1. |
- Gad, Helge, et al.
(författare)
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MTH1 inhibition eradicates cancer by preventing sanitation of the dNTP pool
- 2014
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Ingår i: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 508:7495, s. 215-221
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Tidskriftsartikel (refereegranskat)abstract
- Cancers have dysfunctional redox regulation resulting in reactive oxygen species production, damaging both DNA and free dNTPs. The MTH1 protein sanitizes oxidized dNTP pools to prevent incorporation of damaged bases during DNA replication. Although MTH1 is non-essential in normal cells, we show that cancer cells require MTH1 activity to avoid incorporation of oxidized dNTPs, resulting in DNA damage and cell death. We validate MTH1 as an anticancer target in vivo and describe small molecules TH287 and TH588 as first-in-class nudix hydrolase family inhibitors that potently and selectively engage and inhibit the MTH1 protein in cells. Protein co-crystal structures demonstrate that the inhibitors bindin the active site of MTH1. The inhibitors cause incorporation of oxidized dNTPs in cancer cells, leading to DNA damage, cytotoxicity and therapeutic responses in patient-derived mouse xenografts. This study exemplifies the non-oncogene addiction concept for anticancer treatment and validates MTH1 as being cancer phenotypic lethal.
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2. |
- Plaven-Sigray, Pontus, et al.
(författare)
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Dopamine D1 receptor availability is related to social behavior : A positron emission tomography study
- 2014
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Ingår i: NeuroImage. - : Elsevier BV. - 1053-8119 .- 1095-9572. ; 102, s. 590-595
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Tidskriftsartikel (refereegranskat)abstract
- Dysfunctional interpersonal behavior is thought to underlie a wide spectrum of psychiatric disorders; however, the neurobiological underpinnings of these behavioral disturbances are poorly understood. Previous molecular imaging studies have shown associations between striatal dopamine (DA) D2-receptor binding and interpersonal traits, such as social conformity. The objective of this study was to explore, for the first time, the role of DA D1-receptors (D1-Rs) in human interpersonal behavior. Twenty-three healthy subjects were examined using positron emission tomography and the radioligand [C-11] SCH23390, yielding D1-R binding potential values. Striatal D1-R binding was related to personality scales selected to specifically assess one dimension of interpersonal behavior, namely a combination of affiliation and dominance (i.e., the Social Desirability, Verbal Trait Aggression and Physical Trait Aggression scales from Swedish Universities Scales of Personality). An exploratory analysis was also performed for extrastriatal brain regions. D1-R binding potential values in the limbic striatum(r= .52; p= .015), associative striatum(r= .55; p= .009), and sensorimotor striatum(r= .67; p= .001) were positively related to Social Desirability scores. D1-R binding potential in the limbic striatum (r= -.51; p = .019) was negatively associated with Physical Trait Aggression scores. For extrastriatal regions, Social Desirability scores showed positive correlations in the amygdala (r = .60; p = .006) and medial frontal cortex (r= .60; p = .004). This study provides further support for the role of DA function in the expression of disaffiliative and dominant traits. Specifically, D1-R availability may serve as a marker for interpersonal behavior in humans. Associations were demonstrated for the same dimension of interpersonal behavior as for D2-R, but in the opposite direction, suggesting that the two receptor subtypes are involved in the same behavioral processes, but with different functional roles.
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3. |
- Andersson, J., et al.
(författare)
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Worse survival for TP53 (p53)-mutated breast cancer patients receiving adjuvant CMF
- 2005
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Ingår i: Ann Oncol. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 16:5, s. 743-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: TP53 has been described as a prognostic factor in many malignancies, including breast cancer. Whether it also might be a predictive factor with reference to chemo- and endocrine therapy is more controversial. PATIENTS AND METHODS: We investigated relapse-free (RFS), breast cancer-corrected (BCCS) and overall survival (OS) related to TP53 status in node-positive breast cancer patients that had received polychemotherapy [cyclophosphamide, methotrexate, 5-fluorouracil (CMF)] and/or endocrine therapy (tamoxifen). Sequence analyses of the whole TP53 coding region was performed in 376 patients operated on for primary breast cancer with axillary lymph node metastases between 1984 and 1989 (median follow-up time 84 months). RESULTS: TP53 mutations were found in 105 patients (28%). We found 90 (82%) of the 110 mutations in the more frequently analysed exons 5-8, while the other 20 (18%) were located in exons 3-4 and 9-10, respectively. Univariate analyses showed TP53 to be a significant prognostic factor with regard to RFS, BCCS and OS in patients who received adjuvant CMF. CONCLUSIONS: TP53 mutations might induce resistance to certain modalities of breast cancer therapy. Sequence-determined TP53 mutation was of negative prognostic value in the total patient population and in the CMF treated patients.
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4. |
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5. |
- Andreasson, Thomas, et al.
(författare)
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Evaluation of anamnestic criteria for the identification of patients with acute community onset viral gastroenteritis in the emergency department-A prospective observational study.
- 2014
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Ingår i: Scandinavian journal of infectious diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548. ; 46:8, s. 561-565
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Tidskriftsartikel (refereegranskat)abstract
- Background: To our knowledge no clinical criteria for the identification of community onset viral gastroenteritis in individual patients have been evaluated systematically with modern PCR-based diagnostic assays as gold standard. Objective: The aim of this study was to identify factors independently associated with the detection of virus by PCR in rectal swab samples from patients with acute community onset gastroenteritis. Methods: A prospective observational study was conducted from December 2010 through March 2011 at the emergency department (ED) of a large teaching hospital. All patients who reported vomiting and/or diarrhoea up to 48 h prior to their visit to the ED were asked to participate. A rectal swab sample was obtained from each patient. Symptoms, date of onset, and epidemiological data were recorded. Samples were analysed with a multiple real-time PCR targeting 6 viral agents (astrovirus, adenovirus, rotavirus, sapovirus, and norovirus GI and GII). Results: Two hundred and five patients fulfilled the inclusion criteria, of whom 66 agreed to participate; their median (IQR) age was 65 (38-84) y and 43 (65%) were females. Thirty-one (47%) were positive by PCR for at least 1 of the agents examined (26 norovirus, 2 sapovirus, 2 rotavirus, and 1 adenovirus). Diarrhoea and a short duration of symptoms (≤ 2 days) were independently associated with a positive rectal swab sample, with odds ratios of 7.5 (95% confidence interval (CI) 2.0-28) and 10.4 (95% CI 1.9-56), respectively (p < 0.01 for both). A multivariate model including these 2 variables had a sensitivity of 81% (25/31) and a specificity of 69% (24/35). Conclusions: Diarrhoea and a short duration of symptoms were the only anamnestic criteria independently associated with acute community onset viral gastroenteritis confirmed by PCR.
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6. |
- Andreen, Niklas, et al.
(författare)
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Mortality of COVID-19 is associated with comorbidity in patients with chronic obstructive pulmonary disease
- 2022
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Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 54:7, s. 508-513
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim of this study was to compare the outcome of coronavirus disease 2019 (COVID-19) in hospitalised patients with chronic obstructive pulmonary disease (COPD) with the outcome in matched COVID-19 patients without COPD. Methods Sixty-three COPD patients hospitalised for acute COVID-19 from March through August 2020 were retrospectively identified and 63 hospitalised COVID-19 patients without COPD were selected and matched for age, gender and month of hospital admission. Results COPD patients had a higher rate of comorbidities, especially cardiovascular disease, and a trend towards a higher 30-day mortality than control patients (35% vs. 22%). In the COPD group, high Charlson comorbidity index (p = 0.03) and previous cerebrovascular disease (p = 0.04) were associated with 30-day mortality in univariate analysis. Inhaled corticosteroids maintenance therapy was not associated with lower mortality. Conclusion COPD patients hospitalised for acute COVID-19 disease had significantly more comorbidities and a high risk of severe outcome and death within 30 days. Comorbidity, especially cardiovascular diseases, was associated with mortality among COPD patients.
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7. |
- Andrén, Niclas, et al.
(författare)
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Euron och konkurrens mellan EU-länder
- 2002
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Ingår i: Europaperspektiv 2002. Årsbok för Europaforskning. - 9189449274 ; , s. 73-104
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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8. |
- Arvidsson, Eva, 1959-, et al.
(författare)
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Vägen framåt
- 2013
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Ingår i: Att välja rättvist. - Lund : Studentlitteratur AB. ; , s. 207-214
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Som vi visat har utvecklingen av metoder och strukturer för öppna prioriteringar i Sverige kommit långt. Många frågor återstår likväl. Under vårt arbete med denna bok har vi identifierat ett antal förbättringsområden och utmaningar som vi avslutningsvis vill lyfta fram. Det rör sig om vilka som ska delta i prioriteringarna, tydliggörande av värdegrunden, behov av bättre kunskap, baserad på både vetenskaplig metod och erfarenhet, och fortsatt utveckling av prioriteringsprocesser på olika nivåer och i olika sammanhang. Även om vi i Sverige skulle nå en god enighet kring principer och kriterier för prioriteringar så kommer vi alltid finna många olika sätt att praktiskt lösa specifika prioriteringsproblem.
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9. |
- Beck-Friis, Thomas, et al.
(författare)
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Burden of rotavirus infection in hospitalized elderly individuals prior to the introduction of rotavirus vaccination in Sweden
- 2019
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Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532. ; 119, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Rotavirus gastroenteritis (GE) in the elderly has been much less studied than in children. Objectives: The aim of this study was to determine the morbidity and mortality for elderly hospitalized patients with rotavirus GE prior to the introduction of rotavirus vaccination in Sweden, and to investigate the epidemiology of rotavirus genotypes in these patients. Study design: All patients 60 years or older who were hospitalized at Sahlgrenska University Hospital, Gothenburg, Sweden, and were rotavirus positive in a clinical diagnostic test from 2009 to 2016, were included. Medical records were reviewed and rotavirus genotyping real-time PCR was performed. Results: One hundred and fifty-nine patients were included, corresponding to an annual incidence of hospitalization due to rotavirus GE of 16/100 000 inhabitants aged 60 years or older. G2P[4] was the most common genotype, followed by G1P[8] and G4P[8]. The majority of patients had community-onset of symptoms and no or few pre-existing health disorders. Four patients (2.5%) died within 30 days of sampling. Patients with hospital-onset rotavirus GE had a longer median length of stay following diagnosis compared with patients with community-onset of symptoms (19 vs. 5 days, p = 0.001) and higher 30-day mortality (8.6% (3/35) vs. < 1% (1/124), p = 0.03). Conclusions: Hospitalization due to rotavirus GE among the elderly seems to mainly affect otherwise healthy individuals and is associated with low 30-day mortality.
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10. |
- Beck-Friis, Thomas, et al.
(författare)
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Outdoor Absolute Humidity Predicts the Start of Norovirus GII Epidemics
- 2023
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Ingår i: Microbiology Spectrum. - : American Society for Microbiology. - 2165-0497. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Seasonal variation of viral gastroenteritis is related to weather conditions, but the relationship with the incidence of viral gastroenteritis (GE) is not fully understood. This study examined the impact of outdoor climate factors on seasonal variation in detection rates of gastroenteritis viruses, with emphasis on norovirus. Weekly detection rates of norovirus genogroup I (GI) and II (GII), rotavirus, adenovirus, astrovirus, and sapovirus were analyzed in relation to average weekly means of meteorological parameters. Associations between rates of PCR detection of the viral GE pathogens and climate factors were investigated with generalized linear models. Low absolute humidity was correlated with increased detection of adenovirus (P = 0.007), astrovirus (P = 0.005), rotavirus (P = 0.004), norovirus GI (P = 0.001), and sapovirus (P = 0.002). In each investigated season, a drop in absolute humidity preceded the increase in norovirus GII detections. We found a correlation between declining absolute humidity and increasing norovirus GII detection rate. Absolute humidity was a better predictor of gastrointestinal virus seasonality compared to relative humidity.IMPORTANCE Viral gastroenteritis causes considerable morbidity, especially in vulnerable groups such as the elderly and chronically ill. Predicting the beginning of seasonal epidemics is important for the health care system to withstand increasing demands. In this paper we studied the association of outdoor climate factors on the detection rates of gastrointestinal viruses and the association between these factors and the onset of annual norovirus epidemics. Declining absolute humidity preceded the increase in diagnosed norovirus GII cases by approximately 1 week. These findings contribute to the understanding of norovirus epidemiology and allow health care services to install timely preventive measures and can help the public avoid transmission. Viral gastroenteritis causes considerable morbidity, especially in vulnerable groups such as the elderly and chronically ill. Predicting the beginning of seasonal epidemics is important for the health care system to withstand increasing demands.
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11. |
- Bergbrant, Susanna, et al.
(författare)
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Syndromic testing for respiratory pathogens but not National Early Warning Score can be used to identify viral cause in hospitalised adults with lower respiratory tract infections
- 2024
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Ingår i: INFECTIOUS DISEASES. - 2374-4235 .- 2374-4243. ; 56:7
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCommunity-acquired lower respiratory tract infection (LRTI) is a common reason for hospitalisation. Antibiotics are frequently used while diagnostic microbiological methods are underutilised in the acute setting.ObjectivesWe aimed to investigate the relative proportion of viral and bacterial infections in this patient group and explore methods for proper targeting of antimicrobial therapy.MethodsWe collected nasopharyngeal samples prospectively from adults hospitalised with LRTIs during three consecutive winter seasons (2016-2019). Syndromic nasopharyngeal testing was performed using a multiplex PCR panel including 16 viruses and four bacteria. Medical records were reviewed for clinical data.ResultsOut of 220 included patients, a viral pathogen was detected in 74 (34%), a bacterial pathogen in 63 (39%), both viral and bacterial pathogens in 49 (22%), while the aetiology remained unknown in 34 (15%) cases. The proportion of infections with an identified pathogen increased from 38% to 85% when syndromic testing was added to standard-of-care testing. Viral infections were associated with a low CRP level and absence of pulmonary infiltrates. A high National Early Warning Score did not predict bacterial infections.ConclusionsSyndromic testing by a multiplex PCR panel identified a viral infection or viral/bacterial coinfection in a majority of hospitalised adult patients with community-acquired LRTIs.
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12. |
- Bergström, Anna, et al.
(författare)
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Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings
- 2015
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Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.
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13. |
- Bernfort, Lars, et al.
(författare)
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Disease Burden and Healthcare Costs for T2D Patients With and Without Established Cardiovascular Disease in Sweden: A Retrospective Cohort Study
- 2020
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Ingår i: Diabetes Therapy. - : SPRINGER HEIDELBERG. - 1869-6953 .- 1869-6961. ; 11:7, s. 1537-1549
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionType 2 diabetes (T2D) is a complex chronic disease with an increasing prevalence worldwide. It is commonly associated with complications, such as cardiovascular disease (CVD). Patients with both T2D and established CVD are exposed to increased risk of further cardiovascular events, which means increased healthcare costs and impairments to quality of life and survival. To determine the added burden of CVD for T2D patients, we have analyzed the consumption and costs of healthcare and mortality in two T2D patient cohorts, with and without established CVD, respectively, during a 5-year follow-up in a Swedish region.MethodsPatients with T2D on 1 January 2012 were identified using the administrative database of Region ostergotland and the Swedish National Diabetes Register. Established CVD was defined as the presence of a CVD-related healthcare visit in the period 2002-2011. Identified T2D patients were then followed retrospectively for 5 years (2012-2016) and data collected on utilization of healthcare resources, healthcare costs, and survival. Data pertinent to the study were retrieved from regional databases and national registries.ResultsOn the index date (1 January 2012) there were 19,731 patients with T2D (prevalence 4.5%) in Region ostergotland, of whom 5490 had established CVD. Those patients with established CVD were older, more often men, and had longer diabetes duration and worse kidney function than those without. Compared to T2D patients without CVD, those with CVD had a significantly higher healthcare consumption, experienced higher costs, and had lower survival during the follow-up.ConclusionThis study confirms that established CVD is common among patients with T2D (approximately 30%). Established CVD has negative effects on the utilization of healthcare resources, healthcare costs, and mortality. It is therefore very important to improve the treatment strategy of this patient group.
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14. |
- Bernfort, Lars, et al.
(författare)
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Implementation of Empagliflozin in Patients with Diabetes Mellitus Type 2 and Established Cardiovascular Disease : Estimation of 5-Year Survival and Costs in Sweden
- 2020
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Ingår i: Diabetes Therapy. - : Springer Berlin/Heidelberg. - 1869-6953 .- 1869-6961. ; 11, s. 2921-2930
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionCardiovascular disease (CVD) affects approximately 30% of patients with diabetes mellitus type 2 (T2D) and leads to increased morbidity, decreased survival and increased healthcare utilization. The aim of this study was to estimate the impact of treating these patients with the sodium–glucose cotransporter 2 (SGLT2) inhibitor empagliflozin on survival and healthcare utilization.MethodsActual survival and healthcare utilization data from a 5-year retrospective cohort study on patients with T2D and CVD in the Region of Östergötland, Sweden were used as a starting point. Actual data were adjusted in accordance with risk reductions for mortality and CV events related to empagliflozin treatment as reported in the EMPA-REG OUTCOME study.ResultsApplying the risk reductions related to empagliflozin treatment on the cohort of patients with T2D and CVD in Östergötland resulted in an increase in 5-year survival of 96 days per patient and reduced costs for healthcare and drugs other than empagliflozin. Including the cost of empagliflozin, treatment led to an increased net cost per patient of approximately SEK 18,000 over 5 years.ConclusionEmpagliflozin treatment would reduce mortality and healthcare utilization in the patient group. The treatment strategy should be considered cost-effective, supporting a broad implementation of empagliflozin for patients with T2D and established CVD, in line with current national and international guidelines.
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15. |
- Czarniawska, Barbara, 1948, et al.
(författare)
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Organisering kring hot och risk
- 2007
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Hur hanteras blödarfeberviruset Marburg, hur förbereder man sig för ett eventuellt utbrott av fågelinfluensan, hur kalkylerar man hälsorisker i Europa och Sverige och hur hanterar man risk i samband med äventyrsturism? Vad har stormen Gudrun lärt oss om att hantera akuta situationer och hur skapar katastrofer som Tjörnbron handlingsföreträde i form av särskilda förutsättningar för organisering? Detta är några exempel på studier inkluderade i Organisering kring hot och risk. Boken tittar även närmare på hur man hanterar effekter av datorkriser, hur konst och vad betraktaren bedömer som hot kan bidra till skapande av handlingsnät samt hur tv-serien Kommissionen belyser det svenska beredningsarbetet. Författarna visar att karaktären av organisering kring hot och risk är beroende av tidpunkten: innan, under eller efter en katastrof eller en hotfull händelse. Beredningsarbetet består av resursmobilisering, att skissa planer, att bygga upp strukturer samt bygga eller mobilisera nätverk. När katastrofen väl inträffar visar det sig dock att även de bästa planer inte alltid fungerar som man vill och responsen på de faktiska händelserna består av improvisation samt av att bygga handlingskedjor och handlingsnät. Det finns inget recept på hur man skall organisera kring hot och risk men boken har identifierat ett återkommande problem: varje misslyckande verkar leda till slutsatsen att det behövs mer av planer och strukturer. Författarna hävdar motsatsen. Bokens budskap är att istället för att skapa oändliga planer och strukturer skall man öva lämpliga skickligheter och improvisationsförmåga. Boken vänder sig till studerande inom organisationsteori respektive riskhantering på universitet och högskola samt yrkesverksamma inom krisberedskap och riskhantering.
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16. |
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17. |
- Erlandsson, Martin, et al.
(författare)
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PCR guide for construction products and works - Specifications to and evaluation of EN 15804
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The main question handled in the project ‘Robust LCA’ is how to use LCA for a robust comparison of construction products or any construction works. The project is divided into two parts where the first part deals with a general introduction to methodology problems related to LCA and what we here call ‘choice of system perspective’. The latter aspect deals with the question when to use to use attributional or consequential LCA. An LCA typology is developed in this part of the project, where different ISO 14044 methodologies are classified. The typology also deals with what question these different methodologies address. The second part of the project, given in this report, deals with commonly methodology aspects that are important to find consensus about. These methodical aspects selected and handled here are based on a workshop result. Already existing standards is used as a baseline to describe the current best common practice. The main LCA methodology used as basis for this work is EN 15804, a so call ‘core PCR’, (product category rules) for all constructions products. However, since the common goal within an LCA case study is to use a harmonized method in the entirely study, such PCR are valid for all products and services used in the life cycle of any construction works. For instance, this implies that the impact from different energy wares is to be handled with the same methodology as used for the construction products. This PCR guide includes specifications to EN 15804, as well as the potential development for aspects that are not handled in this standard today. The outlined suggestions and recommendations are the result of a series of workshops, with delegates from different parties within the Swedish building material, construction and real estate sector, including civil engineering work. The PCR guides have been subject to an open consultation that was closed on the 20th of October 2013, where all parties have had the possibility to put forward their opinions. The final recommendation in this report is based on a common understanding within the project group and takes into account the submitted written contributions to the open consultation (version dated 2013-09-18). The recommendation therefore describes the current consensus in the Swedish group participating in this project. Moreover, the PCR Guide was also sent to some EPD program operators (EPD Norway, International EPD system, Institut Bauen und Umwelt (Germany)) and the working group behind EN 16485. This was done to create an opportunity to bring forward dissenting opinion to the specifications given here. Please note that this report shall not be regarded as a PCR, but as an inspiration for future development of such work.
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18. |
- Gustavsson, Catharina, 1961-, et al.
(författare)
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Process evaluation of an implementation intervention to facilitate the use of the Swedish Physical Activity on Prescription in primary healthcare.
- 2023
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Swedish Physical Activity on Prescription (PAP-S) is a method for healthcare to promote physical activity for prevention and treatment of health disorders. Despite scientific support and education campaigns, the use has been low. The aim of this study was to perform a process evaluation of an implementation intervention targeting the use of the PAP-S method in primary healthcare (PHC). Specifically, we wanted to evaluate feasibility of the implementation intervention, and its effect on the implementation process and the outcome (number of PAP-S prescriptions).METHODS: This was a longitudinal study using the Medical Research Council guidance for process evaluation of a 9-month implementation intervention among healthcare staff at three PHC centres in Sweden. Data was collected by: participatory observations of the implementation process; questionnaires to the staff before, after and 6 months after the implementation intervention; interviews after the implementation intervention; and number of PAP-S prescriptions.RESULTS: During the implementation intervention, the workplaces' readiness-to-change and the healthcare staff's confidence in using the PAP-S method were favourably influenced, as was the number of PAP-S prescriptions. After the implementation intervention, the number of PAP-S prescriptions decreased to about the same number as before the implementation intervention, at two out of three PHC centres. Four of the six implementation strategies appeared to impact on the implementation process: external facilitation; leadership engagement by a committed workplace management; local PAP-S coordinator taking a leading role and acting as local champion; educational outreach concerning how to use the PAP-S method.CONCLUSION: The implementation intervention was not sufficient to produce sustained change of the healthcare staff's behaviour, nor did it achieve favourable long-term outcome on the number of PAP-S prescriptions. The healthcare staffs' sparse knowledge of the PAP-S method prior to the implementation intervention hampered the implementation. More hands-on education in how to use the PAP-S method introduced early in the implementation process is imperative for successful implementation of the PAP-S method. The findings also suggest that committed workplace management and local PAP-S coordinators, taking leading roles and acting as local champions, need to be firmly established at the PHC centres before the external facilitator withdraws.TRIAL REGISTRATION: Registered in the ISRCTN registry with study registration number: ISRCTN15551042 (Registration date: 12/01/2016).
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19. |
- Gustavsson, Catharina, et al.
(författare)
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What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare.METHODS: Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis.RESULTS: We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling.CONCLUSION: The study provides knowledge regarding requirements to facilitate the implementation of SPAP in healthcare. There was limited knowledge among health professionals regarding core components of SPAP and how to practise the method, which speaks for in-depth training in the SPAP method. The findings highlight the importance of forming policies and guidelines and establishing organisational supporting structures, and ensuring that these are well known and approved in all parts of the healthcare organisation.
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20. |
- Gustavsson, Eva, 1970, et al.
(författare)
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Min plats i biosfären
- 2019
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- “Min plats i biosfären” är en skrift som presenterar forskningsresultat om vilken roll kulturmiljön och de kulturella ekosystemtjänsterna kulturarv och platsidentitet har för människors välbefinnande och för hållbar landskapsförvaltning inom Biosfärområde Vänerskärgården med Kinnekulle. Resultaten i skriften baseras på forskningsprojektet “Kulturmiljö och kulturarv som en del av hållbar landskapsförvaltning” och har genomförts av forskare vid Göteborgs universitet och Högskolan i Gävle.
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21. |
- Gustavsson, Lars, et al.
(författare)
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Excess mortality following community-onset norovirus enteritis in the elderly.
- 2011
-
Ingår i: The Journal of hospital infection. - : Elsevier BV. - 1532-2939 .- 0195-6701. ; 79:1, s. 27-31
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Tidskriftsartikel (refereegranskat)abstract
- Norovirus has been associated with excess deaths. A retrospective study of mortality following norovirus enteritis (NVE) was undertaken. All hospitalized adult patients with a stool sample positive for norovirus genogroup II on polymerase chain reaction, treated at Sahlgrenska University Hospital, Gothenburg, Sweden between August 2008 and June 2009, were included as cases (N=598, aged 18-101 years). Matched controls without enteritis (N=1196) were selected for comparison. Medical records were reviewed and deaths up to 90 days following positive sampling were noted, as well as comorbidities and length of hospital stay. Thirty- and 90-day survival rates were calculated. Total 30-day mortality was 7.6% and no deaths were recorded in cases aged 18-59 years. Thirty-day mortality was higher in cases with underlying medical conditions compared with those without these comorbidities (age 60-101 years: 89.5% vs 94.7% alive at Day 30, respectively; P<0.05). In cases aged >80 years, mortality was higher in those with community-onset NVE (N=64) compared with hospital-onset NVE (N=305) (81.2% vs 90.2% alive at Day 30, respectively; P<0.05), and compared with controls (N=128) (81.2% vs 91.4% alive at Day 30, respectively; P<0.05). Median length of hospital stay was 20 [interquartile range (IQR) 12-29] days for cases with hospital-onset NVE, and seven (IQR 2-13) days for controls (P<0.001). In conclusion, community-onset NVE requiring hospitalization was associated with higher mortality compared with hospital-onset NVE and matched controls in hospitalized elderly patients.
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22. |
- Gustavsson, Lars, et al.
(författare)
-
Low serum levels of CCL5 are associated with longer duration of viral shedding in norovirus infection
- 2015
-
Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532. ; 69, s. 133-137
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Tidskriftsartikel (refereegranskat)abstract
- Background: The mechanisms that determine the duration of fecal shedding of norovirus in humans have not been described in detail. Objectives: We investigated serum inflammatory mediator levels in relation to the duration of viral shedding in norovirus infection. Study design: A prospective cohort study of patients hospitalized with acute norovirus genogroup II infection. Rectal swab samples were obtained at inclusion and day 7, 14, 21 and 28. Serum levels of 42 inflammatory mediators were determined with a Luminex-based cytokine assay. Sera from 20 healthy blood donors served as controls. Results: Altogether, 28 patients (54% women, median age 83 years, median duration of symptoms 3 days) were included. Twelve subjects cleared the virus within 14 days and 16 were norovirus-RNA positive for >21 days, constituting the two study groups ("rapid" vs. "slow" clearance). Individuals with norovirus infection had higher levels of IL-18, CXCL9, CXCL10, soluble IL-2 receptor and macrophage migration inhibitory factor (MIF), compared to controls (p < 0.05), with the highest median concentrations in the slow clearance group. In contrast, CCL5 levels were lower in the slow compared to the rapid clearance group (median 54 vs. 134 ng/mL, p < 0.05), and lower in norovirus-infected patients than in controls. Conclusion: Low levels of CCL5 were associated with longer duration of viral shedding, suggesting that CCL5 may influence the clearance of norovirus. (C) 2015 Elsevier B.V. All rights reserved.
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23. |
- Gustavsson, Lars, et al.
(författare)
-
Rectal swabs can be used for diagnosis of viral gastroenteritis with a multiple real-time PCR assay.
- 2011
-
Ingår i: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. - : Elsevier BV. - 1873-5967. ; 51:4, s. 279-82
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Tidskriftsartikel (refereegranskat)abstract
- Viral agents, especially norovirus, are the most common cause of nosocomial spread of epidemic gastroenteritis (GE). Rapid and reliable detection of these agents could reduce the risk of outbreaks.
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24. |
- Gustavsson, Lars, et al.
(författare)
-
Rectal swabs can be used for diagnosis of viral gastroenteritis with a multiple real-time PCR assay
- 2011
-
Ingår i: Journal of Clinical Virology. - 1386-6532. ; 51, s. 275-278
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Viral agents, especially norovirus, are the most common cause of nosocomial spread of epidemic gastroenteritis (GE). Rapid and reliable detection of these agents could reduce the risk of outbreaks. Objective: To evaluate the diagnostic performance of rectal swab samples compared to standard stool samples for detection of agents causing viral GE by PCR. Study design: Complete pairs of rectal swab and stool samples, obtained simultaneously from patients with symptoms of acute onset GE, were analysed with a multiple real-time PCR targeting six different gastroenteritis agents (astro-, adeno-, rota-, sapo- and norovirus GI and II). Cycle threshold (Ct) values were registered for positive samples. A positive PCR result in either sample for any virus was considered gold standard. Results: 69 sample pairs were included of which 29 were negative in both sample types and 38 were positive in both sample types. One pair was positive in the stool sample only and another pair was positive in the rectal swab sample only. Sensitivity for both sample types was 97.5% (39/40). Conclusion: Rectal swab samples are as reliable as stool samples for PCR-based diagnosis of viral gastroenteritis in patients with a short duration of symptoms and may be used as a complement to stool samples, especially when immediate sampling is desirable.
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25. |
- Gustavsson, Lars, et al.
(författare)
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Slow Clearance of Norovirus following Infection with Emerging Variants of Genotype GII.4 Strains.
- 2017
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Ingår i: Journal of clinical microbiology. - 1098-660X. ; 55:5, s. 1533-1539
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Tidskriftsartikel (refereegranskat)abstract
- The emergence of new norovirus genotype GII.4 strains is associated with widespread norovirus epidemics. Extended periods of viral shedding can contribute to the epidemic potential of norovirus. To describe the duration of viral shedding in infections with novel emerging GII.4 strains versus infections with previously circulating strains, we performed a prospective cohort study of patients hospitalized with norovirus gastroenteritis during separate winter seasons. Rectal swab samples were obtained at the time of inclusion and weekly during follow-ups. The subgenotype strain was determined from capsid sequences. The outcome was defined by the detection of virus for >14 days (slow clearance) or by the detection of negative samples within 14 days (rapid clearance). Two major epidemic GII.4 strains emerged during the study period, GII.4 New Orleans 2009, in 2010, and GII.4 Sydney 2012, in 2012. From these two seasons, sequences were available from 24 cases where the duration of shedding could be determined. The median age of the patients was 83 years and 50% were women. The majority of patients were infected with virus that clustered with the respective season's epidemic strain (n = 19), whereas 5 patients had previously circulating strains (3 were Den Haag 2006b, in 2010, and 2 were New Orleans 2009, in 2012). Among the patients infected with an epidemic strain, the proportion who shed virus for >14 days was significantly higher (16/19 [84%] versus 1/5 [20%], P = 0.01). In summary, a slow clearance of norovirus from stool was more common in infections with novel epidemic GII.4 strains. This suggests that the average duration of shedding may be longer during seasons when new GII.4 strains have emerged.
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26. |
- Gustavsson, Lars, et al.
(författare)
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Venous lactate levels can be used to identify patients with poor outcome following community-onset norovirus enteritis
- 2012
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 44:10, s. 782-787
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Norovirus enteritis (NVE) can be fatal in frail patients. High blood lactate levels indicate hypoperfusion and predict mortality in many infectious diseases. The objective was to determine the frequency and association with mortality of elevated lactate levels in patients with community-onset NVE. Methods: A retrospective cohort study was performed. All hospitalized adult patients with community-onset NVE verified by polymerase chain reaction during the period August 2008 to June 2009 were included. Vital signs and venous lactate on arrival, co-morbid conditions, and time of death were registered. The outcome measure was 30-day all-cause mortality. Results: Eighty-two patients with a median age of 77 y (interquartile range (IQR) 53-86 y) were included, of whom 47 (57%) were female and 49 (60%) had at least 1 major co-morbid condition. Lactate levels were above the upper limit of normal (ULN; 1.6 mmol/l) in 45 patients (55%). The overall 30-day mortality rate was 7% (6/82). Mortality was 18% (5/28) with lactate >= 2.4 mmol/l (> 50% above the ULN) on admission compared to 2% (1/54) with lactate < 2.4 mmol/l (p < 0.05). Patients who died had a higher median lactate level compared to survivors: 4.5 (IQR 2.7-7.9) mmol/l vs 1.7 (IQR 1.3-2.5) mmol/l, respectively (p < 0.01). The adjusted odds ratio for death within 30 days for a 1 mmol/l increase in lactate was 2.5 (95% confidence interval 1.003-6.3, p = 0.049). Conclusions: We observed a high proportion of patients with elevated lactate levels in community-onset NVE. Lactate elevation could predict mortality. Measurement of blood lactate may be a valuable tool in the clinical management of patients with a suspected norovirus infection.
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27. |
- Gustavsson, Per M., et al.
(författare)
-
Learning Priorities and the Role of Computer-Based Training and Simulation on Military Supply Chain Logistics
- 2013
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Konferensbidrag (refereegranskat)abstract
- Military training involves activities that range from combat operations to strategic decisions on how to locate and transport personal and supplies, such as food, ammunition, fuel and medical equipment. Despite of the fact that most military training is difficult to acquire from real situations, the skills required for learning from combat training technology are different from those required for training on military logistics. This research work aims to analyse learning priorities and the role of Computer-Based Training and Simulation (CBTS) on Military Supply Chain Logistics. Military logistics is a complex task that requires expertise for decisions on such factors as: (i) the mission to accomplish; (ii) the place to locate troops and all military facilities at the Area of Operations (AOO); the (iii) combat readiness level that will be expected to equip all the military operations; and the (iv) use of transportation resources and paths to follow in the AOO. In this work, each one of these factors is represented by a number of variables that must be considered as whole to outline the best decisions on supply chain logistics for each military operation. To identify training priorities for considering the implications of all variables that respond for these four factors, this work carried out a qualitative research with in depth interviews with military personal with expertise on making decisions about military logistics. Results from this research shows the skills that are most important to follow for developing expertise on military supply chain logistics and the technology that should best be applied to enhance the training experience. Conclusions from this work shows that training on military logistics involve decisions that are mostly unique, though the current computer-based technology has an important role for training and simulating field situations, thus enhancing the required expertise for making decisions on real military supply chain operations.
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28. |
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29. |
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30. |
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31. |
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32. |
- Hällström, Waldemar, et al.
(författare)
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Gallium phosphide nanowires as a substrate for cultured neurons
- 2007
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Ingår i: Nano Letters. - : American Chemical Society (ACS). - 1530-6992 .- 1530-6984. ; 7:10, s. 2960-2965
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Tidskriftsartikel (refereegranskat)abstract
- Dissociated sensory neurons were cultured on epitaxial gallium phosphide (GaP) nanowires grown vertically from a gallium phosphide surface. Substrates covered by 2.5 mu m long, 50 nm wide nanowires supported cell adhesion and axonal outgrowth. Cell survival was better on nanowire substrates than on planar control substrates. The cells interacted closely with the nanostructures, and cells penetrated by hundreds of wires were observed as well as wire bending due to forces exerted by the cells.
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33. |
- Johansson, Fredrik, et al.
(författare)
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Nanomodified surfaces and guidance of nerve cell processes
- 2008
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Ingår i: Journal of Vacuum Science and Technology B. - : American Vacuum Society. - 1520-8567 .- 1071-1023. ; 26:6, s. 2558-2561
-
Konferensbidrag (refereegranskat)abstract
- Axonal growth and guidance were studied on different micro- and nanostructured surfaces. Nanoimprinted grooves in a polymer, epitaxial III/V nanowires, porous silicon patterns, and chemically altered surfaces were all shown to induce axonal guidance. Neurons were also found to be able to attach and grow on gallium phosphide nanowires without compromising cell survival. The results are important for the construction of a new generation of neuroelectrical interfaces, including high spatial resolution electrodes. The advantages of the different nanostructured surfaces are discussed.
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34. |
- Jönsson, Lars-Eric, et al.
(författare)
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Landsbygdens landskap
- 2010
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Ingår i: Helsingborgs historia. Landsbygden. - 9789163363696 ; 8:1, s. 17-38
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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35. |
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36. |
- Naredi, Peter, 1955, et al.
(författare)
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The influence of hepatic artery ligation and of vasopressin on liver tumour blood flow in rats.
- 1992
-
Ingår i: Journal of surgical oncology. - : Wiley. - 0022-4790 .- 1096-9098. ; 50:2, s. 70-6
-
Tidskriftsartikel (refereegranskat)abstract
- The blood flow in an experimental adenocarcinoma in the rat liver was determined with the 133Xe-washout technique before and after hepatic artery ligation (HAL). There was an initial reduction of the washout of 50%. This was further reduced after 1 day by 50%, which was maintained for 7 days. Seven days after HAL or sham procedures the 133Xe-washout was of similar magnitude in the liver tumours, although after the sham procedure the tumours were larger (3.4 g vs. 1.5 g). The estimated tumour blood flow was then approximately 0.04 ml x min-1 x g-1. The influence on normal liver parenchyma of HAL was a reduction at 30 minutes, which was maintained for 7 days. Postacton--a synthetic vasopressin--did not influence the 133Xe-washout in normal liver parenchyma in non-tumour, as well as in tumour-bearing animals. There was no influence of Postacton on the 133Xe-washout in the liver tumours. Thirty minutes after HAL Postacton gave a reduction of blood flow in normal liver parenchyma of tumour-bearing animals, which is thus only from the portal vein. In tumours Postacton did not significantly reduce the tumour blood flow immediately after HAL.
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37. |
- Popova, Gergana, et al.
(författare)
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Optimization of Tetrahydroindazoles as Inhibitors of Human Dihydroorotate Dehydrogenase and Evaluation of Their Activity and In Vitro Metabolic Stability
- 2020
-
Ingår i: Journal of Medicinal Chemistry. - : American Chemical Society (ACS). - 0022-2623 .- 1520-4804. ; 63:8, s. 3915-3934
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Tidskriftsartikel (refereegranskat)abstract
- Human dihydroorotate dehydrogenase (DHODH), an enzyme in the de novo pyrimidine synthesis pathway, is a target for the treatment of rheumatoid arthritis and multiple sclerosis and is re-emerging as an attractive target for cancer therapy. Here we describe the optimization of recently identified tetrahydroindazoles (HZ) as DHODH inhibitors. Several of the HZ analogues synthesized in this study are highly potent inhibitors of DHODH in an enzymatic assay, while also inhibiting cancer cell growth and viability and activating p53-dependent transcription factor activity in a reporter cell assay. Furthermore, we demonstrate the specificity of the compounds toward the de novo pyrimidine synthesis pathway through supplementation with an excess of uridine. We also show that induction of the DNA damage marker gamma-H2AX after DHODH inhibition is preventable by cotreatment with the pancaspase inhibitor Z-VAD-FMK. Additional solubility and in vitro m etabolic stability profiling revealed compound 51 as a favorable candidate for preclinical efficacy studies.
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38. |
- Sansone, Martina, et al.
(författare)
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Extensive Hospital In-Ward Clustering Revealed By Molecular Characterization of Influenza A Virus Infection.
- 2020
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Ingår i: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 71:9
-
Tidskriftsartikel (refereegranskat)abstract
- Nosocomial transmission of influenza A virus (InfA) infection is not fully recognized. The aim of this study was to describe the characteristics of hospitalized patients with InfA infections during an entire season and to investigate in-ward transmission at a large, acute-care hospital.During the 2016-17 season, all hospitalized patients≥18 years old with laboratory-verified (real-time polymerase chain reaction) InfA were identified. Cases were characterized according to age; sex; comorbidity; antiviral therapy; viral load, expressed as cycle threshold values; length of hospital stay; 30-day mortality; and whether the InfA infection met criteria for a health care-associated influenza A infection (HCAI). Respiratory samples positive for InfA that were collected at the same wards within 7 days were chosen for whole-genome sequencing (WGS) and a phylogenetic analysis was performed to detect clustering. For reference, concurrent InfA strains from patients with community-acquired infection were included.We identified a total of 435 InfA cases, of which 114 (26%) met the HCAI criteria. The overall 30-day mortality rate was higher among patients with HCAI (9.6% vs 4.6% among non-HCAI patients), although the difference was not statistically significant in a multivariable analysis, where age was the only independent risk factor for death (P<.05). We identified 8 closely related clusters (involving≥3 cases) and another 10 pairs of strains, supporting in-ward transmission.We found that the in-ward transmission of InfA occurs frequently and that HCAI may have severe outcomes. WGS may be used for outbreak investigations, as well as for evaluations of the effects of preventive measures.
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39. |
- Scott, Kirk, et al.
(författare)
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Sustaining Economic Welfare in an Ageing Europe
- 2009
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Ingår i: How Unified Is the European Union? European Integration Between Visions and Popular Legitimacy. - 9783540958543
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Bokkapitel (populärvet., debatt m.m.)
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40. |
- Scott, Kirk, et al.
(författare)
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Välfärden i ett åldrande Europa
- 2009
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Ingår i: Hur Gemensam är den Europeiska Gemenskapen?. - 1403-3879. ; , s. 179-206
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Bokkapitel (populärvet., debatt m.m.)
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41. |
- Sizov, Andrey, 1989, et al.
(författare)
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Thermal conductivity versus depth profiling of inhomogeneous materials using the hot disc technique
- 2016
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Ingår i: Review of Scientific Instruments. - : AIP Publishing. - 1089-7623 .- 0034-6748. ; 87:7, s. 074901-
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Tidskriftsartikel (refereegranskat)abstract
- Transient measurements of thermal conductivity are performed with hot disc sensors on samples having a thermal conductivity variation adjacent to the sample surface. A modified computational approach is introduced, which provides a method of connecting the time-variable to a corresponding depth-position. This allows highly approximate—yet reproducible—estimations of the thermal conductivity vs. depth. Tests are made on samples incorporating different degrees of sharp structural defects at a certain depth position inside a sample. The proposed methodology opens up new possibilities to perform non-destructive testing; for instance, verifying thermal conductivity homogeneity in a sample, or estimating the thickness of a deviating zone near the sample surface (such as a skin tumor), or testing for presence of other defects
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42. |
- Stockeld, Dag, et al.
(författare)
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A Swedish study of chemoradiation in squamous cell carcinoma of the esophagus
- 2001
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 40, s. 566-
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Tidskriftsartikel (refereegranskat)abstract
- This multicenter study describes the development of a chemoradiation protocol for the treatment of non-metastatic squamous cell carcinoma of the esophagus. Eighty patients were treated with three courses of chemotherapy (cisplatinum and 5-fluorouracil) with concomitant radiotherapy (40 Gy) during the last two courses of chemotherapy. Esophagectomy was performed, when feasible. If no operation was performed, patients were planned to receive a target dose of 64 Gy. Toxicity was mainly attributable to hematological impairment and led to two adjustments of the treatment protocol (addition of filgrastim and lowering of the 5-fluorouracil dose). These changes made it possible to administer the planned treatment in a gradually higher proportion of patients (13/23 [57%] before changes of treatment compared with 30/36 [83%] after changes). Treatment-related mortality was 3.75% (3 patients, associated with leucopenic septicemia after chemotherapy). Fifty-four patients were resected. No per- or postoperative mortality was encountered. The complete response (pathological CR) rate in operated patients was 46% (27/59 patients) after chemoradiation. In the whole series the CR rate (including clinical CR for non-resected patients) was 44%. With a minimum follow-up of 37 months, the 3-year survival for the whole group was 31% compared with 57% for the CR patients. Total 5-year survival thus far (July 1999) is 26%.
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43. |
- Sundell, Nicklas, et al.
(författare)
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PCR detection of respiratory pathogens in asymptomatic and symptomatic adults.
- 2019
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Ingår i: Journal of clinical microbiology. - 1098-660X. ; 57:1
-
Tidskriftsartikel (refereegranskat)abstract
- The frequency of viral respiratory pathogens in asymptomatic subjects is poorly defined. The aim of this study was to explore the prevalence of respiratory pathogens in the upper airways of asymptomatic adults, as compared with a reference population of symptomatic patients sampled in the same centres during the same period. Nasopharyngeal (NP) swab samples were prospectively collected from adults with and without ongoing symptoms of respiratory tract infection (RTI) during 12 consecutive months, in primary care centres as well as hospital emergency departments, and analysed for respiratory pathogens by a PCR panel detecting 16 viruses and four bacteria. Altogether, 444 asymptomatic and 75 symptomatic subjects completed sampling as well as follow-up (FU) at day 7. In the asymptomatic subjects the detection rate of viruses was low (4.3%) and the most common virus detected was rhinovirus (3.2%). Streptococcus pneumoniae was found in 5.6% of the asymptomatic subjects and Haemophilus influenzae in 1.4%. The only factor independently associated with low viral detection rate in asymptomatic subjects was age ≥65 (p=0.04). An increased detection rate of bacteria was seen in asymptomatic subjects who were currently smoking (p<0.01) and who had any chronical condition (p<0.01). We conclude that detection of respiratory viruses in asymptomatic adults is uncommon, suggesting that a positive PCR result from a symptomatic patient likely is relevant for ongoing respiratory symptoms. Age influences the likelihood of virus detection among asymptomatic adults and smoking as well as co-morbidity may increase the prevalence of bacterial pathogens in the upper airways.
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44. |
- Vu, Viet Thuy, et al.
(författare)
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RFI Suppression in Ultrawideband SAR Using an Adaptive Line Enhancer
- 2010
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Ingår i: IEEE Geoscience and Remote Sensing Letters. - : IEEE. - 1545-598X .- 1558-0571. ; 7:4, s. 694-698
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Tidskriftsartikel (refereegranskat)abstract
- In this letter, we propose an approach to suppress radio-frequency interference (RFI) in ultrawideband (UWB) low-frequency synthetic aperture radar (SAR). According to the proposal, RFI is suppressed by using an adaptive line enhancer controlled by the normalized least mean square algorithm. The approach is tested successfully on real UWB low-frequency SAR data. In order to keep the computational burden down, possible ways to integrate the RFI suppression approach into SAR imaging algorithms are also suggested.
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45. |
- Ahlberg, Carl, et al.
(författare)
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The Black Pearl: An Autonomous Underwater Vehicle
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The Black Pearl is a custom made autonomous underwater vehicle developed at Mälardalen University, Sweden. It is built in a modular fashion, including its mechanics, electronics and software. After a successful participation at the RoboSub competition in 2012 and winning the prize for best craftsmanship, this year we made minor improvements to the hardware, while the focus of the robot's evolution shifted to the software part. In this paper we give an overview of how the Black Pearl is built, both from the hardware and software point of view.
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46. |
- Ahlmanner, Filip, et al.
(författare)
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CD39+ regulatory T cells accumulate in colon adenocarcinomas and display markers of increased suppressive function
- 2018
-
Ingår i: Oncotarget. - : Impact Journals, LLC. - 1949-2553. ; 9:97, s. 36993-37007
-
Tidskriftsartikel (refereegranskat)abstract
- Increasing knowledge of the function and regulation of tumor-infiltrating lymphocytes has led to new insights in cancer immunotherapy. Regulatory T cells (Treg) accumulate in colon tumors, and we recently showed that CD39+ Treg from cancer patients inhibit transendothelial migration of conventional T cells. CD39 mediates the hydrolysis of ATP to immunosuppressive adenosine and adds to the immunosuppressive effects of Treg. Here, we further investigated the regulatory features of intratumoral CD39+ Treg in colon cancer. Using flow cytometry analyses of cells from 46 colon cancer patients, we confirm the accumulation of CD39+ Treg in the tumor tissue compared to unaffected colon tissue, and also show that tumor-infiltrating Treg express more CD39 and Foxp3 on a per cell basis. Furthermore, CD39+ Treg in tumors express markers indicating increased turnover and suppressive ability. In particular, tumor-infiltrating CD39+ Treg have high expression of surface molecules related to immunosuppression, such as ICOS, PD-L1 and CTLA-4. Functional suppression assays also indicate potent suppressive capacity of CD39+ Treg on proliferation and IFN-γ secretion by conventional T cells. In conclusion, our results identify tumor-infiltrating CD39+ Treg as a numerous and potentially important immunosuppressive subset, and suggest that immunotherapy aimed at reducing the activity of CD39+ Treg may be particularly useful in the setting of colon cancer. © 2018 Ahlmanner et al.
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47. |
- Alhamdow, Ayman, et al.
(författare)
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Chimney sweeps in Sweden : a questionnaire-based assessment of long-term changes in work conditions, and current eye and airway symptoms
- 2017
-
Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 90:2, s. 207-216
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore chimney sweeping work tasks, chimney sweeps’ use of protective equipment, and type of fuel used by clients, over time. Further, to assess work-relatedness of current eye and airway symptoms. Methods: In a cross-sectional study in 2011, male Swedish chimney sweeps (n = 483; age 21–69 years) answered a questionnaire about their occupational history and eye and airway symptoms. Results: Between 1960 and 2010, black-soot-sweeping in private homes was the major task, although it decreased during the time period, for chimney sweeps. Between 1975 and 2010, the use of petroleum oil decreased, whereas the use of pellets and wood increased. Also, the use of gloves and masks increased significantly. Black-soot-sweeping in industry was associated with work-related eye symptoms (prevalence odds ratio POR = 3.76, 95% CI: 1.72–8.24, for every 10% increment of working time, adjusted for age and tobacco smoking). Chimney sweeps also had slightly higher prevalence of cough with increasing black-soot-sweeping (POR = 1.06, 95% CI: 0.99–1.13 for every 10% increment, further adjusted for the use of mask), and the association was more pronounced, although nonsignificant, for black-soot-sweeping in industry (adjusted POR = 1.26, 95% CI: 0.98–1.61). Conclusions: Chimney sweeping tasks and use of protective equipment as well as type of fuel used by the clients changed significantly over the last 35 years, which may have changed chimney sweeps’ exposure to soot. Still, chimney sweeps in Sweden have black-soot-sweeping-related eye and airway symptoms.
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48. |
- Alling, Christer, et al.
(författare)
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Anionic glycerophospholipids in platelets from alcoholics
- 1986
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Ingår i: Drug and Alcohol Dependence. - : Elsevier BV. - 1879-0046 .- 0376-8716. ; 16:4, s. 309-320
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Tidskriftsartikel (refereegranskat)abstract
- Studies on ethanol-exposed animals have revealed changes in anionic phospholipids in brain membranes. The intention of this study was to investigate whether there was a similar effect on man. Assuming platelets to be an adequate model for CNS synaptosomes, concentration and fatty acid composition of anionic phospholipids, phosphatidylserine (PS) and phosphatidylositol (PI) in the platelet membrane from alcoholics after a debauche period were examined and compared to controls. Ethanol effects on neutral lipids were also analysed in order to obtain a comprehensive view. No quantitative difference was found in anionic phospholipids between alcoholics and controls. Fatty acid composition of individual phospholipids revealed significant changes which were more obvious in neutral phospholipids than in anionic. Oleic acid was increased and linoleic and arachidonic acids were decreased. After 1 week of detoxification, the abnormalities did not decrease, on the contrary they increased and total phospholipid concentration per platelet was significantly higher than in controls. It is concluded that the ethanol toxicity on bone marrow hampers the use of platelets as a model for synaptosomes but that the observed lipid abnormalities might play a major role in the impairment of platelet function in alcoholics.
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49. |
- Alrutz, Marie, et al.
(författare)
-
Projektledning
- 2013
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Bok (populärvet., debatt m.m.)abstract
- Projektledning är ett yrke med egen certifiering. Det pågår en spännande utveckling inom området och det blir allt viktigare att hålla sig ajour med utvecklingen.Det övergripande målet med den här handboken är att vara en ständigt aktuell heltäckande bok om projektarbete. Innehållsmässigt täcker den både frågor som har med struktur och styrning att göra och frågor om ledning av människor och mänskliga processer i grupp. Kompetens inom projekt byggs av både kunskap och erfarenhet. Vi följer kontinuerligt aktuell forskning inom dessa områden och bjuder in intressanta forskare att medverka som författare. Vi skildrar verkliga projekt och låter erfarenheterna få plats, både de bästa erfarenheterna och de utmaningar som man tagit sig igenom.Handboken är levande och det innebär att artiklar tas bort för att ge plats för nya, i takt med att den uppdateras fortlöpande.
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- Andersson, J., et al.
(författare)
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Echogenecity of the carotid intima-media complex is related to cardiovascular risk factors, dyslipidemia, oxidative stress and inflammation The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study
- 2009
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 204:2, s. 612-618
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Tidskriftsartikel (refereegranskat)abstract
- Background: Increased carotid artery intima-media thickness (IMT), measured by ultrasound, is related to an increased risk of cardiovascular disease. Since presence of echolucent plaques increases the risk further, we investigated if echogenecity of the carotid intima-media complex is related to markers of cardiovascular risk. Our aim was therefore to investigate if intima-media echogenecity is related to cardiovascular risk factors, or to markers of inflammation and oxidation in an exploratory investigation. Methods: The PIVUS cohort study is an observational study of 1016 (509 women and 507 men) randomly chosen individuals aged 70 living in Uppsala, Sweden. Carotid artery ultrasound measurements were performed. IMT and the grey scale median (GSM) value were calculated in the intima-media complex (IM-GSM) in the far wall of the common carotid artery. Traditional risk factors were evaluated together with indices of oxidative stress and inflammation. Results: In the multiple regression analysis, HDL-cholesterol, body mass index, conjugated diens, glutathione, e-selectin and TNF alfa were significantly related to IM-GSM. IMT was independently related to blood pressure, smoking and body mass index. Conclusion: The echolucency of the carotid intima-media was related to several cardiovascular risk factors not related to IMT, such as dyslipidemia, oxidative stress and inflammation. Since the echogenecity of the carotid intima-media complex was related to different risk factors compared to carotid IMT, it is worthwhile to further explore the usefulness of this new marker of the vascular wall. (C) 2009 Published by Elsevier Ireland Ltd.
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