| 1. |
- Bergman, Lina, 1982, et al.
(författare)
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Preeclampsia and increased permeability over the blood brain barrier - a role of vascular endothelial growth receptor 2.
- 2021
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Ingår i: American journal of hypertension. - : Oxford University Press (OUP). - 1941-7225 .- 0895-7061. ; 34:1, s. 73-81
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral complications in preeclampsia are leading causes of maternal mortality worldwide but the underlying pathophysiology is largely unknown and a challenge to study. Using an in vitro model of the human blood brain barrier (BBB), we explored the role of vascular endothelial growth factor receptor 2 (VEGFR2) in preeclampsia.The human brain endothelial cell line (hCMEC/D3) cultured on Tranwells insert were exposed (12h) to plasma from women with preeclampsia (n=28), normal pregnancy (n=28) and non-pregnant (n=16) controls. Transendothelial electrical resistance (TEER) and permeability to 70kDa FITC-dextran were measured for assessment of BBB integrity. We explored possible underlying mechanisms, with focus on expression of tight junction proteins and phosphorylation of two tyrosine residues of VEGFR2, associated with vascular permeability and migration (pY951) and cell proliferation (pY1175). Plasma concentrations of soluble FMS like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) were measured in order to establish correlations with in vitro results.hCMEC/D3 exposed to plasma from women with preeclampsia exhibited reduced TEER and increased permeability to 70kDa FITC-dextran. Further, these cells up-regulated the mRNA levels of VEGFR2, as well as pY951-VEGFR2; but reduced pY1175-VEGFR2 (p&0.05 in all cases). No difference in mRNA expression of tight junction protein was observed between gruops. There was no correlation between angiogenic biomarkers and BBB permeability.We present a promising in vitro model of the BBB in preeclampsia. Selective tyrosine phosphorylation of VEGFR2 may participate in the increased BBB permeability in preeclampsia irrespective of plasma concentrations of angiogenic biomarkers.
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| 2. |
- Alkmark, Mårten, 1973, et al.
(författare)
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Induction of labour at 41 weeks or expectant management until 42 weeks: A systematic review and an individual participant data meta-analysis of randomised trials.
- 2020
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Ingår i: PLoS medicine. - : Public Library of Science (PLoS). - 1549-1676 .- 1549-1277. ; 17:12
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Tidskriftsartikel (refereegranskat)abstract
- The risk of perinatal death and severe neonatal morbidity increases gradually after 41 weeks of pregnancy. Several randomised controlled trials (RCTs) have assessed if induction of labour (IOL) in uncomplicated pregnancies at 41 weeks will improve perinatal outcomes. We performed an individual participant data meta-analysis (IPD-MA) on this subject.We searched PubMed, Excerpta Medica dataBASE (Embase), The Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsycINFO on February 21, 2020 for RCTs comparing IOL at 41 weeks with expectant management until 42 weeks in women with uncomplicated pregnancies. Individual participant data (IPD) were sought from eligible RCTs. Primary outcome was a composite of severe adverse perinatal outcomes: mortality and severe neonatal morbidity. Additional outcomes included neonatal admission, mode of delivery, perineal lacerations, and postpartum haemorrhage. Prespecified subgroup analyses were conducted for parity (nulliparous/multiparous), maternal age (<35/≥35 years), and body mass index (BMI) (<30/≥30). Aggregate data meta-analysis (MA) was performed to include data from RCTs for which IPD was not available. From 89 full-text articles, we identified three eligible RCTs (n = 5,161), and two contributed with IPD (n = 4,561). Baseline characteristics were similar between the groups regarding age, parity, BMI, and higher level of education. IOL resulted overall in a decrease of severe adverse perinatal outcome (0.4% [10/2,281] versus 1.0% [23/2,280]; relative risk [RR] 0.43 [95% confidence interval [CI] 0.21 to 0.91], p-value 0.027, risk difference [RD] -57/10,000 [95% CI -106/10,000 to -8/10,000], I2 0%). The number needed to treat (NNT) was 175 (95% CI 94 to 1,267). Perinatal deaths occurred in one (<0.1%) versus eight (0.4%) pregnancies (Peto odds ratio [OR] 0.21 [95% CI 0.06 to 0.78], p-value 0.019, RD -31/10,000, [95% CI -56/10,000 to -5/10,000], I2 0%, NNT 326, [95% CI 177 to 2,014]) and admission to a neonatal care unit ≥4 days occurred in 1.1% (24/2,280) versus 1.9% (46/2,273), (RR 0.52 [95% CI 0.32 to 0.85], p-value 0.009, RD -97/10,000 [95% CI -169/10,000 to -26/10,000], I2 0%, NNT 103 [95% CI 59 to 385]). There was no difference in the rate of cesarean delivery (10.5% versus 10.7%; RR 0.98, [95% CI 0.83 to 1.16], p-value 0.81) nor in other important perinatal, delivery, and maternal outcomes. MA on aggregate data showed similar results. Prespecified subgroup analyses for the primary outcome showed a significant difference in the treatment effect (p = 0.01 for interaction) for parity, but not for maternal age or BMI. The risk of severe adverse perinatal outcome was decreased for nulliparous women in the IOL group (0.3% [4/1,219] versus 1.6% [20/1,264]; RR 0.20 [95% CI 0.07 to 0.60], p-value 0.004, RD -127/10,000, [95% CI -204/10,000 to -50/10,000], I2 0%, NNT 79 [95% CI 49 to 201]) but not for multiparous women (0.6% [6/1,219] versus 0.3% [3/1,264]; RR 1.59 [95% CI 0.15 to 17.30], p-value 0.35, RD 27/10,000, [95% CI -29/10,000 to 84/10,000], I2 55%). A limitation of this IPD-MA was the risk of overestimation of the effect on perinatal mortality due to early stopping of the largest included trial for safety reasons after the advice of the Data and Safety Monitoring Board. Furthermore, only two RCTs were eligible for the IPD-MA; thus, the possibility to assess severe adverse neonatal outcomes with few events was limited.In this study, we found that, overall, IOL at 41 weeks improved perinatal outcome compared with expectant management until 42 weeks without increasing the cesarean delivery rate. This benefit is shown only in nulliparous women, whereas for multiparous women, the incidence of mortality and morbidity was too low to demonstrate any effect. The magnitude of risk reduction of perinatal mortality remains uncertain. Women with pregnancies approaching 41 weeks should be informed on the risk differences according to parity so that they are able to make an informed choice for IOL at 41 weeks or expectant management until 42 weeks. Study Registration: PROSPERO CRD42020163174.
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| 3. |
- Barros da Silva Jr., José Mairton, Dr. 1990-, et al.
(författare)
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Full-Duplex and Dynamic-TDD: Pushing the Limits of Spectrum Reuse in Multi-Cell Communications
- 2021
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Ingår i: IEEE wireless communications. - : IEEE Communications Society. - 1536-1284 .- 1558-0687. ; 28:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- Although in cellular networks full duplex and dynamic time-division duplexing promise increased spectrum efficiency, their potential is so far challenged by increased interference. While previous studies have shown that self-interference can be suppressed to a sufficient level, we show that the cross-link interference for both duplexing modes, especially from base station to base station, is the remaining challenge in multi-cell networks, restricting the uplink performance. Using beamforming techniques of low complexity, we show that this interference can be mitigated, and that full duplex and dynamic time-division duplexing can substantially increase the capacity of multi-cell networks. Our results suggest that if we can control the cross-link interference in full duplex, we can almost double the multi-cell network capacity as well as user throughput. Therefore, the techniques in this article have the potential to enable a smooth introduction of full duplex into cellular systems.
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| 4. |
- Bauer, Ilena, et al.
(författare)
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Acute relaxation during pregnancy leads to a reduction in maternal electrodermal activity and self-reported stress levels
- 2021
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393 .- 1471-2393. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Prenatal maternal stress can have adverse effects on birth outcomes and fetal development. Relaxation techniques have been examined as potential countermeasures. This study investigates different relaxation techniques and their effect on self-reported stress levels and physiological stress levels in pregnant women. Methods In this cross-sectional study, 38 pregnant women in their 30th to 40th gestational week were assigned to one of three, 20-min lasting relaxation groups: listening to music (N = 12), following a guided imagery (N = 12) or resting (N = 12). The intervention, i.e., acute relaxation (music, guided imagery or resting) took place once for each study participant. Study inclusion criteria were age over 18 years, German speaking, singleton and uncomplicated pregnancy during the 30th and 40th week of gestation. The stress levels were determined during the study. Current stress level during the study was assessed by a visual analogue scale. Chronic stress levels were assessed by the Trier Inventory of Chronic Stress and the Pregnancy Distress questionnaire. Multivariate analyses of covariance were performed and dependent measures included stress levels as well as physiological measures, i.e., cardiovascular activity (electrocardiogram) and skin conductance levels. Results All three forms of relaxation led to reduced maternal stress which manifested itself in significantly decreased skin conductance, F(3,94) = 18.011, p = .001, eta(2)(p) = .365, and subjective stress levels after the interventions with no significant group difference. Post-intervention stress ratings were further affected by gestational age, with less subjective relaxation in women later in gestation, F (1, 34)=4.971, p = .032, eta(2)(p) = .128. Conclusion Independent of relaxation technique, single, 20-min relaxation intervention (music, guided imagery or resting) can significantly reduce maternal stress. Notably, women at an earlier stage in their pregnancy reported higher relaxation after the intervention than women later in gestation. Hence, gestational age may influence perceived stress levels and should be considered when evaluating relaxation or stress management interventions during pregnancy.
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| 7. |
- Hesselman, Susanne, 1973-, et al.
(författare)
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Association of maternal attention deficit hyperactivity disorder and preterm birth : a cohort study.
- 2020
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 127:12, s. 1480-1487
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) affects 3-7% of women of childbearing age. Whether ADHD is associated with an increased risk of preterm birth is unclear.DESIGN: National register-based cohort study.SETTING: Sweden.POPULATION: Nulliparous women giving birth to singleton infants 2007-2014 (n = 377 381).METHODS: Women were considered to have ADHD if they had been dispensed at least one prescription for ADHD medication, i.e. a central nervous system stimulant or non-stimulant drugs for ADHD, prior to, during or after pregnancy (2005-2014). Women with ADHD were compared with women without ADHD in regard to prevalence, severity and mode of onset of preterm birth. Logistic regression models were used, estimating adjusted odds ratios (aOR) with 95% confidence intervals (CI). Adjustments were made for maternal age and country of birth (model 1), and in addition for body mass index (BMI), education, alcohol or substance use disorders, and pre-gestational medical and psychiatric co-morbidity (model 2).MAIN OUTCOME MEASURES: Preterm birth (<37 weeks).RESULTS: During the study period, 6327 (1.7%) women gave birth and had ADHD according to our definition. These women had a higher rate of preterm birth compared with women without ADHD (7.3 versus 5.8%, aOR model 2: 1.17; 95% CI 1.05-1.30). ADHD was particularly associated with very (<32 weeks) preterm births, and associations were seen with both spontaneous and medically indicated onsets.CONCLUSIONS: Women with ADHD (i.e. who had been dispensed ADHD medication at any time in 2005-2014) had an increased risk of preterm birth.TWEETABLE ABSTRACT: Women with ADHD have a higher risk of preterm birth but most of it is due to modifiable risk factors.
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| 8. |
- Kulkov, Ignat, et al.
(författare)
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The importance of financial resources and ownership of intellectual property rights for university spin-offs : the cases of Finland and Sweden
- 2020
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Ingår i: Journal of Small Business and Enterprise Development. - : Emerald Group Publishing Limited. - 1462-6004 .- 1758-7840. ; 27:7, s. 1125-1147
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This paper focuses on medical device university spin-offs (USOs), taking into account the peculiarities of financial and nonfinancial support and intellectual property rights (IPRs). The authors declare that these parameters play a significant role in business development at the early stages. Design/methodology/approach: This empirical data consist of individual and group interviews in Finland and Sweden, which are later inductively analyzed. Findings: The results show that public financial support contributes to the formation and start of sales stages in small countries and local markets. However, at the validation stage, approaches for supporting entrepreneurship in the field of medical devices may differ. The ownership of IPRs assists in the development of entrepreneurship in the region due to the transfer of research results and researchers to the industry and increases the number of spin-offs and the cooperation of universities with business. Originality/value: This contribution is in the identification of the key parameters for the formation, support and development of the USOs from the point of view of the availability of financial resources and the ownership of IPRs.
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| 9. |
- Lahtinen, M. H., et al.
(författare)
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The impact of thermomechanical pulp fiber modifications on thermoplastic lignin composites
- 2021
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Ingår i: Composites Part C: Open Access. - : Elsevier BV. - 2666-6820. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Cellulose and lignin are abundant renewable biopolymers that can be used for the manufacture of new, environmentally friendly materials. The objective of this study was to produce composites of kraft lignin, which were reinforced with cellulosic thermomechanical pulp (TMP) fibers. Furthermore, the fibers were chemically modified resulting in cross-linking or increased hydrophobicity. Ideally, these modifications improve interaction between the components in the composite. The effects of the modifications on the tensile strength and thermal properties of the composites were investigated, and the interactions between components were examined by infrared spectroscopy and scanning electron microscopy. When the fibers were cross-linked with polyethylene glycol diglycidyl ether (PEGDE), the tensile strength properties of the composite were significantly improved. Depending on the amount of PEGDE added, tensile strength was increased by 16–34%, and Young's Modulus by 6–18%, but at the same time the strain at break remained the same. Similarly, by using PEGDE, the amount of free plasticizer (PEG) could be reduced, which also improved the water-resistance of the composite. According to scanning electron microscopy, all chemical treatments improved the compatibility of the fibers with the lignin matrix. However, the increase in compatibility was highest when the fibers were cross-linked with a combination of glyoxal and neopentyl glycol (GL/NPG) or by increasing hydrophobicity through acetylation (AC), although the tensile strength properties were the best in case of cross-linking with PEGDE.
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| 10. |
- Skalkidou, Alkistis, 1977-, et al.
(författare)
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SSRI use during pregnancy and risk for postpartum haemorrhage : a national register-based cohort study in Sweden
- 2020
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Ingår i: British Journal of Obstetrics and Gynecology. - : John Wiley & Sons. - 1470-0328 .- 1471-0528. ; 127:11, s. 1366-1373
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Evaluate whether selective serotonin reuptake inhibitor (SSRI) use during pregnancy, as well as prior or current untreated psychiatric illness is associated with postpartum haemorrhage (PPH).DESIGN: National register-based cohort study based on data from the Swedish Pregnancy Register.SETTING: Sweden, nationwide coverage.POPULATION: A total of 31 159 pregnant women with singleton deliveries after gestational week 22+0 between January 2013 and July 2017.METHODS: Pregnant women with self-reported SSRI use at any time point during pregnancy were compared with non-SSRI-treated women with prior or current psychiatric illness, as well as wiith healthy women with no psychiatric illness or reporting SSRI use.MAIN OUTCOME MEASURES: Postpartum haemorrhage defined as blood loss >1000 ml during the first 2 hours postpartum reported by the delivering midwife or obstetrician.RESULTS: Postpartum haemorrhage prevalence was 7.0% among healthy women, 7.6% among women with prior or current psychiatric illness and 9.1% among women treated with SSRI. The unadjusted odds for PPH among women with prior or current psychiatric illness and women on SSRI treatment were increased by 9 and 34%, respectively, compared with healthy unmedicated women without a history of psychiatric illness (odds ratio [OR] 1.09, 95% CI 1.04-1.14 and OR 1.34, 95% CI 1.24-1.44, respectively). The estimates remained unchanged after adjustment for several confounders (such as maternal age, body mass index [BMI], parity, prior caesarean section, smoking, occupation and country of birth) and potential covariates (such as delivery mode, polyhydramnion, preterm delivery, labour dystocia and infant birthweight >4000 g).CONCLUSIONS: Higher risk for PPH was observed both among women treated with SSRI during pregnancy and among women with prior or current psychiatric illness.TWEETABLE ABSTRACT: SSRI use at any point during pregnancy and prior or current history of psychiatric illness was associated with an increased likelihood for PPH.
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