| 1. |
- Nelander, Maria, et al.
(författare)
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Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older : a cohort study
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim was to study pregnancy hypertensive disease and subsequent risk of dementia. The second aim was to study if the increased risks of cardiovascular disease (CVD) and stroke after pregnancy hypertensive disease persist in an elderly population.DESIGN: Cohort study.SETTING: Sweden.POPULATION OR SAMPLE: 3232 women 65 years or older (mean 71 years) at inclusion.METHODS: Cox proportional hazards regression analyses were used to calculate risks of dementia, CVD and/or stroke for women exposed to pregnancy hypertensive disease. Exposure data were collected from an interview at inclusion during the years 1998-2002. Outcome data were collected from the National Patient Register and Cause of Death Register from the year of inclusion until the end of 2010. Age at inclusion was set as a time-dependent variable, and adjustments were made for body mass index, education and smoking.MAIN OUTCOME MEASURES: Dementia, CVD, stroke.RESULTS: During the years of follow-up, 7.6% of the women exposed to pregnancy hypertensive disease received a diagnosis of dementia, compared with 7.4% among unexposed women (HR 1.19; 95% CI 0.79 to 1.73). The corresponding rates for CVD were 22.9% for exposed women and 19.0% for unexposed women (HR 1.29; 95% CI 1.02 to 1.61), and for stroke 13.4% for exposed women and 10.7% for unexposed women (HR 1.36; 95% CI 1.00 to 1.81).CONCLUSIONS: There was no increased risk of dementia after self-reported pregnancy hypertensive disease in our cohort. We found that the previously reported increased risk of CVD and stroke after pregnancy hypertensive disease persists in an older population.
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| 2. |
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| 3. |
- Hammarsten, Peter, et al.
(författare)
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Immunoreactivity for prostate specific antigen and Ki67 differentiates subgroups of prostate cancer related to outcome
- 2019
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Ingår i: Modern Pathology. - : Elsevier BV. - 0893-3952 .- 1530-0285. ; 32, s. 1310-1319
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Tidskriftsartikel (refereegranskat)abstract
- Based on gene-expression profiles, prostate tumors can be subdivided into subtypes with different aggressiveness and response to treatment. We investigated if similar clinically relevant subgroups can be identified simply by the combination of two immunohistochemistry markers: one for tumor cell differentiation (prostate specific antigen, PSA) and one for proliferation (Ki67). This was analyzed in men with prostate cancer diagnosed at transurethral resection of the prostate 1975–1991 (n = 331) where the majority was managed by watchful waiting. Ki67 and PSA immunoreactivity was related to outcome and to tumor characteristics previously associated with prognosis. Increased Ki67 and decreased PSA were associated with poor outcome, and they provided independent prognostic information from Gleason score. A combinatory score for PSA and Ki67 immunoreactivity was produced using the median PSA and Ki67 levels as cut-off (for Ki67 the upper quartile was also evaluated) for differentiation into subgroups. Patients with PSA low/Ki67 high tumors showed higher Gleason score, more advanced tumor stage, and higher risk of prostate cancer death compared to other patients. Their tumor epithelial cells were often ERG positive and expressed higher levels of ErbB2, phosphorylated epidermal growth factor receptor (pEGF-R) and protein kinase B (pAkt), and their tumor stroma showed a reactive response with type 2 macrophage infiltration, high density of blood vessels and hyaluronic acid, and with reduced levels of caveolin-1, androgen receptors, and mast cells. In contrast, men with PSA high/Ki67 low tumors were characterized by low Gleason score, and the most favorable outcome amongst PSA/Ki67-defined subgroups. Men with PSA low/Ki67 low tumors showed clinical and tumor characteristics intermediate of the two groups above. A combinatory PSA/Ki67 immunoreactivity score identifies subgroups of prostate cancers with different epithelial and stroma phenotypes and highly different outcome but the clinical usefulness of this approach needs to be validated in other cohorts. © 2019, The Author(s).
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| 4. |
- Lundholm, Marie, et al.
(författare)
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Secreted Factors from Colorectal and Prostate Cancer Cells Skew the Immune Response in Opposite Directions
- 2015
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Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Macrophage infiltration has been associated with an improved prognosis in patients with colorectal cancer (CRC), but a poor prognosis in prostate cancer (PC) patients. In this study, the distribution and prognostic value of proinflammatory M1 macrophages (NOS2(+)) and immunosuppressive M2 macrophages (CD163(+)) was evaluated in a cohort of 234 PC patients. We found that macrophages infiltrating PC were mainly of an M2 type and correlated with a more aggressive tumor and poor patient prognosis. Furthermore, the M1/M2 ratio was significantly decreased in PC compared to CRC. Using in vitro cell culture experiments, we could show that factors secreted from CRC and PC cells induced macrophages of a proinflammatory or immunosuppressive phenotype, respectively. These macrophages differentially affected autologous T lymphocyte proliferation and activation. Consistent with this, CRC specimens were found to have higher degrees of infiltrating T-helper 1 cells and active cytotoxic T lymphocytes, while PC specimens displayed functionally inactive T cells. In conclusion, our results imply that tumour-secreted factors from cancers of different origin can drive macrophage differentiation in opposite directions and thereby regulate the organization of the anti-tumour immune response. Our findings suggest that reprogramming of macrophages could be an important tool in the development of new immunotherapeutic strategies.
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| 5. |
- Simard, Julia F., et al.
(författare)
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Preterm Delivery Phenotypes in Systemic Lupus Erythematosus Pregnancies
- 2019
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Ingår i: American Journal of Perinatology. - : THIEME MEDICAL PUBL INC. - 0735-1631 .- 1098-8785. ; 36:9, s. 964-968
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Women with systemic lupus erythematosus (SLE) are at a greater risk of preterm delivery, many of which may be medically indicated (iatrogenic). We investigated preterm delivery phenotypes in SLE and general population comparators and assessed the role of preeclampsia.Study Design: We used population-based Swedish Register data (2001-2013) and defined maternal SLE as >= 2 SLE-coded discharge diagnoses from the Patient Register with >= 1 coded by an appropriate specialist. Women from the general population were identified using the Total Population Register. Preterm delivery was defined as <37 weeks and separated into spontaneous and iatrogenic, as well as later versus extremely preterm (32 to <37 weeks vs. <32 weeks). Maternal comorbidity was assessed, and the proportion mediated by preeclampsia was calculated examining first, subsequent, and all pregnancies.Results: Preterm delivery was more common in SLE for the first (22 vs. 6%) and subsequent (15 vs. 4%) pregnancies among 781 SLE-exposed pregnancies and 11,271 non-SLE pregnancies. Of SLE-exposed first births, 27% delivered before 32 weeks, and 90% were iatrogenic (compared with 47% of non-SLE first births).Conclusion: Preterm delivery complicates a greater proportion of SLE pregnancies than general population pregnancies, and a considerable proportion of risk is mediated through preeclampsia.
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| 6. |
- Vågberg, Mattias, et al.
(författare)
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Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society
- 2017
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Ingår i: Acta Neurologica Scandinavica. - Hoboken, USA : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 135:1, s. 17-24
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Tidskriftsartikel (refereegranskat)abstract
- Multiple sclerosis (MS) is associated with inflammatory lesions in the brain and spinal cord. The detection of such inflammatory lesions using magnetic resonance imaging (MRI) is important in the consideration of the diagnosis and differential diagnoses of MS, as well as in the monitoring of disease activity and predicting treatment efficacy. Although there is strong evidence supporting the use of MRI for both the diagnosis and monitoring of disease activity, there is a lack of evidence regarding which MRI protocols to use, the frequency of examinations, and in what clinical situations to consider MRI examination. A national workshop to discuss these issues was held in Stockholm, Sweden, in August 2015, which resulted in a Swedish consensus statement regarding the use of MRI in the care of individuals with MS. The aim of this consensus statement is to provide practical advice for the use of MRI in this setting. The recommendations are based on a review of relevant literature and the clinical experience of workshop attendees. It is our hope that these recommendations will benefit individuals with MS and guide healthcare professionals responsible for their care.
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| 7. |
- Wang, C., et al.
(författare)
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Injecting different types of biomass products to the blast furnace and their impacts on the CO2 emission reduction
- 2015
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Ingår i: AISTech - Iron and Steel Technology Conference Proceedings. - : Association for Iron and Steel Technology, AISTECH. - 9781935117476 ; , s. 1525-1535
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Konferensbidrag (refereegranskat)abstract
- Recent years more research has been focusing on utilizing biomass in the blast furnaces (BFs). One driving force is linked to the climate change mitigation, i.e. to reduce CO2 emission from fossil reducing agents or fuels, by using biomass. The amounts of biomass that could be utilized in BF is limited by different parameters, such as metallurgical properties of reducing agents, fuel properties such as volatile content, fixed carbon and oxygen content, ash chemistry (S, Na2O, K2O, etc.). In this paper, different types of biomass products in the form of solid, liquid and gas are investigated as injectants to the blast furnace. The modelling work has been done for a BF from a Nordic country. The possible amounts of injected biomass products are presented. With the replacement ratios of pulverized coal (PC), the potential CO2emission reduction when injecting different biomass products is quantified. In addition, the strategy of using biomass at the studied iron-making plant is discussed. AISTech 2015 Proceedings
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| 8. |
- Wikström, Maude, 1945, et al.
(författare)
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Effect of 12-month weekly professional oral hygiene care on the composition of the oral flora in dentate, dependent elderly residents: A prospective study.
- 2017
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Ingår i: Gerodontology. - : Wiley. - 1741-2358 .- 0734-0664. ; 34:2, s. 240-248
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Tidskriftsartikel (refereegranskat)abstract
- To study the effect of weekly professional oral hygiene care on the proportion of micro-organisms associated with good oral health, caries, and periodontal and soft tissue diseases in oral biofilms in dentate, dependent elderly residents.Assisted oral hygiene care reduces the plaque score and number of micro-organisms in the oral biofilms in elderly residents. Less is known about the effect on the quality/composition of the remaining oral flora.Participants comprised 33 residents in the study and 35 in the control group. Dental status (≥10 natural teeth and no removable dentures to be included), plaque score, salivary secretion rate and prescription medicines were recorded. Duplicate samples, collected from supragingival plaque and tongue, were analysed using cultivation technique. Differences between and within groups were analysed using one-way and two-way ANOVA, respectively.At the baseline, the number of teeth in the participants (mean age, 83.7±7.4years) was 22.0±4.5. The number of prescription medicines was 9.4±4.5. Seventy-six per cent had low salivary secretion rate. Fifty per cent had "visible thick" supragingival plaque. At the 12-month registration, "no visible" or "visible but thin" plaque was recorded in 92% in the study group. The proportions of bacteria associated with good oral health and periodontal diseases were decreased over time, while the frequency and proportions of micro-organisms associated with caries and soft tissue infection were unaffected or increased.The results indicate that assisted oral hygiene care alone is not sufficient to regain an oral microbial flora associated with good oral health in dentate, dependent elderly residents.
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| 9. |
- Wikström, Martina, et al.
(författare)
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Introducing plug-in electric vehicles in public authorities
- 2016
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Ingår i: Research in Transportation Business and Management (RTBM). - : Elsevier. - 2210-5395 .- 2210-5409. ; 18, s. 29-37
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Tidskriftsartikel (refereegranskat)abstract
- Plug-in electric vehicles have the potential to contribute to a more energy-efficient and a less fossil dependent road transport system. Swedish local authorities are obligated through legislation to substitute fossil-fuelled vehicles and plug-in electric vehicles offer an alternative for achieving their climate goals. Previous studies assign certain individuals - the policy entrepreneurs - a central role when implementing new technologies in public authorities. By combining the theoretical model of policy entrepreneurs with the theory of outcome indicators, this paper demonstrates how the policy entrepreneur affects and accelerates the introduction of plug-in electric vehicles in local public authorities. The result shows that policy entrepreneurs undertake actions to inform and persuade the decision-makers and raise the issue on the political agenda. The policy entrepreneurs assess the travel demand, find appropriate applications and supervise the deployment process. The policy entrepreneurs inform and inspire vehicle users as a way to ensure acceptance and to increase usage. There are examples of policy entrepreneurs that have accomplished changes in policies governing vehicle use to favour the plug-in electric vehicles. Practical experiences legitimate the policy entrepreneurs when involving local society. The policy entrepreneurs consolidate the new technology within policy documents, amongst the users and in the surrounding society.
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| 10. |
- Wikström, Solveig, et al.
(författare)
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How is value created? - Extending the value concept in the Swedish context
- 2018
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Ingår i: Journal of Retailing and Consumer Services. - : Elsevier BV. - 0969-6989 .- 1873-1384. ; 40, s. 249-260
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Tidskriftsartikel (refereegranskat)abstract
- This inductive study elaborates on the value concept and unpacks the process of how value is created in the Swedish food industry by combining the theoretical tool of goal hierarchy with the methods of network analysis. Through real world insights, on how consumers and retail firms act and coordinate their activities to fulfill their roles in consumer value creation, this study proposes a differing perspective that extends the value-in-use concept by identifying four sequential consumer activities. They are (i) reflections about what is important (value) in the specific consumption situation (the focal goal), (ii) the starting point of value creation (selection and application of means), (iii) the process involved in providing and enjoying holistic solutions, and (iv) ultimately its contribution to life fulfillment in the sense that value creation is meaningful. Thus, consumers create value by setting clear differential hierarchical goals that include the identification of resources and consumers’ own capacity before choosing the products and using them. The network analyses also reveal an additional space for supporting value creation: firm to firm interactions which add more resources to providers’ support of consumer value creation. The paper provides new real world insights on how consumers and firms act to fulfill their roles in consumer value creation. This knowledge helps retailers to better identify and manage value creation tools to support their customers in value creation.
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