1. |
- Grubb, Anders, et al.
(författare)
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Generation of a new cystatin C-based estimating equation for glomerular filtration rate by use of 7 assays standardized to the international calibrator
- 2014
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 60:7, s. 974-986
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Many different cystatin C-based equations exist for estimating glomerular filtration rate. Major reasons for this are the previous lack of an international cystatin C calibrator and the nonequivalence of results from different cystatin C assays.METHODS:Use of the recently introduced certified reference material, ERM-DA471/IFCC, and further work to achieve high agreement and equivalence of 7 commercially available cystatin C assays allowed a substantial decrease of the CV of the assays, as defined by their performance in an external quality assessment for clinical laboratory investigations. By use of 2 of these assays and a population of 4690 subjects, with large subpopulations of children and Asian and Caucasian adults, with their GFR determined by either renal or plasma inulin clearance or plasma iohexol clearance, we attempted to produce a virtually assay-independent simple cystatin C-based equation for estimation of GFR.RESULTS:We developed a simple cystatin C-based equation for estimation of GFR comprising only 2 variables, cystatin C concentration and age. No terms for race and sex are required for optimal diagnostic performance. The equation, [Formula: see text] is also biologically oriented, with 1 term for the theoretical renal clearance of small molecules and 1 constant for extrarenal clearance of cystatin C.CONCLUSIONS:A virtually assay-independent simple cystatin C-based and biologically oriented equation for estimation of GFR, without terms for sex and race, was produced.
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2. |
- Gertow, Karl, et al.
(författare)
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Identification of the BCAR1-CFDP1-TMEM170A Locus as a Determinant of Carotid Intima-Media Thickness and Coronary Artery Disease Risk
- 2012
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Ingår i: Circulation: Cardiovascular Genetics. - 1942-325X .- 1942-3268. ; 5:6, s. 656-665
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Tidskriftsartikel (refereegranskat)abstract
- Background-Carotid intima-media thickness (cIMT) is a widely accepted marker of subclinical atherosclerosis. To date, large-scale investigations of genetic determinants of cIMT are sparse. Methods and Results-To identify cIMT-associated genes and genetic variants, a discovery analysis using the Illumina 200K CardioMetabochip was conducted in 3430 subjects with detailed ultrasonographic determinations of cIMT from the IMPROVE (Carotid Intima Media Thickness [IMT] and IMT-Progression as Predictors of Vascular Events in a High Risk European Population) study. Segment-specific IMT measurements of common carotid, bifurcation, and internal carotid arteries, and composite IMT variables considering the whole carotid tree (IMTmean, IMTmax, and IMTmean-max), were analyzed. A replication stage investigating 42 single-nucleotide polymorphisms for association with common carotid IMT was undertaken in 5 independent European cohorts (total n=11 590). A locus on chromosome 16 (lead single-nucleotide polymorphism rs4888378, intronic in CFDP1) was associated with cIMT at significance levels passing multiple testing correction at both stages (array-wide significant discovery P=6.75x10(-7) for IMTmax; replication P=7.24x10(-6) for common cIMT; adjustments for sex, age, and population substructure where applicable; minor allele frequency 0.43 and 0.41, respectively). The protective minor allele was associated with lower carotid plaque score in a replication cohort (P=0.04, n=2120) and lower coronary artery disease risk in 2 case-control studies of subjects with European ancestry (odds ratio [95% confidence interval] 0.83 [0.77-0.90], P=6.53x10(-6), n=13 591; and 0.95 [0.92-0.98], P=1.83x10(-4), n= 82 297, respectively). Queries of human biobank data sets revealed associations of rs4888378 with nearby gene expression in vascular tissues (n=126-138). Conclusions-This study identified rs4888378 in the BCAR1-CFDP1-TMEM170A locus as a novel genetic determinant of cIMT and coronary artery disease risk in individuals of European descent. (Circ Cardiovasc Genet. 2012;5:656-665.)
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3. |
- Sundström, Johan, Professor, 1971-, et al.
(författare)
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Risk factors for subarachnoid haemorrhage : a nationwide cohort of 950 000 adults
- 2019
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Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 48:6, s. 2018-2025
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Tidskriftsartikel (refereegranskat)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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4. |
- Zamora, Juan Carlos, et al.
(författare)
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Considerations and consequences of allowing DNA sequence data as types of fungal taxa
- 2018
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Ingår i: IMA Fungus. - : INT MYCOLOGICAL ASSOC. - 2210-6340 .- 2210-6359. ; 9:1, s. 167-185
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Tidskriftsartikel (refereegranskat)abstract
- Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.
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5. |
- Beecham, Ashley H, et al.
(författare)
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Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis.
- 2013
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Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 45:11, s. 1353-60
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Tidskriftsartikel (refereegranskat)abstract
- Using the ImmunoChip custom genotyping array, we analyzed 14,498 subjects with multiple sclerosis and 24,091 healthy controls for 161,311 autosomal variants and identified 135 potentially associated regions (P < 1.0 × 10(-4)). In a replication phase, we combined these data with previous genome-wide association study (GWAS) data from an independent 14,802 subjects with multiple sclerosis and 26,703 healthy controls. In these 80,094 individuals of European ancestry, we identified 48 new susceptibility variants (P < 5.0 × 10(-8)), 3 of which we found after conditioning on previously identified variants. Thus, there are now 110 established multiple sclerosis risk variants at 103 discrete loci outside of the major histocompatibility complex. With high-resolution Bayesian fine mapping, we identified five regions where one variant accounted for more than 50% of the posterior probability of association. This study enhances the catalog of multiple sclerosis risk variants and illustrates the value of fine mapping in the resolution of GWAS signals.
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6. |
- Brikell, Isabell, et al.
(författare)
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Relative Immaturity in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms From Childhood to Early Adulthood : Exploring Genetic and Environmental Overlap Across Development
- 2016
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier. - 0890-8567 .- 1527-5418. ; 55:10, s. 886-895
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Attention-deficit/hyperactivity disorder (ADHD) has been linked to immaturity relative to peers in childhood, yet it is unclear how such immaturity is associated with ADHD across development. This longitudinal twin study examined the genetic and environmental contributions to the association between parents' perception of their child's immaturity relative to peers (RI) in childhood and ADHD symptoms across development.Method: 1,302 twin pairs from the Swedish Twin Study of Child and Adolescent Development were followed prospectively from childhood to early adulthood. Parent ratings of RI were collected at 8 to 9 years and parent and self-ratings of ADHD symptoms were collected at 8 to 9, 13 to 14, 16 to 17, and 19 to 20 years using the Child Behavior Checklist Attention Problems scale. In addition, ADHD symptoms corresponding to DSM criteria were used for sensitivity analysis. Analyses were conducted using longitudinal structural equation modeling with multiple raters.Results: RI-related etiologic factors, predominantly influenced by genes, explained 10-14% of the variance in ADHD symptoms from 8 to 9 up to 16 to 17 years. The influence of these RI-related factors on ADHD symptoms attenuated to 4% by 19 to 20 years of age. The remaining variance in ADHD symptoms was primarily explained by genetic factors independent of RI, which remained relatively stable across development, explaining 19% to 30% of the variance in ADHD symptoms from 13 to 14 up to 19 to 20 years.Conclusion: The results show that RI is significantly associated with ADHD symptoms, particularly during childhood and adolescence, and that the association is primarily explained by a shared genetic liability. Nevertheless, the magnitude of associations across development was modest, highlighting that RI is merely one aspect contributing to the complex etiology of ADHD symptoms.
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7. |
- Caraballo, Remi, et al.
(författare)
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Structure-activity relationships for lipoprotein lipase agonists that lower plasma triglycerides in vivo
- 2015
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Ingår i: European Journal of Medicinal Chemistry. - : Elsevier. - 0223-5234 .- 1768-3254. ; 103, s. 191-209
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Tidskriftsartikel (refereegranskat)abstract
- The risk of cardiovascular events increases in individuals with elevated plasma triglyceride (TG) levels, therefore advocating the need for efficient TG-lowering drugs. In the blood circulation, TG levels are regulated by lipoprotein lipase (LPL), an unstable enzyme that is only active as a non-covalently associated homodimer. We recently reported on a N-phenylphthalimide derivative (1) that stabilizes LPL in vitro, and moderately lowers triglycerides in vivo (Biochem. Biophys. Res. Common. 2014, 450, 1063). Herein, we establish structure activity relationships of 51 N-phenylphthalimide analogs of the screening hit 1. In vitro evaluation highlighted that modifications on the phthalimide moiety were not tolerated and that lipophilic substituents on the central phenyl ring were functionally essential. The substitution pattern on the central phenyl ring also proved important to stabilize LPL However, in vitro testing demonstrated rapid degradation of the phthalimide fragment in plasma which was addressed by replacing the phthalimide scaffold with other heterocyclic fragments. The in vitro potency was retained or improved and substance 80 proved stable in plasma and efficiently lowered plasma TGs in vivo. 2015 The Authors. Published by Elsevier Masson SAS.
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8. |
- Fahnestock, Jesse, 1974-, et al.
(författare)
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RISEnergy: Roadmaps for energy innovation in Sweden through 2030
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- RISE Research Institutes of Sweden is a group of research and technology organisations. RISE is a leading innovation partner working global cooperation with academia, enterprise and society to create value, growth and competitiveness through research excellence and innovation.In the area of Energy, RISE has developed innovation Roadmaps covering:Energy Efficient TransportElectric Power SystemEnergy Efficient and Smart BuildingsSustainable Thermal ProcessesEfficient Energy Use in IndustryDecarbonisation of Basic IndustriesThese Roadmaps describe development pathways for technologies, non-technical elements (market design, user behaviours, policies, etc.) and key actors that deliver on a plausible, desirable vision for each respective innovation area in 2030. These Roadmaps are intended to support RISE’s strategic planning and development, but should be relevant reading for anyone interested in energy innovation in Sweden.
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9. |
- Forsman, Anders, et al.
(författare)
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Pike Esox lucius as an emerging model organism for studies in ecology and evolutionary biology: a review.
- 2015
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Ingår i: Journal of Fish Biology. - : Wiley. - 0022-1112 .- 1095-8649. ; 87:2, s. 472-479
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Forskningsöversikt (refereegranskat)abstract
- The pikeEsox luciusis a large, long-lived, iteroparous, top- predator fish species with a circumpolardistribution that occupies a broad range of aquatic environments. This study reports on a literaturesearch and demonstrates that the publication rate ofE. luciusresearch increases both in absolute termsand relative to total scientific output, and that the focus of investigation has changed over time frombeing dominated by studies on physiology and disease to being gradually replaced by studies on ecol-ogy and evolution.Esox luciuscan be exploited as a model in future research for identifying causes andconsequences of phenotypic and genetic variation at the levels of individuals, populations and speciesas well as for investigating community processes.
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10. |
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11. |
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12. |
- Glimelius, Bengt, et al.
(författare)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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13. |
- Högberg, Niclas, 1979-, et al.
(författare)
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Intestinal intraluminal glycerol and plasma I-FABP levels in preterm infants with necrotizing enterocolitis
- 2016
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Ingår i: Clinics in Surgery. ; 1:1085, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Background/Purpose: Necrotizing enterocolitis (NEC) is highly associated with prematurity and is characterized by bowel necrosis and multi-organ failure. There is a strong need for improved diagnostic methods to reduce the significant morbidity and mortality associated with NEC. The aim of this single centre prospective study was to investigate the possibility to detect early signs of NEC, by using rectal intraluminal microdialysis and plasma intestinal fatty acid binding protein (I-FABP) in preterm infants admitted to a level III neonatal intensive care unit.Methods: The study was performed on extremely preterm infants with a gestational age of less than 28 weeks. During a 4-week period after birth, rectal intraluminal microdialysate levels of glucose, lactate, pyruvate and glycerol were measured, and plasma was collected for I-FABP analysis. Infants not developing NEC served as controls. Results: Microdialysis revealed signs of intestinal hypoxic or ischemic damage and cell membrane degradation, with a marked increase of both intraluminal glycerol and plasma I-FABP in infants developing NEC, as well as in infants suffering from other complications. The microdialysate levels of glucose, lactate and pyruvate were too low to be evaluated in this setting. All infants tolerated the microdialysis well without any complications.Conclusion: Elevated levels of intraluminal glycerol and plasma I-FABP suggests mucosal cell membrane degradation and hypoxic or ischemic damage in preterm infants developing NEC, as well as in preterm infants suffering from other complications such as volvulus, sepsis or respiratory distress. However, it was not possible to predict development of NEC before clinical diagnosis using these markers.
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14. |
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15. |
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16. |
- Karlsson, Stefan, et al.
(författare)
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Möjligheter för multifunktionella fönster i flerbostadshus : Teknik, visualisering och prototyper
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den här förstudien fokuserade på visualisering och prototyptillverkning av dynamiskt fönster och luftrengörande fönster. Detta är viktigt för spridning av kunskap om nya smarta fönster, dels för företag som har intresse för ny teknologi men även för spridning av information till allmänheten. Resultatet av förstudien är en VR-visualisering av Chromogenics dynamiska fönster Converlight® samt en prototyp för luftrengörande fönster. Det senare är ett nytt koncept för smarta fönster där luftreningen drivs av solljus och som även kan kombineras med ett termokromt skikt som ger ett dynamiskt fönster som styrs av temperatur. Med dynamiskt fönster menas att det kan variera i ljusgenomsläpplighet och därmed även energitillförsel till byggnader och det kan användas för att skapa ett bättre inomhusklimat. Rengöringen av inomhusluften är ytterligare en del i att skapa ett bättre inomhusklimat. VR-visualiseringen och prototypen för luftrengörande fönster är viktiga för att skapa en förståelse för innebörden av teknologin och på så vis inducera en snabbare kommersialisering av teknologierna. Projektet är ett exempel på en god samverkan mellan två VINNVÄXT initiativ, Smart Housing Småland och Visual Sweden, där man nyttjat varandras nyckelkompetenser på ett kompletterande sätt.
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17. |
- Larsson, Magnus, 1983-
(författare)
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National environmental evaluation systems : guiding towards sustainability?
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Dealing with environmental threats is one of the largest, if not the largest, challenge contemporary societies face. One way to better deal with this challenge would be to produce knowledge that can be used to improve environmental work and environmental policy and thus ultimately contribute to sustainable development. National environmental evaluations, which this thesis explores, could potentially fill this function because they are supposed to generate applicable and useful knowledge for improving environmental policy and practice for a sustainable transition. However, what different environmental actors view as useful knowledge varies, and needs to be empirically investigated. Against this background, the aim of this thesis is to investigate whether, and how, national environmental evaluation systems contribute to key actors’ environmental work and sustainable development. The thesis explores two national environmental evaluation systems in Sweden.Method: A mixed methods approach is applied that combines three methods. Firstly, a narrative synthesis is developed and applied to compile a list of sustainable development effects from national environmental evaluations. Secondly, a critical program theory is used to investigate the evaluation system’s underlying logic and to assess the likelihood of it achieving its intended effects. Thirdly, a directed content analysis is used to explore the usability and use of environmental evaluations and evaluation systems. The methods are applied to various documents, interviews with key actors, and observations at two environmental seminars.Results: The results show that, to contribute to sustainable development in the context of evaluation systems and network governance, environmental evaluations need to be of sufficient quality and meet different stakeholders’ knowledge needs. However, only some evaluations meet this demand. The main value of national environmental evaluations and evaluation systems is that they reinforce the national objectives, provide a recurrent report on achievement of objectives, and push actors to take responsibility to improve their environmental work.
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18. |
- Larsson, Per, et al.
(författare)
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Ecology, evolution, and management strategies of northern pike populations in the Baltic Sea
- 2015
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Ingår i: Ambio. - : Springer Nature. - 0044-7447 .- 1654-7209. ; 44:S3, s. 451-461
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Forskningsöversikt (refereegranskat)abstract
- Baltic Sea populations of the northern pike (Esox lucius) have declined since the 1990s, and they face additional challenges due to ongoing climate change. Pike in the Baltic Sea spawn either in coastal bays or in freshwater streams and wetlands. Pike recruited in freshwater have been found to make up about 50 % of coastal pike stocks and to show natal homing, thus limiting gene flow among closely located spawning sites. Due to natal homing, sub-populations appear to be locally adapted to their freshwater recruitment environments. Management actions should therefore not involve mixing of individuals originating from different sub-populations. We offer two suggestions complying with this advice: (i) productivity of extant freshwater spawning populations can be boosted by modifying wetlands such that they promote spawning and recruitment; and (ii) new sub-populations that spawn in brackish water can potentially be created by transferring fry and imprinting them on seemingly suitable spawning environments.
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19. |
- Nordahl, Oscar, et al.
(författare)
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Genetic differentiation between and within ecotypes of pike (Esox lucius) in the Baltic Sea
- 2019
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Ingår i: Aquatic conservation. - : John Wiley & Sons. - 1052-7613 .- 1099-0755. ; 29:11, s. 1923-1935
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Tidskriftsartikel (refereegranskat)abstract
- Aquatic systems often lack physical boundaries for gene flow, but ecological and behavioural barriers can form surprisingly fine spatial scale genetic patterns that challenge traditional, large scale management. To detect fine spatial scale structures, understand sources of intraspecific diversity, and design appropriate management plans requires identification of reproductively isolated units. This study reports on genetic differentiation in pike (Esox lucius) within a coastal area stretching 55 km from south to north in the central Baltic Sea. Pike is here an economically and ecologically important top predator that has declined in abundance. However, population structures have mostly been studied on large spatial scales, and without considering the potential for genetic divergence between the sympatric anadromous fresh water and the resident brackish water spawning ecotypes. To this end, 487 individuals from the east coast of Sweden and the island of oland, representing sympatric anadromous and resident spawning individuals, categorized to ecotype based on spawning location or otolith microchemistry, were genotyped for 10 microsatellites and used to test for divergence between ecotypes. Furthermore, divergence between regions (island/mainland), neighbouring spawning locations (n = 13) and isolation by distance within and between regions were evaluated for the anadromous ecotype. The results revealed strong genetic differences between regions, between spawning locations separated by as little as 5 km and the first evidence of genetic differentiation between resident and anadromous ecotypes; despite a high dispersal capacity of pike and a high connectivity within the study area. The signatures of isolation by distance indicated that connectivity among populations differed between regions, probably reflecting availability of spawning habitats. To safeguard against the challenges and uncertainties associated with environmental change, adaptive conservation management should aim to promote high intra-population functional genetic diversity without compromising the continued integrity and coexistence of the different ecotypes and of locally adapted sub-populations.
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20. |
- Nordahl, Oscar, et al.
(författare)
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Sun-basking fish benefit from body temperatures that are higher than ambient water
- 2018
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Ingår i: Proceedings of the Royal Society of London. Biological Sciences. - London : The Royal Society. - 0962-8452 .- 1471-2954. ; 285:1879
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Tidskriftsartikel (refereegranskat)abstract
- In terrestrial environments, cold-blooded animals can attain higher bodytemperatures by sun basking, and thereby potentially benefit from broaderniches, improved performance and higher fitness. The higher heat capacityand thermal conductivity of water compared with air have been universallyassumed to render heat gain from sun basking impossible for aquaticectotherms, such that their opportunities to behaviourally regulate body temperatureare largely limited to choosing warmer or colder habitats. Here wechallenge this paradigm. Using physical modelswe first showthat submergedobjects exposed to natural sunlight attain temperatures in excess of ambientwater. We next demonstrate that free-ranging carp (Cyprinus carpio) canincrease their body temperature during aquatic sun basking close to thesurface. The temperature excess gained by basking was larger in dark thanin pale individuals, increased with behavioural boldness, and was associatedwith faster growth. Overall, our results establish aquatic sun basking as a novelecologically significant mechanism for thermoregulation in fish. The discoveryof this previously overlooked process has practical implications for aquaculture,offers alternative explanations for behavioural and phenotypicadaptations, will spur future research in fish ecology, and calls for modificationsof models concerning climate change impacts on biodiversity inmarine and freshwater environments.
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21. |
- Nylander, Ruta, et al.
(författare)
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Relation between cardiovascular disease risk markers and brain infarcts detected by magnetic resonance imaging in an elderly population
- 2015
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Ingår i: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1052-3057 .- 1532-8511. ; 24:2, s. 312-318
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Established cardiovascular risk markers, such as hypertension, are associated with increased risk of brain infarcts. The newer markers N-terminal pro-brain natriuretic peptide, troponin I, C-reactive protein, and cystatin C may affect the risk of cardiovascular events and potentially, thereby, also stroke. We investigated the association between established and new risk markers for cardiovascular disease and brain infarcts detected by magnetic resonance imaging (MRI) at age 75.METHODS: Four hundred six randomly selected subjects from the Prospective Investigation of the Vasculature in Uppsala Seniors study were examined with MRI of the brain at age 75. Blood samples, measurements, and dedicated questionnaires at age 70 were used for analysis of risk markers. A history of diseases had been obtained at age 70 and 75. MRI was evaluated regarding lacunar and cortical infarcts. Univariate associations between outcomes and risk markers were assessed with logistic regression models.RESULTS: One or more infarcts were seen in 23% of the subjects (20% had only lacunar infarcts, 1% had only cortical infarcts, and 2% had both). Hypertension (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.4, 4.7) and obesity (OR 1.3; CI 1.0, 1.8) were significantly associated with increased risk of brain infarction. The newer risk markers were not significantly associated with the brain infarcts.CONCLUSIONS: The new markers were not associated with the predominantly lacunar infarcts in our 75-year-old population, why troponin I and NT-proBNP may be associated mainly with cardioembolic infarcts as shown recently.
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22. |
- Rydenfält, Christofer, et al.
(författare)
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An action-oriented method for interprofessional organization development at a hospital operating unit
- 2017
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Ingår i: Action Research. - : SAGE Publications. - 1476-7503 .- 1741-2617. ; 15:2, s. 177-197
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Tidskriftsartikel (refereegranskat)abstract
- The complexity of modern interdisciplinary health care practices, where different specialties work together to solve complex problems, challenges traditional approaches to organizational development and quality improvement. An example of this is surgery. This article describes and evaluates an action-oriented method to facilitate organizational development and innovation at an operating unit, centered on interprofessional aspects of health care, a method that shares some features with action learning. At its core the method had a group with members from all specialties in an operating team, who participated in regular meetings facilitated by a process leader, according to experiential learning principles. The group was evaluated using mixed methods (including interaction process analysis (IPA)), of which video recorded group meetings and interviews constituted the main sources of data. Results showed that the group achieved a successful organizational change. Indications of the success of the group process were the low level of conflicts and the high level of task focus. Interprofessional boundaries appeared to be bridged as all members participated in formulation of both problems and solutions while not being afraid to voice different opinions. Problems could be attributed to lack of awareness of the group at the operating unit at which the intervention took place.
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23. |
- Rydenfält, Christofer, et al.
(författare)
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Compliance with the WHO Surgical Safety Checklist: deviations and possible improvements.
- 2013
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1464-3677 .- 1353-4505. ; 25:2, s. 182-187
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: /st>Previous research suggests that the World Health Organization Surgical Safety Checklist time-out reduces communication failures and medical complications and supports development of better safety attitudes. Previous research also indicates that different values can affect the implementation of interventions. OBJECTIVE: /st>To investigate the actual usage of the checklist in practice and to catalogue deviations for the purpose of identifying improvements. DESIGN: /st>Twenty-four surgical procedures were video recorded. The time-out was analysed quantitatively assessing compliance with a predefined observational protocol based on the checklist and qualitatively to describe reasons for non-compliance. SETTING: /st>The operating unit of a Swedish county hospital. MAIN OUTCOME MEASURES: /st>Compliance with checklist items and the participation of different personnel groups. Activities were conducted during the time-out. RESULTS: /st>Highest compliance was associated with patient ID, type of procedure and antibiotics; the worst with site of incision, theatre nurse team reviews and imaging information. Team member introductions occurred in half of the operations. Surgeons and the anaesthesia team dominated the time-out. CONCLUSION: /st>The checklist is not always applied as intended. The components that facilitate communication are often neglected. The time-out does not appear to be conducted as a team effort. It is plausible that the personnel's conception of risk and the perceived importance of different checklist items are factors that influence checklist usage. To improve compliance and involve the whole team, the concept of risk and the perceived relevance of checklist items for all team members should be addressed.
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