| 1. |
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| 2. |
- Maurin Söderholm, Hanna, et al.
(author)
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Research challenges in prehospital care : the need for a simulation-based prehospital research laboratory
- 2019
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In: Advances in Simulation. - : BioMed Central. - 2059-0628 .- 2059-0628. ; 4:3, s. 1-6
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Journal article (peer-reviewed)abstract
- There is a need for improved research in the field of prehospital care. At the same time, there are many barriers in prehospital research due to the complex context, posing unique challenges for research, development, and evaluation. The present paper argues for the potential of simulation for prehospital research, e.g., through the development of an advanced simulation-based prehospital research laboratory. However, the prehospital context is different from other healthcare areas, which implies special requirements for the design of this type of laboratory, in terms of simulation width (including the entire prehospital work process) and depth (level of scenario detail). A set of features pertaining to simulation width, scenario depth, equipment, and personnel and competence are proposed. Close tailoring between these features and the prehospital research problems and context presents great potential to improve and further prehospital research.
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| 3. |
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| 4. |
- Vaht, Krista, 1973, et al.
(author)
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High Graft-versus-Host Disease-Free, Relapse/Rejection-Free Survival and Similar Outcome of Related and Unrelated Allogeneic Stem Cell Transplantation for Aplastic Anemia : A Nationwide Swedish Cohort Study
- 2019
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In: Biology of blood and marrow transplantation. - : Elsevier. - 1083-8791 .- 1523-6536. ; 25:10, s. 1970-1974
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Journal article (peer-reviewed)abstract
- Allogeneic stem cell transplantation (SCT) as primary treatment for aplastic anemia (AA) is being increasingly used. Yet, age, stem cell source, and donor type are important outcome factors. We have recently performed a nationwide cohort study of all patients with AA in Sweden diagnosed from 2000 to 2011 and now present outcome data on SCT patients. In total, 68 patients underwent SCT, and 63% of them had failed immunosuppressive therapy. We found that, with a median follow-up of 109 months (range, 35 to 192 months), 5-year overall survival (OS) for all patients was 86.8%, whereas graft-versus-host disease-free, relapse/rejection-free survival (GRFS) at 5 years was 69.1%. There was no survival impact regarding the donor type or stem cell source. Patients aged >= 40 years had a higher transplant-related mortality (29.4% versus 7.8%; P= .023), which translated into a lower 5-year OS: 70.6% versus 92.2% (A=.022) and a trend of lower GRFS (52.9% versus 74.5%; P = .069). In conclusion, we found in this real-world setting that both OS and GRFS were high, but SCT for patients with AA aged >= 40 years is problematic, and clinical trials addressing this issue are warranted. (C) 2019 American Society for Transplantation and Cellular Therapy.
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| 5. |
- Vaht, Krista, 1973, et al.
(author)
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Low response rate to ATG-based immunosuppressive therapy in very severe aplastic anaemia : A Swedish nationwide cohort study
- 2018
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In: European Journal of Haematology. - : Munksgaard Forlag. - 0902-4441 .- 1600-0609. ; 100:6, s. 613-620
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Journal article (peer-reviewed)abstract
- Objectives: Antithymocyte globulin (ATG)-based immunosuppression remains a cornerstone in aplastic anaemia (AA) treatment. However, most ATG studies are not population-based and knowledge about real-world results concerning response and outcome could offer important information for treating physicians.Methods: We have recently performed a nationwide retrospective cohort study on all AA patients diagnosed in Sweden in 2000–2011 and now present treatment and outcome data on patients receiving first-line ATG. In total, 158 patients showed a 47.0% response rate which was similar in all age groups (range 41.5%-51.7%) with no difference regarding ATG formulation. The response was significantly associated with severity grade—especially at time of treatment initiation: very severe (VSAA) 22.7%; severe (SAA) 54.5% (P <.001); and non-severe 88.5% (P <.001). A logistic regression-based predictive model indicated that VSAA patients with an absolute reticulocyte count <25 × 109/L had only a 19% probability of response. In a multivariable analysis, age and VSAA at the time of treatment were the independent factors for inferior survival.Conclusions: Real-world VSAA patients respond poorly to ATG which indicates the need for a different treatment approach. Our findings suggest that age alone should not be a discriminating factor for administering ATG treatment.
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| 6. |
- Zamora, Juan Carlos, et al.
(author)
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Considerations and consequences of allowing DNA sequence data as types of fungal taxa
- 2018
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In: IMA Fungus. - : INT MYCOLOGICAL ASSOC. - 2210-6340 .- 2210-6359. ; 9:1, s. 167-185
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Journal article (peer-reviewed)abstract
- Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.
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| 7. |
- Alim, Abdul, 1983-
(author)
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Mechanisms in Tendon Healing : Pain, Biomarkers and the Role of Mast Cells
- 2019
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Doctoral thesis (other academic/artistic)abstract
- Tendon injuries and tendinopathy are common disorders, but the underlying mechanisms are not well understood. The overall aim of this thesis was to better understand the mechanisms underlying tendon healing, pain, and inflammation.The aim of the first study was to assess biomarkers of tendon healing, including procollagen type I (PINP) and type III (PIIINP) in relation to patient outcome in 65 patients with Achilles tendon rupture (ATR). At two weeks post-ATR, PINP and PIIINP-levels were quantified using microdialysis followed by ELISA. At one-year post-ATR patient outcome was assessed using the validated Achilles tendon Total Rupture Score. We found that higher ratio of PINP and PIIINP to total protein were significantly associated with less pain but more fatigue in the affected limb.In the second study, we applied Intermittent Pneumatic Compression (IPC) therapy for two weeks to stimulate tendon healing. The patients received either adjuvant IPC treatment or treatment-as-usual in a plaster cast without IPC. We observed that IPC therapy significantly increased PINP levels in the injured tendon, suggesting enhanced healing response.In our third study, we investigated healing response and the role of mast cells (MCs) in-vivo using an ATR rat model. Three weeks postoperatively, we demonstrated an increased number of MCs and a higher proportion of degranulated MCs in the injured tendon compared to the control. We further established that MCs in the injured tendon were positive for the glutamate receptor NMDAR1.In our final study, we assessed the effect of glutamate stimulation on in-vitro-derived mouse bone marrow MCs. Mast cell degranulation was quantified through β-hexosaminidase release, immunofluorescence was used to quantify NMDARs at the protein level, and RT-qPCR/microarray was used to study the expression of NMDARs and associated genes. Glutamate induced a robust upregulation of glutamate receptors of both ionotropic and metabotropic type, both at the mRNA and at protein level. NMDAR1 co-localized with glutamate in the membrane of MCs, thereby confirming an interaction between glutamate and its receptor. Glutamate also induced expression of pro-inflammatory compounds such as IL-6 and CCL2 and transcription factors such as Egr2, Egr3 and FosB. Moreover, the NMDA-channel blocker MK-801 completely abrogated the response of MCs to glutamate, supporting a functional glutamate–glutamate receptor axis in MCs.Together, findings presented in this dissertation reveal possible mechanisms of tendon healing in relation to pain and function, and establish a novel principle for how immune cells can communicate with nerve cells after ATR.
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| 8. |
- Andersson Hagiwara, Magnus, et al.
(author)
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A shorter system delay for haemorrhagic stroke than ischaemic stroke among patients who use emergency medical service
- 2018
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 137:5, s. 523-530
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Journal article (peer-reviewed)abstract
- ObjectivesWe compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. Materials & methodsThe Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital. ResultsOf 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient's decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital. ConclusionsPatients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.
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| 9. |
- Andersson Hagiwara, Magnus, et al.
(author)
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Measuring participants’ immersion in healthcare simulation : the development of an instrument
- 2016
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In: Advances in Simulation. - : BioMed Central. - 2059-0628. ; 2016:1
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Journal article (peer-reviewed)abstract
- BackgroundImmersion is important for simulation-based education; however, questionnaire-based instruments to measure immersion have some limitations. The aim of the present work is to develop a new instrument to measure immersion among participants in healthcare simulation scenarios.MethodsThe instrument was developed in four phases: trigger identification, content validity scores, inter-rater reliability analysis and comparison with an existing immersion measure instrument. A modified Delphi process was used to develop the instrument and to establish validity and reliability. The expert panel consisted of 10 researchers. All the researchers in the team had previous experience of simulation in the health and/or fire and rescue services as researchers and/or educators and simulation designers. To identify triggers, the panel members independently screened video recordings from simulation scenarios. Here, a trigger is an event in a simulation that is considered a sign of reduced or enhanced immersion among simulation participants.ResultsThe result consists of the Immersion Score Rating Instrument (ISRI). It contains 10 triggers, of which seven indicate reduced and three enhanced immersion. When using ISRI, a rater identifies trigger occurrences and assigns them strength between 1 and 3. The content validity analysis shows that all the 10 triggers meet an acceptable content validity index for items (I-CVI) standard. The inter-rater reliability (IRR) among raters was assessed using a two-way mixed, consistency, average-measures intra-class correlation (ICC). The ICC for the difference between weighted positive and negative triggers was 0.92, which indicates that the raters are in agreement. Comparison with results from an immersion questionnaire mirrors the ISRI results.ConclusionsIn conclusion, we present a novel and non-intrusive instrument for identifying and rating the level of immersion among participants in healthcare simulation scenarios.
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| 10. |
- Andersson, Per, et al.
(author)
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Treatment with oral anticoagulant drugs restrained from patients with atrial fibrillation : An assessment in a geographically well-defined catchment area
- 2016
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In: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 23:13, s. 1437-1443
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Journal article (peer-reviewed)abstract
- BACKGROUND: Atrial fibrillation (AF) affects about 3.2% of the adult population in the western world and incurs an annual stroke risk of 4.5%. The use of oral anticoagulant (OAC) drugs significantly reduces this risk. OAC drugs seem to be under-utilized, but little is known about why their use is restrained in routine clinical management. The aim of this study was to assess this issue and, from these data, to estimate the proportion of patients with AF in a general population who were eligible for treatment with OAC drugs.DESIGN: Retrospective study of medical records.METHODS: The study included all identified patients with AF in a well-defined catchment area of 65,532 people, among whom 1616 (3.2%) had documented AF. Of the patients with AF, 588 (36%) were originally reported not to be receiving OAC drugs. The patient-responsible physicians (n = 24) were requested to complete a standardized questionnaire to assess the reason for restraining the use of OAC drugs for each individual patient.RESULTS: Of the 588 patients originally reported not to be receiving OAC drugs, eight were shown to be using OAC drugs and seven were lost to follow up. Thus the reason for restraining OAC drugs was finally assessed in 573 patients. The primary reasons were: lack of indication, 26%; declined general condition, 14%; a history of bleeding, 12%; assumed poor compliance, 11%; repeated falls, 6%; and reason unknown, 9%.CONCLUSIONS: This is, to our knowledge, the first study to assess the reasons for restraining the use of OAC drugs in a geographically well-defined population including all hospital-based and non-hospital-based healthcare. Applying CHA2DS2-VASc and new strategies for OAC drugs to our study data indicated that between 72 and 88% of all patients with AF are eligible for treatment with OAC drugs.
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| 11. |
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| 12. |
- Backlund, Per, 1964-, et al.
(author)
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Breaking Out of the Bubble Putting Simulation Into Context to Increase Immersion and Performance
- 2018
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In: Journal Simulation & Gaming. - : Sage Publications. - 1046-8781 .- 1552-826X. ; 49:6, s. 642-660
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Journal article (peer-reviewed)abstract
- Objective. Simulation based training with full-size mannequins is a prominent means of training within the healthcare sector. Prehospital missions include all parts of the healthcare process which take place before a patient is handed over to the receiving hospital. This implies that the context for prehospital care is varied and potentially challenging or dangerous in several ways. In this article we present a study which explores immersion and performance by emergency medical services (EMS) professionals in in a training situation which takes the specifics of prehospital interventions into account.Methods. The study was carried out as a field experiment at an ambulance unit. The experiment was designed to compare the differences between two types of medical scenarios: basic and contextualized. We analyzed the levels of immersion throughout the scenarios and then team performance was evaluated by independent experts. Both analyses were made by observing video recordings from multiple camera angles with a custom made analysis tool.Results. Our results show that the contextualization of a medical scenario increases both immersion as measured by the Immersion Score Rating Instrument (ISRI) and team performance as measured by the Global Rating Scale (GRS). The overall ISRI score was higher in the contextualized condition as compared to the basic condition, with an average team wise difference of 2.94 (sd = 1.45). This difference is significant using a paired, two-tailed t-test (p<.001). The GRS score was higher for overall clinical performance in the contextualized scenario with an average team wise difference of 0.83 (sd = 0.83, p=.005).Conclusions. Full-size mannequin simulation based training for EMS professionals may be enhanced by contextualizing the medical scenarios. The main benefits are that the contextualized scenarios better take prehospital medical challenges into account and allow participants to perform better.
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| 13. |
- Backlund, Per, 1964-, et al.
(author)
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Enhancing Immersion with Contextualized Scenarios: Role-Playing in Prehospital Care Training
- 2015
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In: 2015 7th International Conference on Games and Virtual Worlds for Serious Applications (VS-Games). - Skövde : IEEE Computer Society. ; , s. 167-170
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Conference paper (peer-reviewed)abstract
- This paper reports on a field experiment with 12 paramedic teams (n=24) exploring how they perceive a novel training approach. The feeling of being engaged in training (i.e. being immersed) is often held forward as a major benefit of roleplaying exercises. Engagement is expected to raise the quality of training as well as improving learning and retention. However, much simulation-based training in prehospital care is decontextualized, meaning that medical care is trained without taking other characteristics of prehospital care into account. In this paper we investigate how a richer setting (contextualization), which includes more of the complicating aspects of prehospital care, affects the perceived immersion of the participants. The results show that contextualization has a significant positive impact on perceived immersion. These results are important for further studies on how to organize and design role-playing exercises.
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| 14. |
- Backlund, Per, 1964-, et al.
(author)
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The S.A.R.E.K Simulation Environment : Technical description of a flexible training environment for prehospital care
- 2017
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Reports (other academic/artistic)abstract
- This report contains a technical description of the result of the S.A.R.E.K (Simulation – Ambulance – Research – Education - Kinship) collaboration project and the Sim2020 project. The projects are collaborations between researchers in healthcare and IT, and prehospital care practitioners, with the aim to design, develop and test a contextualized simulation environment for prehospital care. We built a simulation environment representing the full depth and width of a prehospital care process. Breadth refers to including all phases of a prehospital mission, from dispatch to handover; while depth refers to detailed representations and recreation of artefacts, information and context for each of these phases. This report outlines the details of the overall design, all equipment and practical solutions used to create this. Apart from the installation which is described in this report we have also developed methods and carried out a variety of tests and experiments which are reported elsewhere. The focus of this report is the system and its components.
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| 15. |
- Barucca, G., et al.
(author)
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Precision resonance energy scans with the PANDA experiment at FAIR : Sensitivity study for width and line shape measurements of the X(3872)
- 2019
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In: European Physical Journal A. - : SPRINGER. - 1434-6001 .- 1434-601X. ; 55:3
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Journal article (peer-reviewed)abstract
- This paper summarises a comprehensive Monte Carlo simulation study for precision resonance energy scan measurements. Apart from the proof of principle for natural width and line shape measurements of very narrow resonances with PANDA, the achievable sensitivities are quantified for the concrete example of the charmonium-like X(3872) state discussed to be exotic, and for a larger parameter space of various assumed signal cross-sections, input widths and luminosity combinations. PANDA is the only experiment that will be able to perform precision resonance energy scans of such narrow states with quantum numbers of spin and parities that differ from JPC=1--.
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| 16. |
- Bäcke, Olof, 1984, et al.
(author)
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Enhanced thermal stability of a polymer solar cell blend induced by electron beam irradiation in the transmission electron microscope
- 2017
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In: Ultramicroscopy. - : Elsevier BV. - 1879-2723 .- 0304-3991. ; 173, s. 16-23
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Journal article (peer-reviewed)abstract
- We show by in situ microscopy that the effects of electron beam irradiation during transmission electron microscopy can be used to lock microstructural features and enhance the structural thermal stability of a nanostructured polymer:fullerene blend. Polymer:fullerene bulk-heterojunction thin films show great promise for use as active layers in organic solar cells but their low thermal stability is a hindrance. Lack of thermal stability complicates manufacturing and influences the lifetime of devices. To investigate how electron irradiation affects the thermal stability of polymer:fullerene films, a model bulk-heterojunction film based on a thiophene-quinoxaline copolymer and a fullerene derivative was heat-treated in-situ in a transmission electron microscope. In areas of the film that exposed to the electron beam the nanostructure of the film remained stable, while the nanostructure in areas not exposed to the electron beam underwent large phase separation and nucleation of fullerene crystals. UV–vis spectroscopy shows that the polymer:fullerene films are stable for electron doses up to 2000 kGy.
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| 17. |
- Bäcke, Olof, 1984, et al.
(author)
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Enhanced thermal stability of a polymer solar cell blend induced by electron beam irradiation in the transmission electron microscope
- 2017
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In: Ultramicroscopy. - : Elsevier BV. - 1879-2723 .- 0304-3991. ; 176:Spec. Issue, s. 23-30
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Journal article (peer-reviewed)abstract
- We show by in situ microscopy that the effects of electron beam irradiation during transmission electron microscopy can be used to lock microstructural features and enhance the structural thermal stability of a nanostructured polymer:fullerene blend. Polymer:fullerene bulk-heterojunction thin films show great promise for use as active layers in organic solar cells but their low thermal stability is a hindrance. Lack of thermal stability complicates manufacturing and influences the lifetime of devices. To investigate how electron irradiation affects the thermal stability of polymer:fullerene films, a model bulk-heterojunction film based on a thiophene-quinoxaline copolymer and a fullerene derivative was heat-treated in-situ in a transmission electron microscope. In areas of the film that exposed to the electron beam the nanostructure of the film remained stable, while the nanostructure in areas not exposed to the electron beam underwent large phase separation and nucleation of fullerene crystals. UV–vis spectroscopy shows that the polymer:fullerene films are stable for electron doses up to 2000 kGy.
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| 18. |
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| 19. |
- Collaboration, The PANDA, et al.
(author)
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Feasibility studies of time-like proton electromagnetic form factors at PANDA at FAIR
- 2016
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In: European Physical Journal A. - : Springer Publishing Company. - 1434-6001 .- 1434-601X. ; 52:10
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Journal article (peer-reviewed)abstract
- Simulation results for future measurements of electromagnetic proton form factors at P ¯ ANDA (FAIR) within the PandaRoot software framework are reported. The statistical precision with which the proton form factors can be determined is estimated. The signal channel p¯ p→ e+e- is studied on the basis of two different but consistent procedures. The suppression of the main background channel, i.e.p¯ p→ π+π-, is studied. Furthermore, the background versus signal efficiency, statistical and systematical uncertainties on the extracted proton form factors are evaluated using two different procedures. The results are consistent with those of a previous simulation study using an older, simplified framework. However, a slightly better precision is achieved in the PandaRoot study in a large range of momentum transfer, assuming the nominal beam conditions and detector performance.
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| 20. |
- Colombo, Stefan, et al.
(author)
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Matrix effects in nilotinib formulations with pH-responsive polymer produced by carbon dioxide-mediated precipitation
- 2015
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In: International Journal of Pharmaceutics. - : Elsevier. - 0378-5173 .- 1873-3476. ; 494:1, s. 205-217
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Journal article (peer-reviewed)abstract
- Factors determining the pH-controlled dissolution kinetics of nilotinib formulations with the pH-titrable polymer hydroxypropyl methylcellulose phthalate, obtained by carbon dioxide-mediated precipitation, were mechanistically examined in acid and neutral environment. The matrix effect, modulating the drug dissolution, was characterized with a battery of physicochemical methodologies, including ToF-SIMS for surface composition, SAXS/WAXS and modulated DSC for crystallization characterization, and simultaneous UV-imaging and Raman spectroscopy for monitoring the dissolution process in detail. The hybrid particle formulations investigated consisted of amorphous nilotinib embedded in a polymer matrix in single continuous phase, displaying extended retained amorphicity also under wet conditions. It was demonstrated by Raman and FTIR spectroscopy that the efficient drug dispersion and amorphization in the polymer matrix were mediated by hydrogen bonding between the drug and the phthalate groups on the polymer. Simultaneous Raman and UV-imaging studies of the effect of drug load on the swelling and dissolution of the polymer matrix revealed that high nilotinib load prevented matrix swelling on passage from acid to neutral pH, thereby preventing re-precipitation and re-crystallization of incorporated nilotinib. These findings provide a mechanistic foundation of formulation development of nilotinib and other protein kinase inhibitors, which are now witnessing an intense therapeutic and industrial attention due to the difficulty in formulating these compounds so that efficient oral bioavailability is reached.
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| 21. |
- Dahlin, Mats, et al.
(author)
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Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder : A randomized controlled trial
- 2016
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In: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 77, s. 86-95
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Journal article (peer-reviewed)abstract
- Generalized anxiety disorder (GAD) is a disabling condition which can be treated with cognitive behaviour therapy (CBT). The present study tested the effects of therapist-guided internet-delivered acceptance-based behaviour therapy on symptoms of GAD and quality of life. An audio CD with acceptance and mindfulness exercises and a separate workbook were also included in the treatment. Participants diagnosed with GAD (N = 103) were randomly allocated to immediate therapist-guided internet-delivered acceptance-based behaviour therapy or to a waiting-list control condition. A six month follow-up was also included. Results using hierarchical linear modelling showed moderate to large effects on symptoms of GAD (Cohen's d = 0.70 to 0.98), moderate effects on depressive symptoms (Cohen's d = 0.51 to 0.56), and no effect on quality of life. Follow-up data showed maintained effects. While there was a 20% dropout rate, sensitivity analyses showed that dropouts did not differ in their degree of change during treatment. To conclude, our study suggests that internet-delivered acceptance-based behaviour therapy can be effective in reducing the symptoms of GAD.
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| 22. |
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| 23. |
- Ekerstad, Niklas, 1969-, et al.
(author)
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Short-term Resource Utilization and Cost-Effectiveness of Comprehensive Geriatric Assessment in Acute Hospital Care for Severely Frail Elderly Patients
- 2018
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In: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610 .- 1538-9375. ; 19:10, s. 871-8
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Journal article (peer-reviewed)abstract
- Objective: The objective of this study was to estimate the 3-month within-trial cost-effectiveness of comprehensive geriatric assessment (CGA) in acute medical care for frail elderly patients compared to usual medical care, by estimating health-related quality of life and costs from a societal perspective. Design: Clinical, prospective, controlled, 1-center intervention trial with 2 parallel groups. Intervention: Structured, systematic interdisciplinary CGA-based care in an acute elderly care unit. If the patient fulfilled the inclusion criteria, and there was a bed available at the CGA unit, the patient was included in the intervention group. If no bed was available at the CGA unit, the patient was included in the control group and admitted to a conventional acute medical care unit. Setting and Participants: A large county hospital in western Sweden. The trial included 408 frail elderly patients, 75 years or older, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n = 206) or control group (n = 202). Mean age of the patients was 85.7 years, and 56% were female. Measures: The primary outcome was the adjusted incremental cost-effectiveness ratio associated with the intervention compared to the control at the 3-month follow-up. Results: We undertook cost-effectiveness analysis, adjusted by regression analyses, including hospital, primary, and municipal care costs and effects. The difference in the mean adjusted quality-adjusted life years gained between groups at 3 months was 0.0252 [95% confidence interval (CI): 0.0082-0.0422]. The incremental cost, that is, the difference between the groups, was -3226 US dollars (95% CI: -6167 to -285). Conclusion: The results indicate that the care in a CGA unit for acutely ill frail elderly patients is likely to be cost-effective compared to conventional care after 3 months. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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| 24. |
- Englund, Johanna, 1988, et al.
(author)
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Deactivation of a Pd/Pt Bimetallic Oxidation Catalyst Used in a Biogas-Powered Euro VI Heavy-Duty Engine Installation
- 2019
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In: Catalysts. - : MDPI. - 2073-4344. ; 9:12
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Journal article (peer-reviewed)abstract
- The reduction of anthropogenic greenhouse gas emissions is crucial to avoid further warming of the planet. We investigated how effluent gases from a biogas powered Euro VI heavy-duty engine impact the performance of a bimetallic (palladium and platinum) oxidation catalyst. Using synthetic gas mixtures, the oxidation of NO, CO, and CH4 before and after exposure to biogas exhaust for 900 h was studied. The catalyst lost most of its activity for methane oxidation, and the activity loss was most severe for the inlet part of the aged catalyst. Here, a clear sintering of Pt and Pd was observed, and higher concentrations of catalyst poisons such as sulfur and phosphorus were detected. The sintering and poisoning resulted in less available active sites and hence lower activity for methane oxidation.
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| 25. |
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| 26. |
- Engström, Henrik, 1968-, et al.
(author)
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The impact of contextualization on immersion in healthcare simulation
- 2016
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In: Advances in Simulation. - : BioMed Central. - 2059-0628. ; 1
-
Journal article (peer-reviewed)abstract
- BackgroundThe aim of this paper is to explore how contextualization of a healthcare simulation scenarios impacts immersion, by using a novel objective instrument, the Immersion Score Rating Instrument. This instrument consists of 10 triggers that indicate reduced or enhanced immersion among participants in a simulation scenario. Triggers refer to events such as jumps in time or space (sign of reduced immersion) and natural interaction with the manikin (sign of enhanced immersion) and can be used to calculate an immersion score.MethodsAn experiment using a randomized controlled crossover design was conducted to compare immersion between two simulation training conditions for prehospital care: one basic and one contextualized. The Immersion Score Rating Instrument was used to compare the total immersion score for the whole scenario, the immersion score for individual mission phases, and to analyze differences in trigger occurrences. A paired t test was used to test for significance.ResultsThe comparison shows that the overall immersion score for the simulation was higher in the contextualized condition. The average immersion score was 2.17 (sd = 1.67) in the contextualized condition and −0.77 (sd = 2.01) in the basic condition (p < .001). The immersion score was significantly higher in the contextualized condition in five out of six mission phases. Events that might be disruptive for the simulation participants’ immersion, such as interventions of the instructor and illogical jumps in time or space, are present to a higher degree in the basic scenario condition; while events that signal enhanced immersion, such as natural interaction with the manikin, are more frequently observed in the contextualized condition.ConclusionsThe results suggest that contextualization of simulation training with respect to increased equipment and environmental fidelity as well as functional task alignment might affect immersion positively and thus contribute to an improved training experience.
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| 27. |
- Gdaniec, Sandra, et al.
(author)
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Thorium and Protactinium isotopes as tracers of marine particle fluxes and deep water circulation in the Mediterranean Sea
- 2018
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In: Marine Chemistry. - : Elsevier. - 0304-4203 .- 1872-7581. ; 199, s. 12-23
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Journal article (peer-reviewed)abstract
- 231Pa, 230Th and 232Th were analyzed in unfiltered sea water samples (n = 66) and suspended particles (n = 19) collected in the Mediterranean Sea during the MedSeA-GA04-S cruise along the GEOTRACES section GA04S and used to investigate mechanisms controlling the distribution and fractionation of Pa and Th in an ocean margin environment. 231Pa and230Th are particle reactive radionuclides and are often used astracers of processes such as boundary scavenging, particle transport and ocean circulation. The depth profiles of total 231Pa and 230Th concentrations in the Mediterranean Sea displayed non-linear shapes. Higher total 232Th concentrations were observed at the straits and in deepwaters pointing at lithogenic sources. Fractionation factors FTh/Pa ranged from 1.4 to 9. Application of a box-model illustrated that 94 % of the 231Pa and almost all of the 230Th (99.9 %) produced in the Mediterranean Sea is removed to the sediment by scavenging. The negligible export of 230Th to the Atlantic Ocean, leads to a reevaluation of the mean settling speed of the filtered particles, which is now estimated to 500-1000 m/y. The low FTh/Pa fractionation factors are attributed to the efficient scavenging and lack of transport of 231Pa to the Atlantic Ocean.
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| 28. |
- Hansson, Per-Olof, 1958, et al.
(author)
-
Prehospital assessment of suspected stroke and TIA: An observational study
- 2019
-
In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 140:2, s. 93-99
-
Journal article (peer-reviewed)abstract
- Background Symptoms related to stroke diverge and may mimic many other conditions. Aims To evaluate clinical findings among patients with a clinical suspicion of stroke in a prehospital setting and find independent predictors of a final diagnosis of stroke or transient ischemic attack (TIA). Methods An observational multicenter study includes nine emergency hospitals in western Sweden. All patients transported to hospital by ambulance and in whom a suspicion of stroke was raised by the emergency medical service clinician before hospital admission during a four-month period were included. Results Of 1081 patients, a diagnosis of stroke was confirmed at hospital in 680 patients (63%), while 69 (6%) were diagnosed as TIA and 332 patients (31%) received other final diagnoses. In a multiple logistic regression analysis, factors independently associated with a final diagnosis of stroke or TIA were increasing age, odds ratio (OR) per year: 1.02, P = 0.007, a history of myocardial infarction (OR: 1.77, P = 0.01), facial droop (OR: 2.81, P < 0.0001), arm weakness (OR: 2.61, P < 0.0001), speech disturbance (OR: 1.92, P < 0.0001), and high systolic blood pressure (OR: 1.50, P = 0.02), while low oxygen saturation was significantly associated with other diagnoses (OR: 0.41, P = 0.007). More than half of all patients among patients with both stroke/TIA and other final diagnoses died during the five-year follow-up. Conclusions Seven factors including the three symptoms included in the Face Arm Speech Test were significantly associated with a final diagnosis of stroke or TIA in a prehospital assessment of patients with a suspected stroke.
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| 29. |
- Hansson, Per-Olof, 1958, et al.
(author)
-
Prehospital identification of factors associated with death during one-year follow-up after acute stroke
- 2018
-
In: Brain and Behavior. - : Wiley. - 2162-3279. ; 8:6
-
Journal article (peer-reviewed)abstract
- Objectives: In acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke. Material and Methods: All patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1.6 million inhabitants) during a four-month period were included. There were no exclusion criteria. Results: In all, 1,028 patients with a confirmed diagnosis of stroke who used the EMS were included in the analyses. Among these patients, 360 (35%) died during the following year. Factors that were independently associated with an increased risk of death were as follows: (1) high age, per year OR 1.07; 95% CI 1.05-1.09; (2) a history of heart failure, OR 2.08; 95% CI 1.26-3.42; (3) an oxygen saturation of < 90%, OR 8.05; 95% CI 3.33-22.64; and (4) a decreased level of consciousness, OR 2.19; 95% CI 1.61-3.03. Conclusions: Among patients with a stroke, four factors identified before arrival at hospital were associated with a risk of death during the following year. They were reflected in the patients' age, previous clinical history, respiratory function, and the function of the central nervous system.
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| 30. |
- Hirst, Catherine, et al.
(author)
-
Characterisation of Fe-bearing particles and colloids in the Lena River basin, NE Russia
- 2017
-
In: Geochimica et Cosmochimica Acta. - Cambridge : Elsevier. - 0016-7037 .- 1872-9533. ; 213, s. 553-573
-
Journal article (peer-reviewed)abstract
- Rivers are significant contributors of Fe to theocean. However, the characteristics of chemically reactive Fe remain poorly constrained, especially in large Arctic rivers, which drain landscapes highly susceptible to climate change and carbon cycle alteration. The aim of this study was a detailed characterisation (size, mineralogy, and speciation) of riverine Fe-bearing particles (> 0.22 µm) and colloids (1 kDa – 0.22 µm) and their association with organic carbon (OC), in the Lena River and tributaries, which drain a catchment almost entirely underlain by permafrost. Samples fromthe main channel and tributaries representing watersheds that span a wide rangein topography and lithology were taken after the spring flood in June 2013 and summer baseflow in July 2012. Fe-bearing particles were identified, usingTransmission Electron Microscopy, as large (200 nm – 1 µm) aggregates of smaller (20 nm - 30 nm) spherical colloids of chemically-reactive ferrihydrite.In contrast, there were also large (500 nm – 1 µm) aggregates of clay (illite) particles and smaller (100 - 200 nm) iron oxide particles (dominantly hematite) that contain poorly reactive Fe. TEM imaging and Scanning Transmission X-raymicroscopy (STXM) indicated that the ferrihydrite is present as discrete particles within networks of amorphous particulate organic carbon (POC) and attached to the surface of primary produced organic matter and clay particles.Together, these larger particles act as the main carriers of nanoscale ferrihydrite in the Lena River basin. The chemically reactive ferrihydrite accounts for on average 70 ± 15 % of the total suspended Fe in the Lena River and tributaries. These observations place important constraints on Fe and OC cycling in the Lena River catchment area and Fe-bearing particle transport to the Arctic Ocean.
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| 31. |
- Hirst, Catherine, 1989-
(author)
-
Iron in the Lena River basin, NE Russia : Insights from microscopy, spectroscopy and isotope analysis
- 2018
-
Doctoral thesis (other academic/artistic)abstract
- Iron is an important mediator of biotic and abiotic processes on the Earth’s surface, being an electron acceptor in organic matter degradation, a surface for organic matter and trace element adsorption, and a required element for enzymatic processes during primary production. Yet, the role of iron as a mediator of carbon and trace element cycling in high latitude, permafrost-dominated regions remains poorly investigated. The aim of this study was to characterise the chemical reactivity (by size separation, microscopy and spectroscopy) and sources (by isotope composition) of Fe in the Lena River and major tributaries, spanning a wide range in lithology, topography and climate. The Fe transported in the Lena River and major tributaries carries an integrated signal of Fe weathering processes across the permafrost-dominated terrain.A spatial sample set was collected during the post-spring flood period (July 2012, June 2013), from the main channel and tributaries draining contrasting topography and permafrost extent. Across the basin, Fe is mainly transported as chemically reactive ferrihydrite that spans the particulate (> 0.22 µm) and colloidal (0.22 µm – 1 kDa) fractions. The remaining Fe transported as poorly reactive detrital Fe in clays and crystalline oxides. Fe is transported in larger size fractions than the dissolved OM showing that Fe is not a major carrier of DOM. Nano-sized ferrihydrite was attached to OM in the particulate fraction, evidence of a Fe – OM particle association in the Lena River basin.Ferrihydrite shows distinct isotope values in particulate and colloidal fractions, showing that there is a difference in isotopic composition between different size fractions of the same mineral. A conceptual model was developed to understand ferrihydrite formation in the riparian zone of the Lena River and tributaries. Particulate ferrihydrite has isotope values lower than crustal values resulting from redox and organic-ligand promoted mineral dissolution and precipitation of Fe(II)aq to form coatings of ferrihydrite on particles in the riparian zone. Ferrihydrite colloids span a wider range of isotope values, higher than Fe particles, resulting from variations in the size and isotope composition of the Fe(II)aq pool transported in soil groundwaters, and the isotope fractionation factor for Fe oxidation and organic complexation.A temporal sample set was collected in the main channel between September 2012 – March 2013 and every three days during May 2015. The colloidal Fe shows distinct seasonal Fe isotope signatures and Fe fluxes, with isotope values lower than crustal during winter baseflow, overlying crustal values during spring flood and higher than crustal values during summer, attributed to changing sources and thus conditions for isotope fractionation. The combined understanding of Fe reactivity and isotope composition allows us to isolate the dominant sources of Fe entering the Lena River.
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| 32. |
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| 33. |
- Hordoir, Robinson, et al.
(author)
-
Nemo-Nordic 1.0 : a NEMO-based ocean model for the Baltic and North seas - research and operational applications
- 2019
-
In: Geoscientific Model Development. - : Copernicus GmbH. - 1991-959X .- 1991-9603. ; 12:1, s. 363-386
-
Journal article (peer-reviewed)abstract
- We present Nemo-Nordic, a Baltic and North Sea model based on the NEMO ocean engine. Surrounded by highly industrialized countries, the Baltic and North seas and their assets associated with shipping, fishing and tourism are vulnerable to anthropogenic pressure and climate change. Ocean models providing reliable forecasts and enabling climatic studies are important tools for the shipping infrastructure and to get a better understanding of the effects of climate change on the marine ecosystems. Nemo-Nordic is intended to be a tool for both short-term and long-term simulations and to be used for ocean forecasting as well as process and climatic studies. Here, the scientific and technical choices within Nemo-Nordic are introduced, and the reasons behind the design of the model and its domain and the inclusion of the two seas are explained. The model's ability to represent barotropic and baroclinic dynamics, as well as the vertical structure of the water column, is presented. Biases are shown and discussed. The short-term capabilities of the model are presented, especially its capabilities to represent sea level on an hourly timescale with a high degree of accuracy. We also show that the model can represent longer timescales, with a focus on the major Baltic inflows and the variability in deep-water salinity in the Baltic Sea.
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| 34. |
- Högfeldt, Anna-Karin, et al.
(author)
-
Pedagogisk meritering på KTH - Samarbete, excellens och utbildningsinnovation
- 2019
-
In: Bidrag från 7:e Utvecklingskonferensen för Sveriges ingenjörsutbildningar. - Luleå : Luleå University of Technology. ; , s. 76-81
-
Conference paper (peer-reviewed)abstract
- Detta bidrag beskriver och analyserar förberedelsefasen inför implementeringen av ett högskolepedagogiskt excellensprogram vid Kungliga Tekniska Högskolan, KTH. Programmet syftar till att ytterligare stärka värdet av pedagogiska meriter och samtidigt bidra till lärosätets fortsatta och fördjupade utveckling av utbildningarna och organisationen. De tydligaste riskerna som har identifierats med befintliga pedagogiska meriteringsmodeller är att de kan skapa ett A- och B-lag (mellan en karriär som forskare och en karriär som lärare). Dessutom är det ofta oklart hur personer som har utnämnts till excellenta lärare ska kunna bidra till organisationens och utbildningens utveckling ur ett kortsiktigt såväl som ett långsiktigt perspektiv. En tydlig svaghet med befintliga pedagogiska meriteringsmodeller är att de inte explicit nog ger emfas till aktivt och relevant utvecklingsarbete, utan fokuserar på egenhändigt skrivna pedagogiska portföljer som sällan är framtidsinriktade. KTH:s högskolepedagogiska excellensprogram siktar på att försöka möta dessa risker och svagheter. KTH har, alltjämt sedan det nationella obligatoriet om 15 hp Högskolepedagogik infördes, kvarhållit detta obligatorium. Stora satsningar har gjorts på den högskolepedagogiska verksamheten. Ett gediget utbud av fortbildningsmöjligheter samt arenor för nätverkande har utvecklats. Samtidigt råder svagheter i systemet gällande prövande och tillvaratagande av pedagogisk skicklighet, och det är tydligt att KTH behöver ytterligare utveckling i området. Författarna menar också att i och med att de utmaningar vi står inför gällande pedagogisk meritering ser relativt lika ut vid landets lärosäten, bör ett stärkt nationellt samarbete och nätverkande inom landets ingenjörsutbildningar främjas inom området. Artikelförfattarna representerar KTH:s övergripande ledning, utbildningsledning samt ledningen för den högskolepedagogiska verksamheten.
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| 35. |
- Höglin, Viktor, et al.
(author)
-
Detailed study of the magnetic ordering in FeMnP0.75Si0.25
- 2015
-
In: Journal of Solid State Chemistry. - : Elsevier BV. - 0022-4596 .- 1095-726X. ; 221, s. 240-246
-
Journal article (peer-reviewed)abstract
- Magnetic and crystallographic properties of FeMnP0.75Si0.25 in the hexagonal Fe2P-type structure have been investigated by X-ray powder diffraction, neutron powder diffraction and magnetic measurements. The room temperature diffractograms reveal co-existence of two distinct structural phases in the samples with small, but significant, differences only in the unit cell dimensions. The volume ratio between the two phases is governed by the annealing conditions. One of the phases orders ferromagnetically (TC = 250 K) and the other in an incommensurate antiferromagnetic structure at low temperatures (qx = 0.363(1), TN = 150 K).
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| 36. |
- Johansson, Anders, et al.
(author)
-
Dataset on multichannel connectivity and video transmission carried on commercial 3G/4G networks in southern Sweden
- 2019
-
In: Data in Brief. - : Elsevier BV. - 2352-3409. ; 25
-
Journal article (peer-reviewed)abstract
- In this data article, we report real-world data on multichannel connectivity and videotransmission carried on commercial 3G/4G networks in the region of Skåne, southern Sweden. The data reported here complement the research article “Technical feasibility and ambulance nurses’ view of a digital telemedicine system in pre-hospital stroke care – A pilot study” (1). The dataset was originally collected as part of a project aimed to test in a clinical setting the quality and usefulness of a linked image and sound transmission in the prehospital assessment of patients with suspected stroke. The project built on previous studies indicating that using high-quality telemedicine in stroke cases is feasible and has already impacted local stroke care Schwamm et al., 2009. In addition, studies support the hypothesis that stroke telemedicine consultations, compared with telephone-only, result in more accurate decision-making Demaerschalk et al., 2012. Cellular networks for 3/4G networks have been greatly improved, a prerequisite for the use of these networks for e. g. medical applications. However, connectivity maps for planning purposes are usually based on theoretical values that do not consider smaller features of the terrain such as large trees, hills, rocks etc. and that may interfere with connectivity. To leverage several networks, multichannel devices have been developed that split the original transmission onto several independent channels and recombine the transmission on the receiver side. This setup allows to increase the available bandwidth and introduces at the same time an element of redundancy, provided that several providers with independent networks are used.
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| 37. |
- Johansson, Alina, et al.
(author)
-
miR-31 regulates energy metabolism and is suppressed in Tcells from patients with Sjögren's syndrome
- 2019
-
In: European Journal of Immunology. - : Wiley. - 0014-2980 .- 1521-4141. ; 49:2, s. 313-322
-
Journal article (peer-reviewed)abstract
- Systemic autoimmune diseases are characterized by the overexpression of type I IFN stimulated genes, and accumulating evidence indicate a role for type I IFNs in these diseases. However, the underlying mechanisms for this are still poorly understood. To explore the role of type I IFN regulated miRNAs in systemic autoimmune disease, we characterized cellular expression of miRNAs during both acute and chronic type I IFN responses. We identified a Tcell-specific reduction of miR-31-5p levels, both after intramuscular injection of IFN and in patients with Sjogren's syndrome (SjS). To interrogate the role of miR-31-51p in Tcells we transfected human CD4(+) Tcells with a miR-31-5p inhibitor and performed metabolic measurements. This identified an increase in basal levels of glucose metabolism after inhibition of miR-31-5p. Furthermore, treatment with IFN- also increased the basal levels of human CD4(+) T-cell metabolism. In all, our results suggest that reduced levels of miR-31-5p in Tcells of SjS patients support autoimmune T-cell responses during chronic type I IFN exposure.
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| 38. |
- Johansson, Anders, et al.
(author)
-
Technical feasibility and ambulance nurses’ view of a digital telemedicine system in pre-hospital stroke care – A pilot study
- 2019
-
In: International Emergency Nursing. - : Elsevier BV. - 1755-599X. ; 44, s. 35-40
-
Journal article (peer-reviewed)abstract
- Background: High-quality telemedicine in cases of suspected stroke has comparable precision with on-site medical examinations. A novel technical concept was developed in order to deliver a video/audio system to achieve more efficient patient assessment and diagnostic support. Aims and objectives: The aim of the present pilot-study was to evaluate in a clinical setting the quality of a linked image and sound transmission in the prehospital assessment of patients with suspected stroke. In addition, we wanted to elucidate how ambulance nurses experienced the use of this innovative technology. Design: The study used a quantitative method using questionnaires with fixed response options, combined with a qualitative approach to assess complementary statements of prehospital emergency care nurses (PEN)that had used the system. Methods: The study was conducted in one ambulance care office and one hospital in southern Sweden. Six PEN and one neurological specialist (Dr)expressed their perceptions based on 11 cases with suspected stroke. Responses were assessed in the dimensions of the technology (Dr – image quality/sound quality; Dr and PEN), safety, sense of increased control and uniform assessment. A questionnaire technique was used, complemented with a qualitative part of the content analysis (PEN views). Results: In the technology dimension, the Dr evaluated the image quality as Very good to Good (100%)while 75% of PEN answered that the digital stroke concept felt reliable to use and the digital stroke assessment is believed to increase uniform assessment. Asked if the present digital concept should be further developed and if further digital systems should be developed in general, the PEN were split in their responses (50 vs 50%), which could be related to a conception of unclear efficacy of the concept. Descriptions of the decisive comments emerged in three categories; Minor operating interference, Physician's competence crucial and Unclear efficacy. Conclusion: All respondents seem to have confidence in the assessed digital stroke concept. The image quality is perceived suitable in the assessment situation but the nurses expressed ambiguity about the efficiency of the entire concept. The ambulance nurses also highlighted the physician's skills and personality as important factors for further development of the concept.
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| 39. |
- Johansson, Niklas, 1973-
(author)
-
Measuring and modelling light scattering in paper
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- Avhandlingen behandlar de teoretiska och praktiska aspekterna av att använda spektrala vinkelupplösta reflektansmätningar för optisk karakterisering av fiberbaserade material såsom papper och kartong. En spektral goniofotometer används för att mäta det reflekterade ljusets vinkelfördelning. En stor del av arbetet utgörs av att utvärdera instrumentets noggrannhet, samt utreda hur de vinkelupplösta mätningarna skall utföras på bästa sätt för att erhålla en så fullständig karakterisering som möjligt. Det reflekterade ljuset består av tre komponenter; ytreflektans, bulkreflektans samt fluorescens. En fullständig karakterisering förutsätter att dessa tre komponenter kan analyseras separat, vilket i detta arbete görs genom nyutvecklade metoder.En metod har utvecklats för separation av ytreflektans och bulkreflektans. Metoden bygger på att analysera hur den totala reflektansen förändras vid ökande absorption i det reflekterande materialet. Absorptionen kontrolleras genom inkjet-tryckning där tryckfärg appliceras på substratet i sådan mängd att bulkreflektansen helt släcks ut. Genom att kombinera mätningar på tryckt och otryckt substrat kan de båda komponenterna separeras. Trots att ytreflektansen från ett matt papper är liten i förhållande till bulkreflektansen, så visar resultaten att den ökar markant med ökande betraktningsvinkel och kan därmed ha stor inverkan på den totala reflektansen. Bidraget från fluorescens kan kvantitativt analyseras genom att kombinera mätningar utförda med respektive utan UV-filter. Vinkelupplösta mätningar och Monte Carlo-simuleringar av fluorescensens vinkelfördelning visar att dess anisotropi är relaterad till det medeldjup vid vilket fluorescensen emitteras. Resultaten förklarar observerade skillnader och motstridigheter i tidigare rapporterade studier kring huruvida fluorescens kan anses vara Lamberskt fördelad.Samtliga goniofotometriska mätningar är utförda med ett kompakt, kommersiellt tillgängligt, dubbelstråleinstrument. För att undersöka instrumentets lämplighet för absoluta reflektansmätningar utförs en analys av dess mätnoggrannhet. Resultaten visar att instrumentets kompakta storlek i kombination med den anisotropa reflektansen från papper introducerar systematiska fel av samma storleksordning som den totala mätnoggrannheten. Dessa fel uppstår på grund av den relativt stora detektorapertur som måste användas vid mätningar av diffus reflektans, vilket är karakteristiskt för papper och kartong. Resultaten visar även att felen är störst vid flacka mätvinklar och för prover med hög grad av anisotropisk reflektans, och en geometrisk korrektionsmetod för denna typ av systematiska fel föreslås.Spektrala och vinkelupplösta mätningar medför per automatik stora mängder mätdata. Genom att använda strålningstransportteori som en matematisk modell för hur ljus sprids i papper kan mätdatat reduceras till en uppsättning beskrivande materialparameterar. Att uppskatta dessa optiska parametrar utifrån vinkelupplösta reflektansmätningar är i sig ett komplicerat problem, vilket dessutom är känsligt för mätfel och val av mätvinklar. Detta inversa problem analyseras i detalj, och speciellt hur valet av mätvinklar kan reduceras utan att försämra förutsättningarna för estimeringen. Simuleringar visar att mätningarna kan begränsas till infallsplanet, eller till och med enbart framåtriktningen, så länge tillräckligt flacka mätvinklar är inkluderade i mätsekvensen.
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| 40. |
- Karlsson, Elin, et al.
(author)
-
Coupled Binding and Helix Formation Monitored by Synchrotron-Radiation Circular Dichroism
- 2019
-
In: Biophysical Journal. - : CELL PRESS. - 0006-3495 .- 1542-0086. ; 117:4, s. 729-742
-
Journal article (peer-reviewed)abstract
- Intrinsically disordered proteins organize interaction networks in the cell in many regulation and signaling processes. These proteins often gain structure upon binding to their target proteins in multistep reactions involving the formation of both secondary and tertiary structure. To understand the interactions of disordered proteins, we need to understand the mechanisms of these coupled folding and binding reactions. We studied helix formation in the binding of the molten globule-like nuclear coactivator binding domain and the disordered interaction domain from activator of thyroid hormone and retinoid receptors. We demonstrate that helix formation in a rapid binding reaction can be followed by stopped-flow synchrotron-radiation circular dichroism (CD) spectroscopy and describe the design of such a beamline. Fluorescence-monitored binding experiments of activator of thyroid hormone and retinoid receptors and nuclear coactivator binding domain display several kinetic phases, including one concentration-independent phase, which is consistent with an intermediate stabilized at high ionic strength. Time-resolved CD experiments show that almost all helicity is formed upon initial association of the proteins or separated from the encounter complex by only a small energy barrier. Through simulation of mechanistic models, we show that the intermediate observed at high ionic strength likely involves a structural rearrangement with minor overall changes in helicity. Our experiments provide a benchmark for simulations of coupled binding reactions and demonstrate the feasibility of using synchrotron-radiation CD for mechanistic studies of protein-protein interactions.
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| 41. |
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| 42. |
- Krall, Lindsay, et al.
(author)
-
Submarine groundwater discharge at Forsmark, Gulf of Bothnia, providedby Ra isotopes
- 2017
-
In: Marine Chemistry. - Amsterdam : Elsevier. - 0304-4203 .- 1872-7581. ; 196, s. 162-172
-
Journal article (peer-reviewed)abstract
- Submarine groundwater discharge (SGD) to the Gulf of Bothnia, Baltic Sea, has been believed to be insignificant from hydrological models, yet geochemical investigations of SGD in this basin are limited. In this study, 223Ra, 224Ra, 226Ra, and 228Ra have been complemented by stable δ18O and d2H isotopes to characterize and quantify SGD rates from the coast of Forsmark, Sweden to Öregrundsgrepen Strait (Gulf of Bothnia). In shallow bays, SGD has been traced using relations between Ra, d2H and d18O isotopes and salinity. Zonal SGD from deformation zones, expressed as hydraulically conductive fractures, overlain by the Börstilåsen esker, a strip of conductive gravel sediment, have been traced through offshore 224Raxs and 226Ra trends. On the basis of a 224Raxs mass balance, the SGD flow rate ranges from (5.5 ± 3.0) · 103 m3 d-1 to (950 ± 520) · 103 m3 d-1. These rates are up to two orders of magnitude higher than those determined from local hydrological models, which consider only the fresh component of SGD. From the divergence between the hydrological and 224Raxs models, it is inferred that the site is influenced by a component of recirculated seawater.
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| 43. |
- Kutscher, Liselott, 1976-
(author)
-
Export and sources of organic carbon in the Lena River basin, Northeastern Siberia
- 2016
-
Licentiate thesis (other academic/artistic)abstract
- Permafrost areas are considered to be one of the largest terrestrial storages of carbon. In a warming climate these areas are expected to experience changes in carbon transport to rivers and the oceans due to permafrost thawing, which could enhance erosion, change water flow pathways and increase greenhouse gas emissions. Large amounts of the carbon transported from the terrestrial environment to rivers are in the form of natural organic matter (NOM). The Lena River basin in northeastern Siberia, which is mainly underlain by continuous permafrost, is the largest contributor of NOM to the Arctic Ocean. In this study we present a spatial data set of NOM, including concentrations and stable carbon isotope values (δ13C) of dissolved (DOC) and particulate organic carbon (POC) as well as carbon and nitrogen ratios (C/N) from 77 sample stations in the Lena River and its tributaries. The samples were collected during two field seasons in July 2012 and June 2013.The results from this study showed large spatial variations in concentrations, annual export and fluxes of organic carbon. These variations were primarily due to variations in discharge and topography. The δ13C and C/N indicated that terrestrial sources such as plants and soil organic matter (SOM), were the main sources of the dissolved organic matter (DOM), while particulate organic matter (POM) was mainly derived from aquatic produced material or SOM. There were clear differences in δ13C and C/N of DOM between sampling years, indicating more surficial flow pathways in samples collected earlier in the summer compared to samples collected later in the summer. The δ13C of POM was correlated with water temperatures and topography, showing that tributaries with origin in mountainous areas in general had soil derived POM and lower water temperatures, while tributaries from lowland areas had higher water temperatures and more influence of aquatic sources. We suggest that this pattern is probably due to differences in water flow pathways. Shifts in export of NOM from drainage areas underlain by permafrost will likely be dependent of spatial changes in hydroclimate and the depth of the active layer in a warming climate.
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| 44. |
- Kutscher, Liselott, et al.
(author)
-
Spatial variation in concentration and sources of organic carbon in the Lena River, Siberia
- 2017
-
In: Journal of Geophysical Research - Biogeosciences. - New York. - 2169-8953 .- 2169-8961. ; 122
-
Journal article (peer-reviewed)abstract
- Global warming in permafrost areas is expected to change fluxes of riverine organic carbon (OC) 22 to the Arctic Ocean. Here OC concentrations, stable carbon isotope signatures (δ13C) and carbon-23 nitrogen ratios (C/N) are presented from 22 sampling stations in the Lena River and 40 of its 24 tributaries. Sampling was conducted during two expeditions: the first in July 2012 in the south 25 and southeastern region and the second in June 2013 in the northern region of the Lena basin. 26 The data showed significant spatial differences in concentrations and major sources of OC. Mean 27 sub-catchment slopes were correlated with OC concentrations, implying that mountainous areas 28 in general had lower concentrations than lowland areas. δ13C and C/N data from tributaries 29 originating in mountainous areas indicated that both dissolved and particulate OC (DOC and 30 POC) were mainly derived from soil organic matter (SOM). In contrast, tributaries originating in 31 lowland areas had larger contributions from fresh vegetation to DOC, while aquatically produced 32 OC was the major source of POC. We suggest that these differences in dominant sources 33 indicated differences in dominant flow pathways. Tributaries with larger influence of fresh 34 vegetation probably had surficial flow pathways, while tributaries with more SOM influence had 35 deeper water flow pathways. Thus, the future export of OC to the Arctic Ocean will likely be 36 controlled by changes in spatial patterns in hydroclimatology and the depth of the active layers 37 influencing the dominant water flow pathways in Arctic river basins.
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| 45. |
-
Managing digital transformation
- 2018. - 1
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Editorial collection (other academic/artistic)abstract
- Digitalization has arrived.Digitalization disrupts markets. Changes in power and structures in a fast-paced environment demands strategic and insightful change. A change leaders must act upon.The impact upon organisations is multi-dimensional and profound, affecting both internal and external processes and structures in new and unexpected ways. This book serves as a tool to support managers and other stakeholders in pursuing digital transformation. An inspiring collection of chapters from 27 scholars across various academic disciplines provide several insights, frameworks, and perspectives that will help you leverage and govern organisational change and digital transformation.This inspiring collection of current research can assist you in facing key challenges in today’s organisations, in the quest to adapt to ever-evolving business environments. This book examines new demands and behaviours, and discusses how businesses need to adapt and re-organise in order to bridge the gap to the digital customer. These visions and actions on digitalization can help corporations and organisations discover new ways of earning money and delivering value. This is just the beginning.
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| 46. |
- Murphy, Melissa, et al.
(author)
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Tracingsilicate weathering processes in the permafrost-dominated Lena River watershedusing lithium isotopes
- 2019
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In: Geochimica et Cosmochimica Acta. - : Saunders Elsevier. - 0016-7037 .- 1872-9533. ; 245, s. 154-171
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Journal article (peer-reviewed)abstract
- Increasing global temperatures are causing widespread changes in the Arctic, including permafrost thawing and altered freshwater inputs and trace metal and carbon fluxes into the ocean and atmosphere. Changes in the permafrost active layer thickness can affect subsurface water flow paths and water-rock interaction times, and hence weathering processes. Riverine lithium isotope ratios (reported as δ7Li) are tracers of silicate weathering that are unaffected by biological uptake, redox, carbonate weathering and primary lithology. Here we use Li isotopes to examine silicate weathering processes in one of the largest Russian Arctic rivers: the Lena River in eastern Siberia. The Lena River watershed is a large multi-lithological catchment, underlain by continuous permafrost. An extensive dataset of dissolved Li isotopic compositions of waters from the Lena River main channel, two main tributaries (the Aldan and Viliui Rivers) and a range of smaller sub tributaries are presented from the post-spring flood/early-summer period at the onset of active layer development and enhanced water-rock interactions. The Lena River main channel (average δ7Lidiss ~19‰) has a slightly lower isotopic composition than the mean global average of 23‰ (Huhet al., 1998a). The greatest range of [Li] and δ7Lidiss are observed in catchments draining the south facing slopes of the Verkhoyansk Mountain Range. South-facing slopes in high-latitude, permafrost dominated regions are typically characterised by increased summer insolation and higher daytime temperatures relative to other slope aspects. The increased solar radiation on south-facing catchments promotes repeated freeze-thaw cycles, and contributes to more rapid melting of snow cover, warmer soils, and increased active layer thaw depths. The greater variability in δ7Li and [Li] in the south-facing rivers likely reflect the greater infiltration of melt water and enhanced water rock interactions within the active layer. A similar magnitude of isotopic fractionation is observed between the low-lying regions of the Central Siberian Plateau (and catchments draining into the Viliui River), and catchments draining the Verkhoyansk Mountain Range into the Aldan River. This is in contrast to global rivers in non permafrost terrains that drain high elevations or areas of rapid uplift, where high degrees of physical erosion promote dissolution of freshly exposed primary rock typically yielding low δ7Lidiss, and low lying regions exhibit high riverine δ7Li values resulting from greater water-rock interaction and formation of secondary mineral that fractionates Li isotopes. Overall, the range of Li concentrations and δ7Lidiss observed within the Lena River catchment are comparable to global rivers located in temperate and tropical regions. This suggests that cryogenic weathering features specific to permafrost regions (such as the continual exposure of fresh primary minerals due to seasonal freeze-thaw cycles, frost shattering and salt weathering), and climate (temperature and runoff), are not a dominant control on δ7Li variations. Despite vastly different climatic and weathering regimes, the same range of riverine δ7Li values globally suggests that the same processes govern Li geochemistry – that is, the balance between primary silicate mineral dissolution and the formation (or exchange with) secondary minerals. This has implications for the use of δ7Li as a palaeo weathering tracer for interpreting changes in past weathering regimes.
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| 47. |
- Nordmo, Magnus, et al.
(author)
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Internet-delivered cognitive behavioural therapy with and without an initial face-to-face psychoeducation session for social anxiety disorder : a pilot randomized controlled trial
- 2015
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In: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 2:4, s. 429-436
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Journal article (peer-reviewed)abstract
- Background: Guided Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment of social anxiety disorder (SAD). However, the treatment is not effective for all. The amount and type of therapist contact have been highlighted as a possible moderator of treatment outcome.Objective: The aim of this study was to examine whether treatment effects of ICBT are enhanced with an initial 90 min face-to-face psychoeducation (PE) session for university students with SAD.Method: University students with SAD (N = 37) were randomized into one out of two conditions: 1) an initial therapist-led face-to-face PE session followed by guided ICBT, 2) guided ICBT without an initial PE session. Data was analysed with an intent-to-treat approach.Results: Eight participants (21.6%) dropped out of treatment. A statistically significant reduction in symptoms was found for all outcome measures for both groups. There were no significant additional effects of adding the initial face-to-face PE. Moderate to large within-group effect sizes on self-rated social anxiety symptoms were found at post-treatment (d = 0.70–0.95) and at a six month follow-up (d = 0.70–1.00). Nearly half of the participants were classified as recovered.Conclusions: Notwithstanding limitations due to the small sample size, the findings indicate that guided ICBT is an effective treatment for students with SAD. Adding an initial face-to-face PE session to the guided ICBT did not lead to enhanced outcomes in the present study.
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| 48. |
- Rogne, Per, et al.
(author)
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Nucleation of an Activating Conformational Change by a Cation−Π Interaction
- 2019
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In: Biochemistry. - : American Chemical Society (ACS). - 0006-2960 .- 1520-4995. ; 58:32, s. 3408-3412
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Journal article (peer-reviewed)abstract
- As a key molecule in biology, adenosine triphosphate (ATP) has numerous crucial functions in, for instance, energetics, post-translational modifications, nucleotide biosynthesis, and cofactor metabolism. Here, we have discovered an intricate interplay between the enzyme adenylate kinase and its substrate ATP. The side chain of an arginine residue was found to be an efficient sensor of the aromatic moiety of ATP through the formation of a strong cation−π interaction. In addition to recognition, the interaction was found to have dual functionality. First, it nucleates the activating conformational transition of the ATP binding domain and also affects the specificity in the distant AMP binding domain. In light of the functional consequences resulting from the cation−π interaction, it is possible that the mode of ATP recognition may be a useful tool in enzyme design.
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| 49. |
- Singh, B., et al.
(author)
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Study of doubly strange systems using stored antiprotons
- 2016
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In: Nuclear Physics A. - : Elsevier. - 0375-9474 .- 1873-1554. ; 954, s. 323-340
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Journal article (peer-reviewed)abstract
- Bound nuclear systems with two units of strangeness are still poorly known despite their importance for many strong interaction phenomena. Stored antiprotons beams in the GeV range represent an unparalleled factory for various hyperon-antihyperon pairs. Their outstanding large production probability in antiproton collisions will open the floodgates for a series of new studies of systems which contain two or even more units of strangeness at the PANDA experiment at FAIR. For the first time, high resolution gamma-spectroscopy of doubly strange Lambda Lambda-hypernuclei will be performed, thus complementing measurements of ground state decays of Lambda Lambda-hypernuclei at J-PARC or possible decays of particle unstable hypernuclei in heavy ion reactions. High resolution spectroscopy of multistrange Xi(-) -atoms will be feasible and even the production of Omega(-) -atoms will be within reach. The latter might open the door to the vertical bar S vertical bar = 3 world in strangeness nuclear physics, by the study of the hadronic Omega(-) -nucleus interaction. For the first time it will be possible to study the behavior of Xi(+) in nuclear systems under well controlled conditions.
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| 50. |
- Singh, B., et al.
(author)
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Technical design report for the (P)over-barANDA Barrel DIRC detector
- 2019
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In: Journal of Physics G. - : IOP PUBLISHING LTD. - 0954-3899 .- 1361-6471. ; 46:4
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Journal article (peer-reviewed)abstract
- The (P) over bar ANDA (anti-Proton ANnihiliation at DArmstadt) experiment will be one of the four flagship experiments at the new international accelerator complex FAIR (Facility for Antiproton and Ion Research) in Darmstadt, Germany. (P) over bar ANDA will address fundamental questions of hadron physics and quantum chromodynamics using high-intensity cooled antiproton beams with momenta between 1.5 and 15 GeV/c and a design luminosity of up to 2 x 10(32) cm(-2) S-1. Excellent particle identification (PID) is crucial to the success of the (P) over bar ANDA physics program. Hadronic PID in the barrel region of the target spectrometer will be performed by a fast and compact Cherenkov counter using the detection of internally reflected Cherenkov light (DIRC) technology. It is designed to cover the polar angle range from 22 degrees to 140 degrees and will provide at least 3 standard deviations (s.d.) pi/K separation up to 3.5 GeV/c, matching the expected upper limit of the final state kaon momentum distribution from simulation. This documents describes the technical design and the expected performance of the (P) over bar ANDA Barrel DIRC detector. The design is based on the successful BaBar DIRC with several key improvements. The performance and system cost were optimized in detailed detector simulations and validated with full system prototypes using particle beams at GSI and CERN. The final design meets or exceeds the PID goal of clean pi/K separation with at least 3 s.d. over the entire phase space of charged kaons in the Barrel DIRC.
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