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- Cakir, B., et al.
(författare)
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IGF1, serum glucose, and retinopathy of prematurity in extremely preterm infants
- 2020
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Ingår i: Jci Insight. - : American Society for Clinical Investigation. - 2379-3708. ; 5:19
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. Hyperglycemia, insulin insensitivity, and low IGF1 levels in extremely preterm infants are associated with an increased risk of retinopathy of prematurity (ROP), but the interactions are incompletely understood. METHODS. In 117 extremely preterm infants, serum glucose levels and parenteral glucose intake were recoded daily in the first postnatal week. Serum IGF1 levels were measured weekly. Mice with oxygen-induced retinopathy alone versus oxygen-induced retinopathy plus streptozotocin-induced hyperglycemia/hypoinsulinemia were assessed for glucose, insulin, IGF1, IGFBP1, and IGFBP3 in blood and liver. Recombinant human IGF1 was injected to assess the effect on glucose and retinopathy. RESULTS. The highest mean plasma glucose tertile of infants positively correlated with parenteral glucose intake [r (39) = 0.67, P < 0.0001]. IGF1 plasma levels were lower in the high tertile compared with those in low and intermediate tertiles at day 28 (P = 0.038 and P = 0.03). In high versus lower glucose tertiles, ROP was more prevalent (34 of 39 versus 19 of 39) and more severe (ROP stage 3 or higher; 71% versus 32%). In oxygen-induced retinopathy, hyperglycemia/hypoinsulinemia decreased liver IGF1 expression (P < 0.0001); rh-IGF1 treatment improved normal vascular regrowth (P = 0.027) and reduced neovascularization (P < 0.0001). CONCLUSION. In extremely preterm infants, high early postnatal plasma glucose levels and signs of insulin insensitivity were associated with lower IGF1 levels and increased ROP severity. In a hyperglycemia retinopathy mouse model, decreased insulin signaling suppressed liver IGF1 production, lowered serum IGF1 levels, and increased neovascularization. IGF1 supplementation improved retinal revascularization and decreased pathological neovascularization. The data support IGF1 as a potential treatment for prevention of ROP.
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- Fjordkvist, Erika, 1985-, et al.
(författare)
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First-line managers' experience of guideline implementation during the COVID-19 pandemic
- 2024
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648.
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Tidskriftsartikel (refereegranskat)abstract
- AIM(S): To explore first-line managers' experience of guideline implementation in orthopaedic care during the COVID-19 pandemic.DESIGN: A descriptive, qualitative study.METHODS: Semi-structured interviews with 30 first-line nursing and rehabilitation managers in orthopaedic healthcare at university, regional and local hospitals. The interviews were analysed by thematic analysis.RESULTS: First-line managers described the implementation of guidelines related to the pandemic as different from everyday knowledge translation, with a swifter uptake and time freed from routine meetings in order to support staff in adoption and adherence. The urgent need to address the crisis facilitated guideline implementation, even though there were specific pandemic-related barriers such as staffing and communication issues. An overarching theme, Hanging on to guidelines for dear life, is substantiated by three themes: Adapting to facilitate change, Anchoring safety through guidelines and Embracing COVID guidelines.CONCLUSION: A health crisis such as the COVID-19 pandemic can generate enabling elements for guideline implementation in healthcare, despite prevailing or new hindering components. The experience of guideline implementation during the COVID-19 pandemic can improve understanding of context aspects that can benefit organizations in everyday translation of evidence into practice.IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Recognizing what enabled guideline implementation in a health crisis can help first-line managers to identify local enabling context elements and processes. This can facilitate future guideline implementation.IMPACT: During the COVID-19 pandemic, the healthcare context and staff's motivation for guideline recognition and adoption changed. Resources and ways to bridge barriers in guideline implementation emerged, although specific challenges arose. Nursing managers can draw on experiences from the COVID-19 pandemic to support implementation of new evidence-based practices in the future.REPORTING METHOD: This study adheres to the EQUATOR guidelines by using Standards for Reporting Qualitative Research (SRQR). No Patient or Public Contribution.
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- Granberg, Maria, et al.
(författare)
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Microlitter in arctic marine benthic food chains and potential effects on sediment dwelling fauna
- 2020
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Ingår i: TemaNord report. - : Nordic Council of Ministers. ; :528
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Tidskriftsartikel (refereegranskat)abstract
- Marine litter pollution affects oceans globally and has today also made its way to the pristine arctic environment adding to the microlitter from local pollution sources. Marine litter pollution is recognized as a serious threat to the marine environment at all levels, from the UN to regional (EU, OSPAR, HELCOM) and national authorities. The risk posed by microlitter to marine biota is related to their documented ubiquity and long residence time in marine ecosystems. Risks are also mediated by intrinsic toxicity of added chemicals and potential adsorbance of other pollutants. When released into the marine environment, a major part of microlitter likely accumulate in beach sand and marine sediments either immediately or after acquiring a biofilm. It is therefore expected that benthic food chains will be key to understanding fate and effects (i.e. concentrations, potential trophic transfer and biological impact) of microlitter in the marine environment. The overall aim of the project was to determine abundance of microlitter pollution in marine sediments and benthic food chains in the Arctic, and to evaluate the abundance in relation to potential local sources and background levels. The aim was also to investigate potential effects of microplastic pollution on benthic organisms through laboratory studies using an arctic amphipod as a model organism. The field investigations in Svalbard, Norway and Greenland focused on determining microlitter particle concentrations and characteristics in marine sediments and biota collected close to and far from potential local pollution sources and pathways, i.e. outlets of untreated wastewater and effluents from a dumping site in Sisimiut, West Greenland and outlets of treated (Ny-Ålesund) and untreated (Longyearbyen) wastewater in Svalbard. Overall, higher concentrations and a higher diversity of microlitter types and polymers were found in sediments and organisms (blue mussels and cod) closer to human settlements (wastewater outlets and dumping sites) and in places where lost and/or dumped fishing gear accumulate. Thus, we can confidently conclude that local pollution sources for anthropogenic microlitter do exist in the Arctic. The experimental studies investigated whether environmentally relevant and future predicted concentrations of microplastics could impact feeding rate, microplastic ingestion, respiration and locomotion activity in an arctic sediment dwelling amphipod. The experimental results confirm previous microplastics studies on marine invertebrates showing effect only at very high concentrations not yet relevant in the arctic environment. The shape of the plastic particles was found to affect the particle fate. While microplastic fragments were ingested, short microplastic fibres attached to the carapace of the amphipods and likely obstructed normal ventilation behaviour. Furthermore, biofilm cover was found to affect the behaviour and effects of the particles. Microlitter naturally become covered by biofilms in the environment and our results stress the importance of effect experiments being carried out using naturally fouled plastics for ecological relevance. This report provides both environmental- and impact data related to microlitter pollution in the arctic marine environment. Although the levels of microplastics required to cause effects in experimental organisms in this study were much higher than what was detected in the field, there may be other species that are more sensitive than the one tested in nature. The currently relatively low microlitter concentrations detected in the field should be considered as a “window of opportunity” to act to at least reduce local pollution. Consequently, introduction of sustainable waste management and wastewater treatment should be an important focus of local management initiatives.
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- Lindstrand, Anna, et al.
(författare)
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Genome sequencing is a sensitive first-line test to diagnose individuals with intellectual disability
- 2022
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Ingår i: Genetics in Medicine. - : ELSEVIER SCIENCE INC. - 1098-3600 .- 1530-0366. ; 24:11, s. 2296-2307
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Individuals with intellectual disability (ID) and/or neurodevelopment disorders (NDDs) are currently investigated with several different approaches in clinical genetic diagnostics. Methods: We compared the results from 3 diagnostic pipelines in patients with ID/NDD: genome sequencing (GS) first (N = 100), GS as a secondary test (N = 129), or chromosomal microarray (CMA) with or without FMR1 analysis (N = 421). Results: The diagnostic yield was 35% (GS -first), 26% (GS as a secondary test), and 11% (CMA/FMR1). Notably, the age of diagnosis was delayed by 1 year when GS was performed as a secondary test and the cost per diagnosed individual was 36% lower with GS first than with CMA/FMR1. Furthermore, 91% of those with a negative result after CMA/FMR1 analysis (338 individuals) have not yet been referred for additional genetic testing and remain undiagnosed. Conclusion: Our findings strongly suggest that genome analysis outperforms other testing strategies and should replace traditional CMA and FMR1 analysis as a first-line genetic test in individuals with ID/NDD. GS is a sensitive, time-and cost-effective method that results in a confirmed molecular diagnosis in 35% of all referred patients. (c) 2022 The Authors. Published by Elsevier Inc. on behalf of American College of Medical Genetics and Genomics. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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