| 1. |
- Cajander, Åsa, Professor, 1971-, et al.
(author)
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Effects of patient accessible electronic health records on nurses' work environment : a survey study on expectations in Sweden
- 2022
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:11
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The introduction of information and communication technology influences the work environment of large groups of employees in healthcare. In Sweden, a national healthcare service providing patient accessible electronic health records (PAEHR) has been deployed, and this paper investigates nurses' expected effects of this implementation.SETTING: Nurses associated with the Swedish Association of Health Professionals working in healthcare such as primary care, hospitals and midwives in Sweden. Before a full-scale national implementation of PAEHR, a web survey study was distributed nationally. The respondents represented all 21 Swedish regions. Questions included five-point Likert scale questions and open questions.PARTICIPANTS: A survey link was distributed via email to 8460 registered nurses, midwives and union representatives in Sweden. The response rate was 35.4% (2867 respondents: registered nurses 84%; midwives 6%; chief position 5%; in projects 2% and other 3%). Three reminders were sent out, all of them increasing the response rate. A majority of the respondents were female (89.9%), 8.4% male, whereas 1.7% did not indicate their gender. 31.4% were under 40 years old, 53.8% 40-59 and 13.7% over 60.RESULTS: Data were analysed using exploratory factor analysis with principal component analysis as the extraction method. The analysis revealed three distinct factors related to nurses' expectations of PAEHR: (1) PAEHR improves the quality of care, (2) PAEHR improves the quality of the work environment and (3) risk and fears concerning patients' well-being. Some interesting results include that more experienced nurses are more favourable to PAEHR. Our analysis also shows that the view of the nurse-patient relationship is an essential underlying factor related to positive or negative expectations.CONCLUSIONS: Results show that the expectations and perceptions of PAEHR vary depending on the nurse's view of who the electronic record belongs to. Younger nurses are somewhat more negative towards PAEHR than older nurses.
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| 2. |
- Carlsson, Josefine, 1989-
(author)
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Is your wardrobe making you sick? : Textile Chemicals with Focus on Skin Sensitizers – Analytical Methods, Occurrence and Dermal Exposure
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Textile production includes the use of a large diversity of chemicals, often in high amounts, and their presence in the finished textiles has become a topic of increasing concern. One of the health concerns associated with several of these compounds is skin sensitization, which may lead to the development of textile allergy. This thesis has a special focus on skin allergens and presents analytical methods and workflows to gain a deeper understanding of these chemicals in clothing.In Paper I, a suspect screening of disperse azo dyes in synthetic clothing was conducted using liquid chromatography/high-resolution mass spectrometry (LC/HRMS). In addition, gas chromatography/mass spectrometry (GC/MS) was applied to screen for volatile/semi-volatile dye components. Various disperse azo dyes and arylamines were identified. Notably, most of the dyes used today to diagnose textile allergy were rarely identified. Further, the well-known skin sensitizer 2,4-dinitrochlorobenzene was shown to occur in garments for the first time. Paper II presents a screening method for textiles with automated thermal desorption (ATD) coupled to GC/MS. This method was used for accurate quantification of more than 30 volatile/semi-volatile compounds in textiles, but is also suitable for a wider range of semi-volatiles. Most analytes had method detection limits below 1 µg/g (26 out of 31 analytes) with a relative standard deviation <15%. The ATD-GC/MS method would allow companies to simultaneously screen for multiple components with a minimum of sample preparation, significantly enhancing efficiency and the ability to comply with regulations. Since several compounds identified in Papers I and II are suspected to cause skin sensitization, this was further studied and is the focus of Paper III. A combination of in vitro methods was employed to study the first and third key events of contact allergy as well as mutagenicity. Two hitherto unreported skin sensitizers and two mutagenic compounds were discovered. Despite this, the risks for skin sensitization or other non-carcinogenic health effects from exposure to these compounds in textiles were estimated as acceptable, at least when considering individual compounds and the levels so far reported.In Paper IV, cellulose nanocrystals (CNCs) produced from upcycling post-consumer garments were screened for textile chemicals using a non-target/suspect screening approach with GC/MS and LC/HRMS. Generally, lower levels were detected in the cellulose nanocrystals. However, phthalates were found to remain mainly in the CNCs. Although the levels of phthalates in this case were below the EU regulation, this emphasizes the need for control of the garments.In conclusion, this thesis has developed analytical methods and approaches that can be used for the surveillance and screening of chemicals in textiles, facilitating future identification of substances that constitute potential health risks.
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| 3. |
- Degner, Amanda, et al.
(author)
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Discovery of Novel N-(4-Hydroxybenzyl)valine Hemoglobin Adducts in Human Blood
- 2018
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In: Chemical Research in Toxicology. - : American Chemical Society (ACS). - 0893-228X .- 1520-5010. ; 31:12, s. 1305-1314
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Journal article (peer-reviewed)abstract
- Humans are exposed to a wide range of electrophilic compounds present in our diet and environment or formed endogenously as part of normal physiological processes. These electrophiles can modify nucleophilic sites of proteins and DNA to form covalent adducts. Recently, powerful untargeted adductomic approaches have been developed for systematic screening of these adducts in human blood. Our earlier untargeted adductomics study detected 19 unknown adducts to N-terminal valine in hemoglobin (Hb) in human blood. We now describe a full characterization of one of these adducts, which corresponds to the addition of a 4-hydroxybenzyl (4-OHBn) group to N-terminal valine in Hb to form N(4-hydroxybenzyl)valine (4-OHBn-Val). The adduct structure was determined by comparison of its accurate mass, HPLC retention time, and MS/MS fragmentation to that of authentic standards prepared by chemical synthesis. Average 4-OHBn-Val adduct concentrations in 12 human blood samples were estimated to 380 +/- 160 pmol/g Hb. Two possible routes of 4-OHBnVal adduct formation are proposed using two different precursor electrophiles: 4-quinone methide (4-QM) and 4-hydroxybenzaldehyde (4-OHBA). We found that 4-QM reacts rapidly with valine to form the 4-OHBn-Val adduct; however, the quinone methide is unstable under physiological conditions due to hydrolysis. It was shown that 4-OHBA forms reversible Schiff base adducts with valine, which can be stabilized via reduction in blood generating the 4-OHBn-Val adduct. In addition, trace amounts of isomeric 2-hydroxybenzyl-valine (2-OHBn-Val) adducts were detected in 12 human blood samples (estimated mean adduct level, 5.0 +/- 1.4 pmol/g Hb). Further studies are needed to quantify the contributions from identified possible precursor electrophiles to the observed hydroxybenzyl adducts in humans.
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| 4. |
- Ekebergh, Andreas, 1984, et al.
(author)
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Oxidative Coupling as a Biomimetic Approach to the Synthesis of Scytonemin
- 2011
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In: Organic Letters. - : American Chemical Society (ACS). - 1523-7052 .- 1523-7060. ; 13:16, s. 4458-4461
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Journal article (peer-reviewed)abstract
- The first total synthesis of the dimeric alkaloid pigment scytonemin is described. The key transformations In Its synthesis from 3-indole acetic acid are a Heck carbocyclization and a Suzuki-Miyaura cross-coupling, orchestrated In a stereospecific tandem fashion, followed by a biosynthetically inspired oxidative dimerization. The tandem sequence generates a tetracyclic (E)-3-(arylidene)-3,4-dihydrocyclopenta[b]indol-2(1H)-one that is subsequently dimerized into the unique homodimeric core structure of scytonemin.
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| 5. |
- Friberg, Danielle, et al.
(author)
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Nytt vårdförlopp för barn med OSDB är godkänt att tas i bruk. Obstruktiv sömnrelaterad andningsstörning – ett vanligt och potentiellt allvarligt tillstånd : [New Swedish National care process for pediatric obstructive sleep disordered breathing]
- 2023
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In: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 120
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Journal article (peer-reviewed)abstract
- Obstructive sleep disordered breathing (OSDB) is a spectrum from habitual snoring and labored breathing to obstructive sleep apnea (OSA), which is common and potentially serious in children. The process contains a new question at child care centers, directed at caretakers with children at age 18 months and 3 years, concerning habitual snoring (3 times a week or more). A primary care doctor verifies the suspicion of OSDB in case of a positive answer to one of 7 additional questions or 4 status findings (e.g. tonsil hypertrophy). The process starts with the suspicion of OSDB, from the age of 18 months to 18 years, and ends when symptoms are improved after watchful waiting or upper airway surgery. National equality is a goal, with increased access to nocturnal respiratory recordings of children with comorbidities or doubtful cases. Also, with short waiting time to first visit at ORL department, and to surgery. Children with comorbidities or severe symptoms get postoperative follow-ups with a nurse after 6 months. The new ICD code for OSDB is R06.8A.
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| 6. |
- Friman, Vanda, 1952, et al.
(author)
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Defective peripheral B cell selection in common variable immune deficiency patients with autoimmune manifestations
- 2023
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In: Cell Reports. - : Elsevier. - 2211-1247. ; 42:5
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Journal article (peer-reviewed)abstract
- Common variable immune deficiency (CVID) is a heterogeneous disorder characterized by recurrent infections, low levels of serum immunoglobulins, and impaired vaccine responses. Autoimmune manifestations are common, but B cell central and peripheral selection mechanisms in CVID are incompletely understood. Here, we find that receptor editing, a measure of central tolerance, is increased in transitional B cells from CVID patients and that these cells have a higher immunoglobulin κ:λ ratio in CVID patients with autoimmune manifestations than in those with infection only. Contrariwise, the selection pressure in the germinal center on CD27bright memory B cells is decreased in CVID patients with autoimmune manifestations. Finally, functionally, T cell-dependent activation showed that naive B cells in CVID patients are badly equipped for activation and induction of mismatch repair genes. We conclude that central tolerance is functional whereas peripheral selection is defective in CVID patients with autoimmune manifestations, which could underpin the development of autoimmunity.
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| 7. |
- Gripe, Isabella, et al.
(author)
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Academic orientation and cannabis use—findings from a population-based study of Swedish adolescents in upper secondary school
- 2024
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In: European Journal of Public Health. - 1101-1262 .- 1464-360X.
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Journal article (peer-reviewed)abstract
- AimTo examine the association between academic orientation and frequent cannabis use among Swedish adolescents in upper secondary school and include pupils from introductory programs (IPs), a large group of adolescents previously overlooked in research on adolescent cannabis use.MethodsWe used cross-sectional data from two anonymous school surveys carried out in upper secondary school in 2021. The samples consisted of pupils from all academic orientations, and the analysis included 3151 pupils in higher education preparatory programs (HEPs), 1010 pupils in vocational programs (VPs), and 819 pupils in IPs. The association between the exposure academic orientation and the outcome frequent (21+ times) cannabis was analyzed using multi-level mixed-effects Poisson regression.ResultsEstimates from the first model showed a significant (P < 0.05) 2.45 times higher risk of frequent cannabis use among pupils in IPs compared with in HEPs [incidence rate ratio (IRR) 2.45, 95% confidence interval (CI) 1.28–4.66] and 82% higher in VPs (IRR 1.82, 95% CI 1.09–3.04) compared with in HEPs. However, the associations between academic orientation and frequent (21+ times) cannabis use were attenuated and no longer significant when socioeconomic status, truancy, school dissatisfaction, and early onset of substance use were adjusted for.ConclusionsThere was a higher risk of frequent (21+ times) cannabis use among pupils in IPs, and this differential was explained by higher exposure to risk factors in this group. This result is important from a policy perspective as it provides knowledge of a previously neglected risk group for frequent cannabis use.
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| 8. |
- Gripe, Isabella, et al.
(author)
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Are the well‐off youth in Sweden more likely to use cannabis?
- 2021
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In: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 40:1, s. 126-134
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Journal article (peer-reviewed)abstract
- Introduction and Aims. Results from previous research are inconsistent regarding the association between socioeconomic status (SES) and cannabis use among adolescents. Since there are risks associated with cannabis use, a social gradient in cannabis use may contribute to reproducing socioeconomic differences in life opportunities. The aim of this study was to assess the association between childhood SES and cannabis use among youth in Sweden. Design and Methods. We used repeated cross‐sectional data from three waves (2014–2016) of the Swedish national school survey among 11th graders. The analysis encompassed 9497 individuals in 668 school classes. Childhood SES was measured through parents' highest education, as reported by the students. Cannabis use was measured in terms of lifetime use and frequency of use. Data were analysed using multi‐level mixed‐effects Poisson regression. Results. Adolescents with at least 1 parent with university/college education had 17% (incidence rate ratio 1.17, confidence interval 1.05, 1.30) higher risk of lifetime use of cannabis compared with those whose parents had no university/college education, adjusting for sex, SES of the school environment, academic orientation, truancy, risk assessment and parental permissiveness. Among life‐time users of cannabis, risk for frequent cannabis use was 28% (incidence rate ratio 0.72, confidence interval 0.53, 0.97) lower for those with at least 1 parent with university or college education. Discussion and Conclusions. Childhood SES, in terms of parental education, was associated with cannabis use among Swedish adolescents. Adolescents from families with lower SES were less likely to ever try cannabis, but at higher risk for frequent use.
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| 9. |
- Guerini-Rocco, Elena, et al.
(author)
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Genomic aberrations and late recurrence in postmenopausal women with hormone receptor-positive early breast cancer: Results from the SOLE Trial.
- 2021
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In: Clinical cancer research : an official journal of the American Association for Cancer Research. - 1078-0432. ; 27:2, s. 504-512
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Journal article (peer-reviewed)abstract
- Women with hormone-receptor-positive early breast cancers have a persistent risk of relapse and biomarkers for late recurrence are needed. We sought to identify tumor genomic aberrations associated with increased late recurrence risk.In a secondary analysis of Study of Letrozole Extension (SOLE) trial, a case-cohort-like sampling selected 598 primary breast cancer for targeted next-generation sequencing (NGS) analysis of gene mutations and copy number gains (CNG). Correlations of genomic aberrations with clinicopathologic factors and breast and distant recurrence free-intervals (BCFI and DRFI) were analyzed using weighted Cox models.Analysis of mutations and CNG was successfully performed for 403 and 350 samples, including 148 and 134 patients with breast cancer recurrences (median follow-up time: 5.2 years), respectively. The most frequent alterations were PIK3CA mutations (42%) and CNGs of CCND1 (15%), ERBB2 (10%), FGFR1 (8%) and MYC (8%). PIK3CA mutations and MYC CNG were associated with lower (p=0.03) and higher (p=0.004) tumor grade respectively; a higher Ki67 was seen in tumor with CCND1, ERBB2 and MYC CNGs (p=0.01, <0.001 and 0.03 respectively). FGFR1 CNG was associated with an increased risk of late events in univariate analyses (17/29 patients; BCFI: HR=3.2, 95%CI: 1.48-6.92, p =0.003; DRFI: HR=3.5, 95%CI: 1.61-7.75, p=0.002) and in multivariable models adjusted for clinicopathologic factors.Postmenopausal women with hormone receptor-positive early breast cancer harboring FGFR1 CNG had an increased risk of late recurrence despite extended therapy. FGFR1 CNG may represent a useful prognostic biomarker for late recurrence and a therapeutic target.
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| 10. |
- Hellström, Maria, et al.
(author)
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Artificial light quality changes colonization ability of biocontrol agents under greenhouse conditions
- 2023
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In: Acta Horticulturae. - 0567-7572 .- 2406-6168. ; , s. 299-306
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Conference paper (peer-reviewed)abstract
- Integrated pest control measures are important in order to cope with fungal foliar pathogens in greenhouse settings. Biocontrol agents (BCA) play an important role in this context, but disease control results obtained in laboratory experiments cannot always be repeated in larger greenhouse settings. Impaired dispersal and establishment of BCAs on leaves and sites of action may be among the causes for failing efficacy. We studied the role of basic mechanisms for BCAs’ efficacy under greenhouse conditions, namely dispersal and establishment. In the first experiment three BCAs from three commercial products were applied by foliar spray to greenhouse-grown tomatoes (Solanum lycopersicum L.) and begonias (Begonia × hiemalis). Leaves were harvested according to a pre-determined time schedule and the viable BCA cells were quantified by plate count. In the second experiment tomatoes were sprayed and exposed to an array of wavelengths (full spectrum, 420, 530 and 660 nm) and followed during 48 h post inoculation (hpi). We found that the BCAs lifestyle choices varied depending on light quality and target crop. These appear to be decisive parameters for BCA dispersal and establishment on leaves.
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