| 1. |
- Tesi, Bianca, et al.
(författare)
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Diagnostic yield and clinical impact of germline sequencing in children with CNS and extracranial solid tumors : a nationwide, prospective Swedish study
- 2024
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChildhood cancer predisposition (ChiCaP) syndromes are increasingly recognized as contributing factors to childhood cancer development. Yet, due to variable availability of germline testing, many children with ChiCaP might go undetected today. We report results from the nationwide and prospective ChiCaP study that investigated diagnostic yield and clinical impact of integrating germline whole-genome sequencing (gWGS) with tumor sequencing and systematic phenotyping in children with solid tumors.MethodsgWGS was performed in 309 children at diagnosis of CNS (n = 123, 40%) or extracranial (n = 186, 60%) solid tumors and analyzed for disease-causing variants in 189 known cancer predisposing genes. Tumor sequencing data were available for 74% (227/309) of patients. In addition, a standardized clinical assessment for underlying predisposition was performed in 95% (293/309) of patients.FindingsThe prevalence of ChiCaP diagnoses was 11% (35/309), of which 69% (24/35) were unknown at inclusion (diagnostic yield 8%, 24/298). A second-hit and/or relevant mutational signature was observed in 19/21 (90%) tumors with informative data. ChiCaP diagnoses were more prevalent among patients with retinoblastomas (50%, 6/12) and high-grade astrocytomas (37%, 6/16), and in those with non-cancer related features (23%, 20/88), and ≥2 positive ChiCaP criteria (28%, 22/79). ChiCaP diagnoses were autosomal dominant in 80% (28/35) of patients, yet confirmed de novo in 64% (18/28). The 35 ChiCaP findings resulted in tailored surveillance (86%, 30/35) and treatment recommendations (31%, 11/35).InterpretationOverall, our results demonstrate that systematic phenotyping, combined with genomics-based diagnostics of ChiCaP in children with solid tumors is feasible in large-scale clinical practice and critically guides personalized care in a sizable proportion of patients.
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| 2. |
- Tesi, Bianca, et al.
(författare)
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Diagnostic yield and clinical impact of germline sequencing in children with CNS and extracranial solid tumors : a nationwide, prospective Swedish study
- 2024
-
Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 39
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer predisposition (ChiCaP) syndromes are increasingly recognized as contributing factors to childhood cancer development. Yet, due to variable availability of germline testing, many children with ChiCaP might go undetected today. We report results from the nationwide and prospective ChiCaP study that investigated diagnostic yield and clinical impact of integrating germline whole-genome sequencing (gWGS) with tumor sequencing and systematic phenotyping in children with solid tumors.Methods: gWGS was performed in 309 children at diagnosis of CNS (n = 123, 40%) or extracranial (n = 186, 60%) solid tumors and analyzed for disease-causing variants in 189 known cancer predisposing genes. Tumor sequencing data were available for 74% (227/309) of patients. In addition, a standardized clinical assessment for underlying predisposition was performed in 95% (293/309) of patients.Findings: The prevalence of ChiCaP diagnoses was 11% (35/309), of which 69% (24/35) were unknown at inclusion (diagnostic yield 8%, 24/298). A second-hit and/or relevant mutational signature was observed in 19/21 (90%) tumors with informative data. ChiCaP diagnoses were more prevalent among patients with retinoblastomas (50%, 6/12) and high-grade astrocytomas (37%, 6/16), and in those with non-cancer related features (23%, 20/88), and ≥2 positive ChiCaP criteria (28%, 22/79). ChiCaP diagnoses were autosomal dominant in 80% (28/35) of patients, yet confirmed de novo in 64% (18/28). The 35 ChiCaP findings resulted in tailored surveillance (86%, 30/35) and treatment recommendations (31%, 11/35).Interpretation: Overall, our results demonstrate that systematic phenotyping, combined with genomics-based diagnostics of ChiCaP in children with solid tumors is feasible in large-scale clinical practice and critically guides personalized care in a sizable proportion of patients.Funding: The study was supported by the Swedish Childhood Cancer Fund and the Ministry of Health and Social Affairs.
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| 3. |
- Beery, Thomas, et al.
(författare)
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Perceptions of the ecosystem services concept: Opportunities and challenges in the Swedish municipal context
- 2016
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Ingår i: Ecosystem Services. - : Elsevier BV. - 2212-0416. ; 17, s. 123-130
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Tidskriftsartikel (refereegranskat)abstract
- A current focus of ecosystem services (ES) implementation is on the municipal level of government where international and national legislation and policies have to be translated into practice. Given this focus, an understanding of perceptions within municipalities of the ES concept is crucial to support the implementation process. Against this background, this paper examines the perceptions of Swedish municipal stakeholders for the ES concept. A 2013 Swedish federal mandate that states that the values of ecosystem services should be considered in relevant decision-making processes, provides a timely context. Current perceptions, preconditions and awareness are explored via interviews and analyses. The results show that the views on the ecosystem services concept and its usefulness are generally very positive. Conceptual knowledge use is perceived as important as is the recognition of monetary valuation of ES. However, clarification of the distinction between implicit and explicit use of the concept by stakeholders is needed. Finally, results indicate that a deeper understanding of monetary valuation of ecosystem services by municipal staff members is connected with a more critical view on monetary valuation. It is concluded that detailed and clear definitions and guidelines are needed in order to support the process of implementing ES in municipalities.
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| 4. |
- Dahlgren, David, et al.
(författare)
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Ulcerative colitis progression : a retrospective analysis of disease burden using electronic medical records
- 2022
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Ingår i: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ulcerative colitis (UC) is a debilitating inflammatory bowel disease. Present knowledge regarding UC disease progression over time is limited.Objective: To assess UC progression to severe disease along with disease burden and associated factors.Methods: Electronic medical records linked with Swedish national health registries (2005-2015) were used to identify disease progression of UC. Odds of all-cause and disease-related hospitalization within 1 year were compared between patients with disease progression and those without. Annual indirect costs were calculated based on sick leave, and factors related to UC progression were examined.Results: Of the 1,361 patients with moderate UC, 24% progressed to severe disease during a median of 5.2 years. Severe UC had significantly higher odds for all-cause (OR [odds ratio] 1.47, 95% CI [confidence interval]: 1.12-1.94, P < 0.01) and UC-related hospitalization (OR 2.47, 95% CI: 1.76-3.47, P < 0.0001) compared to moderate disease. Average sick leave was higher in patients who progressed compared to those who did not (64.4 vs 38.6 days, P < 0.001), with higher indirect costs of 151,800 SEK (16,415 ) pound compared with 92,839 SEK (10,039 ) pound (P < 0.001), respectively. UC progression was related to young age (OR 1.62, 95% CI: 1.17-2.25, P < 0.01), long disease duration (OR 1.09, 95% CI: 1.03-1.15, P < 0.001), and use of corticosteroids (OR 2.49, 95% CI: 1.67-3.72, P < 0.001).Conclusion: Disease progression from moderate to severe UC is associated with more frequent and longer hospitalizations and sick leave. Patients at young age with long disease duration and more frequent gluco-corticosteroid medication are associated with progression to severe UC.
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| 5. |
- Ekelund, Nils, et al.
(författare)
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Trends in municipal and comprehensive planning (1980-2012) from an Ecosystem Services Perspective in Southern Sweden
- 2015
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Ingår i: Book abstracts Eight International Ecosystem Services Partnership Conference 2015, Ecosystem Services for Nature, People, and Prosperity, 9-13 November 2015 Stellenbosch, South Africa. ; , s. 103-103
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In Sweden a unique project supported by the Swedish Environmental Protection Agency is developed in close collaboration with seven coastal municipalities in Skåne. These municipalities face a range of different environmental challenges, from municipalities along the eastern coast line to municipalities in the western Öresund region. Research questions and approaches are built on case studies and scenarios to assess local municipality planning processes. The objective is to study the premises of implementing the use of the Ecosystem Service (ES) approach in municipal planning and decision making. This study presents a project component that focuses on the analysis of the comprehensive plans in the city of Malmö from 1980 to 2012. Interviews with staff from municipal departments were done as a complement to the collection of data from the comprehensive plans. The results show current trends in municipal and comprehensive planning from an ES perspective, i.e., the use of ES as a tool for sustainable development. The results further show that the ES concept was explicitly first found in the comprehensive plan from 2012. Implicitly, approaches for ecosystem services management and related planning changed from “land use”, “green areas” and “green space” (1980) towards “recreation” (1990) and “biological life cycle” and “biodiversity” (2000). This change indicates that the process in local municipality planning has shifted towards a more holistic view of the importance of ecosystems for a sustainable society and healthy life, which is currently further advanced via the ES concept.
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| 6. |
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| 7. |
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| 8. |
- Jönsson, K. Ingemar, 1959-, et al.
(författare)
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Implementering av ekosystemtjänst-begreppet i kommunal verksamhet : slutrapport
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet ECOSIMP handlar om förutsättningen för att implementera begreppet ekosystemtjänst, i fortsättningen kallat EST-begreppet, i kommunerna, och undersöker bland annat hur kommunala tjänstemän och politiker ser på denna utmaning. En intervjustudie genomfördes med tjänstemän och politikeri de sju medverkande kommunerna. I en studie av Malmö stad undersöktes hur ekosystemtjänst-relaterade begrepp har integrerats i översiktsplaner ochutvecklats till ett verktyg i hållbar samhällsplanering. Ett annat delprojekt handlar om miljökonsekvens-bedömningar (MKB) och behovet av metodutveckling för att integrera ekosystemtjänstansatsen i MKB, där möjligheten att integrera ekosystemtjänster i den så kallade RIAM-metoden analyserades. Projektet innehåller också en analys av arbetet med att integrera ekosystemtjänsteri kommunernas klimatanpassning, så kallad ekosystembaserad klimatanpassning (EbA). Slutligen redovisas en analys av det transdisciplinära arbetssättet inom ECOSIMP-projektet. Resultaten visar att EST-begreppet idag är relativt välkänt i kommunerna och att det finns en övervägande positiv inställning till det och förhoppningar om att det ska skapa större möjlighet till miljöhänsyn. Förståelsen av begreppet behöver dock fördjupas i den kommunala verksamheten och distinktionen mellan implicit och explicit användning av EST-begreppet och den relaterade EST-ansatsen förtydligas. Ett antal hinder och möjligheter för att börja använda begreppet och för att uppnå etappmålet 2018 identifierades också. Bland annat upplevs innebörden av etappmålet 2018 som oklar, och bara en mindre del av de intervjuade i kommunerna ansåg att etappmålet skulle nås. Betydelsen av att politiker och allmänhet får kännedom om, och förståelse för, EST-begreppet betonades också. Malmö framstår som ett bra exempel på hur långsiktigt arbete för en hållbar stadsutveckling kan skapa förutsättningar att integrera ekosystemtjänster i den fysiska planeringen. Analysen av EbA i kommunerna visade att initiativ relaterade till klimatanpassning och ekosystemtjänster oftast inte är samordnade, men de skulle kunna utvecklas i den riktningen genom bättre samordning mellan kommunernas olika enheter och integrering av EbA i den långsiktiga planeringen utifrån kunskap om nutida och framtida klimatrisker. Verktyg för att värdera förändringar i EST till följd av mänsklig exploatering behövs och här föreslås en utveckling av den såkallade RIAM-metoden, som kan erbjuda ett sätt att väga in olika EST i planeringen. Den transdisciplinära analysen visar på värdet av nära samverkan mellan forskning och kommuner kring implementeringen av EST-ansatsen, men också på behovet av politiskt och ekonomiskt stöd för att frigöra tid för kommunerna att delta i sådana projekt.
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| 9. |
- Jönsson, K. Ingemar, et al.
(författare)
-
Implementering av ekosystemtjänstbegreppet i kommunal verksamhet
- 2017
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet ECOSIMP handlar om förutsättningen för att implementera begreppet ekosystemtjänst, i fortsättningen kallat EST-begreppet, i kommunerna, och undersöker bland annat hur kommunala tjänstemän och politiker ser på denna utmaning. En intervjustudie genomfördes med tjänstemän och politiker i de sju medverkande kommunerna. I en studie av Malmö stad undersöktes hur ekosystemtjänst-relaterade begrepp har integrerats i översiktsplaner och utvecklats till ett verktyg i hållbar samhällsplanering. Ett annat delprojekt handlar om miljökonsekvens-bedömningar (MKB) och behovet av metodutveckling för att integrera ekosystemtjänstansatsen i MKB, där möjligheten att integrera ekosystemtjänster i den så kallade RIAM-metoden analyserades. Projektet innehåller också en analys av arbetet med att integrera ekosystemtjänster i kommunernas klimatanpassning, så kallad ekosystembaserad klimatanpassning (EbA). Slutligen redovisas en analys av det transdisciplinära arbetssättet inom ECOSIMP-projektet. Resultaten visar att EST-begreppet idag är relativt välkänt i kommunerna och att det finns en övervägande positiv inställning till det och förhoppningar om att det ska skapa större möjlighet till miljöhänsyn. Förståelsen av begreppet behöver dock fördjupas i den kommunala verksamheten och distinktionen mellan implicit och explicit användning av EST-begreppet och den relaterade EST-ansatsen förtydligas. Ett antal hinder och möjligheter för att börja använda begreppet och för att uppnå etappmålet 2018 identifierades också. Bland annat upplevs innebörden av etappmålet 2018 som oklar, och bara en mindre del av de intervjuade i kommunerna ansåg att etappmålet skulle nås. Betydelsen av att politiker och allmänhet får kännedom om, och förståelse för, EST-begreppet betonades också. Malmö framstår som ett bra exempel på hur långsiktigt arbete för en hållbar stadsutveckling kan skapa förutsättningar att integrera ekosystemtjänster i den fysiska planeringen. Analysen av EbA i kommunerna visade att initiativ relaterade till klimatanpassning och ekosystemtjänster oftast inte är samordnade, men de skulle kunna utvecklas i den riktningen genom bättre samordning mellan kommunernas olika enheter och integrering av EbA i den långsiktiga planeringen utifrån kunskap om nutida och framtida klimatrisker. Verktyg för att värdera förändringar i EST till följd av mänsklig exploatering behövs och här föreslås en utveckling av den så kallade RIAM-metoden, som kan erbjuda ett sätt att väga in olika EST i planeringen. Den transdisciplinära analysen visar på värdet av nära samverkan mellan forskning och kommuner kring implementeringen av EST-ansatsen, men också på behovet av politiskt och ekonomiskt stöd för att frigöra tid för kommunerna att delta i sådana projekt.
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| 10. |
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| 11. |
- Königsson, Fredrik, 1983-, et al.
(författare)
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Characterization and Potential of Dual FuelCombustion in a Modern Diesel Engine
- 2011
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Ingår i: SAE Technical Paper 2011-01-2223. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International.
-
Konferensbidrag (refereegranskat)abstract
- Diesel Dual Fuel, DDF, is a concept which promises the possibility to utilize CNG/biogas in a compression ignition engine maintaining a high compression ratio, made possible by the high knock resistance of methane, and the resulting benefits in thermal efficiency associated with Diesel combustion.A series of tests has been carried out on a single cylinder lab engine, equipped with a modern common rail injection system supplying the diesel fuel and two gas injectors, placed in the intake runners. One feature of port injected Dual Fuel is that full diesel functionality is maintained, which is of great importance when bringing the dual fuel technology to market. The objective of the study was to characterize and investigate the potential for dual fuel combustion utilizing all degrees of freedom available in a modern diesel engine.Increased diesel pilot proved efficient at reducing NOx emissions at low λ. Advanced combustion phasing has the potential to extend the lean limit for operation. Stoichiometric operation using high levels of EGR is identified as a promising field in conjunction with raised inlet temperature.
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| 12. |
- Königsson, Fredrik, 1983-, et al.
(författare)
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Combustion Modes in a Diesel-CNG Dual Fuel Engine
- 2011
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Ingår i: SAE Technical Paper 2011-01-1962, 2011. - 400 Commonwealth Drive, Warrendale, PA, United States : Society of Automotive Engineers of Japan, Inc. ; , s. 2387-2398
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Konferensbidrag (refereegranskat)abstract
- Diesel Dual Fuel, DDF, is a concept where a combination of methane and diesel is used in a compression ignited engine, maintaining the high compression ratio of a diesel engine with the resulting benefits in thermal efficiency.One benefit of having two fuels on board the vehicle is the additional degree of freedom provided by the ratio between the fuels. This additional degree of freedom enables control of combustion phasing for combustion modes such as Homogenous Charge Compression Ignition, HCCI, and Partly Premixed Compression Ignition, PPCI. These unconventional combustion modes have great potential to limit emissions at light load while maintaining the low pumping losses of the base diesel engine.A series of tests has been carried out on a single cylinder lab engine, equipped with a modern common rail injection system supplying the diesel fuel and two gas injectors, placed in the intake runners. Four load points are investigated and three different types of combustion are evaluated.The study confirmed the desirable emission characteristics of HCCI and PPCI combustion and demonstrated the potential to control the combustion phasing by utilizing all degrees of freedom provided by a common rail injection system and two fuels.
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| 13. |
- Königsson, Fredrik, 1983-, et al.
(författare)
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Controlling the Injector Tip Temperature in a DieselDual Fuel Engine
- 2012
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Ingår i: SAE Technical Paper Series. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International. - 0148-7191.
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Konferensbidrag (refereegranskat)abstract
- Diesel Dual Fuel, DDF, is a concept where a combination of methane and diesel is used in a compression ignited engine, maintaining the high compression ratio of a diesel engine with the resulting benefits in thermal efficiency. Attention has recently been drawn to the fact that the tip of the diesel injector may reach intolerable temperatures. The high injector tip temperatures in the DDF engine are caused by the reduction in diesel flow through the injector. For dual fuel operation, as opposed to diesel, high load does not necessarily imply a high flow of diesel through the injector nozzle.This research investigated the factors causing high injector tip temperatures in a DDF engine and the underlying mechanisms which transfer heat to and from the injector tip. Parameter sweeps of each influential parameter were carried out and evaluated. In addition to this, a simple and useful model was constructed based on the heat balance of the injector tip.Decreasing the thermal resistance between the injector tip and the cooling water by inserting a copper sleeve around the injector tip has the potential to greatly reduce the injector tip temperature and effectively remove it as a limiting factor.
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| 14. |
- Martinell, Mats, 1971-, et al.
(författare)
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Characterization of Cellular Immunology in LADA Patients
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Patients with latent autoimmune diabetes mellitus in adults (LADA) have antibodies against the insulin-producing b-cells but at disease onset they are not insulin-dependent. This study presents cellular immunological differences between LADA, type 1, type 2 diabetes and healthy controls.Research Design and Methods: All patients and matched (by age, gender and body mass index) healthy controls were recruited from the County of Uppsala, Sweden. Peripheral blood mononuclear cells were isolated from freshly collected blood to determine proportions of innate, adaptive and regulatory immune cells by using flow cytometry. Results: Included were 14 patients with LADA, 16 with type 1 diabetes, 16 with type 2 diabetes and 13 healthy controls. The proportion of CD11c+CD123- antigen presenting cells (APCs) was lower, whilst proportions of CD11c+CD123+ APCs and Interleukin (IL)-35+ tolerogenic APCs were higher in LADA patients compared to patients with type 1 diabetes. The proportion of CD3-CD56highCD16+ Natural Killer (NK) cells was higher in LADA patients than in both healthy controls and type 2 diabetes patients. IL-35+ Treg cell numbers were similar to those observed in both type 1 diabetes and type 2 diabetes patients, but a lower frequency of IL-35+ regulatory T (Treg) cells was observed in LADA patients than in healthy controls. The proportion of regulatory B (Breg) cells in LADA patients was higher than in healthy controls, type 1 and type 2 diabetes patients and IL-35+ Breg cell numbers were higher than in type 1 diabetes patients. Conclusions: LADA patients present a mixed cellular immunological pattern compared to type 1 and type 2 diabetes patients. Numbers of APCs, IL-35+ tolerogenic APCs and IL-35+ Breg cells in LADA patients are similar to those observed in type 2 diabetes patients, whereas the changes in NK cells are similar to those observed in type 1 diabetes patients.
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| 15. |
- Morén, Staffan, et al.
(författare)
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Speech in Adults Treated for Unilateral Cleft Lip and Palate : Long-Term Follow-Up After One- or Two-Stage Palate Repair
- 2017
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 54:6, s. 639-649
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group.DESIGN: Cross-sectional study with long-term follow-up.PARTICIPANTS/SETTING: All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers.MAIN OUTCOME MEASURE(S): Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings.RESULTS: Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables.CONCLUSIONS: The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.
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| 16. |
- Morén, Staffan, et al.
(författare)
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Speech in Adults Treated for Unilateral Cleft Lip and Palate as Rated by Naïve Listeners, Speech-Language Pathologists and Patients
- 2022
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Ingår i: Journal of Plastic, Reconstructive & Aesthetic Surgery. - : Elsevier. - 1748-6815 .- 1878-0539. ; 75:10
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Tidskriftsartikel (refereegranskat)abstract
- Speech may be affected in patients with cleft lip and palate (CLP). Professional listeners, naïve listeners, and patients may perceive speech differently. The aim of the study was to assess speech among adults treated for unilateral CLP (UCLP) as rated by naïve listeners, speech-language pathologists (SLPs), and self-assessment and to evaluate how well these ratings correlate.All patients with complete UCLP treated at the Uppsala University Hospital, Uppsala, Sweden, in 1960–1987 were invited. A total of 73 of 109 patients (67%) participated, with a mean of 35 years since the initiation of treatment. The noncleft control group consisted of 55 volunteers. All participants answered questionnaires for self-rating of speech, and their speech was audio-recorded digitally. Fourteen naïve listeners and four SLPs rated the speech individually from blinded recordings.There were more speech abnormalities among patients compared to controls according to the ratings of naïve listeners and SLPs. In controls and patients, there were positive correlations between the speech ratings by naïve listeners and SLPs r = 0.44 to 0.71, p < 0.001, Spearman). The patients were less satisfied and rated to have more speech abnormalities than controls (p < 0.001).Although adults treated for UCLP considered their speech as fairly good, they were less satisfied than noncleft controls. The agreement between ratings by naïve listeners and SLPs were good, while the agreement between these ratings and self-assessment varied widely. When assessing speech in adults treated for UCLP, differences in perception of speech abnormalities by professionals, laymen, and patients should be considered.
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| 17. |
- Pettersson, Billie, et al.
(författare)
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Prevalence of lipid abnormalities before and after introduction of lipid modifying therapy among Swedish patients with dyslipidemia (PRIMULA)
- 2010
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Data on the prevalence of dyslipidemia and attainment of goal/normal lipid levels in a Swedish population are scarce. The objective of this study is to estimate the prevalence of dyslipidemia and attainment of goal/normal lipid levels in patients treated with lipid modifying therapy (LMT). Methods: This longitudinal retrospective observational study covers time periods before and after treatment. Data were collected from 1994-2007 electronic patient records in public primary healthcare centers in Uppsala County, Sweden. Patients were included if they had been treated with LMT and had at least one lipid abnormality indicating dyslipidemia and if complete lipid profile data were available. Thresholds levels for lipids were defined as per Swedish guidelines. Results: Among 5,424 patients included, at baseline, the prevalence of dyslipidemia (andgt;= 1 lipid abnormality) was by definition 100%, while this figure was 82% at follow-up. At baseline, 60% had elevated low-density lipoprotein (LDL-C) combined with low high-density lipoprotein (HDL-C) and/or elevated triglycerides (TG s), corresponding figure at follow-up was 36%. Low HDL-C and/or elevated TGs at follow-up remained at 69% for patients with type 2 diabetes mellitus (T2DM), 50% among patients with coronary heart disease (CHD) and 66% among patients with 10 year CHD risk andgt;20%. Of the total sample, 40% attained goal levels of LDL-C and 18% attained goal/normal levels on all three lipid parameters. Conclusions: Focusing therapy on LDL-C reduction allows 40% of patients to achieve LDL-C goal and helps reducing triglyceride levels. Almost 60% of patients experience persistent HDL-C and/or triglyceride abnormality independently of LDL-C levels and could be candidates for additional treatments.
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| 18. |
- Schubert, Per, et al.
(författare)
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Content analysis of ecosystem service concepts in comprehensive plans for Malmö municipality in southern Sweden
- 2015
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Supported by the Swedish Environmental Protection Agency a research project is developed in close collaboration with seven coastal municipalities in the county of Skåne in southern Sweden. Since the municipalities along the coastline face a range of environmental challenges, several case studies are aimed at understanding local municipality planning processes. The overall research objective is to understand the premises of implementing the Ecosystem Service (ES) approach in municipal planning and decision making. This case study examines to what extent ES concepts are accounted for in Malmö municipality comprehensive plans through a content analysis of ES concepts in the 1980, 1990, 2000, and 2012 plans. The ES concepts were categorized according to the 2005 Millennium Ecosystem Assessment into supporting, provisioning, regulating and cultural services. Preliminary results show that the “ecosystem service” concept itself is not used before the 2012 comprehensive plan. Quantitative analysis of the total number of different ES concepts used in the comprehensive plans shows a large increase from 1980 to 1990 and thereafter a gradual decrease to 2000 and 2012, where 2012 is lower than 1980. The introduction of the Swedish natural resources law in 1987 could explain the peaking number in 1990. If latter comprehensive plans build upon former, the concept usage can be interpreted as increasing from 1980 and forward. These results indicate a shift into using the ES approach in municipality planning processes. Qualitative analysis shows that there is a change in the ES concepts used, e.g. “land use” and “green areas” in 1980 and “biological life cycle” and “biodiversity” in 2000 indicates a shift in municipality planning processes towards a more holistic view of the importance of ecosystems for a sustainable society and healthy life. Although somewhat uncertain, these results could indicate an introduction of the ES approach in the Malmö municipality planning processes.
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| 19. |
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| 20. |
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| 21. |
- Schubert, Per, et al.
(författare)
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Implementation of the ecosystem services approach in Swedish municipal planning
- 2018
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Ingår i: Journal of Environmental Policy and Planning. - : Routledge. - 1523-908X .- 1522-7200. ; 20:3, s. 298-312
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Tidskriftsartikel (refereegranskat)abstract
- While ecosystem-based planning approaches are increasingly promoted through international and national policies, municipalities are still struggling with translating them into practice. Against this background, this paper aims to increase the knowledge of current advances and possible ways to support the implementation of the ecosystem services (ES) approach at the municipal level. More specifically, we analyze how ES have been integrated into comprehensive planning within the municipality of Malmö in Sweden over the last 60 years, a declared forerunner in local environmental governance. Based on a content analysis of comprehensive plans over the period 1956–2014 and interviews with municipal stakeholders, this paper demonstrates how planning has shifted over time toward a more holistic view of ES and their significance for human well-being and urban sustainability. Both explicit and implicit applications of the ES concept were found in the analyzed comprehensive plans and associated programs and projects. Our study shows how these applications reflect international, national, and local policy changes, and indicates how municipalities can gradually integrate the ES approach into comprehensive planning and facilitate the transition from implicit to more explicit knowledge use.
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| 22. |
- Singh, Kailash, et al.
(författare)
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Cellular immunological changes in patients with LADA are a mixture of those seen in patients with type 1 and type 2 diabetes
- 2019
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Ingår i: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 0009-9104 .- 1365-2249. ; 197:1, s. 64-73
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Tidskriftsartikel (refereegranskat)abstract
- There is currently scarce knowledge of the immunological profile of patients with latent autoimmune diabetes mellitus in the adult (LADA) when compared with healthy controls (HC) and patients with classical type 1 diabetes (T1D) and type 2 diabetes (T2D). The objective of this study was to investigate the cellular immunological profile of LADA patients and compare to HC and patients with T1D and T2D. All patients and age-matched HC were recruited from Uppsala County. Peripheral blood mononuclear cells were isolated from freshly collected blood to determine the proportions of immune cells by flow cytometry. Plasma concentrations of the cytokine interleukin (IL)-35 were measured by enzyme-linked immunosorbent assay (ELISA). The proportion of CD11c(+)CD123(-) antigen-presenting cells (APCs) was lower, while the proportions of CD11c(+)CD123(+) APCs and IL-35(+) tolerogenic APCs were higher in LADA patients than in T1D patients. The proportion of CD3(-)CD56(high)CD16(+) natural killer (NK) cells was higher in LADA patients than in both HC and T2D patients. The frequency of IL-35(+) regulatory T cells and plasma IL-35 concentrations in LADA patients were similar to those in T1D and T2D patients, but lower than in HC. The proportion of regulatory B cells in LADA patients was higher than in healthy controls, T1D and T2D patients, and the frequency of IL-35(+) regulatory B cells was higher than in T1D patients. LADA presents a mixed cellular immunological pattern with features overlapping with both T1D and T2D.
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| 23. |
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| 24. |
- Stålhammar, Anna, et al.
(författare)
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Resource test-driving for service innovation : How ordinary employees innovate new value propositions
- 2012
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Ingår i: Proceedings of the 15th QMOD-ICQSS conference. - Poznan, Poland : COMPRINT, Poznan Univ. of Technology.
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Konferensbidrag (refereegranskat)abstract
- PurposeThe purpose of this paper is to investigate the role of ordinary employees in service innovation. Departing from the service-dominant (S-D) logic, service innovation is conceptualized as a resource integration process leading to the creation of value propositions.MethodologyThe paper reports on a case study of service development at three different organizations. Twenty ordinary employees were interviewed. Ordinary employees are defined as those lacking a formal innovation obligation, e.g. frontline employees. These normally have knowledge of both the customers’ needs and the firm’s ability to realize these.FindingsThe findings suggest that ordinary employees contribute to service innovation by test-driving resource integrations and potential value propositions. Specifically, the findings suggest that ordinary employees use three different ways of test-driving resources: Cognitive test-driving; Test-driving in practice, and Discursive test-driving. Although the findings suggest that these ways of test-driving resources are intertwined, they also suggest that parts of the innovation process are dominated by one of these.Research limitations/implicationsThis article is based on a case study of three organizations, thus limiting the possibility of statistical generalization.Originality/valueThe study is novel in several respects: (i) it introduces the notion of resource test-driving; (ii) it provides a systematic empirical analysis of how ordinary employees contribute to service innovation through test-driving resource integrations and new value propositions; (iii) it offers an S-D logic informed service innovation model; (iv) it contributes to the S-D logic by detailing how resource integration takes place in practice.
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| 25. |
- Stålhammar, Jacob, 1967, et al.
(författare)
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Neuropsychological Test Performance Among Native and Non-Native Swedes: Second Language Effects. : Neuropsykologisk testprestation hos infödda och icke infödda svensktalande: andraspråkseffekter
- 2022
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Ingår i: Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists. - : Oxford University Press (OUP). - 1873-5843. ; 37:4, s. 826-838
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to study second language effects on neuropsychological (NP) test performance.We administered an NP test battery in Swedish to 322 healthy community dwelling participants, recruited through the Gothenburg Pilot phase of the Swedish CArdioPulmonary BioImage Study (SCAPIS Pilot). All participants were conversationally fluent Swedish speakers (237 native, 85 non-native, mean age 61.1years). We compared the NP scores of native and non-native participants. We also investigated the influence of (a) age of arrival to Sweden, (b) majority language family of the birth country, and (c) proficiency in Swedish as assessed with a 30 item Boston naming test (BNT).Native speakers obtained better results on all NP tasks with a verbal component, whereas no significant differences were seen on completely nonverbal tasks (Rey complex figure). For non-native speakers, lower age at arrival to Sweden, arrival from a country where Swedish was also spoken, or arrival from a country with a majority language closer to Swedish, were all linked to better NP scores. Dichotomizing by BNT showed that normally-to-highly proficient non-native speakers obtained better scores.Second language effects may contribute to misclassification of non-native speakers. Assumptions of fluency based on short conversations may be misleading. A proficiency assessment with BNT may improve NP score interpretation among non-native speakers.
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| 26. |
- Åkesson, Maria, 1979-, et al.
(författare)
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Value proposition test-driving for service innovation : How frontline employees innovate value propositions
- 2016
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Ingår i: Journal of service theory and practice. - 2055-6225 .- 2055-6233. ; 26:3, s. 338-362
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – The purpose of this paper is to investigate the role of frontline employees in service innovation from a service-dominant logic (SDL) perspective. Frontline employees lack a formal innovation obligation. Service innovation is a resource integration process resulting in the creation of new value propositions.Design/methodology/approach – A case study of service innovation projects that includes three different businesses in the IT sector and personal interviews with 25 frontline employees.Findings – The findings suggest that frontline employees contribute to service innovation by test-driving potential value propositions. Three types of value proposition test-driving have been identified: cognitive, practical, and discursive. The findings suggest interdependencies between the different modes of value proposition test-driving, as well as specific phases of the service innovation process dominated by one form or another.Research limitations/implications – Value proposition test-driving offers a fruitful context for managers to involve frontline employees and use their creativity and expertise. The case study approach, however, limits the statistical generalizability of the findings.Originality/value – The study is novel in that it introduces the notion of value proposition test-drivingfor service innovation; provides a systematic empirical analysis of how frontline employees contribute toservice innovation by test-driving value propositions; offers a service innovation model informed by the SDL; and contributes to the SDL by detailing how service innovation occurs in practice.
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