| 1. |
- Ekelund, Mikael, et al.
(author)
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Effects of total parenteral nutrition on rat enteric nervous system, intestinal morphology, and motility.
- 2005
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In: Journal of Surgical Research. - : Elsevier BV. - 1095-8673 .- 0022-4804. ; 124:2, s. 187-193
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Journal article (peer-reviewed)abstract
- Total parenteral nutrition (TPN) is often crucial for patients not being able to feed enterally or having intestinal absorptive deficits. Enteral nutrition is, however, frequently regarded vital for maintaining functional and structural intestinal integrity. The aim of this study was to investigate possible effects of TPN on rat distal small intestine compared to enterally fed identically housed controls, regarding the enteric nervous system (ENS), motility in vitro, and morphology. This study shows that motor responses evoked by electrical stimulation or exposure to vasoactive intestinal peptide (VIP), pituitary adenylate cyclase activating peptide-27 (PACAP-27), and nitric oxide (NO) donor were unchanged. By using immunohistochemistry, the numbers of submucous (P < 0.05) and myenteric (P < 0.05) nerve cells were found to increase, expressed as numbers per unit length. The percentage of neurons expressing VIP, PACAP-27, NO-synthase, and galanin remained unchanged, however. By in situ hybridization the number of submucous neurons expressing neuropeptide Y-mRNA was found to decrease (P < 0.05); the other populations were unaltered. Morphometry revealed an increased submucosal thickness (P < 0.05), while intestinal circumference markedly decreased (P < 0.0001) in TPN-treated rats. In conclusion, TPN treatment resulted in reduced intestinal circumference leading to condensation of enteric neurons. No marked changes in neurotransmitter expression of the enteric neurons or in motor activity were noted.
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| 2. |
- Ekelund Ugge, Gustaf Magnus Oskar, et al.
(author)
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Molecular biomarker responses in the freshwater mussel Anodonta anatina exposed to an industrial wastewater effluent
- 2022
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In: Environmental Science and Pollution Research. - : Springer. - 0944-1344 .- 1614-7499. ; 29:2, s. 2158-2170
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Journal article (peer-reviewed)abstract
- Using a selection of molecular biomarkers, we evaluated responses in freshwater mussels (Anodonta anatina) exposed to effluent from an industrial wastewater treatment facility. The aims of this work were to (1) assess biomarkers of general toxicity under sublethal exposure to an anthropogenic mixture of chemicals, represented by an arbitrary effluent, and (2) evaluate the potential of A. anatina as a bioindicator of pollution. Adult mussels (n = in total 32; 24 males and 8 females) were exposed (96 h) in the laboratory to a fixed dilution of effluent or to a control treatment of standardized freshwater. Metal concentrations were in general higher in the effluent, by an order of magnitude or more, compared to the control. Toxic unit estimates were used as proxies of chemical stress, and Cu, Ni, and Zn were identified as potential major contributors (Cu> Ni > Zn). Six transcriptional (cat, gst, hsp70, hsp90, mt, sod) and two biochemical (AChE, GST) biomarkers were analyzed in two tissues, gills, and digestive glands. Out of the 16 responses (eight biomarkers x two tissues), 14 effect sizes were small (within +/- 28 % of control) and differences non-significant (p > 0.05). Results did however show that (1) AChE activity increased by 40% in gills of exposed mussels compared to control, (2) hsp90 expression was 100% higher in exposed female gills compared to control, and (3) three marker signals (AChE in both tissues, and hsp70 in gills) differed between sexes, independent of treatment. Results highlight a need for further investigation of molecular biomarker variability and robustness in A. anatina.
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| 3. |
- Nyström, Thomas, et al.
(author)
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Evaluation of Effects of Continuous Glucose Monitoring on Physical Activity Habits and Blood Lipid Levels in Persons With Type 1 Diabetes Managed With MDI: An Analysis Based on the GOLD Randomized Trial (GOLD 8)
- 2024
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In: Journal of diabetes science and technology. - : SAGE Publications. - 1932-2968. ; 18:1, s. 89-98
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Journal article (peer-reviewed)abstract
- Background: People with type 1 diabetes generally view it easier to exercise when having continuous information of the glucose levels. We evaluated whether patients with type 1 diabetes managed with multiple daily insulin injections (MDI) exercised more after initiating continuous glucose monitoring (CGM) and whether the improved glycemic control and well-being associated with CGM translates into improved blood lipids and markers of inflammation. Method: The GOLD trial was a randomized cross-over trial over 16 months where patients used either CGM or capillary self-monitoring of blood glucose (SMBG) over six months, with a four-month wash-out period between the two treatment periods. We compared grade of physical activity, blood lipids, apolipoproteins, and high-sensitivity C-reactive protein (hsCRP) levels during CGM and SMBG. Results: There were 116 patients with information of physical activity estimated by the International Physical Activity Questionnaire (IPAQ) during both CGM and SMBG. No changes were found during CGM or SMBG, IPAQ scores 3305 versus 3878 (P =.16). In 136 participants with information of blood lipid levels with no change in lipid-lowering medication during the two treatment periods, HbA1c differed by 4.2 mmol/mol (NGSP 0.39%) between SMBG and CGM treatment (P <.001). No significant changes existed in low-density lipoprotein, high-density lipoprotein, triglycerides, total cholesterol, apolipoprotein A1, apolipoprotein B1, or hsCRP, during CGM and SMBG. Conclusion: Although many patients experience it easier to perform physical activity when monitoring glucose levels with CGM, it does not influence the amount of physical activity in persons with type 1 diabetes. Blood lipids, apolipoprotein, and hsCRP levels were similar during CGM and SMBG.
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| 4. |
- Olafsdottir, Arndis, 1978, et al.
(author)
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The majority of people with type 1 diabetes and multiple daily insulin injections benefit from using continuous glucose monitoring: An analysis based on the GOLD randomized trial (GOLD-5)
- 2021
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In: Diabetes Obesity & Metabolism. - : Wiley. - 1462-8902 .- 1463-1326. ; 23:2, s. 619-630
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Journal article (peer-reviewed)abstract
- Aim To identify responders to continuous glucose monitoring (CGM) in relation to reductions in HbA1c and percentage of time spent in hypoglycaemia after initiation of CGM for individuals with type 1 diabetes treated with multiple daily insulin injections. Materials and Methods We analysed data from 142 participants in the GOLD randomized clinical trial. We evaluated how many lowered their HbA1c by more than 0.4% (>4.7 mmol/mol) or decreased the time spent in hypoglycaemia over 24 hours by more than 20 or 30 minutes, and which baseline variables were associated with those improvements. Results Lower reduction of HbA1c was associated with greater reduction of hypoglycaemia (r = -0.52; P < .0001). During CGM, 47% of participants lowered their HbA1c values by more than 0.4% (>4.7 mmol/mol) than with self-measurement of blood glucose, and 47% decreased the time spent in hypoglycaemia by more than 20 minutes over 24 hours. Overall, 78% either reduced their HbA1c by more than 0.4% (>4.7 mmol/mol) or the time spent in hypoglycaemia by more than 20 minutes over 24 hours, but only 14% improved both. Higher HbA1c, a lower percentage of time at less than 3.0 or 3.9 mmol/L, a lower coefficient of variation (CV) and a higher percentage of time above 13.9 mmol/L (P = .016) were associated with greater HbA1c reduction during CGM. The variables associated with a greater reduction of time in hypoglycaemia were female sex, greater time with glucose levels at less than 3.0 mmol/L, higher CV, and higher hypoglycaemia confidence as evaluated by a hypoglycaemic confidence questionnaire. Conclusion The majority of people with type 1 diabetes managed by multiple daily insulin injections benefit from CGM; some experienced reduced HbA1c while others reduced the time spent in hypoglycaemia. These factors need to be considered by healthcare professionals and decision-makers for reimbursement and diabetes guidelines.
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| 5. |
- Söfteland, John M., 1977, et al.
(author)
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Longevity of anti-spike and anti-nucleocapsid antibodies after COVID-19 in solid organ transplant recipients compared to immunocompetent controls.
- 2022
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In: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. - : Elsevier BV. - 1600-6143. ; 22:4, s. 1245-1252
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Journal article (peer-reviewed)abstract
- Solid organ transplant recipients (SOTRs) are on lifelong immunosuppression, which may interfere with adaptive immunity to COVID-19. The data on dynamics and duration of antibody response in SOTRs are limited. This longitudinal study examined the longevity of both anti-spike (S)- and anti-nucleocapsid (N)-specific IgG-antibodies after COVID-19 in SOTRs compared to matched immunocompetent persons. SOTRs (n=65) were matched with controls (n=65) for COVID-19 disease severity, age, and sex in order of priority. Serum-IgG-antibodies against N- and S-antigens of SARS-CoV-2 were analyzed. At 1 and 9 months after COVID-19, anti-S-IgG detectability decreased from 91% to 82% in SOTRs versus 100% to 95% in controls, whereas the anti-N-IgG decreased from 63% to 29% in SOTRs versus 89% to 46% in controls. A matched paired analysis showed SOTRs having significantly lower levels of anti-N-IgG at all time points (1-month P=0.007, 3-months P<0.001, 6-months P=0.019 and 9-months P=0.021) but not anti-S-IgG at any time points. A mixed-model analysis confirmed these findings except for anti-S-IgG at one month (p=0.005) and identified severity score as the most important predictor of antibody response. SOTRs mount comparable S-specific, but not N-specific, antibody responses to SARS-CoV-2 infection compared to immunocompetent controls.
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| 6. |
- Berggren, Jonas, et al.
(author)
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1980-talets lågenergihus: hur fungerar de efter tio år
- 1997
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Reports (other academic/artistic)abstract
- Syftet med detta forskningsprojekt är att undersöka hur ett antal väl dokumenterade experimenthus har fungerat under en tioårsperiod. Undersökningen jämför i första hand uppgifter om energianvändning och de driftfrågor som hör till energianvändningen. Vidare har de boendes upplevda inomhusklimat studerats för att kunna se om, och i så fall hur, experimenthusens låga energianvändning har påverkat det upplevda inomhusklimatet.
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| 7. |
- Brink, Ebba, et al.
(author)
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On the road to research municipalities : Analysing transdisciplinarity in municipal ecosystem services and adaptation planning
- 2018
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In: Sustainability Science. - : Springer. - 1862-4065 .- 1862-4057. ; 13:3, s. 765-784
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Journal article (peer-reviewed)abstract
- Transdisciplinary research and collaboration is widely acknowledged as a critical success factor for solution- oriented approaches that can tackle complex sustainability challenges, such as biodiversity loss, pollution, and climate-related hazards. In this context, city governments’ engagement in transdisciplinarity is generally seen as a key condition for societal transformation towards sustainability. However, empirical evidence is rare. This paper presents a self-assessment of a joint research project on ecosystem services and climate adaptation planning (ECOSIMP) undertaken by four universities and seven Swedish municipalities. We apply a set of design principles and guiding questions for transdisciplinary sustainability projects and, on this basis, identify key aspects for supporting university–municipality collaboration. We show that: (1) selecting the number and type of project stakeholders requires more explicit consideration of the purpose of societal actors’ participation; (2) concrete, interim benefits for participating practitioners and organisations need to be continuously discussed; (3) promoting the ‘inter’, i.e., interdisciplinary and inter-city learning, can support transdisciplinarity and, ultimately, urban sustainability and long-term change. In this context, we found that design principles for transdisciplinarity have the potential to (4) mitigate project shortcomings, even when transdisciplinarity is not an explicit aim, and (5) address differences and allow new voices to be heard. We propose additional guiding questions to address shortcomings and inspire reflexivity in transdisciplinary projects.
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| 8. |
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| 9. |
- Claesson, Rickard, et al.
(author)
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The potential impact of new diagnostic criteria on the frequency of gestational diabetes mellitus in Sweden.
- 2013
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 92:10, s. 1223-1226
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Journal article (peer-reviewed)abstract
- The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has suggested new diagnostic criteria for gestational diabetes mellitus. Many centers in Europe still use the World Health Organization (WHO) criteria. In southern Sweden we use the 2-h threshold of the European Association for the Study of Diabetes criteria based on universal screening with a 75-g oral glucose tolerance test. We have retrospectively scrutinized oral glucose tolerance tests in a subset of 174 women included in a previous study, diagnosed with gestational diabetes mellitus 1996-1999. A complete repeat oral glucose tolerance test was performed directly after diagnosis in 120 women. When applying the current Swedish criteria, and the IADPSG and the WHO criteria to the material, gestational diabetes mellitus was confirmed in 67% (80/120), 84% (101/120), and 80% (96/120), respectively. Hence, 26% (101/80) more women were identified by the IADPSG criteria and 20% (96/80) more women by the WHO criteria, compared with the criteria presently in use.
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| 10. |
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| 11. |
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| 12. |
- Ekelund, Magnus
(author)
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Genetic and Metabolic Markers for the Development of Diabetes after Gestational Diabetes Mellitus
- 2010
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Doctoral thesis (other academic/artistic)abstract
- The aims of this work were to determine the prevalence of postpartum diabetes among women with gestational diabetes mellitus (GDM) in a prospective study 5 years postpartum; to characterize these women according to insulin secretion, insulin sensitivity, autoimmunity and genetics; and to identify possible markers and predictors for the development of manifest diabetes. The subjects were recruited through a regional screening programme in which oral glucose tolerance tests (OGTTs) are routinely offered to all pregnant women. The prevalence of MODY mutations among women with GDM and a family history of diabetes was found to be 5%. Arabian women were more insulin resistant than Scandinavian women with the same BMI, and showed impaired beta cell compensation for their degree of insulin resistance. GDM might share some genetic features with type 1 diabetes in Scandinavian women. The prevalence of manifest diabetes 5 years after GDM was 30% in our population. Antenatal levels of fasting glucose and HbA1c were identified as biochemical predictors of diabetes following GDM. These are easy to measure, and are relatively cheap, and could help identify women at particularly high risk of developing diabetes postpartum. Counselling regarding future risk of diabetes could then be initiated during pregnancy in high-risk individuals. The rs8050136 variant in the FTO (fat mass and obesity associated) gene was associated with an increased risk of developing postpartum diabetes, probably due to its effect on increasing obesity . Thus, genetic testing may provide a means of identifying pregnant women at high risk of developing postpartum diabetes.
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| 13. |
- Ekelund, Magnus, et al.
(author)
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Genetic prediction of postpartum diabetes in women with gestational diabetes mellitus
- 2012
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In: Diabetes Research and Clinical Practice. - : Elsevier BV. - 1872-8227 .- 0168-8227. ; 97:3, s. 394-398
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Journal article (peer-reviewed)abstract
- Aims: To examine whether genetic variants that predispose individuals to type 2 diabetes (T2D) could predict the development of diabetes after gestational diabetes mellitus (GDM). Methods: 13 SNPs (FTO rs8050136, CDKAL1 rs7754840 and rs7756992, CDKN2A/2B rs10811661, HHEX rs1111875, IGF2BP2 rs1470579 and rs4402960, SLC30A8 rs13266634, TCF7L2 rs7903146, PPARG rs1801282, GCK rs1799884, HNF1A rs1169288, and KCNJ11 rs5219) were genotyped in 793 women with GDM after a median follow-up of 57 months. Results: After adjustment for age and ethnicity, the TCF7L2 rs7903146 and the FTO rs8050136 variants significantly predicted postpartum diabetes; hazard ratio (95% confidence interval 1.29 (1.01-1.66) and 1.36 (1.06-1.74), respectively (additive model) versus 1.45 (1.01-2.08) and 1.56 (1.06-2.29) (dominant model)). Adjusting for BMI attenuated the effect of the FTO variant, suggesting that the effect was mediated through its effect on BMI. Combining all risk alleles to a weighted risk score was significantly associated with the risk of postpartum diabetes (hazard ratio 1.11, 95% confidence interval 1.05-1.18, p = 0.00016 after adjustment for age and ethnicity). Conclusions: The TCF7L2 rs7903146 and FTO rs8050136 polymorphisms, and particularly a weighted risk score of T2D risk alleles, predict diabetes after GDM. Further studies in other populations are needed to confirm our results. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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| 14. |
- Ekelund, Malin, et al.
(author)
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Hotels re-explored: Experience and influence of reciprocity and social normative appeals
- 2023
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In: PLOS ONE. - 1932-6203. ; 18:12
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Journal article (peer-reviewed)abstract
- In this paper we report two high-powered and pre-registered experiments, testing the robustness and conceptual development of reciprocity and social norm appeals. Both experiments assessed both psychological processes for complying with these appeals and pro-environmental behavioral intention in tourism settings. In Experiment 1 (N = 2004), participants reported lower psychological reactance levels after learning that the hotel engaged in resource conservation (i.e., indirect homeomorphic reciprocity). No statistically significant effect was obtained for either obligatory motivation, prosocial motivation, skepticism, or behavioral intentions to reuse hotel towels. Importantly, high baseline intention of reusing hotel towels might have limited the effect of appeals. Therefore, we targeted meat consumption in Experiment 2 (n = 2540). Results first showed stronger obligatory and prosocial motivation for all three reciprocity appeals, compared to the standard appeal. No statistically significant results were found for either reactance or skepticism. Finally, after learning that the hotel had made a financial contribution to an environmental organization (i.e., indirect heteromorphic reciprocity) participants showed reduced meat consumption intentions compared to the standard appeal. Overall, the results provide initial evidence for conceptually refining the norm of reciprocity to encourage pro-environmental behaviors and for understanding the underlying psychological processes.
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| 15. |
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| 16. |
- Ekelund Ugge, Gustaf Magnus Oskar, et al.
(author)
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Evaluation of transcriptional biomarkers using a high-resolution regression approach : Concentration-dependence of selected transcripts in copper-exposed freshwater mussels (Anodonta anatina)
- 2022
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In: Environmental Toxicology and Pharmacology. - : Elsevier. - 1382-6689 .- 1872-7077. ; 90
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Journal article (peer-reviewed)abstract
- We tested concentration-dependence of selected gene transcripts (cat, gst, hsp70, hsp90, mt and sod) for evaluation as biomarkers of chemical stress. Contrary to the common approach of factorial designs and few exposure concentrations, we used regression across a high-resolution concentration series. Specifically, freshwater mussels (Anodonta anatina) were acutely (96 h) exposed to Cu (13 nominal concentrations, measuring 0.13–1 600 µg/L), and transcripts were measured by RT-qPCR. In digestive glands, cat, hsp90 and mt decreased with water Cu (p < 0.05), but response magnitudes saturated at < 2-fold decreases. In gills, gst, hsp70, hsp90 and mt increased with water Cu (p < 0.05). While hsp70, hsp90 and mt exceeded 2-fold increases within the exposure range, high Cu concentrations were required (38–160 µg/L). Although gill responses were generally more robust compared to digestive glands, overall small response magnitudes and moderate sensitivity may set limit for potential application as general biomarkers of chemical stress.
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| 17. |
- Ekelund Ugge, Gustaf Magnus Oskar, et al.
(author)
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Transcriptional and biochemical biomarker responses in a freshwater mussel (Anodonta anatina) under environmentally relevant Cu exposure
- 2020
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In: Environmental Science and Pollution Research. - : Springer Berlin/Heidelberg. - 0944-1344 .- 1614-7499. ; 27:9, s. 9999-10010
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Journal article (peer-reviewed)abstract
- Molecular biomarkers, like gene transcripts or enzyme activities, are potentially powerful tools for early warning assessment of pollution. However, a thorough understanding of response and baseline variation is required to distinguish actual effects from pollution. Here, we assess the freshwater mussel Anodonta anatina as a biomarker model species for freshwater ecosystems, by testing responses of six transcriptional (cat, gst, hsp70, hsp90, mt, and sod) and two biochemical (AChE and GST) biomarkers to environmentally relevant Cu water concentrations. Mussels (n = 20), collected from a stream free from point source pollution, were exposed in the laboratory, for 96 h, to Cu treatments (< 0.2 mu g/L, 0.77 +/- 0.87 mu g/L, and 6.3 +/- 5.4 mu g/L). Gills and digestive glands were extracted and analyzed for transcriptional and biochemical responses. Biological and statistical effect sizes from Cu treatments were in general small (mean log(2) fold-change <= 0.80 and Cohen's f <= 0.69, respectively), and no significant treatment effects were observed. In contrast, four out of eight biomarkers (cat, gst, hsp70, and GST) showed a significant sex:tissue interaction, and additionally one (sod) showed significant overall effects from sex. Specifically, three markers in gills (cat, mt, GST) and one in digestive gland (AChE) displayed significant sex differences, independent of treatment. Results suggest that sex or tissue effects might obscure low-magnitude biomarker responses and potential early warnings. Thus, variation in biomarker baselines and response patterns needs to be further addressed for the future use of A. anatina as a biomarker model species.
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| 18. |
- Ekelund Ugge, Gustaf Magnus Oskar, 1990-
(author)
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Transcriptional biomarkers of toxicity – powerful tools or random noise? : An applied perspective from studies on bivalves
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Aquatic organisms are constantly at risk of being exposed to potentially harmful chemical compounds of natural or anthropogenic origin. Biological life can for instance respond to chemical stressors by changes in gene expression, and thus, certain gene transcripts can potentially function as biomarkers, i.e. early warnings, of toxicity and chemical stress. A major challenge for biomarker application is the extrapolation of transcriptional data to potential effects at the organism level or above. Importantly, successful biomarker use also requires basal understanding of how to distinguish actual responses from background noise. The aim of this thesis is, based on response magnitude and variation, to evaluate the biomarker potential in a set of putative transcriptional biomarkers of general toxicity and chemical stress.Specifically, I addressed a selection of six transcripts involved in cytoprotection and oxidative stress: catalase (cat), glutathione-S-transferase (gst), heat shock proteins 70 and 90 (hsp70, hsp90), metallothionein (mt) and superoxide dismutase (sod). Moreover, I used metal exposures to serve as a proxy for general chemical stress, and due to their ecological relevance and nature as sedentary filter-feeders, I used bivalves as study organisms.In a series of experiments, I tested transcriptional responses in the freshwater duck mussel, Anodonta anatina, exposed to copper or an industrial wastewater effluent, to address response robustness and sensitivity, and potential controlled (e.g. exposure concentration) and random (e.g. gravidness) sources of variation. In addition, I performed a systematic review and meta-analysis on transcriptional responses in metal exposed bivalves to (1) evaluate what responses to expect from arbitrary metal exposures, (2) assess the influence from metal concentration (expressed as toxic unit), exposure time and analyzed tissue, and (3) address potential impacts from publication bias in the scientific literature.Response magnitudes were generally small in relationship to the observed variation, both for A. anatina and bivalves in general. The expected response to an arbitrary metal exposure would generally be close to zero, based on both experimental observations and on the estimated impact from publication bias. Although many of the transcripts demonstrated concentration-response relationships, large background noise might in practice obscure the small responses even at relatively high exposures. As demonstrated in A. anatina under copper exposure, this can be the case already for single species under high resolution exposures to single pollutants. As demonstrated by the meta-regression, this problem can only be expected to increase further upon extrapolation between different species and exposure scenarios, due to increasing heterogeneity and random variation. Similar patterns can also be expected for time-dependent response variation, although the meta-regression revealed a general trend of slightly increasing response magnitude with increasing exposure times.In A. anatina, gravidness was identified as a source of random variability that can potentially affect the baseline of most assessed biomarkers, particularly when quantified in gills. Response magnitudes and variability in this species were generally similar for selected transcripts as for two biochemical biomarkers included for comparison (AChE, GST), suggesting that the transcripts might not capture early warnings more efficiently than other molecular endpoints that are more toxicologically relevant. Overall, high concentrations and long exposure durations presumably increase the likelihood of a detectable transcriptional response, but not to an extent that justifies universal application as biomarkers of general toxicity and chemical stress. Consequently, without a strictly defined and validated application, this approach on its own appears unlikely to be successful for future environmental risk assessment and monitoring. Ultimately, efficient use of transcriptional biomarkers might require additional implementation of complementary approaches offered by current molecular techniques.
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| 19. |
- Ekelund Ugge, Gustaf Magnus Oskar, et al.
(author)
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Transcriptional Responses as Biomarkers of General Toxicity : A Systematic Review and Meta-Analysis on Metal-Exposed Bivalves
- 2023
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In: Environmental Toxicology and Chemistry. - : John Wiley & Sons. - 0730-7268 .- 1552-8618. ; 42:3, s. 628-641
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Research review (peer-reviewed)abstract
- Through a systematic review and a series of meta-analyses, we evaluated the general responsiveness of putative transcriptional biomarkers of general toxicity and chemical stress. We targeted metal exposures performed on bivalves under controlled laboratory conditions, and selected six transcripts associated with general toxicity for evaluation: catalase (cat), glutathione-S-transferase (gst), heat shock proteins 70 and 90 (hsp70, hsp90), metallothionein (mt) and superoxide dismutase (sod). Transcriptional responses (n = 396) were extracted from published scientific articles (k = 22) and converted to log response ratios (lnRRs). By estimating toxic units (TUs), we normalized different metal exposures to a common scale, as a proxy of concentration. Using Bayesian hierarchical random effect models, we then tested the effects of metal exposure on lnRR, both for metal exposure in general and in meta-regressions using TU and exposure time as independent variables. Corresponding analyses were also repeated with transcript and tissue as additional moderators. Observed patterns were similar for general as for transcript- and tissue-specific responses. The expected overall response to arbitrary metal exposure was a lnRR of 0.50, corresponding to a 65 % increase relative a non-exposed control. However, when accounting for publication bias, the estimated ‘true’ response showed no such effect. Furthermore, expected response magnitude increased slightly with exposure time, but there was little support for general monotonic concentration-dependence with regards to TU. Altogether, this work reveals potential limitations that need consideration prior to applying the selected transcripts as biomarkers in environmental risk assessment. This article is protected by copyright. All rights reserved. Environ Toxicol Chem 2022;00:0–0.
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| 20. |
- Golparian, Daniel, 1984-, et al.
(author)
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Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014
- 2014
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In: Eurosurveillance. - : European Centre for Disease Prevention and Control (ECDC). - 1025-496X .- 1560-7917. ; 19:30, s. 2-5
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Journal article (peer-reviewed)abstract
- We describe four cases in Sweden of verified treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg; n=3) or cefotaxime (500 mg; n=1) monotherapy. All the ceftriaxone treatment failures were caused by the internationally spreading multidrug-resistant gonococcal NG-MAST genogroup 1407 clone. Increased awareness of treatment failures is crucial particularly when antimicrobial monotherapy is used. Frequent test of cure and appropriate verification/falsification of suspected treatment failures, as well as implementation of recommended dual antimicrobial therapy are imperative.
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| 21. |
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| 22. |
- Gustafsson, Silje, et al.
(author)
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Factors Influencing Early Postoperative Recovery After Laparoscopic Cholecystectomy
- 2020
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In: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 35:1, s. 80-84
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Journal article (peer-reviewed)abstract
- PurposeTo study the factors influencing early postoperative recovery after laparoscopic cholecystectomy.DesignA nonexperimental retrospective study.MethodsThe study was performed using records from all patients who had undergone laparoscopic cholecystectomy at a hospital in Northern Sweden in 2017 (219 patients in total). Nonparametric data were analyzed using Spearman's rho, Mann-Whitney U test, and logistic regression. Parametric data were analyzed using Pearson's correlation, an independent t test, and analysis of variance.FindingsThe length of stay in the postanesthesia care unit was not predicted by factors such as age, gender, body mass index, American Society of Anesthesiologists classification, postoperative nausea and vomiting, premedication, or type of surgery. Younger age and high classification level were significant predictors of pain during rest and pain when in motion. No significant predictors of postoperative nausea were found. The majority of study participants experienced little or no pain or nausea. The documentation of pain, nausea, and premedication was inadequate in many cases.ConclusionsNurses in postanesthesia care units should work to preventively identify and address patients’ medical and emotional needs so that optimal conditions for postoperative recovery can be provided.
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| 23. |
- Hagelsteen, Kristine, et al.
(author)
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Faster acquisition of laparoscopic skills in virtual reality with haptic feedback and 3D vision
- 2017
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In: Minimally Invasive Therapy and Allied Technologies. - : Informa UK Limited. - 1364-5706 .- 1365-2931. ; 26:5, s. 269-277
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Journal article (peer-reviewed)abstract
- BACKGROUND: The study investigated whether 3D vision and haptic feedback in combination in a virtual reality environment leads to more efficient learning of laparoscopic skills in novices.MATERIAL AND METHODS: Twenty novices were allocated to two groups. All completed a training course in the LapSim(®) virtual reality trainer consisting of four tasks: 'instrument navigation', 'grasping', 'fine dissection' and 'suturing'. The study group performed with haptic feedback and 3D vision and the control group without. Before and after the LapSim(®) course, the participants' metrics were recorded when tying a laparoscopic knot in the 2D video box trainer Simball(®) Box.RESULTS: The study group completed the training course in 146 (100-291) minutes compared to 215 (175-489) minutes in the control group (p = .002). The number of attempts to reach proficiency was significantly lower. The study group had significantly faster learning of skills in three out of four individual tasks; instrument navigation, grasping and suturing. Using the Simball(®) Box, no difference in laparoscopic knot tying after the LapSim(®) course was noted when comparing the groups.CONCLUSIONS: Laparoscopic training in virtual reality with 3D vision and haptic feedback made training more time efficient and did not negatively affect later video box-performance in 2D. [Formula: see text].
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| 24. |
- Hagelsteen, Kristine, et al.
(author)
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Performance and perception of haptic feedback in a laparoscopic 3D virtual reality simulator
- 2019
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In: Minimally Invasive Therapy and Allied Technologies. - : Informa UK Limited. - 1364-5706 .- 1365-2931. ; 28:5, s. 309-316
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Journal article (peer-reviewed)abstract
- Background: The benefit of haptic feedback in laparoscopic virtual reality simulators (VRS) is ambiguous. A previous study found 32% faster acquisition of skills with the combination of 3 D and haptic feedback compared to 2 D only. This study aimed to validate perception and effect on performance of haptic feedback by experienced surgeons in the previously tested VRS. Material and methods: A randomized single blinded cross-over study with laparoscopists (>100 laparoscopic procedures) was conducted in a VRS with 3 D imaging. One group started with haptic feedback, and the other group without. After performing the suturing task with haptics either enabled or disabled, the groups crossed over to the opposite setting. Face validity was assessed through questionnaires. Metrics were obtained from the VRS. Results: The haptics for ‘handling the needle’, ‘needle through tissue’ and ‘tying the knot’ was scored as completely realistic by 3/22, 1/22 and 2/22 respectively. Comparing the metrics for maximum stretch damage between the groups revealed a significantly lower score when a group performed with haptics enabled p =.027 (haptic first group) and p <.001(haptic last group). Conclusion: Haptic feedback in VRS has limited fidelity according to the tested laparoscopic surgeons. In spite of this, significantly less stretch damage was caused with haptics enabled.
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| 25. |
- Hedenbro, Jan, et al.
(author)
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Formation of the Scandinavian Obesity Surgery Registry, SOReg
- 2015
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In: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 25:10, s. 1893-1900
-
Journal article (peer-reviewed)abstract
- Obesity surgery is expanding, the quality of care is ever more important, and learning curve assessment should be established. A large registry cohort can show long-term effects on obesity and its comorbidities, complications, and long-term side effects of surgery, as well as changes in health-related quality of life (QoL). Sweden is ideally suited to the task of data collection and audit, with universal use of personal identification numbers, nation-wide registries permitting cross-matching to analyze causes of death, in-hospital care, and health-related absenteeism. In 2004, the Scandinavian Obesity Surgery Registry (SOReg) was initiated and government financing secured. A project group created a national database covering all public as well as private hospitals. Data entry was to be made online, operative definitions of comorbidity were formed, and complication severity scored. Several forms of audit were devised. After pilot studies, the system has been running in its present form since 2007. Since 15 January 2013, SOReg covers all bariatric surgery centers in Sweden. The number of operations in the database exceeded 40,000 (March 2014), with a median follow-up of 2.94 years. Audit shows that > 98 % of data are correct. All results are publicized annually on the Internet. Using this systematic approach, it has been possible to cover > 99 % of all bariatric surgery, cross-matching our data with nation-wide registries for in-hospital care, cause of death, and permitting regular nation-wide audit. Several scientific studies have used, or are using, what seems to be the most comprehensive database in obesity surgery.
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| 26. |
- Ideland, Malin, et al.
(author)
-
Forskningscirkel om lärande för hållbar utveckling : inspiration till och reflektion över hur hållbarhetsperspektiv kan integreras i olika skolämnen
- 2016
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Reports (other academic/artistic)abstract
- Begreppet hållbar utveckling är idag ett väletablerat begrepp, samtidigt som det är komplext och öppet för olika tolkningar. Hållbar utveckling innebär att samhället måste planera utifrån såväl ekologiska och sociala som ekonomiska aspekter. Eftersom begreppet kan förstås på olika sätt är utbildning en viktig del i utvecklingen av ett hållbart samhälle – inte bara för att utveckla kunskaper utan även för att få möjlighet att reflektera över problem och möjligheter. Betydelsen av en hållbar samhällsutveckling förstärktes i och med att FN utlyste en dekad för lärande om hållbar utveckling mellan åren 2005 och 2014. Målet med denna dekad var att elever och studenter skall kunna utveckla verktyg för att på så sätt kunna göra medvetna fram- tida val med hänsyn till ekologisk, ekonomisk och social hållbarhet. Med detta som grund har även Naturskyddsföreningen arbetat med att stärka och utveckla utbildningen för hållbar utveckling. Latinskolan i Malmö har fungerat som en modellskola för utvecklingen av lärande om hållbar utveckling med stöd av Naturskyddsföreningen. Projektet har även inkluderat samverkan med Malmö högskola, vilket har inneburit att forskare med förankring inom forskningsområdet hållbar utveckling arbetat med en forskningscirklel för lärare från Latinskolan för att på så sätt fördjupa kunskaperna inom området lärande för hållbar utveckling. Denna rapport är resultaten av denna forskningscirkel. I rapporten kan man läsa om följande projekt: Lena Ansner och Sofia Gustafson Aarnivaara har undersökt hur estetiska designprocesser kan bidra till att utveckla elevers kritiska tänkande såväl som deras möjligheter att ta plats i offentligheten. För att undersöka detta genomförde de ett projekt om gatukonst – där eleverna dels studerade befintlig gatukonst, dels gjorde egen gatukonst. Detta reste frågor om vems röst som får höras i samhället, och på vilken plats. I sin analys utforskade Lena och Sofia hur elever kan använda den konstnärliga processen för att ta plats och göra avtryck i det offentliga rummet och därmed stärka sin känsla av delaktighet i stadens utveckling. Josefine Lindeberg och Helena Heister har undersökt hur ett undervisningstema tillsammans där språkämnena svenska och engelska och biologiämnet skulle hjälpa eleverna att använda sina kunskaper för att argumentera och ta ställning i en hållbarhetsfråga. Ämnesområdet var genteknik, ett spännande case för att lyfta hållbar utveckling eftersom frågor kring hälsa, ekologi, men även ekonomiska vinstintressen är ständigt närvarande inom detta område. Ett resultat från studien handlar om frågan om att arbeta och svårigheten att försöka sammansmälta olika ämnen. I skolan finns en mängd olika strukturella motstånd som stör lärandet. Lars Berggren undersökte, inom ramen för ett ämnesövergripande medieprojekt, hur detta kunde bidra till att eleverna utvecklar en global handlingskompetens och en pluralistisk syn på vad som är »hållbart«. Tillsammans i projektet – som handlade om mänskliga rättigheter – arbetade en medieklass på estetiska programmet och en språkintroduktionsklass med nyanlända flyktingar. I inledningsfasen av hade esteteleverna en ganska gängse uppfattning om att svenskar är bättre än andra på mänskliga rättigheter, men efterhand infann sig en viss ödmjukhet inför språkintroduktionsklassens elevers kunskaper och erfarenheter.
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| 27. |
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| 28. |
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| 29. |
- Ignell, Claes, et al.
(author)
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Model for individual prediction of diabetes up to 5 years after gestational diabetes mellitus
- 2016
-
In: SpringerPlus. - : Springer Science and Business Media LLC. - 2193-1801. ; 5
-
Journal article (peer-reviewed)abstract
- AIMS: To identify predictors of diabetes development up to 5 years after gestational diabetes mellitus (GDM) and to develop a prediction model for individual use.METHODS: Five years after GDM, a 75-g oral glucose tolerance test (OGTT) was performed in 362 women, excluding women already diagnosed with diabetes at 1- to 2-year follow-up or later (n = 45). All but 21 women had results from follow-up at 1-2 years, while 84 women were lost from that point. Predictive variables were identified by logistic regression analysis.RESULTS: Five years after GDM, 28/362 women (8 %) were diagnosed with diabetes whereas 187/362 (52 %) had normal glucose tolerance (NGT). Of the latter, 139/187 (74 %) also had NGT at 1- to 2-year follow-up. In simple regression analysis, using NGT at 1-2 years and at 5 years as the reference, diabetes at 1- to 2-year follow-up or later was clearly associated with easily assessable clinical variables, such as BMI at 1- to 2-year follow-up, 2-h OGTT glucose concentration during pregnancy, and non-European origin (P < 0.0001). A prediction model based on these variables resulting in 86 % correct classifications, with an area under the receiver-operating characteristic curve of 0.91 (95 % CI 0.86-0.95), was applied in a function-sheet line diagram illustrating the individual effect of weight on diabetes risk.CONCLUSIONS: The results highlight the importance of BMI as a potentially modifiable risk factor for diabetes after GDM. Our proposed prediction model performed well, and should encourage validation in other populations in future studies.
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| 30. |
- Ignell, Claes, et al.
(author)
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The impact of ethnicity on glucose homeostasis after gestational diabetes mellitus.
- 2013
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In: Acta Diabetologica. - : Springer Science and Business Media LLC. - 1432-5233 .- 0940-5429. ; 50:6, s. 927-934
-
Journal article (peer-reviewed)abstract
- The objective of this study was to examine measures of insulin resistance and beta cell function in relation to ethnicity and the development of diabetes after gestational diabetes mellitus (GDM). Glucose homeostasis was assessed during a 75 g oral glucose tolerance test 1-2 years after delivery in 456 women with previous GDM (362 European, 94 non-European; including 41 Arab and 43 Asian women) and 133 control women. Insulin resistance was estimated using homeostasis model assessment of insulin resistance (HOMA-IR). The insulinogenic index (I/G30) and the disposition index [(I/G30)/HOMA-IR] were used to quantify insulin secretion. Women developing diabetes after GDM were characterized by increased HOMA-IR [p = 0.010, adjusted for body mass index (BMI)], whereas the disposition index was decreased in all women with previous GDM irrespective of glucose tolerance, most pronounced in the presence of diabetes (BMI-adjusted p = 1 × 10(-5)). Non-European origin was associated with increased HOMA-IR (p = 0.001 vs. European), strengthened by adjustment for BMI in Asian women (p = 0.046 vs. p = 0.016), but eradicated among Arab women (p = 0.004 vs. p = 0.65). Non-European women exhibited an increased frequency of diabetes after GDM (17 % vs. European 4 %, p = 2 × 10(-5)). In addition to BMI, non-European and Asian origin was associated with the development of diabetes after GDM in a multivariate logistic regression analysis, whereas Arab origin was not. Our results highlight the importance of preventive measures to ensure a healthy lifestyle in women with GDM, particularly in high-risk ethnic groups.
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| 31. |
- Ignell, Claes, et al.
(author)
-
The impact of ethnicity on glucose homeostasis after gestational diabetes mellitus
- 2012
-
In: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 55:Suppl 1, s. 440-441
-
Conference paper (peer-reviewed)abstract
- Background and aims: Ethnicity influences the prevalence of gestationaldiabetes (GDM) and its progression to manifest diabetes postpartum, beinghigher in non-European populations. This may partly be explained by differences in insulin secretion and action. Aims of the present study were toevaluate glucose homeostasis after GDM, the impact of ethnicity and otherdeterminants of glucose tolerance postpartum.Material and methods: Women in southern Sweden undergoing a 75 g oralglucose tolerance test (OGTT) during pregnancy in 2003-2005 were invited to follow-up postpartum. Diagnostic criteria were those defined by theWHO in 1999. At 1-2 years after delivery 470 women with GDM and 166women with normal glucose tolerance (NGT) during pregnancy performedan OGTT with measurements of plasma glucose and insulin concentrationsat fasting, 30 min and 120 min. Homeostasis model assessment (HOMA-IR)was used to estimate insulin resistance. Beta cell function was quantified asthe ratio of the incremental insulin to glucose during the first 30 min of theOGTT (I/G30). The disposition index was used to adjust insulin secretion forthe degree of insulin resistance ([I/G30)]/HOMA-IR). Women were groupedaccording to ethnicity based on stated country of origin in at least three oftheir grandparents. Indices were log transformed and differences in meanswere tested by ANCOVA, adjusting for age, parity and interval to follow-up(results given as geometric mean [95% confidence interval (CI)]). Frequencydifferences were tested by the Chi-square test. Multivariate logistic regressionanalysis was used to assess the association of known predictor variables (age,BMI, parity, first degree relative(s) with diabetes, non-European origin) withdiabetes postpartum, adjusting for time to follow-up.Results: Comparing women with previous GDM (n=470) to controls (NGTduring pregnancy and follow-up, n=150), the former had higher HOMA-IR Diabetologia (2012) 55:[Suppl1]S1–S538 S 4411 C(1.5 [1.4-1.7] vs. 1.3 [1.2-1.5], p=0.020) and lower disposition index (8.4 [7.7-9.2] vs. 12.8 [10.8-15.2], p<0.001). These differences were more pronouncedin women with GDM who had diabetes postpartum (HOMA-IR 3.1 [2.2-4.4],disposition index 2.6 [1.9-3.7]) compared to controls (p<0.001), while thosewho stayed normoglycaemic had similar HOMA-IR as controls but lower disposition index (9.6 [8.7-10.6], p<0.001). Among women with GDM, estimatesof beta cell function did not differ between non-European (n=94) and European women (n=362), whereas non-European women were more insulin resistant (HOMA-IR 2.0 [1.7-2.3] vs. 1.5 [1.3-1.6], p=0.002, after adjustment forBMI p=0.015). Similarly, Arabic women (n=41) had higher HOMA-IR (2.1[1.6-2.7]) than European women (p=0.006), but insignificant after adjustment for BMI. Non-European origin was associated with higher frequency ofdiabetes at follow-up (16%) than was European origin (4%, p<0.001). Of thepredictor variables tested for an association with diabetes after GDM, BMIand non-European origin showed the highest associations; odds ratio (95%CI), 1.1 (1.1-1.2), p<0.001, and 5.3 (1.9-14.9), p=0.002, respectively.Conclusions: Women with a history of GDM display abnormalities in glucose homeostasis, also in the presence of NGT postpartum, including betacell dysfunction and insulin resistance. These derangements may be influenced by ethnicity and BMI.
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| 32. |
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| 33. |
- Jemt, Erik, et al.
(author)
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Outcomes in Emergency Department Patients with Dyspnea versus Chest Pain : A Retrospective Consecutive Cohort Study
- 2022
-
In: Emergency Medicine International. - : Hindawi Limited. - 2090-2840 .- 2090-2859. ; 2022, s. 1-7
-
Journal article (peer-reviewed)abstract
- Dyspnea and chest pain are major and important causes of contact at the emergency department (ED). Dyspnea is associated with high morbidity and mortality, but data on characteristics and outcomes compared with chest pain in the ED are limited. This was a retrospective cohort study of consecutive patients with contact causes of dyspnea or chest pain at two Swedish EDs from 2010 to 2014. Hospital admittance, ED revisits, and mortality were analyzed using multivariable regression models, adjusted for ED and markers of disease severity (age, sex, centre, Charlson comorbidity index, c-reactive protein, troponin T, and arrival by ambulance). 29,291 patients (mean age 58.3 years; 48.9% women) with dyspnea (n = 8,812) or chest pain (n = 20,479) were included. Dyspnea patients were older than patients with chest pain (64 vs. 56 years, p < 0.001) and had more comorbidity and higher average blood troponin T and c-reactive protein levels. Dyspnea patients also had higher hospitalization rates (48% vs. 30%; adjOR (95% CI) 2.1-2.3), including the intensive care unit (1.4% vs. 0.1%; adjOR 6.9-15.9), and more ED revisits (11% vs. 7%; adjOR 1.2-1.7) in 30 days. Dyspnea patients had five-fold increased mortality compared to those with chest pain; hazard ratio (HR) 5.1 (4.8-5.4), adjusted for markers of disease severity, the mortality was two-fold higher, HR 2.2 (2.0-2.4). Compared with chest pain patients, ED dyspnea patients are older, have more comorbidity, and have worse outcomes in terms of hospitalization, morbidity, and mortality.
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| 34. |
- Jonsson, Magnus H., et al.
(author)
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Plasma lactate at admission does not predict mortality and complications in hip fracture patients : a prospective observational study
- 2018
-
In: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 78:6, s. 508-514
-
Journal article (peer-reviewed)abstract
- Hip fractures in elderly carry a high mortality. Our objective was to test the hypothesis that plasma lactate concentration at hospital admission can be used to identify patients with a high risk for poor outcome. Hip fracture patients admitted to a university hospital in Sweden from January 2011 to August 2014 in whom a venous lactate was obtained at admission were included in this prospective observational study. Primary outcome measure was 30-d mortality and secondary outcome measure was a composite outcome of 30-d mortality and postoperative complications. Lactate concentration was evaluated as a continuous predictor using logistic regression, crude and adjusted for age, gender and American Society of Anesthesiology Physical Status (ASA PS) score. Discrimination was evaluated using receiver operating characteristics (ROC) analysis. Totally, 690 patients were included. Median age was 84 years (interquartile range [IQR] 77–90). At 30-d follow-up, mortality was 7.2%, and 45% of the patients had suffered the composite outcome. Median lactate level was 1.3 mmol/L (IQR 1.0–1.8 mmol/L). The odds ratio (OR) by each 1.0 mmol/L increase in the lactate concentration for 30-d mortality was 1.13 (95% CI 0.77–1.68) while for the composite outcome it was 1.06 (95% CI 0.85–1.3). Similar results were obtained after adjustment for age, sex and ASA PS classification for both outcomes. Area under the ROC curve for lactate as a predictor of 30-d mortality was 0.51 (95% CI 0.45–0.57). In our cohort, plasma lactate at admission does not appear to be a useful biomarker to identify high-risk patients after hip fracture.
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| 35. |
- Karason, Kristjan, 1962, et al.
(author)
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Effect of growth hormone treatment on circulating levels of NT-proBNP in patients with ischemic heart failure.
- 2020
-
In: Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society. - : Elsevier BV. - 1532-2238. ; 55
-
Journal article (peer-reviewed)abstract
- Growth hormone (GH) therapy in heart failure (HF) is controversial. We investigated the cardiovascular effects of GH in patients with chronic HF due to ischemic heart disease.In a double-blind, placebo-controlled trial, we randomly assigned 37 patients (mean age 66years; 95% male) with ischemic HF (ejection fraction [EF]<40%) to a 9-month treatment with either recombinant human GH (1.4mg every other day) or placebo, with subsequent 3-month treatment-free follow-up. The primary outcome was change in left ventricular (LV) end-systolic volume measured by cardiac magnetic resonance (CMR). Secondary outcomes comprised changes in cardiac structure and EF. Prespecified tertiary outcomes included changes in New York Heat Association (NYHA) functional class and quality of life (QoL), as well as levels of insulin-like growth factor-1 (IGF-1) and N-terminal pro-brain natriuretic peptide (NT-proBNP).No changes in cardiac structure or systolic function were identified in either treatment group; nor did GH treatment affect QoL or functional class. In the GH group, circulating levels of IGF-1 doubled from baseline (+105%; p<0.001) and NT-proBNP levels halved (-48%; p<0.001) during the treatment period, with subsequently a partial return of both towards baseline levels. No changes in IGF-1 or NT-proBNP were observed in the placebo group at any time during the study.In patients with chronic ischemic HF, nine months of GH treatment was associated with significant increases in levels of IGF-1 and reductions in levels of NT-proBNP, but did not affect cardiac structure, systolic function or functional capacity.
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| 36. |
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| 37. |
- Klintman, Mikael, et al.
(author)
-
Maten märks: förutsättningar för konsumentmakt
- 2008
-
Book (pop. science, debate, etc.)abstract
- Många människor anser sig numera ha större makt i rollen som konsumenter än som medborgare som röstar i partival. Som konsumenter kan vi idag ta ställning till en rad olika anspråk som görs på produkter och tjänster. Hur ser vi konsumenter på livsmedel som genom olika märken påstås ha unika egenskaper i produktionsledet: för miljön, för konsumentens hälsa, för arbetsförhållanden för fabriks- och jordbruksarbetarna, för djurens väl och ve, eller för det egna produktionslandets välstånd? Förekommer motsättningar och konkurrens mellan olika miljö- och varumärken? Vilka aktörer har makt att vara med och bestämma om vad som ska räknas som miljövänligt, socialt rättvis eller djurvänlig produktion? Går det – om det är önskvärt – att göra den gröna och etiska konsumtionens informationsredskap mer “demokratiska”? Finns det viktiga egenskaper hos varor och produktion som måste falla utanför konsumentmakten? Dessa frågor, som alla behandlas i boken, knyter an till frågan om vilka förutsättningar konsumenter egentligen har att fatta fria och politiska beslut som även går bortom var och ens egennytta. I den allmänna samhällsdebatten ses konsumenters makt av allt fler aktörer som en central förutsättning för att miljöproblem och andra samhällsproblem ska kunna lösas. Därmed blir en ökad kunskap om konsumentmaktens förutsättningar extra betydelsefull. Boken riktar sig till studenter, forskare, myndigheter och till alla andra med intresse för samhällsvetenskap och humaniora med inrikning på konsument- och livsmedelsfrågor, samt andra livsmedelsrelaterade vetenskaper. Mikael Klintman är docent och universitetslektor vid Forskningspolitiska institutet, Lunds universitet. Magnus Boström är docent, lektor och forskare vid institutionen för livsvetenskaper, Södertörns Högskola. Lena Ekelund är fil dr i nationalekonomi och docent i trägårdsvetenskap med ekonomisk inriktning vid Sveriges lantbruksuniversitet i Alnarp. Anna-Lisa Lindén är professor vid sociologiska institutionen, Lunds universitet.
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| 38. |
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| 39. |
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| 40. |
- Lundin, Magnus, et al.
(author)
-
Left ventricular global wall thickness is easily calculated, detects and characterizes hypertrophy, and has prognostic utility
- 2019
-
Conference paper (other academic/artistic)abstract
- BACKGROUND: Cardiovascular magnetic resonance (CMR) can be used to measure left ventricular end-diastolic volume (LVEDV) and left ventricular mass (LVM). However, there is currently no good way to measure the normality of LVM in relation to a given LVEDV. We hypothesized that a simple measure of left ventricular global wall thickness (GWT) would be accurate, beneficial for detecting and characterizing hypertrophy, and have prognostic significance.METHODS: Subjects underwent CMR at 1.5T, including healthy volunteers (n=99) and patients assessed for heart disease (n=2828).RESULTS: GWT calculated from LVEDV and LVM had excellent agreement with measured mean end-diastolic wall thickness of the entire left ventricle (bias 0.01±0.23mm). GWT was most predictive of death or hospitalization for heart failure in patients with normal findings by CMR (n=326, log-rank 26.8, p<0.001, median [interquartile range] follow-up 5.8 [5.0–6.7] years). GWT indexed to body surface area (GWTi) was most predictive of outcomes in patients with normal LVEDV index (n=1352, log-rank 36.4, p<0.001, follow-up 5.5 [4.1–6.5] years). Patients with concentric remodeling had worse prognosis than the normal patients (p=0.02), and the patients with hypertrophy had worse prognosis than both normal patients (p<0.001) and patients with concentric remodeling (p=0.045), see Figure 1. Of patients with suspected heart disease but normal CMR findings regarding left ventricular volumes, function, mass, and scar, 22% were found to have increased mean GWTi corresponding to concentric remodeling, see Figure 2.CONCLUSIONS: Left ventricular GWT is an intuitive measure that can be easily calculated from mass and volume with high accuracy, and has prognostic utility in patients with normal CMR findings. Also, GWTi classifies hypertrophy as concentric or eccentric, and detects concentric remodeling in a substantial portion of patients with otherwise normal findings.
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| 41. |
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| 42. |
- Lundin, Magnus, et al.
(author)
-
Prognostic utility and characterization of left ventricular hypertrophy using global thickness
- 2023
-
In: Scientific Reports. - 2045-2322. ; 13:1
-
Journal article (peer-reviewed)abstract
- Cardiovascular magnetic resonance (CMR) can accurately measure left ventricular (LV) mass, and several measures related to LV wall thickness exist. We hypothesized that prognosis can be used to select an optimal measure of wall thickness for characterizing LV hypertrophy. Subjects having undergone CMR were studied (cardiac patients, n = 2543; healthy volunteers, n = 100). A new measure, global wall thickness (GT, GTI if indexed to body surface area) was accurately calculated from LV mass and end-diastolic volume. Among patients with follow-up (n = 1575, median follow-up 5.4 years), the most predictive measure of death or hospitalization for heart failure was LV mass index (LVMI) (hazard ratio (HR)[95% confidence interval] 1.16[1.12-1.20], p < 0.001), followed by GTI (HR 1.14[1.09-1.19], p < 0.001). Among patients with normal findings (n = 326, median follow-up 5.8 years), the most predictive measure was GT (HR 1.62[1.35-1.94], p < 0.001). GT and LVMI could characterize patients as having a normal LV mass and wall thickness, concentric remodeling, concentric hypertrophy, or eccentric hypertrophy, and the three abnormal groups had worse prognosis than the normal group (p < 0.05 for all). LV mass is highly prognostic when mass is elevated, but GT is easily and accurately calculated, and adds value and discrimination amongst those with normal LV mass (early disease).
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| 43. |
- Pedersen, Hanne, et al.
(author)
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Visuospatial ability is associated to 2D laparoscopic simulator performance amongst surgical residents
- 2023
-
In: Surgery Open Science. - : Elsevier BV. - 2589-8450. ; 11, s. 56-61
-
Journal article (peer-reviewed)abstract
- Background: The technical skills of a surgeon influence surgical outcome. Testing technical aptitude at point of recruitment of surgical residents is only conducted in a few countries. This study investigated the impact of visuospatial ability (VSA), background factors, and manual dexterity on performance in two different laparoscopic surgical simulators amongst applicants and 1st year surgical residents. Method: Applicants from general surgery, pediatric surgery, and urology were included from seven hospitals in Sweden between 2017 and 2021. Some 73 applicants were invited and 50 completed. Participants filled out a background form, and were tested for manual dexterity, and visuospatial ability. Two laparoscopic simulators were used, one 2D video box trainer and one 3D Virtual Reality Simulator. Results: A significant association was found between the visuospatial ability test and 2D video box laparoscopic performance (95 % CI: 1.028–1.2, p-value <0.01). For every point on the visuospatial test the odds of accomplishing the task increased by 11 %. No association was found between VSA and performance in a laparoscopic VR simulator using 3D vision. No other background factors were associated with performance in the two laparoscopic simulators. Conclusion: Visuospatial ability in applicants to surgical residency positions is associated to performance in a 2D video box trainer. Knowledge of a resident's visuospatial ability can be used to tailor individualized laparoscopic training programs, and in the future might function as a selection tool concerning laparoscopic ability. Key message: Visuospatial ability differs greatly amongst applicants for surgical residency and is associated to laparoscopic simulator performance. Testing applicants' visuospatial ability could possibly be used to tailor individualized laparoscopic training programs or in the future as a selection tool concerning laparoscopic ability.
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| 44. |
- Picelli, Simone, et al.
(author)
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Common variants in human CRC genes as low-risk alleles
- 2010
-
In: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 46:6, s. 1041-1048
-
Journal article (peer-reviewed)abstract
- The genetic susceptibility to colorectal cancer (CRC) has been estimated to be around 35% and yet high-penetrance germline mutations found so far explain less than 5% of all cases. Much of the remaining variations could be due to the co-inheritance of multiple low penetrant variants. The identification of all the susceptibility alleles could have public health relevance in the near future. To test the hypothesis that what are considered polymorphisms in human CRC genes could constitute low-risk alleles, we selected eight common SNPs for a pilot association study in 1785 cases and 1722 controls. One SNP, rs3219489:G>C (MUTYH Q324H) seemed to confer an increased risk of rectal cancer in homozygous status (OR = 1.52; CI = 1.06-2.17). When the analysis was restricted to our 'super-controls', healthy individuals with no family history for cancer, also rs1799977:A>G (MLH1 I219V) was associated with an increased risk in both colon and rectum patients with an odds ratio of 1.28 (CI = 1.02-1.60) and 1.34 (CI = 1.05-1.72), respectively (under the dominant model); while 2 SNPs, rs1800932:A>G (MSH6 P92P) and rs459552:T>A (APC D1822V) seemed to confer a protective effect. The latter, in particular showed an odds ratio of 0.76 (CI = 0.60-0.97) among colon patients and 0.73 (CI = 0.56-0.95) among rectal patients. In conclusion, our study suggests that common variants in human CRC genes could constitute low-risk alleles. (C) 2010 Elsevier Ltd. All rights reserved.
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| 45. |
- Planck, Maria, et al.
(author)
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Cytogenetic aberrations and heterogeneity of mutations in repeat-containing genes in a colon carcinoma from a patient with hereditary nonpolyposis colorectal cancer.
- 2002
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In: Cancer Genetics and Cytogenetics. - 0165-4608. ; 134:1, s. 46-54
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Journal article (peer-reviewed)abstract
- The majority of tumors from patients affected by hereditary nonpolyposis colorectal cancer (HNPCC) exhibit a mutator phenotype characterized by widespread microsatellite instability (MSI) and somatic mutations in repeated sequences in several cancer-associated genes. An inverse relationship between MSI and chromosomal instability (CIN) has been demonstrated and HNPCC-associated tumors are generally characterized by diploid or near-diploid cells with few or no chromosomal rearrangements. We have studied MSI, somatic mutations in repeat-containing genes, DNA-ploidy, and cytogenetic aberrations in a colon carcinoma from a patient with a germline MLH1 mutation. Mutations in coding repeats were assessed in 10 macroscopically separate areas of the primary tumor and in two lymph nodes. Some of the genes studied (E2F4, MSH3, MSH6, TCF4, and TGFBRII) showed a consistent lack of mutations, whereas others (BAX, Caspase-5 and IGFIIR) displayed alterations in some tumor regions but not in others. The tumor had DNA-index 1.1-1.2 and a stable, aberrant karyotype with extra copies of chromosomes 7 and 12 and the structural aberrations i(1q), der(20)t(8;20), and der(22)t(1;22). The finding of CIN, MSI, and somatic mutations in coding repeats in this tumor suggests that these phenomena may act together in HNPCC tumorigenesis. Furthermore, the observed intratumoral heterogeneity of mutations in coding repeats implies these changes occur late in tumorigenesis and, thus, probably play a role in tumor progression rather than initiation.
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| 46. |
- Sha, Yongcui, et al.
(author)
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Diel vertical migration of copepods and its environmental drivers in subtropical Bahamian blue holes
- 2021
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In: Aquatic Ecology. - : Springer. - 1386-2588 .- 1573-5125. ; 55:4, s. 1157-1169
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Journal article (peer-reviewed)abstract
- Diel vertical migration (DVM) is the most common behavioral phenomenon in zooplankton, and numerous studies have evaluated DVM under strong seasonality at higher latitudes. Yet, our understanding of the environmental drivers of DVM at low latitudes, where seasonal variation is less pronounced, remains limited. Therefore, we here examined patterns of vertical distribution in copepods in six subtropical Bahamian blue holes with different food web structure and tested the role of several key environmental variables potentially affecting this behavior. Day and night samplings showed that copepods generally performed DVM, characterized by downward migration to deeper depths during the day and upward migration to surface waters at night. Across all blue holes, the daytime vertical depth distribution of calanoid copepods correlated positively with both predation risk and depth of food resources (Chlorophyll a), but was less affected by ultraviolet radiation (UVR). A potential explanation is that since UVR is a continuous threat across seasons, zooplankton have established photoprotective pigmentation making them less vulnerable to this threat. The copepods also showed a size-structured depth segregation, where larger individuals were found at deeper depths during the day, which further strengthens the suggestion that predation is a major driver of DVM in these systems. Hence, in contrast to studies performed at higher latitudes, we show that despite the constant exposure to UVR, predator avoidance and food availability are the most pronounced drivers of copepod DVM at those low latitudes, suggesting that the main driver of DVM may vary among systems, but also systematically by latitude.
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| 47. |
- Sofizadeh, Sheyda, et al.
(author)
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Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
- 2019
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In: Diabetes Therapy. - : Springer Science and Business Media LLC. - 1869-6953 .- 1869-6961. ; 10:6, s. 2115-2130
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Journal article (peer-reviewed)abstract
- Introduction: The effects of the GLP-1 analogue liraglutide on time in hypoglycaemia, time in hyperglycaemia, and time in range for type 2 diabetes patients initially treated with multiple daily insulin injections (MDI) were investigated. Variables associated with hypoglycaemia in the current population were also identified. Methods: Analyses were based on data from a previously performed double-blind, placebo-controlled trial in which 124 MDI-treated patients with type 2 diabetes were randomized to liraglutide or placebo. Masked continuous glucose monitoring (CGM) was performed at baseline and week 24 in 99 participants. Results: The mean time in hypoglycaemia was similar for participants receiving liraglutide and those receiving placebo after 24 weeks of treatment. Mean time in target was greater in the liraglutide group than in the placebo group: 430 versus 244 min/24 h (p < 0.001) and 960 versus 695 min/24 h (p < 0.001) for the two glycaemic ranges considered, 4–7 mmol/l and 4–10 mmol/l, respectively. Mean time in hyperglycaemia was lower in the liraglutide group: 457 versus 723 min/24 h (p = 0.001) and 134 versus 264 min/24 h (p = 0.023) for the two cutoffs considered, > 10 mmol/l and > 14 mmol/l, respectively. Lower mean glucose level, lower C-peptide, and higher glucose variability were associated with an increased risk of hypoglycaemia in both treatment groups. Higher proinsulin level was associated with a lower risk of hypoglycaemia in the liraglutide group. Conclusion: For type 2 diabetes patients initially treated with MDI, introducing liraglutide had a beneficial effect on glucose profiles estimated by masked CGM. Mean glucose level, glycaemic variability, C-peptide, and proinsulin level influenced the risk of hypoglycaemia in this population. Trial Registration: ClinicalTrials.gov, number (EudraCT nr: 2012-001941-42). Funding: Novo Nordisk funded this study. The Diabetes Research Unit, NU-Hospital Group funded the journal’s Rapid Service Fee.
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| 48. |
- Somajo, Sofia, et al.
(author)
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Detection of antimicrobial resistance in <5 h in Neisseria gonorrhoeae isolates using flow cytometry-proof of concept for seven clinically relevant antimicrobials
- 2024
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In: Journal of Antimicrobial Chemotherapy. - : Oxford University Press. - 0305-7453 .- 1460-2091. ; 79:4, s. 815-819
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Journal article (peer-reviewed)abstract
- Introduction: Antimicrobial resistance in Neisseria gonorrhoeae compromises gonorrhoea treatment and rapid antimicrobial susceptibility testing (AST) would be valuable. We have developed a rapid and accurate flow cytometry method (FCM) for AST of gonococci. Methods: The 2016 WHO gonococcal reference strains, and WHO Q, R and S (n = 17) were tested against seven clinically relevant antibiotics (ceftriaxone, cefixime, azithromycin, spectinomycin, ciprofloxacin, tetracycline and gentamicin). After 4.5 h incubation of inoculated broth, the fluorescent dye Syto (TM) 9 was added, followed by FCM analysis. After gating, the relative remaining population of gonococci, compared with unexposed growth control samples, was plotted against antimicrobial concentration, followed by non-linear curve regression analysis. Furthermore, the response at one single concentration/tested antibiotic was evaluated with the intention to use as a screening test for detection of resistant gonococci. Results: A dose-dependent response was seen in susceptible isolates for all tested antimicrobials. There was a clear separation between susceptible/WT and resistant/non-WT isolates for ceftriaxone, cefixime, spectinomycin, ciprofloxacin and tetracycline. In contrast, for azithromycin, only high-level-resistant isolates were distinguished, while resistant isolates with MICs of 4 mg/L were indistinguishable from WT (MIC <= 1 mg/L) isolates. For gentamicin, all tested 17 isolates were WT and FCM analysis resulted in uniform dose-response curves. Using a single antibiotic concentration and a 50% remaining cell population cut-off, the overall sensitivity and specificity for resistance detection were 93% and 99%, respectively. Conclusions: By providing results in <5 h for gonococcal isolates, FCM-based AST can become a rapid screening method for antimicrobial resistance or antimicrobial susceptibility in gonococci.
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| 49. |
- Vinterstare, Jerker, et al.
(author)
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Predation risk and the evolution of a vertebrate stress response : Parallel evolution of stress reactivity and sexual dimorphism
- 2021
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In: Journal of Evolutionary Biology. - : John Wiley & Sons. - 1010-061X .- 1420-9101. ; 34:10, s. 1554-1567
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Journal article (peer-reviewed)abstract
- Predation risk is often invoked to explain variation in stress responses. Yet, the answers to several key questions remain elusive, including the following: (1) how predation risk influences the evolution of stress phenotypes, (2) the relative importance of environmental versus genetic factors in stress reactivity and (3) sexual dimorphism in stress physiology. To address these questions, we explored variation in stress reactivity (ventilation frequency) in a post-Pleistocene radiation of live-bearing fish, where Bahamas mosquitofish (Gambusia hubbsi) inhabit isolated blue holes that differ in predation risk. Individuals of populations coexisting with predators exhibited similar, relatively low stress reactivity as compared to low-predation populations. We suggest that this dampened stress reactivity has evolved to reduce energy expenditure in environments with frequent and intense stressors, such as piscivorous fish. Importantly, the magnitude of stress responses exhibited by fish from high-predation sites in the wild changed very little after two generations of laboratory rearing in the absence of predators. By comparison, low-predation populations exhibited greater among-population variation and larger changes subsequent to laboratory rearing. These low-predation populations appear to have evolved more dampened stress responses in blue holes with lower food availability. Moreover, females showed a lower ventilation frequency, and this sexual dimorphism was stronger in high-predation populations. This may reflect a greater premium placed on energy efficiency in live-bearing females, especially under high-predation risk where females show higher fecundities. Altogether, by demonstrating parallel adaptive divergence in stress reactivity, we highlight how energetic trade-offs may mould the evolution of the vertebrate stress response under varying predation risk and resource availability.
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| 50. |
- Weng, Jianping, et al.
(author)
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Screening for MODY mutations, GAD antibodies, and type 1 diabetes--associated HLA genotypes in women with gestational diabetes mellitus.
- 2002
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In: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 25:1, s. 68-71
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate whether genetic susceptibility to type 1 diabetes or maturity-onset diabetes of the young (MODY) increases susceptibility to gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: We studied mutations in MODY1-4 genes, the presence of GAD antibodies, and HLA DQB1 risk genotypes in 66 Swedish women with GDM and a family history of diabetes. An oral glucose tolerance test was repeated in 46 women at 1 year postpartum. RESULTS: There was no increase in type 1 diabetes-associated HLA-DQB1 alleles or GAD antibodies when compared with a group of type 2 diabetic patients (n = 82) or healthy control subjects (n = 86). Mutations in known MODY genes were identified in 3 of the 66 subjects (1 MODY2, 1 MODY3, and 1 MODY4). Of the 46 GDM subjects, 2 had diabetes (4%) and 17 had impaired glucose tolerance (IGT) (37%) at 1 year postpartum. Of the two subjects who developed manifest diabetes, one carried a MODY3 mutation (A203H in the hepatocyte nuclear factor-1alpha gene). There was no increase in high-risk HLA alleles or GAD antibodies in the women who had manifest diabetes or IGT at 1 year postpartum. CONCLUSIONS: MODY mutations but not autoimmunity contribute to GDM in Swedish women with a family history of diabetes and increase the risk of subsequent diabetes.
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