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Sökning: WFRF:(Holmen Johan)

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1.
  • Locke, Adam E, et al. (författare)
  • Genetic studies of body mass index yield new insights for obesity biology.
  • 2015
  • Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 518:7538, s. 197-401
  • Tidskriftsartikel (refereegranskat)abstract
    • Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.
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2.
  • Shungin, Dmitry, et al. (författare)
  • New genetic loci link adipose and insulin biology to body fat distribution.
  • 2015
  • Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 518:7538, s. 187-378
  • Tidskriftsartikel (refereegranskat)abstract
    • Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms.
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3.
  • Axelsson, Christer, et al. (författare)
  • PCI De Lucs. : A clinical pathway directly to the PCI lab in out of hospital cardiac arrest
  • 2016
  • Ingår i: American Heart Association.
  • Konferensbidrag (refereegranskat)abstract
    • Purpose: In Sweden, the ambulance response time from call to arrival is 11 minutes in patients with an out-of-hospital cardiac arrest (OHCA). However, there is a small group of OHCA patients (20%) in whom this delay is minimized, namely those that occur minutes before or after the arrival of the ambulance. Despite CPR and/or defibrillation within one minute, only 20% survive to hospital discharge. The objective was therefore to determine whether a pathway with direct transportation to the cath lab, using mechanical chest compression (LUCAS), could improve survival in this selected group.Aim: To describe characteristics, feasibility and outcome among a selected group of OHCA patients transported directly to the cath lab by the ambulance in a new pathwayMethod: A prospective observational study from November 2013 to November 2015Inclusion criteria: 1. Crew-witnessed cardiac arrest (CA) of cardiac origin or CA immediately defibrillated to return of spontaneous circulation (ROSC) by public access. 2. CA occurring two to three minutes before ambulance arrival where the patient had immediate bystander CPR of high quality. 4. CA occurring two to three minutes before ambulance arrival where the patient was still breathing at ambulance arrival.Exclusion criteria: Non-cardiac origin CA or high physiologic age (hospice patients)Result: Sixty-four patients fulfilled the inclusion criteria and 14 were excluded. Of the remaining 50 patients, 25 were transported with mechanical CPR to the cath lab. The time from CA to hospital was a median of 38 minutes. Survival to 30 days was 38% among all patients, 47% among VF (N=34) and 12% (N=25) among those who were transported with mechanical CPR.Conclusion: The pathway appears safe and feasible, but the inclusion criteria need to be less complex. The vast majority of survivors were found in the VF population. There were survivors (12%) among patients transported with ongoing CPR (N=25) directly to the cath lab by the ambulance.
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5.
  • Fovaeus, Hannah, et al. (författare)
  • Out-of-hospital cardiac arrest: Survival in children and young adults over 30 years, a nationwide registry-based cohort study
  • 2024
  • Ingår i: Resuscitation. - 0300-9572 .- 1873-1570.
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: We studied short-term (30-day) and long-term (up to ten-year) survival among children and young adults following out-of-hospital cardiac arrest (OHCA) in Sweden over the course of the past 30 years. We also studied the causes of OHCA in children and examined predictors of survival. SETTING This was a nationwide, registry-based cohort study, using the Swedish Registry of Cardiopulmonary Resuscitation. Our study comprised a cohort of 4,804 individuals aged 0 to 30 years who suffered OHCA between 1990 and 2020, in whom cardiopulmonary resuscitation (CPR) was initiated. We stratified the study cohort to distinct age groups and time periods.Results: We found an increase in 30-day survival from 7% to 20% over the span of 30 years. In those under 1 year of age, survival increased from 2% to 19%. Time to CPR decreased from 14 to 2 minutes. The 10-year survival was high among those who survived 30 days. The etiology of cardiac arrests exhibited significant variations across different age groups but remained relatively consistent over time. Causes linked to mental illness constituted a substantial percentage of these cases. Compared to the reference period (1990-1994), the odds of survival in 2015-2020 was 3.00 (95% CI: 1.43, 6.94; p = 0.006).Conclusion: Survival rate after OHCA in children and young adults has increased three-fold over the past 30 years. Still overall mortality is high underscoring the need for continued efforts to mitigate risk factors and optimize survival.
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7.
  • Holmén, Johan, et al. (författare)
  • Passive leg raising in out-of-hospital cardiac arrest.
  • 2019
  • Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 137, s. 94-101
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The use of passive leg raising (PLR) in cardiopulmonary resuscitation (CPR) is sometimes discussed and even recommended. The effect of this intervention has never been properly addressed. We planned to determine whether PLR in out-of-hospital cardiac arrest (OHCA) is associated with an improved survival to 30 days.METHODS: In eight districts in western Sweden, we introduced PLR within five minutes after the start of CPR, among patients with OHCA. Patients in whom PLR was not performed, within the same district, served as a control group. Thirty-day survival was the primary endpoint. A propensity score analysis, as well as a standard multivariate analysis, was used to assess possible differences between the two groups.RESULTS: We identified 3554 patients with OHCA from the eight districts. Forty-four percent were treated with PLR during CPR. Patients who received PLR differed from those who did not, by having more risk factors for an adverse outcome (fewer crew-witnessed cases, more OHCA at home, a greater need for medication and prolonged delays to treatment). The overall survival to 30 days was 7.9% among patients who received PLR versus 13.5% among those who did not. A comparison of the groups, using propensity score matching, revealed a 30 -day survival of 8.6% in the PLR group versus 8.2% in the control group (odds ratio 1.07; 95% confidence interval 0.80-1.44).CONCLUSION: In an observational study, we introduced PLR as an addition to standard treatment in patients with OHCA. We did not find any evidence that this treatment improves survival to 30 days.
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8.
  • Holmén, Johan, et al. (författare)
  • Shortening Ambulance Response Time Increases Survival in Out-of-Hospital Cardiac Arrest
  • 2020
  • Ingår i: Journal of the American Heart Association. - : Wiley Blackwell. - 2047-9980. ; 9:21
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The ambulance response time in out-of-hospital cardiac arrest (OHCA) has doubled over the past 30 years in Sweden. At the same time, the chances of surviving an OHCA have increased substantially. A correct understanding of the effect of ambulance response time on the outcome after OHCA is fundamental for further advancement in cardiac arrest care. Methods and ResultsWe used data from the SRCR (Swedish Registry of Cardiopulmonary Resuscitation) to determine the effect of ambulance response time on 30-day survival after OHCA. We included 20 420 cases of OHCA occurring in Sweden between 2008 and 2017. Survival to 30 days was our primary outcome. Stratification and multiple logistic regression were used to control for confounding variables. In a model adjusted for age, sex, calendar year, and place of collapse, survival to 30 days is presented for 4 different groups of emergency medical services (EMS)-crew response time: 0 to 6 minutes, 7 to 9 minutes, 10 to 15 minutes, and >15 minutes. Survival to 30 days after a witnessed OHCA decreased as ambulance response time increased. For EMS response times of >10 minutes, the overall survival among those receiving cardiopulmonary resuscitation before EMS arrival was slightly higher than survival for the sub-group of patients treated with compressions-only cardiopulmonary resuscitation.ConclusionsSurvival to 30 days after a witnessed OHCA decreases as ambulance response times increase. This correlation was seen independently of initial rhythm and whether cardiopulmonary resuscitation was performed before EMS-crew arrival. Shortening EMS response times is likely to be a fast and effective way of increasing survival in OHCA.
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9.
  • Holmén, Johan, et al. (författare)
  • Survival in ventricular fibrillation with emphasis on the number of defibrillations in relation to other factors at resuscitation.
  • 2017
  • Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 113, s. 33-38
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Mortality after out of hospital cardiac arrest (OHCA) is high and a shockable rhythm is a key predictor of survival. A concomitant need for repeated shocks appears to be associated with less favorable outcome.AIM: To, among patients found in ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) describe: (a) factors associated with 30-day survival with emphasis on the number of defibrillatory shocks delivered; (b) the distribution of and the characteristics of patients in relation to the number of defibrillatory shocks that were delivered.METHODS: Patients who were reported to The Swedish Register for Cardiopulmonary Resuscitation (SRCR) between January 1 1990 and December 31 2015 and who were found in VF/pVT took part in the survey.RESULTS: In all there were 19,519 patients found in VF/pVT. The 30-day survival decreased with an increasing number of shocks among all patients regardless of witnessed status and regardless of time period in the survey. In a multivariate analysis there were 12 factors that were associated with the chance of 30-day survival one of which was the number of shocks that was delivered. For each shock that was added the chance of survival decreased. Factors associated with an increased 30-day survival included CPR before arrival of EMS, female sex, cardiac etiology and year of OHCA (increasing survival over years). Factors associated with a decreased chance of 30-day survival included: increasing age, OHCA at home, the use of adrenaline and intubation and an increased delay to CPR, defibrillation and EMS arrival.CONCLUSION: Among patients found in VF/pVT, 7.5% required more than 10 shocks. For each shock that was added the chance of 30-day survival decreased. There was an increase in 30-day survival over time regardless of the number of shocks. On top of the number of defibrillations, eleven further factors were associated with 30-day survival.
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11.
  • Aamaas, Borgar, et al. (författare)
  • Elemental carbon deposition to Svalbard snow from Norwegian settlements and long-range transport
  • 2011
  • Ingår i: Tellus. Series B, Chemical and physical meteorology. - : Stockholm University Press. - 0280-6509 .- 1600-0889. ; 63:3, s. 340-351
  • Tidskriftsartikel (refereegranskat)abstract
    • The impact on snow pack albedo from local elemental carbon (EC) sources in Svalbard has been investigated for the winter of 2008. Highly elevated EC concentrations in the snow are observed around the settlements of Longyearbyen and Svea (locally > 1000 ng g(-1), about 200 times over the background level), while EC concentrations similar to the background level are seen around Ny-Alesund. Near Longyearbyen and Svea, darkened snow influenced by wind transported coal dust from open coal stockpiles is clearly visible from satellite images and by eye at the ground. As a first estimate, the reduction in snow albedo caused by local EC pollution from the Norwegian settlements has been compared to the estimated reduction caused by long-range transported EC for entire Svalbard. The effect of local EC from Longyearbyen, Svea and all Norwegian settlements are estimated to 2.1%, 7.9% and 10% of the total impact of EC, respectively. The EC particles tend to stay on the surface during melting, and elevated EC concentrations due to the spring melt was observed. This accumulation of EC enhances the positive albedo feedbacks. The EC concentrations were observed to be larger in metamorphosed snow than in fresh snow, and especially around ice lenses.
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13.
  • Brink, Johan, 1976, et al. (författare)
  • Why do firms change? Sequences of opportunity and changes in business models and capabilities in bioscience firms
  • 2007
  • Ingår i: RIDE working paper series. ; :84426-015, s. 47-
  • Konferensbidrag (refereegranskat)abstract
    • Our paper sets out to explain how firms change and acts upon additional opportunities by analysing the development of three young bioscience firms by focusing on the relationship between experimentation of their business models and the capabilities that these firms gradually develop over time. We show that only by combining the initial technological capability with a more generic business capability, these firms were able to fully develop and pursue the initially perceived opportunity. Our analysis of these bioscience firms also reveal that the linkages between the initial technological capabilities that these companies develop are only indirectly related to subsequent opportunities acted upon. As the initial opportunity increasingly becomes economically or technologically irrelevant, the more recently acquired generic capabilities provided the firms with the ability to act upon new technological opportunities. That is, the initial technological capability of the firm is frequently not directly linked to the second pursued opportunity. We infer that as these initial capabilities generally are very technologically based they are also rather specific. Instead the link is by the necessary creation of the additional, and indeed more generic, capability within the firm. As these firms develop they are hence continuously leveraging only parts of their accumulated capabilities, meaning that they are both path-dependent and path-breaking in their development. The paper argues that a firm-based analysis of the development of capabilities and business models is warranted as a complement to the numerous sector-level studies of the biosciences. The internalist perspective of the co-evolution of capabilities and business models developed here cannot be substituted by industry or environmental explanations.
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14.
  • Bäfver, Linda, et al. (författare)
  • Slambränsleblandningar : Förbränning och fosforutvinning
  • 2013
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • For sustainable phosphorus recycling, the phosphorus in sewage sludge needs to be recovered, as it is a major phosphorus-source. However, all sludge is not suitable for direct recycling on agricultural land, e.g. when the content of heavy metals is too high. To achieve an increased recycling of phosphorus from sewage sludge there is a need of research and development of alternative methods to return the phosphorus from sewage sludge to agricultural land.The aim of the project is to show that sewage sludge can be co-combusted with demolition wood in existing boilers, and that the ash can be processed for extraction of phosphorus, together with valuable by-products from the process. Further effects of the project will be the development of new knowledge about combustion with a high sludge to demolition wood ratio in a grate boiler (up to 45 % sludge with respect to wet mixture), which has not been studied in full-scale combustion earlier. The project's goal is to demonstrate mixing and combustion of fuel mixtures of sludge and demolition wood, and subsequent extraction of phosphorus from ash. The target groups for this work are energy companies, suppliers of grate boilers, municipalities, wastewater treatment plants and authorities.The project involves the mixing of sewage sludge and demolition wood, combustion-tests of the fuel mixtures and laboratory experiments on bottom ash and fly ash for phosphorus extraction using EasyMining Sweden's method for phosphorus extraction from ash. Extensive analyses have been carried out on fuel, bottom ash and fly ash, as well as thermodynamic equilibrium calculations on the formed compounds containing phosphorus.The experience of preparing sludge fuel mixtures shows that the mixtures should be prepared in the near future to when they are to be combusted, to avoid a composting process in the fuel. The project shows that it is possible to combust sludge fuel mixtures with an admixture of up to 45 % sludge relative wet fuel, in an existing grate boiler during one day. However, to combust sludge fuel mixtures over a longer period of time and at a higher load, modifications of the de-ashing system and the flue gas cleaning system are needed. The results indicate a reduced tendency of slagging on the fuel bed at the combustion of sludge mixtures. The analyses of the fly ash showed a trend towards less corrosive ash at combustion of sludge mixtures. The phosphorus content in the ash in this work was 3-4 %. For process economics and from the phosphorus extraction point, as high phosphorus content as possible in the ash is preferable. Higher phosphorus content can be accomplished by mixing sludge with a fuel with lower ash content than demolition wood, co-combustion with a fuel with higher phosphorus content than demolition wood, or by increasing the percentage of sewage sludge in the fuel mixture. Still, a higher proportion of sludge in the mixture would require a higher dry matter content of the sludge in order to get proper combustion conditions. It is primarily bottom ash that is suitable for phosphorus extraction using Easy Mining Sweden's method. If fly ash are to be used for phosphorus extraction, an optimization of the dissolution conditions is required, which was not included in this project. In this project, phosphorus is extracted as ammonium phosphate. The purity of ammonium phosphate is very high, which means that unwanted substances and heavy metals in sewage sludge will not be returned to contaminate fields.
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15.
  • Calcagnile, Olga, et al. (författare)
  • S100B levels are affected by older age but not by alcohol intoxication following mild traumatic brain injury
  • 2013
  • Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 21
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Biomarkers of brain damage and head injury are potentially useful tools in the management of afflicted patients. Particularly S100B has received much attention and has been adapted into clinical guidelines. Alcohol intoxication and higher age (65 years and over) have been used as risk factors for serious complications following head injury. The effect of these factors on S100B levels has not been fully established in a relevant patient cohort. Methods: We prospectively included 621 adult patients with mild traumatic brain injury (TBI) and S100B sampling. Mild TBI was defined as Glasgow Come Scale 14-15 with loss of consciousness and/or amnesia, but without high-risk factors for intracranial complications. These patients would normally require CT scanning according to local and most international guidelines. S100B was sampled within 3 hours following trauma. Results: 280 patients (45%) were intoxicated by alcohol. Alcohol intoxication had no effect on S100B levels (p = 0.65) and the performance of S100B remained unchanged in these patients. 115 patients (22%) were 65 years or older with elevated S100B levels being more common in this group compared to patients under 65 (p = 0.029). Although the sensitivity of S100B was unchanged in older patients, the specificity was poorer. Conclusion: S100B can be used reliably in mild TBI patients with alcohol intoxication. The clinically utility of S100B in older patients may be limited by very poor specificity leading to only a small decrease in CT scanning.
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17.
  • Egeskog, Andrea, 1981, et al. (författare)
  • Actions and opinions of Brazilian farmers who shift to sugarcane : an interview-based assessment with discussion of implications for land-use change
  • 2016
  • Ingår i: Land use policy. - Kidlington : Elsevier. - 0264-8377 .- 1873-5754. ; 57, s. 594-604
  • Tidskriftsartikel (refereegranskat)abstract
    • Sugarcane ethanol systems can deliver large greenhouse gas emissions savings if emissions associated with land-use change are kept low. This qualitative study documents and analyzes actions and opinions among Brazilian farmers who shift to sugarcane production. Semi-structured interviews were held with 28 actors associated with sugarcane production in three different regions: one traditional sugarcane region and two regions where sugarcane is currently expanding. Most farmers considered sugarcane a land diversification option with relatively low economic risk, although higher risk than their previous land use. Beef production was considered a low-risk option, but less profitable than sugarcane. In conjunction with converting part of their land to sugarcane, most farmers maintained and further intensified their previous agricultural activity, often beef production. Several farmers invested in expanded production in other regions with relatively low land prices. Very few farmers in the expansion regions shifted all their land from the former, less profitable, use to sugarcane. Very few farmers in this study had deforested any land in connection with changes made when shifting to sugarcane. The respondents understand "environmental friendliness" as compliance with the relevant legislation, especially the Brazilian Forest Act, which is also a requirement for delivering sugarcane to the mills. Indirect land-use change is not a concern for the interviewed farmers, and conversion of forests and other native vegetation into sugarcane plantations is uncontroversial if legal. We derive hypotheses regarding farmers' actions and opinions from our results. These hypotheses aim to contribute to better understanding of what takes place in conjunction with expansion of sugarcane and can, when tested further, be of use in developing, e.g., policies for iLUC-free biofuel production.
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18.
  • Engdahl, Johan, 1968, et al. (författare)
  • Geographic and socio-demographic differences in uptake of population-based screening for atrial fibrillation: The STROKESTOP I study
  • 2016
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 222, s. 430-435
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The rationale behind screening for atrial fibrillation (AF) is to prevent ischemic stroke. Socio-demographic differences are expected to affect screening uptake. Geographic differences may provide further insights leading to targeted interventions for improved uptake. The objective of this study was to evaluate geographic and socio-demographic differences in uptake of AF screening in the population-based study STROKESTOP I. METHODS: STROKESTOP was carried out in two Swedish counties with a total population of 2.3 million inhabitants. Half of the residents aged 75-76years were randomized to the screening arm: invitation to clinical examination followed by ambulant ECG recording. Information on each invited person's residential parish (n=157) was used. On parish-level, aggregated data for the participants and non-participants, respectively, were obtained with respect to socioeconomic variables: educational level, disposable income, immigrant and marital status. Geo-maps displaying participation ratios were estimated by hierarchical Bayes methods. RESULTS: The overall participation rate was similar in men and women but lower in Stockholm, 47.6% (5665/11,903) than in Halland, 61.2% (1495/2443). Participation was clearly associated with the socioeconomic variables. Participation not taking into account socioeconomy varied more markedly across the parishes in the Stockholm county (range: 0.65-1.26) than in the Halland county (0.94-1.27). After adjustment for socioeconomic variables, a geographic variation remained in Stockholm, but not in Halland. CONCLUSION: Participation in AF screening varied according to socioeconomic conditions. Geographic variation in participation was marked in the Stockholm county, with only one screening clinic. Geo-mapping of participation yielded useful information needed to intervene for improved screening uptake.
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19.
  • Engdahl, Johan, et al. (författare)
  • Uptake of atrial fibrillation screening aiming at stroke prevention: geo-mapping of target population and non-participation
  • 2013
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 35, s. 163-164
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In a screening study for silent atrial fibrillation (AF), which is a frequent source of cardiac emboli with ischemic stroke, the proportion of non-participants was considerable and their clinical profile differed from the participants' profile. We intended to geo-map the target population and non-participation in an attempt to understand factors related to screening uptake and, thereby, obtain useful information needed to intervene for improved uptake. Method: In the municipality of Halmstad, Sweden, all residents born in 1934-1935 were invited to the screening study during April 2010 to February 2012. The total study group included 848 participants and 367 non-participants from 12 parishes. Geo-maps displaying participation, along with target-population-based geo-maps displaying proportion of immigrants and ischemic stroke incidence, were used. Results: Smoothed non-participation ratios (SmNPR) varied from 0.81 to 1.24 across different parishes (SmNRP = 1 corresponds to the expected participation based on the total study group). Among high risk individuals, the geographical variation was more pronounced (SmNPR range 0.75-1.51). Two parishes with higher share of immigrants and elevated population-based ischemic stroke incidence showed markedly lower participation, particularly among high-risk individuals. Conclusion: AF screening uptake varied evidently between parishes, particularly among high-risk individuals. Geo-mapping of target population and non-participation yielded useful information needed to intervene for improved screening uptake.
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20.
  • Fazey, Ioan, et al. (författare)
  • Transforming knowledge systems for life on Earth : Visions of future systems and how to get there
  • 2020
  • Ingår i: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 70
  • Tidskriftsartikel (refereegranskat)abstract
    • Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent.
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21.
  • Gaulton, Kyle J, et al. (författare)
  • Genetic fine mapping and genomic annotation defines causal mechanisms at type 2 diabetes susceptibility loci.
  • 2015
  • Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 47:12, s. 1415-1415
  • Tidskriftsartikel (refereegranskat)abstract
    • We performed fine mapping of 39 established type 2 diabetes (T2D) loci in 27,206 cases and 57,574 controls of European ancestry. We identified 49 distinct association signals at these loci, including five mapping in or near KCNQ1. 'Credible sets' of the variants most likely to drive each distinct signal mapped predominantly to noncoding sequence, implying that association with T2D is mediated through gene regulation. Credible set variants were enriched for overlap with FOXA2 chromatin immunoprecipitation binding sites in human islet and liver cells, including at MTNR1B, where fine mapping implicated rs10830963 as driving T2D association. We confirmed that the T2D risk allele for this SNP increases FOXA2-bound enhancer activity in islet- and liver-derived cells. We observed allele-specific differences in NEUROD1 binding in islet-derived cells, consistent with evidence that the T2D risk allele increases islet MTNR1B expression. Our study demonstrates how integration of genetic and genomic information can define molecular mechanisms through which variants underlying association signals exert their effects on disease.
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22.
  • Gustavsson, Eva, et al. (författare)
  • Visioner och praktik : om examensarbetet i professionslärosätet
  • 2010
  • Ingår i: PUH - Pedagogiska utvecklingsprojekt i högskolan 2010. - : Högskolan i Borås. ; , s. 15-25
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Bakgrunden till denna uppsats är en diskussion mellan oss författare vid ett litteraturseminarium vid Högskolan i Borås (HB). Diskussionen handlade om vår pedagogiska verksamhet och att ta hänsyn till motstridiga krav. Utbildning ska vara flexibel men samtidigt standardiserad, utbildning ska förbereda studenterna för specifika yrken men samtidigt ”lära studenterna för livet”. Vi har observerat att liknande resonemang kommer till uttryck också i andra sammanhang. Ett exempel är propositionerna ”Fokus på kunskap i den högre utbildningen”1 och ”En akademi i tiden - ökad frihet för universitet och högskolor”2. Ett annat är den seminarieserie – Från HB till Humboldt: Perspektiv på universitetsidén under 200 år – som genomförs nu i vår vid HB. Vi kan konstatera att de motsägelsefulla krav vi upplever i vår roll som pedagoger hänger samman med en mer övergripande utveckling inom den högre utbildningen. De ideal som typiskt förknippats med högre utbildning har på senare tid kommit att ställas mot mer politiskt orienterade modeller. Vad betyder denna utveckling för vår praktik? Vi tar utgångspunkt i centrala utvecklingstendenser inom den högre utbildningen i Europa. Detta för att visa på förekomsten av alternativa tolkningar och anpassningar till ”Bologna” som utgör den rådande styrmodellen för högre utbildning i Europa. Vi förflyttar oss därefter till HB och dess utbildning av civilekonomer. Genom exempel visar vi hur den svenska tolkningen av den högre utbildningens styrmodell påverkar vårt pedagogiska utvecklingsarbete. Syftet är att problematisera och ifrågasätta den ”svenska tolkningen” genom att lyfta fram dess för praktiken motsägelsefulla konsekvenser.
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23.
  • Gustavsson, Eva, 1960, et al. (författare)
  • Visioner och praktik - om examensarbetet i professionslärosätet
  • 2010
  • Ingår i: Peter Sigrén (red.) PUH - Pedagogiska utvecklingsprojekt i högskolan 2010, Rapport från Västra Götalands högskolor. - Borås : Högskolan i Borås. ; , s. 15-25
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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24.
  • Haitina, Tatjana, et al. (författare)
  • Further evidence for ancient role of ACTH peptides at melanocortin (MC) receptors; pharmacology of dogfish and lamprey peptides at dogfish MC receptors
  • 2007
  • Ingår i: Peptides. - : Elsevier BV. - 0196-9781 .- 1873-5169. ; 28:4, s. 798-805
  • Tidskriftsartikel (refereegranskat)abstract
    • The cloning of melanocortin (MC) receptors in distant species has provided us tools to get insight in how the ligand–receptors interactions in the MC system have evolved. We have however lacked studies on pharmacology of native ancient melanocortin peptides at the ancient MC receptors. In this paper we synthesized melanocortin peptides from both the sea lamprey (Petromyzon marinus) and spiny dogfish (Squalus acanthias) and tested them on the MC3 and MC4 receptors from spiny dogfish. The results show that both the dogfish and lamprey ACTH peptides have similar or higher affinity than the dogfish α-, β- and γ-MSH peptides to the dogfish MC3 and MC4 receptors. Moreover, both the dogfish and lamprey ACTH peptides have more than 10-fold higher affinity than α-MSH to the dogfish MC4 receptor. We also show that dogfish δ-MSH is able to bind to MC receptors and its potency is higher than of dogfish β-MSH, which is considered to be its precursor. Our results provide the first evidence that native ACTH ligands from dogfish and lamprey have a preference above native MSH peptides to ancient version of the MC3 and MC4 receptors. This further strengthens the hypotheses that the ligand contributing to the first version of the melanocortin ligand-receptor system resembled ACTH.
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25.
  • Hansson, Karl, 1985, et al. (författare)
  • Expanding the cerebrospinal fluid endopeptidome
  • 2017
  • Ingår i: Proteomics. - : Wiley. - 1615-9853. ; 17:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Biomarkers of neurodegenerative disorders are needed to assist in diagnosis, to monitor disease progression and therapeutic interventions, and to provide insight into disease mechanisms. One route to identify such biomarkers is by proteomic and peptidomic analysis of cerebrospinal fluid (CSF). In the current study, we performed an in-depth analysis of the human CSF endopeptidome to establish an inventory thatmay serve as a basis for future targeted biomarker studies. High-pH RP HPLC was employed for off-line sample prefractionation followed by low-pH nano-LC-MS analysis. Different software programs and scoring algorithms for peptide identification were employed and compared. A total of 18 031 endogenous peptides were identified at a FDR of 1%, increasing the number of known endogenous CSF peptides 10fold compared to previous studies. The peptides were derived from 2 053 proteins of which more than 60 have been linked to neurodegeneration. Notably, among the findings were six peptides derived from microtubule-associated protein tau, three of which span the diagnostically interesting threonine-181 (Tau-F isoform). Also, 213 peptides from amyloid precursor protein were identified, 58 of which were partially or completely within the sequence of amyloid beta 1-40/42, as well as 109 peptides from apolipoprotein E, spanning sequences that discriminate between the E2/E3/E4 isoforms of the protein.
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26.
  • Hansson, Karl, 1985, et al. (författare)
  • Sample Preparation for Endopeptidomic Analysis in Human Cerebrospinal Fluid
  • 2017
  • Ingår i: Jove-Journal of Visualized Experiments. - : MyJove Corporation. - 1940-087X. ; :130
  • Tidskriftsartikel (refereegranskat)abstract
    • This protocol describes a method developed to identify endogenous peptides in human cerebrospinal fluid (CSF). For this purpose, a previously developed method based on molecular weight cut-off (MWCO) filtration and mass spectrometric analysis was combined with an offline high-pH reverse phase HPLC pre-fractionation step. Secretion into CSF is the main pathway for removal of molecules shed by cells of the central nervous system. Thus, many processes in the central nervous system are reflected in the CSF, rendering it a valuable diagnostic fluid. CSF has a complex composition, containing proteins that span a concentration range of 8-9 orders of magnitude. Besides proteins, previous studies have also demonstrated the presence of a large number of endogenous peptides. While less extensively studied than proteins, these may also hold potential interest as biomarkers. Endogenous peptides were separated from the CSF protein content through MWCO filtration. By removing a majority of the protein content from the sample, it is possible to increase the sample volume studied and thereby also the total amount of the endogenous peptides. The complexity of the filtrated peptide mixture was addressed by including a reverse phase (RP) HPLC pre-fractionation step at alkaline pH prior to LC-MS analysis. The fractionation was combined with a simple concatenation scheme where 60 fractions were pooled into 12, analysis time consumption could thereby be reduced while still largely avoiding co-elution. Automated peptide identification was performed by using three different peptide/protein identification software programs and subsequently combining the results. The different programs were complementary rather than comparable with less than 15% of the identifications overlapped between the three.
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27.
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28.
  • Holmberg, John, 1963, et al. (författare)
  • Higher Education Leadership: Cruise or Expedition?
  • 2022
  • Ingår i: NORRAG: Network for international policies and cooperation in education and training. - 2571-8010. ; :7, s. 110-113
  • Tidskriftsartikel (refereegranskat)abstract
    • Higher education can create space for learning where students can work with integrated real-world issues, thereby creating value for others while building transformative leadership capabilities. It requires organisational leaders understand how to distinguish between two logics for leadership: the cruise and expedition logic, respectively. Good leadership understands the value of expeditions for the development of the entire system.
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29.
  • Holmén, Johan, 1990, et al. (författare)
  • Comparing sustainability transition labs across process, effects and impacts: Insights from Canada and Sweden
  • 2022
  • Ingår i: Energy Research and Social Science. - : Elsevier BV. - 2214-6296. ; 89
  • Tidskriftsartikel (refereegranskat)abstract
    • Purposeful transformative change on a level of societal systems, structures and practices is called for in response to contemporary sustainability challenges. Sustainability transition labs and arenas represent a particular set of governance innovations seeking to foster systemic change based on deliberate engagement of multiple actors around complex issues of concern. Most labs aim for long-term contributions in addressing persistent societal challenges and transitioning into sustainability, yet are seldomly evaluated on whether, how and to what extents such contributions become realised in practice. In this paper, we further an analytical framework for comparatively analysing sustainability transition labs and arenas with emphasis on their processes, effects and impacts. The framework is applied on two cases: Energy Futures Lab initiated in Alberta, Canada and the arenas for a Fossil Independent West Sweden - Climate 2030. In particular, the comparison showcases how contextual difference in terms of urgency and turbulence may influence lab activities and how ownership and governance conditions may influence the various directions outputs, effects and wider impacts took. The comparison further illuminates how backcasting and the multi-level perspective may serve as complementary frameworks and tools in lab processes, whose respective role may depend on aspiration and context. We end the paper by providing a series of key considerations in furthering the comparative analytical framework and its application in practice. They orient around the three guiding questions on the why's, what's, and how's of doing comparative research on sustainability transition arenas and labs across their processes, effects and impacts.
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30.
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31.
  • Holmén, Johan, 1990 (författare)
  • Navigating Sustainability Transformations: Backcasting, transdisciplinarity and social learning
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Complex and persistent sustainability challenges necessitate transformations into futures that are fundamentally different to what was before. Such change processes cannot be planned in traditional ways; they require reflexive modes of governing where we collectively learn how to navigate uncharted terrain while exploring it. The aim of this thesis is to contribute knowledge on how sustainability transformations can be navigated in practice. Such efforts are essentially transdisciplinary where actors across sectors, perspectives and disciplines are brought together around a complex issue, question or challenge of concern in context. By drawing from knowledge and experience on how systems develop and the possibility to influence how they should develop, such processes seek to both understand and address complex challenges by means of resolving problematic situations and transforming established systems, structures and practices. Efforts to navigate sustainability transformations in practice are far from straightforward; they require adequate conditions including methodological support to become meaningful as well as impactful. This thesis builds upon a backcasting from principles methodology to support engagement with complex sustainability challenges and transformations. It recognises the transdisciplinary condition of reflexive governance and the contextual contingency of such practices. It is underlaboured with critical realism and a systems-based approach and approaches deliberate and purposeful attempts to navigate transformations as processes of transformative social learning. Further, the thesis puts key attention to issues of Education for Sustainable Development. The thesis adheres to an ethnographic research tradition with qualitative/intensive research designs, guided by three interrelated methodological moves: (1) initial engagement with cases focusing on gathering experiences from participating actors and societal effects from backcasting processes in their wider governance and learning setting, educational as well as informal; (2) conceptual development to enhance backcasting processes in transdisciplinary settings, with focus on how guiding principles for sustainability can be collectively negotiated, and; (3) analytical deepening to better understand and explain how and why experiences and effects are generated in backcasting processes with attention to their surrounding contexts. These three methodological moves resulted in five research papers, for which I dedicate this thesis to position and further discuss. The main contributions of this thesis are: (1) a positioning of a principles-based purposeful, systemic, transformative and reflexive praxis with an associated and further developed backcasting from principles methodology. This methodology consists of a series of suggested steps, actions, guiding questions, qualities and features that seek to enhance the way complex sustainability challenges can be addressed to make efforts of navigating sustainability transformations in practice meaningful and impactful; (2) studies into a concrete curriculum model with transformational sustainability ambitions, Challenge Lab, whose curriculum design has been further conceptualised and mechanisms of learning empirically investigated. The curriculum design and associated mechanisms of learning may support the design, development, evaluation and comparison of educational initiatives that seek to create space for students to engage with complex sustainability challenges in their authentic societal context in open-ended processes together with societal actors, and; (3) an exploration of the necessity and potential value of comparing processes, effects and impacts from transformative, transdisciplinary and reflexive governance initiatives across contexts to better establish what works, for whom and why. Such knowledge moves beyond cumulation of knowledge on the particular methods and tools deployed in cases, into underlying features and mechanisms on which knowledge may be cumulated, generalised and transferred across cases and contexts. Finally, navigating sustainability transformations in practice is as much dependent on our collective capability of stepping back to reflect by asking questions of why, as stepping forward to act by asking questions of how. This thesis introduces a further interest in exploring whether, how and to what extent backcasting as methodological frame may guide the concrete design of transdisciplinary sustainability-oriented initiatives and condition processes of transformative social learning.
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32.
  • Holmén, Johan, 1990, et al. (författare)
  • Student-led sustainability transformations: employing realist evaluation to open the black box of learning in a Challenge Lab curriculum
  • 2021
  • Ingår i: International Journal of Sustainability in Higher Education. - 1467-6370. ; 22:8, s. 1-24
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose – While sustainability-oriented education is increasingly placing importance on engaging students in inter- and transdisciplinary learning processes with societal actors and authentic challenges in the centre, little research attends to how and what students learn in such educational initiatives. This paper aims to address this by opening the ‘black box’ of learning in a Challenge Lab curriculum with transformational sustainability ambitions. Design/methodology/approach – Realist evaluation was employed as an analytical frame that takes social context into account to unpack learning mechanisms and associated learning outcomes. A socio-cultural perspective on learning was adopted, and ethnographic methods, including interviews and observations, were used. Findings – Three context-mechanism-outcome (CMO) configurations were identified, capturing what students placed value and emphasis on when developing capabilities for leading sustainability transformations:  (1) engaging with complex ‘in-between’ sustainability challenges in society with stakeholders across sectors and perspectives; (2) navigating purposeful and transformative change via backcasting; and (3) ‘whole-person’ learning from the inside-out as an identity-shaping process, guided by personal values. Originality – This paper delineates and discusses important learning mechanisms and outcomes when students act as co-creators of knowledge in a sustainability-oriented educational initiative, working with authentic challenges together with societal actors. Practical implications – The findings of this paper can inform the design, development, evaluation, and comparison of similar educational initiatives across institutions, while leaving room for contextual negotiation and adjustment.
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33.
  • Holmén, Johan (författare)
  • The fight against time in prehospital cardiac arrest - a true medical emergency
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • ABSTRACT Background: The chances of survival after an out-of-hospital cardiac arrest (OHCA) are one in ten. The majority of survivors have no or relatively mild neurological sequelae. Interventions are time critical and well-timed management is challenging. All aspects of resuscitation in an OHCA are based on knowledge of clinically important actions and their timing in OHCA management. Randomised trials face ethical and legal barriers. The victim is unable to give informed consent and obtaining consent from a legal surrogate delays resuscitation actions. This highlights the need for observational efforts in cardiac arrest research, together with the further exploration of clinically relevant factors and their importance to survival chances in OHCA. Methods: Study I describes the importance of the number of defibrillations in OHCA and their association with survival chances. It is based on data from the Swedish Registry of Cardiopulmonary Resuscitation (SRCR). Study II describes the implementation and feasibility of a direct pathway to immediate coronary angiography after OHCA and its outcome. Patients were screened in the field by ambulance crews and referred to the catheterisation laboratory after consultation with the interventionalist. Study III examines the effect of a basic manoeuvre (passive leg-raising, PLR) in cardiopulmonary resuscitation (CPR) in an observation comparing PLR with standard CPR. Study IV determines the association between ambulance response time and survival after an OHCA, based on data reported to the SRCR. Results: Study I: Between 1990 and 2015, 19,519 patients with a shockable rhythm were reported to the SRCR and included in the study. The chances of survival decreased as the number of defibrillations required increased. Among patients found in a shockable rhythm, 7.5% required more than 10 shocks. Among the witnessed cases, we identified 12 factors associated with survival to 30 days, one of which was the number of shocks that were delivered. Study II: Prehospital screening identified 86 OHCA patients, but only 58% fulfilled the given criteria for pathway activation. Among these, the angiography procedure was started within an hour after collapse in half the cases and the majority had a culprit lesion. Thirty per cent of the patients survived to 30 days and 92% of the survivors presented with a shockable rhythm. All survivors had a good cerebral performance or sufficient function to manage activities of daily life independently. Study III: The PLR manoeuvre was performed in 44% of the n=3,554 OHCA patients included in the study. Survival to 30 days was 7.9% among patients who received PLR and 13.5% among those who did not (OR 0.55; 95% CI 0.44-0.69; p < 0.0001). When matching 1:1 on a propensity score, the difference in 30-day survival between the two groups disappeared (OR 1.07; CI 0.80-1.44; p = 0.65). The matched comparison showed a 30-day survival rate of 8.6% in the PLR group versus 8.2% in the control group. Study IV: Survival chances after a witnessed OHCA decreased as ambulance response times increased. This was seen independently of the initial rhythm and whether or not CPR was performed before EMS arrival. The chances of survival to 30 days was 19.5% when the EMS crew arrived within 0-6 minutes in an OHCA situation, as compared with 9.4% if the crew arrived within 10-15 minutes. Conclusion: I) The chances of survival after an OHCA decreased for each defibrillatory shock administered. II) The prehospital activation of a pathway to immediate coronary angiography in OHCA showed limited feasibility. The criteria for the prehospital initiation of a pathway of this kind have to be clear and simple in this time-critical situation. The initial rhythm could be an accurate criterion for prehospital screening to immediate coronary angiography after OHCA. III) We found no indications that the PLR manoeuvre during CPR was beneficial when performed by the EMS crew within five minutes of arriving on the scene. IV) The ambulance response time is important to survival chances in OHCA. Possible actions to reduce EMS response times need to be considered urgently, as this can be lifesaving for future OHCA patients.
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34.
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35.
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36.
  • Hölttä, Mikko, et al. (författare)
  • An Integrated Workflow for Multiplex CSF Proteomics and Peptidomics-Identification of Candidate Cerebrospinal Fluid Biomarkers of Alzheimer's Disease
  • 2015
  • Ingår i: Journal of Proteome Research. - : American Chemical Society (ACS). - 1535-3893 .- 1535-3907. ; 14:2, s. 654-663
  • Tidskriftsartikel (refereegranskat)abstract
    • Many disease processes in the brain are reflected in the protein composition of the cerebrospinal fluid (CSF). In addition to proteins, CSF also contains a large number of endogenous peptides whose potential as disease biomarkers largely remains to be explored. We have developed a novel workflow in which multiplex isobaric labeling is used for simultaneous quantification of endogenous CSF peptides and proteins by liquid chromatography coupled with mass spectrometry. After the labeling of CSF samples, endogenous peptides are separated from proteins by ultrafiltration. The proteins retained on the filters are trypsinized, and the tryptic peptides are collected separately. We evaluated this technique in a comparative pilot study of CSF peptide and protein profiles in eight patients with Alzheimer's disease (AD) and eight nondemented controls. We identified several differences between the AD and control group among endogenous peptides derived from proteins known to be associated with AD, including neurosecretory protein VGF (ratios AD/controls 0.45-0.81), integral membrane protein 2B (ratios AD/controls 0.72-0.84), and metallothionein-3 (ratios AD/controls 0.51-0.61). Analysis of tryptic peptides identified several proteins that were altered in the AD group, some of which have previously been reported as changed in AD, for example, VGF (ratio AD/controls 0.70).
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37.
  • Isgren, Anniella, et al. (författare)
  • Markers of neuroinflammation and neuronal injury in bipolar disorder: Relation to prospective clinical outcomes.
  • 2017
  • Ingår i: Brain, behavior, and immunity. - : Elsevier BV. - 1090-2139 .- 0889-1591. ; 65, s. 195-201
  • Tidskriftsartikel (refereegranskat)abstract
    • Neuroimmune mechanisms have been linked to the pathophysiology of bipolar disorder based on studies of biomarkers in plasma, cerebrospinal fluid (CSF), and postmortem brain tissue. There are, however, no longitudinal studies investigating if CSF markers of neuroinflammation and neuronal injury predict clinical outcomes in patients with bipolar disorder. We have in previous studies found higher CSF concentrations of interleukin-8 (IL-8), monocyte chemoattractant protein 1 (MCP-1/CCL-2), chitinase-3-like protein 1 (CHI3L1/YKL-40), and neurofilament light chain (NF-L) in euthymic patients with bipolar disorder compared with controls. Here, we investigated the relationship of these CSF markers of neuroinflammation and neuronal injury with clinical outcomes in a prospective study. 77 patients with CSF analyzed at baseline were followed for 6-7years. Associations of baseline biomarkers with clinical outcomes (manic/hypomanic and depressive episodes, suicide attempts, psychotic symptoms, inpatient care, GAF score change) were investigated. Baseline MCP-1 concentrations were positively associated with manic/hypomanic episodes and inpatient care during follow-up. YKL-40 concentrations were negatively associated with manic/hypomanic episodes and with occurrence of psychotic symptoms. The prospective negative association between YKL-40 and manic/hypomanic episodes survived multiple testing correction. Concentrations of IL-8 and NF-L were not associated with clinical outcomes. High concentrations of these selected CSF markers of neuroinflammation and neuronal injury at baseline were not consistently associated with poor clinical outcomes in this prospective study. The assessed proteins may be involved in adaptive immune processes or reflect a state of vulnerability for bipolar disorder rather than being of predictive value for disease progression.
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38.
  • Lönngren, Johanna, Docent, 1985-, et al. (författare)
  • Learning for an unknown future : emotional positioning in and for expansive learning
  • 2023
  • Konferensbidrag (refereegranskat)abstract
    • STUDY OVERVIEW AND PURPOSE: We live in troubled times. Faced with increasingly serious and urgent, wicked sustainability challenges (Lönngren & van Poeck, 2021; United Nations, 2015), such as climate change, pandemics, and violent conflict , more and more people experience anxiety, hopelessness, and worries about the future (Barrineau et al., 2022; Ojala et al., 2021; Pihkala, 2020). The United Nations’ Agenda 2030 with its 17 Sustainable Development Goals (SDGs; United Nations, 2015) may offer a comforting illusion of a yellow brick road to a known and livable future. Yet, complex systems studies have shown that the future is not only unknown but ultimately unknowable (Dewulf & Biesbroek, 2018; Funtowicz & Ravetz, 1993). In light of such radical uncertainty, Barrineau et al. (2022) argued that environmental and sustainability education (ESE) is not only about “promoting [pre-defined] skills and competencies in sustainability education with which to equip students to tackle sustainability challenges” (p.3) since we do not know yet what competencies they will need. The only thing we know for certain is that future generations will need to develop knowledge, skills, and practices that are different from those we know today, that is, those that have given rise to our current predicaments. In other words, students need to “learn something that is not yet there” (Engeström & Sannino, 2010, p. 2).In recent years, a range of educational theories and concepts that touch upon this type of learning have increased in popularity. For example, Engeström et al. (Engeström et al., 2022; Engeström & Sannino, 2010) have drawn on cultural historical activity theory to examine expansive learningprocesses that allow learners to develop “expanded pattern[s] of activity, corresponding theoretical concept[s], and new types of agency” (Engeström & Sannino, 2010, p. 7). Similarly, Barrineau et al. (2022) have described emergentist education as a form of teaching and learning that engages with “the possibilities of the not-yet-imagined” (p.2). Others have described related theories, such as transformative and transgressive social learning as crucially important in ESE (Lotz-Sisitka et al., 2015).These and other traditions of transformative and expansive learning theories have in common that they attend to the role of social interaction for learning, stressing that learning always takes place in social contexts (Lenglet, 2022; Lotz-Sisitka et al., 2015; Van Poeck et al., 2020). Another common thread through many approaches is an attention to spirituality, affect, and/or emotions (Hoggan, 2016; Lenglet, 2022; Lotz-Sisitka et al., 2015). For example, Hoggan (2016) argued that learners must be “emotionally capable of change” (p. 61), pay attention to emotional experiences, and learn to utilize emotional ways of knowing. Similarly, Östman et al. (2019) have used pragmatist theories to argue that strong embodied experiences can trigger transformative learning. This intersection between expansive learning, social interaction, and emotions is the focus of our contribution.The aim of our study is to explore how expansive learning can manifest in and through emotional interaction when student groups engage with wicked sustainability challenges. To do so, we draw on positioning theory as a theoretical tool that allows us to study emotions as a form of social interaction (Harré & van Langenhove, 1999) rather than something individuals have and experience. More specifically, we explore processes of emotional positioning (Lönngren et al., 2021; Lönngren & Berge, forthcoming), analyzing how students use emotions discursively to position themselves – and each other – in relation to their (expansive) learning and (future) agency to work for sustainable and desired futures.METHODS: Emotions can be expressed through a wide range of modalities (e.g., speech, gestures, facial expressions, intonation, bodily positions). Therefore, multimodal approaches are particularly suitable for studying how emotions are expressed and used in social interaction (Goodwin et al., 2012; Hufnagel & Kelly, 2018; Lönngren & Berge, forthcoming). For this study, we video-recorded group work conducted by four groups of engineering students. The group work sessions took place during two sustainability courses for engineering students at two Swedish universities and they were part of the students’ regular course work. No researchers were present during the sessions, but teachers entered each room occasionally to check on the groups’ progress. In total, we recorded approximately 70 hours of video data. To analyze the data, we first watched all recordings (~70h) to familiarize ourselves with the data. Thereafter, we formulated sensitizing concepts (consensus/dissensus, convergence/divergence, comfort/vulnerability, intensity, and social positions) to narrow our focus on situations in which we could study emotional positioning and/or expansive learning processes. The sensitizing concepts allowed us to select a smaller number of excerpts for in-depth analysis. For each excerpt, we then developed narrative descriptions of any processes of expansivity and expansive learning we could observe. Finally, we applied the analytic tools of positioning theory to make sense of the ways in which students used emotions discursively while engaging (or not) in expansive learning.PRELIMINARY FINDINGS AND CONCLUSIONS: Our preliminary findings point to multiple ways in which emotional positioning could facilitate expansive learning during group engagement with wicked challenges. For example, when students suggested norm-breaking methods or solution approaches, other students could validate those ideas by listening attentively and expressing excitement. By validating unconventional ideas, the students also positioned themselves and each other as expansive learners with rights and duties to reach beyond known approaches and solutions. In other excerpts, we observed high levels of emotional congruence between the group members. When one student laughed, others would often join in. In other instances, students would fall silent simultaneously, much like a general pause in an orchestra concert. By enacting these and other forms of emotional congruence, the students could co-construct their group as a team – working together, building on each other’s ideas, and taking collective responsibility for any outcomes they produced. Thus, they also constructed a shared safety-net, reducing perceived risks associated with expansive learning: If the outcomes of their work had turned out to be flawed or ridiculed by others, they could have shared the burden of the perceived (!) failure and helped each other focus on the exceptional learning they had achieved. These findings demonstrate how students could use emotions discursively to position themselves and each other as (a) students who can and should engage in expansive learning, and (b) sustainability agents who can and should contribute to developing innovative solutions to wicked issues. The findings also show how emotions expressed in interaction can have profound impacts on learning, which further stresses the importance of more ESE research on emotions in and as social interaction. A better understanding of emotional interaction in ESE would also support educators in developing teaching and learning environments conducive to expansive learning.
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39.
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40.
  • Lönngren, Johanna, 1985-, et al. (författare)
  • Taking emotions seriously in sustainability education : A theoretical exploration of “emotional scaffolding” and how it can be used in research and practice
  • 2021
  • Konferensbidrag (refereegranskat)abstract
    • Background: Research has shown that emotions profoundly affect teaching and learning in all disciplines and at all levels of education. Emotions may be particularly important in environmental and sustainability education (ESE) due the seriousness and complexity of sustainability concerns and the presence of conflicting norms and values (Lönngren, Adawi, & Svanström, 2019; Ojala, 2015). For example, emotions may motivate students and teachers to engage in discussions about controversial topics (such as climate change) and guide judgment and decision-making in the face of uncertainty and ambiguity. However, they may also lead to denial of uncomfortable knowledge (Bossér & Lindahl, 2019; Ojala, 2013). Despite the importance of emotions in ESE, research on this topic is only emerging at this point. In addition, most of the existing research focuses on emotions as individual and private phenomena (Zembylas, 2007), such as hope or individual emotional regulation. However, research also suggests that expressing emotions in social contexts may play an important role in ESE. Emotions are closely related to personal values and explicating personal values is important in ESE (Ojala, 2013). An interesting theoretical concept for exploring emotions in ESE as social and relational phenomena is “emotional scaffolding” (also called affective scaffolding), which refers to pedagogical support teachers provide to influence students’ emotions in order to improve learning (Rosiek, 2003). While emotional scaffolding has been used previously (Park, 2016; van de Pol, Volman, & Beishuizen, 2010), we argue that it is conceptualized in a narrow way and remains under-theorized. Specifically, the current definition of emotional scaffolding seems to be based on a narrow empirical context or a narrow set of identified discursive practices, and it ignores recent theory and research on emotions in education. In this theoretical contribution, we draw on a nascent body of research on emotional scaffolding across various disciplines as well as a typology of academic emotions to (1) develop a broader and more theoretically informed definition of emotional scaffolding, (2) explore ways of researching emotional scaffolding, and (3) suggest ways of drawing out educational implications from research on emotional scaffolding. Method: To this end, we start from Rosiek’s widely cited definition of emotional scaffolding as “teachers’ pedagogical use of analogies, metaphors, and narratives to influence students’ emotional response to specific aspects of the subject matter in a way that promotes student learning” (Rosiek, 2003, p. 402). We broaden and unpack this definition in four important ways. First, to broaden it beyond the “use of analogies, metaphors, and narratives”, we identify additional tools and strategies teachers can use, such as acknowledging and validating expression of emotions (Ojala, 2013; Park, 2016), providing encouragement and reassurance (Lönngren et al., 2019; Meyer & Turner, 2007), adjusting subject content to students’ needs (Lönngren, 2017; McCaughtry, 2004), and building positive relationships in the classroom (Ojala, 2013; Park, 2016). Second, to unpack the definition of “emotional response”, we draw on research describing different types of emotional responses, such as emotional experiences (e.g. confidence rather than anxiety) or expressions (e.g. expressing trust or engagement) (Meyer & Turner, 2007; van de Pol et al., 2010). Third, to broaden the definition beyond students’ emotional response to “subject matter”, we use Pekrun and Linnenbrink-Garcia’s (2012) typology of academic emotions, according to which emotional responses to subject matter can be described as topic emotions. The typology contains three additional types of academic emotions that are relevant for emotional scaffolding: achievement emotions (i.e. emotions related to students’ perception of their academic performance, such as worry about not being able to provide a perfect solution to a sustainability problem), epistemic emotions (i.e. emotions related to the process of learning, such as grappling with uncertainty and ambiguity), and social emotions (i.e. emotions related to classroom interaction and social relationships). Finally, we adopt a critical lens to unpack the overall aim of emotional scaffolding — what it could mean that emotional scaffolding in ESE “promotes student learning”. Here, we ask questions such as “What types of learning?” and “Learning for whom?”. Based on our broadened definition of emotional scaffolding, we then explore ways of researching emotional scaffolding in terms of possible types of research questions, empirical contexts, and methods for data collection and analysis. This includes how we are planning to use positioning theory (Harré & van Langenhove, 1999) to explore emotional scaffolding in ESE in the context of engineering education. We also explore what types of results could be obtained and how those results could be made useful in and for ESE practice. Expected outcomes: In conclusion, this theoretical contribution seeks to take stock of the current understanding of emotional scaffolding, develop a broader and more theoretically informed definition of emotional scaffolding, and draw out implications for educational research and practice. We argue that emotional scaffolding is conceptualized in a narrow way and remains under-theorized: It fails to recognize the wide range of pedagogical tools and strategies teachers can use to influence a variety of types of students’ emotional responses. Most notably, emotional responses should be broadened to include all four types of academic emotions: topic emotions, achievement emotions, epistemic emotions, and social emotions. Our broadened definition of emotional scaffolding opens up a large array of research questions that should be highly relevant not only for ESE but also for educational research more broadly. References Bossér, U., & Lindahl, M. (2019). Students’ Positioning in the Classroom: a Study of Teacher-Student Interactions in a Socioscientific Issue Context. Research in Science Education, 49, 371-390. Harré, R., & van Langenhove, L. (1999). Positioning Theory: Moral Contexts of Intentional Action. Malden: Blackwell. Lönngren, J. (2017). Wicked Problems in Engineering Education: Preparing Future Engineers to Work for Sustainability. Chalmers University of Technology, Gothenburg. Lönngren, J., Adawi, T., & Svanström, M. (2019). Scaffolding strategies in a rubric-based intervention to promote engineering students’ ability to address wicked problems. European Journal of Engineering Education, 44(1-2), 196-221. McCaughtry, N. (2004). The Emotional Dimensions of a Teacher’s Pedagogical Content Knowledge: Influences on Content, Curriculum, and Pedagogy. Journal of Teaching in Physical Education, 23, 30-47. Meyer, D. K., & Turner, J. C. (2007). Scaffolding Emotions in Classrooms. In P. A. Schutz & R. Pekrun (Eds.), Emotion in Education (pp. 243-258). Cambridge: Academic Press. Ojala, M. (2013). Emotional Awareness: On the Importance of Including Emotional Aspects in Education for Sustainable Development (ESD). Journal of Education for Sustainable Development, 7(2), 167-182. Ojala, M. (2015). Hope in the Face of Climate Change: Associations With Environmental Engagement and Student Perceptions of Teachers’ Emotion Communication Style and Future Orientation. The Journal of Environmental Education, 46(3), 133-148. Park, M.-H. (2016). Emotional Scaffolding as a Strategy to Support Children's Engagement in Instruction. Universal Journal of Educational Research, 4(10), 2353-2358. Abstract till European Conference of Education Research (ECER) 2021 Pekrun, R., & Linnenbrink-Garcia, L. (2012). Academic Emotions and Student Engagement. In S. Christenson, A. Reschly, & C. Wylie (Eds.), Handbook of Research on Student Engagement. Boston: Springer. Rosiek, J. (2003). Emotional Scaffolding: An Exploration of The Teacher Knowledge at the Intersection of Student Emotion and the Subject Matter. Journal of Teacher Education, 54(5), 399-412. van de Pol, J., Volman, M., & Beishuizen, J. (2010). Scaffolding in Teacher-Student Interaction: A Decade of Research. Educational Psychology Review, 22, 271-296. Zembylas, M. (2007). The Power and Politics of Emotions in Teaching. In P. A. Schutz & R. Pekrun (Eds.), Emotion in Education (pp. 293-309). Cambridge: Academic Press. 
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41.
  • Lönngren, Johanna, 1985-, et al. (författare)
  • Workshop: When emotions are not outlawed: using emotional scaffolding to enhance student learning
  • 2021
  • Ingår i: SEFI 49th Annual Conference: Blended Learning in Engineering Education: Challenging, Enlightening - and Lasting?. - : European Society for Engineering Education (SEFI). - 9782873520236 ; , s. 1556-1560
  • Konferensbidrag (refereegranskat)abstract
    • WORKSHOP AIMS: The aim of this workshop was three-fold: (1) to introduce participants to educational emotion research and the notion of “emotional scaffolding”, (2) to provide examples of emotional scaffolding, with a special focus on engineering education for sustainable development, and (3) to let participants collaboratively develop strategies for emotional scaffolding they can use in their own teaching. 
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42.
  • Magdalinou, N. K., et al. (författare)
  • Identification of candidate cerebrospinal fluid biomarkers in parkinsonism using quantitative proteomics
  • 2017
  • Ingår i: Parkinsonism & Related Disorders. - : Elsevier BV. - 1353-8020 .- 1873-5126. ; 37, s. 65-71
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Neurodegenerative parkinsonian syndromes have significant clinical and pathological overlap, making early diagnosis difficult. Cerebrospinal fluid (CSF) biomarkers may aid the differentiation of these disorders, but other than a-synuclein and neurofilament light chain protein, which have limited diagnostic power, specific protein biomarkers remain elusive. Objectives: To study disease mechanisms and identify possible CSF diagnostic biomarkers through discovery proteomics, which discriminate parkinsonian syndromes from healthy controls. Methods: CSF was collected consecutively from 134 participants; Parkinson's disease (n = 26), atypical parkinsonian syndromes (n = 78, including progressive supranuclear palsy (n = 36), multiple system atrophy (n = 28), corticobasal syndrome (n = 14)), and elderly healthy controls (n = 30). Participants were divided into a discovery and a validation set for analysis. The samples were subjected to tryptic digestion, followed by liquid chromatography-mass spectrometry analysis for identification and relative quantification by isobaric labelling. Candidate protein biomarkers were identified based on the relative abundances of the identified tryptic peptides. Their predictive performance was evaluated by analysis of the validation set. Results: 79 tryptic peptides, derived from 26 proteins were found to differ significantly between atypical parkinsonism patients and controls. They included acute phase/inflammatory markers and neuronal/synaptic markers, which were respectively increased or decreased in atypical parkinsonism, while their levels in PD subjects were intermediate between controls and atypical parkinsonism. Conclusion: Using an unbiased proteomic approach, proteins were identified that were able to differentiate atypical parkinsonian syndrome patients from healthy controls. Our study indicates that markers that may reflect neuronal function and/or plasticity, such as the amyloid precursor protein, and inflammatory markers may hold future promise as candidate biomarkers in parkinsonism. (C) 2017 Published by Elsevier Ltd.
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43.
  • McCrory, Gavin, 1990, et al. (författare)
  • Learning to Frame Complex Sustainability Challenges in Place: Explorations Into a Transdisciplinary “Challenge Lab” Curriculum
  • 2021
  • Ingår i: Frontiers in Sustainability. - : Frontiers Media SA. - 2673-4524. ; 2
  • Tidskriftsartikel (refereegranskat)abstract
    • Complex sustainability challenges may never be fully solved, rather requiring continuous, adaptive, and reflexive responses over time. Engagement of this nature departs from well-structured problems that entail expected solutions; here, focus shifts toward ill-structured or ill-defined issues characterized by wickedness. In the context of complex challenges, inadequate or absent framing has performative implications on action. By overlooking the value of framing, eventual responses may not only fall short; they may even displace, prolong, or exacerbate situations by further entrenching unsustainability. In educational settings, we know little about how curriculum designs support challenge framing, and how students experience and learn framing processes. In this paper we explore a transdisciplinary “Challenge Lab” (C-Lab) curriculum from a perspective of challenge framing. When considering framing in higher education, we turn to the agenda in education for, as and with sustainable development to be problem-solving, solutions-seeking or challenge-driven. We introduce framing as a boundary object for transformative praxis, where sustainability is held to be complex and contextual. This study is qualitative and case-based, designed to illuminate processes of and experiences into sustainability challenge framing in a transdisciplinary learning setting. Methodologically, we draw from student reflective diaries that span the duration of a curriculum design. We structure our results with the support of three consecutive lenses for understanding “curriculum”: intended, enacted, and experienced curriculum. First, we present and describe a C-Lab approach at the level of ambition and design. Here it is positioned as a student-centered space, process, and institutional configuration, working with framing and re-framing complex sustainability challenges in context. Second, we present a particular C-Lab curriculum design that unfolded in 2020. Third, we illustrate the lived experiences and practical realities of participating in C-Lab as students and as teachers. We reflect upon dilemmas that accompany challenge framing in C-Lab and discuss the methodological implications of this study. Finally, we point toward fruitful research avenues that may extend understandings of challenge framing in higher education.
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44.
  • McCrory, Gavin, 1990, et al. (författare)
  • Sustainability-oriented labs in real-world contexts: An exploratory review
  • 2020
  • Ingår i: Journal of Cleaner Production. - : Elsevier BV. - 0959-6526. ; 277, s. 1-18
  • Forskningsöversikt (refereegranskat)abstract
    • There are growing claims that meaningfully engaging with complex sustainability challenges requires change of a systemic nature. In governing transitions to sustainability, laboratories in real world contexts are growing in presence and promise. Yet, they span an array of contexts, conceptualisations and cases, making it difficult to find and relate labs across disciplines. Moreover, it is unclear how these labs vary in their approaches to sustainability, the importance of which has been voiced by the sustainability transitions community. In addressing these concerns, we adopted the broad research question: How can sustainability-oriented labs in real-world contexts be understood? We systematically reviewed 53 labs from disparate fields of research that broadly share a focus on sustainability. Through a mixed-methods analysis, we present three levels of results. Firstly, we provide an overview of the diversity in distribution, thematic focus and setup of labs. Secondly, we trace 7 different research communities where sustainability-oriented labs have been conceptualized (Living, Urban Living, Real-world, Evolutionary Learning, Urban Transition, Change and Transformation labs). Thirdly, we identify three key dimensions of labs, space, process and organisation, enabling a structured understanding of lab approaches towards sustainability. We then situate our results within salient transitions research areas, namely transition geographies, governance and innovation. In concluding, we point towards fruitful avenues for future research, capable of 1) unpacking lab approaches to sustainability as a dynamic normative property, and 2) providing a basis for complementary case-based comparison.
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45.
  • McCrory, Gavin, 1990, et al. (författare)
  • Sustainability-oriented labs in transitions: An empirically grounded typology
  • 2022
  • Ingår i: Environmental Innovation and Societal Transitions. - : Elsevier BV. - 2210-4224. ; 43, s. 99-117
  • Tidskriftsartikel (refereegranskat)abstract
    • Sustainability is high on the political agenda, with its analytical and practical importance underscored in the field of sustainability transitions. Experiments, arenas, and laboratories are frequently highlighted as real-world objects to investigate sustainability in place. Despite existing lab studies, attempts at comparison at the empirical level remain unconvincing. Here, sustainability remains oversimplified, warranting further investigation to unpack how labs compare in their orientation towards sustainability. This article presents a rigorous and transparent empirically grounded typology, intended to discern ways to engage with sustainability. We outline and elaborate upon six distinctive types entitled: 1) Fix and control, 2) (Re-)Design and optimize, 3) Make and relate, 4) Educate and engage, 5) Empower and govern, and 6) Explore and shape. This study highlights similarities and differences between labs, and across different types. These findings are discussed with reference to ongoing conceptualizations on directionality, providing a fruitful point of departure for ongoing transitions research.
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46.
  • Overgaard, Morten F, et al. (författare)
  • Physician staffed emergency medical service for children: a retrospective population-based registry cohort study in Odense region, Southern Denmark
  • 2020
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:8
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives The aim of this study is to determine diagnostic patterns in the prehospital paediatric population, age distribution, the level of monitoring and the treatment initiated in the prehospital paediatric case. Hypothesis was that advanced prehospital interventions are rare in the paediatric patient population. Setting We performed a retrospective population-based registry cohort study of children attended by a physician-staffed emergency medical service (EMS) unit (P-EMS), in the Odense area of Denmark during a 10-year study period. Participants We screened 44 882 EMS contacts and included 5043 children. Patient characteristics, monitoring and interventions performed by the P-EMS crews were determined. Results We found that paediatric patients were a minority among patients attended by P-EMS units: 11.2% (10.9 to 11.5) (95% CI) of patients were children. The majority of the children were <5 years old; one-third being <2 years old. Respiratory problems, traffic accidents and febrile seizures were the three most common dispatch codes. Oxygen supplementation, intravenous access and application of a cervical collar were the three most common interventions. Oxygen saturation and heart rate were documented in more than half of the cases, but more than one-third of the children had no vital parameters documented. Only 22% of the children had respiratory rate, saturation, heart rate and blood pressure documented. Prehospital invasive procedures such as tracheal intubation (n=74), intraosseous access (n=22) and chest drainage (n=2) were infrequently performed. Conclusion Prehospital paediatric contacts are uncommon, more frequently involving smaller children. Monitoring or at least documentation of basic vital parameters is infrequent and may be an area for improvement. Advanced and potentially life-saving prehospital interventions provide a dilemma since these likely occur too infrequently to allow service providers to maintain their technical skills working solely in the prehospital environment.
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47.
  • Platt, Stephen M., et al. (författare)
  • Atmospheric composition in the European Arctic and 30 years of the Zeppelin Observatory, Ny-Ålesund
  • 2022
  • Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 22:5, s. 3321-3369
  • Tidskriftsartikel (refereegranskat)abstract
    • The Zeppelin Observatory (78.90∘ N, 11.88∘ E) is located on Zeppelin Mountain at 472 m a.s.l. on Spitsbergen, the largest island of the Svalbard archipelago. Established in 1989, the observatory is part of Ny-Ålesund Research Station and an important atmospheric measurement site, one of only a few in the high Arctic, and a part of several European and global monitoring programmes and research infrastructures, notably the European Monitoring and Evaluation Programme (EMEP); the Arctic Monitoring and Assessment Programme (AMAP); the Global Atmosphere Watch (GAW); the Aerosol, Clouds and Trace Gases Research Infrastructure (ACTRIS); the Advanced Global Atmospheric Gases Experiment (AGAGE) network; and the Integrated Carbon Observation System (ICOS). The observatory is jointly operated by the Norwegian Polar Institute (NPI), Stockholm University, and the Norwegian Institute for Air Research (NILU). Here we detail the establishment of the Zeppelin Observatory including historical measurements of atmospheric composition in the European Arctic leading to its construction. We present a history of the measurements at the observatory and review the current state of the European Arctic atmosphere, including results from trends in greenhouse gases, chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs), other traces gases, persistent organic pollutants (POPs) and heavy metals, aerosols and Arctic haze, and atmospheric transport phenomena, and provide an outline of future research directions.
  •  
48.
  • Ried, Janina S., et al. (författare)
  • A principal component meta-analysis on multiple anthropometric traits identifies novel loci for body shape
  • 2016
  • Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 7
  • Tidskriftsartikel (refereegranskat)abstract
    • Large consortia have revealed hundreds of genetic loci associated with anthropometric traits, one trait at a time. We examined whether genetic variants affect body shape as a composite phenotype that is represented by a combination of anthropometric traits. We developed an approach that calculates averaged PCs (AvPCs) representing body shape derived from six anthropometric traits (body mass index, height, weight, waist and hip circumference, waist-to-hip ratio). The first four AvPCs explain >99% of the variability, are heritable, and associate with cardiometabolic outcomes. We performed genome-wide association analyses for each body shape composite phenotype across 65 studies and meta-analysed summary statistics. We identify six novel loci: LEMD2 and CD47 for AvPC1, RPS6KA5/C14orf159 and GANAB for AvPC3, and ARL15 and ANP32 for AvPC4. Our findings highlight the value of using multiple traits to define complex phenotypes for discovery, which are not captured by single-trait analyses, and may shed light onto new pathways.
  •  
49.
  • Skoglund, Nils, et al. (författare)
  • Fuel design in co-combustion of demolition wood chips and municipal sewage sludge
  • 2016
  • Ingår i: Fuel processing technology. - : Elsevier BV. - 0378-3820 .- 1873-7188. ; 141:2, s. 196-201
  • Tidskriftsartikel (refereegranskat)abstract
    • Municipal sewage sludge (MSS) is a waste stream resource which contains both energy and elements such as phosphorus which could be recycled. If these two aspects of this waste stream resource are to be used to their full potential the sludge should not be used in landfills or road construction. There is some use of sludge in agriculture today but not all MSS produced is suitable for direct use on arable land due to its content of potentially harmful elements, pathogens or anthropogenic chemicals. By combusting sludge that is not used directly in agriculture the problematic organic content could be destroyed. The combustion process also produces an ash that possibly could be used either directly in agriculture or as a raw material for recovering phosphorus and energy could be recovered. Building mono-combustion plants for sewage sludge is not economically feasible in all parts of the world so it is of interest to investigate how MSS can be introduced together with other fuels in existing infrastructure which already have extensive cleaning systems for potentially harmful elements. To investigate this possible path, demolition wood chips (DWC) were co-combusted with municipal sewage sludge (MSS) in a grate-fired combined heat and power plant running at 50% capacity producing 25 MWth and 9 MWel. The amount of MSS that was suitable to introduce in blends was determined using a "fuel fingerprint" based on the composition of the raw materials. Thermodynamic equilibrium calculations were made to evaluate potential problems with slagging based on the ash content prior to the combustion experiments. The fuels were introduced as a reference case with only demolition wood and pre-blended fuel mixtures in two ratios; 65 w/w-% DWC/35 w/w-% MSS and 55 w/w-% DWC/45 w/w-% MSS and were fired for 12 h. The high water content of the MSS affected how much MSS that could be introduced without compromising the heat and power production. The fuel blends worked nicely for 12 h of continuous combustion with small adjustments where the primarily the air inlet configuration was changed. The main problems encountered related to cleaning of the flue gases and to some extent ash removal. The bed ash and fly ash produced was analysed both using ICP-AES (elemental) and XRD (speciation) and the bottom ash was subjected to ash melting tests. The major nutrient phosphorus was mainly found in bottom ash (80 w/w-%) as whitlockites with some hydroxyapatite whereas fly ash (20 w/w-%) contained larger amounts of hydroxyapatite, especially for the reference fuel. The amount of alkali chloride in the fly ash was reduced in favour of alkali sulphate formation.
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50.
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