| 1. |
- Ahlgren-Moritz, Charlotte, et al.
(författare)
-
Vägen till samverkanssäkrad utbildning. [1] : Metoder och strategier
- 2016
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Universitet och högskolor bidrar till samhällsutvecklingen genom att forskningsbaserad kunskap tillämpas av olika aktörer i samhället. För att möta dagens och morgondagens samhällsutmaningar utgör således kunskapsutbyte och samverkan mellan lärosäten och samhället en värdefull möjlighet. Att ha starka relationer med samhällets aktörer identifieras också som viktigt i utvecklingen av ett internationellt starkt lärosäte.Samverkan i högre utbildning främjar samhällets förändringsförmåga och stärker utbildningens kvalitet, men samverkan förbereder också studenterna för ett livslångt lärande och underlättar övergången mellan utbildning och arbetsliv. Ett lärosäte i nära samverkan med aktörer i samhället är ett relevant lärosäte, det vill säga ett lärosäte som är till nytta för sin omvärld och för sina medarbetare och studenter.Ett grundläggande problem vad gäller möjligheterna att integrera samverkan i akademisk utbildning står att finna i statens fördelning av medel till lärosätena. De statliga medlen utgår nämligen i två separata anslag, ett vardera för de båda huvuduppdragen utbildning och forskning. Samverkan kan sägas ingå i bägge uppdragen. Till skillnad från forskningssamverkan finns det för utbildningssamverkan ingen särskild uppföljning och inte heller några ekonomiska incitament. Utvärdering av forskning och utbildning bör således breddas så att kvalitetsstärkande samverkansinslag också inkluderas i resursfördelningsprinciperna. Statens bristande strukturer för fördelning och uppföljning återspeglas i hur lärosätena fördelar resurser till och följer upp samverkan: lärare ges sällan resurser (i form av särskild tid) för att på ett pedagogiskt genomtänkt sätt kunna inkludera samverkansinslag i undervisningen; samverkan är sällan meriterande eller lönegrundande; och den utbildningssamverkan som bedrivs följs sällan upp – varken på institutions-, fakultets- eller lärosätesnivå. Samma sak kan sägas gälla på nationell nivå – det samverkande lärosätet erhåller inga extra anslag och det bestraffas ej heller för försummelse av detsamma. Att göra samverkan till en integrerad del av utbildningen innebär att samverkan bör ingå i de pedagogiska modeller som lärare använder för att leda studenternas kunskapsutveckling mot de mål som finns angivna i kurs- och utbildningsplaner. Det betyder också att arbetet med samverkan bör inkluderas i processer för styrning, planering och uppföljning av utbildning och undervisning på såväl kurs- och programnivå som på institutions-, fakultets- och lärosätesnivå. Att göra samverkan till en integrerad del av utbildningen är att sträva mot att externa aktörer ska bli en självklar del i den dagliga verksamheten – för studenter såväl som för medarbetare och för de organisationer man samverkar med. För att svenska lärosäten ska ges en realistisk möjlighet att göra samverkan till en integrerad del av utbildningsverksamheten krävs det framför allt följande:att politiker och departement utformar ett fördelningssystem där framgångsrika samverkansinsatser inom utbildningen leder till en förstärkning av resursbasen på lärosätena;att lärosätesledningar tar tydlig ställning för samverkansfrågan i sina strategiska styrdokument och att samverkan införs i lärosätenas kvalitetssäkringssystem för utbildning, samt att lärosätena inför system för att styra och följa upp samverkan i utbildningen på lärosätesövergripande nivå;att ledningen för fakulteter, institutioner eller motsvarande omsätter lärosätets strategiska åtaganden i handlingsplaner och lokala styrdokument samt utformar system för dokumentation, styrning och uppföljning av samverkan i utbildningsprogram;att lärare samt kurs- och programansvariga inför samverkan i utbildningens styrande dokument (t.ex. kurs- och utbildningsplaner) samt i den ordinarie undervisningsverksamheten.Dessutom bör lärosätena – både gemensamt men också vart och ett för sig – införa system och karriärvägar där medarbetares insatser i det vardagliga samverkansarbetet uppmärksammas och belönas.Mot bakgrund av detta kan man konstatera att det är angeläget att lärosätenas strategiska arbete avseende utveckling och uppföljning av samverkan i utbildningen vidareutvecklas. Men, med vilka verktyg, var i verksamheten och på vilka sätt?I följande skrift samlas erfarenheter och goda exempel gjorda inom ramen för ett flerårigt lärosätesövergripande samarbetsprojekt, Samverkanssäkrade utbildningsprogram, där utgångspunkten har varit att identifiera strategier och metoder för att integrera samverkan i utbildningsprogram. Målet har varit att undersöka och beskriva hur samverkan kan vara ett medel som bidrar till att stärka utbildningens kvalitet och relevans, samt ge förslag på hur vägen till samverkanssäkrad utbildning kan se ut.Den centrala slutsatsen är att samverkan, när den är en integrerad del av utbildningen, bidrar till kvalitet och säkerställer att utbildningen blir till nytta för samhället. Det finns också andra vinster med att bedriva ett systematiskt samverkansarbete, till exempel att det leder till pedagogisk utveckling för undervisande personal, att det ökar förutsättningarna för ett utmaningsbaserat lärande med studenten i centrum, att det underlättar övergången från studier till arbetsliv, och att det möjliggör fördjupade relationer med den värld lärosätet finns i. Resan mot samverkanssäkrad utbildning är, med andra ord, mödan väl värd.
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| 2. |
- Ahlgren-Moritz, Charlotte, et al.
(författare)
-
Vägen till samverkanssäkrad utbildning. [2] : Möjligheter och utmaningar
- 2016
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Universitet och högskolor bidrar till samhällsutvecklingen genom att forskningsbaserad kunskap tillämpas av olika aktörer i samhället. För att möta dagens och morgondagens samhällsutmaningar utgör således kunskapsutbyte och samverkan mellan lärosäten och samhället en värdefull möjlighet. Att ha starka relationer med samhällets aktörer identifieras också som viktigt i utvecklingen av ett internationellt starkt lärosäte.Samverkan i högre utbildning främjar samhällets förändringsförmåga och stärker utbildningens kvalitet, men samverkan förbereder också studenterna för ett livslångt lärande och underlättar övergången mellan utbildning och arbetsliv. Ett lärosäte i nära samverkan med aktörer i samhället är ett relevant lärosäte, det vill säga ett lärosäte som är till nytta för sin omvärld och för sina medarbetare och studenter.Ett grundläggande problem vad gäller möjligheterna att integrera samverkan i akademisk utbildning står att finna i statens fördelning av medel till lärosätena. De statliga medlen utgår nämligen i två separata anslag, ett vardera för de båda huvuduppdragen utbildning och forskning. Samverkan kan sägas ingå i bägge uppdragen. Till skillnad från forskningssamverkan finns det för utbildningssamverkan ingen särskild uppföljning och inte heller några ekonomiska incitament. Utvärdering av forskning och utbildning bör således breddas så att kvalitetsstärkande samverkansinslag också inkluderas i resursfördelningsprinciperna. Statens bristande strukturer för fördelning och uppföljning återspeglas i hur lärosätena fördelar resurser till och följer upp samverkan: lärare ges sällan resurser (i form av särskild tid) för att på ett pedagogiskt genomtänkt sätt kunna inkludera samverkansinslag i undervisningen; samverkan är sällan meriterande eller lönegrundande; och den utbildningssamverkan som bedrivs följs sällan upp – varken på institutions-, fakultets- eller lärosätesnivå. Samma sak kan sägas gälla på nationell nivå – det samverkande lärosätet erhåller inga extra anslag och det bestraffas ej heller för försummelse av detsamma. Att göra samverkan till en integrerad del av utbildningen innebär att samverkan bör ingå i de pedagogiska modeller som lärare använder för att leda studenternas kunskapsutveckling mot de mål som finns angivna i kurs- och utbildningsplaner. Det betyder också att arbetet med samverkan bör inkluderas i processer för styrning, planering och uppföljning av utbildning och undervisning på såväl kurs- och programnivå som på institutions-, fakultets- och lärosätesnivå. Att göra samverkan till en integrerad del av utbildningen är att sträva mot att externa aktörer ska bli en självklar del i den dagliga verksamheten – för studenter såväl som för medarbetare och för de organisationer man samverkar med. För att svenska lärosäten ska ges en realistisk möjlighet att göra samverkan till en integrerad del av utbildningsverksamheten krävs det framför allt följande:att politiker och departement utformar ett fördelningssystem där framgångsrika samverkansinsatser inom utbildningen leder till en förstärkning av resursbasen på lärosätena;att lärosätesledningar tar tydlig ställning för samverkansfrågan i sina strategiska styrdokument och att samverkan införs i lärosätenas kvalitetssäkringssystem för utbildning, samt att lärosätena inför system för att styra och följa upp samverkan i utbildningen på lärosätesövergripande nivå;att ledningen för fakulteter, institutioner eller motsvarande omsätter lärosätets strategiska åtaganden i handlingsplaner och lokala styrdokument samt utformar system för dokumentation, styrning och uppföljning av samverkan i utbildningsprogram;att lärare samt kurs- och programansvariga inför samverkan i utbildningens styrande dokument (t.ex. kurs- och utbildningsplaner) samt i den ordinarie undervisningsverksamheten.Dessutom bör lärosätena – både gemensamt men också vart och ett för sig – införa system och karriärvägar där medarbetares insatser i det vardagliga samverkansarbetet uppmärksammas och belönas.Mot bakgrund av detta kan man konstatera att det är angeläget att lärosätenas strategiska arbete avseende utveckling och uppföljning av samverkan i utbildningen vidareutvecklas. Men, med vilka verktyg, var i verksamheten och på vilka sätt?I följande skrift samlas erfarenheter och goda exempel gjorda inom ramen för ett flerårigt lärosätesövergripande samarbetsprojekt, Samverkanssäkrade utbildningsprogram, där utgångspunkten har varit att identifiera strategier och metoder för att integrera samverkan i utbildningsprogram. Målet har varit att undersöka och beskriva hur samverkan kan vara ett medel som bidrar till att stärka utbildningens kvalitet och relevans, samt ge förslag på hur vägen till samverkanssäkrad utbildning kan se ut.Den centrala slutsatsen är att samverkan, när den är en integrerad del av utbildningen, bidrar till kvalitet och säkerställer att utbildningen blir till nytta för samhället. Det finns också andra vinster med att bedriva ett systematiskt samverkansarbete, till exempel att det leder till pedagogisk utveckling för undervisande personal, att det ökar förutsättningarna för ett utmaningsbaserat lärande med studenten i centrum, att det underlättar övergången från studier till arbetsliv, och att det möjliggör fördjupade relationer med den värld lärosätet finns i. Resan mot samverkanssäkrad utbildning är, med andra ord, mödan väl värd.
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| 3. |
- Alm, Anna-Karin, et al.
(författare)
-
Vägen till samverkanssäkrad utbildning
- 2016
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Kunskapsutbyte och samverkan mellan lärosäten och andra aktörer i samhället är viktigt för att vi ska kunna möta morgondagens utmaningar. Man måste arbeta över sektorsgränser, inte bara inom forskning utan också inom utbildning. “Vägen till samverkanssäkrad utbildning: metoder och strategier” handlar om hur samverkan kan integreras i högre utbildning. Slutsatserna baseras på de erfarenheter som gjorts i projektet Samverkanssäkrade utbildningsprogram som letts av lärosätena i Linköping, Malmö och Umeå. Publikationens andra del, “Möjligheter och utmaningar”, berättar ett antal historier ur samverkansvardagen. // Att med andra samhällsaktörer samverka kring utformningen av utbildningsprogram och i undervisningen bidrar till kvalitetsutveckling och säkerställer att utbildningen är till nytta för samhället. Samverkan förbereder också studenterna för ett livslångt lärande och underlättar övergången mellan utbildning och arbetsliv. För att man långsiktigt ska kunna integrera samverkan i utbildningsprogram krävs insatser på flera nivåer. Till exempel måste lärosätesledningar ta tydlig ställning i samverkansfrågan i sina styrdokument, och samverkansaspekten måste vara en självklar del av lärosätets kvalitetssäkringssystem. Det krävs också att ledningen för fakulteter och institutioner utformar system för dokumentation, styrning och uppföljning av samverkan. Vidare bör samverkan ingå i de pedagogiska modeller som lärare använder för att leda studenternas kunskapsutveckling, och lärosätena bör också uppmärksamma och belöna framgångsrikt samverkansarbete. Slutligen bör politiker och departement utforma ett fördelningssystem där framgångsrika samverkansinsatser inom utbildningen leder till en förstärkning av resursbasen på lärosätena.
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| 4. |
- Stockfelt, Marit, et al.
(författare)
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Activated low-density granulocytes in peripheral and intervillous blood and neutrophil inflammation in placentas from SLE pregnancies
- 2021
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Ingår i: Lupus Science and Medicine. - : BMJ. - 2053-8790. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective Women with SLE face an increased risk of adverse pregnancy outcomes compared with healthy women, but the underlying immunological mechanisms are unknown. Given the recognised association of neutrophil activation with SLE pathogenesis, we examined whether there is increased neutrophil activation and inflammation in blood and placenta in SLE relative to healthy pregnancy. Methods At delivery, peripheral blood, maternal-derived intervillous blood and placentas were collected from 12 SLE and 10 healthy control pregnancies. The proportion of low-density granulocytes (LDGs) and the activation status of LDG and normal-density granulocytes were examined with flow cytometry. The chemokines CXCL8 and CXCL1 were quantified with a cytometric bead-based assay and interferon alpha (IFNα) protein levels with a Simoa method. IFNα-stimulated maternal-derived decidual stromal cells were examined for CXCL8 gene expression with qPCR. A pathologist, blinded to the patient background, examined all placentas. Results Women with SLE had significantly higher proportions of LDG in peripheral blood compared with controls (p=0.02), and LDG in both peripheral and intervillous blood were more activated in SLE relative to healthy pregnancies (peripheral blood: p=0.002 and intervillous blood: p=0.05). There were higher levels of CXCL8 and CXCL1 in intervillous compared with peripheral blood in women with SLE (p=0.004 and p=<0.0001, respectively) but not in controls. In SLE pregnancy, IFNα was detectable in 6 out of 10 intervillous blood samples but only in one control. Stimulation with IFNα upregulated CXCL8 gene expression in decidual stromal cells from both SLE and healthy pregnancy. Histological chorioamnionitis was present in 6 out of 12 placentas from women with SLE and in 1 out of 10 controls. Conclusions In women with SLE, locally produced chemokines in the placenta are increased and may attract and activate neutrophils. This in turn could contribute to placental inflammation and dysfunction and increased risk of placenta-related pregnancy complications.
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| 5. |
- Andersson, Maria L.E., et al.
(författare)
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Autoantibodies to Disease-Related Proteins in Joints as Novel Biomarkers for the Diagnosis of Rheumatoid Arthritis
- 2023
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Ingår i: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 75:7, s. 1110-1119
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Tidskriftsartikel (refereegranskat)abstract
- Objective. This study was undertaken to develop and characterize a multiplex immunoassay for detection of autoantibodies against peptides derived from proteins known to play a role in development of arthritis and that are also expressed in joints.Methods. We selected peptides from the human counterpart of proteins expressed in the joints, based on mouse models that showed these to be targeted by pathogenic or regulatory antibodies in vivo. Using bead-based flow immunoassays measuring IgG antibodies, we selected triple helical or cyclic peptides, containing the epitopes, to avoid collinear reactivity. We characterized the analytical performance of the immunoassay and then validated it in 3 independent rheumatoid arthritis (RA) cohorts (n = 2,110), Swedish age- and sex-matched healthy controls, and patients with osteoarthritis (OA), patients with psoriatic arthritis (PsA), and patients with systemic lupus erythematosus (SLE).Results. Screening assays showed 5 peptide antigens that discriminated RA patients from healthy controls with 99% specificity (95% confidence interval [CI] 98-100%). In our validation studies, we reproduced the discriminatory capacity of the autoantibodies in 2 other RA cohorts, showing that the autoantibodies had high discriminatory capacity for RA versus OA, PsA, and SLE. The novel biomarkers identified 22.5% (95% CI 19-26%) of early RA patients seronegative for anti-cyclic citrullinated peptide and rheumatoid factor. The usefulness of the biomarkers in identifying seronegative RA patients was confirmed in validation studies using 2 independent cohorts of RA patients and cohorts of patients with OA, PsA, and SLE.Conclusion. A multiplex immunoassay with peptides from disease-related proteins in joints was found to be useful for detection of specific autoantibodies in RA serum. Of note, this immunoassay had high discriminatory capacity for early seronegative RA.
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| 6. |
- Barman, Malin, 1983, et al.
(författare)
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Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE): a prospective birth cohort in northern Sweden
- 2018
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Ingår i: BMJ Open. - : BMJ. - 2044-6055 .- 2044-6055. ; 8:10
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Tidskriftsartikel (refereegranskat)abstract
- © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. INTRODUCTION: Prenatal and neonatal environmental factors, such as nutrition, microbes and toxicants, may affect health throughout life. Many diseases, such as allergy and impaired child development, may be programmed already in utero or during early infancy. Birth cohorts are important tools to study associations between early life exposure and disease risk. Here, we describe the study protocol of the prospective birth cohort, 'Nutritional impact on Immunological maturation during Childhood in relation to the Environment' (NICE). The primary aim of the NICE cohort is to clarify the effect of key environmental exposures-diet, microbes and environmental toxicants-during pregnancy and early childhood, on the maturation of the infant's immune system, including initiation of sensitisation and allergy as well as some secondary outcomes: infant growth, obesity, neurological development and oral health.METHODS AND ANALYSIS: The NICE cohort will recruit about 650 families during mid-pregnancy. The principal inclusion criterion will be planned birth at the Sunderby Hospital in the north of Sweden, during 2015-2018. Questionnaires data and biological samples will be collected at 10 time-points, from pregnancy until the children reach 4 years of age. Samples will be collected primarily from mothers and children, and from fathers. Biological samples include blood, urine, placenta, breast milk, meconium, faeces, saliva and hair. Information regarding allergic heredity, diet, socioeconomic status, lifestyle including smoking, siblings, pet ownership, etc will be collected using questionnaires. Sensitisation to common allergens will be assessed by skin prick testing and allergic disease will be diagnosed by a paediatrician at 1 and 4 years of age. At 4 years of age, the children will also be examined regarding growth, neurobehavioural and neurophysiological status and oral health.ETHICS AND DISSEMINATION: The NICE cohort has been approved by the Regional Ethical Review Board in Umeå, Sweden (2013/18-31M). Results will be disseminated through peer-reviewed journals and communicated on scientific conferences.
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| 7. |
- Bergman, Lina, 1982, et al.
(författare)
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Study for Improving Maternal Pregnancy And Child ouTcomes (IMPACT): a study protocol for a Swedish prospective multicentre cohort study
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055 .- 2044-6055. ; 10:9, s. e033851-e033851
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Tidskriftsartikel (refereegranskat)abstract
- Introduction First-trimester pregnancy risk evaluation facilitates individualised antenatal care, as well as application of preventive strategies for pre-eclampsia or birth of a small for gestational age infant. A range of early intervention strategies in pregnancies identified as high risk at the end of the first trimester has been shown to decrease the risk of preterm pre-eclampsia (<37 gestational weeks). The aim of this project is to create the Improving Maternal Pregnancy And Child ouTcomes (IMPACT) database; a nationwide database with individual patient data, including predictors recorded at the end of the first trimester and later pregnancy outcomes, to identify women at high risk of pre-eclampsia. A second aim is to link the IMPACT database to a biobank with first-trimester blood samples. Methods and analysis This is a Swedish prospective multicentre cohort study. Women are included between the 11th and 14th weeks of pregnancy. At inclusion, pre-identified predictors are retrieved by interviews and medical examinations. Blood samples are collected and stored in a biobank. Additional predictors and pregnancy outcomes are retrieved from the Swedish Pregnancy Register. Inclusion in the study began in November 2018 with a targeted sample size of 45 000 pregnancies by end of 2021. Creation of a new risk prediction model will then be developed, validated and implemented. The database and biobank will enable future research on prediction of various pregnancy-related complications. Ethics and dissemination Confidentiality aspects such as data encryption and storage comply with the General Data Protection Regulation and with ethical committee requirements. This study has been granted national ethical approval by the Swedish Ethical Review Authority (Uppsala 2018-231) and national biobank approval at Uppsala Biobank (18237 2 2018 231). Results from the current as well as future studies using information from the IMPACT database will be published in peer-reviewed journals.
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| 8. |
- Håkansson, Stellan, et al.
(författare)
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Real-time PCR-assay in the delivery suite for determination of group B streptococcal colonization in a setting with risk-based antibiotic prophylaxis
- 2014
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Ingår i: Journal of Maternal-Fetal & Neonatal Medicine. - : Informa UK Limited. - 1476-7058 .- 1476-4954. ; 27:4, s. 328-332
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Intrapartum antibiotic prophylaxis (IAP) reduces the incidence of neonatal early onset group B streptococcal infections. The present study investigated if an automated PCR-assay, used bedside by the labor ward personnel was manageable and could decrease the use of IAP in a setting with a risk-based IAP strategy. Methods: The study comprises two phases. Phase 1 was a multicenter, randomized, controlled trial. Women with selected risk-factors were allocated either to PCR-IAP (prophylaxis given if positive or indeterminate) or IAP. A vaginal/rectal swab and superficial swabs from the neonate for conventional culture were also obtained. Phase 2 was non-randomized, assessing an improved version of the assay. Results: Phase 1 included 112 women in the PCR-IAP group and 117 in the IAP group. Excluding indeterminate results, the assay showed a sensitivity of 89% and a specificity of 90%. In 44 % of the PCR assays the result was indeterminate. The use of IAP was lower in the PCR group (53 versus 92%). Phase 2 included 94 women. The proportion of indeterminate results was reduced (15%). The GBS colonization rate was 31%. Conclusion: The PCR assay, in the hands of labor ward personnel, can be useful for selection of women to which IAP should be offered.
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| 9. |
- Sundqvist, Martina, et al.
(författare)
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Cord blood neutrophils display a galectin-3 responsive phenotype accentuated by vaginal delivery.
- 2013
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Ingår i: BMC pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Term neonates are at increased risk of infections due to undeveloped immune mechanisms, and proper neutrophil function is important for perinatal immune defence. Galectin-3, an endogenous β-galactoside-binding lectin, is emerging as an inflammatory mediator and we have previously shown that primed/activated, but not resting, adult neutrophils respond to this lectin by production of reactive oxygen species (ROS). We investigated if galectin-3 is of importance in perinatal immune defence, focusing on plasma levels and neutrophil responsiveness.
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| 10. |
- Thorarinsdottir, Katrin, et al.
(författare)
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Cartilage destruction in early rheumatoid arthritis patients correlates with CD21−/low double-negative B cells
- 2024
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Ingår i: Arthritis Research and Therapy. - 1478-6354 .- 1478-6362. ; 26:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Involvement of B cells in the pathogenesis of rheumatoid arthritis (RA) is supported by the presence of disease-specific autoantibodies and the efficacy of treatment directed against B cells. B cells that express low levels of or lack the B cell receptor (BCR) co-receptor CD21, CD21−/low B cells, have been linked to autoimmune diseases, including RA. In this study, we characterized the CD21+ and CD21−/low B cell subsets in newly diagnosed, early RA (eRA) patients and investigated whether any of the B cell subsets were associated with autoantibody status, disease activity and/or joint destruction. Methods: Seventy-six eRA patients and 28 age- and sex-matched healthy donors were recruited. Multiple clinical parameters were assessed, including disease activity and radiographic joint destruction. B cell subsets were analysed in peripheral blood (PB) and synovial fluid (SF) using flow cytometry. Results: Compared to healthy donors, the eRA patients displayed an elevated frequency of naïve CD21+ B cells in PB. Amongst memory B cells, eRA patients had lower frequencies of the CD21+CD27+ subsets and CD21−/low CD27+IgD+ subset. The only B cell subset found to associate with clinical factors was the CD21−/low double-negative (DN, CD27−IgD−) cell population, linked with the joint space narrowing score, i.e. cartilage destruction. Moreover, in SF from patients with established RA, the CD21−/low DN B cells were expanded and these cells expressed receptor activator of the nuclear factor κB ligand (RANKL). Conclusions: Cartilage destruction in eRA patients was associated with an expanded proportion of CD21−/low DN B cells in PB. The subset was also expanded in SF from established RA patients and expressed RANKL. Taken together, our results suggest a role for CD21−/low DN in RA pathogenesis.
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| 11. |
- Torell, Agnes, 1993, et al.
(författare)
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Low-density granulocytes are related to shorter pregnancy duration but not to interferon alpha protein blood levels in systemic lupus erythematosus.
- 2023
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Ingår i: Arthritis research & therapy. - : BMC. - 1478-6362 .- 1478-6354. ; 25
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Tidskriftsartikel (refereegranskat)abstract
- An increased risk of pregnancy complications is seen in women with systemic lupus erythematosus (SLE), but the specific immunopathological drivers are still unclear. Hallmarks of SLE are granulocyte activation, type I interferon (IFN) overproduction, and autoantibodies. Here we examined whether low-density granulocytes (LDG) and granulocyte activation increase during pregnancy, and related the results to IFNα protein levels, autoantibody profile, and gestational age at birth.Repeated blood samples were collected during pregnancy in trimesters one, two, and three from 69 women with SLE and 27 healthy pregnant women (HC). Nineteen of the SLE women were also sampled late postpartum. LDG proportions and granulocyte activation (CD62L shedding) were measured by flow cytometry. Plasma IFNα protein concentrations were quantified by single molecule array (Simoa) immune assay. Clinical data were obtained from medical records.Women with SLE had higher LDG proportions and increased IFNα protein levels compared to HC throughout pregnancy, but neither LDG fractions nor IFNα levels differed during pregnancy compared to postpartum in SLE. Granulocyte activation status was higher in SLE relative to HC pregnancies, and it was increased during pregnancy compared to after pregnancy in SLE. Higher LDG proportions in SLE were associated with antiphospholipid positivity but not to IFNα protein levels. Finally, higher LDG proportions in trimester three correlated independently with lower gestational age at birth in SLE.Our results suggest that SLE pregnancy results in increased peripheral granulocyte priming, and that higher LDG proportions late in pregnancy are related to shorter pregnancy duration but not to IFNα blood levels in SLE.
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| 12. |
- Ankarcrona, Victoria, et al.
(författare)
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Delivery outcome after trial of labor in nulliparous women 40 years or older-A nationwide population-based study
- 2019
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : WILEY. - 0001-6349 .- 1600-0412. ; 98:9, s. 1195-1203
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The number of women postponing childbirth until an advanced age is increasing. Our aim was to study the outcome of labor in nulliparous women >= 40 years, compared with women 25-29 years, after both spontaneous onset and induction of labor. Material and methods The nationwide population-based Swedish Medical Birth Register was used to study the perinatal outcome in nulliparous women with a singleton, term (gestational weeks 37-44), live fetus in cephalic presentation and a planned vaginal delivery from 1992 to 2011. We included 7796 nulliparous women >= 40 years and 264 262 nulliparous women 25-29 years. Prevalence and risk of intrapartum cesarean section, operative vaginal delivery, obstetric anal sphincter injury and a 5-minute Apgar score <7 were calculated for women >= 40 years stratified for spontaneous onset and induction of labor, using women 25-29 years as the reference in both strata. Crude and adjusted odds ratios (aOR) were calculated by unconditional logistic regression and presented with 95% confidence intervals (CI). Results Overall, 79% of women >= 40 years with a trial of labor reached a vaginal delivery. After spontaneous onset, intrapartum cesarean section was performed in 15.4% of women >= 40 years compared with 5.4% of women 25-29 years (aOR 3.07, 95% CI 2.81-3.35). Operative vaginal delivery was performed in 22.3% of women >= 40 years compared with 14.2% of women 25-29 years (aOR 1.71, 95% CI 1.59-1.85). After induction of labor, an intrapartum cesarean section was performed in 37.2% women >= 40 years compared with 20.2% women 25-29 years (aOR 2.51, 95% CI 2.24-2.81). Operative vaginal delivery was performed in 22.6% of women >= 40 years compared with 18.4% women 25-29 years (aOR 1.45, 95% CI 1.28-1.65). The risk of obstetric anal sphincter injury or a 5-minute Apgar score <7 was not increased in women >= 40 years, regardless of onset of labor. Conclusions Trial of labor ended in vaginal delivery in 79% of nulliparous women >= 40 years. The risks of intrapartum cesarean section and operative vaginal delivery were higher in women >= 40 years compared with women 25-29 years, after both spontaneous onset and induction of labor. The risk of obstetric anal sphincter injury or a 5-minute Apgar score <7 was not increased.
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| 13. |
- Bengtsson, Karin, et al.
(författare)
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Cardiac conduction disturbances in patients with ankylosing spondylitis : results from a 5-year follow-up cohort study
- 2019
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Ingår i: RMD Open. - : BMJ Publishing Group Ltd. - 2056-5933. ; 5:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe electrocardiographic (ECG) development in patients with ankylosing spondylitis (AS) and identify associations between baseline characteristics and cardiac conduction disturbances (CCD) at 5-year follow-up.Methods: In a longitudinal cohort study, 172 patients (54% men, mean age (SD) of 50 (13) years at baseline) with AS underwent ECG, physical examination, questionnaires and laboratory testing at baseline and at 5-year follow-up. Descriptive statistics and univariate and age- and sex-adjusted logistic regression analyses were used. CCD included both atrioventricular and intraventricular blocks.Results: Twenty-three of the 172 patients (13.4%) had a CCD at follow-up. Eight patients had developed a new CCD and eight had normalised their ECG. In the age- and sex-adjusted analyses, CCD at baseline (OR 24.8, 95% CI 7.3 to 84.5), male sex (OR 6.4, 95% CI 2.0 to 20.8), history of anterior uveitis (OR 4.4, 95% CI 1.3 to 14.5), higher ASDAS-CRP (OR 2.3, 95% CI 1.3 to 4.0), greater waist circumference (OR 1.3, 95% CI 1.1 to 1.6, per 5 cm), and medication with antiplatelets (OR 7.0, 95% CI 1.5 to 31.8) and beta-blockers (OR 3.4, 95% CI 1.0 to 11.5) were associated with a CCD at follow-up. Higher age and longer symptom duration were highly correlated and were both associated with a CCD at follow-up.Conclusions: The presence of CCD in AS is in part dynamic and associated with both AS and non-AS characteristics. Our results suggest that patients especially prone to present with CCDs are older men with a previous CCD, longer symptom duration, higher AS disease activity, a history of anterior uveitis and medication reflecting cardiovascular disease.
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| 14. |
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| 15. |
- Bengtsson, Karin, 1980, et al.
(författare)
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Comparisons between comorbid conditions and health care consumption in rheumatoid arthritis patients with or without biological disease-modifying antirheumatic drugs : a register-based study
- 2016
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Symptoms and prognosis of patients with rheumatoid arthritis (RA) have improved with more intensive therapy, including the biological disease-modifying anti-rheumatic drugs (bDMARDs). Real life data concerning how comorbidities are distributed among patients treated or not treated with bDMARDs are scarce. Our objective was to investigate differences in comorbidity and health care consumption in RA patients, with and without bDMARDs.METHODS: This cross-sectional study was performed in the Southwestern part of Sweden. Patients, aged ≥ 18 years and diagnosed with RA in secondary health care during 2009-2010, were identified in the regional health care database. Aggregated data of comorbidity and health care consumption were retrieved between 2006 and 2010. RA patients treated with bDMARDs on 31st December 2010 were identified in the Swedish Rheumatology Quality Register (SRQ), which includes the biologics register Anti-Rheumatic Therapy in Sweden (ARTIS). Descriptive, comparative, univariate and multiple logistic regression analyses were used to identify factors associated with bDMARDs.RESULTS: Seven thousand seven hundred and twelve (7712) RA patients were identified (age 64.8 ± 14.9 years, women 74.3%), of whom 1137 (14.7%) were treated with bDMARDs. Overall, the most common comorbidities were infections (69.2%), hypertension (41.1%), chronic respiratory disease (15.3%), ischemic heart disease (14.0%) and malignancy (13.7%). Patients without bDMARDs were older and had more comorbidity. In the multiple logistic regression analysis, older age, cerebrovascular and chronic respiratory disease, heart failure, depression and malignancy were all associated with no present bDMARDs. Infections were associated with bDMARDs. Patients treated with bDMARDs consumed more secondary outpatient care but less visits in primary health care compared to patients without bDMARDs.CONCLUSIONS: Patients treated with bDMARDs versus no bDMARDs were younger and had significantly lower period prevalence for most common comorbidities, with the exception of infections. Differences in comorbidities between RA patients with or without bDMARDs should be taken into consideration when evaluating effectiveness and safety of bDMARDs in ordinary care.
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| 16. |
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| 17. |
- Bengtsson, Karin, 1980, et al.
(författare)
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Incidence of extra-articular manifestations in ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis : Results from a national register-based cohort study
- 2021
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Ingår i: Rheumatology (United Kingdom). - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 60:6, s. 2725-2734
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate the incidence and strength of association of extra-articular manifestations [EAMs, here: anterior uveitis (AU), IBD and psoriasis] in patients with AS, undifferentiated SpA (uSpA) and PsA, compared with controls. Methods: Three mutually exclusive cohorts of patients aged 18-69 years with AS (n = 8517), uSpA (n = 10 245) and PsA (n = 22 667) were identified in the Swedish National Patient Register 2001-2015. Age-, sex- and geography-matched controls were identified from the Swedish Population Register. Follow-up began 1 January 2006, or six months after the first SpA diagnosis, whichever occurred later, and ended at the first date of the EAM under study, death, emigration, 70 years of age, and 31 December 2016. Incidence rates (IRs) and incidence rate ratios were calculated for each EAM, and stratified by sex and age. Results: Incidence rate ratios for incident AU, IBD and psoriasis were significantly increased in AS (20.2, 6.2, 2.5), uSpA (13.6, 5.7, 3.8) and PsA (2.5, 2.3, n.a) vs controls. Men with AS and uSpA had significantly higher IRs per 1000 person-years at risk for incident AU than women with AS (IR 15.8 vs 11.2) and uSpA (IR 10.1 vs 6.0), whereas no such sex difference was demonstrated in PsA or for the other EAMs. Conclusions: AU, followed by IBD and psoriasis, is the EAM most strongly associated with AS and uSpA. Among the SpA subtypes, AS and uSpA display a largely similar pattern of EAMs, whereas PsA has a considerably weaker association with AU and IBD.
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| 18. |
- Bengtsson, Karin, 1980, et al.
(författare)
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Occurrence and relative risks for non-vertebral fractures in patients with ankylosing spondylitis compared with the general population: a register-based study from Sweden
- 2023
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Ingår i: Rmd Open. - : BMJ. - 2056-5933. ; 9:1
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo estimate the incidence of non-vertebral fractures in ankylosing spondylitis (AS) compared with the general population.MethodsNationwide register-based cohort study including patients with AS (n=11 611, 65% men, mean age 48 years), and matched general population controls (n=58 050). Five prespecified fracture outcomes: (1) non-vertebral; (2) fracture of the proximal humerus, distal forearm or hip; (3) proximal humerus; (4) distal forearm and (5) hip) were identified through register linkages with follow-up 2007-2016. We used Poisson regression to calculate incidence rates (IRs), number of fractures per 1000 person-years at risk and IR ratios (IRRs), overall and by sex and age. IRRs were adjusted for history of any prior fracture.ResultsIRs (men/women) for non-vertebral fracture in AS were 11.9 (95% CI 11.0 to 12.9)/14.5 (95% CI 13.1 to 16.1) and in controls 10.0 (95% CI 9.7 to 10.4)/11.8 (95% CI 11.1 to 12.4), IRR (men/women) 1.2 (95% CI 1.1 to 1.3)/1.2 (95% CI 1.1 to 1.4). IRs (men/women) for fractures of the humerus, forearm or hip in AS were 4.0 (95% CI 3.5 to 4.6)/6.3 (95% CI 5.4 to 7.3) and in controls 2.7 (95% CI 2.5 to 2.9)/5.5 (95% CI 5.1 to 6.0), IRR (men/women) 1.5 (95% CI 1.3 to 1.7)/1.1 (95% CI 0.9 to 1.3). IRRs were statistically significantly elevated in men with AS versus controls for forearm fracture (1.4 (95% CI 1.1 to 1.7)) and hip fracture (1.8 (95% CI 1.4 to 2.3)), whereas not in women with AS where the IRRs were 1.1 (95% CI 0.9 to 1.4) and 1.0 (95% CI 0.6 to 1.4). For humerus fracture, IRRs were 1.4 (95% CI 0.99 to 1.9) in men with AS versus controls and 1.1 (95% CI 0.8 to 1.6) in women.ConclusionsBoth men and women with AS have a slightly higher risk of non-vertebral fractures than the general population. A statistically significantly higher risk of fractures of the proximal humerus, distal forearm or hip was found in men with AS in comparison to general population, where the relative risk was especially pronounced for hip fracture.
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| 19. |
- Bungum, Leif, et al.
(författare)
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Circadian variation in concentration of anti-Mullerian hormone in regularly menstruating females: relation to age, gonadotrophin and sex steroid levels.
- 2011
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 26, s. 678-684
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Anti-Müllerian hormone (AMH) is a promising marker of ovarian reserve. The aim of the study is to assess the circadian variation in AMH, and to evaluate its clinical relevance and biological aspects as an effect of age and other endocrine mechanisms involved in the regulation of AMH secretion. METHODS Nineteen healthy non-smoking, regularly menstruating female volunteers with body mass index below 30 kg/m(2), 10 aged 20-30 years (Group A) and 9 aged 35-45 (Group B) were included. Blood sampling, initiated at 8:00 a.m. on Days 2-6 of the menstrual cycle, was continued every second hour until 8:00 a.m. the following day. Serum levels of AMH, FSH, LH, progesterone and estradiol were measured. RESULTS With 8:00 a.m. values at the first day of investigation as a reference, the mean concentrations in the pooled data revealed a significantly lower level at 4:00 a.m. (P = 0.021) and 6:00 a.m. (P = 0.005) with a maximum mean difference of 1.9 pmol/l (10.6%). The same pattern was seen in both the age groups. Including both the age groups, the overall circadian variation of the AMH levels did not reach statistical significance (P = 0.059). A significant positive correlation between AMH and LH concentration was seen over the 24-h period (P < 0.001). CONCLUSIONS A slight decrease in serum AMH levels during the late night appears not clinically relevant. Co-variation in the levels of LH and AMH might indicate joint regulatory mechanisms for the latter hormone and gonadotrophins.
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| 20. |
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| 21. |
- Edberg, Karin, 1984-
(författare)
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Energilandskap i förändring : Inramningar av kontroversiella lokaliseringar på norra Gotland
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Energisystemet omstruktureras. Nya energikällor tillkommer och andra fasas ut samtidigt som efterfrågan på energi kvarstår ur ett globalt perspektiv. Lokaliseringen av de fysiska strukturer som genererar och distribuerar energi innebär en högst praktisk påverkan i den fysiska omgivningen liksom i det sociala landskapet innan, under och efter en etablering, vilket gör det relevant att undersöka hur nya lokaliseringar av energiinfrastruktur tas emot. Det övergripande syftet med den här avhandlingen i sociologi är därför att bidra till en ökad förståelse av lokal hantering av globala energidilemman.I avhandlingen analyseras lokaliseringar av kontroversiella energiprojekt, eller mer specifikt hur två sådana fall förstås och tolkas av berörda aktörer. Det görs genom ett teoretiskt ramverk baserat på inramningsteori (frame analysis) och sociala praktiker. Studien erbjuder en sociologiskt grundad förståelse av plats och förståelsens betydelse för inställningen till lokaliseringar av energiinfrastruktur.Avhandlingens empiriska fall utgörs av lokaliseringen av logistiskt arbete kring byggandet av en storskalig naturgasledning och av en planerad men inte realiserad etablering av en vindkraftspark till nordöstra Gotland. Dessa studeras genom intervjuer, observationer och textanalyser.Studien visar hur olika aktörer kombinerar och väger olika aspekter mot varandra i sina inramningskonstruktioner. Resultaten visar att även komponenter bortom det lokala ingår i inramningarna och att de inkluderar relationer mellan olika aktörer liksom förändring över tid. Denna förståelse presenteras genom en analys av fyra centrala aspekter – platsrelaterade, platsöverskridande, position och process – vilka tillsammans fångar den multidimensionalitet och komplexitet som kännetecknar kontroversiella lokaliseringar. Ett resultat är att den mest framgångsrika inramningsstrategin visade sig vara att särkoppla olika aspekter, det vill säga att uppmärksamma flera olika aspekter men på olika sätt hålla dem isär. En av studiens styrkor är att den inkluderar såväl strategiska inramningar som görs av olika aktörer i syfte att exempelvis få en lokalisering till stånd eller förhindra densamma, som inramningar som görs av dem som inte tar aktiv del i den formella lokaliseringsprocessen. Det ger en komplex bild som sträcker sig bortom policynivån och som visar att det inte finns en enstämmig förståelse i ”lokalsamhället”. Avhandlingen bidrar därmed till att bredda förståelsen av inramningar av kontroversiella lokaliseringar.
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| 22. |
- Håkansson, Stellan, et al.
(författare)
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Group B streptococcal carriage in Sweden : a national study on risk factors for mother and infant colonisation
- 2008
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - Stockholm : Wiley. - 0001-6349 .- 1600-0412. ; 87:1, s. 50-58
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Tidskriftsartikel (refereegranskat)abstract
- Background. To study group B streptococcus (GBS) colonisation in parturients and infants in relation to obstetric outcome and to define serotypes and antibiotic resistance in GBS isolates acquired. Methods. A population-based, national cohort of parturients and their infants was investigated. During 1 calendar week in 2005 all women giving birth (n=1,754) were requested to participate in the study. Results. A total of 1,569 mother/infant pairs with obstetric and bacteriological data were obtained. Maternal carriage rate was 25.4% (95% confidence interval (CI): 23.3-27.6). In GBS-positive mothers with vaginal delivery and no intrapartum antibiotics, the infant colonisation rate was 68%. Some 30% of infants were colonised after acute caesarean section, and 0% were colonised after an elective procedure. Duration of transport of maternal recto/vaginal swabs of more than 1 day impeded culture sensitivity. Infant mMales were more frequently colonised than females (76.9 versus 59.8%, odds ratio (OR): 2.16; 95% CI: 1.27-3.70), as were infants born after rupture of membranes ≥24 h (p =0.039). Gestational age, birth weight and duration of labor did not significantly influence infant colonisation. Some 30% of parturients with at least one risk factor for neonatal disease received intrapartum antibiotics. The most common GBS serotypes were type III and V. Some 5% of the isolates were resistant to clindamycin and erythromycin, respectively. Conclusions. Maternal GBS prevalence and infant transfer rate were high in Sweden. Males were more frequently colonised than females. The sensitivity of maternal cultures decreased with the duration of sample transport. Clindamycin resistance was scarce. The use of intrapartum antibiotics was limited in parturients with obstetric risk factors for early onset group B streptococcal disease.
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| 23. |
- Hägglund, Moa, et al.
(författare)
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Accounting for bacterial overlap between raw water communities and contaminating sources improves the accuracy of signature-based microbial source tracking
- 2018
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Ingår i: Frontiers in Microbiology. - : Frontiers Media S.A.. - 1664-302X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Microbial source tracking (MST) analysis is essential to identifying and mitigating the fecal pollution of water resources. The signature-based MST method uses a library of sequences to identify contaminants based on operational taxonomic units (OTUs) that are unique to a certain source. However, no clear guidelines for how to incorporate OTU overlap or natural variation in the raw water bacterial community into MST analyses exist. We investigated how the inclusion of bacterial overlap between sources in the library affects source prediction accuracy. To achieve this, large-scale sampling-including feces from seven species, raw sewage, and raw water samples from water treatment plants - was followed by 16S rRNA amplicon sequencing. The MST library was defined using three settings: (i) no raw water communities represented; (ii) raw water communities selected through clustering analysis; and (iii) local water communities collected across consecutive years. The results suggest that incorporating either the local background or representative bacterial composition improves MST analyses, as the results were positively correlated to measured levels of fecal indicator bacteria and the accuracy at which OTUs were assigned to the correct contamination source increased fourfold. Using the proportion of OTUs with high source origin probability, underpinning a contaminating signal, is a solid foundation in a framework for further deciphering and comparing contaminating signals derived in signature-based MST approaches. In conclusion, incorporating background bacterial composition of water in MST can improve mitigation efforts for minimizing the spread of pathogenic and antibiotic resistant bacteria into essential freshwater resources.
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| 24. |
- Jacobsson, Bo, 1960, et al.
(författare)
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Preterm delivery: an overview on prediction, prevention and treatment : Prediktion, prevention och behandlingsmetoder.
- 2019
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Ingår i: Läkartidningen. - 1652-7518. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- Due to a low level of understanding of mechanisms involved in spontaneous preterm delivery there is a lack of reliable biomarkers. Existing biomarkers have a low positive predictive value but a high negative predictive value. Use of tests with high negative predictive value will reduce unnecessary interventions and hospitalization of women with threatening preterm delivery. When given to the right pregnant women, antenatal corticosteroid treatment are still the most important obstetrical intervention and reduces both neonatal mortality and short- and long-term morbidity.Several ongoing national Swedish multicenter studies may increase the understanding of the roles of cervical length, preeclampsia screening and magnesium sulfate dosage in the context of preterm delivery in a Nordic setting. Major development has been achieved in prediction and prevention of preterm preeclampsia at the cost of a 10% screen positive rate.
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| 25. |
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| 26. |
- Ljungstrom, L., et al.
(författare)
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Clinical evaluation of commercial nucleic acid amplification tests in patients with suspected sepsis
- 2015
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Ingår i: Bmc Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sepsis is a serious medical condition requiring timely administered, appropriate antibiotic therapy. Blood culture is regarded as the gold standard for aetiological diagnosis of sepsis, but it suffers from low sensitivity and long turnaround time. Thus, nucleic acid amplification tests (NAATs) have emerged to shorten the time to identification of causative microbes. The aim of the present study was to evaluate the clinical utility in everyday practice in the emergency department of two commercial NAATs in patients suspected with sepsis. Methods: During a six-week period, blood samples were collected consecutively from all adult patients admitted to the general emergency department for suspicion of a community-onset sepsis and treated with intravenous antibiotics. Along with conventional blood cultures, multiplex PCR (Magicplex (TM)) was performed on whole blood specimens whereas portions from blood culture bottles were used for analysis by microarray-based assay (Prove-it (TM)). The aetiological significance of identified organisms was determined by two infectious disease physicians based on clinical presentation and expected pathogenicity. Results: Among 382 episodes of suspected sepsis, clinically relevant microbes were detected by blood culture in 42 episodes (11%), by multiplex PCR in 37 episodes (9.7%), and by microarray in 32 episodes (8.4%). Although moderate agreement with blood culture (kappa 0.50), the multiplex PCR added diagnostic value by timely detection of 15 clinically relevant findings in blood culture-negative specimens. Results of the microarray corresponded very well to those of blood culture (kappa 0.90), but were available just marginally prior to blood culture results. Conclusions: The use of NAATs on whole blood specimens in adjunct to current culture-based methods provides a clinical add-on value by allowing for detection of organisms missed by blood culture. However, the aetiological significance of findings detected by NAATs should be interpreted with caution as the high analytical sensitivity may add findings that do not necessarily corroborate with the clinical diagnosis.
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| 27. |
- Ljungstrom, L., et al.
(författare)
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Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis
- 2017
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- Background Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis. All sampling were performed prior to antibiotic administration. Discriminant analysis was used to construct two composite biomarkers consisting of linear combinations of the investigated biomarkers, one including three selected biomarkers (i.e., NLCR, CRP, and lactate), and another including all four (i.e., PCT, NLCR, CRP, and lactate). The diagnostic performances of the composite biomarkers as well as the individual biomarkers were compared using the area under the receiver operating characteristic curve (AUC). For diagnosis of bacterial sepsis based on Sepsis-3 criteria, the AUC for PCT (0.68; 95% CI 0.65-0.71) was comparable to the AUCs for the both composite biomarkers. Using the Sepsis- 2 criteria for bacterial sepsis diagnosis, the AUC for the NLCR (0.68; 95% CI 0.65-0.71) but not for the other single biomarkers, was equal to the AUCs for the both composite biomarkers. For diagnosis of severe bacterial sepsis or septic shock based on the Sepsis-2criteria, the AUCs for both composite biomarkers were significantly greater than those of the single biomarkers (0.85; 95% CI 0.82-0.88 for the composite three-biomarker, and 0.86; 95% CI 0.83-0.89 for the composite four-biomarker). Combinations of biomarkers can improve the diagnosis of verified bacterial sepsis in the most critically ill patients, but in less severe septic conditions either the NLCR or PCT alone exhibit equivalent performance.
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| 28. |
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| 29. |
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| 30. |
- Neubeck, Anna-Karin, 1971-
(författare)
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The Prodromal Phase of What? : A Metapsychiatric Analysis of the Prodromal Phase of Schizophrenia
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Prodromes of schizophrenia or prodromes of psychosis are a relatively new and expanding field of interest in psychiatric research. They are seen by some researchers as the initial symptom of having schizophrenia and have become a crucial topic in early psychosis research and intervention.In this thesis current psychiatric research publications were analysed and eleven prospectively psychotic patients were interviewed. The research publications analysed were applyed on the information given by the patients, and the analysis showed that it was easy to find prodromes or prodrome-like phenomena in all the collected interviews. In addition a second analysis was performed on the material, a phenomenological psychological analysis, showing a more subject-oriented dimension of the interviews. This led to a further aim, analysing what explanations could be given of these phenomena.There are probably many possibilities of getting the diagnosis of schizophrenia, but the examples in this study show that long-term abuse, often sexual actually can trigger psychiatric conditions corresponding to the definition of “prodromes of schizophrenia” according to some psychiatric publications as well as “schizophrenia” according to DSMand ICD. This means that trauma and/or neglect proved to be a likely partial causal condition of the prodrome- like phenomena or schizophrenia to occur.However, trauma has not been shown to be a necessary condition for the occurrence of prodrome-like phenomena or schizophrenia.In the discussion of the results some consequences deriving from using different interpretations and explanations of the phenomena are analysed, for example using the prodromes of psychosis for the assessments of a coming psychosis, especially schizophrenia. I emphasize, because of the results of the phenomenological case analyses, the value of several dimensions of understanding prodrome-like phenomena as well as schizophrenia and schizophrenia-like conditions, especially as early as the initial phase.
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| 31. |
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| 32. |
- Rostelien, T., et al.
(författare)
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The plant sesquiterpene germacrene D specifically activates a major type of antennal receptor neuron of the tobacco budworm moth Heliothis virescens
- 2000
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Ingår i: Chemical Senses. - : Oxford University Press (OUP). - 0379-864X .- 1464-3553. ; 25:2, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- Plants release hundreds of volatiles that are important in interactions with insects or other organisms. However, knowledge is scarce as to which of the compounds are detected by the organism's olfactory receptor neurons. In the present study, single receptor neurons on the antennae of the tobacco budworm moth, Heliothis virescens, were screened far their sensitivities to naturally produced plant volatiles by the use of gas chromatography linked to electrophysiological recordings from single cells (GC-SCR). Plant volatiles, collected by aeration of host and non-host plants, were tested on each receptor neuron via parallel GC-columns. Thus, simultaneous recordings of the gas chromatogram and the neuron responses to each component were obtained. One type of receptor neuron, appearing in 80% of all experiments, responded with high sensitivity and selectivity to one particular component, present in host as well as non-host mixtures. The component, identified as a sesquiterpene hydrocarbon by linked gas chromatography-mass spectrometry, was isolated from a sesquiterpene fraction of cubebe oil and identified by NMR as germacrene D. The purified compound was then re-tested via gas chromatography on the same receptor neuron type, verifying the identification. A weaker response to another sesquiterpene hydrocarbon was also recorded.
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| 33. |
- Södergren, Anna, 1977-, et al.
(författare)
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Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis
- 2021
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Ingår i: Clinical Rheumatology. - : Springer Science and Business Media LLC. - 0770-3198 .- 1434-9949. ; 40, s. 1321-1329
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To study clinical characteristics, mortality, and secondary prevention, after a first incident acute myocardial infarction (AMI) in patients with ankylosing spondylitis (AS) compared with the general population. Methods In total, 292 subjects with AS and a first AMI between Jan 2006 and Dec 2014 were identified using the Swedish national patient register. Each subject was matched with up to 5 general population comparators per AS-patient (n = 1276). Follow-up started at the date of admission for AMI and extended until death or 365 days of follow-up. Cox regression was used to assess mortality in two time intervals: days 0-30 and days 31-365. For a subgroup with available data, clinical presentation at admission, course, treatment for AMI, and secondary prevention were compared. Results During the 365-day follow-up, 56/292 (19%) AS patients and 184/1276 (14%) comparators died. There were no difference in mortality due to cardiovascular-related causes, although the overall mortality day 31-365 was increased among patients with AS compared with comparators (HR [95% CI] = 2.0 [1.3;3.0]). At admission, AS patients had a higher prevalence of cardiovascular comorbidities compared with comparators. At discharge, patients with AS were less often prescribed lipid-lowering drugs and non-aspirin antiplatelet therapy. Conclusions Patients with AS tend to have a higher comorbidity burden at admission for first AMI. The mortality after a first AMI due to cardiovascular-related causes does not seem to be elevated, despite an increased overall mortality during days 31-365 among patients with AS compared with the general population.
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| 34. |
- Thorell, Anna, et al.
(författare)
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Microbial invasion of the amniotic cavity is associated with impaired cognitive and motor function at school age in preterm children.
- 2020
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Ingår i: Pediatric research. - : Springer Science and Business Media LLC. - 1530-0447 .- 0031-3998. ; 87:5, s. 924-931
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Tidskriftsartikel (refereegranskat)abstract
- Chorioamnionitis is an important cause of preterm delivery. Data on neurodevelopmental outcome in exposed infants are inconsistent due to difficulties in diagnosing intrauterine infection/inflammation and lack of detailed long-term follow-up. We investigate cognitive and motor function in preterm infants at early school age and relate the findings to bacteria in amniotic fluid obtained by amniocentesis (microbial invasion of the amniotic cavity (MIAC)) or placenta findings of histological chorioamnionitis (HCA) or fetal inflammatory response syndrome (FIRS).Sixty-six infants with gestational age <34 weeks at birth and without major disabilities were assessed using WISC-III and the Bruininks-Oseretsky Test of Motor Proficiency. Results were corrected for gestational age and sex.Children exposed to MIAC had significantly lower scores for full-scale IQ and verbal IQ compared to the non-MIAC group and the difference in full-scale IQ remained after correction for confounding factors. The MIAC group had also significantly lower motor scores after correction. In contrast, motor function was not affected in infants exposed to HCA or FIRS and differences between groups for cognitive scores were lost after corrections.Exposure to bacteria in amniotic fluid is associated with lower motor and cognitive scores in school age preterm infants without major disabilities.
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