| 1. |
- Fava, Cristiano, et al.
(författare)
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A genetic risk score for hypertension associates with the risk of ischemic stroke in a Swedish case-control study
- 2015
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Ingår i: European Journal of Human Genetics. - : Springer Science and Business Media LLC. - 1018-4813 .- 1476-5438. ; 23, s. 969-974
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Tidskriftsartikel (refereegranskat)abstract
- Genetic risk scores (GRS), summing up the total effect of several single-nucleotide polymorphisms (SNPs) in genes associated with either coronary risk or cardiovascular risk factors, have been tested for association with ischemic stroke with conflicting results. Recently an association was found between a GRS based on 29 SNPs discovered by genome-wide association studies and hypertension. The aim of our study was to investigate the possible association of the same GRS with ischemic stroke on top of other ‘traditional risk factors’, also testing its potential improvement in indices of discrimination and reclassification, in a Swedish case–control study. Twenty-nine SNPs were genotyped in 3677 stroke cases and 2415 controls included in the Lund Stroke Register (LSR), the Malmö Diet and Cancer (MDC) study and the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). The analysis was conducted in the combined sample, and separately for the three studies. After adjustment for hypertension, diabetes mellitus and smoking habits, the GRS was associated with ischemic stroke in the combined sample (OR (95% CI) 1.086 (1.029–1.147) per SD increase in the GRS P=0.003) with similar trends in all three samples: LSR (1.050 (0.967–1.140); P=0.25), MDC (1.168 (1.060–1.288); P=0.002) and SAHLSIS (1.124 (0.997–1.267); P=0.055). Measures of risk discrimination and reclassification improved marginally using the GRS. A blood pressure GRS is independently associated with ischemic stroke risk in three Swedish case–control studies, however, the effect size is low and adds marginally to prediction of stroke on top of traditional risk factors including hypertension.
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| 2. |
- Grunditz, Sofia, 1973-
(författare)
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Vilan i förskolan 1910-2013 : Visuella material och visuell metodologi
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to explore preschool naptime during the period 1910–2013 through visual materials, films and photographs produced by different actors for various purposes at various historical times, and to develop a visual methodology that works with complex visual materials. Even though naptime is central to everyday life in preschool, it is an activity that is rarely a focus of Early Childhood Education research. The empirical data derives from two separate but interrelated studies, the first a video ethnographic field study and the second an archival ethnographic study. Both studies include films and photographs that visualise the material environments and social interactions that take place during preschool naptime.A theoretical framework based on ethnomethodology, visual studies, childhood studies and the history of childhood studies is used. The concept the look of is a theoretical and analytical focus as the photographic image contains visual information about what things and actions look like. The look of children’s and adults’ participation in naptime, the material objects and the preschool environment are the focus when scrutinising the visual data of the study to gain knowledge about how embodied actions, along with the material and spatial design of the preschool environment, form practices at naptime. The thesis takes a post-positivist stance towards the photographic image.A transdisciplinary methodology, the visual remake, is developed for visual analysis and is used as a tool for comparisons, visualisation of results and reflection. A visual remake maintains the visual aspects of the data in order to keep them visible throughout the research process. It is a tool that visualises observable findings and conceptualises a reflection process through images, and not exclusively via the written word.The study provides knowledge about everyday life in preschool. The results show how the material and spatial organisation of the room and the participants’ embodied actions in this environment constitute naptime in both historical and contemporary preschools. There are recurrent patterns in the social interaction, as well as similarities in the design of the environment that are stable over time. These are the ways in which the participants use their bodies and interact through embodied interactions. The comparative visual analyses, focusing on continuity and change, suggest that some of these practices can be theorised as path-dependent. The present-day study shows that children constitute a peer culture within naptime, often through secondary adjustments to institutional and adult-structured order. Although the ideal naptime is visualised in the historical materials, it is possible to trace the same sort of naptime peer culture. There are features in the design of the beds used during preschool naptime that are typical of the preschool institution, and this design and the overall organisation of naptime have a path-dependence to ideals in the half-day preschools.Methodologically, the thesis expands our knowledge of how different visual materials can serve as sources in ECE research and how a research design focusing on the comparison of present-day and historical data opens up space for new research questions.
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| 3. |
- Gårdfeldt, Katarina, 1959, et al.
(författare)
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SWEDARCTIC Arctic Ocean 2016: Expedition Report
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Key words: Nyckelord [sv]geophysical mapping, seismic reflection, seismic refraction, water column imaging, physical oceanography, heavy metals, mercury, microplastics, trace gases, biogeochemistry, dredging, sediment coring, sediment properties, meteorology, atmospheric boundary-layer, surface fluxes, ice management, ice thickness, polar on stage
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| 4. |
- Hallén, Katarina, et al.
(författare)
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A simple method for isocapnic hyperventilation evaluated in a lung model.
- 2016
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 60:5, s. 597-606
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Tidskriftsartikel (refereegranskat)abstract
- Isocapnic hyperventilation (IHV) has the potential to increase the elimination rate of anaesthetic gases and has been shown to shorten time to wake-up and post-operative recovery time after inhalation anaesthesia. In this bench test, we describe a technique to achieve isocapnia during hyperventilation (HV) by adding carbon dioxide (CO2 ) directly to the breathing circuit of a standard anaesthesia apparatus with standard monitoring equipment.
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| 5. |
- Hallén, Katarina, et al.
(författare)
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Evaluation of a method for isocapnic hyperventilation: a clinical pilot trial.
- 2018
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 62:2, s. 186-195
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Tidskriftsartikel (refereegranskat)abstract
- Isocapnic hyperventilation (IHV) is a method that shortens time to extubation after inhalation anaesthesia using hyperventilation (HV) without lowering airway CO2 . In a clinical trial on patients undergoing long-duration sevoflurane anaesthesia for major ear-nose-throat (ENT) surgery, we evaluated the utility of a technique for CO2 delivery (DCO2 ) to the inspiratory limb of a closed breathing circuit, during HV, to achieve isocapnia.Fifteen adult ASA 1-3 patients were included. After end of surgery, mechanical HV was started by doubling baseline minute ventilation. Simultaneously, CO2 was delivered and dosed using a nomogram developed in a previous experimental study. Time to extubation and eye opening was recorded. Inspired (FICO2 ) and expired (FETCO2 ) CO2 and arterial CO2 levels were monitored during IHV. Cognition was tested pre-operatively and at 20, 40 and 60 min after surgery.A DCO2 of 285 ± 45 ml/min provided stable isocapnia during HV (13.5 ± 4.1 l/min). The corresponding FICO2 level was 3.0 ± 0.3%. Time from turning off the vaporizer (1.3 ± 0.1 MACage) to extubation (0.2 ± 0.1 MACage) was 11.3 ± 1.8 min after 342 ± 131 min of anaesthesia. PaCO2 and FETCO2 remained at normal levels during and after IHV. In 85% of the patients, post-operative cognition returned to pre-operative values within 60 min.In this cohort of patients, a DCO2 nomogram for IHV was validated. The patients were safely extubated shortly after discontinuing long-term sevoflurane anaesthesia. Perioperatively, there were no adverse effects on arterial blood gases or post-operative cognition. This technique for IHV can potentially be used to decrease emergence time from inhalation anaesthesia.
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| 6. |
- Hallén, Katarina, et al.
(författare)
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Isocapnic hyperventilation provides early extubation after head and neck surgery: A prospective randomized trial
- 2018
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 62:8, s. 1064-1071
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIsocapnic hyperventilation (IHV) shortens recovery time after inhalation anaesthesia by increasing ventilation while maintaining a normal airway carbon dioxide (CO2)-level. One way of performing IHV is to infuse CO2 to the inspiratory limb of a breathing circuit during mechanical hyperventilation (HV). In a prospective randomized study, we compared this IHV technique to a standard emergence procedure (control). MethodsThirty-one adult ASA I-III patients undergoing long-duration (>3hours) sevoflurane anaesthesia for major head and neck surgery were included and randomized to IHV-treatment (n=16) or control (n=15). IHV was performed at minute ventilation 13.64.3L/min and CO2 delivery, dosed according to a nomogram tested in a pilot study. Time to extubation and eye-opening was recorded. Inspired (FICO2) and expired (FETCO2) CO2 and arterial CO2 levels (PaCO2) were monitored. Cognition was tested preoperatively and at 20, 40 and 60minutes after surgery. ResultsTime from turning off the vapourizer to extubation was 13.7 +/- 2.5minutes in the IHV group and 27.4 +/- 6.5minutes in controls (P<.001). Two minutes after extubation, PaCO2 was 6.2 +/- 0.5 and 6.2 +/- 0.6 kPa in the IHV and control group respectively. In 69% (IHV) vs 53% (controls), post-operative cognition returned to pre-operative values within 40 minutes after surgery (NS). Incidences of pain and nausea/vomiting did not differ between groups. ConclusionsIn this randomized trial comparing an IHV method with a standard weaning procedure, time to extubation was reduced with 50% in the IHV group. The described IHV method can be used to decrease emergence time from inhalation anaesthesia.
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| 7. |
- Hallén, Katarina, et al.
(författare)
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Isocapnic hyperventilation shortens washout time for sevoflurane - an experimental in vivo study
- 2016
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 60:9, s. 1261-1269
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIsocapnic hyperventilation (IHV) is a method that fastens weaning from inhalation anaesthesia by increasing airway concentration of carbon dioxide (CO2) during hyperventilation (HV). In an animal model, we evaluated a technique of adding CO2 directly to the breathing circuit of a standard anaesthesia apparatus. MethodsEight anaesthetised pigs weighing 28 2 kg were intubated and mechanically ventilated. From a baseline ventilation of 5 l/min, HV was achieved by doubling minute volume and fresh gas flow. Respiratory rate was increased from 15 to 22/min. The CO2 absorber was disconnected and CO2 was delivered (DCO2) to the inspiratory limb of a standard breathing circuit via a mixing box. Time required to decrease end-tidal sevoflurane concentration from 2.7% to 0.2% was defined as washout time. Respiration and haemodynamics were monitored by blood gas analysis, spirometry, electric impedance tomography and pulse contour analysis. ResultsA DCO2 of 261 +/- 19 ml/min was necessary to achieve isocapnia during HV. The corresponding FICO2-level remained stable at 3.1 +/- 0.3%. During IHV, washout of sevoflurane was three times faster, 433 +/- 135 s vs. 1387 +/- 204 s (P < 0.001). Arterial CO2 tension and end-tidal CO2, was 5.2 +/- 0.4 kPa and 5.6 +/- 0.4%, respectively, before IHV and 5.1 +/- 0.3 kPa and 5.7 +/- 0.3%, respectively, during IHV. ConclusionsIn this experimental in vivo model of isocapnic hyperventilation, the washout time of sevoflurane anaesthesia was one-third compared to normal ventilation. The method for isocapnic hyperventilation described can potentially be transferred to a clinical setting with the intention to decrease emergence time from inhalation anaesthesia.
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| 8. |
- Hanberger, Anders, 1953-, et al.
(författare)
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Tillsyn och öppna jämförelser : exemplet äldreomsorgen
- 2015
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Konferensbidrag (populärvet., debatt m.m.)abstract
- Äldreomsorg har genom olika former av utvärdering fått avsevärt ökad uppmärksamhet i media och politisk debatt. I denna session diskuteras vilka konsekvenser som två dominerande former av utvärdering – tillsyn och öppna jämförelser – har för äldreomsorgens styrning, ansvarsutkrävande och verksamhetsutveckling. Sessionen utgår från resultat från ett Forte-finansierat forskningsprojekt om användning av utvärdering i äldreomsorgen.
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| 9. |
- Irewall, Anna-Lotta, 1987-
(författare)
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Recurrent events and secondary prevention after acute cerebrovascular disease
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Patients who experience a stroke or transient ischemic attack (TIA) are at high risk of recurrent stroke, but little is known about temporal trends in unselected populations. Reports of low adherence to recommended treatments indicate a need for enhanced secondary preventive follow-up to achieve the full potential of evidence-based treatments. In addition, socioeconomic factors have been associated with poor health outcomes in a variety of contexts. Therefore, it is important to assess the implementation and results of secondary prevention in different socioeconomic groups.Aims The aims of this thesis were to assess temporal trends in ischemic stroke recurrence and evaluate the implementation and results of a nurse-led, telephone-based follow-up program to improve blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels after stroke/TIA.Methods In study I, we collected baseline data for unique patients with an ischemic stroke event between 1998 and 2009 (n=196 765) from the Swedish Stroke Register (Riksstroke). Recurrent ischemic stroke events within 1 year were collected from the Swedish National Inpatient Register (IPR) and the cumulative incidence was compared between four time periods using the Kaplan-Meier survival analysis and the logrank test. Implementation (study II) and 1-year results (study III-IV) for the secondary preventive follow-up were studied in the NAILED (Nurse-based Age-independent Intervention to Limit Evolution of Disease) study. Between 1 Jan 2010 and 31 Dec 2013, the baseline characteristics of consecutive patients admitted to Östersund Hospital for acute stroke or TIA were collected prospectively (n=1776). Consenting patients in a condition permitting telephone-based follow-up were randomized to nurse-led, telephone-based follow-up or follow-up according to usual care. Follow-up was cunducted at 1 and 12 months after discharge and the intervention included BP and LDL-C measurements, titration of medication, and lifestyle counseling. In study II, we analyzed factors associated with non-participation in the randomized phase of the NAILED study, including association with education level. In addition, we compared the 1-year prognosis in terms of cumulative survival between participants and non-participants. In study III, we compared differences in BP and LDL-C levels between the intervention and control groups during the first year of follow-up and, in study IV, in relation to level of education (low, ≤10 years; high, >10 years).Results The cumulative 1-year incidence of recurrent ischemic stroke decreased from 15.0% to 12.0%. Among surviving stroke and TIA patients, 53.1% were included for randomization, 35.7% were excluded mainly due to physical or cognitive disability, and 11.2% declined participation in the randomized phase. A low level of education was independently associated with exclusion, as well as the patient’s decision to abstain from randomization. Excluded patients had a more than 12-times higher risk of death within 1 year than patients who were randomized. After 1 year of follow-up, the mean systolic BP, diastolic BP, and LDL-C levels were 3.3 mmHg (95% CI 0.3 to 6.3), 2.3 mmHg (95% CI 0.5 to 4.2), and 0.3 mmol/L (95% CI 0.1 to 0.4) lower in the intervention group than among controls. Among participants with values above the treatment goal at baseline, the differences in systolic BP and LDL-C levels were more pronounced (8.0 mmHg, 95% CI 4.0 to 12.1; 0.6 mmol/L, 95% CI 0.4 to 0.9). In the intervention group, participants with a low level of education achieved similar or larger improvements in BP and LDL-C than participants with a high level of education. In the control group, BP remained unaltered and the LDL-C levels increased among participants with a low level of education.Conclusion The 1-year risk of ischemic stroke recurrence decreased in Sweden between 1998 and 2010. Nurse-led, telephone-based secondary preventive follow-up is feasible in just over half of the survivors of acute stroke and TIA and achieve better than usual care in terms of BP and LDL-C levels, and equality in BP improvements across groups defined by education level. However, a large proportion of stroke survivors are in a general condition precluding this form of follow-up, and their prognosis in terms of 1-year survival is poor. Patients with a low education level are over-represented within this group and among patients declining randomization for secondary preventive follow-up.
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| 10. |
- Johansson, Björn Axel, et al.
(författare)
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Implementing a salutogenic treatment model in a clinical setting of emergency child and adolescent psychiatry in Sweden
- 2018
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Ingår i: Journal of Child and Adolescent Psychiatric Nursing. - : John Wiley & Sons. - 1073-6077 .- 1744-6171. ; 31:2-3, s. 79-86
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Tidskriftsartikel (refereegranskat)abstract
- PROBLEM: Emergency care in child and adolescent psychiatry often lacks a coherent treatment model. This study reports on the development and implementation of a salutogenic treatment model at the Child & Adolescent Psychiatric Emergency Unit in Malmo, Sweden. METHODS: The development and implementation involved all staff categories and was guided by a recognized authority on salutogenesis. Generalized resistance resources (GRR) were identified that could be implemented at the unit to improve patients' sense of coherence. FINDINGS: Eight GRR were developed and implemented at the unit. During the 6-month period following the implementation, patients (n = 41) and parents reported satisfaction with the treatment, while mental health improved between admission and discharge, and both treatment length and readmission rates were reduced. CONCLUSION: A salutogenic treatment model involving GRR seems to be a promising approach in child and adolescent psychiatric emergency treatment.
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| 11. |
- Johnsen, Annika, et al.
(författare)
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Literature review on the acceptance and road safety, ethical, legal, social and economic implications of automated vehicles
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This deliverable summarizes the findings of an extensive literature review on the acceptance, behavioural intentions, road safety, as well as ethical, legal, social (ELSI) and economic considerations in the scope of vehicle automation.The theoretical fundaments and relevant findings of recent public opinion research regarding user acceptance of automation are presented. Also the view of organised stakeholders is taken into account.Regarding road safety there is a potential for increased road safety but drivers tend to pick up non-related driving tasks instead. These problems are due to several traditional HMI concerns. In the future autonomous cars must make decisions that touch on ethical issues that have not yet been sufficiently and transparently discussed. Although in many countries legislation is now reacting to the new technology, many aspects – like liability and privacy / data protection – are not yet regulated by law. Automated vehicles promise to have several clear benefits that might change the entire transport system. The positive externalities that come from the technological advantages of automated vehicles might be outweighed by the negative externalities coming from the potential increases in travelling by private vehicles.
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| 12. |
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| 13. |
- Jour, Pia, et al.
(författare)
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Decreased water usage in a softwood ECF bleaching sequence : full mill simulations
- 2018
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Ingår i: TAPPI Journal. - : TAPPI. - 0734-1415. ; 17:6, s. 353-360
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Tidskriftsartikel (refereegranskat)abstract
- In this study, an elemental chlorine free (ECF) bleach plant with a D0(EOP)D1(EP)D2 sequence was studied with the aim of identifying options for significantly decreasing (fresh) water usage in the bleach plant and decreasing the effluent volume. A base-case simulation model for a softwood kraft market pulp mill was made based on a reference model representing the best available techniques as well as data produced in an extensive laboratory pulp bleaching study. This model was used to evaluate increased closure within the bleach plant and the recirculation of bleach plant effluent to the brownstock system and their effects on both the bleach plant and the recovery cycle. The results indicate that it is possible to reduce the fresh water consumption from 15 metric tons/a.d. metric ton in the base case to about 2 metric tons/a.d. metric ton, without increasing the carryover of chemical oxygen demand (COD) to the pulp machine. Nonprocess elements in wood contribute to the levels of metals found in the bleach plant and thus to the risk of precipitates such as calcium oxalate, barium sulfate, and calcium carbonate. The risk of precipitates forming is a key factor determining the possible degree of closure. In addition, chloride concentration in the black liquor is another important factor that is affected by recirculating bleach plant filtrate to the brownstock washer and by the grade of the sodium hydroxide used in the mill.
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| 14. |
- Jour, Pia, et al.
(författare)
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ECF bleaching of eucalyptus kraft pulp : simulation of a mill with a high degree of closure
- 2017
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Ingår i: International pulp bleaching conference. - : Suprema Grafica e Editora. - 9788581791340 ; , s. 106-110
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The composition of non-process elements (NPEs) in wood significantly affects the level of metals in the pulp in the bleach plant and contributes to the risk of forming precipitates. The possible degree of closure is often limited by calcium oxalate formation, mainly around the D0-stage, which can be prevented by increasing the temperature and/or decreasing the pH in this stage. This paper presents the effect of a decreased pH in the D0-stage when bleaching a eucalyptus kraft pulp as well as the influence it has on environmental parameters such as chemical oxygen demand (COD) and adsorbable organic halogens (AOX). The increased AOX measured when applying a low pH in the D0-stage was shown to be easily decomposed under process conditions. To be able to predict the effect on both the recovery cycle and the bleach plant itself as a consequence of increased closure of the bleach plant, a full mill simulation model (WinGEMS) was used based on a theoretical mill using the best available technology (BAT) in combination with data produced in laboratory trials. The model pulp mill was exclusively equipped with wash presses. According to the simulations, the effluent volume could be significantly decreased from 20.7 t/air dry tonne (ADt) pulp to 8.7 t/ADt in a D(EOP)DP sequence. Using a wood raw material with a calcium content of 520 mg/kg dry solids, no formation of calcium oxalate was predicted. However, for a wood raw material with a higher content, 800 mg/kg, calcium oxalate formation was likely to occur. By decreasing the final pH in the D0-stage from 3.0 to 2.5, formation of calcium oxalate could be avoided. At the effluent volume of 8.7 t/ADt, no fresh water was used in the bleach plant except for the water used for dilution of chemicals.
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| 15. |
- Kulén, Martina, et al.
(författare)
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Methyl sulfonamide substituents improve the pharmacokinetic properties of bicyclic 2-pyridone based Chlamydia trachomatis inhibitors
- 2019
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Ingår i: MedChemComm. - : Royal Society of Chemistry. - 2040-2503 .- 2040-2511. ; 10:11, s. 1966-1987
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Tidskriftsartikel (refereegranskat)abstract
- Chlamydia trachomatis infections are a global health problem and new approaches to treat C. trachomatis with drugs of high specificity would be valuable. A library of substituted ring fused 2-pyridones has been synthesized and evaluated for their ability to attenuate C. trachomatis infectivity. In vivo pharmacokinetic studies were performed, with the best candidates demonstrating that a C8-methylsulfonamide substituent improved pharmacokinetic properties important for oral administration. C8-Methyl sulfonamide analogue 30 inhibited C. trachomatis infectivity in low micromolar concentrations. Further pharmacokinetic evaluation at an oral dose of 10 mg kg(-1) showed an apparent bioavailability of 41%, compared to C8-cyclopropyl and -methoxy analogues which had negligible oral uptake. In vitro ADME (absorption, distribution, metabolism and excretion) testing of solubility and Caco-2 cell permeability revealed that both solubility and permeability is greatly improved with the C8-methyl sulfonamide 30, effectively moving it from BCS (Biopharmaceutical Classification System) class IV to II.
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| 16. |
- Lagging, Cecilia, et al.
(författare)
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APOE ε4 is associated with younger age at ischemic stroke onset but not with stroke outcome
- 2019
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Ingår i: Neurology. - 1526-632X. ; 93:19, s. 849-853
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Tidskriftsartikel (refereegranskat)abstract
- Stroke outcome is determined by a complex interplay, where age and stroke severity are predominant predictors. Studies on hemorrhagic stroke indicate that APOE genotype is a predictor of poststroke outcomes,1,2 but results from studies on ischemic stroke are more conflicting.1,3 There is 1 study suggesting an influence of APOE genotype on age at ischemic stroke onset,4 and sex-specific effects on outcome have been reported.5 Taken together, there is a need for larger studies on APOE and ischemic stroke outcomes with integrated information on age, severity, and sex.The 3 common APOE alleles ε2, ε3, and ε4 can be separated by a combination of 2 single nucleotide polymorphisms (SNPs), rs429358 and rs7412. Thus, associations with APOE alleles are not directly captured in a regular genome-wide association study (GWAS), where each SNP is investigated separately. We derived the 3 common APOE alleles and investigated the interplay between APOE, age at ischemic stroke onset, severity, sex, and outcome within a large international collaboration, the Genetics of Ischaemic Stroke Functional Outcome (GISCOME) network.
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| 17. |
- Lindblom, Anders, et al.
(författare)
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Prevalence of Rickettsia spp. in Ticks and Serological and Clinical Outcomes in Tick-Bitten Individuals in Sweden and on the Åland Islands
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:11
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Tidskriftsartikel (refereegranskat)abstract
- Tick-transmitted diseases are an emerging health problem, and the hard tick Ixodes ricinus is the main vector for Borrelia spp., tick-borne encephalitis virus and most of the spotted fever Rickettsiae in Europe. The aim of the present study was to examine the incidence of rickettsial infection in the southernmost and south central parts of Sweden and the Aland Islands in Finland the risk of infection in humans and its correlation with a bite of a Rickettsia-infected tick, the self-reported symptoms of rickettsial disease, and the prevalence of co-infection between Rickettsia spp. and Borrelia spp. Persons with a recent tick bite were enrolled through public media and asked to answer a questionnaire, provide a blood sample and bring detached ticks at enlistment and at follow-up three months later. Blood samples were previously analysed for Borrelia spp. antibodies and, for this report, analysed for antibodies to Rickettsia spp. by immunofluorescence and in 16 cases also using Western Blot. Ninety-six (44.0%) of the 218 participants were seropositive for IgG antibodies to Rickettsia spp. Forty (18.3%) of the seropositive participants had increased titres at the follow-up, indicating recent/current infection, while four (1.8%) had titres indicating probable recent/current infection (>= 1: 256). Of 472 ticks, 39 (8.3%) were Rickettsia sp. positive. Five (31.3%) of 16 participants bitten by a Rickettsia-infected tick seroconverted. Experience of the selfreported symptoms nausea (p = 0.006) and radiating pain (p = 0.041) was more common among those with recent, current or probable infection compared to those who did not seroconvert. Participants who showed seroreactivity or seroconversion to Rickettsia spp. had more symptoms than those who were seronegative. Seven (3.2%) participants showed seroconversion to Borrelia spp., and three (1.4%) of these showed seroconversion to both Rickettsia spp. and Borrelia spp., in accordance with previous studies in Sweden. Symptoms of rickettsial disease were in most of the cases vague and general that were difficult to differentiate from other tick-borne diseases.
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| 18. |
- Lindgren, Eva-Carin M, et al.
(författare)
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Voices from Pupil Participation in the Health Promotion Intervention "Pulse for Learning and Health PuLH" in Primary and Middle School
- 2019
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI AG. - 1660-4601 .- 1661-7827. ; 16:22
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Tidskriftsartikel (refereegranskat)abstract
- In order to improve the learning conditions and health of schoolchildren, the Pulse for Learning and Health [PuLH] program in Sweden has introduced additional mandatory moderate to vigorous physical activity [MVPA] that lasts for 30 min three times a week. The PE teachers used a child-centered coaching approach to support all pupils. The aim of this study was to explore pupils' perception and experience of PuLH that has been implemented in primary and middle schools in Sweden. We have taken into account children's rights perspectives and adopted an exploratory and interpretive approach. In total, 73 pupils (34 girls, 39 boys, grades 4-9) were recruited through purposive sampling. 13 focus group interviews (n = 71) and individual interviews (n = 2) were carried out. All interviews were analyzed using qualitative content analysis. The analysis resulted in three major themes: 'promotes academic performance and a learning school environment', 'promotes health and well-being', and 'individual and structural barriers'. From children's perspective, the results highlight the importance of teachers and principals taking into account the interests and needs of all pupils, to have a well-planned MVPA intervention and to deal with issues regarding body ideals.
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| 19. |
- Lindgren, Eva-Carin, 1962-, et al.
(författare)
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‘Pulse for learning and health [PuLH]’ in primary school; pupil’s experiences
- 2019
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Konferensbidrag (refereegranskat)abstract
- To improve academic performance and health in schoolchildren, the program Pulse for learning and health [PuLH] in Sweden has introduced moderate to vigorous physical activities [MVPA] three times a week (á 30 minutes). The teachers used a child-centered coaching approach, which has the child’s best interests in mind and focused on having fun. The objective of this contribution is to describe what Swedish pupils convey, using their own voices, about their experiences of participating in the school-based program PuLH. We have taken on children’s perspectives in order to be able to understand the children’s own culture. Eight schools in the Region of Jönköping, Sweden, have implemented PuLH. In total, 73 pupils (34 girls, 39 boys, grades 4-9) were recruited through purposive sampling. Thirteen focus group interviews (n=71) and individual interviews (n=2) were carried out. An explorative design was employed, in which data were categorized using qualitative content analysis. The analysis resulted in four major themes, which we classify as ‘promotes academic performance’, ‘promotes a learning school environment’, ‘promotes health and well-being’, and ‘individual and structural barriers’. The pupils stated that they increased their working capacity, the classroom environment became more calm and peaceful, they got more cohesion and new friends, their needs and interest were in focus, they felt more alert and got in a better mood, they increased their physical competence, their habits became healthier and illness decreased. However, some of the pupils revealed individual and structural barriers, which reduced pleasure and motivation to participate in MVPA due to; poor planning and that they felt time pressure, felt uncomfortable showing their bodies and digital challenges. We recommend that schools take pupils’ interests and needs into consideration when planning for and implementing MVPA activities and not use MVPA as a 'quick fix' i.e. to solve complex problems regarding pupil's learning.
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| 20. |
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| 21. |
- Lindgren, Erik, 1993, et al.
(författare)
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Vocational outcome in cerebral venous thrombosis: Long-term follow-up study.
- 2018
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 137:3, s. 299-307
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have investigated long-term functional outcome in patients with cerebral venous thrombosis (CVT). We aimed to evaluate return to work (RTW) after CVT and its association with self-reported life satisfaction, quality of life, health, participation, fatigue, depression, and anxiety.From hospital records, we identified all patients diagnosed with CVT in Sahlgrenska University Hospital between 1996 and 2016 and invited all survivors to a clinical follow-up visit >1year after onset. Primary outcome was RTW within the follow-up period which was defined as ≥50% of gainful work or equivalent activity. Patients that were >62years when they developed CVT were excluded. Cox regression analyses identified associated factors to RTW and Mann-Whitney U tests compared distributions of self-reported questionnaires on life satisfaction and health.Of 62 eligible and consenting patients (median age: 41.5years (28.75-51.0); 61.3% female), 44 (71.0%) did RTW within the follow-up period (median 135months, IQR 64-197). Median time to RTW was 7.0months (IQR 1.4-12.7). Female sex (HR=0.50, 95% CI=0.25-0.99, P=.049) and parenchymal lesion detected during acute hospital stay (HR=0.45, 95% CI=0.24-0.82, P=.009) were significantly associated with no RTW. Patients with RTW reported significantly higher life satisfaction, quality of life, health, participation and lesser impact of fatigue, depression, and anxiety.Return to work after CVT is associated with higher life satisfaction, participation, and health. Parenchymal lesion in acute phase and female sex were associated with no RTW. Despite the young age of the patients, a significant portion did not regain working ability.
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| 22. |
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| 23. |
- Lindgren, Sophie, 1971, et al.
(författare)
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Comment on De Baerdemaeker et al.
- 2019
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 63:6, s. 833-834
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 24. |
- Maguire, Jane M., et al.
(författare)
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GISCOME – Genetics of Ischaemic Stroke Functional Outcome network : A protocol for an international multicentre genetic association study
- 2017
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Ingår i: European Stroke Journal. - : SAGE Publications. - 2396-9873 .- 2396-9881. ; 2:3, s. 229-237
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Genome-wide association studies have identified several novel genetic loci associated with stroke risk, but how genetic factors influence stroke outcome is less studied. The Genetics of Ischaemic Stroke Functional outcome network aims at performing genetic studies of stroke outcome. We here describe the study protocol and methods basis of Genetics of Ischaemic Stroke Functional outcome. Methods: The Genetics of Ischaemic Stroke Functional outcome network has assembled patients from 12 ischaemic stroke projects with genome-wide genotypic and outcome data from the International Stroke Genetics Consortium and the National Institute of Neurological Diseases Stroke Genetics Network initiatives. We have assessed the availability of baseline variables, outcome metrics and time-points for collection of outcome data. Results: We have collected 8831 ischaemic stroke cases with genotypic and outcome data. Modified Rankin score was the outcome metric most readily available. We detected heterogeneity between cohorts for age and initial stroke severity (according to the NIH Stroke Scale), and will take this into account in analyses. We intend to conduct a first phase genome-wide association outcome study on ischaemic stroke cases with data on initial stroke severity and modified Rankin score within 60–190 days. To date, we have assembled 5762 such cases and are currently seeking additional cases meeting these criteria for second phase analyses. Conclusion: Genetics of Ischaemic Stroke Functional outcome is a unique collection of ischaemic stroke cases with detailed genetic and outcome data providing an opportunity for discovery of genetic loci influencing functional outcome. Genetics of Ischaemic Stroke Functional outcome will serve as an exploratory study where the results as well as the methodological observations will provide a basis for future studies on functional outcome. Genetics of Ischaemic Stroke Functional outcome can also be used for candidate gene replication or assessing stroke outcome non-genetic association hypotheses.
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| 25. |
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| 26. |
- Mellroth, Elisabet, et al.
(författare)
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En forskningscirkel för lärare om särskild begåvning i matematik
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta är en rapport från en forskningscirkel med syfte att fördjupa lärares kunskaper kring teorier om matematisk begåvning, och att leda lärarna i att vetenskapligt utforska sin egen praktik gällande att identifiera och stödja matematiskt begåvade elever. Genom utökad kunskap om matematisk begåvning och genom olika identifieringsmetoder kunde lärarna ana vilka elever som var matematiskt begåvade. Dock var ingen helt säker på att alla identifierade elever var matematiskt begåvade eller att de hade hittat alla begåvade elever. För att stödja de matematiskt begåvade i det vanliga klassrummet lades stor vikt på uppgifter. Lärarna observerade hur två utprövade uppgifter fungerade för identifierade respektive icke-identifierade elever. Identifierade elever upplevde båda uppgifterna mer positivt, de icke-identifierade blev mer positiva till framförallt den ena uppgiften efter att ha arbetat med den. Vi har bekräftat att fortbildning inom matematisk begåvning underlättar för läraren i arbetet med att upptäcka de matematiskt begåvade. Arbetet i forskningscirkeln indikerar även att den typ av uppgifter som användes, tilltalar matematiskt begåvade elever och verkar ha en positiv effekt gällande intresse och glädje för matematik även för de elever som inte blev identifierade.
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| 27. |
- Pulit, SL, et al.
(författare)
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Loci associated with ischaemic stroke and its subtypes (SiGN): a genome-wide association study.
- 2016
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Ingår i: The Lancet. Neurology. - 1474-4465. ; 15:2, s. 174-84
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Tidskriftsartikel (refereegranskat)abstract
- The discovery of disease-associated loci through genome-wide association studies (GWAS) is the leading genetic approach to the identification of novel biological pathways underlying diseases in humans. Until recently, GWAS in ischaemic stroke have been limited by small sample sizes and have yielded few loci associated with ischaemic stroke. We did a large-scale GWAS to identify additional susceptibility genes for stroke and its subtypes.To identify genetic loci associated with ischaemic stroke, we did a two-stage GWAS. In the first stage, we included 16851 cases with state-of-the-art phenotyping data and 32473 stroke-free controls. Cases were aged 16 to 104 years, recruited between 1989 and 2012, and subtypes of ischaemic stroke were recorded by centrally trained and certified investigators who used the web-based protocol, Causative Classification of Stroke (CCS). We constructed case-control strata by identifying samples that were genotyped on nearly identical arrays and were of similar genetic ancestral background. We cleaned and imputed data by use of dense imputation reference panels generated from whole-genome sequence data. We did genome-wide testing to identify stroke-associated loci within each stratum for each available phenotype, and we combined summary-level results using inverse variance-weighted fixed-effects meta-analysis. In the second stage, we did in-silico lookups of 1372 single nucleotide polymorphisms identified from the first stage GWAS in 20941 cases and 364736 unique stroke-free controls. The ischaemic stroke subtypes of these cases had previously been established with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification system, in accordance with local standards. Results from the two stages were then jointly analysed in a final meta-analysis.We identified a novel locus (G allele at rs12122341) at 1p13.2 near TSPAN2 that was associated with large artery atherosclerosis-related stroke (first stage odds ratio [OR] 1·21, 95% CI 1·13-1·30, p=4·50×10(-8); joint OR 1·19, 1·12-1·26, p=1·30×10(-9)). Our results also supported robust associations with ischaemic stroke for four other loci that have been reported in previous studies, including PITX2 (first stage OR 1·39, 1·29-1·49, p=3·26×10(-19); joint OR 1·37, 1·30-1·45, p=2·79×10(-32)) and ZFHX3 (first stage OR 1·19, 1·11-1·27, p=2·93×10(-7); joint OR 1·17, 1·11-1·23, p=2·29×10(-10)) for cardioembolic stroke, and HDAC9 (first stage OR 1·29, 1·18-1·42, p=3·50×10(-8); joint OR 1·24, 1·15-1·33, p=4·52×10(-9)) for large artery atherosclerosis stroke. The 12q24 locus near ALDH2, which has previously been associated with all ischaemic stroke but not with any specific subtype, exceeded genome-wide significance in the meta-analysis of small artery stroke (first stage OR 1·20, 1·12-1·28, p=6·82×10(-8); joint OR 1·17, 1·11-1·23, p=2·92×10(-9)). Other loci associated with stroke in previous studies, including NINJ2, were not confirmed.Our results suggest that all ischaemic stroke-related loci previously implicated by GWAS are subtype specific. We identified a novel gene associated with large artery atherosclerosis stroke susceptibility. Follow-up studies will be necessary to establish whether the locus near TSPAN2 can be a target for a novel therapeutic approach to stroke prevention. In view of the subtype-specificity of the associations detected, the rich phenotyping data available in the Stroke Genetics Network (SiGN) are likely to be crucial for further genetic discoveries related to ischaemic stroke.US National Institute of Neurological Disorders and Stroke, National Institutes of Health.
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| 28. |
- Rannikmäe, Kristiina, et al.
(författare)
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COL4A2 is associated with lacunar ischemic stroke and deep ICH: Meta-analyses among 21,500 cases and 40,600 controls.
- 2017
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Ingår i: Neurology. - 1526-632X .- 0028-3878. ; 89:17, s. 1829-1839
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Tidskriftsartikel (refereegranskat)abstract
- To determine whether common variants in familial cerebral small vessel disease (SVD) genes confer risk of sporadic cerebral SVD.We meta-analyzed genotype data from individuals of European ancestry to determine associations of common single nucleotide polymorphisms (SNPs) in 6 familial cerebral SVD genes (COL4A1, COL4A2, NOTCH3, HTRA1, TREX1, and CECR1) with intracerebral hemorrhage (ICH) (deep, lobar, all; 1,878 cases, 2,830 controls) and ischemic stroke (IS) (lacunar, cardioembolic, large vessel disease, all; 19,569 cases, 37,853 controls). We applied data quality filters and set statistical significance thresholds accounting for linkage disequilibrium and multiple testing.A locus in COL4A2 was associated (significance threshold p < 3.5 × 10-4) with both lacunar IS (lead SNP rs9515201: odds ratio [OR] 1.17, 95% confidence interval [CI] 1.11-1.24, p = 6.62 × 10-8) and deep ICH (lead SNP rs4771674: OR 1.28, 95% CI 1.13-1.44, p = 5.76 × 10-5). A SNP in HTRA1 was associated (significance threshold p < 5.5 × 10-4) with lacunar IS (rs79043147: OR 1.23, 95% CI 1.10-1.37, p = 1.90 × 10-4) and less robustly with deep ICH. There was no clear evidence for association of common variants in either COL4A2 or HTRA1 with non-SVD strokes or in any of the other genes with any stroke phenotype.These results provide evidence of shared genetic determinants and suggest common pathophysiologic mechanisms of distinct ischemic and hemorrhagic cerebral SVD stroke phenotypes, offering new insights into the causal mechanisms of cerebral SVD.
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| 29. |
- Silvis, S M, et al.
(författare)
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Cancer and risk of cerebral venous thrombosis: a case-control study.
- 2018
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Ingår i: Journal of thrombosis and haemostasis : JTH. - : Elsevier BV. - 1538-7836. ; 16:1, s. 90-95
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Tidskriftsartikel (refereegranskat)abstract
- Essentials The risk of cerebral venous thrombosis (CVT) in patients with cancer is not known. We performed a case-control study including 594 patients with CVT and 6278 controls. History of cancer increased the risk of CVT approximately 5-fold. The association was strongest with hematological cancer in the first year after diagnosis.Background Cancer is an established risk factor for leg vein thrombosis and pulmonary embolism. Controlled studies assessing the risk of cerebral venous thrombosis (CVT) in patients with cancer have not been performed. Objective To assess whether cancer is a risk factor for CVT. Patients/Methods This was a case-control study. We assessed consecutive adult patients with CVT from three academic hospitals from 1987 to 2015, and control subjects from the Dutch MEGA study (Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis). We adjusted for age, sex and oral contraceptive use, and stratified for type of cancer and time since diagnosis of cancer. Results We included 594 cases and 6278 controls. In total, 53 cases (8.9%) and 160 controls (2.5%) had a history of cancer. Cases were younger (median 42 vs. 48 years), more often female (68% vs. 54%) and more often used oral contraceptives (55% vs. 23%) than controls. The risk of CVT was increased in patients with cancer compared with those without cancer (adjusted odds ratio [aOR], 4.86; 95% confidence interval [CI], 3.46-6.81). Patients with a hematological type of cancer had a higher risk of CVT (aOR, 25.14; 95% CI, 11.64-54.30) than those with a solid type of cancer (aOR, 3.07; 95% CI, 2.03-4.65). The association was strongest in the first year after diagnosis of cancer (hematological aOR, 85.57; 95% CI, 19.70-371.69; solid aOR, 10.50; 95% CI, 5.40-20.42). Conclusions Our study indicates that cancer is a strong risk factor for CVT, particularly within the first year of diagnosis and in patients with a hematological type of cancer.
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| 30. |
- Silvis, Suzanne M, et al.
(författare)
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Postpartum Period Is a Risk Factor for Cerebral Venous Thrombosis.
- 2019
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Ingår i: Stroke. - 1524-4628. ; 50:2, s. 501-503
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose- Pregnancy and the postpartum period are generally considered to be risk factors for cerebral venous thrombosis (CVT), but no controlled studies have quantified the risk. Methods- Case-control study using data of consecutive adult patients with CVT from 5 academic hospitals and controls from the Dutch MEGA study (Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis). Men, women over the age of 50, women using oral contraceptives or with a recent abortion or miscarriage were excluded. We adjusted for age and history of cancer, and stratified for pregnancy versus postpartum, and 0 to 6 versus 7 to 12 weeks postpartum. Results- In total 163/813 cases and 1230/6296 controls were included. Cases were younger (median 38 versus 41 years) and more often had a history of cancer (14% versus 4%) than controls. In total 41/163 (25%) cases and 82/1230 (7%) controls were pregnant or postpartum (adjusted odds ratio, 3.8; 95% CI, 2.4-6.0). The association was fully attributable to an increased risk of CVT during the postpartum period (adjusted odds ratio, 10.6; 95% CI, 5.6-20.0). We found no association between pregnancy and CVT (adjusted odds ratio, 1.2; 95% CI, 0.6-2.3). The risk was highest during the first 6 weeks postpartum (adjusted odds ratio, 18.7; 95% CI, 8.3-41.9). Conclusions- Women who have recently delivered are at increased risk of developing CVT, while there does not seem to be an increased risk of CVT during pregnancy.
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| 31. |
- Soderholm, M., et al.
(författare)
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Genome-wide association meta-analysis of functional outcome after ischemic stroke
- 2019
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 92:12
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Tidskriftsartikel (refereegranskat)abstract
- Objective To discover common genetic variants associated with poststroke outcomes using a genome-wide association (GWA) study. Methods The study comprised 6,165 patients with ischemic stroke from 12 studies in Europe, the United States, and Australia included in the GISCOME (Genetics of Ischaemic Stroke Functional Outcome) network. The primary outcome was modified Rankin Scale score after 60 to 190 days, evaluated as 2 dichotomous variables (0-2 vs 3-6 and 0-1 vs 2-6) and subsequently as an ordinal variable. GWA analyses were performed in each study independently and results were meta-analyzed. Analyses were adjusted for age, sex, stroke severity (baseline NIH Stroke Scale score), and ancestry. The significance level was p < 5 x 10(-8). Results We identified one genetic variant associated with functional outcome with genome-wide significance (modified Rankin Scale scores 0-2 vs 3-6, p = 5.3 x 10(-9)). This intronic variant (rs1842681) in the LOC105372028 gene is a previously reported trans-expression quantitative trait locus for PPP1R21, which encodes a regulatory subunit of protein phosphatase 1. This ubiquitous phosphatase is implicated in brain functions such as brain plasticity. Several variants detected in this study demonstrated suggestive association with outcome (p < 10(-5)), some of which are within or near genes with experimental evidence of influence on ischemic stroke volume and/or brain recovery (e.g., NTN4, TEK, and PTCH1). Conclusions In this large GWA study on functional outcome after ischemic stroke, we report one significant variant and several variants with suggestive association to outcome 3 months after stroke onset with plausible mechanistic links to poststroke recovery. Future replication studies and exploration of potential functional mechanisms for identified genetic variants are warranted.
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| 32. |
- Söderholm, M, et al.
(författare)
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Exome array analysis of ischaemic stroke : results from a southern Swedish study
- 2016
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Ingår i: European Journal of Neurology. - : Wiley. - 1351-5101 .- 1468-1331. ; 23:12, s. 1722-1728
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Genome-wide association (GWA) studies have identified a few risk loci for ischaemic stroke, but these variants explain only a small part of the genetic contribution to the disease. Coding variants associated with amino acid substitutions or premature termination of protein synthesis could have a large effect on disease risk. We performed an exome array analysis for ischaemic stroke.METHODS: Patients with ischaemic stroke (n = 2385) and control subjects (n = 6077) from three Swedish studies were genotyped with the Illumina HumanOmniExpressExome BeadChip. Single-variant association analysis and gene-based tests were performed of exome variants with minor allele frequency of < 5%. A separate GWA analysis was also performed, based on 700 000 genotyped common markers and subsequent imputation.RESULTS: No exome variant or gene was significantly associated with all ischaemic stroke after Bonferroni correction (all P > 1.8 × 10(-6) for single-variant and >4.15 × 10(-6) for gene-based analysis). The strongest association in single-variant analysis was found for a missense variant in the DNAH11 gene (rs143362381; P = 5.01 × 10(-6) ). In gene-based tests, the strongest association was for the ZBTB20 gene (P = 7.9 × 10(-5) ). The GWA analysis showed that the sample was homogenous (median genomic inflation factor = 1.006). No genome-wide significant association with overall ischaemic stroke risk was found. However, previously reported associations for the PITX2 and ZFHX3 gene loci with cardioembolic stroke subtype were replicated (P = 7 × 10(-15) and 6 × 10(-3) ).CONCLUSIONS: This exome array analysis did not identify any single variants or genes reaching the pre-defined significance level for association with ischaemic stroke. Further studies on exome variants should be performed in even larger, well-defined and subtyped samples.
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| 33. |
- Söderholm, Martin, et al.
(författare)
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Genome-wide association meta-analysis of functional outcome after ischemic stroke
- 2019
-
Ingår i: Neurology. - 1526-632X. ; 92:12, s. 1271-1283
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To discover common genetic variants associated with poststroke outcomes using a genome-wide association (GWA) study. METHODS: The study comprised 6,165 patients with ischemic stroke from 12 studies in Europe, the United States, and Australia included in the GISCOME (Genetics of Ischaemic Stroke Functional Outcome) network. The primary outcome was modified Rankin Scale score after 60 to 190 days, evaluated as 2 dichotomous variables (0-2 vs 3-6 and 0-1 vs 2-6) and subsequently as an ordinal variable. GWA analyses were performed in each study independently and results were meta-analyzed. Analyses were adjusted for age, sex, stroke severity (baseline NIH Stroke Scale score), and ancestry. The significance level was p < 5 × 10-8. RESULTS: We identified one genetic variant associated with functional outcome with genome-wide significance (modified Rankin Scale scores 0-2 vs 3-6, p = 5.3 × 10-9). This intronic variant (rs1842681) in the LOC105372028 gene is a previously reported trans-expression quantitative trait locus for PPP1R21, which encodes a regulatory subunit of protein phosphatase 1. This ubiquitous phosphatase is implicated in brain functions such as brain plasticity. Several variants detected in this study demonstrated suggestive association with outcome (p < 10-5), some of which are within or near genes with experimental evidence of influence on ischemic stroke volume and/or brain recovery (e.g., NTN4, TEK, and PTCH1). CONCLUSIONS: In this large GWA study on functional outcome after ischemic stroke, we report one significant variant and several variants with suggestive association to outcome 3 months after stroke onset with plausible mechanistic links to poststroke recovery. Future replication studies and exploration of potential functional mechanisms for identified genetic variants are warranted.
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| 34. |
- Wassrin, Siri, 1987-
(författare)
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Why is it difficult to design innovative IT? : An agential realist study of designing IT for healthcare innovation
- 2018
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- It may seem strange to claim that it is difficult to design innovative information technology (IT) in a time when the technological progress leaps forward like never before. However, despite the numerous opportunities that this rapid progress provides, we often design IT that is similar to existing artifacts, making IT design incremental rather than radical. At the same time, IT innovations are pointed out as crucial to meet the societal challenges we are facing, not least in the public sector, including a growing and older population, increasing demands from citizens and reduced tax revenues. This calls for us to better understand why it is difficult to design innovative IT. Previous research on this topic have mainly focused on human and social aspects, not paying close attention to IT. In this thesis, it is suggested that the sociomaterial theory agential realism can help shed light on the role of IT in innovative IT design, acknowledging the sociomateriality of IT. Thus, the overarching aim of this thesis is to apply agential realism on an empirical case in order to explore and explain why it is difficult to design innovative IT. To fulfill the aim, a qualitative case study was conducted in publicly funded healthcare. The empirical case is an example of an attempt to design innovative IT in a healthcare context. The empirical material was generated through participant observations, including video recordings, and semi-structured interviews. The material was analyzed in several rounds, with and without a theoretical lens. In the agential realist analysis, IT has been viewed as entangled with the world. The analysis focused on what boundaries IT produced and how these boundaries were consequential for what was possible and impossible to design. The thesis illustrates how IT is produced and productive in terms of both matter and meaning, and thus, is agential – IT makes differences in the world. What is possible to design is not only constrained by social structures but by the materiality of IT, what boundaries IT helps produce and the material-discursive practices that enact IT. Innovative IT design means to design material configurations that produce boundaries that are different from what have been enacted before and, thus, deviate from existing material-discursive practices. However, it is difficult to deviate from these since material-discursive practices are agential and define what boundaries are meaningful and legitimate. Hence, it is difficult to design innovative IT since innovative IT design has to both enact boundaries that deviate from agential material-discursive practices and also gain legitimacy. Through this explanation, the thesis makes an explanatory knowledge contribution which differs from and adds to earlier explanations. It also makes a contribution to conceptualizing the IT artifact by emphasizing IT as sociomaterial and providing examples of how IT can be understood as produced, productive, agential and entangled. Finally, the thesis also makes an empirical and methodological contribution in the sense that it demonstrates how an agential realist case study can be conducted in the field of Information Systems.
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| 35. |
- Zuurbier, Susanna M, et al.
(författare)
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Cerebral Venous Thrombosis in Older Patients.
- 2018
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Ingår i: Stroke. - 1524-4628. ; 49:1, s. 197-200
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral venous thrombosis (CVT) is rare in older patients. We investigated whether clinical features and outcomes differ in older and younger patients.We used data from a multicenter observational registry of consecutive adult patients with CVT admitted between 1987 and 2016. We compared demographics, clinical manifestations, and outcomes between older (upper quartile of the age distribution) and younger (lower 3 quartiles of the age distribution) patients.Data for 843 patients with CVT were available. The median age was 43 years (interquartile range, 30-55 years). Older patients (≥55 years; n=222) were less often women than younger patients (48% versus 71%; P<0.001) and less often reported headache (63% versus 87%; P<0.001). Cancer was more common in older patients (24% versus 9%; P<0.001), especially solid malignancies (19% versus 5%; P<0.001). Outcome at follow-up was worse in older patients (modified Rankin Scale, 3-6; adjusted odds ratio, 2.68; 95% confidence interval, 1.78-4.03; mortality, adjusted odds ratio, 2.13; 95% confidence interval, 1.09-4.19).The sex ratio of CVT is evenly distributed in older patients, probably because of the dissipation of hormonal influences. Malignancy should be considered as a potential precipitant in older patients with CVT.
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