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| 2. |
- Carbajal, Ricardo, et al.
(författare)
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Pain Assessment in Ventilated and Non-Ventilated Neonates in NICUs across Europe : EUROpean Pain Audit in Neonates (EUROPAIN Survey)
- 2014
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Konferensbidrag (refereegranskat)abstract
- Background: Neonates undergo many painful procedures during their NICU stay. These may include tracheal intubation/ventilation, skin-breaking procedures, drainage/suctioning of body orifices or cavities. Inherent subjectivity and difficulties of neonatal pain assessment contribute to a wide variety of assessment tools and clinical practices. To date, these practices have been not studied at a large scale. OBJECTIVE: To determine current clinical practices for neonatal pain assessment in NICUs across Europe. DESIGN/METHODS: An epidemiological observational study on bedside pain assessment practices collected data for all neonates in participating NICUs until infants left the unit (discharge, death, transfer to another hospital) or for 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to a gestational age of 44 weeks were included. RESULTS: From October 2012 to June 2013, 243 NICUs from 18 European countries collected pain assessment data in 6680 neonates. Of these, 2142 received tracheal ventilation (ventilated) and 4538 had spontaneous breathing or non- invasive ventilation (non-ventilated). The median (IQR) gestational age of ventilated neonates [32.1 (28.1-37.4)] was less than non-ventilated neonates [36.6 (33.6-39.1), p<0.001]. Overall, 58.5% of ventilated neonates and 35.2%% of non-ventilated neonates received bedside pain assessments (p<0.001). CONCLUSIONS: Over half (58.5%) of ventilated neonates and about one third (35.2%) of non-ventilated neonates had pain assessments performed in European NICUs. Wide variations in the methods used and rates of pain assessment exist among countries
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| 3. |
- Carbajal, Ricardo, et al.
(författare)
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Pain Assessment In Ventilated And Non-ventilated Neonates In Nicus Across Europe : European Pain Audit In Neonates (europain Survey)
- 2014
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Ingår i: Archives of Disease in Childhood. - London, United Kingdom : BMJ Publishing Group Ltd. - 0003-9888 .- 1468-2044. ; 99, s. A68-A68
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Tidskriftsartikel (refereegranskat)abstract
- Background: Neonates undergo many painful procedures during their NICU stay. These may include tracheal intubation/ventilation, skin-breaking procedures, drainage/suctioning of body orifices or cavities. Inherent subjectivity and difficulties of neonatal pain assessment contribute to a wide variety of assessment tools and clinical practices. To date, these practices have been not studied at a large scale.Objective: To determine current clinical practices for neonatal pain assessment in NICUs across Europe.Methods: An epidemiological observational study on bedside pain assessment practices collected data for all neonates in participating NICUs until infants left the unit (discharge, death, transfer to another hospital) or for 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to a gestational age of 44 weeks were included.Results: From October 2012 to June 2013, 243 NICUs from 18 European countries collected pain assessment data in 6680 neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, 58.5% of TV neonates, 45.0% of NIV neonates and 30.4% of SV neonates received bedside pain assessments (p < 0.001). Fig. shows pain assessments by country.Conclusions: Over half (58.5%) of TV neonates and less than half (45.0%) of NIV neonates had pain assessments performed in European NICUs. Wide variations in the rates of pain assessment exist among countries and an important improvement seems necessary.
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| 4. |
- Carbajal, Ricardo, et al.
(författare)
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Sedation And Analgesia For Neonates In Nicus Across Europe : The Europain Survey
- 2014
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Ingår i: Archives of Disease in Childhood. - London, United Kingdom : BMJ Publishing Group Ltd. - 0003-9888 .- 1468-2044. ; 99, s. A64-A64
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain and stress induced by mechanical ventilation, invasive procedures, or painful diseases supports the use of sedation/analgesia (S/A) in newborns admitted to Neonatal Intensive Care Units (NICUs). To date, these practices have not been studied at a large scale.Objective: To determine current clinical practices regarding the use of S/A drugs in NICUs across Europe.Methods: This epidemiological observational study on bedside clinical practices regarding S/A collected data for all neonates in participating NICUs until the infant left the unit (discharge, death, transfer) or for up to 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to 44 weeks gestation were included.Results: From October 2012 to June 2013, 243 NICUs from 18 European countries collected data on 6680 eligible neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, more TV neonates [81.5% (n = 1746)] received S/A drugs than NIV neonates [17.8% (n = 266)] and SV neonates [9.3% (n = 282)]; p < 0.001. Fig. shows the rate of S/A use by country; table shows S/A drugs used.Conclusions: Most ventilated but few non-ventilated neonates (NIV and SV) receive S/A therapy in European NICUs. Wide variations in S/A use, drugs used, and mode of administration (continuous, bolus, or both) exist among countries.
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| 7. |
- Koch, Sina, et al.
(författare)
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NRP1 Presented in trans to the Endothelium Arrests VEGFR2 Endocytosis, Preventing Angiogenic Signaling and Tumor Initiation
- 2014
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Ingår i: Developmental Cell. - : Elsevier BV. - 1534-5807 .- 1878-1551. ; 28:6, s. 633-646
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Tidskriftsartikel (refereegranskat)abstract
- Neuropilin 1 (NRP1) modulates angiogenesis by binding vascular endothelial growth factor (VEGF) and its receptor, VEGFR2. We examined the consequences when VEGFR2 and NRP1 were expressed on the same cell (cis) or on different cells (trans). In cis, VEGF induced rapid VEGFR2/NRP1 complex formation and internalization. In trans, complex formation was delayed and phosphorylation of phospholipase C gamma (PLC gamma) and extracellular regulated kinase 2 (ERK2) was prolonged, whereas ERK1 phosphorylation was reduced. Trans complex formation suppressed initiation and vascularization of NRP1-expressing mouse fibrosarcoma and melanoma. Suppression in trans required high-affinity, steady-state binding of VEGF to NRP1, which was dependent on the NRP1 C-terminal domain. Compatible with a trans effect of NRP1, quiescent vasculature in the developing retina showed continuous high NRP1 expression, whereas angiogenic sprouting occurred where NRP1 levels fluctuated between adjacent endothelial cells. Therefore, through communication in trans, NRP1 can modulate VEGFR2 signaling and suppress angiogenesis.
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| 8. |
- Mathurin, Frédéric A., et al.
(författare)
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High cesium concentrations in groundwater in the upper 1.2km of fractured crystalline rock - Influence of groundwater origin and secondary minerals
- 2014
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Ingår i: Geochimica et Cosmochimica Acta. - : Elsevier Ltd. - 0016-7037 .- 1872-9533. ; 132, s. 187-213
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Tidskriftsartikel (refereegranskat)abstract
- Dissolved and solid phase cesium (Cs) was studied in the upper 1.2km of a coastal granitoid fracture network on the Baltic Shield (Äspö Hard Rock Laboratory and Laxemar area, SE Sweden). There unusually high Cs concentrations (up to 5-6μgL-1) occur in the low-temperature (<20°C) groundwater. The material includes water collected in earlier hydrochemical monitoring programs and secondary precipitates (fracture coatings) collected on the fracture walls, as follows: (a) hydraulically pristine fracture groundwater sampled through 23 surface boreholes equipped for the retrieval of representative groundwater at controlled depths (Laxemar area), (b) fracture groundwater affected by artificial drainage collected through 80 boreholes drilled mostly along the Äspö Hard Rock Laboratory (underground research facility), (c) surface water collected in local streams, a lake and sea bay, and shallow groundwater collected in 8 regolith boreholes, and (d) 84 new specimens of fracture coatings sampled in cores from the Äspö HRL and Laxemar areas. The groundwater in each area is different, which affects Cs concentrations. The highest Cs concentrations occurred in deep-seated saline groundwater (median Äspö HRL: 4.1μgL-1; median Laxemar: 3.7μgL-1) and groundwater with marine origin (Äspö HRL: 4.2μgL-1). Overall lower, but variable, Cs concentrations were found in other types of groundwater. The similar concentrations of Cs in the saline groundwater, which had a residence time in the order of millions of years, and in the marine groundwater, which had residence times in the order of years, shows that duration of water-rock interactions is not the single and primary control of dissolved Cs in these systems. The high Cs concentrations in the saline groundwater is ascribed to long-term weathering of minerals, primarily Cs-enriched fracture coatings dominated by illite and mixed-layer clays and possibly wall rock micaceous minerals. The high Cs concentrations in the groundwater of marine origin are, in contrast, explained by relatively fast cation exchange reactions. As indicated by the field data and predicted by 1D solute transport modeling, alkali cations with low-energy hydration carried by intruding marine water are capable of (NH4 + in particular and K+ to some extent) replacing Cs+ on frayed edge (FES) sites on illite in the fracture coatings. The result is a rapid and persistent (at least in the order of decades) buildup of dissolved Cs concentrations in fractures where marine water flows downward. The identification of high Cs concentrations in young groundwater of marine origin and the predicted capacity of NH4 + to displace Cs from fracture solids are of particular relevance in the disposal of radioactive nuclear waste deep underground in crystalline rock. © 2014 Elsevier Ltd.
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| 9. |
- Nyberg, Elisabeth, et al.
(författare)
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Sakrapport Övervakning av metaller och organiska miljögifter i limnisk biota, 2013
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The environmental contaminants examined in this report can be classified into four groups – trace metals, chlorinated compounds, brominated flame retardants and perfluoroalkyl substances. Each of these contaminants has been examined in pike, perch and Arctic char from 32 lakes geographically spread from the north to the south of Sweden. The following summary examines overall trends, spatial and temporal, for the four groups.Fat Content, Age and LengthPike and perch displayed a decreasing trend in fat content at 50 % of the sites examined. An increasing trend in fat content could be seen for Arctic char from Lake Tjulträsk. The age of the perch sampled within the programme was somewhat lower in the most southern and south eastern parts of Sweden, whereas the length of the perch was homogenous in all lakes sampled.Trace MetalsNo general temporal trend could be observed for mercury in the freshwater environment. However, in all lakes and species, except Arctic char from Abiskojaure, these concentrations are above the suggested EU-target level of 20 ng/g wet weight.Lead is generally decreasing over the study period (in time series of sufficient length), supposedly due to the elimination of lead in gasoline. In all lakes, Pb concentration is below the suggested EU-target level of 1.0 ug/g wet weight. This result has to be interpreted carefully as the recalculation between levels of lead in whole-body and liver is based on only one study.Cadmium concentrations show no consistent trends over the monitored period. It is worth noting that despite several measures taken to reduce discharges of cadmium, the most recent concentrations in Arctic char and pike are similar to concentrations measured 30 years ago in the longer time series. In a majority of the lakes, Cd concentration in perch is above the suggested EU target level of 0.16 ug/g wet weight. This result has to be interpreted carefully as the recalculation between levels of cadmium in whole-body and liver is based on only one study.Nickel concentrations showed a general increasing trend in perch. Chromium concentrations showed a general decreasing trend in all matrices during the monitoring period,but this decrease is most probably caused by the change of method for chromium analysis in 2004. The concentrations of Zinc in perch liver are consistent in all lakes monitored. The concentrations are decreasing significantly at a majority of the perch sampling sites and in pike from Lake Storvindeln.No general temporal trend were observed for copper, arsenic, silver, aluminium, tin, and bismuth concentrations in fish liver during the monitoring period.22Chlorinated CompoundsGenerally, a decreasing trend was observed for all compounds (DDT’s, PCB’s, HCH’s, HCB and PCDD/PCDF) in all species examined (with a few exceptions).The chlorinated compounds generally show a somewhat higher concentration in the southern parts of Sweden than in the north.CB-153 concentration is below the suggested target level of 1.6 ug/g lipid weight in all species and areas, while the target level for CB-118 of 0.024 ug/g lipid weight is exceeded in perch from Lake Fysingen and Lake Krankesjön. For DDE the concentration is below the suggested target level of 0.005 ug/g wet weight for all species and areas. sHCH is below the suggested target level of 0.026 ug/g wet weight for all species and areas. HCB is below the suggested target level of 0.010 ug/g wet weight for all species and areas. TCDD-eqvivalents is below the suggested target level of 3.5 pg WHO05-TEQ/g wet weight for all species and areas.Brominated Flame RetardantsNo general linear trend is observed during the whole monitoring period for the BDEs. However the concentrations of BDEs in Lake Bolmen increased from the start of the monitoring period until the late 80s to the mid 90s and appear to have decreased since then. The lower brominated flame retardants (BDE-47, BDE-99 and BDE-100) peaked earlier than the higher (BDE-153 and BDE-154).In all areas, BDE-47 is above the suggested target level of 0.0085 ng/g wet weight for all species.The concentration of HBCDD is under LOQ in a majority of the freshwater samples.PFASsPFNA, PFDA, and PFUnDA all show significantly increasing concentrations in Arctic char liver from Lake Abiskojaure. PFDA, PFUnDA, PFDoDA, and PFTrDA show increasing trends in perch liver from Lake Skärgölen. A decreasing trend in PFOS is also indicated for perch in Lake Skärgölen for the last ten years.In about 40 % of the perch lakes, PFOS concentrations in liver are above the suggested target level for PFOS inwhole fish (9.1 ng/g wet weight). This result has to be interpreted with caution since no recalculation for the results from the liver analysis has been made, especially since liver in most cases contains higher concentrations of PFASs than muscle tissue.Priority substances 2007 and 2010For four of the five priority substances - DEHP, HCBD, pentachlorobenzene, and organotin compounds – all or most values were below LOQ in the years examined. The chloroalkane SCCP did have values above LOQ, however, no consistent spatial variation was seen. The highest concentrations of SCCP (approximately 30 ng/g wet weight) were found in Lake Stor-Backsjön in Jämtland County and in Lake Fiolen in Kronobergs County. No statistical difference in concentration of SCCP between year 2007 and 2010 was found.Information about the lakes sampled within the programme can be seen in Appendix 1.
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| 10. |
- Nyberg, Elisabeth, et al.
(författare)
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Sakrapport Övervakning av metaller och organiska miljögifter i limnisk biota, 2014
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The report summarises the monitoring activities within the National Swedish Contaminant Programme for freshwater biota. Each monitored contaminant has been examined in pike, perch and Arctic char from 32 lakes from the north to the south in Sweden.No general trend could be seen for mercury, and all samples, except Arctic char from Abiskojaure, were above the EU target level. Lead was generally decreasing. Nickel showed a general upward trend in perch. An increase, or indication of an increase, was seen for chromium during the last ten years. Zinc concentrations were decreasing in a majority of the perch samples and in pike from Lake Storvindeln. No general trend was observed for copper, arsenic, silver, aluminum, tin, bismuth, and cadmium.In general, downward trends were seen for; PCBs, HCHs, DDT, DDE and PCDD/Fs in all species (with a few exceptions). The chlorinated compounds generally show a somewhat higher concentration in the southern parts of Sweden. Most chlorinated compounds were below the suggested target levels.No general trend was seen during the monitoring period for PBDEs. Concentrations of PBDEs in Lake Bolmen increased from the 60s and peaked in the late 80s to mid-90s and have subsequently decreased. The concentration of HBCDD was under LOQ in a majority of the samples.A majority of the perfluorinated compounds showed an increase in concentration in perch, except PFOS and FOSA. Higher concentrations of perfluorinated compounds can in general be seen in the southern part of Sweden.
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| 11. |
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| 12. |
- Oefner, Carolin M., et al.
(författare)
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Tolerance induction with T cell-dependent protein antigens induces regulatory sialylated IgGs
- 2012
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 1097-6825 .- 0091-6749. ; 129:6, s. 1647-1647
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Tidskriftsartikel (refereegranskat)abstract
- Background: Under inflammatory conditions, T cell-dependent (TD) protein antigens induce proinflammatory T-and B-cell responses. In contrast, tolerance induction by TD antigens without costimulation triggers the development of regulatory T cells. Under both conditions, IgG antibodies are generated, but whether they have different immunoregulatory functions remains elusive. Objective: It was shown recently that proinflammatory or anti-inflammatory effector functions of IgG molecules are determined by different Fc N-linked glycosylation patterns. We sought to examine the Fc glycosylation and anti-inflammatory quality of IgG molecules formed on TD tolerance induction. Methods: We administered chicken ovalbumin (OVA) with or without costimulus to mice and analyzed OVA-reactive IgG Fc glycosylation. The anti-inflammatory function of differentially glycosylated anti-OVA IgGs was further investigated in studies with dendritic cell cultures and in an in vivo model of allergic airway disease. Additionally, we analyzed the Fc glycosylation pattern of birch pollen-reactive serum IgGs after successful allergen-specific immunotherapy in patients. Results: Stimulation with TD antigens under inflammatory conditions induces plasma cells expressing low levels of alpha 2,6-sialyltransferase and producing desialylated IgGs. In contrast, plasma cells induced on tolerance induction did not downregulate alpha 2,6-sialyltransferase expression and secreted immunosuppressive sialylated IgGs that were sufficient to block antigen-specific T- and B-cell responses, dendritic cell maturation, and allergic airway inflammation. Importantly, successful specific immunotherapy in allergic patients also induced sialylated allergen-specific IgGs. Conclusions: Our data show a novel antigen-specific immunoregulatory mechanism mediated by anti-inflammatory sialylated IgGs that are formed on TD tolerance induction. These findings might help to develop novel antigen-specific therapies for the treatment of allergy and autoimmunity. (J Allergy Clin Immunol 2012;129:1647-55.)
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| 13. |
- Vierke, Lena, et al.
(författare)
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Estimation of the Acid Dissociation Constant of Perfluoroalkyl Carboxylic Acids through an Experimental Investigation of their Water-to-Air Transport
- 2013
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Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 47:19, s. 11032-11039
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Tidskriftsartikel (refereegranskat)abstract
- The acid dissociation constants (pK(a)s) of perfluoroalkyl carboxylic acids (PFCAs) have been the subject of discussion in the literature; for example, values from -0.2 to 3.8 have been suggested for perfluorooctanoic acid (PFOA). The dissociated anionic conjugate bases of PFCAs have negligible air-water partition coefficients (K(AW)s) and do not volatilize from water. The neutral acids, however, have relatively high K(AW)s and volatilization from water has been demonstrated. The extent of volatilization of PFCAs in the environment will depend on the water pH and their pK(a). Knowledge of the pK(a)s of PFCAs is therefore vital for,understanding their environmental transport and fate. We investigated the water-to-air transfer of PFCAs in a novel experimental setup. We used similar to 1 mu g L-1 of PFCAs in water (above environmental background concentrations but below the concentration at which self-association occurs) at different water pH (pH 0.3 to pH 6.9) and sampled the PFCAs volatilized from water during a 2-day experiment. Our results suggest that the pK(a)s of C4-11 PFCAs are <1.6. For PFOA, we derived a pK(a) of 0.5 from fitting the experimental measurements with a volatilization model. Perfluoroalkane sulfonic acids were not volatilized, suggesting that their pK(a)s are below the investigated pH range (pK(a) <0.3).
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