| 1. |
- Hamdan, Mohammed, 1978-
(författare)
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Effects of temperature and terrestrial carbon on primary production in lake ecosystems
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Climate warming is predicted to affect northern lake food webs in two ways: (1)directly via changes in water temperature and ice conditions, and (2) indirectlyvia changes in catchment characteristics and processes that influence input ofallochthonous coloured dissolved organic matter (cDOM) and nutrients. Input ofcDOM increases carbon dioxide (CO2) availability, causes brownification andreduced light conditions, and may increase nutrient availability especially forpelagic primary producers. Increased water temperature and light penetrationand longer ice-free periods affect metabolic rates. These changes are expected toinfluence gross primary production (GPP) and growth of higher trophic levels.However, majority of studies focus on pelagic processes and net effects at wholelake scale is not well understood. Consequently, the lack of knowledge of whatfactors control benthic GPP makes predictions of net effects of climate change onwhole-ecosystem GPP spurious. The aim of this thesis was to experimentally testeffects of warming and increased input of allochthonous cDOM on habitatspecific and whole-ecosystem GPP in lakes. First, by manipulating the CO2concentrations in large scale pond ecosystems, we showed that increased CO2stimulated whole-ecosystem GPP. In a separate incubation study with naturallake sediments in a boreal lake, we tested the role of CO2 as a limiting factor forbenthic GPP under different light levels. The results showed that CO2 supplystimulated benthic GPP at high but not at low light availability, suggesting thatbenthic GPP can be CO2-limited. In the same experimental pond ecosystems, thecombined effect of increased allochthonous cDOM and warming (+3.5°C) on GPPwas studied. The results showed that cDOM input decreases whole-ecosystemGPP, mainly as a result of decreased benthic GPP due to light limitation not fullycounteracted by an increase in pelagic GPP under ambient conditions. Warmingon the other caused a hump shaped increase in whole-ecosystem GPP withincreasing cDOM input mainly due to a positive response in pelagic GPP due torelaxed nutrient limitation. Finally, by manipulating the fish consumer biomassin the same experimental pond ecosystems we showed that whole-ecosystem GPPcan be controlled by top-down effects under warm (+ 3.0°C) but not ambienttemperature conditions. The decline in whole-ecosystem GPP was mainlyattributed to a warming-stimulated consumer-driven trophic cascade in thepelagic habitat and top-down control by zooplankton on phytoplankton growth,while no corresponding cascade was evident in the benthic habitat.Taken together, the results suggest that climate change impacts, as increasinginputs of cDOM, warming and changes in food webs, have different effects onhabitat specific GPP and alone or in combination have impacts on whole-lakeGPP. This thesis offers important insights to better understand the factors thatcontrol lake GPP and to predict future lake ecosystem responses to environmentalchange.
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| 2. |
- Heuman, Anna, 1990-
(författare)
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Negotiating standard language ideology : Metalinguistic discussions in mundane, online interaction
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis investigates how ordinary language users enact language policy and thus negotiate (standard) language ideology in mundane, online interaction. The language policy work is found in metalinguistic discussions on various social media. The discussions have been triggered by deviations from standard written language, mostly on the level of orthography. The discussions mainly target different aspects of standard language ideology. The three studies included in this compilation thesis identify discursive strategies and reveal the contradictory ideologies underpinning the discussions.The discussions are analysed with an interactional and procedural focus, highlighting the unfolding negotiations of standard language ideology. The results show that standard language ideology is prevailing which, in turn, enables certain realisations. When drawing on standard norms, the participants can use strategies that do not include explicit arguments. However, the discussions also include contradictions and strategies that challenge traditional standard beliefs. These results illustrate the mundane, vivid metalinguistic negotiations in which standard language ideology is primarily enforced, but also challenged.The results illuminate how standardisation is not a mythical and imperceptible process, but one of constant and visible iteration, also in very mundane situations. Furthermore, the pervasiveness of standard language ideology could make it harder for those who deviate from it to be listened to or even to participate at all. In this way, everyday metalinguistic discussions are one among many language policy activities that can enforce loyalty to the standard variety and its position as unmarked.
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| 3. |
- Karlsson, Kåre
(författare)
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Health problems and work-related stress in Swedish ambulance personnel
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Previous studies have shown a high incidence of both acute and post-traumatic stress among ambulance personnel. It has been shown that ambulance personnel are at a higher risk of being affected of heart disease, high blood pressure and cancer. Studies have also seen a higher incidence of substance abuse and suicide. One cause of these health problems can be work-related stress. No previous research has focused on the body's physical reactions in the form of changes in heart rate and stress hormones in ambulance personnel in connection with work-related stress. Nor is there any overall picture of what actually affects Swedish ambulance personnel in terms of reported morbidity.Aim: The overall aim of the thesis is to investigate health problems in Swedish ambulance personnel and to study if there are any factors related to the work environment and the special conditions occurring in the prehospital environment that can be linked to the findings that appear.The questions that should be answered are: Are there health problems that affect Swedish ambulance personnel to a higher extent than other professions in Sweden? Are there any factors relating to morbidity that can be linked to the profession and can be regarded as potentially dangerous? If so, are there methods to prevent health problems that can be implemented in daily work?Methods: Studies I, II and III were all studies where stress markers (heart rate and cortisol levels) were measured during different conditions linked to the profession. Study I was a study where this was measured during physical exertion e.g. to carry a stretcher. Study II was a validated theoretical stress test to see how the ambulance personnel reacted to unknown factors. Study III meant measuring stress markers during priority-1 alarms. Study IV was carried out as a longitudinal register study where data about ICD-codes was collected from Statistics Sweden and the National Board of Health and Welfare.Results: In study I it was shown that the use of lifting aids reduced the measurable stress in the form of both reduced heart rate and decreased cortisol levels. Study II showed that personnel were stressed of the unknown test though women had the highest salivary cortisol levels before the Trier social stress test while the highest value for men occurred 10 to 20 minutes after the test. Study III showed that there was an increase in heart rate during priority-1 alarms that could not be linked to physical activity. It also indicated/showed that traffic accidents, patients with heart attacks in need of acute PCI or thrombectomy and alarms regarding children generate the highest stress onset seen as prolonged elevation of cortisol levels. This was seen regardless of gender, age, education or experience in all three studies. Study IV showed that Swedish ambulance personnel run the risk of being affected by certain diseases such as cardiac arrhythmias and injuries as arthrosis of the knee, dorsopathies and intervertebral disc disorders to a greater extent compared to other health care workers and other professions in Sweden.Conclusion: Swedish ambulance personnel have a higher incidence of certain health problems and diseases such as paroxysmal tachycardia, atrial fibrillation and flutter, other cardiac arrhythmias, high blood pressure, of the knee and dorsopathies and intervertebral disc disorders compared to other professions. These conditions can be caused by work-related stress, although they are not the only cause. Some factors that cause a stress reaction that can be linked to the ambulance profession have emerged in the studies. But the extent to which these factors alone cause the health problems that Swedish ambulance personnel suffer from is more difficult to determine with certainty based on these studies. Using shoulder straps reduces both heart rate and cortisol secretion.Clinical implications: Greater use of aids both in terms of lifting, moving and carrying heavy loads should mean that the physical load on the body would be reduced. These aids could also prevent some musculoskeletal problems that have emerged in this thesis by relieving and distributing the burden throughout the body. An important aspect in preventing work-related stress is that sufficient time is given for recovery. The organizations need to be dimensioned so that there is sufficient standby time so that there is time for recovery and reflection but also time for education and training. This is something that is far from reality in many Swedish ambulance organizations. It is also time to seriously discuss what is an actual reality in many countries, namely that employees in the ambulance service can benefit from a lower retirement age after a certain number of years of service.
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| 4. |
- Abdellah, Tebani, et al.
(författare)
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Integration of molecular profiles in a longitudinal wellness profiling cohort.
- 2020
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Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- An important aspect of precision medicine is to probe the stability in molecular profiles among healthy individuals over time. Here, we sample a longitudinal wellness cohort with 100 healthy individuals and analyze blood molecular profiles including proteomics, transcriptomics, lipidomics, metabolomics, autoantibodies andimmune cell profiling, complementedwith gut microbiota composition and routine clinical chemistry. Overall, our results show high variation between individuals across different molecular readouts, while the intra-individual baseline variation is low. The analyses show that each individual has a unique and stable plasma protein profile throughout the study period and that many individuals also show distinct profiles with regards to the other omics datasets, with strong underlying connections between the blood proteome and the clinical chemistry parameters. In conclusion, the results support an individual-based definition of health and show that comprehensive omics profiling in a longitudinal manner is a path forward for precision medicine.
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| 5. |
- Hortlund, Cecilia, 1989-
(författare)
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Svenskar, krigare, söner av Finland : maskulinitet, minoritetsnationalism, nationell identitet och sociala skillnader inom svenskspråkiga skyddskårer i Österbotten och Åboland 1918-1939
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation is a study on the Swedish-speaking Civil Guards in Ostrobothnia and Turunmaa in Finland during the Finnish interwar period (1918-1939). The study focuses on how they created their own Swedish minority nationalist identity in regards to the national project of White (bourgeois) Finland. They did so with the aid of conceptions and ideals of masculinities, nationalism, national identity and social differences. The Swedish-speaking Civil Guards were part of a turbulent time in Finnish history with Finland declaring independence and separating from Russia in 1917. The Finnish Civil Guard was an organisation forged by the Finnish Civil War of 1918 where it acted as the primary armed force on the White (bourgeois) side of the conflict. In 1919 the Civil Guard had about 107 000 members, which was the highest number during their active years, and membership was voluntary. During the 1920’s the total number of members remained relatively steady at about 80 000 members.This study implements an intersectional perspective consisting of four different main categories: masculinities, minority nationalism, national identity and social differences. These categories are then analysed together with theory on nationalist projects as presented by Nira Yuval-Davis. The empirical basis of this study is composed of material such as yearly summaries, minutes, and similar documents from different local civil guards in the two Swedish-speaking civil guard districts of Vaasa and Turunmaa. The study also bases itself on an analysis of two civil guard periodicals: Svenska Skyddskåristen (1919-1927) and Skyddskåristen (1928-1939).This study shows that the Swedish-speaking Civil Guards reproduced their own version of a bourgeois minority nationalist identity where militarised masculine ideals blended together with a focus on their Swedish heritage and blood, the responsibilities to the Finnish nation, and conceptions on social differences where different members of society received different status in their narrative. They romanticised the idea of the Ostrobothnian peasant as the cradle of Swedish heritage in Finland and a symbol of strength, honour and power. In addition, they reproduced a myth of heroic, manly sacrifice for the nation that was meant to urge its members and the Finnish people to act and defend the country.
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| 6. |
- Nilsson, Erik, et al.
(författare)
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The grade of individual prostate cancer lesions predicted by magnetic resonance imaging and positron emission tomography
- 2023
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Ingår i: Communications Medicine. - : Springer Nature. - 2730-664X. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multiparametric magnetic resonance imaging (mpMRI) and positron emission tomography (PET) are widely used for the management of prostate cancer (PCa). However, how these modalities complement each other in PCa risk stratification is still largely unknown. We aim to provide insights into the potential of mpMRI and PET for PCa risk stratification.Methods: We analyzed data from 55 consecutive patients with elevated prostate-specific antigen and biopsy-proven PCa enrolled in a prospective study between December 2016 and December 2019. [68Ga]PSMA-11 PET (PSMA-PET), [11C]Acetate PET (Acetate-PET) and mpMRI were co-registered with whole-mount histopathology. Lower- and higher-grade lesions were defined by International Society of Urological Pathology (ISUP) grade groups (IGG). We used PET and mpMRI data to differentiate between grades in two cases: IGG 3 vs. IGG 2 (case 1) and IGG ≥ 3 vs. IGG ≤ 2 (case 2). The performance was evaluated by receiver operating characteristic (ROC) analysis.Results: We find that the maximum standardized uptake value (SUVmax) for PSMA-PET achieves the highest area under the ROC curve (AUC), with AUCs of 0.72 (case 1) and 0.79 (case 2). Combining the volume transfer constant, apparent diffusion coefficient and T2-weighted images (each normalized to non-malignant prostatic tissue) results in AUCs of 0.70 (case 1) and 0.70 (case 2). Adding PSMA-SUVmax increases the AUCs by 0.09 (p < 0.01) and 0.12 (p < 0.01), respectively.Conclusions: By co-registering whole-mount histopathology and in-vivo imaging we show that mpMRI and PET can distinguish between lower- and higher-grade prostate cancer, using partially discriminative cut-off values.
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| 7. |
- Sandgren, Kristina, et al.
(författare)
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Histopathology-validated lesion detection rates of clinically significant prostate cancer with mpMRI, [68Ga]PSMA-11-PET and [11C]Acetate-PET
- 2023
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Ingår i: Nuclear medicine communications. - : Lippincott Williams & Wilkins. - 0143-3636 .- 1473-5628. ; 44:11, s. 997-1004
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Tidskriftsartikel (refereegranskat)abstract
- Objective: PET/CT and multiparametric MRI (mpMRI) are important diagnostic tools in clinically significant prostate cancer (csPC). The aim of this study was to compare csPC detection rates with [68Ga]PSMA-11-PET (PSMA)-PET, [11C] Acetate (ACE)-PET, and mpMRI with histopathology as reference, to identify the most suitable imaging modalities for subsequent hybrid imaging. An additional aim was to compare inter-reader variability to assess reproducibility.Methods: During 2016–2019, all study participants were examined with PSMA-PET/mpMRI and ACE-PET/CT prior to radical prostatectomy. PSMA-PET, ACE-PET and mpMRI were evaluated separately by two observers, and were compared with histopathology-defined csPC. Statistical analyses included two-sided McNemar test and index of specific agreement.Results: Fifty-five study participants were included, with 130 histopathological intraprostatic lesions >0.05 cc. Of these, 32% (42/130) were classified as csPC with ISUP grade ≥2 and volume >0.5 cc. PSMA-PET and mpMRI showed no difference in performance (P = 0.48), with mean csPC detection rate of 70% (29.5/42) and 74% (31/42), respectively, while with ACE-PET the mean csPC detection rate was 37% (15.5/42). Interobserver agreement was higher with PSMA-PET compared to mpMRI [79% (26/33) vs 67% (24/38)]. Including all detected lesions from each pair of observers, the detection rate increased to 90% (38/42) with mpMRI, and 79% (33/42) with PSMA-PET.Conclusion: PSMA-PET and mpMRI showed high csPC detection rates and superior performance compared to ACE-PET. The interobserver agreement indicates higher reproducibility with PSMA-PET. The combined result of all observers in both PSMA-PET and mpMRI showed the highest detection rate, suggesting an added value of a hybrid imaging approach.
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| 8. |
- Sandgren, Kristina, et al.
(författare)
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Registration of histopathology to magnetic resonance imaging of prostate cancer
- 2021
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Ingår i: Physics and Imaging in Radiation Oncology. - : Elsevier. - 2405-6316. ; 18, s. 19-25
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: The diagnostic accuracy of new imaging techniques requires validation, preferably by histopathological verification. The aim of this study was to develop and present a registration procedure between histopathology and in-vivo magnetic resonance imaging (MRI) of the prostate, to estimate its uncertainty and to evaluate the benefit of adding a contour-correcting registration.Materials and methods: For twenty-five prostate cancer patients, planned for radical prostatectomy, a 3D-printed prostate mold based on in-vivo MRI was created and an ex-vivo MRI of the specimen, placed inside the mold, was performed. Each histopathology slice was registered to its corresponding ex-vivo MRI slice using a 2D-affine registration. The ex-vivo MRI was rigidly registered to the in-vivo MRI and the resulting transform was applied to the histopathology stack. A 2D deformable registration was used to correct for specimen distortion concerning the specimen's fit inside the mold. We estimated the spatial uncertainty by comparing positions of landmarks in the in-vivo MRI and the corresponding registered histopathology stack.Results: Eighty-four landmarks were identified, located in the urethra (62%), prostatic cysts (33%), and the ejaculatory ducts (5%). The median number of landmarks was 3 per patient. We showed a median in-plane error of 1.8 mm before and 1.7 mm after the contour-correcting deformable registration. In patients with extraprostatic margins, the median in-plane error improved from 2.1 mm to 1.8 mm after the contour-correcting deformable registration.Conclusions: Our registration procedure accurately registers histopathology to in-vivo MRI, with low uncertainty. The contour-correcting registration was beneficial in patients with extraprostatic surgical margins.
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| 9. |
- Zarei, Maryam, et al.
(författare)
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Accuracy of gross tumour volume delineation with [68Ga]-PSMA-PET compared to histopathology for high-risk prostate cancer
- 2024
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Ingår i: Acta Oncologica. - : MJS Publishing, Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 503-510
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The delineation of intraprostatic lesions is vital for correct delivery of focal radiotherapy boost in patients with prostate cancer (PC). Errors in the delineation could translate into reduced tumour control and potentially increase the side effects. The purpose of this study is to compare PET-based delineation methods with histopathology.MATERIALS AND METHODS: The study population consisted of 15 patients with confirmed high-risk PC intended for prostatectomy. [68Ga]-PSMA-PET/MR was performed prior to surgery. Prostate lesions identified in histopathology were transferred to the in vivo [68Ga]-PSMA-PET/MR coordinate system. Four radiation oncologists manually delineated intraprostatic lesions based on PET data. Various semi-automatic segmentation methods were employed, including absolute and relative thresholds, adaptive threshold, and multi-level Otsu threshold.RESULTS: The gross tumour volumes (GTVs) delineated by the oncologists showed a moderate level of interobserver agreement with Dice similarity coefficient (DSC) of 0.68. In comparison with histopathology, manual delineations exhibited the highest median DSC and the lowest false discovery rate (FDR) among all approaches. Among semi-automatic approaches, GTVs generated using standardized uptake value (SUV) thresholds above 4 (SUV > 4) demonstrated the highest median DSC (0.41), with 0.51 median lesion coverage ratio, FDR of 0.66 and the 95th percentile of the Hausdorff distance (HD95%) of 8.22 mm.INTERPRETATION: Manual delineations showed a moderate level of interobserver agreement. Compared to histopathology, manual delineations and SUV > 4 exhibited the highest DSC and the lowest HD95% values. The methods that resulted in a high lesion coverage were associated with a large overestimation of the size of the lesions.
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| 10. |
- Öberg, Sandra, 1974-
(författare)
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The Hit-IT project : The development and evaluation of an internet-based complex intervention for primary healthcare patients with cardiovascular disease and insomnia
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a need to explore insomnia among patients with cardiovascular disease (CVD), since they have increased risk for disease deterioration, poor quality of life and a shorter lifetime expectancy. Cognitive behavioral therapy (CBT) is the main recommended insomnia treatment, although it is a rare treatment choice in the healthcare due to lack of certified CBT therapists.The aim of the thesis was therefore to investigate a nurse-led internet-based CBT for insomnia (I-CBTI) tailored for patients with CVD, that includes qualitative and quantitative measures to explore the patients’ characteristics and treatment motive, insomnia experience, treatment effect, adherence and the usability of a complex intervention called the Hit-IT program.The first paper had a mixed study design to investigate the participants (n=126) sleep, physical and psychological characteristics in relation to insomnia via baseline questionnaires, as well as interviews (n=19) covering their motivation and expectations when participating in the Hit-IT treatment study. The second paper was a qualitative study using a Critical incident technique, to capture the experience of the participants (n=20) with CVD and insomnia sleep situation, and determine how they managed their insomnia. The third paper included 48 participants who were randomised to test the nine-week nurse-led I-CBTI treatment, tailored for patients with CVD or a three-week of self-studies (control group) without support. Paper four was a qualitative study to explore the experience and management of the Hit-IT program.The thesis findings showed that the participants were primarily male participants of older age, and that insomnia symptoms were significantly associated with worse somatic symptom severity, reduced physical quality of life, increased levels of depressive symptoms and cardiac anxiety. The participants were motivated to engage in the Hit-IT study, but were concerned the comorbid condition would be a hindering factor for the required behavioral change if randomized to the nine-week Hit-IT program. The participants also experience physical and cognitive insomnia triggers caused by cardiac symptoms at night. However, the participants in the Hit-IT program group significantly improved their insomnia symptoms compared to the three-week self-study control group. Also, the participants adherent to the Hit-IT program significantly increased their physical quality of life compared to those not adherent to treatment. Moreover, the results showed that the participants had trust in the Hit-IT program and experienced the intervention as very interesting yet challenging. The major treatment adherence facilitator was to experience improved sleep during the course of treatment.The thesis findings conclude that nurses have the skills to deliver a nurse-led I-CBTI treatment, tailored for patients’ with CVD with a sleep improvement outcome. The findings also confirm that primary healthcare patients of older age living with CVD and insomnia, are interested in and able to use internet-based complex interventions to improve their sleep.
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