| 1. |
- Binesse, Johan, et al.
(författare)
-
Roles of Reactive Oxygen Species-Degrading Enzymes of Francisella tularensis SCHU S4
- 2015
-
Ingår i: Infection and Immunity. - 0019-9567 .- 1098-5522. ; 83:6, s. 2255-2263
-
Tidskriftsartikel (refereegranskat)abstract
- Francisella tularensis is a facultative intracellular bacterium utilizing macrophages as its primary intracellular habitat and is therefore highly capable of resisting the effects of reactive oxygen species (ROS), potent mediators of the bactericidal activity of macrophages. We investigated the roles of enzymes presumed to be important for protection against ROS. Four mutants of the highly virulent SCHU S4 strain with deletions of the genes encoding catalase (katG), glutathione peroxidase (gpx), a DyP-type peroxidase (FTT0086), or double deletion of FTT0086 and katG showed much increased susceptibility to hydrogen peroxide (H2O2) and slightly increased susceptibility to paraquat but not to peroxynitrite (ONOO-) and displayed intact intramacrophage replication. Nevertheless, mice infected with the double deletion mutant showed significantly longer survival than SCHU S4-infected mice. Unlike the aforementioned mutants, deletion of the gene coding for alkyl-hydroperoxide reductase subunit C (ahpC) generated a mutant much more susceptible to paraquat and ONOO- but not to H2O2. It showed intact replication in J774 cells but impaired replication in bone marrow-derived macrophages and in internal organs of mice. The live vaccine strain, LVS, is more susceptible than virulent strains to ROS-mediated killing and possesses a truncated form of FTT0086. Expression of the SCHU S4 FTT0086 gene rendered LVS more resistant to H2O2, which demonstrates that the SCHU S4 strain possesses additional detoxifying mechanisms. Collectively, the results demonstrate that SCHU S4 ROS-detoxifying enzymes have overlapping functions, and therefore, deletion of one or the other does not critically impair the intracellular replication or virulence, although AhpC appears to have a unique function.
|
|
| 2. |
- Elenis, Evangelia, et al.
(författare)
-
The histidine-rich glycoprotein A1042G polymorphism and recurrent miscarriage : a pilot study
- 2014
-
Ingår i: Reproductive Biology and Endocrinology. - : Springer Science and Business Media LLC. - 1477-7827. ; 12, s. 70-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Histidine-rich Glycoprotein (HRG) has previously been shown to have an impact on implantation and fertility. The aim of this study was to investigate if there is an association between the HRG A1042G single nucleotide polymorphism (SNP) and recurrent miscarriage. Methods: The study was designed as a case-control study and the women were included at University Hospitals in Sweden. 186 cases with recurrent miscarriage were compared with 380 pregnant controls with no history of miscarriage. Each woman was genotyped for the HRG A1042G SNP. Results: The results indicated that the frequency of heterozygous HRG A1042G carriers was higher among controls compared to cases (34.7% vs 26.3%; p < 0.05). In a bivariate regression analysis, a negative association was found between recurrent miscarriage and heterozygous A/G carriers both in the entire study population (OR 0.67, 95% CI 0.45 - 0.99; p < 0.05) as well as in a subgroup of women with primary recurrent miscarriage (OR 0.37, 95% CI 0.16 - 0.84; p < 0.05). These results remained even after adjustment for known confounders such as age, BMI and thyroid disease (OR 0.36, 95% CI 0.15 - 0.84; p < 0.05). Conclusions: Women who are heterozygous carriers of the HRG A1042G SNP suffer from recurrent miscarriage more seldom than homozygous carriers. Thus, analysis of the HRG A1042G SNP might be of importance for individual counseling regarding miscarriage.
|
|
| 3. |
- Erlandsson, Kerstin, 1961-, et al.
(författare)
-
Development of a tool to analyse what resources are needed to implement a midwife-led care framework : the MIDWIZE conceptual framework
- 2022
-
Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 33
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A midwife led care project targeting to decide what to do to achieve the SDG 2030 in maternal and child health, made a project team develop a tool to analyse what health care systems need, to adopt the MIDWIZE Conceptual Framework. The MIDWIZE Conceptual Framework wish to introduce the comprehensive midwifery-managed care provided women in Sweden to other countries, regions, and units where the framework is not fully applied.METHODS: In order to determine what resource needs would have to be met to improve midwife led care, a tool was developed using Delphi study technique.RESULTS: Using Delphi study technique together with on-site visits to two Sub-Saharan African countries, members of a project team went to Ethiopia and Uganda, where they visited governments, clinical or educational institutions and together with African leaders developed availability and efficiency of a tool to determine resource needs.CONCLUSION: If at some future time, a single country, region or unit, might want to use the tool for quality improvement purpose of midwife led care, then the tool might aid in taking the first step to determine what resources might be required and what changes might be recommended as concerns policy at the clinical or educational institution level that are part of already existing health care structures.
|
|
| 4. |
- Erlandsson, Kerstin, 1961-, et al.
(författare)
-
Women's experience of unplanned out-of-hospital birth in Sweden : a phenomenological description
- 2015
-
Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 6:4, s. 226-229
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Between 0.5 and 2 percent of women planning to give birth in a hospital environment in Sweden will have an unplanned out-of-hospital birth. Few studies have described mothers' experiences of out-of-hospital births and none on a Swedish population. In an attempt to fill this gap, we have made this pilot study designed to capture mothers' experiences of unplanned out-of-hospital births in Sweden.Method: Qualitative interviews with eight Swedish women, one to three years after they experienced an unplanned out-of-hospital birth. Data were analysed using the method of phenomenological description.Results: The meaning of giving unplanned birth outside a hospital environment was “The lived experience of a pendular movement between the good fortune and pride in managing the situation and the fear of what could have happened when giving unplanned birth outside a hospital environment.” In the analysis two clusters emerged that supported the essence: Balancing Emotions and Handling Unfamiliar Actions.Conclusions: This study contributes to an understanding of the natural processes when giving birth. The findings can be useful when communicating the experience of unplanned out-of-hospital birth to parents in antenatal classes. The women could be encouraged to listen and trust their own body signs as a preparation for giving birth in any type of setting. Guidelines for taking care of women with out-of-hospital birth experiences are suggested.
|
|
| 5. |
- Hawamdeh, Shurouq, 1982, et al.
(författare)
-
Midwives’ attitude towards labour pain: Expectations and perceptions by Jordanian women
- 2016
-
Ingår i: NJF congress, May 2016, Sweden..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: In Jordan, as in other countries, the majority of women give birth in public hospitals where the midwives are the main birth attendants. Although most women have trust in their midwives; there are studies describing dissatisfaction of childbirth experience, fears associated with experiencing painful births and ineffective pain management during childbirth. Thus, there is a need to understand the Jordanian midwives' attitude towards labour pain from both the midwives and the women’s perspectives. Aim: To explore the Jordanian midwives' attitude towards labour pain by assessing the midwives' knowledge and attitude towards pain and the women's expectations and perceptions of their midwives' approach towards pain. Methods: The research took place in the largest public hospital in Jordan in the postnatal ward and involved midwives and their clients, including 60 midwives (out of 61 randomly sampled midwives), who responded to a study-specific validated survey for midwives (Survey Questionnaire for Midwives), and 360 women (out of 384 sampled women), who responded to a study-specific validated survey for women (Survey Questionnaire for Women). Findings: The study is ongoing. The findings are presented at the NJF conference (May 2016) and as a part of doctoral thesis that should be defended in May 2017.
|
|
| 6. |
- Lindgren, Helena, et al.
(författare)
-
Mechanisms of heme utilization by Francisella tularensis
- 2015
-
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:3
-
Tidskriftsartikel (refereegranskat)abstract
- Francisella tularensis is a highly virulent facultative intracellular pathogen causing the severe disease tularemia in mammals. As for other bacteria, iron is essential for its growth but very few mechanisms for iron acquisition have been identified. Here, we analyzed if and how F. tularensis can utilize heme, a major source of iron in vivo. This is by no means obvious since the bacterium lacks components of traditional heme-uptake systems. We show that SCHU S4, the prototypic strain of subspecies tularensis, grew in vitro with heme as the sole iron source. By screening a SCHU S4 transposon insertion library, 16 genes were identified as important to efficiently utilize heme, two of which were required to avoid heme toxicity. None of the identified genes appeared to encode components of a potential heme-uptake apparatus. Analysis of SCHU S4 deletion mutants revealed that each of the components FeoB, the siderophore system, and FupA, contributed to the heme-dependent growth. In the case of the former two systems, iron acquisition was impaired, whereas the absence of FupA did not affect iron uptake but led to abnormally high binding of iron to macromolecules. Overall, the present study demonstrates that heme supports growth of F. tularensis and that the requirements for the utilization are highly complex and to some extent novel.
|
|
| 7. |
- Lindgren, Karin Elvine, 1984-, et al.
(författare)
-
Differences in secretome in culture media when comparing blastocysts and arrested embryos using multiplex proximity assay
- 2018
-
Ingår i: Upsala Journal of Medical Sciences. - : TAYLOR & FRANCIS LTD. - 0300-9734 .- 2000-1967. ; 123:3, s. 143-152
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to assess different patterns of the human embryo secretome analysed as protein levels in culture media. Furthermore, analyses to correlate protein levels with quality and timing to development of human embryos were performed.Material and methods: Human day-2 cryopreserved embryos were cultured for four days in an EmbryoScope((R)) with a time-lapse camera, and embryo quality was evaluated retrospectively. After culture, the media were collected and relative levels of secreted proteins were analysed using Proseek Multiplex Assays. Protein levels were evaluated in relation to timing to development and the ability to form a blastocyst.Results: Specific patterns of timing of development of blastocysts were found, where a difference in time to start of cavitation was found between high- and low-quality blastocysts. There appeared to be a correlation between specific protein patterns and successful formation of morulae and blastocysts. Embryos developing into blastocysts had higher levels of EMMPRIN than arrested embryos, and levels of caspase-3 were lower in high- versus low-quality blastocysts. Also, higher levels of VEGF-A, IL-6, and EMMPRIN correlated with shorter times to morula formation.Conclusions: The secretome and timing to development differ in embryos forming blastocysts and those that become arrested, and in high- versus low-quality blastocysts. The levels of certain proteins also correlate to specific times to development.
|
|
| 8. |
- Lindgren, Karin E., et al.
(författare)
-
Histidine-rich glycoprotein gene polymorphism in patients with recurrent miscarriage
- 2013
-
Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 92:8, s. 974-977
-
Tidskriftsartikel (refereegranskat)abstract
- Association between the histidine-rich glycoprotein (HRG) C633T single nucleotide polymorphism (SNP) and recurrent miscarriage was investigated in a case-control study. The cases constituted 187 women with recurrent miscarriage that were compared with 395 controls who had delivered a child and had no history of miscarriage. Blood samples were collected from each woman, genomic DNA was extracted and genotyped for the HRG C633T SNP. In the whole study population, the percentage of miscarriage was the same, regardless of genotype (C/C 31.2%, C/T 32.9% and T/T 32.5%). However, an association between homozygous T/T carriers and recurrent miscarriage was detected in a subgroup of women with primary recurrent miscarriage (odds ratio 2.44, 95% CI 1.01-5.92). Our results indicate an important role for the HRG C633T SNP in the occurrence of recurrent miscarriage.
|
|
| 9. |
|
|
| 10. |
- Ahlsén, Göran, et al.
(författare)
-
Resistance profiles of cyclic and linear inhibitors of HIV-1 protease
- 2002
-
Ingår i: Antiviral Chemistry & Chemotherapy. - 0956-3202 .- 2040-2066. ; 13:1, s. 27-37
-
Tidskriftsartikel (refereegranskat)abstract
- Resistance to anti-HIV protease drugs is a major problem in the design of AIDS drugs with long-term efficacy. To identify structural features associated with a certain resistance profile, the inhibitory properties of a series of symmetric and asymmetric cyclic sulfamide, cyclic urea and linear transition-state analogue inhibitors of HIV-1 protease were investigated using wild-type and mutant enzyme. To allow a detailed structure-inhibition analysis, enzyme with single, double, triple and quadruple combinations of G48V, V82A, 184V and L90M substitutions was used. Kinetic analysis of the mutants revealed that catalytic efficiency was 1-30% of that for the wild-type enzyme, a consequence of reduced kcat in all cases and an increased KM for all mutants except for the G48V enzyme. The overall structure-inhibitory profiles of the cyclic compounds were similar, and the inhibition of the V82A, 184V and G48V/L90M mutants were less efficient than of the wild-type enzyme. The greatest increase in Ki was generally observed for the 184V mutant and least for the G48V/L90M mutant, and additional combinations of mutations did not result in improved inhibition profiles for the cyclic compounds. An extended analysis of additional mutants, and including a set of linear compounds, showed that the profile was unique for each compound, and did not reveal any general structural features associated with a certain inhibition profile. The effects of structural modifications in the inhibitors, or of mutations, were not additive and they differed depending on their context. The results demonstrate the difficulties in predicting resistance, even for closely related compounds, and designing compounds with improved resistance profiles.
|
|
| 11. |
- Ahmad, Farooq, et al.
(författare)
-
Selection of foundational ontology for collaborative knowledge modeling in healthcare domain
- 2010
-
Ingår i: Artificial intelligence. - Berlin, Heidelberg : Springer Berlin/Heidelberg. - 9783642154300 - 9783642154317 ; , s. 261-262
-
Konferensbidrag (refereegranskat)abstract
- Ontology design is an important process for structuring knowledge to be reused in different projects in the health domain. In this paper, we describe an ontology design for the collaborative knowledge building system ACKTUS to be used for developing personalized knowledge applications for different domains. Different foundational ontologies were compared with respect to selected criteria considered vital for the project, such as modularity and descriptiveness.
|
|
| 12. |
- Akselsson, Anna
(författare)
-
Awareness of fetal movements and pregnancy outcomes
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Fetal movements are one, among others, of the measurable factors indicating wellbeing of the fetus. Decreased fetal movements are associated with intrauterine growth restriction and stillbirth. Women with experience of stillbirth have often noticed decreased and weaker fetal movements preceding the intrauterine death. Further, seeking care for decreased fetal movements is a common reason for unscheduled contact with health care. The aim of this thesis was to investigate whether a method, aimed to increase women’s awareness of the fetal movement pattern, had an effect on pregnancy outcomes. Further, the thesis aimed to study pregnancy outcomes for women seeking care for decreased or altered fetal movements.In Study I, 2683 women completed questionnaires when they presented for decreased fetal movements, after an examination of their unborn baby, that did not result in any interventions aimed at ending the pregnancy. In Studies II–IV, we evaluated Mindfetalness, a method aimed to increase women’s awareness of the fetal movement pattern. Women were given a leaflet of how to practise Mindfetalness in third trimester: lie down on your side when the baby is awake and focus on the strength, character and frequency of the movements for about 15 minutes daily (but do not count each movement). Women’s attitudes to and compliance with Mindfetalness were investigated in Study II, comprising 104 women. In studies III-IV we studied the effect of Mindfetalness on pregnancy outcomes and, through cluster-randomisation, 19 639 women in Stockholm were randomised to Mindfetalness and 20 226 to routine care. Study IV comprised a sub-analysis, where we compared women born in Somalia and Sweden.Women in the Mindfetalness group (Study III) had spontaneous onset of labour to a higher extent (RR 1.02, CI 1.01–1.03), less cesarean sections (RR 0.95, CI 0.91–0.99) and labour inductions (RR 0.96, CI 0.92–1.00), than women in the Routine-care group. More women in the Mindfetalness group contacted healthcare due to decreased fetal movements (RR 1.72, CI 1.57–1.87). A decreased number of babies born small for gestational age (RR 0.95, CI 0.90–1.00) and those transferred to neonatal care (RR 0.93, CI 0.86–1.00) was seen in the Mindfetalness group. No differences were found in Apgar score <7 at 5 minutes. Women born in Somalia had a higher risk of Apgar score <7 at 5 minutes (RR 2.17, CI 1.19–3.61) and of having a baby small for gestational age (RR 2.19, CI 1.85–2.56), than women born in Sweden (Study IV). The majority of the women had a positive attitude towards Mindfetalness and practised the method daily (Study II). Women contacting healthcare due to decreased fetal movements had labour induction to a higher extent than women not seeking care due to decreased fetal movements (Study I).Increased maternal awareness of fetal movements by Mindfetalness in the third trimester is advantageous for mother and baby. Spontaneous start of labour increased and interventions, notably cesarean sections, decreased. Fewer babies were born small for gestational age and in need of neonatal care. Women expressed having positive attitudes to the method and feelings of safety and calm, when they practised Mindfetalness.
|
|
| 13. |
- Akselsson, Anna, et al.
(författare)
-
Daily structured approach to awareness of fetal movements and pregnancy outcome - a prospective study
- 2019
-
Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 20, s. 32-37
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We investigated how women, seeking care due to decreased movements, had paid attention to fetal movements and if the method of monitoring was associated with pregnancy outcome.METHODS: A questionnaire was distributed to women from gestational week 28, who had sought care due to decreased fetal movements in Stockholm between January 1st and December 31st, 2014. Women were included in the study if the examination did not reveal any signs of a compromised fetus requiring immediate intervention. Birth outcome and sociodemographic data were collected from the obstetric record register.RESULTS: There were 29166 births in Stockholm in 2014, we have information from 2683 women who sought care for decreased fetal movements. The majority (96.6%) of the women stated that they paid attention to fetal movements. Some women observed fetal movements weekly (17.2%) and 69.5% concentrated on fetal movements daily (non-structured group). One in ten (9.9%) used counting methods daily for observing fetal movements (structured group). Women in the structured group more often had caesarean section before onset of labor (RR 1.6, 95% CI 1.2-2.2) and a lower risk of their baby being transferred to neonatal nursery (RR 0.25, 95% CI 0.03-0.94) compared to women in the non-structured group.CONCLUSIONS: Women, who had a daily and structured approach to awareness of fetal movements, were more likely to have a caesarean section but their babies were less likely to be transferred to a neonatal nursery as compared with women who used a non-structured method daily.
|
|
| 14. |
- Akselsson, Anna, et al.
(författare)
-
Increased labor induction and women presenting with decreased or altered fetal movements : A population-based survey
- 2019
-
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:5
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Women's awareness of fetal movements is important as perception of decreased fetal movements can be a sign of a compromised fetus. We aimed to study rate of labor induction in relation to number of times women seek care due to decreased or altered fetal movements during their pregnancy compared to women not seeking such care. Further, we investigated the indication of induction.MATERIAL AND METHODS: A prospective population-based cohort study including all obstetric clinics in Stockholm, Sweden. Questionnaires were distributed to women who sought care due to decreased or altered fetal movements ≥ 28 week's gestation in 2014, women for whom an examination did not indicate a compromised fetus that required induction of labor or cesarean section when they sought care. Women who gave birth at ≥ 28 weeks' gestation in 2014 in Stockholm comprises the reference group.RESULTS: Labor was induced more often among the 2683 women who had sought care due to decreased or altered fetal movements (RR 1.4, 95% CI 1.3-1.5). In women who presented with decreased or altered fetal movements induction of labor occurred more frequently for fetal indication than those with induction of labor and no prior fetal movement presentation (RR 1.6, 95% CI 1.4-1.8). The rate of induction increased with number of times a woman sought care, RR 1.3 for single presentation to 3.2 for five or more.CONCLUSIONS: We studied women seeking care for decreased or altered fetal movements and for whom pregnancy was not terminated with induction or caesarean section. Subsequent (median 20 days), induction of labor and induction for fetal indications were more frequent in this group compared to the group of women with no fetal movement presentations. Among women seeking care for altered or decreased fetal movements, the likelihood of induction of labor increased with frequency of presentation.
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
- Akselsson, Anna, et al.
(författare)
-
Women's attitudes, experiences and compliance concerning the use of Mindfetalness- a method for systematic observation of fetal movements in late pregnancy
- 2017
-
Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Maternal perception of decreased fetal movements and low awareness of fetal movements are associated with a negative birth outcome. Mindfetalness is a method developed for women to facilitate systematic observations of the intensity, character and frequency of fetal movements in late pregnancy. We sought to explore women's attitudes, experiences and compliance in using Mindfetalness.METHODS: We enrolled 104 pregnant women treated at three maternity clinics in Stockholm, Sweden, from February to July of 2016. We educated 104 women in gestational week 28-32 by providing information about fetal movements and how to practice Mindfetalness. Each was instructed to perform the assessment daily for 15 min. At each subsequent follow-up, the midwife collected information regarding their perceptions of Mindfetalness, and their compliance. Content analyses, descriptive and analytic statistics were used in the analysis of data.RESULTS: Of the women, 93 (89%) were positive towards Mindfetalness and compliance was high 78 (75%). Subjective responses could be binned into one of five categories: Decreased worry, relaxing, creating a relationship, more knowledge about the unborn baby and awareness of the unborn baby. Eleven (11%) women had negative perceptions of Mindfetalness, citing time, and the lack of need for a method to observe fetal movements as the most common reasons.CONCLUSION: Women in late pregnancy are generally positive about Mindfetalness and their compliance with daily use is high. The technique helped them to be more aware of, and create a relationship with, their unborn baby. Mindfetalness can be a useful tool in antenatal care. However, further study is necessary in order to determine whether the technique is able to reduce the incidence of negative birth outcome.
|
|
| 19. |
- Anderson, Christopher D., et al.
(författare)
-
Genetic variants in CETP increase risk of intracerebral hemorrhage
- 2016
-
Ingår i: Annals of Neurology. - : Wiley. - 1531-8249 .- 0364-5134. ; 80:5, s. 730-740
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In observational epidemiologic studies, higher plasma high-density lipoprotein cholesterol (HDL-C) has been associated with increased risk of intracerebral hemorrhage (ICH). DNA sequence variants that decrease cholesteryl ester transfer protein (CETP) gene activity increase plasma HDL-C; as such, medicines that inhibit CETP and raise HDL-C are in clinical development. Here, we test the hypothesis that CETP DNA sequence variants associated with higher HDL-C also increase risk for ICH.METHODS: We performed 2 candidate-gene analyses of CETP. First, we tested individual CETP variants in a discovery cohort of 1,149 ICH cases and 1,238 controls from 3 studies, followed by replication in 1,625 cases and 1,845 controls from 5 studies. Second, we constructed a genetic risk score comprised of 7 independent variants at the CETP locus and tested this score for association with HDL-C as well as ICH risk.RESULTS: Twelve variants within CETP demonstrated nominal association with ICH, with the strongest association at the rs173539 locus (odds ratio [OR] = 1.25, standard error [SE] = 0.06, p = 6.0 × 10(-4) ) with no heterogeneity across studies (I(2) = 0%). This association was replicated in patients of European ancestry (p = 0.03). A genetic score of CETP variants found to increase HDL-C by ∼2.85mg/dl in the Global Lipids Genetics Consortium was strongly associated with ICH risk (OR = 1.86, SE = 0.13, p = 1.39 × 10(-6) ).INTERPRETATION: Genetic variants in CETP associated with increased HDL-C raise the risk of ICH. Given ongoing therapeutic development in CETP inhibition and other HDL-raising strategies, further exploration of potential adverse cerebrovascular outcomes may be warranted. Ann Neurol 2016;80:730-740.
|
|
| 20. |
- Andersson, Bertil, et al.
(författare)
-
End-expiratory lung volume and ventilation distribution with different continuous positive airway pressure systems in volunteers.
- 2011
-
Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:2, s. 157-64
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Continuous positive airway pressure (CPAP) has been shown to improve oxygenation and a number of different CPAP systems are available. The aim of this study was to assess lung volume and ventilation distribution using three different CPAP techniques. Methods: A high-flow CPAP system (HF-CPAP), an ejector-driven system (E-CPAP) and CPAP using a Servo 300 ventilator (V-CPAP) were randomly applied at 0, 5 and 10 cmH2O in 14 volunteers. End-expiratory lung volume (EELV) was measured by N2 dilution at baseline; changes in EELV and tidal volume distribution were assessed by electric impedance tomography. Results: Higher end-expiratory and mean airway pressures were found using the E-CPAP vs. the HF-CPAP and the V-CPAP system (P<0.01). EELV increased markedly from baseline, 0 cmH2O, with increased CPAP levels: 1110±380, 1620±520 and 1130±350 ml for HF-, E- and V-CPAP, respectively, at 10 cmH2O. A larger fraction of the increase in EELV occurred for all systems in ventral compared with dorsal regions (P<0.01). In contrast, tidal ventilation was increasingly directed toward dorsal regions with increasing CPAP levels (P<0.01). The increase in EELV as well as the tidal volume redistribution were more pronounced with the E-CPAP system as compared with both the HF-CPAP and the V-CPAP systems (P<0.05) at 10 cmH2O. Conclusion: EELV increased more in ventral regions with increasing CPAP levels, independent of systems, leading to a redistribution of tidal ventilation toward dorsal regions. Different CPAP systems resulted in different airway pressure profiles, which may result in different lung volume expansion and tidal volume distribution.
|
|
| 21. |
|
|
| 22. |
- Andrén, Anna, et al.
(författare)
-
Miscommunication influences how women act when fetal movements decrease : An interview study with Swedish Somali migrant women
- 2023
-
Ingår i: Midwifery. - 0266-6138 .- 1532-3099. ; 126
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore how Swedish Somali migrant women perceive fetal movements, process information about fetal movements, and take actions if decreased fetal activity occurs.DESIGN: A qualitative study based on individual semi-structured interviews. The interviews were analysed using content analysis.SETTING: The study was conducted in Sweden.PARTICIPANTS: Swedish Somali migrant women (n=15) pregnant in their third trimester or recently given birth.FINDINGS: The analysis led to the main category: tailored information about fetal movements enhances the possibility to seek care if the movements decrease. The results are described in the generic categories: explanatory models determine action; and understand and interpret information.KEY CONCLUSIONS: Miscommunication on fetal movements can be a hurdle for Swedish Somali migrant women that may have impact on stillbirth prevention and the quality of care. Improved communication and information tailored to individual needs is essential to achieve equality for women and their newborns.IMPLICATIONS FOR PRACTICE: The midwife can be used as a hub for reassuring that adequate information about fetal movements reaches each individual woman in antenatal care. Individualised information on fetal movements based on the women's own understanding is suggested to increase the possibility that the pregnant woman will seek care if the movements decrease. Somali women's verbal communication can be used to spread accurate information in the Somali community on the importance of seeking care if fetal movements decrease.
|
|
| 23. |
- Andrén, Anna, et al.
(författare)
-
One size does not fit all : Perspectives from Swedish midwives on fetal movement counselling
- 2024
-
Ingår i: Women and Birth. - 1871-5192 .- 1878-1799. ; 37:4
-
Tidskriftsartikel (refereegranskat)abstract
- PROBLEM: Migration continues to play a role in determining health outcomes related to pregnancy and childbirth in Sweden.BACKGROUND: Migrant women have, compared to Swedish-born women, increased risks of adverse birth outcomes. Previous research suggests that migrant women seek care for decreased fetal movements less than Swedish-born women. Given these documented risks, understanding midwives' perspectives in this context is crucial to address maternal health inequities.AIM: To explore midwives' experiences conveying information about fetal movement to migrant women in antenatal healthcare settings.METHODS: Semi-structured, individual interviews with midwives (n=15) experienced in providing information about fetal movements to migrant women. The interviews were analysed using reflexive thematic analysis.FINDINGS: The midwives' efforts to compensate for the deficiencies within the antenatal healthcare organisation and to ensure that all women received access to information and care regarding fetal movements are described in four themes: (a) building a trusting relationship; (b) empowering women through guidance and support; (c) overcoming communication challenges; and d) navigating safety measures.DISCUSSION: Our findings suggest that the standard antenatal care programme does not support midwives to provide holistic and individualised care that aligns with midwifery care philosophy.CONCLUSION: To reduce health inequities for migrant women, this study highlights the need for more flexible guidelines within the standard antenatal care programme. These guidelines should prioritise the individual woman's needs over institutional protocols, acknowledge the midwife-woman relationship as the core of midwifery practice and support midwives to build a partnership with women through continuity of care.
|
|
| 24. |
|
|
| 25. |
- Asaye, Mengstu Melkamu, et al.
(författare)
-
Effect of fetal malposition, primiparous, and premature rupture of membrane on Neonatal Near miss mediated by grade three meconium-stained amniotic fluids and duration of the active first stage of labor : Mediation analysis
- 2023
-
Ingår i: PLOS ONE. - 1932-6203. ; 18:5
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In many low-income countries, including Ethiopia, neonatal mortality remains a major concern. For every newborn that dies, many more neonates survived (near-miss neonates) the first 28 days after birth from life-threatening conditions. The generation of evidence on neonatal near-miss determinants could be a critical step in reducing neonatal mortality rates. However, studies causal pathway determinants are limited in Ethiopia. This study aimed to investigate the Neonatal Near-miss determinants in public health hospitals in Amhara Regional State, northwest Ethiopia.METHOD: A cross-sectional study was conducted on 1277 mother-newborn pairs at six hospitals between July 2021 and January 2022. A validated interviewer-administered questionnaire and a review of medical records were used to collect data. Data were entered into Epi-Info version 7.1.2 and exported to STATA version 16 in California, America for analysis. The paths from exposure variables to Neonatal Near-Miss via mediators were examined using multiple logistic regression analysis. The adjusted odds ratio (AOR) and ß-coefficients were calculated and reported with a 95% confidence interval and a p-value of 0.05.RESULTS: The proportion of neonatal near-misses was 28.6% (365/1277) (95% CI: 26-31%). Women who could not read and write (AOR = 1.67,95%CI:1.14-2.47), being primiparous (AOR = 2.48,95% CI:1.63-3.79), pregnancy-induced hypertension (AOR = 2.10,95% CI:1.49-2.95),being referred from other health facilities (AOR = 2.28,95% CI:1.88-3.29), premature rupture of membrane (AOR = 1.47,95% CI:1.09-1.98), and fetal malposition (AOR = 1.89,95% CI:1.14-3.16) were associated with Neonatal Near-miss. Grade III meconium stained amniotic fluid partially mediated the relationship between primiparous (ß = 0.517), fetal malposition (ß = 0.526), pregnant women referred from other health facilities (ß = 0.948) and Neonatal Near-Miss at P-value < 0.01. Duration of the active first stage of labour partially mediated the relationship between primiparous (ß = -0.345), fetal malposition (ß = -0.656), premature rupture of membranes (ß = -0.550) and Neonatal Near-Miss at P- value <0.01.It had also a significant indirect effect (ß = 0.581, P<0.001) on NNM with variables (primiparous, fetal malposition, and premature rupture of membranes).CONCLUSIONS: The relationship between fetal malposition, primiparous, referred from other health facilities, premature rupture of membrane, and Neonatal Near miss were partially mediated by grade III meconium stained amniotic fluid and duration of the active first stage of labour. Early diagnosis of these potential danger signs and appropriate intervention could be of supreme importance in reducing NNM.
|
|
| 26. |
- Asaye, Mengstu Melkamu, et al.
(författare)
-
Experience and perceptions of healthcare providers on clinical management and care of near-miss infants : a qualitative content analysis
- 2023
-
Ingår i: BMC Health Services Research. - 1472-6963. ; 23:1
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Neonatal Near Miss (NNM) refers to neonates with severe complications who almost died but survived immediately after birth. In Ethiopia, the prevalence of NNM has been assessed using a validated Neonatal Near-Miss Assessment Scale. However, understanding the experiences and perceptions of healthcare providers in the clinical management and care of NNM infants remains unexplored. The aim was to investigate the determinants contributing to the survival of neonatal near-miss babies and to identify any barriers encountered, as reported by the experiences of healthcare providers in public hospitals of Amhara Regional State, northwest Ethiopia.METHODS: Semi structured interviews were used to collect data from 25 midwives, nurses, and pediatricians with at least six months of prior experience in one of the labor wards or neonatal intensive care units at one of the four public health hospitals in the Amhara Regional state of northwest Ethiopia included in a large intervention study assessing a NNM scale. Purposeful sampling was used, selecting participants based on their experiences related to the aim of this study. The participants had a varying level of education and years of experience to care for NNM infants. The average age of the healthcare providers was 31 years, with 7 years of work experience. The transcripts of the interviews with the healthcare providers were analyzed using qualitative content analysis.RESULTS: The experience and perceptions of healthcare providers was described in the main category "A sense of hopelessness when caring for the baby" capturing a broader emotional and professional aspect, while the subcategories "Unclear responsibilities discharging one's mission", "Provision of kangaroo mother care" and "Quick action required at birth" are more specific and practical. Healthcare providers perceived a sense of hopelessness when caring for the NNM infant, particularly providing Kangaroo Mother Care (KMC) and quick actions when required at birth to save the life of the infant.CONCLUSION: Unclear responsibilities and a sense of hopelessness could have acted as barriers, hindering the ability of healthcare providers to fulfill their mission of taking swift actions and providing KMC to NNM infants, thus impacting their ability to save the lives of these infants. Healthcare providers' and parents' attitudes must be changed towards hope rather than hopelessness when caring for NNM infants.
|
|
| 27. |
- Baskar, Jayalakshmi, 1985-
(författare)
-
Adaptive human-agent dialogues for reasoning about health
- 2014
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this research is to develop new theories, methods and technology, which enables adaptive and personalised dialogues between a human and a software agent, to handle everyday queries about health that are perceived as meaningful and useful to the human. Some of the challenges to build such human-agent dialogue system are the following. The agent needs to have knowledge about the human, the topic of the dialogue, the knowledge domain of the topic, and also about the physical and social environment. Moreover, the agent must know about itself, its role, purpose and limitations. It must know how to be cooperative and be able to behave and express with empathy while conducting a dialogue activity. In some situations, it needs to reason and make decisions about a topic together with the human and about its own behavior. To be able to do this, it needs the capability to evaluate its behavior in the context in which the dialogue takes place. These challenges are addressed by developing formal semantic models to provide the agent with tools to build their knowledge and to be able to reason and make decisions. These models were developed based on literature studies, theories of human activity, argumentation theory, personas and scenarios.The models were formalised and implemented using Semantic Web technology, and integrated into a human-agent dialogue system. The system was evaluated with a group of therapists and a group of elderly people, who showed curiosity and interest in having dialogues with a software agent on various topics.The formal models that the agent constructs are adapted to the specific situation and to the human actor participating in a dialogue. They are based on four models: a model with knowledge about the human actor, a model of itself, a domain model, and a dialogue activity model. The dialogue activity is based on argumentation schemes, which function as patterns of reasoning and for the dialogue execution. These models allow the agent and the human actor to conduct flexible and nested sub-dialogues with different purposes within a main dialogue about a topic. The agent can adapt its moves to the human actor's trail of reasoning, to the human's priorities and goals, and to some human's emotional state. A method for the agent to be able to evaluate its behavior was also developed and evaluated. The proportion of appropriate moves in relation to the local context of earlier moves in the dialogue was 90% in the pilot study, which indicates that the agent's strategies for selecting moves can be improved.Future research will focus on further development of reasoning methods, learning and assessment methods, and interface design. The results will be applied to additional knowledge domains to test its domain independence and will be evaluated with different groups of potential users.
|
|
| 28. |
- Baskar, Jayalakshmi, 1985-, et al.
(författare)
-
Cognitive Architecture of an Agent for Human-Agent Dialogues
- 2014
-
Ingår i: Highlights of Practical Applications of Heterogeneous Multi-Agent Systems. - Cham : Springer. - 9783319077673 - 9783319077666 ; , s. 89-100
-
Konferensbidrag (refereegranskat)abstract
- This paper proposes a cognitive architecture of an intelligent agent that can have a dialogue with a human agent on health-related topics. This architecture consists of four main components, namely, the Belief Base, the Dialogue Manager, the Task Manager and the Plan Generator. Each component has sub-components that perform a set of tasks for the purpose to enable the agent to be enrolled in a dialogue. In this paper the particular sub-component of the Dialogue Manager, the Dialogue Strategy has been discussed in detail. A notion of scheme is introduced, which functions as a template with variables that are instantiated each time a state is entered. The agent’s dialogue strategy is implemented as a combination of the schemes and the state transitions that the agent makes in response to the human’s request. We used a combination of finite-state and agent-based dialogue strategies for dialogue management. This combined dialogue strategy enables a multi-topic dialogue between a human and an agent.
|
|
| 29. |
- Baskar, Jayalakshmi, et al.
(författare)
-
Human-Agent Dialogues and Their Purposes
- 2017
-
Ingår i: Proceedings of the European Conference on Cognitive Ergonomics 2017. - New York, NY, USA : ACM Digital Library. - 9781450352567 ; , s. 101-104
-
Konferensbidrag (refereegranskat)abstract
- A common conversation between an older adult and a nurse about health-related issues includes topics such as troubles with sleep, reasons for walking around nighttime, pain conditions, etc. Such a dialogue can be regarded as a "natural" dialogue emerging from the participating agents' lines of thinking, their roles, needs and motives, while switching between topics as the dialogue unfolds. The purpose of this work is to define a generic conceptual model of purposeful human-agent dialogue activity including different types of argumentation dialogues, suitable for health-related topics. This is done based on analyses of a scenario, persona and models of human behaviour. The model will be shared between the human and the agent, allowing for adaptation to the human's reasoning, needs and motives.
|
|
| 30. |
- Baskar, Jayalakshmi, 1985-, et al.
(författare)
-
Human-Agent Dialogues on Health Topics - An Evaluation Study
- 2015
-
Ingår i: Highlights of practical applications of agents, multi-agent systems, and sustainability. - Cham : Springer International Publishing. - 9783319190334 - 9783319190327 ; , s. 28-39
-
Konferensbidrag (refereegranskat)abstract
- A common conversation between an older adult and a nurse about health-related issues includes topics such as troubles with sleep, reasons for walking around nighttime, pain conditions, etc. This dialogue emerges from the participating human's lines of thinking, their roles, needs and motives, while switching between topics as the dialogue unfolds. This paper presents a dialogue system that enables a human to engage in a dialogue with a software agent to reason about health-related issues in a home environment. The purpose of this work is to conduct a pilot evaluation study of a prototype system for human-agent dialogues, which is built upon a set of semantic models and integrated in a web application designed for older adults. Focus of the study was to receive qualitative results regarding purpose and content of the agent-based dialogue system, and to evaluate a method for the agent to evaluate its behavior based on the human agent's perception of appropriateness of moves. The participants include five therapists and 11 older adults. The results show users' feedback on the purpose of dialogues and the appropriateness of dialogues presented to them during the interaction with the software agent.
|
|
| 31. |
- Baskar, Jayalakshmi, et al.
(författare)
-
Instrument-Oriented Approach to Detecting and Representing Human Activity for Supporting Executive Functions and Learning
- 2017
-
Ingår i: Proceedings of the European Conference on Cognitive Ergonomics 2017. - New York, NY, USA : ACM Digital Library. - 9781450352567 ; , s. 105-112
-
Konferensbidrag (refereegranskat)abstract
- The goal of this study is to develop a computer-interpretable model for activity detection and representation, based on existing informal models of how humans perform activity. Appropriate detection of purposeful human activity is an essential functionality of active assistive technology aiming at providing tailored support to individuals for improving activity performance and completion. The main contribution is the design of a model for detection and representation of human activities based on three categories of instruments, which is implemented as two generic and supplementary terminology models: an event ontology and a core ontology. The core ontology is extended for each new knowledge domain into a domain ontology. The model builds the base for personalization of services generated by the cooperative reasoning performed by a human collaborating with an intelligent and social software agent. Ongoing and future work includes user studies in the different application domains.
|
|
| 32. |
- Baskar, Jayalakshmi, et al.
(författare)
-
Personalisation and user models for support in daily living
- 2012
-
Ingår i: The 27th annual workshop of the Swedish Artificial Intelligence Society (SAIS), 14–15 May 2012. ; , s. 7-16
-
Konferensbidrag (refereegranskat)abstract
- In recent years, the interest in developing personalised applications for home environment has grown since it has a wide reach in helping people in their daily activities. However, for our purposes the concept activities of daily living also need to include work and leisure activities not necessarily performed in home environments. In this article, we describe an ongoing effort to develop a generic framework for assessing ability and tailoring of support applications in the health domain. We also give an overview of the approaches that have been adopted for personalisation and user modelling to various application areas. Suggestions of future development are provided.
|
|
| 33. |
- Baskar, Jayalakshmi, 1985-, et al.
(författare)
-
Semantic model for adaptive human-agent dialogues
- 2014
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- A common conversation between an older adult and a nurse about health-related issues includes topics such as troubles with sleep, reasons for walking around nighttime, pain conditions, etc. Such a dialogue can be regarded as a "natural" dialogue emerging from the participating agents' lines of thinking, their roles, needs and motives, while switching between topics as the dialogue unfolds. The purpose of this work is to define a generic model of purposeful human-agent dialogues suitable for health-related topics. This is done based on analyses of scenarios, personas and models of human behavior. The results include four models, which need to be included in a software agent's belief base; i) a user model, ii) a model of the domain knowledge related to the topic of the dialogue, iii) an agent model, and iv) a dialogue activity model. The models were implemented into a prototype system for human-agent dialogues, which was evaluated by therapists and a group of older adults.
|
|
| 34. |
|
|
| 35. |
- Baskar, Jayalakshmi, et al.
(författare)
-
User's control of personalised intelligent environments supporting health
- 2013
-
Ingår i: Intelligent Environments (IE), 2013 9th International Conference on. - : IEEE Computer Society. - 9780769550381 ; , s. 270-273
-
Konferensbidrag (refereegranskat)abstract
- This research project aims at supporting workers in the mining and construction industries and older adults at home, in monitoring the risks of their daily work or living situation. A goal is to create awareness in the individual about risks and how to decrease risks. Methods and knowledge-based applications are developed, which synthesise knowledge about the user, the user’s activities, the environment and generic domain knowledge for the purpose of providing tailored support and advice to individuals. This knowledge is also what the user can relate to, interact with and control through different methods. In this paper we investigate different approaches to user control of intelligent environments and propose a dialogue-based method for user control.
|
|
| 36. |
- Begum, Shahina, 1977-
(författare)
-
A Case-Based Reasoning System for the Diagnosis of Individual Sensitivity to Stress in Psychophysiology
- 2009
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Increased stress is a continuing problem in our present world. Especiallynegative stress could cause serious health problems if it remainsundiagnosed/misdiagnosed and untreated. In the stress medicine, clinicians’measure blood pressure, ECG, finger temperature and breathing rate during anumber of exercises to diagnose stress-related disorders. One of the physiologicalparameters for quantifying stress levels is the finger temperature that helps theclinicians in diagnosis and treatment of stress. However, in practice, it is difficultand tedious for a clinician to understand, interpret and analyze complex, lengthysequential sensor signals. There are only few experts who are able to diagnose andpredict stress-related problems. A system that can help the clinician in diagnosingstress is important, but the large individual variations make it difficult to build sucha system.This research work has attempted to investigate several artificial Intelligencetechniques to develop an intelligent, integrated sensor system for diagnosis andtreatment plan in the Psychophysiological domain. To diagnose individualsensitivity to stress, case-based reasoning is applied as a core technique to facilitateexperience reuse by retrieving previous similar cases. Further, fuzzy techniques arealso employed and incorporated into the case-based reasoning system to handlevagueness, uncertainty inherently existing in clinicians reasoning process. Thevalidation of the approach is based on close collaboration with experts andmeasurements from twenty four persons used as reference.Thirty nine time series from these 24 persons have been used to evaluate theapproach (in terms of the matching algorithms) and an expert has ranked andestimated similarity which shows a level of performance close to an expert. Theproposed system could be used as an expert for a less experienced clinician or as asecond option for an experienced clinician to their decision making process.
|
|
| 37. |
- Berg, Marie, 1955, et al.
(författare)
-
Normal förlossning
- 2013
-
Ingår i: Omvårdnad på avancerad nivå. Kärnkompetenser inom sjuksköterskans specialistområden. A-K. Edberg, A. Ehrenberg, F. Friberg, L. Wallin, H. Wijk & J. Öhlén (red). Artikelsamling på bokens webbutgåva. - Lund : Studentlitteratur. - 9789144071459 ; , s. 1-7
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Begreppet normal förlossning diskuteras inom obstetriken och gränserna för vad som betraktas som normalt skiljer sig i tid och kultur. Det som var normalt i Sverige för 100 år sedan är inte det samma i dag. Ur ett globalt perspektiv, och såsom det senast definierats av världshälsoorganisationen (WHO 1996) och av Socialstyrelsen i Sverige (Socialstyrelsen 2001), ska följande kriterier vara uppfyllda i en normal förlossning: förlossningen ska starta med spontana värkar eller vattenavgång hos en kvinna som väntar ett barn och är i graviditetsvecka 37+0 – 41+6 (fullgången graviditet). Barnet ska ligga i huvudbjudning och hela förlossningsförloppet ska förlöpa utan komplikation hos mor och/eller barn, och utan onödiga medicinska interventioner. Kvinnan ska som helhet uppleva förlossningen positivt. I denna artikel ges en summarisk beskrivning av det centrala i ett normalt förlossningsförlopp och vård vid sådant. Ansvaret för vård under normal graviditet och förlossning ligger hos barnmorskeprofessionen. Förloppet vid normal förlossning beskrivs genom fyra situationer med helt normala förlossningsförlopp som handläggs av barnmorskor. Fördjupad information om normal förlossning och dess handläggning ges i Kaplan m.fl. (2009), Berg (2010) och Lundgren (2010). Verktyg för att stödja beskrivs mer ingående i Hallgren och Lundgren (2010).
|
|
| 38. |
- Bergh, Gösta, et al.
(författare)
-
Altered expression of the retinoblastoma tumor-suppressor gene in leukemic cell lines inhibits induction of differentiation but not G1-accumulation
- 1997
-
Ingår i: Blood. - 1528-0020. ; 89:8, s. 2938-2950
-
Tidskriftsartikel (refereegranskat)abstract
- The retinoblastoma tumor-suppressor gene, RB, has been implicated in tumor suppression, in regulation of the cell cycle, and in mediating cell differentiation. RB is necessary for hematopoiesis in mice, and aberrant RB-expression is associated with the progress and prognosis of leukemia. We have used antisense oligonucleotides, established clones stably expressing an antisense RB construct, and also established clones over expressing the retinoblastoma protein (pRb) to study the role of RB expression in monocytic differentiation induced by all-trans retinoic acid (ATRA) or 1-alpha-25-dihyroxycholecalciferol (Vit D3) in the monoblastic cell line U-937 and erythroid differentiation induced by transforming growth factor beta1 (TGFbeta1) and hemin in the erythroleukemic cell line K562. A reduction in pRb production in antisense RB-transfected U-937 clones was shown. Antisense oligonucleotides as well as expression of the antisense RB construct suppressed differentiation responses to ATRA or Vit D3, as judged by the capability to reduce nitro blue tetrazolium, by the appearance of monocyte-related cell surface antigens and by morphologic criteria. K562 cells showed decreased differentiation response to TGFbeta1, but not to hemin, when incubated with antisense oligonucleotides. U-937 antisense RB-transfected cells were also suppressed in their ability to upregulate levels of hypophosphorylated pRb when induced to differentiate. Although U-937 cells incubated with antisense oligonucleotides and clones expressing the antisense RB construct were hampered in their ability to differentiate on incubation with ATRA or Vit D3, the induced G0/G1-accumulation was similar to differentiating control cells treated with ATRA or Vit D3. Intriguingly, U-937 clones overexpressing RB were also inhibited in their differentiation response to ATRA or Vit D3 but not inhibited in their ability to respond with G0/G1 accumulation when induced with these substances. The results indicate that pRb plays a role in induced differentiation of U-937 cells as well as K562 cells involving mechanisms that, at least partially, are distinct from those inducing G1 accumulation.
|
|
| 39. |
- Biffi, Alessandro, et al.
(författare)
-
APOE genotype and extent of bleeding and outcome in lobar intracerebral haemorrhage: a genetic association study
- 2011
-
Ingår i: Lancet Neurology. - 1474-4465. ; 10:8, s. 702-709
-
Tidskriftsartikel (refereegranskat)abstract
- Background Carriers of APOE epsilon 2 and epsilon 4 have an increased risk of intracerebral haemorrhage (ICH) in lobar regions, presumably because of the effects of these gene variants on risk of cerebral amyloid angiopathy. We aimed to assess whether these variants also associate with severity of ICH, in terms of haematoma volume at presentation and subsequent outcome. Methods We investigated the association of APOE epsilon 2 and epsilon 4 with ICH volume and outcomes in patients with primary ICH in three phases: a discovery phase of 865 individuals of European ancestry from the Genetics of Cerebral Hemorrhage on Anticoagulation study, and replication phases of 946 Europeans (replication 1) and 214 African-Americans (replication 2) from an additional six studies. We also assessed the association of APOE variants with ICH volume and outcomes in meta-analyses of results from all three phases, and the association of APOE epsilon 4 with mortality in a further meta-analysis including data from previous reports. Admission ICH volume was quantified on CT scan. We assessed functional outcome (modified Rankin scale score 3-6) and mortality at 90 days. We used linear regression to establish the effect of genotype on haematoma volume and logistic regression to assess the effect on outcome from ICH. Findings For patients with lobar ICH, carriers of the APOE epsilon 2 allele had larger ICH volumes than did non-carriers in the discovery phase (p=2. 5x10(-5)), in both replication phases (p=0.008 in Europeans and p=0.016 in African-Americans), and in the meta-analysis (p=3.2x10(-8)). In the meta-analysis, each copy of APOE epsilon 2 increased haematoma size by a mean of 5.3 mL (95% CI 4.7-5.9; p=0.004). Carriers of APOE epsilon 2 had increased mortality (odds ratio [OR] 1.50, 95% CI 1.23-1.82; p=2.45x10(-5)) and poorer functional outcomes (modified Rankin scale score 3-6; 1-52, 1.25-1.85; p=1.74x10(-5)) compared with non-carriers after lobar ICH. APOE epsilon 4 was not associated with lobar ICH volume, functional outcome, or mortality in the discovery phase, replication phases, or meta-analysis of these three phases; in our further meta-analysis of 2194 patients, this variant did not increase risk of mortality (1.08,0.86-1.36; p=0.52). APOE allele variants were not associated with deep ICH volume, functional outcome, or mortality. Interpretation Vasculopathic changes associated with the APOE epsilon 2 allele might have a role in the severity and clinical course of lobar ICH. Screening of patients who have ICH to identify the epsilon 2 variant might allow identification of those at increased risk of mortality and poor functional outcomes.
|
|
| 40. |
- Biffi, Alessandro, et al.
(författare)
-
Variants at APOE Influence Risk of Deep and Lobar Intracerebral Hemorrhage
- 2010
-
Ingår i: Annals of Neurology. - : Wiley. - 1531-8249 .- 0364-5134. ; 68:6, s. 934-943
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Prior studies investigating the association between APOE alleles epsilon 2/epsilon 4 and risk of intracerebral hemorrhage (ICH) have been inconsistent and limited to small sample sizes, and did not account for confounding by population stratification or determine which genetic risk model was best applied. Methods: We performed a large-scale genetic association study of 2189 ICH cases and 4041 controls from 7 cohorts, which were analyzed using additive models for epsilon 2 and epsilon 4. Results were subsequently meta-analyzed using a random effects model. A proportion of the individuals (322 cases, 357 controls) had available genome-wide data to adjust for population stratification. Results: Alleles epsilon 2 and epsilon 4 were associated with lobar ICH at genome-wide significance levels (odds ratio [OR] = 1.82, 95% confidence interval [CI] = 1.50-2.23, p = 6.6 x 10(-10); and OR = 2.20, 95%CI = 1.85-2.63, p = 2.4 x 10(-11), respectively). Restriction of analysis to definite/probable cerebral amyloid angiopathy ICH uncovered a stronger effect. Allele epsilon 4 was also associated with increased risk for deep ICH (OR = 1.21, 95% CI = 1.08-1.36, p = 2.6 x 10(-4)). Risk prediction evaluation identified the additive model as best for describing the effect of APOE genotypes. Interpretation: APOE epsilon 2 and epsilon 4 are independent risk factors for lobar ICH, consistent with their known associations with amyloid biology. In addition, we present preliminary findings on a novel association between APOE epsilon 4 and deep ICH. Finally, we demonstrate that an additive model for these APOE variants is superior to other forms of genetic risk modeling previously applied. ANN NEUROL 2010;68:934-943
|
|
| 41. |
- Blix, E., et al.
(författare)
-
Transfer to hospital in planned home births: a systematic review
- 2014
-
Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 14
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is concern about the safety of homebirths, especially in women transferred to hospital during or after labour. The scope of transfer in planned home births has not been assessed in a systematic review. This review aimed to describe the proportions and indications for transfer from home to hospital during or after labour in planned home births. Methods: The databases Pubmed, Embase, Cinahl, Svemed+, and the Cochrane Library were searched using the MeSH term "home childbirth". Inclusion criteria were as follows: the study population was women who chose planned home birth at the onset of labour; the studies were from Western countries; the birth attendant was an authorised midwife or medical doctor; the studies were published in 1985 or later, with data not older than from 1980; and data on transfer from home to hospital were described. Of the 3366 titles identified, 83 full text articles were screened, and 15 met the inclusion criteria. Two of the authors independently extracted the data. Because of the heterogeneity and lack of robustness across the studies, there were considerable risks for bias if performing meta-analyses. A descriptive presentation of the findings was chosen. Results: Fifteen studies were eligible for inclusion, containing data from 215,257 women. The total proportion of transfer from home to hospital varied from 9.9% to 31.9% across the studies. The most common indication for transfer was labour dystocia, occurring in 5.1% to 9.8% of all women planning for home births. Transfer for indication for foetal distress varied from 1.0% to 3.6%, postpartum haemorrhage from 0% to 0.2% and respiratory problems in the infant from 0.3% to 1.4%. The proportion of emergency transfers varied from 0% to 5.4%. Conclusion: Future studies should report indications for transfer from home to hospital and provide clear definitions of emergency transfers.
|
|
| 42. |
- Blomgren, Johanna, et al.
(författare)
-
Maternal health leaders' perceptions of barriers to midwife-led care in Ethiopia, Kenya, Malawi, Somalia, and Uganda
- 2023
-
Ingår i: Midwifery. - 0266-6138 .- 1532-3099. ; 124, s. 103734-
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify and examine barriers to midwife-led care in Eastern Africa and how these barriers can be reduced DESIGN: A qualitative inductive study with online focus group discussions and semi-structured interviews using content analysis SETTING: The study examines midwife-led care in Ethiopia, Malawi, Kenya, Somalia, and Uganda -five African countries with an unmet need for midwives and a need to improve maternal and neonatal health outcomes.PARTICIPANTS: Twenty-five participants with a health care profession background and current position as a maternal and child health leader from one of the five study countries.FINDINGS: The findings demonstrate barriers to midwife-led care connected to organisational structures, traditional hierarchies, gender disparities, and inadequate leadership. Societal and gendered norms, organisational traditions, and differences in power and authority between professions are some factors explaining why the barriers persist. A focus on intra- and multisectoral collaborations, the inclusion of midwife leaders, and providing midwives with role models to leverage their empowerment are examples of how to reduce the barriers.KEY CONCLUSIONS: This study provides new knowledge on midwife-led care from the perspectives of health leaders in five African countries. Transforming outdated structures to ensure midwives are empowered to deliver midwife-led care at all healthcare system levels is crucial to moving forward.IMPLICATIONS FOR PRACTISE: This knowledge is important as enhancing the midwife-led care provision is associated with substantially improved maternal and neonatal health outcomes, higher satisfaction of care, and enhanced utilisation of health system resources. Nevertheless, the model of care is not adequately integrated into the five countries' health systems. Future studies are warranted to further explore how reducing barriers to midwife-led care can be adapted at a broader level.
|
|
| 43. |
- Blusi, Madeleine, 1968-, et al.
(författare)
-
Factors to consider when introducing digital social activities to older persons with home care
- 2023
-
Ingår i: Caring is sharing. - : IOS Press. - 9781643683881 - 9781643683898 ; , s. 453-457
-
Konferensbidrag (refereegranskat)abstract
- Social isolation and loneliness have become everyday concerns forpopulations all over the world as these factors are affecting both physical and mentalhealth in a negative way. Feelings of isolation and loneliness are increasinglyacknowledged as a health risk among older persons. ICTs have been recognized aseffective tools to combat social isolation among older people. The aim of this studywas to explore factors of significance when introducing a tablet-based systemproviding digital social activities for older persons with home care. Participants were17 persons, age 70 and older, who lived alone and had assistance from home care.This exploratory study used cross-sectional qualitative data analyzed throughthematic analysis. Three themes were generated: 1) lacking vocabulary related tothe context, 2) intuitive user interface may replace extensive instructions and 3)unwillingness to commit to a pre-defined measure of performance.
|
|
| 44. |
- Blusi, Madeleine, et al.
(författare)
-
Older adults co-creating meaningful individualized social activities online for healthy ageing
- 2018
-
Ingår i: Building continents of knowledge in oceans of data. - : IOS Press. - 9781614998518 - 9781614998525 ; , s. 775-779
-
Bokkapitel (refereegranskat)abstract
- Social isolation and loneliness among older people is a growing problem with negative effects on physical and mental health. In co-creation with older adults individualized social activities were designed where older adults through computer mediated communication were able to participate in social activities without leaving their homes. Four types of activities were designed; outdoor activity, music event, visiting a friend and leisure activity. A participatory action research design was applied, where end users together with scientists from two research fields developed, tested and evaluated online participation in the activities. Usability and safety of the systems were major concerns among older adults. The evaluation pointed out that level of simplicity, usability and audio-video quality determined the level of satisfaction with the human interaction during the activity, thereby affecting the meaningfulness of the activity. The research presented in this paper constitutes the first step in a long-term research process aiming at developing a digital coaching system that gives older adults personalized support for increasing participation in meaningful social activities.
|
|
| 45. |
- Bogren Jungmarker, Emily, et al.
(författare)
-
Playing Second Fiddle Is Okay-Swedish Fathers' Experiences of Prenatal Care
- 2010
-
Ingår i: Journal of midwifery & women's health. - : Wiley. - 1526-9523 .- 1542-2011. ; 55:5, s. 421-429
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners' involvement in prenatal care as very important. The aim of this study was to describe expectant fathers' experiences of and involvement in prenatal care in Sweden. Methods: Data were drawn from a 1-year cohort study of 827 Swedish-speaking fathers recruited during their partners' midpregnancy and followed up 2 months after childbirth. Results: The participants reported that the most important issues in prenatal care were the woman's physical and emotional well-being and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers' involvement. "Excessive'' care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional well-being. Discussion: Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers' needs and incorporate a family-oriented approach to prenatal care.
|
|
| 46. |
- Bybrant, M. C., et al.
(författare)
-
Celiac disease can be predicted by high levels of tissue transglutaminase antibodies in children and adolescents with type 1 diabetes
- 2021
-
Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 22:3, s. 417-424
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives Children with type 1 diabetes (T1D) are not included in guidelines regarding diagnosis criteria for celiac disease (CD) without a diagnostic biopsy, due to lack of data. We explored whether tissue transglutaminase antibodies (anti-tTG) that were >= 10 times the upper limit of normal (10x ULN) predicted CD in T1D. Methods Data from the Swedish prospective Better Diabetes Diagnosis study was used, and 2035 children and adolescents with T1D diagnosed between 2005-2010 were included. Of these, 32 had been diagnosed with CD before T1D. The children without CD were repeatedly screened for CD using anti-tTG antibodies of immunoglobulin type A. In addition, their human leukocyte antigen (HLA) were genotyped. All children with positive anti-tTG were advised to undergo biopsy. Biopsies were performed on 119 children and graded using the Marsh-Oberhuber classification. Results All of the 60 children with anti-tTG >= 10x ULN had CD verified by biopsies. The degree of mucosal damage correlated with anti-tTG levels. Among 2003 screened children, 6.9% had positive anti-tTG and 5.6% were confirmed CD. The overall CD prevalence, when including the 32 children with CD before T1D, was 7.0% (145/2035). All but one of the children diagnosed with CD had HLA-DQ2 and/or DQ8. Conclusions As all screened children and adolescents with T1D with tissue transglutaminase antibodies above 10 times the positive value 10x ULN had CD, we propose that the guidelines for diagnosing CD in screened children, when biopsies can be omitted, should also apply to children and adolescents with T1D as a noninvasive method.
|
|
| 47. |
- Bönquist, Linda, 1974-, et al.
(författare)
-
MglA and Igl proteins contribute to the modulation of Francisella tularensis live vaccine strain-containing phagosomes in murine macrophages
- 2008
-
Ingår i: Infection and Immunity. - 0019-9567 .- 1098-5522. ; 76:8, s. 3502-3510
-
Tidskriftsartikel (refereegranskat)abstract
- The Francisella tularensis live vaccine strain (LVS), in contrast to its iglC mutant, replicates in the cytoplasm of macrophages. We studied the outcome of infection of the murine macrophagelike cell line J774A.1 with LVS and with iglC, iglD, and mglA mutants, the latter of which is deficient in a global regulator. Compared to LVS, all of the mutants showed impaired intracellular replication up to 72 h, and the number of the mglA mutant bacteria even decreased. Colocalization with LAMP-1 was significantly increased for all mutants compared to LVS, indicating an impaired ability to escape into the cytoplasm. A lysosomal acidity-dependent dye accumulated in approximately 40% of the vacuoles containing mutant bacteria but not at all in vacuoles containing LVS. Preactivation of the macrophages with gamma interferon inhibited the intracellular growth of all strains and significantly increased acidification of phagosomes containing the mutants, but it only slightly increased the LAMP-1 colocalization. The intracellular replication and phagosomal escape of the iglC and iglD mutants were restored by complementation in trans. In conclusion, the IglC, IglD, and MglA proteins each directly or indirectly critically contribute to the virulence of F. tularensis LVS, including its intracellular replication, cytoplasmic escape, and inhibition of acidification of the phagosomes.
|
|
| 48. |
- Chalkias, Helena, et al.
(författare)
-
Identification of novel candidate genes for the inverted teat defect in sows using a genome-wide marker panel
- 2017
-
Ingår i: Journal of Applied Genetics. - : Springer Science and Business Media LLC. - 1234-1983 .- 2190-3883. ; 58, s. 249-259
-
Tidskriftsartikel (refereegranskat)abstract
- The number of functional teats is an important selection criterion in pig breeding. Inherited defects of the udder, such as the inverted teat, do have a considerable negative impact on the nursing ability of the sow. To investigate the genetic background of this defect and the number of functional teats in Swedish maternal lines, samples from 230 Yorkshire pigs were selected for genotyping using the PorcineSNP60K BeadChip (Illumina Inc.), each pig with at least one inverted teat was matched with one non-affected pig (fullsib or pairs with matching herd and gender). A genome-wide association study on these 230 pigs was performed using the two-step approach implemented in GenABEL using 46,652 single nucleotide polymorphisms across all autosomes and the X chromosome. A number of significant regions were identified for the inverted teat defect on chromosomes 2, 10, and 18. Many of the regions associated with the number of functional teats were located in the same or close regions, except two associated markers on the X chromosome and one on chromosome 3. We identified some of the regions on chromosomes previously reported in one linkage and one gene expression study. We conclude, despite being able to suggest new candidate genes, that further studies are needed to better understand the biologic background of the teat development. Despite the in-depth comparison of identified regions for the inverted teat defect done here, more studies are required to allow a clear identification of genetic regions relevant for this defect across many pig populations.
|
|
| 49. |
|
|
| 50. |
|
|
