SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Blomberg Eva) srt2:(2020-2024)"

Sökning: WFRF:(Blomberg Eva) > (2020-2024)

  • Resultat 1-50 av 56
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  • Bergström, Göran, 1964, et al. (författare)
  • Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
  • 2021
  • Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
  •  
2.
  • Bergström, Göran, et al. (författare)
  • Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
  • 2021
  • Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
  •  
3.
  • Engström, Gunnar, et al. (författare)
  • Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
  • 2024
  • Ingår i: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
  • Tidskriftsartikel (refereegranskat)abstract
    • Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
  •  
4.
  • Pesonen, Ida, et al. (författare)
  • High prevalence of interstitial lung abnormalities in middle-aged never-smokers
  • 2023
  • Ingår i: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 9:5
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Interstitial lung abnormalities (ILA) are incidental findings on chest computed tomography (CT). These patterns can present at an early stage of fibrotic lung disease. Our aim was to estimate the prevalence of ILA in the Swedish population, in particular in never-smokers, and find out its association with demographics, comorbidities and symptoms.METHODS: Participants were recruited to the Swedish CArdioPulmonary BioImage Study (SCAPIS), a population-based survey including men and women aged 50-64 years performed at six university hospitals in Sweden. CT scan, spirometry and questionnaires were performed. ILA were defined as cysts, ground-glass opacities, reticular abnormality, bronchiectasis and honeycombing.FINDINGS: Out of 29 521 participants, 14 487 were never-smokers and 14 380 were men. In the whole population, 2870 (9.7%) had ILA of which 134 (0.5%) were fibrotic. In never-smokers, the prevalence was 7.9% of which 0.3% were fibrotic. In the whole population, age, smoking history, chronic bronchitis, cancer, coronary artery calcium score and high-sensitive C-reactive protein were associated with ILA. Both ILA and fibrotic ILA were associated with restrictive spirometric pattern and impaired diffusing capacity of the lung for carbon monoxide. However, individuals with ILA did not report more symptoms compared with individuals without ILA.INTERPRETATION: ILA are common in a middle-aged Swedish population including never-smokers. ILA may be at risk of being underdiagnosed among never-smokers since they are not a target for screening.
  •  
5.
  • Backman, Helena, et al. (författare)
  • Lung function trajectories and associated mortality among adults with and without airway obstruction
  • 2023
  • Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:10, s. 1063-1074
  • Tidskriftsartikel (refereegranskat)abstract
    • Rationale: Spirometry is essential for diagnosis and assessment of prognosis in COPD.Objectives: To identify FEV1 trajectories and their determinants, based on annual spirometry measurements among individuals with and without airway obstruction. Furthermore, to assess mortality in relation to trajectories.Methods: In 2002-04, individuals with airway obstruction (AO) (FEV1/VC<0.70, n=993) and age- and sex-matched non-obstructive (NO) referents were recruited from population-based cohorts. Annual spirometries until 2014 were utilized in joint-survival Latent Class Mixed Models to identify lung function trajectories. Mortality data were collected during 15 years of follow-up.Results: Three trajectories were identified among the AO-cases and two among the NO referents. Trajectory membership was driven by baseline FEV1%predicted (%pred) in both groups and additionaly, pack-years in AO and current smoking in NO. Longitudinal FEV1%pred level depended on baseline FEV1%pred, pack-years and obesity. The trajectories were distributed: 79.6% T1AO FEV1-high with normal decline, 12.8% T2AO FEV1-high with rapid decline, and 7.7% T3AO FEV1-low with normal decline (mean 27, 72 and 26 mL/year) among AO-individuals, and 96.7% T1NO FEV1-high with normal decline and 3.3% T2NO FEV1-high with rapid decline (mean 34 and 173 mL/year) among referents. Hazard for death was increased for T2AO (HR1.56) and T3AO (HR3.45) vs. T1AO, and for T2NO (HR2.99) vs. T1NO.Conclusions: Three different FEV1 trajectories were identified among those with airway obstruction and two among the referents, with different outcomes in terms of FEV1-decline and mortality. The FEV1 trajectories among airway obstructive and the relationship between low FVC and trajectory outcome are of particular clinical interest.
  •  
6.
  • Blomberg, Eva, 1952- (författare)
  • Att förstå världen – och akademin
  • 2021
  • Ingår i: Från arbetets horisont. - Lund : Arkiv förlag & tidskrift. - 9789179243548
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
  •  
7.
  • Blomberg, Eva, 1952- (författare)
  • Epilog
  • 2021
  • Ingår i: En qvinna läkare!. - Stockholm : Appell förlag. - 9789198548716 ; , s. 363-
  • Bokkapitel (populärvet., debatt m.m.)
  •  
8.
  •  
9.
  •  
10.
  • Blomberg, Eva, 1952- (författare)
  • Inledning
  • 2021
  • Ingår i: En qvinna läkare!. - Stockholm : Appell förlag. - 9789198548716 ; , s. 7-8
  • Bokkapitel (populärvet., debatt m.m.)
  •  
11.
  • Blomberg, Eva, 1961-, et al. (författare)
  • Weathering and Antimicrobial Properties of Laminate and Powder Coatings Containing Silver Phosphate Glass Used as High-Touch Surfaces
  • 2022
  • Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 14:12, s. 7102-
  • Tidskriftsartikel (refereegranskat)abstract
    • Increasing the use of hygienic high-touch surfaces with antimicrobial properties in health care and public spaces is one way to hinder the spread of bacteria and infections. This study investigates the antimicrobial efficacy and surface reactivity of commercial laminate and powder coated surfaces treated with silver-doped phosphate glass as antimicrobial additive towards two model bacterial strains, Escherichia coli and Bacillus subtilis, in relation to surface weathering and repeated cleaning. High-touch conditions in indoor environments were simulated by different extents of pre-weathering (repeated daily cycles in relative humidity at constant temperature) and simplified fingerprint contact by depositing small droplets of artificial sweat. The results elucidate that the antimicrobial efficacy was highly bacteria dependent (Gram-positive or Gram-negative), not hampered by differences in surface weathering but influenced by the amount of silver-doped additive. No detectable amounts of silver were observed at the top surfaces, though silver was released into artificial sweat in concentrations a thousand times lower than regulatory threshold values stipulated for materials and polymers in food contact. Surface cleaning with an oxidizing chemical agent was more efficient in killing bacteria compared with an agent composed of biologically degradable constituents. Cleaning with the oxidizing agent resulted further in increased wettability and presence of residues on the surfaces, effects that were beneficial from an antimicrobial efficacy perspective.
  •  
12.
  • Chang, Tingru, et al. (författare)
  • A novel methodology to study antimicrobial properties of high-touch surfaces used for indoor hygiene applications-A study on Cu metal
  • 2021
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Metal-based high-touch surfaces used for indoor applications such as doorknobs, light switches, handles and desks need to remain their antimicrobial properties even when tarnished or degraded. A novel laboratory methodology of relevance for indoor atmospheric conditions and fingerprint contact has therefore been elaborated for combined studies of both tarnishing/corrosion and antimicrobial properties of such high-touch surfaces. Cu metal was used as a benchmark material. The protocol includes pre-tarnishing/corrosion of the high touch surface for different time periods in a climatic chamber at repeated dry/wet conditions and artificial sweat deposition followed by the introduction of bacteria onto the surfaces via artificial sweat droplets. This methodology provides a more realistic and reproducible approach compared with other reported procedures to determine the antimicrobial efficiency of high-touch surfaces. It provides further a possibility to link the antimicrobial characteristics to physical and chemical properties such as surface composition, chemical reactivity, tarnishing/corrosion, surface roughness and surface wettability. The results elucidate that bacteria interactions as well as differences in extent of tarnishing can alter the physical properties (e.g. surface wettability, surface roughness) as well as the extent of metal release. The results clearly elucidate the importance to consider changes in chemical and physical properties of indoor hygiene surfaces when assessing their antimicrobial properties.
  •  
13.
  • Chang, Tingru, et al. (författare)
  • Effect of blue light illumination on atmospheric corrosion and bacterial adhesion on copper
  • 2024
  • Ingår i: Corrosion Science. - : Elsevier BV. - 0010-938X .- 1879-0496. ; 230
  • Tidskriftsartikel (refereegranskat)abstract
    • The effect of blue light on atmospheric corrosion of Cu and on the antimicrobial properties was explored upon exposure mimicking the condition of hygienic surface disinfection. The results show that blue light illumination enhanced the formation of Cu2O, resulting in a slightly increased corrosion resistance of Cu without pre-deposited NaCl, whereas the enhanced formation of Cu2O, CuCl and/or Cu(OH)3Cl on copper with pre-deposited NaCl caused concomitant corrosion product flaking and a reduced corrosion resistance. The blue light induced enhancement of Cu corrosion led to increased surface roughness and more pronounced integration of bacteria within the corrosion products.
  •  
14.
  • Chang, Tingru, et al. (författare)
  • Effects of interactions between natural organic matter and aquatic organism degradation products on the transformation and dissolution of cobalt and nickel-based nanoparticles in synthetic freshwater
  • 2023
  • Ingår i: Journal of Hazardous Materials. - : Elsevier BV. - 0304-3894 .- 1873-3336. ; 445, s. 130586-130586
  • Tidskriftsartikel (refereegranskat)abstract
    • Expanding applications and production of engineered nanoparticles lead to an increased risk for their environmental dispersion. Systematic knowledge of surface transformation and dissolution of nanoparticles is essential for risk assessment and regulation establishment. Such aspects of Co- and Ni-based nanoparticles including metals, oxides, and solution combustion synthesized metal nanoparticles (metal cores with carbon shells) were investigated upon environmental interaction with organic matter, simulated by natural organic matter (NOM) and degradation products from zooplankton and algae (eco-corona biomolecules, EC) in freshwater (FW). The presence of NOM and EC in FW results in negative surface charges of the nanoparticles reduces the extent of nanoparticles agglomeration, and increases concentration, mainly due to the surface adsorption of carboxylate groups of the organic matter. The dissolution of the Co-based nanoparticles was for all conditions (FW, FW with NOM or EC) higher than the Ni-based, except for Co3O4 being nearly non-soluble. The surface transformation and dissolution of nanoparticles are highly exposure and time-dependent, and surface- and environment specific. Therefore, no general correlation was observed between dissolution and, particle types, surface conditions, or EC/NOM adsorption. This underlines the importance of thorough investigations of nanoparticles adsorption/desorption, degradation, and exposure scenarios for developing regulatory relevant protocols and guidelines.
  •  
15.
  • Chang, Tingru, et al. (författare)
  • The interplay between atmospheric corrosion and antimicrobial efficiency of Cu and Cu5Zn5Al1Sn during simulated high-touch conditions
  • 2021
  • Ingår i: Corrosion Science. - : Elsevier BV. - 0010-938X .- 1879-0496. ; 185
  • Tidskriftsartikel (refereegranskat)abstract
    • The interplay between atmospheric corrosion and antimicrobial efficiency of bare Cu and Cu5Zn5Al1Sn was studied upon exposures simulating high-touch surface conditions. The survival of the bacteria Bacillus subtilis during surface contact with Cu and Cu5Zn5Al1Sn was examined under different degrees of surface oxidation, tarnishing, wettability and copper ion release. Depending on surface conditions complete bacteria inhibition was obtained within 4 min on Cu and within 6-10 min on Cu5Zn5Al1Sn. The antibacterial efficiency increases slightly with copper release rate and is governed by complex interactions between the corroded metal surface, bacteria and extracellular polymeric substances produced by the bacteria.
  •  
16.
  •  
17.
  • Chaplin, John, et al. (författare)
  • Translation and cross-cultural adaptation of ten pediatric PROMIS (R) item banks into Swedish
  • 2020
  • Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 29:Suppl. 1, s. S175-S176
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Aims: We describe the first large-scale translation and cross-cultural adaptation into Swedish of ten pediatric PROMIS item banks: Anger (9-items), Anxiety (15-items), Depressive symptoms (14-items) ,Cognitive function (43-items), Family relationships (47-items), Fatigue (25-items), Pain interference (20-items), Peer relationships (15-items), Physical activity (10-items), Positive affect (38-items) and Profile-25.Methods: ISPOR recommendations were followed. There view was carried out in multi-professional small groups of twelve health-related quality-of-life researchers, pediatric clinicians and linguists from different geographical regions in a two-day workshop. Cross-cultural comparisons were made to identify problems and to produce a consensus-derived version, which was then back translated, evaluated, and revised where necessary. Prior translations and review of version 1 of the item-banks were utilized (4 item-banks). There viewed item-banks were presented in four sessions of cognitive debriefings over 2 years with twenty-two young people (8-18 years) in three dialectically different regions of Sweden before finalization.Results: One hundred and seventy-five items were translated. All item banks had translation issues to be resolved. Sixty-six items (38%) needed resolution at the cognitive debriefing stage, the majority of issues were in the area of unclear definitions in the English items (35 items), followed by language and cultural differences (16 issues) and age appropriate language (14 items). The cultural issues identified were 1) identifying suitable word alternative to match the English where Swedish lacked the volume of words to choose from; 2) adjectival agreement on intensity levels of the concept to be translated; 3) culturally specific idiomatic phrases; 4) use of linguistically specific homonyms in English that did not match Swedish word usage; 5) cultural differences in describing members of the family unit and the family unit itself.Conclusion: The Swedish translations of ten PROMIS Pediatric item banks and Profile-25 were rigorously translated using internationally standardized methods. Close consideration of the translations, and multiple translations helped to ensure conceptual equivalence and comprehensibility. The banks are culturally adapted and appropriate for the age range 8 to 18 years. They can be used for clinical trials and routine pediatric health care.
  •  
18.
  •  
19.
  • Ekström, Magnus, et al. (författare)
  • Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women.
  • 2024
  • Ingår i: Respiratory research. - : BioMed Central (BMC). - 1465-993X .- 1465-9921. ; 25:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population.Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50-64years. Breathlessness (modified Medical Research Council [mMRC]≥2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease.We included 25,948 people aged 57.5±[SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0-29.9), 21% obese (BMI≥30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6-66.0%), stress (31.6-76.8%), respiratory disease (20.1-37.1%), depression (17.1-26.6%), cardiac disease (6.3-12.7%), anemia (0.8-3.3%), and peripheral arterial disease (0.3-0.8%). Stress was the main factor in women and current smokers.Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting-supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.
  •  
20.
  • En qvinna läkare! : Doktor Karolina Widerström
  • 2021
  • Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
    • Karolina Widerström (1846–1949) var Sveriges första kvinnliga läkare och kirurg. Hennes mottagning i Stockholms Klarakvarter blev en stor framgång och hon arbetade oavbrutet för kvinnors hälsa och rättigheter. Sex författare ger en unik inblick i hennes liv, gärning, relationer och roll i samhällsdebatten.
  •  
21.
  • Eriksson, Mats, Professor, 1959-, et al. (författare)
  • Did the organization of primary care practices during the COVID-19 pandemic influence quality and safety? an international survey
  • 2024
  • Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 24
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Changes in demographics with an older population, the illness panorama with increasing prevalence of non-communicable diseases, and the shift from hospital care to home-based care place demand on primary health care, which requires multiprofessional collaboration and team-based organization of work. The COVID-19 pandemic affected health care in various ways, such as heightened infection control measures, changing work practices, and increased workload.Objectives: This study aimed to investigate the association between primary care practices’ organization, and quality and safety changes during the COVID-19 pandemic.Design: Data were collected from 38 countries in a large online survey, the PRICOV-19 study. For this paper, the participating practices were categorized as “Only GPs”, comprising practices with solely general practitioners (GPs) and/or GP trainees, without any other health care professionals (n = 1,544), and “Multiprofessional,” comprising practices with at least one GP or GP trainee and one or more other health professionals (n = 3,936).Results: Both categories of practices improved in infection control routines when compared before and during the COVID-19 pandemic. A larger proportion of the multiprofessional practices changed their routines to protect vulnerable patients. Telephone triage was used in more “Multiprofessional” practices, whereas “Only GPs” were more likely to perform video consultations as an alternative to physical visits. Both types of practices reported that the time to review new guidelines and scientific literature decreased during the pandemic. However, both had more meetings to discuss directives than before the pandemic.Conclusions: Multiprofessional teams were keener to introduce changes to the care organization to protect vulnerable patients. However, practices with only GPs were found to be more aligned with video consultations, perhaps reflecting the close patient-doctor relationship. In contrast, telephone triage was used more in multiprofessional teams.
  •  
22.
  • Hjertberg, Linda, et al. (författare)
  • Body mass index and complications after obstetric anal sphincter injury, 8 weeks postpartum
  • 2022
  • Ingår i: International Urogynecology Journal. - : Springer London Ltd. - 0937-3462 .- 1433-3023. ; 33, s. 3465-3472
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction and hypothesis The impact of body mass index (BMI) on pelvic floor recovery after an obstetric anal sphincter injury (OASI) is unclear. The aim of this study was to evaluate the hypothesis that urinary incontinence (UI) and anal incontinence (AI) are more common in overweight and obese women than in normal-weight women 8 weeks postpartum in women with OASI. Methods A population-based cohort study including 6,595 primiparous women, with an OASI, delivered between 2014 and 2019. Exposure and questionnaire data were retrieved from the Swedish Perineal Laceration Registry. Uni- and multivariate analyses were used to compare normal-weight (BMI <= 24.9, reference), overweight (25.0-29.9), and obese (>= 30) women with regard to UI and AI at 8 weeks post-partum. Results Multivariate analyses showed an increased risk for urinary incontinence (OR 1.54, 95% CI 1.27-1.87) among overweight women as well as among obese women (OR 1.72, 95% CI 1.32-2.24). In contrast to our hypothesis, both overweight women (OR 0.68, 95% CI 0.56-0.83) and obese women (OR 0.65, 95% CI 0.49-0.87) were at a decreased risk for any gas and/or faecal incontinence after adjustment to possible confounding factors. The absolute rate of AI was 40.1% among normal-weight women, 34.2% among overweight women, and 29.1% in the obese group. Conclusions Urinary incontinence is more common, whereas AI is less common among overweight and obese women than in primiparous women with a BMI <24.9, 8 weeks after an OASI. The new finding, that overweight women report less AI than normal-weight women, merits further study.
  •  
23.
  • Hjertberg, Linda, 1978- (författare)
  • The impact of maternal body mass index on pelvic floor during labor and after childbirth, and a new anesthetic approach for repair of perineal lacerations
  • 2024
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Objectives: This thesis aimed to assess the impact of maternal body mass index (BMI) on pelvic floor during labor and focusing on pelvic floor function following an anal sphincter injury (OASI). Additionally, the objective was to design a study protocol for a randomized controlled trial (RCT) with the objective to evaluate the impact of supplementary anesthesia during the examination and repair of obstetric perineal lacerations.Material and Methods: Study I was an observational prospective cohort study, conducted at the maternity ward Linköping University Hospital, including 207 primiparous women in the active phase of labor. Transperineal ultrasound was used for measurement of the anovaginal distance (AVD) during active phase of labor, with AVD measurements analyzed in relation to the women's BMI groups. Study II and III were nationwide Swedish register studies, including 6595 women with a first time vaginal birth complicated by an OASI. Data was sourced from the Swedish Perineal Laceration Register (PLR), based on medical records and patient reported outcome measurements (PROM). Women were categorized by BMI, and analyses were performed on PROM data at the 8 week follow-up (Study II), and at the 12 month follow-up (Study III), after an OASI. Study IV, a study protocol for a RCT, with parallel groups. Women who undergo examination and repair of obstetric perineal lacerations (grade I and II) are randomized into two arms (1:1); analgesia with pudendal nerve block (PNB) with Ropivacaine®-the PNB group or analgesia with PNB in combination with patient-controlled sedation (PCS) with propofol, the PCS group.Results: Obese women exhibited a higher AVD compared to normal weight women. The mean AVD was 25 mm for primiparous women in the active phase of labor. Overweight and obese women reported fewer wound complications than normal weight women at 8 weeks postpartum. Additionally, overweight and obese women had a lower risk of anal incontinence (AI) at 8 weeks after an OASI compared to normal weight counterparts. However, at 12 months after an OASI, the risk of AI was comparable across BMI groups. Urinary incontinence (UI) was more prevalent among overweight and obese women, with a higher risk of UI both at 8 weeks and 12 months after an OASI compared to normal weight women. Overweight and obese women had a lower risk of reporting dyspareunia at 12 months after an OASI compared to normal weight women. Results from the ongoing RCT are pending.Conclusions: Differences in the AVD during active phase of labor were observed between women with normal weight and those who were overweight or obese. The higher AVD in obese women compared to normal weight women may indicate a valuable anatomical distinction that could be protective for pelvic floor muscles vulnerable during labor. Furthermore, women sustaining an OASI after their first vaginal birth reported distinct complications at 8 weeks and 12 months postpartum based on BMI. Various explanations may underlie these differences in reported complications, including the hypothesis that women with overweight and obesity may experience less extensive involvement of other pelvic floor muscles and nerves, leading to a reduced risk of AI and dyspareunia during the initial postpartum year. Overweight and obese women demonstrated a lower risk of AI and wound complications at 8 weeks, as well as a lower risk of dyspareunia 12 months after a first time vaginal delivery complicated by an OASI. However, the risk of UI was higher among overweight and obese women at both 8 weeks and at 12 months after a first-time vaginal delivery complicated by an OASI. The divergence in complications and symptoms among women in different BMI groups during the initial postpartum year following an OASI underscores the importance of tailored postpartum care, necessitating to individualize advice and follow-ups.
  •  
24.
  • Holmner, Åsa, et al. (författare)
  • How stable is lung function in patients with stable chronic obstructive pulmonary disease when monitored using a telehealth system? : A longitudinal and home-based study
  • 2020
  • Ingår i: BMC Medical Informatics and Decision Making. - : BioMed Central. - 1472-6947. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Many telehealth systems have been designed to identify signs of exacerbations in patients with chronic obstructive pulmonary disease (COPD), but few previous studies have reported the nature of recorded lung function data and what variations to expect in this group of individuals. The aim of the study was to evaluate the nature of individual diurnal, day-to-day and long-term variation in important prognostic markers of COPD exacerbations by employing a telehealth system developed in-house.Methods: Eight women and five men with COPD performed measurements (spirometry, pulse oximetry and the COPD assessment test (CAT)) three times per week for 4-6 months using the telehealth system. Short-term and long-term individual variations were assessed using the relative density and weekly means respectively. Quality of the spirometry measurements (forced expiratory volume in one second (FEV1) and inspiratory capacity (IC)) was assessed employing the criteria of American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines.Results: Close to 1100 measurements of both FEV1 and IC were performed during a total of 240 patient weeks. The two standard deviation ranges for intra-individual short-term variation were approximately +/- 210 mL and +/- 350 mL for FEV1 and IC respectively. In long-term, spirometry values increased and decreased without notable changes in symptoms as reported by CAT, although it was unusual with a decrease of more than 50 mL per measurement of FEV1 between three consecutive measurement days. No exacerbation occurred. There was a moderate to strong positive correlation between FEV1 and IC, but weak or absent correlation with the other prognostic markers in the majority of the participants.Conclusions: Although FEV1 and IC varied within a noticeable range, no corresponding change in symptoms occurred. Therefore, this study reveals important and, to our knowledge, previously not reported information about short and long-term variability in prognostic markers in stable patients with COPD. The present data are of significance when defining criteria for detecting exacerbations using telehealth strategies.
  •  
25.
  • Johannesson, Kerstin, 1955, et al. (författare)
  • Ten years of marine evolutionary biology - challenges and achievements of a multidisciplinary research initiative
  • 2023
  • Ingår i: Evolutionary Applications. - : Wiley. - 1752-4571. ; 16:2, s. 530-41
  • Tidskriftsartikel (refereegranskat)abstract
    • The Centre for Marine Evolutionary Biology (CeMEB) at the University of Gothenburg, Sweden, was established in 2008 through a 10-year research grant of 8.7 m€ to a team of senior researchers. Today, CeMEB members have contributed >500 scientific publications, 30 PhD theses and have organised 75 meetings and courses, including 18 three-day meetings and four conferences. What are the footprints of CeMEB, and how will the centre continue to play a national and international role as an important node of marine evolutionary research? In this perspective arcticle we first look back over the 10 years of CeMEB activities and briefly survey some of the many achievements of CeMEB. We furthermore compare the initial goals, as formulated in the grant application, with what has been achieved, and discuss challenges and milestones along the way. Finally, we bring forward some general lessons that can be learnt from a research funding of this type, and we take also look ahead, discussing how CeMEB’s achievements and lessons can be used as a springboard to the future of marine evolutionary biology.
  •  
26.
  • Kessler, Amanda, et al. (författare)
  • Adsorption of Horseradish Peroxidase on Metallic Nanoparticles : Effects on Reactive Oxygen Species Detection Using 2′,7′-Dichlorofluorescin Diacetate
  • 2021
  • Ingår i: Chemical Research in Toxicology. - : American Chemical Society. - 0893-228X .- 1520-5010. ; 350, s. S215-S216
  • Tidskriftsartikel (refereegranskat)abstract
    • The fluorescent probe 2′,7′-dichlorofluorescein diacetate (DCFH-DA) together with the enzyme horseradish peroxidase (HRP) is widely used in nanotoxicology to study acellular reactive oxygen species (ROS) production from nanoparticles (NPs). This study examined whether HRP adsorbs onto NPs of Mn, Ni, and Cu and if this surface process influences the extent of metal release and hence the ROS production measurements using the DCFH assay in phosphate buffered saline (PBS), saline, or Dulbecco's modified Eagle's medium (DMEM). Adsorption of HRP was evident onto all NPs and conditions, except for Mn NPs in PBS. The presence of HRP resulted in an increased release of copper from the Cu NPs in PBS and reduced levels of nickel from the Ni NPs in saline. Both metal ions in solution and the adsorption of HRP onto the NPs can change the activity of HRP and thus influence the ROS results. The effect of HRP on the NP reactivity was shown to be solution chemistry dependent. Most notable was the evident affinity/adsorption of phosphate toward the metal NPs, followed by a reduced adsorption of HRP, the concomitant reduction in released manganese from the Mn NPs, and increased levels of released metals from the Cu NPs in PBS. Minor effects were observed for the Ni NPs. The solution pH should be monitored since the release of metals can change the solution pH and the activity of HRP is known to be pH-dependent. It is furthermore essential that solution pH adjustments are made following the addition of NaOH during diacetyl removal of DCFH-DA. Even though not observed for the given exposure conditions of this study, released metal ions could possibly induce agglomeration or partial denaturation of HRP, which in turn could result in steric hindrance for H2O2 to reach the active site of HRP. This study further emphasizes the influence of HRP on the background kinetics, its solution dependence, and effects on measured ROS signals. Different ways of correcting for the background are highlighted, as this can result in different interpretations of generated results. The results show that adsorption of HRP onto the metal NPs influenced the extent of metal release and may, depending on the investigated system, result in either under- or overestimated ROS signals if used together with the DCFH assay. HRP should hence be used with caution when measuring ROS in the presence of reactive metallic NPs. © 2021 The Authors. 
  •  
27.
  • Kessler, Amanda, et al. (författare)
  • Reactive Oxygen Species Formed by Metal and Metal Oxide Nanoparticles in Physiological Media-A Review of Reactions of Importance to Nanotoxicity and Proposal for Categorization
  • 2022
  • Ingår i: Nanomaterials. - : MDPI AG. - 2079-4991. ; 12:11, s. 1922-
  • Forskningsöversikt (refereegranskat)abstract
    • Diffusely dispersed metal and metal oxide nanoparticles (NPs) can adversely affect living organisms through various mechanisms and exposure routes. One mechanism behind their toxic potency is their ability to generate reactive oxygen species (ROS) directly or indirectly to an extent that depends on the dose, metal speciation, and exposure route. This review provides an overview of the mechanisms of ROS formation associated with metal and metal oxide NPs and proposes a possible way forward for their future categorization. Metal and metal oxide NPs can form ROS via processes related to corrosion, photochemistry, and surface defects, as well as via Fenton, Fenton-like, and Haber-Weiss reactions. Regular ligands such as biomolecules can interact with metallic NP surfaces and influence their properties and thus their capabilities of generating ROS by changing characteristics such as surface charge, surface composition, dissolution behavior, and colloidal stability. Interactions between metallic NPs and cells and their organelles can indirectly induce ROS formation via different biological responses. H2O2 can also be generated by a cell due to inflammation, induced by interactions with metallic NPs or released metal species that can initiate Fenton(-like) and Haber-Weiss reactions forming various radicals. This review discusses these different pathways and, in addition, nano-specific aspects such as shifts in the band gaps of metal oxides and how these shifts at biologically relevant energies (similar to activation energies of biological reactions) can be linked to ROS production and indicate which radical species forms. The influences of kinetic aspects, interactions with biomolecules, solution chemistry (e.g., Cl- and pH), and NP characteristics (e.g., size and surface defects) on ROS mechanisms and formation are discussed. Categorization via four tiers is suggested as a way forward to group metal and metal oxide NPs based on the ROS reaction pathways that they may undergo, an approach that does not include kinetics or environmental variations. The criteria for the four tiers are based on the ability of the metallic NPs to induce Fenton(-like) and Haber-Weiss reactions, corrode, and interact with biomolecules and their surface catalytic properties. The importance of considering kinetic data to improve the proposed categorization is highlighted.
  •  
28.
  • Kessler, Amanda, et al. (författare)
  • Unravelling the Mechanistic Understanding of Metal Nanoparticle-Induced Reactive Oxygen Species Formation : Insights from a Cu Nanoparticle Study
  • 2023
  • Ingår i: Chemical Research in Toxicology. - : American Chemical Society (ACS). - 0893-228X .- 1520-5010. ; 36:12, s. 1891-1900
  • Tidskriftsartikel (refereegranskat)abstract
    • Humans can be exposed to engineered and nonintentionally formed metal and metal oxide nanoparticles (Me NPs) in occupational settings, in public transportation areas, or by means of contact with different consumer products. A critical factor in the toxic potency of Me NPs is their ability to induce oxidative stress. It is thus essential to assess the potential reactive oxygen species (ROS) formation properties of Me NPs. A common way to assess the relative extent of ROS formation in vitro is to use fluorescence spectroscopy with the DCFH-DA (2 ',7'-dichlorofluorescein diacetate) probe, with and without HRP (horseradish peroxidase). However, this method does not provide any information about specific ROS species or reaction mechanisms. This study investigated the possibility of using complementary techniques to obtain more specific information about formed ROS species, both the type and reaction mechanisms. Cu NPs in PBS (phosphate buffered saline) were chosen as a test system to have the simplest (least interference from other components) aqueous solution with a physiologically relevant pH. ROS formation was assessed using fluorescence by means of the DCFH-DA method (information on relative amounts of oxygen radicals without selectivity), the Ghormley's triiodide method using UV-vis spectrophotometry (concentrations of H2O2), and electron paramagnetic resonance with DMPO as the spin-trap agent (information on specific oxygen radicals). This approach elucidates that Cu NPs undergo ROS-generating corrosion reactions, which previously have not been assessed in situ. In the presence of H2O2, and based on the type of oxygen radical formed, it was concluded that released copper participates in Haber-Weiss and/or Fenton reactions rather than in Fenton-like reactions. The new combination of techniques used to determine ROS induced by Me NPs provides a way forward to gain a mechanistic understanding of Me NP-induced ROS formation, which is important for gaining crucial insight into their ability to induce oxidative stress.
  •  
29.
  • Khort, Alexander, et al. (författare)
  • Corrosion and transformation of solution combustion synthesized Co, Ni and CoNi nanoparticles in synthetic freshwater with and without natural organic matter
  • 2021
  • Ingår i: Scientific Reports. - : Nature Research. - 2045-2322. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Pure metallic Co, Ni, and their bimetallic compositions of Co3Ni, CoNi, and CoNi3 nanomaterials were prepared by solution combustion synthesis. Microstructure, phase composition, and crystalline structure of these nanoparticles (NPs) were characterized along with studies of their corrosion and dissolution properties in synthetic freshwater with and without natural organic matter (NOM). The nanomaterials consisted of aggregates of fine NPs (3–30 nm) of almost pure metallic and bimetallic crystal phases with a thin surface oxide covered by a thin carbon shell. The nanomaterials were characterized by BET surface areas ranging from ~ 1 to 8 m2/g for the Ni and Co NPs, to 22.93 m2/g, 14.86 m2/g, and 10.53 m2/g for the Co3Ni, CoNi, CoNi3 NPs, respectively. More Co and Ni were released from the bimetallic NPs compared with the pure metals although their corrosion current densities were lower. In contrast to findings for the pure metal NPs, the presence of NOM increased the release of Co and Ni from the bimetallic NPs in freshwater compared to freshwater only even though its presence reduced the corrosion rate (current density). It was shown that the properties of the bimetallic nanomaterials were influenced by multiple factors such as their composition, including carbon shell, type of surface oxides, and the entropy of mixing. © 2021, The Author(s).
  •  
30.
  • Khort, Alexander, et al. (författare)
  • Eco-corona-mediated transformation of nano-sized Y2O3 in simulated freshwater : A short-term study
  • 2024
  • Ingår i: NanoImpact. - 2452-0748. ; 33
  • Tidskriftsartikel (refereegranskat)abstract
    • The use of metal and metal oxide nanomaterials (NMs) is experiencing a significant surge in popularity due to their distinctive structures and properties, making them highly attractive for a wide range of applications. This increases the risks of their potential negative impact on organisms if dispersed into the environment. Information about their behavior and transformation upon environmental interactions in aquatic settings is limited. In this study, the influence of naturally excreted biomolecules from the zooplankton Daphnia magna on nanosized Y2O3 of different concentrations was systematically examined in synthetic freshwater in terms of adsorption and eco-corona formation, colloidal stability, transformation, dissolution, and ecotoxicity towards D. magna. The formation of an eco-corona on the surface of the Y2O3 NMs leads to improved colloidal stability and a reduced extent of dissolution. Exposure to the Y2O3 NMs lowered the survival probability of D. magna considerably. The ecotoxic potency was slightly reduced by the formation of the eco-corona, though shown to be particle concentration-specific. Overall, the results highlight the importance of systematic mechanistic and fundamental studies of factors that can affect the environmental fate and ecotoxic potency of NMs.
  •  
31.
  • Khort, Aliaksandr, Dr, 1987-, et al. (författare)
  • Influence of natural organic matter on the transformation of metal and metal oxide nanoparticles and their ecotoxic potency in vitro
  • 2022
  • Ingår i: Nanoimpact. - : Elsevier BV. - 2452-0748. ; 25
  • Tidskriftsartikel (refereegranskat)abstract
    • Increased use and production of engineered nanoparticles (NPs) lead to an elevated risk of their diffuse dispersion into the aquatic environment and increased concern on unknown effects induced by their release into the aquatic ecosystem. An improved understanding of the environmental transformation processes of NPs of various surface characteristics is hence imperative for risk assessment and management. This study presents results on effects of natural organic matter (NOM) on the environmental transformation and dissolution of metal and metal oxide NPs of different surface and solubility properties in synthetic freshwater (FW) with and without NOM. Adsorption of NOM was evident on most of the studied NPs, except Sb and Sb2O3, which resulted in the formation of negatively charged colloids of higher stability and smaller size distribution compared with the same NPs in FW only. The dissolution rate of the NPs in the presence of NOM correlated with the strength of interactions between the carboxylate group of NOM and the particle surface, and resulted in either no (Mn, Sb, ZnO NPs), increased (Co, Sn NPs) and decreased (Ni, NiO, Sb2O3, Y2O3 NPs) levels of dissolution. One type of metal NP from each group (Mn, Ni, Sn) were investigated to assess whether observed differences in adsorption of NOM and dissolution would influence their ecotoxic potency. The results showed Mn, Ni, and Sn NPs to generate intracellular reactive oxygen species (ROS) in a time and dose-dependent manner. The extent of ROS generation in FW was similar for both Mn and Ni NPs but higher for Sn NPs. These findings are possibly related to interactions and infiltration of the NPs with the cells, which lead to redox imbalances which could induce oxidative stress and cell damage. At the same time, the presence of NOM generally reduced the intracellular ROS generation by 20-40% for the investigated NPs and also reduced cytotoxicity of Sn NPs, which can be attributed to the stronger interaction of carboxylate groups of NOM with the surface of the NPs.
  •  
32.
  • Lagrange, Eva, et al. (författare)
  • hsCRP is associated with 10-year mortality in COPD
  • 2020
  • Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 56
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
  •  
33.
  • Landberg, Eva, et al. (författare)
  • Evaluation of venous plasma glucose measured by point-of-care testing (Accu-Chek Inform II) and a hospital laboratory hexokinase method (Cobas c701) in oral glucose tolerance testing during pregnancy - a challenge in diagnostic accuracy
  • 2021
  • Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Taylor & Francis. - 0036-5513 .- 1502-7686. ; 81:8, s. 607-614
  • Tidskriftsartikel (refereegranskat)abstract
    • To diagnose gestational diabetes mellitus (GDM), plasma glucose measurements during oral glucose tolerance test (OGTT) put high demands on the methods in terms of accuracy. The aim was to evaluate and compare diagnostic performance of a point-of-care test and a glucose hexokinase laboratory method. Using risk-based screening, 175 pregnant women were included. They underwent a 75 g OGTT in their 28th (median) week of gestation. Venous blood was collected in two different tubes. Plasma glucose was measured on Cobas c701 and in duplicates on AccuChek Inform II (both methods from Roche Diagnostics). Accuracy was assessed by participating in external control programs with reference method assigned values. The methods were compared for all samples (n = 512) by regression analysis; slope of 0.90 (95% CI: 0.89-0.92), intercept of 0.12 (95% CI: 0.011-0.22) and r(s) of 0.968. The average bias between AccuChek Inform II and Cobas c701 was -8%. The proportion of women diagnosed with GDM was 25% based on AccuChek Inform II versus 55% for Cobas c701. Results from the external control program showed a bias of approximately 5% for Cobas c701 and no significant bias for AccuChek Inform II. Cobas c701 showed a large bias both towards Accu-Chek Inform II and the reference method used in the external control program, clearly exceeding the desirable bias of <2.6%. The lack of accuracy has great implications on either over- or under-diagnosis of GDM.
  •  
34.
  • Lindberg, Aleksandra (författare)
  • Efficiency and Selectivity in the Chlorate Process
  • 2021
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This licentiate thesis presents experimental studies concerning two parts of the electrochemical cell in the chlorate process: a cathode and an anode.Newly synthesized MnOx electrodes were investigated for the cathodic reaction, hydrogen evolution reaction (HER) in the chlorate process. In industry addition of toxic and carcinogenic chromium (VI) as sodium dichromate provides high efficiency. Here undesirable addition of sodium dichromate was avoided while high cathodic efficiency was achieved. Cathodic efficiency and selectivity towards HER, achieved by the MnOx electrodes annealed at different temperatures, were measured by means of mass spectrometry (MS). The second study investigated oxygen evolution in the chlorate process, which is an anodic side reaction. The evolution of oxygen decreases anodic efficiency and also presents a safety risk due to occurrence of HER in the undivided cell. We followed the amount of produced oxygen by two types of the electrode TiRu, similar to that industrially used, and synthesized TiRuSnSb, by means of MS. The produced oxygen amount was compared to the amount produced by Pt. To our best knowledge, this was the first study that successfully disentangles three different sources of oxygen with good time resolution. Oxygen is produced by homogenous hypochlorite decomposition, heterogeneously by different catalysts present in the electrolyte solution and anodically during the electrolysis i.e. electrochemically. Different electrode materials catalyzed hypochlorite decomposition differently and led to a different volume of oxygen produced. 
  •  
35.
  • Lövgren, Tanja, et al. (författare)
  • Complete and long-lasting clinical responses in immune checkpoint inhibitor-resistant, metastasized melanoma treated with adoptive T cell transfer combined with DC vaccination
  • 2020
  • Ingår i: Oncoimmunology. - : TAYLOR & FRANCIS INC. - 2162-4011 .- 2162-402X. ; 9:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Development of T cell-directed immune checkpoint inhibitors (ICI) has revolutionized metastatic melanoma (MM) therapy, but <50% of treated patients experience durable responses. This phase I trial (NCT01946373) investigates the safety/feasibility of tumor-infiltrating lymphocyte (TIL) adoptive cell therapy (ACT) combined with dendritic cell (DC) vaccination in MM patients progressing on ICI. An initial cohort (5 patients) received TIL therapy alone to evaluate safety and allow for optimization of TIL expansion protocols. A second cohort (first-in-man, 5 patients) received TIL combined with autologous tumor lysate-loaded DC vaccination. All patients received cyclophosphamide/fludarabine preconditioning prior to, and intravenous (i.v.) IL-2 after, TIL transfer. The DC vaccine was given as five intradermal injections after TIL and IL-2 administration. [F-18]-FDG PET/CT radiology was performed to evaluate clinical response, according to RECIST 1.1 (on the CT part). Immunological monitoring was performed by flow cytometry and T-cell receptor (TCR) sequencing. In the safety/optimization cohort, all patients had a mixed response or stable disease, but none durable. In the combination cohort, two patients experienced complete responses (CR) that are still ongoing (>36 and >18 months, respectively). In addition, two patients had partial responses (PR), one still ongoing (>42 months) with only a small bone-lesion remaining, and one of short duration (<4 months). One patient died early during treatment and did not receive DC. Long-lasting persistency of the injected TILs was demonstrated in blood. In summary, we report clinical responses by TIL therapy combined with DC vaccination in 4 out of 4 treated MM patients who previously failed ICI.
  •  
36.
  • Malinovschi, Andrei, 1978-, et al. (författare)
  • Consequences of Using Post- or Prebronchodilator Reference Values in Interpreting Spirometry
  • 2023
  • Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:4, s. 461-471
  • Tidskriftsartikel (refereegranskat)abstract
    • RATIONALE: Post-bronchodilator (BD) spirometry is used for diagnosis of chronic obstructive pulmonary disease (COPD). However, pre-BD reference values are used for spirometry interpretation.OBJECTIVES: To compare the resulting prevalence rates of abnormal spirometry and study the consequences of using pre- or post-BD reference values generated within the Swedish CArdioPulmonary bioImage Study (SCAPIS) when interpreting post-BD spirometry in a general population.METHODS: SCAPIS reference values for post-BD and pre-BD spirometry were based on 10,156 and 1,498 never-smoking, healthy participants, respectively. We studied the associations of abnormal spirometry, defined by using pre- or post-BD reference values, with respiratory burden in the SCAPIS general population (28,851 individuals).MEASUREMENTS AND MAIN RESULTS: Bronchodilation resulted in higher predicted median and lower limit of normal (LLN) for FEV1/FVC ratio. The prevalence of post-BD FEV1/FVC < pre-bronchodilator LLN was 4.8% and that of post-BD FEV1/FVC < post-bronchodilator LLN was 9.9% for the general population. An additional 5.1% was identified as having an abnormal post-BD FEV1/FVC ratio and this group had more respiratory symptoms, emphysema (13.5% vs. 4.1%, p<0.001) and self-reported physician-diagnosed COPD (2.8% vs. 0.5%, p<0.001) than subjects with post-BD FEV1/FVC ratio > LLN for both pre- and post-bronchodilation).CONCLUSIONS: Pre- and post-bronchodilator spirometry reference values differ with regard to FEV1/FVC ratio. Use of post-bronchodilator reference values doubled the population prevalence of airflow obstruction; this was related to a higher respiratory burden. Using post-bronchodilator reference values when interpreting post-bronchodilator spirometry might enable identification of individuals with mild disease and be clinically relevant.
  •  
37.
  • Matilainen, Noora, et al. (författare)
  • Longitudinal Study on Correlations Between Body Image, Physical Activity, and the Subjective Well-Being Among Adolescents Aged 14–16
  • 2023
  • Ingår i: Journal of School Nursing. - : SAGE Publications Inc.. - 1059-8405 .- 1546-8364.
  • Tidskriftsartikel (refereegranskat)abstract
    • This study examined the relationship between physical activity, body image, and subjective well-being among Swedish adolescents over time. Surveying 2308 students, with 137 providing longitudinal data, we conducted a multivariate logistic regression analysis. No significant correlations were found between physical activity (p =.268), body functioning (p =.567), or body appearance (p =.075) at age 14 and subjective well-being at age 16. Among control variables, sex (p =.038) and subjective well-being at age 14 (p =.013) showed significant correlations, while economic status did not (p =.39). The correlation between a positive subjective well-being at age 14 and age 16 indicates the importance of impacting the sense of well-being early. Further longitudinal studies are needed to explore the potential long-term correlation between body image and adolescent subjective well-being.
  •  
38.
  • McCarrick, S., et al. (författare)
  • Toxtracker reporter cell lines as a tool for mechanism-based (Geno)toxicity screening of nanoparticles—metals, oxides and quantum dots
  • 2020
  • Ingår i: Nanomaterials. - : MDPI AG. - 2079-4991. ; 10:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The increased use of nanoparticles (NPs) requires efficient testing of their potential toxic effects. A promising approach is to use reporter cell lines to quickly assess the activation of cellular stress response pathways. This study aimed to use the ToxTracker reporter cell lines to investigate (geno)toxicity of various metal-or metal oxide NPs and draw general conclusions on NP-induced effects, in combination with our previous findings. The NPs tested in this study (n = 18) also included quantum dots (QDs) in different sizes. The results showed a large variation in cytotoxicity of the NPs tested. Furthermore, whereas many induced oxidative stress only few activated reporters related to DNA damage. NPs of manganese (Mn and Mn3O4) induced the most remarkable ToxTracker response with activation of reporters for oxidative stress, DNA damage, protein unfolding and p53-related stress. The QDs (CdTe) were highly toxic showing clearly size-dependent effects and calculations suggest surface area as the most relevant dose metric. Of all NPs investigated in this and previous studies the following induce the DNA damage reporter; CuO, Co, CoO, CdTe QDs, Mn, Mn3O4, V2O5, and welding NPs. We suggest that these NPs are of particular concern when considering genotoxicity induced by metal-and metal oxide NPs. 
  •  
39.
  • Mei, Nanxuan, et al. (författare)
  • Transfer of Cobalt Nanoparticles in a Simplified Food Web : From Algae to Zooplankton to Fish
  • 2021
  • Ingår i: Applied nano. - : MDPI. - 2673-3501. ; 2:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Cobalt (Co) nanoparticles (NPs) may be diffusely dispersed into natural ecosystems from various anthropogenic sources such as traffic settings and eventually end up in aquatic systems. As environmentally dispersed Co NPs may be transferred through an aquatic food web, this study investigated this transfer from algae (Scendesmus sp.) to zooplankton (Daphnia magna) to fish (Crucian carp, Carassius carassius). Effects of interactions between naturally excreted biomolecules from D. magna and Co NPs were investigated from an environmental fate perspective. ATR-FTIR measurements showed the adsorption of both algae constituents and excreted biomolecules onto the Co NPs. Less than 5% of the Co NPs formed heteroagglomerates with algae, partly an effect of both agglomeration and settling of the Co NPs. The presence of excreted biomolecules in the solution did not affect the extent of heteroagglomeration. Despite the low extent of heteroagglomeration between Co NPs and algae, the Co NPs were transferred to the next trophic level (D. magna). The Co uptake in D. magna was 300 times larger than the control samples (without Co NP), which were not influenced by the addition of excreted biomolecules to the solution. Significant uptake of Co was observed in the intestine of the fish feeding on D. magna containing Co NPs. No bioaccumulation of Co was observed in the fish. Moreover, 10–20% of the transferred Co NP mass was dissolved after 24 h in the simulated gut solution of the zooplankton (pH 7), and 50–60% was dissolved in the simulated gut solution of the fish (pH 4). The results elucidate that Co NPs gain different properties upon trophic transfer in the food web. Risk assessments should hence be conducted on transformed and weathered NPs rather than on pristine particles.
  •  
40.
  • Mei, Nanxuan, et al. (författare)
  • Transfer of Cobalt Nanoparticles in a Simplified Food Web : From Algae to Zooplankton to Fish
  • 2021
  • Ingår i: Applied Nano. - : MDPI AG. - 2673-3501. ; 2:3, s. 184-205
  • Tidskriftsartikel (refereegranskat)abstract
    • Cobalt (Co) nanoparticles (NPs) may be diffusely dispersed into natural ecosystems from various anthropogenic sources such as traffic settings and eventually end up in aquatic systems. As environmentally dispersed Co NPs may be transferred through an aquatic food web, this study investigated this transfer from algae (Scendesmus sp.) to zooplankton (Daphnia magna) to fish (Crucian carp, Carassius carassius). Effects of interactions between naturally excreted biomolecules from D. magna and Co NPs were investigated from an environmental fate perspective. ATR-FTIR measurements showed the adsorption of both algae constituents and excreted biomolecules onto the Co NPs. Less than 5% of the Co NPs formed heteroagglomerates with algae, partly an effect of both agglomeration and settling of the Co NPs. The presence of excreted biomolecules in the solution did not affect the extent of heteroagglomeration. Despite the low extent of heteroagglomeration between Co NPs and algae, the Co NPs were transferred to the next trophic level (D. magna). The Co uptake in D. magna was 300 times larger than the control samples (without Co NP), which were not influenced by the addition of excreted biomolecules to the solution. Significant uptake of Co was observed in the intestine of the fish feeding on D. magna containing Co NPs. No bioaccumulation of Co was observed in the fish. Moreover, 10–20% of the transferred Co NP mass was dissolved after 24 h in the simulated gut solution of the zooplankton (pH 7), and 50–60% was dissolved in the simulated gut solution of the fish (pH 4). The results elucidate that Co NPs gain different properties upon trophic transfer in the food web. Risk assessments should hence be conducted on transformed and weathered NPs rather than on pristine particles.
  •  
41.
  • Mei, Nanxuan (författare)
  • Transformation/dissolution characteristics of cobalt and welding fume nanoparticles in physiological and environmental media: surface interactions and trophic transfer
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Nanoparticles (NPs) and nanomaterials (NMs) are present everywhere in the environment. They can form both as an act of nature and during human activities. Various kinds of NPs and NMs are engineered for different applications in the ongoing development of nanoscience and technology. Nowadays, concerns have emerged related to potential adverse effects of NPs on human health and the environment. Knowledge related to effects induced by more reactive metal NPs is scarce or even missing in some cases. Such information is crucial for risk assessments. The focus of this doctoral thesis has therefore mainly been placed on reactive metal NPs: stainless steel welding fume particles, cobalt (Co) NPs, and solution combustion synthesized (SCS) Co NPs, to investigate their transformation/dissolution characteristics in environmental and biological media.Environmental interaction studies were performed in terms of adsorption of biomolecules and natural organic matter (NOM) onto the surfaces of the NPs and their influence on dissolution, agglomeration, and size of the NPs in solution. Trophic transfer of Co NPs was investigated in an aquatic food web.The Co NPs rapidly agglomerated and sedimented in solution. Co ions were released from the NPs in both phosphate buffer solution and in freshwater, dissolution processes that were influenced by the adsorption of biomolecules and NOM. The trophic transfer of Co in the aquatic food web was shown to be affected by the extent of both agglomeration and sedimentation. No biomagnification was observed during the trophic transfer, and the addition of excreted biomolecules had no effect on the transfer.The dissolution of stainless steel welding fume particles was studied in PBS. The metal release data could help estimate the risk assessment of stainless steel welding fume particles.
  •  
42.
  • Miras, Jonathan, et al. (författare)
  • pH-responsive chitosan nanofilms crosslinked with genipin
  • 2021
  • Ingår i: Colloids and Surfaces A. - : Elsevier BV. - 0927-7757 .- 1873-4359. ; 616
  • Tidskriftsartikel (refereegranskat)abstract
    • Crosslinked chitosan-based nanofilms (thickness approximately 40 nm) were prepared using a naturally occurring and nontoxic reagent, genipin, and the surface properties were studied as a function of crosslinking degree and pH, by combining three techniques: dynamic contact angle of sessile drops, quartz crystal microbalance with dissipation (QCM-D) and atomic force microscopy (AFM). The results showed a pH-response of these crosslinked chitosan nanofilms, which swelled at pH 3 and shrank at pH 6. This transition was facilitated by chitosan crosslinking, although the wettability, studied by contact angle measurements, decreased with crosslinking. QCM-D and AFM were used to study the swelling capacity and elastic properties of crosslinked chitosan nanofilms, demonstrating that the response of the nanofilms was fully reversible between pH 3 and 6, but irreversible changes occurred at pH 9. QCM-D showed variations in frequency (Delta f) generated by the processes of swelling/shrinkage and variations in dissipation (Delta D), related to the changes in the structure of chitosan nanofilms under different pH values. Under various pH conditions, the AFM results also showed swelling at pH 3 and shrinking at pH 6, observing an increase in the elastic modulus from similar to 500 MPa at pH 3 to similar to 700 MPa at pH 6. These results allowed us to understand the pH-sensitive properties of genipin-crosslinked chitosan nanofilms, which can be very useful in smart biomaterial-based textiles.
  •  
43.
  • Nevander, Sofia, et al. (författare)
  • Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II
  • 2020
  • Ingår i: Diagnostics (Basel). - : MDPI. - 2075-4418. ; 10:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous puncture while fasting and 1 h and 2 h after an OGTT. Both samples were analyzed on Accu-Chek Inform II. The cutoffs for a GDM diagnosis using capillary samples were corrected from 5.1 to 5.3 mmol/L for the fasting sample, from 10.0 to 11.1 mmol/L for the 1 h sample, and from 8.5 to 9.4 mmol/L for the 2-h sample using half of the dataset. Applying these cutoffs to the remaining dataset resulted in a sensitivity, specificity, and accuracy of 85.0%, 95.0%, and 90.3%, respectively, with a positive predictive value (PPV) of 83%, an negative predictive value (NPV) of 96%, and a positive negative likelihood ratio (LHR) of 16.4 using capillary sampling for the GDM diagnosis at fasting and 2-h after. Corrected cutoffs and capillary samples can be used for the diagnosis of GDM with maintained diagnostic accuracy using Accu-Chek Inform II.
  •  
44.
  • Nilsson, Ulf, et al. (författare)
  • Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease
  • 2020
  • Ingår i: Respiratory Research. - : Springer Nature. - 1465-9921 .- 1465-993X. ; 21
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundIschemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively.MethodsIn 2002–04, all individuals with airway obstruction (FEV1/VC < 0.70, n = 993) were identified from population-based cohorts, together with age and sex-matched non-obstructive referents. At re-examination in 2005, spirometry, Minnesota-coded ECG and analyses of high-sensitivity cardiac troponin I (hs-cTnI) were performed in individuals with COPD (n = 601) and those with normal lung function (n = 755). Deaths were recorded until December 31st, 2010.ResultsHs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46–5.07 and 4.54; 2.25–9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease.ConclusionsIn this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity.
  •  
45.
  • Nilsson, Ulf, et al. (författare)
  • Elevated cardiac troponin predicts 11-year mortality in COPD
  • 2020
  • Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 56:Suppl 64
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Ischemic heart disease (IHD) is a common multimorbidity in individuals with COPD. High sensitive cardiac troponin I (hs-cTnI) has been shown to predict short-term mortality, but longer follow-ups has rarely been performed in population-cohorts.Aim: To evaluate the predictive value of elevated hs-cTnI on mortality among individuals with COPD compared with normal lung function (NLF).Methods: In 2002-04, subjects with FEV1/VC <0.70 (COPD, n=993) and age and sex-matched referents withoutCOPD were identified from OLIN’s population-based cohorts. In 2005, structured interviews, post-bronchodilator spirometry, blood sampling and ECG were performed in individuals with COPD (n=599) and NLF (n=756). Hs-cTnI was analysed in serum and concentrations ≥5 ng/L were defined as elevated. Mortality data were collected until 2016.Results: In 2005, the prevalence of reported IHD and elevated hs-cTnI was higher in COPD than NLF (16.2% vs 11.9% p=.02 and 31.1% vs 25.0% p=.01). The cumulative mortality was higher in COPD than NLF, both overall (36.5% vs 19.2% p<.001), and when restricting comparison to individuals with hs-cTnI≥5 (59.1% vs 34.9% p<.001). In a Cox-regression model adjusting for common confounders including reported IHD and ischemic ECG changes, hs-cTnI≥5 was associated with an increased risk for death in COPD (HR 1.41, 95%CI 1.03-1.93), but not in NLF (HR 0.84 95%CI 0.58-1.22). The increased risk remained after adjusting for FEV1% predicted.Conclusion: Elevated hs-cTnI was associated with increased mortality over a 11 -year follow-up among individuals with COPD, but not among those with NLF in this population-based study. The use of troponin could identify individuals with stable COPD at the highest risk of death.
  •  
46.
  • Oldgren, Jonas, 1964-, et al. (författare)
  • Systematic Coronary Risk Evaluation estimated risk and prevalent subclinical atherosclerosis in coronary and carotid arteries: A population-based cohort analysis from the Swedish Cardiopulmonary Bioimage Study
  • 2021
  • Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 28:3, s. 250-259
  • Tidskriftsartikel (refereegranskat)abstract
    • Background It is not clear if the European Systematic Coronary Risk Evaluation algorithm is useful for identifying prevalent subclinical atherosclerosis in a population of apparently healthy individuals. Our aim was to explore the association between the risk estimates from Systematic Coronary Risk Evaluation and prevalent subclinical atherosclerosis. Design The design of this study was as a cross-sectional analysis from a population-based study cohort. Methods From the general population, the Swedish Cardiopulmonary Bioimage Study randomly invited individuals aged 50-64 years and enrolled 13,411 participants mean age 57 (standard deviation 4.3) years; 46% males between November 2013-December 2016. Associations between Systematic Coronary Risk Evaluation risk estimates and coronary artery calcification and plaques in the carotid arteries by using imaging data from a computed tomography of the heart and ultrasonography of the carotid arteries were examined. Results Coronary calcification was present in 39.5% and carotid plaque in 56.0%. In men, coronary artery calcium score >0 ranged from 40.7-65.9% and presence of carotid plaques from 54.5% to 72.8% in the age group 50-54 and 60-65 years, respectively. In women, the corresponding difference was from 17.1-38.9% and from 41.0-58.4%. A doubling of Systematic Coronary Risk Evaluation was associated with an increased probability to have coronary artery calcium score >0 (odds ratio: 2.18 (95% confidence interval 2.07-2.30)) and to have >1 carotid plaques (1.67 (1.61-1.74)). Conclusion Systematic Coronary Risk Evaluation estimated risk is associated with prevalent subclinical atherosclerosis in two major vascular beds in a general population sample without established cardiovascular disease or diabetes mellitus. Thus, the Systematic Coronary Risk Evaluation risk chart may be of use for estimating the risk of subclinical atherosclerosis.
  •  
47.
  • Otterheim, Maria, et al. (författare)
  • Complications 8 weeks after an obstetric second-degree perineal laceration in relation to body mass index
  • 2024
  • Ingår i: International Urogynecology Journal. - : SPRINGER LONDON LTD. - 0937-3462 .- 1433-3023. ; 35:1, s. 77-84
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction and hypothesisHow body mass index (BMI) affects pelvic floor function after a second-degree perineal laceration is unknown. The hypothesis of this study is that pelvic floor dysfunction and complications after an obstetric second-degree perineal laceration are more common in women with a higher BMI 8 weeks postpartum.MethodsThis register-based cohort study includes 10,876 primiparous women with an obstetric second-degree perineal laceration between 2014 and 2021. Data were retrieved from the Swedish Perineal Laceration Registry. Outcomes in relation to maternal BMI were urinary incontinence (UI), anal incontinence (AI) and common complications attributable to the laceration. Uni- and multivariate logistic regressions were used for comparison between normal weight (BMI < 24.9, reference), overweight (25.0-29.9) and obese (& GE; 30) women.ResultsMultivariate analyses showed an increased risk for UI in both overweight and obese women compared to normal-weight women 8 weeks after a second-degree perineal laceration with an adjusted odds ratio (aOR) of 1.21 (CI 1.02-1.44) and 1.27 (CI 1.13-1.58) respectively. Overweight and obese women had a decreased risk for AI (aOR 0.81, CI 0.68-0.96; aOR 0.72, CI 0.57-0.90 respectively) compared with normal-weight women. No significant differences were found in the univariate analyses over BMI strata concerning complications after perineal laceration.ConclusionsPrimiparous overweight and obese women report less AI and more UI than normal-weight women 8 weeks after a second-degree perineal laceration. No differences were found regarding complications. These findings are new and merit further study to find potential preventive factors and interventions after a second-degree perineal laceration.
  •  
48.
  • Pettersson, Miriam, 1977-, et al. (författare)
  • Home phototherapy for hyperbilirubinemia in neonates : an unblinded multicentre randomised controlled trial
  • 2023
  • Ingår i: Örebro University's Nobel Day Festivities. - 9789187789922
  • Konferensbidrag (refereegranskat)abstract
    • Background/Objective: The aim of this study was to assess whether home phototherapy is a safe alternative to hospital treatment.Method: This was a randomised controlled, multicentre, trial in which term newborns with a total serum bilirubin of 300-400 μmol/ were randomized to either home phototherapy or conventional in-hospital phototherapy.The outcome measurements were parent-infant bonding, stress and measurements of safety and feasibility. A descriptive qualitative study based on interviews was performed as well as a health economic analysis.Result: 147 patients were recruited from 6 hospitals, Results showed no difference between groups in the safety and feasibility outcomes. Parents in the intervention group had better scores on bonding and lower levels of stress. The interviews showed that parents felt secure at home. The cost per patient was €337 for home phototherapy compared with €1156 for the hospital alternative indicating average cost savings of €819 or 71% per patient.Conclusion: Home phototherapy can be considered a safe and feasible alternative to hospital care for well selected patients. It improves bonding and stress for parents and reduces health care costs. Since the first publication from this study was published home phototherapy is now recommended by the American Academy of Pediatrics as an alternative to hospital care for patients with uncomplicated hyperbilirubinemia.
  •  
49.
  • Pihl, Sofia, et al. (författare)
  • Internal anal sphincter injury in the immediate postpartum period; Prevalence, risk factors and diagnostic methods in the Swedish perineal laceration registry
  • 2020
  • Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - Amsterdam : Elsevier. - 0301-2115 .- 1872-7654. ; 245, s. 1-6
  • Tidskriftsartikel (refereegranskat)abstract
    • Risk factors for obstetric external anal sphincter injury are well known. Maternal and obstetric risk factors for internal anal sphincter injury are not extensively studied.The rationale of this study was to evaluate the proportion of internal anal sphincter injury in women with external anal sphincter injury, diagnosed immediately after delivery.This study will assess whether there are additional risks for obstetric internal anal sphincter injury.ObjectivesThe primary aim was to assess the proportion of internal anal sphincter injury immediately in women with an external sphincter injury and to evaluate maternal and obstetric risk factors for internal anal sphincter injury in women with an external anal sphincter injury only.A secondary aim was to relate the diagnostic methods used for obstetric perineal lacerations to the presence of an internal anal sphincter injury.Study DesignA registry study with data from the Swedish Perineal Laceration Registry 2014–2018.From the registry, the maternal and obstetric characteristics of 3,333 primiparous women with isolated external (N = 2,236) versus both external and internal (N = 1,097) anal sphincter injuries were studied, as were the methods used for examining the obstetric anal sphincter injuries.ResultsIn 32.9 % (1,097/3,333) of primiparous women with an external anal sphincter injury, an internal anal sphincter injury was diagnosed immediately after delivery. A perineal palpatory thickness of less than 10 mm was a diagnostic sign for internal sphincter injury. Well-known risk factors associated with obstetric anal sphincter injuries could not be confirmed as independent risk factors for internal sphincter injury. When the infant is born with an arm beside the head, there is an almost two-fold increased risk for internal sphincter injury.ConclusionsOur main finding is that 32.9 % of women with external anal sphincter injury also have an internal anal sphincter injury. A palpable perineal thickness of less than 10 mm, a degree 4-laceration and an infant born with a hand by the head increases the risk of internal sphincter injury and should be a clinical warning sign.
  •  
50.
  • Runngren, Eva, 1963-, et al. (författare)
  • Attitudes and knowledge about HPV vaccination of school children and their parents following a targeted information
  • 2022
  • Konferensbidrag (refereegranskat)abstract
    • Background/Objective: This study aimed to investigate children’s’ and parents’attitudes and knowledge about HPV (human papilloma virus) following introductionof gender neutral HPV vaccination in the national immunization program (NIP) inSweden. An evaluation of a tailored information package for parents and childrenlaunched by the Public Health Agency (PHAS) alongside the introduction of genderneutral HPV vaccination was also performed.Method: In total, 276 parents and 206 children from 22 School Health Servicesresponded to a web-based survey, spring 2021 to January 2022.Result: Overall, parents (78%) perceived HPV vaccination to be of importance fortheir child’s health. About half of the participating children and two thirds of theparents had used the tailored information package for the HPV vaccination. The factsheet was mostly used by parents (55%) and children (20%) and also perceived as easyto understand (99% and 68% respectively). For both children and parents the schoolnurse (70% respectively) was the primary source for information. The teacher (59%)was also a common source of information of HPV vaccination for the children.Conclusion: The school health nurse is essential for informing about HPV vaccinationfor both children and parents. There is a need to strengthen the knowledge regardingHPV vaccination among teachers as they also are a key source of information for themajority of the children. Additional interventions are needed to support parents inmaking informed decisions for HPV vaccinations.POSTER 1Page 1
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-50 av 56
Typ av publikation
tidskriftsartikel (42)
konferensbidrag (4)
bokkapitel (4)
doktorsavhandling (2)
samlingsverk (redaktörskap) (1)
forskningsöversikt (1)
visa fler...
licentiatavhandling (1)
recension (1)
visa färre...
Typ av innehåll
refereegranskat (43)
övrigt vetenskapligt/konstnärligt (11)
populärvet., debatt m.m. (2)
Författare/redaktör
Blomberg, Anders, 19 ... (13)
Blomberg, Eva, 1961- (11)
Blomberg, Karin, 197 ... (8)
Lindberg, Eva (8)
Eriksson, Mats, Prof ... (7)
Engvall, Jan (7)
visa fler...
Lindberg, Anne (7)
Odnevall, Inger, 196 ... (6)
Odnevall Wallinder, ... (6)
Östgren, Carl Johan (6)
Blomberg, Eva, 1952- (6)
Wollmer, Per (5)
Bergström, Göran, 19 ... (5)
Sundström, Johan, Pr ... (5)
Hagström, Emil (5)
Jernberg, Tomas (5)
Swahn, Eva (5)
Backman, Helena (5)
Engström, Gunnar (4)
Nilsson, Ulf (4)
Angerås, Oskar, 1976 (4)
Torén, Kjell, 1952 (4)
Andersson, Anders (4)
Malinovschi, Andrei, ... (4)
Persson, Margaretha (4)
Rosengren, Annika, 1 ... (4)
Hedman, Linnea, 1979 ... (4)
Blomberg, Eva (4)
Persson, Anders (4)
Söderberg, Stefan (4)
Stridsman, Caroline (4)
Tanash, Hanan (4)
Brandberg, John, 196 ... (4)
Cederlund, Kerstin (4)
Janson, Christer (3)
Lind, Lars (3)
Erlinge, David (3)
Rönmark, Eva (3)
Persson, Lennart (3)
Goncalves, Isabel (3)
Ostenfeld, Ellen (3)
Cedervall, Tommy (3)
Hjelmgren, Ola (3)
Mannila, Maria (3)
Blomberg, Marie (3)
Fagman, Erika (3)
Khort, Aliaksandr, D ... (3)
Duvernoy, Olov (3)
Torén, Kjell (3)
Lilliecreutz, Caroli ... (3)
visa färre...
Lärosäte
Karolinska Institutet (22)
Umeå universitet (15)
Kungliga Tekniska Högskolan (15)
Linköpings universitet (15)
Lunds universitet (12)
Göteborgs universitet (11)
visa fler...
Uppsala universitet (11)
Örebro universitet (9)
Södertörns högskola (6)
RISE (5)
Luleå tekniska universitet (3)
Högskolan Kristianstad (1)
Gymnastik- och idrottshögskolan (1)
visa färre...
Språk
Engelska (50)
Svenska (6)
Forskningsämne (UKÄ/SCB)
Medicin och hälsovetenskap (34)
Naturvetenskap (11)
Teknik (6)
Humaniora (6)

År

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy