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- van Bragt, JJMH, et al.
(författare)
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Characteristics and treatment regimens across ERS SHARP severe asthma registries
- 2020
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Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 55:1
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg·m−2 (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 µg·day−1 between those from Slovenia versus Poland when starting anti-interleukin (IL)-5 antibody and from 772 to 1344 µg·day−1 in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries.
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- Dagnegård, H.H., et al.
(författare)
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Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics
- 2022
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Ingår i: Journal of Thoracic and Cardiovascular Surgery. - : Mosby Inc.; Elsevier Inc.. - 0022-5223 .- 1097-685X. ; 164:6, s. 1712-1724
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement. Methods: Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery. Results: We included 1030 implantations in 1008 patients with elective indications for surgery: aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications: endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, 83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis. Conclusions: At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics. © 2021 The Authors
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- Edfors, R., et al.
(författare)
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Use of proteomics to identify biomarkers associated with chronic kidney disease and long-term outcomes in patients with myocardial infarction
- 2020
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 288:5, s. 581-592
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Tidskriftsartikel (refereegranskat)abstract
- Background Patients with chronic kidney disease (CKD) have poor outcomes following myocardial infarction (MI). We performed an untargeted examination of 175 biomarkers to identify those with the strongest association with CKD and to examine the association of those biomarkers with long-term outcomes. Methods A total of 175 different biomarkers from MI patients enrolled in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) registry were analysed either by a multiple reaction monitoring mass spectrometry assay or by a multiplex assay (proximity extension assay). Random forests statistical models were used to assess the predictor importance of biomarkers, CKD and outcomes. Results A total of 1098 MI patients with a median estimated glomerular filtration rate of 85 mL min(-1)/1.73 m(2)were followed for a median of 3.2 years. The random forests analyses, without and with adjustment for differences in demography, comorbidities and severity of disease, identified six biomarkers (adrenomedullin, TNF receptor-1, adipocyte fatty acid-binding protein-4, TNF-related apoptosis-inducing ligand receptor 2, growth differentiation factor-15 and TNF receptor-2) to be strongly associated with CKD. All six biomarkers were also amongst the 15 strongest predictors for death, and four of them were amongst the strongest predictors of subsequent MI and heart failure hospitalization. Conclusion In patients with MI, a proteomic approach could identify six biomarkers that best predicted CKD. These biomarkers were also amongst the most important predictors of long-term outcomes. Thus, these biomarkers indicate underlying mechanisms that may contribute to the poor prognosis seen in patients with MI and CKD.
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- Karlsson, P., et al.
(författare)
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Stakeholder consensus for decision making in eye-gaze control technology for children, adolescents and adults with cerebral palsy service provision: findings from a Delphi study
- 2021
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Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLimited research exists to guide clinical decisions about trialling, selecting, implementing and evaluating eye-gaze control technology. This paper reports on the outcomes of a Delphi study that was conducted to build international stakeholder consensus to inform decision making about trialling and implementing eye-gaze control technology with people with cerebral palsy.MethodsA three-round online Delphi survey was conducted. In Round 1, 126 stakeholders responded to questions identified through an international stakeholder Advisory Panel and systematic reviews. In Round 2, 63 respondents rated the importance of 200 statements generated by in Round 1. In Round 3, 41 respondents rated the importance of the 105 highest ranked statements retained from Round 2.ResultsStakeholders achieved consensus on 94 of the original 200 statements. These statements related to person factors, support networks, the environment, and technical aspects to consider during assessment, trial, implementation and follow-up. Findings reinforced the importance of an individualised approach and that information gathered from the user, their support network and professionals are central when measuring outcomes. Information required to support an application for funding was obtained.ConclusionThis Delphi study has identified issues which are unique to eye-gaze control technology and will enhance its implementation with people with cerebral palsy.
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- Kurilshikov, Alexander, et al.
(författare)
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Large-scale association analyses identify host factors influencing human gut microbiome composition
- 2021
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Ingår i: Nature Genetics. - : Nature Publishing Group. - 1061-4036 .- 1546-1718. ; 53:2, s. 156-165
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Tidskriftsartikel (refereegranskat)abstract
- To study the effect of host genetics on gut microbiome composition, the MiBioGen consortium curated and analyzed genome-wide genotypes and 16S fecal microbiome data from 18,340 individuals (24 cohorts). Microbial composition showed high variability across cohorts: only 9 of 410 genera were detected in more than 95% of samples. A genome-wide association study of host genetic variation regarding microbial taxa identified 31 loci affecting the microbiome at a genome-wide significant (P < 5 x 10(-8)) threshold. One locus, the lactase (LCT) gene locus, reached study-wide significance (genome-wide association study signal: P = 1.28 x 10(-20)), and it showed an age-dependent association with Bifidobacterium abundance. Other associations were suggestive (1.95 x 10(-10) < P < 5 x 10(-8)) but enriched for taxa showing high heritability and for genes expressed in the intestine and brain. A phenome-wide association study and Mendelian randomization identified enrichment of microbiome trait loci in the metabolic, nutrition and environment domains and suggested the microbiome might have causal effects in ulcerative colitis and rheumatoid arthritis.
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- Berendse, F, et al.
(författare)
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Raised atmospheric CO2 levels and increased N deposition cause shifts in plant species composition and production in Sphagnum bogs
- 2001
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 7:5, s. 591-598
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Tidskriftsartikel (refereegranskat)abstract
- Part of the missing sink in the global CO2 budget has been attributed to the positive effects of CO2 fertilization and N deposition on carbon sequestration in Northern Hemisphere terrestrial ecosystems. The genus Sphagnum is one of the most important groups of plant species sequestrating carbon in temperate and northern bog ecosystems, because of the low decomposability of the dead material it produces. The effects of raised CO2 and increased atmospheric N deposition on growth of Sphagnum and other plants were studied in bogs at four sites across Western Europe. Contrary to expectations, elevated CO2 did not significantly affect Sphagnum biomass growth. Increased N deposition reduced Sphagnum mass growth, because it increased the cover of vascular plants and the tall moss Polytrichum strictum. Such changes in plant species composition may decrease carbon sequestration in Sphagnum-dominated bog ecosystems.
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- Brannon, A Rose, et al.
(författare)
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Molecular Stratification of Clear Cell Renal Cell Carcinoma by Consensus Clustering Reveals Distinct Subtypes and Survival Patterns.
- 2010
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Ingår i: Genes & cancer. - : Sage. - 1947-6027 .- 1947-6019. ; 1:2, s. 152-163
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Tidskriftsartikel (refereegranskat)abstract
- Clear cell renal cell carcinoma (ccRCC) is the predominant RCC subtype, but even within this classification, the natural history is heterogeneous and difficult to predict. A sophisticated understanding of the molecular features most discriminatory for the underlying tumor heterogeneity should be predicated on identifiable and biologically meaningful patterns of gene expression. Gene expression microarray data were analyzed using software that implements iterative unsupervised consensus clustering algorithms to identify the optimal molecular subclasses, without clinical or other classifying information. ConsensusCluster analysis identified two distinct subtypes of ccRCC within the training set, designated clear cell type A (ccA) and B (ccB). Based on the core tumors, or most well-defined arrays, in each subtype, logical analysis of data (LAD) defined a small, highly predictive gene set that could then be used to classify additional tumors individually. The subclasses were corroborated in a validation data set of 177 tumors and analyzed for clinical outcome. Based on individual tumor assignment, tumors designated ccA have markedly improved disease-specific survival compared to ccB (median survival of 8.6 vs 2.0 years, P = 0.002). Analyzed by both univariate and multivariate analysis, the classification schema was independently associated with survival. Using patterns of gene expression based on a defined gene set, ccRCC was classified into two robust subclasses based on inherent molecular features that ultimately correspond to marked differences in clinical outcome. This classification schema thus provides a molecular stratification applicable to individual tumors that has implications to influence treatment decisions, define biological mechanisms involved in ccRCC tumor progression, and direct future drug discovery.
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- Ekholm, M, et al.
(författare)
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Long-term angiotensin-converting enzyme inhibition with ramipril reduces thrombin generation in human hypertension
- 2002
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Ingår i: Clinical science (London, England : 1979). - : Portland Press Ltd.. - 0143-5221 .- 1470-8736. ; 103:2, s. 151-155
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Tidskriftsartikel (refereegranskat)abstract
- Antihypertensive treatment reduces the risk of thromboembolic events in hypertension. The aim of this study was to examine the influence of angiotensin-converting enzyme inhibition on blood coagulation in subjects with mild-to-moderate essential hypertension. Fibrinogen, thrombin–antithrombin complex (TAT) and Factor VII were determined in plasma at rest and after a mental stress test following placebo for 6 weeks, or ramipril for 6 weeks or 6 months. Ramipril reduced resting TAT, and tended to reduce fibrinogen; Factor VII remained unchanged. Mental stress increased fibrinogen, but did not alter TAT or Factor VII activity. The reduced thrombin generation in patients taking ramipril may explain in part why angiotensin-converting enzyme inhibitors reduce thromboembolic complications in patients with cardiovascular disease.
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- Elmhagen, Bodil, et al.
(författare)
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Åtgärdsprogram för fjällräv, 2017–2021 : (Vulpes lagopus)
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Fjällräven är klassificerad som starkt hotad i Sverige och akut hotad i Norge. På 1800-talet var det en vanligt förekommande art, men till följd av intensivt jakttryck reducerades populationen kraftigt i slutet av 1800-talet. Fjällräven fridlystes 1928 i Sverige och 1930 i Norge. Trots skydd har populationen inte återhämtat sig. Detta beror på ett flertal samverkande faktorer, framförallt låg populationsstorlek, ökad konkurrens från rödrävar som expanderar in i fjällvärlden, samt uteblivna eller mer oregelbundna lämmeltoppar som leder till födobrist. Dessutom har inavel och inavelsdepression med ökad dödlighet och minskad reproduktion dokumenterats i vissa delbestånd. Sjukdomar och parasiter utgör ett ytterligare hot mot de små delpopulationernas fortlevnad. Störningar från mänskliga aktiviteter kan utgöra ytterligare bidragande faktorer.År 2015 fanns omkring 240 reproducerande vuxna fjällrävar i Sverige och Norge, vilket utgör ett mått på beståndets minimala storlek. Inom EU är fjällräven en prioriterad art enligt habitatdirektivet, i Sverige är fjällräven fridlyst enligt artskyddsförordningen, och i Norge är fjällräven skyddad med ”fjällrävförskriften” enligt naturmangfoldloven.Åtgärder för att rädda fjällräven genomfördes i Sverige och Finland under 1998–2002 genom EU-Life Nature projektet SEFALO. Projektet fortsatte i en andra fas, SEFALO+ (2003–2008) som även involverade Norge. Båda projekten inkluderade åtgärder som stödutfodring, rödrävsjakt och inventeringar. I Norge startade flera åtgärder 2004 på uppdrag av Miljødirektoratet (tidigare Direktoratet for naturforvaltning). Sedan dess har en kombination av åtgärder genomförts i olika delbestånd: avel och utsättning av valpar, stödutfodring, samt kontroll av rödrävsbestånden. Avelsprojekt för fjällräv startade 2005 och de första valparna sattes ut 2006. Inom EU-Interregprojektet Felles Fjellrev (2010–2013) genomfördes utvidgade åtgärder i Jämtlands län samt Nord- och Sør-Trøndelag, med riktade åtgärder i mindre fjällområden mellan de fyra större delbestånden av fjällräv.För att fjällrävsstammen ska återuppnå en gynnsam bevarandestatus bör bevarandeåtgärderna fortsätta inom ramen för det svensk-norska åtgärdsprogrammet. Den långsiktiga visionen är att skapa en stabil och livskraftig stam med gynnsam bevarandestatus utan behov av ytterligare åtgärder. Det är emellertid långt tills denna vision uppnås och i detta program definieras konkreta målsättningar på lång (2035) och kort (2021) sikt. I detta program föreslås fortsatt genomförande av centrala åtgärder i form av stödutfodring och rödrävskontroll. Dessutom ska orsakerna till rödrävens ökade förekomst på fjället hanteras genom åtgärder mot de faktorer som gynnar expansionen. Avel och utsättning från det norska avelsprojektet, alternativt translokering av rävar mellan delpopulationerna, föreslås som åtgärd för att förstärka små populationer, etablera fjällrävar i mellanområden samt minska graden av inavel. Populationernas hälsostatus bör övervakas och vid ett utbrott ska behandling sättas in. Riktade informationskampanjer ska utformas för att minska konflikt och störning med människan.De åtgärder som förutsätts finansieras av Naturvårdsverket och Miljødirektoratet för genomförande av åtgärdsprogram för hotade arter beräknas totalt uppgå till 15, 1 miljoner kronor respektive 47,6 miljoner kronor under programmets giltighetsperiod 2017–2021.
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- Falkengren-Grerup, Ursula, et al.
(författare)
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Förändras floran av kvävenedfallet?
- 2000
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Ingår i: Effekter av kvävenedfall på skogsekosystem. - 9162050664
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Abstract is not available
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- Leemann, Simon, et al.
(författare)
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Status of the MAX IV Storage Rings
- 2010
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Ingår i: Proceedings of IPAC’10. - 9789290833529 ; , s. 2618-2620
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Konferensbidrag (refereegranskat)abstract
- In 2009 the MAX IV facility was granted funding by Swedish authorities. Construction of the facility will begin this summer and user operation is expected by 2015. MAX IV will consist of a 3.4 GeV linac as a driver for a short-pulse radiation facility (with planned upgrade to a seeded/cascaded FEL) as well as an injector for two storage rings at different energies serving user communities in separate spectral ranges. Thanks to a novel compact multibend-achromat design, the 3 GeV ring will deliver a 500 mA electron beam with a horizontal emittance below 0.3 nmrad to x-ray insertion devices located in 19 dispersion-free 5 m straight sections. When the 3 GeV ring goes into operation in 2015 it is expected to become the highest electron-brightness storage ring light source world-wide. The 1.5 GeV ring will serve as a replacement for both present-day MAX II and MAX III storage rings. Its below 6 nm rad horizontal emittance electron beam will be delivered to IR and UV insertion devices in twelve 3.5 m straight sections. We report on design progress for the two new storage rings of the MAX IV facility.
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- Manfredi, L, et al.
(författare)
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A bioinspired autonomous swimming robot as a tool for studying goal-directed locomotion
- 2013
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Ingår i: Biological Cybernetics. - : Springer Science and Business Media LLC. - 0340-1200 .- 1432-0770. ; 107:5, s. 513-527
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Tidskriftsartikel (refereegranskat)abstract
- The bioinspired approach has been key in combining the disciplines of robotics with neuroscience in an effective and promising fashion. Indeed, certain aspects in the field of neuroscience, such as goal-directed locomotion and behaviour selection, can be validated through robotic artefacts. In particular, swimming is a functionally important behaviour where neuromuscular structures, neural control architecture and operation can be replicated artificially following models from biology and neuroscience. In this article, we present a biomimetic system inspired by the lamprey, an early vertebrate that locomotes using anguilliform swimming. The artefact possesses extra- and proprioceptive sensory receptors, muscle-like actuation, distributed embedded control and a vision system. Experiments on optimised swimming and on goal-directed locomotion are reported, as well as the assessment of the performance of the system,which shows high energy efficiency and adaptive behaviour. While the focus is on providing a robotic platform for testing biological models, the reported system can also be of major relevance for the development of engineering system applications.
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- Miglietta, F, et al.
(författare)
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Spatial and Temporal Performance of the MiniFACE (Free Air CO2 Enrichment) System on Bog Ecosystems in Northern and Central Europe
- 2001
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Ingår i: Environmental Monitoring & Assessment. - 1573-2959. ; 66:2, s. 107-127
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Tidskriftsartikel (refereegranskat)abstract
- The Bog Ecosystem Research Initiative (BERI) projectwas initiated to investigate, at five climaticallydifferent sites across Europe, the effects of elevatedCO2 and N deposition on the net exchange ofCO2 and CH4 between bogs and the atmosphere,and to study the effects of elevated CO2 and Ndeposition on the plant biodiversity of bogcommunities. A major challenge to investigate theeffects of elevated CO2 on vegetation andecosystems is to apply elevated CO2concentrations to growing vegetation without changingthe physical conditions like climate and radiation.Most available CO2 enrichment methods disturb thenatural conditions to some degree, for instance closedchambers or open top chambers. Free Air CO2Enrichment (FACE) systems have proven to be suitableto expose plants to elevated CO2 concentrationswith minimal disturbance of their natural environment.The size and spatial scale of the vegetation studiedwithin the BERI project allowed the use of a modifiedversion of a small FACE system called MiniFACE. Thispaper describes the BERI MiniFACE design as well asits temporal and spatial performance at the five BERIfield locations. The temporal performance of theMiniFACE system largely met the quality criteriadefined by the FACE Protocol. One minute averageCO2 concentrations measured at the centre of thering stayed within 20% of the pre-set target for morethan 95% of the time. Increased wind speeds werefound to improve the MiniFACE system's temporalperformance. Spatial analyses showed no apparentCO2 gradients across a ring during a 4 day periodand the mean differences between each sampling pointand the centre of the ring did not exceed 10%.Observations made during a windy day, causing aCO2 concentration gradient, and observations madeduring a calm day indicated that short term gradientstend to average out over longer periods of time. On aday with unidirectional strong winds, CO2concentrations at the upwind side of the ring centrewere higher than those made at the centre and at thedownwind side of the ring centre, but the bell-shapeddistribution was found basically the same for thecentre and the four surrounding measurement points,implying that the short term (1 sec) variability ofCO2 concentrations across the MiniFACE ring isalmost the same at any point in the ring. Based on gasdispersion simulations and measured CO2concentration profiles, the possible interferencebetween CO2-enriched and control rings was foundto be negligible beyond a centre-to-centre ringdistance of 6 m.
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- Mobarrez, Fariborz, et al.
(författare)
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Microparticles in the blood of patients with systemic lupus erythematosus (SLE) : phenotypic characterization and clinical associations
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease characterized by circulating autoantibodies and the formation of immune complexes. In these responses, the selecting self-antigens likely derive from the remains of dead and dying cells, as well as from disturbances in clearance. During cell death/activation, microparticles (MPs) can be released to the circulation. Previous MP studies in SLE have been limited in size and differ regarding numbers and phenotypes. Therefore, to characterize MPs more completely, we investigated 280 SLE patients and 280 individually matched controls. MPs were measured with flow cytometry and phenotyped according to phosphatidylserine expression (PS(+)/PS(-)), cellular origin and inflammatory markers. MPs, regardless of phenotype, are 2-10 times more abundant in SLE blood compared to controls. PS(-) MPs predominated in SLE, but not in controls (66% vs. 42%). Selectively in SLE, PS(-) MPs were more numerous in females and smokers. MP numbers decreased with declining renal function, but no clear association with disease activity was observed. The striking abundance of MPs, especially PS(-) MPs, suggests a generalized disturbance in SLE. MPs may be regarded as "liquid biopsies" to assess the production and clearance of dead, dying and activated cells, i.e. pivotal events for SLE pathogenesis.
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