| 1. |
- Lundgren, Markus, et al.
(författare)
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Analgesic antipyretic use among young children in the TEDDY study : No association with islet autoimmunity
- 2017
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Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.
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| 2. |
- Haghighi, Mona, et al.
(författare)
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A Comparison of Rule-based Analysis with Regression Methods in Understanding the Risk Factors for Study Withdrawal in a Pediatric Study
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Regression models are extensively used in many epidemiological studies to understand the linkage between specific outcomes of interest and their risk factors. However, regression models in general examine the average effects of the risk factors and ignore subgroups with different risk profiles. As a result, interventions are often geared towards the average member of the population, without consideration of the special health needs of different subgroups within the population. This paper demonstrates the value of using rule-based analysis methods that can identify subgroups with heterogeneous risk profiles in a population without imposing assumptions on the subgroups or method. The rules define the risk pattern of subsets of individuals by not only considering the interactions between the risk factors but also their ranges. We compared the rule-based analysis results with the results from a logistic regression model in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Both methods detected a similar suite of risk factors, but the rule-based analysis was superior at detecting multiple interactions between the risk factors that characterize the subgroups. A further investigation of the particular characteristics of each subgroup may detect the special health needs of the subgroup and lead to tailored interventions.
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| 3. |
- Johnson, Randi K., et al.
(författare)
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Metabolite-related dietary patterns and the development of islet autoimmunity
- 2019
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- The role of diet in type 1 diabetes development is poorly understood. Metabolites, which reflect dietary response, may help elucidate this role. We explored metabolomics and lipidomics differences between 352 cases of islet autoimmunity (IA) and controls in the TEDDY (The Environmental Determinants of Diabetes in the Young) study. We created dietary patterns reflecting pre-IA metabolite differences between groups and examined their association with IA. Secondary outcomes included IA cases positive for multiple autoantibodies (mAb+). The association of 853 plasma metabolites with outcomes was tested at seroconversion to IA, just prior to seroconversion, and during infancy. Key compounds in enriched metabolite sets were used to create dietary patterns reflecting metabolite composition, which were then tested for association with outcomes in the nested case-control subset and the full TEDDY cohort. Unsaturated phosphatidylcholines, sphingomyelins, phosphatidylethanolamines, glucosylceramides, and phospholipid ethers in infancy were inversely associated with mAb+ risk, while dicarboxylic acids were associated with an increased risk. An infancy dietary pattern representing higher levels of unsaturated phosphatidylcholines and phospholipid ethers, and lower sphingomyelins was protective for mAb+ in the nested case-control study only. Characterization of this high-risk infant metabolomics profile may help shape the future of early diagnosis or prevention efforts. © 2019, The Author(s).
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| 4. |
- Krischer, Jeffrey P, et al.
(författare)
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Predicting Islet Cell Autoimmunity and Type 1 Diabetes : An 8-Year TEDDY Study Progress Report
- 2019
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 42:6, s. 1051-1060
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Assessment of the predictive power of The Environmental Determinants of Diabetes in the Young (TEDDY)-identified risk factors for islet autoimmunity (IA), the type of autoantibody appearing first, and type 1 diabetes (T1D).RESEARCH DESIGN AND METHODS: A total of 7,777 children were followed from birth to a median of 9.1 years of age for the development of islet autoantibodies and progression to T1D. Time-dependent sensitivity, specificity, and receiver operating characteristic (ROC) curves were calculated to provide estimates of their individual and collective ability to predict IA and T1D.RESULTS: HLA genotype (DR3/4 vs. others) was the best predictor for IA (Youden's index J = 0.117) and single nucleotide polymorphism rs2476601, in PTPN22, was the best predictor for insulin autoantibodies (IAA) appearing first (IAA-first) (J = 0.123). For GAD autoantibodies (GADA)-first, weight at 1 year was the best predictor (J = 0.114). In a multivariate model, the area under the ROC curve (AUC) was 0.678 (95% CI 0.655, 0.701), 0.707 (95% CI 0.676, 0.739), and 0.686 (95% CI 0.651, 0.722) for IA, IAA-first, and GADA-first, respectively, at 6 years. The AUC of the prediction model for T1D at 3 years after the appearance of multiple autoantibodies reached 0.706 (95% CI 0.649, 0.762).CONCLUSIONS: Prediction modeling statistics are valuable tools, when applied in a time-until-event setting, to evaluate the ability of risk factors to discriminate between those who will and those who will not get disease. Although significantly associated with IA and T1D, the TEDDY risk factors individually contribute little to prediction. However, in combination, these factors increased IA and T1D prediction substantially.
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| 5. |
- Smith, Laura B., et al.
(författare)
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Psychological manifestations of celiac disease autoimmunity in young children
- 2017
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 139:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVES: Psychological symptoms can be associated with celiac disease; abstract however, this association has not been studied prospectively in a pediatric cohort. We examined mother report of psychological functioning in children persistently positive for tissue transglutaminase autoantibodies (tTGA), defined as celiac disease autoimmunity (CDA), compared with children without CDA in a screening population of genetically at-risk children. We also investigated differences in psychological symptoms based on mothers' awareness of their child's CDA status. METHODS: The Environmental Determinants of Diabetes in the Young study followed 8676 children to identify triggers of type 1 diabetes and celiac disease. Children were tested for tTGA beginning at 2 years of age. The Achenbach Child Behavior Checklist assessed child psychological functioning at 3.5 and 4.5 years of age. RESULTS: At 3.5 years, 66 mothers unaware their child had CDA reported more child anxiety and depression, aggressive behavior, and sleep problems than 3651 mothers of children without CDA (all Ps ≤ .03). Unaware-CDA mothers also reported more child anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems than 440 mothers aware of their child's CDA status (all Ps ≤.04). At 4.5 years, there were no differences. CONCLUSIONS: In 3.5-year-old children, CDA is associated with increased reports of child depression and anxiety, aggressive behavior, and sleep problems when mothers are unaware of their child's CDA status. Mothers' knowledge of their child's CDA status is associated with fewer reports of psychological symptoms, suggesting that awareness of the child's tTGA test results affects reporting of symptoms.
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| 6. |
- Törn, Carina, et al.
(författare)
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Complement gene variants in relation to autoantibodies to beta cell specific antigens and type 1 diabetes in the TEDDY Study
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- A total of 15 SNPs within complement genes and present on the ImmunoChip were analyzed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. A total of 5474 subjects were followed from three months of age until islet autoimmunity (IA: n = 413) and the subsequent onset of type 1 diabetes (n = 115) for a median of 73 months (IQR 54-91). Three SNPs within ITGAM were nominally associated (p < 0.05) with IA: rs1143678 [Hazard ratio; HR 0.80; 95% CI 0.66-0.98; p = 0.032], rs1143683 [HR 0.80; 95% CI 0.65-0.98; p = 0.030] and rs4597342 [HR 1.16; 95% CI 1.01-1.32; p = 0.041]. When type 1 diabetes was the outcome, in DR3/4 subjects, there was nominal significance for two SNPs: rs17615 in CD21 [HR 1.52; 95% CI 1.05-2.20; p = 0.025] and rs4844573 in C4BPA [HR 0.63; 95% CI 0.43-0.92; p = 0.017]. Among DR4/4 subjects, rs2230199 in C3 was significantly associated [HR 3.20; 95% CI 1.75-5.85; p = 0.0002, uncorrected] a significance that withstood Bonferroni correction since it was less than 0.000833 (0.05/60) in the HLA-specific analyses. SNPs within the complement genes may contribute to IA, the first step to type 1 diabetes, with at least one SNP in C3 significantly associated with clinically diagnosed type 1 diabetes.
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| 7. |
- Indira Chandran, Vineesh, et al.
(författare)
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Ultrasensitive Immunoprofiling of Plasma Extracellular Vesicles Identifies Syndecan-1 as a Potential Tool for Minimally Invasive Diagnosis of Glioma
- 2019
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Ingår i: Clinical Cancer Research. - 1078-0432 .- 1557-3265. ; 25:10, s. 3115-3127
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Liquid biopsy has great potential to improve the management of brain tumor patients at high risk of surgery-associated complications. Here, the aim was to explore plasma extracellular vesicle (plEV) immunoprofiling as a tool for noninvasive diagnosis of glioma.Experimental Design: PlEV isolation and analysis were optimized using advanced mass spectrometry, nanoparticle tracking analysis, and electron microscopy. We then established a new procedure that combines size exclusion chromatography isolation and proximity extension assay-based ultrasensitive immunoprofiling of plEV proteins that was applied on a well-defined glioma study cohort (n = 82).Results: Among potential candidates, we for the first time identify syndecan-1 (SDC1) as a plEV constituent that can discriminate between high-grade glioblastoma multiforme (GBM, WHO grade IV) and low-grade glioma [LGG, WHO grade II; area under the ROC curve (AUC): 0.81; sensitivity: 71%; specificity: 91%]. These findings were independently validated by ELISA. Tumor SDC1 mRNA expression similarly discriminated between GBM and LGG in an independent glioma patient population from The Cancer Genome Atlas cohort (AUC: 0.91; sensitivity: 79%; specificity: 91%). In experimental studies with GBM cells, we show that SDC1 is efficiently sorted to secreted EVs. Importantly, we found strong support of plEVSDC1 originating from GBM tumors, as plEVSDC1 correlated with SDC1 protein expression in matched patient tumors, and plEVSDC1 was decreased postoperatively depending on the extent of surgery.Conclusions: Our studies support the concept of circulating plEVs as a tool for noninvasive diagnosis and monitoring of gliomas and should move this field closer to the goal of improving the management of cancer patients.
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| 8. |
- Blomqvist, Maria K., 1975, et al.
(författare)
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High-throughput analysis of sulfatides in cerebrospinal fluid using automated extraction and UPLC-MS/MS
- 2017
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Ingår i: Journal of Lipid Research. - 0022-2275. ; 58:7, s. 1482-1489
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Tidskriftsartikel (refereegranskat)abstract
- Sulfatides (STs) are a group of glycosphingolipids that are highly expressed in brain. Due to their importance for normal brain function and their potential involvement in neurological diseases, development of accurate and sensitive methods for their determination is needed. Here we describe a high-throughput oriented and quantitative method for the determination of STs in cerebrospinal fluid (CSF). The STs were extracted using a fully automated liquid/liquid extraction method and quantified using ultra-performance liquid chromatography coupled to tandem mass spectrometry. With the high sensitivity of the developed method, quantification of 20 ST species from only 100 mu l of CSF was performed. Validation of the method showed that the STs were extracted with high recovery (90%) and could be determined with low inter-and intra-day variation. Our method was applied to a patient cohort of subjects with an Alzheimer's disease biomarker profile. Although the total ST levels were unaltered compared with an age-matched control group, we show that the ratio of hydroxylated/nonhydroxylated STs was increased in the patient cohort. In conclusion, we believe that the fast, sensitive, and accurate method described in this study is a powerful new tool for the determination of STs in clinical as well as preclinical settings.-Blomqvist, M., J. Boren, H. Zetterberg, K. Blennow, J-E. Mansson, and M. Stahlman. High-throughput analysis of sulfatides in cerebrospinal fluid using automated extraction and UPLC-MS/MS.
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| 9. |
- Cassinger, Cecilia, et al.
(författare)
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Geographies of fear – communicating safety in urban destinations
- 2019
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Konferensbidrag (refereegranskat)abstract
- Countering fear and promoting experiences of security and safety among visitors are key issues in creating socially sustainable urban destinations. Security branding is a growing place branding paradigm through which to enhance experiences and perceptions of safety in cities, nations and regions (Coaffee and Van Ham, 2008; Coaffee and Rogers, 2008; Avraham and Ketter, 2008). This paper discusses how brand communication can be incorporated in urban policy and planning to accomplish socially sustainable city centres. Our focus is on relation between the mediatisation of cities and perceptions and experiences of safety among domestic and international visitors. Recent terror attacks, political unrest, and violent conflicts in many European countries are highly mediatised events (Couldry and Hepp, 2018) that influence images of urban destinations, which are particularly vulnerable to rumours and images circulating in media (Avraham, 2009; Avraham and Ketter, 2008). The study focuses on 10 Swedish urban destinations. Sweden is an interesting case in point due to high levels of media coverage, which is characterised by polarised narratives concerning the country as a utopia respectively dystopia (see e.g. Rapacioli, 2018). The research questions we seek to answer concern 1) how perceptions of safety are influenced by the image of Sweden conveyed on online news and social media (Instagram and Twitter) platforms, and 2) the relation between visitors’ overall image of the destinations and their experiences of safety. The research questions are addressed by a mixed methods approach using survey methods and media analysis to capture the role of place image for visitors’ perceptions and experiences of safety. The findings demonstrate that the mediatisation of the country of Sweden follows narratives of safety respectively unsafety, which influence the way Swedish cities are perceived. Furthermore, findings indicate a correlation between positive city image and high levels of perceived safety among visitors. The paper discusses these findings in relation to social sustainability and proposes communicative strategies to handle and counter fears in urban destinations. References Avraham, E. and Ketter, E. (2008), “Will we be safe there? Analysing strategies for altering unsafe place images”, Place Branding and Public Diplomacy, Vol. 4 No. 3, pp. 196-204. Avraham, E. (2009), “Marketing and managing nation branding during prolonged crisis: The case of Israel”, Place Branding and Public Diplomacy, Vol. 5 No. 3, pp. 202-212. Coaffee, J., & Rogers, P. (2008), “Reputational risk and resiliency: The branding of security in place-making”, Place Branding and Public Diplomacy, Vol. 4 No. 3, pp. 205-217. Coaffee, J., & Van Ham, P. (2008), “‘Security branding’: The role of security in marketing the city, region or state”, Place Branding and Public Diplomacy, Vol. 4 No. 3, pp. 191-195. Couldry, N. and Hepp, A. (2018), “The continuing lure of the mediated centre in times of deep mediatization: Media Events and its enduring legacy”, Media, Culture & Society, Vol. 40 No. 1, pp. 114–117. Rapacioli, P. (2018), Good Sweden, Bad Sweden: The use and abuse of Swedish values in a post-truth world. Stockholm: Volante.
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| 10. |
- Cassinger, Cecilia, et al.
(författare)
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Geographies of fear – visitors’ perceptions of safety in urban destinations
- 2019
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Konferensbidrag (refereegranskat)abstract
- Countering fear and promoting experiences of security and safety among visitors are key issues in creating socially sustainable urban destinations. Security branding is a growing place branding paradigm through which to enhance experiences and perceptions of safety in cities, nations and regions (Coaffee and Van Ham, 2008; Coaffee and Rogers, 2008; Avraham and Ketter, 2008). This paper discusses how brand communication can be incorporated in urban policy and planning to accomplish socially sustainable city centres. Our focus is on relation between the mediatisation of cities and perceptions and experiences of safety among domestic and international visitors. Recent terror attacks, political unrest, and violent conflicts in many European countries are highly mediatised events (Couldry and Hepp, 2018) that influence images of urban destinations, which are particularly vulnerable to rumours and images circulating in media (Avraham, 2009; Avraham and Ketter, 2008). The study focuses on 10 Swedish urban destinations. Sweden is an interesting case in point due to high levels of media coverage, which is characterised by polarised narratives concerning the country as a utopia respectively dystopia (see e.g. Rapacioli, 2018). The research questions we seek to answer concern 1) how perceptions of safety are influenced by the image of Sweden conveyed on online news and social media (Instagram and Twitter) platforms, and 2) the relation between visitors’ overall image of the destinations and their experiences of safety. The research questions are addressed by a mixed methods approach using survey methods and media analysis to capture the role of place image for visitors’ perceptions and experiences of safety. The findings demonstrate that the mediatisation of the country of Sweden follows narratives of safety respectively unsafety, which influence the way Swedish cities are perceived. Furthermore, findings indicate a correlation between positive city image and high levels of perceived safety among visitors. The paper discusses these findings in relation to social sustainability and proposes communicative strategies to handle and counter fears in urban destinations. Keywords: place image, urban destinations, branding security, social sustainability, mediatisation References Avraham, E. and Ketter, E. (2008), “Will we be safe there? Analysing strategies for altering unsafe place images”, Place Branding and Public Diplomacy, Vol. 4 No. 3, pp. 196-204. Avraham, E. (2009), “Marketing and managing nation branding during prolonged crisis: The case of Israel”, Place Branding and Public Diplomacy, Vol. 5 No. 3, pp. 202-212. Coaffee, J., & Rogers, P. (2008). “Reputational risk and resiliency: The branding of security in placemaking”, Place Branding and Public Diplomacy, Vol. 4 No. 3, pp. 205-217. Coaffee, J., & Van Ham, P. (2008). “‘Security branding’: The role of security in marketing the city, region or state”, Place Branding and Public Diplomacy, Vol. 4 No. 3, pp. 191-195. Couldry, N. and Hepp, A. (2018), “The continuing lure of the mediated centre in times of deep mediatization: Media Events and its enduring legacy”, Media, Culture & Society, Vol. 40 No. 1, pp. 114–117. Rapacioli, P. (2018), Good Sweden, Bad Sweden: The use and abuse of Swedish values in a posttruth world. Stockholm: Volante.
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