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| 4. |
- Bergqvist, Jenny, et al.
(author)
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Finfish Aquaculture: Animal Welfare, the Environment, and Ethical Implications
- 2013
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In: Journal of Agricultural and Environmental Ethics. - : Springer Science and Business Media LLC. - 1187-7863 .- 1573-322X. ; 26, s. 75-99
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Journal article (peer-reviewed)abstract
- The aim of this review is to assess the ethical implications of finfish aquaculture, regarding fish welfare and environmental aspects. The finfish aquaculture industry has grown substantially the last decades, both as a result of the over-fishing of wild fish populations, and because of the increasing consumer demand for fish meat. As the industry is growing, a significant amount of research on the subject is being conducted, monitoring the effects of aquaculture on the environment and on animal welfare. The areas of concern when it comes to animal welfare have here been divided into four different stages: breeding period; growth period; capturing and handling; and slaughter. Besides these stages, this report includes a chapter on the current evidence of fish sentience, since this issue is still being debated among biologists. However, most biologists are at present acknowledging the probability of fish being sentient creatures. Current aquaculture practices are affecting fish welfare during all four of the cited stages, both on physical and mental levels, as well as on the ability of fish to carry out natural behaviors. The effect fish farming has on the environment is here separated into five different categories: the decline of wild fish populations; waste and chemical discharge; loss of habitat; spreading of diseases; and invasion of exotic organisms. There is evidence of severe negative effects on the environment when looking at these five categories, even when considering the difficulty of studying environmental effects, due to the closely interacting variables. The ethical arguments and scientific evidences here reviewed have not all come to the same conclusions. Nevertheless, the general agreement is that current aquaculture practices are neither meeting the needs of fish nor environment. Thus, the obvious environmental and animal welfare aspects of finfish aquaculture make it hard to ethically defend a fish diet.
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| 5. |
- Bergqvist, Jenny, et al.
(author)
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Healthcare resource use, comorbidity, treatment and clinical outcomes for patients with primary intracranial tumors : a Swedish population-based register study
- 2017
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In: Acta Oncologica. - 0284-186X .- 1651-226X. ; 56:3, s. 405-414
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Journal article (peer-reviewed)abstract
- Background: Primary intracranial tumors are relatively uncommon and heterogeneous, which make them challenging to study. We coupled data from unique Swedish population-based registries in order to deeper analyze the most common intracranical tumor types. Patient characteristics (e.g. comorbidities), care process measures like adherence to national guidelines, healthcare resource use and clinical outcome was evaluated.Materials and methods: A register-based study including several population-based registries for all patients living in Stockholm-Gotland, diagnosed with primary intracranial tumor between 2001 and 2013 was performed. Patient characteristics were captured and investigated in relation to survival, healthcare resource use (inpatient-, outpatient- and primary care) and treatment process.Results: High-grade glioma and meningioma were the most common tumor types and most patients (76%) were above the age of 40 in the patient population (n = 3664). Older age, comorbidity (Elixhauser comorbidity index) and type of tumor (high-grade glioma) were associated with lower survival rate and increased use of healthcare resources, analyzed for patients living in Stockholm (n = 3031). The analyses of healthcare use and survival showed no differences between males and females, when stratifying by tumor types. Healthcare processes were not always consistent with existing national treatment recommendations for patients with high-grade gliomas (n = 474) with regard to specified lead times, analyzed in the Swedish Brain Tumor Registry, as also observed at the national level.Conclusions: Age, comorbidity and high-grade gliomas, but not sex, were associated with decreased survival and increased use of healthcare resources. Fewer patients than aimed for in national guidelines received care according to specified lead times. The analysis of comprehensive population-based register data can be used to improve future care processes and outcomes.
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| 6. |
- Bergqvist, Jenny
(author)
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HER2 and TP53 in human breast cancer : studies of methods and prognostic value
- 2006
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Doctoral thesis (other academic/artistic)abstract
- Prognostic and predictive factors are needed for tailored therapy strategies, aimed at reducing breast cancer relapse and improving survival. The present arsenal of such factors is insufficient. The aims of this thesis were to study the TP53 gene, and the human epidermal growth factor receptor 2 (HER2), also known as c-erbB-2 and HER2/neu, in human breast cancer, especially in relation to outcome after tamoxifen therapy. In order to make the best out of the biological markers prognostic and predictive values, optimal methods for their determinations are required, and this is also addressed in the thesis. We found mutated TP53 to be associated with worse outcome after adjuvant chemotherapy (CMF), but to be of no statistically significant importance with regard to the outcome of adjuvant tamoxifen. However, in the total patient population, women with wild type TP53 tumours had better survival compared with women whose tumours were TP53 mutated. We used sequenced-based methodology for analysis of all TP53 exons, based on indications that this method is superior to immunohistochemistry (IHC) in prognostication of breast cancer relapse and survival. The monoclonal antibody trastuzumab, directed against HER2, is one of many examples of emerging targeting therapies, of which tamoxifen was the first. We describe the first patients in Sweden who received trastuzumab on a named patient basis, all with advanced breast cancer failing on conventional therapy. The previously demonstrated efficacy and acceptable toxicity in randomised studies were confirmed in our small population-based patient cohort. Endocrine therapy with tamoxifen, mediating both anti-oestrogen, and oestrogen-like effects, has been used for more than three decades. Subsequently, tamoxifen resistance is a problem for a large cohort of breast cancer patients. Preclinical as well as clinical studies have hypothesised HER2 to be involved in tamoxifen resistance through cross-talk signalling with the oestrogen receptor, via the mitogen activated protein kinase, extra cellular regulated kinases 1 and 2 (ERK1/2) pathway. We confirmed HER2 to be associated with worse outcome after tamoxifen therapy while, in contrast to other studies, we found that activated ERK1/2 immunohistochemical staining, prognosticate better outcome. The increasing number of patients eligible for trastuzumab therapy requires reproducible, cost-effective, and high throughput assays for HER2 determinations. Immunohistochemistry and fluorescence in situ hybridisation are the most frequently used methods for evaluation of HER2 status. We demonstrate quantitative real-time PCR and an RNA expression-based methodology to generate high-quality HER2 assessments with equivalent, and in some aspects improved results, compared with immunohistochemistry and fluorescence in situ hybridisation/chromogenic in situ hybridisation.
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| 8. |
- Bergqvist, Jenny, et al.
(author)
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Quantitative real-time PCR analysis and microarray-based RNA expression of HER2 in relation to outcome
- 2007
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In: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 18:5, s. 845-850
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Journal article (peer-reviewed)abstract
- BACKGROUND: Our aim was to use quantitative real-time PCR (Q-PCR) and RNA expression profiles (RNA-EPs) to investigate HER2 status in relation to outcome. PATIENTS AND METHODS: Cut-off levels for Q-PCR and RNA-EP were established in relation to immunohistochemistry (IHC) validated by FISH in a test set of frozen tissue samples from 40 primary breast cancers. The HER2 status was subsequently studied in another validation set of 306 tumors, where Q-PCR and RNA-EP results were compared with previously carried out IHC that we had validated by chromogenic in situ hybridization (CISH). RESULTS: Q-PCR and RNA-EP offered similar sensitivity (90% versus 77%), specificity (93% versus 95%), and negative (99% versus 98%) and positive (63% versus 61%) predictive values for HER2 determinations. Analyses of relapse-free survival (RFS) and overall survival on the basis of 5 and 10 years of follow-up indicated equivalent hazard ratios for all three techniques. In contrast to IHC/CISH, both Q-PCR and RNA-EP analyses of HER2 also gave statistically significant results regarding RFS and breast cancer-corrected survival after 10 years of follow-up. CONCLUSION: The use of RNA-EP and Q-PCR to analyze HER2 in frozen and formalin-fixed breast cancer samples may be an alternate approach to IHC in combination with FISH/CISH.
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| 9. |
- Bergqvist, Jenny, et al.
(author)
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The effects of clinical and sociodemographic factors on survival, resource use and lead times in patients with high-grade gliomas : a population-based register study
- 2018
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In: Journal of Neuro-Oncology. - : Springer. - 0167-594X .- 1573-7373. ; 139:3, s. 599-608
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Journal article (peer-reviewed)abstract
- Background: Previous studies indicate an effect of sociodemographic factors on risk for being diagnosed with, as well as on survival of cancer in general. Our primary aim was to analyse sociodemographic factors, resource use and lead times in health care after diagnosis with high grade malignant glioma (HGG) in a large population based cohort.Methods: A register-based study using several unique high-coverage registries. All patients over the age of 18 diagnosed with HGG in the Swedish Stockholm-Gotland region between 2001 and 2013 (n=1149) were included.Results: In multivariable cox proportional hazard model of survival, older age, male sex and high tumour grade were associated with worse survival. No significant differences could be seen related to country of birth. A high disposable income was associated with better survival and fewer occasions of pre-diagnostic inpatient care. Older age and comorbidities were correlated with a significantly increased number of outpatient visits the year before HGG diagnosis. In addition, male sex, being born outside Sweden was associated to a higher number of outpatient visits the year after diagnosis in multivariable analysis. Leadtime from diagnosis (first suspicion on brain scan) to surgery showed that the oldest patients, patients with comorbidity and patients born outside Europe had to wait longer for surgery.Conclusions: Sociodemographic factors like education, income and country of birth have impact on care processes both before and after the diagnosis HGG. This needs to be acknowledged in addition to important clinical factors like age, comorbidity and tumour grade, in order to accomplish more equal cancer care.
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| 10. |
- Bäckstrand, Jenny, 1979-, et al.
(author)
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How are we doing? – Taking the pulse on collaboration
- 2019
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Conference paper (other academic/artistic)abstract
- SPARK is the research and educational environment at the School of Engineering at Jönköping University focusing on knowledge intensive product realization. SPARK ECG is our process for measuring and ensuring consensus and co-production between researchers and their industrial partners.
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| 12. |
- Gabrielson, Marike, et al.
(author)
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Baseline breast tissue characteristics determine the effect of tamoxifen on mammographic density change
- 2024
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In: International Journal of Cancer. - 0020-7136 .- 1097-0215.
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Journal article (peer-reviewed)abstract
- Tamoxifen prevents recurrence of breast cancer and is also approved for preventive, risk-reducing, therapy. Tamoxifen alters the breast tissue composition and decreases the mammographic density. We aimed to test if baseline breast tissue composition influences tamoxifen-associated density change. This biopsy-based study included 83 participants randomised to 6 months daily intake of placebo, 20, 10, 5, 2.5, or 1 mg tamoxifen. The study is nested within the double-blinded tamoxifen dose-determination trial Karolinska Mammography Project for Risk Prediction of Breast Cancer Intervention (KARISMA) Study. Ultrasound-guided core-needle breast biopsies were collected at baseline before starting treatment. Biopsies were quantified for epithelial, stromal, and adipose distributions, and epithelial and stromal expression of proliferation marker Ki67, oestrogen receptor (ER) and progesterone receptor (PR). Mammographic density was measured using STRATUS. We found that greater mammographic density at baseline was positively associated with stromal area and inversely associated with adipose area and stromal expression of ER. Premenopausal women had greater mammographic density and epithelial tissue, and expressed more epithelial Ki67, PR, and stromal PR, compared to postmenopausal women. In women treated with tamoxifen (1–20 mg), greater density decrease was associated with higher baseline density, epithelial Ki67, and stromal PR. Women who responded to tamoxifen with a density decrease had on average 17% higher baseline density and a 2.2-fold higher PR expression compared to non-responders. Our results indicate that features in the normal breast tissue before tamoxifen exposure influences the tamoxifen-associated density decrease, and that the age-associated difference in density change may be related to age-dependant differences in expression of Ki67 and PR.
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| 13. |
- Gabrielson, Marike, et al.
(author)
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Effects of tamoxifen on normal breast tissue histological composition : Results from a randomised six-arm placebo-controlled trial in healthy women
- 2023
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In: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 152:11, s. 2362-2372
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Journal article (peer-reviewed)abstract
- Tamoxifen prevents recurrence of breast cancer and is suggested for preventive risk-reducing therapy. Tamoxifen reduces mammographic density, a proxy for therapy response, but little is known about its effects in remodelling normal breast tissue. Our study, a substudy within the double-blinded dose-determination trial KARISMA, investigated tamoxifen-specific changes in breast tissue composition and histological markers in healthy women. We included 83 healthy women randomised to 6 months daily intake of 20, 10, 5, 2.5, 1 mg of tamoxifen or placebo. The groups were combined to “no dose” (0-1 mg), “low-dose” (2.5-5 mg) or “high-dose” (10-20 mg) of tamoxifen. Ultrasound-guided biopsies were collected before and after tamoxifen exposure. In each biopsy, epithelial, stromal and adipose tissues was quantified, and expression of epithelial and stromal Ki67, oestrogen receptor (ER) and progesterone receptor (PR) analysed. Mammographic density using STRATUS was measured at baseline and end-of-tamoxifen-exposure. We found that different doses of tamoxifen reduced mammographic density and glandular-epithelial area in premenopausal women and associated with reduced epithelium and increased adipose tissue. High-dose tamoxifen also decreased epithelial ER and PR expressions in premenopausal women. Premenopausal women with the greatest reduction in proliferation also had the greatest epithelial reduction. In postmenopausal women, high-dose tamoxifen decreased the epithelial area with no measurable density decrease. Tamoxifen at both low and high doses influences breast tissue composition and expression of histological markers in the normal breast. Our findings connect epithelial proliferation with tissue remodelling in premenopausal women and provide novel insights to understanding biological mechanisms of primary prevention with tamoxifen.
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| 15. |
- Hammarström, Mattias, et al.
(author)
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Side effects of low-dose tamoxifen : results from a six-armed randomised controlled trial in healthy women
- 2023
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In: British Journal of Cancer. - 0007-0920 .- 1532-1827. ; 129:1, s. 61-71
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Journal article (peer-reviewed)abstract
- Background: Adherence to adjuvant tamoxifen therapy is suboptimal, and acceptance of tamoxifen for primary prevention is poor. Published results indicate effect of low-dose tamoxifen therapy. Using questionnaire data from a randomised controlled trial, we describe side effects of standard and low-dose tamoxifen in healthy women. Methods: In the KARISMA trial, 1440 healthy women were randomised to 6 months of daily intake of 20, 10, 5, 2.5, 1 mg of tamoxifen or placebo. Participants completed a 48-item, five-graded Likert score symptom questionnaire at baseline and follow-up. Linear regression models were used to identify significant changes in severity levels across doses and by menopausal status. Results: Out of 48 predefined symptoms, five were associated with tamoxifen exposure (hot flashes, night sweats, cold sweats, vaginal discharge and muscle cramps). When comparing these side effects in premenopausal women randomised to low doses (2.5, 5 mg) versus high doses (10, 20 mg), the mean change was 34% lower in the low-dose group. No dose-dependent difference was seen in postmenopausal women. Conclusions: Symptoms related to tamoxifen therapy are influenced by menopausal status. Low-dose tamoxifen, in contrast to high-dose, was associated with less pronounced side effects, a finding restricted to premenopausal women. Our findings give new insights which may influence future dosing strategies of tamoxifen in both the adjuvant and preventive settings. Trial registration: ClinicalTrials.gov ID: NCT03346200.
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| 16. |
- Hildenwall, Helena, et al.
(author)
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Low validity of caretakers’ reports on antimalarial and antibiotic use in children with severe pneumonia at hospital in Uganda
- 2009
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In: Transactions of the Royal Society of Tropical Medicine and Hygiene. - : Elsevier. - 0035-9203 .- 1878-3503. ; 103:1, s. 95-101
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Journal article (peer-reviewed)abstract
- Febrile children in low-income countries receive care from multiple sources, and caretakers’ ability to report drug intake is crucial for appropriate prescription of drugs when reaching health facilities. This study describes and validates caretakers’ reported use of sulfamethoxazole, chloroquine and sulfadoxine in their children. We performed a cross-sectional study in 139 children diagnosed with severe pneumonia at hospital in Kampala, Uganda. Caretakers were interviewed regarding treatments given prior to arrival at the hospital. Reported drug intake was compared to drug levels in blood sampled on filter paper, analyzed by HPLC methods. Caretakers under-reported intake of the studied drugs. Positive and negative predictive values were 67 and 64% for sulfamethoxazole, 69 and 52% for chloroquine and 85 and 62% for sulfadoxine. Many caretakers were unaware of what drug had been given to the child, and more so if treated outside the home (risk ratio 2.6, 95% CI 1.2–5.6). We conclude that caretakers’ reports of drug intake have limited validity. Health workers need to improve counseling of caretakers during drug dispensing, especially for antibiotics. The roles and names of different drugs should be emphasized during counseling, and existing information systems such as immunization cards should be considered for record-keeping of treatment given.
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| 17. |
- Idvall, Ewa, 1950-, et al.
(author)
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Perspectives of Swedish patients on postoperative pain management
- 2008
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In: Nursing and Health Sciences. - : Wiley. - 1441-0745 .- 1442-2018. ; 10:2, s. 131-136
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Journal article (peer-reviewed)abstract
- This study aimed to describe the perspectives of surgical patients towards postoperative pain management during their hospital stay. Thirty strategically chosen postoperative inpatients from different surgical wards in a university hospital in Sweden participated. A qualitative, descriptive approach using individual interviews was chosen. These were tape-recorded, transcribed verbatim, and analyzed according to a qualitative content analysis. The patients' descriptions of postoperative pain management indicated that pain was a symptom that was always in focus, either because it was constantly present or because pain could appear abruptly during different activities and movements. Although the focus was on pain and an awareness that it should be relieved or avoided, the solutions were often routine, short-term, and involved the regular intake of drugs, plus additional medication if needed for an acute pain episode. From the patients' descriptions of their experience with postoperative pain management, we distinguished three categories: "patients' pain knowledge", "patients' pain management approaches", and "patients' views of health-care professionals". The findings from this study highlight important aspects of nursing care that should receive greater attention in postoperative pain management. The patients' narratives could be a valuable asset in the quality improvement of postoperative pain management as these narratives highlight episodes difficult to elicit in other ways. © 2008 The Authors Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.
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| 19. |
- Lindkvist, Jenny, et al.
(author)
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Straightforward and rapid determination of sulfadoxine and sulfamethoxazole in capillary blood on sampling paper with liquid chromatography and UV detection
- 2009
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In: Transactions of the Royal Society of Tropical Medicine and Hygiene. - : Oxford University Press (OUP). - 0035-9203 .- 1878-3503. ; 103:4, s. 371-376
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Journal article (peer-reviewed)abstract
- A method for the determination of sulfadoxine and sulfamethoxazole in capillary blood on sampling paper has been developed and validated. The method is straightforward with minimal sample preparation, and is suitable for rural settings. Separation of sulfadoxine, sulfamethoxazole and internal standard was performed using a Purospher STAR RP-18 endcapped LC column (150×4.6mm) with a mobile phase consisting of acetonitrile:sodium acetate buffer pH 5.2, I=0.1 (1:2, v/v). For sulfadoxine, the within-day precision was 5.3% at 15μmol/l and 3.7% at 600μmol/l, while for sulfamethoxazole it was 5.7% at 15μmol/l and 3.8% at 600μmol/l. The lower limit of quantification was determined to 5μmol/l and precision was 5.5% and 5.0% for sulfadoxine and sulfamethoxazole, respectively.
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| 20. |
- Malm, Mikaela, et al.
(author)
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Importance of pre-analytical factors contributing to measurement uncertainty, when determining sulfadoxine and sulfamethoxazole from capillary blood dried on sampling paper
- 2008
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In: Journal of Chromatographic Science. - 0021-9665 .- 1945-239X. ; 16:10, s. 837-843
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Journal article (peer-reviewed)abstract
- A bioanalytical method is developed and validated for determination of sulfadoxine (SD) and sulfamethoxazole (SM) in 100 microL capillary blood dried on sampling paper (Whatman 31ET Chr). SD and SM are extracted with 2000 microL perchloric acid and the liquid phase is loaded onto ENV+ solid-phase extraction columns. SD, SM, and the internal standard are separated on a Purospher STAR RP-18 liquid chromatography column (150 x 4.6 mm) with a mobile phase consisting of acetonitrile-sodium acetate buffer pH 5.2, I = 0.1 (33:67, v/v). Analytes are detected with UV at 256 nm. Lower limit of quantitation is 5 micromol/L, where precisions are 4.2% and 3.9% for SD and SM, respectively. Three brands of sampling papers have been compared with respect to absorption properties, extraction recoveries, and variations. Punching out dried blood spots (DBS) instead of cutting spots into strips prior to extraction has been evaluated by examining precision and accuracy of SD and SM determinations. Importance of uniformity of types of sampling paper, sampling volume and biological matrix, benefit of punching out discs from DBS, and impact on absorption properties of different brands of sampling papers are discussed. Avoiding pre-analytical errors whenever possible results in concentrations determined being more accurate and precise.
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| 21. |
- Språngberg, A, et al.
(author)
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SBU. Godartad prostataförstoring med avflödeshinder. En systematisk litteraturöversikt : Godartad prostataförstoring med avflödeshinder
- 2011
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Reports (other academic/artistic)abstract
- Slutsatser Godartad prostataförstoring (benign prostatahyperplasi, BPH) är ett vanligt tillstånd som med stigande ålder drabbar i princip alla män. En del av dessa män får urineringsproblem och cirka 4 500 opereras varje år för en förstorad prostata. Många med lindrigare besvär behandlas med läkemedel eller behöver ingen behandling alls. Avflödeshinder kan obehandlat ge allvarlig urinretention som skadar njurarna, och en urinstämma kan vara livshotande. För att avgränsa den grupp av män där problemen med urineringen beror på en förstorad prostata används ett tiotal olika diagnostiska metoder. När det gäller behandling finns det flera olika kirurgiska metoder, varav några är väl etablerade och andra av mer experimentell karaktär. Under 1990-talet har också flera läkemedel introducerats. SBU har därför bedömt att det funnits ett behov av att göra en systematisk genomgång av den vetenskapliga grunden för dessa olika metoder. Nedan följer de viktigaste slutsatserna av arbetet.
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| 22. |
- Styhre, Linda, et al.
(author)
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Environmentally differentiated port dues
- 2019
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Reports (other academic/artistic)abstract
- This is the final report of the research project Environmentally differentiated port dues. The purposes of the research are to examine how environmentally differentiated dues and incentives in ports can reduce the environmental impact caused by transport modes that call at the port, and their consequences from legal, political and goods flow perspectives. Both land and sea transport are addressed. The project examines how ports, as important parts of international transport chains, can contribute to the environmental and climate objectives, by introducing environmentally differentiated port dues to promote a shift to more environmentally efficient transport, vehicles, ships, technologies and alternative fuels.
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| 23. |
- Sullivan Hellgren, Jenny, 1973-, et al.
(author)
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Argumentation in university textbooks : comparing biology, chemistry and mathematics
- 2017
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In: NFSUN 2017. ; , s. 55-55
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Conference paper (peer-reviewed)abstract
- Argumentation is a key skill in most school subjects and academic disciplines, including science and mathematics. This study compares explicit argumentation in first-semester university textbooks in biology, chemistry and mathematics in order to increase the understanding of how similarities and differences between disciplines can contribute to, or disrupt, students’ transferrable argumentation skills. Results show that there is significantly more explicit argumentation in the mathematics textbook compared to the biology and chemistry textbooks, and signifycantly more explicit argumentation in the chemistry textbook compared to the biology textbook. Further, the biology textbook contains less argumentation marked by classical argumentative markers such as “since”and “because” and more marked with other, less clear, types of markers such as “which is why” and “when” compared to the other two textbooks. The mathematics textbook contains more complex (recursive) argumentation than the science books. Thereby, the subject-specific languages inthe disciplines have potential to offer students different examples of argumentation. The results will be discussed in relation to students’ development of scientific literacy.
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