| 1. |
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| 2. |
- Charalampopoulos, Dimitrios, et al.
(författare)
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Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries: A Cross-sectional Analysis of 64,666 Children and Adolescents With Type 1 Diabetes
- 2018
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Ingår i: Diabetes Care. - : AMER DIABETES ASSOC. - 0149-5992 .- 1935-5548. ; 41:6, s. 1180-1187
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA(1c) levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA(1c) across and within eight high-income countries to best inform international benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS Data were collected between 2013 and 2014 from 64,666 children with T1D who were amp;lt; 18 years of age across 528 centers in Germany, Austria, England, Wales, U.S., Sweden, Denmark, and Norway. We used fixed-and random-effects models adjusted for age, sex, diabetes duration, and minority status to describe differences between center means and to calculate the proportion of total variation in HbA(1c) levels that is attributable to between-center differences (intraclass correlation [ICC]). We also explored the association between within-center variation and childrens glycemic control. RESULTS Sweden had the lowest mean HbA(1c) (59mmol/mol [7.6%]) and together with Norway and Denmark showed the lowest between-center variations (ICC amp;lt;= 4%). Germany and Austria had the next lowest mean HbA(1c) (61-62 mmol/mol [7.7-7.8%]) but showed the largest center variations (ICC similar to 15%). Centers in England, Wales, and the U.S. showed low-to-moderate variation around high mean values. In pooled analysis, differences between counties remained significant after adjustment for children characteristics and center effects (P value amp;lt; 0.001). Across all countries, children attending centers with more variable glycemic results had higher HbA(1c) levels (5.6mmol/mol [0.5%] per 5mmol/mol [0.5%] increase in center SD of HbA(1c) values of all children attending a specific center). CONCLUSIONS A tsimilar average levels of HbA(1c), countries display different levels of center variation. The distribution of glycemic achievement within countries should be considered in developing informed policies that drive quality improvement.
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| 3. |
- Björkdahl, Ann, 1959, et al.
(författare)
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A randomized study of computerized working memory training and effects on functioning in everyday life for patients with brain injury
- 2013
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Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 27:13-14, s. 1658-65
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Tidskriftsartikel (refereegranskat)abstract
- Background: Working memory (WM) problems influence most activities of daily living. The aim was to evaluate if computerized working memory training after brain injury has a significant effect on functioning in daily life. Method: Outpatients with WM deficits, aged 22-63 years, were randomized to either intervention group (IG, n = 20) or control group (CG, n = 18) and received 5 weeks standard rehabilitation. The IG also received WM training with the Cogmed QM training program. Assessments were made before (A1), immediately (A2) and 3 months (A3) after intervention. After follow-up, the CG was offered the computerized training and assessed after this (A4; n = 8). Assessments included the WAIS-III Digit span reversed, Fatigue Impact Scale (FIS), Assessment of Motor and Process Skills (AMPS), Rivermead Behavioural Memory Test-II (RBMT-II) and a WM questionnaire. Results: The IG improved on digit span and FIS, A1-A2, and significantly more than the CG on the WM questionnaire, A1-A3. Both groups improved in AMPS motor skill and the AMPS process skill score tended towards significant improvement in the IG, from A1-A3. After training (A3-A4), the CG improved in digit span and RBMT-II. Conclusion: The WM training seems to have a generalized effect on functional activity and lessens fatigue.
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| 4. |
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| 5. |
- Högberg, Carl, et al.
(författare)
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Succinate independently stimulates full platelet activation via cAMP and PI3β kinase signaling.
- 2011
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Ingår i: Journal of Thrombosis and Haemostasis. - : Elsevier BV. - 1538-7933 .- 1538-7836. ; 9:2, s. 361-372
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Tidskriftsartikel (refereegranskat)abstract
- Background: The citric cycle intermediate succinate has recently been identified as ligand for the G-protein coupled receptor (GPCR) SUCNR1. We have previously found that this receptor is one of the most expressed GPCRs in human platelets. Objective: The aim of this study was to investigate the role of SUCNR1 in platelet aggregation and to explore the signalling pathways of this receptor in platelets. Methods and Results: Using RT-PCR, we could demonstrate that SUCNR1 is expressed in human platelets at a level corresponding to that of the P2Y(1) receptor. Light transmission aggregation experiments showed a dose-dependent aggregation induced by succinate reaching a maximum response at 0.5mM. The effect of succinate on platelet aggregation was confirmed with flow cytometry showing increased surface expression of activated GPIIb/IIIa, and P-selectin. Intracellular SUCNR1 signalling was found to result in decreased cAMP levels, Akt phosphorylation mediated by PI3Kβ activation and receptor desensitisation. Further, succinate-induced platelet aggregation was demonstrated to depend on Src, generation of thromboxane A(2) and ATP release. The platelet SUCNR1 is subject to desensitization through both homologous and heterologous mechanisms. In addition, the P2Y(12) receptor inhibitor ticagrelor completely prevented platelet aggregation induced by succinate. Conclusions: Our experiments show that succinate induces full aggregation of human platelets via SUCNR1. Succinate-induced platelet aggregation depends on thromboxane A(2) generation, ATP release and P2Y(12) activation.
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| 6. |
- Larsson, Pär, et al.
(författare)
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The complete genome sequence of Francisella tularensis, the causative agent of tularemia
- 2005
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 37:2, s. 153-159
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Tidskriftsartikel (refereegranskat)abstract
- Francisella tularensis is one of the most infectious human pathogens known. In the past, both the former Soviet Union and the US had programs to develop weapons containing the bacterium. We report the complete genome sequence of a highly virulent isolate of F. tularensis (1,892,819 bp). The sequence uncovers previously uncharacterized genes encoding type IV pili, a surface polysaccharide and iron-acquisition systems. Several virulence-associated genes were located in a putative pathogenicity island, which was duplicated in the genome. More than 10% of the putative coding sequences contained insertion-deletion or substitution mutations and seemed to be deteriorating. The genome is rich in IS elements, including IS630 Tc-1 mariner family transposons, which are not expected in a prokaryote. We used a computational method for predicting metabolic pathways and found an unexpectedly high proportion of disrupted pathways, explaining the fastidious nutritional requirements of the bacterium. The loss of biosynthetic pathways indicates that F. tularensis is an obligate host-dependent bacterium in its natural life cycle. Our results have implications for our understanding of how highly virulent human pathogens evolve and will expedite strategies to combat them.
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| 7. |
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| 8. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 9. |
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| 10. |
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| 11. |
- Rosén, Siv, 1956-, et al.
(författare)
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Calm or not calm : the question of anxiety in the perianesthesia patient
- 2008
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Ingår i: Journal of Perianesthesia Nursing. - Amsterdam : Elsevier. - 1089-9472 .- 1532-8473. ; 23:4, s. 237-246
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Tidskriftsartikel (refereegranskat)abstract
- Preoperative anxiety can be a major problem for the patient. Three distinct dimensions of preoperative anxiety are known: fear of the unknown, fear of feeling ill, and fear for life. The aim of this study was to investigate whether patients feel anxiety (calm or not calm) preoperatively before undergoing an elective day care surgery and also to elucidate the factors contributing to a patient's current state of mind. A prospective study with 161 American Society of Anesthesiologists I-II outpatients scheduled for elective surgery was conducted. In a questionnaire the patients were asked to state if they were feeling calm or not and to describe factors contributing to their current mood. If responding that they did not feel calm, the participants were asked to rate the level of anxiety on a Numeric Rating Scale, 1-10. The results showed that 57% (n = 91) of the participants stated that they did not feel calm. A significantly higher proportion of women did not feel calm (65%), P < .05. Significantly more participants with a previous experience of surgery felt calm (90%), P < .01. In all, 190 statements were submitted. The results show that nearly half of the participants felt calm before surgery. The reasons were earlier positive experiences, feeling of security and caring, being well-informed, and having positive expectations. Furthermore, a higher proportion of women did not feel calm preoperatively. This indicates a need before surgery to routinely document and evaluate the individual patient's state of mind and reasons for the state of mind. This individual preoperative care can make it possible to provide emotional support, decrease anxiety, and give the patient a more positive surgical experience.
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| 12. |
- Svensson, M, et al.
(författare)
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Local warming to reduce pain on peripheral intravenous cannula insertion : a randomised controlled study
- 2006
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Ingår i: Journal of advanced perioperative care. - 1470-5664. ; 2:3, s. 107-111
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Tidskriftsartikel (refereegranskat)abstract
- Insertion of intravenous cannulas (IVCs) is one of the most commonly used invasive procedures in healthcare and can be perceived as very painful by the patient.The aim of this study was to evaluate whether venous dilatation produced by local warming (LW) reduces pain on peripheral IVC insertion.The study with a sample size of 125 patients was undertaken in a day care unit.Patients were randomised to an experimental group (n = 61) or a control group (n = 64).The experimental group received LW during 60 seconds before cannula insertion.The control group received no treatment.The intravenous catheter used was optiva, an 18 gauge over-the-needle catheter.Pain was measured with a 10cm visual analogue scale (VAS) with a possible pain score of 0–10.The results showed no statistical significance between the groups in mean pain, with 1.74 measured in the LW group versus 2.01 scored in the control group.The percentage of patients who had a VAS >3 was 15.6% in the LW group versus 22.9% in the control group.However, this difference was not statistically significant. In conclusion, LW before peripheral IVC insertion appears not to have any pain-reducing effect. Altogether 20% of all the participants experienced the insertion as a painful procedure.
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| 13. |
- Svensson, Siv, et al.
(författare)
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A Comparison between Two Instruments for Assessing Dependency in Daily Activities: Agreement of the Northwick Park Dependency Score with the Functional Independence Measure.
- 2012
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Ingår i: Rehabilitation research and practice. - : Hindawi Limited. - 2090-2875 .- 2090-2867. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Background. There is a need for tools to assess dependency among persons with severe impairments. Objectives. The aim was to compare the Functional Independence Measure (FIM) and the Northwick Park Dependency Score (NPDS), in a sample from in-patient rehabilitation. Material and Methods. Data from 115 persons (20 to 65 years of age) with neurological impairments was gathered. Analyses were made of sensitivity, specificity, positive predictive value, and negative predictive value. Agreement of the scales was assessed with kappa and concordance with Goodman-Kruskal's gamma. Scale structures were explored using the Rank-Transformable Pattern of Agreement (RTPA). Content validation was performed. Results. The sensitivity of the NPDS as compared to FIM varied between 0.53 (feeding) and 1.0 (mobility) and specificity between 0.64 (mobility) and 1.0 (bladder). The positive predictive value varied from 0.62 (mobility) to 1.0 (bladder), and the negative predictive value varied from 0.48 (bowel) to 1.0 (mobility). Agreement between the scales was moderate to good (four items) and excellent (three items). Concordance was good, with a gamma of -.856, an asymptotic error (ase) of .025, and P < .000. The parallel reliability between the FIM and the NPDS showed a tendency for NPDS to be more sensitive (having more categories) when dependency is high. Conclusion. FIM and NPDS complement each other. NPDS can be used as a measure for severely injured patients who are sensitive when there is a high need of nursing time.
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| 14. |
- Svensson, Siv, et al.
(författare)
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Reliability and validity of the Northwick Park Dependency Score (NPDS) Swedish version 6.0
- 2005
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Ingår i: Clin Rehabil. ; 19:4, s. 419-25
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To translate, to test inter-rater and intra-rater reliability and concurrent validity of the Basic Care Needs (BCN) section of the Northwick Park Dependency Score (NPDS). DESIGN: Test-retest reliability and validity testing. Observed data were collected by the staff (nursing staff, occupational therapists). SETTING: Three rehabilitation units. SUBJECTS: Forty inpatients between 16 and 65 years of age with brain injury were included. MAIN MEASURES: Inter-rater and intra-rater reliability was calculated by percentage agreement (PA) and unweighted kappa measure. Concurrent validity was examined by computing Goodman-Kruskal's gamma, a nonparametric statistic for degree of association between the BCN score and the total score of the Functional Independence Measure (FIM). RESULTS: Inter-rater reliability showed a good percentage agreement between nursing staff. Between nursing staff and occupational therapists the percentage agreement was lower especially in one item. Intra-rater reliability showed a good percentage agreement for all assessors. Concordance was good with a gamma--0.83 and an asymptotic error (ase) of 0.04, for nursing staff and for occupational therapists -0.87, ase 0.04. CONCLUSION: The BCN section of NPDS was found to be inter-rater and intra-rater reliable, to have concurrent validity. Further studies are needed on clinical utility. The instrument can be used for assessment of dependency for individual patients with brain injury, and information when transferring between different caregivers. Further studies need to investigate the sensitivity of the instrument.
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| 15. |
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| 16. |
- Sörbo, Ann, 1955, et al.
(författare)
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Outcome after severe brain damage, what makes the difference?
- 2005
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Ingår i: Brain Inj. ; 19:7, s. 493-503
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess and compare the consequences for outcome in terms of the dimensions of activity and participation for two groups: group A, which received early formalized rehabilitation, and group B, which received late or no formalized rehabilitation. RESEARCH DESIGN: A cross-sectional study. PROCEDURE: Twenty-six patients (A: n = 14 and B: n = 12) with severe brain damage were included. The participants were assessed a mean of 26.6 months (SD 7.1, median 25, range 14-41) after the incident using the structured form for the Swedish Neuro database, the Glasgow Outcome Scale (GOS), the Extended Glasgow Outcome Scale (GOSE) and the Functional Independence Measure (FIM). RESULTS: The study reveals a better outcome for group A. No patient remained in a vegetative state in group A as compared with three in group B. In group A, 50% were independent as compared with 17% in group B. The frequency of return to work was 43% in group A, but no patient in group B had returned to work.
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| 17. |
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| 18. |
- Tan, Chanyuan, et al.
(författare)
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ADP receptor P2Y(13) induce apoptosis in pancreatic beta-cells.
- 2010
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Ingår i: Cellular and Molecular Life Sciences. - : Springer Science and Business Media LLC. - 1420-9071 .- 1420-682X. ; 67, s. 445-453
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Tidskriftsartikel (refereegranskat)abstract
- Pancreatic beta-cell loss represents a key factor in the pathogenesis of diabetes. Since the influence of purinergic signaling in beta-cell apoptosis has not been much investigated, we examined the role of the ADP receptor P2Y(13) using the pancreatic insulinoma-cell line MIN6c4 as a model system. Real time-PCR revealed high expression of the ADP receptors P2Y(1) and P2Y(13). Adding the ADP analogue, 2MeSADP, to MIN6c4 cells induced calcium influx/mobilization and inhibition of cAMP production by activation of P2Y(1) and P2Y(13), respectively. 2MeSADP reduced cell proliferation and increased Caspase-3 activity; both these effects could be fully reversed by the P2Y(13) receptor antagonist MRS2211. We further discovered that blocking the P2Y(13) receptor results in enhanced ERK1/2, Akt/PKB and CREB phosphorylation mechanisms involved in beta-cell survival. These results indicate that P2Y(13) is a proapoptotic receptor in beta-cells as the P2Y(13) receptor antagonist MRS2211 is able to protect the cells from ADP induced apoptosis.
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| 19. |
- Tan, Chanyuan, et al.
(författare)
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High glucose and free fatty acids induce beta cell apoptosis via autocrine effects of ADP acting on the P2Y(13) receptor.
- 2013
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Ingår i: Purinergic Signalling. - : Springer Science and Business Media LLC. - 1573-9546 .- 1573-9538. ; 9:1, s. 67-79
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Tidskriftsartikel (refereegranskat)abstract
- While high levels of glucose and saturated fatty acids are known to have detrimental effects on beta cell function and survival, the signalling pathways mediating these effects are not entirely known. In a previous study, we found that ADP regulates beta cell insulin secretion and beta cell apoptosis. Using MIN6c4 cells as a model system, we investigated if autocrine/paracrine mechanisms of ADP and purinergic receptors are involved in this process. High glucose (16.7 mmol/l) and palmitate (100 μmol/l) rapidly and potently elevated the extracellular ATP levels, while mannitol was without effect. Both tolbutamide and diazoxide were without effect, while the calcium channel blocker nifedipine, the volume-regulated anion channels (VRAC) inhibitor NPPB, and the pannexin inhibitor carbenoxolone could inhibit both effects. Similarly, silencing the MDR1 gene also blocked nutrient-generated ATP release. These results indicate that calcium channels and VRAC might be involved in the ATP release mechanism. Furthermore, high glucose and palmitate inhibited cAMP production, reduced cell proliferation in MIN6c4 and increased activated Caspase-3 cells in mouse islets and in MIN6c4 cells. The P2Y(13)-specific antagonist MRS2211 antagonized all these effects. Further studies showed that blocking the P2Y(13) receptor resulted in enhanced CREB, Bad and IRS-1 phosphorylation, which are known to be involved in beta cell survival and insulin secretion. These findings provide further support for the concept that P2Y(13) plays an important role in beta cell apoptosis and suggest that autocrine/paracrine mechanisms, related to ADP and P2Y(13) receptors, contribute to glucolipotoxicity.
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| 20. |
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