verktyg inom vård- och omsorg: en litteratursammanställning, en workshopserie i två delar och en enkätundersökning. Den primära målgruppen har varit verksamhetsutvecklare och projektledare i regioner och kommuner. Antalet svarande i enkätstudien var för lågt för att kunna dra några statistiska slutsatser, men resultatet kan, tillsammans med workshopserien, ändå användas för att identifiera områden där det verkar finnas utmaningar. Både litteratursammanställningen och enkätundersökningen pekar på ett behov av att utveckla strukturerade utvärderingsmodeller för implementering. Även under workshoppen diskuterades den bristande förmågan att ”samla in evidens under projektens gång”, och det fanns en önskan om att ett sådant arbetssätt skulle utvecklas. Enkäten och workshoppen pekar även på flera återkommande problem under implementeringsprojekts olika faser. I den inledande fasen efterfrågas bättre analyser och förankringsarbete. Analyser med användarfokus missas speciellt ofta, så som användarresa, hållbarhetsanalys och intressent- och behovsanalys. Även i andra ändan av processen, då system och arbetssätt ska avvecklas, finns utmaningar och förbättringsförslag, t.ex. saknas ofta beslut om utfasning av gamla lösningar, och ett förslag är att man redan när man skriver kontakt med en leverantör ska säkerställa att leverantören hjälper till med migrering vid utfasning. En annan genomgående problematik är osäkerhet, och ibland avsaknad, av roller, ansvar och kommunikation. Detta handlar om att man inte riktigt vet varför man ska göra saker, eller att verksamheten och personerna som ska göra förändringen inte är tillräckligt inblandade. Det kan också handla om att support och förvaltning inte är tillräckligt väl utvecklat, och om att man inte vet hur man kan samarbeta med leverantörer. Här identifieras även förändringsledning som ett viktigt verktyg för att underlätta en god implementering.
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| 28. |
- Arvastson, Gösta, et al.
(författare)
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Det urbana rummet
- 1999
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Bok (populärvet., debatt m.m.)
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| 29. |
- Arvastson, Gösta, Lennartsson, Rebecka, Andersson, Maria, Zackariasson, Maria, Ljung, Anna , Ek-Nilsson, Katarina, Mebius, Anders, Vallström, Mikael
(författare)
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Järnbur eller frigörelse.Studier i moderniseringen av Sverige.
- 1999
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Bok (övrigt vetenskapligt/konstnärligt)
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| 30. |
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| 31. |
- Bachrach-Lindström, Margaretha, 1957-, et al.
(författare)
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Assessment of nutritional status using biochemical and anthropometric variables in a nutritional intervention study of women with hip fracture
- 2001
-
Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 20:3, s. 217-223
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: The aim of this study of women with hip fracture was to describe nutritional status with biochemical markers and anthropometric variables, and to evaluate the effect of nutritional intervention with the intention of increasing protein and energy intake.Methods: The first consecutive 44 women were included, and used as controls. The next 44 were matched for age, fracture and mental state. Anthropometric variables, IGF-I, hormones and serum albumin were collected 4–6 days (baseline), 1 and 3 months after surgery. Twenty-four women filled out a 7-day food record.Results: At baseline, one fourth had BMI <20 kg/m2and subnormal triceps skinfold thickness. Baseline serum albumin, IGF-I and growth hormone levels were low, probably as an acute response to trauma. Women with BMI <20 kg/m2had lower IGF-I levels compared to those with higher BMI. At 3 months, one-third of both groups were protein and energy malnourished. The intervention group obtained higher daily energy percentage from fat but none of the groups reached their calculated energy need.Conclusions: Using biochemical markers in the acute postoperative situation to assess nutritional status is not recommended. The intervention had no impact on anthropometric or biochemical variables.
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| 32. |
- Bachrach-Lindström, Margaretha, 1957-, et al.
(författare)
-
Förebygg undernäring!
- 2002
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Ingår i: Äldre i centrum. - 1401-5110. ; 3, s. 16-17
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 33. |
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| 34. |
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| 35. |
- Bachrach-Lindström, Margaretha, 1957-, et al.
(författare)
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Nutritional state and functional capacity among elderly Swedish people with acute hip fracture
- 2000
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 14:4, s. 268-274
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to describe characteristics in a group of elderly men and women with hip fracture, regarding presumed risk factors, such as nutritional state and functional capacity. A total of 142 men and women aged 75 years or more were consecutively included on admittance to the hospital. Anthropometry and body composition were measured 4-6 days after the fracture. Data on functional status, activities of daily living and living arrangements at the time of the fracture were collected. The women and men had a body mass index (BMI) of 22.3 ▒ 3.7 kg/m2 and 21.7 ▒ 2.1 kg/m2, respectively. Of the whole group, 71% had a BMI < 24 kg/m2 and 25% a BMI < 20.0 kg/m2. Forty-five percent of the patients needed daily home help, and a majority of them were mentally impaired (p < 0.0001). Women with a trochanteric hip fracture were shorter, had lower body weight, lower lean body mass and lower arm muscle circumference (AMC) than the cervical fracture group (p < 0.05). Fewer women with a trochanteric fracture and fewer women with mental impairment took walks outside before the fracture, (p = 0.023 and p = 0.002, respectively). Characteristics found in the group were low BMI, low muscle mass as indicated by low lean body mass and mental impairment. It seems important to evaluate such factors when developing post-operative care plans aimed at avoiding further deterioration. Extra frail sub-groups of patients, such as people who are mentally impaired, women with trochanteric fracture and women with high dependency concerning ADL functions were identified.
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| 36. |
- Bachrach-Lindström, Margareta, et al.
(författare)
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Nutritional status and functional capacity after femoral neck fractures : a prospective randomized one-year follow-up study
- 2000
-
Ingår i: Aging. - 1945-4589. ; 12:5, s. 366-374
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim of this study was to evaluate the effect of two different surgical methods on nutritional status and functional capacity during the first postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatment group received protein- and energy-enriched food in the hospital in addition to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity were examined at baseline, one and three months, and one year after the operation. Pain was examined at three months and one year. The effect of nutritional intervention was equal within both surgical groups. Logistic regression showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental impairment and deteriorated nutritional status were predominant in the non-survivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pain. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rate.
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| 37. |
- Baresel, Christian, et al.
(författare)
-
Läkemedelsrester och andra skadliga ämnen i avloppsreningsverk - koncentrationer, kvantifiering, beteende och reningsalternativ
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Många läkemedelsrester och andra prioriterade substanser passerar igenom dagens avloppsreningsverk (ARV) och hamnar antingen i slammet eller i recipienten, ibland i nivåer som kan påverka vattenlevande organismer. Substanser som släpps ut via avlopps-reningsverk kan också anrikas i den akvatiska näringskedjan och orsaka effekter i högre organismer såsom fiskätande fåglar eller däggdjur, inklusive människor. Studier har också visat att antibiotika som hamnar i miljön kan bidra till uppkomsten av antibiotikaresistenta gener i bakterier, vilket är ett allvarligt globalt hot mot möjligheten att bota livshotande sjukdomar. Eftersom nuvarande vattenreningstekniker har utvecklats främst för att avlägsna partikulärt material samt kväve och fosfor är de oftast inte anpassade för att rena bort mikrobiellt stabila kemiska föroreningar. Utvärderingar av effektiviteten hos olika behandlingstekniker för avlägsnande av sådana ämnen baseras vanligtvis på analyser av förekomst av ett ämne i inkommande och utgående vatten från reningsverket. Det finns dock problem med detta tillvägagångssätt eftersom vissa ämnen metaboliseras till potentiellt mer skadliga substanser, som då inte automatiskt fångas i analysen. Dessutom kan vissa ämnen spontant bildas i reningsverken, vilket kan resultera i högre nivåer i utgående än i inkommande vatten. Ett ytterligare problem är att de utgående koncentrationerna ibland kan vara lägre än detektions-gränserna, men trots det ändå vara högre än eller nära etablerade risknivåer. This report is only available in Swedish.
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| 38. |
- Baresel, Christian, et al.
(författare)
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Pharmaceutical residues and other emerging substances in the effluent of sewage treatment plants
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Pharmaceutical residues and other emerging substances pass through modern sewage treatment plants (STPs) and end up in the receiving waters and sludge. In several studies, recipient concentrations have been detected with expected effects on aquatic organisms. Chemicals released via STPs may also enter the aquatic food-web and cause effects in higher organisms such as fish-eating birds or mammals including humans. Studies have also shown that antibiotics in the environment may contribute to the increase of antibiotic resistant genes in bacteria, which is a serious threat to our possibility to cure life-threatening diseases on the global scale. Current STP treatment technologies are usually not fit to remove microbial stable chemical pollutants and the evaluation of the removal efficiency of the STP systems applied today, is not complete. The evaluation of the removal efficiency of the substances in the STP systems is usually based on chemical analysis of the presence of certain substances in influent and effluent waters. However, there are difficulties associated with this approach, e.g. since some substances are metabolized into potentially more harmful substances which are not captured in the analysis unless they are actively sought for. Furthermore, some substances are formed in the STPs, resulting in higher levels in effluents than in influents. In addition, effluent concentrations may sometimes be lower than the analytical detection limits, yet still higher than or close to established risk concentrations emphasizing the need for developments of the analytical methods.
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| 39. |
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| 40. |
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| 41. |
- Bergstrand, Sara, et al.
(författare)
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Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques
- 2009
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Ingår i: Skin research and technology. - : Wiley-Blackwell. - 0909-752X .- 1600-0846. ; 15:2, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Background/purpose: This study has evaluated a multi-parametric system combining laser Doppler flowmetry and photoplethysmography in a single probe for the simultaneous measurement of blood flow at different depths in the tissue. This system will be used to facilitate the understanding of pressure ulcer formation and in the evaluation of pressure ulcer mattresses.Methods: The blood flow in the tissue over the sacrum was measured before, during and after loading with 37.5 mmHg, respectively, 50.0 mmHg. The evaluation of the system consisted of one clinical part, and the other part focusing on the technicalities of the probe prototype.Results: An increase in blood flow while loading was the most common response, but when the blood flow decreased during loading it was most affected at the skin surface and the blood flow responses may be different due to depths of measurement. Reactive hyperaemia may occur more frequently in the superficial layers of the tissue.Conclusion: The study showed that the new system is satisfactory for measuring tissue blood flow at different depths. The laser Doppler complements the photoplethysmography, and further development of the system into a thin flexible probe with the ability to measure a larger area is required.
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| 42. |
- Bergstrand, Sara, et al.
(författare)
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Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype
- 2010
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Ingår i: MICROCIRCULATION. - : Taylor and Francis. - 1073-9688 .- 1549-8719. ; 17:4, s. 311-319
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Tidskriftsartikel (refereegranskat)abstract
- Pandgt;Objective: The aim was to investigate the existence of sacral tissue blood flow at different depths in response to external pressure and compression in elderly individuals using a newly developed optical probe prototype. Methods: The tissue blood flow and tissue thickness in the sacral area were measured during load in 17 individuals using laser Doppler flowmetry and photoplethysmography in a combined probe, and digital ultrasound. Results: The mean age was 68.6 +/- 7.0 years. While loading, the mean compression was 60.3 +/- 11.9%. The number of participants with existing blood flow while loading increased with increased measurement depth. None had enclosed blood flow deep in the tissue and at the same time an existing more superficial blood flow. Correlation between tissue thickness and BMI in unloaded and loaded sacral tissue was shown: r = 0.68 (P = 0.003) and r = 0.68 (P = 0.003). Conclusions: Sacral tissue is highly compressed by external load. There seems to be a difference in responses to load in the different tissue layers, as occluded blood flow in deeper tissue layers do not occur unless the blood flow in the superficial tissue layers is occluded.
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| 43. |
- Bergstrand, Sara, et al.
(författare)
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Microcirculatory responses of sacral tissue in healthy individuals and in patients on different pressure-redistribution mattresses
- 2015
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Ingår i: Journal of Wound Care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 24:8, s. 346-358
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore the interaction between interface pressure and pressure-induced vasodilation and reactive hyperemia with different pressureredistribution mattresses.Method: A cross-sectional study was performed with a convenience sample of 42 healthy individuals between 18 and 64 years of age, 38 healthy individuals 65 years or older, and 35 inpatients 65 years or older at a university hospital in Sweden. Blood flow was measured at depths of 1 mm, 2 mm, and 10 mm using a combined system of laser Doppler flowmetry and photoplethysmography. The blood flow, interface pressure and skin temperature were measured in the sacral tissue before, during, and after load while lying on one standard hospital mattress and three different pressure-redistribution mattresses.Results: There were significant differences between the three foam mattresses with regard to average sacral pressure, peak sacral pressure, and local probe pressure with the lowest values at the visco-elastic foam/air mattress (23.5 ± 2.5 mmHg, 49.3 ± 11.1 mmHg, 29.2 ± 14.0 mmHg respectively). A greater proportion of subjects had affected blood flow in terms of lack of pressure-induced vasodilation on the visco-elastic foam/air mattress compared to the alternating pressure mattress at tissue depths of 2 mm (39.0% vs. 20.0%, respectively) and 10 mm (56.9 % vs. 35.1%, respectively). Eleven individuals, including subjects in all three subject groups were identified with no pressure-induced vasodilation or reactive hyperemia in any mattress, and this was considered a high-risk blood flow response.Conclusion: Interface pressure magnitudes considered not harmful during pressure-exposure lying on different pressure-redistribution mattresses can affect the microcirculation in different tissue structures. Despite having the lowest pressure values compared to the other mattresses, the visco-elastic foam/air mattress had the highest proportion of subjects with decreased blood flow indicating a more affected blood flow. Three young healthy individuals were identified with the high-risk blood flow response, indicating an innate vulnerability to pressure exposure and may not benefit from pressure-redistribution mattresses. Finally it was shown that the evaluation of pressure-redistribution support surfaces in terms of mean blood flow during and after tissue exposure is not feasible but assessment of pressure-induced vasodilation and reactive hyperemia could be a new possibility to assess individualized physiological measurements of mechanisms known to be related to pressure ulcer development.
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| 44. |
- Bergstrand, Sara, et al.
(författare)
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Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
- 2014
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Ingår i: Microcirculation. - : John Wiley & Sons. - 1073-9688 .- 1549-8719. ; 21:8, s. 761-771
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To characterize pressure-induced vasodilatation and reactive hyperemia at different sacral tissue depths in different populations under clinically relevant pressure exposure.METHODS: Forty-two subjects (< 65 years), 38 subjects (≥ 65 years), and 35 patients (≥ 65 years) participated. Interface pressure, skin temperature, and blood flow at tissue depths of 1 mm, 2 mm, and 10 mm (using laser Doppler flowmetry and photoplethysmography) were measured in the sacral tissue before, during, and after load in a supine position.RESULTS: pressure-induced vasodilatation and reactive hyperemia were observed at three tissue depths. At 10 mm depth, the proportion of subjects with a lack of pressure-induced vasodilatation was higher compared to superficial depths. The patients had higher interface pressure during load than the healthy individuals, but there were no significant differences in blood flow. Twenty-nine subjects in all three study groups were identified with a lack of pressure-induced vasodilatation and reactive hyperemia.CONCLUSIONS: pressure-induced vasodilatation and reactive hyperemia can be measured at different tissue depths. A lack of these responses was found in healthy individuals as well as in patients indicating an innate susceptibility in some individuals, and are potential important factors to evaluate in order to better understand the etiology of pressure ulcers.
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| 45. |
- Bergstrand, Sara, 1978-
(författare)
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Preventing pressure ulcers by assessment of the microcirculation in tissue exposed to pressure
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to combine optical methods into a system with the ability to simultaneously measure blood flow changes at different tissue depths. The goal of such a system was to reveal vascular mechanisms relevant to pressure ulcer etiology under clinically relevant conditions and in relation to the evaluation of pressure-redistribution support surfaces.This thesis consists of four quantitative, cross-sectional studies measuring blood flow responses before, during, and after pressure exposure of the sacral tissue. Two optical methods – photoplethysmography and laser Doppler flowmetry – were combined in a newly developed system that has the ability to discriminate blood flows at different tissue depths. Studies I and II explored blood flow responses at different depths in 17 individuals. In Study I the blood flow was related to tissue thickness and tissue compression during pressure exposure of ≥ 220 mmHg. In Study II, the sacral tissue was loaded with 37.5 mmHg and 50.0 mmHg, and the variation in blood flow was measured. Studies III and IV included 42 healthy individuals < 65 years, 38 healthy individuals ≥ 65 years, and 35 patients ≥ 65 years. Study III included between-subject comparisons of blood flow and pressure between individuals in the three study groups lying in supine positions on a standard hospital mattress. Study IV added within-subject comparisons while the individual was lying on four different types of mattress. The studies explored the vascular phenomena pressure-induced vasodilation (PIV) and reactive hyperemia (RH).The most common blood flow response to tissue exposure in this thesis was PIV, although a decrease in blood flow (a lack of PIV) was observed in some individuals. The patients tended to have higher interface pressure during pressure exposure than the healthy groups but no differences in blood flow responses were seen. Our results showed that pressure levels that are normally considered to be harmless could have a significant effect on the microcirculation in different tissue structures. Differences in individual blood flow responses in terms of PIV and RH were seen, and a larger proportion of individuals lacked these responses in the deeper tissue structures compared to more superficial tissue structures.This thesis identified PIV and RH that are important vascular mechanisms for pressure ulcer development and revealed for the first time that PIV and RH are present at different depths under clinically relevant conditions. The thesis also identified a population of individuals not previously identified who lack both PIV and RH and seem to be particularly vulnerable to pressure exposure. Further, this thesis has added a new perspective to the microcirculation in pressure ulcer etiology in terms of blood flow regulation and endothelial function that are anchored in clinically relevant studies. Finally, the evaluation of pressureredistribution support surfaces in terms of mean blood flow during and after tissue exposure was shown to be unfeasible, but the assessment of PIV and RH could provide a new possibility for measuring individual physiological responses that are known to be related to pressure ulcer development.
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| 46. |
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| 47. |
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| 48. |
- Bergstrand, Sara, 1978-
(författare)
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Tissue Blood Flow Responses to External Pressure Using LDF and PPG : Testing a System Developed for Pressure Ulcer Research
- 2009
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Pressure ulcers are a problem for immobile individuals, and having pressure ulcers impact and restrict the daily and are often associated with pain. Pressure ulcers occur frequently and cause high costs for the health care system. The prevention of pressure ulcers by focussing on different mattresses and overlays aimed to reduce the interface pressure or the pressure exposure of the tissue. The problem is the poor evaluation of this type of equipment. There are important factors regarding pressure ulcer development, pressure, shear, temperature and humidity. People are affected by external pressure in different ways and therefore it is preferable to measure the effect of pressure as a complement to the pressure measurement and thus we consider blood flow measurements to be a suitable method.Aims: The aim of Study I, the first part in this thesis was to investigate the existence of sacral tissue blood flow at different depths in response to external pressure in elderly individuals as a part of evaluation of a. newly developed system. The aim of Study II, the second part was to evaluate a multiparametric system combining LDF and photoplethysmography into a single probe, for the simultaneous measurement of blood flow at different depths in the sacral tissue when the tissue is exposed to external load. This new system will be used to facilitate the understanding of pressure ulcer formation.Methods: To be able to observe tissue blood flow, the non-invasive optical methods laser Doppler flowmetry and photoplethysmography were used. In this thesis a newly developed prototype probe was used, combining the two methods. Green light and infrared light were used in the PPG instrument for penetrating the depths of approximately 2 mm, 8 mm and 20 mm depths. A HeNe laser was used to measure the superficial skin blood flow, <1 mm depth. The prototype probe, made of silicone was fixed in a stiff 10×10 cm plate.Seventeen active individuals over the age of 60 were recruited for the two studies. In Study I, the subject´s sacral blood flow and tissue thickness (using ultrasound) were measured in unloaded position and in supine position loading the area with their own body weight. In Study II, the sacral area was provoked with external load at 37.5 mmHg and 50.0 mmHg and the relative change in blood flow at different depths was observed before, during and after load.Results: Study I showed that the sacral tissue in elderly individuals is highly affected by load and is compressed by 60.3 ± 11.9%. The mean sacral tissue thickness was 26 ± 13 mm in unloaded tissue and 10 ± 6 mm in loaded tissue. Correlations were found between BMI and tissue thickness: both TTunload r=0.68 (p=0.003) and TTload r=0.68 (p=0.003). Almost all subjects had affected blood flow superficially but only occasionally deeper in the tissue and findings may indicate that the blood flow is occluded in the superficial layer before it is occluded deeper in the tissue structure. The most common response in Study II was an increase in blood flow while loading. In those occasions when the blood flow decreased, it was mostly affected at the skin surface and the reactive hyperaemia occurred more frequently in the superficial tissue structures. The blood flow responses may be different in the different tissue layers.Conclusions: The newly developed system was found to be suitable for measuring tissue blood flow at different depths; however the prototype probe had some limitations that will be solved in the further development of the system into a thin flexible probe with ability to measure a larger area.
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| 49. |
- Bermon, Stephane, et al.
(författare)
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Lifetime Prevalence of Verbal, Physical, and Sexual Abuses in Young Elite Athletics Athletes
- 2021
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Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media SA. - 2624-9367. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- To examine prevalence of verbal, physical, and sexual abuses in young elite athletes, a cross sectional questionnaire-based survey was conducted during the World Athletics under 20 World Championships. This questionnaire aimed at distinguishing between abuses perpetrated in the context of Athletics from those which were unrelated to Athletics. Four hundred and eighty athletes (52.3%, male) from North America, South America, Europe, Africa, Asia, and Oceania took part in the electronic anonymous survey. Outside Athletics setting, no gender difference was found for the prevalence of verbal, physical, and sexual abuses. However, 45 males (18% of the male population) and 34 females (15% of the female population) athletes reported sexual abuse. Asian athletes reported a slightly higher rate of sexual abuse; three quarters of them being non-touching abuses. Inside Athletics setting, no gender difference was found for the prevalence of verbal, physical, and non-touching sexual abuses. However, 58 males (23%) and 47 females (21%) reported verbal abuses. Thirty-one males (12%) and 20 females (9%) reported physical abuses, whereas 30 males (12%) and 17 females (7%) reported sexual abuses. Physical abuses were slightly more frequent in Asia and in Africa and less frequent in South America. Sexual abuses inside Athletics also differed over regions, and were unexpectedly twice more frequent than expected in Asia and slightly less frequent than expected in Europe. Friends and partners were identified as the more frequent (> 50%) abusers outside or inside the Athletics settings, whereas outside Athletics and inside Athletics, coaches were identified as sexual abuse perpetrators in 8 and 25% of cases, respectively. The prevalence of verbal, physical, or sexual abuses is high but consistent with what has been reported in United Kingdom, Norway, Canada, and Sweden at national level in recreational or elite athletes. Sexual abuse, including touching or penetrative abuses, occurred significantly more often in male athletes when compared to female athletes. This finding invites healthcare and social workers, and policymakers to also consider the risk of sexual abuse of young male athletes in Athletics. These results also call for longitudinal studies on young elite athletes.
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| 50. |
- Berntsson, Tommy, et al.
(författare)
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Ambulanssjukvården måste bli jämlik
- 2013
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Ingår i: Helsingborgs Dagblad. - Helsingborg : Helsingborgs Dagblad. - 1103-9388. ; 2013-06-17
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Skiftande vårdkvalité hotar patientsäkerheten inom ambulanssjukvården. Nu måste regeringen och Socialstyrelsen skapa nationella riktlinjer, skriver Nätverket för utbildning av ambulanssjuksköterskor .
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