SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Tack J.) "

Sökning: WFRF:(Tack J.)

  • Resultat 1-50 av 166
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  •  
2.
  • Santangelo, James S., et al. (författare)
  • Global urban environmental change drives adaptation in white clover
  • 2022
  • Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 375
  • Tidskriftsartikel (refereegranskat)abstract
    • Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural dines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale.
  •  
3.
  •  
4.
  • Smeets, F. G. M., et al. (författare)
  • Development of a real-time patient-reported outcome measure for symptom assessment in patients with functional dyspepsia using the experience sampling method
  • 2019
  • Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 31:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Patient-reported outcome measures (PROMs) are used to assess symptoms in patients with functional dyspepsia (FD). Current end-of-day questionnaires have several limitations including sensitivity to recall and ecological bias. The experience sampling method (ESM) is characterized by random and repeated assessments across momentary states in daily life and therefore less sensitive to these limitations. This study describes the development of a novel PROM based on ESM technology. Methods An initial draft of the PROM was developed based on literature. Focus group interviews with FD patients according to Rome IV criteria, and an expert meeting with international opinion leaders in the field of functional gastrointestinal disorders were conducted in order to select items for the PROM. Cognitive interviews were performed to evaluate patients' understanding of the selected items and to create the definitive PROM. Key results A systematic literature search revealed 59 items across four domains (ie, physical status; mood and psychological factors; context and environment; and nutrition, medication, and substance use). After patient focus group interviews and an international expert meeting, the number of items was reduced to 33. Cognitive interviews resulted in some minor linguistic changes in order to improve patients' understanding. Conclusions and inferences A novel digital ESM-based PROM for real-time symptom assessment in patients with functional dyspepsia was developed. This novel PROM has the potential to identify individual symptom patterns and specific triggers for dyspeptic symptoms, and optimize treatment strategies.
  •  
5.
  • Caizergues, Aude E., et al. (författare)
  • Does urbanisation lead to parallel demographic shifts across the world in a cosmopolitan plant?
  • 2024
  • Ingår i: Molecular Ecology. - 0962-1083 .- 1365-294X. ; 33:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Urbanisation is occurring globally, leading to dramatic environmental changes that are altering the ecology and evolution of species. In particular, the expansion of human infrastructure and the loss and fragmentation of natural habitats in cities is predicted to increase genetic drift and reduce gene flow by reducing the size and connectivity of populations. Alternatively, the 'urban facilitation model' suggests that some species will have greater gene flow into and within cities leading to higher diversity and lower differentiation in urban populations. These alternative hypotheses have not been contrasted across multiple cities. Here, we used the genomic data from the GLobal Urban Evolution project (GLUE), to study the effects of urbanisation on non-adaptive evolutionary processes of white clover (Trifolium repens) at a global scale. We found that white clover populations presented high genetic diversity and no evidence of reduced Ne linked to urbanisation. On the contrary, we found that urban populations were less likely to experience a recent decrease in effective population size than rural ones. In addition, we found little genetic structure among populations both globally and between urban and rural populations, which showed extensive gene flow between habitats. Interestingly, white clover displayed overall higher gene flow within urban areas than within rural habitats. Our study provides the largest comprehensive test of the demographic effects of urbanisation. Our results contrast with the common perception that heavily altered and fragmented urban environments will reduce the effective population size and genetic diversity of populations and contribute to their isolation.
  •  
6.
  • Klaassen, T., et al. (författare)
  • Psychometric evaluation of an experience sampling method-based patient-reported outcome measure in functional dyspepsia
  • 2021
  • Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 33:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Due to important biases, conventional end-of-day and end-of-week assessment methods of gastrointestinal symptoms in functional dyspepsia (FD) are considered suboptimal. Real-time symptom assessment based on the experience sampling method (ESM) could be a more accurate measurement method. This study aimed to evaluate validity and reliability of an ESM-based patient-reported outcome measure (PROM) for symptom assessment in FD. Methods Thirty-five patients with FD (25 female, mean age 44.7 years) completed the ESM-based PROM (a maximum of 10 random moments per day) and an end-of-day symptom diary for 7 consecutive days. On day 7, end-of-week questionnaires were completed including the Nepean Dyspepsia Index (NDI) and Patient Assessment of Gastrointestinal Symptom Severity Index (PAGI-SYM). Key Results Experience sampling method and corresponding end-of-day scores for gastrointestinal symptoms were significantly associated (ICCs range 0.770-0.917). However, end-of-day scores were significantly higher (Delta 0.329-1.031) than mean ESM scores (p < 0.05). Comparing ESM with NDI and PAGI-SYM scores, correlations were weaker (Pearson's r range 0.467-0.846). Cronbach's alpha coefficient was good for upper gastrointestinal symptoms (alpha = 0.842). First half-week and second half-week scores showed very good consistency (ICCs range 0.913-0.975). Conclusion and Inferences Good validity and reliability of a novel ESM-based PROM for assessing gastrointestinal symptoms in FD patients was demonstrated. Moreover, this novel PROM allows to evaluate individual symptom patterns and can evaluate interactions between symptoms and environmental/contextual factors. ESM has the potential to increase patients' disease insight, provide tools for self-management, and improve shared decision making. Hence, this novel tool may aid in the transition toward personalized health care for FD patients.
  •  
7.
  • Sperber, A. D., et al. (författare)
  • Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study
  • 2021
  • Ingår i: Gastroenterology. - : Elsevier BV. - 0016-5085. ; 160:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND & AIMS: Although functional gastrointestinal disorders (FGIDs), now called disorders of gut-brain interaction, have major economic effects on health care systems and adversely affect quality of life, little is known about their global prevalence and distribution. We investigated the prevalence of and factors associated with 22 FGIDs, in 33 countries on 6 continents. METHODS: Data were collected via the Internet in 24 countries, personal interviews in 7 countries, and both in 2 countries, using the Rome IV diagnostic questionnaire, Rome III irritable bowel syndrome questions, and 80 items to identify variables associated with FGIDs. Data collection methods differed for Internet and household groups, so data analyses were conducted and reported separately. RESULTS: Among the 73,076 adult respondents (49.5% women), diagnostic criteria were met for at least 1 FGID by 40.3% persons who completed the Internet surveys (95% confidence interval [CI], 39.9-40.7) and 20.7% of persons who completed the household surveys (95% CI, 20.2-21.3). FGIDs were more prevalent among women than men, based on responses to the Internet survey (odds ratio, 1.7; 95% CI, 1.6-1.7) and household survey (odds ratio, 1.3; 95% CI, 1.3-1.4). FGIDs were associated with lower quality of life and more frequent doctor visits. Proportions of subjects with irritable bowel syndrome were lower when the Rome IV criteria were used, compared with the Rome III criteria, in the Internet survey (4.1% vs 10.1%) and household survey (1.5% vs 3.5%). CONCLUSIONS: In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews.
  •  
8.
  • Boon, Hanneke, 1981-, et al. (författare)
  • Intravenous AICAR administration reduces hepatic glucose output and inhibits whole body lipolysis in type 2 diabetic patients
  • 2008
  • Ingår i: Diabetologia. - Heidelberg : Springer Berlin/Heidelberg. - 0012-186X .- 1432-0428. ; 51:10, s. 1893-1900
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS/HYPOTHESIS: The 5'-AMP-activated protein kinase (AMPK) pathway is intact in type 2 diabetic patients and is seen as a target for diabetes treatment. In this study, we aimed to assess the impact of the AMPK activator 5-aminoimidazole-4-carboxamide riboside (AICAR) on both glucose and fatty acid metabolism in vivo in type 2 diabetic patients. METHODS: Stable isotope methodology and blood and muscle biopsy sampling were applied to assess blood glucose and fatty acid kinetics following continuous i.v. infusion of AICAR (0.75 mg kg(-1) min(-1)) and/or NaCl (0.9%) in ten male type 2 diabetic patients (age 64 +/- 2 years; BMI 28 +/- 1 kg/m(2)). RESULTS: Plasma glucose rate of appearance (R (a)) was reduced following AICAR administration, while plasma glucose rate of disappearance (R (d)) was similar in the AICAR and control test. Consequently, blood glucose disposal (R (d) expressed as a percentage of R (a)) was increased following AICAR infusion (p < 0.001). Accordingly, a greater decline in plasma glucose concentration was observed following AICAR infusion (p < 0.001). Plasma NEFA R (a) and R (d) were both significantly reduced in response to AICAR infusion, and were accompanied by a significant decline in plasma NEFA concentration. Although AMPK phosphorylation in skeletal muscle was not increased, we observed a significant increase in acetyl-CoA carboxylase phosphorylation (p < 0.001). CONCLUSIONS/INTERPRETATION: The i.v. administration of AICAR reduces hepatic glucose output, thereby lowering blood glucose concentrations in vivo in type 2 diabetic patients. Furthermore, AICAR administration stimulates hepatic fatty acid oxidation and/or inhibits whole body lipolysis, thereby reducing plasma NEFA concentration. © 2008 The Author(s).
  •  
9.
  • Keller, J., et al. (författare)
  • Advances in the diagnosis and classification of gastric and intestinal motility disorders
  • 2018
  • Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Springer Science and Business Media LLC. - 1759-5045 .- 1759-5053. ; 15:5, s. 291-308
  • Tidskriftsartikel (refereegranskat)abstract
    • Disturbances of gastric, intestinal and colonic motor and sensory functions affect a large proportion of the population worldwide, impair quality of life and cause considerable health-care costs. Assessment of gastrointestinal motility in these patients can serve to establish diagnosis and to guide therapy. Major advances in diagnostic techniques during the past 5-10 years have led to this update about indications for and selection and performance of currently available tests. As symptoms have poor concordance with gastrointestinal motor dysfunction, clinical motility testing is indicated in patients in whom there is no evidence of causative mucosal or structural diseases such as inflammatory or malignant disease. Transit tests using radiopaque markers, scintigraphy, breath tests and wireless motility capsules are noninvasive. Other tests of gastrointestinal contractility or sensation usually require intubation, typically represent second-line investigations limited to patients with severe symptoms and are performed at only specialized centres. This Consensus Statement details recommended tests as well as useful clinical alternatives for investigation of gastric, small bowel and colonic motility. The article provides recommendations on how to classify gastrointestinal motor disorders on the basis of test results and describes how test results guide treatment decisions.
  •  
10.
  • McClory, R. W., et al. (författare)
  • Spring phenology dominates over light availability in affecting seedling performance and plant attack during the growing season
  • 2021
  • Ingår i: Forest Ecology and Management. - : Elsevier BV. - 0378-1127 .- 1872-7042. ; 495
  • Tidskriftsartikel (refereegranskat)abstract
    • Climate change can have important effects on plant performance by altering the relationship between spring temperature and other abiotic factors, such as light availability. Higher temperatures can advance plant phenology so that seedling germination takes place when days are shorter, and affect light availability for understory plants by altering the relative timing of seedling germination and canopy closure. To predict the effects of climate-induced changes in phenology and light availability on plant performance and species interactions during the growing season, we need to determine i) how effects of plant phenology on plant performance and the plant-associated community depend on light availability, and ii) to what extent effects of phenology and light availability on plant performance are direct vs. mediated by changes in the plant-associated community. We conducted a multifactorial field experiment to test for the effect of germination timing and light availability on Quercus robur seedling traits and performance, as well as attack by specialist plant pathogens, insects, and small mammals. Germination timing strongly affected seedling performance whereas light availability’s effects were limited. Likewise, germination timing strongly affected herbivore and pathogen attack, whereas light availability and its interaction with germination timing explained a minor part of the variation. Small mammals preferentially attacked later germinating seedlings, which strongly affected plant survival, while insect herbivores and pathogens did not mediate the effect of germination timing and light availability on plant performance. The results showed that the effect of germination timing can have greater influence than light availability on plant performance and plant attack, and that small mammal herbivores can play a larger role than diseases and insect herbivores in mediating the effect of spring phenology on plant performance. Together, these findings advance our understanding of the consequences of climate-induced changes in spring phenology and the abiotic environment on plant performance within a community context.
  •  
11.
  • Moreira, Xoaquín, et al. (författare)
  • Impacts of urbanization on insect herbivory and plant defences in oak trees
  • 2019
  • Ingår i: Oikos. - : Wiley. - 0030-1299 .- 1600-0706. ; 128:1, s. 113-123
  • Tidskriftsartikel (refereegranskat)abstract
    • Systematic comparisons of species interactions in urban versus rural environments can improve our understanding of shifts in ecological processes due to urbanization. However, such studies are relatively uncommon and the mechanisms driving urbanization effects on species interactions (e.g. between plants and insect herbivores) remain elusive. Here we investigated the effects of urbanization on leaf herbivory by insect chewers and miners associated with the English oak Quercus robur by sampling trees in rural and urban areas throughout most of the latitudinal distribution of this species. In performing these comparisons, we also controlled for the size of the urban areas (18 cities) and gathered data on CO2 emissions. In addition, we assessed whether urbanization affected leaf chemical defences (phenolic compounds) and nutritional traits (phosphorus and nitrogen), and whether such changes correlated with herbivory levels. Urbanization significantly reduced leaf chewer damage but did not affect leaf miners. In addition, we found that leaves from urban locations had lower levels of chemical defences (condensed and hydrolysable tannins) and higher levels of nutrients (nitrogen and phosphorus) compared to leaves in rural locations. The magnitude of urbanization effects on herbivory and leaf defences was not contingent upon city size. Importantly, while the effects of urbanization on chemical defences were associated with CO2 emissions, changes in leaf chewer damage were not associated with either leaf traits or CO2 levels. These results suggest that effects of urbanization on herbivory occur through mechanisms other than changes in the plant traits measured here. Overall, our simultaneous assessment of insect herbivory, plant traits and abiotic correlates advances our understanding of the main drivers of urbanization effects on plant-herbivore interactions.
  •  
12.
  • Pauwels, A, et al. (författare)
  • How to select patients for antireflux surgery? The ICARUS guidelines (international consensus regarding preoperative examinations and clinical characteristics assessment to select adult patients for antireflux surgery)
  • 2019
  • Ingår i: Gut. - : BMJ. - 1468-3288 .- 0017-5749. ; 68:11, s. 1928-1941
  • Tidskriftsartikel (refereegranskat)abstract
    • Antireflux surgery can be proposed in patients with GORD, especially when proton pump inhibitor (PPI) use leads to incomplete symptom improvement. However, to date, international consensus guidelines on the clinical criteria and additional technical examinations used in patient selection for antireflux surgery are lacking. We aimed at generating key recommendations in the selection of patients for antireflux surgery.DesignWe included 35 international experts (gastroenterologists, surgeons and physiologists) in a Delphi process and developed 37 statements that were revised by the Consensus Group, to start the Delphi process. Three voting rounds followed where each statement was presented with the evidence summary. The panel indicated the degree of agreement for the statement. When 80% of the Consensus Group agreed (A+/A) with a statement, this was defined as consensus. All votes were mutually anonymous.ResultsPatients with heartburn with a satisfactory response to PPIs, patients with a hiatal hernia (HH), patients with oesophagitis Los Angeles (LA) grade B or higher and patients with Barrett’s oesophagus are good candidates for antireflux surgery. An endoscopy prior to antireflux surgery is mandatory and a barium swallow should be performed in patients with suspicion of a HH or short oesophagus. Oesophageal manometry is mandatory to rule out major motility disorders. Finally, oesophageal pH (±impedance) monitoring of PPI is mandatory to select patients for antireflux surgery, if endoscopy is negative for unequivocal reflux oesophagitis.ConclusionWith the ICARUS guidelines, we generated key recommendations for selection of patients for antireflux surgery.
  •  
13.
  • Romero, Gustavo Q., et al. (författare)
  • Climate variability and aridity modulate the role of leaf shelters for arthropods : A global experiment
  • 2022
  • Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 28:11, s. 3694-3710
  • Tidskriftsartikel (refereegranskat)abstract
    • Current climate change is disrupting biotic interactions and eroding biodiversity worldwide. However, species sensitive to aridity, high temperatures, and climate variability might find shelter in microclimatic refuges, such as leaf rolls built by arthropods. To explore how the importance of leaf shelters for terrestrial arthropods changes with latitude, elevation, and climate, we conducted a distributed experiment comparing arthropods in leaf rolls versus control leaves across 52 sites along an 11,790 km latitudinal gradient. We then probed the impact of short- versus long-term climatic impacts on roll use, by comparing the relative impact of conditions during the experiment versus average, baseline conditions at the site. Leaf shelters supported larger organisms and higher arthropod biomass and species diversity than non-rolled control leaves. However, the magnitude of the leaf rolls' effect differed between long- and short-term climate conditions, metrics (species richness, biomass, and body size), and trophic groups (predators vs. herbivores). The effect of leaf rolls on predator richness was influenced only by baseline climate, increasing in magnitude in regions experiencing increased long-term aridity, regardless of latitude, elevation, and weather during the experiment. This suggests that shelter use by predators may be innate, and thus, driven by natural selection. In contrast, the effect of leaf rolls on predator biomass and predator body size decreased with increasing temperature, and increased with increasing precipitation, respectively, during the experiment. The magnitude of shelter usage by herbivores increased with the abundance of predators and decreased with increasing temperature during the experiment. Taken together, these results highlight that leaf roll use may have both proximal and ultimate causes. Projected increases in climate variability and aridity are, therefore, likely to increase the importance of biotic refugia in mitigating the effects of climate change on species persistence.
  •  
14.
  • Savarino, E., et al. (författare)
  • Functional bowel disorders with diarrhoea: Clinical guidelines of the United European Gastroenterology and European Society for Neurogastroenterology and Motility
  • 2022
  • Ingår i: United European Gastroenterology Journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 10:6, s. 556-584
  • Tidskriftsartikel (refereegranskat)abstract
    • Irritable bowel syndrome with diarrhoea (IBS-D) and functional diarrhoea (FDr) are the two major functional bowel disorders characterized by diarrhoea. In spite of their high prevalence, IBS-D and FDr are associated with major uncertainties, especially regarding their optimal diagnostic work-up and management. A Delphi consensus was performed with experts from 10 European countries who conducted a literature summary and voting process on 31 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation criteria. Consensus (defined as >80% agreement) was reached for all the statements. The panel agreed with the potential overlapping of IBS-D and FDr. In terms of diagnosis, the consensus supports a symptom-based approach also with the exclusion of alarm symptoms, recommending the evaluation of full blood count, C-reactive protein, serology for coeliac disease, and faecal calprotectin, and consideration of diagnosing bile acid diarrhoea. Colonoscopy with random biopsies in both the right and left colon is recommended in patients older than 50 years and in presence of alarm features. Regarding treatment, a strong consensus was achieved for the use of a diet low fermentable oligo-, di-, monosaccharides and polyols, gut-directed psychological therapies, rifaximin, loperamide, and eluxadoline. A weak or conditional recommendation was achieved for antispasmodics, probiotics, tryciclic antidepressants, bile acid sequestrants, 5-hydroxytryptamine-3 antagonists (i.e. alosetron, ondansetron, or ramosetron). A multinational group of European experts summarized the current state of consensus on the definition, diagnosis, and management of IBS-D and FDr.
  •  
15.
  • Sperber, A. D., et al. (författare)
  • Face-to-face interviews versus Internet surveys: Comparison of two data collection methods in the Rome foundation global epidemiology study: Implications for population-based research
  • 2023
  • Ingår i: Neurogastroenterology and Motility. - 1350-1925. ; 35:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and AimsThe Rome Foundation Global Epidemiology Study (RFGES) assessed the prevalence, burden, and associated factors of Disorders of Gut-Brain Interaction (DGBI) in 33 countries around the world. Achieving worldwide sampling necessitated use of two different surveying methods: In-person household interviews (9 countries) and Internet surveys (26 countries). Two countries, China and Turkey, were surveyed with both methods. This paper examines the differences in the survey results with the two methods, as well as likely reasons for those differences. MethodsThe two RFGES survey methods are described in detail, and differences in DGBI findings summarized for household versus Internet surveys globally, and in more detail for China and Turkey. Logistic regression analysis was used to elucidate factors contributing to these differences. ResultsOverall, DGBI were only half as prevalent when assessed with household vs Internet surveys. Similar patterns of methodology-related DGBI differences were seen within both China and Turkey, but prevalence differences between the survey methods were dramatically larger in Turkey. No clear reasons for outcome differences by survey method were identified, although greater relative reduction in bowel and anorectal versus upper gastrointestinal disorders when household versus Internet surveying was used suggests an inhibiting influence of social sensitivity. ConclusionsThe findings strongly indicate that besides affecting data quality, manpower needs and data collection time and costs, the choice of survey method is a substantial determinant of symptom reporting and DGBI prevalence outcomes. This has important implications for future DGBI research and epidemiological research more broadly.
  •  
16.
  • van Dijk, Laura J. A., et al. (författare)
  • Urbanization affects oak–pathogen interactions across spatial scales
  • 2022
  • Ingår i: Ecography. - : Wiley. - 0906-7590 .- 1600-0587. ; 2022:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The world is rapidly urbanizing, thereby transforming natural landscapes and changing the abundance and distribution of organisms. However, insights into the effects of urbanization on species interactions, and plant–pathogen interactions in particular, are lacking. We investigated the effects of urbanization on powdery mildew infection on Quercus robur at continental and within-city scales. At the continental scale, we compared infection levels between urban and rural areas of different-sized cities in Europe, and investigated whether plant traits, climatic variables and CO2 emissions mediated the effect of urbanization on infection levels. Within one large city (Stockholm, Sweden), we further explored whether local habitat features and spatial connectivity influenced infection levels during multiple years. At the continental scale, infection severity was consistently higher on trees in urban than rural areas, with some indication that temperature mediated this effect. Within Stockholm city, temperature had no effect, while local accumulation of leaf litter negatively affected powdery mildew incidence in one out of three years, and more connected trees had lower infection levels. This study is the first to describe the effects of urbanization on plant–pathogen interactions both within and among cities, and to uncover the potential mechanisms behind the observed patterns at each scale. 
  •  
17.
  • Vork, L., et al. (författare)
  • Development, content validity, and cross-cultural adaptation of a patient-reported outcome measure for real-time symptom assessment in irritable bowel syndrome
  • 2018
  • Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925. ; 30:3
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundEnd-of-day questionnaires, which are considered the gold standard for assessing abdominal pain and other gastrointestinal (GI) symptoms in irritable bowel syndrome (IBS), are influenced by recall and ecological bias. The experience sampling method (ESM) is characterized by random and repeated assessments in the natural state and environment of a subject, and herewith overcomes these limitations. This report describes the development of a patient-reported outcome measure (PROM) based on the ESM principle, taking into account content validity and cross-cultural adaptation. MethodsFocus group interviews with IBS patients and expert meetings with international experts in the fields of neurogastroenterology & motility and pain were performed in order to select the items for the PROM. Forward-and-back translation and cognitive interviews were performed to adapt the instrument for the use in different countries and to assure on patients' understanding with the final items. Key resultsFocus group interviews revealed 42 items, categorized into five domains: physical status, defecation, mood and psychological factors, context and environment, and nutrition and drug use. Experts reduced the number of items to 32 and cognitive interviewing after translation resulted in a few slight adjustments regarding linguistic issues, but not regarding content of the items. Conclusions and InferencesAn ESM-based PROM, suitable for momentary assessment of IBS symptom patterns was developed, taking into account content validity and cross-cultural adaptation. This PROM will be implemented in a specifically designed smartphone application and further validation in a multicenter setting will follow.
  •  
18.
  • Vork, L., et al. (författare)
  • Patient-Specific Stress-Abdominal Pain Interaction in Irritable Bowel Syndrome: An Exploratory Experience Sampling Method Study
  • 2020
  • Ingår i: Clinical and Translational Gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 2155-384X. ; 11:7
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION:Gastrointestinal symptoms in irritable bowel syndrome (IBS) have been correlated with psychological factors using retrospective symptom assessment. However, real-time symptom assessment might reveal the interplay between abdominal and affective symptoms more reliably in a longitudinal perspective. The aim was to evaluate the association between stress and abdominal pain, using the Experience Sampling Method (ESM) as a real-time, repeated measurement method.METHODS:Thirty-seven patients with IBS (26 women; mean age 36.7 years) and 36 healthy controls (HC; 24 women; mean age 31.1 years) completed an electronic ESM during 7 consecutive days. Abdominal pain and stress were scored on an 11-point Numeric Rating Scale at a maximum of 10 random moments each day.RESULTS:Abdominal pain scores were 2.21 points higher in patients with IBS compared with those in HC (P < 0.001), whereas stress levels did not differ significantly (B: 0.250, P = 0.406). In IBS, a 1-point increase in stress was associated with, on average, 0.10 points increase in abdominal pain (P = 0.017). In HC, this was only 0.02 (P = 0.002). Stress levels at t = -1 were not a significant predictor for abdominal pain at t = 0 in both groups, and vice versa.DISCUSSION:Our results demonstrate a positive association between real-time stress and abdominal pain scores and indicate a difference in response to stress and not a difference in experienced stress per se. Furthermore, an in-the-moment rather than a longitudinal association is suggested. This study underlines the importance of considering the individual flow of daily life and supports the use of real-time measurement when interpreting potential influencers of abdominal symptoms in IBS.
  •  
19.
  •  
20.
  • Barr, Anna E., et al. (författare)
  • Local habitat factors and spatial connectivity jointly shape an urban insect community
  • 2021
  • Ingår i: Landscape and Urban Planning. - : Elsevier BV. - 0169-2046 .- 1872-6062. ; 214
  • Tidskriftsartikel (refereegranskat)abstract
    • As the world becomes more and more urbanized, it is increasingly important to understand the impacts of urban landscapes on biodiversity. Urbanization can change local habitat factors and decrease connectivity among local habitats, with major impacts on the structure of natural food webs. However, most studies have focused on single species, or compared rural to urban habitats, which do not inform us on how to design and manage cities to optimize biodiversity. To understand the local and spatial drivers of ecological communities within urban landscapes, we assessed the relative impact of local habitat factors (sunlight exposure and leaf litter) and spatial connectivity on an oak-associated herbivore community within an urban landscape. From the local habitat factors, leaf litter but not sunlight exposure was related to herbivore species richness, with leaf litter contributing to the maintenance of high species richness on isolated trees. Guilds and species differed strongly in their response to local habitat factors and connectivity, resulting in predictable variation in insect community composition among urban oaks. Taken together, our study shows an interactive effect of local and spatial factors on species richness and species composition within an urban context, with guild- and species-specific life histories determining the response of insects to urban landscapes. To maintain biodiversity in the urban landscape, preserving a dense network of local habitats is essential. Moreover, allowing leaf litter to accumulate can be a simple, cost-effective conservation management practice.
  •  
21.
  • Bosselaar, Marlies, et al. (författare)
  • Intra-arterial AICA-riboside administration induces NO-dependent vasodilation in vivo in human skeletal muscle
  • 2009
  • Ingår i: American Journal of Physiology. Endocrinology and Metabolism. - Bethesda, MD : American Physiological Society. - 0193-1849 .- 1522-1555. ; 297:3, s. E759-E766
  • Tidskriftsartikel (refereegranskat)abstract
    • In animal models, administration of the adenosine analog AICA-riboside has shown beneficial effects on ischemia-reperfusion injury and glucose homeostasis. The vascular and/or metabolic effects of AICA-riboside administration in humans remain to be established. AICA-riboside was infused intra-arterially in four different dosages up to 8 mg·min-1·dl-1 in 24 healthy subjects. Forearm blood flow (FBF) and glucose uptake and plasma glucose, free fatty acid, and AICA-riboside concentrations were assessed. We also combined AICAriboside infusion (2 mg·min-1·dl -1) with the intra-arterial administration of the adenosine receptor antagonist caffeine (90 μg·min-1·dl-1; n = 6) and with the endothelial NO synthase inhibitor L-NMMA (0.4 mg·min-1·dl-1; n = 6). Additional in vitro experiments were performed to explain our in vivo effects of AICA-riboside in humans. AICA-riboside increased FBF dose dependently from 2.0 ± 0.2 to 13.2 ± 1.9 ml·min-1·dl-1 maximally (P < 0.05 for all dosages). The latter was not reduced by caffeine administration but was significantly attenuated by L-NMMA infusion. Despite high plasma AICA-riboside concentrations, forearm glucose uptake did not change. In vitro experiments showed rapid uptake of AICA-riboside by the equilibrative nucleoside transporter in erythrocytes and subsequent phosphorylation to AICA-ribotide. We conclude that AICA-riboside induces a potent vasodilator response in humans that is mediated by NO. Despite high local plasma concentrations, AICA-riboside does not increase skeletal muscle glucose uptake. Copyright © 2009 the American Physiological Society.
  •  
22.
  • Enck, P, et al. (författare)
  • Functional dyspepsia
  • 2017
  • Ingår i: Nature reviews. Disease primers. - : Springer Science and Business Media LLC. - 2056-676X. ; 3, s. 17081-
  • Tidskriftsartikel (refereegranskat)
  •  
23.
  • Gaytán, Álvaro, 1988-, et al. (författare)
  • Changes in the foliar fungal community between oak leaf flushes along a latitudinal gradient in Europe
  • 2022
  • Ingår i: Journal of Biogeography. - : Wiley. - 0305-0270 .- 1365-2699. ; 49:12, s. 2269-2280
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: Leaves support a large diversity of fungi, which are known to cause plant diseases, induce plant defences or influence leaf senescence and decomposition. To advance our understanding of how foliar fungal communities are structured and assembled, we assessed to what extent leaf flush and latitude can explain the within- and among-tree variation in foliar fungal communities.Location: A latitudinal gradient spanning c. 20 degrees in latitude in Europe.Taxa: The foliar fungal community associated with a foundation tree species, the pedunculate oak Quercus robur.Methods: We examined the main and interactive effects of leaf flush and latitude on the foliar fungal community by sampling 20 populations of the pedunculate oak Quercus robur across the tree's range. We used the ITS region as a target for characterization of fungal communities using DNA metabarcoding.Results: Species composition, but not species richness, differed between leaf flushes. Across the latitudinal gradient, species richness was highest in the central part of the oak's distributional range, and foliar fungal community composition shifted along the latitudinal gradient. Among fungal guilds, the relative abundance of plant pathogens and mycoparasites was lower on the first leaf flush, and the relative abundance of plant pathogens and saprotrophs decreased with latitude.Conclusions: Changes in community composition between leaf flushes and along the latitudinal gradient were mostly a result of species turnover. Overall, our findings demonstrate that leaf flush and latitude explain 5%–22% of the small- and large-scale spatial variation in the foliar fungal community on a foundation tree within the temperate region. Using space-for-time substitution, we expect that foliar fungal community structure will change with climate warming, with an increase in the abundance of plant pathogens and mycoparasites at higher latitudes, with major consequences for plant health, species interactions and ecosystem dynamics.
  •  
24.
  • Gaytán, Álvaro, 1988-, et al. (författare)
  • The co-existence of multiple oak leaf flushes contributes to the large within-tree variation in chemistry, insect attack and pathogen infection
  • 2022
  • Ingår i: New Phytologist. - : Wiley. - 0028-646X .- 1469-8137. ; 235:4, s. 1615-1628
  • Tidskriftsartikel (refereegranskat)abstract
    • Many plant species produce multiple leaf flushes during the growing season, which might have major consequences for within-plant variation in chemistry and species interactions. Yet, we lack a theoretical or empirical framework for how differences among leaf flushes might shape variation in damage by insects and diseases.We assessed the impact of leaf flush identity on leaf chemistry, insect attack and pathogen infection on the pedunculate oak Quercus robur by sampling leaves from each leaf flush in 20 populations across seven European countries during an entire growing season.The first leaf flush had higher levels of primary compounds, and lower levels of secondary compounds, than the second flush, whereas plant chemistry was highly variable in the third flush. Insect attack decreased from the first to the third flush, whereas infection by oak powdery mildew was lowest on leaves from the first flush. The relationship between plant chemistry, insect attack and pathogen infection varied strongly among leaf flushes and seasons.Our findings demonstrate the importance of considering differences among leaf flushes for our understanding of within-tree variation in chemistry, insect attack and disease levels, something particularly relevant given the expected increase in the number of leaf flushes with climate change.
  •  
25.
  • Huang, I. H., et al. (författare)
  • Worldwide prevalence and burden of gastroparesis-like symptoms as defined by the United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis
  • 2022
  • Ingår i: United European Gastroenterology Journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 10:8, s. 888-897
  • Tidskriftsartikel (refereegranskat)abstract
    • Background/Objectives The global epidemiology of gastroparesis is unknown. The European UEG and European Society for Neurogastroenterology and motility consensus defines Gastroparesis as a condition characterized by delayed gastric emptying in the absence of mechanical obstruction, with a symptom pattern of nausea and/or vomiting and overlapping postprandial distress syndrome (PDS). Real-world evidence of this gastroparesis-like symptom pattern is a crucial step in understanding the epidemiology of gastroparesis. Methods In the Rome Foundation Global Epidemiology Study, 54,127 respondents from 26 countries completed the Rome IV Diagnostic Questionnaire and variables associated with disorders of gut-brain interaction via Internet. We selected subjects with gastroparesis-like symptoms (GPLS) (nausea and/or vomiting >= 1 day/week and simultaneous PDS). Patients reporting organic gastrointestinal disease, or fulfilling criteria for self-induced vomiting, cyclic vomiting or cannabinoid hyperemesis syndrome were excluded. We determined prevalence, associated comorbidities, quality of life (QoL) (PROMIS Global-10), symptoms of anxiety and depression (PHQ-4), somatic symptoms (PHQ-12), and healthcare utilization. Results The global prevalence of GPLS was 0.9% overall and 1.3% among diabetic individuals. Subjects with GPLS showed frequent overlapping of epigastric pain syndrome and irritable bowel syndrome. Subjects with GPLS had significantly lower body mass index, QoL, more non-gastrointestinal somatic complaints, symptoms of anxiety and depression, higher medication usage and doctor visits in the overall and diabetic population, compared to subjects without these symptoms. Conclusions GPLS are common worldwide and more common in diabetic patients. The symptom complex is associated with multiple aspects of illness and an increased healthcare consumption.
  •  
26.
  •  
27.
  • Lacy, B. E., et al. (författare)
  • Diagnostic Evaluation of Gastric Motor and Sensory Disorders
  • 2021
  • Ingår i: American Journal of Gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 0002-9270 .- 1572-0241. ; 116:12, s. 2345-2356
  • Tidskriftsartikel (refereegranskat)abstract
    • Disorders of gastricmotor and sensory function affect 10%-20% of the world's population and adversely impact nutrition, quality of life, work productivity, and health care costs. Classifying these disorders can be challenging given the heterogeneity of symptom presentation, the presence of symptoms unexplained by endoscopic, radiographic and/or laboratory evaluation, and overlap with other luminal gastrointestinal disorders. Accurately diagnosing these highly prevalent disorders relies upon an understanding of epidemiology and risk factors, the ability to take a careful clinical history focused on symptoms, and the presence of predisposingmedical, surgical, and psychological conditions. A variety of diagnostic studies are now available to assess gastric motor function and identify maladaptive relaxation, accommodation, and abnormal sensation. FDA-approved treatment options are limited and thus many patients undergo a series of empirical treatment trials that target individual symptoms, often without much benefit. This article provides updated recommendations for identifying and classifying the most common gastric motor and sensory disorders using currently accepted diagnostic tests, and provides a brief supplemental overview on treatment options. "Things sweet to taste prove in digestion sour." -Shakespeare, Richard II, 1595.
  •  
28.
  •  
29.
  •  
30.
  • Moreira, Xoaquín, et al. (författare)
  • Effects of latitude and conspecific plant density on insect leaf herbivory in oak saplings and seedlings
  • 2021
  • Ingår i: American Journal of Botany. - : Wiley. - 0002-9122 .- 1537-2197. ; 108:1, s. 172-176
  • Tidskriftsartikel (refereegranskat)abstract
    • PremiseAbiotic factors and plant species traits have been shown to drive latitudinal gradients in herbivory, and yet, population‐level factors have been largely overlooked within this context. One such factor is plant density, which may influence the strength of herbivory and may vary with latitude.MethodsWe measured insect herbivory and conspecific plant density (CPD) of oak (Quercus robur) seedlings and saplings along a 17° latitudinal gradient (2700 km) to test whether herbivory exhibited a latitudinal gradient, whether herbivory was associated with CPD, and whether such an association changed with latitude.ResultsWe found a positive but saturating association between latitude and leaf herbivory. Furthermore, we found no significant relationship between CPD and herbivory, and such lack of density effects remained consistent throughout the sampled latitudinal gradient.ConclusionsDespite the apparently negligible influence of plant density on herbivory for Q. robur, further research with other plant taxa and in different types of plant communities are needed to investigate density‐dependent processes shaping geographical variation in plant–herbivore interactions.
  •  
31.
  • Moreira, Xoaquin, et al. (författare)
  • Latitudinal variation in seed predation correlates with latitudinal variation in seed defensive and nutritional traits in a widespread oak species
  • 2020
  • Ingår i: Annals of Botany. - : Oxford University Press (OUP). - 0305-7364 .- 1095-8290. ; 125:6, s. 881-890
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Aims Classic theory on geographical gradients in plant-herbivore interactions assumes that herbivore pressure and plant defences increase towards warmer and more stable climates found at lower latitudes. However, the generality of these expectations has been recently called into question by conflicting empirical evidence. One possible explanation for this ambiguity is that most studies have reported on patterns of either herbivory or plant defences whereas few have measured both, thus preventing a full understanding of the implications of observed patterns for plant-herbivore interactions. In addition, studies have typically not measured climatic factors affecting plant-herbivore interactions, despite their expected influence on plant and herbivore traits. Methods Here we tested for latitudinal variation in insect seed predation and seed traits putatively associated with insect attack across 36 Quercus robur populations distributed along a 20 degrees latitudinal gradient. We then further investigated the associations between climatic factors, seed traits and seed predation to test for climate-based mechanisms of latitudinal variation in seed predation. Key Results We found strong but contrasting latitudinal clines in seed predation and seed traits, whereby seed predation increased whereas seed phenolics and phosphorus decreased towards lower latitudes. We also found a strong direct association between temperature and seed predation, with the latter increasing towards warmer climates. In addition, temperature was negatively associated with seed traits, with populations at warmer sites having lower levels of total phenolics and phosphorus. In turn, these negative associations between temperature and seed traits led to a positive indirect association between temperature and seed predation. Conclusions These results help unravel how plant-herbivore interactions play out along latitudinal gradients and expose the role of climate in driving these outcomes through its dual effects on plant defences and herbivores. Accordingly, this emphasizes the need to account for abiotic variation while testing concurrently for latitudinal variation in plant traits and herbivore pressure.
  •  
32.
  • Mutz, Jessie, et al. (författare)
  • Pathogen infection influences the relationship between spring and autumn phenology at the seedling and leaf level
  • 2021
  • Ingår i: Oecologia. - : Springer Science and Business Media LLC. - 0029-8549 .- 1432-1939. ; 197:2, s. 447-457
  • Tidskriftsartikel (refereegranskat)abstract
    • Seasonal life history events are often interdependent, but we know relatively little about how the relationship between different events is influenced by the abiotic and biotic environment. Such knowledge is important for predicting the immediate and evolutionary phenological response of populations to changing conditions. We manipulated germination timing and shade in a multi-factorial experiment to investigate the relationship between spring and autumn phenology in seedlings of the pedunculate oak, Quercus robur, and whether this relationship was mediated by natural colonization of leaves by specialist fungal pathogens (i.e., the oak powdery mildew complex). Each week delay in germination corresponded to about 2 days delay in autumn leaf senescence, and heavily shaded seedlings senesced 5–8 days later than seedlings in light shade or full sun. Within seedlings, leaves on primary-growth shoots senesced later than those on secondary-growth shoots in some treatments. Path analyses demonstrated that germination timing and shade affected autumn phenology both directly and indirectly via pathogen load, though the specific pattern differed among and within seedlings. Pathogen load increased with later germination and greater shade. Greater pathogen load was in turn associated with later senescence for seedlings, but with earlier senescence for individual leaves. Our findings show that relationships between seasonal events can be partly mediated by the biotic environment and suggest that these relationships may differ between the plant and leaf level. The influence of biotic interactions on phenological correlations across scales has implications for understanding phenotypic variation in phenology and for predicting how populations will respond to climatic perturbation.
  •  
33.
  • Robinson, M. L., et al. (författare)
  • Plant size, latitude, and phylogeny explain within-population variability in herbivory
  • 2023
  • Ingår i: Science. - 0036-8075 .- 1095-9203. ; 382:6671, s. 679-683
  • Tidskriftsartikel (refereegranskat)abstract
    • Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.
  •  
34.
  • Scarpellini, E., et al. (författare)
  • International consensus on the diagnosis and management of dumping syndrome
  • 2020
  • Ingår i: Nature Reviews Endocrinology. - : Springer Science and Business Media LLC. - 1759-5029 .- 1759-5037. ; 16:8, s. 448-466
  • Tidskriftsartikel (refereegranskat)abstract
    • Dumping syndrome is a common but underdiagnosed complication of gastric and oesophageal surgery. We initiated a Delphi consensus process with international multidisciplinary experts. We defined the scope, proposed statements and searched electronic databases to survey the literature. Eighteen experts participated in the literature summary and voting process evaluating 62 statements. We evaluated the quality of evidence using grading of recommendations assessment, development and evaluation (GRADE) criteria. Consensus (defined as >80% agreement) was reached for 33 of 62 statements, including the definition and symptom profile of dumping syndrome and its effect on quality of life. The panel agreed on the pathophysiological relevance of rapid passage of nutrients to the small bowel, on the role of decreased gastric volume capacity and release of glucagon-like peptide 1. Symptom recognition is crucial, and the modified oral glucose tolerance test, but not gastric emptying testing, is useful for diagnosis. An increase in haematocrit >3% or in pulse rate >10 bpm 30 min after the start of the glucose intake are diagnostic of early dumping syndrome, and a nadir hypoglycaemia level <50 mg/dl is diagnostic of late dumping syndrome. Dietary adjustment is the agreed first treatment step; acarbose is effective for late dumping syndrome symptoms and somatostatin analogues are preferred for patients who do not respond to diet adjustments and acarbose. Dumping syndrome is a frequent complication of oesophageal and gastric surgery, as well as bariatric surgery; however, guidance on how to manage patients with this condition is lacking. In this Evidence-based guideline, the authors use a Delphi consensus process to develop uniform guidance for the definition, diagnosis and management of dumping syndrome.
  •  
35.
  • Scarpellini, E., et al. (författare)
  • Nutrient Drinking Test as Biomarker in Functional Dyspepsia
  • 2021
  • Ingår i: American Journal of Gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 0002-9270 .- 1572-0241. ; 116:7, s. 1387-1395
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Functional dyspepsia (FD) is a prevalent condition with multifactorial pathophysiology, including impaired gastric accommodation (GA), hypersensitivity to gastric distention, and delayed gastric emptying. Drink tests (DT) have been proposed as a potential biomarker for the presence and severity of gastric sensorimotor dysfunction. Thus, we aimed to summarize the state of knowledge on different DT and their potential as a biomarker for FD. METHODS: A PubMed and MEDLINE search was conducted for English language articles, reviews, meta-analyses, case series, and randomized controlled trials, including also published meeting abstracts. RESULTS: Several DT have been described in literature (e.g., different type of liquid, number of calories used, pace of drinking, and subject's awareness of the amount of liquid drunk). FD patients ingest significantly less volume in the different variants of the tests. The slow nutrient ("satiety drinking") test (SDT) studies show the most consistent separation between health and FD and correlation with GA. However, sensitivity to distention may be correlated with rapid DT. SDTs were used to evaluate the effect of several pharmacological agents, often showing concordance between their effects on GA and tolerated nutrient volume. This correlation was not found mainly for agents with central actions. DISCUSSION: An SDT is a potential diagnostic biomarker in FD, reflecting GA. Additional studies are required to confirm its role as a predictive biomarker for treatment outcome in FD.
  •  
36.
  • Schol, J., et al. (författare)
  • Postinfectious onset in functional dyspepsia is a risk factor for weight loss
  • 2022
  • Ingår i: Journal of Gastroenterology. - : Springer Science and Business Media LLC. - 0944-1174 .- 1435-5922. ; 57:3, s. 156-163
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Functional dyspepsia (FD) is differentiated into two subgroups: the postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Acute gastroenteritis and Helicobacter pylori (HP) infection have been identified as risk factors for FD. It is unclear how these risk factors relate to Rome IV subgroups and their clinical impact. We aimed to study the association of postinfectious FD (PI-FD) and HP status with clinical profiles and weight loss. Methods: Consecutive FD patients were assessed for symptom frequency and severity. Patients were identified as PDS, EPS or the overlap group according to severity scores. Additionally, PI history and HP status were determined. Results: In a cohort of 459 FD-patients, 36% were characterized as having PDS, 9% as having EPS and 55% showed overlap. PI onset and positive HP status were reported by, respectively, 20% and 14% of patients, not significantly differing between subgroups (respectively, p = 0.31 and p = 0.40). Weight loss was reported by 63% in PDS, 36% in EPS and 56% in overlap patients (p = 0.011). Only early satiety severity correlated with more severe weight loss in the PDS (r 0.31, p < 0.0001) and overlap group (r 0.38, p < 0.0001). PI-FD patients were more likely to experience weight loss (OR 2.27, p = 0.0013). HP status was not significantly associated with weight loss (p = 0.90). Conclusion: In this cohort, PI onset of FD symptoms emerged as a risk factor for weight loss, but was not associated with the symptom patterns of PDS, EPS or overlap subgroups. Patients with HP infection were not more likely to experience important weight loss. © 2022, Japanese Society of Gastroenterology.
  •  
37.
  • Sperber, A. D., et al. (författare)
  • Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life
  • 2022
  • Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier BV. - 1542-3565. ; 20:5
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND AIMS: Conditions such as irritable bowel syndrome (IBS), functional dyspepsia, and functional constipation are among the prevalent gastrointestinal (GI) disorders classified as disorders of gutbrain interaction (DGBI), which can adversely affect the lives of sufferers. This study aimed to assess the degree and consequences of overlapping DGBI in a large population-based global scale. METHODS: Internet survey data from 54,127 adults (49.1% women) in 26 countries were analyzed by 4 GI anatomic regions (esophageal, gastroduodenal, bowel, and anorectal). The number of DGBIaffected GI regions was assessed, including associations with sex, age, disease severity, quality of life, psychosocial variables, and health care utilization. RESULTS: A total of 40.3% of surveyed individuals met Rome IV criteria for a DGBI. The percentages with 1-4 DGBI-affected GI regions were 68.3%, 22.3%, 7.1%, and 2.3%, respectively. The IBS symptom severity score increased significantly from 1 (207.6) to 4 (291.6) regions, as did nonGI symptom reporting (somatization), anxiety and depression, concerns and embarrassment about bowel function, doctor visits, medications, and abdominal surgeries (all P <.0001). Quality of life decreased with increasing number of DGBI regions (P <.0001). In a logistic mixed model, non-GI symptoms (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.08-1.10), being very vs not concerned (OR, 2.55; 95% CI, 2.27-2.90), being very vs not embarrassed about bowel function (OR, 1.20; 95% CI, 1.08-1.33), and mean number of doctor visits (OR, 1.23; 95% CI, 1.115-1.32) were most strongly associated with number of DGBI regions. CONCLUSIONS: DGBI in multiple anatomic GI regions is associated with increased psychological comorbidity, health care utilization, and IBS severity. Physician awareness of overlap could improve quality of care, prevent unnecessary interventions, and yield more positive health outcomes.
  •  
38.
  • Tack, Ayco J. M., et al. (författare)
  • Below-ground abiotic and biotic heterogeneity shapes above-ground infection outcomes and spatial divergence in a host-parasite interaction
  • 2015
  • Ingår i: New Phytologist. - : Wiley. - 0028-646X .- 1469-8137. ; 207:4, s. 1159-1169
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated the impact of below-ground and above-ground environmental heterogeneity on the ecology and evolution of a natural plant-pathogen interaction. We combined field measurements and a reciprocal inoculation experiment to investigate the potential for natural variation in abiotic and biotic factors to mediate infection outcomes in the association between the fungal pathogen Melampsora lini and its wild flax host, Linum marginale, where pathogen strains and plant lines originated from two ecologically distinct habitat types that occur in close proximity (bog' and hill'). The two habitat types differed strikingly in soil moisture and soil microbiota. Infection outcomes for different host-pathogen combinations were strongly affected by the habitat of origin of the plant lines and pathogen strains, the soil environment and their interactions. Our results suggested that tradeoffs play a key role in explaining the evolutionary divergence in interaction traits among the two habitat types. Overall, we demonstrate that soil heterogeneity, by mediating infection outcomes and evolutionary divergence, can contribute to the maintenance of variation in resistance and pathogenicity within a natural host-pathogen metapopulation.
  •  
39.
  • Tack, Jan, 1962, et al. (författare)
  • A survey on the impact of the COVID-19 pandemic on motility and functional investigations in Europe and considerations for recommencing activities in the early recovery phase
  • 2020
  • Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 32:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The COVID-19 pandemic, declared by WHO on March 13, 2020, had a major global impact on the healthcare system and services. In the acute phase, the presence of the SARS-CoV-2 virus in the aerodigestive tract limited activities in the gastroenterology clinic and procedures to emergencies only. Motility and function testing was interrupted and as we enter the recovery phase, restarting these procedures requires a safety-focused approach with adequate infection prevention for patients and healthcare professionals. Methods We summarized knowledge on the presence of the SARS-CoV-2 virus in the aerodigestive tract and the risk of spread with motility and functional testing. We surveyed 39 European centers documenting how the pandemic affected activities and which measures they are considering for restarting these measurements. We propose recommendations based on current knowledge as applied in our center. Results Positioning of catheters for gastrointestinal motility tests carries a concern for aerosol-borne infection of healthcare workers. The risk is low with breath tests. The surveyed centers stopped almost all motility and function tests from the second half of March. The speed of restarting and the safety measures taken varied highly. Conclusions and Inferences Based on these findings, we provided recommendations and practical relevant information for motility and function test procedures in the COVID-19 pandemic era, to guarantee a high-quality patient care with adequate infection prevention.
  •  
40.
  • Tack, J., et al. (författare)
  • An expert consensus definition of failure of a treatment to provide adequate relief (F-PAR) for chronic constipation - an international Delphi survey
  • 2017
  • Ingår i: Alimentary Pharmacology & Therapeutics. - : Wiley. - 0269-2813. ; 45:3, s. 434-442
  • Tidskriftsartikel (refereegranskat)abstract
    • Background As treatments for constipation become increasingly available, it is important to know when to progress along the treatment algorithm if the patient is not better. To establish the definition of failure of a treatment to provide adequate relief (F-PAR) to support this management and referral process in patients with chronic constipation. We conducted an international Delphi Survey among gastroenterologists and general practitioners with a special interest in chronic constipation. An initial questionnaire based on recognised rating scales was developed following a focus group. Data were collected from two subsequent rounds of questionnaires completed by all authors. Likert scales were used to establish a consensus on a shorter list of more severe symptoms. The initial focus group yielded a first round questionnaire with 84 statements. There was good consensus on symptom severity and a clear severity response curve, allowing 67 of the symptom-severity pairings to be eliminated. Subsequently, a clear consensus was established on further reduction to eight symptom statements in the final definition, condensed by the steering committee into five diagnostic statements (after replicate statements had been removed). We present an international consensus on chronic constipation, of five symptoms and their severities, any of which would be sufficient to provide clinical evidence of treatment failure. We also provide data representing an expert calibration of commonly used rating scales, thus allowing results of clinical trials expressed in terms of those scales to be converted into estimates of rates of provision of adequate relief.
  •  
41.
  • Tack, J, et al. (författare)
  • Diagnosis and treatment of chronic constipation--a European perspective.
  • 2011
  • Ingår i: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. - : Wiley. - 1365-2982. ; 23:8, s. 697-710
  • Forskningsöversikt (refereegranskat)abstract
    • BACKGROUND: Although constipation can be a chronic and severe problem, it is largely treated empirically. Evidence for the efficacy of some of the older laxatives from well-designed trials is limited. Patients often report high levels of dissatisfaction with their treatment, which is attributed to a lack of efficacy or unpleasant side-effects. Management guidelines and recommendations are limited and are not sufficiently current to include treatments that became available more recently, such as prokinetic agents in Europe. PURPOSE: We present an overview of the pathophysiology, diagnosis, current management and available guidelines for the treatment of chronic constipation, and include recent data on the efficacy and potential clinical use of the more newly available therapeutic agents. Based on published algorithms and guidelines on the management of chronic constipation, secondary pathologies and causes are first excluded and then diet, lifestyle, and, if available, behavioral measures adopted. If these fail, bulk-forming, osmotic, and stimulant laxatives can be used. If symptoms are not satisfactorily resolved, a prokinetic agent such as prucalopride can be prescribed. Biofeedback is recommended as a treatment for chronic constipation in patients with disordered defecation. Surgery should only be considered once all other treatment options have been exhausted.
  •  
42.
  •  
43.
  • Tack, J., et al. (författare)
  • Long-term safety and efficacy of acotiamide in functional dyspepsia (postprandial distress syndrome)results from the European phase 3 open-label safety trial
  • 2018
  • Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925. ; 30:6
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundsAcotiamide is a novel acetylcholinesterase inhibitor for treatment of postprandial distress syndrome (PDS) symptoms of functional dyspepsia (FD). This European phase 3 open-label safety trial has been conducted to evaluate the long-term safety of acotiamide and explore the efficacy of acotiamide on PDS symptoms using the validated LPDS, quality of life using SF-36 and SF-NDI, and work productivity using WPAI. MethodsFD-PDS patients (defined by ROME III criteria) aged 18years with active PDS symptoms and without predominant overlapping symptoms of epigastric pain syndrome and related disorders were enrolled to receive 100mg acotiamide three times daily for 1year. Patients' safety profile and efficacy of acotiamide were monitored. Key ResultsThe majority of patients (81.6%) maintained exposure to acotiamide for >50weeks, with a mean duration of 320.3days. No specific clinically significant safety concerns have been shown, with no deaths, treatment-related severe/serious adverse events, or any clinically significant laboratory test results. Although being an open-label trial, acotiamide showed a change in severity larger than the minimum clinically important difference at weeks 1 and 2 for postprandial fullness and early satiation (meal-related symptoms), and showed improvement of quality of life and work productivity from the first measurement (at week 12) up to 1year. Conclusions & InferencesThe long-term safety of acotiamide treatment was confirmed. A clinically important change for PDS symptoms, QoL, and work productivity was suggested; however a controlled trial is required to confirm this hypothetic efficacy of acotiamide. (NCT01973790).
  •  
44.
  • Tack, J., et al. (författare)
  • Plausibility criteria for putative pathophysiological mechanisms in functional gastrointestinal disorders: a consensus of experts
  • 2018
  • Ingår i: Gut. - : BMJ. - 0017-5749 .- 1468-3288. ; 67:8, s. 1425-1433
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims The functional gastrointestinal disorders (FGIDs) are extremely common conditions associated with a considerable personal, social and health economic burden. Managing FGIDs in clinical practice is challenging because of the uncertainty of symptom-based diagnosis, the high frequency of overlap between these conditions and the limited efficacy of available therapies. It has often been argued that successful drug development and management of FGIDs requires knowledge of the underlying pathophysiology. Numerous and highly variable candidate pathophysiological mechanisms have been implicated in the generation of FGID symptoms, but there is no current consensus on how to best define the relevance of these disturbances. Methods A group of international experts on FGIDs developed plausibility criteria that should be fulfilled by relevant pathophysiological mechanisms in FGIDs. Results Five criteria are proposed: (1) the presence of the abnormality in a subset of patients, (2) temporal association between proposed mechanism and symptom(s), (3) correlation between the level of impairment of the mechanism and symptom(s), (4) induction of the symptom(s) by provoking the pathophysiological abnormality in healthy subjects and (5) treatment response by a therapy specifically correcting the underlying disorder or congruent natural history of symptoms and dysfunction in the absence of specific therapy. Based on strength of evidence for these five criteria according to the Grading of Recommendations Assessment, Development and Evaluation system, a plausibility score can be calculated for each mechanism. Conclusion Evaluation of the strength of evidence for candidate pathophysiological abnormalities fulfilling these five plausibility criteria will help to identify the most relevant mechanisms to target for novel diagnostic approaches and for the development of new therapies.
  •  
45.
  • van Dijk, Laura J. A., et al. (författare)
  • Belowground microorganisms drive aboveground plant–pathogen–insect interactions
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Plants interact with a large diversity of microorganisms and insects, both below and above ground. While studies have shown that belowground microorganisms affect the performance of plants and aboveground attackers, we lack insights into how belowground microbial communities may shape interactions between aboveground pathogens and insects. In this study, we investigated the effects of soil biota and aboveground attackers on plant performance, and examined whether soil biota influence interactions between plants and attackers. We conducted a growth-chamber experiment with oak seedlings (Quercus robur) growing with three distinct natural soil microbial communities. Plants were subjected to single or dual attack by powdery mildew (Erysiphe alphitoides) and aphids (Tuberculatus annulatus), either in the presence or absence of prior attack by a free-feeding caterpillar (Phalera bucephala). Plant height was influenced by soil biota, and seedlings with multiple attackers had more but smaller leaves than healthy seedlings. The soil community affected mildew performance, and mediated the impact of co-occurring attackers on aphid performance. Our study highlights that plant performance is affected both by soil biota and aboveground attackers, and that plant–pathogen–insect interactions are shaped by belowground biota. These findings are important for our understanding of species interactions in nature as well as for practical applications such as integrated pest management.   
  •  
46.
  • van Dijk, Laura J. A, et al. (författare)
  • Direct and insect-mediated effects of pathogens on plant growth and fitness
  • 2021
  • Ingår i: Journal of Ecology. - : British Ecological Society. - 0022-0477 .- 1365-2745. ; 109:7, s. 2769-2779
  • Tidskriftsartikel (refereegranskat)abstract
    • 1. Plants are attacked by a large diversity of pathogens. These pathogens can affectplant growth and fitness directly but also indirectly by inducing changes in the host plant that affect interactions with beneficial and antagonistic insects. Yet, we lack insights into the relative importance of direct and indirect effects of pathogens on their host plants, and how these effects differ among pathogen species.2. In this study, we examined four fungal pathogens on the wood anemone Anemone nemorosa. We used field observations to record the impacts of each pathogen species on plant growth and fitness throughout the season, and experimental hand pollination and insect feeding trials to assess whether fitness impacts were mediated by pathogen-induced changes in plant–pollinator and plant–herbivore interactions.3. Three out of four pathogens negatively affected plant size, and pathogens differed strongly in their effect on plant architecture. Infected plants had lower fitness, but this effect was not mediated by pollinators or herbivores. Even so, two out of four pathogens reduced herbivory on anemones in the field, and we found negative effects of pathogen infection on herbivore preference and performance in feeding trials.4. Synthesis. Our results are of broader significance in two main respects. First, we demonstrated that pathogens negatively affected plant growth and fitness, and that the magnitude of these effects varied among pathogen species, suggesting that pathogens constitute important selective agents that differ in strength. Second, direct effects on plant fitness were more important than effects mediatedby beneficial and antagonistic insects. In addition, although we did not detect insect-mediated effects on plant fitness, the negative effects of some pathogens on herbivore preference and performance indicate that pathogen communities influence the distribution and abundance of herbivores.
  •  
47.
  • van Dijk, Laura J. A., 1990- (författare)
  • Interactions between plants, microbes and insects
  • 2021
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Plants interact with an astonishing diversity of insects and microorganisms. Both above- and belowground, plants are attacked by herbivores and pathogens, and interact with mutualists such as pollinating insects and beneficial microorganisms. Insects and microorganisms interacting with plants may also affect one another when sharing the same host, leading to direct and indirect interactions between plants, microorganisms and insects. These interactions may have important ecological and evolutionary consequences for all involved species, and interaction outcomes might be dependent on the timing of the interaction as well as the abiotic and biotic context. Thus, in order to predict the outcome of plant–microbe–insect interactions, we need insights into how interactions vary over time and space and how these are influenced by biotic context, from the perspective of all involved species.In this thesis, my overarching aim was to investigate when and where species interact, and to examine the influence of relative timing and biotic context on the outcomes of plant–microbe–insect interactions from a multi-species perspective. I focussed on two study systems, the pedunculate oak Quercus robur and the wood anemone Anemone nemorosa, and the insects and microorganisms associated with these plants. First, I looked into the drivers behind the spatiotemporal distribution of several fungal pathogens on plants. Specifically, I investigated whether life history traits of pathogens were linked to their metapopulation dynamics. Second, I examined the relative importance of direct and insect-mediated effects of these pathogens on plant performance. Third, I conducted multifactorial growth chamber experiments to investigate performance impacts of interactions from the perspectives of all involved species (plant, insect and pathogen). Lastly, I investigated the influence of time of attacker arrival, early arriving attackers and soil microbial communities on interaction outcomes.I found that life history traits of pathogens were related to some aspects of metapopulation dynamics. These pathogens had direct, negative impacts on plant growth and fitness, while I did not find evidence for insect-mediated effects. For the multifactorial experiments, I observed some impacts of multiple attackers (pathogens and insects) on plant growth, though plants were mostly tolerant to attack. Attackers that shared a host could affect each other’s performances, with effects mostly being asymmetric, though the interaction outcomes were dependent on the time of arrival, early arriving attackers and soil microbial communities.In conclusion, my findings show that i) life history traits may influence where pathogen species occur in space and time, that ii) direct effects of pathogens on plant fitness can dominate insect-mediated effects, and that iii) the outcome of species interactions is often asymmetric and dependent on relative timing as well as biotic context. By identifying some of the drivers behind, and consequences of, plant–microbe–insect interactions, this thesis contributes to the development of a predictive framework for species interactions.
  •  
48.
  • van Dijk, Laura J. A., 1990-, et al. (författare)
  • Single, but not dual, attack by a biotrophic pathogen and a sap-sucking insect affects the oak leaf metabolome
  • 2022
  • Ingår i: Frontiers in Plant Science. - : Frontiers Media S.A.. - 1664-462X. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Plants interact with a multitude of microorganisms and insects, both below- and above ground, which might influence plant metabolism. Despite this, we lack knowledge of the impact of natural soil communities and multiple aboveground attackers on the metabolic responses of plants, and whether plant metabolic responses to single attack can predict responses to dual attack. We used untargeted metabolic fingerprinting (gas chromatography-mass spectrometry, GC-MS) on leaves of the pedunculate oak, Quercus robur, to assess the metabolic response to different soil microbiomes and aboveground single and dual attack by oak powdery mildew (Erysiphe alphitoides) and the common oak aphid (Tuberculatus annulatus). Distinct soil microbiomes were not associated with differences in the metabolic profile of oak seedling leaves. Single attacks by aphids or mildew had pronounced but different effects on the oak leaf metabolome, but we detected no difference between the metabolomes of healthy seedlings and seedlings attacked by both aphids and powdery mildew. Our findings show that aboveground attackers can have species-specific and non-additive effects on the leaf metabolome of oak. The lack of a metabolic signature detected by GC-MS upon dual attack might suggest the existence of a potential negative feedback, and highlights the importance of considering the impacts of multiple attackers to gain mechanistic insights into the ecology and evolution of species interactions and the structure of plant-associated communities, as well as for the development of sustainable strategies to control agricultural pests and diseases and plant breeding.
  •  
49.
  • van Dijk, Laura J. A., 1990-, et al. (författare)
  • Soil microbiomes drive aboveground plant–pathogen–insect interactions
  • 2022
  • Ingår i: Oikos. - : Wiley. - 0030-1299 .- 1600-0706. ; 2022:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Plants interact with a large diversity of microbes and insects, both below and above ground. While studies have shown that belowground microbes affect the performance of plants and aboveground organisms, we lack insights into how belowground microbial communities may shape interactions between aboveground pathogens and insects. We investigated how soil microbiomes and aboveground organisms affect plant growth and development, and whether differences in soil microbiomes influence interactions between aboveground organisms. We conducted a growth-chamber experiment with oak seedlings Quercus robur growing in three soils with similar abiotic soil properties but with distinct natural soil microbiomes. Seedlings were subjected to single or dual attack by powdery mildew Erysiphe alphitoides and aphids Tuberculatus annulatus, either in the presence or absence of prior attack by a free-feeding caterpillar Phalera bucephala. Soil microbiomes were associated with differences in seedling height, and seedlings with multiple aboveground organisms had more but smaller leaves than healthy seedlings. The soil microbiome affected the severity of powdery mildew infection, and mediated the impact of co-occurring aboveground organisms on aphid population size. Our study highlights that plant performance is affected by natural soil microbiomes as well as aboveground organisms, and that natural soil microbiomes can affect interactions between pathogens and insects. These findings are important to understand species interactions in natural systems, as well as for practical applications, such as manipulation of soil microbiomes to manage agricultural pests and diseases.
  •  
50.
  • van Dijk, Laura J.A., et al. (författare)
  • Temperature and water availability drive insect seasonality across a temperate and a tropical region
  • 2024
  • Ingår i: Proceedings of the Royal Society of London. Biological Sciences. - : The Royal Society. - 0962-8452 .- 1471-2954. ; 291:2025
  • Tidskriftsartikel (refereegranskat)abstract
    • The more insects there are, the more food there is for insectivores and the higher the likelihood for insect-associated ecosystem services. Yet, we lack insights into the drivers of insect biomass over space and seasons, for both tropical and temperate zones. We used 245 Malaise traps, managed by 191 volunteers and park guards, to characterize year-round flying insect biomass in a temperate (Sweden) and a tropical (Madagascar) country. Surprisingly, we found that local insect biomass was similar across zones. In Sweden, local insect biomass increased with accumulated heat and varied across habitats, while biomass in Madagascar was unrelated to the environmental predictors measured. Drivers behind seasonality partly converged: In both countries, the seasonality of insect biomass differed between warmer and colder sites, and wetter and drier sites. In Sweden, short-term deviations from expected season-specific biomass were explained by week-to-week fluctuations in accumulated heat, rainfall and soil moisture, whereas in Madagascar, weeks with higher soil moisture had higher insect biomass. Overall, our study identifies key drivers of the seasonal distribution of flying insect biomass in a temperate and a tropical climate. This knowledge is key to understanding the spatial and seasonal availability of insects-as well as predicting future scenarios of insect biomass change.
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-50 av 166
Typ av publikation
tidskriftsartikel (136)
annan publikation (12)
konferensbidrag (8)
doktorsavhandling (5)
forskningsöversikt (5)
Typ av innehåll
refereegranskat (146)
övrigt vetenskapligt/konstnärligt (20)
Författare/redaktör
Tack, Ayco J. M. (73)
Tack, J (43)
Simrén, Magnus, 1966 (39)
Roslin, Tomas (26)
Törnblom, Hans, 1966 (25)
Hylander, Kristoffer (18)
visa fler...
Van Oudenhove, L. (16)
Tack, Ayco J. M., 19 ... (15)
Abdelfattah, Ahmed (12)
De Frenne, Pieter (11)
Palsson, O. S. (11)
van Dijk, Laura J. A ... (11)
Nemomissa, Sileshi (11)
Rasmussen, Pil, U. (11)
Castagneyrol, Bastie ... (10)
Ehrlén, Johan (10)
Faticov, Maria (10)
Zewdie, Beyene, 1983 ... (9)
Sperber, A. D. (9)
Adugna, Girma (9)
Bangdiwala, S. I. (8)
Pulkkinen, Pertti (8)
Vanuytsel, T. (8)
Moreira, Xoaquin (8)
Whitehead, W. E. (7)
Keszthelyi, D. (7)
Ayalew, Biruk (7)
Timmermans, Bart G. ... (7)
Gotthard, Karl (6)
Verheyen, Kris (6)
Nordenstrom, A (6)
Zewdie, Beyene (6)
Cools, M (6)
Drossman, D. A. (6)
Ekholm, Adam (6)
Tack, Jan, 1962 (6)
Corsetti, M. (6)
Hylander, Kristoffer ... (6)
Ten Hoopen, Jan P. J ... (6)
Andersson, Anders F. (5)
Clevers, Egbert (5)
Bryce, J (5)
Stuckey, Peter J. (5)
Tack, Guido (5)
Balsamo, A (5)
Baronio, F (5)
Gaytán, Álvaro (5)
Mendesil, Esayas (5)
Jaatinen, Raimo (5)
Gaytán, Álvaro, 1988 ... (5)
visa färre...
Lärosäte
Stockholms universitet (95)
Göteborgs universitet (46)
Sveriges Lantbruksuniversitet (27)
Karolinska Institutet (16)
Kungliga Tekniska Högskolan (7)
Uppsala universitet (7)
visa fler...
Umeå universitet (4)
Lunds universitet (3)
Högskolan i Halmstad (2)
Linköpings universitet (2)
Naturhistoriska riksmuseet (2)
visa färre...
Språk
Engelska (166)
Forskningsämne (UKÄ/SCB)
Naturvetenskap (96)
Medicin och hälsovetenskap (48)
Lantbruksvetenskap (18)

År

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy