| 1. |
- Axmon, Anna, et al.
(författare)
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Tidstrender för perfluorerade ämnen i plasma från svenska kvinnor 1987-2007
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Perfluorerade kemikalier (PFC) är en stor grupp ämnen som är misstänkt hormon- störande. De är svårnedbrytbara och stannar länge i både miljö och människa. De mest kända PFC är PFOS och PFOA. Dessa användes under många år för att im- pregnera textilier, skor, möbler och mattor, i golv- och bilvax och målarfärger, mm. Användningen började minska i början av detta århundrade då PFOS och PFOA ersattes av andra PFC. Vi använde sparade plasmaprover från 80 kvinnor. Proven togs ursprungligen mellan 1987 och 2007 i samband med bröstförminskningsoperationer, från kvinnor som vi- sade sig friska vid screening för ärftlig cancer och från kvinnor vars äkta män hade cancer. Proverna analyserades för ett antal olika PFC (se textruta nedan), och vi undersökte därefter tidstrender för varje kemikalie. Vi tittade dels på linjära tidstrender, dvs vi an- tog att förändringen i halter var lika stor för varje år, och dels på förändringar mellan perioderna före 1990, 1990-2000 och efter 2000. • PFNA och PFDA ökade över hela tidsperioden, men allra mest efter 2000. Från 1987 till 2007 ökade PFNA med 305% och PFDA med 312%. • PFUnDA ökade med 155% från 1987 till 2007. Detta berodde framför allt på en stor ökning från 2000 och framåt. • PFOS och PFOA låg som högst under perioden 1990-2000. Sett över hela studieperioden, dvs 1987 till 2007, minskade PFOS med 36% och PFOA med 7%. • Även PFHxS låg som högst under perioden 1990-2000. Till skillnad från PFOS och PFOA uppvisade PFHxS en ökning – 142% – mellan 1987 och 2007.
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| 2. |
- Axmon, Anna, et al.
(författare)
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Time trends between 1987 and 2007 for perfluoroalkyl acids in plasma from Swedish women.
- 2014
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Ingår i: Chemosphere. - : Elsevier BV. - 1879-1298 .- 0045-6535. ; 102, s. 61-67
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Tidskriftsartikel (refereegranskat)abstract
- Perfluoroalkyl acids (PFAAs) are a large group of chemicals which are highly persistent in both nature and humans. The use of the most prominent ones, perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA), was reduced in the early 21st century, and since then levels in human matrices have decreased. However, these two compounds have been exchanged by other PFAAs, for which time trends have not been as extensively investigated. By the use of 80 plasma samples collected between 1987 and 2007 from healthy women (n=1-9 yearly for 1987-2001, n=15 from 2006, and n=10 from 2007), possible time trends of six PFAAs were assessed. Time trends were evaluated for the entire study period, as well as for three sub-periods. As seen in previous studies, levels of perfluorohexane sulfonate (PFHxS), PFOS, and PFOA peaked during the middle time period (1990-2000), with medians of 0.98ngmL(-1), 18.06ngmL(-1), and 3.73ngmL(-1), respectively. However, levels of perfluorononanic acid (PFNA), perfluorodecanic acid (PFDA), and perfluoroundecanoic acid (PFUnDA) increased over the whole study period and most markedly so after year 2000, with medians of 0.73ngmL(-1), 0.28ngmL(-1), and 0.24ngmL(-1), respectively, during the last study period.
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| 3. |
- Elfving, Kristina, et al.
(författare)
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Real-time PCR threshold cycle (Ct) cut-offs help to identify agents causing acute childhood diarrhea in Zanzibar.
- 2014
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Ingår i: Journal of clinical microbiology. - 1098-660X. ; 52:3, s. 916-923
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Tidskriftsartikel (refereegranskat)abstract
- Molecular assays might improve identification of causes of acute diarrheal disease, but may lead to more frequent detection of asymptomatic infections. In the present study real-time PCR targeting 14 pathogens was applied on rectal swabs from 330 children aged 2-59 months in Zanzibar, 165 with acute diarrhea and 165 asymptomatic controls. At least one pathogen was detected in 94% of patients and 84% of controls, with higher rates in patients for norovirus genogroup II (20% vs. 2.4%, p<0.0001), rotavirus (10% vs. 1.8%, p=0.003) and Cryptosporidium (30% vs. 11%, p<0.0001). Detection rates did not differ significantly for enterotoxigenic Escherichia coli (ETEC)-estA (33% vs. 24%), ETEC-eltB (44% vs. 46%), Shigella (35% vs. 33%), and Campylobacter (35% vs. 33%), but for these agents Ct (threshold cycle) values were lower (pathogen loads were higher) in sick children than in controls. In multivariate analysis, Ct values for norovirus genogroup II, rotavirus, Cryptosporidium, ETEC-estA and Shigella were independently associated with diarrhea. We conclude that this real-time PCR allows convenient detection of essentially all diarrheagenic agents, and provides Ct values that may be critical for interpretation of results for pathogens with similar detection rates in patients and controls. The results indicate that assessment of pathogen load may improve identification of agents causing gastroenteritis in children.
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| 4. |
- Kristensen, Ingrid, et al.
(författare)
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Assessment of volume segmentation in radiotherapy of adolescents; a treatment planning study by the Swedish Workgroup for Paediatric Radiotherapy
- 2014
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Ingår i: Acta Oncologica. - : Informa Healthcare. - 0284-186X .- 1651-226X. ; 53:1, s. 126-133
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose. The variability in target delineation for similar cases between centres treating paediatric and adolescent patients, and the apparent differences in interpretation of radiotherapy guidelines in the treatment protocols encouraged us to perform a dummy-run study as a part of our quality assurance work. The aim was to identify and quantify differences in the segmentation of target volumes and organs at risk (OARs) and to analyse the treatment plans and dose distributions. Materials and methods. Four patient cases were selected: Wilms tumour, Hodgkins disease, rhabdomyosarcoma of the prostate and chordoma of the skull base. The five participating centres received the same patient-related material. They introduced the cases in their treatment planning system, delineated target volumes and OARs and created treatment plans. Dose-volume histograms were retrieved for relevant structures and volumes and dose metrics were derived and compared, e. g. target volumes and their concordance, dose homogeneity index (HI), treated and irradiated volumes, remaining volume at risk and relevant V x and D x values. Results. We found significant differences in target segmentation in the majority of the cases. The planning target volumes (PTVs) varied two-to four-fold and conformity indices were in the range of 0.3-0.6. This resulted in large variations in dose distributions to OARs as well as in treated and irradiated volumes even though the treatment plans showed good conformity to the PTVs. Potential reasons for the differences in target delineation were analysed. Conclusion. Considerations of the growing child and difficulties in interpretation of the radiotherapy information in the treatment protocols were identified as reasons for the variation. As a result, clarified translated detailed radiotherapy guidelines for paediatric/adolescent patients have been recognised as a way to reduce this variation.
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| 5. |
- Lagging, Martin, 1965, et al.
(författare)
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Reply.
- 2014
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Ingår i: Hepatology (Baltimore, Md.). - : Ovid Technologies (Wolters Kluwer Health). - 1527-3350 .- 0270-9139. ; 60:6, s. 2130-1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Lindh, Kristina, 1964-
(författare)
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Reciprocal Engagement : A grounded theory of an interactive process of actions to establish, maintain, and develop an enterprise
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Reciprocal engagement is a theory of a basic social process that addresses how an organization establishes, maintains, and develops its enterprise by focusing on strengthening its relationships with other actors. It rests on the rationale that one’s relationships are foremost dependent on how well one manages to engage others. If one’s own engagement is demonstrated to others, it stimulates them to respond with actions of engagement in return. When they do respond in such a manner, it expresses an appreciation of a relationship and a will to contribute to maintaining it. The process of reciprocal engagement consists of two categories of actions, i.e. convincing manifestation and caring embrace, each of which has three dimensions of actions. The dimensions of convincing manifestation are framing, meriting, and avowing and of caring embrace they are friending, enriching, and opportunizing. Together these actions imply that to influence others’ willingness to act engaged, an actor such as an organization needs to mediate trustworthy messages that demonstrate and assure them of its identity and intentions. It also needs to treat and include them in a way that they can relate to as having a meaning of personal and/or social value to them. As the theory can be seen as conceptualizing marketing related behaviors, its practical and theoretical contribution is that of a model of thinking that argues that marketing should be viewed as a relationship developing process of interactive communicative actions with rhetorical and creative features. The research that led to the discovery of the theory aimed its attention at an art museum and its interaction with various external actors in its surrounding environment. In order to discover the main pattern of behaviors that take place in interactions as a consequence of the museum’s main area of concerns, the classical grounded theory method was used. It is an empirical reflective method that has an inductive and conceptual approach to research.
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| 7. |
- Olsson, Anna Karin, 1964-, et al.
(författare)
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Driving forces for sustainable destination development : A Nordic study based on maritime culture and inland sea-regions
- 2012
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Ingår i: Developing Tourism - Sustaining Regions. - Umeå : Umeå universitet. ; , s. 110-110
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Konferensbidrag (refereegranskat)abstract
- This study focuses on sustainable destination development in a Nordic context. At most destinations stakeholders from private, public and voluntary sectors interact and there is a need for coordination and cooperation. An escalating competition among destinations has raised calls for innovative offerings that are well-coordinated. Studies of tourism destinations show that networks are crucial since successful destinations are based on interrelated stakeholders that understand the concept of the destination and are committed to cooperate in offering a holistic experience to visitors. The aim of this paper is to discuss the driving forces of sustainable destination development. In particular the study focuses on stakeholder cooperation and sharing of knowledge and experiences among two Nordic regions based on maritime culture and inland sea-regions.The data collection includes a combination of different methods: interviews with main stakeholders, collection of existing documents related to the regions, observation of stakeholder meetings, and participant observations of attractions and events. The project is ongoing but so far we have interviewed a few stakeholders in each destination and gained their insights into how to cooperate in order to develop tourism sustainable regions.
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| 8. |
- Rembeck, Karolina, et al.
(författare)
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Variants of the inosine triphosphate pyrophosphatase gene are associated with reduced relapse risk following treatment for HCV genotype 2/3.
- 2014
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Ingår i: Hepatology (Baltimore, Md.). - : Ovid Technologies (Wolters Kluwer Health). - 1527-3350 .- 0270-9139. ; 59:6, s. 2131-2139
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Tidskriftsartikel (refereegranskat)abstract
- The present study evaluated the impact of variations in the inosine triphosphate pyrophosphatase (ITPase) gene (ITPA) on treatment outcome in patients with hepatitis C virus (HCV) genotype 2/3 infection receiving peginterferon-α2a and lower, conventional 800 mg daily dose of ribavirin. Previous studies using higher, weight-based ribavirin dosing report that patients carrying polymorphisms encoding reduced predicted ITPase activity show decreased risk of ribavirin-induced anemia but increased risk of thrombocytopenia, with no impact on elimination of virus. Three hundred fifty-four treatment naïve HCV genotype 2/3 infected patients, enrolled in a phase III trial (NORDynamIC), were genotyped for ITPA (rs1127354 and rs7270101). Homo- or heterozygosity at Ars1127354 or Crs7270101, entailing reduced ITPase activity, was observed in 37% of patients and was associated with increased likelihood of achieving sustained virological response (SVR) (P=0.0003 in univariate and multivariate analyses) accompanied by a reduced risk of relapse among treatment-adherent patients. The association between ITPA variants and SVR remained significant when patients were subdivided by the 12- and 24-week treatment duration arms, HCV genotype, fibrosis stage and IL28B genotype, and was not secondary to improved adherence to therapy or less pronounced anemia. Gene variants predicting reduced predicted ITPase activity also were associated with decreased risk of anemia (P<0.0001), increased risk of thrombocytopenia (P=0.007), and lower ribavirin concentrations (P=0.02). Conclusion: These findings demonstrate a novel ribavirin-like association between polymorphisms at ITPA and treatment efficacy in chronic hepatitis C mediated by reduced relapse risk. We hypothesize that patients (63%) being homozygous for both major alleles, leading to normal ITPase activity, may benefit more from the addition of ribavirin to present and future treatment regimens for HCV in spite of concomitant increased risk of anemia.
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| 9. |
- Rondahl, E., et al.
(författare)
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The risk of HCV RNA contamination in serology screening instruments with a fixed needle for sample transfer
- 2014
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Ingår i: Journal of Clinical Virology. - : Elsevier BV. - 1386-6532 .- 1873-5967. ; 60:2, s. 172-173
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hepatitis C diagnostics involve antibody screening and confirmation of current infection by detection of HCV RNA positivity. In screening instruments with fixed pipetting needle, there is a risk of sample carry-over contamination. Objectives: The aim of this study was to evaluate the risk of such contamination in a proposed clinical setting. Study design: In the present study, known HCV RNA positive (n= 149) and negative (n= 149) samples were analysed by anti-HCV Abbott in an Architect instrument in an alternating fashion in order to test for contamination. Results: In subsequent retesting of the previously HCV RNA-negative samples, six samples (4%) were positive by the Cobas Taqman assay with a maximum level of 33. IU/mL. The results show that there is a risk for transfer of HCV in the Architect instrument but they also show that the levels of HCV RNA observed are low. Conclusions: We conclude that complementary HCV RNA testing on samples identified as anti-HCV positive by screening can be recommended because the complementary results are reliable in the majority of cases when either HCV RNA is negative or HCV RNA is positive with a level >1000. IU/mL. In a minority of cases, with low HCV RNA after anti-HCV antibody screening, cross-contamination should be suspected and a new sample requested for HCV RNA testing. This strategy would reduce the need for obtaining a new sample from the vast majority of patients with a newly discovered HCV antibody positivity. © 2014 The Authors.
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| 10. |
- Vrethem, Magnus, et al.
(författare)
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A patient with both narcolepsy and multiple sclerosis in association with Pandemrix vaccination
- 2012
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Ingår i: Journal of the Neurological Sciences. - : Elsevier BV. - 0022-510X .- 1878-5883. ; 321:1-2, s. 89-91
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Tidskriftsartikel (refereegranskat)abstract
- Narcolepsy with cataplexy is caused by a selective loss of hypocretin-producing neurons, but symptomatic narcolepsy can also result from hypothalamic and brainstem lesions caused by multiple sclerosis (MS). We report a previously healthy man who developed clinical and laboratory verified narcolepsy without having any indication of hypothalamic lesions and MS after vaccination against the influenza H1N1 with Pandemrix. HLA typing showed both DRB1*15:01, associated with MS and DQB1*06:02, associated with narcolepsy. The genetic susceptibility in this patient makes it tempting to speculate upon an immune-mediated mechanism and a common etiology for both diseases in this patient. (C) 2012 Elsevier B.V. All rights reserved.
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