| 1. |
- Abdulla, Maysaa, et al.
(författare)
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PD-L1 and IDO1 are potential targets for treatment in patients with primary diffuse large B-cell lymphoma of the CNS
- 2021
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 60:4, s. 531-538
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundProgrammed cell death 1 (PD-1) and its ligands PD-L1 and PD-L2, as well as Indoleamine 2,3-deoxygenase (IDO1) can be expressed both by tumor and microenvironmental cells and are crucial for tumor immune escape. We aimed to evaluate the role of PD-1, its ligands and IDO1 in a cohort of patients with primary diffuse large B-cell lymphoma of the CNS (PCNSL).Material and methodsTissue microarrays (TMAs) were constructed in 45 PCNSL cases. RNA extraction from whole tissue sections and RNA sequencing were successfully performed in 33 cases. Immunohistochemical stainings for PD-1, PD-L1/paired box protein 5 (PAX-5), PD-L2/PAX-5 and IDO1, and Epstein-Barr virus encoding RNA (EBER) in situ hybridization were analyzed.ResultsHigh proportions of PD-L1 and PD-L2 positive tumor cells were observed in 11% and 9% of cases, respectively. High proportions of PD-L1 and PD-L2 positive leukocytes were observed in 55% and 51% of cases, respectively. RNA sequencing revealed that gene expression of IDO1 was high in patients with high proportion of PD-L1 positive leukocytes (p = .01). Protein expression of IDO1 in leukocytes was detected in 14/45 cases, in 79% of these cases a high proportion of PD-L1 positive leukocytes was observed. Gene expression of IDO1 was high in EBER-positive cases (p = .0009) and protein expression of IDO1 was detected in five of six EBER-positive cases.ConclusionOur study shows a significant association between gene and protein expression of IDO1 and protein expression of PD-L1 in the tumor microenvironment of PCNSL, possibly of importance for prediction of response to immunotherapies.
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| 2. |
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| 3. |
- Berglund, Björn, et al.
(författare)
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Clonal spread of carbapenem-resistant Klebsiella pneumoniae among patients at admission and discharge at a Vietnamese neonatal intensive care unit
- 2021
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Ingår i: Antimicrobial Resistance and Infection Control. - : BMC. - 2047-2994. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is a growing problem globally, particularly in low- to middle-income countries (LMICs). Previous studies have shown high rates of CRE colonisation among patients at hospitals in LMICs, with increased risk of hospital-acquired infections. Methods We isolated carbapenem-resistant Klebsiella pneumoniae (CRKP) from faecal samples collected in 2017 from patients at admission and discharge at a Vietnamese neonatal intensive care unit (NICU). 126 CRKP were whole-genome sequenced. The phylogenetic relationship between the isolates and between clinical CRKP isolates collected in 2012-2018 at the same hospital were investigated. Results NDM-type carbapenemase-(61%) and KPC-2-encoding genes (41%) were the most common carbapenem resistance genes observed among the admission and discharge isolates. Most isolates (56%) belonged to three distinct clonal clusters of ST15, carrying bla(KPC-2), bla(NDM-1) and bla(NDM-4), respectively. Each cluster also comprised clinical isolates from blood collected at the study hospital. The most dominant ST15 clone was shown to be related to isolates collected from the same hospital as far back as in 2012. Conclusions Highly resistant CRKP were found colonising admission and discharge patients at a Vietnamese NICU, emphasising the importance of continued monitoring. Whole-genome sequencing revealed a population of CRKP consisting mostly of ST15 isolates in three clonally related clusters, each related to blood isolates collected from the same hospital. Furthermore, clinical isolates collected from previous years (dating back to 2012) were shown to likely be clonally descended from ST15 isolates in the largest cluster, suggesting a successful hospital strain which can colonise inpatients.
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| 4. |
- Berglund, Ellinor, et al.
(författare)
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Effect of Smartphone Dispatch of Volunteer Responders on Automated External Defibrillators and Out-of-Hospital Cardiac Arrests : The SAMBA Randomized Clinical Trial
- 2023
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Ingår i: JAMA cardiology. - : American Medical Association (AMA). - 2380-6583 .- 2380-6591. ; 8:1, s. 81-88
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Tidskriftsartikel (refereegranskat)abstract
- Importance Smartphone dispatch of volunteer responders to nearby out-of-hospital cardiac arrests (OHCAs) has emerged in several emergency medical services, but no randomized clinical trials have evaluated the effect on bystander use of automated external defibrillators (AEDs).Objective To evaluate if bystander AED use could be increased by smartphone-aided dispatch of lay volunteer responders with instructions to collect nearby AEDs compared with instructions to go directly to patients with OHCAs to start cardiopulmonary resuscitation (CPR).Design, Setting, and Participants This randomized clinical trial assessed a system for smartphone dispatch of volunteer responders to individuals experiencing OHCAs that was triggered at emergency dispatch centers in response to suspected OHCAs and randomized 1:1. The study was conducted in 2 main Swedish regions: Stockholm and Västra Götaland between December 2018 and January 2020. At study start, there were 3123 AEDs in Stockholm and 3195 in Västra Götaland and 24 493 volunteer responders in Stockholm and 19 117 in Västra Götaland. All OHCAs in which the volunteer responder system was activated by dispatchers were included. Excluded were patients with no OHCAs, those with OHCAs not treated by the emergency medical services, and those with OHCAs witnessed by the emergency medical services.Interventions Volunteer responders were alerted through the volunteer responder system smartphone application and received map-aided instructions to retrieve nearest available public AEDs on their way to the OHCAs. The control arm included volunteer responders who were instructed to go directly to the OHCAs to perform CPR.Main Outcomes and Measures Overall bystander AED attachment, including those attached by volunteer responders and lay volunteers who did not use the smartphone application.Results Volunteer responders were activated for 947 patients with OHCAs. Of those, 461 were randomized to the intervention group (median [IQR] age of patients, 73 [61-81] years; 295 male patients [65.3%]) and 486 were randomized to the control group (median [IQR] age of patients, 73 [63-82] years; 312 male patients [65.3%]). Primary outcome of AED attachment occurred in 61 patients (13.2%) in the intervention arm vs 46 patients (9.5%) in the control arm (difference, 3.8% [95% CI, −0.3% to 7.9%]; P = .08). The majority of AEDs were attached by lay volunteers who were not using the smartphone application (37 in intervention arm, 28 in control). There were no significant differences in secondary outcomes. Among the volunteer responders using the application, crossover was 11% and compliance to instructions was 31%. Volunteer responders attached 38% (41 of 107) of all AEDs and provided 45% (16 of 36) of all defibrillations and 43% (293 of 666) of all CPR.Conclusions and Relevance In this study, smartphone dispatch of volunteer responders to OHCAs to retrieve nearby AEDs vs instructions to directly perform CPR did not significantly increase volunteer AED use. High baseline AED attachement rate and crossover may explain why the difference was not significant.Trial Registration ClinicalTrials.gov Identifier: NCT02992873
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| 5. |
- Berglund, Ellinor, et al.
(författare)
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Wellbeing, emotional response and stress among lay responders dispatched to suspected out-of-hospital cardiac arrests
- 2022
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Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 170, s. 352-360
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Tidskriftsartikel (refereegranskat)abstract
- Background: Systems for smartphone dispatch of lay responders to perform cardio-pulmonary resuscitation (CPR) and bring automated external defibrillators to out-of-hospital cardiac arrests (OHCAs) are advocated by recent international guidelines and emerging worldwide. Objectives: This study aimed to investigate the emotional responses, posttraumatic stress reactions and levels of wellbeing among smartphone-alerted lay responders dispatched to suspected OHCAs. Methods: Lay responders were stratified by level of exposure: unexposed (Exp-0), tried to reach (Exp-1), and reached the suspected OHCA (Exp-2). Participants rated their emotional responses online, at 90 minutes and at 4–6 weeks after an incident. Level of emotional response was measured in two dimensions of core affect: “alertness” – from deactivation to activation, and “pleasantness” – from unpleasant to pleasant. At 4–6 weeks, WHO wellbeing index and level of posttraumatic stress (PTSD) were also rated. Results: Altogether, 915 (28%) unexposed and 1471 (64%) exposed responders completed the survey. Alertness was elevated in the exposed groups: Exp-0: 6.7 vs. Exp-1: 7.3 and Exp-2: 7.5, (p < 0.001) and pleasantness was highest in the unexposed group: 6.5, vs. Exp-1: 6.3, and Exp-2: 6.1, (p < 0.001). Mean scores for PTSD at follow-up was below clinical cut-off, Exp-0: 9.9, Exp-1: 8.9 and Exp-2: 8.8 (p = 0.065). Wellbeing index showed no differences, Exp-0: 78.0, Exp-1: 78.5 and Exp-2: 79.9 (p = 0.596). Conclusion: Smartphone dispatched lay responders rated the experience as high-energy and mainly positive. No harm to the lay responders was seen. The exposed groups had low posttraumatic stress scores and high-level general wellbeing at follow-up. © 2021
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| 6. |
- Berglund, Mattias, 1984-
(författare)
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An intra-organizational perspective on municipal innovation – Innovation capabilities, barriers and enablers
- 2022
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Ingår i: International Reasearch Society for Public Management (IRSPM) conference 2022. 19-22 april 2022, virtual conference.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There is a pressure for the public sector to promote innovation but the research-based insights into how public sector organizations innovate is still low. Managers are in a constant balancing act between the conflicting demands of exploit and explore where the public sector are challenged by the disruptive nature of innovation. This paper explores the embedded innovation capabilities in a municipal organization by identifying enablers/barriers which affect the readiness to innovate.The study is a qualitative, instrumental case study based on interviews with managers in a Swedish municipality which investigates the antecedents to innovation, which in turn contributes to knowledge on the managerial balancing act between exploit/explore in an empirical setting. The paper identifies a balancing act which risks defaulting towards optimization rather than innovation because of barriers for innovation being seen existing while enablers are assumed. There is a contested meaning behind innovation, making the balancing act between the known and the unknown which leads to a low readiness to innovate.
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| 7. |
- Berglund, Mattias, et al.
(författare)
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Fighting catch-22 – Intra-organizational collaboration, exploring capabilities for local innovation
- 2021
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Ingår i: ISPIM Connects Valencia (2021) - Reconnect, Rediscover, Reimagine. - 9789523356917
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Konferensbidrag (refereegranskat)abstract
- There is a growing pressure for innovation in the public sector. Research on innovation suggests a new role for organizations, from a producer of predefined goods and services to a facilitator of co-creation and new forms of network-based governance. Previous research is mostly focused on the need for organizations to collaborate across sectors (inter-organizational) to promote innovation, less on the need for collaboration across local governments different departments (intra-organizational) but also across smaller units (inter-departmental). The aim is to explore how internal conditions affect a municipality’s innovation capability. This is done through a study based on interviews with departmental managers. The study reveals a heterogenic organizational environment where managing is situated and intra-departmental on the expense of inter-departmental and intra-organizational collaborations. The study also reveals that the situation is created by established practices, processes and structures which do not promote inter-departmental collaborations and thus does not build intra-organizational innovation capabilities.
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| 8. |
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| 9. |
- Berglund, Mattias
(författare)
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Middle-managers role in supporting public sector innovation - Shared spaces and directionless collaboration
- 2023
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Ingår i: 8th annual conference of International Research Society for Public Management, Budapest april 3 - 5 2023.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Middle managers have an important, but rarely recognized role in supporting innovation. This paper follows a group of middle-managers in a Swedish municipality over a five-year period in an attempt to understand middle managers role in innovation support, what they do and what they need. The study identifies that the creation and maintenance of innovation space as crucial for supporting innovation by others. Innovation support in this case where trough trust-based management rather than conscious promotion of innovation. This study also identified potential problems concerning the relationships with other parts of the municipality external to the innovation space. The results highlight a need to look further into concepts such as co-governance and the continuous management which supports employee driven innovation.
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| 10. |
- Berglund, Mattias
(författare)
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Organisational ambidexterity across multiple levels of analysis – The importance of routinization for promoting innovation
- 2024
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Ingår i: European Journal of Workplace Innovation. - 2387-4570 .- 2387-4570. ; 8:2, s. 32-55
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Tidskriftsartikel (refereegranskat)abstract
- The concept of organizational ambidexterity, balancing act between the conflicting demands of exploit and explore, has been a part of the discussion in innovation research for a long time. Managers ability to balance tensions is a crucial capacity for organisations to be able to promote and support innovation. However, there is still a lack of research which takes multiple levels of analysis into account, how organisations can become ambidextrous, and which focuses on a single organisation.The study is a qualitative case study which investigates the balancing of tensions in a Swedish municipality and the connections between the organisational and individual levels of contextual ambidexterity. The article identifies a low ambidextrous environment, how this is affected by the interplay between the two levels of analysis where the organsational mechanism enforce routines which contributes to a lack of ability to balance tensions amongst individuals and at a group level. Further, in low ambidextrous environments, behaviors amongst individuals does not appear to be enough to promote organisational ambidexterity.The article finds the routinization of innovation to be an important step for organisations which wish to improve the environment for ambidexterity. The article contributes to the understanding of ambidexterity by the need to focus on both mechanisms and behaviors, as well as the aggregated group level, to further develop the understanding of how public sector organisations promote and support innovation.
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