| 1. |
- Höskuldsdóttir, Gudrun, et al.
(author)
-
Design and baseline data in the BAriatic surgery SUbstitution and Nutrition study (BASUN): a 10-year prospective cohort study
- 2020
-
In: BMC Endocrine Disorders. - : Springer Science and Business Media LLC. - 1472-6823. ; 20:1
-
Journal article (peer-reviewed)abstract
- Background There is still a lack of knowledge on long-term effects of surgical and non-surgical weight-lowering treatments. BASUN is a prospective study with 10 years of follow-up that will observe the effects and consequences of surgical and medical treatment of obesity. The aims are to cover areas where data on long-term outcomes are lacking, e.g., nutritional deficiencies, substance abuse, psychiatric health, as well as patient-reported outcomes. Methods BASUN is a cohort study that recruited study persons with obesity (BMI >= 35 kg/m(2)) referred to the Regional Obesity Centre of Region Vastra Gotaland. The interventions were Roux-en-Y gastric bypass (RYGB) or Sleeve gastrectomy (SG), or 12 months of structured, multi-professional medical treatment (MT), including very low energy diet, followed by diet and pharmaceutical treatment. The study is not randomized, but based on patients preferences and multidisciplinary assessments. The study persons are examined at baseline, 2, 5, and 10 years with blood tests, measurements and questionnaires. The recruitment period lasted from May 2015 to November 2017. Results One thousand one hundred twenty-seven patients were included (74% female). Three hundred eighty-two patients were accepted for medical treatment, 589 for surgical treatment (388 RYGB and 201 SG) and 156 patients left the study without treatment, leaving a final study population of 971 patients. There were slight differences between the treatment groups with regards to age and BMI. Pharmaceutical treatments, level of education, smoking and marital status were not significantly different between the groups. Conclusion This study will follow 971 obese subjects in clinical practice treated with the best surgical or medical methods currently available. It has the potential to evaluate outcomes usually not reported in short-term studies, and to assist in identifying factors that are of importance for the choices of treatment. The main limitations are non-randomization and differences in baseline characteristics. The large number of participants and the length of the prospective follow-up are major strengths of the study. BASUN is designed to identify both early and late benefits and adverse events of treatment of obesity.
|
|
| 2. |
- Lundtoft, Christian, et al.
(author)
-
Complement C4 Copy Number Variation is Linked to SSA/Ro and SSB/La Autoantibodies in Systemic Inflammatory Autoimmune Diseases
- 2022
-
In: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 74:8, s. 1440-1450
-
Journal article (peer-reviewed)abstract
- Objective Copy number variation of the C4 complement components, C4A and C4B, has been associated with systemic inflammatory autoimmune diseases. This study was undertaken to investigate whether C4 copy number variation is connected to the autoimmune repertoire in systemic lupus erythematosus (SLE), primary Sjogrens syndrome (SS), or myositis. Methods Using targeted DNA sequencing, we determined the copy number and genetic variants of C4 in 2,290 well-characterized Scandinavian patients with SLE, primary SS, or myositis and 1,251 healthy controls. Results A prominent relationship was observed between C4A copy number and the presence of SSA/SSB autoantibodies, which was shared between the 3 diseases. The strongest association was detected in patients with autoantibodies against both SSA and SSB and 0 C4A copies when compared to healthy controls (odds ratio [OR] 18.0 [95% confidence interval (95% CI) 10.2-33.3]), whereas a weaker association was seen in patients without SSA/SSB autoantibodies (OR 3.1 [95% CI 1.7-5.5]). The copy number of C4 correlated positively with C4 plasma levels. Further, a common loss-of-function variant in C4A leading to reduced plasma C4 was more prevalent in SLE patients with a low copy number of C4A. Functionally, we showed that absence of C4A reduced the individuals capacity to deposit C4b on immune complexes. Conclusion We show that a low C4A copy number is more strongly associated with the autoantibody repertoire than with the clinically defined disease entities. These findings may have implications for understanding the etiopathogenetic mechanisms of systemic inflammatory autoimmune diseases and for patient stratification when taking the genetic profile into account.
|
|
| 3. |
- Siegbahn, Agneta, 1947-, et al.
(author)
-
Development and validation of a quantitative Proximity Extension Assay instrument with 21 proteins associated with cardiovascular risk (CVD-21)
- 2023
-
In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:11
-
Journal article (peer-reviewed)abstract
- Background Treatment of cardiovascular diseases (CVD) is a substantial burden to healthcare systems worldwide. New tools are needed to improve precision of treatment by optimizing the balance between efficacy, safety, and cost. We developed a high-throughput multi-marker decision support instrument which simultaneously quantifies proteins associated with CVD. Methods and findings Candidate proteins independently associated with different clinical outcomes were selected from clinical studies by the screening of 368 circulating biomarkers. We then custom-designed a quantitative PEA-panel with 21 proteins (CVD-21) by including recombinant antigens as calibrator samples for normalization and absolute quantification of the proteins. The utility of the CVD-21 tool was evaluated in plasma samples from a case-control cohort of 4224 patients with chronic coronary syndrome (CCS) using multivariable Cox regression analyses and machine learning techniques. The assays in the CVD-21 tool gave good precision and high sensitivity with lower level of determination (LOD) between 0.03-0.7 pg/ml for five of the biomarkers. The dynamic range for the assays was sufficient to accurately quantify the biomarkers in the validation study except for troponin I, which in the modeling was replaced by high-sensitive cardiac troponin T (hs-TnT). We created seven different multimarker models, including a reference model with NT-proBNP, hs-TnT, GDF-15, IL-6, and cystatin C and one model with only clinical variables, for the comparison of the discriminative value of the CVD-21 tool. All models with biomarkers including hs-TnT provided similar discrimination for all outcomes, e.g. c-index between 0.68-0.86 and outperformed models using only clinical variables. Most important prognostic biomarkers were MMP-12, U-PAR, REN, VEGF-D, FGF-23, TFF3, ADM, and SCF. Conclusions The CVD-21 tool is the very first instrument which with PEA simultaneously quantifies 21 proteins with associations to different CVD. Novel pathophysiologic and prognostic information beyond that of established biomarkers were identified by a number of proteins.
|
|
| 4. |
- Sköldberg, Håkan, et al.
(author)
-
BIO-CCS I FJÄRRVÄRMESEKTORN – SYNTES
- 2022
-
Reports (other academic/artistic)abstract
- Den svenska fjärrvärmesektorn har stor potential att bidra med negativa koldioxidutsläpp genom bio-CCS, minst 10 Mton per år. Den största osäkerheten beträffande möjligheterna för bio-CCS gäller marknads förutsättningarna. Uppvärmningsbranschen har en vision om att år 2045 utgöra en kolsänka. Ett sätt att åstadkomma detta är genom att avskilja och lagra koldioxidutsläpp med biogent ursprung. Ett antal fjärrvärmeföretag har redan olika långt gångna planer på att satsa på bio-CCS. De har sett ett värde i att samarbeta kring hur detta kan åstadkommas. Ett led i detta är projektet Bio-CCS i fjärrvärmesektorn som består av ett gediget underlag baserat på forskning kring olika aspekter av frågan samt en strategi baserad på det underlaget. I denna rapport redovisas en syntes av detta forskningsarbete. Projektet visar att fjärrvärmesektorn har stor teoretisk potential att bidra med negativa koldioxidutsläpp, minst 10 Mton per år. I huvudsak är avskiljning, transport och lagring av koldioxid beprövad teknik även om tillämpningen i detta fall är ny. Även om bio-CCS är förknippad med energianvändning så bidrar tekniken sett ur ett systemperspektiv med stor nytta för att minska koldioxid[1]utsläppen. Bio-CCS är en relativt dyr teknik och det är angeläget att utnyttja samverkan och kluster för att exempelvis skapa ökad kostnadseffektivitet i transport och mellanlagring. Tillgång till lagringsplatser är en förutsättning för framgång och flera alternativ bedöms bli tillgängliga. Det kan dock uppstå konkurrens om tillgången till lagringsplatserna. De regelmässiga förutsättningarna för bio-CCS i Sverige har förbättrats avsevärt de senaste dryga decenniet. Flera regelmässiga hinder kvarstår dock. En del utgör mindre barriärer, andra är av mer betydande karaktär. Den största osäkerheten beträffande möjligheterna för bio-CCS gäller ekonomin. Flera potentiella finansieringsmetoder har studerats, både stöd, regleringar och frivilligmarknader. Det finns fortfarande oklarheter kring syftet med planerade stöd och det framtida ägandet av de negativa utsläppen. Det genomförda projektet har skapat ett forum för kunskapsuppbyggnad, erfarenhetsutbyte och nätverkande, vilket de deltagande företagen bedömt vara mycket värdefullt.
|
|
| 5. |
- Stathakarou, N., et al.
(author)
-
Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them?
- 2021
-
In: Health Informatics Journal. - : SAGE Publications. - 1460-4582 .- 1741-2811. ; 27:4
-
Journal article (peer-reviewed)abstract
- Surgical training in civilian hospitals may not be sufficient for managing complex trauma in a setting where such care is not commonly practiced. Understanding the challenges that civilian teams face when moving to austere environments can inform the competencies that need to be trained. The aim of this study was to explore the competencies required in austere environments for teams managing complex trauma, and how they can be trained with simulation technologies. Ethnographic field observations were conducted, and field notes were synthesized. The field notes were structured with the elements of Activity Theory to generate the teams' competencies that need to be trained. A literature review was conducted to verify the results and identify examples of relevant simulation modalities. The analysis resulted in a structured list of competencies for civilian teams to manage complex trauma in an austere environment and recommendations which simulation technologies could be used in training of those competencies based on published studies. Our study contributes to understanding the challenges that civilian teams face when operating in an austere environment. A systematized list of competencies with suggested simulation technologies directs future research to improve quality of complex trauma training in civilian and military collaboration.
|
|
