| 1. |
- Engström, Gunnar, et al.
(författare)
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Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
- 2024
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Ingår i: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
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Tidskriftsartikel (refereegranskat)abstract
- Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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| 2. |
- Larsson, Glenn, et al.
(författare)
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Pediatric trauma patients in Swedish ambulance services : a retrospective observational study of assessments, interventions, and clinical outcomes
- 2024
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - 1757-7241. ; 32:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPediatric trauma patients constitute a significant portion of the trauma population treated by Swedish Emergency Medical Services (EMS), and trauma remains a notable cause of death among Swedish children. Previous research has identified potential challenges in prehospital assessments and interventions for pediatric patients. In Sweden, there is limited information available regarding pediatric trauma patients in the EMS. The aim of this study was to investigate the prevalence of pediatric trauma patients within the Swedish EMS and describe the prehospital assessments, interventions, and clinical outcomes.MethodsThis retrospective observational study was conducted in a region of Southwestern Sweden. A random sample from ambulance and hospital records from the year 2019 was selected. Inclusion criteria were children aged 0–16 years who were involved in trauma and assessed by EMS clinicians.ResultsA total of 440 children were included in the study, representing 8.4% of the overall trauma cases. The median age was 9 years (IQR 3–12), and 60.5% were male. The leading causes of injury were low (34.8%) and high energy falls (21%), followed by traffic accidents. The children were assessed as severely injured in 4.5% of cases. A quarter of the children remained at the scene after assessment. Complete vital signs were assessed in 29.3% of children, and 81.8% of children were assessed according to the ABCDE structure. The most common intervention performed by prehospital professionals was the administration of medication. The mortality rate was 0.2%.ConclusionsPediatric trauma cases accounted for 8.4% of the overall trauma population with a variations in injury mechanisms and types. Vital sign assessments were incomplete for a significant proportion of children. The adherence to the ABCDE structure, however, was higher. The children remained at the scene after assessment requires further investigation for patient safety.
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| 3. |
- Larsson, Marcus, 1979-, et al.
(författare)
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Curvature based Antenna Selection Method Evaluated Using the Data Age Metric and V2V Measurements
- 2015
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Ingår i: 2015 IEEE International Conference on Communication Workshop (ICCW). - Piscataway, NJ : IEEE Press. - 9781467363051 ; , s. 2356-2362
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Konferensbidrag (refereegranskat)abstract
- In this paper, we compare a method for selecting transmission antenna based on road curvature to a method based on periodically alternating between left and right hand side transmission antennas. Both methods aim to improve the success rate for communication between participants in a platoon of vehicles. Moreover, we propose the data age metric for online use as input to the algorithm controlling the inter-vehicle distance in platooning, e.g. to decide appropriate gap between the vehicles depending on the V2V communication quality. The methods have been evaluated through V2V communication measurements performed using heavy duty vehicles on public highway. We show that, when using the curvature-based method, a 150 ms data age deadline is only missed approximately half as often compared to when periodically alternating between left and right hand side transmission antennas. The methods have also been compared for different antenna combinations. © 2015 IEEE
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| 4. |
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| 5. |
- Malmgren, Linnea, et al.
(författare)
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The complexity of kidney disease and diagnosing it - Cystatin C, selective glomerular hypofiltration syndromes and proteome regulation.
- 2023
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Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 0954-6820 .- 1365-2796. ; 293:3, s. 293-308
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Tidskriftsartikel (refereegranskat)abstract
- Estimation of kidney function is often part of daily clinical practice, mostly done by using the endogenous GFR-markers creatinine or cystatin C. A recommendation to use both markers in parallel in 2010 has resulted in new knowledge concerning the pathophysiology of kidney disorders by identification of a new set of kidney disorders, selective glomerular hypofiltration syndromes. These syndromes, connected to strong increases in mortality and morbidity, are characterised by a selective reduction in the glomerular filtration of 5-30 kDa molecules, such as cystatin C, compared to the filtration of small molecules < 1kDa dominating the glomerular filtrate e.g., water, urea, creatinine. At least two types of such disorders, shrunken or elongated pore syndrome, are possible according to the pore model for glomerular filtration. Selective glomerular hypofiltration syndromes are prevalent in investigated populations, and patients with these syndromes often display normal measured GFR or creatinine-based GFR-estimates. The syndromes are characterised by proteomic changes promoting the development of atherosclerosis, indicating antibodies and specific receptor-blocking substances as possible new treatment modalities. Presently, the KDIGO guidelines for diagnosing kidney disorders do not recommend cystatin C as a general marker of kidney function and will therefore not allow the identification of a considerable number of patients with selective glomerular hypofiltration syndromes. Furthermore, as cystatin C is uninfluenced by muscle mass, diet or variations in tubular secretion and cystatin C-based GFR-estimation equations do not require controversial race or sex terms, it is obvious that cystatin C should be a part of future KDIGO guidelines.
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| 6. |
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| 7. |
- Andersson, J., et al.
(författare)
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Worse survival for TP53 (p53)-mutated breast cancer patients receiving adjuvant CMF
- 2005
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Ingår i: Ann Oncol. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 16:5, s. 743-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: TP53 has been described as a prognostic factor in many malignancies, including breast cancer. Whether it also might be a predictive factor with reference to chemo- and endocrine therapy is more controversial. PATIENTS AND METHODS: We investigated relapse-free (RFS), breast cancer-corrected (BCCS) and overall survival (OS) related to TP53 status in node-positive breast cancer patients that had received polychemotherapy [cyclophosphamide, methotrexate, 5-fluorouracil (CMF)] and/or endocrine therapy (tamoxifen). Sequence analyses of the whole TP53 coding region was performed in 376 patients operated on for primary breast cancer with axillary lymph node metastases between 1984 and 1989 (median follow-up time 84 months). RESULTS: TP53 mutations were found in 105 patients (28%). We found 90 (82%) of the 110 mutations in the more frequently analysed exons 5-8, while the other 20 (18%) were located in exons 3-4 and 9-10, respectively. Univariate analyses showed TP53 to be a significant prognostic factor with regard to RFS, BCCS and OS in patients who received adjuvant CMF. CONCLUSIONS: TP53 mutations might induce resistance to certain modalities of breast cancer therapy. Sequence-determined TP53 mutation was of negative prognostic value in the total patient population and in the CMF treated patients.
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| 8. |
- Andersson, Petra, et al.
(författare)
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Lion Fire: Extinguishment and mitigation of fires in Li-ion batteries at sea
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The shipping industry is facing increasing pressure to cut emissions. Diesel-electric hybrid or fully electrical propulsion systems can offer significant savings in fuel consumption and reduce emissions. However, the use of energy storage battery systems on board vessels is introducing new fire hazards and advice on suitable fire extinguishing systems and agents is desired. In a series of tests, both total compartment application water spray and water mist systems and direct injection (using several different agents) into the module were evaluated in fire tests conducted to compare different fire extinguishing approaches for a fire in a battery cell. A test compartment was constructed to simulate a battery room and a commercially available lithium-ion (Li-ion) battery cell was positioned inside a cubic box that mimicked a battery module. By heating the battery cell, combustible gases were generated, and these gases were ignited by a pilot flame inside the simulated battery module. The tests indicated that fire extinguishment of a battery cell fire inside a battery module is unlikely when using total compartment water spray or water mist fire protection systems. The water droplets are simply not able to penetrate the battery module and reach to the seat of the fire. Direct injection of the fire extinguishing agent inside the battery module is necessary. The tests also showed that agents such as water and low-expansion foam, with a high heat capacity, provide rapid cooling and fire extinguishment. The reduced water surface tension associated with low-expansion foam may improve the possibilities for water penetration whilst agents with a high viscosity may not be able to spread to the seat of the fire. Agents with less heat capacity, such as high-expansion foam and nitrogen gas, provide less cooling but fire extinguishment can still be achieved if designed correctly.
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| 9. |
- Anton, Nicholas, et al.
(författare)
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AXIAL TURBINE DESIGN FOR A TWIN-TURBINE HEAVY-DUTY TURBOCHARGER CONCEPT
- 2018
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Ingår i: PROCEEDINGS OF THE ASME TURBO EXPO. - : ASME Press. - 9780791851005
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Konferensbidrag (refereegranskat)abstract
- In the process of evaluating a parallel twin-turbine pulse-turbocharged concept, the results considering the turbine operation clearly pointed towards an axial type of turbine. The radial turbine design first analyzed was seen to suffer from sub-optimum values of flow coefficient, stage loading and blade speed-ratio. Modifying the radial turbine by both assessing the influence of "trim" and inlet tip diameter all concluded that this type of turbine is limited for the concept. Mainly, the turbine stage was experiencing high values of flow coefficient, requiring a more high flowing type of turbine. Therefore, an axial turbine stage could be feasible as this type of turbine can handle significantly higher flow rates very efficiently. Also, the design spectrum is broader as the shape of the turbine blades is not restricted by a radially fibred geometry as in the radial turbine case. In this paper, a single stage axial turbine design is presented. As most turbocharger concepts for automotive and heavy-duty applications are dominated by radial turbines, the axial turbine is an interesting option to be evaluated for pulse charged concepts. Values of crank-angle-resolved turbine and flow parameters from engine simulations are used as input to the design and subsequent analysis. The data provides a valuable insight into the fluctuating turbine operating conditions and is a necessity for matching a pulse-turbocharged system. Starting on a 1D-basis, the design process is followed through, resulting in a fully defined 3D-geometry. The 3D-design is evaluated both with respect to FEA and CFD as to confirm high performance and durability. Turbine maps were used as input to the engine simulation in order to assess this design with respect to "on-engine" conditions and to engine performance. The axial design shows clear advantages with regards to turbine parameters, efficiency and tip speed levels compared to a reference radial design. Improvement in turbine efficiency enhanced the engine performance significantly. The study concludes that the proposed single stage axial turbine stage design is viable for a pulse-turbocharged six cylinder heavy-duty engine. Taking into account both turbine performance and durability aspects, validation in engine simulations, a highly efficient engine with a practical and realizable turbocharger concept resulted.
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| 10. |
- Anton, Nicholas, et al.
(författare)
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ON THE CHOICE OF TURBINE TYPE FOR A TWIN-TURBINE HEAVY-DUTY TURBOCHARGER CONCEPT
- 2018
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Ingår i: PROCEEDINGS OF THE ASME TURBO EXPO. - : AMER SOC MECHANICAL ENGINEERS. ; 8
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Konferensbidrag (refereegranskat)abstract
- In this study, a fundamental approach to the choice of turbocharger turbine for a pulse-charged heavy-duty diesel engine is presented. A standard six-cylinder engine build with a production exhaust manifold and a Twin-scroll turbocharger is used as a baseline case. The engine exhaust configuration is redesigned and evaluated in engine simulations for a pulse-charged concept consisting of a parallel twin-turbine layout. This concept will allow for pulse separation with minimized exhaust pulse interference and low exhaust manifold volume. This turbocharger concept is uncommon, as most previous studies have considered two stage systems, various multiple entry turbine stages etc. Even more rare is the fundamental aspect regarding the choice of turbine type as most manufacturers tend to focus on radial turbines, which by far dominate the turbochargers of automotive and heavy-duty applications. By characterizing the turbine operation with regards to turbine parameters for optimum performance found in literature a better understanding of the limitations of turbine types can be achieved. A compact and low volume exhaust manifold design is constructed for the turbocharger concept and the reference radial turbine map is scaled in engine simulations to a pre-set AFR-target at a low engine RPM. By obtaining crank-angle-resolved data from engine simulations, key turbine parameters are studied with regard to the engine exhaust pulse-train. At the energetic exhaust pressure pulse peak, the reference radial turbine is seen to operate with suboptimum values of Blade-Speed-Ratio, Stage Loading and Flow Coefficient. The study concludes that in order to achieve high turbine efficiency for this pulse-charged turbocharger concept, a turbine with efficiency optimum towards low Blade-Speed Ratios, high Stage Loading and high Flow Coefficient is required. An axial turbine of low degree of reaction-design could be viable in this respect.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Garnier-Laplace, Jacqueline, et al.
(författare)
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Assessing ecological effects of radionuclides : data gaps and extrapolation issues
- 2004
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Ingår i: Journal of Radiological Protection. - 0952-4746 .- 1361-6498. ; 24:4A, s. A139-A155
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Tidskriftsartikel (refereegranskat)abstract
- By inspection of the FASSET database on radiation effects on non-human biota, one of the major difficulties in the implementation of ecological risk assessments for radioactive pollutants is found to be the lack of data for chronic low-level exposure. A critical review is provided of a number of extrapolation issues that arise in undertaking an ecological risk assessment: acute versus chronic exposure regime; radiation quality including relative biological effectiveness and radiation weighting factors; biological effects from an individual to a population level, including radiosensitivity and lifestyle variations throughout the life cycle; single radionuclide versus multi-contaminants. The specificities of the environmental situations of interest (mainly chronic low-level exposure regimes) emphasise the importance of reproductive parameters governing the demography of the population within a given ecosystem and, as a consequence, the structure and functioning of that ecosystem. As an operational conclusion to keep in mind for any site-specific risk assessment, the present state-of-the-art on extrapolation issues allows us to grade the magnitude of the uncertainties as follows: one species to another > acute to chronic = external to internal = mixture of stressors > individual to population > ecosystem structure to function.
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| 15. |
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| 16. |
- Herlitz, Johan, 1949-, et al.
(författare)
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Över 100 doktorsavhandlingar inom den prehospitala akutsjukvården i Sverige
- 2023
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Ingår i: Läkartidningen. - : Läkartidningen Förlag AB. - 1652-7518. ; 120
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Forskningsöversikt (refereegranskat)abstract
- HUVUDBUDSKAPÖver 100 avhandlingar har i dagsläget skrivits om den prehospitala akutsjukvården i Sverige.Dessa täcker ett omfattande kunskapsfält, allt ifrån prognostiska faktorer vid akut sjukdom till ambulans personalens psykiska och fysiska hälsa.Endast ett kunskapsområde har belysts mera om fattande, och det är hjärt–lungräddning vid plötsligt hjärtstopp.Vården av patienter med psykisk ohälsa har inte belysts i någon avhandling.Det finns stora kunskapsluckor, och vidare forskning inom området behövs.
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| 17. |
- Hoang, Hoai, et al.
(författare)
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Deadline first scheduling in switched real-time Ethernet - deadline partitioning issues and software implementation experiments
- 2002
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Ingår i: Euromicro RTS 2002. - Los Alamitos, Calif. : IEEE Computer Society. - 0769516653 - 9780769516653 - 076951667X - 9780769516677 ; , s. 68-71
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Konferensbidrag (refereegranskat)abstract
- This paper presents work on a switched Ethernet network extended to allow for earliest deadline first (EDF) scheduling. We show by example that asymmetric deadline partitioning between the links of a real-time channel can increase the utilization substantially, still not violating the real-time guarantees. We also report measurements on a software implementation of the switch on an ordinary PC.
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| 18. |
- Jansson, Carl Magnus, et al.
(författare)
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Theoretical Calculations of Kinetic Isotope Effects for a Series of Aziridines
- 2004
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Ingår i: Fundamental World of Quantum Chemistry. - Dordrecht : Kluwer Academic Publishers. - 9781402025839 - 9789048166879
-
Bokkapitel (refereegranskat)abstract
- The nitrogen inversion in aziridine and som parent substituted aziridines is investigated using various computational methods. The stationary points on each potential energy surface are optimized using the B3LYP functional of density functional theory (DFT) in conjuction with the popular 6-31G(d) basis set. Rate constants and thereby kinetic isotope effects (KIEs) are computed at different temperatures using transiton state theory (TST) and various techniques of variational transition state theory (VTST). Moreover, corrections are made for tunneling and non-classical reflection, using three semiclassic correction methods: the Wigner tunneling correction as well as the zero-curvature and the samll-curvature corrections. The performance of the various methods to compute KIEs are compared and the effects of tunneling are discussed.
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| 19. |
- Knutsson, Sven, et al.
(författare)
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Snö på lutande tak : en typ av laviner
- 2007
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Ingår i: Bygg och Teknik. - 0281-658X .- 2002-8350. ; 99:4, s. 49-54
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 20. |
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Larsson, Carl, et al.
(författare)
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Overvoltage Mitigation of Medium Voltage Electric Drives with Long Cables using Multilevel-Converters and Passive Filters
- 2019
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Ingår i: 2019 21st European Conference on Power Electronics and Applications, EPE 2019 ECCE Europe.
-
Konferensbidrag (refereegranskat)abstract
- Variable-speed drives with long cables between the electrical machine and the power converters suffer from overvoltages at the connection terminals of the cables. These overvoltages which are caused by reflections of the PWM voltage pulses to the two ends of the cable are investigated in this paper. Suitable passive filters are proposed in order to mitigate the overvoltages to an acceptable level, which is not harmful for the devices of the system. Additionally, the use of multilevel power converters can help to minimize the size of the passive filters. The filter design for drives with up to 7-level converters is described in this paper and simulations results on LTspice are presented in order to validate the mathematical analysis.
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| 25. |
- Larsson, Glenn, et al.
(författare)
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Characteristics of a trauma population in an ambulance organisation in Sweden: results from an observational study
- 2023
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - 1757-7241. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundGlobally, injuries are a major health problem, and in Sweden, injuries are the second most common reason for ambulance dispatch. However, there is a knowledge gap regarding the epidemiology of injuries requiring assessment by emergency medical services (EMS) in Sweden. The aim of the present study was to describe the prehospital population with injuries that have been assessed and treated by EMS.MethodsA randomly selected retrospective sample was collected from 1 January through 31 December 2019 in a region in southwestern Sweden. Data were collected from ambulance and hospital medical records.ResultsAmong 153,724 primary assignments, 26,697 (17.4%) were caused by injuries. The study cohort consisted of 5,235 patients, of whom 50.5% were men, and the median age was 63 years. The most common cause of injury was low-energy fall (51.4%), and this was the cause in 77.8% of those aged > 63 years and in 26.7% of those aged & LE; 63 years. The injury mechanism was a motor vehicle in 8.0%, a motorcycle in 2.1% and a bicycle in 4.0%. The most common trauma location was the residential area (55.5% overall; 77.9% in the elderly and 34.0% in the younger group). In the prehospital setting, the most frequent clinical sign was a wound (33.2%), a closed fracture were seen in 18.9% and an open fracture in 1.0%. Pain was reported in 74.9% and 42.9% reported severe pain. Medication was given to 42.4% of patients before arrival in the hospital. The most frequent triage colour according to the RETTS was orange (46.7%), whereas only 4.4% were triaged red. Among all patients, 83.6% were transported to the hospital, and 27.8% received fracture treatment after hospital admission. The overall 30-day mortality rate was 3.4%.ConclusionAmong EMS assignments in southwestern Sweden, 17% were caused by injury equally distributed between women and men. More than half of these cases were caused by low-energy falls, and the most common trauma location was a residential area. The majority of the victims had pain upon arrival of the EMS, and a large proportion appeared to have severe pain.
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| 26. |
- Larsson, Glenn, et al.
(författare)
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Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study
- 2024
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Ingår i: BMC Emergency Medicine. - 1471-227X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThere is a lack of knowledge regarding the epidemiology of severe trauma assessed by Swedish emergency medical services (EMS).AimTo investigate the prevalence of trauma in Sweden assessed by EMS from a national perspective and describe patient demography, aetiology, trauma type, prehospital triage and clinical outcomes.MethodsData from two national quality registries, the Swedish Ambulance Registry and the Swedish Trauma Registry (SweTrau) were collected from January 1 to December 31, 2019. Inclusion criteria were an Emergency Symptoms and Signs code equivalent to trauma in the Swedish Ambulance Registry and criteria fulfilled for SweTrau inclusion. Exclusion criteria were patients < 18 years old, those not transported to a hospital and those without a personal identification number.ResultsIn total, 53,120 patients with trauma were included (14% of primary EMS missions involving a personal identification number). Of those, 2,278 (4.3%) patients (median age: 45 years; 32% women) were reported in SweTrau to have severe or potentially severe trauma (penetrating: 7%, blunt: 93%). In terms of including all causes of trauma, the code for ‘trauma alert activation’ was most frequent (55%). The most frequent injury mechanism was an injury caused by a car (34%). Most (89%) cases were assigned Priority 1 (life-threatening condition) at the dispatch centre. 62% were regarded as potentially life threatening upon EMS arrival, whereas 29% were assessed as non-life-threatening. Overall, 25% of the patients had new injury severity scores > 15. 12% required invasive treatment, 11% were discharged with severe disability and the 30-day mortality rate was 3.6%.ConclusionIn this cross-sectional study, 14% of the primary EMS missions for one year were caused by trauma. However, only a small proportion of these cases are severe injuries, and the risk of severe disabilities and death appears to be limited. The most frequent aetiology of a severe trauma is injury caused by a car, and most severe traumas are blunt. Severe traumas are given the highest priority at the dispatch centre in the vast majority of cases, but nearly one-third of these cases are considered a low priority by the EMS nurse. The latter leaves room for improvement.
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| 27. |
- Larsson, Kristina, et al.
(författare)
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CD4+ T-cells have a key instructive role in educating dendritic cells in allergy
- 2009
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Ingår i: International Archives of Allergy and Immunology. - : S. Karger AG. - 1423-0097 .- 1018-2438. ; 149:1, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dendritic cells (DCs) are central in allergy as regulators of the Th1/Th2 balance. We have recently demonstrated a unique transcriptional profile of DCs in patients with ongoing allergy compared with healthy subjects and shown that crosstalk between DCs and memory T cells affects the transcriptional profile of T cells. However, the transcriptional profile of DCs educated by T cells in allergy is unknown. Methods: In the present study, we have examined the transcriptional profiles of DCs after stimulation with grass pollen allergens, Phleum pratense and coculture with autologous CD4+ memory T cells using high-density microarray. Protein analysis was performed using flow cytometry and recombinant antibody protein microarrays. Patients with allergic rhinitis and healthy subjects were compared. Results: The results reveal a distinct T-cell-induced DC profile in atopic individuals. Accordingly, about 170 genes were upregulated and 40 genes downregulated. For example, the chemokine receptor CXCR4 and the tumor necrosis factor receptor CD30 were upregulated in DCs derived from atopic donors, and this could also be verified at the protein level. Conclusion: We conclude that crosstalk between CD4+ memory T cells and autologous DCs induces transcriptional reprogramming in DCs. This finding suggests that T cells have a key instructive role in educating DCs in Th2-type responses.
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| 28. |
- Lindstedt, Malin, et al.
(författare)
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Genomic and functional delineation of dendritic cells and memory T cells derived from grass pollen-allergic patients and healthy individuals.
- 2005
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Ingår i: International Immunology. - : Oxford University Press (OUP). - 1460-2377 .- 0953-8178. ; 17:4, s. 401-409
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Tidskriftsartikel (refereegranskat)abstract
- Dendritic cells (DCIs) possess a potent ability to modulate and activate specific T-cell responses to allergens, which play a pivotal role in allergic inflammation by secreting cytokines and other mediators. However, the molecular mechanisms by which allergen-challenged DCs regulate specific T-cell responses are still not well characterized. This study aims at elucidating the molecular mechanisms underlying the DC–T-cell interaction during an allergic immune response to grass pollen, using a genomic and functional approach. Transcriptional analysis was performed on grass allergen Phleum pratense-stimulated DCs and on autologous memory CD4+ T cells co-cultured with allergen-challenged DCs from healthy and allergic donors. DCs from the allergic donors were potent inducers of T-cell proliferation and Th2 polarization, as demonstrated by high IL-4, IL-5 and IL-13, and low IFN- production. A gradual up-regulation of activation markers on both DCs and T cells was evident during the co-culture period, demonstrating an educational element of the DC–T-cell interaction. The global transcriptional analysis revealed a differential gene regulation in DCs and T cells derived from allergic donors after stimulation with allergen, as compared with the healthy donors. Peripheral memory CD4+ T cells from healthy and allergic donors also responded differently after stimulation with allergen-loaded DCs with respect to cytokine production, proliferation, surface marker expression and gene transcription. We found up-regulated genes involved in Th2 cell biology, such as genes important for homing, adhesion, signaling and transcription, in addition to genes previously not described in the context of allergy. The panel of differentially expressed genes in the allergic group will form the basis for an increased understanding of the molecular mechanisms in allergy.
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| 29. |
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| 30. |
- Magnusson, Carl, 1976, et al.
(författare)
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Suboptimal prehospital decision- making for referral to alternative levels of care - frequency, measurement, acceptance rate and room for improvement
- 2022
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Ingår i: Bmc Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The emergency medical services (EMS) have undergone dramatic changes during the past few decades. Increased utilisation, changes in care-seeking behaviour and competence among EMS clinicians have given rise to a shift in EMS strategies in many countries. From transport to the emergency department to at the scene deciding on the most appropriate level of care and mode of transport. Among the non-conveyed patients some may suffer from "time-sensitive conditions" delaying diagnosis and treatment. Thus, four questions arise: How often are time-sensitive cases referred to primary care or self-care advice? How can we measure and define the level of inappropriate clinical decision-making? What is acceptable? How to increase patient safety? Main text To what extent time-sensitive cases are non-conveyed varies. About 5-25% of referred patients visit the emergency department within 72 hours, 5% are hospitalised, 1-3% are reported to have a time-sensitive condition and seven-day mortality rates range from 0.3 to 6%. The level of inappropriate clinical decision-making can be measured using surrogate measures such as emergency department attendances, hospitalisation and short-term mortality. These measures do not reveal time-sensitive conditions. Defining a scoring system may be one alternative, where misclassifications of time-sensitive cases are rated based on how severely they affected patient outcome. In terms of what is acceptable there is no general agreement. Although a zero-vision approach does not seem to be realistic unless under-triage is split into different levels of severity with zero-vision in the most severe categories. There are several ways to reduce the risk of misclassifications. Implementation of support systems for decision-making using machine learning to improve the initial assessment is one approach. Using a trigger tool to identify adverse events is another. Conclusion A substantial number of patients are non-conveyed, including a small portion with time-sensitive conditions. This poses a threat to patient safety. No general agreement on how to define and measure the extent of such EMS referrals and no agreement of what is acceptable exists, but we conclude an overall zero-vision is not realistic. Developing specific tools supporting decision making regarding EMS referral may be one way to reduce misclassification rates.
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| 31. |
- Mellner, Carl, et al.
(författare)
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Increased risk for postoperative periprosthetic fracture in hip fracture patients with the Exeter stem than the anatomic SP2 Lubinus stem
- 2021
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Ingår i: European Journal of Trauma and Emergency Surgery. - : Springer. - 1863-9933 .- 1863-9941. ; 47, s. 803-809
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The purpose of this study was to compare the cumulative incidence of postoperative periprosthetic fracture (PPF) in a cohort of femoral neck fracture (FNF) patients treated with two commonly used cemented stems: either a collarless, polished, tapered Exeter stem or the anatomic Lubinus SP2 stem.METHODS: In this retrospective multicenter cohort study of a consecutive series of patients, we included 2528 patients of age 60 years and above with an FNF who were treated with either hemiarthroplasty or total hip arthroplasty using either a polished tapered Exeter stem or an anatomic Lubinus SP2 stem. The incidence of PPF was assessed at a minimum of 2 years postoperatively.RESULTS: The incidence of PPF was assessed at a median follow-up of 47 months postoperatively. Thirty nine patients (1.5%) sustained a PPF at a median of 27 months (range 0-96 months) postoperatively. Two of the operatively treated fractures were Vancouver A (5%), 7 were Vancouver B1 (18%), 10 were Vancouver B2 (26%), 7 were Vancouver B3 (18%), and 13 were Vancouver C (32%). The cumulative incidence of PPF was 2.3% in the Exeter group compared with 0.7% in the SP2 group (p < 0.001). The HR was 5.4 (95% CI 2.4-12.5, p < 0.001), using the SP2 group as the denominator.CONCLUSIONS: The Exeter stem was associated with a higher risk for PPF than the Lubinus SP2 stem. We suggest that the tapered Exeter stem should be used with caution in the treatment of FNF.TRIAL REGISTRATION: The study was registered at clinicaltrials.gov (identifier: NCT03326271).
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- Pelliccione, Patrizio, 1975, et al.
(författare)
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Architecting cars as constituents of a system of systems
- 2016
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Ingår i: ACM International Conference Proceeding Series. - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450363990 ; , s. 1-7
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Konferensbidrag (refereegranskat)abstract
- Future transportation systems will be a heterogeneous mix of items with varying connectivity and interoperability. A mix of new technologies and legacy systems will co-exist to realize a variety of scenarios involving not only connected cars but also road infrastructures, pedestrians, cyclists, etc. Future transportation systems can be seen as a System of Systems (SoS), where each constituent system - one of the units that compose an SoS - can act as a standalone system, but the cooperation among the constituent systems enables new emerging and promising scenarios. In this paper we investigate how to architect cars so that they can be constituents of future transportation systems. This work is realized in the context of two Swedish projects coordinated by Volvo Cars and involving some universities and research centers in Sweden and many suppliers of the OEM, including Autoliv, Arccore, Combitech, Cybercom, Knowit, Prevas, ÅF-Technology, Semcom, and Qamcom.
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