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| 2. |
- Grote, Ludger, 1964, et al.
(författare)
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National Knowledge-Driven Management of Obstructive Sleep Apnea-The Swedish Approach
- 2023
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Ingår i: Diagnostics. - : MDPI AG. - 2075-4418. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This paper describes the development of "Swedish Guidelines for OSA treatment" and the underlying managed care process. The Apnea Hypopnea Index (AHI) is traditionally used as a single parameter for obstructive sleep apnea (OSA) severity classification, although poorly associated with symptomatology and outcome. We instead implement a novel matrix for shared treatment decisions based on available evidence. Methods: A national expert group including medical and dental specialists, nurses, and patient representatives developed the knowledge-driven management model. A Delphi round was performed amongst experts from all Swedish regions (N = 24). Evidence reflecting treatment effects was extracted from systematic reviews, meta-analyses, and randomized clinical trials. Results: The treatment decision in the process includes a matrix with five categories from a "very weak"" to "very strong" indication to treat, and it includes factors with potential influence on outcome, including (A) OSA-related symptoms, (B) cardiometabolic comorbidities, (C) frequency of respiratory events, and (D) age. OSA-related symptoms indicate a strong incitement to treat, whereas the absence of symptoms, age above 65 years, and no or well-controlled comorbidities indicate a weak treatment indication, irrespective of AHI. Conclusions: The novel treatment matrix is based on the effects of treatments rather than the actual frequency of respiratory events during sleep. A nationwide implementation of this matrix is ongoing, and the outcome is monitored in a prospective evaluation by means of the Swedish Sleep Apnea Registry (SESAR).
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| 3. |
- Rieke, Johanna Magdalena, et al.
(författare)
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SLC20A1Is Involved in Urinary Tract and Urorectal Development
- 2020
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Ingår i: Frontiers in Cell and Developmental Biology. - : FRONTIERS MEDIA SA. - 2296-634X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies in developingXenopusand zebrafish reported that the phosphate transporterslc20a1ais expressed in pronephric kidneys. The recent identification ofSLC20A1as a monoallelic candidate gene for cloacal exstrophy further suggests its involvement in the urinary tract and urorectal development. However, little is known of the functional role ofSLC20A1in urinary tract development. Here, we investigated this using morpholino oligonucleotide knockdown of the zebrafish orthologslc20a1a. This caused kidney cysts and malformations of the cloaca. Moreover, in morphants we demonstrated dysfunctional voiding and hindgut opening defects mimicking imperforate anus in human cloacal exstrophy. Furthermore, we performed immunohistochemistry of an unaffected 6-week-old human embryo and detectedSLC20A1in the urinary tract and the abdominal midline, structures implicated in the pathogenesis of cloacal exstrophy. Additionally, we resequencedSLC20A1in 690 individuals with bladder exstrophy-epispadias complex (BEEC) including 84 individuals with cloacal exstrophy. We identified two additional monoallelicde novovariants. One was identified in a case-parent trio with classic bladder exstrophy, and one additional novelde novovariant was detected in an affected mother who transmitted this variant to her affected son. To study the potential cellular impact ofSLC20A1variants, we expressed them in HEK293 cells. Here, phosphate transport was not compromised, suggesting that it is not a disease mechanism. However, there was a tendency for lower levels of cleaved caspase-3, perhaps implicating apoptosis pathways in the disease. Our results suggestSLC20A1is involved in urinary tract and urorectal development and implicateSLC20A1as a disease-gene for BEEC.
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| 4. |
- Bengtson, Annika, et al.
(författare)
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Phylogeny of Anisopappus with species circumscriptions revisited (Asteraceae: Athroismeae)
- 2021
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Ingår i: Taxon. - : Wiley. - 0040-0262 .- 1996-8175. ; 70:2, s. 351-364
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Tidskriftsartikel (refereegranskat)abstract
- Anisopappus (Asteraceae: Athroismeae) is a genus with its main distribution in Africa (one species also in Asia), currently considered to include around 21 species. A molecular phylogenetic study of Anisopappus is presented for the first time, based on plastid (ndhF, trnL-trnF, trnQ-rps16) and nuclear (ETS, ITS) data. Anisopappus is confirmed to be monophyletic, and species interrelationships are resolved. The results differ from earlier treatments based on morphology, and the phylogenetic analyses reveal a need for changes in species circumscriptions as compared to those of the most recent treatment. Consequently, many taxa currently treated as synonyms are here shown to represent separate species indicating that the genus includes well over 40 species. Distribution patterns now emerge where several clades are found to consist of species restricted to a particular geographical region. The Anisopappus of Madagascar, many of which were earlier placed in synonymy with species found on the African continent, are here shown to be endemic, and the results reveal a need for further studies of that group.
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| 5. |
- Bengtson, Annika, et al.
(författare)
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The Malagasy enigmatic genus Apodocephala (Asteraceae), a new member of the tribe Athroismeae
- 2021
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Ingår i: Willdenowia. - : Botanic Garden and Botanical Museum Berlin, Freie Universitaet Berlin. - 0511-9618 .- 1868-6397. ; 51:2, s. 221-230
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Tidskriftsartikel (refereegranskat)abstract
- Apodocephala is a small genus of nine species of shrubs and trees endemic to Madagascar and currently classified in the tribe Astereae (Asteraceae). However, its present tribal position has been questioned, as it lacks some of the salient morphological features of that tribe. This study includes for the first time DNA sequences from Apodocephala (two species including the type of the generic name) to test its phylogenetic position. Phylogenetic analyses based on sequence data from nuclear ribosomal (ETS and ITS) and plastid (ndhF and trnL–trnF) DNA regions, using Bayesian inference and maximum parsimony methods, strongly reject the placement of Apodocephala in the Astereae. Our results, instead, support its position as sister to the Malagasy monospecific genus Lowryanthus within the tribe Athroismeae. Morphological comparison of these sister genera reveal similarities in cypsela morphology, and the inclusion of Apodocephala in the subtribe Lowryanthinae is proposed here. The tribe Athroismeae is now represented by ten genera (Anisochaeta, Anisopappus, Apodocephala, Artemisiopsis, Athroisma, Blepharispermum, Centipeda, Leucoblepharis, Lowryanthus and Symphyllocarpus), six of which occur in Madagascar. The Malagasy Athroismeae occur in all Malagasy terrestrial ecosystems (rainforests, deciduous dry forests, thicket spiny forests and savannas) and are likely the result of multiple independent colonization events mostly from mainland Africa.
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| 7. |
- Huckriede, Joram, et al.
(författare)
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Evolution of NETosis markers and DAMPs have prognostic value in critically ill COVID-19 patients
- 2021
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Coronavirus disease 19 (COVID-19) presents with disease severities of varying degree. In its most severe form, infection may lead to respiratory failure and multi-organ dysfunction. Here we study the levels and evolution of the damage associated molecular patterns (DAMPS) cell free DNA (cfDNA), extracellular histone H3 (H3) and neutrophil elastase (NE), and the immune modulators GAS6 and AXL in relation to clinical parameters, ICU scoring systems and mortality in patients (n = 100) with severe COVID-19. cfDNA, H3, NE, GAS6 and AXL were increased in COVID-19 patients compared to controls. These measures associated with occurrence of clinical events and intensive care unit acquired weakness (ICUAW). cfDNA and GAS6 decreased in time in patients surviving to 30 days post ICU admission. A decrease of 27.2 ng/mL cfDNA during ICU stay associated with patient survival, whereas levels of GAS6 decreasing more than 4.0 ng/mL associated with survival. The presence of H3 in plasma was a common feature of COVID-19 patients, detected in 38% of the patients at ICU admission. NETosis markers cfDNA, H3 and NE correlated well with parameters of tissue damage and neutrophil counts. Furthermore, cfDNA correlated with lowest p/f ratio and a lowering in cfDNA was observed in patients with ventilator-free days.
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| 8. |
- Luther, Tomas, et al.
(författare)
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Renal mitochondrial dysfunction in ovine experimental sepsis-associated acute kidney injury
- 2023
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Ingår i: American Journal of Physiology - Renal Physiology. - : American Physiological Society. - 1931-857X .- 1522-1466. ; 324:6, s. 571-580
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Tidskriftsartikel (refereegranskat)abstract
- Sheep develop sepsis-associated acute kidney injury (SA-AKI) during experimental sepsis despite normal to increased renal oxygen delivery. A disturbed relation between oxygen consumption (V_ O2) and renal Na thorn transport has been demonstrated in sheep and in clinical studies of AKI, which could be explained by mitochondrial dysfunction. We investigated the function of isolated renal mitochondria compared with renal oxygen handling in an ovine hyperdynamic model of SA-AKI. Anesthetized sheep were randomized to either an infusion of live Escherichia coli with resuscitative measures (sepsis group; n = 13 animals) or served as controls (n = 8 animals) for 28 h. Renal V_ O2 and Na thorn transport were repeatedly measured. Live cortical mitochondria were isolated at baseline and at the end of the experiment and assessed in vitro with high-resolution respirometry. Sepsis markedly reduced creatinine clearance, and the relation between Na thorn transport and renal V_ O2 was decreased in septic sheep compared with control sheep. Cortical mitochondrial function was altered in septic sheep with a reduced respiratory control ratio (6.0 & PLUSMN; 1.5 vs. 8.2 & PLUSMN; 1.6, P = 0.006) and increased complex II-to-complex I ratio during state 3 (1.6 & PLUSMN; 0.2 vs. 1.3 & PLUSMN; 0.1, P = 0.0014) mainly due to decreased complex I-dependent state 3 respiration (P = 0.016). However, no differences in renal mitochondrial efficiency or mitochondrial uncoupling were found. In conclusion, renal mitochondrial dysfunction composed of a reduction of the respiratory control ratio and an increased complex II/complex I relation in state 3 was demonstrated in an ovine model of SA-AKI. However, the disturbed relation between renal V_ O2 and renal Na thorn transport could not be explained by a change in renal cortical mitochondrial efficiency or uncoupling.NEW & NOTEWORTHY We studied the function of renal cortical mitochondria in relation to oxygen consumption in an ovine model of sepsis with acute kidney injury. We demonstrated changes in the electron transport chain induced by sepsis consisting of a reduced respiratory control ratio mainly by a reduced complex I-mediated respiration. Neither an increase in mitochondrial uncoupling nor a reduction in mitochondrial efficiency was demonstrated and cannot explain why oxygen consumption was unaffected despite reduced tubular transport.
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| 9. |
- Nordenskjöld, A., et al.
(författare)
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Copy number variants suggest different molecular pathways for the pathogenesis of bladder exstrophy
- 2023
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Ingår i: American Journal of Medical Genetics, Part A. - : Wiley. - 1552-4825 .- 1552-4833. ; 191:2, s. 378-390
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Tidskriftsartikel (refereegranskat)abstract
- Bladder exstrophy is a rare congenital malformation leaving the urinary bladder open in the midline of the abdomen at birth. There is a clear genetic background with chromosome aberrations, but so far, no consistent findings apart from 22q11-duplications detected in about 2%–3% of all patients. Some genes are implicated like the LZTR1, ISL1, CELSR3, and the WNT3 genes, but most are not explained molecularly. We have performed chromosomal microarray analysis on a cohort of 140 persons born with bladder exstrophy to look for submicroscopic chromosomal deletions and duplications. Pathogenic or possibly pathogenic microdeletions or duplications were found in 16 patients (11.4%) and further 9 with unknown significance. Two findings were in regions linked to known syndromes, two findings involved the same gene (MCC), and all other findings were unique. A closer analysis suggests a few gene networks that are involved in the pathogenesis of bladder exstrophy; the WNT-signaling pathway, the chromosome 22q11 region, the RIT2 and POU families, and involvement of the Golgi apparatus. Bladder exstrophy is a rare malformation and is reported to be associated with several chromosome aberrations. Our data suggest involvement of some specific molecular pathways.
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| 10. |
- Shekar, S., et al.
(författare)
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The genus Duhaldea in India
- 2020
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Ingår i: Rheedea. - Calicut, India. ; 30:2, s. 257-269
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Tidskriftsartikel (refereegranskat)abstract
- Based on the field and herbarium data, six species of the genus Duhaldea (sensu stricto) are recognized in India. A key to the Indian species, brief descriptions and illustrations are provided along with data on phenology, distribution, ecology, chromosome numbers and ethnobotanical uses.
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