| 1. |
- Bruce, Peter, 1986-, et al.
(författare)
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Inconsistencies in How Environmental Risk Is Evaluated in Sweden for Dumping Dredged Sediment at Sea
- 2021
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Ingår i: Frontiers in Marine Science. - : Frontiers Media SA. - 2296-7745. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Millions of tons of dredged sediment are dumped at sea annually. International conventions limit dumping when there is a risk of adverse ecological effects, for example if the sediment is contaminated. However, the perception of risk differs substantially among stakeholders and in Sweden there is a lack of guidelines for how to address such risk. In the current study, we examined exemptions to the Swedish ban on dumping at sea, to explore the extent of dumping and how ecological aspects were considered in the evaluation of risks. We analyzed data from all cases granted exemption by county administrative boards and all court cases considering exemption to the ban from the beginning of 2015 to June 2020. We found that while dumping is the least common alternative management method for dredged sediment in total number of cases (98/792), dumping is the main method in terms of volume (30.8/38.2 million m3). When considering exemptions, the courts mainly evaluated the risk of exposure to contaminants and resuspended sediment for the environment adjacent to the dumpsite. The risks from contaminants were characterized based on various lines of reasoning, mainly relying on reference values not based on a scientific correlation to environmental risk. We argue that the evaluations were not in line with current regulations and international conventions as they insufficiently accounted for the ecotoxicological risk of the dumped sediment. These issues are potentially similar in other Baltic Sea countries, where there is a similar dependency on binary chemical limit values.
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| 2. |
- Ohlsson, Lars, et al.
(författare)
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Increased level of circulating cell-free mitochondrial DNA due to a single bout of strenuous physical exercise
- 2020
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Ingår i: European Journal of Applied Physiology. - : Springer. - 1439-6319 .- 1439-6327. ; 120, s. 897-905
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Physical exercise is reported to affect the immune response in various ways. Thus, the levels of pro-inflammatory cytokines as well as the abundance of circulating leukocytes are changed. In this study, the occurence of circulating cell-free mitochondrial DNA (cfmtDNA) and nuclear DNA (nDNA) was investigated in connection with a single bout of strenuous physical exercise. Methods Healthy volunteers performed a controlled ergo-spirometry cycle test and venous blood samples were taken at different time-points to analyze the concentration of blood components before, during and after the test. The number of circulating leukocytes was measured, as well as secretion of the soluble urokinase activator receptor (suPAR). Results Cf-mtDNA significantly increased during exercise, compared to baseline values and after 30 and 90 min of rest. Circulating leukocytes increased during exercise, but returned to baseline levels afterwards. Surface expression of the urokinase plasminogen activating receptor (uPAR) on neutrophils decreased significantly during exercise. The concentration of suPAR tended to increase during exercise but only significantly after 90 min of rest. Conclusion Increased concentration of cf-mtDNA indicates that cell damage takes place during high intensity training. Hypoxia and tissue damage are likely causes of cf-mtDNA from muscle cells. The levels of cf-mtDNA remain high during the initial rest, due to the decreasing numbers of leukocytes normally clearing the plasma from cf-mtDNA. The increased levels of suPAR further emphasize that strenuous physical exercise causes a reaction similar to inflammation. Further studies are needed to detect the source of increased cf-mtDNA and the corresponding increase of suPAR liberation.
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| 3. |
- Schrage, Benedikt, et al.
(författare)
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Lower socioeconomic status predicts higher mortality and morbidity in patients with heart failure
- 2021
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Ingår i: Heart. - : BMJ PUBLISHING GROUP. - 1355-6037 .- 1468-201X. ; 107:3, s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- Objective It is not fully understood whether and how socioeconomic status (SES) has a prognostic impact in patients with heart failure (HF). We assessed SES and its association with patient characteristics and outcomes in a contemporary and well-characterised HF cohort. Methods Socioeconomic risk factors (SERF) were defined in the Swedish HF Registry based on income (low vs high according to the annual median value), education level (no degree/compulsory school vs university/secondary school) and living arrangement (living alone vs cohabitating). Results Of 44 631 patients, 21% had no, 33% one, 30% two and 16% three SERF. Patient characteristics strongly and independently associated with lower SES were female sex and no specialist referral. Additional independent associations were older age, more severe HF, heavier comorbidity burden, use of diuretics and less use of HF devices. Lower SES was associated with higher risk of HF hospitalisation/mortality, and overall cardiovascular and non-cardiovascular events. These associations persisted after extensive adjustment for patient characteristics, treatments and care. The magnitude of the association increased linearly with the increasing number of coexistent SERF: HR (95% CI) 1.09 (1.05 to 1.13) for one, 1.16 (1.12 to 1.20) for two and 1.22 (1.18 to 1.28) for three SERF (p<0.01). Conclusions In a contemporary and well-characterised HF cohort and after comprehensive adjustment for confounders, lower SES was linked with multiple factors such as less use of HF devices and age, but most strongly with female sex and lack of specialist referral; and associated with greater risk of morbidity/mortality.
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| 4. |
- Stenvall, Anna, et al.
(författare)
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Relationships between uptake of [68Ga]Ga-DOTA-TATE and absorbed dose in [177Lu]Lu-DOTA-TATE therapy
- 2022
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Ingår i: EJNMMI Research. - : Springer Science and Business Media LLC. - 2191-219X. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Somatostatin receptor 68Ga PET imaging is standard for evaluation of a patient’s suitability for 177Lu peptide receptor radionuclide therapy of neuroendocrine tumours (NETs). The 68Ga PET serves to ensure sufficient somatostatin receptor expression, commonly evaluated qualitatively. The aim of this study is to investigate the quantitative relationships between uptake in 68Ga PET and absorbed doses in 177Lu therapy. Method: Eighteen patients underwent [68Ga]Ga-DOTA-TATE PET imaging within 20 weeks prior to their first cycle of [177Lu]Lu-DOTA-TATE. Absorbed doses for therapy were estimated for tumours, kidney, spleen, and normal liver parenchyma using a hybrid SPECT/CT–planar method. Gallium-68 activity concentrations were retrieved from PET images and also used to calculate SUVs and normalized SUVs, using blood and tissue for normalization. The 68Ga activity concentrations per injected activity, SUVs, and normalized SUVs were compared with 177Lu activity concentrations 1 d post-injection and 177Lu absorbed doses. For tumours, for which there was a variable number per patient, both inter- and intra-patient correlations were analysed. Furthermore, the prediction of 177Lu tumour absorbed doses based on a combination of tumour-specific 68Ga activity concentrations and group-based estimates of the effective half-lives for grade 1 and 2 NETs was explored. Results: For normal organs, only spleen showed a significant correlation between the 68Ga activity concentration and 177Lu absorbed dose (r = 0.6). For tumours, significant, but moderate, correlations were obtained, with respect to both inter-patient (r = 0.7) and intra-patient (r = 0.45) analyses. The correlations to absorbed doses did not improve when using 68Ga SUVs or normalized SUVs. The relationship between activity uptakes for 68Ga PET and 177Lu SPECT was stronger, with correlation coefficients r = 0.8 for both inter- and intra-patient analyses. The 177Lu absorbed dose to tumour could be predicted from the 68Ga activity concentrations with a 95% coverage interval of − 65% to 248%. Conclusions: On a group level, a high uptake of [68Ga]Ga-DOTA-TATE is associated with high absorbed doses at 177Lu-DOTA-TATE therapy, but the relationship has a limited potential with respect to individual absorbed dose planning. Using SUV or SUV normalized to reference tissues do not improve correlations compared with using activity concentration per injected activity.
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| 5. |
- Aglago, Elom K., et al.
(författare)
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Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort
- 2020
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier BV. - 1542-3565 .- 1542-7714. ; 18:3, s. 6-666
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: Dietary intake of fish (total, fatty/oily, lean/white) and n-3 LC-PUFA were estimated by food frequency questionnaires given to 521,324 participants in the EPIC study; among these, 6291 individuals developed CRC (median follow up, 14.9 years). Levels of phospholipid LC-PUFA were measured by gas chromatography in plasma samples from a sub-group of 461 CRC cases and 461 matched individuals without CRC (controls). Multivariable Cox proportional hazards and conditional logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs), respectively, with 95% CIs. Results: Total intake of fish (HR for quintile 5 vs 1, 0.88; 95% CI, 0.80–0.96; Ptrend = .005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82–0.98; Ptrend = .009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83–1.00; Ptrend = .016) were inversely associated with CRC incidence. Intake of total n-3 LC-PUFA (HR for quintile 5 vs 1, 0.86; 95% CI, 0.78–0.95; Ptrend = .010) was also associated with reduced risk of CRC, whereas dietary ratio of n-6:n-3 LC-PUFA was associated with increased risk of CRC (HR for quintile 5 vs 1, 1.31; 95% CI, 1.18–1.45; Ptrend < .001). Plasma levels of phospholipid n-3 LC-PUFA was not associated with overall CRC risk, but an inverse trend was observed for proximal compared with distal colon cancer (Pheterogeneity = .026). Conclusions: In an analysis of dietary patterns of participants in the EPIC study, we found regular consumption of fish, at recommended levels, to be associated with a lower risk of CRC, possibly through exposure to n-3 LC-PUFA. Levels of n-3 LC-PUFA in plasma were not associated with CRC risk, but there may be differences in risk at different regions of the colon.
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| 6. |
- Austin, Thomas R, et al.
(författare)
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Large-scale circulating proteome association study (CPAS) meta-analysis identifies circulating proteins and pathways predicting incident hip fractures.
- 2024
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Ingår i: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. - 1523-4681. ; 39:2, s. 139-149
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Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are associated with significant disability, high cost, and mortality. However, the exact biological mechanisms underlying susceptibility to hip fractures remain incompletely understood. In an exploratory search of the underlying biology as reflected through the circulating proteome, we performed a comprehensive Circulating Proteome Association Study (CPAS) meta-analysis for incident hip fractures. Analyses included 6430 subjects from two prospective cohort studies (Cardiovascular Health Study and Trøndelag Health Study) with circulating proteomics data (aptamer-based 5K SomaScan version 4.0 assay; 4979 aptamers). Associations between circulating protein levels and incident hip fractures were estimated for each cohort using age and sex-adjusted Cox regression models. Participants experienced 643 incident hip fractures. Compared with the individual studies, inverse-variance weighted meta-analyses yielded more statistically significant associations, identifying 23 aptamers associated with incident hip fractures (conservative Bonferroni correction 0.05/4979, P<1.0×10-5). The aptamers most strongly associated with hip fracture risk corresponded to two proteins of the growth hormone/insulin growth factor system (GHR and IGFBP2), as well as GDF15 and EGFR. High levels of several inflammation-related proteins (CD14, CXCL12, MMP12, ITIH3) were also associated with increased hip fracture risk. Ingenuity pathway analysis identified reduced LXR/RXR activation and increased acute phase response signaling to be overrepresented among those proteins associated with increased hip fracture risk. These analyses identified several circulating proteins and pathways consistently associated with incident hip fractures. These findings underscore the usefulness of the meta-analytic approach for comprehensive CPAS in a similar manner as has previously been observed for large-scale human genetic studies. Future studies should investigate the underlying biology of these potential novel drug targets.
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| 7. |
- Bernhardsson, Katarina, et al.
(författare)
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Obduktion och mjuka texter : Shared Reading som metod på universitetet
- 2022
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Ingår i: Shared Reading i Skandinavia : Forskning og praksis - Forskning og praksis. - 9788293298212 - 9788293298229 ; , s. 257-287
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Bokkapitel (refereegranskat)abstract
- This chapter discusses how Shared Reading (SR) can be used as a method when teaching university students in professional education. Drawing on experiences from both the Medical School and the Creative Writing Program, the chapter shows how SR can be used to enhance professional development in two different settings. In Medical School, SR is used to create a space for exploration of relational and emotional aspects of the profession, which is here exemplified with the reading of poetry after the students’ first autopsy. In the Creative Writing Program, SR is used to slow down the reading, giving the students the opportunity to read the text as if it was still a work-in-progress, and a so-called ‘flexible’ text. The discussion shows the versatility of the method: how as, even as the method is the same, the differences come from the educational context, and what the students learn is to a large extent dependent on their future profession.
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| 8. |
- Borg, Sixten, et al.
(författare)
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Performance of standardized cancer patient pathways in Sweden visualized using observational data and a state-transition model
- 2023
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Ingår i: Scientific Reports. - 2045-2322. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Standardized Cancer Patient Pathways (CPPs) were introduced in Swedish healthcare starting in 2015 to improve diagnostics for patients with symptoms of cancer, patient satisfaction and equity of care between healthcare providers. An inclusion target and a time target were set. Our primary aim was to visualize the patient population going through CPPs, in terms of investigation time and indications of the various outcomes including cancer diagnoses. Our secondary aims were to examine if targets were met, and to examine frequencies of undetected cancer. We collected data from 19,204 patients starting in a CPP, and 7895 patients diagnosed with cancer in 2018 in a region of Sweden. A state transition model was developed and used as analytical framework, and patients were mapped over time in the states of the model. Visualization of the patient-flow through the model illustrates speed of investigation, time to treatment, frequencies of detected and undetected cancer. Twelve CPPs out of 28 met the inclusion target, five met the time target. After suspicion of cancer rejected, 0.8% of patients were diagnosed with the primarily suspected cancer, 1.0% with another cancer. In patients not meeting the criteria for well-founded suspicion less than 3% were later diagnosed with cancer. The visualization of the patient flow into and through standardized cancer patient pathways illustrates investigation time, events occurring and outcomes. The use of standardized cancer patient pathways detects cancer efficiently.
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| 9. |
- Bruce, Peter, 1986-
(författare)
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A Deep Dive into Sediments : Exploring approaches to assess environmental risks and achieving environmental goals in management of contaminated sediments in Sweden
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Contaminated sediments are common, especially near urban and industrialized areas, and they can have negative ecological effects. In three studies, I explore the challenges for environmental management of contaminated sediments, focusing on environmental risk assessment (ERA) in Sweden. I investigate the scientific basis and ecological relevance of the knowledge that is produced in, and evaluated from, assessments. I then relate that knowledge to environmental goals set for general management, but also within individual assessments.Study I identified environmental goals set by society that ERA of contaminated sediment sites should address through a survey conducted among governmental agencies working with contaminated sediment. To investigate to what extent the practice of ERA addressed the goals which had been identified in the survey, the study also analyzed seven cases of ERA, from 2008-2015. Study II reviewed established strategies for assessing risks from contaminated sediments, from four countries. Then, with the ERAs included in study I, the Swedish ERA practice was characterized and contrasted to the review. Study III investigated to what extent dumping dredged sediment at sea was used as an alternative to manage dredged sediments. The study further investigated how courts, in 14 cases from 2015-2020, evaluated environmental risk when considering to allow dumping.The five environmental goals identified as most relevant focused on ecosystem services and management of environmental resources. While the ERAs occasionally addressed these goals, their priorities were not well aligned with that of the agencies (I). In studies II-III, the case-specific goals were not clearly addressed with the methods used. The results indicate that there is a focus on contaminant concentrations and sediment mobility. Four out of the seven ERAs in study II, and none in study III, measured potential effects from contaminants. The ERAs in study II surveyed benthic species and one conducted a toxicity test. When characterizing risk, there was also a frequent use of references not related to toxicity (II-III). Furthermore, uncertainties were not quantified and rarely discussed. Transparency was lacking regarding what weight individual types of measurements had in characterizing risk (II). In study III, sediment accumulation and contaminant concentrations were the decisive factors. However, in evaluating concentrations, the courts’ reasoning was inconsistent. The ERA practice in Sweden does not clearly produce the information needed to effectively characterize or evaluate risk in line with case specific or societal goals and risk underestimating the risks from contaminated sediments.Additional development and research could improve the capability to produce information for efficient management. Issues that should be addressed are, for example, requirements and guidance for designing case specific ERAs, including setting measurement and assessment endpoints in line with the ERA goals; additional types of measurement of contaminant effects; a system for criteria when characterizing risk; and requirements and guidance for how to consider future changes of site-specific conditions, such as climate change.This thesis highlights some of the potential and limitations in the Swedish practice to inspire management in how to incorporate existing best available methods as well as point to additional research needs.
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| 10. |
- Bruce, Peter, et al.
(författare)
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Risk assessments of contaminated sediments from the perspective of weight of evidence strategies – a Swedish case study
- 2021
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Ingår i: Human and Ecological Risk Assessment. - : Informa UK Limited. - 1080-7039 .- 1549-7860. ; 27:5, s. 1366-1387
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Tidskriftsartikel (refereegranskat)abstract
- Several countries currently lack common recommendations specific to Ecological Risk Assessment (ERA) of contaminated sediments and stakeholders report inconsistencies between currently used approaches. The objective of this study was to provide an increased understanding of how ERAs of contaminated sediments are conducted in comparison to established guidelines. For this, we use Sweden as a case study and compare seven ERAs with four internationally established strategies. Our results indicate that contaminant concentrations receive a comparatively high weight, despite a lack of appropriate benchmarks; toxicity measurements are uncommon, while routine in established strategies; and the integration and interpretation of results lack transparency. We identify three areas that may help improve the practice of ERAs: a common approach to benchmarks, recommendations for how to assess toxic effects, and a common approach for integrating and interpreting results.
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| 11. |
- Bärnarp, Tora, et al.
(författare)
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Skönhet hållbarhet funktion
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna publikation redovisar studenternas enskilda arbeten. Materialet har tillkommit inom ramen för läsårets tema ”Skönhet, hållbarhet och funktion”, men varje studie utgår ifrån studenternas egna val av ämne.
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| 12. |
- Dahlqvist, Johanna, 1979-, et al.
(författare)
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Identification and functional characterization of a novel susceptibility locus for small vessel vasculitis with MPO-ANCA
- 2022
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Ingår i: Rheumatology. - Oxford, United Kingdom : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 61:8, s. 3461-3470
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Tidskriftsartikel (refereegranskat)abstract
- Objective To identify and characterize genetic loci associated with the risk of developing ANCA-associated vasculitides (AAV). Methods Genetic association analyses were performed after Illumina sequencing of 1853 genes and subsequent replication with genotyping of selected single nucleotide polymorphisms in a total cohort of 1110 Scandinavian cases with granulomatosis with polyangiitis or microscopic polyangiitis, and 1589 controls. A novel AAV-associated single nucleotide polymorphism was analysed for allele-specific effects on gene expression using luciferase reporter assay. Results PR3-ANCA(+) AAV was significantly associated with two independent loci in the HLA-DPB1/HLA-DPA1 region [rs1042335, P = 6.3 x 10(-61), odds ratio (OR) 0.10; rs9277341, P = 1.5 x 10(-44), OR 0.22] and with rs28929474 in the SERPINA1 gene (P = 2.7 x 10(-10), OR 2.9). MPO-ANCA(+) AAV was significantly associated with the HLA-DQB1/HLA-DQA2 locus (rs9274619, P = 5.4 x 10(-25), OR 3.7) and with a rare variant in the BACH2 gene (rs78275221, P = 7.9 x 10(-7), OR 3.0), the latter a novel susceptibility locus for MPO-ANCA(+) granulomatosis with polyangiitis/microscopic polyangiitis. The rs78275221-A risk allele reduced luciferase gene expression in endothelial cells, specifically, as compared with the non-risk allele. Conclusion We identified a novel susceptibility locus for MPO-ANCA(+) AAV and propose that the associated variant is of mechanistic importance, exerting a regulatory function on gene expression in specific cell types.
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| 13. |
- Ekman, Diana, et al.
(författare)
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Stratified genetic analysis reveals sex differences in MPO-ANCA-associated vasculitis
- 2023
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Ingår i: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332. ; 62:9, s. 3213-3218
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To identify and genetically characterize subgroups of patients with ANCA-associated vasculitides (AAV) based on sex and ANCA subtype. Methods: A previously established SNP dataset derived from DNA sequencing of 1853 genes and genotyping of 1088 Scandinavian cases with AAV and 1589 controls was stratified for sex and ANCA subtype and analysed for association with five top AAV SNPs. rs9274619, a lead variant at the HLA-DQB1/HLA-DQA2 locus previously associated with AAV positive for myeloperoxidase (MPO)-ANCA, was analysed for association with the cumulative disease involvement of ten different organ systems. Results: rs9274619 showed a significantly stronger association to MPO-ANCA-positive females than males [P = 2.0 × 10-4, OR = 2.3 (95% CI 1.5, 3.5)], whereas proteinase 3 (PR3)-ANCA-associated variants rs1042335, rs9277341 (HLA-DPB1/A1) and rs28929474 (SERPINA1) were equally associated with females and males with PR3-ANCA. In MPO-ANCA-positive cases, carriers of the rs9274619 risk allele were more prone to disease engagement of eyes [P = 0.021, OR = 11 (95% CI 2.2, 205)] but less prone to pulmonary involvement [P = 0.026, OR = 0.52 (95% CI 0.30, 0.92)]. Moreover, AAV with both MPO-ANCA and PR3-ANCA was associated with the PR3-ANCA lead SNP rs1042335 [P = 0.0015, OR = 0.091 (95% CI 0.0022, 0.55)] but not with rs9274619. Conclusions: Females and males with MPO-ANCA-positive AAV differ in genetic predisposition to disease, suggesting at least partially distinct disease mechanisms between the sexes. Double ANCA-positive AAV cases are genetically similar to PR3-ANCA-positive cases, providing clues to the clinical follow-up and treatment of these patients.
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| 14. |
- Eriksson, Anna L, et al.
(författare)
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Serum Glycine Levels Are Associated With Cortical Bone Properties and Fracture Risk in Men.
- 2021
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 106:12
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Tidskriftsartikel (refereegranskat)abstract
- In a recent study a pattern of 27 metabolites, including serum glycine, associated with bone mineral density (BMD).To investigate associations for serum and urinary glycine levels with BMD, bone microstructure, and fracture risk in men.In the population-based Osteoporotic Fractures in Men (MrOS) Sweden study (men, 69-81 years) serum glycine and BMD were measured at baseline (n=965) and 5-year follow-up (n=546). Cortical and trabecular bone parameters of the distal tibia were measured at follow-up using high-resolution peripheral quantitative computed tomography. Urinary (n=2682) glycine was analyzed at baseline. X-ray-validated fractures (n=594) were ascertained during a median follow-up of 9.6 years. Associations were evaluated using linear regression (bone parameters) or Cox regression (fractures).Circulating glycine levels were inversely associated with femoral neck (FN)-BMD. A meta-analysis (n=7543) combining MrOS Sweden data with data from 3 other cohorts confirmed a robust inverse association between serum glycine levels and FN-BMD (P=7.7×10-9). Serum glycine was inversely associated with the bone strength parameter failure load in the distal tibia (P=0.002), mainly as a consequence of an inverse association with cortical cross-sectional area and a direct association with cortical porosity. Both serum and urinary glycine levels predicted major osteoporotic fractures (serum: hazard ratio [HR] per SD increase=1.22, 95% CI, 1.05-1.43; urine: HR=1.13, 95% CI, 1.02-1.24). These fracture associations were only marginally reduced in models adjusted by FRAX with BMD.Serum and urinary glycine are indirectly associated with FN-BMD and cortical bone strength, and directly associated with fracture risk in men.
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| 15. |
- Fjellström, Sanna, et al.
(författare)
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Difference in balance capacity for Special Olympics athletes and non-athletes with intellectual disabilities
- 2024
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Ingår i: European Journal of Adapted Physical Activity. - : European Federation of Adapted Physical Activities. - 1803-3857. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Fall incidents are a significant health problem for people with intellectual disabilities (ID) and physical activity improves balance capacity and can prevent the risk of falling. The Special Olympics Healthy Athletes® offers health screenings and education to athletes with ID. The aim of this cross-sectional study was to explore whether Special Olympics athletes have better balance capacity than non-athletes with ID. During the Special Olympics Sweden Invitational Games 2020, athletes and non-athletes participated in the Healthy Athletes programme. The results of athletes (n=47) and non-athletes (n=25) for balance tests (i.e. single leg stance, functional reach and timed sit-to stand test) and health markers (i.e. blood pressure and body mass index) were analysed. Athletes showed higher balance capacity, more physical activity at moderate intensity and a lower body mass index and diastolic blood pressure compared to non-athletes. However, the balance capacity of both athletes and non-athletes with ID were low, lower than for people without ID. From this study, Special Olympics athletes showed higher physical activity on moderate intensity and higher balance capacity which can decrease the risk of fall incidents compared to non-athletes.
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| 16. |
- Fjellström, Sanna, et al.
(författare)
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Increasing physical activity through an adapted web-based exercise program for people with intellectual disabilities : Support staff are crucial for feasibility
- 2024
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Ingår i: JARID. - : John Wiley & Sons. - 1360-2322 .- 1468-3148. ; 37:2
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPeople with intellectual disabilities are less physically active and suffer from ill-health more than the general population. Support staff play an important role in the person's life. This study aimed to explore the support staff's experiences regarding the feasibility of adapted web-based exercise for people with intellectual disabilities.MethodParticipants with intellectual disabilities living in community-based settings were recruited for a web-based exercise study. Eight semi-structured interviews were carried out with their support staff before and after the intervention period.ResultsThe main theme, ‘Support staff are crucial for feasibility’ encompasses the importance of communication, structure, and motivation in improving physical activity for people with intellectual disabilities.ConclusionThe experiences of support staff, indicate that a web-based exercise program is feasible for the target group, and one way to overcome challenges for PA, where the role of the staff is crucial.
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| 17. |
- Flanagan, Erin, et al.
(författare)
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Health impact assessment of road traffic noise exposure based on different densification scenarios in Malmö, Sweden
- 2023
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120. ; 174
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Tidskriftsartikel (refereegranskat)abstract
- While urbanization provides many opportunities to those arriving in thriving urban areas, a greater number of residents necessitates the expansion of housing and infrastructure. This is often achieved through densification, which can lead to increased noise, particularly through increased road traffic. A key challenge of promoting healthy urban planning is to understand potential health effects, especially on the local level. The aim of the present study is, therefore, to estimate and compare the health impacts of road traffic noise exposure for various urban densification scenarios within a neighborhood (Lorensborg) in Malmö, Sweden. The three scenarios include 1) Present-day, representing the study area as it is presently organized; 2) Planned municipal strategy (the city of Malmö’s own densification plans) and 3) Health-centred, which involves major structural alterations and reflects an effort prioritize a health-centred approach. Noise was modelled using the Nordic prediction method for road traffic. Health outcomes included noise annoyance, adverse sleep disturbance, ischemic heart disease (IHD) incidence and mortality. Within all scenarios, a large proportion of the study population was exposed above the WHO's health-based guideline value (Lden 53 dB): >80% for Present-day and Planned municipal strategy scenarios, and almost 50% in the Health-centred scenario. Still, densifying Lorensborg (population ≈9,600) according to the Health-centred scenario could prevent 549 cases of highly annoyed, 193 cases of adverse sleep disturbance, 4.7 new cases of IHD (8.9% of total cases), and 1.5 deaths due to IHD (17.8% of IHD mortality) annually. The results demonstrated that it is possible to considerably lower the health impact with a more health-centred densification strategy. Important co-benefits for public and environmental health include air pollution reduction and green space creation, although their health effects were not quantified in the present study. Urban planning initiatives must be more ambitious in order to create healthy, sustainable cities.
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| 18. |
- Frodlund, Martina, et al.
(författare)
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The serological immunogenicity of the third and fourth doses of COVID-19 vaccine in patients with inflammatory rheumatic diseases on different biologic or targeted DMARDs : a Swedish nationwide study (COVID-19-REUMA)
- 2024
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Ingår i: Microbiology Spectrum. - : AMER SOC MICROBIOLOGY. - 2165-0497. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Studies investigating the immunogenicity of additional COVID-19 vaccine doses in immunosuppressed patients with inflammatory rheumatic diseases (IRD) are still limited. The objective was to explore the antibody response including response to omicron virus subvariants (sBA.1 and sBS.2) after third and fourth COVID-19 vaccine doses in Swedish IRD patients treated with immunomodulating drugs compared to controls. Antibody levels to spike wild-type antigens (full-length protein and S1) and the omicron variants sBA.1 and sBA.2 (full-length proteins) were measured. A positive response was defined as having antibody levels over cut-off or ≥fourfold increase in post-vaccination levels for both antigens. Patients with arthritis, vasculitis, and other autoimmune diseases (n = 414), and controls (n = 61) receiving biologic/targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) with or without conventional synthetic DMARDs participated. Of these, blood samples were available for 370 patients and 52 controls after three doses, and 65 patients and 15 controls after four doses. Treatment groups after three vaccine doses were rituximab (n = 133), abatacept (n = 22), IL6r inhibitors (n = 71), JAnus Kinase inhibitors (JAK-inhibitors) (n = 56), tumor necrosis factor inhibitor (TNF-inhibitors) (n = 61), IL12/23/17 inhibitors (n = 27), and controls (n = 52). The percentage of responders after three and four vaccine doses was lower in rituximab-treated patients (59% and 57%) compared to controls (100%) (P < 0.001). After three doses, the percentage of responders in all other groups was 100%, including response to omicron sBA.1 and sBA.2. In rituximab-treated patients, higher baseline immunoglobulin G (IgG) and longer time-period between rituximab and vaccination predicted better response. In this Swedish nationwide study including IRD patients three and four COVID-19 vaccine doses were immunogenic in patients treated with IL6r inhibitors, TNF-inhibitors, JAK-inhibitors, and IL12/23/17-inhibitors but not in rituximab. As >50% of rituximab patients responded to vaccines including omicron subvariants, these patients should be prioritized for additional vaccine doses.
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| 19. |
- Frodlund, Martina, et al.
(författare)
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The serological immunogenicity of the third and fourth doses of COVID-19 vaccine in patients with inflammatory rheumatic diseases on different biologic or targeted DMARDs: a Swedish nationwide study (COVID-19-REUMA)
- 2024
-
Ingår i: Microbiology Spectrum. - : AMER SOC MICROBIOLOGY. - 2165-0497.
-
Tidskriftsartikel (refereegranskat)abstract
- Studies investigating the immunogenicity of additional COVID-19 vaccine doses in immunosuppressed patients with inflammatory rheumatic diseases (IRD) are still limited. The objective was to explore the antibody response including response to omicron virus subvariants (sBA.1 and sBS.2) after third and fourth COVID-19 vaccine doses in Swedish IRD patients treated with immunomodulating drugs compared to controls. Antibody levels to spike wild-type antigens (full-length protein and S1) and the omicron variants sBA.1 and sBA.2 (full-length proteins) were measured. A positive response was defined as having antibody levels over cut-off or >= fourfold increase in post-vaccination levels for both antigens. Patients with arthritis, vasculitis, and other autoimmune diseases (n = 414), and controls (n = 61) receiving biologic/targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) with or without conventional synthetic DMARDs participated. Of these, blood samples were available for 370 patients and 52 controls after three doses, and 65 patients and 15 controls after four doses. Treatment groups after three vaccine doses were rituximab (n = 133), abatacept (n = 22), IL6r inhibitors (n = 71), JAnus Kinase inhibitors (JAK-inhibitors) (n = 56), tumor necrosis factor inhibitor (TNF-inhibitors) (n = 61), IL12/23/17 inhibitors (n = 27), and controls (n = 52). The percentage of responders after three and four vaccine doses was lower in rituximab-treated patients (59% and 57%) compared to controls (100%) (P < 0.001). After three doses, the percentage of responders in all other groups was 100%, including response to omicron sBA.1 and sBA.2. In rituximab-treated patients, higher baseline immunoglobulin G (IgG) and longer time-period between rituximab and vaccination predicted better response. In this Swedish nationwide study including IRD patients three and four COVID-19 vaccine doses were immunogenic in patients treated with IL6r inhibitors, TNF-inhibitors, JAK-inhibitors, and IL12/23/17-inhibitors but not in rituximab. As >50% of rituximab patients responded to vaccines including omicron subvariants, these patients should be prioritized for additional vaccine doses. IMPORTANCE Results from this study provide further evidence that additional doses of COVID-19 vaccines are immunogenic and result in satisfactory antibody response in a majority of patients with inflammatory rheumatic diseases (IRD) receiving potent immunomodulating treatments such as biological or targeted disease-modifying anti-rheumatic drugs (DMARDs) given as monotherapy or combined with traditional DMARDs. We observed that rituximab treatment, both as monotherapy and combined with csDMARDs, impaired antibody response, and only roughly 50% of patients developed a satisfactory antibody response including response to omicron subvariants after the third vaccine. In addition, higher IgG levels at the last rituximab course before the third vaccine dose and a longer time after the last rituximab treatment increased the chance of a satisfactory antibody response. These results indicate that rituximab-treated patients should be prioritized for additional vaccine doses. CLINICAL TRIALS EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) with number 2021-000880-63.
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| 20. |
- Frodlund, Martina, et al.
(författare)
-
The serological immunogenicity of the third and fourth doses of COVID-19 vaccine in patients with inflammatory rheumatic diseases on different biologic or targeted DMARDs: a Swedish nationwide study (COVID-19-REUMA)
- 2024
-
Ingår i: MICROBIOLOGY SPECTRUM. - : AMER SOC MICROBIOLOGY. - 2165-0497. ; 12:4
-
Tidskriftsartikel (refereegranskat)abstract
- Studies investigating the immunogenicity of additional COVID-19 vaccine doses in immunosuppressed patients with inflammatory rheumatic diseases (IRD) are still limited. The objective was to explore the antibody response including response to omicron virus subvariants (sBA.1 and sBS.2) after third and fourth COVID-19 vaccine doses in Swedish IRD patients treated with immunomodulating drugs compared to controls. Antibody levels to spike wild-type antigens (full-length protein and S1) and the omicron variants sBA.1 and sBA.2 (full-length proteins) were measured. A positive response was defined as having antibody levels over cut-off or >= fourfold increase in post-vaccination levels for both antigens. Patients with arthritis, vasculitis, and other autoimmune diseases (n = 414), and controls (n = 61) receiving biologic/targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) with or without conventional synthetic DMARDs participated. Of these, blood samples were available for 370 patients and 52 controls after three doses, and 65 patients and 15 controls after four doses. Treatment groups after three vaccine doses were rituximab (n = 133), abatacept (n = 22), IL6r inhibitors (n = 71), JAnus Kinase inhibitors (JAK-inhibitors) (n = 56), tumor necrosis factor inhibitor (TNF-inhibitors) (n = 61), IL12/23/17 inhibitors (n = 27), and controls (n = 52). The percentage of responders after three and four vaccine doses was lower in rituximab-treated patients (59% and 57%) compared to controls (100%) (P < 0.001). After three doses, the percentage of responders in all other groups was 100%, including response to omicron sBA.1 and sBA.2. In rituximab-treated patients, higher baseline immunoglobulin G (IgG) and longer time-period between rituximab and vaccination predicted better response. In this Swedish nationwide study including IRD patients three and four COVID-19 vaccine doses were immunogenic in patients treated with IL6r inhibitors, TNF-inhibitors, JAK-inhibitors, and IL12/23/17-inhibitors but not in rituximab. As >50% of rituximab patients responded to vaccines including omicron subvariants, these patients should be prioritized for additional vaccine doses. IMPORTANCE Results from this study provide further evidence that additional doses of COVID-19 vaccines are immunogenic and result in satisfactory antibody response in a majority of patients with inflammatory rheumatic diseases (IRD) receiving potent immunomodulating treatments such as biological or targeted disease-modifying anti-rheumatic drugs (DMARDs) given as monotherapy or combined with traditional DMARDs. We observed that rituximab treatment, both as monotherapy and combined with csDMARDs, impaired antibody response, and only roughly 50% of patients developed a satisfactory antibody response including response to omicron subvariants after the third vaccine. In addition, higher IgG levels at the last rituximab course before the third vaccine dose and a longer time after the last rituximab treatment increased the chance of a satisfactory antibody response. These results indicate that rituximab-treated patients should be prioritized for additional vaccine doses. CLINICAL TRIALS EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) with number 2021-000880-63.
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| 21. |
- Grahnemo, Louise, et al.
(författare)
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Low Circulating Valine Associate With High Risk of Hip Fractures
- 2023
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Ingår i: Journal of Clinical Endocrinology & Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197. ; 108:11
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Tidskriftsartikel (refereegranskat)abstract
- Context Hip fractures constitute a major health concern. An adequate supply of amino acids is crucial to ensure optimal acquisition and remodeling of bone. Circulating amino acid levels have been proposed as markers of bone mineral density, but data on their ability to predict incident fractures are scarce. Objectives To investigate the associations between circulating amino acids and incident fractures. Methods We used UK Biobank (n = 111 257; 901 hip fracture cases) as a discovery cohort and the Umea Fracture and Osteoporosis (UFO) hip fracture study (hip fracture cases n = 2225; controls n = 2225) for replication. Associations with bone microstructure parameters were tested in a subsample of Osteoporotic Fractures in Men Sweden (n = 449). Results Circulating valine was robustly associated with hip fractures in the UK Biobank (HR per SD increase 0.79, 95% CI 0.73-0.84), and this finding was replicated in the UFO study (combined meta-analysis including 3126 incident hip fracture cases, odds ratio per SD increase 0.84, 95% CI 0.80-0.88). Detailed bone microstructure analyses showed that high circulating valine was associated with high cortical bone area and trabecular thickness. Conclusion Low circulating valine is a robust predictor of incident hip fractures. We propose that circulating valine may add information for hip fracture prediction. Future studies are warranted to determine whether low valine is causally associated with hip fractures.
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| 22. |
- Gustafsson, Anna, et al.
(författare)
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Effect of IFN-γ on the kynurenine/tryptophan ratio in monolayer-cultured keratinocytes and a 3D reconstructed human epidermis model
- 2020
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Ingår i: Journal of dermatological science (Amsterdam). - : Japanese Society for Investigative Dermatology. - 0923-1811 .- 1873-569X. ; 99:3, s. 177-184
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Interferon-gamma (IFN-γ) represents a potent inducer for keratinocyte inflammatory and immune activation in vitro. Since tryptophan (trp) conversion to kynurenine (kyn) is involved in inflammation, the topical kyn/trp ratio may serve as a biomarker of skin inflammation. However, the trp metabolism in keratinocytes exposed to IFN-γ is not yet fully understood.OBJECTIVE: The aim of this study was to establish a human epidermis model in order to quantify cytokine and kyn/trp secretion from IFN-γ stimulated cells and tissues. Moreover, to compare the cell response of 2D-cultured keratinocytes and the 3D epidermis model.METHODS: Polycarbonate filters were used on which primary keratinocytes could attach and stratify in order to form the typical layers of reconstructed human epidermis (RHE). After IFN-γ treatment, secretion of kyn/trp was measured by high performance liquid chromatography. Gene and protein expression of indoleamine 2,3-dioxygenase 1 (IDO) was analyzed with real-time PCR and immunohistochemistry. The secretion of cytokines was quantified with ELISA.RESULTS: Trp catabolism to kyn was significantly increased (P < 0.01) in the 2D culture in response to IFN-γ treatment. Before kyn secretion, IDO was strongly upregulated (P < 0.001). IFN-γ treatment also increased the secretion of IL-6 and IL-8 from the keratinocytes. In the RHE, IDO was upregulated by IFN-γ, and kyn secretion could be detected. Interestingly, IDO expression was only present in the basal cells of the RHE.CONCLUSION: Our results suggest that IFN-γ acts as an inducer of trp degradation preferentially in undifferentiated keratinocytes, indicated by the IDO expression in the basal layer of the RHE.
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| 23. |
- Gustafsson, Anna W, et al.
(författare)
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An intricate dance of intersubjectivity : The social and cognitive benefits of a digital shared reading group
- 2023
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Ingår i: Scientific Study of Literature. - 2210-4380. ; 12:1, s. 103-132
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Tidskriftsartikel (refereegranskat)abstract
- This article deepens the understanding of characteristic features of Shared Reading (SR) that can shed light on health benefits of this literary practice suggested by previous research. We provide a detailed analysis of language, interaction, reading strategies and collaborative meaning-making in an online SR group in which participants read and discussed a modernist poem. We triangulate our analysis with results from a focus group with the participants. Our study is informed by psychological theories about joint attention and its effects on social cohesion, mentalisation and perspective-taking. The analysis shows how the SR format provides a space in which ingroupness, intersubjectivity, and perspective-taking are created and realised in language use and interaction. Furthermore, our study suggests that many characteristic features of SR identified in earlier research can still be observed in an online SR group. The study lays the ground for more conclusive research of the benefits of this reading practice.
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| 24. |
- Hadad, Ronza, 1984-, et al.
(författare)
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First National Genomic Epidemiological Study of Neisseria gonorrhoeae Strains Spreading Across Sweden in 2016
- 2022
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Ingår i: Frontiers in Microbiology. - : Frontiers Media S.A.. - 1664-302X. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- The increasing transmission and antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global health concern with worrying trends of decreasing susceptibility to also the last-line extended-spectrum cephalosporin (ESC) ceftriaxone. A dramatic increase of reported gonorrhea cases has been observed in Sweden from 2016 and onward. The aim of the present study was to comprehensively investigate the genomic epidemiology of all cultured N. gonorrhoeae isolates in Sweden during 2016, in conjunction with phenotypic AMR and clinical and epidemiological data of patients. In total, 1279 isolates were examined. Etest and whole-genome sequencing (WGS) were performed, and epidemiological data obtained from the Public Health Agency of Sweden. Overall, 51.1%, 1.7%, and 1.3% resistance to ciprofloxacin, cefixime, and azithromycin, respectively, was found. No isolates were resistant to ceftriaxone, however, 9.3% of isolates showed a decreased susceptibility to ceftriaxone and 10.5% to cefixime. In total, 44 penA alleles were found of which six were mosaic (n = 92). Using the typing schemes of MLST, NG-MAST, and NG-STAR; 133, 422, and 280 sequence types, respectively, and 93 NG-STAR clonal complexes were found. The phylogenomic analysis revealed two main lineages (A and B) with lineage A divided into two main sublineages (A1 and A2). Resistance and decreased susceptibility to ESCs and azithromycin and associated AMR determinants, such as mosaic penA and mosaic mtrD, were predominantly found in sublineage A2. Resistance to cefixime and azithromycin was more prevalent among heterosexuals and MSM, respectively, and both were predominantly spread through domestic transmission. Continuous surveillance of the spread and evolution of N. gonorrhoeae, including phenotypic AMR testing and WGS, is essential for enhanced knowledge regarding the dynamic evolution of N. gonorrhoeae and gonorrhea epidemiology.
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| 25. |
- Hagberg Thulin, Malin, et al.
(författare)
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Inhibition of STAT3 prevents bone metastatic progression of prostate cancer in vivo
- 2021
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Ingår i: Prostate. - : Wiley. - 0270-4137 .- 1097-0045. ; 81:8, s. 452-462
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Tidskriftsartikel (refereegranskat)abstract
- Background Prostate cancer (PC) metastasizes to the skeleton forming predominantly sclerotic lesions, and there is currently no cure for bone metastatic disease. The transcription factor signal transducer and activator of transcription 3 (STAT3) is implicated as a metastatic driver, but its potential as therapeutic target in bone metastasis has not been investigated. In this study, we evaluated for the first time a STAT3 inhibitor, Napabucasin, as a therapeutic option for bone metastatic PC. Methods Effects of STAT3 inhibitors, Stattic and Napabucasin, on metastatic potential in PC cells were studied in vitro by assessment of migration capacity, self-renewal potential, and tumorsphere formation. For evaluation of the role of STAT3 in initial skeletal establishment of PC cells as well as in progressed castration-resistant PC (CRPC) in bone, human VCaP prostate cancer cells were inoculated in the tibia of mice which subsequently were treated with the STAT3 inhibitor Napabucasin. Bone specimens were analyzed using computed tomography (CT), immunohistochemistry, and quantitative polymerase chain reaction. Results The small molecule STAT3 inhibitors Stattic and Napabucasin both effectively impaired metastatic potential of PC cells in vitro. Furthermore, treatment with Napabucasin prevented metastatic establishment in tibial bones in vivo and thereby also the tumor-induced sclerotic bone response seen in vehicle-treated VCaP xenografts. In addition, treatment with Napabucasin of established bone CRPC significantly decreased both tumor burden and tumor-induced trabecular bone volume compared with effects seen in vehicle-treated animals. Anti-mitotic effects were confirmed by decreased Ki67 staining in Napabucasin-treated xenografts compared with vehicle-treated xenografts. Alterations of gene expression in the femoral bone marrow (BM) niche toward the maintenance of hematopoietic stem cells and the myeloid lineage were demonstrated by quantitative real-time polymerase chain reaction and were further reflected by a substantial increase in the number of erythrocytes in BM of Napabucasin-treated mice. Furthermore, a unique pattern of STAT3 phosphorylation in osteoblasts/stromal cells surrounding the areas of tumor cells was demonstrated immunohistochemically in bone xenograft models using several different PC cell lines. Conclusion Inhibition of STAT3 activity disrupts the bone metastatic niche and targets both the skeletal establishment of PC and advanced bone metastatic CRPC in mice, suggesting STAT3 as a candidate for molecular targeted therapies of skeletal metastatic disease.
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| 26. |
- Henning, Petra, 1974, et al.
(författare)
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WNT16 is Robustly Increased by Oncostatin M in Mouse Calvarial Osteoblasts and Acts as a Negative Feedback Regulator of Osteoclast Formation Induced by Oncostatin M
- 2021
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Ingår i: Journal of Inflammation Research. ; 14, s. 4723-4741
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bone loss is often observed adjacent to inflammatory processes. The WNT signaling pathways have been implicated as novel regulators of both immune responses and bone metabolism. WNT16 is important for cortical bone mass by inhibiting osteoclast differentiation, and we have here investigated the regulation of WNT16 by several members of the pro-inflammatory gp130 cytokine family. Methods: The expression and regulation of Wnt16 in primary murine cells were studied by qPCR, scRNAseq and in situ hybridization. Signaling pathways were studied by siRNA silencing. The importance of oncostatin M (OSM)-induced WNT16 expression for osteoclastogenesis was studied in cells from Wnt16-deficient and wild-type mice. Results: We found that IL-6/sIL-6R and OSM induce the expression of Wnt16 in primary mouse calvarial osteoblasts, with OSM being the most robust stimulator. The induction of Wnt16 by OSM was dependent on gp130 and OSM receptor (OSMR), and downstream signaling by the SHC1/STAT3 pathway, but independent of ERK. Stimulation of the calvarial cells with OSM resulted in enhanced numbers of mature, oversized osteoclasts when cells were isolated from Wnt16 deficient mice compared to cells from wild-type mice. OSM did not affect Wnt16 mRNA expression in bone marrow cell cultures, explained by the finding that Wnt16 and Osmr are expressed in distinctly different cells in bone marrow, nor was osteoclast differentiation different in OSM-stimulated bone marrow cell cultures isolated from Wnt16-/- or wild-type mice. Furthermore, we found that Wnt16 expression is substantially lower in cells from bone marrow compared to calvarial osteoblasts. Conclusion: These findings demonstrate that OSM is a robust stimulator of Wnt16 mRNA in calvarial osteoblasts and that WNT16 acts as a negative feedback regulator of OSMinduced osteoclast formation in the calvarial bone cells, but not in the bone marrow.
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| 27. |
- Jakszyn, Paula, et al.
(författare)
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Inflammatory potential of the diet and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition study
- 2020
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 147:4, s. 1027-1039
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Tidskriftsartikel (refereegranskat)abstract
- Proinflammatory diets are associated with risk of developing colorectal cancer (CRC), however, inconsistencies exist in subsite- and sex-specific associations. The relationship between CRC and combined lifestyle-related factors that contribute toward a low-grade inflammatory profile has not yet been explored. We examined the association between the dietary inflammatory potential and an inflammatory profile and CRC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. This cohort included 476,160 participants followed-up of 14 years and 5,991 incident CRC cases (3,897 colon and 2,094 rectal tumors). Dietary inflammatory potential was estimated using an Inflammatory Score of the Diet (ISD). An Inflammatory Profile Score (IPS) was constructed, incorporating the ISD, physical activity level and abdominal obesity. The associations between the ISD and CRC and IPS and CRC were assessed using multivariable regression models. More proinflammatory diets were related to a higher CRC risk, particularly for colon cancer; hazard ratio (HR) for highest versus lowest ISD quartile was 1.15 (95% confidence interval [CI] 1.04–1.27) for CRC, 1.24 (95% CI 1.09–1.41) for colon cancer and 0.99 (95% CI 0.83–1.17) for rectal cancer. Associations were more pronounced in men and not significant in women. The IPS was associated with CRC risk, particularly colon cancer among men; HRs for the highest versus lowest IPS was 1.62 (95% CI 1.31–2.01) for colon cancer overall and 2.11 (95% CI 1.50–2.97) for colon cancer in men. Our study shows that more proinflammatory diets and a more inflammatory profile are associated with higher risk of CRC, principally colon cancer and in men.
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| 28. |
- Johansson, Birgitta, 1959-, et al.
(författare)
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The effect of internet-administered support (carer eSupport) on preparedness for caregiving in informal caregivers of patients with head and neck cancer compared with support as usual: a study protocol for a randomized controlled trial.
- 2024
-
Ingår i: BMC cancer. - 1471-2407. ; 24:1
-
Tidskriftsartikel (refereegranskat)abstract
- Informal caregivers (ICs) of patients with cancer provide essential and mainly uncompensated care. A self-perceived preparedness to care for the patient is associated with a lower caregiver burden, described as the extent to which caregiving is perceived as having adverse effects on IC functioning and well-being. ICs' well-being is associated with patient-perceived quality of care, suggesting that interventions to optimize ICs' health are essential in order to improve patient care. Head and neck cancer (HNC) is the seventh most common malignant disease in the world. The disease and its treatment have a significant negative impact on the patient's health and quality of life. Symptoms usually interfere with swallowing, food and fluid intake, breathing, speaking, and communication. ICs frequently manage patients' symptoms and side effects, especially problems related to nutrition and oral pain, without being properly prepared. Carer eSupport is an Internet-administered intervention, based on focus group discussions with ICs, developed in collaboration with ICs and healthcare professionals, tested for feasibility, and deemed feasible. This study protocol outlines the methods of investigating the effects of Carer eSupport plus support as usual (SAU) on self-reported preparedness for caregiving, caregiver burden, and well-being in the ICs of patients with HNC, compared with ICs receiving SAU only.In this randomized controlled trial, 110 ICs of patients with HNC, undergoing radiotherapy combined with surgery and/or medical oncological treatment, will be randomized (1:1) to Carer eSupport plus SAU or SAU only. Data will be collected at baseline (before randomization), post-intervention (after 18 weeks), and 3 months after post-intervention. The primary outcome is self-reported preparedness for caregiving. Secondary outcomes are self-reported caregiver burden, anxiety, depression, and health-related quality of life. The effect of Carer eSupport plus SAU on preparedness for caregiving and secondary outcomes, compared with SAU only, will be evaluated by intention to treat analyses using linear regression models, mixed-model regression, or analysis of covariance.If proven effective, Carer eSupport has the potential to significantly improve ICs' preparedness for caregiving and their wellbeing, thereby improving patient-perceived quality of care and patient wellbeing.ClinicalTrials.gov; NCT06307418, registered 12.03.2024 (https://clinicaltrials.gov/search? term=NCT06307418).
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| 29. |
- Kanis, J A, et al.
(författare)
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Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.
- 2023
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Ingår i: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - : Springer Nature. - 1433-2965 .- 0937-941X. ; 34:12, s. 2027-2045
-
Tidskriftsartikel (refereegranskat)abstract
- A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX.The aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD).We studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients.A previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination.A previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.
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| 30. |
- Kanoni, Stavroula, et al.
(författare)
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Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis.
- 2022
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Ingår i: Genome biology. - : Springer Science and Business Media LLC. - 1474-760X .- 1465-6906 .- 1474-7596. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Genetic variants within nearly 1000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery.To expand our understanding of the underlying biological pathways and mechanisms controlling blood lipid levels, we leverage a large multi-ancestry meta-analysis (N=1,654,960) of blood lipids to prioritize putative causal genes for 2286 lipid associations using six gene prediction approaches. Using phenome-wide association (PheWAS) scans, we identify relationships of genetically predicted lipid levels to other diseases and conditions. We confirm known pleiotropic associations with cardiovascular phenotypes and determine novel associations, notably with cholelithiasis risk. We perform sex-stratified GWAS meta-analysis of lipid levels and show that 3-5% of autosomal lipid-associated loci demonstrate sex-biased effects. Finally, we report 21 novel lipid loci identified on the X chromosome. Many of the sex-biased autosomal and X chromosome lipid loci show pleiotropic associations with sex hormones, emphasizing the role of hormone regulation in lipid metabolism.Taken together, our findings provide insights into the biological mechanisms through which associated variants lead to altered lipid levels and potentially cardiovascular disease risk.
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| 31. |
- Laurell, Cecilia, et al.
(författare)
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Transcriptome analysis shows nicotinamide seed treatment alters expression of genes involved in defense and epigenetic processes in roots of seedlings of Picea abies
- 2021
-
Ingår i: Journal of Forestry Research. - : Springer Nature. - 1007-662X .- 1993-0607.
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Tidskriftsartikel (refereegranskat)abstract
- Nicotinamide treatment of plants and plant cell cultures has been shown to promote defense and decrease levels of DNA methylation. In the present study, we used RNA-seq technology to study overall changes in gene expression induced in roots of 3-month-old spruce (Picea abies) seedlings grown from nicotinamide-treated seeds to examine the molecular mechanisms underlying the defense promotion. Approximately 350 genes were identi- fied as differentially expressed in roots after the seed treat- ment. Stress response genes, including transcription factors MYB77 and LHY and two chitinase enzymes, were gen- erally upregulated, whereas genes thought to be involved in epigenetic regulation such as DDM1, known to promote DNA methylation, were present at high frequency among the downregulated genes. Across all samples, the expression of downregulated epigenetic-related genes was highly cor- related with the nicotinamide treatment, indicating a com- mon regulation. Our results support an earlier hypothesis regarding a potential role of nicotinamide as a defense-signal mediator.
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| 32. |
- Manti, M., et al.
(författare)
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Excess of ovarian nerve growth factor impairs embryonic development and causes reproductive and metabolic dysfunction in adult female mice
- 2020
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Ingår i: FASEB Journal. - : John Wiley & Sons. - 0892-6638 .- 1530-6860. ; 34:11, s. 14440-14457
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Tidskriftsartikel (refereegranskat)abstract
- Nerve growth factor (NGF) is critical for the development and maintenance of the peripheral sympathetic neurons. NGF is also involved in the ovarian sympathetic innervation and in the development and maintenance of folliculogenesis. Women with the endocrine disorder, polycystic ovary syndrome (PCOS), have an increased sympathetic nerve activity and increased ovarian NGF levels. The role of ovarian NGF excess in the PCOS pathophysiology and in the PCOS-related features is unclear. Here, using transgenic mice overexpressesing NGF in the ovarian theca cells (17NF mice), we assessed the female embryonic development, and the reproductive and metabolic profile in adult females. Ovarian NGF excess caused growth restriction in the female fetuses, and a delayed gonocyte and primary oocyte maturation. In adulthood, the 17NF mice displayed irregular estrous cycles and altered ovarian expression of steroidogenic and epigenetic markers. They also exhibited an increased sympathetic output with increased circulating dopamine, and metabolic dysfunction reflected by aberrant adipose tissue morphology and function, impaired glucose metabolism, decreased energy expenditure, and hepatic steatosis. These findings indicate that ovarian NGF excess leads to adverse fetal development and to reproductive and metabolic complications in adulthood, mirroring common features of PCOS. This work provides evidence that NGF excess may be implicated in the PCOS pathophysiology.
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| 33. |
- Nezami, Zainu, et al.
(författare)
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The impact of myocardial fibrosis biomarkers in a heart failure population with atrial fibrillation-The HARVEST-Malmö study.
- 2022
-
Ingår i: Frontiers in cardiovascular medicine. - : Frontiers Media S.A.. - 2297-055X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several studies suggest that circulating biomarkers of myocardial fibrosis are associated with worse prognosis in subjects with atrial fibrillation (AF). Here, we aimed to explore associations between fibrosis biomarkers, prevalent AF, and left atrial volume (LAV) enlargement in subjects with heart failure (HF). Additionally, we evaluated the prognostic impact of fibrotic biomarkers in HF with co-existing AF.Materials and methods: Patients hospitalized for HF (n = 316, mean age 75 years; 30% women) were screened for AF. Seven proteins previously associated with myocardial fibrosis [metalloproteinase inhibitor 4 (TIMP-4), suppression of tumorigenicity 2 (ST-2), galectin-3 (GAL-3), growth/differentiation factor-15 (GDF-15), and matrix metalloproteinase 2, 3, and 9 (MMP-3, MMP-3, and MMP-9, respectively)] were analyzed using a proximity extension assay. Proteins with significant Bonferroni-corrected associations with mortality and re-hospitalization risk were taken forward to multivariable Cox regression analyses. Further, Bonferroni-corrected multivariable logistic regression models were used to study associations between protein plasma levels, prevalent AF, and severely enlarged left atrial volume index (LAVI ≥ 48 ml/m2).Results: Prevalent AF was observed in 194 patients at the hospitalization of whom 178 (92%) were re-hospitalized and 111 (57%) died during the follow-up period. In multivariable logistic regression models, increased plasma levels of TIMP-4, GDF-15, and ST-2 were associated with the prevalence of AF, whereas none of the seven proteins showed any significant association with severely enlarged LAVI. Increased plasma levels of five proteins yielded significant associations with all-cause mortality in patients with co-existing AF; TIMP-4 (HR 1.33; CI95% 1.07-1.66; p = 0.010), GDF-15 (HR 1.30; CI95% 1.05-1.62; p = 0.017), GAL-3 (HR 1.29; CI95% 1.03-1.61; p = 0.029), ST-2 (HR 1.48; CI95% 1.18-1.85; p < 0.001), and MMP-3 (HR 1.33; CI95% 1.09-1.63; p = 0.006). None of the proteins showed any significant association with re-hospitalization risk.Conclusion: In this study, we were able to demonstrate that elevated levels of three plasma proteins previously linked to myocardial fibrosis are associated with prevalent AF in a HF population. Additionally, higher levels of five plasma proteins yielded an increased risk of mortality in the HF population with or without co-existing AF.
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| 34. |
- Ohlsson, Anna, 1975-, et al.
(författare)
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Effectiveness by gender and age of renin-angiotensin system blockade in heart failure-A national register-based cohort study
- 2020
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 29:5, s. 518-529
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Investigate effectiveness by gender and age and equity implications of treatment with renin‐angiotensin system blockade (RASb) in heart failure (HF) patients.Methods: In this population‐based register study, we used inpatient data from 2006 to 2010 for patients age 20 years or older with no HF hospitalisation for minimum of 1 year before an index hospitalisation. A wash‐out period for RASb of 6 months preceding admission was used.Hospital data were linked with drug dispensation data and cause of death data. The associations between time‐dependent RASb exposure and all‐cause death and HF death, respectively, were examined by Cox regression models. Interactions by gender and age were also investigated on the multiplicative and additive scales.Results: Thirty thousand seven hundred twenty‐one patients were analysed. Fifty‐one percent were women. Median age was 83. Fifty‐three percent of women and 64% of men received RASb after the index hospitalisation. Younger patients were more likely to receive RASb than older ones. One‐year mortality was 28%. RASb was associated with an overall hazard ratio (HR) for all‐cause death of 0.72 (95% confidence interval 0.69‐0.75), and an HR of 0.85 (0.77‐0.93) for HF death. Interaction analyses showed HRs for all‐cause death associated with RASb between 0.12 (0.10‐0.13) in the youngest, and 0.80 (0.76‐0.84) in the oldest patients.Conclusions: RASb appeared effective for women and men and for patients of all ages in this hospitalised HF cohort. No gender difference in effectiveness was found. RASb exposure was low overall, indicating a need for improved adherence to treatment guidelines. Treatment with RASb may be inequitable for women and older patients.
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| 35. |
- Ohlsson, Anna, 1975-
(författare)
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Equity in Treatment and Outcomes among Heart Failure Patients in Sweden : The role of gender, age and socioeconomic factors in access to treatment and mortality
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is extensive empirical evidence for inequity in health and health care between and within countries across all economic levels worldwide. In Sweden, the Health and Medical Services Act states that health care should provide good health and equal health care for the entire population, but this goal has yet to be fulfilled. Equity has been defined as “differences which are unnecessary and avoidable, but in addition are considered unfair and unjust”. Equity in health is closely linked with the so-called social determinants of health, or the conditions in which people are born, grow, live, work, and age.Heart failure (HF) is a common disease globally, carrying high morbidity and mortality, and is one of the major causes of hospitalisations in Sweden. There is a strong evidence base for renin angiotensin system blockers (RASb) as well as beta-blockers (BB) reducing mortality in HF, and long-standing recommendations for these medications in treatment guidelines. However, not all eligible patients receive this first-line treatment. There has been some evidence of inequity by gender and age in treatment of HF, but evidence regarding socioeconomic risk factors has been scarce.In this thesis, differences in access to pharmacological therapy by demographic and socioeconomic factors were investigated.Observational studies with cohort designs were performed. In Study I–III large national population-level interlinked register materials were investigated, and in Study IV a well characterised cohort including clinical and prescription data from the SwedeHF, a Swedish HF quality register, was analysed.In Study I, we investigated differences in access to angiotensin-converting enzyme inhibitors (a type of RASb) by gender, age, educational level, employment status, income and immigration status among hospitalised HF patients in Sweden. In Study II we aimed to investigate effectiveness, i.e., the association between RASb exposure and mortality, among hospitalised HF patients in Sweden, and whether effectiveness varied with gender and age. In Study III, RASb access and mortality by employment status and educational level among hospitalised HF patients in Sweden of working age was analysed, along with possible excess mortality among non-employed patients without access to RASb. In Study IV, medication adherence to mortality-reducing HF medications, i.e., RASb and BB, was examined by age, gender, educational level, marital status and income.In conclusion, the studies in the thesis showed that access to RASb treatment appeared inequitable for women, the non-employed, and the elderly among hospitalised HF patients, although this treatment was associated with lower mortality for all these groups. Furthermore, RASb treatment was associated with similar reductions in mortality for women and men, but the association was somewhat weaker among older compared with younger hospitalised HF patients. In addition, non-employment and lower educational level were associated with higher mortality in hospitalised HF patients, and non-employment was associated with less access to RASb treatment. Finally, lower income and single status were associated with lower adherence to mortality-reducing treatment with BB and RASb in a quality register HF cohort, while associations were more unclear regarding gender and age.
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| 36. |
- Ohlsson, Anna, 1975-, et al.
(författare)
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Non-employment and low educational level as risk factors for inequitable treatment and mortality in heart failure : a population-based cohort study of register data
- 2021
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The risk of heart failure is disproportionately high among the socioeconomically disadvantaged. Furthermore, socioeconomically deprived patients are at risk of inequitable access to heart failure treatment and poor outcomes. Non-employment as a risk factor in this respect has not previously been studied at the level of the individual. The aim of this register-based cohort study was to analyse equity in access to renin-angiotensin system blockers and mortality, by employment status and educational level. Methods: The study population consisted of Swedish patients aged 20–64 years hospitalised for heart failure in July 2006–December 2010, without a heart failure hospitalisation within one year or more before index hospitalisation and without renin-angiotensin system blocker dispensation in the 6 months preceding index hospitalisation. Non-access to renin-angiotensin system blockers, measured as drug dispensations, was investigated by employment status and educational level through logistic regression. Cox regression models were used to obtain hazard ratios for all-cause death by educational level and employment status. Interaction analysis was used to test whether associations between access to treatment and mortality differed by employment status. Results: Among the 3,874 patients, 1,239 (32%) were women. The median age was 57 years. Fifty-three percent were employed. The non-employed patients had more comorbidity and lower access (68%) to renin-angiotensin system blockers compared with the employed (82%). The adjusted odds ratio for non-access to renin-angiotensin system blockers among the non-employed was 1.76. Non-employment was associated with an adjusted hazard ratio of 1.76 for death. Low educational level was associated with a higher death risk. Mortality was highest among the non-employed without access to renin-angiotensin system blockers and the association between access to renin-angiotensin system blockers and survival was slightly weaker in this group.Conclusions: Non-employment and low educational level were associated with elevated mortality in heart failure. Non-employment was a risk factor for lower access to evidence-based treatment, and among the non-employed access to treatment was associated with a slightly smaller risk reduction than among the employed. The results underscore that clinicians need to be aware of the importance of socioeconomic factors in heart failure care.
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| 37. |
- Ohlsson, Claes, 1965, et al.
(författare)
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Low Progesterone and Low Estradiol Levels Associate with Abdominal Aortic Aneurysms in Men.
- 2022
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 107:4
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Tidskriftsartikel (refereegranskat)abstract
- Male sex is a major risk factor for abdominal aortic aneurysms (AAA) but few studies have addressed associations between sex hormone levels and AAA.To describe the associations between serum sex steroids and early, screening-detected AAA in men.We validated a high-sensitivity liquid chromatography-tandem mass spectrometry assay for comprehensive serum sex hormone profiling. This assay was then employed in a case-control study including 147 men with AAA (infrarenal aorta ≥30mm) and 251 AAA-free controls recruited at the general population-based ultrasound screening for AAA in 65-year-old Swedish men.Associations between dehydroepiandrosterone, progesterone, 17α-hydroxyprogesterone, androstenedione, estrone, testosterone, dihydrotestosterone, and estradiol and AAA presence.Dehydroepiandrosterone, progesterone, 17α-hydroxyprogesterone, testosterone, and estradiol, but not the other hormones, were lower in men with AAA. In models with adjustments for known AAA risk factors and comorbidity, only progesterone (odds ratio per SD decrease 1.62 [95% CI 1.18-2.22]) and estradiol (1.40 [95% CI 1.04-1.87]) remained inversely associated with the presence of AAA. Progesterone and estradiol contributed with independent additive information for prediction of AAA presence; compared with men with high (above median) levels, men with low (below median) levels of both hormones had a 4-fold increased odds ratio for AAA (4.06 [95% CI 2.25-7.31]).Measured by a high-performance sex steroid assay, progesterone and estradiol are inversely associated with AAA in men, independently of known risk factors. Future studies should explore whether progesterone and estradiol, which are important reproductive hormones in women, are protective in human AAA.
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| 38. |
- Ohlsson, Claes, 1965, et al.
(författare)
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Phosphorylation site S122 in estrogen receptor α has a tissue-dependent role in female mice
- 2020
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Ingår i: FASEB Journal. - 0892-6638 .- 1530-6860. ; 34, s. 15991-16002
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Tidskriftsartikel (refereegranskat)abstract
- Estrogen treatment increases bone mass and reduces fat mass but is associated with adverse effects in postmenopausal women. Knowledge regarding tissue-specific estrogen signaling is important to aid the development of new tissue-specific treatments. We hypothesized that the posttranslational modification phosphorylation in estrogen receptor alpha (ERα) may modulate ERα activity in a tissue-dependent manner. Phosphorylation of site S122 in ERα has been shown in vitro to affect ERα activity, but the tissue-specific role in vivo is unknown. We herein developed and phenotyped a novel mouse model with a point mutation at the phosphorylation site 122 in ERα (S122A). Female S122A mice had increased fat mass and serum insulin levels but unchanged serum sex steroid levels, uterus weight, bone mass, thymus weight, and lymphocyte maturation compared to WT mice. In conclusion, phosphorylation site S122 in ERα has a tissue-dependent role with an impact specifically on fat mass in female mice. This study is the first to demonstrate in vivo that a phosphorylation site in a transactivation domain in a nuclear steroid receptor modulates the receptor activity in a tissue-dependent manner.
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| 39. |
- Ohlsson, Elisabeth, et al.
(författare)
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Student teachers’ experiences and understandings of academic writing in their professional training
- 2023
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Ingår i: WRAB 2023: Writing Research Across Borders VI, From early literacy learning to writing in professional life, 18–22 February 2023, NTNU, Trondheim, Norway.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The degree objectives for primary school teacher education in Sweden stipulate that students should be able to “demonstrate communicative ability in listening, speaking and writing in support of the educational activities” (SFS 1993:100/SFS 2021:1338). In contrast, the student teachers take part in, for example, two degree thesis courses of 15 ECTSC points each and hand in multiple written assignments where their academic writing ability is put to the test. For instance, in the courses in mother tongue (Swedish), they are expected to “convey the core content of the course in writing in accordance with academic written language conventions”. The incongruity between the degree objectives and course objectives forms the bases and the research questions of this study where teacher students’ experiences of academic writing, both prior and during teacher education, are investigated. The study includes interpretations of the student teachers’ understandings of what is expected of them as regards academic writing, along with support structures. We highlight similarities and differences in the statements between different types of student groups and whether factors such as age and previous university studies affect their experiences and understandings. Data in this study consist of student teachers’ responses to a survey sent out to students in three courses, at three different stages of their primary teacher education; at the beginning, in the middle and at the end of their four year program. The survey was sent out in March 2020 and May 2021. A total of 126 students responded to the survey, ranging in ages from 21 to 53, of which approximately half of them stated having a previous vocational training. The survey was constructed in Google Forms and distributed to all students in the three courses through the courses’ digital platform. It was presented both as a notification on the portal’s notice board and sent out individually to all participants in the courses. The anonymous survey was open for three weeks (and a reminder was sent out). The survey had twelve questions which were yes/no questions and nine of these also had the option to add comments in order to be able to obtain both qualitative and quantitative responses. The responses have been analysed in several stages starting with the automatic descriptive results that are created in Google Forms which provide an overview of the individual answers to each question and diagrams illustrating percentages relating to the answers. This was followed by a division between which primary teacher education program the students participates in (for lower or upper primary school) and tables distinguishing between variables (the questions) which were all colour coded. The responses were furthermore analysed to discover connections and patterns along with Ricoeur’s (1993) theory of interpretation. The results show that a majority of the student teachers say that they have previous knowledge of some form of academic and/or scientific writing. However, they also express a need of increased support in their writing and ask for more academic writing practice during their teacher education. Respondents also indicate knowing about the support structure at the university, the Unit for Academic Language (ASK), but do not use it, instead the respondents have sought support among their peers. Furthermore, the incongruities between the degree objectives and course objectives in the steering documents also appear in the student responses; they are for example uncertain of what is expected of them concerning both criteria and assessment on academic writing demands in different courses. The study might be seen as limited by the size of the respondents. There might also be an issue regarding the student teachers’ interpretation of “academic writing” which led to a wide range of responses. Nevertheless, the study seem to capture the essentials put forward, that writing needs to be a part of education, from early literacy to professional life as a matter of democracy.
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| 40. |
- Ohlsson, Håkan, et al.
(författare)
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Impact of Specific Bowel Symptoms on Quality of Life in Patients with Midgut Neuroendocrine Tumours
- 2021
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 45, s. 2793-2803
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Patients with midgut neuroendocrine tumours (NETs) suffer from decreased health-related quality of life (HRQoL), in large part due to bowel symptoms. However, it is unknown which bowel symptoms affect HRQoL the most. An enhanced understanding of this is essential to better focus treatment on this aspect of the disease. This study aimed to determine which bowel symptoms affect HRQoL the most in patients with midgut NETs. Methods: Consenting patients with midgut NET completed the Memorial Sloan Kettering Bowel Function Instrument and the HRQoL questionnaire (EORTC QLQ-C30). The correlation between bowel symptoms and HRQoL was analysed using multiple linear regression, adjusting for age, Charlson Comorbidity Index score, presence of metastatic disease, chromogranin A, and BMI yielding ß-coefficients with 95% confidence intervals. Results: Totally, 119 patients with midgut NET completed the questionnaires and were included in the study. Loose stool and bowel frequency ≥ 3/day were the most common bowel symptoms, reported by 47% and 56% of patients, respectively. However, sensitivity to certain types of food and beverages, a feeling of incomplete emptying of the bowel, and soiling were the symptoms most strongly correlated with decreased HRQoL, especially within domains concerning role and social function, with ß-coefficients for the strongest correlated symptoms of 15.0 and 14.6, respectively. Discussion: While symptoms concerning stool consistency and frequency are common in patients with midgut NET, our study suggests that other, more socially stigmatising symptoms affect patients’ HRQoL more. Our findings could help caregivers understand patients’ perceptions of the disease and provide avenues for more directed therapies.
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| 41. |
- Ohlsson, Håkan, et al.
(författare)
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Relationship between somatostatin receptor expressing tumour volume and health-related quality of life in patients with metastatic GEP-NET
- 2022
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Ingår i: Journal of Neuroendocrinology. - : Wiley. - 0953-8194 .- 1365-2826. ; 34:6
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Tidskriftsartikel (refereegranskat)abstract
- For patients with gastroenteropancreatic neuroendocrine tumours (GEP-NET), health-related quality of life (HRQoL) is important. Meanwhile, whether tumour volume is associated with HRQoL is unknown. Hence, the aim of this study was to assess if total somatostatin receptor expressing tumour volume is correlated with HRQoL in patients with metastatic GEP-NET. Some 71 patients were included in the study. HRQoL and NET-specific symptoms were assessed with EORTC QLQ-C30 and EORTC GI.NET21. A summary score was calculated from the output of the QLQ-C30. Total somatostatin receptor expressing tumour volume was retrospectively evaluated on somatostatin receptor imaging with positron emission tomography-computed tomography (68Ga-DOTA-TATE/TOC PET-CT) in each patient. Simple and multiple linear regression were used to evaluate the correlation between tumour volume and HRQoL, controlling for potential confounders. No correlation was found between total somatostatin receptor expressing tumour volume and QLQ-C30 summary score. Weak positive correlations were found between total tumour volume and the specific symptoms dyspnoea, diarrhoea and flushing. To the best of our knowledge, this is the first study to evaluate the association between total somatostatin expressing tumour volume and HRQoL. Our results indicate that, while tumour volume is weakly associated with symptom severity of the carcinoid syndrome, other factors might impact more on overall HRQoL.
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| 42. |
- Ohlsson, Jonas, et al.
(författare)
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Biomass Recalcitrance in Willow Under Two Biological Conversion Paradigms: Enzymatic Hydrolysis and Anaerobic Digestion
- 2020
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Ingår i: BioEnergy Research. - : Springer Science and Business Media LLC. - 1939-1234 .- 1939-1242. ; 13, s. 260-270
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Tidskriftsartikel (refereegranskat)abstract
- Biomass recalcitrance, the inherent resistance of plants towards deconstruction, negatively affects the viability of biorefineries. This trait is not only dictated by the properties of the biomass but also by the conversion system used and its interactions with specific features of the biomass. Here, biomass recalcitrance to anaerobic digestion (AD) was assessed using a biomethanation potential (BMP) assay. Plant material (n = 94) was selected from a large population of natural Salix viminalis accessions, previously evaluated for biomass recalcitrance using hydrothermal pretreatment-enzymatic hydrolysis. Correlations between yields from the two biological conversion systems were evaluated, as well as the influence of biomass compositional features, analyzed by pyrolysis-molecular beam mass spectrometry (py-MBMS), and other biomass physical properties on conversion performance. BMP values averaged 198.0 Nml CH4/g biomass after 94 days, ranging from 28.6 to 245.9. S lignin and carbohydrate-derived spectral features were positively correlated with performance under both systems, whereas G lignin, p-coumaric acid, and ferulic acid-derived ions were negatively correlated with yields and rates. Most spectral features were more strongly correlated with enzymatic hydrolysis yields compared to methane production. For early-stage methane production and rate, recalcitrance factors were similar compared to enzymatic hydrolysis, with weaker correlations observed at later timepoints. The results suggest that although variation in methane potential was considerably lower than enzymatic hydrolysis yields, a reduced recalcitrance under this system will still be of importance to improve early conversion rates. Spectral features of low methane-producing samples indicate the presence of inhibitory substances, warranting further study.
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| 43. |
- Ohlsson, Jonas, et al.
(författare)
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Co-digestion of salix and manure for biogas: importance of clone choice, coppicing frequency and reactor setup
- 2020
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Ingår i: Energies. - : MDPI AG. - 1996-1073. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Animalmanure represents amajor source of renewable energy that can be converted into biogasusing anaerobic digestion. In order to most efficiently utilize this resource, it can be co-digested withenergy dense, high biomethanation potential feedstocks such as energy crops. However, such feedstockstypically require pretreatments which are not feasible for small-scale facilities.We investigated theuse of single-stage and the sequential co-digestion of comminuted but otherwise non-pretreated Salixwith animal manure, and further investigated the effects of coppicing frequency and clone choice onbiomethanation potential and the area requirements for a typical Swedish farm-scale anaerobic digesterusing Salix and manure as feedstock. In comparison with conventional single-stage digestion, sequentialdigestion increased the volumetric and specific methane production by 57% to 577 NmL L?1 d?1 and192 NmL (g volatile solids (VS))?1, respectively. Biomethanation potential was the highest for the twoyear-old shoots, although gains in biomass productivity suggest that every-third-year coppicing maybe a better strategy for supplying Salix feedstock for anaerobic digestion. The biomethane productionperformance of the sequential digestion of minimally pretreated Salix mirrors that of hydrothermallypretreated hardwoods and may provide an option where such pretreatments are not feasible.
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| 44. |
- Ohlsson, Marcus Andreas, et al.
(författare)
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Risk prediction of future cardiac arrest by evaluation of a genetic risk score alone and in combination with traditional risk factors
- 2020
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572. ; 146, s. 74-79
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Coronary heart disease (CHD) is a leading cause of death globally, commonly through sudden cardiac death. Cardiac arrest of cardiac origin (CA) is associated with a poor prognosis and there is a great need for risk assessment and intensified preventive actions. In this study we aim to assess if a genetic risk score for CHD, composed of 50 common CHD susceptibility variants (GRS), predicts CA and to evaluate a novel composite risk score including traditional risk factors as well as GRS. Methods: The GRS score alone and in combination with traditional CHD risk factors were examined in relation to CA incidence among 23 000 middle aged subjects during 18.9 years of follow-up. The cohort excluded patients with a diagnosed history of CHD, heart failure or stroke. Results: Two-hundred-fifty-two patients suffered a cardiac arrest during the follow up, of which 181 were CA. In a multivariate model with CHD risk factors, high versus low genetic risk predicted CA with a hazard ratio (HR) of 2.49 {(95% CI 1.50–4.12) (P < 0.001)}, surpassed only by higher estimates for male sex {HR = 2.91 (95% CI 2.09–4.06) (P < 0.001)}, ages 50–65 {HR = 2.74 (95% CI 1.42–5.25) (P = 0.003)} and ages 65–74 {HR = 5.10 (95% CI 2.56–10.16) (P < 0.001)}. Smoking, dyslipidemia, hypertension and diabetes mellitus also predicted CA but with lower HRs than GRS. A novel composite risk score including CHD risk factors as well as GRS predicted CA with a HR = 110.81 {(95% CI 15.43–795.63) (P < 0.001)} for the highest (5) versus the lowest quintile (1) of the risk score. Conclusions: Genetic risk of CHD is strongly associated with incident CA and when combined with traditional CHD risk factors may identify individuals who benefit from intensified preventive pharmacological treatment.
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| 45. |
- Ohlsson, Mattias, et al.
(författare)
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Proteomic data analysis for differential profiling of the autoimmune diseases SLE, RA, SS, and ANCA-associated vasculitis
- 2021
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Ingår i: Journal of Proteome Research. - Washington : American Chemical Society (ACS). - 1535-3893 .- 1535-3907. ; 20:2, s. 1252-1260
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Tidskriftsartikel (refereegranskat)abstract
- Early and correct diagnosis of inflammatory rheumatic diseases (IRD) poses a clinical challenge due to the multifaceted nature of symptoms, which also may change over time. The aim of this study was to perform protein expression profiling of four systemic IRDs, systemic lupus erythematosus (SLE), ANCA-associated systemic vasculitis (SV), rheumatoid arthritis (RA), and Sjögren's syndrome (SS), and healthy controls to identify candidate biomarker signatures for differential classification. A total of 316 serum samples collected from patients with SLE, RA, SS, or SV and from healthy controls were analyzed using 394-plex recombinant antibody microarrays. Differential protein expression profiling was examined using Wilcoxon signed rank test, and condensed biomarker panels were identified using advanced bioinformatics and state-of-the art classification algorithms to pinpoint signatures reflecting each disease (raw data set available at https:// figshare.com/s/3bd3848a28ef6e7ae9a9.). In this study, we were able to classify the included individual IRDs with high accuracy, as demonstrated by the ROC area under the curve (ROC AUC) values ranging between 0.96 and 0.80. In addition, the groups of IRDs could be separated from healthy controls at an ROC AUC value of 0.94. Disease-specific candidate biomarker signatures and general autoimmune signature were identified, including several deregulated analytes. This study supports the rationale of using multiplexed affinity-based technologies to reflect the biological complexity of autoimmune diseases. A multiplexed approach for decoding multifactorial complex diseases, such as autoimmune diseases, will play a significant role for future diagnostic purposes, essential to prevent severe organ- and tissue-related damage.
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| 46. |
- Ohlsson, Mikael, et al.
(författare)
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Spatial resolution and location impact group structure in a marine food web
- 2020
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Ingår i: Ecology Letters. - : WILEY. - 1461-023X .- 1461-0248. ; 23:10, s. 1451-1459
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Tidskriftsartikel (refereegranskat)abstract
- Ecological processes in food webs depend on species interactions. By identifying broad-scaled interaction patterns, important information on species ecological roles may be revealed. Here, we use the group model to examine how spatial resolution and proximity influence group structure. We examine a data set from the Barents Sea, with food webs described for both the whole region and 25 subregions. We test how the group structure in the networks differ comparing (1) the regional metaweb to subregions and (2) subregion to subregion. We find that more than half the species in the metaweb change groups when compared to subregions. Between subregions, networks with similar group structure are spatially related. Interestingly, although species overlap is important for similarity in group structure, there are notable exceptions. Our results highlight that species ecological roles vary depending on fine-scaled differences in the patterns of interactions, and that local network characteristics are important to consider.
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| 47. |
- Ohlsson, Mikael, 1983-
(författare)
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The significance of species groups for food web structure and functioning
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In ecosystems across the world, species co-exist, compete, and consume, all while adapting to environmental conditions and disruptions. An important key to the puzzle of understanding how species will respond to changes in the ecosystems, caused by for example climate change, pollution, habitat destruction, and overexploitation, is what current roles species have in a larger context. Species interactions are the basis for many ecological processes, for example, describing who eats whom in food webs. Finding groups of species that have similar interactions can provide insight into what roles species have in a food web, as well as identify core structures and functions of said food webs. Food webs are often based on data aggregates of large areas. Consequently, there is a possibility of blurring local aspects of the food web structure, thus blurring locally realized species roles. In Paper I, I used the group model to analyze local and regional group structures of a food web in the Barents Sea. The group model identifies groups linked to their niche, in which species eat, and are eaten by similar species. I found the large, regional food web diverged from the local group structures, indicating that locally scaled food webs may be required to find more accurately realized species roles. On a local scale, similar group structures were generally spatially clustered and environmentally similar. This was to some extent explained by similarities in species compositions, but more fine-grained patterns related to species identities further impacted the group structures. In essence, the group model is a type of community detection based on stochastic block models. Generated groups contain groups of species with similar sets of prey and predators. Groups are related to both trophic similarity and modularity, but the process itself is, as the name implies, stochastic. Various methodologies to determine a "best fit" group structure out of multiple iterations exist. Arguments can however be made, that discarded, alternative group structures may still hold ecological relevance. In Paper II, I investigated five food webs by creating a solution landscape from their respective alternative group structures. My results showed, that the core group structure remained intact across alternative solutions, while potential changes in the group structure were generally limited to smaller subsets of groups or species. Expanding on the analysis of Paper II, Paper III, accounts for the inherent un-certainty of interactions in food webs. Food webs are based on data sets, potentially covering hundreds of species and thousands of interactions. How-ever, spatial and temporal aspects, and the dynamical nature of whether interactions are realized, can impact the food web structure. Here, I investigated how group structures responded to disturbing interactions (i.e., random removal of different fractions). The key findings showed how in general, core group structures remained intact, and already unstable groups turned increasingly unstable. Species traits distinctly defined group identities, but I found no particular species traits ubiquitously linked to unstable group structures. How species interact is intrinsic to their traits; basic trait-matching constraints must be fulfilled for an interaction to be realized, such as a predator being large enough to eat a specific prey. Traits are however also subject to change, with potentially strong selective pressures from for example environmental change or overexploitation. If traits change sufficiently, species interactions can also change, potentially putting affected species in a new ecological context with new predators, prey, and competitive relationships. Possibly related, the cod population in the Baltic Sea, has failed to recover even after ceasing fishing. In Paper IV, I formulated an eco-evolutionary model, which considered cod’s changed ecological role after the collapse, highlighting how competition with flounder species can contribute to blocking the cod population in the Baltic Sea from recovering. With this thesis, I aimed to improve understanding of how species groups based on interactions relate to food web structure. My results highlight how the group model can generate robust groups, which are generally resilient to even moderate disturbances while providing a coarse-grained representation of species roles in a food web. The spatial context of the food web, with its included species and interactions, needs to be considered to get a more accurate representation of locally realized species roles. I have further modeled how species traits may be altered by eco-evolutionary dynamics under strong selective pressure, with subsequent shifts in ecological roles. These aspects are pivotal in understanding how species in our ecosystems will be affected by today’s multitude of environmental impacts.
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- Ohlsson-Nevo, Emma, 1960-, et al.
(författare)
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Digitally distributed Yoga Intervention in Breast Cancer Rehabilitation (DigiYoga CaRe) : protocol for a randomised controlled trial
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:11
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Breast cancer is the most prevalent cancer among women. The treatment is extensive; in addition to surgery, various combinations of radiation therapy, chemotherapy and antibody and endocrine treatment can be applied. Cancer-related fatigue (CRF) is high in patients with breast cancer, peaking during chemotherapy, but may persist for several years. Physical activity has proven to be effective in reducing CRF in breast cancer rehabilitation, but many patients tend to be less active after the diagnosis. Yoga has a previously demonstrated effect on energy levels and digitally distributed yoga intervention can potentially increase accessibility in pandemic times and facilitate participation for patients susceptible to infection and those living far from organised rehabilitation opportunities. The purpose of this study, Digital Yoga Intervention in Cancer Rehabilitation (DigiYoga CaRe) is to investigate whether a 12-week digitally distributed yoga intervention can reduce CRF and stress, improve health-related quality of life (HRQL) and affect pro-inflammatory and metabolic markers in patients with breast cancer.METHODS AND ANALYSIS: This multicentre study will adopt a randomised controlled design including 240 persons after their breast cancer surgery. They will be randomised to a 12-week digitally distributed yoga intervention or to a control group. The intervention group practice yoga two times a week, one yoga class live-streamed to the patient's computer or mobile device and one prerecorded video class for self-training. The controls receive standardised care, gift cards for flowers and access to yoga video links after the data collection has ended. The primary analysis will be performed following the principle of intention to treat. Data will be collected by questionnaires, blood samples, accelerometers and interviews.ETHICS AND DISSEMINATION: The DigiYoga CaRe study was approved by the Regional Ethical Review Board in Lund. The final results of this study will be disseminated to conference, patient and public involvements and peer-reviewed publications.TRIAL REGISTRATION NUMBER: NCT04812652.
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- Paul, Enni, et al.
(författare)
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Från en till flera tolkningar : Symposium om tolkning av skönlitterär text
- 2021
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund och syfteAtt utveckla en förmåga till tolkning av skönlitterär text hör till ett av svenskämnenasgrundläggande uppdrag. STLS-projektet Budskap bortom raderna är ett forskar- och lärardrivetundervisnings-utvecklande projekt som syftar till att undersöka hur denna förmåga kan utvecklas.Projektet utgår från litteraturdidaktisk teori (Langer, 2011) i kombination med en designbaseradforskningsansats (Cobb et al., 2003). Under de två år projektet pågått har en designprincip, enprincip för utformning av undervisning, mejslats fram, med stöd i Langers (2011) teorier omlitterära föreställningsvärldar och läsarpositioner.Designprincipen kan beskrivas som att undervisning som syftar till att främja förmågan till tolkningav skönlitterär text bör utformas så att eleverna själva får författa text som kan tolkas, tolka andrastexter samt konfronteras med andras tolkning av den egna texten. En ytterligare designprincip, somprövas i projektets nu pågående fas, är att den tolkande läsningen ytterligare kan fördjupas då elevermöter - och författar - texter i olika uttrycksformer, såsom poesi, bild, låttexter, dramatiseringaretc.Symposiets presentationer utgår från fyra delprojekt som ingår i Budskap bortom raderna och där denovan beskrivna designprincipen utformas i olika skolår. I presentationerna av dessa delprojektbeskrivs hur designprincipen omsatts i undervisningspraktik och vilka förändringar i eleverstolkande läsning som då kan utläsas.• Presentation 1: Sagor och fablerElever på lågstadiet har med utgångspunkt i sagor och fabler arbetat med att göra egnaberättelser i text och bild för att gestalta budskap.• Presentation 2: Serier, bilder och vad som händer i mellanrummenElever på mellan- och högstadiet har i detta delprojekt arbetat med poesi, serieberättelseroch illustrationer av berättande text för att skapa tolkningsbar text.• Presentation 3: Dramatisering av DostojevskijGymnasieelever har arbetat med Dostojevskijs novell “En löjlig människas dröm” och ikreativa uttrycksformer, som film och drama, gestaltat textens möjliga idéer.• Presentation 4: Tolkning av låttexterElever i vuxenutbildning har arbetat med tolkning av kända låttexter och skapande avegna låttexter.MaterialEmpiriskt material i form av elevintervjuer, inspelade samtal, lärarreflektioner ochelevtexter har samlats in under en serie iterativa undervisningsinterventioner under flera 72läsår. Materialet har analyserats med utgångspunkt i Langers (2011) teorier om litteräraföreställningsvärldar och läsarpositioner.Resultat och diskussionPreliminära resultat från det pågående projektet pekar på att ett samspel mellan a) elevers egenproduktion av tolkningsbara texter; b) att möta andra elevers tolkningar i samtal; samt c) lärarensstöttning och modellering av tillämpning av begrepp för litterär analys tillsammans bidrar till attfrämja elevers uppfattningar av skönlitterära texters tolkningsmöjligheter som pluralistiska ochkompletterande snarare än som singulära ”budskap”.Under presentationen ges tillfälle att diskutera resultat och slutsatser från de olika delprojektensamt från projektet i sin helhet.
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