| 1. |
- Alexandersson, Gunnar, et al.
(författare)
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Coping with unforeseen circumstances : The COVID-19 crisis and bus contract renegotiation in Sweden
- 2024
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Ingår i: Journal of Industrial and Business Economics. - : Springer Nature. - 1972-4977 .- 0391-2078.
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Tidskriftsartikel (refereegranskat)abstract
- In principle, competitively tendered contracts in Swedish public bus transport are not supposed to be renegotiated during the contract period. In practice, it happens quite frequently. The need for renegotiations became evident during the COVID-19 crisis. This external shock to the system was unusually strong. Demand for bus services dropped abruptly, affecting revenues of procuring authorities and, depending on contract type, also bus operators. To make the situation even worse, costs typically remained constant, as frequent services were supposed to be upheld to avoid the spreading of the virus in crowded buses. Contract renegotiations during the COVID-19 crisis were clearly caused by unexpected exogenous events. Contracts with passenger incentives, linking a substantial part of compensation to the number of passengers, have been more likely to be renegotiated than gross-cost contracts, which were easier to adjust to the drop in demand. Typically, renegotiations were triggered by operators. While being a pragmatically rational response to an extreme situation, the renegotiations and their outcome may not in all cases have been compliant with the legal framework for public procurements, even when taking into account the exemptions made possible by the framework. In cases where passenger incentive contracts have been transformed into gross-cost contracts it could be argued that the nature of the contract has been changed. A new tender should then probably have been performed instead, although this has not been tried in court. The COVID-19 crisis could have long-term impact on contracts and procurements in the industry, affecting how effective competition will be in future tenders. For now, gross-cost contracts seem to be the norm, and it is possible that passenger-incentive contracts will become less common overall. One way to handle unexpected events with profound impact could be to include so-called threat-points that trigger renegotiation of a contract.
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| 2. |
- Appelberg, Kajsa, et al.
(författare)
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Cost-Effectiveness of Newborn Screening for Phenylketonuria and Congenital Hypothyroidism
- 2023
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Ingår i: The Journal of Pediatrics. - : MOSBY-ELSEVIER. - 0022-3476 .- 1097-6833. ; 256, s. 38-43.e3
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the long-term costs and health effects of the Swedish newborn screening program for classic phenylketonuria (PKU) alone and in combination with congenital hypothyroidism compared with no screening. Study design A decision-analytic model was developed to estimate and compare the long-term (80 years) costs and health effects of newborn screening for PKU and congenital hypothyroidism. Data were obtained from the liter-ature and translated to Swedish conditions. A societal perspective was taken, including costs falling on health care providers, municipal care and services, as well as production loss due to morbidity. Results Screening 100 000 newborns for PKU resulted in 73 gained quality-adjusted life-years (QALYs) compared with no screening. When adding congenital hypothyroidism, the number of gained QALYs was 232 compared with PKU alone, adding up to a total of 305 QALYs gained. Corresponding cost estimates were $80.8, $70.3, and $10.05 million USD for no screening, PKU screening, and PKU plus congenital hypothyroidism screening, respectively, indicating that screening for PKU plus congenital hypothyroidism was more effective and less costly compared with the other strategies. The majority of cost savings with PKU plus congenital hypothyroidism screening was due to reductions in productivity losses and municipal care and services costs. Conclusion The Swedish newborn screening program for PKU and congenital hypothyroidism saves substantial costs for society while generating additional QALYs, emphasizing the importance of public investments in early diagnosis and treatment. (J Pediatr 2023;256:38-43).
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| 3. |
- Barra, Mathias, et al.
(författare)
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Do not despair about severity—yet
- 2020
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Ingår i: Journal of Medical Ethics. - : BMJ Publishing Group Ltd. - 0306-6800 .- 1473-4257. ; 46:8, s. 557-558
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In a recent extended essay, philosopher Daniel Hausman goes a long way towards dismissing severity as a morally relevant attribute in the context of priority setting in healthcare. In this response, we argue that although Hausman certainly points to real problems with how severity is often interpreted and operationalised within the priority setting context, the conclusion that severity does not contain plausible ethical content is too hasty. Rather than abandonment, our proposal is to take severity seriously by carefully mapping the possibly multiple underlying accounts to well-established ethical theories, in a way that is both morally defensible and aligned with the term’s colloquial uses.
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| 4. |
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| 5. |
- Berg, Lars-Erik, et al.
(författare)
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Introduktion av värmekameror i undervisningen vid Lillerudsgymnasiet
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Vi har bedrivit en forskningscirkel med syfte att utvärdera värmekameran som visualiseringsteknik i olika ämnen på naturbruksprogrammet genom att planera, genomföra och reflektera kring lektionsupplägg, där elever har fått möjlighet att använda värmekameror med olika grad av styrning. Resultatet visar att värmekameran har många skilda tillämpningsområden inom lantbruk och djurhållning och kan användas i undervisningen som ett verktyg för elevers praktiska undersökningar av t.ex. djurs fysiologi, eller som ett mätinstrument då tillfälle ges, t.ex. för att studera juverbölder hos suggor eller temperaturökning när en skruv tar fel gäng. En utmaning i undervisningen är att finna en balans mellan öppenhet och styrning, där eleverna upplever att de har möjlighet att undersöka fenomen de själva är intresserade av, men utifrån ett etablerat, systematiskt arbetssätt. Sammanfattningsvis har vi upplevt användning av värmekameror som ett effektivt och intresseväckande sätt att konkretisera och individanpassa undervisningen på naturbruksprogrammet, vilket vi kan rekommendera andra lärare att prova.
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| 6. |
- Berglund, Jennie, et al.
(författare)
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Acetylation and Sugar Composition Influence the (In)Solubility of Plant beta-Mannans and Their Interaction with Cellulose Surfaces
- 2020
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Ingår i: ACS Sustainable Chemistry and Engineering. - : AMER CHEMICAL SOC. - 2168-0485. ; 8:27, s. 10027-10040
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Tidskriftsartikel (refereegranskat)abstract
- Plant beta-mannans are complex heteropolysaccharides that represent an abundant resource from lignocellulosic biomass. The influence of the molecular motifs of plant mannans on the backbone flexibility, solubility, and the interaction with cellulose was investigated by computational and experimental approaches. The regioselectivity of the acetyl substitutions at C2 and C3 distinctively influenced backbone flexibility in aqueous media, as revealed by molecular dynamic simulations. The molecular weight and degree of acetylation were tailored for two model seed mannans (galactomannan and glucomannan) and compared to spruce acetylated galactoglucomannan. The thermal stability was enhanced with increasing acetyl substitutions, independently of the type of mannan. Dynamic light scattering and atomic force microscopy revealed that the occurrence of galactosylation and a low degree of acetylation (similar to that of native acetylated galactoglucomannans) enhanced solubility/dispersibility of mannans, whereas the solubility/dispersibility decreased for higher degrees of acetylation. Mannan solubility influenced their interactions with cellulose at water-cellulose interfaces in terms of adsorbed mass and viscoelastic properties of the adsorbed mannan layers. Our results reveal that modulating the molecular motifs of plant beta-mannans influences their macromolecular conformation and physicochemical properties, with fundamental implications for their role in the plant cell wall and the design of wood-based materials.
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| 7. |
- Bergstrom, Charlotta, et al.
(författare)
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Do young adults with cancer receive information about treatment- related impact on sex life? : Results from a population-based study
- 2023
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Ingår i: Cancer Medicine. - : WILEY. - 2045-7634. ; 12:8, s. 9893-9901
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Tidskriftsartikel (refereegranskat)abstract
- Background Sexual dysfunction is common following a cancer diagnosis in young adulthood (18-39 years) and problems related to sex life are ranked among the core concerns in this age group. Yet, few studies have investigated to what extent adults younger than 40, receive information from healthcare providers about the potential impact of cancer and its treatment on their sex life.Methods A population-based cross-sectional survey study was conducted with 1010 young adults 1.5 years after being diagnosed with cancer (response rate 67%). Patients with breast, cervical, ovarian and testicular cancer, lymphoma, and brain tumors were identified in national quality registries. Sociodemographic and clinical factors associated with receiving information were examined using multivariable binary logistic regression.Results Men to a higher extent than women reported having received information about potential cancer-related impact on their sex life (68% vs. 54%, p < 0.001). Receipt of information varied across diagnoses; in separate regression models, using lymphoma as reference, both women and men with brain tumors were less likely to receive information (women: OR 0.10, CI = 0.03-0.30; men: OR 0.37, CI = 0.16-0.85). More intensive treatment was associated with higher odds of receiving information in both women (OR 1.89; CI = 1.28-2.79) and men (OR 2.08; CI = 1.09-3.94). None of the sociodemographic factors were associated with receipt of information.Conclusions To improve sexual health communication to young adults with cancer, we recommend diagnosis-specific routines that clarify when in the disease trajectory to discuss these issues with patients and what to address in these conversations.
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| 8. |
- Bonagas, Nadilly, et al.
(författare)
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Pharmacological targeting of MTHFD2 suppresses acute myeloid leukemia by inducing thymidine depletion and replication stress
- 2022
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Ingår i: NATURE CANCER. - : Springer Science and Business Media LLC. - 2662-1347. ; 3:2, s. 156-
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Tidskriftsartikel (refereegranskat)abstract
- The folate metabolism enzyme MTHFD2 (methylenetetrahydrofolate dehydrogenase/cyclohydrolase) is consistently overexpressed in cancer but its roles are not fully characterized, and current candidate inhibitors have limited potency for clinical development. In the present study, we demonstrate a role for MTHFD2 in DNA replication and genomic stability in cancer cells, and perform a drug screen to identify potent and selective nanomolar MTHFD2 inhibitors; protein cocrystal structures demonstrated binding to the active site of MTHFD2 and target engagement. MTHFD2 inhibitors reduced replication fork speed and induced replication stress followed by S-phase arrest and apoptosis of acute myeloid leukemia cells in vitro and in vivo, with a therapeutic window spanning four orders of magnitude compared with nontumorigenic cells. Mechanistically, MTHFD2 inhibitors prevented thymidine production leading to misincorporation of uracil into DNA and replication stress. Overall, these results demonstrate a functional link between MTHFD2-dependent cancer metabolism and replication stress that can be exploited therapeutically with this new class of inhibitors. Helleday and colleagues describe a nanomolar MTHFD2 inhibitor that causes replication stress and DNA damage accumulation in cancer cells via thymidine depletion, demonstrating a potential therapeutic strategy in AML tumors in vivo.
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| 9. |
- Bäck, Sophia, et al.
(författare)
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Comprehensive left atrial flow component analysis reveals abnormal flow patterns in paroxysmal atrial fibrillation
- 2024
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Ingår i: American Journal of Physiology. Heart and Circulatory Physiology. - : AMER PHYSIOLOGICAL SOC. - 0363-6135 .- 1522-1539. ; 326:3, s. H511-H521
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Tidskriftsartikel (refereegranskat)abstract
- Left atrial (LA) blood flow plays an important role in diseases such as atrial fibrillation (AF) and atrial cardiomyopathy since alterations in the blood flow might lead to thrombus formation and stroke. Using traditional techniques, such as echocardiography, atrial flow velocities can be measured at the pulmonary veins and the mitral valve, but a comprehensive understanding of the three-dimensional atrial flow field is missing. Previously, ventricular flow has been analyzed using flow component analysis, revealing new insights into ventricular flow and function. Thus, the aim of this project was to develop a comprehensive flow component analysis method for the LA and explore its utility in 21 patients with paroxysmal atrial fibrillation compared with a control group of 8 participants. The flow field was derived from time-resolved CT acquired during sinus rhythm using computational fluid dynamics. Flow components were computed from particle tracking. We identified six atrial flow components: conduit, reservoir, delayed ejection, retained inflow, residual volume, and pulmonary vein backflow. It was shown that conduit flow, defined as blood entering and leaving the LA within the same diastolic phase, exists in most subjects. Although the volume of conduit and reservoir is similar in patients with paroxysmal AF in sinus rhythm and controls, the volume of the other components is increased in paroxysmal AF. Comprehensive quantification of LA flow using flow component analysis makes atrial blood flow quantifiable, thus facilitating investigation of mechanisms underlying atrial dysfunction and can increase understanding of atrial blood flow in disease progression and stroke risk. NEW & NOTEWORTHY We developed a new comprehensive approach to atrial blood component analysis that includes both conduit flow and residual volume and compared the flow components of atrial fibrillation (AF) patients in sinus rhythm with controls. Conduit and reservoir flow were similar between the groups, whereas components with longer residence time in the left atrium were increased in the AF group. This could add to the pathophysiological understanding of atrial diseases and possibly clinical management.
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