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Sökning: WFRF:(Jönsson Hanna)

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2.
  • Ahmad, Nouman, et al. (författare)
  • Voxel-wise body composition analysis using image registration of a three-slice CT imaging protocol : methodology and proof-of-concept studies
  • 2024
  • Ingår i: Biomedical engineering online. - : Springer Nature. - 1475-925X. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Computed tomography (CT) is an imaging modality commonly used for studies of internal body structures and very useful for detailed studies of body composition. The aim of this study was to develop and evaluate a fully automatic image registration framework for inter-subject CT slice registration. The aim was also to use the results, in a set of proof-of-concept studies, for voxel-wise statistical body composition analysis (Imiomics) of correlations between imaging and non-imaging data.Methods The current study utilized three single-slice CT images of the liver, abdomen, and thigh from two large cohort studies, SCAPIS and IGT. The image registration method developed and evaluated used both CT images together with image-derived tissue and organ segmentation masks. To evaluate the performance of the registration method, a set of baseline 3-single-slice CT images (from 2780 subjects including 8285 slices) from the SCAPIS and IGT cohorts were registered. Vector magnitude and intensity magnitude error indicating inverse consistency were used for evaluation. Image registration results were further used for voxel-wise analysis of associations between the CT images (as represented by tissue volume from Hounsfield unit and Jacobian determinant) and various explicit measurements of various tissues, fat depots, and organs collected in both cohort studies.Results Our findings demonstrated that the key organs and anatomical structures were registered appropriately. The evaluation parameters of inverse consistency, such as vector magnitude and intensity magnitude error, were on average less than 3 mm and 50 Hounsfield units. The registration followed by Imiomics analysis enabled the examination of associations between various explicit measurements (liver, spleen, abdominal muscle, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), thigh SAT, intermuscular adipose tissue (IMAT), and thigh muscle) and the voxel-wise image information.Conclusion The developed and evaluated framework allows accurate image registrations of the collected three single-slice CT images and enables detailed voxel-wise studies of associations between body composition and associated diseases and risk factors.
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3.
  • Bergkvist, John, et al. (författare)
  • Maintenance and enhancement of forest ecosystem services: a non-industrial private forest owner perspective
  • 2023
  • Ingår i: European Journal of Forest Research. - 1612-4669 .- 1612-4677.
  • Tidskriftsartikel (refereegranskat)abstract
    • The transition to a fossil-free society in Sweden is expected to cause an increased demand for forest-derived products which may intensify existing conflicts between forest ecosystem services. This study investigated the preferences among non-industrial private forest owners for maintaining multiple forest ecosystem services and their preferences for future forest development. The findings were related to their prioritizations for and knowledge of forest management. The study results were generated through the means of a survey which revealed a consistent high valuation among all respondents of ecosystem services relating to water quality, timber quality, recreation, and biodiversity. A majority of the respondents desired increasing proportions of mixed species and broadleaved stands within the future forest landscape. Certified forest owners who were members of a forest owner association (CMs) prioritized achieving high economic income through roundwood production with strong preferences for the ecosystem services high stand growth and high timber quality. For CMs, carbon substitution was the preferred means of mitigating climate change. Forest owners lacking both certification and membership in a forest owner association ranked the ecosystem services recreation and biodiversity significantly higher, and also preferred retaining more old forest within the landscape. The survey results revealed a higher management activity among CMs, resulting in a more frequent establishment of mixed and broadleaved stands. Forest owners with medium to large scale properties were well-represented within the CM category. The results indicated that while the CMs have stronger preferences for roundwood production compared to owners of small properties, they are also more likely to have taken adaptive measures favoring risk management and biodiversity.
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  • Ekedahl, Anders, et al. (författare)
  • Differences between the data in the electronic medical record, the prescriptions stored in the Swedish national prescription repository and and the patient’s knowledge of the present treatment
  • 2010
  • Ingår i: Pharmacy World & Science. - : Springer. - 0928-1231 .- 1573-739X. ; 32:5, s. 679-
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Background and objective Patient adherence to prescribed treatmentfor chronic conditions has been estimated to be on average about 50%(1), drug related problems may cause as much as 30% of acuteadmittances to hospital care (2), and the costs have been estimated tobe of the same magnitude as the direct costs for pharmaceutical drugs.A reason for lack of adherence to the treatment and medication errorsmay be that patients with many drugs, especially when changes in thetreatment have occurred, may have knowledge gaps on the drugsrepresenting the actual prescribed treatment.E-prescribing, from the physicians’ electronic medical record(EMR) directly to the pharmacies, constitute[75% of all prescriptionsin Sweden and [70% of patients in Sweden store theirprescriptions electronically at the national prescription repository(NPR), accessible from any pharmacy in Sweden. Any new e-prescriptionwill automatically be stored in the NPR.However, the NPR may contain both prescriptions for the present,actual treatment, prescription duplicates, and prescriptions for previous,terminated or changed treatment. For patients with manymedications and/or many changes in the treatment it is obvious thatthe risk for medication errors is increased.The objective of the present study was to compare the prescribedtreatment in the EMR, the prescriptions in the NPR, and patient’sknowledge of her/his present prescribed treatment.Design Compare prescribed treatment in the EMR with the prescriptionsin the NPR, and patients knowledge of her/his presentprescribed treatment with regard to prescriptions; prescribed drug,strength; formula and dosing.Setting Ten HCCs in four cities in Sweden, February 2010.Main outcome measures Differences between the computerisedpatients health care journal record and the prescriptions in the NPR,and patients view of her/his actual present prescribed treatment withregard to prescriptions; prescribed drug, strength; formula and dosing.Results The results are available in March 2010.Conclusions Conclusion.References1. Adherence to long-term therapies: evidence for action. WHO,2003.2. Fryckstedt J, Asker-Hagelberg C. Drug-related problems commonat the medical acute care clinic—the cause of admission foralmost one-third of patients. [Läkemedelsrelaterade problemvanliga på medicinakuten - Orsak till inläggning hos nästan vartredje patient, enligt kvalitetsuppföljning] Läkartidningen 2008;105(12–13): 894–898.
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7.
  • Ekedahl, Anders, 1949-, et al. (författare)
  • Discrepancies between the electronic medical record, the prescriptions in the Swedish national prescription repository and the current medication reported by patients.
  • 2011
  • Ingår i: Pharmacoepidemiology and Drug Safety. - : John Wiley & Sons, Inc.. - 1053-8569 .- 1099-1557. ; 20:11, s. 1177-1183
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To study discrepancies between (i) the prescribed current treatment stated by patients with congestive heart failure (CHF) compared with patients with other chronic diseases, (ii) the data in the medication list (ML) in the electronic medical record and (iii) the data in the prescription list (PL) on the prescriptions stored in the national prescription repository in Sweden, to determine current, noncurrent, duplicate and missing prescriptions.Methods At one healthcare centre, a random sample of patients 18 years and older with a diagnosis of CHF, diabetes mellitus (DM) or osteoarthritis (OA) provided written informed consent to participate. Participants were interviewed by telephone on the prescribed current treatment.Results Of 161 invited patients (61 CHF, 50 DM and 50 OA), 66 patients were included. More than 80% of the patients had at least one discrepancy, a noncurrent, a duplicate or a missing prescription, in the ML and PL. The overall congruence for unique prescriptions on current treatment between the ML and the PL was only 55%. Patients with CHF had overall more discrepancies and patients with DM fewer discrepancies in the ML.Conclusions Prescriptions for noncurrent treatment, duplicates and missing prescriptions are common in both the ML in the electronic medical record and the list on prescriptions stored in the Swedish National Prescription Repository. Patients with CHF had more discrepancies in the ML. The risk for medication errors in primary care due to incorrect information on prescribed treatment may be substantial.
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8.
  • Eriksson Stenström, Kristina, et al. (författare)
  • Identifying radiologically important ESS-specific radionuclides and relevant detection methods
  • 2020
  • Bok (refereegranskat)abstract
    • The European Spallation Source (ESS) is under construction in the outskirts of Lund in southern Sweden. When ESS has entered the operational phase in a few years, an intense beam of high-energy protons will not only produce the desired spallation neutrons from a large target of tungsten, but a substantial number of different radioactive by-products will also be generated. A small part of these will be released to the environment during normal operation. During an accident scenario, a wide range of gases and aerosols may be released from the tungsten target. The palette of radionuclides generated in the ESS target will differ from that of e.g. medical cyclotrons or nuclear power plants, thus presenting new challenges e.g. in the required environmental monitoring to ensure that dose limits to the public are not exceeded. This project (SSM2018-1636), financed by the Swedish Radiation Safety Authority (SSM), aimed to strengthen competence at Lund University for measurement and analysis of ESS-specific radionuclides. First, an extensive literature review, including modelling as well as experimental analyses, of ESS-relevant radionuclides was performed. We found that radionuclide production in particle accelerators is well-known, while experience with tungsten targets is very limited. As a second part of the project, an independent simplified model of the ESS target sector for the calculations of radionuclide production in the ESS tungsten target was developed using the FLUKA code. We conclude that we have a fairly good agreement with results of other authors, except for 148Gd, and that the calculated radionuclide composition is sensitive to the nuclear interaction models used.In the third part of the project, known environmental measurement technologies for various ESS-relevant radionuclides were reviewed, focussing on pure difficult-to-measure alpha- and beta-emitters. Liquid scintillation counting (LSC) is a suitable technique e.g. for the important beta emitters 3H, 14C, 35S, 31P and 33P. Several ESS radionuclides of relevance for dose estimates have never been investigated by environmental analytical techniques, due to their absence in the normal environment. Alpha spectrometry seems promising for the analysis of alpha-emitting lanthanides, in particular for 148Gd. Among the many types of mass spectrometry techniques, ICP-MS (inductively coupled plasma mass spectrometry) and AMS (accelerator mass spectrometry) seem to be the most suitable for the analysis of long-lived ESS radionuclides in environmental samples (e.g. 243Am and possibly lanthanides for ICP-MS and 10Be, 14C, 32Si, 36Cl, 60Fe and 129I for AMS).Three experimental parts were performed during the project, related to initiation of radioactivity measurements of aerosols at Lund University, mapping of environmental tritium in the Lund area, and establishment of a method to measure tritium in urine followed by a study of tritium in persons presently living or working in Lund. Aerosols were collected at a rural background station (Hyltemossa near Perstorp, northern Skåne) using a high-volume aerosol sampler with automatic filter change (DHA-80, Digitel). Gamma spectrometry measurements of 7Be agreed rather well with results from a nearby air monitoring station (SSM/FOI). Tritium (radioactive hydrogen) is expected to dominate the source term from the ESS target station to the environment. We have performed several investigations to monitor the current situation of tritium in Lund using LSC: the matrices investigated included air humidity, precipitation, pond water, indoor air at one accelerator facility and urine from the general public as well as from persons who may be occupationally exposed to tritium. Environmental tritium was generally very low (<3.4 Bq L-1), with somewhat higher concentration in the springtime than during the rest of the year. Tritium in the vast majority of the 55 urine samples was also very low: only a few exposed workers were found to have up to 11 Bq L-1 in their urine, which still is very low compared to e.g. reactor workers. Suggestions for further actions and work related to measurement and analysis of ESS relevant radionuclides are presented.
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  • Gyllensten, Hanna, 1979, et al. (författare)
  • Comparing Methods for Estimating Direct Costs of Adverse Drug Events
  • 2017
  • Ingår i: Value in Health. - : Elsevier BV. - 1098-3015 .- 1524-4733. ; 20:10, s. 1299-1310
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To estimate how direct health care costs resulting from adverse drug events (ADEs) and cost distribution are affected by methodological decisions regarding identification of ADEs, assigning relevant resource use to ADEs, and estimating costs for the assigned resources. Methods: ADEs were identified from medical records and diagnostic codes for a random sample of 4970 Swedish adults during a 3-month study period in 2008 and were assessed for causality. Results were compared for five cost evaluation methods, including different methods for identifying ADEs, assigning resource use to ADEs, and for estimating costs for the assigned resources (resource use method, proportion of registered cost method, unit cost method, diagnostic code method, and main diagnosis method). Different levels of causality for ADEs and ADEs contribution to health care resource use were considered. Results: Using the five methods, the maximum estimated overall direct health care costs resulting from ADEs ranged from Sk10,000 (Sk = Swedish krona; similar to(sic)1,500 in 2016 values) using the diagnostic code method to more than Sk3,000,000 (similar to(sic)414,000) using the unit cost method in our study population. The most conservative definitions for ADEs contribution to health care resource use and the causality of ADEs resulted in average costs per patient ranging from Sk0 using the diagnostic code method to Sk4066 (similar to(sic)500) using the unit cost method. Conclusions: The estimated costs resulting from ADEs varied considerably depending on the methodological choices. The results indicate that costs for ADEs need to be identified through medical record review and by using detailed unit cost data. Copyright (C) 2017, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.
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  • Gyllensten, Hanna, 1979, et al. (författare)
  • Cost of illness of patient-reported adverse drug events: a population-based cross-sectional survey.
  • 2013
  • Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 3:6
  • Tidskriftsartikel (refereegranskat)abstract
    • To estimate the cost of illness (COI) of individuals with self-reported adverse drug events (ADEs) from a societal perspective and to compare these estimates with the COI for individuals without ADE. Furthermore, to estimate the direct costs resulting from two ADE categories, adverse drug reactions (ADRs) and subtherapeutic effects of medication therapy (STE).
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  • Gyllensten, Hanna, 1979, et al. (författare)
  • Economic Impact of Adverse Drug Events – A Retrospective Population-Based Cohort Study of 4970 Adults
  • 2014
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The aim was to estimate the direct costs caused by ADEs, including costs for dispensed drugs, primary care, other outpatient care, and inpatient care, and to relate the direct costs caused by ADEs to the societal COI (direct and indirect costs), for patients with ADEs and for the entire study population. Methods We conducted a population-based observational retrospective cohort study of ADEs identified from medical records. From a random sample of 5025 adults in a Swedish county council, 4970 were included in the analyses. During a three-month study period in 2008, direct and indirect costs were estimated from resource use identified in the medical records and from register data on costs for resource use. Results Among 596 patients with ADEs, the average direct costs per patient caused by ADEs were USD 444.9 [95% CI: 264.4 to 625.3], corresponding to USD 21 million per 100 000 adult inhabitants per year. Inpatient care accounted for 53.9% of all direct costs caused by ADEs. For patients with ADEs, the average societal cost of illness was USD 6235.0 [5442.8 to 7027.2], of which direct costs were USD 2830.1 [2260.7 to 3399.4] (45%), and indirect costs USD 3404.9 [2899.3 to 3910.4] (55%). The societal cost of illness was higher for patients with ADEs compared to other patients. ADEs caused 9.5% of all direct healthcare costs in the study population. Conclusions Healthcare costs for patients with ADEs are substantial across different settings; in primary care, other outpatient care and inpatient care. Hence the economic impact of ADEs will be underestimated in studies focusing on inpatient ADEs alone. Moreover, the high proportion of indirect costs in the societal COI for patients with ADEs suggests that the observed costs caused by ADEs would be even higher if including indirect costs. Additional studies are needed to identify interventions to prevent and manage ADEs.
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  • Gyllensten, Hanna, et al. (författare)
  • How are the Costs of Drug-Related Morbidity Measured? : A Systematic Literature Review
  • 2012
  • Ingår i: Drug Safety. - : Wolters Kluwer. - 0114-5916 .- 1179-1942. ; 35:3, s. 207-219
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Drug-related morbidity has been associated with increased healthcare costs and has been suggested as one of the leading causes of death. Previous reviews have identified heterogeneity in research methods in studies measuring the cost of drug-related morbidity. To date, no attempt has been made to analyse different methods and cost sources used when estimating the costs of drug-related morbidity. Objective: The aim of this review was to evaluate and compare methods and data sources in cost estimates of drug-related morbidity. Methods: A literature search was conducted in three electronic databases (CINAHL, EMBASE and MEDLINE) to identify peer-reviewed articles written in English and published between January 1990 and November 2011. Articles were included if estimating the direct or indirect costs of drug-related morbidity based on clinical data from general patient groups. The general patient groups were defined as patients visiting, being admitted to, treated at or discharged from a general hospital, excluding studies from nursing homes or specialized hospitals. Study information was collected using a standardized data collection sheet. Studies were categorized according to the type of costs included in the cost analysis. Thereafter, the cost analyses of included studies were reviewed regarding viewpoint, costing methods and adjustments for timing of costs. Results: In total, 9569 articles were identified, of which 25 publications were included in this review, and four additional articles were identified from reference or citation lists of publications already included. Eighteen studies measured either the total or attributable costs of drug-related morbidity, while seven studies estimated the increased costs using matched controls or regression analyses. Six studies measured costs from a payer perspective, while the other 23 measured costs to the hospital. One study included costs resulting after discharge, and discounted future costs, while the remaining 28 studies measured costs during the initial admission only and involved no adjustment for timing of costs. Conclusions: The data sources and costs measured in the included studies varied considerably in terms of perspectives and use of data sources. Even though there is a trend towards more studies estimating costs from the payer perspective, the identified studies still focused on costs resulting from patients attending hospital, therefore underestimating the cost of drug-related morbidity. There is thus a need for more research on the costs of drug-related morbidity to providers other than hospitals, and costs occurring outside of hospitals and after the initial care episode. Such studies require clear descriptions of how the costs of drug-related morbidity are measured, and should adhere to published guidelines for observational studies and economic evaluation studies.
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  • Hakkarainen, K M, et al. (författare)
  • Prevalence, nature and potential preventability of adverse drug events - A population-based medical record study of 4970 adults
  • 2014
  • Ingår i: British Journal of Clinical Pharmacology. - : Wiley-Blackwell. - 0306-5251 .- 1365-2125. ; 78:1, s. 170-183
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To estimate the 3-month prevalence of adverse drug events (ADEs), categories of ADEs, and preventable ADEs, and the preventability of ADEs among adults in Sweden. Further, to identify drug classes and organ systems associated with ADEs and estimate their seriousness.METHODS: A random sample of 5025 adults in Swedish county council in 2008 was drawn from the Total Population Register. All their medical records in 29 inpatient care departments in three hospitals, 110 specialised outpatient clinics, and 51 primary care units were reviewed retrospectively in a stepwise manner, and complemented with register data on dispensed drugs. ADEs, including adverse drug reactions (ADRs), sub-therapeutic effects of drug therapy (STEs), drug dependence and abuse, drug intoxications from overdose, and morbidities due to drug-related untreated indication, were detected during a 3-month study period, and assessed for preventability.RESULTS: Among included 4970 individuals, the prevalence of ADEs was 12.0% (95% confidence interval 11.1-12.9%), and preventable ADEs 5.6% (5.0-6.2%). ADRs (6.9%; 6.2-7.6%) and STEs (6.4%; 5.8-7.1%) were more prevalent than the other ADEs. Of the ADEs, 38.8% (35.8-41.9%) was preventable, varying by ADE category and seriousness. ADEs were frequently associated with nervous system and cardiovascular drugs, but the associated drugs and affected organs varied by ADE category.CONCLUSIONS: The considerable burden of ADEs and preventable ADEs from commonly used drugs across care settings warrants large-scale efforts to redesign safer, higher quality healthcare systems. The heterogeneous nature of the ADE categories should be considered in research and clinical practice for preventing, detecting and mitigating ADEs.
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14.
  • Hebsgaard, Josephine, et al. (författare)
  • Dopamine neuron precursors within the developing human mesencephalon show radial glial characteristics.
  • 2009
  • Ingår i: GLIA. - : Wiley. - 1098-1136 .- 0894-1491. ; 57, s. 1648-1659
  • Tidskriftsartikel (refereegranskat)abstract
    • Specification and differentiation of neural precursors into dopaminergic neurons within the ventral mesencephalon has been subject to much attention due to the implication of dopaminergic neurons in Parkinson's disease and the perspective of generating sources of therapeutically active cells to be used for cell replacement therapy for the disease. However, despite intensive research efforts, little is known about the characteristics of the dopamine neuron progenitors in human. We show that the dopamine neuron determinant LMX1a is expressed in the diencephalic and mesencephalic dopaminergic neuron domains during human development. Within the mesencephalon, LMX1a is expressed in the dopaminergic neurons and their progenitors located in the ventricular zone of the floor plate region. Furthermore, the neural progenitors in the developing human ventral mesencephalon have a radial morphology and express the radial glial markers Vimentin and BLBP. These radial glia are mitotic and act as precursors for the dopaminergic neurons. Finally, we show that progenitors isolated from the human ventral mesencephalon maintain their radial glial characteristics and neurogenic capacity after expansion in vitro, making them a promising future source of cells to be used in cell replacement therapy for Parkinson's disease. (c) 2009 Wiley-Liss, Inc.
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15.
  • Herz, Marcus, 1978-, et al. (författare)
  • Avslutning
  • 2022. - 2
  • Ingår i: Kritiskt socialt arbete. - Stockholm : Liber. - 9789147144235 ; , s. 214-228
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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16.
  • Herz, Marcus, 1978, et al. (författare)
  • Mot ett kritiskt socialt arbete
  • 2022. - 2
  • Ingår i: Kritiskt socialt arbete. - Malmö : Liber. - 9789147144235 ; , s. 214-228
  • Bokkapitel (refereegranskat)
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17.
  • Holmquist, Hanna, 1982, et al. (författare)
  • Choosing a rain coating – life cycle assessment to guide substitution of hazardous durable water repellent chemistry
  • 2017
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Many actors in the textile industry are currently substituting hazardous long-chain per- and polyfluoroalkyl substances (PFAS). One application of PFAS in the textile industry is in finishing to impart water (and oil) resistance to the textile (chemicals that provide this function are called durable water repellents; DWR). In a review of properties of the DWRs that are alternatives to DWRs containing long-chain PFASs, we could show that several of the alternatives also have hazardous properties and that a substitution of the DWR may lead to a shift in the environmental burden of the garment, e.g. by the need of more frequent wash or shorter life length. It is clear that to achieve an environmentally sound substitution thorough assessment of the alternatives is needed. The project Substitution in Practice of Prioritized Fluorinated Chemicals to Eliminate Diffuse Sources (SUPFES, www.supfes.eu, funded by the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (FORMAS) under grant agreement No. 2012-2148) set out to guide this substitution by assessment of the DWR alternatives, both with regards to their functionality and the environmental consequences of their use. In life cycle assessments (LCA) the environmental performance of four different types of garments (two types of shell jackets, an ambulance jacket and a children’s overall), meeting different user protection needs, are investigated. The LCAs are intended to make possible a holistic assessment where toxicological hazards as well as risks of problem shifting (e.g. between impact categories) are addressed. Connected with technical performance testing of the DWR alternatives the LCAs allow for a unique possibility to include also functionality aspects. One important prerequisite for the LCAs is the availability of characterisation factors for (eco)toxicological effects and a review of existing characterisation factors (CF) for textile chemicals showed that CFs are missing for many DWR-related substances. The calculation of new CFs with UseTox 2.01 made it clear that several of the DWR-related substances are particularly difficult to model due to physical-chemical properties affecting their fate. In addition, many of the substances are persistent, bioaccumulative and toxic (PBT) or very persistent and very mobile (vPvM) and as such their environmental consequences may not be well captured by existing life cycle impact assessment (LCIA) methods, if for example relevant accumulation compartments are not included in the models. In this contribution we will report on our results from the SUPFES project’s screening LCAs on the four garments and these results’ implications for the DWR substitution case. Which DWR alternative will provide sufficient functionality and environmental soundness, making possible a substitution lasting in the long run? We will also use these cases as basis for the discussion about LCIA methods and practices suitable in substitution cases involving PBT or vPvM substances in general, and PFAS in particular.
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18.
  • Holmquist, Hanna, 1982, et al. (författare)
  • Implementing a life cycle perspective in chemical alternatives assessment - the case of per- an polyfluoroalkyl substances in textile applications
  • 2018
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Informed chemical substitution is about eliminating chemicals that give rise to unacceptable (eco)toxicological risks, while avoiding problem shifting within a product’s or chemical’s life cycle, or between types of impacts. For this reason, the life cycle perspective becomes crucial. Chemical alternatives assessment (CAA) has been increasingly in focus in the last years, and life cycle assessment (LCA) and life cycle thinking are part of the more comprehensive CAA methods available. However, more detailed guidance is lacking and few practical examples have been published. A substitution case of current relevance is the phase-out of hazardous per- and polyfluoroalkyl substances (PFAS) from durable water repellent (DWR) textile applications. Alternatives are sought which offer sustained technical performance but an improved environmental and human health profile compared to the hazardous PFAS. To support an informed substitution of hazardous PFAS, and complement our previous hazard assessment, we have conducted an LCA to compare environmental and human health impacts across DWR alternatives on a functional basis. Based on this case we were also able to further elaborate on the inclusion of the life cycle perspective in a CAA framework by identifying both possibilities and challenges.    We conclude that the inclusion of a life cycle perspective in CAA is crucial for an informed and sustainable substitution, as lack of life cycle thinking can lead to problem shifting. We show that LCA, with its focus on function, is a tool that can identify such problem shifting as well as the key chemical properties to be considered. Consideration of (eco)toxicological effects in such an assessment can however turn out to be difficult, especially for substances such as the PFAS if they are outside the domain of the LCIA model. In the case under study here we conclude that the DWR should be selected with three main considerations: (i) the intrinsic hazard properties of the chemistry, selecting the DWR associated with the lowest hazard but, (ii) providing the functionality as needed and, (iii) giving the garment the longest life length.
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19.
  • Holmquist, Hanna, 1982, et al. (författare)
  • What difference can drop-in substitution actually make? : A life cycle assessment of alternative water repellent chemicals
  • 2021
  • Ingår i: Journal of Cleaner Production. - : Elsevier Ltd. - 0959-6526 .- 1879-1786. ; 329
  • Tidskriftsartikel (refereegranskat)abstract
    • Per- and polyfluoroalkyl substances (PFASs) are used in durable water repellents (DWRs) on outdoor garments and manufacturers are currently phasing out hazardous PFASs. A critical question is: which alternatives should be chosen? The answer should depend on a holistic assessment, but the published inventory data and methodological guidance for assessing PFAS in products is slim and typically limited to hazard assessment. We aim to provide a holistic assessment of the potential environmental consequences of this phase out of DWRs, going beyond the more traditional hazard-focused substitution assessment to also include a broad life-cycle-based assessment of PFASs and their drop-in alternatives. In this study, potential environmental consequences of the phase out were evaluated by applying a life cycle assessment (LCA) to shell jackets with side-chain fluorinated polymer based (i.e., PFASs) or non-fluorinated alternative DWRs with the aim to support a substitution assessment. We demonstrated an innovative approach to impact assessment by inclusion of PFAS related fate and toxicity and invested effort towards contributing new primary inventory data by using a combination of industry dialogue and performance measurements from our larger project context. From a methodological point of view, this paper demonstrates the state-of-the-art in product LCA of persistent textile chemicals and identifies the current limits of this assessment approach. It also delivers new LCI data of use to other analysts. The LCA results in this paper suggest that jackets without PFASs are environmentally preferable. Potential problem shifting due to increased washing and reimpregnation of the jackets did not outweigh PFAS-related potential toxicity impacts as indicated by LCA results. Based on the results presented here, specific DWRs within the non-fluorinated DWR group could not be identified as preferable to others. This LCA does however provide a relevant starting point for more detailed studies on specific DWR systems and it supports moves to phase-out PFASs from non-essential DWR uses. © 2021 The Authors
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20.
  • Hyltbäck, Ida, et al. (författare)
  • Study on Treatment of Atrial Fibrillation Care at Nurse Based Clinics in Sweden
  • 2014
  • Ingår i: Nordic Journal of Nursing Research. - : SAGE Publications. - 0107-4083 .- 2057-1593 .- 2057-1585. ; 34:3, s. 14-17
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim of the study was to illuminate activities at nurse- based atrial fibrillation/arrhythmia clinics in Sweden. Background: Atrial fibrillation is the most common cause of arrhythmia and it is expected that the number of patients with atrial fibrillation will continue to increase. It has been shown that in-patient care can be reduced by following up these patients using guidelines at a nurse-based clinic. The patients were better informed about their illness and guidelines were more comprehensively implemented. Method: An interview study with a descriptive approach and telephone interviews based on a questionnaire with quantitative and qualitative questions was carried out with staff from 14 clinics. Findings: The results show that patients with atrial fibrillation were treated using the recommended guidelines, but the inclusion criteria for this population differed among clinics. Patients with atrial fibrillation are in need of structured follow-up and designated support. Conclusion: Nurse-based clinics for patients with atrial fibrillation are not yet common in Sweden. The results of the study indicate that more atrial fibrillation/arrhythmia clinics should be started, and show how structured care at the clinics should be implemented.
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21.
  • Häggström, Margaretha, 1962, et al. (författare)
  • Att undervisa i hållbar utveckling - Relationellt perspektiv
  • 2022
  • Bok (övrigt vetenskapligt/konstnärligt)abstract
    • Hur kan lärare arbeta med hållbar utveckling i en tid då globala kriser och klimatförändringar väcker både rädsla och oro? Och hur kan elever samtidigt känna hopp inför sin framtid och sitt vuxna liv? Dessa frågor är utgångspunkt för det utvecklings- och forskningsprojekt som utgör basen i denna bok. Du får följa med i berättelser som lärare och elever skapat tillsammans för att utveckla kunskap om social, ekologisk och ekonomisk hållbarhet. Boken redogör för de pedagogiska utgångspunkterna, men ger också rikligt med praktiska exempel på metoder och former för undervisning i och genom demokratiska och relationella förhållningssätt. Du får konkreta tips på hur du kan integrera hållbar utveckling i undervisningen. Såväl kritiska aspekter som lärdomar och möjligheter lyfts fram. I centrum står eleven och läraren utifrån det relationspedagogiska perspektivet. Att undervisa i hållbar utveckling: Relationellt perspektiv vänder sig till lärarstudenter och verksamma lärare i årskurs F-6. Bokens syfte är att inspirera, stödja och utgöra diskussionsunderlag i skolans arbete med miljöperspektivet och hållbar utveckling.
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22.
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23.
  • Johansson, Kristin, et al. (författare)
  • Effect of pigment volume concentration and drying aspects on the enzyme activity of clay coatings
  • 2010
  • Ingår i: 11th Advanced Coating Fundamentals Symposium Proceedings. - : TAPPI Press. - 1595102035 - 9781595102034 ; , s. 129-143
  • Konferensbidrag (refereegranskat)abstract
    • The oxygen content in food packaging may be reduced by attaching oxygen scavengers to the packaging material. The critical parameters that determine the oxygen scavenging ability of an enzyme-based coating i.e. pH, heat and coating color formulation were evaluated. Glucose oxidase, Catalase and glucose were added to latex dispersions in the preparation of the coating colors. The enzymes were entrapped in the coating layers after coating and drying. The clay concentration and drying conditions were varied and the enzymatic activity of the coated layer was evaluated. The need for a pH-buffered system was also studied and the results indicated that, when using a carboxylated latex of a standard coating grade, a buffered system was not needed. A rapid drying at a high temperature was preferred over a slow drying at a low temperature in order to prevent pre-oxidation of the substrate in the wet coating color. The scavenging capacity of the coating was dependent on the amount of substrate for the enzyme reaction left after complete drying. The concentration of clay in the coating formulation was shown to have a marked impact on the oxygen-scavenging ability of the coated layer. The enzyme activity was increased by the addition of clay up to a pigment volume concentration (PVC) of ca. 10%. At higher concentrations of clay, the enzyme activity decreased until the critical pigment volume concentration (CPVC) was reached, probably due to the prevention of diffusion of oxygen and consumption of glucose in the coating process before the layer was completely dried. Further additions of clay above the CPVC resulted in an increased enzyme activity, probably due to the creation of a porous structure.
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24.
  • Johansson, Kristin, et al. (författare)
  • The effects of coating structure and water-holding capacity on the oxygen-scavenging ability of enzymes embedded in the coating layer
  • 2013
  • Ingår i: TAPPI Journal. - : TAPPI Press. - 0734-1415. ; 12:6, s. 43-52
  • Tidskriftsartikel (refereegranskat)abstract
    • Enzymes catalyzing oxygen scavenging were embedded in latex-based coatings with and without barrier kaolin clay to produce material for active packages. The clay was used to create a porous structure, and the closed-structure matrix consisted of a biopolymer comprising either starch or gelatin to increase the water uptake of the coating. The effects of the porous open structure and of the water uptake of the coated layer on the oxygen-scavenging ability of the embedded enzymes were examined at both 75% and 100% relative humidity. The results showed that the porous clay structure led to higher oxygen-scavenging capacity than that of a closed structure at both test conditions by enabling a high diffusion rate for oxygen and glucose to the active sites of the enzymes. The addition of a water-holding biopolymer did not always significantly affect the oxygen-scavenging capacity. However for a less-porous layer at 100% relative humidity, an increase in the amount of biopolymer resulted in an increase in oxygen-scavenging capacity. The results were treated statistically using multiple-factor analysis where the most important factor for the oxygen-scavenging ability was found to be the addition of clay. The coatings were also characterized with respect to water vapor uptake, overall migration, porosity, and scanning electron microscopy images.
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25.
  • Jönsson, Hanna, et al. (författare)
  • An image registration method for voxel-wise analysis of whole-body oncological PET-CT
  • 2022
  • Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • Whole-body positron emission tomography-computed tomography (PET-CT) imaging in oncology provides comprehensive information of each patient's disease status. However, image interpretation of volumetric data is a complex and time-consuming task. In this work, an image registration method targeted towards computer-aided voxel-wise analysis of whole-body PET-CT data was developed. The method used both CT images and tissue segmentation masks in parallel to spatially align images step-by-step. To evaluate its performance, a set of baseline PET-CT images of 131 classical Hodgkin lymphoma (cHL) patients and longitudinal image series of 135 head and neck cancer (HNC) patients were registered between and within subjects according to the proposed method. Results showed that major organs and anatomical structures generally were registered correctly. Whole-body inverse consistency vector and intensity magnitude errors were on average less than 5 mm and 45 Hounsfield units respectively in both registration tasks. Image registration was feasible in time and the nearly automatic pipeline enabled efficient image processing. Metabolic tumor volumes of the cHL patients and registration-derived therapy-related tissue volume change of the HNC patients mapped to template spaces confirmed proof-of-concept. In conclusion, the method established a robust point-correspondence and enabled quantitative visualization of group-wise image features on voxel level.
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26.
  • Jönsson, Hanna, et al. (författare)
  • Spatial mapping of tumor heterogeneity in whole-body PET-CT : a feasibility study
  • 2023
  • Ingår i: Biomedical engineering online. - : BioMed Central (BMC). - 1475-925X. ; 22
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Tumor heterogeneity is recognized as a predictor of treatment response and patient outcome. Quantification of tumor heterogeneity across all scales may therefore provide critical insight that ultimately improves cancer management.Methods: An image registration-based framework for the study of tumor heterogeneity in whole-body images was evaluated on a dataset of 490 FDG-PET-CT images of lung cancer, lymphoma, and melanoma patients. Voxel-, lesion- and subject-level features were extracted from the subjects' segmented lesion masks and mapped to female and male template spaces for voxel-wise analysis. Resulting lesion feature maps of the three subsets of cancer patients were studied visually and quantitatively. Lesion volumes and lesion distances in subject spaces were compared with resulting properties in template space. The strength of the association between subject and template space for these properties was evaluated with Pearson's correlation coefficient.Results: Spatial heterogeneity in terms of lesion frequency distribution in the body, metabolic activity, and lesion volume was seen between the three subsets of cancer patients. Lesion feature maps showed anatomical locations with low versus high mean feature value among lesions sampled in space and also highlighted sites with high variation between lesions in each cancer subset. Spatial properties of the lesion masks in subject space correlated strongly with the same properties measured in template space (lesion volume, R = 0.986, p < 0.001; total metabolic volume, R = 0.988, p < 0.001; maximum within-patient lesion distance, R = 0.997, p < 0.001). Lesion volume and total metabolic volume increased on average from subject to template space (lesion volume, 3.1 +/- 52 ml; total metabolic volume, 53.9 +/- 229 ml). Pair-wise lesion distance decreased on average by 0.1 +/- 1.6 cm and maximum within-patient lesion distance increased on average by 0.5 +/- 2.1 cm from subject to template space.Conclusions: Spatial tumor heterogeneity between subsets of interest in cancer cohorts can successfully be explored in whole-body PET-CT images within the proposed framework. Whole-body studies are, however, especially prone to suffer from regional variation in lesion frequency, and thus statistical power, due to the non-uniform distribution of lesions across a large field of view.
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27.
  • Jönsson, Hanna, 1977 (författare)
  • Vätgasens historia i Sverige: Aktörer och aktiviteter inom vätgas- och bränslecellsområdet mellan 1960 och 2005
  • 2006
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Higher oil prices, climate changes and problems with poor local air quality is leading to an intensified debate on alternative fuels. Hydrogen is one of them. In Sweden the history of hydrogen can be traced several decades back, but the different activities have uptil now never been surveyed and documented.The objective of this study was to describe and raise awareness of activities and actors in the field of hydrogen and fuel cells in Sweden between 1960 and 2005, focusing on hydrogen as an alternative fuel for vehicles. Through historical studies of how new technologies have been perceived, considered, developed and introduced, new knowledge about the dynamics of that kind of processes can be created. A look back in time can help us notice that what is happening today, in many ways are steps in a process that started many decades ago. Hence, the lessons learnt from successful and failed projects can be transfered to the actors of current or future hydrogen projects or activities.During the study, planned and completed activities have been identified and described, e.g. technology survey, research, development work, demonstrations and building of contact networks, together with involved actors and individuals. The investigation was based on litterature studies and interviews with more than 25 persons that have been working in the field during the period.The result of the study shows that the hydrogen history in Sweden is long and that there have been many activities during the years, even if the level of interest has varied. There was an interest in hydrogen vehicles already in the 60´s when ASEA carried out a fuel cell R&D programme and was one of the leading companies in the world. The competence from ASEA was later transfered to the Royal Institute of Technology, which has been one of the key players in the history. The Swedish Govenment started to support hydrogen avtivities in 1975 when the first energy research programme started, as a result of the oil crisis. The main activities then were technology surveys, international collaboration and research projects. There has been research on both production and storage technologies, as well as the use of hydrogen in either vehicles with combustion engines or fuel cells. The first hydrogen fueled car was demonstrated in 1985 in Härnösand, on the initiative of a local entrepreneur. This was followed by initiatives in several other cities to demonstrate bus fleets for public transportation. The Govenment supported some pre-studies, but none of the projects were realized. Durung the 70´s and 80´s the focus was on hydrogen powered combustion engines. The interest in fuel cell vehicles started to increase at the end of the 90´s, as it did in many other countries. At that time some large fuel cell programmes were initiated, based on the Swedish competence that had been built up during many years of research. As a result two fuel cell companies were founded. The increased interest at this time also resulted in that demonstrations were planned in several cities, e.g. Sundsvall, Malmö, Göteborg, Visby, Stockholm and Karlstad. Two of the projects have been realized. The first was located to Malmö where the first Swedish hydrogen refueling station was inaugurated in 2003 and a hythane bus fleet has been demonstrated since then. The second was the CUTE-project in Stockholm where the first fuel cell busses were demonstated during 2003-2005.Some reflections can be made on the Swedish hydrogen history. (1) There have been activities in the field during at least 45 years. (2) Most of the activities can be caracteriezed as technology studies or research, while there have not been so many demonstrations. (3) In most cases the first intiative to demonstrate vehicles have come from small local actors, while the majority of projects that have been realized have been strongly supported by large actors. (4) Several times there have been very high expectations from the project participants on the potential of hydrogen as an economically competitive fuel. These projects would probably have had a better chance of succeeding if smaller fleets had been investigated. (5) The amount of actors in the field has been limited and the most of them know each other. Therefore it might have been hard for new actors to enter the network. (6) The Swedish Government has on several occations defined hydrogen as a fuel interesting only in a longer timeframe. That may have contributed to a situation where it have been difficult for the authorities and companies to make priorities and long term commitments.
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28.
  • Jönsson, Lena M, et al. (författare)
  • Management of Radioactive Waste in Nuclear Medicine
  • 2022. - 1
  • Ingår i: Handbook of Nuclear Medicine and Molecular Imaging for Physicists : Radiopharmaceuticals and Clinical Applications, Volume III - Radiopharmaceuticals and Clinical Applications, Volume III. - 9781138593312 - 9780429489501 ; 3
  • Bokkapitel (refereegranskat)abstract
    • The use of radionuclides in medicine will inevitably result in various forms of radioactive waste. The waste emerges from the production of radionuclides and radiopharmaceuticals, diagnostic and therapeutic use, and in biomedical research. Radioactive waste can also include spent sealed sources used for calibration, or quality control of different kind of medical equipment. The waste can lie within a wide range of activities and half-lives and be in different forms, solids, liquids, or airborne. In nuclear medical applications the main part of the radioactive waste consists of radionuclides with short half-life and low radiotoxicity, but other risks associated with the waste must also be considered. The philosophy of all work with radioactive material is to minimize any hazards on human health and impact on the environment both in the short and long term. To meet this, the basic principles of radiation safety must be applied – that is, justification, optimization, and the use of dose limits. This also includes radioactive waste management, and therefore the radioactive waste generated must be kept to a minimum as well as adapted to the work situation. The management of radioactive waste from medical applications is guided by international recommendations and regulated by regional and national authorities. The organization and regulations may vary in different countries due to the national legal framework, but the purpose is the same – to minimize a negative impact of the waste in all aspects.
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29.
  • Jönsson, Malin, et al. (författare)
  • CaRA – A multi-purpose phage display library for selection of calcium-regulated affinity proteins
  • 2022
  • Ingår i: New Biotechnology. - : Elsevier B.V.. - 1871-6784 .- 1876-4347. ; 72, s. 159-167
  • Tidskriftsartikel (refereegranskat)abstract
    • Protein activity regulated by interactions with metal ions can be utilized for many different purposes, including biological therapies and bioprocessing, among others. Calcium ions are known to interact with the frequently occurring EF-hand motif, which can alter protein activity upon binding through an induced conformational change. The calcium-binding loop of the EF-hand motif has previously been introduced into a small protein domain derived from staphylococcal Protein A in a successful effort to render antibody binding dependent on calcium. Presented here, is a combinatorial library for calcium-regulated affinity, CaRA, based on this domain. CaRA is the first alternative scaffold library designed to achieve novel target specificities with metal-dependent binding. From this library, several calcium-dependent binders could be isolated through phage display campaigns towards a set of unrelated target proteins (IgE Cε3-Cε4, TNFα, IL23, scFv, tPA, PCSK9 and HER3) useful for distinct applications. Overall, these monomeric CaRA variants showed high stability and target affinities within the nanomolar range. They displayed considerably higher melting temperatures in the presence of 1 mM calcium compared to without calcium. Further, all discovered binders proved to be calcium-dependent, with the great majority showing complete lack of target binding in the absence of calcium. As demonstrated, the CaRA library is highly capable of providing protein-binding domains with calcium-dependent behavior, independent of the type of target protein. These binding domains could subsequently be of great use in gentle protein purification or as novel therapeutic modalities.
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30.
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31.
  • Jönsson, Simon, et al. (författare)
  • Increased Levels of Leukocyte-Derived MMP-9 in Patients with Stable Angina Pectoris
  • 2011
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: There is a growing interest for matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in plasma as novel biomarkers in coronary artery disease (CAD). We aimed to identify the sources of MMP-8, MMP-9, TIMP-1 and TIMP-2 among peripheral blood cells and further explore whether gene expression or protein release was altered in patients with stable angina pectoris (SA). Methods: In total, plasma MMP-9 was measured in 44 SA patients and 47 healthy controls. From 10 patients and 10 controls, peripheral blood mononuclear cells (PBMC) and neutrophils were isolated and stimulated ex vivo. MMPs, TIMPs and myeloperoxidase were measured in plasma and supernatants by ELISA. The corresponding gene expression was measured by real-time PCR. Results: Neutrophils were the dominant source of MMP-8 and MMP-9. Upon moderate stimulation with IL-8, the neutrophil release of MMP-9 was higher in the SA patients compared with controls (p andlt; 0.05). In PBMC, the TIMP-1 and MMP-9 mRNA expression was higher in SA patients compared with controls, p andlt; 0.01 and 0.05, respectively. There were no differences in plasma levels between patients and controls except for TIMP-2, which was lower in patients, p andlt; 0.01. Conclusion: Measurements of MMPs and TIMPs in plasma may be of limited use. Despite similar plasma levels in SA patients and controls, the leukocyte-derived MMP-9 and TIMP-1 are significantly altered in patients. The findings indicate that the leukocytes are more prone to release and produce MMP-9 in symptomatic and angiographically verified CAD-a phenomenon that may have clinical implications in the course of disease.
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32.
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33.
  • Khedidja, Hedna, et al. (författare)
  • Adherence to Antihypertensive Therapy and Elevated Blood Pressure: Should We Consider the Use of Multiple Medications?
  • 2015
  • Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 10:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Although a majority of patients with hypertension require a multidrug therapy, this is rarely considered when measuring adherence from refill data. Moreover, investigating the association between refill non-adherence to antihypertensive therapy (AHT) and elevated blood pressure (BP) has been advocated. Identify factors associated with non-adherence to AHT, considering the multidrug therapy, and investigate the association between non-adherence to AHT and elevated BP. A retrospective cohort study including patients with hypertension, identified from a random sample of 5025 Swedish adults. Two measures of adherence were estimated by the proportion of days covered method (PDC >= 80%): (1) Adherence to any antihypertensive medication and, (2) adherence to the full AHT regimen. Multiple logistic regressions were performed to investigate the association between sociodemographic factors (age, sex, education, income), clinical factors (user profile, number of antihypertensive medications, healthcare use, cardiovascular comorbidities) and non-adherence. Moreover, the association between non-adherence (long-term and a month prior to BP measurement) and elevated BP was investigated. Non-adherence to any antihypertensive medication was higher among persons < 65 years (Odds Ratio, OR 2.75 [95% CI, 1.18-6.43]) and with the lowest income (OR 2.05 [95% CI, 1.01-4.16]). Non-adherence to the full AHT regimen was higher among new users (OR 2.04 [95% CI, 1.32-3.15]), persons using specialized healthcare (OR 1.63, [95% CI, 1.14-2.32]), and having multiple antihypertensive medications (OR 1.85 [95% CI, 1.25-2.75] and OR 5.22 [95% CI, 3.48-7.83], for 2 and >= 3 antihypertensive medications, respectively). Non-adherence to any antihypertensive medication a month prior to healthcare visit was associated with elevated BP. Sociodemographic factors were associated with non-adherence to any antihypertensive medication while clinical factors with non-adherence to the full AHT regimen. These differing findings support considering the use of multiple antihypertensive medications when measuring refill adherence. Monitoring patients' refill adherence prior to healthcare visit may facilitate interpreting elevated BP.
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34.
  • Khedidja, Hedna, et al. (författare)
  • Potentially inappropriate prescribing and adverse drug reactions in the elderly: a population-based study
  • 2015
  • Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 71:12, s. 1525-1533
  • Tidskriftsartikel (refereegranskat)abstract
    • Potentially inappropriate prescriptions (PIPs) criteria are widely used for evaluating the quality of prescribing in elderly. However, there is limited evidence on their association with adverse drug reactions (ADRs) across healthcare settings. The study aimed to determine the prevalence of PIPs, defined by the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, in the Swedish elderly general population and to investigate the association between PIPs and occurrence of ADRs. Persons a parts per thousand yen65 years old were identified from a random sample of 5025 adults drawn from the Swedish Total Population Register. A retrospective cohort study was conducted among 813 elderly with healthcare encounters in primary and specialised healthcare settings during a 3-month period in 2008. PIPs were identified from the Swedish Prescribed Drug Register, medical records and health administrative data. ADRs were independently identified by expert reviewers in a stepwise manner using the Howard criteria. Multivariable logistic regression examined the association between PIPs and ADRs. Overall, 374 (46.0 %) persons had a parts per thousand yen1 PIPs and 159 (19.5 %) experienced a parts per thousand yen1 ADRs during the study period. In total, 29.8 % of all ADRs was considered caused by PIPs. Persons prescribed with PIPs had more than twofold increased odds of experiencing ADRs (OR 2.47; 95 % CI 1.65-3.69). PIPs were considered the cause of 60 % of ADRs affecting the vascular system, 50 % of ADRs affecting the nervous system and 62.5 % of ADRs resulting in falls. PIPs are common among the Swedish elderly and are associated with increased odds of experiencing ADRs. Thus, interventions to decrease PIPs may contribute to preventing ADRs, in particular ADRs associated with nervous and vascular disorders and falls.
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35.
  • Lilja, Karl, et al. (författare)
  • Bedömning av miljögiftspåverkan i vattenmiljö. Samordnad metodutveckling
  • 2010
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Ett förslag till vägledning för att bedriva miljögiftsövervakning och för hur framtagna data skall kunna användas i vattenförvaltningen har inom denna studie tagits fram. Förslaget till vägledning syftar också till att ge underlag för en sammanhållen metodik för hur existerande datakällor på ett effektivt sätt skall kunna utnyttjas vid bedömning av miljögiftspåverkan i vattendirektivsarbetet. Förslag och rekommendationer har baserats på krav som ställs enligt EUs vattendirektiv och har kompletteras utifrån resultaten i föreliggande studie. En kritisk granskning av de översättningar mellan EQS för ytvatten, och motsvarande halter i sediment och biota, som tidigare har utförts med hjälp av jämviktsfördelningsmetodik och bioackumuleringsfaktorer enligt den metodik som beskrivs i TGD (Technical Guidance Document on Risk Assessment) (TGD, 2003) har utförts för att bedöma huruvida metoden är tillämplig i svenska förhållanden. Halter av miljögifter i sediment, biota och vatten har jämförts med gränsvärden, antingen beräknade med översättningsmetodik eller uppsatta i direktiv
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36.
  • Lucander, Henriette, et al. (författare)
  • “I’ll Never Forget This” : evaluating a pilot workshop in effective communication for dental students
  • 2012
  • Ingår i: Journal of Dental Education. - : American Dental Education Association. - 0022-0337 .- 1930-7837. ; 76:10, s. 1311-1316
  • Tidskriftsartikel (refereegranskat)abstract
    • This study evaluated a pilot workshop for teaching communication skills to dental students. The methodology is based on an experiential learning approach, the use of realistic clinical scenarios, simulated patients, and an integrated teaching team of both educational researchers and dentists. Furthermore, the methodology was adapted for short workshops, which is thought to offer better possibilities for frequent and effective training of communication skills throughout the curriculum. The workshop was piloted with groups of six to ten students from the sixth and tenth semesters (n=94). Results show that the majority of students found the tasks meaningful and well aligned with how they perceived their future profession as dentists. Most students also thought that they learned from the task. An interesting finding is that students not only found it instructive to practice how to communicate in authentic situations, but that they generally found the workshop to be thought-provoking while at the same time providing structure and intellectual tools for the future. A possible explanation for this finding is the sharing of explicit criteria for high-quality communication.
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37.
  • Lundahl, Christian, 1972-, et al. (författare)
  • Fel att låta 24 timmar avgöra elevers betyg
  • 2017
  • Ingår i: Aftonbladet. - Stockholm : Aftonbladet Hierta AB. - 1103-9000.
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
  •  
38.
  • Mravinacová, Sára, et al. (författare)
  • A cell-free high throughput assay for assessment of SARS-CoV-2 neutralizing antibodies
  • 2022
  • Ingår i: New Biotechnology. - : Elsevier BV. - 1871-6784 .- 1876-4347. ; 66, s. 46-52
  • Tidskriftsartikel (refereegranskat)abstract
    • Highly accurate serological tests are key to assessing the prevalence of SARS-CoV-2 antibodies and the level of immunity in the population. This is important to predict the current and future status of the pandemic. With the recent emergence of new and more infectious SARS-CoV-2 variants, assays allowing for high throughput analysis of antibodies able to neutralize SARS-CoV-2 become even more important. Here, we report the development and validation of a robust, high throughput method, which enables the assessment of antibodies inhibiting the binding between the SARS-CoV-2 spike protein and angiotensin converting enzyme 2 (ACE2). The assay uses recombinantly produced spike-f and ACE2 and is performed in a bead array format, which allows analysis of up to 384 samples in parallel per instrument over seven hours, demanding only one hour of manual handling. The method is compared to a microneutralization assay utilising live SARS-CoV-2 and is shown to deliver highly correlating data. Further, a comparison with a serological method that measures all antibodies recognizing the spike protein shows that this type of assessment provides important insights into the neutralizing efficiency of the antibodies, especially for individuals with low antibody levels. This method can be an important and valuable tool for large-scale assessment of antibody-based neutralization, including neutralization of new spike variants that might emerge.
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39.
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40.
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41.
  • Möller, Christine, et al. (författare)
  • Stem cell factor promotes mast cell survival via inactivation of FOXO3a-mediated transcriptional induction and MEK-regulated phosphorylation of the proapoptotic protein Bim
  • 2005
  • Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 106:4, s. 1330-1336
  • Tidskriftsartikel (refereegranskat)abstract
    • Mast cells are found in tissues throughout the body where they play important roles in the regulation of inflammatory responses. One characteristic feature of mast cells is their longevity. Although it is well established that mast cell survival is dependent on stem cell factor (SCF), it has not been described how this process is regulated. Herein, we report that SCF promotes mast cell survival through inactivation of the Forkhead transcription factor FOXO3a (forkhead box, class O3A) and down-regulation and phosphorylation of its target Bim (Bcl-2 [B-cell lymphoma-2] interacting modulator of cell death), a Bcl-2 homology 3 (BH3)-only proapoptotic protein. SCF induced a rapid and transient phosphorylation of Akt (protein kinase B) and FOXO3a. SCF treatment prevented up-regulation of Bim protein expression and led to increased Bim phosphorylation. Bim phosphorylation was inhibited by PD98059 and LY294002 treatment, suggesting the involvement of mitogen-activated protein kinase kinase/mitogen-activated protein kinase (MEKJMAPK) and phosphatidylinositol 3 (PI3)-kinase pathways in this process. Overexpression of phosphorylation-deficient FOXO3a caused an up-regulation of Bim and induced mast cell apoptosis even in the presence of SCF. Mast cell apoptosis induced by the phosphorylation-deficient FOXO3a was attenuated in bim(-/-) mast cells. Because apoptosis is abnormally reduced in bim(-/-) mast cells, these data provide evidence that Akt-mediated inhibition of FOXO3a and its transcription target Bim provides an important mechanism by which SCF acts to prevent apoptosis in mast cells.
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42.
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43.
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44.
  • Rešić Lindehammer, Sabina, et al. (författare)
  • Seroconversion to Islet Autoantibodies After Enterovirus Infection in Early Pregnancy.
  • 2012
  • Ingår i: Viral Immunology. - : Mary Ann Liebert Inc. - 0882-8245 .- 1557-8976. ; 25:4, s. 254-261
  • Tidskriftsartikel (refereegranskat)abstract
    • Gestational enterovirus (EV) infections have been associated with an increased risk for type 1 diabetes in the offspring. We therefore analyzed non-diabetic mothers for EV exposure in early pregnancy in relation to type 1 diabetes HLA-DQ risk genotypes and seroconversion to islet autoantibodies during pregnancy. Non-diabetic mothers who had islet autoantibodies (n=365) against glutamic acid decarboxylase (GADA), islet antigen-2 autoantibodies (IA-2A), or insulin autoantibodies (IAA), in early pregnancy and at delivery were compared to islet autoantibody-negative mothers (n=1457) matched for age and sampling date. Mothers were genotyped for HLA-DQ and analyzed for both EV-RNA and EV-IgM. EV-IgM, but not EV-RNA, was detected during early pregnancy in 12% of islet autoantibody-positive mothers compared to 11% of the controls. In early pregnancy, mothers with HLA-DQ 2/2 or 2/X genotypes showed an increased risk for islet autoantibodies at delivery (OR 1.85; p=0.001). After adjusting for parity, maternal age, year of birth, and season of early pregnancy, early pregnancy EV-IgM combined with DQ2/2 or 2/X increased the risk for islet autoantibodies (OR 3.10; 95% CI 1; p=0.008). EV-IgM in early pregnancy increased the risk for islet autoantibodies at delivery in non-diabetic mothers with HLA-DQ 2/2 or 2/X type 1 diabetes risk genotypes.
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45.
  • Roos, Sandra, 1977, et al. (författare)
  • A Function‐Based Approach for Life Cycle Management of Chemicals in the Textile Industry
  • 2020
  • Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 12:1273, s. 1-14
  • Tidskriftsartikel (refereegranskat)abstract
    • Consumer products such as clothes and footwear sometimes contain chemical substances with properties that pose a risk to human health and the environment. These substances, restricted by law or company policy, are in focus for chemicals management processes by textile retailers. However, complex and non‐transparent supply chains, and limited chemical knowledge, makes chemicals management challenging. Therefore, a function‐based approach for life cycle management (LCM) of chemicals was developed, based on results of previous projects and evaluated using a two‐step Delphi process. The resulting approach aims to help retailers identify and substitute hazardous substances in products, and consists of three parts: (i) a function‐based chemicals management concept model for different levels of chemical information within the supply chain, (ii) tools for non‐chemists which explain chemical information, and (iii) a continuous provision of knowledge to stakeholders (e.g., retailers) in a network. This approach is successfully implemented by over 100 retailers in the Nordic countries, providing the textile industry with practical and robust tools to manage and substitute hazardous chemicals in products and production processes. We conclude that the developed approach provides an explicit link, communication, and knowledge sharing between actors in the supply chain, which has proven important in chemicals LCM.
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46.
  • Roos, Sandra, 1977, et al. (författare)
  • USEtox characterisation factors for textile chemicals based on a transparent data source selection strategy
  • 2018
  • Ingår i: International Journal of Life Cycle Assessment. - : Springer Science and Business Media LLC. - 1614-7502 .- 0948-3349. ; 23:4, s. 890-903
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose Life cycle assessments (LCAs) of textile products which do not include the use and emission of textile chemicals, such as dyes, softeners and water-repellent agents,will give non-comprehensive results for the toxicity impact potential. The purpose of this paper is twofold: (1) to provide a set of characterisation factors (CFs) for some of the most common textile chemicals and (2) to propose a data source selection strategy in order to increase transparency when calculating new CFs. Methods A set of 72 common textile-related substances was matched with the USEtox 2.01, USEtox 1.01 and the COSMEDE databases in order to investigate coverage and coherence. For the 25 chemicals that did not already have established CFs in any of these databases, new CFs were calculated. A data source selection strategy was developed and followed in order to ensure consistency and transparency,and USEtox 2.01 was used for calculations. The parameters that caused the most uncertainty were identified during the modelling and strategies for handling them were developed. Results and discussion Of the 72 textile-related substances, 48 already had calculated recommended or indicative CFs in existing databases, which showed good coherence. The main uncertainty identified during the calculation of 25 new CFs was the selection of input data regarding toxicity and degradation in water. However, for substances such as per- and polyfluoroalkyl substances (PFAS), the acid dissociation constant (pKa) and partitioning coefficients (Kow and KOC)also require special considerations. Other input parameters had less than one order of magnitude impact on the CF result for essentially all substances. Conclusions The paper presents a strategy for how to provide a complete set of toxicity CFs for a given list of substances. In addition, such a set of CFs for common textile-related substances is presented. The data source selection strategy provides a structured and transparent way of calculating additional CFs for textile chemicals with USEtox. Consequently, this study can help future LCA studies to provide relevant guidance towards environmentally benign chemical management in the textile industry.
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47.
  • Sandvik, Ann-Helen, et al. (författare)
  • Sjuksköterskestudenters erfarenheter av sin första kliniska utbildningsperiod : en nordisk kvantitativ studie
  • 2012
  • Ingår i: Vård i Norden. - 0107-4083 .- 1890-4238. ; 32:1, s. 20-25
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Differences in quality of clinical education and support to students occur and there are demands for a unification of higher education in Europe.Aim: The aim of the study was to describe the nursing students’ experiences of their first clinical education period in relation to learning and professional development.Methods: The sample consisted of 139 nursing students from Finland and Sweden. The data was collected by questionnaire and analyzed statistically.Findings: Students’ experiences of clinical competence were examined from four perspectives: clinical preception, learning, learning objectives and reflection. Overall, students rated highly, however there were statistically significant differences among the students concerning nationality and length of clinical education. Students did not always get a clear picture of what was expected of them in clinical education and there were deficits in continuing feedback. Students’ clinical learning was associated with the length of clinical education.Conclusions: Clinical preceptoring as a catalyst in student's understanding and learning is central. Students rated learning of tasks and skills higher than abilities that require more reflection and consideration, which may indicate a more task-centered preception. A conscious didactic approach would help students to reflect and develop into professionals in nursing and caring science.
  •  
48.
  •  
49.
  • Stjernberg (Zetterblad), Jenny (författare)
  • Knock Knock Knock, Who is there? - Cell Crosstalk within the Bone Marrow
  • 2011
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis is focused on the subject of cell-cell interaction. Our body is composed of cells, most of them are integrated in a network with other cells that together forms tissues and organs. Every cell type in these complex organs has its special task and location. This is true whether we are doing research on humans or, as we have been, investigating mice. Mice are excellent models for studies of blood cell development since this process in mice resembles human blood cell generation in many regards.Cells communicate with each other by sending out small molecules or by directly binding to surrounding cells; to cells of the same kind as well as to cells with different origins and tasks. A cell is surrounded by hundreds of different signal-carrying entities; soluble, bound to the extra cellular matrix or bound to its surface. Every cell has to distinguish and respond to the environment according to its own specific nature.In the first article interleukin 7 (IL-7) a growth factor expressed by the stroma cells was studied. Results show that IL-7 is crucial for the immature progenitor cell in its development towards antibody producing B-lymphocytes. The second article is about stroma cells and their ability to support the development of B-cells. It is a comparative study on two different cell lines, where we focus on transcription factors and their regulation of protein induction of factors supporting B-cells. This study increased our knowledge of stroma cells. In the third paper we combined our knowledge from the first two papers in regard to stroma cells as well as B-cell development by testing if there is a possibility to theoretically find new factors of importance for the maturing B-cell. We achieved this by the development of GCINT, a database investigating possible receptorligand interactions between two cells, verifying these results in vitro with cell lines as well as primary cells. This revealed a two way communication between blood cells and stroma cells, highlighting the complexity of the bone marrow environment. In the last article we continued this work with primary FACS sorted stroma cells investing the potential connections between each of the stroma cell populations with primary blood cells in different stages of development. This work supports a model where hematopoietic cells can interact with stroma cells in a stage-specific manner and that the exchange between cells is of importance for their maturation.
  •  
50.
  • Tarai, Sambit, et al. (författare)
  • Improved automated tumor segmentation in whole-body 3D scans using multi-directional 2D projection-based priors
  • 2024
  • Ingår i: Heliyon. - : Elsevier. - 2405-8440. ; 10:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Early cancer detection, guided by whole-body imaging, is important for the overall survival and well-being of the patients. While various computer-assisted systems have been developed to expedite and enhance cancer diagnostics and longitudinal monitoring, the detection and segmentation of tumors, especially from whole-body scans, remain challenging. To address this, we propose a novel end -to-end automated framework that first generates a tumor probability distribution map (TPDM), incorporating prior information about the tumor characteristics (e.g. size, shape, location). Subsequently, the TPDM is integrated with a state-of-the-art 3D segmentation network along with the original PET/CT or PET/MR images. This aims to produce more meaningful tumor segmentation masks compared to using the baseline 3D segmentation network alone. The proposed method was evaluated on three independent cohorts (autoPET, CAR-T, cHL) of images containing different cancer forms, obtained with different imaging modalities, and acquisition parameters and lesions annotated by different experts. The evaluation demonstrated the superiority of our proposed method over the baseline model by significant margins in terms of Dice coefficient, and lesion-wise sensitivity and precision. Many of the extremely small tumor lesions (i.e. the most difficult to segment) were missed by the baseline model but detected by the proposed model without additional false positives, resulting in clinically more relevant assessments. On average, an improvement of 0.0251 (autoPET), 0.144 (CAR-T), and 0.0528 (cHL) in overall Dice was observed. In conclusion, the proposed TPDM-based approach can be integrated with any state-of-the-art 3D UNET with potentially more accurate and robust segmentation results.
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