| 1. |
- Mylrea-Foley, Bronacha, et al.
(författare)
-
Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise : the TRUFFLE 2 randomised trial protocol
- 2022
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:4
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area. We propose a randomised, controlled trial to establish the optimum method of timing delivery between 32 weeks and 36 weeks 6 days of gestation. We hypothesise that delivery on evidence of cerebral blood flow redistribution reduces a composite of perinatal poor outcome, death and short-term hypoxia-related morbidity, with no worsening of neurodevelopmental outcome at 2 years.Methods and analysis: Women with non-anomalous singleton pregnancies 32+0 to 36+6 weeks of gestation in whom the estimated fetal weight or abdominal circumference is <10th percentile or has decreased by 50 percentiles since 18-32 weeks will be included for observational data collection. Participants will be randomised if cerebral blood flow redistribution is identified, based on umbilical to middle cerebral artery pulsatility index ratio values. Computerised cardiotocography (cCTG) must show normal fetal heart rate short term variation (>= 4.5 msec) and absence of decelerations at randomisation. Randomisation will be 1:1 to immediate delivery or delayed delivery (based on cCTG abnormalities or other worsening fetal condition). The primary outcome is poor condition at birth and/or fetal or neonatal death and/or major neonatal morbidity, the secondary non-inferiority outcome is 2-year infant general health and neurodevelopmental outcome based on the Parent Report of Children's Abilities-Revised questionnaire.Ethics and dissemination: The Study Coordination Centre has obtained approval from London-Riverside Research Ethics Committee (REC) and Health Regulatory Authority (HRA). Publication will be in line with NIHR Open Access policy.
|
|
| 2. |
- Back, Julia, et al.
(författare)
-
Evidence of support used for drug treatments in pediatric cardiology
- 2021
-
Ingår i: Health Science Reports. - : WILEY. - 2398-8835. ; 4:2
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Clinical support systems are widely used in pediatric care. The aim of this study was to assess the support for drug treatments used at pediatric cardiac wards and intensive care units in Sweden.Methods: Drug information, such as type of drug, indication, dose, and route of administration, for all in-hospital pediatric cardiac patients, was included in the study. Treatments were classified as either on-label (based on product information) or off-label. Support for off-label treatment was stratified by the use of clinical support systems (the national database on drugs, local, or other clinical experience guidelines).Results: In all, 28 patients were included in the study. The total number of drug treatments was 233, encompassing 65 different drugs. Overall, 175 (75%) treatments were off-label. A majority of off-label drug treatments were supported by other sources of information shared by experts. A total of 7% of the drug treatments were used without support.Conclusion: Off-label drug treatment is still common in Swedish pediatric cardiac care. However, the majority of treatments were supported by the experience shared in clinical support systems.Key Points:Seventy-five percent of all prescriptions in pediatric cardiology care were off-label.A majority of patients received three or more drug treatments off-label.Use of clinical support systems and guidelines was common, but in 7% of all drug treatments, no support was found for the chosen treatment.
|
|
| 3. |
- Barouki, Robert, et al.
(författare)
-
The COVID-19 pandemic and global environmental change : Emerging research needs
- 2021
-
Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 146
-
Tidskriftsartikel (refereegranskat)abstract
- The outbreak of COVID-19 raised numerous questions on the interactions between the occurrence of new infections, the environment, climate and health. The European Union requested the H2020 HERA project which aims at setting priorities in research on environment, climate and health, to identify relevant research needs regarding Covid-19. The emergence and spread of SARS-CoV-2 appears to be related to urbanization, habitat destruction, live animal trade, intensive livestock farming and global travel. The contribution of climate and air pollution requires additional studies. Importantly, the severity of COVID-19 depends on the interactions between the viral infection, ageing and chronic diseases such as metabolic, respiratory and cardiovascular diseases and obesity which are themselves influenced by environmental stressors. The mechanisms of these interactions deserve additional scrutiny. Both the pandemic and the social response to the disease have elicited an array of behavioural and societal changes that may remain long after the pandemic and that may have long term health effects including on mental health. Recovery plans are currently being discussed or implemented and the environmental and health impacts of those plans are not clearly foreseen. Clearly, COVID-19 will have a longlasting impact on the environmental health field and will open new research perspectives and policy needs.
|
|
| 4. |
- Bergman-Larsson, Julia, et al.
(författare)
-
Combined expression of HOXA11 and CD10 identifies endometriosis versus normal tissue and tumors
- 2022
-
Ingår i: Annals of Diagnostic Pathology. - : Elsevier. - 1092-9134 .- 1532-8198. ; 56
-
Tidskriftsartikel (refereegranskat)abstract
- The gold standard for diagnosing endometriosis is by laparoscopic visual demonstration of ectopic endometrial lesions outside the uterus, preferably verified by biopsy and microscopical examination. Molecular markers to facilitate the microscopical diagnosis of endometriosis and for distinguishing endometriosis from other benign and malignant lesions are lacking. Our aim was to test and validate an immunohistochemical antibody panel for improved diagnostic accuracy of endometriosis. Both CD10 and HOXA11 have been implicated in regulation of endometrial homeostasis. Here we have analyzed the expression pattern of these two proteins using immunohistochemistry on human tissues in a tissue microarray format. CD10 and HOXA11 expression in endometriosis lesions were compared to expression patterns in a range of normal tissues and in primary- and metastatic lesions of endometrial-, cervical- and ovarian cancer. HOXA11 and CD10 were expressed in 98% and 91% of endometriosis lesions and the combined double-positive expression profile of both HOXA11 and CD10 was highly sensitive for ectopic endometrial tissue (90%). The specificity and sensitivity for this double-positive signature in endometriosis was significantly different from all investigated tissues, cancers and metastases except normal, eutopic endometrial- and cervical mucosa. The combination of HOXA11 and CD10 expression profiles provides a useful tool to identify ectopic endometrial tissue and for distinguishing endometriosis from various types of gynecological malignancies and metastases.
|
|
| 5. |
- Enroth, Stefan, 1976-, et al.
(författare)
-
Data-driven analysis of a validated risk score for ovarian cancer identifies clinically distinct patterns during follow-up and treatment
- 2022
-
Ingår i: Communications Medicine. - : Springer Nature. - 2730-664X. ; 2:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundOvarian cancer is the eighth most common cancer among women and due to late detection prognosis is poor with an overall 5-year survival of 30–50%. Novel biomarkers are needed to reduce diagnostic surgery and enable detection of early-stage cancer by population screening. We have previously developed a risk score based on an 11-biomarker plasma protein assay to distinguish benign tumors (cysts) from malignant ovarian cancer in women with adnexal ovarian mass.MethodsProtein concentrations of 11 proteins were characterized in plasma from 1120 clinical samples with a custom version of the proximity extension assay. The performance of the assay was evaluated in terms of prediction accuracy based on receiver operating characteristics (ROC) and multiple hypothesis adjusted Fisher’s Exact tests on achieved sensitivity and specificity.ResultsThe assay’s performance is validated in two independent clinical cohorts with a sensitivity of 0.83/0.91 and specificity of 0.88/0.92. We also show that the risk score follows the clinical development and is reduced upon treatment, and increased with relapse and cancer progression. Data-driven modeling of the risk score patterns during a 2-year follow-up after diagnosis identifies four separate risk score trajectories linked to clinical development and survival. A Cox proportional hazard regression analysis of 5-year survival shows that at time of diagnosis the risk score is the second-strongest predictive variable for survival after tumor stage, whereas MUCIN-16 (CA-125) alone is not significantly predictive.ConclusionThe robust performance of the biomarker assay across clinical cohorts and the correlation with clinical development indicates its usefulness both in the diagnostic work-up of women with adnexal ovarian mass and for predicting their clinical course.
|
|
| 6. |
- Gao, Yu, et al.
(författare)
-
Immunodeficiency syndromes differentially impact the functional profile of SARS-CoV-2-specific T cells elicited by mRNA vaccination
- 2022
-
Ingår i: Immunity. - : Elsevier. - 1074-7613 .- 1097-4180. ; 55:9, s. 1732-1746.e5
-
Tidskriftsartikel (refereegranskat)abstract
- Many immunocompromised patients mount suboptimal humoral immunity after SARS-CoV-2 mRNA vaccination. Here, we assessed the single-cell profile of SARS-CoV-2-specific T cells post-mRNA vaccination in healthy individuals and patients with various forms of immunodeficiencies. Impaired vaccine-induced cell-mediated immunity was observed in many immunocompromised patients, particularly in solid-organ transplant and chronic lymphocytic leukemia patients. Notably, individuals with an inherited lack of mature B cells, i.e., X-linked agammaglobulinemia (XLA) displayed highly functional spike-specific T cell responses. Single-cell RNA-sequencing further revealed that mRNA vaccination induced a broad functional spectrum of spike-specific CD4+ and CD8+ T cells in healthy individuals and patients with XLA. These responses were founded on polyclonal repertoires of CD4+ T cells and robust expansions of oligoclonal effector-memory CD45RA+ CD8+ T cells with stem-like characteristics. Collectively, our data provide the functional continuum of SARS-CoV-2-specific T cell responses post-mRNA vaccination, highlighting that cell-mediated immunity is of variable functional quality across immunodeficiency syndromes.
|
|
| 7. |
- Humbert, Marion, et al.
(författare)
-
Functional SARS-CoV-2 cross-reactive CD4+ T cells established in early childhood decline with age
- 2023
-
Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 120:12
-
Tidskriftsartikel (refereegranskat)abstract
- Pre-existing SARS-CoV-2-reactive T cells have been identified in SARS-CoV-2-unexposed individuals, potentially modulating COVID-19 and vaccination outcomes. Here, we provide evidence that functional cross-reactive memory CD4+ T cell immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is established in early childhood, mirroring early seroconversion with seasonal human coronavirus OC43. Humoral and cellular immune responses against OC43 and SARS-CoV-2 were assessed in SARS-CoV-2-unexposed children (paired samples at age two and six) and adults (age 26 to 83). Pre-existing SARS-CoV-2-reactive CD4+ T cell responses targeting spike, nucleocapsid, and membrane were closely linked to the frequency of OC43-specific memory CD4+ T cells in childhood. The functional quality of the cross-reactive memory CD4+ T cell responses targeting SARS-CoV-2 spike, but not nucleocapsid, paralleled OC43-specific T cell responses. OC43-specific antibodies were prevalent already at age two. However, they did not increase further with age, contrasting with the antibody magnitudes against HKU1 (β-coronavirus), 229E and NL63 (α-coronaviruses), rhinovirus, Epstein–Barr virus (EBV), and influenza virus, which increased after age two. The quality of the memory CD4+ T cell responses peaked at age six and subsequently declined with age, with diminished expression of interferon (IFN)-γ, interleukin (IL)-2, tumor necrosis factor (TNF), and CD38 in late adulthood. Age-dependent qualitative differences in the pre-existing SARS-CoV-2-reactive T cell responses may reflect the ability of the host to control coronavirus infections and respond to vaccination. Copyright © 2023 the Author(s).
|
|
| 8. |
- Lagou, Vasiliki, et al.
(författare)
-
Sex-dimorphic genetic effects and novel loci for fasting glucose and insulin variability
- 2021
-
Ingår i: Nature Communications. - : Nature Publishing Group. - 2041-1723. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- Differences between sexes contribute to variation in the levels of fasting glucose and insulin. Epidemiological studies established a higher prevalence of impaired fasting glucose in men and impaired glucose tolerance in women, however, the genetic component underlying this phenomenon is not established. We assess sex-dimorphic (73,089/50,404 women and 67,506/47,806 men) and sex-combined (151,188/105,056 individuals) fasting glucose/fasting insulin genetic effects via genome-wide association study meta-analyses in individuals of European descent without diabetes. Here we report sex dimorphism in allelic effects on fasting insulin at IRS1 and ZNF12 loci, the latter showing higher RNA expression in whole blood in women compared to men. We also observe sex-homogeneous effects on fasting glucose at seven novel loci. Fasting insulin in women shows stronger genetic correlations than in men with waist-to-hip ratio and anorexia nervosa. Furthermore, waist-to-hip ratio is causally related to insulin resistance in women, but not in men. These results position dissection of metabolic and glycemic health sex dimorphism as a steppingstone for understanding differences in genetic effects between women and men in related phenotypes.
|
|
| 9. |
- Malmborg, Julia, PhD, 1988-, et al.
(författare)
-
Associations between pain, health, and lifestyle factors in 10-year-old boys and girls from a Swedish birth cohort
- 2023
-
Ingår i: BMC Pediatrics. - London : BioMed Central (BMC). - 1471-2431. ; 23:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPain is common in children and its associations with various biopsychosocial factors is complex. Comprehensive pain assessments could contribute to a better understanding of pediatric pain, but these assessments are scarce in literature. The aim of this study was to examine differences in pain prevalence and pain patterns in 10-year-old boys and girls from a Swedish birth cohort and to study associations between pain, health-related quality of life and various lifestyle factors stratified by sex.Methods866 children (426 boys and 440 girls) and their parents from the "Halland Health and Growth Study" participated in this cross-sectional study. Children were categorized into two pain groups, "infrequent pain" (never-monthly pain) or "frequent pain" (weekly-almost daily pain), based on a pain mannequin. Univariate logistic regression analyses, stratified by sex, were performed to study associations between frequent pain and children's self-reports of disease and disability and health-related quality of life (Kidscreen-27, five domains), and parents' reports of their child's sleep (quality and duration), physical activity time, sedentary time, and participation in organized physical activities.ResultsThe prevalence of frequent pain was 36.5% with no difference between boys and girls (p = 0.442). Boys with a longstanding disease or disability had higher odds of being in the frequent pain group (OR 2.167, 95% CI 1.168-4.020). Higher scores on health-related quality of life in all five domains for girls, and in two domains for boys, was associated with lower odds of being categorized into the frequent pain group. Frequent pain was associated with poor sleep quality (boys OR 2.533, 95% CI 1.243-5.162; girls OR 2.803, 95% CI 1.276-6.158) and more sedentary time (boys weekends OR 1.131, 95% CI 1.022-1.253; girls weekdays OR 1.137, 95% CI 1.032-1.253), but not with physical activity.ConclusionsThe high prevalence of frequent pain needs to be acknowledged and treated by school health-care services and the healthcare sector in order to prevent pain from influencing health and lifestyle factors negatively in children.
|
|
| 10. |
|
|
| 11. |
- Malmborg, Julia, PhD, 1988-, et al.
(författare)
-
Pain and its association with health-related quality of life, sleep, physical activity, and sedentary behavior in 10-year-old children from a Swedish birth cohort
- 2022
-
Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 81:Suppl. 1, s. 988-988
-
Tidskriftsartikel (refereegranskat)abstract
- Pain in children may be underreported and undertreated today, but due to methodological variations, pain prevalence is difficult to determine. Moreover, it is unclear to what extent pediatric pain is associated with health-related quality of life (HRQoL) and other lifestyle habits. There is a need for an increased understanding of pain in children.ObjectivesTo study pain prevalence and cross-sectional associations between pain, HRQoL, sleep, physical activity, and sedentary behavior in 10-year-old children from a Swedish birth cohort.MethodsThe Swedish birth cohort the “Halland Health and Growth Study” (H2GS) recruited 2860 children at birth (2007–2009). At 10 years of age the children answered questionnaires regarding pain (mannequin with 20 regions, frequency never–daily for each region) and HRQoL (Kidscreen-27, 27 questions, 5 domains scored worst–best). Parents estimated their child’s sleep (6–8, 9, or 10–12 hours/night), physical activity time, and sedentary time (hours/weekdays and hours/weekends respectively). Children were categorized into the groups of “infrequent pain” (never–monthly pain) or “frequent pain” (weekly–almost daily pain) from the highest reported pain frequency from at least one body region. Differences in pain prevalence between boys and girls were analyzed with chi2-test. Logistic regression analyses were performed to study associations between frequent pain (dependent variable) and HRQoL, sleep, physical activity, and sedentary behavior (independent variables). Each variable was adjusted for sex.Results733 children (351 boys and 382 girls) answered pain and HRQoL questions at 10 years of age. Frequent pain was reported by 37% (boys 35% vs. girls 39%, p=0.267). The number of frequent pain regions ranged from 1–13 in boys and 1–20 in girls. Higher HRQoL in the domains physical wellbeing (OR 0.965; 95%CI 0.948–0.983; p<0.001), psychological wellbeing (OR 0.971; 95%CI 0.955–0.987; p<0.001), autonomy and parents (OR 0.971; 95%CI 0.954–0.988; p=0.001), peers and social support (OR 0.977; 95%CI 0.961–0.994; p=0.007), and school environment (OR 0.972; 95%CI 0.956–0.989; p=0.002) was associated with less risk of belonging to the frequent pain group. More sedentary time in weekdays (OR 1.107; 95%CI 1.028–1.192; p=0.007) and weekends (OR 1.122; 95%CI 1.037–1.215; p=0.004) was associated with having frequent pain, but no associations were found between frequent pain and the amount of physical activity or sleep.ConclusionThe high prevalence of frequent pain in 10-year-old children must receive attention by the school and health-care services. The association between frequent pain and low HRQoL is troublesome. Improving HRQoL and reducing sedentary time is beneficial for children’s health, but further studies are needed to follow associations over time.Disclosure of InterestsNone declared
|
|
| 12. |
- Malmborg, Julia, 1988-, et al.
(författare)
-
Risk Factors for Persistence and Development of Frequent Musculoskeletal Pain in Adolescent Athletes
- 2020
-
Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 79:Suppl 1, s. 206-206
-
Tidskriftsartikel (refereegranskat)abstract
- Physical activity has a positive impact on health, but adolescent athletes often report musculoskeletal pain (MP) which is negative in the aspect of sustaining physical activity over time. There is a lack of longitudinal assessments of MP and potential risk factors, such as timing of physical maturation, in adolescent athletes.Objectives:To identify risk factors associated with the persistence or development of frequent MP at a 2-year follow-up in adolescent sport school students.Methods:Fourteen-year-old sport school students (n=233) were invited to participate in this 2-year longitudinal study. Self-reports of MP was assessed as frequency, distribution, and intensity, and health status by EQ-5D. Physical maturation was calculated by the Mirwald equation (height, weight, and sitting height) (1), and categorized as early (>1 year), average (±1 year), or late (<–1 year). Students were grouped at baseline and follow-up into infrequent (never to monthly) or frequent (weekly to daily) MP groups. Logistic regression analysis was used to study associations between frequent MP at follow-up and baseline variables.Results:131 students (79 boys and 52 girls) were included in the study. Development or persistence of frequent MP at follow-up (n=61) was associated with being a girl, late physical maturation (only boys were categorized as late), non-contact sports participation, frequent MP at baseline, and reporting ≥2 MP sites at baseline. Students with a better health status at baseline were less likely to belong to the frequent MP group at follow-up (Table).Conclusion:Frequent MP is common in sport school students. MP in young athletes may become a future health problem and there is a need for recognition and interventions by coaches and health services to prevent MP from becoming persistent.References:[1]Mirwald, R. L., Baxter-Jones, A. D., Bailey, D. A., & Beunen, G. P. (2002). An assessment of maturity from anthropometric measurements.Med Sci Sports Exerc, 34(4), 689-694.Table.Associations between background variables at baseline and frequent MP at follow-up based on crude logistic regression analysis controlling each variable for sex.Baseline variablesModelInfrequent MP vs. Frequent MPOR(95% CI; p-value)SexBoys1.00Girls2.76(1.34–5.68; p<0.01)Physical maturationAverage (±1 year)1.00Early (>1 year)0.41(0.05–3.65; p=0.42)Late (<–1 year)3.83(1.13–12.95; p=0.03)Sport categoriesContact1.00Non-contact5.16(2.07–12.88; p<0.001)MP groupsInfrequent1.00Frequent2.74(1.31–5.72; p<0.01)MP intensity last week (NRS 0–10, best to worst)1.15(0.98–1.35; p=0.10)Number of MP sites01.0012.32(0.71–7.58; p=0.16)≥22.87(1.32–6.25; p<0.01)EQ-5D (0.00–1.00, worst to best)0.03(0.001–0.58; p=0.02)Disclosure of Interests:None declared
|
|
| 13. |
- Malmborg, Julia S., 1988-, et al.
(författare)
-
Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up
- 2022
-
Ingår i: Bmc Sports Science Medicine and Rehabilitation. - London : Springer Science and Business Media LLC. - 2052-1847. ; 14:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Musculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance. Methods Sport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never-monthly) or frequent (weekly-almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex. Results A higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146-13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001-11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033-12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026-12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011-34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength. Conclusions Baseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent.
|
|
| 14. |
|
|
| 15. |
- Meyer, Antoine, et al.
(författare)
-
Dietary index based on the Food Standards Agency nutrient profiling system and risk of Crohn's disease and ulcerative colitis
- 2024
-
Ingår i: Alimentary Pharmacology and Therapeutics. - : John Wiley & Sons. - 0269-2813 .- 1365-2036. ; 59:4, s. 558-568
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Nutri-score is now widely available in food packages in Europe.Aim: To study the overall nutritional quality of the diet in relation to risks of Crohn's disease (CD) and ulcerative colitis (UC), in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.Methods: We collected dietary data at baseline from validated food frequency questionnaires. We used a dietary index based on the UK Food Standards Agency modified nutrient profiling system (FSAm-NPS-DI) underlying the Nutri-Score label, to measure the nutritional quality of the diet. We estimated the association between FSAm-NPS-DI score, and CD and UC risks using Cox models stratified by centre, sex and age; and adjusted for smoking status, BMI, physical activity, energy intake, educational level and alcohol intake.Results: We included 394,255 participants (68.1% women; mean age at recruitment 52.1 years). After a mean follow-up of 13.6 years, there were 184 incident cases of CD and 459 incident cases of UC. Risk of CD was higher in those with a lower nutritional quality, that is higher FSAm-NPS-DI Score (fourth vs. first quartile: aHR: 2.04, 95% CI: 1.24–3.36; p-trend: <0.01). Among items of the FSAm-NPS-DI Score, low intakes of dietary fibre and fruits/vegetables/legumes/nuts were associated with higher risk of CD. Nutritional quality was not associated with risk of UC (fourth vs. first quartile of the FSAm-NPS-DI Score: aHR: 0.91, 95% CI: 0.69–1.21; p-trend: 0.76).Conclusions: A diet with low nutritional quality as measured by the FSAm-NPS-DI Score is associated with a higher risk of CD but not UC.
|
|
| 16. |
- Müller, Thomas R., et al.
(författare)
-
Additive effects of booster mRNA vaccination and SARS-CoV-2 Omicron infection on T cell immunity across immunocompromised states
- 2023
-
Ingår i: Science Translational Medicine. - 1946-6234 .- 1946-6242. ; 15:704, s. eadg9452-
-
Tidskriftsartikel (refereegranskat)abstract
- Suboptimal immunity to SARS-CoV-2 mRNA vaccination has frequently been observed in individuals with various immunodeficiencies. Given the increased antibody evasion properties of emerging SARS-CoV-2 subvariants, it is necessary to assess whether other components of adaptive immunity generate resilient and protective responses against infection. We assessed T cell responses in 279 individuals, covering five different immunodeficiencies and healthy controls, before and after booster mRNA vaccination, as well as after Omicron infection in a subset of patients. We observed robust and persistent Omicron-reactive T cell responses that increased markedly upon booster vaccination and correlated directly with antibody titers across all patient groups. Poor vaccination responsiveness in immunocompromised or elderly individuals was effectively counteracted by the administration of additional vaccine doses. Functionally, Omicron-reactive T cell responses exhibited a pronounced cytotoxic profile and signs of longevity, characterized by CD45RA+ effector memory subpopulations with stem cell-like properties and increased proliferative capacity. Regardless of underlying immunodeficiency, booster-vaccinated and Omicron-infected individuals appeared protected against severe disease and exhibited enhanced and diversified T cell responses against conserved and Omicron-specific epitopes. Our findings indicate that T cells retain the ability to generate highly functional responses against newly emerging variants, even after repeated antigen exposure and a robust immunological imprint from ancestral SARS-CoV-2 mRNA vaccination.
|
|
| 17. |
- Söderström Malmborg, Julia, 1988-
(författare)
-
Pain and health in adolescents and young adults – pieces of a puzzle
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Musculoskeletal pain is a burden for the individual and for society, and it has a negative impact on overall health. The biological, psychological, and social factors that govern pain and health form a complex puzzle to put together. Musculoskeletal pain conditions may be alleviated by physical activity, but a too high level of physical activity may also increase the risk of pain. Youth athletes may be especially vulnerable to developing pain due to factors related to training load and physical maturity. Being physically active and maintaining a healthy diet is associated with better health, but if carried out to excess these health behaviours may become unhealthy. Our understanding of musculoskeletal pain and health in adolescents and young adults needs to be developed, both in individuals involved in sports and exercise and in the general population.Aim: The overall aim was to study musculoskeletal pain and its relationship to various health-related factors in adolescents and young adults enrolled in sport or general education programmes.Methods: Study I was a cross-sectional study on university students (aged 19–29) from an exercise science programme (n = 118) and a business programme (n = 89), assessing health status, physical activity, and orthorexia nervosa (an exaggerated fixation on healthy food). Study II was a cross-sectional study (n = 178), and Study III a 2-year longitudinal (n = 131) study on sport school students (aged 14 at baseline), assessing musculoskeletal pain, health status, physical maturity, and sports performance. Study IV was a 3-year longitudinal study on students from a general upper secondary school (n = 256, aged 16 at baseline), assessing chronic musculoskeletal pain, health status, physical activity, sleep, stress, anxiety, and depression.Results: In Study I, compared to business students, exercise science students reported more pain, but better general health. A high level of physical activity in combination with orthorexia nervosa was most prevalent in men from the exercise science programme. In Studies II and III, pain was common in sport school students. At baseline, boys with constant pain were not as physically mature as boys with infrequent pain. Students with constant pain reported a worse health status than students with infrequent pain. At follow-up, frequent pain, frequent pain in two or more body regions, and a worse health status at baseline were identified as risk factors for having frequent pain at follow-up in girls. For boys, late physical maturation at baseline was a risk factor. Involvement in non-contact sports was also an identified risk factor over time in both sexes. Pain was associated with a worse sports performance in boys at both baseline and follow-up. In Study IV, chronic musculoskeletal pain was common in students from a general upper secondary school. A worse health status, severe sleeping problems, anxiety, and chronic musculoskeletal pain at baseline were associated with reporting chronic musculoskeletal pain at follow-up.Conclusions: Pain was prevalent, and also persistent, in adolescents and young adults, irrespective of attending sport or general education programmes. Pain is a biopsychosocial phenomenon and must be treated as such. Pain should be frequently monitored, and treatment should be introduced early on to prevent pain from becoming persistent.
|
|
| 18. |
- vom Saal, Frederick S., et al.
(författare)
-
The Conflict between Regulatory Agencies over the 20,000-Fold Lowering of the Tolerable Daily Intake (TDI) for Bisphenol A (BPA) by the European Food Safety Authority (EFSA)
- 2024
-
Ingår i: Journal of Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 132:4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The European Food Safety Authority (EFSA) recommended lowering their estimated tolerable daily intake (TDI) for bisphenol A (BPA) 20,000-fold to 0.2 ng/kg body weight (BW)/day. BPA is an extensively studied high production volume endocrine disrupting chemical (EDC) associated with a vast array of diseases. Prior risk assessments of BPA by EFSA as well as the US Food and Drug Administration (FDA) have relied on industry-funded studies conducted under good laboratory practice protocols (GLP) requiring guideline end points and detailed record keeping, while also claiming to examine (but rejecting) thousands of published findings by academic scientists. Guideline protocols initially formalized in the mid-twentieth century are still used by many regulatory agencies. EFSA used a 21st century approach in its reassessment of BPA and conducted a transparent, but time-limited, systematic review that included both guideline and academic research. The German Federal Institute for Risk Assessment (BfR) opposed EFSA’s revision of the TDI for BPA.Objectives: We identify the flaws in the assumptions that the German BfR, as well as the FDA, have used to justify maintaining the TDI for BPA at levels above what a vast amount of academic research shows to cause harm. We argue that regulatory agencies need to incorporate 21st century science into chemical hazard identifications using the CLARITY-BPA (Consortium Linking Academic and Regulatory Insights on BPA Toxicity) nonguideline academic studies in a collaborative government–academic program model.Discussion: We strongly endorse EFSA’s revised TDI for BPA and support the European Commission’s (EC) apparent acceptance of this updated BPA risk assessment. We discuss challenges to current chemical risk assessment assumptions about EDCs that need to be addressed by regulatory agencies to, in our opinion, become truly protective of public health. Addressing these challenges will hopefully result in BPA, and eventually other structurally similar bisphenols (called regrettable substitutions) for which there are known adverse effects, being eliminated from all food-related and many other uses in the EU and elsewhere.
|
|
