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- Thiele, I., et al.
(författare)
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A community-driven global reconstruction of human metabolism
- 2013
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Ingår i: Nature Biotechnology. - : Springer Science and Business Media LLC. - 1087-0156 .- 1546-1696. ; 31:5, s. 419-
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Tidskriftsartikel (refereegranskat)abstract
- Multiple models of human metabolism have been reconstructed, but each represents only a subset of our knowledge. Here we describe Recon 2, a community-driven, consensus 'metabolic reconstruction', which is the most comprehensive representation of human metabolism that is applicable to computational modeling. Compared with its predecessors, the reconstruction has improved topological and functional features, including similar to 2x more reactions and similar to 1.7x more unique metabolites. Using Recon 2 we predicted changes in metabolite biomarkers for 49 inborn errors of metabolism with 77% accuracy when compared to experimental data. Mapping metabolomic data and drug information onto Recon 2 demonstrates its potential for integrating and analyzing diverse data types. Using protein expression data, we automatically generated a compendium of 65 cell type-specific models, providing a basis for manual curation or investigation of cell-specific metabolic properties. Recon 2 will facilitate many future biomedical studies and is freely available at http://humanmetabolism.org/.
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- Fellinger, Joris, et al.
(författare)
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Tungsten based divertor development for Wendelstein 7-X
- 2023
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Ingår i: Nuclear Materials and Energy. - 2352-1791. ; 37
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Tidskriftsartikel (refereegranskat)abstract
- Wendelstein 7-X, the world’s largest superconducting stellarator in Greifswald (Germany), started plasma experiments with a water-cooled plasma-facing wall in 2022, allowing for long pulse operation. In parallel, a project was launched in 2021 to develop a W based divertor, replacing the current CFC divertor, to demonstrate plasma performance of a stellarator with a reactor relevant plasma facing materials with low tritium retention. The project consists of two tasks: Based on experience from the previous experimental campaigns and improved physics modelling, the geometry of the plasma-facing surface of the divertor and baffles is optimized to prevent overloads and to improve exhaust. In parallel, the manufacturing technology for a W based target module is qualified. This paper gives a status update of project. It focusses on the conceptual design of a W based target module, the manufacturing technology and its qualification, which is conducted in the framework of the EUROfusion funded WPDIV program. A flat tile design in which a target module is made of a single target element is pursued. The technology must allow for moderate curvatures of the plasma-facing surface to follow the magnetic field lines. The target element is designed for steady state heat loads of 10 MW/m2 (as for the CFC divertor). Target modules of a similar size and weight as for the CFC divertor are assumed (approx. < 0.25 m2 and < 60 kg) using the existing water cooling infrastructure providing 5 l/s and roughly maximum 15 bar pressure drop per module. The main technology under qualification is based on a CuCrZr heat sink made either by additive manufacturing using laser powder bed fusion (LPBF) or by uniaxial diffusion welding of pre-machined forged CuCrZr plates. After heat treatment, the plasma-facing side of the heat sink is covered by W or if feasible by the more ductile WNiFe, preferably by coating or alternatively by hot isostatic pressing W based tiles with a soft OFE-Cu interlayer. Last step is a final machining of the plasma-exposed surface and the interfaces to the water supply lines and supports to correct manufacturing deformations.
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- Constant, D, et al.
(författare)
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Immediate versus delayed insertion of the copper intrauterine device after medical abortion at 17-20 gestational weeks: a randomised controlled trial
- 2022
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Ingår i: BMJ sexual & reproductive health. - : BMJ. - 2515-2009 .- 2515-1991. ; 48:1, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- This trial reports on use of the copper intrauterine device (IUD) after immediate compared with delayed insertion following medical abortion at 17–20 gestational weeks (GW).MethodsThis randomised controlled trial was conducted at one tertiary hospital and five community healthcare centres in Cape Town, South Africa. Eligible consenting women were randomised to immediate (within 24 hours) or delayed (3 weeks post-abortion) insertion of the copper IUD. Follow-up was at 6 weeks, 3 months and 6 months. Main outcomes were use of the original IUD and use of any IUD, including replacement IUDs at 6 weeks post-abortion. Secondary outcomes included rates of expulsion and malposition at 6 weeks, use of any IUD at 3 and 6 months, and acceptability of the IUD.ResultsWe recruited and randomised 114 women admitted for elective medical abortion between August 2018 and June 2019. In the immediate and delayed study arms, respectively, 45/55 (82%) and 12/57 (21%) women received the IUD as planned. By intention-to-treat, 56% in the immediate and 19% in the delayed arms were using the original IUD at 6 weeks (p<0.001), and 76% in the immediate and 40% in the delayed arms were using any IUD (p<0.001). Complete expulsion or removal occurred in 32% in the immediate and 7% in the delayed arms (p=0.044).ConclusionsInsertion of an IUD immediately after medical abortion at 17–20 GW results in increased use after 6 weeks compared with delayed insertion, however expulsion rates are higher than with interval insertion.Clinical trials registrationNCT03505047), Pan African Trials Registry (www.pactr.org), 201804003324963
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- VanBenschoten, H, et al.
(författare)
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Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health: a scoping review
- 2022
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 7:10
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has negatively impacted health systems globally and widened preexisting disparities. We conducted a scoping review on the impact of the COVID-19 pandemic on women and girls’ access to and utilisation of sexual and reproductive health (SRH) services for contraception, abortion, gender-based and intimate partner violence (GBV/IPV) and sexually transmitted infections (STIs).MethodsWe systematically searched peer reviewed literature and quantitative reports, published between December 2019 and July 2021, focused on women and girls’ (15–49 years old) access to and utilisation of selected SRH services during the COVID-19 pandemic. Included studies were grouped based on setting, SRH service area, study design, population and reported impact. Qualitative data were coded, organised thematically and grouped by major findings.ResultsWe included 83 of 3067 identified studies and found that access to contraception, in-person safe abortion services, in-person services for GBV/IPV and STI/HIV testing, prevention and treatment decreased. The geographical distribution of this body of research was uneven and significantly less representative of countries where COVID-19 restrictions were very strict. Access was limited by demand and supply side barriers including transportation disruptions, financial hardships, limited resources and legal restrictions. Few studies focused on marginalised groups with distinct SRH needs.ConclusionReports indicated negative impacts on access to and utilisation of SRH services globally, especially for marginalised populations during the pandemic. Our findings call for strengthening of health systems preparedness and resilience to safeguard global access to essential SRH services in ongoing and future emergencies.
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| 12. |
- Endler, M, et al.
(författare)
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Editorial: Women facing crises
- 2023
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Ingår i: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. - 1879-3479. ; 163:2, s. 343-344
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Endler, M, et al.
(författare)
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Office hysteroscopy: a scientific overview
- 2011
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Ingår i: MENOPAUSE REVIEW-PRZEGLAD MENOPAUZALNY. - 1643-8876. ; 10:2, s. 85-90
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Endler, M., et al.
(författare)
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Retained placenta is associated with pre-eclampsia, stillbirth, giving birth to a small-for-gestational-age infant, and spontaneous preterm birth : a national register-based study
- 2014
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 121:12, s. 1462-1470
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo evaluate whether defective placentation disorders, i.e. pre-eclampsia, stillbirth, small for gestational age (SGA), and spontaneous preterm birth, are associated with risk of retained placenta. DesignPopulation-based cohort study. SettingSweden. PopulationPrimiparous women in Sweden with singleton vaginal deliveries between 1997 and 2009 at 32-41weeks of gestation (n=386607), without placental abruption or infants with congenital malformations. MethodsRisks were calculated as odds ratios (ORs) by unconditional logistic regression with 95% confidence intervals (95%CIs) after adjustments for maternal, delivery, and infant characteristics. Main outcome measureRetained placenta, defined by the presence of both a diagnostic code (of retained placenta) and a procedure code (for the manual removal of the placenta). ResultsThe overall rate of retained placenta was 2.17%. The risk of retained placenta was increased for women with pre-eclampsia (adjusted OR, aOR, 1.37, 95%CI 1.21-1.54), stillbirth (aOR1.71, 95%CI 1.28-2.29), SGA birth (aOR1.47, 95%CI 1.28-1.70), and spontaneous preterm birth (32-34weeks of gestation, aOR2.35, 95%CI 1.97-2.81; 35-36weeks of gestation, aOR1.55, 95%CI 1.37-1.75). The risk was further increased for women with preterm pre-eclampsia (aOR1.69, 95%CI 1.25-2.28) and preterm SGA birth (aOR2.19, 95%CI 1.42-3.38). There was no association between preterm stillbirth (aOR1.10, 95%CI 0.63-1.92) and retained placenta, but the exposed group comprised only 15 cases. ConclusionsDefective placentation disorders are associated with an increased risk of retained placenta. Whether these relationships indicate a common pathophysiology remains to be investigated.
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- Endler, M., et al.
(författare)
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The inherited risk of retained placenta : a population based cohort study.
- 2018
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 125:6, s. 737-744
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether retained placenta in the first generation is associated with an increased risk of retained placenta in the second generation.Design: Population‐based cohort study.Setting: Sweden.Population: Using linked generational data from the Swedish Medical Birth Register 1973–2012, we identified 494 000 second‐generation births with information on the birth of the mother (first‐generation index birth). For 292 897 of these births there was information also on the birth of the father.Methods: Risk of retained placenta in the second generation was calculated as adjusted odds ratios (aOR) by unconditional logistic regression with 95% confidence intervals (95% CI) according to whether retained placenta occurred in a first generation birth or not.Main outcome: Retained placenta in the second generation.Results: The risk of retained placenta in a second‐generation birth was increased if retained placenta had occurred at the mother's own birth (aOR 1.66, 95% CI 1.52–1.82), at the birth of one of her siblings (aOR 1.58, 95% CI 1.43–1.76) or both (aOR 2.75, 95% CI 2.18–3.46). The risk was slightly increased if retained placenta had occurred at the birth of the father (aOR 1.23, 95% CI 1.07–1.41). For preterm births in both generations, the risk of retained placenta in the second generation was increased six‐fold if retained placenta had occurred at the mother's birth (OR 6.55, 95% CI 2.68–16.02).Conclusion: There is an intergenerational recurrence of retained placenta on the maternal and most likely also on the paternal side. The recurrence risk seems strongest in preterm pregnancies.Tweetable abstract: A population‐based cohort study suggests that there is an intergenerational recurrence of retained placenta.
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| 24. |
- Killinger, K, et al.
(författare)
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Why women choose abortion through telemedicine outside the formal health sector in Germany: a mixed-methods study
- 2022
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Ingår i: BMJ sexual & reproductive health. - : BMJ. - 2515-2009 .- 2515-1991. ; 48:E1e1, s. E6-E12
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Tidskriftsartikel (refereegranskat)abstract
- Women on Web (WoW) is a global medical abortion telemedicine service operating outside the formal health sector. In April 2019 they opened their helpdesk to Germany. Our aim was to understand the motivations, and perceived barriers to access, for women who choose telemedicine abortion outside the formal health sector in Germany.MethodsWe conducted a parallel convergent mixed-methods study among 1090 women consulting WoW from Germany between 1 January and 31 December 2019. We performed a cross-sectional study of data contained in online consultations and a content analysis of 108 email texts. Analysis was done until saturation; results were merged and triangulation used to validate results.ResultsThe quantitative analysis found that the need for secrecy (n=502, 48%) and the wish for privacy (n=500, 48%) were frequent reasons for choosing telemedicine abortion. Adolescents were more likely to report secrecy, cost, stigma and legal restrictions as reasons for using telemedicine abortion compared with older women. The content analysis developed two main themes and seven subsidiary categories, (1) internal motivations for seeking telemedicine abortion encompassing (i) autonomy, (ii) perception of external threat and (iii) shame and stigma, and (2) external barriers to formal abortion care encompassing (iv) financial stress, (v) logistic barriers to access, (vi) provider attitudes and (vii) vulnerability of foreigners.ConclusionsWomen in Germany who choose telemedicine abortion outside the formal health sector do so both from a place of empowerment and a place of disempowerment. Numerous barriers to abortion access exist in the formal sector which are of special relevance to vulnerable groups such as adolescents and undocumented immigrants.
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