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Sökning: WFRF:(Mattsson Jenny)

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1.
  • Ljungars, A., et al. (författare)
  • A platform for phenotypic discovery of therapeutic antibodies and targets applied on Chronic Lymphocytic Leukemia
  • 2018
  • Ingår i: JCO Precision Oncology. - : Springer Science and Business Media LLC. - 2473-4284 .- 2397-768X. ; 2:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Development of antibody drugs against novel targets and pathways offers great opportunities to improve current cancer treatment. We here describe a phenotypic discovery platform enabling efficient identification of therapeutic antibody-target combinations. The platform utilizes primary patient cells throughout the discovery process and includes methods for differential phage display cell panning, high-throughput cell-based specificity screening, phenotypic in vitro screening, target deconvolution, and confirmatory in vivo screening. In this study the platform was applied on cancer cells from patients with Chronic Lymphocytic Leukemia resulting in discovery of antibodies with improved cytotoxicity in vitro compared to the standard of care, the CD20-specific monoclonal antibody rituximab. Isolated antibodies were found to target six different receptors on Chronic Lymphocytic Leukemia cells; CD21, CD23, CD32, CD72, CD200, and HLA-DR of which CD32, CD200, and HLA-DR appeared as the most potent targets for antibody-based cytotoxicity treatment. Enhanced antibody efficacy was confirmed in vivo using a patient-derived xenograft model.
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2.
  • Sylvan, Sandra Eketorp, et al. (författare)
  • First-line therapy in chronic lymphocytic leukemia : a Swedish nation-wide real-world study on 1053 consecutive patients treated between 2007 and 2013
  • 2019
  • Ingår i: Haematologica. - : FERRATA STORTI FOUNDATION. - 0390-6078 .- 1592-8721. ; 104:4, s. 797-805
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate long-term outcome following first-line therapy in consecutive chronic lymphocytic leukemia (CLL) patients in a well-defined geographic area: Sweden. All patients diagnosed with CLL (2007-2013) (n=3672) were identified from national registries, screening of patient files identified all (100%) treated first line (n=1053) and for those, an in-depth analysis was performed. End points were overall response rate, progression-free survival (PFS), overall survival (OS), and safety. Median age was 71 years; 53% had Rai stage III-IV and 97% had performance status grade 0-2. Fluorescence in situ hybridization (FISH) was performed in 57% of patients: 15% had del(17p). Chlorambucil + prednisone was used in 39% (5% also received rituximab). Fludarabine+cyclophosphamide+rituximab or fludarabine+cyclophosphamide was used in 43% and bendamustine + rituximab in 6%. Overall response rate was 64%; chlorambucil 43%, fludarabine+cyclophosphamide+rituximab 84%, fludarabine+cyclophosphamide 75% and bendamustine + rituximab 75%. Median PFS and OS was 24 and 58 months, respectively, both were significantly associated (multivariate analysis) with type of treatment, del(17p), performance status, gender, age and geographical region (OS only). Chlorambucil-treated patients had a median PFS and OS of only 9 and 33 months, respectively. Chlorambucil usage declined gradually throughout the study period, but one-third of patients still received chlorambucil + rituximab in 2013. Infections >= grade III were significantly associated with treatment; chlorambucil 19% versus fludarabine+cyclophosphamide+rituximab 30%. Richter transformation occurred in 5.5% of the patients, equally distributed across therapies. This is the largest retrospective, real-world cohort of consecutive first-line treated CLL patients with a complete follow up. In elderly patients, an unmet need for more effective, well-tolerated therapies was identified.
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5.
  • Adler, Andrew F., et al. (författare)
  • hESC-Derived Dopaminergic Transplants Integrate into Basal Ganglia Circuitry in a Preclinical Model of Parkinson's Disease
  • 2019
  • Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 28:13, s. 5-3473
  • Tidskriftsartikel (refereegranskat)abstract
    • Cell replacement is currently being explored as a therapeutic approach for neurodegenerative disease. Using stem cells as a source, transplantable progenitors can now be generated under conditions compliant with clinical application in patients. In this study, we elucidate factors controlling target-appropriate innervation and circuitry integration of human embryonic stem cell (hESC)-derived grafts after transplantation to the adult brain. We show that cell-intrinsic factors determine graft-derived axonal innervation, whereas synaptic inputs from host neurons primarily reflect the graft location. Furthermore, we provide evidence that hESC-derived dopaminergic grafts transplanted in a long-term preclinical rat model of Parkinson's disease (PD) receive synaptic input from subtypes of host cortical, striatal, and pallidal neurons that are known to regulate the function of endogenous nigral dopamine neurons. This refined understanding of how graft neurons integrate with host circuitry will be important for the design of clinical stem-cell-based replacement therapies for PD, as well as for other neurodegenerative diseases. Adler et al. graft hESC-derived dopaminergic progenitors into a rat model of Parkinson's disease. They find grafts correctly innervate host targets and receive appropriate synaptic input after intranigral and intrastriatal placement. Furthermore, the same host neurons projecting toward endogenous dopamine neurons are found to also connect to the grafts.
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8.
  • Ali, Neserin, et al. (författare)
  • Analysis of nanoparticle-protein coronas formed in vitro between nanosized welding particles and nasal lavage proteins.
  • 2016
  • Ingår i: Nanotoxicology. - : Taylor & Francis. - 1743-5390 .- 1743-5404. ; 10:2, s. 226-234
  • Tidskriftsartikel (refereegranskat)abstract
    • Welding fumes include agglomerated particles built up of primary nanoparticles. Particles inhaled through the nose will to some extent be deposited in the protein-rich nasal mucosa, and a protein corona will be formed around the particles. The aim was to identify the protein corona formed between nasal lavage proteins and four types of particles with different parameters. Two of the particles were formed and collected during welding and two were manufactured iron oxides. When nasal lavage proteins were added to the particles, differences were observed in the sizes of the aggregates that were formed. Measurements showed that the amount of protein bound to particles correlated with the relative size increase of the aggregates, suggesting that the surface area was associated with the binding capacity. However, differences in aggregate sizes were detected when nasal proteins were added to UFWF and Fe2O3 particles (having similar agglomerated size) suggesting that yet parameters other than size determine the binding. Relative quantitative mass spectrometric and gel-based analyses showed differences in the protein content of the coronas. High-affinity proteins were further assessed for network interactions. Additional experiments showed that the inhibitory function of secretory leukocyte peptidase inhibitor, a highly abundant nasal protein, was influenced by particle binding suggesting that an understanding of protein function following particle binding is necessary to properly evaluate pathophysiological events. Our results underscore the importance of including particles collected from real working environments when studying the toxic effects of particles because these effects might be mediated by the protein corona.
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9.
  • Andersson, Hanna, et al. (författare)
  • Natur på skolgården för lärande, hälsa och hållbarhet
  • 2024. - 2024
  • Rapport (populärvet., debatt m.m.)abstract
    • Gröna och artrika utemiljöer främjar barns och ungas välbefinnande och kunskap, bådegenom hälsofördelar kopplade till biologisk mångfald och genom att skapa förutsättningarför lek och lärande om natur och miljöfrågor. Skolgården skulle kunna bidra till allt detta,men är idag i hög grad en outnyttjad plats för biologisk mångfald och klimatanpassningav städer. I denna policy brief presenteras huvudsakliga motiv och möjliga åtgärder för attutveckla gröna miljöer och biologisk mångfald på skolgårdar och förskolegårdar.
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10.
  • Birtele, Marcella, et al. (författare)
  • Single-cell transcriptional and functional analysis of dopaminergic neurons in organoid-like cultures derived from human fetal midbrain
  • 2022
  • Ingår i: Development: For advances in developmental biology and stem cells. - : The Company of Biologists. - 1477-9129. ; 149:23
  • Tidskriftsartikel (refereegranskat)abstract
    • Significant efforts are ongoing to develop refined differentiation protocols to generate midbrain dopamine (DA) neurons from pluripotent stem cells (PSCs) for application in disease modeling, diagnostics, drug screening, and cell-based therapies for Parkinson's Disease (PD). An increased understanding of the timing and molecular mechanisms promoting the generation of distinct subtypes of human midbrain DA during development will be essential for guiding future efforts to generate molecularly defined and subtype-specific DA neurons from PSCs. Here, we used droplet-based single-cell RNA sequencing to transcriptionally profile the developing human ventral midbrain (VM) when the DA neurons are generated (6-11 weeks post-conception) and their subsequent differentiation into functional mature DA neurons in primary fetal 3D organoid-like cultures. This approach revealed that 3D cultures are superior to monolayer conditions for their ability to generate and maintain mature DA neurons; hence they have the potential to be used for studying human VM development. These results provide a unique transcriptional profile of the developing human fetal VM and functionally mature human DA neurons, which can be used to guide stem cell-based therapies and disease modeling approaches in PD.
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11.
  • Bäckstrand, Jenny, 1979- (författare)
  • Levels of Interaction in Supply Chain Relations
  • 2007
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • To be able to retain the manufacturing industry durably, in Europe in general and in Sweden in specific, manufacturing companies have to be competitive also on the global market. One way for companies to realize this ambition is to interact with suppliers and customers in different kinds of supply chains. In the dyadic relation between two companies, three different levels of interaction have been identified. To be able to enhance the competitiveness instead of requiring excess workload, the level of interaction has to be adequate for the specific company and their market conditions. The aim of this thesis is to clarify the characteristics of supply chain interaction, both in terms of different levels of interaction and concerning the factors affecting the appropriate level of interaction. A basic prerequisite to enable companies to select an appropriate level of interaction within their supply chain is also to clarify the present use of terminology. This research is conducted through theoretical studies. The theoretical findings are synthesized in order to fulfill the research objective. Characteristics of supply chain interaction in terms of affecting categories and factors are identified. The factors are sorted according to the category they support. An interaction framework that can be used to gain an overview over the categories and factors affecting the level of interaction in a specific situation is developed. The resulting interaction framework is aiming at industry applicability but is based only on theoretical studies (which in turn are based on empirical data). The aim is to support the interaction level decision for, primarily, small and medium sized manufacturing companies in order to increase their competitiveness. Despite the amount of research within the supply chain area, the question how companies should select the way to interact within their supply chain has so far been left unanswered. In this thesis, a number of categories and factors that affects the appropriate level of interaction are identified and listed.
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12.
  • Cardoso, Tiago, et al. (författare)
  • Target-specific forebrain projections and appropriate synaptic inputs of hESC-derived dopamine neurons grafted to the midbrain of parkinsonian rats
  • 2018
  • Ingår i: Journal of Comparative Neurology. - 0021-9967. ; 526:13, s. 2133-2146
  • Tidskriftsartikel (refereegranskat)abstract
    • Dopamine (DA) neurons derived from human embryonic stem cells (hESCs) are a promising unlimited source of cells for cell replacement therapy in Parkinson's disease (PD). A number of studies have demonstrated functionality of DA neurons originating from hESCs when grafted to the striatum of rodent and non-human primate models of PD. However, several questions remain in regard to their axonal outgrowth potential and capacity to integrate into host circuitry. Here, ventral midbrain (VM) patterned hESC-derived progenitors were grafted into the midbrain of 6-hydroxydopamine-lesioned rats, and analyzed at 6, 18, and 24weeks for a time-course evaluation of specificity and extent of graft-derived fiber outgrowth as well as potential for functional recovery. To investigate synaptic integration of the transplanted cells, we used rabies-based monosynaptic tracing to reveal the origin and extent of host presynaptic inputs to grafts at 6 weeks. The results reveal the capacity of grafted neurons to extend axonal projections toward appropriate forebrain target structures progressively over 24weeks. The timing and extent of graft-derived dopaminergic fibers innervating the dorsolateral striatum matched reduction in amphetamine-induced rotational asymmetry in the animals where recovery could be observed. Monosynaptic tracing demonstrated that grafted cells integrate with host circuitry 6 weeks after transplantation, in a manner that is comparable with endogenous midbrain connectivity. Thus, we demonstrate that VM patterned hESC-derived progenitors grafted to midbrain have the capacity to extensively innervate appropriate forebrain targets, integrate into the host circuitry and that functional recovery can be achieved when grafting fetal or hESC-derived DA neurons to the midbrain.
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13.
  • Cossio Grageda, Claudia, 1974, et al. (författare)
  • EVAS - a practical tool to assess the sustainability of small wastewater treatment systems in low and lower-middle-income countries
  • 2020
  • Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 746
  • Tidskriftsartikel (refereegranskat)abstract
    • Small wastewater treatment systems (WWTSs) in low and lower-middle income countries still face challenges to achieve optimal performance and acceptable levels of sustainability. Thus, a practical tool, easy to apply by locals, to diagnose the actual status of WWTSs is required in order to identify weak areas for further improvement. This study presents a sustainability assessment tool, EVAS (EVAluación de Sostenibilidad: EVAluation of Sustainability), for small WWTSs in low and lower-middle income countries. The EVAS tool is developed based on a set of contextualized sustainability indicators and sub-indicators in five dimensions (technical, environmental, social, economic, institutional). Each indicator or sub-indicator is broken down into factors, each associated with specific targets to fulfil, and scored using a traffic light scale (0 to 4) indicating unsustainable-low-medium to high levels of sustainability. The tool was developed taking into consideration that local data may sometimes be incomplete and encourages the collection and monitoring of relevant data. The assessment results support local managers or other stakeholders responsible for wastewater management with the identification of weaknesses that need to be addressed. The tool was tested using two case studies involving WWTSs in Bolivia. One WWTS received a medium sustainability rating, whereas the other system received a low sustainability rating, which indicates that several improvements are required in all sustainability dimensions. Stakeholders in the case studies found the tool useful, and suggested ways in which it could be further improved. It is expected that the application of this tool can contribute to raising the sustainability level of small WWTSs in low and lower-middle-income countries.
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14.
  • Davis, Marion, et al. (författare)
  • Trees in home gardens: Making the most of an age-old practice to improve food security and nutrition.
  • 2014
  • Ingår i: Stockholm Environment Institute: Swedish International Agricultural Network Initiative (SIANI) and Forest, Climate & Livelihood Research Network (Focali), “Forests, Landscapes and Food Security” theme brief.
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Home gardens have been vital to human societies for thousands of years: from clusters of beneficial trees and shrubs planted on forest edges in pre-historic times, to the lush ediblegardens grown traditionally in many tropical regions, to the tiny, densely planted backyards that dot cities worldwide.
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15.
  • Fiorenzano, Alessandro, et al. (författare)
  • Single-cell transcriptomics captures features of human midbrain development and dopamine neuron diversity in brain organoids
  • 2021
  • Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Three-dimensional brain organoids have emerged as a valuable model system for studies of human brain development and pathology. Here we establish a midbrain organoid culture system to study the developmental trajectory from pluripotent stem cells to mature dopamine neurons. Using single cell RNA sequencing, we identify the presence of three molecularly distinct subtypes of human dopamine neurons with high similarity to those in developing and adult human midbrain. However, despite significant advancements in the field, the use of brain organoids can be limited by issues of reproducibility and incomplete maturation which was also observed in this study. We therefore designed bioengineered ventral midbrain organoids supported by recombinant spider-silk microfibers functionalized with full-length human laminin. We show that silk organoids reproduce key molecular aspects of dopamine neurogenesis and reduce inter-organoid variability in terms of cell type composition and dopamine neuron formation.
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16.
  • Hoban, Deirdre B, et al. (författare)
  • Impact of α-synuclein pathology on transplanted hESC-derived dopaminergic neurons in a humanized α-synuclein rat model of PD
  • 2020
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 117:26, s. 15209-15220
  • Tidskriftsartikel (refereegranskat)abstract
    • Preclinical assessment of the therapeutic potential of dopamine (DA) neuron replacement in Parkinson's disease (PD) has primarily been performed in the 6-hydroxydopamine toxin model. While this is a good model to assess graft function, it does not reflect the pathological features or progressive nature of the disease. In this study, we establish a humanized transplantation model of PD that better recapitulates the main disease features, obtained by coinjection of preformed human α-synuclein (α-syn) fibrils and adeno-associated virus (AAV) expressing human wild-type α-syn unilaterally into the rat substantia nigra (SN). This model gives rise to DA neuron dysfunction and progressive loss of DA neurons from the SN and terminals in the striatum, accompanied by extensive α-syn pathology and a prominent inflammatory response, making it an interesting and relevant model in which to examine long-term function and integrity of transplanted neurons in a PD-like brain. We transplanted DA neurons derived from human embryonic stem cells (hESCs) into the striatum and assessed their survival, growth, and function over 6 to 18 wk. We show that the transplanted cells, even in the presence of ongoing pathology, are capable of innervating the DA-depleted striatum. However, on closer examination of the grafts, we found evidence of α-syn pathology in the form of inclusions of phosphorylated α-syn in a small fraction of the grafted DA neurons, indicating host-to-graft transfer of α-syn pathology, a phenomenon that has previously been observed in PD patients receiving fetal tissue grafts but has not been possible to demonstrate and study in toxin-based animal models.
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17.
  • Håkansson Lindqvist, Marcia, et al. (författare)
  • Sustainability in Mid Sweden University everyday life (HIMUV) : Project design and preliminary results to date.
  • 2022
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The base of this presentation is the project Sustainability in Mid Sweden University everyday life (HIMUV). The aim of the project is to increase knowledge regarding sustainable development among all university employees and students. Thereby, the project aspires to provide the opportunity to contribute to Mid Sweden University becoming an important player in the work for increased knowledge regarding sustainable development. During the project period of June 2021-2023, work in progress will increase and strengthen the sustainability culture among the university’s employees and students. However, to be able to work with sustainably, employees and students must know how the University defines sustainability and how it can become a natural part of everyday work to contribute to sustainable development. Therefore, the project will map the knowledge about sustainability work among the university’s different professional categories and design training materials for employees and students and suggest procedures for its use. Deliverables and goals include suggestions regarding what employees and students should know about sustainability. A collection of examples that show how different functions and subjects at the university can incorporate sustainability in everyday life will be used to produce a digital education material for employees and students. In this presentation, the project work to date will be reported.  Interviews, surveys and group meetings with employees in the area of sustainability will be presented as well as next steps in the project.  
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18.
  • Kirkeby, Agnete, et al. (författare)
  • Preclinical quality, safety, and efficacy of a human embryonic stem cell-derived product for the treatment of Parkinson's disease, STEM-PD
  • 2023
  • Ingår i: Cell Stem Cell. - 1934-5909. ; 30:10, s. 1299-1314
  • Tidskriftsartikel (refereegranskat)abstract
    • Cell replacement therapies for Parkinson's disease (PD) based on transplantation of pluripotent stem cell-derived dopaminergic neurons are now entering clinical trials. Here, we present quality, safety, and efficacy data supporting the first-in-human STEM-PD phase I/IIa clinical trial along with the trial design. The STEM-PD product was manufactured under GMP and quality tested in vitro and in vivo to meet regulatory requirements. Importantly, no adverse effects were observed upon testing of the product in a 39-week rat GLP safety study for toxicity, tumorigenicity, and biodistribution, and a non-GLP efficacy study confirmed that the transplanted cells mediated full functional recovery in a pre-clinical rat model of PD. We further observed highly comparable efficacy results between two different GMP batches, verifying that the product can be serially manufactured. A fully in vivo-tested batch of STEM-PD is now being used in a clinical trial of 8 patients with moderate PD, initiated in 2022.
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19.
  • Klang, Nina, 1978-, et al. (författare)
  • Intervention combining cooperative learning and instruction in reading comprehension strategies in heterogeneous classrooms
  • 2022
  • Ingår i: Nordic Journal of Literacy Research. - : Nordic Open Access Scholarly Publishing (NOASP). - 2464-1596. ; 8:1, s. 44-64
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate the effects of intervention, combining instruction in cooperative learning and reading comprehension strategies on students’ reading comprehension in grade 5. The teachers in the experiment group implemented the intervention while the teachers in the control group received training in reading comprehension strategies and taught as usual. Students in the experiment group and control group participated in tests of reading comprehension before and after the intervention. The results showed that being a part of the experiment group did not lead to greater gains in reading comprehension above the control group. Students of teachers who did not fully implement the intervention attained higher scores on reading comprehension than students in the control group. Students of teachers who fully implemented the intervention, on the other hand, received lower scores. The results are discussed with regard to research on teachers’ integration of intervention into their instructional routines.
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20.
  • Klarare, Anna, et al. (författare)
  • Caring Behaviors Inventory-24 : Translation, cross-cultural adaptation and psychometric testing for use in a Swedish context
  • 2021
  • Ingår i: Human Resources for Health. - : Springer Science and Business Media LLC. - 1478-4491. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patients’ health and wellbeing are promoted when nurses successfully conceptualize caring in clinical practice. Measuring caring behaviors can advance knowledge about caring and has potential to improve caring practices and the outcomes of care. The Caring Behaviors Inventory-24 (CBI-24) is an empirical instrument for measuring caring, developed to determine perceptions of caring among patients and nurses. Since the instrument was not available in Swedish, the aim of this study was therefore to translate into Swedish and cross-culturally adapt CBI-24 for a Swedish healthcare context, and to psychometrically analyze the Swedish version of CBI-24.Methods: The study used a traditional forward and back translation process in six stages: (1) two simultaneous translations by bilingual experts; (2) expert review committee synthesis; (3) blind back translation; (4) expert review committee deliberations; (5) pre-testing with cognitive interviews, and (6) psychometric evaluations. Results: The translation process was systematically conducted and entailed discussions regarding semantic, idiomatic, experiential and conceptual equivalence. The cognitive interviews generated thoughts and reflections, which resulted in adjusting three items of the CBI-24 SWE. For psychometric analyses, 234 persons answered the questionnaire. Results indicated acceptable overall model fit in the χ2-value for the confirmatory factor analysis, while for the heuristic goodness-of-fit indices, the comparative fit index (CFI) and the standardized mean square residual (SMSR) indicated good model fits, and the root mean square error approximation (RMSEA) indicated an acceptable fit. Conclusions: CBI-24 SWE has been shown to be a psychometrically acceptable instrument for use in Swedish research contexts. Further studies regarding the clinical usefulness of the instrument may be in order. In particular, CBI-24 SWE should be evaluated among nurses in rural areas.
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21.
  • Klarare, Anna, et al. (författare)
  • Translation, Cross-Cultural Adaptation, and Psychometric Analysis of the Attitudes Towards Homelessness Inventory for Use in Sweden
  • 2021
  • Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 18:1, s. 42-49
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Homelessness is an increasing problem worldwide, and the origins of homelessness in high-income countries are multifaceted. Due to stigma and discrimination, persons in homelessness delay seeking health care, resulting in avoidable illness and death. The Attitudes Towards Homelessness Inventory (ATHI) was developed to cover multiple dimensions of attitudes toward persons in homelessness and to detect changes in multiple segments of populations. It has, however, not previously been translated to Swedish.AIMS: The aim of the present study was to translate, cross-culturally adapt, and psychometrically test the ATHI for use in a Swedish healthcare context.METHODS: The project used a traditional forward- and back-translation process in six stages: (1) two simultaneous translations by bilingual experts; (2) expert review committee synthesis; (3) blind back-translation; (4) expert review committee deliberations; (5) pre-testing with cognitive interviews including registered nurses (n = 5), nursing students (n = 5), and women in homelessness (n = 5); and (6) psychometric evaluations. The final ATHI questionnaire was answered by 228 registered nurses and nursing students in the year 2019.RESULTS: The translation process was systematically conducted and entailed discussions regarding semantic, idiomatic, experiential, and conceptual equivalence. Confirmatory factor analysis was used to examine if the collected data fitted the hypothesized four-factor structure of the ATHI. Overall, it was found that the model had an acceptable fit and that the Swedish version of ATHI may be used in a Swedish healthcare context.LINKING EVIDENCE TO ACTION: The ATHI has been shown to be a psychometrically acceptable research instrument for use in a Swedish healthcare context. The systematic and rigorous process applied in this study, including experts with diverse competencies in translation proceedings and testing, improved the reliability and validity of the final Swedish version of the ATHI. The instrument may be used to investigate attitudes toward women in homelessness among nursing students and RNs in Sweden.
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22.
  • Li Zweifel, Ulla, et al. (författare)
  • God havsmiljö 2020 : Marin strategi för Nordsjön och Östersjön Del 2: God miljöstatus och miljökvalitetsnormer
  • 2012
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Havsmiljöförordningens övergripande mål är att upprätthålla eller uppnå en god miljöstatus i de svenska förvaltningsområdena Nordsjön och Östersjön till år 2020. En av uppgifterna i den första förvaltningsperioden är att bestämma vad som kännetecknar god miljöstatus i respektive förvaltningsområde samt att ta fram miljökvalitetsnormer.   God miljöstatus baseras på ett ramverk av så kallade deskriptorer som anges i havsmiljödirektivet, det vill säga det EU-direktiv som i Sverige genomförs genom havsmiljöförordningen. Deskriptorerna beskriver god miljöstatus på en övergripande nivå för 11 temaområden. Till varje deskriptor hör en rad kriterier som anger vad som ska ingå i en bedömning av miljöstatus. I Sverige har god miljöstatus formulerats för samtliga 29 kriterier som ska beaktas enligt direktivet. Dessa kvalitativa beskrivningar anger vad som kännetecknar god miljöstatus i Nordsjön och Östersjön.   För att praktiskt bedöma om god miljöstatus har uppnåtts föreslås 37 nationella indikatorer. En uppsättning av indikatorer omfattar miljöns tillstånd och avspeglar ekosystemets komponenter i form av nyckelarter, samhällen, och livsmiljöer. En utgångspunkt vid val av indikatorer för miljöns tillstånd har varit koppling till de belastningar som i den inledande bedömningen av miljötillståndet i Nordsjön och Östersjön bedömts ha stor negativ påverkan på ekosystemet. En annan uppsättning indikatorer berör påverkan och belastning på miljön i form av tillförsel av näringsämnen och farliga ämnen, samt biologisk och fysisk störning av miljön. Tillsammans utgör indikatorerna ett verktyg för att följa utvecklingen av miljötillståndet och effekter av åtgärder i havsmiljön.  Vid val av indikatorer har arbetet delvis utgått från existerande miljöövervakning och redan utvecklade indikatorer. Med denna utgångspunkt uppfylls en rad av havsmiljödirektivets krav, bland annat en god uppföljning av effekter av tillförsel av näringsämnen. Funktionella indikatorer, det vill säga indikatorer som utvärderats och för vilka god miljöstatus har definierats, saknas dock för tio av havsmiljödirektivets 29 kriterier. För uppföljning av biologisk mångfald saknas bland annat miljöövervakning och metoder för att bedöma livsmiljöers tillstånd. För att kunna bedöma fysiska skador på havsbotten saknas en övergripande sammanställning av information om aktiviteter som påverkar havsbottnar samt metodik för att bedöma effekterna.  Det saknas också utvecklade indikatorer för det kriterium som berör uppföljning av storleks- och åldersstruktur hos fiskar. Brist på kunskap gör också att inga förslag på svenska indikatorer kan ges för effekter på levande organismer från marint avfall, undervattensbuller, och främmande arter samt att endast ett begränsat antal indikatorer tagits fram som speglar effekter av farliga ämnen. De indikatorer som fastställs i juli 2012 utgör således inte en slutlig lista för att följa upp havsmiljödirektivet. Bristerna kommer att beaktas i det fortsatta genomförandet av havsmiljöförordningen där nästa steg är att anpassa miljöövervakningsprogrammen till uppföljning av miljötillståndet med valda indikatorer senast år 2014 samt att ta fram åtgärdsprogram till år 2015.  God miljöstatus ska uppnås genom tillämpning av miljökvalitetsnormer det vill säga rättsligt bindande regler som avspeglar den lägsta godtagbara miljökvaliteten i Nordsjön och Östersjön. För att nå god miljöstatus har elva svenska miljökvalitetsnormer formulerats. Dessa miljökvalitetsnormer omfattar belastning i form av näringsämnen, farliga ämnen, främmande arter, uttag av arter, fysisk påverkan på havsbottnar och avfall i havsmiljön. Målsättningen har varit att utforma miljökvalitetsnormer som motsvarar alla de belastningar som i den inledande bedömningen har identifierats ha en stor påverkan på miljön.   
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23.
  • Mattsson, H., et al. (författare)
  • Improved infrastructure and support needed for paediatric clinical trials in Sweden
  • 2020
  • Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 109:12, s. 2740-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim There is a lack of authorised medicines for paediatric patients and improved drug development is necessary. The aim of this study was to evaluate the need for infrastructure and support for paediatric clinical trials in Sweden. Methods A web-based survey was sent to doctors and nurses involved in the care of neonates, children and adolescents assessing the current situation and future needs for paediatric clinical trials in Sweden. Questions regarding premises, competence, organisation, support for paediatric clinical trials and Good Clinical Practice Training were addressed. Results In total, 137 individuals responded to the survey (109 doctors and 28 nurses). Overall, 61% of the respondents had previous experience of paediatric clinical trials. Some respondents had access to trial units, but only 34% had used the trial unit for support. Half of the responders were interested in recurrent paediatric Good Clinical Practice training. Doctors responded that clinical work often had to be prioritised and emphasised the need for research time. Conclusion This study clearly shows the commitment for clinical trials among doctors and nurses involved in paediatric care in Sweden, but also that administrative, logistic and economic support in a sustainable setting and an expanded national collaboration are needed.
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24.
  • Mattsson, Jenny, et al. (författare)
  • Accelerating target deconvolution for therapeutic antibody candidates using highly parallelized genome editing
  • 2021
  • Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Therapeutic antibodies are transforming the treatment of cancer and autoimmune diseases. Today, a key challenge is finding antibodies against new targets. Phenotypic discovery promises to achieve this by enabling discovery of antibodies with therapeutic potential without specifying the molecular target a priori. Yet, deconvoluting the targets of phenotypically discovered antibodies remains a bottleneck; efficient deconvolution methods are needed for phenotypic discovery to reach its full potential. Here, we report a comprehensive investigation of a target deconvolution approach based on pooled CRISPR/Cas9. Applying this approach within three real-world phenotypic discovery programs, we rapidly deconvolute the targets of 38 of 39 test antibodies (97%), a success rate far higher than with existing approaches. Moreover, the approach scales well, requires much less work, and robustly identifies antibodies against the major histocompatibility complex. Our data establish CRISPR/Cas9 as a highly efficient target deconvolution approach, with immediate implications for the development of antibody-based drugs.
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25.
  • Mattsson, Jenny, 1974 (författare)
  • But That's Like, It's not All that I Am, You Know. The Swedish subtitling of discourse particle You Know in ten US films
  • 2010
  • Ingår i: New Insights into Audiovisual Translation and Media Accessibility. - Amsterdam - New York : Rodopi. - 9789042031807 ; , s. 51-65
  • Bokkapitel (refereegranskat)abstract
    • Due to the time and space constraints on subtitling, many features in the original soundtrack of a film have to be omitted. One feature that is often considered redundant, and therefore frequently not translated, is discourse particles. These words express different functions in discourse depending on the type of context they are in. The present study investigates further the discourse particle you knowand its Swedish translations in ten US films. Focus is on the textual and interpersonal functions of you knowand on the different treatment of these in the subtitles. The study demonstrates a tendency for the textual function to be translated more often than the interpersonal one.
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26.
  • Mattsson, Jenny, 1974, et al. (författare)
  • Get a Room! How Writing Groups Aid the Development of Junior Academics’ Writing Practice and Writer Identity
  • 2020
  • Ingår i: Journal of Academic Writing (JoAW). - : Coventry University, Lanchester Library. - 2225-8973. ; 10:1, s. 59-74
  • Tidskriftsartikel (refereegranskat)abstract
    • The present study revisits writing retreat participants who have spontaneously formed writing groups before or after attending a retreat hosted by the Unit for Academic Language at the University of Gothenburg, Sweden. All in all, 11 doctoral students and one postdoc were interviewed using a semi-structured interview model. The answers were thematically analysed based on Murray’s (2014) concept of coherence in writing groups as well as parts of Aitchison and Lee’s (2006) key characteristics of writing groups. The two main research questions posed concern (i) whether the informants have changed their writing practice and/or the way they think and feel about writing since joining a writing group, and (ii) whether possible changes have aided the development of their identity as academic writers. Results show that the informants have indeed changed central aspects of their writing practice and that this in turn has positively influenced how they now think and feel about writing. This has to some extent contributed to the informants’ development of their writer identity; however, the present study also sheds light on the fact that more needs to be done at departmental levels across the university to make academic writing visible.
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27.
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28.
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29.
  • Mattsson, Jenny, et al. (författare)
  • Sequence enrichment profiles enable target-agnostic antibody generation for a broad range of antigens
  • 2023
  • Ingår i: Cell reports methods. - 2667-2375. ; 3:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Phenotypic drug discovery (PDD) enables the target-agnostic generation of therapeutic drugs with novel mechanisms of action. However, realizing its full potential for biologics discovery requires new technologies to produce antibodies to all, a priori unknown, disease-associated biomolecules. We present a methodology that helps achieve this by integrating computational modeling, differential antibody display selection, and massive parallel sequencing. The method uses the law of mass action-based computational modeling to optimize antibody display selection and, by matching computationally modeled and experimentally selected sequence enrichment profiles, predict which antibody sequences encode specificity for disease-associated biomolecules. Applied to a phage display antibody library and cell-based antibody selection, ∼105 antibody sequences encoding specificity for tumor cell surface receptors expressed at 103–106 receptors/cell were discovered. We anticipate that this approach will be broadly applicable to molecular libraries coupling genotype to phenotype and to the screening of complex antigen populations for identification of antibodies to unknown disease-associated targets.
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30.
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31.
  • Mattsson, Jenny, 1974 (författare)
  • The Subtitling of Discourse Particles. A corpus-based study of well, you know, I mean, and like, and their Swedish translations in ten American films
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of the present study is to investigate the four discourse particles (DPs) well, you know, I mean, and like, and their Swedish subtitle translations. This is done in order to see to what extent it is possible to translate these elusive words and expressions in subtitling, which is a greatly constrained form of translation. The main reason for choosing well, you know, I mean, and like for this study, is the fact that the degree of translation difficulty differs between the four DPs: you know and I mean have clear correspondences in Swedish, whereas well and like do not to the same extent. A multimodal corpus of subtitled films was compiled especially for the present study. The corpus consists of the fully transcribed soundtrack of ten US films, each with up to four different subtitle versions, including the cinema and DVD subtitles, as well as the subtitles aired on the public service TV channel SVT and either of the two commercial TV channels TV3 and TV4. All in all, the corpus consists of approximately 420,000 words. DPs are multifunctional and their context-dependent functions can be difficult to identify. However, analysing DPs in a multimodal film corpus often makes the identification of the DP functions possible through direct access to speakers’ body language, intonation, social status, etc. A number of parameters (Svartvik 1980) are used for a closer analysis of each occurrence of well, you know, I mean, and like, including e.g. intonation, pauses, collocation, and body language of the speakers. To further facilitate the analysis of the four DPs, a cross-theoretical approach is taken. This includes aspects of three theories, i.e. Politeness theory (Brown & Levinson 1987), Coherence-based theory (Schiffrin 1987), and Relevance theory (Sperber & Wilson 1995). The translations of the DPs are analysed in terms of their pragmatic and/or grammatical realisations, as well as of various translation strategies used by the subtitlers. Results confirm that well, you know, I mean, and like can signal both textual functions (i.e. functions signalling the structuring of discourse), and interpersonal functions (i.e. functions signalling the relation between speakers). The textual and interpersonal functions are not mutually exclusive, but one DP occurrence may have both functions simultaneously. However, it is most often possible to distinguish one DP function as more salient than other functions in a given context. The study demonstrates that the textual function of the DPs is translated more often than the interpersonal function, even though there are more DPs with an interpersonal function in the films. Nevertheless, overall, a variety of Swedish translation solutions is employed. This is in itself a verification of both the multifunctionality and versatility of each of the four DPs, and the fact that the translations often reflect the most salient functions of the DPs in the films. In conclusion, the study shows that well, you know, I mean, and like are all translatable from English to Swedish, but in a majority of cases they are not in fact translated in the subtitles. The study also provides an insight into pragmatic functions of English and Swedish, and the fact that these two languages can express the same or similar pragmatic functions even though they do so in different ways.
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32.
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33.
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34.
  • Mezheyeuski, Artur, et al. (författare)
  • An immune score reflecting pro- and anti-tumoural balance of tumour microenvironment has major prognostic impact and predicts immunotherapy response in solid cancers
  • 2023
  • Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 88
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Cancer immunity is based on the interaction of a multitude of cells in the spatial context of the tumour tissue. Clinically relevant immune signatures are therefore anticipated to fundamentally improve the accuracy in predicting disease progression.Methods: Through a multiplex in situ analysis we evaluated 15 immune cell classes in 1481 tumour samples. Single-cell and bulk RNAseq data sets were used for functional analysis and validation of prognostic and predictive associations.Findings: By combining the prognostic information of anti-tumoural CD8+ lymphocytes and tumour supportive CD68+CD163+ macrophages in colorectal cancer we generated a signature of immune activation (SIA). The prognostic impact of SIA was independent of conventional parameters and comparable with the state-of-art immune score. The SIA was also associated with patient survival in oesophageal adenocarcinoma, bladder cancer, lung adenocarcinoma and melanoma, but not in endometrial, ovarian and squamous cell lung carcinoma. We identified CD68+CD163+ macrophages as the major producers of complement C1q, which could serve as a surrogate marker of this macrophage subset. Consequently, the RNA-based version of SIA (ratio of CD8A to C1QA) was predictive for survival in independent RNAseq data sets from these six cancer types. Finally, the CD8A/C1QA mRNA ratio was also predictive for the response to checkpoint inhibitor therapy.Interpretation: Our findings extend current concepts to procure prognostic information from the tumour immune microenvironment and provide an immune activation signature with high clinical potential in common human cancer types.
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35.
  • Mezheyeuski, Artur, et al. (författare)
  • The ratio of CD8+ lymphocytes to CD68+CD163+ macrophages is prognostic in immunogenic tumors and predicts immunotherapy response
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Immune cells in the microenvironment shape tumor development and progression. Through in situ analyses we assessed 15 immune cell classes in 352 colorectal cancers and identified a simpleprognostic signature based on the ratio of anti-tumoral CD8+ lymphocytes to tumor-supportiveCD68+CD163+ macrophages in the tumor microenvironment. The prognostic ability of this signature was superior to the state-of-art immune score and was also demonstrated in four other tumor types. Single-cell analyses identified these CD68+CD163+ macrophages as the source of complement C1q, and the ratio of CD8A to C1QA gene expression levels in bulk RNA predicted survival in five tumor types. In single cell analyses, RNA-based versions of the signature also predicted response to checkpoint inhibitor therapy. This supports broad clinical applicability of immune scores considering CD68+CD163+ macrophages as prognostic and predictive biomarkers in common cancers.
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36.
  • Micke, Patrick, et al. (författare)
  • The prognostic impact of the tumour stroma fraction : A machine learning-based analysis in 16 human solid tumour types
  • 2021
  • Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 65
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The development of a reactive tumour stroma is a hallmark of tumour progression and pronounced tumour stroma is generally considered to be associated with clinical aggressiveness. The variability between tumour types regarding stroma fraction, and its prognosis associations, have not been systematically analysed.Methods: Using an objective machine-learning method we quantified the tumour stroma in 16 solid cancer types from 2732 patients, representing retrospective tissue collections of surgically resected primary tumours. Image analysis performed tissue segmentation into stromal and epithelial compartment based on pan-cytokeratin staining and autofluorescence patterns.Findings: The stroma fraction was highly variable within and across the tumour types, with kidney cancer showing the lowest and pancreato-biliary type periampullary cancer showing the highest stroma proportion (median 19% and 73% respectively). Adjusted Cox regression models revealed both positive (pancreato-biliary type periampullary cancer and oestrogen negative breast cancer, HR(95%CI)=0.56(0.34-0.92) and HR (95%CI)=0.41(0.17-0.98) respectively) and negative (intestinal type periampullary cancer, HR(95%CI)=3.59 (1.49-8.62)) associations of the tumour stroma fraction with survival.Interpretation: Our study provides an objective quantification of the tumour stroma fraction across major types of solid cancer. Findings strongly argue against the commonly promoted view of a general associations between high stroma abundance and poor prognosis. The results also suggest that full exploitation of the prognostic potential of tumour stroma requires analyses that go beyond determination of stroma abundance.
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37.
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38.
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39.
  • Olsson, Jenny, et al. (författare)
  • Pre-medical dental evaluation and treatment of oral infection - a survey study among hospital-affiliated dentists in Sweden
  • 2022
  • Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 80:1, s. 29-37
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To examine how hospital-affiliated dentists assess risk and evaluate oral foci of infection in patients facing certain medical treatments, and whether the nature of upcoming medical treatment affects the choice of dental intervention. Materials and methods A survey comprising six clinical cases (50 teeth) was sent to hospital-affiliated dentists in Sweden. A treatment option for the affected tooth/teeth in each case was selected whether the patient was facing heart valve surgery, chemotherapy, radiation therapy, intravenous bisphosphonate treatment, solid organ transplantation or was diagnosed with endocarditis. Results Consensus in choice of dental treatment was high in 62%, moderate in 32% and low in 6% of the assessments. High variability of choice of treatment was seen for eight teeth whereas the remaining 42 teeth often received the same therapy regardless of medical issue. Chemotherapy and radiotherapy were thought to entail the highest risk for oral infectious sequelae with a risk ranging from 1% to 100%. Conclusion Pre-medical dental evaluations and recommended treatments are often uniform with the exception of the management of asymptomatic root canal treated teeth with persisting apical radiolucency and heavily decayed molars. In many instances, dental diagnosis has a greater impact on choice of treatment than the underlying medical issue and associated implications thereof.
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40.
  • Paulsson, Jenny, 1974- (författare)
  • 3D property rights : an analysis of key factors based on international experience
  • 2007
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The objectives of this thesis are to establish the fundamental principles in the field of 3D property rights by studying such systems in different countries with a particular focus on management questions, to systemize the acquired knowledge and demonstrate different ways of dealing with key factors essential to a well-functioning 3D property rights system. A theoretical background to the 3D property concept is given by presenting proposals as to a definition of 3D property and a classification of the primary forms of 3D property rights examined into specific types and categories, as well as an overview of international 3D property use. A general description of the characteristics of 3D property, with a focus on the condominium form, is also presented. A presentation of three different 3D property rights models is given as exemplified by the countries investigated, including the independent 3D property model in Sweden, the condominium form model in Germany, and a combination of the independent 3D property form and the condominium form as evidenced by the legal systems of two Australian states, New South Wales and Victoria. It has been possible to discern from this study a number of key factors related to 3D property rights that seem to be common for most forms and systems. These include the delimitation of property units, the content of the definition of common property, the creation of easements, the forms of cooperation between property units, management and regulation issues, as well as the settlement of disputes and insurance solutions. The problems experienced within the 3D property systems studied to a large extent have concerned issues within these mentioned key areas, where the management aspect seems particularly difficult. Changes in society and the creation of new development forms to a large extent have also contributed to the need for statutory amendments. More or less substantial amendments have been required in both the Australian and German statutes studied, with shortcomings still remaining after many years of use. However, these systems in general seem to be working well, and the condominium form in particular seems to be a well-functioning concept. Based on these systems, it has been possible to discern a tendency that the more detailed and complex the legislation, the greater the need for gradual amendments. In conclusion, it would be of benefit for countries planning on introducing a system for 3D property rights to utilize the experiences of other countries, while not forgetting to consider differences in legal systems, society, etc.
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41.
  • Söderberg, Marcus, et al. (författare)
  • Evaluation of image reconstruction methods for 123I-MIBG-SPECT: a rank-order study.
  • 2012
  • Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 53:7, s. 778-784
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is an opportunity to improve the image quality and lesion detectability in single photon emission computed tomography (SPECT) by choosing an appropriate reconstruction method and optimal parameters for the reconstruction. Purpose: To optimize the use of the Flash 3D reconstruction algorithm in terms of equivalent iteration (EI) number (number of subsets times the number of iterations) and to compare with two recently developed reconstruction algorithms ReSPECT and orthogonal polynomial expansion on disc (OPED) for application on (123)I-metaiodobenzylguanidine (MIBG)-SPECT. Material and Methods: Eleven adult patients underwent SPECT 4 h and 14 patients 24 h after injection of approximately 200 MBq (123)I-MIBG using a Siemens Symbia T6 SPECT/CT. Images were reconstructed from raw data using the Flash 3D algorithm at eight different EI numbers. The images were ranked by three experienced nuclear medicine physicians according to their overall impression of the image quality. The obtained optimal images were then compared in one further visual comparison with images reconstructed using the ReSPECT and OPED algorithms.ResultsThe optimal EI number for Flash 3D was determined to be 32 for acquisition 4 h and 24 h after injection. The average rank order (best first) for the different reconstructions for acquisition after 4 h was: Flash 3D(32) > ReSPECT > Flash 3D(64) > OPED, and after 24 h: Flash 3D(16) > ReSPECT > Flash 3D(32) > OPED. A fair level of inter-observer agreement concerning optimal EI number and reconstruction algorithm was obtained, which may be explained by the different individual preferences of what is appropriate image quality. Conclusion: Using Siemens Symbia T6 SPECT/CT and specified acquisition parameters, Flash 3D(32) (4 h) and Flash 3D(16) (24 h), followed by ReSPECT, were assessed to be the preferable reconstruction algorithms in visual assessment of (123)I-MIBG images.
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42.
  • Wising, Jenny, et al. (författare)
  • ‘Life with a device’ : the octogenarians’ experiences with an implantable cardioverter-defibrillator—a qualitative study
  • 2021
  • Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 21:2, s. 161-168
  • Tidskriftsartikel (refereegranskat)abstract
    • AimsImplantable cardioverter-defibrillator (ICD) treatment has expanded due to its effectiveness. However, there are concerns about complications, and use in the most elderly has been questioned. There is scarce data on qualitative aspects regarding experiences of living with an ICD among patients above the age of 80 years. The aim of this study was to explore octogenarians’ experience, knowledge, and attitude of living with an ICD.Method and resultsWe used semi-structured interviews to collect data from 20 patients, aged 80–89 years (90% men). The data were then structured and analysed through deductive thematic analysis network approach using the ATLAS.ti v.8.4 software. The framework of the analysis was based on the Successful Aging Theory. Three main themes emerged regarding the patients’ experiences: Life goes on; Their Health, The Janus-Faced Device; Their attitudes, and Mind the gap; Their knowledge. None of the octogenarians regretted receiving their ICD, instead, they presented with feelings such as gratitude towards the device. However, a lack of knowledge about the devices was expressed, which can be a risk for potential complications, in turn causing suffering and unnecessary concerns.ConclusionOverall, the ICD did not pose a threat towards successful ageing. It was mainly considered a life-saving device. However, the lack of knowledge might hinder informed choices close to death and contribute to ethical dilemmas when deactivation of the ICD is a reasonable option.
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