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1.	Locke, Adam E, et al. (author) Genetic studies of body mass index yield new insights for obesity biology. 2015 In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 518:7538, s. 197-401 Journal article (peer-reviewed)abstract Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ∼2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.
2.	Martinsson, Klara, et al. (author) Elevated free secretory component in early rheumatoid arthritis and prior to arthritis development in patients at increased risk 2020 In: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332. ; 59:5, s. 979-987 Journal article (peer-reviewed)abstract Objectives. Considering growing evidence of mucosal involvement in RA induction, this study investigated circulating free secretory component (SC) in patients with either recent-onset RA or with ACPA and musculoskeletal pain. Methods. Two prospective cohorts were studied: TIRA-2 comprising 452 recent-onset RA patients with 3 years of clinical and radiological follow-up, and TIRx patients (n = 104) with ACPA IgG and musculoskeletal pain followed for 290 weeks (median). Blood donors and three different chronic inflammatory diseases served as controls. Free SC was analysed by sandwich ELISA. Results. Serum levels of free SC were significantly higher in TIRA-2 patients compared with TIRx and all control groups (P < 0.01). Among TIRx patients who subsequently developed arthritis, free SC levels were higher compared with all control groups (P < 0.05) except ankylosing spondylitis (P = 0.74). In TIRA-2, patients with ACPA had higher baseline levels of free SC compared with ACPA negative patients (P < 0.001). Free SC status at baseline did not predict radiographic joint damage or disease activity over time. In TIRx, elevated free SC at baseline trendwise associated with arthritis development during follow-up (P = 0.066) but this disappeared when adjusting for confounders (P = 0.72). Cigarette smoking was associated with higher levels of free SC in both cohorts. Conclusion. Serum free SC levels are increased in recent-onset RA compared with other inflammatory diseases, and associate with ACPA and smoking. Free SC is elevated before arthritis development among ACPA positive patients with musculoskeletal pain, but does not predict arthritis development. These findings support mucosal engagement in RA development.
3.	Palmgren, Madelene, et al. (author) Quantification of the Intracellular Life Time of Water Molecules to Measure Transport Rates of Human Aquaglyceroporins 2017 In: Journal of Membrane Biology. - : Springer Science and Business Media LLC. - 0022-2631 .- 1432-1424. ; 250:6, s. 629-639 Journal article (peer-reviewed)abstract Orthodox aquaporins are transmembrane channel proteins that facilitate rapid diffusion of water, while aquaglyceroporins facilitate the diffusion of small uncharged molecules such as glycerol and arsenic trioxide. Aquaglyceroporins play important roles in human physiology, in particular for glycerol metabolism and arsenic detoxification. We have developed a unique system applying the strain of the yeast Pichia pastoris, where the endogenous aquaporins/aquaglyceroporins have been removed and human aquaglyceroporins AQP3, AQP7, and AQP9 are recombinantly expressed enabling comparative permeability measurements between the expressed proteins. Using a newly established Nuclear Magnetic Resonance approach based on measurement of the intracellular life time of water, we propose that human aquaglyceroporins are poor facilitators of water and that the water transport efficiency is similar to that of passive diffusion across native cell membranes. This is distinctly different from glycerol and arsenic trioxide, where high glycerol transport efficiency was recorded.
4.	Shungin, Dmitry, et al. (author) New genetic loci link adipose and insulin biology to body fat distribution. 2015 In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 518:7538, s. 187-378 Journal article (peer-reviewed)abstract Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms.
5.	Stoor, Jon Petter A., et al. (author) Hur mår samer i Sverige? : Resultat från en enkätundersökning om hälsa, livsvillkor och levnadsvanor bland samer 2023 Reports (other academic/artistic)abstract I den här rapporten presenterar vi resultat från enkätundersökningen Samisk hälsapå lika villkor. Den genomfördes under våren 2021 och besvarades av 3 658 sameri åldern 18–84 år i Sverige. Syftet med rapporten är att översiktligt beskriva hälsa,livsvillkor och levnadsvanor bland samer. Resultaten har även jämförts medbefolkningen i övrigt genom data från den nationella folkhälsoenkäten Hälsa pålika villkor, också den genomförd under våren 2021.Resultaten i korthetDe flesta samer i den här studien, 73 procent, uppger att de har en god allmänhälsa. Nästan alla, 87 procent, har ett gott psykiskt välbefinnande. Totalt 41 procentav samerna uppger att de har en långvarig sjukdom eller funktionsnedsättning.Andelen som uppger att de röker dagligen är 4 procent, och andelen som snusar 23procent.Jämförelsen mellan samer och befolkningen i övrigt visar följande:• En lika stor andel samer som befolkningen i övrigt uppger en god allmänhälsa. Även andelen samer som uppger sjukdomar som högt blodtryck ochdiabetes eller psykiska besvär som ängslan, oro eller ångest är lika stor som ibefolkningen i övrigt.• En mindre andel samer än befolkningen i övrigt uppger sömnsvårigheter,trötthet och psykisk påfrestning. Det är också en mindre andel samer somuppger att de är stillasittande mer än tio timmar per dag, har en riskkonsumtionav alkohol, uppger att de röker dagligen eller att de någon gång har använtcannabis.• En mindre andel samer jämfört med befolkningen i övrigt uppger bra tandhälsaoch att de äter frukt och grönsaker minst en gång per dag.• En större andel samer än befolkningen i övrigt har ett gott psykisktvälbefinnande. Däremot uppger en större andel samer att de har en långvarigsjukdom eller funktionsnedsättning, värk i olika delar av kroppen, astma,allergi, övervikt och fetma. Även andelen samer som uppger att de snusardagligen är större än i befolkningen i övrigt.• En större andel samer än befolkningen i övrigt uppger att de någon gångallvarligt övervägt att ta sitt liv eller att de någon gång försökt att ta sitt liv.Vidare är det en större andel samer som uppger att de har haft svårt att klara delöpande utgifterna under de senaste 12 månaderna. Andelen samer som uppgeratt de någon gång under de senaste 3 månaderna blivit behandlade ellerbemötta så att de har känt sig kränkta är större än i befolkningen i övrigt.Vad gäller covid-19-pandemin, uppger en mindre andel samer än befolkningen iövrigt att de har testat positivt för covid-19. Däremot uppger en större andel sameratt de har varit oroliga för att de själva eller någon närstående ska bli allvarligt sjuk. 8Samers hälsa behöver fortsatt följasDen här kartläggningen är ett första viktigt steg för att följa hälsosituationen blandsamer i Sverige och är en av de mest omfattande enkätundersökningar som hargenomförts hittills. Studien bidrar till viktig kunskap om samers hälsa, livsvillkoroch levnadsvanor och kan ligga till grund både för fortsatt kunskapsutveckling ochutformning av hälsofrämjande och förebyggande insatser på lokal, regional ochnationell nivå. Det behövs även fortsatta och fördjupade analyser med särskiltfokus på olika grupper bland samer som kan ha sämre hälsa eller sämreförutsättningar för en god hälsa.
6.	Zillikens, M Carola, et al. (author) Erratum: Large meta-analysis of genome-wide association studies identifies five loci for lean body mass. 2017 In: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 8:1 Journal article (peer-reviewed)abstract A correction to this article has been published and is linked from the HTML version of this article.
7.	Berglund, Anna, 1949-, et al. (author) Våldsutsatta kvinnor- samhällets ansvar 2014. - 3 In: Lärobok, tredje upplagan, framtagen av Nationellt centrum för kvinnofrid, Uppsala universitet. - Uppsala : Studentlitteratur AB. - 9789144094441 Book chapter (other academic/artistic)
8.	Brorsson, Annelie, 1963, et al. (author) Development and evaluation of a new seated heel-rise test in the early stages of rehabilitation after an acute Achilles tendon rupture. 2014 In: 16th ESSKA (European Society of Sports Traumatology, Knee Surgery and Arthroscopy) Congress, 14-17 May 2014, Amsterdam, Netherlands. Conference paper (other academic/artistic)abstract The early stages of rehabilitation appear to be of great importance for outcome after an Achilles tendon rupture. It is a challenge to evaluate the patients’ calf muscle endurance at this stage in a safe and adequate way. The aim of our study was to develop a seated heel-rise test suitable for evaluating calf muscle endurance three months after an Achilles tendon rupture. Furthermore we wanted to evaluate how the seated heel-rise test correlated to the ability to perform one-legged standing heel-rise and patient-reported symptoms. Method: Ninety-three patients, 79 men and 14 women, mean age of 40 (20-63) years, were included from a cohort of 100 patients participating in a prospective, randomized controlled trial comparing non-surgical and surgical treatment after Achilles tendon rupture. Forty-seven were treated with surgery and 46 with non-surgery. They were evaluated after 3, 6 and 12 months. Patient reported outcome was evaluated with Achilles Tendon Rupture Score (ATRS) and functional outcome with seated and standing heel-rise test. The seated heel-rise test was performed with the patient sitting with hip and knee in 90°. A leg extension weight-training machine was used to provide load onto the patient’s thigh at 50% body weight. The limb symmetry index (LSI=injured/healthy x 100) was calculated in order to compare the results from the seated and standing heel-rise test. Results: Ninety-one patients out of 93 (98%) could perform the seated heel-rise test. At the 3-month follow-up there was a significant difference (p<0.01) in the seated heel-rise test between the injured and the healthy side. There were no significant differences between the surgical and non-surgical treatment groups. There were significant differences in the seated heel-rise test and in ATRS (p<0.01) when comparing the group who could perform a standing heel-rise test at the 3-months follow-up, with the group who could not. There were significant correlations between the LSI-values in the seated heel-rise height at the 3-month follow-up and the standing heel-rise height at the 6-month (r=0.36, p<0.001, n= 91) and the 12-month follow-up (r=0.35, p=0.001, n=85). There were also significant correlations (r=0.22-0.37, p=<0.04) between the seated heel-rise test and ATRS. Conclusions: The seated heel-rise-test has the capacity to identify differences between the injured and the healthy side three months after injury. This test also correlates with patient reported outcomes and the heel-rise ability at 6 and 12 months. This test appears to be a safe and suitable test for evaluating calf muscle endurance and function in the early stages of rehabilitation after an Achilles tendon rupture.
9.	Brorsson, Annelie, 1963, et al. (author) Long-term follow up after acute Achilles tendon rupture. 2015 In: Danish Sports Medicine Congress, Copenhagen, January 22-24, 2015. - : Danish Association of Sports Medicine. Conference paper (other academic/artistic)abstract It is still unknown why many patients never fully recover after an Achilles tendon rupture (ATR). The aim of this study was to perform a long-term follow-up (5-9 years) of patients treated either surgically or non-surgically after an ATR. Furthermore, we wanted to examine if the patients had a tendon elongation on the injured side and evaluate if this correlated to function, symptoms and foot structure. Material and Method Sixty-seven patients (13 women) mean age of 50 years were evaluated 5-9 years after injury. Thirty-five patients were treated with surgery and 32 with non-surgery. Patient reported outcome and activity level, lower leg function, tendon length, and foot-structure were evaluated. Both the healthy and the injured side were examined and the limb symmetry index (LSI=injured/healthy x 100) was calculated. Results There were significant differences between the healthy and injured side in all function tests (p<0.001-0.015) and the tendon was significantly longer on the injured side (p<0.001) independent of treatment. There were no significant correlations between tendon length and patient reported outcome, function or foot structure. The heel-rise height increased significantly (p<0.000) from the 1 year- to the 5-9-years-follow up. The mean Achilles tendon Total Rupture Score (ATRS) was 91/100, indicating minor symptoms. Conclusion: Patients with an Achilles tendon rupture continues to have significant deficits in tendon structure and function 5-9 years after injury. There is, however continued improvement between the 1 and 5-9 year follow-up.
10.	Brorsson, Annelie, 1963, et al. (author) Recovery of calf muscle endurance 3 months after an Achilles tendon rupture. 2016 In: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 26:7, s. 844-853 Journal article (peer-reviewed)abstract The purpose of this study was to evaluate calf muscle endurance in a seated position 3 months after an Achilles tendon rupture and to evaluate how the ability to perform standardized seated heel-rises correlated to the single-leg standing heel-rise test and to patient-reported symptoms evaluated with the Achilles tendon Total Rupture Score (ATRS) 3 and 6 months after the injury. Ninety-three patients were included from a cohort of 101 patients participating in a prospective, randomized controlled trial comparing surgical and nonsurgical treatment after Achilles tendon rupture. Forty-seven patients were treated surgically and 46 nonsurgically. Ninety-one patients out of 93 (98%) could perform the standardized seated heel-rises. At the 3-month follow-up, there was a significant difference (P<0.001) between the injured and the healthy side performing standardized seated heel-rises. There were also significant correlations (r=0.29-0.37, P=<0.05) between the standardized seated heel-rises and ATRS 3 and 6 months after injury in the group who could not perform single-leg standing heel-rises. There were no significant differences between the surgical and nonsurgical treatment groups. The evaluation of standardized seated heel-rises appears to be a useful tool to quantify progress and predict future functional performance and patient-reported symptoms.
11.	Engberg, Alva Vilpi, et al. (author) Prevalence of Dysphagia and Risk of Malnutrition in Elderly Living in Nursing Homes 2024 In: DYSPHAGIA. - 0179-051X .- 1432-0460. Journal article (peer-reviewed)abstract Swallowing difficulties commonly co-occur with malnutrition in the elderly. However, there is no consensus on which assessment tools to use, and thus reported prevalence varies. The aim of this study was to survey the prevalence of dysphagia and risk of malnutrition in elderly people in nursing homes, evaluate the possible associations between swallowing function and malnutrition and survey whether there were associations between self-perceived function and the results of a screening of dysphagia. A total of 35 residents (aged 67-100 years old) without serious cognitive impairment in the general wards of two nursing homes in Gothenburg were investigated. Swallowing ability was assessed with the Gugging Swallowing Screen (GUSS) test, self-rated swallowing ability with the 4QT and the Swedish Eating Assessment Tool-10 (S-EAT-10) and risk of malnutrition with the Minimal Eating Observation and Nutrition Form-Version 2 (MEONF-II). Eleven participants (31.4%) exhibited dysphagia according to the GUSS and 10 participants (29.4%) showed moderate or high risk of malnutrition. In total 16 (46%) participants reported abnormal swallowing on 4QT and 14 (40%) participants reported abnormal swallowing on S-EAT-10. However, less than half of these had dysphagia according to the GUSS. No association was found between swallowing ability measured by the GUSS and risk of malnutrition, although a tendency towards a weak association was noted, or self-rated swallowing ability measured by the 4QT and S-EAT-10. The study found that approximately one-third of the tested participants presented with signs of dysphagia as measured with the screening instrument GUSS, even though only a few were known to have any difficulties prior to testing. This highlights that dysphagia is probably more prevalent than patients themselves and caregivers are aware of, thus, screening is of importance, to enable safer nutritional intake.
12.	Eriksson, Karin, 1965, et al. (author) Aspects of rating communicative interaction: Effects on reliability and agreement 2014 In: Journal of Interactional Research in Communication Disorders/Equinox. - : Equinox Publishing. - 2040-5111 .- 2040-512X. ; 5:2, s. 245-267 Journal article (peer-reviewed)abstract Communication partner training can be effective in improving communication in aphasia. However, further research is needed on how to measure the outcome of such interventions. In this paper we discuss the phenomenon of reliability in assessments in relation to the results of analyses using a rating scale designed to measure the ability to support a person with aphasia in natural conversational interaction. The scale was used by four assessors to rate 45 video recordings. Calculations of reliability and agreement produced varying results but were mostly satisfactory. However, the results highlight how interaction between factors such as complexity of assessments; design of the rating scale; factors inherent in the individual assessor; and the statistical measures used to analyse the outcome may result in a conflict between aspects of validity and reliability. Interpretations of outcome obtained with rating scales thus need to be based on knowledge about factors influencing the results.
13.	Eriksson, Karin, 1965, et al. (author) Communication partner training of enrolled nurses working in nursing homes with people with communication disorders caused by stroke or Parkinson's disease 2016 In: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:12, s. 1187-1203 Journal article (peer-reviewed)abstract Purpose: To evaluate the effect of a communication partner training programme directed to enrolled nurses working with people with communication disorders in nursing homes, using an individualised approach. Method: Five dyads consisting of a person with stroke-induced aphasia (n = 4) or Parkinson’s disease (n = 1) living in different nursing homes and his/her enrolled nurse participated in the study, which had a replicated single subject design with multiple baselines across individuals. The main element of the intervention was supervised analysis of video-recorded natural interaction in everyday nursing situations and the formulation of individual goals to change particular communicative strategies. Results: Outcome was measured via blinded assessments of filmed natural interaction obtained at baseline, intervention and follow-up and showed an increased use of the target communicative strategies. Subjective measures of goal attainment by the enrolled nurses were consistent with these results. Measures of perceived functional communication on behalf of the persons with communication disorders were mostly positive; four of the five participants with communication disorders and two of five enrolled nurses reported improved functional communication after intervention. Conclusions: The use of an individualised communication partner training programme led to significant changes in natural interaction, which contributes importantly to a growing body of knowledge regarding communication partner training.
14.	Eriksson, Karin, 1965, et al. (author) Communicative Intervention in Neurogenic Speech and Language Disorders: Intervention With Focus on the Conversation Partner 2011 In: 3rd Nordic Aphasia Conference. ; 2011 Conference paper (other academic/artistic)
15.	Eriksson, Karin, 1965, et al. (author) Conversation partner training in a group setting with spouses of persons with aphasia 2012 In: ICPLA2012, 14. ; 2012 Conference paper (other academic/artistic)
16.	Eriksson, Karin, 1965, et al. (author) Conversation partner training with a professional caregiver of a person with aphasia - Effects on everyday interaction 2013 In: Konferens: "Atypical Interaction: Conversation Analysis and Communication Impairments", 130627-130628, University of Sheffield. Conference paper (other academic/artistic)abstract Introduction One aspect of the concept of functional communication is the focus on ability to get information across and conversation partners may be trained to support communication in relation to communication disorders (Simmons-Mackie et al., 2010). However, if the main aim for an interaction is to get a message across it may have consequences for the amount of repair needed to accomplish the goal. As frequent and prolonged repair sequences may be seen as revealing incompetence in participants in interaction, such goals may be in conflict with goals related to the notion of face (Goffman, 1955; Wilkinson et al, 2003). The aim of this study is to describe the effects of a communication partner training program on everyday interaction between a person with aphasia and a professional carer at a nursing home. Method The study presented here is a case study with a time series design supplemented with conversation analysis. At each of seven baseline sessions and eight training sessions a sample of natural conversational interaction between the person with aphasia and his carer was video-recorded. Outcome of intervention was assessed with a rating scale by an assessor, blinded to where in the process of intervention the recordings were obtained. The scale is measuring the caregivers’ ability to apply strategies to support communication with this particular person with aphasia. The result from this quantitative measure is supplemented with qualitative analysis of the effects from the training on repair sequences in the interaction. Results and discussion Analyses of data are presently being performed and results will be discussed and related to a potential conflict between aspects of the concept of functional communication versus the concept of face in interaction in relation to communication disorders. References Goffman, E., (1955). On Face-work: An Analysis of Ritual Elements of Social Interaction. Psychiatry: Journal for the Study of Interpersonal Processes 18(3), 213-231. Simmons-Mackie, N., Raymer, A., Armstrong, E., Holland A., and Cherney, L.R. (2010) Communication partner training in aphasia: A systematic review. Archives of Physical Medicine and Rehabilitation, 91, 1814-1837. Wilkinson, R., Beeke, S. & Maxim, J., (2003). Adapting to conversation. In: Goodwin (Ed), Conversation and Brain Damage. New York: Oxford university press, pp 59-89.
17.	Eriksson, Karin, 1965, et al. (author) On the diverse outcome of communication partner training of significant others of people with aphasia: an experimental study of six cases 2016 In: International journal of language and communication disorders. - : Wiley. - 1368-2822. ; 51:4, s. 402-414 Journal article (peer-reviewed)abstract Abstract Background: Communication partner training (CPT) has been shown to improve the communicative environment of people with aphasia. Interaction-focused training is one type of training that provides an individualized intervention to participants. Although shown to be effective, outcomes have mostly been evaluated in nonexperimental case studies. Aims: The aim of the controlled experimental intervention study was to evaluate an individualized approach in a CPT programme directed to significant others of people with aphasia. Specifically the effects on conversation partners’ ability to support the person with aphasia in conversation and on the individuals with aphasias’ perception of their functional communication were explored. Methods & Procedures: Six dyads consisting of a person with aphasia and a significant other were included in a replicated single-subject design with multiple baselines across individuals. The intervention followed the interaction-focused communication training programme included in Supporting Partners of People with Aphasia in Relationships and Conversation (SPARRC). The main elements of the training consisted of supervised viewing of the couples’ own video-recorded natural interaction and the formulation of individual goals for the adaptation of particular communicative strategies. Outcome was measured via blinded ratings of filmed conversational interaction obtained once a week throughout the different phases of baseline, intervention and follow-up. A rating scale to assess overall quality of conversation was used, taking into account both transfer of information and social aspects of conversation. Measures of perceived functional communication in the persons with aphasia were also collected from the individuals with aphasia and their conversation partners. Outcomes & Results: The results were mixed, with two of the six participants showing small improvements in ability to support their partner with aphasia in conversation. Half the participants with aphasia and half the significant others reported improvements on perceived functional communication in the person with aphasia after intervention, but no changes were statistically significant. Conclusions & Implications: This study adds to the growing body of research concerning CPT by pinpointing the importance of careful consideration regarding set-up of training, suitability of participants and evaluation of outcome.
18.	Eriksson, Karin, 1965, et al. (author) Participant characteristics and observed support in conversations involving people with communication disorders 2016 In: International Journal of Speech-Language Pathology. - : Informa UK Limited. - 1754-9507 .- 1754-9515. ; 18:5, s. 429-449 Journal article (peer-reviewed)abstract Purpose: Communication partner training is an increasingly common approach to improve the possibilities for people with communication disorders to participate in everyday interaction. So far, though, little is known about what conversation partner characteristics might influence the ability to be a supportive partner in conversation. The current study explored possible associations between the observed skill to support a person with communication difficulties in conversation and the following characteristics of the conversation partner; executive function, inference ability, age, education level and relationship to the person with communication disorder. The impact of the aetiology of the communication difficulties was also explored. Method: Thirty-five dyads participated: 23 people with aphasia along with 18 significant others and five enrolled nurses and 12 people with Parkinson’s disease along with 10 significant others and two enrolled nurses. Result: Only tendencies of associations were found between observed skill to support conversation and executive function for the significant others and inference ability for the enrolled nurses. Conclusion: Although type of activity involved in the conversation may be a key factor, the results indicate that executive function and ability to make mental inferences may matter for the ability to support a person with communication disorder in conversation.
19.	Eriksson, Karin, 1965 (author) The supporting conversation partner in disordered communication 2015 Doctoral thesis (other academic/artistic)abstract Aim: The overall aim of the thesis was to examine some aspects of conversation partners (CP) of people with communication disorder caused by stroke-induced aphasia or Parkinson’s disease (PwCD). Central questions were (i) can conversation partners learn to adapt their communicative behaviour in conversation to the specific needs of the persons with communication impairment and (ii) are there any associations between characteristics of the participants in conversation and the ability to be a supportive communication partner? Factors that might influence the quantitative measurement of communicative behaviour were also examined. Method: The reliability of a global rating scale (MIC) for assessment of ability to support a PwCD in conversation was analysed. Four assessors rated 45 video recordings of natural interaction, and reliability and agreement were investigated. Data from 35 different dyads consisting of a person with a communication disorder following stroke-induced aphasia or Parkinson’s disease and his or her CP, either a significant other or an enrolled nurse, were collected. Performance on tasks exploring certain executive functions of the conversation partners and theory of mind (ToM) were collected along with demographic data, measures of severity of language difficulties and video recordings of natural interaction. Possible associations of the results with ability to support communication were explored. The effects of an interaction-focused communication partner training programme (CPT) were investigated with significant others of persons with stroke-induced aphasia (n=6) and enrolled nurses working with people with neurogenic communication disorders (n=5). The outcome was evaluated through blinded assessors’ ratings of communicative support in video-recorded natural conversations, without knowledge about when the recordings were obtained. Reports on participants’ perceived functional communication were also collected before and after intervention, as well as at follow-up. Results: The reliability of the MIC rating scale was mostly satisfactory and factors influencing the ratings were highlighted. There was a tendency for moderate correlation between certain aspects of executive function and MIC results for the significant others. For the enrolled nurses there was a tendency of a strong correlation with ToM. No associations between MIC and severity of language difficulty were found. Results from the CPT of enrolled nurses were predominantly positive on all outcome measures. The results of training of significant others were more ambiguous with some participants showing small improvements on ratings by blind assessors. Conclusions: Rating scales for quantitative assessment of ability to support communication can be reliably applied but are susceptible to factors outside the actual assessment. Factors inherent in the CP and not in the PwCD seem to influence the ability of CPs to support disordered communication in conversation. CPT is a successful way for some CPs to learn the use of supporting strategies in natural everyday conversation with PwCDs , but might not be effective for everyone. CPT may also have an impact on the perceived functional communication of PwCDs. Thus, everyday conversations of people with communication disorders can be affected through conversation partner training.
20.	Fängström, Karin, et al. (author) “And they gave me a shot, it really hurt” – Evaluative content in investigative interviews with young children 2017 In: Children and youth services review. - : Elsevier. - 0190-7409 .- 1873-7765. ; 82, s. 434-443 Journal article (peer-reviewed)abstract Research is scarce on the suitability of the evidence-based components of child investigative interviews when used in non-forensic contexts such as social work or school, particularly in relation to children’s reports on emotional content.This explorative study investigated to what extent a structured forensic interview protocol aids children in verbalizing negative emotional experiences of distress or discomfort. To do this we assessed and compared children’s displayed distress or discomfort during a video-recorded health visit with the verbalized distress or discomfort in interviews 2-4 weeks later about this visit. The children, aged 4 and 5 years (N = 26), were interviewed with a forensic interview protocol. Children’s statements regarding distress and discomfort and the interviewer questions preceding these statements were analyzed qualitatively.The results showed that 46% of the 4-year-olds and 39 % of the 5-year-olds displayed discomfort or distress during their health visit. In the interviews, open-ended questions were posed to all children, however, these questions were sufficient to aid only some children (n = 6) to share evaluative content. None of the children who displayed distress or discomfort during the visit verbalized such experiences after an invitation only. Most children who described experiences of distress or discomfort did so in relation to evaluative questions.The results suggest that more research is warranted to investigate exactly how and when evaluative questions should be posed and whether this differs depending on severity of experience or the child’s age. The need for protocol development and its suitability when used in other fields of practice is discussed.
21.	Grävare Silbernagel, Karin, 1965, et al. (author) A new measurement of heel-rise endurance with the ability to detect functional deficits in patients with Achilles tendon rupture. 2010 In: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 18:2, s. 258-64 Journal article (peer-reviewed)abstract Studies evaluating treatment effects on muscle function after an Achilles tendon rupture often use various tests for evaluating calf muscle strength. However, these tests rarely demonstrate the difference between treatment groups; therefore, new tests with a higher ability to detect possible differences in outcome are needed. The purpose of this study was to evaluate the validity and ability to detect differences in outcome of a heel-rise work test that would measure both the height of each heel-rise and the number of repetitions. Seventy-eight patients (65 men and 13 women) at a mean (standard deviation) age of 42 (9) years with Achilles tendon ruptures were included. The patients were evaluated with the new heel-rise test at 6 and 12 months after injury. The limb symmetry index (LSI = involved/uninvolved x 100) was calculated to determine the size of the difference in function between the injured and the uninjured side. The heel-rise height differed significantly between the injured and uninjured sides at the 6- and 12-month evaluations (P < 0.001). At the 6-month evaluation, the patients had achieved a mean LSI of 84% on the number of repetitions parameter but only a mean LSI of 61% on the work parameter. At the 12-month evaluation the mean, LSI of the heel-rise repetition parameter was 95%, indicating that the patients had fully recovered function, but on the work parameter the mean LSI was only 76%. The heel-rise work test in the present study has good validity and greater ability to detect differences between the injured and the uninjured sides than a test that measures only the number of heel-rise repetitions in patients with Achilles tendon rupture.
22.	Grävare Silbernagel, Karin, 1965, et al. (author) Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study 2007 In: Am J Sports Med. - : SAGE Publications. - 0363-5465. ; 35:6, s. 897-906 Journal article (peer-reviewed)abstract BACKGROUND: Achilles tendinopathy is a common overuse injury, especially among athletes involved in activities that include running and jumping. Often an initial period of rest from the pain-provoking activity is recommended. PURPOSE: To prospectively evaluate if continued running and jumping during treatment with an Achilles tendon-loading strengthening program has an effect on the outcome. STUDY DESIGN: Randomized clinical control trial; Level of evidence, 1. METHODS: Thirty-eight patients with Achilles tendinopathy were randomly allocated to 2 different treatment groups. The exercise training group (n = 19) was allowed, with the use of a pain-monitoring model, to continue Achilles tendon-loading activity, such as running and jumping, whereas the active rest group (n = 19) had to stop such activities during the first 6 weeks. All patients were rehabilitated according to an identical rehabilitation program. The primary outcome measures were the Swedish version of the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A-S) and the pain level during tendon-loading activity. RESULTS: No significant differences in the rate of improvements were found between the groups. Both groups showed, however, significant (P < .01) improvements, compared with baseline, on the primary outcome measure at all the evaluations. The exercise training group had a mean (standard deviation) VISA-A-S score of 57 (15.8) at baseline and 85 (12.7) at the 12-month follow-up (P < .01). The active rest group had a mean (standard deviation) VISA-A-S score of 57 (15.7) at baseline and 91 (8.2) at the 12-month follow-up (P < .01). CONCLUSIONS: No negative effects could be demonstrated from continuing Achilles tendon-loading activity, such as running and jumping, with the use of a pain-monitoring model, during treatment. Our treatment protocol for patients with Achilles tendinopathy, which gradually increases the load on the Achilles tendon and calf muscle, demonstrated significant improvements. A training regimen of continued, pain-monitored, tendon-loading physical activity might therefore represent a valuable option for patients with Achilles tendinopathy.
23.	Grävare Silbernagel, Karin, 1965, et al. (author) Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy 2007 In: BRITISH JOURNAL OF SPORTS MEDICINE. - : BMJ. - 0306-3674. ; 41:4, s. 276-280 Journal article (peer-reviewed)
24.	Grävare Silbernagel, Karin, 1965, et al. (author) Sex Differences in Outcome After an Acute Achilles Tendon Rupture. 2015 In: Orthopaedic journal of sports medicine. - : SAGE Publications. - 2325-9671. ; 3:6 Journal article (peer-reviewed)abstract Tendon healing differs between the sexes. Comparisons in outcome between the sexes after an Achilles tendon rupture are often not possible because of the small cohort (<20%) of women.
25.	Halilovic, Amra, 1965- (author) Ett praktikperspektiv på hantering av mjukvarukomponenter 2006 Licentiate thesis (other academic/artistic)abstract Nyutveckling och förvaltning av ett informationssystem står ständigt inför nya krav och förutsättningar. Utvecklingen skall ske på kortare tid och med ökad produktivitet. Ur förvaltningssynpunkt skall IT-systemen snabbt kunna anpassas till förändringar i verksamhet och teknik, samtidigt som dessa IT-system även skall ha en hög kvalitet och säkerhet. Allt detta kräver nya sätt att arbeta och att organisera IT-verksamheten på. Ett av dessa nya arbetssätt gäller hantering av mjukvarukomponenter. Den grundläggande idén med detta arbetssätt är att utveckling och förvaltning av IT-system inte skall basera sig på nyutveckling av mjukvara, utan på återanvändning av befintliga mjukvarukomponenter.Forskningsprocessen har haft en kvalitativ ansats med induktiva och deduktiva inslag. Datainsamlingen har skett via källstudier och intervjuer. Hanteringen av mjukvarukomponenter har studerats på två interna IT-avdelningar hos två myndigheter. Syftet har varit att kartlägga vad komponenthantering innebär och på vilket sätt arbetet på IT-avdelningarna har förändrats. Komponenthanteringen beskrivs ur ett praktikperspektiv, vilket innebär att IT-verksamhetens förutsättningar, handlingar, resultat och klienter analyseras.Avhandlingens resultat utgörs av en praktikteori för komponenthantering. Praktiken ”Komponenthantering” består av fyra subpraktiker: komponentanskaffning, komponentförvaltning, komponentbaserad systemutveckling och komponentbaserad systemförvaltning. Produkten av denna praktik är användbara IT-system. I avhandlingen diskuteras olika sätt att organisera denna praktik, samt vilka grundläggande förutsättningar som behövs för att bedriva denna praktik. Syftet med den praktikteori som presenteras är att den skall visa på hur intern IT-verksamhet kan bedrivas för att kunna möta de nya krav på effektivitet, förändringsbarhet, kvalitet och säkerhet som ställs på verksamheten.
26.	Hansen, Dorthe, et al. (author) 'They get the opportunity to say what is important for them': exploring staff's early perceptions of the implementation of a new communicative approach to patients with aphasia. 2022 In: Disability and rehabilitation. - : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 44:13, s. 3071-3080 Journal article (peer-reviewed)abstract This study explored the perceptions of staff members regarding the implementation of a new communicative approach at a multidisciplinary neurorehabilitation centre in Denmark. Communication partner training according to Supported Conversation for Adults with Aphasia (SCATM) was combined with augmentative strategies from the KomHIT programme to increase the influence of patients with aphasia on their own rehabilitation process.A qualitative approach was used involving two semi-structured group interviews with multidisciplinary staff in two wards. Three staff members from each ward participated. The recorded interviews were transcribed, and a thematic analysis of the data was conducted.Three main themes emerged from the analysis. Participants reported increased influence of patients with aphasia on their own rehabilitation process, as well as an increased focus on communication with patients with aphasia. Challenges included time restrictions and dilemmas in goal setting.Increasing staff knowledge of communication support and augmentative strategies seemed to improve the influence of patients with aphasia on their own rehabilitation process. Because the results were based on interviews with a small number of staff, they cannot be generalized and require further investigation that should also include interviews with the patients themselves and their families.IMPLICATIONS FOR REHABILITATIONThe combination of partner training with augmentative strategies may increase staff understanding of all individuals' rights to have their communicative needs met.The combination of partner training with augmentative strategies may support the influence of persons with aphasia on their own rehabilitation.Goal setting discrepancies between staff and patients with aphasia can be brought to light by more successful communication.The implementation of a new communicative approach can be challenged by a number of factors, e.g., time restrictions.The implementation process needs to be supported by actions on a higher organisational level.
27.	Jennbacken, Karin, et al. (author) Phenotypic Screen with the Human Secretome Identifies FGF16 as Inducing Proliferation of iPSC-Derived Cardiac Progenitor Cells 2019 In: International Journal of Molecular Sciences. - : MDPI. - 1661-6596 .- 1422-0067. ; 20:23 Journal article (peer-reviewed)abstract Paracrine factors can induce cardiac regeneration and repair post myocardial infarction by stimulating proliferation of cardiac cells and inducing the anti-fibrotic, antiapoptotic, and immunomodulatory effects of angiogenesis. Here, we screened a human secretome library, consisting of 923 growth factors, cytokines, and proteins with unknown function, in a phenotypic screen with human cardiac progenitor cells. The primary readout in the screen was proliferation measured by nuclear count. From this screen, we identified FGF1, FGF4, FGF9, FGF16, FGF18, and seven additional proteins that induce proliferation of cardiac progenitor cells. FGF9 and FGF16 belong to the same FGF subfamily, share high sequence identity, and are described to have similar receptor preferences. Interestingly, FGF16 was shown to be specific for proliferation of cardiac progenitor cells, whereas FGF9 also proliferated human cardiac fibroblasts. Biosensor analysis of receptor preferences and quantification of receptor abundances suggested that FGF16 and FGF9 bind to different FGF receptors on the cardiac progenitor cells and cardiac fibroblasts. FGF16 also proliferated naive cardiac progenitor cells isolated from mouse heart and human cardiomyocytes derived from induced pluripotent cells. Taken together, the data suggest that FGF16 could be a suitable paracrine factor to induce cardiac regeneration and repair.
28.	Kjellander Hellqvist, Eva, 1965-, et al. (author) Gestaltande av ämnesinnehåll i högstadiets klassrumsundervisning i musik 2019 In: HumaNetten. - Växjö : Linnaeus University. - 1403-2279. ; :42, s. 31-59 Journal article (peer-reviewed)
29.	Kjellander Hellqvist, Eva, 1965-, et al. (author) Ämnesspråk i klassrummet 2018 In: Musikforskning idag 2018, Uppsala 13–15 juni. - Uppsala : Uppsala University. ; , s. 8-8 Conference paper (other academic/artistic)abstract Som en del i ett större projekt om ämnesspråk vid Centrum för ämnesdidaktisk forskning vid Linnéuniversitetet (CÄHL), studerar vi ämnesspråket i högstadiets klassrumsundervisning i musik. Studien är deskriptiv till sin karaktär, och syftet är primärt att beskriva hur ämnesspråket i musikundervisningen på högstadiet gestaltar sig. Studien baseras på filminspelningar av sex lektioner i musik runt om i södra Sverige.Två centrala utgångspunkter för studien är att det finns ett ämnesspråk i musikundervisningen och att det är multimodalt till sin karaktär. Det vill säga att ämnesspråket inte enkelt kan beskrivas som något som sägs (verbalt) eller gestaltas genom olika skriftliga strategier (exv. på tavlan, i textmaterial och liknande).Vid Musikforskning i dag vill vi ge en överblick över vilka olika former av ”språk” (vardagligt,skolspråk, ämnesspråk, ”musikerspråk”, vetenskapligt språk) som förekommer i de lektioner vihar dokumenterat. Därefter vill vi beskriva de delar av materialet som vi har kategoriserat som ämnesspråk och ge exempel på hur vi arbetat med dem utifrån ett multimodalt perspektiv i vår analys. Mer specifikt analyserar vi det insamlade materialet utifrån ett social-semiotiskt perspektiv med fokus på vilka semiotiska resurser som lärarna använder sig av i sin undervisning.Studiens preliminära resultat visar att olika semiotiska resurser såsom tal, skrift, sång, instrumentspelande, gestik och liknande, ofta samverkar för att framföra ett innehåll i undervisningen. Dessutom samsas musikundervisningens ämnesspråk, med språk från andra domäner, såsom skolspråk, vardagsspråk, ”musikerspråk”, vetenskapligt språk.
30.	Knobloch, K., et al. (author) Letter to the editor * authors' response 2007 In: Am J Sports Med. - 0363-5465. ; 35:7, s. 1208-9 Journal article (other academic/artistic)
31.	Langegård, Ulrica, 1969, et al. (author) Evaluation of quality of care in relation to health-related quality of life of patients diagnosed with brain tumor : a novel clinic for proton beam therapy 2019 In: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 27:7, s. 2679-2691 Journal article (peer-reviewed)abstract Purpose: Patients with brain tumors constitute a vulnerable group, and it is important that they receive the highest quality of care (QoC). The study aim was to describe the perceptions of QoC and its association with health-related quality of life in brain tumor patients undergoing proton beam therapy in a newly established clinic.Method: Data were collected at the start of treatment and after 3 and 6weeks. Adult patients (18years old) with brain tumors (n=186) completed two self-administered questionnaires: a modified Quality from the Patients' Perspective, which measures perceived reality and subjective importance of care, and the EORTC QLQ-C30. Data were analyzed using parametric and non-parametric statistical tests.Results: The perceived QoC was highest for treatment information and lowest for dietician and smoking information, whereas interaction with doctors and nurses was rated as the most important aspect of quality of care. Subjective importance ratings were significantly higher than perceived reality ratings for 60% of items. A better global health was moderately correlated with a higher perceived support for fatigue.Conclusions: A need for quality improvement was identified for several aspects of patient care. Greater symptom distress during the treatment period led to greater perceived importance of symptom support. Ensuring QoC is complex and collaboration with other health care professionals is essential.Relevance to clinical practice: The clinic could improve QoC regarding information about possible symptoms, adjust care according to patient perceptions of importance, and involve patients in care decisions.
32.	Langegård, Ulrica, 1969, et al. (author) Health-related quality of life in patients with primary brain tumors during and three months after treatment with proton beam therapy 2021 In: Technical Innovations & Patient Support in Radiation Oncology. - : Elsevier BV. - 2405-6324. ; 17, s. 5-17 Journal article (peer-reviewed)abstract Background Proton beam therapy (PBT) is increasingly administered to patients with primary brain tumors. Benefits of new treatments must be weighed against side effects and possible deterioration in health-related quality of life (HRQoL). The aim of this study was to describe and compare HRQoL, including acute symptom experiences and associated factors, in patients with malignant and benign brain tumors treated with PBT. Materials and Methods Adult PBT-treated patients with primary brain tumors (n=266) were studied. HRQoL was assessed with EORTC QLQ-C30, QLQ-BN20, HADS, ISI and MFI before, during and three months after treatment. Associations with demographic and medical factors were explored. Results Between baseline and three months post-treatment: HRQoL decreased significantly in the global health/QOL domains physical functioning, role functioning and cognitive functioning in the malignant group, global health/QOL and physical functioning decreased significantly in the benign group, more comorbidity was significantly associated with increased motor dysfunction, leg weakness, headache and future uncertainty. Fatigue and depression were the most frequent symptoms in both groups. Independent predictors of risk factor recognition were age, sex, chemotherapy, comorbidity and education level. Discussion Global health/QOL in patient with brain tumors is very complex and multidimensional. Symptoms are interrelated and related to patient, tumor and treatment factors. It is important to identify aspects of HRQoL that may be affected by treatment. These include both benefits, expected to improve HRQoL, and negative changes such as symptom experience and influencing factors. Evidence-based guidelines are needed for symptom management, and for high quality of care for patients experiencing low PBT-related HRQoL.
33.	Langegård, Ulrica, 1969, et al. (author) Symptom Clusters in Patients With Brain Tumors Undergoing Proton Beam Therapy 2019 In: Oncology Nursing Forum. - : Oncology Nursing Society. - 0190-535X .- 1538-0688. ; 46:3, s. 349-363 Journal article (peer-reviewed)abstract OBJECTIVES: To explore symptom clusters during proton beam therapy in patients with primary brain tumors and investigate associations among symptom clusters, demographic variables, and comorbidity in this patient population.SAMPLE & SETTING: Data were collected from 187 adult patients with primary brain tumors during their treatment periods in the Skandion Clinic in Uppsala, Sweden. Symptoms were assessed with the Radiotherapy-Related Symptoms Assessment Scale, and comorbidity was evaluated with the Self-Administered Comorbidity Questionnaire.METHODS & VARIABLES: The study used a quantitative and longitudinal design. Exploratory factor analysis was used to determine the underlying structure of symptom clusters.RESULTS: Three clusters were identified: mood, reduced appetite, and reduced energy. The mood cluster had the highest factor loadings (0.71-0.86). In addition, demographic and comorbidity characteristics were associated with symptom clusters in this group of patients.IMPLICATIONS FOR NURSING: Building knowledge about how these symptoms interact and are clustered will support healthcare professionals to more efficiently relieve symptom clusters during proton beam therapy.
34.	Langegård, Ulrica, 1969, et al. (author) The Art of Living With Symptoms : A Qualitative Study Among Patients With Primary Brain Tumors Receiving Proton Beam Therapy 2020 In: Cancer Nursing. - Philadelphia : LIPPINCOTT WILLIAMS & WILKINS. - 0162-220X .- 1538-9804. ; 43:2, s. E79-E86 Journal article (peer-reviewed)abstract Background: Symptom management in conjunction with proton beam therapy (PBT) from patient's perspective has not been explored. Such knowledge is essential to optimize the care in this relatively new treatment modality.Objective: The aim of this study was to explore the process of symptom management in patients with brain tumor receiving PBT.Methods: Participants were 22 patients with primary brain tumor who received PBT, recruited in collaboration with a national center for proton therapy and 2 oncology clinics at 2 university hospitals in Sweden. Interviews using open-ended questions were conducted before, during, and/or after treatment. Verbatim interview transcripts were analyzed using classic Grounded Theory.Results: "The art of living with symptoms" emerged as the core concept. This encompassed 3 interconnected symptom management concepts: "Adapting to limited ability," "Learning about oneself," and "Creating new routines." These concepts were summarized in a substantive theoretical model of symptom management. Despite the struggle to manage symptoms, participants lived a satisfactory life.Conclusions: Symptom management in conjunction with PBT comprises a process of action, thoughts, and emotions. The concepts that emerged indicated patients' symptom management strategies were based on their own resources.Implications for Practice: It is important that PBT facilities develop an approach that facilitates the symptom management process based on patients' experiences of symptoms, as well as their actions and available resources.
35.	Liljeqvist, Jan-Åke, 1954, et al. (author) Human Antibodies against Herpes Simplex Virus 2 Glycoprotein G Do Not Neutralize but Mediate Antibody-Dependent Cellular Cytotoxicity 2024 In: ANTIBODIES. - 2073-4468. ; 13:2 Journal article (peer-reviewed)abstract Herpes simplex virus 2 (HSV-2) is a sexually transmitted infection affecting 491 million individuals globally. Consequently, there is a great need for both prophylactic and therapeutic vaccines. Unfortunately, several vaccine clinical trials, primarily employing the glycoprotein D of HSV-2 (gD-2), have failed. The immune protection conferred by human anti-HSV-2 antibodies in genital infection and disease remains elusive. It is well-known that gD-2 elicits cross-reactive neutralizing antibodies, i.e., anti-gD-2 antibodies recognize gD in HSV-1 (gD-1). In contrast, anti-glycoprotein G in HSV-2 (mgG-2) antibodies are exclusively type-specific for HSV-2. In this study, truncated versions of gD-2 and mgG-2 were recombinantly produced in mammalian cells and used for the purification of anti-gD-2 and anti-mgG-2 antibodies from the serum of five HSV-2-infected subjects, creating a pool of purified antibodies. These antibody pools were utilized as standards together with purified mgG-2 and gD-2 antigens in ELISA to quantitatively estimate and compare the levels of cross-reactive anti-gD-1 and anti-gD-2 antibodies, as well as anti-mgG-2 antibodies in sera from HSV-1+2-, HSV-2-, and HSV-1-infected subjects. The median concentration of anti-mgG-2 antibodies was five times lower in HSV-1+2-infected subjects as compared with cross-reactive anti-gD-1 and anti-gD-2 antibodies, and three times lower in HSV-2 infected subjects as compared with anti-gD-2 antibodies. The pool of purified anti-gD-2 antibodies presented neutralization activity at low concentrations, while the pool of purified anti-mgG-2 antibodies did not. Instead, these anti-mgG-2 antibodies mediated antibody-dependent cellular cytotoxicity (ADCC) by human granulocytes, monocytes, and NK-cells, but displayed no complement-dependent cytotoxicity. These findings indicate that antibodies to mgG-2 in HSV-2-infected subjects are present at low concentrations but mediate the killing of infected cells via ADCC rather than by neutralizing free viral particles. We, and others, speculate that Fc-receptor mediated antibody functions such as ADCC following HSV-2 vaccination may serve as a better marker of protection correlate instead of neutralizing activity. In an mgG-2 therapeutic vaccine, our findings of low levels of anti-mgG-2 antibodies in HSV-2-infected subjects may suggest an opportunity to enhance the immune responses against mgG-2. In a prophylactic HSV-2 mgG-2 vaccine, a possible interference in cross-reactive immune responses in already infected HSV-1 subjects can be circumvented.
36.	Lindberg, Marie K, 1975, et al. (author) Identification of estrogen-regulated genes of potential importance for the regulation of trabecular bone mineral density. 2002 In: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. - : Wiley. - 0884-0431. ; 17:12, s. 2183-95 Journal article (peer-reviewed)abstract Estrogen is of importance for the regulation of trabecular bone mineral density (BMD). The aim of this study was to search for possible mechanisms of action of estrogen on bone. Ovariectomized (OVX) mice were treated with 17beta-estradiol. Possible effects of estrogen on the expression of 125 different bone-related genes in humerus were analyzed using the microarray technique. Estrogen regulated 12 of these genes, namely, two growth factor-related genes, 8 cytokines, and 2 bone matrix-related genes. Five of the 12 genes are known to be estrogen-regulated, and the remaining 7 genes are novel estrogen-regulated genes. Seven genes, including interleukin-1 receptor antagonist (IL-1ra), IL-1receptor type II (IL-1RII), insulin-like growth factor-binding protein 4 (IGFBP-4), transforming growth factor beta (TGF-beta), granulocyte colony-stimulating factor receptor (G-CSFR), leukemia inhibitory factor receptor (LIFR), and soluble IL-4 receptor (sIL-4R) were selected as probable candidate genes for the trabecular bone-sparing effect of estrogen, as the mRNA levels of these genes were highly correlated (r2 > 0.65) to the trabecular BMD. The regulation of most of these seven genes was predominantly estrogen receptor alpha (ER-alpha)-mediated (5/7) while some genes (2/7) were regulated both via ER-alpha and ER-beta. In conclusion, by using the microarray technique, we have identified four previously known and three novel estrogen-regulated genes of potential importance for the trabecular bone-sparing effect of estrogen.
37.	Lu, Yingchang, et al. (author) New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk 2016 In: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 7 Journal article (peer-reviewed)abstract To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P<5 × 10(-8)), of which eight were previously associated with increased overall adiposity (BMI, BF%) and four (in or near COBLL1/GRB14, IGF2BP1, PLA2G6, CRTC1) were novel associations with BF%. Seven loci showed a larger effect on BF% than on BMI, suggestive of a primary association with adiposity, while five loci showed larger effects on BMI than on BF%, suggesting association with both fat and lean mass. In particular, the loci more strongly associated with BF% showed distinct cross-phenotype association signatures with a range of cardiometabolic traits revealing new insights in the link between adiposity and disease risk.
38.	Nilsson-Helander, Katarina, 1957, et al. (author) A new surgical method to treat chronic ruptures and reruptures of the Achilles tendon 2008 In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 16:6, s. 614-20 Journal article (peer-reviewed)abstract In patients with a chronic rupture or rerupture of the Achilles tendon, the recommended treatment is surgical. Various surgical techniques have been reported in the literature; however, the outcome is rarely evaluated with a sufficiently long follow-up, using appropriate end-points. The purpose of this study was to evaluate the subjective and objective outcome following a new surgical treatment for chronic rupture or rerupture of the Achilles tendon using augmentation with a free gastrocnemius aponeurosis flap. A total of 28 consecutive patients (22 male and 6 female) with a mean (SD) age of 46 (10.4) years were evaluated at a median (range) of 29 (12-117) months after surgery. The surgical technique involved making a single incision and then using a free gastrocnemius aponeurosis flap to cover the tendon gap after an end-to-end suture. The patients were evaluated using the Achilles tendon rupture score (ATRS) and a detailed questionnaire relating to symptoms, physical activity and satisfaction with treatment. The functional evaluation consisted of a validated test battery measuring different aspects of muscle/tendon function of the gastrocnemius/soleus and Achilles tendon complex. The median (range) ATRS was 83 (24-100). There were no reruptures. In terms of surgical complications, there was one deep infection, three wound closure complications and deep venous thrombosis in two patients. All but one patient returned to work within 6 months of surgery. Sixteen (57%) patients were satisfied with the treatment. There was a significant decrease in the level of physical activity after the injury compared with before the injury (p = 0.004). Of the 25 patients who participated in recreational sports prior to injury, 13 (52%) returned to the same activity level after treatment. In terms of jump performance, no significant differences were found between the healthy and injured sides. There was, however, a significant decrease in strength, in terms of both concentric and eccentric-concentric toe raises and the toe-raise test for endurance compared with the healthy side. The use of a free gastrocnemius aponeurosis flap to treat chronic ruptures and reruptures of the Achilles tendon rendered a good overall subjective and objective outcome in the majority of patients. The use of a single incision in combination with a free flap augmentation produced favourable results.
39.	Nilsson-Helander, Katarina, 1957, et al. (author) Acute achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures 2010 In: The American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 38:11, s. 2186-2193 Journal article (peer-reviewed)abstract BACKGROUND: There is no consensus regarding the optimal treatment for patients with acute Achilles tendon rupture. Few randomized controlled studies have compared outcomes after surgical or nonsurgical treatment with both groups receiving early mobilization. PURPOSE: This study was undertaken to compare outcomes of patients with acute Achilles tendon rupture treated with or without surgery using early mobilization and identical rehabilitation protocols. STUDY DESIGN: Randomized, controlled trial; Level of evidence, 1. METHODS: Ninety-seven patients (79 men, 18 women; mean age, 41 years) with acute Achilles tendon rupture were treated and followed for 1 year. The primary end point was rerupturing. Patients were evaluated using the Achilles tendon Total Rupture Score (ATRS), functional tests, and clinical examination at 6 and 12 months after injury. RESULTS: There were 6 (12%) reruptures in the nonsurgical group and 2 (4%) in the surgical group (P = .377). The mean 6- and 12-month ATRS were 72 and 88 points in the surgical group and 71 and 86 points in the nonsurgical group, respectively. Improvements in ATRS between 6 and 12 months were significant for both groups, with no significant between-group differences. At the 6-month evaluation, the surgical group had better results compared with the nonsurgically treated group in some of the muscle function tests; however, at the 12-month evaluation there were no differences between the 2 groups except for the heel-rise work test in favor of the surgical group. At the 12-month follow-up, the level of function of the injured leg remained significantly lower than that of the uninjured leg in both groups. CONCLUSION: The results of this study did not demonstrate any statistically significant difference between surgical and nonsurgical treatment. Furthermore, the study suggests that early mobilization is beneficial for patients with acute Achilles tendon rupture whether they are treated surgically or nonsurgically. The preferred treatment strategy for patients with acute Achilles tendon rupture remains a subject of debate. Although the study met the sample size dictated by the authors' a priori power calculation, the difference in the rerupture rate might be considered clinically important by some.
40.	Nilsson-Helander, Katarina, 1957, et al. (author) The Achilles tendon Total Rupture Score (ATRS): development and validation 2007 In: The American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 35:3, s. 421-426 Journal article (peer-reviewed)abstract BACKGROUND: There is a need for a patient-relevant instrument to evaluate outcome after treatment in patients with a total Achilles tendon rupture. PURPOSE: To develop and validate a new patient-reported instrument for measuring outcome after treatment for total Achilles tendon rupture. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 1. METHODS: Development of this instrument consisted of item generation and test construction, item reduction, validation, evaluation of structure and internal consistency, test-retest, and test for responsiveness. The final version, the Achilles tendon Total Rupture Score (ATRS), was tested for validity, structure, and internal consistency (Cronbach's alpha) on 82 patients and 52 healthy persons. A correlation analysis was performed of the ATRS with the 2 validated foot/ankle/Achilles tendon scores, the Foot and Ankle Outcome Score (FAOS) and the Swedish version of the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A-S). Structure was evaluated with factor analysis. Test-retest reliability was evaluated on 43 patients. The ATRS responsiveness was tested on 43 patients by calculating the effect size. RESULTS: The total score for the patients ranged from 17 to 100 with a mean (median) of 77 (85) and a standard deviation (interquartile range) of 21.4 (23). A significantly (P < .0001) higher total score was found for the healthy subjects, ranging from 94 to 100 with a mean (median) of 99.8 (100) and a standard deviation (interquartile range) of 1.1 (0). The ATRS correlated significantly (P < .01) with all subscales of the FAOS (r = 0.60-0.84) and the VISA-A-S (r = 0.78). The factor analysis gave 1 factor of importance. The internal consistency was 0.96 as measured with Cronbach's alpha. The test-retest produced an intraclass correlation coefficient of 0.98. The tests for responsiveness showed an effect size between 0.87 and 2.21. CONCLUSION: The ATRS is a patient-reported instrument with high reliability, validity, and sensitivity for measuring outcome after treatment in patients with a total Achilles tendon rupture. CLINICAL RELEVANCE: The ATRS is a self-administered instrument with high clinical utility, and we suggest the score for measuring the outcome, related to symptoms and physical activity, after treatment in patients with a total Achilles tendon rupture.
41.	Olsson, Niklas, et al. (author) Ability to perform a single heel-rise is significantly related to patient-reported outcome after Achilles tendon rupture. 2014 In: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 24:1, s. 152-158 Journal article (peer-reviewed)abstract This study evaluated the short-term recovery of function after an acute Achilles tendon rupture, measured by a single-legged heel-rise test, with main emphasis on the relation to the patient-reported outcomes and fear of physical activity and movement (kinesiophobia). Eighty-one patients treated surgically or non-surgically with early active rehabilitation after Achilles tendon rupture were included in the study. Patient's ability to perform a single-legged heel-rise, physical activity level, patient-reported symptoms, general health, and kinesiophobia was evaluated 12 weeks after the injury. The heel-rise test showed that 40 out of 81 (49%) patients were unable to perform a single heel-rise 12 weeks after the injury. We found that patients who were able to perform a heel-rise were significantly younger, more often of male gender, reported a lesser degree of symptoms, and also had a higher degree of physical activity at 12 weeks. There was also a significant negative correlation between kinesiophobia and all the patient-reported outcomes and the physical activity level. The heel-rise ability appears to be an important early achievement and reflects the general level of healing, which influences patient-reported outcome and physical activity. Future treatment protocols focusing on regaining strength early after the injury therefore seem to be of great importance. Kinesiophobia needs to be addressed early during the rehabilitation process.
42.	Olsson, Niklas, et al. (author) Major functional deficits persist 2years after acute Achilles tendon rupture. 2011 In: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 19:8, s. 1385-93 Journal article (peer-reviewed)abstract The purpose of this prospective randomized controlled study was to evaluate the long-term results after an acute Achilles tendon rupture in patients treated surgically or non-surgically. The focus was to evaluate whether any improvements occurred between the one and 2-year evaluation.
43.	Olsson, Niklas, et al. (author) Predictors of Clinical Outcome After Acute Achilles Tendon Ruptures. 2014 In: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 42:6, s. 1448-1455 Journal article (peer-reviewed)abstract BACKGROUND:In patients with an acute Achilles tendon rupture, it has not been possible to determine the superiority of a single specific treatment modality over other treatments with respect to symptoms and function. When several pertinent treatment protocols are available for an injury, it is of interest to understand how other variables, such as age, sex, or physical activity level, affect outcome to better individualize the treatment. PURPOSE:To investigate predictors of both symptomatic and functional outcomes after an acute Achilles tendon rupture. STUDY DESIGN:Cohort study (Prognosis); Level of evidence, 2. METHODS:Ninety-three patients (79 men and 14 women; mean age, 40 years) were evaluated prospectively at 3, 6, and 12 months. The main outcome measures in this study were the Achilles tendon Total Rupture Score (ATRS) for symptoms and maximum heel-rise height for function. The independent variables evaluated as possible predictors of outcome included treatment, sex, age, body mass index (BMI), physical activity level, symptoms, and quality of life. RESULTS:Treatment, age, BMI, physical activity level, heel-rise height at 6 months, and the ATRS at 3 months were eligible for further analysis. Only male sex was included for the prediction models. The 4 different multiple linear regression models (predicting the ATRS at 6 and 12 months and heel-rise height at 6 and 12 months) were significant (P < .001-.002), and the R(2) values for the models were 0.222 to 0.409. Surgical or nonsurgical treatment is a moderate predictor of symptoms and a weak predictor of heel-rise height after an acute Achilles tendon rupture. At the 6-month follow-up, surgical treatment was associated with a larger heel-rise height, but the opposite was seen at 12 months. Surgical treatment resulted in a lower degree of symptoms. Increasing age was a strong predictor of reduced heel-rise height, and an increase in age of 10 years reduced the expected heel-rise height by approximately 8%. A higher BMI was also a strong predictor of a greater degree of symptoms, and a 5-unit higher BMI predicted a reduction of approximately 10 points in the ATRS. CONCLUSION:The present study identified important possible predictors of outcome. Despite having a wide range of clinically relevant variables, the models had a limited ability to predict the final individual outcome. In general, the models appear to be better at predicting function than symptoms.
44.	Olsson, Niklas, et al. (author) Stable Surgical Repair With Accelerated Rehabilitation Versus Nonsurgical Treatment for Acute Achilles Tendon Ruptures: A Randomized Controlled Study. 2013 In: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 41:12, s. 2867-2876 Journal article (peer-reviewed)abstract BACKGROUND:The optimal treatment for acute Achilles tendon ruptures is still a subject of debate. Early loading of the tendon is a factor that has been shown to be beneficial to recovery and to minimize complications. The main outcome of previous studies has been complications such as reruptures and deep infections, without focusing on the functional outcome relevant to the majority of patients who do not experience these complications. PURPOSE:To evaluate whether stable surgical repair and early loading of the tendon could improve patient-reported outcome and function after an acute Achilles tendon rupture. STUDY DESIGN:Randomized controlled trial; Level of evidence, 1. METHODS:A total of 100 patients (86 men, 14 women; mean age, 40 years) with an acute total Achilles tendon rupture were randomized to either surgical treatment, including an accelerated rehabilitation protocol, or nonsurgical treatment. The primary outcome was the Achilles tendon Total Rupture Score (ATRS). The patients were evaluated at 3, 6, and 12 months for symptoms, physical activity level, and function. RESULTS:There were no significant differences between the groups in terms of symptoms, physical activity level, or quality of life. There was a trend toward improved function in surgically treated patients; the results were significantly superior when assessed by the drop countermovement jump (95% CI, 0.03-0.15; P = .003) and hopping (95% CI, 0.01-0.33; P = .040). No reruptures occurred in the surgical group, while there were 5 in the nonsurgical group (P = .06). There were 6 superficial infections in the surgically treated group; however, these superficial infections had no bearing on the final outcome. Symptoms, reduced quality of life, and functional deficits still existed 12 months after injury on the injured side in both groups. CONCLUSION:The results of the present study demonstrate that stable surgical repair with accelerated tendon loading could be performed in all (n = 49) patients without reruptures and major soft tissue-related complications. However, this treatment was not significantly superior to nonsurgical treatment in terms of functional results, physical activity, or quality of life.
45.	Pettersson, Karin, et al. (author) Holistic methodological framework for assessing the benefits of delivering industrial excess heat to a district heating network 2020 In: International Journal of Energy Research. - : John Wiley and Sons Ltd. - 0363-907X .- 1099-114X. ; 44:4, s. 2634-2651 Journal article (peer-reviewed)abstract In Sweden, over 50% of building heating requirements are covered by district heating. Approximately 8% of the heat supply to district heating systems comes from excess heat from industrial processes. Many studies indicate that there is a potential to substantially increase this share, and policies promoting energy efficiency and greenhouse gas emissions reduction provide incentives to do this. Quantifying the medium and long-term economic and carbon footprint benefits of such investments is difficult because the background energy system against which new investments should be assessed is also expected to undergo significant change as a result of the aforementioned policies. Furthermore, in many cases, the district heating system has already invested or is planning to invest in non-fossil heat sources such as biomass-fueled boilers or CHP units. This paper proposes a holistic methodological framework based on energy market scenarios for assessing the long-term carbon footprint and economic benefits of recovering excess heat from industrial processes for use in district heating systems. In many studies of industrial excess heat, it is assumed that all emissions from the process plant are allocated to the main products, and none to the excess heat. The proposed methodology makes a distinction between unavoidable excess heat and excess heat that could be avoided by increased heat recovery at the plant site, in which case it is assumed that a fraction of the plant emissions should be allocated to the exported heat. The methodology is illustrated through a case study of a chemical complex located approximately 50 km from the city of Gothenburg on the West coast of Sweden, from which substantial amounts of excess heat could be recovered and delivered to heat to the city's district heating network which aims to be completely fossil-free by 2030.
46.	Schützer, Kajs-Marie, et al. (author) Reversible elevations of serum creatinine levels but no effect on glomerular filtration during treatment with the direct thrombin inhibitor AZD0837. 2010 In: European journal of clinical pharmacology. - : Springer Science and Business Media LLC. - 1432-1041 .- 0031-6970. ; 66:9, s. 903-10 Journal article (peer-reviewed)abstract Reversible mean increases in serum creatinine (approx. 10%) have been observed during clinical investigations of the oral direct thrombin inhibitor AZD0837. The aim of this study was to evaluate whether the increase in s-creatinine is due to a decrease in renal glomerular filtration rate (GFR) or an inhibition of the tubular secretion of creatinine.
47.	Soderhielm, K., et al. (author) Communicative participation in goal-setting meetings for patients with aphasia after stroke. A study using patients' and healthcare professionals' self-ratings 2023 In: International Journal of Language & Communication Disorders. - : Wiley. - 1368-2822 .- 1460-6984. ; 58:2, s. 342-356 Journal article (peer-reviewed)abstract Purpose Communicative participation poses a challenge in meetings between healthcare professionals (HCPs) and people with aphasia (PwA). How communication is affected by aphasia in group meetings, where several healthcare professionals participate together with the patient, is largely unexplored. The aim of this study was to investigate self-rated communicative participation during goal-setting meetings among PwA compared to patients without aphasia and to investigate whether communicative participation among PwA was associated with self-rated knowledge about aphasia among HCPs. A further aim was to investigate if there was a difference in the use of communication strategies among HCPs in the respective situations. Methods Nine PwA and nine control patients without aphasia rated their experience of communication during a goal-setting meeting. Thirty-eight HCPs rated their knowledge about aphasia and communication, and their use of communication strategies during goal-setting meetings. Results The PwA reported being listened to by the HCPs as well as being able to comprehend the meeting. PwA with more severe language impairment did not report a lower level of communicative participation compared to PwA with milder impairment. Half of the patients from both groups indicated some difficulty asking questions during the meeting. Patients' ratings of communication were not correlated to HCPs' knowledge of communication strategies. There was a significant difference in self-rated use of communication strategies among HCPs for the two conditions, although the individual variation was large. Conclusion Results from both PwA and controls imply that patients may need more support to be able to ask questions in meetings with HCPs. Although self-ratings increase the ecological validity of the study of participation, further studies could benefit from using video observations in combination with self-reported experience, since awareness might influence results. What this paper ads What is already known on this subject Aphasia is an acquired language disorder that affects patient-provider communication. In stroke rehabilitation, person-centred goal setting is a key component. If healthcare professionals (HCPs) are not able to use adequate communication strategies, a lack of accessible communication can become a barrier to person-centredness. There are evidence-based communication strategies which can be used to overcome this barrier. What this paper adds to existing knowledge This study aimed to investigate communicative participation during goal-setting meetings from the perspective of patients with aphasia and HCPs. To our knowledge, this is the first study where persons with aphasia are asked to rate communicative participation in goal-setting meetings. To broaden the perspective on communication and goal setting, ratings of patients with aphasia are compared to ratings by patients with stroke but no aphasia. The results of this study indicate that there is room for improvement regarding communication during goal-setting meetings. However, asking direct questions on communicative participation to persons with severe aphasia may not be feasible. What are the potential or actual clinical implications of this work? The results of this study imply that both patients with and without aphasia may need more support to be able to express themselves during goal-setting meetings. There also seems to be a need for further education on aphasia and communication strategies among rehabilitation professionals.
48.	Sparrman, Anna, 1965-, et al. (author) Archives and children’s cultural heritage 2023 In: Archives and records. - : Taylor & Francis. - 2325-7962 .- 2325-7989. Journal article (peer-reviewed)abstract In this explorative and collectively written paper, researchers and archivists from the research project Children’s cultural heritage — the visual voices of the archive ponder, wrestle with, confront, and dig deeper into what it means to preserve and include children’s own voices in archives. The authors acknowledge that child-produced cultural objects are historical landmarks and significant parts of national heritage. The article raises questions about where and how the ‘doing’ of what is here called children’s cultural heritage takes place, what it means to archive from children’s perspectives, and what aspects of children are saved during these preservation and archival management processes. To collect, preserve and provide access to heritage might empower and affirm individuals and subordinated groups of people who have not been seen or heard in the historical past, in the present, or in future pasts. Children, as a category, is one such subordinated group in heritage contexts. Adults therefore have a responsibility to empower children by strengthening their position towards other social groups, towards society and the heritage domain. This article provides insights into the challenges that heritage establishments face in taking children’s cultural heritage seriously.
49.	Stengård, Johanna, et al. (author) CHEFiOS; Chefskap, Hälsa, Effektivitet, Förutsättningar i Offentlig Sektor : Teknisk rapport 2013 Reports (other academic/artistic)abstract ISM rapport nr 13 från Institutet för Stressmedicin, Västra Götalandsregionen
50.	Wikström, Anna-Karin, 1965- (author) Biochemical and Epidemiological Studies of Early-Onset and Late-Onset Pre-Eclampsia 2007 Doctoral thesis (other academic/artistic)abstract Biochemical and epidemiological aspects of pre-eclampsia were investigated, with the main focus on possible pathophysiological differences between early-onset and late-onset disease.In pre-eclamptic women poor correlation was found between albumin-creatinine ratio (ACR) in a random urine sample and total amount of albumin in a 24-hour urine collection. (Paper I) In a cohort of women giving birth in Sweden in 1973-82 we estimated the adjusted incidence rate ratio (IRR) for ischaemic heart disease (IHD) during the years 1987–2001. The adjusted IRR for development of IHD was 1.6-2.8 in woman exposed to gestational hypertensive disease during her pregnancy compared with unexposed women. The higher risk represents more severe or recurrent hypertensive disease. (Paper II)Before delivery, in early-onset pre-eclampsia (24-32 weeks) there were pronounced alterations in plasma concentrations of soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PlGF), and also a higher placental 8-iso-PGF2α concentration and an elevated serum ratio of plasminogen-activator inhibitor (PAI)-1 to PAI-2 compared with early controls. In late-onset pre-eclampsia (35-42 weeks) there were only moderate alterations in sFlt1 and PlGF concentrations, and the placental 8-iso-PGF2α concentration and PAI-1/ PAI-2 ratio were similar to those in late controls. (Papers III, V) There was a rapid postpartum decrease in sFlt1 concentration in all groups. One week postpartum the sFlt1 concentration was persistently higher, however, in women with early-onset pre-eclampsia compared with early controls. (Paper IV)In conclusion: random ACR cannot replace 24-hour urine collections for quantification of albuminuria in pre-eclamptic women; gestational hypertensive disease, especially severe or recurrent, increases the risk for later IHD; early-onset, but not late-onset pre-eclampsia is associated with pronounced alterations of angiogenesis-related markers and only early-onset pre-eclampsia is associated with placental oxidative stress and an increased PAI-1/ PAI-2 ratio, all suggesting a stronger link between early-onset than late-onset pre-eclampsia and a dysfunctional placenta.

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