| 1. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Björklund, Fredrik, et al.
(författare)
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Emotion and social motivation in university students´ real life moral dilemmas
- 2002
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Studied the relationship between motivation and approaches to moral decision-making, and the emotions experienced in moral dilemmas. 44 students were interviewed about a dilemma they had faced. Intimacy was related to a preference for making decisions after having consulted others and to being open to their values and norms, whereas achievement was related to consequence-oriented reasoning and concrete construal of moral problems. When asked to relive their moral dilemma, participants scored lower than their baseline level on a mood questionnaire, females scoring lower than the males. Possible implications of emotion on cognitive processes involved in solving moral dilemmas are discussed.
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| 3. |
- Jönbrink, Anna Karin, et al.
(författare)
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Create Competitiveness In A Sustainable Society : - Use Ecodesign, In Cooperation
- 2011
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Ingår i: Design for Innovative Value Towards a Sustainable Society. - Dordrecht : Springer Science+Business Media B.V.. ; , s. 430-433
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Konferensbidrag (refereegranskat)abstract
- This paper will describe a new methodology for the use of Ecodesign, where various competences are combined to obtain high quality results. The competences needed are: Environmental experts, who can evaluate the environmental performance of a product or service through Life Cycle Assessment, LCA, material- and process experts for the materials and processes in the targeted product or service, experts of the final product or service who can provide high quality data for the LCA. This cross functional team can develop new products or services, with high performance combined with low environmental impact, applying ecodesign when cooperating closely. Using this methodology is a feasible way to obtain improved competitiveness for the industry in a sustainable society.
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| 4. |
- Adolfo, Eldridge Vigil, et al.
(författare)
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Electoral Violence in Africa
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- In the time period 2012–2013, over 20 national elections and two constitutional referendums are scheduled in Africa. In several of these elections, violence is anticipated to play a prominent role. There is great urgency to support the establishment of effective and legitimate electoral institutions and electoral frameworks; institute reforms aimed at lowering the stakes of elections; encourage the devolution of powers; improve the socio-economic standing of the populace; and devise strategies to prevent and manage electoral violence.
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| 5. |
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| 6. |
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| 7. |
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| 8. |
- Andersson, Mats, 1957, et al.
(författare)
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Non-pluripolar energy and the complex Monge-Ampere operator
- 2022
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Ingår i: Journal Fur Die Reine Und Angewandte Mathematik. - : Walter de Gruyter GmbH. - 0075-4102 .- 1435-5345. ; 2022:792, s. 145-188
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Tidskriftsartikel (refereegranskat)abstract
- Given a domain Omega subset of C-n we introduce a class of plurisubharmonic (psh) functions G(Omega) and Monge-Ampere operators u -> [dd(c)u](p), p <= n, on G(Omega) that extend the Bedford-Taylor-Demailly Monge-Ampere operators. Here [dd(c)u](p) is a closed positive current of bidegree (p, p) that dominates the non-pluripolar Monge-Ampere current < dd(c)u >(p). We prove that [dd(c)u](p) is the limit of Monge-Ampere currents of certain natural regularizations of u. On a compact Kahler manifold (X, omega) we introduce a notion of non-pluripolar energy and a corresponding finite energy class G(X, omega) subset of PSH(X, omega) that is a global version of the class G(Omega). From the local construction we get global Monge-Ampere currents [dd(c)phi + omega](p) for phi is an element of G(X, omega) that only depend on the current dd(c)phi + omega. The limits of Monge-Ampere currents of certain natural regularizations of phi can be expressed in terms of [dd(c)phi + omega](j) for j <= p. We get a mass formula involving the currents [dd(c)phi + omega](p) that describes the loss of mass of the non-pluripolar Monge-Ampere measure < dd(c)phi + omega >(n). The class G(X, omega) includes omega-psh functions with analytic singularities and the class E(X, omega) of omega-psh functions of finite energy and certain other convex energy classes, although it is not convex itself.
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| 9. |
- Andersson, Mats, et al.
(författare)
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Strategi för utveckling av en samhällsekonomisk analysmodell för drift, underhåll och reinvestering av väg- och järnvägsinfrastruktur
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Möjligheten att fatta beslut om behovet av anslagsmedel till drift, underhåll och reinvestering av vägaroch järnvägar baserat på ett väl strukturerat underlag är idag små. Detta skapar betydande risker attmedel används på ett samhällsekonomiskt ineffektivt sätt. För att Trafikverket ska kunna genomföradenna verksamhet så att sannolikheten att medlen används på rätt sätt ökar krävs därför en utveckling avett transparent beslutstöd.VTI redovisar i föreliggande rapport en kartläggning av kunskapsläget inom de olika delområden därkunskaper krävs för att få till stånd en samhällsekonomisk analys av drift, underhåll och reinvestering.Vår bedömning är att det idag inte finns modellverktyg som gör det möjligt att utan vidare genomförasådana analyser. Samtidigt visar genomgången att det finns goda förutsättningar att redan inom relativtkort tid ta fram ett underlag som gör det möjligt att besvara åtminstone delar av de frågeställningar somformulerats. Genomgången pekar således på att det finns stora möjligheter att flytta fram positionernabåde inom väg- och järnvägsområdet. Fem specifika projekt har utformats varav tre avser insatser på kortsikt och två på lång sikt. Målsättningen på lång sikt är att kunna göra en bedömning av vilkenkostnadsvolym och tillståndsnivå som behövs utifrån ett samhällsekonomiskt perspektiv på olika vägaroch järnvägar.
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| 10. |
- Bergenudd, Helena, et al.
(författare)
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Heterogeneous iron(II)-chloride mediated radical polymerization of styrene
- 2009
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Ingår i: Journal of Molecular Catalysis A. - : Elsevier BV. - 1381-1169 .- 1873-314X. ; 306:1-2, s. 69-76
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Tidskriftsartikel (refereegranskat)abstract
- In an attempt to perform atom transfer radical polymerization (ATRP) with a more environmentally friendly mediator, polymerization of styrene in the presence of iron(II)-chloride and EDTA was explored from a mechanistic point of view. The presence of EDTA, which normally can form a complex with FeCl2, had no influence on the polymerization results as both the mediator and EDTA were insoluble in the polymerization medium. A mechanism is suggested for the heterogeneous polymerization of styrene mediated by iron (II)-chloride in p-xylene at 50 °C. Varying the mediator amount more than 10-fold revealed that the rate limiting step at low mediator amounts was the adsorption of the initiator or dormant polymer to the mediator surface, whereas at higher mediator amounts, the rate limiting step was instead the activation step in the ATRP equilibrium. The mechanism changed to free radical polymerization in solution at a certain conversion, resulting in lower apparent rate constant and an increased amount of transfer and termination reactions. Chain extension with MMA showed that a significant proportion of the polymer chain ends were active also at high conversions.
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| 11. |
- Bertilsson, Johan, et al.
(författare)
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Stress Levels Escalate When Repeatedly Performing Tasks Involving Threats
- 2019
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 10, s. 1562-1562
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Tidskriftsartikel (refereegranskat)abstract
- Police work may include performing repeated tasks under the influence of psychological stress, which can affect perceptual, cognitive and motor performance. However, it is largely unknown how repeatedly performing stressful tasks physically affect police officers in terms of heart rate and pupil diameter properties. Psychological stress is commonly assessed by monitoring the changes in these biomarkers. Heart rate and pupil diameter was measured in 12 male police officers when performing a sequence of four stressful tasks, each lasting between 20 and 130 s. The participants were first placed in a dimly illuminated anteroom before allowed to enter a brightly lit room where a scenario was played out. After each task was performed, the participants returned to the anteroom for about 30 s before performing the next sequential task. Performing a repeated sequence of stressful tasks caused a significant increase in heart rate (p = 0.005). The heart rate started to increase already before entering the scenario room and was significantly larger just after starting the task than just before starting the task (p < 0.001). This pattern was more marked during the first tasks (p < 0.001). Issuance of a verbal "abort" command which terminated the tasks led to a significant increase of heart rate (p = 0.002), especially when performing the first tasks (p = 0.002). The pupil diameter changed significantly during the repeated tasks during all phases but in a complex pattern where the pupil diameter reached a minimum during task 2 followed by an increase during tasks 3 and 4 (p ≤ 0.020). During the initial tasks, the pupil size (p = 0.014) increased significantly. The results suggest that being repeatedly exposed to stressful tasks can produce in itself an escalation of psychological stress, this even prior to being exposed to the task. However, the characteristics of both the heart rate and pupil diameter were complex, thus, the findings highlight the importance of studying the effects and dynamics of different stress-generating factors. Monitoring heart rate was found useful to screen for stress responses, and thus, to be a vehicle for indication if and when rotation of deployed personnel is necessary to avoid sustained high stress exposures.
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| 12. |
- Bertilsson, Johan, et al.
(författare)
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Towards systematic and objective evaluation of police officer performance in stressful situations
- 2020
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Ingår i: Police Practice and Research. - : Informa UK Limited. - 1561-4263 .- 1477-271X. ; 21:6, s. 655-669
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Tidskriftsartikel (refereegranskat)abstract
- To ensure a continuous high standard of police units, it is critical to recruit people who perform well in stressful situations. Today, this selection process includes performing a large series of tests, which still may not objectively reveal a person’s capacity to handle a life-threatening situation when subjected to high levels of stress. To obtain more systematic and objective data, 12 police officers were exposed to six scenarios with varying levels of threat while their heart rate and pupil size were monitored. The scenarios were filmed and six expert evaluators assessed the performance of the police officers according to seven predefined criteria. Four of the scenarios included addressing a moderate threat level task and the scenarios were executed in a rapid sequence. Two further scenarios included a familiar firearm drill performed during high and low threat situations. The results showed that there was a large agreement between the experts in how they judged the performance of the police officers (p < 0.001). Performance increased significantly over tasks in four of the seven evaluation criteria (p ≤ 0.037). There was also a significant effect of pupil size (p = 0.004), but not heart rate, when comparing the different sequential scenarios. Moreover, a high level of threat considerably impaired the motor performance of the police officers during the firearms drill (p = 0.002). Finally, the pupil seemed to systematically dilate more when a threat appeared immediately than with a delay in the scenarios (p = 0.007). We conclude that systematic and quantitative judgments from experts provide valuable and reliable information about the performance of participants in realistic and stressful policing scenarios. Furthermore, objective physiological measures of heart rate and pupil size may help to explain and understand why performance sometimes deteriorates.
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| 13. |
- Blomstrand, Peter, et al.
(författare)
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Overweight and obesity impair left ventricular systolic function as measured by left ventricular ejection fraction and global longitudinal strain
- 2018
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Ingår i: Cardiovascular Diabetology. - : BioMed Central. - 1475-2840. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- AimsObesity is associated with type 2 diabetes mellitus, left ventricular diastolic dysfunction and heart failure but it is unclear to which extent it is related to left ventricular systolic dysfunction. The aim of the study was to explore the effects of overweight and obesity on left ventricular systolic function in patients with type 2 diabetes mellitus and a control group of non-diabetic persons.MethodsWe prospectively investigated 384 patients with type 2 diabetes mellitus, and 184 controls who participated in the CARDIPP and CAREFUL studies. The participants were grouped according to body mass index (normal weight < 25 kg/m2, overweight 25–29 kg/m2, and obesity ≥ 30 kg/m2). Echocardiography was performed at the beginning of the study and after 4-years in the patient group.ResultsUnivariable and multivariable regression analysis revealed that variations in left ventricular ejection fraction, global longitudinal strain, left ventricular mass and diastolic function expressed as E/é (the ratio between early diastolic mitral flow and annular motion velocities) all are related to body mass index. The mean and standard deviation of left ventricular ejection fraction and global longitudinal strain values were 57% (8%) vs. − 18.6% (2.3%) for normal weight patients, 53% (8%) vs. − 17.5% (2.3%) for overweight, and 49% (9%) vs. − 16.2% (3.0%) for obese (p < 0.05 vs. p < 0.05). Corresponding results in the control group were 58% (6%) vs. − 22.3% (3.0%), 55% (7%) vs. − 20.8% (3.1%) and 54% (8%) − 19.6% (4.0%) (p < 0.05 vs. p < 0.05). Patients who gained weight from baseline to follow-up changed left ventricular ejection fraction (median and interquartile range) by − 1.0 (9.0) % (n = 187) and patients who lost weight changed left ventricular ejection fraction by 1.0 (10.0) % (n = 179) (p < 0.05).ConclusionOverweight and obesity impair left ventricular ejection fraction and global longitudinal strain in both patients with type 2 diabetes mellitus and non-diabetic persons.
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| 14. |
- Borssén, Magnus, et al.
(författare)
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DNA Methylation Adds Prognostic Value to Minimal Residual Disease Status in Pediatric T-Cell Acute Lymphoblastic Leukemia
- 2016
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 63:7, s. 1185-1192
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Tidskriftsartikel (refereegranskat)abstract
- Background. Despite increased knowledge about genetic aberrations in pediatric T-cell acute lymphoblastic leukemia (T-ALL), no clinically feasible treatment-stratifying marker exists at diagnosis. Instead patients are enrolled in intensive induction therapies with substantial side effects. In modern protocols, therapy response is monitored by minimal residual disease (MRD) analysis and used for postinduction risk group stratification. DNA methylation profiling is a candidate for subtype discrimination at diagnosis and we investigated its role as a prognostic marker in pediatric T-ALL. Procedure. Sixty-five diagnostic T-ALL samples from Nordic pediatric patients treated according to the Nordic Society of Pediatric Hematology and Oncology ALL 2008 (NOPHO ALL 2008) protocol were analyzed by HumMeth450K genome wide DNA methylation arrays. Methylation status was analyzed in relation to clinical data and early T-cell precursor (ETP) phenotype. Results. Two distinct CpG island methylator phenotype (CIMP) groups were identified. Patients with a CIMP-negative profile had an inferior response to treatment compared to CIMP-positive patients (3-year cumulative incidence of relapse (CIR3y) rate: 29% vs. 6%, P = 0.01). Most importantly, CIMP classification at diagnosis allowed subgrouping of high-risk T-ALL patients (MRD >= 0.1% at day 29) into two groups with significant differences in outcome (CIR3y rates: CIMP negative 50% vs. CIMP positive 12%; P = 0.02). These groups did not differ regarding ETP phenotype, but the CIMP-negative group was younger (P = 0.02) and had higher white blood cell count at diagnosis (P = 0.004) compared with the CIMP-positive group. Conclusions. CIMP classification at diagnosis in combination with MRD during induction therapy is a strong candidate for further risk classification and could confer important information in treatment decision making.
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| 15. |
- Boyer, Robert, et al.
(författare)
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Three-dimensional product circularity
- 2021
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Ingår i: Journal of Industrial Ecology. - : John Wiley & Sons, Ltd. - 1088-1980 .- 1530-9290. ; 25:4, s. 824-
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Understanding product circularity as ?three-dimensional? could anchor the Circular Economy to common principles while affording its followers flexibility about how to measure it in their specific sectors and disciplines and within their organization's means. Inspired by a heuristic developed for the urban planning profession to cope with the inherent conflicts of Sustainable Development, this article argues that measuring product-level circularity should consider ways to achieve (1) high material recirculation, (2) high utilization, and (3) high endurance in products and service offerings. Achieving all three dimensions ensures that material flowing through the economy is recovered from prior use phases, that it is used intensely, and that it retains its value in spite of exogenous changes. The article argues further that these three dimensions ought to be measured and reported separately rather than as a composite metric and that certain applications will have opportunities to improve circularity through certain dimensions better than others. The article also explains how researchers at RISE (Research Institutes of Sweden AB) are working with industry and government partners to measure the three dimensions and how diverse actors interested in the Circular Economy can use the three dimensions to take the first steps in their transition to circularity.
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| 16. |
- Brunström, Mattias, et al.
(författare)
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From efficacy in trials to effectiveness in clinical practice : The Swedish Stroke Prevention Study
- 2016
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Ingår i: Blood Pressure. - : Informa UK Limited. - 0803-7051 .- 1651-1999. ; 25:4, s. 206-211
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Tidskriftsartikel (refereegranskat)abstract
- Blood pressure treatment has shown great efficacy in reducing cardiovascular events in randomized controlled trials. If this is effective in reducing cardiovascular disease in the general population, is less studied. Between 2001 and 2009 we performed an intervention to improve blood pressure control in the county of Vasterbotten, using Sodermanland County as a control. The intervention was directed towards primary care physicians and included lectures on blood pressure treatment, a computerized decision support system with treatment recommendations, and yearly feed back on hypertension control. Each county had approximately 255000 inhabitants. Differences in age and incidence of cardiovascular disease were small. During follow-up, more than 400000 patients had their blood pressure recorded. The mean number of measurements was eight per patient, yielding a total of 3.4 million blood pressure recordings. The effect of the intervention will be estimated combining the blood pressure data collected from the electronic medical records, with data on stroke, myocardial infarction and mortality from Swedish health registers. Additional variables, from health registers and Statistics Sweden, will be collected to address for confounders. The blood pressure data collected within this study will be an important asset for future epidemiological studies within the field of hypertension.
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| 17. |
- Dahl, Mats, et al.
(författare)
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Quiet Eye and Computerized Precision Tasks in First-Person Shooter Perspective Esport Games
- 2021
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 12, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- The gaze behavior in sports and other applied settings has been studied for more than 20 years. A common finding is related to the “quiet eye” (QE), predicting that the duration of the last fixation before a critical event is associated with higher performance. Unlike previous studies conducted in applied settings with mobile eye trackers, we investigate the QE in a context similar to esport, in which participants click the mouse to hit targets presented on a computer screen under different levels of cognitive load. Simultaneously, eye and mouse movements were tracked using a high-end remote eye tracker at 300 Hz. Consistent with previous studies, we found that longer QE fixations were associated with higher performance. Increasing the cognitive load delayed the onset of the QE fixation, but had no significant influence on the QE duration. We discuss the implications of our results in the context of how the QE is defined, the quality of the eye-tracker data, and the type of analysis applied to QE data.
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| 18. |
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| 19. |
- Ekevad, Mats, et al.
(författare)
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Modelling of adequate pretwist for obtaining straight timber
- 2006
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Ingår i: Wood Material Science & Engineering. - : Informa UK Limited. - 1748-0272 .- 1748-0280. ; 1:2, s. 76-84
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Tidskriftsartikel (refereegranskat)abstract
- Wood in general and wooden studs in particular are often distorted owing to uneven shrinkage during the drying process in the sawmill. Twist is often the most detrimental of all types of distortion, and it is caused by spiral grain in combination with variations in moisture content. For sawmills, the objective is to produce dried, straight boards, and one method of dealing with boards with excessive spiral grain is to sort them out and then dry them in a pretwisted position to obtain straight boards after drying. A model using the finite element (FE) method for the simulation of drying twist distortions was first calibrated against laboratory experiments in which boards were dried with and without restraints and pretwists. After the calibration, the FE results were compared with industrial test results for boards that were dried without restraints or with restraints with zero pretwist, i.e. straight restraints. The FE model used an elastic-ideally plastic material model to obtain permanent deformations. The calibration was to set the yield stresses so that there was a good match between FE results and results from the laboratory experiments. The comparison between the industrial test results and the FE results showed that the FE model is capable of realistic simulations of drying boards with and without restraints and presumably also pretwists
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| 20. |
- Eklund, Patrik, 1958-, et al.
(författare)
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Rule generation as an alternative to knowledge acquisition : a systems architecture for medical informatics
- 1994
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Ingår i: Fuzzy sets and systems (Print). - : Elsevier. - 0165-0114 .- 1872-6801. ; 66:2, s. 195-205
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes a clinical support systems workbench, DiagaiD, based on an efficient transfer of patient data between health care professionals and clinical subsystems. The DiagaiD workbench provides tools for decision support developments for open-loop systems.A leading ambition for our development work has been to establish a data analysis and knowledge elicitation workbench, in which medical professionals entirely by themselves can create stand-alone expert systems.
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| 21. |
- Enshaei, Amir, et al.
(författare)
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A validated novel continuous prognostic index to deliver stratified medicine in pediatric acute lymphoblastic leukemia
- 2020
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Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 135:17, s. 1438-1446
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Tidskriftsartikel (refereegranskat)abstract
- Risk stratification is essential for the delivery of optimal treatment in childhood acute lymphoblastic leukemia. However, current risk stratification algorithms dichotomize variables and apply risk factors independently, which may incorrectly assume identical associations across biologically heterogeneous subsets and reduce statistical power. Accordingly, we developed and validated a prognostic index (PIUKALL) that integrates multiple risk factors and uses continuous data. We created discovery (n = 2405) and validation (n = 2313) cohorts using data from 4 recent trials (UKALL2003, COALL-03, DCOG-ALL10, and NOPHO-ALL2008). Using the discovery cohort, multivariate Cox regression modeling defined a minimal model including white cell count at diagnosis, pretreatment cytogenetics, and end-of-induction minimal residual disease. Using this model, we defined PIUKALL as a continuous variable that assigns personalized risk scores. PIUKALL correlated with risk of relapse and was validated in an independent cohort. Using PIUKALL to risk stratify patients improved the concordance index for all end points compared with traditional algorithms. We used PIUKALL to define 4 clinically relevant risk groups that had differential relapse rates at 5 years and were similar between the 2 cohorts (discovery: low, 3% [95% confidence interval (CI), 2%-4%]; standard, 8% [95% CI, 6%-10%]; intermediate, 17% [95% CI, 14%-21%]; and high, 48% [95% CI, 36%-60%; validation: low, 4% [95% CI, 3%-6%]; standard, 9% [95% CI, 6%-12%]; intermediate, 17% [95% CI, 14%-21%]; and high, 35% [95% CI, 24%-48%]). Analysis of the area under the curve confirmed the PIUKALL groups were significantly better at predicting outcome than algorithms employed in each trial. PIUKALL provides an accurate method for predicting outcome and more flexible method for defining risk groups in future studies.
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| 22. |
- Flejmer, Anna M., et al.
(författare)
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Respiratory gating for proton beam scanning versus photon 3D-CRT for breast cancer radiotherapy
- 2016
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 55:5, s. 577-583
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Tidskriftsartikel (refereegranskat)abstract
- Background Respiratory gating and proton therapy have both been proposed to reduce the cardiopulmonary burden in breast cancer radiotherapy. This study aims to investigate the additional benefit of proton radiotherapy for breast cancer with and without respiratory gating.Material and methods Twenty left-sided patients were planned on computed tomography (CT)-datasets acquired during enhanced inspiration gating (EIG) and free-breathing (FB), using photon three-dimensional conformal radiation therapy (3D-CRT) and scanned proton beams. Ten patients received treatment to the whole breast only (WBO) and 10 were treated to the breast and the regional lymph nodes (BRN). Dosimetric parameters characterizing the coverage of target volumes and the cardiopulmonary burden were compared using a paired, two-tailed Student’s t-test.Results Protons ensured comparable or better target coverage than photons in all patients during both EIG and FB. The heterogeneity index decreased from 12% with photons to about 5% with protons. The mean dose to the ipsilateral lung was reduced in BRN patients from 12 Gy to 7 Gy (RBE) in EIG and from 14 Gy to 6-7 Gy (RBE) in FB, while for WBO patients all values were about 5-6 Gy (RBE). The mean dose to heart decreased by a factor of four in WBO patients [from 1.1 Gy to 0.3 Gy (RBE) in EIG and from 2.1 Gy to 0.5 Gy (RBE) in FB] and 10 in BRN patients [from 2.1 Gy to 0.2 Gy (RBE) in EIG and from 3.4 Gy to 0.3 Gy (RBE) in FB]. Similarly, the mean and the near maximum dose to left anterior descending artery (LAD) were significantly lower (p<0.05) with protons in comparison with photons.Conclusion Proton spot scanning has a high potential to reduce the irradiation of organs at risk and other normal tissues for most patients, beyond what could be achieved with EIG and photon therapy. The largest dose sparing has been seen for BRN patients, both in terms of cardiopulmonary burden and integral dose.
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| 23. |
- Forsström, J. J., et al.
(författare)
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Using data preprocessing and single layer perceptron to analyze laboratory data
- 1995
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa Healthcare. - 0036-5513 .- 1502-7686. ; 55:s222, s. 75-81
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Tidskriftsartikel (refereegranskat)abstract
- During daily work in hospitals a large amount of clinical data is produced each day. Totally computerized patient records are not yet widely used but a large part of essential information is already stored on computer files. These include laboratory test results, diagnoses, codes for operations, codes of histopathological diagnoses and maybe even the patient's medication. Accordingly, these databases include much clinical knowledge that would be useful for clinicians.Laboratories try to support clinicians by producing reference values for laboratory tests. It is, of course, necessary information but, however, it does not give very much information about the weight of evidence that an abnormal laboratory test will give in special clinical settings.We have developed a software package - DiagaiD - in order to build a smart link between patient databases and clinicians. It utilizes neural network-based machine learning techniques and can produce decision support which meets the special needs of clinicians. From example cases it can learn clinically relevant transformations from original numeric values to logical values. By using data transformation together with a single layer perceptron it is possible to build nonlinear models from a set of preclassified example cases.In this paper, we use two small datasets to show how this scheme works in the diagnosis of acute appendicitis and in the diagnosis of myocardial infarction. Results are compared with those obtained using logistic regression or backpropagation neural networks. The performance of our neuro-fuzzy tool seemed to be slightly better in these two materials but the differences did not reach statistical significance.
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| 24. |
- Franck, Niclas, et al.
(författare)
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Identification of adipocyte genes regulated by caloric intake
- 2011
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : Endocrine society. - 0021-972X .- 1945-7197. ; 96:2, s. E413-E418
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Changes in energy intake have marked and rapid effects on metabolic functions and some of the effects may be due to changes in adipose tissue gene expression that precede alterations in body weight. OBJECTIVE: To identify genes in adipose tissue regulated by changes in caloric intake independent of changes in body weight. RESEARCH DESIGN AND METHODS: Obese subjects were given a very-low calorie diet (VLCD; 450 kcal/day) for 16 weeks. After the diet, ordinary food was gradually reintroduced during 2 weeks while there were minimal changes in body weight. Adipose tissue gene expression was measured by microarray analysis. First, genes regulated during caloric restriction and in the opposite direction during the weight stable re-feeding phase were identified. To verify opposite regulation to that observed during caloric restriction, identified genes were further analyzed using adipocyte expression profiles from healthy subjects before and after overfeeding. Results were confirmed using real time PCR or immunoassay. RESULTS: Using a significance level of p<0.05 for all comparisons, 52 genes were downregulated and 50 were up-regulated by caloric restriction and regulated in the opposite direction by re-feeding and overfeeding. Among these were genes that affect lipogenesis (ACLY, ACACA, FASN, SCD), protein synthesis (4EBP1, 4EBP2), beta-oxidation (CPT1B), liberation of fatty acids (CIDEA) and glyceroneogenesis (PCK2). Interestingly, several of these are under control of the master regulator mTOR. CONCLUSIONS: The observed transcriptional changes indicate that mTOR plays a central role in the control of diet-regulated adipocyte genes involved in lipogenesis and protein synthesis.
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| 25. |
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| 26. |
- Granström, Emma, et al.
(författare)
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Digital tools as promoters for person-centered care practices in chronic care? : Healthcare professionals' experiences from rheumatology care
- 2020
-
Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Person-centered care (PCC) emphasize the importance of supporting individuals' involvement in care provided and self-care. PCC has become more important in chronic care as the number of people living with chronic conditions is increasing due to the demographic changes. Digital tools have potential to support interaction between patients and healthcare providers, but empirical examples of how to achieve PCC in chronic care and the role of digital tools in this process is limited. The aim of this study was to investigate strategies to achieve PCC used by the healthcare professionals at an outpatient Rheumatology clinic (RC), the strategies' relation to digital tools, and the perceived impact of the strategies on healthcare professionals and patients.METHODS: A single case study design was used. The qualitative data consisted of 14 semi-structured interviews and staff meeting minutes, covering the time period 2017-2019. The data were analyzed using conventional content analysis, complemented with document analyses.RESULTS: Ten strategies on two levels to operationalize PCC, and three categories of perceived impact were identified. On the individual patient level strategies involved several digital tools focusing on flexible access to care, mutual information sharing and the distribution of initiatives, tasks, and responsibilities from provider to patients. On the unit level, strategies concerned involving patient representatives and individual patients in development of digital services and work practices. The roles of both professionals and patients were affected and the importance of behavioral and cultural change became clear.CONCLUSIONS: By providing an empirical example from chronic care the study contributes to the knowledge on strategies for achieving PCC, how digital tools and work practices interact, and how they can affect healthcare staff, patients and the unit. A conclusion is that the use of the digital tools, spanning over different dimensions of engagement, facilitated the healthcare professionals' interaction with patients and the patients' involvement in their own care. Digital tools complemented, rather than replaced, care practices.
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| 27. |
- Granström, Emma, et al.
(författare)
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Enhancing policy implementation to improve healthcare practices : The role and strategies of hybrid national-local support structures
- 2018
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Ingår i: International Journal of Health Planning and Management. - : John Wiley & Sons. - 0749-6753 .- 1099-1751. ; 33:4, s. E1262-E1278
-
Tidskriftsartikel (refereegranskat)abstract
- Background In this study, we followed a national initiative to enhance the use of quality indicators gathered in national quality registries (NQRs) for improvement of clinical practices in Swedish healthcare, more specifically by investigating the support strategies of regional support centers with national and local missions. The aim was to increase knowledge on the role, challenges, and strategies of support structures with mixed and complex missions in the healthcare system. Methods Documents and 25 semistructured interviews with staff at 6 regional support centers, ie, quality registry centers, formed this multiple case study. Data were analyzed using conventional content analysis. Results The centers' strategies varied from developing the NQRs to become more suitable for improvement to supporting healthcare's use of NQRs, from the use of task to process-oriented support strategies, and from taking on national responsibilities to responding to local initiatives. All quality registry centers engaged in initiatives inspired by the Breakthrough Series approach. Some used preexisting change concepts or collaborated with local development units. A main challenge was to overcome a lack of formal mandate to act in the healthcare organizations they served. Conclusions Support functions with mixed and complex missions have to use a variation of strategies to reach relevant actors and achieve changes. This study provides valuable input for policy and decision-makers on the support strategies used and challenges of support functions with complex missions situated in-between national and local levels of the healthcare system, here denoted hybrid national-local support structures.
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| 28. |
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| 29. |
- Guldbrand, Hans, et al.
(författare)
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In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss
- 2012
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Ingår i: Diabetologia. - : Springer. - 0012-186X .- 1432-0428. ; 55:8, s. 2118-2127
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: The study aimed to compare the effects of a 2 year intervention with a low-fat diet (LFD) or a low-carbohydrate diet (LCD), based on four group meetings to achieve compliance. METHODS: This was a prospective randomised parallel trial involving 61 adults with type 2 diabetes consecutively recruited in primary care and randomised by drawing ballots. Patients that did not speak Swedish could not be recruited. The primary outcomes in this non-blinded study were weight and HbA(1c). Patients on the LFD aimed for 55-60 energy per cent (E%) and those on LCD for 20 E% from carbohydrate. RESULTS: The mean BMI and HbA(1c) of the participants were 32.7 ± 5.4 kg/m(2) and 57.0 ± 9.2 mmol/mol, respectively. No patients were lost to follow-up. Weight loss did not differ between groups and was maximal at 6 months: LFD -3.99 ± 4.1 kg (n = 31); LCD -4.31 ± 3.6 kg (n = 30); p < 0.001 within groups. At 24 months, patients on the LFD had lost -2.97 ± 4.9 kg and those on LCD -2.34 ± 5.1 kg compared with baseline (p = 0.002 and p = 0.020 within groups, respectively). HbA(1c) fell in the LCD group only (LCD at 6 months -4.8 ± 8.3 mmol/mol, p = 0.004, at 12 months -2.2 ± 7.7 mmol/mol, p = 0.12; LFD at 6 months -0.9 ± 8.8 mmol/mol, p = 0.56). At 6 months, HDL-cholesterol had increased with the LCD (from 1.13 ± 0.33 mmol/l to 1.25 ± 0.47 mmol/l, p = 0.018) while LDL-cholesterol did not differ between groups. Insulin doses were reduced in the LCD group (0 months, LCD 42 ± 65 E, LFD 39 ± 51 E; 6 months, LCD 30 ± 47 E, LFD 38 ± 48 E; p = 0.046 for between-group change). CONCLUSIONS/INTERPRETATION: Weight changes did not differ between the diet groups, while insulin doses were reduced significantly more with the LCD at 6 months, when compliance was good. Thus, aiming for 20% of energy intake from carbohydrates is safe with respect to cardiovascular risk compared with the traditional LFD and this approach could constitute a treatment alternative. TRIAL REGISTRATION: ClinicalTrials.gov NCT01005498 FUNDING: University Hospital of Linköping Research Funds, Linköping University, the County Council of Östergötland, and the Diabetes Research Centre of Linköping University.
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| 30. |
- Hansen, Ewa, 1973-
(författare)
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Centralized Routing for Prolonged Network Lifetime in Wireless Sensor Networks
- 2008
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this thesis centralized routing methods for wireless sensor networks have been studied. The aim has been to prolong network lifetime by reducing the energy consumed by sensor-node communication.Wireless sensor networks are rapidly becoming common in application areas where information from many sensors is to be collected and acted upon. The use of wireless sensor networks adds flexibility to the network, and the cost of cabling can be avoided.Wireless sensor networks may consist of several hundreds of small devices, equipped with sensors (e.g. acoustic, seismic or image) that form a wireless network. Each sensor node collects information from its surroundings and sends it to a base station, either from sensor node to sensor node, or directly to the base station.We have made simulations that show that asymmetric communication with multihop extends the lifetime of large wireless sensor networks. We have also investigated the usefulness of enforcing a minimum separation distance between cluster heads in a cluster based wireless sensor network. The results show that our sensor network performs up to 150% better when introducing a minimum separation distance between cluster heads. The simulations also show that the minimum separation distance resulting in the lowest energy consumption in our network varies with the number of clusters. We have also made an initial study of maximum lifetime routing in sparse wireless sensor networks to be able to see how different heuristic routing algorithms influence the energy consumption of individual sensor nodes, and thus the lifetime of a sparse sensor network. We have also compared the maximum lifetime of the heuristic algorithms to the maximum lifetime of an optimal routing solution. These simulations showed that for some types of applications the choice of heuristic algorithm is more important to prolong network lifetime, than for other types of applications.
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| 31. |
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| 32. |
- Hoffman, Tove, et al.
(författare)
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Alkhurma Hemorrhagic Fever Virus RNA in Hyalomma rufipes Ticks Infesting Migratory Birds, Europe and Asia Minor
- 2018
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Ingår i: Emerging Infectious Diseases. - Atlanta, United States : U.S. Department of Health and Human Services * Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 24:5, s. 879-882
-
Tidskriftsartikel (refereegranskat)abstract
- Alkhurma hemorrhagic fever virus RNA was detected in immature Hyalomma rufipes ticks infesting northward migratory birds caught in the North Mediterranean Basin. This finding suggests a role for birds in the ecology of the Alkhurma hemorrhagic fever virus and a potential mechanism for dissemination to novel regions. Increased surveillance is warranted.
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| 33. |
- Holmberg, Mats, 1958, et al.
(författare)
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A Longitudinal Study of Medial Temporal Lobe Volumes in Graves Disease
- 2022
-
Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 107:4, s. 1040-1052
-
Tidskriftsartikel (refereegranskat)abstract
- Context: Neuropsychiatric symptoms are common features of Graves disease (GD) in hyperthyroidism and after treatment. The mechanism behind these symptoms is unknown, but reduced hippocampal volumes have been observed in association with increased thyroid hormone levels. Objective: This work aimed at investigating GD influence on regional medial temporal lobe (MTL) volumes. Methods: Sixty-two women with newly diagnosed GD underwent assessment including magnetic resonance (MR) imaging in hyperthyroidism and 48 of them were followed up after a mean of 16.4±4.2 SD months of treatment. Matched thyroid-healthy controls were also assessed twice at a 15-month interval. MR images were automatically segmented using multiatlas propagation with enhanced registration. Regional medial temporal lobe (MTL) volumes for amygdalae and hippocampi were compared with clinical data and data from symptom questionnaires and neuropsychological tests. Results: Patients had smaller MTL regions than controls at inclusion. At follow-up, all 4 MTL regions had increased volumes and only the volume of the left amygdala remained reduced compared to controls. There were significant correlations between the level of thyrotropin receptor antibodies (TRAb) and MTL volumes at inclusion and also between the longitudinal difference in the levels of free 3,5,3′-triiodothyronine and TRAb and the difference in MTL volumes. There were no significant correlations between symptoms or test scores and any of the 4 MTL volumes. Conclusion: Dynamic alterations in the amygdalae and hippocampi in GD reflect a previously unknown level of brain involvement both in the hyperthyroid state of the condition and after treatment. The clinical significance, as well as the mechanisms behind these novel findings, warrant further study of the neurological consequences of GD.
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| 34. |
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| 35. |
- Holmberg, Mats, 1958, et al.
(författare)
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Structural brain changes in hyperthyroid Graves' disease: protocol for an ongoing longitudinal, case-controlled study in Göteborg, Sweden-the CogThy project.
- 2019
-
Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 9:11
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive impairment and reduced well-being are common manifestations of Graves' disease (GD). These symptoms are not only prevalent during the active phase of the disease but also often prevail for a long time after hyperthyroidism is considered cured. The pathogenic mechanisms involved in these brain-derived symptoms are currently unknown. The overall aim of the CogThy study is to identify the mechanism behind cognitive impairment to be able to recognise GD patients at risk.The study is a longitudinal, single-centre, case-controlled study conducted in Göteborg, Sweden on premenopausal women with newly diagnosed GD. The subjects are examined: at referral, at inclusion and then every 3.25 months until 15 months. Examinations include: laboratory measurements; eye evaluation; neuropsychiatric and neuropsychological testing; structural MRI of the whole brain, orbits and medial temporal lobe structures; functional near-infrared spectroscopy of the cerebral prefrontal cortex and self-assessed quality of life questionnaires. The primary outcome measure is the change in medial temporal lobe structure volume. Secondary outcome measures include neuropsychological, neuropsychiatric, hormonal and autoantibody variables. The study opened for inclusion in September 2012 and close for inclusion in October 2019. It will provide novel information on the effect of GD on medial temporal lobe structures and cerebral cortex functionality as well as whether these changes are associated with cognitive and affective impairment, hormonal levels and/or autoantibody levels. It should lead to a broader understanding of the underlying pathogenesis and future treatment perspectives.The study has been reviewed and approved by the Regional Ethical Review Board in Göteborg, Sweden. The results will be actively disseminated through peer-reviewed journals, national and international conference presentations and among patient organisations after an appropriate embargo time.44321 at the public project database for research and development in Västra Götaland County, Sweden (https://www.researchweb.org/is/vgr/project/44321).
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| 36. |
- Holmström, Mats, et al.
(författare)
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Allergisk rinit hos barn och vuxna : Råd vid behandling anpassade till svenska förhållanden med avstamp i de senaste internationella riktlinjerna [Allergic rhinitis in children and adults - international recommendations adapted to the clinical situation in Sweden]
- 2023
-
Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 120
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Forskningsöversikt (refereegranskat)abstract
- Allergic rhinitis is the most common chronic disease in Sweden, with impact on quality of life and with a heavy economic burden for the society. More than 20 years have passed since national recommendations were launched, and meanwhile both ARIA (Allergic rhinitis and its impact of asthma) and EUFOREA (The European Forum for Research and Education in Allergy and Airway Diseases) have presented international guidelines which in this article have been adapted to the clinical situation in Sweden. Visual analogue scale (VAS) is recommended for symptom evaluation, and the importance of correct allergen analysis and examination for coexisting asthma is emphasized. Treatment is recommended according to EUFOREA. Follow-up is important, and if VAS is =5 the disease is regarded as uncontrolled and must lead to a change of treatment. Since self-treatment is common in allergic rhinitis the importance of patient cooperation and information is underlined.
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| 37. |
- Höglund, Lars, et al.
(författare)
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Från Högskolan i Borås till Humboldt, volym 1
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under våren 2010 genomfördes en serie om fyra seminarier med namnet ”Från Högskolan i Borås till Humboldt: Perspektiv på universitetsidén under 200 år”. Det primära syftet var att diskutera den svenska högskolans roller i en tid präglad av stora förväntningar och motsägelsefulla krav på akademin. Denna rapport utgör en dokumentation av seminarieseriens innehåll. Professor Sven-Eric Liedman skriver med samtidskritisk udd om universitetens historia; professor Mats Benner beskriver och analyserar fyra historiska idealtyper av universitet samt belyser det förändringstryck som högskolesektorn verkar under; professor Kerstin Sahlin riktar intresset mot hur universitet skiljer sig från andra organisationer och ger sin bild av hur detta faktum bör återspegla sig i besluts- och ledningsstrukturer. Seminarieserien och rapporten är ett led i Högskolan i Borås kontinuerligt pågående självreflektion och arbete med frågor som rör professionslärosätets identitet och profil. I rapportens senare del presenteras sex korta reflektioner om och/eller seminarieseriens teman utifrån Högskolan i Borås horisont. Reflektionerna är skrivna av professorer från alla högskolans sex institutioner.
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| 38. |
- Ingves, Simon, et al.
(författare)
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A randomized cross-over study of the effects of macronutrient composition and meal frequency on GLP-1, ghrelin and energy expenditure in humans
- 2017
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Ingår i: Peptides. - : ELSEVIER SCIENCE INC. - 0196-9781 .- 1873-5169. ; 93, s. 20-26
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Little is known about human postprandial increase of energy expenditure and satiety-associated hormones in relation to both meal frequency and macronutrient composition. Design: Randomized cross-over study with four conditions for each participant. Methods: Seven men and seven women (mean age 23 +/- 1.5 years) were randomly assigned to the order of intake of a 750 kcal drink with the same protein content while having either 20 energy-percent (E%) or 55 E% from carbohydrates and the remaining energy from fat. Participants were also randomized to consume the drinks as one large beverage or as five 150 kcal portions every 30 min, starting in the fasting state in the morning. Energy expenditure (EE) was determined every 30 min by indirect calorimetry. Hormonal responses and suppression of hunger (by visual-analogue scales) were also studied. A p amp;lt; 0.013 was considered statistically significant following Bonferroni-correction. Results: The area under the curve (AUC) for EE was higher during the 2.5 h after the high-carbohydrate drinks (p = 0.005 by Wilcoxon) and also after ingesting one drink compared with five (p = 0.004). AUC for serum active GLP-1 was higher after single drinks compared with five beverages (p = 0.002). Although GLP-1 levels remained particularly high at the end of the test during the low-carbohydrate meals, the AUC did not differ compared with the high-carbohydrate occasions (low-carbohydrate: 58.9 +/- 18 pg/ml/h, high-carbohydrate: 45.2 +/- 16 pg/ml/h, p = 0.028). Hunger sensations were suppressed more after single beverages compared with five small drinks (p = 0.009). Conclusions: We found higher EE during 2.5 h following one large drink compared with five smaller beverages. Since hunger was also suppressed more efficiently, and serum GLP-1 levels were higher after one compared with five smaller drinks, our findings do not support nibbling to avoid hunger or to keep up EE from morning to noon.
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| 39. |
- Jennersjö, Pär, et al.
(författare)
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A prospective observational study of all-cause mortality in relation to serum 25-OH vitamin D-3 and parathyroid hormone levels in patients with type 2 diabetes
- 2015
-
Ingår i: Diabetology & Metabolic Syndrome. - : BioMed Central. - 1758-5996. ; 7:53
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Low levels of vitamin D have been related to increased mortality and morbidity in several non-diabetic studies. We aimed to prospectively study relationships between serum 25-OH vitamin D-3 (vitamin D) and of serum parathyroid hormone (PTH) to total mortality in type 2 diabetes. We also aimed to compare the levels of these potential risk-factors in patients with and without diabetes. Methods: The main study design was prospective and observational. We used baseline data from 472 men and 245 women who participated in the "Cardiovascular Risk factors in Patients with Diabetes-a Prospective study in Primary care" study. Patients were 55-66 years old at recruitment, and an age-matched non-diabetic sample of 129 individuals constituted controls for the baseline data. Carotid-femoral pulse-wave velocity (PWV) was measured with applanation-tonometry and carotid intima-media thickness (IMT) with ultrasound. Patients with diabetes were followed for all-cause mortality using the national Swedish Cause of Death Registry. Results: Levels of vitamin D were lower in patients with diabetes than in controls, also after correction for age and obesity, while PTH levels did not differ. Nine women and 24 men died during 6 years of median follow up of the final cohort (n = 698). Vitamin D levels were negatively related to all-cause mortality in men independently of age, PTH, HbA1c, waist circumference, 24-h systolic ambulatory-blood pressure (ABP) and serum-apoB (p = 0.049). This finding was also statistically significant when PWV and IMT were added to the analyses (p = 0.028) and was not affected statistically when medications were also included in the regression-analysis (p = 0.01). In the women with type 2 diabetes, levels of PTH were positively related with all-cause mortality in the corresponding calculations (p = 0.016 without PWV and IMT, p = 0.006 with PWV and IMT, p = 0.045 when also adding medications to the analysis), while levels of vitamin D was without statistical significance (p greater than 0.9). Conclusions: Serum vitamin D in men and serum PTH in women give prognostic information in terms of total-mortality that are independent of regular risk factors in addition to levels of ABP, IMT and PWV.
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| 40. |
- Jensen, Karen Schow, et al.
(författare)
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Temporal changes in incidence of relapse and outcome after relapse of childhood acute lymphoblastic leukemia over three decades : a Nordic population-based cohort study
- 2022
-
Ingår i: Leukemia. - : Springer Nature. - 0887-6924 .- 1476-5551. ; 36, s. 1274-1282
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Tidskriftsartikel (refereegranskat)abstract
- Relapse remains the main obstacle to curing childhood acute lymphoblastic leukemia (ALL). The aims of this study were to compare incidence of relapse, prognostic factors, and survival after relapse between three consecutive Nordic Society of Pediatric Hematology and Oncology trials. Relapse occurred as a primary event in 638 of 4 458 children (1.0–14.9 years) diagnosed with Ph-negative ALL between 1992 and 2018. The 5-year cumulative incidence of relapse was 17.3% (95% CI 15.4–19.2%) and 16.5% (95% CI 14.3–18.8%) for patients in the ALL1992 and ALL2000 trials, respectively, but decreased to 8.4% (95% CI 7.0–10.1%) for patients in the ALL2008 trial. No changes in duration of first complete remission and site of relapse were observed over time; however, high hyperdiploidy, and t(12;21) decreased in the ALL2008 trial. The 4-year overall survival after relapse was 56.6% (95% CI 52.5–60.5%) and no statistically significant temporal improvements were observed. Age ≥10 years, T-cell immunophenotype, bone-marrow involvement, early and very early relapse, hypodiploidy, and Down syndrome all independently predicted worse outcome after relapse. Improvements in the primary treatment of childhood ALL has resulted in fewer relapses. However, failure to improve outcome of remaining relapses suggests a selection of harder-to-cure relapses and calls for new therapeutic strategies.
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| 41. |
- Johansson, Birgitta, 1957, et al.
(författare)
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The relationship between mental fatigue, depression, and cognition in Graves' disease.
- 2023
-
Ingår i: European thyroid journal. - 2235-0640 .- 2235-0802. ; 12:4
-
Tidskriftsartikel (refereegranskat)abstract
- Mental fatigue, depression, anxiety, and cognitive complaints are common in Graves' disease (GD). Our aims were to assess the relationship between these variables in patients with GD during both hyperthyroidism and a long stable euthyroidism.A prospective longitudinal case-control study where 65 premenopausal women diagnosed with GD and 65 matched controls were assessed twice with 15 months in between. The first visit for patients was in overt hyperthyroidism and the second after treatment.During the hyperthyroid phase, mental fatigue, depression, and anxiety were significantly increased for GD patients compared to controls (all P < 0.001). Among GD patients, 89% reported mental fatigue and among controls 14%. No difference in cognitive tests was found. After 15 months, significant improvements for GD patients after treatment were found for the items of mental fatigue, depression, and anxiety (all P < 0.001), but these were unchanged in controls. GD patients reported residual mental fatigue (38%), 23% without depression, and 15% mental fatigue combined with depression. Self-reported cognitive complaints were pronounced while cognitive tests did not reveal any deficiencies.Mental fatigue and emotional distress are common in the hyperthyroid phase. These improve with treatment but are still more common in GD patients after 15 months of therapy than in controls. The residual mental fatigue is shown to be a phenomenon distinct from depression in this study. This indicates the importance of assessing mental fatigue in GD patients and underlines the need for rehabilitation and healthcare support as fatigue will have consequences for work ability.
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| 42. |
- Johnson, Tomas, 1979, et al.
(författare)
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A Multi-Scale Simulation Method for the Prediction of Edge Wicking in Multi-Ply Paperboard
- 2015
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Ingår i: Nordic Pulp and Paper Research Journal. - 2000-0669 .- 0283-2631. ; 30:4, s. 640-650
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Tidskriftsartikel (refereegranskat)abstract
- When liquid packaging board is made aseptic in the filling machine the unsealed edges of the board are exposed to a mixture of water and hydrogen peroxide. A high level of liquid penetration may lead to aesthetic as well as functional defects. To be able to make a priori predictions of the edge wicking properties of a certain paperboard material is therefore of great interest to the paper industry as well as to packaging manufacturers. In this paper an extended multi-scale model of edge wicking in multi-ply paperboard is presented. The geometric and physical properties of the paperboard are modeled on the micro-scale, and include fillers and fines. The absolute air permeabilities and pore size distributions are validated with experimental and tomographic values. On the macro-scale random porosity and sizing distributions, time and sizing dependent contact angles, and inter-ply dependence are modeled. Arbitrary shapes of the paperboard are handled through an unstructured 3D surface mesh. Stationary and transient edge wicking simulations are validated against experiments with excellent agreement. The simulations show that the diffusive menisci between the liquid and air phases together with the two-ply model is necessary to achieve good agreement with the transient edge wicking experiments.
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| 43. |
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| 44. |
- Keindl, Magdalena, et al.
(författare)
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Increased Plasma Soluble Interleukin-2 Receptor Alpha Levels in Patients With Long-Term Type 1 Diabetes With Vascular Complications Associated With IL2RA and PTPN2 Gene Polymorphisms
- 2020
-
Ingår i: Frontiers in Endocrinology. - : Frontiers Media S.A.. - 1664-2392. ; 11
-
Tidskriftsartikel (refereegranskat)abstract
- Type 1 diabetes (T1D) is largely considered an autoimmune disease leading to the destruction of insulin-producing pancreatic beta cells. Further, patients with T1D have 3-4-fold increased risk of developing micro- and macrovascular complications. However, the contribution of immune-related factors contributing to these diabetes complications are poorly understood. Individuals with long-term T1D who do not progress to vascular complications offer a great potential to evaluate end-organ protection. The aim of the present study was to investigate the association of inflammatory protein levels with vascular complications (retinopathy, nephropathy, cardiovascular disease) in individuals with long-term T1D compared to individuals who rapidly progressed to complications. We studied a panel of inflammatory markers in plasma of patients with long-term T1D with (n = 81 and 26) and without (n = 313 and 25) vascular complications from two cross-sectional Scandinavian cohorts (PROLONG and DIALONG) using Luminex technology. A subset of PROLONG individuals (n = 61) was screened for circulating immune cells using multicolor flow cytometry. We found that elevated plasma levels of soluble interleukin-2 receptor alpha (sIL-2R) were positively associated with the complication phenotype. Risk carriers of polymorphisms in the IL2RA and PTPN2 gene region had elevated plasma levels of sIL-2R. In addition, cell surface marker analysis revealed a shift from naive to effector T cells in T1D individuals with vascular complications as compared to those without. In contrast, no difference between the groups was observed either in IL-2R cell surface expression or in regulatory T cell population size. In conclusion, our data indicates that IL2RA and PTPN2 gene variants might increase the risk of developing vascular complications in people with T1D, by affecting sIL-2R plasma levels and potentially lowering T cell responsiveness. Thus, elevated sIL-2R plasma levels may serve as a biomarker in monitoring the risk for developing diabetic complications and thereby improve patient care.
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| 45. |
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| 46. |
- Khamisi, Selwan, et al.
(författare)
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Fracture Incidence in Graves' Disease: A Population-Based Study.
- 2023
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Ingår i: Thyroid : official journal of the American Thyroid Association. - : Mary Ann Liebert. - 1557-9077 .- 1050-7256. ; 33:11, s. 1349-1357
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Tidskriftsartikel (refereegranskat)abstract
- Background: Population-based studies have indicated an increase in bone turnover in hyperthyroidism with a subsequent decrease in bone mineral density and an increased risk of fractures, especially in postmenopausal women. However, heterogeneity between studies prevents a definitive conclusion. Graves' disease (GD) is an autoimmune disease, and it is the most common cause of hyperthyroidism. The aim of this study was to investigate fracture risk in patients with GD. Methods: A total of 2134 patients with incident GD and 21,261 age, sex- and county-matched controls were included 16-18 years after diagnosis in a retrospective cohort study. Drug and patient national registries in Sweden were used to assess the risk of developing skeletal complications. Up to 10 years of age, sex- and county-matched controls per patient were selected from databases from the National Board of Health and Welfare and Statistics Sweden. Cox proportional hazards models were fitted to estimate hazard ratios (HR) and confidence intervals [CI]. Results: There were no significant differences in fracture rates between GD and controls but after adjustment for comorbidities, the data showed higher vertebral fracture rates in male GD patients aged >52 years compared to male controls, HR=2.83 [CI 1.05-7.64]. The rates of osteoporosis treatments as well as treatment with corticosteroids were higher in patients with GD. However, HR for the association between GD and fractures remained largely unchanged after adjustment for osteoporosis treatments and treatments with corticosteroids. Conclusions: There were no significant differences in total fracture rate between GD and the general population. However, men older than 52 years had a higher vertebral fracture rate. This study also shows that patients with treated GD receive more osteoporosis treatments compared to the general population.
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| 47. |
- Kotta, Jonne, et al.
(författare)
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Cleaning up seas using blue growth initiatives: Mussel farming for eutrophication control in the Baltic Sea
- 2020
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 709
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Authors Eutrophication is a serious threat to aquatic ecosystems globally with pronounced negative effects in the Baltic and other semi-enclosed estuaries and regional seas, where algal growth associated with excess nutrients causes widespread oxygen free “dead zones” and other threats to sustainability. Decades of policy initiatives to reduce external (land-based and atmospheric) nutrient loads have so far failed to control Baltic Sea eutrophication, which is compounded by significant internal release of legacy phosphorus (P) and biological nitrogen (N) fixation. Farming and harvesting of the native mussel species (Mytilus edulis/trossulus) is a promising internal measure for eutrophication control in the brackish Baltic Sea. Mussels from the more saline outer Baltic had higher N and P content than those from either the inner or central Baltic. Despite their relatively low nutrient content, harvesting farmed mussels from the central Baltic can be a cost-effective complement to land-based measures needed to reach eutrophication status targets and is an important contributor to circularity. Cost effectiveness of nutrient removal is more dependent on farm type than mussel nutrient content, suggesting the need for additional development of farm technology. Furthermore, current regulations are not sufficiently conducive to implementation of internal measures, and may constitute a bottleneck for reaching eutrophication status targets in the Baltic Sea and elsewhere.
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- Krali, Olga, et al.
(författare)
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Multimodal classification of molecular subtypes in pediatric acute lymphoblastic leukemia
- 2023
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Ingår i: npj Precision Oncology. - : Springer Nature. - 2397-768X. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Genomic analyses have redefined the molecular subgrouping of pediatric acute lymphoblastic leukemia (ALL). Molecular subgroups guide risk-stratification and targeted therapies, but outcomes of recently identified subtypes are often unclear, owing to limited cases with comprehensive profiling and cross-protocol studies. We developed a machine learning tool (ALLIUM) for the molecular subclassification of ALL in retrospective cohorts as well as for up-front diagnostics. ALLIUM uses DNA methylation and gene expression data from 1131 Nordic ALL patients to predict 17 ALL subtypes with high accuracy. ALLIUM was used to revise and verify the molecular subtype of 281 B-cell precursor ALL (BCP-ALL) cases with previously undefined molecular phenotype, resulting in a single revised subtype for 81.5% of these cases. Our study shows the power of combining DNA methylation and gene expression data for resolving ALL subtypes and provides a comprehensive population-based retrospective cohort study of molecular subtype frequencies in the Nordic countries.
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