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1.	Alm, Johan S, et al. (författare) An anthroposophic lifestyle and intestinal microflora in infancy. 2002 Ingår i: Pediatr Allergy Immunol. - : Wiley. - 0905-6157. ; 109:1, s. S50-S51 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
2.	Bergström, Göran, 1964, et al. (författare) Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS. 2023 Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54 Tidskriftsartikel (refereegranskat)abstract Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p<0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
3.	Djärv, Therese, et al. (författare) Health related quality of life after surviving an out-of-hospital compared to an in-hospital cardiac arrest : a national population-based Swedish cohort study 2019 Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 142:s1, s. e27-e27 Tidskriftsartikel (refereegranskat)
4.	Djärv, Therese, et al. (författare) Health-related quality of life after surviving an out-of-hospital compared to an in-hospital cardiac arrest : a Swedish population-based registry study 2020 Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 151, s. 77-84 Tidskriftsartikel (refereegranskat)abstract BackgroundHealth-related quality of life (HRQoL) has been reported for out-hospital (OHCA) and in-hospital cardiac arrest (IHCA) separately, but potential differences between the two groups are unknown. The aim of this study is therefore to describe and compare HRQoL in patients surviving OHCA and IHCA.MethodsPatients ≥18 years with Cerebral Performance Category 1–3 included in the Swedish Registry for Cardiopulmonary Resuscitation between 2014 and 2017 were included. A telephone interview was performed based on a questionnaire sent 3–6 months post cardiac arrest, including EQ-5D-5L and the Hospital Anxiety and Depression Scale. Mann–Whitney U test and multiple linear- and ordinal logistic regression analyses were used to describe and compare HRQoL in OHCA and IHCA survivors. Adjustments were made for sex, age and initial rhythm.ResultsIn all, 1369 IHCA and 772 OHCA survivors were included. Most OHCA and IHCA survivors reported no symptoms of with anxiety (88% and 84%) or depression (87% and 85%). IHCA survivors reported significantly more problems in the health domains mobility, self-care, usual activities and pain/discomfort (p < 0.001 for all) and scored lower general health measured by EQ-VAS (median 70 vs. 80 respectively, p < 0.001) compared with the OHCA survivors.ConclusionSurvivors of IHCA reported significantly worse HRQoL compared to survivors of OHCA. Consequently, research data gathered from one of these populations may not be generalizable to the other.
5.	Hagstrom, Emil, et al. (författare) IMPACT OF BODY WEIGHT AT AGE 20 AND WEIGHT GAIN DURING ADULTHOOD ON MIDLIFE CORONARY ARTERY CALCIUM IN 15,000 MEN AND WOMEN : AN INTERIM ANALYSIS OF THE SWEDISH CARDIOPULMONARY BIOIMAGE STUDY 2019 Ingår i: Journal of the American College of Cardiology. - : ELSEVIER SCIENCE INC. - 0735-1097 .- 1558-3597. ; 73:9, s. 1692-1692 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract BackgroundElevated body weight in adolescence is strongly associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, or to weight gain with subsequent high adult weight is not known. Using data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), we investigated the association between weight at age 20, weight gain to midlife and coronary artery calcium score (CACS) at midlife.MethodsIn the first 15,810 participants in SCAPIS (mean age 58 years, 52% women), data on CACS at midlife, self-reported body weight at age 20 and weight at examination in SCAPIS were recorded.ResultsCACS in midlife was significantly higher with increasing weight at age 20 (p<0.001 for both sexes), and then increased with weight gain until midlife at all levels of body weight at age 20 after adjusting for age, height, smoking, alcohol intake, education level, exercise levels and LDL cholesterol. However, the association with weight gain was only significant in men (p = 0.047), not in women (p=0.474). No significant interaction was seen between weight at age 20 and midlife weight with CACS. The effect of weight at age 20 on CACS was significantly more marked in men than in women, as was the effect of weight gain (p<0.001 for both interactions).ConclusionWeight at age 20 and weight gain to midlife were both related to CACS, but much more markedly so in men than in women, indicating a generally larger effect of both early adult weight and further weight gain until midlife on CACS in men, compared to women.
6.	Israelsson, Johan, et al. (författare) Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender 2017 Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 114, s. 27-33 Tidskriftsartikel (refereegranskat)abstract AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.
7.	Israelsson, Johan, et al. (författare) Neurologic outcome, health-related quality of life, anxiety and symptoms of depression among in-hospital cardiac arrest survivors 2015 Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 96:Supplement 1 Konferensbidrag (refereegranskat)
8.	Lang, Margareta, et al. (författare) Standardised and automated assessment of head computed tomography reliably predicts poor functional outcome after cardiac arrest: a prospective multicentre study 2024 Ingår i: Intensive Care Medicine. - : SPRINGER. - 0342-4642 .- 1432-1238. Tidskriftsartikel (refereegranskat)abstract Purpose: Application of standardised and automated assessments of head computed tomography (CT) for neuroprognostication after out-of-hospital cardiac arrest. Methods: Prospective, international, multicentre, observational study within the Targeted Hypothermia versus Targeted Normothermia after out-of-hospital cardiac arrest (TTM2) trial. Routine CTs from adult unconscious patients obtained > 48 h <= 7 days post-arrest were assessed qualitatively and quantitatively by seven international raters blinded to clinical information using a pre-published protocol. Grey-white-matter ratio (GWR) was calculated from four (GWR-4) and eight (GWR-8) regions of interest manually placed at the basal ganglia level. Additionally, GWR was obtained using an automated atlas-based approach. Prognostic accuracies for prediction of poor functional outcome (modified Rankin Scale 4-6) for the qualitative assessment and for the pre-defined GWR cutoff < 1.10 were calculated. Results: 140 unconscious patients were included; median age was 68 years (interquartile range [IQR] 59-76), 76% were male, and 75% had poor outcome. Standardised qualitative assessment and all GWR models predicted poor outcome with 100% specificity (95% confidence interval [CI] 90-100). Sensitivity in median was 37% for the standardised qualitative assessment, 39% for GWR-8, 30% for GWR-4 and 41% for automated GWR. GWR-8 was superior to GWR-4 regarding prognostic accuracies, intra- and interrater agreement. Overall prognostic accuracy for automated GWR (area under the curve [AUC] 0.84, 95% CI 0.77-0.91) did not significantly differ from manually obtained GWR. Conclusion: Standardised qualitative and quantitative assessments of CT are reliable and feasible methods to predict poor functional outcome after cardiac arrest. Automated GWR has the potential to make CT quantification for neuroprognostication accessible to all centres treating cardiac arrest patients.
9.	Lilja, Johan, 1978-, et al. (författare) Is Innovation the Future of Quality Management? : Searching for signs of quality and innovation management merging in current practices and concepts 2016 Ingår i: Proceedings of the 19th QMOD Conference. Konferensbidrag (refereegranskat)abstract PurposeCurrently, upcoming as well as mature industries are facing pressure as regards successfully managing operational excellence and continuous improvement, and at the same time driving and managing innovation. Quality management concepts and practices’ ability to tackle this challenge have been questioned and previous research even suggests that quality management initiatives can impede firms’ abilities to innovate and quickly adapt to changes. It has also been suggested that there is a need to provide and promote an updated/changed, and even re-branded, version of the Total Quality Management (TQM) concept, merging quality and innovation management. Such a shift would indeed be a fundamental and groundbreaking shift in the history of Quality Management so far. Can such a shift then actually be spotted? The purpose of this paper is to explore and see if there are any signs suggesting that quality and innovation management actually are about to merge.ApproachThe study is based on literature reviews, document studies, and interviews.FindingsThe paper highlights three signs indicating that quality and innovation management indeed are approaching each other, and that it is a movement driven from both sectors, e.g., in the work with new ISO-standards and the Toyota Kata framework.Relevance/contributionThe indicated development has fundamental and extensive practical implications. It will for example have to be followed by a similar merging of the two fields in the educational system, and in the competences of future managers.
10.	Lilja, Johan, et al. (författare) Is Innovation the Future of Quality Management? : Searching for signs of quality and innovation management merging 2017 Ingår i: International Journal of Quality and Service Sciences. - 1756-669X .- 1756-6703. ; 9:3-4, s. 232-240 Tidskriftsartikel (refereegranskat)abstract Purpose: Upcoming as well as mature industries are facing pressure as regards successfully managing operational excellence, and, at the same time, driving and managing innovation. Quality management concepts and practices’ ability to tackle this challenge have been questioned. It has even been suggested that there is a need to provide and promote an updated/changed, and even re-branded, version of Total Quality Management, merging quality management (QM) and innovation management (IM). Can such a shift then actually be spotted? The purpose of this paper is to explore and see if there are any signs suggesting that QM and IM actually are about to merge. Design/methodology/approach: The study is based on literature reviews, document studies and interviews. Findings: The paper highlights three signs indicating that QM and IM indeed are approaching each other, and that it is a movement driven from both sectors, e.g., in the work with new ISO-standards and the Toyota Kata framework. Originality/value: The indicated development has fundamental and extensive practical implications. It will for example have to be followed by a similar merging of the two fields in the educational system, and in the competences of future managers.
11.	Ness, Ottar, et al. (författare) Shaping a Wellbeing Future for People and Planet 2023 Ingår i: Nordic journal of wellbeing and sustainable development. - : Universitetsförlaget. - 2703-9986. ; 2:1, s. 1-4 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
12.	Ness, Ottar, et al. (författare) Welcome to the Nordic Journal of Wellbeing and Sustainable Welfare Development (NJWEL) 2022 Ingår i: Nordic Journal of Wellbeing and Sustainable Welfare Development. - : Scandinavian University Press / Universitetsforlaget AS. - 2703-9986. ; 1:1, s. 1-5 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
13.	Riesbeck, Johan, et al. (författare) Global effects of closing down sinter plant at Ruukki Raahe integrated steel works 2013 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
14.	Robba, Chiara, et al. (författare) Oxygen targets and 6-month outcome after out of hospital cardiac arrest : a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial 2022 Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26, s. 1-13 Tidskriftsartikel (refereegranskat)abstract Background: Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO2) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO2 with patients’ outcome. Methods: Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO2 < 60 mmHg and severe hyperoxemia as PaO2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results: 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO2-AUC), for hyperoxemia was significantly associated with mortality (p = 0.003). Conclusions: In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration: clinicaltrials.gov NCT02908308, Registered September 20, 2016.
15.	Sävblom, C, et al. (författare) Association between polymorphisms in the prostate-specific antigen (PSA) promoter and release of PSA 2009 Ingår i: International Journal of Andrology. - : Wiley-Blackwell. - 0105-6263 .- 1365-2605. ; 32:5, s. 479-485 Tidskriftsartikel (refereegranskat)abstract Variations in serum prostate-specific antigen (PSA) have been ascribed to A/G nucleotide polymorphisms located at -158 bp (rs266882) and -4643 bp (rs925013), relative to the transcription start site within the promoter of the PSA gene. PSA is also an androgen receptor target (AR) gene and polymorphisms in AR gene are known to affect AR function. Our objective was to compare the impact of these A/G polymorphisms separately or in combination with AR CAG micro satellite on regulation of PSA secretion into seminal plasma and blood in young men. Leukocyte DNA was extracted from 291 conscripts and genotyping performed with the Sequenom Mass Array System. PSA was measured with an immunofluorometric assay. Linear regression analysis was used to test the association of polymorphism frequencies with serum and seminal plasma levels of PSA. PSA gene polymorphisms at -158 bp or -4643 bp did not alone influence total PSA (tPSA) levels in seminal plasma or in blood. Homozygotes for the A-allele at -158 bp in combination with CAG > 22 had significantly higher serum levels of tPSA than subjects carrying the G-allele (p = 0.01). In conclusion, the PSA gene polymorphisms did not importantly influence the levels of tPSA in seminal plasma or in blood. tPSA in serum was influenced by interactions between PSA promoter variants and AR CAG polymorphism.
16.	Vamstad, Johan, 1977-, et al. (författare) Leaving no one behind : from ideal to a complex reality? 2024 Ingår i: Nordic Journal of Wellbeing and Sustainable Welfare Development. - : Universitetsforlaget. - 2703-9986. ; 3:1, s. 1-3 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
17.	Årestedt, Kristofer, 1968-, et al. (författare) Psychometric properties of the Hospital Anxiety and Depression scale in cardiac arrest survivors 2017 Konferensbidrag (refereegranskat)abstract Background: The Hospital Anxiety and Depression scale (HAD) is commonly used to assess emotional distress in different group of patients. Despite emotional distress is common in sudden cardiac arrest survivors (SCA), HAD have not to our best knowledge been psychometrically evaluated in this patient group.Purpose: The aim was to evaluate the psychometric properties of the HAD, with focus on factor structure, internal consistency and differential item functioning (DIF) for sex and age, in SCA survivors.Methods: Data from the national Swedish Register of Cardiopulmonary Resuscitation were used, including HAD ratings from in-hospital cardiac arrest survivors, collected 3-12 months after resuscitation. Confirmatory factor analysis (CFA) was used to evaluate the hypothesized two factor structure for Anxiety and Depression, respectively. Ordinal version of Cronbach’s alpha was calculated to evaluate internal consistency reliability of the two factors. Multiple indicator multiple causes CFA models (MIMIC) were used to detect presence of DIF.Results: The sample consisted of 604 in-hospital cardiac arrest survivors (mean age 69.4±12.6), 384 men and 220 women. The suggested two-factor model was confirmed after item 7 was allowed to cross-load on Depression. The internal consistency was satisfactory for both Anxiety (.92) and Depression (.91). No DIF for sex and age was demonstrated.Conclusion: This study shows that the HAD Anxiety and Depression subscales are unidimensional. Both scales can also be used to make invariant comparisons between groups of different sex and age. Therefore, HAD can be used to assess psychological distress (anxiety and depression) in SCA survivors.
18.	Abé, Christoph, et al. (författare) Cytarabine dose intensification improves survival in older patients with secondary/high-risk acute myeloid leukemia in matched real-world versus clinical trial data 2024 Ingår i: Leukemia and Lymphoma. - 1042-8194 .- 1029-2403. Tidskriftsartikel (refereegranskat)abstract Since 1980’s, the established/standard treatment of acute myeloid leukemia (AML) is cytarabine infusion with anthracycline (7 + 3 regimen). We compared the 7 + 3 regimen in older secondary/high-risk AML patientsfrom a clinical trial with a matched population from the Swedish AML Registrytreated withan increased cytarabine dose in induction and consolidation as recommended in the Swedish National Guidelines since 2005. After successfulpropensity score matching, 104 patients per group were included. The primary outcome was overall survival (OS), and standard dosed patients had a median OS of 6.4 versus 10.7 months with increased dose intensity (hazard ratio:0.69, p = 0.012), with 5-year OS of 8.7% and 18.1%, andremission rates of 36% and 60%, respectively (p < 0.001). Median OS after allogeneic hematopoietic cell transplantation (in 27.9% per group) was 10.4 and 20.7 months, respectively. We conclude that the more intensive cytarabine schedule seems to provide improved outcomes inthe investigated AML patient group.
19.	Abrahamsson, Camilla, et al. (författare) Towards New Levels of Creating/Improving and Understanding Value in Swedish Municipalities : A Review of Research on Understanding and Creating Value in Municipal Quality Development by Qualitative Approaches (and Co-Creation) 2017 Konferensbidrag (refereegranskat)abstract PurposeQuality management and Lean initiatives are currently widespread in the Swedish municipal sector. It is also made clear that all Lean initiatives should be initiated to benefit the customer and not for internal organizational reasons. However, the practices currently used for understanding value creation in the municipalities tend to focus heavily on the use of numerical, quantitative approaches. In sharp contrast, the growing field of, for example, design thinking argue that qualitative approaches are key when it comes to getting closer to the citizens, establishing new levels of understanding and thereby inspiring new and better solutions. In sum, it seems likely that municipalities are struggling with developing quality due to relying, in too one-sided on the use of quantitative rather than qualitative approaches to understand and spark new levels of value creation. The purpose of this paper is to contribute with a review of research concerning qualitative approaches for understanding and co-creating value in municipal quality development. Methodology/Approach The paper is based on a literature review. Findings The paper provides an overview of previous research concerning practices for evaluating and understanding value creation in the context of a municipal quality development. Value of the paperThis overview is of value for practitioners within the context, as well as researchers that wants to contribute within this area.
20.	Adamczuk, Katarzyna, et al. (författare) Amyloid imaging in cognitively normal older adults : comparison between F-18-flutemetamol and C-11-Pittsburgh compound B 2016 Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 43:1, s. 142-151 Tidskriftsartikel (refereegranskat)abstract Purpose Preclinical, or asymptomatic, Alzheimer's disease (AD) refers to the presence of positive AD biomarkers in the absence of cognitive deficits. This research concept is being applied to define target populations for clinical drug development. In a prospective community-recruited cohort of cognitively intact older adults, we compared two amyloid imaging markers within subjects: F-18-flutemetamol and C-11-Pittsburgh compound B (PIB). Methods In 32 community-recruited cognitively intact older adults aged between 65 and 80 years, we determined the concordance between binary classification based on F-18-flutemetamol versus C-11-PIB according to semiquantitative assessment (standardized uptake value ratio in composite cortical volume, SUVRcomp) and, alternatively, according to visual reads. We also determined the correlation between F-18-flutemetamol and C-11-PIB SUVR and evaluated how this was affected by the reference region chosen (cerebellar grey matter versus pons) and the use of partial volume correction (PVC) in this population. Results Binary classification based on semiquantitative assessment was concordant between F-18-flutemetamol and C-11-PIB in 94 % of cases. Concordance of blinded binary visual reads between tracers was 84 %. The Spearman correlation between F-18-flutemetamol and C-11-PIB SUVRcomp with cerebellar grey matter as reference region was 0.84, with a slope of 0.98. Correlations in neocortical regions were significantly lower with the pons as reference region. PVC improved the correlation in striatum and medial temporal cortex. Conclusion For the definition of preclinical AD based on F-18-flutemetamol, concordance with C-11-PIB was highest using semiquantitative assessment with cerebellar grey matter as reference region.
21.	Adamczuk, Katarzyna, et al. (författare) Diagnostic value of cerebrospinal fluid A beta ratios in preclinical Alzheimer's disease 2015 Ingår i: Alzheimer's Research & Therapy. - : Springer Science and Business Media LLC. - 1758-9193. ; 7 Tidskriftsartikel (refereegranskat)abstract Introduction: In this study of preclinical Alzheimer's disease (AD) we assessed the added diagnostic value of using cerebrospinal fluid (CSF) A beta ratios rather than A beta 42 in isolation for detecting individuals who are positive on amyloid positron emission tomography (PET). Methods: Thirty-eight community-recruited cognitively intact older adults (mean age 73, range 65-80 years) underwent F-18-flutemetamol PET and CSF measurement of A beta 1-42, A beta 1-40, A beta 1-38, and total tau (ttau). F-18-flutemetamol retention was quantified using standardized uptake value ratios in a composite cortical region (SUVRcomp) with reference to cerebellar grey matter. Based on a prior autopsy validation study, the SUVRcomp cut-off was 1.57. Sensitivities, specificities and cut-offs were defined based on receiver operating characteristic analysis with CSF analytes as variables of interest and F-18-flutemetamol positivity as the classifier. We also determined sensitivities and CSF cut-off values at fixed specificities of 90 % and 95 %. Results: Seven out of 38 subjects (18 %) were positive on amyloid PET. A beta 42/ttau, A beta 42/A beta 40, A beta 42/A beta 38, and A beta 42 had the highest accuracy to identify amyloid-positive subjects (area under the curve (AUC) >= 0.908). A beta 40 and A beta 38 had significantly lower discriminative power (AUC = 0.571). When specificity was fixed at 90 % and 95 %, A beta 42/ttau had the highest sensitivity among the different CSF markers (85.71 % and 71.43 %, respectively). Sensitivity of A beta 42 alone was significantly lower under these conditions (57.14 % and 42.86 %, respectively). Conclusion: For the CSF-based definition of preclinical AD, if a high specificity is required, our data support the use of A beta 42/ttau rather than using A beta 42 in isolation.
22.	Adler, Jan-Olof, et al. (författare) The upgraded photon tagging facility at the MAX IV Laboratory 2013 Ingår i: Nuclear Instruments & Methods in Physics Research. Section A: Accelerators, Spectrometers, Detectors, and Associated Equipment. - : Elsevier BV. - 0167-5087 .- 0168-9002. ; 715, s. 1-10 Tidskriftsartikel (refereegranskat)abstract A description is given of the upgraded photon tagging facility at the MAX IV Laboratory. Two magnetic spectrometers are used to momentum analyze post-bremsstrahlung electrons. The tagged photon range extends from 10 to 180 MeV with an energy resolution of about 300 keV. The system has been operated at rates up to 4 x 10(6) photons s(-1) MeV (-1). Different diagnostic tools are described as well as the experimental program.
23.	Adler, Sara, et al. (författare) Symptoms and risk factors of Cryptosporidium hominis infection in children : data from a large waterborne outbreak in Sweden 2017 Ingår i: Parasitology Research. - : Springer Berlin/Heidelberg. - 0932-0113 .- 1432-1955. ; 116:10, s. 2613-2618 Tidskriftsartikel (refereegranskat)abstract Cryptosporidium is a major cause of diarrheal disease worldwide. In developing countries, this infection is endemic and in children, associated with growth faltering and cognitive function deficits, with the most severe impact on those aged <2 years. Little has been reported about symptoms and risk factors for children in industrialized countries, although the disease incidence is increasing in such regions. In November 2010, a large waterborne outbreak of C. hominis occurred in the city of Östersund in Sweden. Approximately 27,000 of the 60,000 inhabitants were symptomatic. We aimed to describe duration of symptoms and the risk factors for infection with C. hominis in children aged <15 years in a Western setting. Within 2 months after a boil water advisory, a questionnaire was sent to randomly selected inhabitants of all ages, including 753 children aged <15 years. Those with ≥3 loose stools/day were defined as cases of diarrhoea. The response rate was 70.3%, and 211 children (39.9%) fulfilled the case definition. Mean duration of diarrhoea was 7.5 days (median 6, range 1-80 days). Recurrence, defined as a new episode of diarrhoea after ≥2 days of normal stools, occurred in 52.5% of the cases. Significant risk factors for infection, besides living within the distribution area of the contaminated water plant, included a high level of water consumption, male sex, and a previous history of loose stools. The outbreak was characterized by high attack and recurrence rates, emphasizing the necessity of water surveillance to prevent future outbreaks.
24.	Ahmad Tajudin, Asilah, et al. (författare) Integrated acoustic immunoaffinity-capture (IAI) platform for detection of PSA from whole blood samples. 2013 Ingår i: Lab on a Chip. - : Royal Society of Chemistry (RSC). - 1473-0189 .- 1473-0197. ; 13:9, s. 1790-1796 Tidskriftsartikel (refereegranskat)abstract On-chip detection of low abundant protein biomarkers is of interest to enable point-of-care diagnostics. Using a simple form of integration, we have realized an integrated microfluidic platform for the detection of prostate specific antigen (PSA), directly in anti-coagulated whole blood. We combine acoustophoresis-based separation of plasma from undiluted whole blood with a miniaturized immunoassay system in a polymer manifold, demonstrating improved assay speed on our Integrated Acoustic Immunoaffinity-capture (IAI) platform. The IAI platform separates plasma from undiluted whole blood by means of acoustophoresis and provides cell free plasma of clinical quality at a rate of 10 uL/min for an online immunoaffinity-capture of PSA on a porous silicon antibody microarray. The whole blood input (hematocrit 38-40%) rate was 50 μl min(-1) giving a plasma volume fraction yield of ≈33%. PSA was immunoaffinity-captured directly from spiked female whole blood samples at clinically significant levels of 1.7-100 ng ml(-1) within 15 min and was subsequently detected via fluorescence readout, showing a linear response over the entire range with a coefficient of variation of 13%.
25.	Ahmad Tajudin, Asilah, et al. (författare) MALDI-target integrated platform for affinity-captured protein digestion. 2014 Ingår i: Analytica Chimica Acta. - : Elsevier BV. - 1873-4324 .- 0003-2670. ; 807:Jan 7, s. 1-8 Tidskriftsartikel (refereegranskat)abstract To address immunocapture of proteins in large cohorts of clinical samples high throughput sample processing is required. Here a method using the proteomic sample platform, ISET (integrated selective enrichment target) that integrates highly specific immunoaffinity capture of protein biomarker, digestion and sample cleanup with a direct interface to mass spectrometry is presented. The robustness of the on-ISET protein digestion protocol was validated by MALDI MS analysis of model proteins, ranging from 40fmol to 1pmol per nanovial. On-ISET digestion and MALDI MS/MS analysis of immunoaffinity captured disease-associated biomarker PSA (prostate specific antigen) from human seminal plasma are presented.
26.	Alakukku, Laura, et al. (författare) Maatalouden ympäristötuen vaikuttavuuden seurantatutkimus (MYTVAS 3) : loppuraportti 2014 Rapport (övrigt vetenskapligt/konstnärligt)abstract Since 1995, agri-environmental support partly funded by the EU has formed the core of Finland’s agri-environmental policy. This system has had a variety of impacts on the relationship between agriculture and the environment. Today’s agri-environmental support is one of the packages included in the Rural Development Programme for Mainland Finland (2007–2013/2014), which both in itself and through the underlying EU legislation requires monitoring of the impacts of the measures implemented. The study monitoring the impact of the 2nd Finnish agri-environmental scheme (MYTVAS 3), which ran from 2008 to 2013, forms part of this monitoring. The MYTVAS 3 monitoring study was also financed by the Ministry of the Environment. The monitoring study was carried out by a consortium coordinated by MTT Agrifood Research Finland and including the Finnish Environment Institute (SYKE), the University of Helsinki, the Finnish Game and Fisheries Research Institute and the University of Turku.The purpose of the MYTVAS 3 monitoring study was to find out how agri-environmental support and its various measures have affected the state of the environment in agricultural areas, how agri-environmental support has affected the potential for farming and how agri-environmental support should be developed to increase its impact. The monitoring focused on the impacts of agri-environmental support on the nutrient load from agriculture on the waterways and on biodiversity. When evaluating the findings presented, we should remember that while monitoring data shows that something happened, it does not necessarily explain what caused it. It is not always possible to show that particular developments were a specific outcome of the current agri-environmental support system and the implementation of its measures. The delay between a measure and its observed impact is often long, and the cause-and-effect relationships are complicated and partly unknown. Also, other agricultural policy and fluctuations on the market may affect the state of the agricultural environment directly or indirectly.The monitoring data show that agri-environmental support has not had a detrimental impact on the potential for farming. Despite a slight increase in the incidence of weeds, they do not cause problems of the kind that would require amendments to the content of agri-environmental measures. Carbon levels in the surface stratum of arable land seems to be continuing their slow decline, and there is still need for measures to preserve organic material in the soil.Compliance with the fertilisation limits in the agri-environmental support system would seem to have had very little impact on crop quality. Variations in the weight and protein content per hectolitre and per 1,000 seeds were of the same order between 2006 and 2012 as they were between 1995 and 2005. Crop quantities have also not been noticeably affected by compliance with the fertilisation limits. Average crop yields remained stable between 1986 and 2013, and no clearly different crop years were observed in the 2000s. It is possible, however, that the lower fertilisation levels could have lowered crop potential in the years with advantageous weather conditions in the 2000s and that protein contents have been lower in advantageous years.The monitoring data also show that the nutrient load potential of agriculture, measured by nutrient balances, has decreased continuously for nitrogen and particularly for phosphorus. The decrease in the nutrient load potential is due above all to a decrease in the use of synthetic fertilisers. The decline in nitrogen fertilisation has bottomed out in recent years, and low protein levels measured in high crop yield years show that there is no point in further reducing nitrogen fertilisation. Optimising nitrogen fertilisation according to how advantageous the growing season is and effectively using the soluble nitrogen in cattle manure are key measures in achieving reasonable nitrogen balances and good crop quality despite fluctuations in growing season conditions. New crop variants have been found to make more efficient use of nitrogen than old ones, and thus the introduction of new variants should be promoted. Despite the decrease in the nutrient balances, there are indications that nutrient loads in runoff water from domestic animal production sites are becoming an increasing problem. Indeed, the fundamental problem with the nutrient load from agriculture is the diversification of livestock farming and crop farming, which has made it more difficult to use nutrients appropriately. Therefore attention must be paid to measures that both boost the use of nutrients in manure and reduce the levels of nutrients that end up in manure. Based on nutrient load monitoring in the catchment areas of rivers, the phosphorus load per hectare of cropland has decreased in each programme period, being about 80% of the level of the first period (1995–1999) in the third period (2007–2013). Because of the increase in the area of cropland, the nitrogen load on waterways from agriculture continued to grow during the second programme period (2000–2006) but peaked in the third (2007–2013). A similar trend was found in the nitrogen load per hectare of cropland.The most important threat to biodiversity is caused by the development of landscape structure, typically involving a decrease in the number of open or half-open areas excluded from actual cultivation. The consequence of the clearing of margins and ecological islands located in crop fields, drainage measures aimed at increasing arable land and all rationalisation of cultivated areas is the diminishing of exactly those areas that are the most important from the perspective of the biodiversity of the agricultural environment. However, the measure-specific findings in the monitoring study show that biodiversity benefits have been locally achieved where measures have been implemented on a broad enough scale (biodynamic farming, traditional biotopes, wetlands, buffer zones, green fallow / nature management areas). Particular care should therefore be taken that all cultivated land continues to have a sufficient percentage of non-cultivated areas, whether they be natural meadows, nature management areas, biodiversity strips, buffer zones, filter strips, headlands, ecological islands, etc. Including the rather popular nature management areas as a new voluntary measure under basic measures was a significant contribution to biodiversity.Regarding the rural landscape, it may be noted that by visual inspection the area of cropland has remained largely unchanged, at the level of the landscape as a whole it is far more common for the landscape to become more closed than to become more open. This trend was also observed in the visual inspection of traditional biotopes, even if the openness of the meadows monitored largely remained unchanged.The only measures that directly address the reduction of gaseous emissions in the agri-environmental support system are the longterm grass cultivation on peat fields and special aid agreements for slurry injection in cropland. While other measures have indirectly affected gaseous emissions, the impact of agri-environmental support as a whole on reducing gaseous emissions from agriculture has been negligible. In general, we may conclude that the goals, content and support levels of agri-environmental support measures must be increasingly adapted and customised by region, by type of farming and by farm, because both the state of the agricultural environment and the needs of society differ greatly between different types of rural area.
27.	Andersson, Peder, et al. (författare) Predicting neurological outcome after out-of-hospital cardiac arrest with cumulative information; development and internal validation of an artificial neural network algorithm 2021 Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535. ; 25:1 Tidskriftsartikel (refereegranskat)abstract BackgroundPrognostication of neurological outcome in patients who remain comatose after cardiac arrest resuscitation is complex. Clinical variables, as well as biomarkers of brain injury, cardiac injury, and systemic inflammation, all yield some prognostic value. We hypothesised that cumulative information obtained during the first three days of intensive care could produce a reliable model for predicting neurological outcome following out-of-hospital cardiac arrest (OHCA) using artificial neural network (ANN) with and without biomarkers.MethodsWe performed a post hoc analysis of 932 patients from the Target Temperature Management trial. We focused on comatose patients at 24, 48, and 72 h post-cardiac arrest and excluded patients who were awake or deceased at these time points. 80% of the patients were allocated for model development (training set) and 20% for internal validation (test set). To investigate the prognostic potential of different levels of biomarkers (clinically available and research-grade), patients' background information, and intensive care observation and treatment, we created three models for each time point: (1) clinical variables, (2) adding clinically accessible biomarkers, e.g., neuron-specific enolase (NSE) and (3) adding research-grade biomarkers, e.g., neurofilament light (NFL). Patient outcome was the dichotomised Cerebral Performance Category (CPC) at six months; a good outcome was defined as CPC 1-2 whilst a poor outcome was defined as CPC 3-5. The area under the receiver operating characteristic curve (AUROC) was calculated for all test sets.ResultsAUROC remained below 90% when using only clinical variables throughout the first three days in the ICU. Adding clinically accessible biomarkers such as NSE, AUROC increased from 82 to 94% (p<0.01). The prognostic accuracy remained excellent from day 1 to day 3 with an AUROC at approximately 95% when adding research-grade biomarkers. The models which included NSE after 72 h and NFL on any of the three days had a low risk of false-positive predictions while retaining a low number of false-negative predictions.ConclusionsIn this exploratory study, ANNs provided good to excellent prognostic accuracy in predicting neurological outcome in comatose patients post OHCA. The models which included NSE after 72 h and NFL on all days showed promising prognostic performance.
28.	Andreassen, Eva, et al. (författare) Kokbok för förändringsledare : Metdoder för att stötta engagerade människor att förverkliga idéer 2020 Bok (övrigt vetenskapligt/konstnärligt)abstract Det här är en kokbok för förändringsledare. Du kan använda denna bok om du ska leda utvecklingsaktiviteter och letar efter bra och beprövade metoder för att leda grupper och processer. Vi beskriver metoderna som vi har använt inom vårt projekt SMICE, i vilket sammanhang metoderna använts och när de olika metoderna fungerat bra. Vår förhoppning med att nedteckna dessa metoder är att du ska inspireras och vågar prova något nytt för att skapa nytta. Vi tror att ett detaljerat sätt att dokumentera metoderna gör dem mer användbara för dig men också för oss själva. Metoderna är graderade efter vilket behov av förkunskap och förberedelser du behöver, från det enklaste, där du kan öppna kokboken och använda metoden på en gång, till metoder som kräver utbildning eller specialistkompetens innan du sätter igång. Boken är indelad i fyra huvuddelar; Starta, Forma, Utveckla och förankra och Bygga vidare. Till dessa delar har vi identifierat metodstöd som kan användas vid en rad olika tillfällen; vid idégenerering, vid idéutveckling, vid affärsutveckling, för att inspirera, för att skapa samsyn och samverkan och för att mobilisera större grupper av människor och organisationer. Något för alla, alltså. Avslutningsvis finner du tips och stöd för att driva dessa utvecklingsprocesser på distans med digitala verktyg i digitala möten. Ska vi sammanfatta någon lärdom av detta arbete så blir det våra nycklar som presenteras på nästa sida. Du kan se dessa nycklar som våra bästa råd för att du ska lyckas med ditt arbete med att leda processer och att ordna möten. Lycka till! Metoderna har testats och utvecklats inom SMICE - Samskapande Mittnordisk Innovationsarena för Cirkulär Ekonomi, ett projekt inom Interreg som pågått 2017-2020.
29.	Angsten, Gertrud, et al. (författare) Outcome of laparoscopic versus open gastrostomy in children 2015 Ingår i: Pediatric surgery international (Print). - : Springer Science and Business Media LLC. - 0179-0358 .- 1437-9813. ; 31:11, s. 1067-1072 Tidskriftsartikel (refereegranskat)abstract Laparoscopic gastrostomy (LAPG) has gained popularity in children. The aim of this study was to compare the outcome of LAPG versus open gastrostomy (OG) in children with focus on complications, operative times and postoperative length of stay. Retrospective study of children who had gastrostomies inserted at our tertiary Pediatric Surgery Center from 2000 until 2013. The indications for a gastrostomy were an anticipated need for enteral support for at least 6 months. Totally 243 children were included in the study, 83 with LAPG and 160 with OG. We found a significant difference in postoperative length of stay, 3 days in the LAPG group versus 4 days in the OG group but no difference in a sub-group analysis from 2010 to 2013 when both techniques were used. There was no difference in median operative time or complications rates. Granuloma was the dominating complication in both groups. These two feeding-access techniques are comparable regarding complications, operative times and postoperative length of stay. The choice of surgical method should be individualized based on the patient's characteristics and the experience of the surgeon. The favorable results with LAPG in adults are not necessarily transferable to children since there are physiological and anatomical differences.
30.	Annerén, Göran, et al. (författare) Lethal autosomal recessive syndrome with intrauterine growth retardation, intra- and extrahepatic biliary atresia, and esophageal and duodenal atresia 1998 Ingår i: American Journal of Medical Genetics. - 0148-7299 .- 1096-8628. ; 78:3, s. 306-307 Tidskriftsartikel (refereegranskat)
31.	Aregger Lundh, Stefan, et al. (författare) Association between Life satisfaction, self-reported health, and psychological distress among cardiac arrest survivors : A structural equation modelling study 2023 Konferensbidrag (refereegranskat)
32.	Aregger Lundh, Stefan, et al. (författare) Life satisfaction in cardiac arrest survivors : A nationwide Swedish registry study 2023 Ingår i: Resuscitation Plus. - : Elsevier. - 2666-5204. ; 15 Tidskriftsartikel (refereegranskat)abstract IntroductionMost cardiac arrest (CA) survivors report good health and quality of life. Life satisfaction on the other hand has not yet been studied in a large scale in the CA population. We aimed to explore life satisfaction as perceived by CA survivors with three research questions addressed: (1) how do CA survivors report their life satisfaction, (2) how are different domains of life satisfaction associated with overall life satisfaction, and (3) how are demographic and medical factors associated with overall life satisfaction?MethodsThis registry study had a cross-sectional design. Life satisfaction was assessed using the 11-item Life Satisfaction checklist (LiSat-11). The sample included 1435 survivors ≥18 years of age. Descriptive statistics and binary logistic regression analyses were used.ResultsSurvivors were most satisfied with partner relation (85.6%), family life (82.2%), and self-care (77.8%), while 60.5% were satisfied with overall life. Satisfaction with psychological health was strongest associated with overall life satisfaction. Among medical and demographic factors, female sex and poor cerebral performance were associated with less overall life satisfaction.ConclusionsGenerally, CA survivors seem to perceive similar levels of overall life satisfaction as general populations, while survivors tend to be significantly less satisfied with their sexual life. Satisfaction with psychological health is of special interest to identify and treat. Additionally, female survivors and survivors with poor neurological outcome are at risk for poorer overall life satisfaction and need special attention by healthcare professionals.
33.	Aregger Lundh, Stefan, et al. (författare) Life satisfaction in persons surviving cardiac arrest : a nationwide registry study 2022 Konferensbidrag (populärvet., debatt m.m.)
34.	Aus, Gunnar, 1958, et al. (författare) Individualized screening interval for prostate cancer based on prostate-specific antigen level. 2005 Ingår i: Arch Intern Med. ; 165:16, s. 1857-1861 Tidskriftsartikel (refereegranskat)abstract Background The aim of the present study was to evaluate the future cumulative risk of prostate cancer in relation to levels of prostate-specific antigen (PSA) in blood and to determine whether this information could be used to individualize the PSA testing interval. Methods The study included 5855 of 9972 men (aged 50-66 years) who accepted an invitation to participate in a prospective, randomized study of early detection for prostate cancer. We used a protocol based on biennial PSA measurements starting from 1995 and 1996. Men with serum PSA levels of 3.0 ng/mL or more were offered prostate biopsies. Results Among the 5855 men, 539 cases of prostate cancer (9.2%) were detected after a median follow-up of 7.6 years (up to July 1, 2003). Cancer detection rates during the follow-up period in relation to PSA levels were as follows: 0 to 0.49 ng/mL, 0% (0/958); 0.50 to 0.99 ng/mL, 0.9% (17/1992); 1.00 to 1.49 ng/mL, 4.7% (54/1138); 1.50 to 1.99 ng/mL, 12.3% (70/571); 2.00 to 2.49 ng/mL, 21.4% (67/313); 2.50 to 2.99 ng/mL, 25.2% (56/222); 3.00 to 3.99 ng/mL, 33.3% (89/267); 4.00 to 6.99 ng/mL, 38.9% (103/265); 7.00 to 9.99 ng/mL, 50.0% (30/60); and for men with an initial PSA of 10.00 ng/mL or higher, 76.8% (53/69). Not a single case of prostate cancer was detected within 3 years in 2950 men (50.4% of the screened population) with an initial PSA level less than 1 ng/mL. Conclusions Retesting intervals should be individualized on the basis of the PSA level, and the large group of men with PSA levels of less than 1 ng/mL can safely be scheduled for a 3-year testing interval.
35.	Balldin, Jutta, et al. (författare) Introduktion 2014 Ingår i: Om förskolan och de yngre barnen. - : Studentlitteratur AB. - 9789144101163 ; , s. 11-16 Bokkapitel (övrigt vetenskapligt/konstnärligt)
36.	Bjartell, Anders, et al. (författare) Distribution and tissue expression of semenogelin I and II in man as demonstrated by in situ hybridization and immunocytochemistry 1996 Ingår i: Journal of Andrology. - 0196-3635. ; 17, s. 17-26 Tidskriftsartikel (refereegranskat)abstract Semenogelin I and II (Sgl, Sgll) are two separate gene products of chromosome 20 with extensive (80%) identity in primary structure. They are mainly responsible for immediate gel formation of freshly ejaculated semen. Degradation of Sgl and Sgll is due to the proteolytic action of prostate-specific antigen (PSA); it results within 5-15 minutes in liquefaction of semen and release of progressively motile spermatozoa. By means of cDNA cloning and Northern blots, Sgl and Sgll transcripts have previously been shown to be abundant in human seminal vesicles, but Sgll alone is suggested to be expressed at low levels in the epididymis. To characterize the expression and tissue distribution of Sgl and Sgll in greater detail, we produced monoclonal immunoglobulin Gs (lgGs for immunocytochemistry (lCC) and specific [35S]-, digoxigenin-, or alkaline phosphatase-labeled 30-mer antisense probes to Sgl and Sgll for in situ hybridization (lSH). Immunocytochemical staining for both Sgl and Sgll, and lSH detection of both Sgl and Sgll transcripts, were demonstrated in the cytoplasm of seminal vesicle epithelium. lSH showed Sgll alone to be expressed in the epithelium of the epididymal cauda. Neither lCC nor lSH yielded any evidence of Sgl or Sgll expression in caput or corpus epithelium or in any stromal cells of the epididymis. Consistent with our previous findings using polyclonal lgG, monoclonal anti-Sgll Sgll lgGs identified epitopes on the posterior head, midpiece, and tail of ejaculated spermatozoa. Spermatozoa in the epididymal cauda were also immunoreactive, but those in the caput or corpus region of the epididymis as well as those in the testis were negative. As shown by lCC, neither Sgl nor Sgll were expressed in the testis, the prostate, the female genital tract, or other normal human tissue specimens. Although the significance of Sg attachment to epididymal and ejaculated spermatozoa remains to be established, monoclonal anti-Sg lgG might prove useful in establishing the origin of seminal vesicle tissue components in prostate core biopsies or other biopsy specimens.
37.	Bjerner, Johan, et al. (författare) Baseline Serum Prostate-specific Antigen Value Predicts the Risk of Subsequent Prostate Cancer Death-Results from the Norwegian Prostate Cancer Consortium. 2024 Ingår i: European Urology. - 0302-2838. ; 86:1, s. 20-26 Tidskriftsartikel (refereegranskat)abstract Prostate-specific antigen (PSA) levels in midlife are strongly associated with the long-term risk of lethal prostate cancer in cohorts not subject to screening. This is the first study evaluating the association between PSA levels drawn as part of routine medical care in the Norwegian population and prostate cancer incidence and mortality.To determine the association between midlife PSA levels <4.0 ng/ml, drawn as part of routine medical care, and long-term risk of prostate cancer death.The Norwegian Prostate Cancer Consortium collected >8 million PSA results from >1 million Norwegian males ≥40 yr of age. We studied 176099 men (predefined age strata: 40-54 and 55-69 yr) without a prior prostate cancer diagnosis who had a nonelevated baseline PSA level (<4.0 ng/ml) between January 1, 1995 and December 31, 2005.Baseline PSA.We assessed the 16-yr risk of prostate cancer mortality. We calculated the discrimination (C-index) between predefined PSA strata (<0.5, 0.5-0.9, 1.0-1.9, 2.0-2.9, and 3.0-3.9 ng/ml) and subsequent prostate cancer death. Survival curves were plotted using the Kaplan-Meier method.The median follow-up time of men who did not get prostate cancer was 17.9 yr. Overall, 84% of men had a baseline PSA level of <2.0 ng/ml and 1346 men died from prostate cancer, with 712 deaths (53%) occurring in the 16% of men with the highest baseline PSA of 2.0-3.9 ng/ml. Baseline PSA levels were associated with prostate cancer mortality (C-index 0.72 for both age groups, 40-54 and 55-69 yr). The fact that the reason for any given PSA measurement remains unknown represents a limitation.We replicated prior studies that baseline PSA at age 40-69 yr can be used to stratify a man's risk of dying from prostate cancer within the next 15-20 yr.A prostate-specific antigen level obtained as part of routine medical care is strongly associated with a man's risk of dying from prostate cancer in the next two decades.
38.	Blennow Nordström, Erik, et al. (författare) Neuropsychological outcome after cardiac arrest : results from a sub-study of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial 2023 Ingår i: Critical Care. - : BioMed Central (BMC). - 1364-8535 .- 1466-609X. ; 27:1 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Cognitive impairment is common following out-of-hospital cardiac arrest (OHCA), but the nature of the impairment is poorly understood. Our objective was to describe cognitive impairment in OHCA survivors, with the hypothesis that OHCA survivors would perform significantly worse on neuropsychological tests of cognition than controls with acute myocardial infarction (MI). Another aim was to investigate the relationship between cognitive performance and the associated factors of emotional problems, fatigue, insomnia, and cardiovascular risk factors following OHCA.METHODS: This was a prospective case-control sub-study of The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Eight of 61 TTM2-sites in Sweden, Denmark, and the United Kingdom included adults with OHCA of presumed cardiac or unknown cause. A matched non-arrest control group with acute MI was recruited. At approximately 7 months post-event, we administered an extensive neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes.RESULTS: Of 184 eligible OHCA survivors, 108 were included, with 92 MI controls enrolled. Amongst OHCA survivors, 29% performed z-score ≤ - 1 (at least borderline-mild impairment) in ≥ 2 cognitive domains, 14% performed z-score ≤ - 2 (major impairment) in ≥ 1 cognitive domain while 54% performed without impairment in any domain. Impairment was most pronounced in episodic memory, executive functions, and processing speed. OHCA survivors performed significantly worse than MI controls in episodic memory (mean difference, MD = - 0.37, 95% confidence intervals [- 0.61, - 0.12]), verbal (MD = - 0.34 [- 0.62, - 0.07]), and visual/constructive functions (MD = - 0.26 [- 0.47, - 0.04]) on linear regressions adjusted for educational attainment and sex. When additionally adjusting for anxiety, depression, fatigue, insomnia, hypertension, and diabetes, executive functions (MD = - 0.44 [- 0.82, - 0.06]) were also worse following OHCA. Diabetes, symptoms of anxiety, depression, and fatigue were significantly associated with worse cognitive performance.CONCLUSIONS: In our study population, cognitive impairment was generally mild following OHCA. OHCA survivors performed worse than MI controls in 3 of 6 domains. These results support current guidelines that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue.TRIAL REGISTRATION: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018.
39.	Blennow Nordström, Erik, et al. (författare) Neuropsychological outcome after cardiac arrest : A prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2) 2020 Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 20:1 Tidskriftsartikel (refereegranskat)abstract Background: This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA. Methods: This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses. Discussion: In this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA. Trial registration: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018
40.	Blennow Nordström, Erik, et al. (författare) Neuropsychological Outcome After Cardiac Arrest: Results from a Sub-study of the Targeted Hypothermia Versus Targeted Normothermia After Out-of-hospital Cardiac Arrest (TTM2) Trial 2023 Ingår i: Journal of the International Neuropsychological Society. - 1469-7661. ; 29:Supplement s1, s. 789-790 Konferensbidrag (refereegranskat)
41.	Bohm, Mattias, et al. (författare) Caregiver burden and health-related quality of life amongst caregivers of out-of-hospital cardiac arrest survivors 2021 Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 167:October, s. 118-127 Tidskriftsartikel (refereegranskat)abstract Aims:To describe burden and health-related quality of life amongst caregivers of out-of-hospital cardiac arrest survivors and explore the potential association with cognitive function of the survivors. Caregivers of patients with ST-elevation myocardial infarction were used as controls.Methods:Data were collected from the cognitive substudy of the Targeted Temperature Management-trial. Caregiver burden was assessed with the 22-item Zarit Burden Interview, with scores <20 considered as no burden. Health-related quality of life was assessed with the SF-36v2 (R), with T scores 47-53 representing the norm. Cardiac arrest survivors were categorized based on the results from cognitive assessments as having "no cognitive impairment" or "cognitive impairment".Results:Follow-up 6 months post event was performed for caregivers of 272 cardiac arrest survivors and 108 matched myocardial infarction controls, included at an intended ratio of 2:1. In general, caregivers of cardiac arrest survivors and controls reported similar caregiver burden. The overall scores for quality of life were within normative levels and similar for caregivers of cardiac arrest survivors and control patients. Compared to those with no cognitive impairment, caregivers of cognitively impaired cardiac arrest survivors (n = 126) reported higher levels of burden (median 18 versus 8, p < 0.001) and worse quality of life in five of eight domains, particularly "Role-Emotional" (mean 45.7 versus 49.5, p = 0.002).Conclusions: In general, caregivers of cardiac arrest survivors and myocardial infarction controls reported similar levels of burden and quality of life. Cognitive outcome and functional dependency of the cardiac arrest survivor impact burden and quality of life of the caregiver.
42.	Bohm, Mattias, et al. (författare) Detailed analysis of health-related quality of life after out-of-hospital cardiac arrest 2019 Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 135:February, s. 197-204 Tidskriftsartikel (refereegranskat)abstract Aim:To describe the detailed health-related quality of life (HRQoL) in survivors from the TTM-trial and to investigate potential differences related to sex and age.Methods:This is a cross-sectional study originating from a large prospective international, multicentre trial, including 442 respondents who answered the Short Form-36 item Questionnaire Health Survey version 2® (SF-36v2®) at a structured follow-up 6 months after out-of-hospital cardiac arrest (OHCA). Statistical analysis between independent groups were performed with Mann-Whitney U or Chi-square. Age was analysed primarily as a dichotomised variable.Results:Although overall physical and mental health were within the normal range, a substantial proportion of respondents had impaired function at domain-specific levels, particularly in Role-Physical (50%) and Role-Emotional (35%). Females scored significantly lower than males in; Physical Functioning (41.7 vs. 47.9, p < 0.001), Role-Physical (40.4 vs. 44.3, p = 0.02), General Health (47.0 vs. 50.5, p = 0.02), Vitality (47.2 vs. 52.7, p < 0.001), and Role-Emotional (41.5 vs. 46.2, p = 0.009). Those ≤65 years scored significantly better in Physical Functioning (47.9 vs. 44.1 p < 0.001), while those >65 years scored significantly better in Vitality (50.8 vs. 53.7, p = 0.006) and Mental Health (50.3 vs. 52.6, p = 0.04).Conclusions:Many OHCA survivors demonstrated impaired function in HRQoL at a domain level, despite most patients reporting an acceptable general HRQoL. Females reported worse HRQoL than males. Older age was associated with a worse Physical Functioning but better Vitality and Mental Health. Role-Physical and Role-Emotional aspects of health were especially affected, even when effects of age and sex where accounted for.
43.	Bollack, Ariane, et al. (författare) Evaluation of novel data-driven metrics of amyloid β deposition for longitudinal PET studies 2023 Ingår i: NeuroImage. - 1053-8119. ; 280 Tidskriftsartikel (refereegranskat)abstract Purpose: Positron emission tomography (PET) provides in vivo quantification of amyloid-β (Aβ) pathology. Established methods for assessing Aβ burden can be affected by physiological and technical factors. Novel, data-driven metrics have been developed to account for these sources of variability. We aimed to evaluate the performance of four of these amyloid PET metrics against conventional techniques, using a common set of criteria. Methods: Three cohorts were used for evaluation: Insight 46 (N=464, [18F]florbetapir), AIBL (N=277, [18F]flutemetamol), and an independent test-retest data (N=10, [18F]flutemetamol). Established metrics of amyloid tracer uptake included the Centiloid (CL) and where dynamic data was available, the non-displaceable binding potential (BPND). The four data-driven metrics computed were the amyloid load (Aβ load), the Aβ-PET pathology accumulation index (Aβ index), the Centiloid derived from non-negative matrix factorisation (CLNMF), and the amyloid pattern similarity score (AMPSS). These metrics were evaluated using reliability and repeatability in test-retest data, associations with BPND and CL, variability of the rate of change and sample size estimates to detect a 25% slowing in Aβ accumulation. Results: All metrics showed good reliability. Aβ load, Aβ index and CLNMF were strong associated with the BPND. The associations with CL suggest that cross-sectional measures of CLNMF, Aβ index and Aβ load are robust across studies. Sample size estimates for secondary prevention trial scenarios were the lowest for CLNMF and Aβ load compared to the CL. Conclusion: Among the novel data-driven metrics evaluated, the Aβ load, the Aβ index and the CLNMF can provide comparable performance to more established quantification methods of Aβ PET tracer uptake. The CLNMF and Aβ load could offer a more precise alternative to CL, although further studies in larger cohorts should be conducted.
44.	Boström, Jonas, et al. (författare) Balancing a seesaw – leaders perspectives on design and traditional quality improvement in healthcare 2023 Ingår i: The TQM Journal. - 1754-2731 .- 1754-274X. ; 35:9, s. 173-190 Tidskriftsartikel (refereegranskat)abstract Purpose – The purpose of this paper is to explore and describe the perspectives and reasoning of seniordevelopment leaders in healthcare organizations, when reflecting on design as theory and practice in relation tomore traditional methods and tools for improving quality and support innovation.Design/methodology/approach – The paper is based on a qualitative interview design with fivedevelopment and innovation leaders from separate healthcare regions in Sweden. They have, to varyingdegrees, applied design theory and practice for quality improvement and innovation in their organizations. Theinterview transcript was analysed using a content analysis together with an interpretive approach.Findings – The major findings are to be found in the balancing act for leadership and organizations inhealthcare when it comes to introducing and combining different theories and practices for improving qualityand support innovation. The balance is between the change in power dynamics and pushing traditional boundaries in a complex healthcare world.Practical implications – The narratives from the leaders’ experience of applying design theory and practicefor improving healthcare quality can help us create readiness and knowledge about how we prevent and/orfacilitate planning and implementing design theories, practices, methods and tools in a healthcare context.Originality/value – The study provides a unique insight when it captures and illustrates five differentorganizations’ experiences when applying design for developing healthcare quality.
45.	Boström, Jonas, et al. (författare) Cultural Change of Applying User Involvement for Improving Healthcare Quality : A Review of the Impact on Attitudes, Values and Assumptions among Healthcare Professionals and Users 2017 Ingår i: Quality Innovation Prosperity. - : Technical University of Kosice, Faculty of Materials, Metallurgy and Recycling. - 1335-1745 .- 1338-984X. ; 21:3, s. 158-172 Tidskriftsartikel (refereegranskat)abstract Purpose: The purpose of this study is to provide a review of the impact on culture (attitudes, values and assumptions) among both healthcare professionals, as well as users, when involving users for improving quality in healthcare.Methodology/Approach: The paper is based on an extensive, narrative literature review considering studies that included professional’s and users experiences of user involvement in quality improvement. The included articles were analyzed using an interpretive, along with a deductive, approach according to a theoretical framework.Findings: The results indicate that there is currently limited research focusing on the impact of user involvement in quality improvement processes regarding professionals’ and users’ attitudes, values and/or assumptions. The articles identified during the study provides situations and statements, during the process of development, which can be interpreted as change in the culture. Although few articles specifically draw conclusions on user involvement as a “tool” for cultural change, the authors interpret several findings which strengthens that theory.Research Limitation/implication: Research published in other databases could have been missed. The authors have tried to avoid this by using a snowball method reading references in identified articles.Originality/Value of paper: The review provides a platform for both future research and the development of current practice within the area. There have been literature reviews showing obstacles and enablers when using patients, users and relatives in quality improvement work, but few which investigates cultural change.
46.	Boström, Jonas, et al. (författare) Cultural dynamics and tensions when applying design thinking for improving health-care quality 2021 Ingår i: International Journal of Quality and Service Sciences. - 1756-669X .- 1756-6703. ; 13:1, s. 16-28 Tidskriftsartikel (refereegranskat)abstract PurposeThe purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking (DT) for improving quality in a health-care setting.Design/methodology/approachThis paper is based on a case study following a quality improvement (QI) project in a medium-sized Swedish county council in the field of somatic care. The project involved eight health-care professionals, one designer, four patients and two relatives. A multiple data collection method over a period of ten months was used. It included individual interviews, e-mail correspondence and observations of workshops that covered the QI project.FindingsThe result shows tensions between QI work and the daily clinical work of the participants. These tensions primarily concern the conflict between fast and slow processes, the problem of moving between different fields of knowledge, being a resource for the individual clinic and the system and the participants’ expectations and assumptions about roles and responsibilities in a QI project. Furthermore, these findings could be interpreted as signs of a development culture in the health-care context.Practical implicationsThere are several practical implications. Among others, the insights can inspire how to approach and contextualize the current concepts, roles and methods of DT and user involvement so that they can be more easily understood and integrated into the existing culture and way of working in the health-care sector.Originality/valueThis study provides a unique insight into a case, trying to uncover what actually is going on and perhaps, why certain things are not happening at all, when user involvement and design practices are applied for improving health-care quality.
47.	Boström, Jonas, et al. (författare) Cultural Impact of Applying User Involvement for Improving Healthcare Quality : A review of the impact on attitudes, values and assumptions among healthcare professionals and users 2016 Ingår i: Proceedings of the 19th QMOD Conference. Konferensbidrag (refereegranskat)abstract PurposeThe purpose of this study is to provide a review of the impact on culture (attitudes, values and assumptions) among both healthcare professionals, as well as users, when involving users for improving quality in healthcare.MethodThe paper is based on an extensive, narrative literature review, covering 3786 papers.FindingsThe results indicate that there is currently limited research focusing on the impact of user involvement in quality improvement processes regarding professionals’ and users´ attitudes, values and/or assumptions. The articles identified during the study mentions situations and things which are said, during the process of development, and which can be interpreted as change in the culture. Although few articles specifically draw conclusions on user involvement as a “tool” for cultural change, the authors interpret several findings which strengthens that theory.Research limitationsResearch published in other databases could have been missed. The authors have tried to avoid this by using a snowball method reading references in identified articles.Practical implicationsFuture research is needed to see if involvement activities in quality improvement processes can affect attitudes, values and assumptions in a positive way.OriginalityThe review provides a platform for both future research and the development of current practice within the area. There has been literature reviews showing obstacles and enablers when using patients, users and relatives in quality improvement work, but few which investigates cultural change.
48.	Boström, Jonas, et al. (författare) Exploring Cultural Dynamics and Tensions when Applying Design Thinking for Improving Healthcare Quality : What is really going on? 2018 Ingår i: Proceedings of the 21th QMOD Conference. Konferensbidrag (refereegranskat)abstract Purpose:The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking for improving quality in a healthcare setting.Method:The paper is based on a case study following a quality improvement project (QI) in a medium sized Swedish county council in the field of somatic care. The project involved eight healthcare professionals, one designer, four patients and two relatives. A multiple data collection method over a period of 10 months was used. It included individual interviews, e-mail correspondence and observations of workshops that covered the QI project.Findings:The result shows tensions between QI work and the daily clinical work of the participants. These tensions primarily concern the conflict between fast and slow processes, the problem of moving between different fields of knowledge, being a resource for the individual clinic and the system, and the participants' expectations and assumptions about roles and responsibilities in a QI project. Furthermore these findings could be interpreted as signs of a development culture in the healthcare context.Practical Implications:There are several practical implications. Among others, the insights can inspire how to approach and contextualize the current concepts, roles and methods of design thinking and user involvement so that they can be more easily understood and integrated into the existing culture and way of working in the healthcare sector.Originality:The study provides a unique insight into a case, trying to uncover what actually is going on, and perhaps why certain things are not happening at all, when user involvement and design practices are applied for improving healthcare quality.
49.	Boström, Jonas (författare) Knowledge for Improving Healthcare Service Quality : Combining Three Perspectives 2020 Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract The Swedish public sector in general, and healthcare specifically, is struggling with large deficits: 19 of 21 regions have large negative results in 2019. The demands made by the citizens and their elected politicians that healthcare should offer effective, accessible, good and equal care are difficult to meet. However, when it comes to emergency care, Swedish healthcare scores high on international rankings. The difficulties and challenges today lie in ensuring good and equal care for the large groups of people with multiple illnesses, and patients who need long-term care from different healthcare providers. A complicated system has become even more complex.Organizational research has shown conflicts between different ways of working to improve and change the organization and the methods that support the daily work of providing healthcare services. Furthermore, quality research shows that there are knowledge gaps to be filled when it comes to understanding how complex problems should be handled and what kind of knowledge could contribute. This also applies to the tensions and conflicts that can arise when knowledge from patients, other professions and fields of knowledge must be integrated with the knowledge that the professions (physicians, nursing) possess. Several public organizations have in recent years also adopted methods, tools and approaches from the design field. Especially user involvement (human-centric), collaboration and visualization. Design research often highlights the methods which are favorable for handling complexity.The overall purpose of this thesis was therefore to gain a deeper understanding of how the quality development work in healthcare is expressed and how it is affected when different perspectives of knowledge are integrated - with a focus on improvement knowledge, professional knowledge and design thinking. Since the purpose of the licentiate thesis was to gain a deeper understanding of what happens when new knowledge to develop quality in healthcare emerges, the method is based on a qualitative approach. Three research questions were formulated and led to three studies. The first study, a literature review, showed that there is limited research in the area but that there are indications that user involvement in development work affects employees' attitudes and values. In study number two, a case study was set up using design methods and involving users. The results showed tensions between the improvement work and the daily clinical operations. This tension could primarily be attributed to the conflict between faster and slowerxviprocesses (doing and thinking), when moving between different practicing skills (design, improvement and professional). The last study aimed to understand more about the management's view of this, relatively new knowledge (design) in healthcare, in relation to the traditional way to work with improvement and change. The result stresses that there are potential conflicts between the different fields of knowledge. But the interviews were also interpreted as showing the synergy effects that can arise when different practitioners meet, and the results also show that different ways of thinking can challenge the traditional ways of handling improvement and change in the development of healthcare.The thesis result overall strengthens the research that shows that design can add another dimension to traditional improvement work in healthcare. However, there is also frustration about something which is perceived as more abstract and reflective and which can sometimes be slower than what the solutions-oriented professions, who work under great time pressure and with scarce resources, are used to. Furthermore, the thesis highlights the problem that also has been described in previous research and which signals the (in)ability to both share new knowledge and to absorb it.
50.	Bäckström, Ingela, 1963-, et al. (författare) Capturing Value-based leadership in Practice: : Insights from developing and applying an AI-interview guide 2017 Ingår i: Challenges and Opportunities of Quality in the 4th Industrial Revolution. - 9789176230862 Konferensbidrag (refereegranskat)abstract AbstractOne of the most critical aspects for building quality and innovation in organizations is the role of values. Performance suffers when organizations fail to prioritize values. A challenge for many leaders is to understand deep-rooted values together with what they are and how they are developed. These deep-rooted values are reflected in the behaviors, language and signs occurring in the organization and can be seen as the organizations culture. When a culture is shaped, leadership is central and the managers in the organization are vital. Managers in an organization affect the predominating culture through their behaviors and approach to their co-workers. This make it interesting to try to find out underlying values held by managers striving for good leadership and performance. Underlying values can be unconscious and taken for granted, and thereby hard to ask about. By using an interview guide inspired by Appreciative Inquiry (AI) (an approach based on generativity and positivity), underlying values and the leadership used by top managers can be discovered. Purpose - The purpose of this paper is to present and discuss the results from the Appreciative Inquiry (AI) inspired interviews to explore the underlying values held by top manager and to identify soft aspects of leadership. Methodology/approach – Top managers were interviewed as a part of a research project with the aim to support the development of value-based leadership that integrates company values, organizational culture, customer needs and sustainable development. A structured interview guide, inspired by AI, was developed and used to pinpoint their motivation and vision of a good organization in order to understand the values the leaders had and to identify soft aspects of leadership. The interviews were analyzed in workshops with the whole research group and structured and visualized through affinity chart. Findings – The results show underlying values held by top managers and identified soft aspects of leadership. Practical implications – The presented interview guide can be used to identify the top managers underlying values and the presented results from the interviews can be used to inspire other leaders to develop their leadership in their striving of good leadership and effective organizations.

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