| 1. |
- Bućin, Dragan, et al.
(författare)
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Desensitization and Heart Transplantation of a Patient With High Levels of Donor-Reactive Anti-Human Leukocyte Antigen Antibodies.
- 2010
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Ingår i: Transplantation. - 1534-6080. ; 90, s. 1220-1225
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND.: To prepare a highly immunized recipient for heart transplantation, reduction of high levels of cytotoxic antibodies against human leukocyte antigen (HLA) was deemed essential to prevent antibody-mediated graft failure. METHODS.: Antibodies were analyzed by lymphocytotoxic and solid-phase assays. The pretransplant desensitization treatment protocol included daily tacrolimus and mycophenolate mofetil, weekly protein-A immunoadsorption (IA), intravenous immunoglobulin, and daclizumab. Posttransplant treatment consisted of tacrolimus, mycophenolate mofetil, prednisolone, IA, and daclizumab. RESULTS.: During pretransplant desensitization, each of the weekly immunoadsorption treatments reduced anti-HLA antibody levels by 50% to 70%, but they returned to the pretreatment level within 1 week as measured by flow cytometry. Cytotoxic antibodies remained reduced. After perioperative immunoadsorption, the donor-reactive antibodies (DRAs) were reduced to low levels. The patient underwent successful heart transplantation after 6 weeks on a waiting list. During the first week posttransplant, DRAs remained low. However, after the first week, anti-HLA DRAs reappeared and increased slightly over a 3-week period and then decreased slowly. Cytotoxic crossmatches were negative before and 3 week after transplantation. No clinical rejection was encountered. The patient was doing well 3 years after transplantation, and yearly clinical cardiac investigations were all normal. Three hyperimmunized patients have now undergone successful heart transplantation at our center using this desensitization protocol. CONCLUSIONS.: IA in combination with pretransplant immunosuppressive drug treatment temporarily reduces antibody levels. The therapeutic levels of drug treatment at the time of transplantation may be of crucial importance. The treatment protocol resulted in freedom from rejection and other clinical adverse events.
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| 2. |
- Hogberg, Göran, et al.
(författare)
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Depressed adolescents in a case-series were low in vitamin D and depression was ameliorated by vitamin D supplementation
- 2012
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 101:7, s. 779-783
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The relationship between depression in adolescents and vitamin D was studied in a case-series that included effects of vitamin D supplementation. Methods: Serum 25OH vitamin D (25OHD) levels in 54 Swedish depressed adolescents were investigated. Subjects with vitamin D deficiency were given vitamin D3 over 3 months (n = 48). To evaluate well-being and symptoms related to depression and vitamin D status, the WHO-5 well-being scale, the Mood and Feelings Questionnaire (MFQ-S) and a vitamin D deficiency scale were used. Results: Mean serum 25OHD in the depressed adolescents was 41 at baseline and 91 nmol/L (p < 0.001) after supplementation. Basal 25OHD levels correlated positively with well-being (p < 0.05). After vitamin D supplementation, well-being increased (p < 0.001) and there was a significant improvement in eight of the nine items in the vitamin D deficiency scale: depressed feeling (p < 0.001), irritability (p < 0.05), tiredness (p < 0.001), mood swings (p < 0.01), sleep difficulties (p < 0.01), weakness (p < 0.01), ability to concentrate (p < 0.05) and pain (p < 0.05). There was a significant amelioration of depression according to the MFQ-S (p < 0.05). Conclusion: This study showed low levels of vitamin D in 54 depressed adolescents, positive correlation between vitamin D and well-being, and improved symptoms related to depression and vitamin D deficiency after vitamin D supplementation.
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| 3. |
- Omstedt, Anders, 1949, et al.
(författare)
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Future changes in the Baltic Sea acid-base (pH) and oxygen balances
- 2012
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Ingår i: Tellus. Series B, Chemical and physical meteorology. - : Stockholm University Press. - 0280-6509 .- 1600-0889. ; 64
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Tidskriftsartikel (refereegranskat)abstract
- Possible future changes in Baltic Sea acid–base (pH) and oxygen balances were studied using a catchment–sea coupled model system and numerical experiments based on meteorological and hydrological forcing datasets and scenarios. By using objective statistical methods, climate runs for present climate conditions were examined and evaluated using Baltic Sea modelling. The results indicate that increased nutrient loads will not inhibit future Baltic Sea acidification; instead, the seasonal pH cycle will be amplified by increased biological production and mineralization. All examined scenarios indicate future acidification of the whole Baltic Sea that is insensitive to the chosen global climate model. The main factor controlling the direction and magnitude of future pH changes is atmospheric CO2 concentration (i.e. emissions). Climate change and land-derived changes (e.g. nutrient loads) affect acidification mainly by altering the seasonal cycle and deep-water conditions. Apart from decreasing pH, we also project a decreased saturation state of calcium carbonate, decreased respiration index, and increasing hypoxic area – all factors that will threaten the marine ecosystem. We demonstrate that substantial reductions in fossil-fuel burning are needed to minimize the coming pH decrease and substantial reductions in nutrient loads are needed to reduce the coming increase in hypoxic and anoxic waters.
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| 4. |
- Ragnarsdottir, Bryndis, et al.
(författare)
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Toll-like receptor 4 promoter polymorphisms: common TLR4 variants may protect against severe urinary tract infection.
- 2010
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 5:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Polymorphisms affecting Toll-like receptor (TLR) structure appear to be rare, as would be expected due to their essential coordinator role in innate immunity. Here, we assess variation in TLR4 expression, rather than structure, as a mechanism to diversify innate immune responses. METHODOLOGY/PRINCIPAL FINDINGS: We sequenced the TLR4 promoter (4,3 kb) in Swedish blood donors. Since TLR4 plays a vital role in susceptibility to urinary tract infection (UTI), promoter sequences were obtained from children with mild or severe disease. We performed a case-control study of pediatric patients with asymptomatic bacteriuria (ABU) or those prone to recurrent acute pyelonephritis (APN). Promoter activity of the single SNPs or multiple allelic changes corresponding to the genotype patterns (GPs) was tested. We then conducted a replication study in an independent cohort of adult patients with a history of childhood APN. Last, in vivo effects of the different GPs were examined after therapeutic intravesical inoculation of 19 patients with Escherichia coli 83972. We identified in total eight TLR4 promoter sequence variants in the Swedish control population, forming 19 haplotypes and 29 genotype patterns, some with effects on promoter activity. Compared to symptomatic patients and healthy controls, ABU patients had fewer genotype patterns, and their promoter sequence variants reduced TLR4 expression in response to infection. The ABU associated GPs also reduced innate immune responses in patients who were subjected to therapeutic urinary E. coli tract inoculation. CONCLUSIONS: The results suggest that genetic variation in the TLR4 promoter may be an essential, largely overlooked mechanism to influence TLR4 expression and UTI susceptibility.
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| 5. |
- Ahlsson, Fredrik, 1967-, et al.
(författare)
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Adipokines and their relation to maternal energy substrate production, insulin resistance and fetal size
- 2013
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 168:1, s. 26-29
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:The role of adipokines in the regulation of energy substrate production in non-diabetic pregnant women has not been elucidated. We hypothesize that serum concentrations of adiponectin are related to fetal growth via maternal fat mass, insulin resistance and glucose production, and further, that serum levels of leptin are associated with lipolysis and that this also influences fetal growth. Hence, we investigated the relationship between adipokines, energy substrate production, insulin resistance, body composition and fetal weight in non-diabetic pregnant women in late gestation.STUDY DESIGN:Twenty pregnant women with normal glucose tolerance were investigated at 36 weeks of gestation at Uppsala University Hospital. Levels of adipokines were related to rates of glucose production and lipolysis, maternal body composition, insulin resistance, resting energy expenditure and estimated fetal weights. Rates of glucose production and lipolysis were estimated by stable isotope dilution technique.RESULTS:Median (range) rate of glucose production was 805 (653-1337)μmol/min and that of glycerol production, reflecting lipolysis, was 214 (110-576)μmol/min. HOMA insulin resistance averaged 1.5±0.75 and estimated fetal weights ranged between 2670 and 4175g (-0.2 to 2.7 SDS). Mean concentration of adiponectin was 7.2±2.5mg/L and median level of leptin was 47.1 (9.9-58.0)μg/L. Adiponectin concentrations (7.2±2.5mg/L) correlated inversely with maternal fat mass, insulin resistance, glucose production and fetal weight, r=-0.50, p<0.035, r=-0.77, p<0.001, r=-0.67, p<0.002, and r=-0.51, p<0.032, respectively. Leptin concentrations correlated with maternal fat mass and insulin resistance, r=0.76, p<0.001 and r=0.73, p<0.001, respectively. There was no correlation between maternal levels of leptin and rate of glucose production or fetal weight. Neither were any correlations found between levels of leptin or adiponectin and maternal lipolysis or resting energy expenditure.CONCLUSION:The inverse correlations between levels of maternal adiponectin and insulin resistance as well as endogenous glucose production rates indicate that low levels of adiponectin in obese pregnant women may represent one mechanism behind increased fetal size. Maternal levels of leptin are linked to maternal fat mass and its metabolic consequences, but the data indicate that leptin lacks a regulatory role with regard to maternal lipolysis in late pregnancy.
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| 6. |
- Ahlsson, Fredrik, et al.
(författare)
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Insulin Resistance, a Link between Maternal Overweight and Fetal Macrosomia in Nondiabetic Pregnancies
- 2010
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Ingår i: Hormone research in paediatrics. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 74:4, s. 267-274
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: During the last decades the number of large for gestational age infants delivered by nondiabetic mothers has increased. Our aim was to investigate to what extent fetal growth in nondiabetic pregnant women can be explained by rates of maternal energy substrate production and resting energy expenditure. Methods: Twenty nonsmoking pregnant women without impaired glucose tolerance and with a wide range of fetal weights (0.2-2.7 SDS) were investigated at 36 weeks of gestation. Maternal lipolysis, glucose production, resting energy expenditure, body composition and insulin resistance were assessed.Results: Median (range) glucose production rate was 805 (653-1,337) mumol/min and that of glycerol, reflecting lipolysis, was 214 (110-576) mumol/min. Multiple linear regression analysis showed that maternal fat mass explained 36% of the variation in insulin resistance, accounting for 62% of the variation in glucose production. Further, glucose production explained 31% of the variation in fetal weight. Resting energy expenditure explained 51% of the variation in estimated fetal weight. Conclusion: Fetal weight is dependent on maternal glucose production, which is in turn determined by the degree of insulin resistance, induced in part by the maternal fat mass. The variation in maternal resting energy expenditure is closely related to fetal weight.
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| 7. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Growth hormone dose-dependent pubertal growth : a randomized trial in short children with low growth hormone secretion
- 2014
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Ingår i: Hormone Research in Paediatrics. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 82:3, s. 158-170
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i. e. idiopathic isolated GH deficiency.Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH(33) mu g/kg/day for >= 1 year. They were randomized to receive 67 mu g/kg/day (GH(67)) given as one (GH(67x1); n = 35) or two daily injections (GH(33x2); n = 36), or to remain on a single 33 mu g/kg/day dose (GH(33x1); n = 40). Growth was assessed as height SDS gain for prepubertal, pubertal and total periods, as well as AH SDS versus the population and the midparental height.Results: Pubertal height SDS gain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33x1), 0.41, p < 0.05). AH(SDS) was greater on GH(67) (GH(67x1), -0.84; GH(33x2), -0.83) than GH(33) (-1.25, p < 0.05), and height SDS gain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target height SDS.Conclusion: Pubertal height SDS gain and AH SDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once-and twice-daily GH(67) regimens. (C) 2014 S. Karger AG, Basel.
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| 8. |
- Altenbernd, Peter, et al.
(författare)
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Automatic Generation of Timing Models for Timing Analysis of High-Level Code
- 2011
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Ingår i: 19th International Conference on Real-Time and Network Systems (RTNS2011).
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Konferensbidrag (refereegranskat)abstract
- Traditional timing analysis is applied only in the late stages of embedded system software development, when the hardware is available and the code is compiled and linked. However, preliminary timing estimates are often needed already in early stages of system development, both for hard and soft real-time systems. If the hardware is not yet fully accessible, or the code is not yet ready to compile or link, then the timing estimation must be done for the source code rather than for the binary. This paper describes how source-level timing models can be derived automatically for given combinations of hardware architecture and compiler. The models are identified from measured execution times for a set of synthetic "training programs" compiled for the hardware platform in question. The models can be used to derive source-level WCET estimates, as well as for estimating the execution times for single program runs. Our experiments indicate that the models can predict the execution times of the final, compiled code with a deviation up to 20%.
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| 9. |
- Avango, Dag, 1965-, et al.
(författare)
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Industrial heritage in the Polar areas as sources for historical research
- 2010
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Konferensbidrag (refereegranskat)abstract
- Remains of industrial sites in the Polar Regions are increasingly becoming popular visitor’s sites for the expanding tourism industry and a concern for researchers, authorities and other actors who are dealing with environmental issues and heritage management there. How shall we balance between the need to protect the environment and the heritage values of industrial remains? One question which is to seldom touched upon in the discussion, is the source value of industrial sites for historical research. In this presentation we will discuss this, by focusing on the remains of two whaling stations on South Georgia – Prince Olav Harbour and Ocean Harbour. These stations were mapped during a historical-archaeological expedition in March 2009, within the framework of the IPY project LASHIPA. This project aims to explain the development of large scale natural resource exploitation in the Polar Areas and its consequences for the geo-political situation there. How can these research problems be addressed by analysing the remains of these whaling stations? We will show that these whaling stations provide information pertaining to the following research themes in LASHIPA: driving forces behind industrial development in the polar areas, design of technology and settlements in polar environments, and international competition over natural resources and polar territories. The remains of the stations reflect the multiple roles they have played since they were established in the early twentieth century. Initially they were socio-technical networks with productive purposes, and at the same time anchor points for territorial claims. After the stations were closed, they were turned in to refuges for scientific expeditions and later also for military troops. Finally, we will present an example on the results of an extensive environmental clean-up at a whaling station – Grytviken – and its consequences for the source value of industrial heritage sites for historical research.
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| 10. |
- Begum, Syeda Shahanara, 1960, et al.
(författare)
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Economic growth and child poverty reduction in Bangladesh and China
- 2012
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Ingår i: Journal of Asian Economics. - : Elsevier BV. - 1049-0078. ; 23:1, s. 73-85
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Tidskriftsartikel (refereegranskat)abstract
- This paper analyzes child poverty in Bangladesh and China during periods of rapid economic growth. It compares the extent as well as profile of child poverty in both countries. Comparisons on the extent of child poverty over time and across countries are made using a decomposition framework attributing child poverty differences to differences in three components: mean child income, demographic circumstances and the distribution of child income. Child poverty is found to be more extensive in Bangladesh than in China, and is very much a problem for rural children in both countries. The results show that economic growth can reduce child poverty but does not always do so. For understanding changes over time and across countries in the extent of child poverty, it can be necessary to also consider changes/differences in the distribution of child income as well as in the demographic composition.
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