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2.
  • Chirumalla, Koteshwar, et al. (author)
  • The influence of different media instructions on solving a procedural task
  • 2015
  • In: ICED 15, Vol. 11. - 9781904670742
  • Conference paper (peer-reviewed)abstract
    • This study investigates the influence of different forms of media instructions on the process and outcomes of completing a specific procedural task. The experiment was conducted with four student groups having an education in the area of Information Design. In the experiment four media instructions - text only, text plus drawings, a series of pictures and video with narration - were considered. The findings show that the type of media has an influence on the ability to solve a procedural task and on group interaction and the way groups solve a task. Compared with the other instructions, video instruction triggered a different interaction and behavioural pattern during assembly. Participants considered both video and picture instructions as more usable in terms of facilitating the ability to understand, select and apply possible solutions to a given task. However, the video medium showed little influence on dialogue in the group during assembly. The instructions, such as text plus drawings, pictures and video had a similar influence on task performance times, whereas text instructions took three times longer to implement than other instructions.
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3.
  • Eriksson, Daniel, et al. (author)
  • Cytokine Autoantibody Screening in the Swedish Addison Registry Identifies Patients With Undiagnosed APS1
  • 2018
  • In: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 103:1, s. 179-186
  • Journal article (peer-reviewed)abstract
    • Context: Autoimmune polyendocrine syndrome type 1 (APS1) is a monogenic disorder that features autoimmune Addison disease as a major component. Although APS1 accounts for only a small fraction of all patients with Addison disease, early identification of these individuals is vital to prevent the potentially lethal complications of APS1.Objective: To determine whether available serological and genetic markers are valuable screening tools for the identification of APS1 among patients diagnosed with Addison disease.Design: We systematically screened 677 patients with Addison disease enrolled in the Swedish Addison Registry for autoantibodies against interleukin-22 and interferon-α4. Autoantibody-positive patients were investigated for clinical manifestations of APS1, additional APS1-specific autoantibodies, and DNA sequence and copy number variations of AIRE.Results: In total, 17 patients (2.5%) displayed autoantibodies against interleukin-22 and/or interferon-α4, of which nine were known APS1 cases. Four patients previously undiagnosed with APS1 fulfilled clinical, genetic, and serological criteria. Hence, we identified four patients with undiagnosed APS1 with this screening procedure.Conclusion: We propose that patients with Addison disease should be routinely screened for cytokine autoantibodies. Clinical or serological support for APS1 should warrant DNA sequencing and copy number analysis of AIRE to enable early diagnosis and prevention of lethal complications.
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4.
  • Eriksson, Olof, et al. (author)
  • The Positron Emission Tomography ligand [11C]5-Hydroxy-Tryptophan can be used as a surrogate marker for the human endocrine pancreas
  • 2014
  • In: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 63:10, s. 3428-3437
  • Journal article (peer-reviewed)abstract
    • In humans a well-developed serotonin system is localized to the pancreatic islets while being absent in exocrine pancreas. Assessment of pancreatic serotonin biosynthesis could therefore be used to estimate the human endocrine pancreas. Proof of concept was tested in a prospective clinical trial by comparisons of type 1 diabetic (T1D) patients, with extensive reduction of beta cells, with healthy volunteers (HV).C-peptide negative (i.e. insulin-deficient) T1D subjects (n=10) and HV (n=9) underwent dynamic Positron Emission Tomography with the radiolabeled serotonin precursor [(11)C]5-Hydroxy-Tryptophan ([(11)C]5-HTP).A significant accumulation of [(11)C]5-HTP was obtained in the pancreas of the HV, with large inter-individual variation. A substantial and highly significant reduction (66%) in the pancreatic uptake of [(11)C]5-HTP in T1D subjects was observed, and this was most evident in the corpus and caudal regions of the pancreas where beta-cells normally are the major constituent of the islets.[(11)C]5-HTP retention in the pancreas was reduced in T1D compared to non-diabetic subjects. Accumulation of [(11)C]5-HTP in the pancreas of both HV and subjects with T1D were in agreement with previously reported morphological observations on the beta cell volume implying that [(11)C]5-HTP retention is a useful non-invasive surrogate marker for the human endocrine pancreas.
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5.
  • Huang, Yezi, et al. (author)
  • Enabling DSL and Radio on the Same Copper Pair
  • 2015
  • In: 2015 IEEE International Conference on Communications (ICC). - 9781467364324 ; , s. 1031-1035
  • Conference paper (peer-reviewed)abstract
    • To increase indoor coverage for mobile services, we propose a residential small cell infrastructure making use of the existing copper plant. The system is cabinet-based, collocated with VDSL2 and uses small pieces of spectrum next to VDSL2. Inspired by the Ericsson Radio Dot System, it challenges the femtocell paradigm offering full macro functionality in the small cells. An interesting service potential is offered albeit the added mobile traffic capacity is moderate as it is limited by the copper fronthaul.
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6.
  • Huang, Yezi, et al. (author)
  • LTE Over Copper - Potential and Limitations
  • 2015
  • In: 2015 IEEE 26th Annual International Symposium on Personal, Indoor, and Mobile Radio Communications (PIMRC). - 9781467367820 ; , s. 1339-1343
  • Conference paper (peer-reviewed)abstract
    • The densification of mobile networks in order to meet increased capacity demands is ongoing, needed and costly. A few papers have been published based on the insight that the fixed broadband networks offer a multitude of sites, for instance our homes, for potential small cell deployment providing backhaul capacity and power without site costs. However, in order to reach economical large-scale benefits, we explore the case when radio systems are deployed in coexistence with DSL. In this paper, we establish the feasibility of such a concept under constraints invoked by state-of-the-art and emerging systems (3GPP, VDSL2 and G.fast) and make statements about the required architecture. We also point out that the enthusiasm of previously published results should be lowered a notch.
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7.
  • Huang, Yezi, et al. (author)
  • Time-Domain Precoding for LTE-over-Copper Systems
  • 2016
  • In: 2016 IEEE International Conference on Communications (ICC). - 9781479966646 - 9781479966653 ; , s. 1-6
  • Conference paper (peer-reviewed)abstract
    • Crosstalk cancellation is a crucial issue for traditional digital subscriber line systems. For LTE-over-copper systems, however, the need for crosstalk cancellation varies depending on the analog fronthauling architecture and its parameters. A crosstalk handler that is decoupled as much as possible from the rest of the system architecture is thus preferred. Therefore, we propose a time-domain precoding scheme specifically in downstream direction to separate the precoding unit from the LTE signal flow, and perform crosstalk cancellation in an on-demand manner. Estimation of all direct and crosstalk paths is assisted by LTE cell-specific reference signals. The time-domain precoder transforms the interference channel into a crosstalk-free channel with identical direct paths, which allows for low-complexity inter-symbol interference mitigation. We evaluate the concept in terms of signal-to-noise ratio provided for LTE signals using measured wireline channel data.
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8.
  • Joffrin, E., et al. (author)
  • Overview of the JET preparation for deuterium-tritium operation with the ITER like-wall
  • 2019
  • In: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 59:11
  • Research review (peer-reviewed)abstract
    • For the past several years, the JET scientific programme (Pamela et al 2007 Fusion Eng. Des. 82 590) has been engaged in a multi-campaign effort, including experiments in D, H and T, leading up to 2020 and the first experiments with 50%/50% D-T mixtures since 1997 and the first ever D-T plasmas with the ITER mix of plasma-facing component materials. For this purpose, a concerted physics and technology programme was launched with a view to prepare the D-T campaign (DTE2). This paper addresses the key elements developed by the JET programme directly contributing to the D-T preparation. This intense preparation includes the review of the physics basis for the D-T operational scenarios, including the fusion power predictions through first principle and integrated modelling, and the impact of isotopes in the operation and physics of D-T plasmas (thermal and particle transport, high confinement mode (H-mode) access, Be and W erosion, fuel recovery, etc). This effort also requires improving several aspects of plasma operation for DTE2, such as real time control schemes, heat load control, disruption avoidance and a mitigation system (including the installation of a new shattered pellet injector), novel ion cyclotron resonance heating schemes (such as the three-ions scheme), new diagnostics (neutron camera and spectrometer, active Alfven eigenmode antennas, neutral gauges, radiation hard imaging systems...) and the calibration of the JET neutron diagnostics at 14 MeV for accurate fusion power measurement. The active preparation of JET for the 2020 D-T campaign provides an incomparable source of information and a basis for the future D-T operation of ITER, and it is also foreseen that a large number of key physics issues will be addressed in support of burning plasmas.
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  • Lindgren, Johan, et al. (author)
  • Soft-tissue evidence for homeothermy and crypsis in a Jurassic ichthyosaur
  • 2018
  • In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 564:7736
  • Journal article (peer-reviewed)abstract
    • Ichthyosaurs are extinct marine reptiles that display a notable external similarity to modern toothed whales. Here we show that this resemblance is more than skin deep. We apply a multidisciplinary experimental approach to characterize the cellular and molecular composition of integumental tissues in an exceptionally preserved specimen of the Early Jurassic ichthyosaur Stenopterygius. Our analyses recovered still-flexible remnants of the original scaleless skin, which comprises morphologically distinct epidermal and dermal layers. These are underlain by insulating blubber that would have augmented streamlining, buoyancy and homeothermy. Additionally, we identify endogenous proteinaceous and lipid constituents, together with keratinocytes and branched melanophores that contain eumelanin pigment. Distributional variation of melanophores across the body suggests countershading, possibly enhanced by physiological adjustments of colour to enable photoprotection, concealment and/or thermoregulation. Convergence of ichthyosaurs with extant marine amniotes thus extends to the ultrastructural and molecular levels, reflecting the omnipresent constraints of their shared adaptation to pelagic life.
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  • 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.
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  • Malinovschi, Andrei, 1978-, et al. (author)
  • Consequences of Using Post- or Prebronchodilator Reference Values in Interpreting Spirometry
  • 2023
  • In: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:4, s. 461-471
  • Journal article (peer-reviewed)abstract
    • RATIONALE: Post-bronchodilator (BD) spirometry is used for diagnosis of chronic obstructive pulmonary disease (COPD). However, pre-BD reference values are used for spirometry interpretation.OBJECTIVES: To compare the resulting prevalence rates of abnormal spirometry and study the consequences of using pre- or post-BD reference values generated within the Swedish CArdioPulmonary bioImage Study (SCAPIS) when interpreting post-BD spirometry in a general population.METHODS: SCAPIS reference values for post-BD and pre-BD spirometry were based on 10,156 and 1,498 never-smoking, healthy participants, respectively. We studied the associations of abnormal spirometry, defined by using pre- or post-BD reference values, with respiratory burden in the SCAPIS general population (28,851 individuals).MEASUREMENTS AND MAIN RESULTS: Bronchodilation resulted in higher predicted median and lower limit of normal (LLN) for FEV1/FVC ratio. The prevalence of post-BD FEV1/FVC < pre-bronchodilator LLN was 4.8% and that of post-BD FEV1/FVC < post-bronchodilator LLN was 9.9% for the general population. An additional 5.1% was identified as having an abnormal post-BD FEV1/FVC ratio and this group had more respiratory symptoms, emphysema (13.5% vs. 4.1%, p<0.001) and self-reported physician-diagnosed COPD (2.8% vs. 0.5%, p<0.001) than subjects with post-BD FEV1/FVC ratio > LLN for both pre- and post-bronchodilation).CONCLUSIONS: Pre- and post-bronchodilator spirometry reference values differ with regard to FEV1/FVC ratio. Use of post-bronchodilator reference values doubled the population prevalence of airflow obstruction; this was related to a higher respiratory burden. Using post-bronchodilator reference values when interpreting post-bronchodilator spirometry might enable identification of individuals with mild disease and be clinically relevant.
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  • Medeiros, Eduardo, et al. (author)
  • Crosstalk Mitigation for LTE-over-Copper in Downlink Direction
  • 2016
  • In: IEEE Communications Letters. - 1089-7798. ; 20:7, s. 1425-1428
  • Journal article (peer-reviewed)abstract
    • Radio-over-copper is a niche idea that has potential to become a cornerstone in the deployment of dense 5G networks. We address one of the remaining hurdles and present an architecture for transparent crosstalk mitigation in LTE-over-copper systems. By taking advantage of reference symbols present in the downlink LTE signals we propose two methods for estimating the copper channel. System performance is evaluated using channel measurements and error vector magnitude calculations with promising results.
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  • Sandin, Per, et al. (author)
  • Precautionary defaults - A new strategy for chemical risk management
  • 2004
  • In: Human and Ecological Risk Assessment. - : Informa UK Limited. - 1080-7039 .- 1549-7860. ; 10, s. 1-18
  • Journal article (peer-reviewed)abstract
    • In order to give adequate support to risk managers, new risk assessment methods should be developed that are (1) scientifically sound, (2) simplified, and (3) suited for precautionary risk management. In this Perspective we propose that the notion of a precautionary default can be a useful tool in the development of such methods. A precautionary default is a cautious or pessimistic assumption that is used in the absence of adequate information and that should be replaced when such information is obtained. Furthermore, we point out some promising research areas for the development of such indicators, viz. connections between chemical characteristics such as persistence and effect parameters, monitoring of contaminants in polar regions, monitoring of contaminants in breast milk, application of results from (human) toxicology in ecotoxicology and vice versa, (eco) toxicological test systems that are sensitive to effects on reproduction, and the application of bioinformatic methods to complex data, both in genomic research and in ecotoxicology. We conclude that precautionary decision-making does not require less science, but to the contrary it requires more science and improved communication between scientists and risk managers.
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  • Sundström, Johan, Professor, 1971-, et al. (author)
  • Risk factors for subarachnoid haemorrhage : a nationwide cohort of 950 000 adults
  • 2019
  • In: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 48:6, s. 2018-2025
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.
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  • Aldenlöv, Jens (author)
  • Exploring Public Procurement of Swedish Railway Infrastructure Maintenance
  • 2019
  • Licentiate thesis (other academic/artistic)abstract
    • In 2002, Sweden started to outsource its railway infrastructure maintenance. Through gradual exposure (i.e. outsourcing one contract area at a time), the Swedish Transport Administration has developed its competence of being a client towards its contractors. The last contract was outsourced in 2014. In the last decade, the development of governance techniques and maintenance cost has not matched the increase in traffic. Due to an increased awareness in environmentally friendlier transportation, traffic is only expected to increase further in the coming years. Governance techniques and maintenance cost ultimately depends on the client-contractor relationship through public procurement. Hence, there is a need to understand public procurement of railway infrastructure maintenance. Therefore, the purpose of this thesis is to contribute to the knowledge of public procurement of railway infrastructure maintenance. Three separate studies were conducted. Study 1 was a literature review to explore and determine the state-of-the-art for the field of public procurement of railway maintenance. Study 2 was a linear regression analysis to examine the relationship between contract design and the output of maintenance in Sweden. Study 3 was an interview study in Sweden that explored what factors that supports or hinders collaboration in railway maintenance.The main results of these studies are that asset knowledge is important for both the client and the contractor. Through reliable asset knowledge, incentives and contracts can be designed to support governance and collaboration. Today, railway infrastructure maintenance is dominated by informal relationships that lack the support of formal partnering activities. When an informal relationship is supported by a formal structure it provides a basis for innovation. This formal structure should be centralized around gaining and sharing asset knowledge. By establishing such a system to increase the asset knowledge and supporting collaboration, public organizations of maintenance can provide a basis for the improvement of maintenance.
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18.
  • Amloy, Supaluck, et al. (author)
  • Excitons and biexcitons in InGaN quantum dot like localization centers
  • 2014
  • In: Nanotechnology. - : IOP Publishing. - 0957-4484 .- 1361-6528. ; 25:49, s. 495702-
  • Journal article (peer-reviewed)abstract
    • Indium segregation in a narrow InGaN single quantum well creates quantum dot (QD) like exciton localization centers. Cross-section transmission electron microscopy reveals varying shapes and lateral sizes in the range ∼1–5 nm of the QD-like features, while scanning near field optical microscopy demonstrates a highly inhomogeneous spatial distribution of optically active individual localization centers. Microphotoluminescence spectroscopy confirms the spectrally inhomogeneous distribution of localization centers, in which the exciton and the biexciton related emissions from single centers of varying geometry could be identified by means of excitation power dependencies. Interestingly, the biexciton binding energy (Ebxx) was found to vary from center to center, between 3 to −22 meV, in correlation with the exciton emission energy. Negative binding energies are only justified by a three-dimensional quantum confinement, which confirms QD-like properties of the localization centers. The observed energy correlation is proposed to be understood as variations of the lateral extension of the confinement potential, which would yield smaller values of Ebxx for reduced lateral extension and higher exciton emission energy. The proposed relation between lateral extension and Ebxx is further supported by the exciton and the biexciton recombination lifetimes of a single QD, which suggest a lateral extension of merely ∼3 nm for a QD with strongly negative Ebxx = −15.5 meV. 
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  • Bergquist, Filip, et al. (author)
  • Pharmacokinetics of Intravenously (DIZ101), Subcutaneously (DIZ102), and Intestinally (LCIG) Infused Levodopa in Advanced Parkinson Disease
  • 2022
  • In: Neurology. - : Lippincott, Williams & Wilkins. - 0028-3878 .- 1526-632X. ; 99:10, s. E965-E976
  • Journal article (peer-reviewed)abstract
    • Background and Objectives Intestinal levodopa/carbidopa gel infusion (LCIG) is superior to oral treatment in advanced Parkinson disease. The primary objective of this trial was to investigate whether continuous subcutaneous or intravenous infusion with a continuously buffered acidic levodopa/carbidopa solution yields steady-state plasma concentrations of levodopa that are equivalent in magnitude, and noninferior in variability, to those obtained with LCIG in patients with advanced Parkinson disease. Methods A concentrated acidic levodopa/carbidopa (8:1) solution buffered continuously and administered intravenously (DIZ101) or subcutaneously (DIZ102) was compared with an approved LCIG in a randomized, 3-period crossover, open-label, multicenter trial. Formulations were infused for 16 hours to patients with Parkinson disease who were using LCIG as their regular treatment. Patients were recruited from several university neurology clinics but came to the same phase I unit for treatment. Pharmacokinetic variables and safety including dermal tolerance are reported. The primary outcomes were bioequivalence and noninferior variability of DIZ101 and DIZ102 vs LCIG with respect to levodopa plasma concentrations. Results With dosing adjusted to estimated bioavailability, DIZ101 and DIZ102 produced levodopa plasma levels within standard bioequivalence limits compared with LCIG in the 18 participants who received all treatments. Although the levodopa bioavailability for DIZ102 was complete, it was 80% for LCIG. Therapeutic concentrations of levodopa were reached as quickly with subcutaneous administration of DIZ102 as with LCIG and remained stable throughout the infusions. Owing to poor uptake of LCIG, carbidopa levels in plasma were higher with DIZ101 and DIZ102 than with the former. All individuals receiving any of the treatments (n = 20) were included in the evaluation of safety and tolerability. Reactions at the infusion sites were mild and transient. Discussion It is feasible to rapidly achieve high and stable levodopa concentrations by means of continuous buffering of a subcutaneously administered acidic levodopa/carbidopa-containing solution.
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  • Brechmann, Nils Arnold, et al. (author)
  • Pilot-scale process for magnetic bead purification of antibodies directly from non-clarified CHO cell culture
  • 2019
  • In: Biotechnology progress (Print). - : AIChE. - 8756-7938 .- 1520-6033.
  • Journal article (peer-reviewed)abstract
    • High capacity magnetic protein A agarose beads, LOABeads PrtA, were used in the developmentof a new process for affinity purification of monoclonal antibodies (mAbs) from non-clarifiedCHO cell broth using a pilot-scale magnetic separator. The LOABeads had a maximum bindingcapacity of 65 mg/mL and an adsorption capacity of 25–42 mg IgG/mL bead in suspension for anIgG concentration of 1 to 8 g/L. Pilot-scale separation was initially tested in a mAb capture stepfrom 26 L clarified harvest. Small-scale experiments showed that similar mAb adsorptions wereobtained in cell broth containing 40 Å~ 106 cells/mL as in clarified supernatant. Two pilot-scalepurification runs were then performed on non-clarified cell broth from fed-batch runs of 16 L,where a rapid mAb adsorption ≥96.6% was observed after 1 h. This process using 1 L of magnetic beads had an overall mAb yield of 86% and 16 times concentration factor. After this single proteinA capture step, the mAb purity was similar to the one obtained by column chromatography, whilethe host cell protein content was very low, <10 ppm. Our results showed that this magnetic beadmAb purification process, using a dedicated pilot-scale separation device, was a highly efficientsingle step, which directly connected the culture to the downstream process without cell clarification.Purification of mAb directly from non-clarified cell broth without cell separation can providesignificant savings in terms of resources, operation time, and equipment, compared to legacy procedure of cell separation followed by column chromatography step.
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  • Brodin, N. Patrik, et al. (author)
  • Life years lost-comparing potentially fatal late complications after radiotherapy for pediatric medulloblastoma on a common scale
  • 2012
  • In: Cancer. - : Wiley. - 1097-0142 .- 0008-543X. ; 118:21, s. 5432-5440
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: The authors developed a framework for estimating and comparing the risks of various long-term complications on a common scale and applied it to 3 different techniques for craniospinal irradiation in patients with pediatric medulloblastoma. METHODS: Radiation dose-response parameters related to excess hazard ratios for secondary breast, lung, stomach, and thyroid cancer; heart failure, and myocardial infarction were derived from large published clinical series. Combined with age-specific and sex-specific hazards in the US general population, the dose-response analysis yielded excess hazards of complications for a cancer survivor as a function of attained age. After adjusting for competing risks of death, life years lost (LYL) were estimated based on excess hazard and prognosis of a complication for 3-dimensional conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), and intensity-modulated proton therapy (IMPT). RESULTS: Lung cancer contributed most to the estimated LYL, followed by myocardial infarction, and stomach cancer. The estimates of breast or thyroid cancer incidence were higher than those for lung and stomach cancer incidence, but LYL were lower because of the relatively good prognosis. Estimated LYL ranged between 1.90 years for 3D CRT to 0.28 years for IMPT. In a paired comparison, IMPT was associated with significantly fewer LYL than both photon techniques. CONCLUSIONS: Estimating the risk of late complications is associated with considerable uncertainty, but including prognosis and attained age at an event to obtain the more informative LYL estimate added relatively little to this uncertainty. Cancer 2012. (c) 2012 American Cancer Society.
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  • Brodin, N Patrik, et al. (author)
  • Radiobiological risk estimates of adverse events and secondary cancer for proton and photon radiation therapy of pediatric medulloblastoma.
  • 2011
  • In: Acta oncologica (Stockholm, Sweden). - 1651-226X. ; 50:6, s. 806-16
  • Journal article (peer-reviewed)abstract
    • Abstract Introduction. The aim of this model study was to estimate and compare the risk of radiation-induced adverse late effects in pediatric patients with medulloblastoma (MB) treated with either three-dimensional conformal radiotherapy (3D CRT), inversely-optimized arc therapy (RapidArc(®) (RA)) or spot-scanned intensity-modulated proton therapy (IMPT). The aim was also to find dose-volume toxicity parameters relevant to children undergoing RT to be used in the inverse planning of RA and IMPT, and to use in the risk estimations. Material and methods. Treatment plans were created for all three techniques on 10 pediatric patients that have been treated with craniospinal irradiation (CSI) at our institution in 2007-2009. Plans were generated for two prescription CSI doses, 23.4 Gy and 36 Gy. Risk estimates were based on childhood cancer survivor data when available and secondary cancer (SC) risks were estimated as a function of age at exposure and attained age according to the organ-equivalent dose (OED) concept. Results. Estimates of SC risk was higher for the RA plans and differentiable from the estimates for 3D CRT at attained ages above 40 years. The risk of developing heart failure, hearing loss, hypothyroidism and xerostomia was highest for the 3D CRT plans. The risks of all adverse effects were estimated as lowest for the IMPT plans, even when including secondary neutron (SN) irradiation with high values of the neutron radiation weighting factors (WR(neutron)). Conclusions. When comparing RA and 3D CRT treatment for pediatric MB it is a matter of comparing higher SC risk against higher risks of non-cancer adverse events. Considering time until onset of the different complications is necessary to fully assess patient benefit in such a comparison. The IMPT plans, including SN dose contribution, compared favorably to the photon techniques in terms of all radiobiological risk estimates.
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  • Carvalho, Eugénia, 1967, et al. (author)
  • Low cellular IRS 1 gene and protein expression predict insulin resistance and NIDDM.
  • 1999
  • In: The FASEB journal : official publication of the Federation of American Societies for Experimental Biology. - 0892-6638 .- 1530-6860. ; 13:15, s. 2173-8
  • Journal article (peer-reviewed)abstract
    • We examined the gene and protein expression of IRS 1 (insulin receptor substrate 1) in adipocytes from two groups of healthy individuals with an increased propensity for non-insulin-dependent diabetes mellitus (NIDDM): those with two first-degree relatives with diabetes and another group with massive obesity. A low expression of IRS 1 (
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  • Dalin, Frida, 1984-, et al. (author)
  • Clinical and immunological characteristics of Autoimmune Addison's disease : a nationwide Swedish multicenter study
  • 2017
  • In: Journal of Clinical Endocrinology and Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197. ; 102:2, s. 379-389
  • Journal article (peer-reviewed)abstract
    • CONTEXT: Studies on clinical and immunological features of Autoimmune Addison's disease (AAD) are needed to understand the disease burden and increased mortality.OBJECTIVE: To provide upgraded data on autoimmune comorbidities, replacement therapy, autoantibody profiles and cardiovascular risk factors.DESIGN, SETTING AND PARTICIPANTS: Cross sectional, population-based study. 660 AAD patients were included utilizing the Swedish Addison Registry (SAR) 2008-2014. When analyzing cardiovascular risk factors, 3,594 individuals from the population-based survey in Northern Sweden, MONICA (MONItoring of Trends and Determinants of CArdiovascular Disease), served as controls.MAIN OUTCOME MEASURE: Prevalence of autoimmune comorbidities and cardiovascular risk factors. Autoantibodies against 13 autoantigens were determined.RESULTS: Sixty percent of the SAR cohort consisted of females. Mean age at diagnosis was significantly higher for females than for males (36.8 vs. 31.1 years). The proportion of 21-hydroxylase autoantibody positive patients was 83% and 62% of patients had one or more associated autoimmune diseases, more frequently coexisting in females (p<0.0001). AAD patients had lower BMI (p<0.0001) and prevalence of hypertension (p=0.027) compared with controls. Conventional hydrocortisone tablets were used by 89% of patients; with the mean dose 28.1±8.5 mg/day. The mean hydrocortisone equivalent dose normalized to body surface was 14.8±4.4 mg/m(2)/day. Higher hydrocortisone equivalent dose was associated with higher incidence of hypertension (p=0.046).CONCLUSIONS: Careful monitoring of AAD patients is warranted to detect associated autoimmune diseases. Contemporary Swedish AAD patients do not have increased prevalence of overweight, hypertension, T2DM or hyperlipidemia. However, high glucocorticoid replacement doses may be a risk factor for hypertension.
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30.
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31.
  • Ekstrom, Mattias, et al. (author)
  • Stimulated in vivo synthesis of plasminogen activator inhibitor 1 in human adipose tissue
  • 2012
  • In: Thrombosis and Haemostasis. - 0340-6245 .- 2567-689X. ; 108:3, s. 485-492
  • Journal article (peer-reviewed)abstract
    • Plasminogen activator inhibitor type-1 (PAI-1) is one of the most important inhibitors of endogenous fibrinolysis. Adipose tissue is a suggested source of the elevated plasma levels o(-) PAI-1 in obesity. The relation between PAI-1 and inflammation is of particular interest, but current knowledge regarding regulation of PAI-1 in adipose tissue is mainly based on animal studies or ex vivo experiments on human cultured adipocytes. So far, no study has described stimulated gene expression and protein synthesis of PAI-1 in vivo in human adipose tissue. We used open heart surgery as a model of acute systemic inflammation. Twenty-two male patients underwent blood sampling and omental and subcutaneous adipose tissue biopsies for gene expression studies before and after surgery. Expression and localisation of PAI-1 antigen was evaluated by immunohistochemistry. After surgery gene expression of PAI-1 increased 27-fold in omental adipose tissue and three-fold in subcutaneous adipose tissue, but no differences were found in tissue-type plasminogen activator (t-PA) mRNA. PAI-1 antigen was localised within endothelial cells and in the adipose tissue interstitium close to vessels. The upregulated gene expression and protein synthesis in adipose tissue was followed by increased concentrations of PAI-1 antigen in plasma. In conclusion, we present for the first time that an acute systemic inflammation in humans increased gene expression and protein synthesis of PAI-1 in adipose tissue and that this increase was most prominent in omental adipose tissue. PAI-1 synthesis in adipose tissue due to acute systemic inflammation may be a link between inflammation and impaired endogenous fibrinolysis.
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32.
  • Ekström, Erik, 1989-, et al. (author)
  • Epitaxial Growth of CaMnO3-y Films on LaAlO3 (112 over bar 0) by Pulsed Direct Current Reactive Magnetron Sputtering
  • 2022
  • In: Physica Status Solidi. Rapid Research Letters. - : Wiley-V C H Verlag GMBH. - 1862-6254 .- 1862-6270. ; 16:4
  • Journal article (peer-reviewed)abstract
    • CaMnO3 is a perovskite with attractive magnetic and thermoelectric properties. CaMnO3 films are usually grown by pulsed laser deposition or radio frequency magnetron sputtering from ceramic targets. Herein, epitaxial growth of CaMnO3-y (002) films on a (112 over bar 0)-oriented LaAlO3 substrate using pulsed direct current reactive magnetron sputtering is demonstrated, which is more suitable for industrial scale depositions. The CaMnO3-y shows growth with a small in-plane tilt of <approximate to 0.2 degrees toward the (200) plane of CaMnO3-y and the (1 over bar 104) with respect to the LaAlO3 (112 over bar 0) substrate. X-ray photoelectron spectroscopy of the electronic core levels shows an oxygen deficiency described by CaMnO2.58 that yields a lower Seebeck coefficient and a higher electrical resistivity when compared to stoichiometric CaMnO3. The LaAlO3 (112 over bar 0) substrate promotes tensile-strained growth of single crystals. Scanning transmission electron microscopy and electron energy loss spectroscopy reveal antiphase boundaries composed of Ca on Mn sites along and , forming stacking faults.
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33.
  • Ekström, Erik, et al. (author)
  • Microstructure control and property switching in stress-free van der Waals epitaxial VO2 films on mica
  • 2023
  • In: Materials & design. - : ELSEVIER SCI LTD. - 0264-1275 .- 1873-4197. ; 229
  • Journal article (peer-reviewed)abstract
    • Realizing stress-free inorganic epitaxial films on weakly bonding substrates is of importance for applications that require film transfer onto surfaces that do not seed epitaxy. Film-substrate bonding is usually weakened by harnessing natural van der Waals layers (e.g., graphene) on substrate surfaces, but this is difficult to achieve in non-layered materials. Here, we demonstrate van der Waals epitaxy of stress-free films of a non-layered material VO2 on mica. The films exhibit out-of-plane 010 texture with three inplane orientations inherited from the crystallographic domains of the substrate. The lattice parameters are invariant with film thickness, indicating weak film-substrate bonding and complete interfacial stress relaxation. The out-of-plane domain size scales monotonically with film thickness, but the in-plane domain size exhibits a minimum, indicating that the nucleation of large in-plane domains supports subsequent island growth. Complementary ab initio investigations suggest that VO2 nucleation and van der Waals epitaxy involves subtle polarization effects around, and the active participation of, surface potassium atoms on the mica surface. The VO2 films show a narrow domain-size-sensitive electrical-conductiv ity-temperature hysteresis. These results offer promise for tuning the properties of stress-free van der Waals epitaxial films of non-layered materials such as VO2 through microstructure control (C) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
  •  
34.
  • Ekström, Erik, et al. (author)
  • The effects of microstructure, Nb content and secondary Ruddlesden-Popper phase on thermoelectric properties in perovskite CaMn1-xNbxO3 (x=0-0.10) thin films
  • 2020
  • In: RSC Advances. - : Royal Society of Chemistry. - 2046-2069. ; 10:13, s. 7918-7926
  • Journal article (peer-reviewed)abstract
    • CaMn1-xNbxO3 (x = 0, 0.5, 0.6, 0.7 and 0.10) thin films have been grown by a two-step sputtering/annealing method. First, rock-salt-structured (Ca,Mn1-x,Nb-x)O thin films were deposited on 11 & x304;00 sapphire using reactive RF magnetron co-sputtering from elemental targets of Ca, Mn and Nb. The CaMn1-xNbxO3 films were then obtained by thermally induced phase transformation from rock-salt-structured (Ca,Mn1-xNbx)O to orthorhombic during post-deposition annealing at 700 degrees C for 3 h in oxygen flow. The X-ray diffraction patterns of pure CaMnO3 showed mixed orientation, while Nb-containing films were epitaxially grown in [101] out of-plane-direction. Scanning transmission electron microscopy showed a Ruddlesden-Popper (R-P) secondary phase in the films, which results in reduction of the electrical and thermal conductivity of CaMn1-xNbxO3. The electrical resistivity and Seebeck coefficient of the pure CaMnO3 film were measured to 2.7 omega cm and -270 mu V K-1 at room temperature, respectively. The electrical resistivity and Seebeck coefficient were reduced by alloying with Nb and was measured to 0.09 omega cm and -145 mu V K-1 for x = 0.05. Yielding a power factor of 21.5 mu W K-2 m(-1) near room temperature, nearly eight times higher than for pure CaMnO3 (2.8 mu W K-2 m(-1)). The power factors for alloyed samples are low compared to other studies on phase-pure material. This is due to high electrical resistivity originating from the secondary R-P phase. The thermal conductivity of the CaMn1-xNbxO3 films is low for all samples and is the lowest for x = 0.07 and 0.10, determined to 1.6 W m(-1) K-1. The low thermal conductivity is attributed to grain boundary scattering and the secondary R-P phase.
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35.
  • Eriksson, Bjorn, et al. (author)
  • Limited value of NT-proBNP as a prognostic marker of all-cause mortality in patients with heart failure with preserved and mid-range ejection fraction in primary care : A report from the swedish heart failure register
  • 2019
  • In: Scandinavian Journal of Primary Health Care. - : TAYLOR & FRANCIS LTD. - 0281-3432 .- 1502-7724. ; 37:4, s. 434-443
  • Journal article (peer-reviewed)abstract
    • Aim: The prognostic value of natriuretic peptides in the management of heart failure (HF) patients with ejection fraction (EF) <40% is well established, but is less known for those with EF >= 40% managed in primary care (PC). Therefore, the aim of this study is to describe the prognostic significance of plasma NT-proBNP in such patients managed in PC. Subjects: We included 924 HF patients (48% women) with EF >= 40% and NT-proBNP registered in the Swedish Heart Failure Registry. Follow-up was 1100 +/- 687 days. Results: One-, three- and five-year mortality rates were 8.1%, 23.9% and 44.7% in patients with EF 40-50% (HFmrEF) and 7.3%, 23.6% and 37.2% in patients with EF >= 50% (HFpEF) (p = 0.26). Patients with the highest mean values of NT-proBNP had the highest all-cause mortality but wide standard deviations (SDs). In univariate regression analysis, there was an association only between NT-proBNP quartiles and all-cause mortality. In HFmrEF patients, hazard ratio (HR) was 1.96 (95% CI 1.60-2.39) p < 0.0001) and in HFpEF patients, HR was 1.72 (95% CI 1.49-1.98) p < 0.0001). In a multivariate Cox proportional hazard regression analysis, adjusted for age, NYHA class, atrial fibrillation and GFR class, this association remained regarding NT-proBNP quartiles [HR 1.83 (95% CI 1.38-2.44), p < 0.0001] and [HR 1.48 (95% CI 1.16-1.90), p = 0.0001], HFmrEF and HFpEF, respectively. Conclusion: NT-proBNP has a prognostic value in patients with HF and EF >= 40% managed in PC. However, its clinical utility is limited due to high SDs and the fact that it is not independent in this population which is characterized by high age and much comorbidity.
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36.
  • Eriksson, D, et al. (author)
  • Extended exome sequencing identifies BACH2 as a novel major risk locus for Addison's disease
  • 2016
  • In: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 286:6, s. 595-608
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Autoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addison's disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology.METHODS: To understand the genetic background of Addison's disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected set of 1853 genes and their potential regulatory elements, for the purpose of sequencing 479 patients with Addison's disease and 1394 controls.RESULTS: We identified BACH2 (rs62408233-A, OR = 2.01 (1.71-2.37), P = 1.66 × 10(-15) , MAF 0.46/0.29 in cases/controls) as a novel gene associated with Addison's disease development. We also confirmed the previously known associations with the HLA complex.CONCLUSION: Whilst BACH2 has been previously reported to associate with organ-specific autoimmune diseases co-inherited with Addison's disease, we have identified BACH2 as a major risk locus in Addison's disease, independent of concomitant autoimmune diseases. Our results may enable future research towards preventive disease treatment.
  •  
37.
  • Eriksson, Daniel, et al. (author)
  • GWAS for autoimmune Addison’s disease identifies multiple risk loci and highlights AIRE in disease susceptibility
  • 2021
  • In: Nature Communications. - : Nature Publishing Group. - 2041-1723. ; 12:1
  • Journal article (peer-reviewed)abstract
    • Autoimmune Addison's disease (AAD) is characterized by the autoimmune destruction of the adrenal cortex. Low prevalence and complex inheritance have long hindered successful genetic studies. We here report the first genome-wide association study on AAD, which identifies nine independent risk loci (P < 5 × 10-8). In addition to loci implicated in lymphocyte function and development shared with other autoimmune diseases such as HLA, BACH2, PTPN22 and CTLA4, we associate two protein-coding alterations in Autoimmune Regulator (AIRE) with AAD. The strongest, p.R471C (rs74203920, OR = 3.4 (2.7-4.3), P = 9.0 × 10-25) introduces an additional cysteine residue in the zinc-finger motif of the second PHD domain of the AIRE protein. This unbiased elucidation of the genetic contribution to development of AAD points to the importance of central immunological tolerance, and explains 35-41% of heritability (h2). 
  •  
38.
  • Eriksson, Frida, 1986, et al. (author)
  • Impact of fast ions on density peaking in JET : fluid and gyrokinetic modeling
  • 2019
  • In: Plasma Physics and Controlled Fusion. - : Institute of Physics Publishing (IOPP). - 0741-3335 .- 1361-6587. ; 61:7
  • Journal article (peer-reviewed)abstract
    • The effect of fast ions on turbulent particle transport, driven by ion temperature gradient (ITG)/trapped electron mode turbulence, is studied. Two neutral beam injection (NBI) heated JET discharges in different regimes are analyzed at the radial position rho(t) = 0.6, one of them an L-mode and the other one an H-mode discharge. Results obtained from the computationally efficient fluid model EDWM and the gyro-fluid model TGLF are compared to linear and nonlinear gyrokinetic GENE simulations as well as the experimentally obtained density peaking. In these models, the fast ions are treated as a dynamic species with a Maxwellian background distribution. The dependence of the zero particle flux density gradient (peaking factor) on fast ion density, temperature and corresponding gradients, is investigated. The simulations show that the inclusion of a fast ion species has a stabilizing influence on the ITG mode and reduces the peaking of the main ion and electron density profiles in the absence of sources. The models mostly reproduce the experimentally obtained density peaking for the L-mode discharge whereas the H-mode density peaking is significantly underpredicted, indicating the importance of the NBI particle source for the H-mode density profile.
  •  
39.
  • Eriksson, Frida, 1986, et al. (author)
  • Interpretative and predictive modelling of Joint European Torus collisionality scans
  • 2019
  • In: Plasma Physics and Controlled Fusion. - : Institute of Physics Publishing (IOPP). - 0741-3335 .- 1361-6587. ; 61:11
  • Journal article (peer-reviewed)abstract
    • Transport modelling of Joint European Torus (JET) dimensionless collisionality scaling experiments in various operational scenarios is presented. Interpretative simulations at a fixed radial position are combined with predictive JETTO simulations of temperatures and densities, using the TGLF transport model. The model includes electromagnetic effects and collisions as well as (E)over-right-arrow x (b)over-right-arrow shear in Miller geometry. Focus is on particle transport and the role of the neutral beam injection (NBI) particle source for the density peaking. The experimental 3-point collisionality scans include L-mode, and H-mode (D and H and higher beta D plasma) plasmas in a total of 12 discharges. Experimental results presented in (Tala et al 2017 44th EPS Conf.) indicate that for the H-mode scans, the NBI particle source plays an important role for the density peaking, whereas for the L-mode scan, the influence of the particle source is small. In general, both the interpretative and predictive transport simulations support the experimental conclusions on the role of the NBI particle source for the 12 JET discharges.
  •  
40.
  • Eriksson, Håkan, et al. (author)
  • A robust correlation receiver for distance estimation
  • 1994
  • In: IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control. - New York : Institute of Electrical and Electronics Engineers (IEEE). - 0885-3010 .- 1525-8955. ; 41:5, s. 596-603
  • Journal article (peer-reviewed)abstract
    • Many methods for distance estimation, such as the ultrasonic pulse-echo method, involve the estimation of a time-of-flight (TOF). In this paper, a signal model is developed that, apart from the TOF, accounts for an unknown, linear frequency dependent distortion as well as for additive noise. We derive a TOF estimator for this model based on the criteria of maximum likelihood. The resulting receiver can be seen as an extension or generalization of the well known cross-correlation, or "matched filter", estimator described, e.g., by Nilsson. The novel receiver is found to be more robust against unknown pulse shape distortion than the cross-correlation estimator, giving less biased TOF estimates. Also, bias versus noise sensitivity can be controlled by proper model order selection
  •  
41.
  • Eriksson, Håkan B., et al. (author)
  • A genie-aided detector with a probabilistic description of the side information
  • 1995
  • In: Proceedings. - Piscataway, NJ : IEEE Communications Society. - 0780324536 ; , s. 332-
  • Conference paper (peer-reviewed)abstract
    • Building on Forney's concept of the genie (1972), and introducing the idea of an explicit statistical description of the side information provided to the genie-aided detector, we develop a generic tool for derivation of lower bounds on the bit-error rate of any actual receiver. With this approach, the side information statistics become design parameters, which may be chosen to give the resulting bound a desired structure. To illustrate this, we choose statistics in order to obtain a special case: the lower bound derived by Mazo (1975). The statistical description of the side information makes the lower bounding a transparent application of Bayesian theory
  •  
42.
  • Eriksson, Håkan B., et al. (author)
  • Simultaneous time of flight and channel estimation using a stochastic channel model
  • 1993
  • In: Radiovetenskaplig konferens på Lunds tekniska högskola 5-7 april 1993. - Lund : Lunds tekniska högskola. ; , s. 43-46
  • Conference paper (peer-reviewed)abstract
    • In this paper we address the problem of estimating the Time-of-Flight of a transmitted signal when the shape of the received waveform is stochastic. Specifically, we examine the case when the transmission system model is stochastic, linear and time discrete, with additive Gaussian noise, and where the transmitted waveform is known to the receiver. The joint estimation is couched in terms of Maximum a Posteriori (MAP) and Maximum Likelihood estimation. When deriving the MAP estimator we assume a priori knowledge of the probability density of the transmission system impulse response. The MAP estimator is then compared to estimators derived using less a priori information and lower order system models. The ordinary correlation based Time-of-Flight estimator assumes knowledge of the received waveform, that is has a one-dimensional transmission system model. This investigation indicates that a more complex model structure is worthwhile when distortion in excess of low additive noise is present.
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43.
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44.
  • Eriksson, John, et al. (author)
  • Surgery and radiofrequency ablation for treatment of liver metastases from midgut and foregut carcinoids and endocrine pancreatic tumors
  • 2008
  • In: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 32:5, s. 930-938
  • Journal article (peer-reviewed)abstract
    • BACKGROUND:Many neuroendocrine tumors (NETs) have a tendency to metastasize to the liver. In case of limited number of metastases, liver surgery or radiofrequency ablation (RFA) may result in apparently total clearance of metastases. However, it is not clear whether such therapy will provide symptom reduction or increased survival.METHODS: Seventy-three patients with foregut (n=6) or midgut carcinoids (n=37) or endocrine pancreatic tumors (n=28), and two patients with NETs without discernable origin were studied. Symptoms were evaluated using a Symptom Severity Score. Liver surgery was performed in 42 operations and RFA on 205 lesions.RESULTS:Apparently total clearance of liver metastases was attained in 1 of 6 patients with foregut carcinoids, 15 of 37 with midgut carcinoids, and 13 of 28 with EPT. Symptom improvement was noted in 12 of 17 (70.6%) patients with carcinoid syndrome, and 75% also reduced their 5-HIAA and P-CgA by at least 50%. Patients with nonfunctioning EPT generally had no improvement of symptoms after surgical/RFA liver treatment, but eight patients had functioning EPT, and four of these reduced their biochemical markers by at least 50%. NETs with higher Ki67 index tended to recur more often. Complications occurred in 9 of 45 open surgery procedures, and in 8 of 203 RFA procedures.CONCLUSIONS:Treatment of liver metastases is successful in midgut carcinoid patients with limited liver metastases. Patients with foregut carcinoid and EPTs recur more often, possibly related to higher Ki67 index, and treatment of liver lesions less often reduces symptoms. Liver resections and RFA may be safely performed, and RFA is associated with few complications.
  •  
45.
  • Eriksson, Jan W., et al. (author)
  • Effects of dapagliflozin and n-3 carboxylic acids on non-alcoholic fatty liver disease in people with type 2 diabetes: a double-blind randomised placebo-controlled study
  • 2018
  • In: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 61:9, s. 1923-1934
  • Journal article (peer-reviewed)abstract
    • Aims/hypothesis The EFFECT-II study aimed to investigate the effects of dapagliflozin and omega-3 (n-3) carboxylic acids (OM-3CA). individually or combined, on liver fat content in individuals with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Methods This randomised placebo-controlled double-blind parallel-group study was performed at five clinical research centres at university hospitals in Sweden. 84 participants with type 2 diabetes and NAFLD were randomly assigned 1:1:1:1 to four treatments by a centralised randomisation system, and all participants as well as investigators and staff involved in the study conduct and analyses were blinded to treatments. Each group received oral doses of one of the following: 10 mg dapagliflozin (n = 21). 4 g OM3-CA (n = 20), a combination of both (n = 22) or placebo (n = 21). The primary endpoint was liver fat content assessed by MRI (proton density fat fraction [PDFF]) and, in addition, total liver volume and markers of glucose and lipid metabolism as well as of hepatocyte injury and oxidative stress were assessed at baseline and after 12 weeks of treatment (completion of the trial). Results Participants had a mean age of 65.5 years (SD 5.9), BMI 31.2 kg/m(2) (3.5) and liver PDFF 18% (9.3). All active treatments significantly reduced liver PDFF from baseline, relative changes: OM-3CA, -15%; dapagliflozin, -13%; OM-3CA + dapagliflozin, -21%. Only the combination treatment reduced liver PDFF (p = 0.046) and total liver fat volume (relative change, -24%,p = 0.037) in comparison with placebo. There was an interaction between the PNPLA31148M polymorphism and change in liver PDFF in the active treatment groups (p = 0.03). Dapagliflozin monotherapy, but not the combination with OM-3CA, reduced the levels of hepatocyte injury biomarkers, including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transfcrase (gamma-GT), cytokeratin (CK) 18-M30 and CK 18-M65 and plasma fibroblast growth factor 21 (FGF21). Changes in gamma-GT correlated with changes in liver PDFF (rho = 0.53, p = 0.02). Dapagliflozin alone and in combination with OM-3CA improved glucose control and reduced body weight and abdominal fat volumes. Fatty acid oxidative stress biomarkers were not affected by treatments. There were no new or unexpected adverse events compared with previous studies with these treatments. Conclusions/interpretation Combined treatment with dapagliflozin and OM-3CA significantly reduced liver fat content. Dapagliflozin monotherapy reduced all measured hepatocyte injury biomarkers and FGF21, suggesting a disease-modifying effect in NAFLD.
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46.
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47.
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48.
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49.
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50.
  • Eriksson, Per Erik, et al. (author)
  • How gaze time on screen impacts the efficacy of visual instructions
  • 2018
  • In: Heliyon. - : Elsevier BV. - 2405-8440. ; 4:6
  • Journal article (peer-reviewed)abstract
    • This article explores whether GTS (gaze time on screen) can be useful as an engagement measure in the screen mediated learning context. Research that exemplifies ways of measuring engagement in the on-line education context usually does not address engagement metrics and engagement evaluation methods that are unique to the diverse contemporary instructional media landscape. Nevertheless, unambiguous construct definitions of engagement and standardized engagement evaluation methods are needed to leverage instructional media's efficacy. By analyzing the results from a mixed methods eye-tracking study of fifty-seven participants evaluating their visual and assembly performance levels in relation to three visual, procedural instructions that are versions of the same procedural instruction, we found that the mean GTS-values in each group were rather similar. However, the original GTS-values outputted from the ET-computer were not entirely correct and needed to be manually checked and cross validated. Thus, GTS appears not to be a reliable, universally applicable automatic engagement measure in screen-based instructional efforts. Still, we could establish that the overall performance of learners was somewhat negatively impacted by lower than mean GTS-scores, when checking the performance levels of the entire group (N = 57). When checking the stimuli groups individually (N = 17, 20, 20), the structural diagram group's assembly time durations were positively influenced by higher than mean GTS-scores.
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