1. |
- Birse, Kenzie D., et al.
(författare)
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Genital Injury Signatures and Microbiome Alterations Associated With Depot Medroxyprogesterone Acetate Usage and Intravaginal Drying Practices
- 2017
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Ingår i: Journal of Infectious Diseases. - : Oxford University Press. - 0022-1899 .- 1537-6613. ; 215:4, s. 590-598
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Tidskriftsartikel (refereegranskat)abstract
- Background. Increasing evidence suggests depot medroxyprogesterone acetate (DMPA) and intravaginal practices may be associated with human immunodeficiency virus (HIV-1) infection risk; however, the mechanisms are not fully understood. This study evaluated the effect of DMPA and intravaginal practices on the genital proteome and microbiome to gain mechanistic insights. Methods. Cervicovaginal secretions from 86 Kenyan women, including self-reported DMPA users (n = 23), nonhormonal contraceptive users (n = 63), and women who practice vaginal drying (n = 46), were analyzed using tandem-mass spectrometry. Results. We identified 473 human and 486 bacterial proteins from 18 different genera. Depot medroxyprogesterone acetate use associated with increased hemoglobin and immune activation (HBD, HBB, IL36G), and decreased epithelial repair proteins (TFF3, F11R). Vaginal drying associated with increased hemoglobin and decreased phagocytosis factors (AZU1, MYH9, PLAUR). Injury signatures were exacerbated in DMPA users who also practiced vaginal drying. More diverse (H index: 0.71 vs 0.45; P =.009) bacterial communities containing Gardnerella vaginalis associated with vaginal drying, whereas DMPA showed no significant association with community composition or diversity. Conclusions. These findings provide new insights into the impact of DMPA and vaginal drying on mucosal barriers. Future investigations are needed to confirm their relationship with HIV risk in women.
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2. |
- Brown, Nils W. O., 1977-
(författare)
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Managing high environmental performance? : Applying life cycle approaches and environmental certification tools in the building and real estate sectors
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aim of this thesis is to demonstrate and critically assess life cycle approaches’ and environmental certification (EC) tools’ potential for supporting decisions for improved environmental performance in the building and real estate sectors.Using life cycle approaches, the thesis shows that for new build and renovation cases aiming for low operational energy use that embodied global warming potential (GWP) due to material production can constitute a large portion of a building’s lifetime GWP. Therefore life cycle based information about materials’ embodied GWP needs to be made available to and utilized by design process decision makers.It was also shown that applying the Swedish EC tool Miljöbyggnad was useful in highlighting potential positive and negative changes in indoor environmental quality arising from renovation packages aiming at significant operational energy use reduction in existing multifamily buildings. However such renovation packages are not profitable from a property owner perspective. Miljöbyggnad may be useful when designing policy instruments to overcome this. The thesis also showed that EC and related environmental enhancements contribute to achieving property owners’ and tenants’ overall strategic objectives for value creation. For property owners this arises for example through lower energy costs and attracting desirable tenants. For tenants, value creation arises as support for internal and external environmental communication.For the further development of life cycle approaches’ and EC tools’ application to buildings and real estate it is important to consider how they can be adapted to consider ‘distance to sustainable’ targets referencing for instance the planetary boundaries approach. It is also interesting to investigate how valuation of buildings and real estate may be performed in a way that expands from the current narrow focus on the economic perspective to also include environmental and social perspectives.
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3. |
- Häggmark, Anna, 1985-, et al.
(författare)
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A High-throughput Bead-based Affinity Assay Enables Analysis of Genital Protein Signatures in Women At Risk of HIV Infection
- 2019
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Ingår i: Molecular & Cellular Proteomics. - : AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC. - 1535-9476 .- 1535-9484. ; 18:3, s. 461-476
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Tidskriftsartikel (refereegranskat)abstract
- Women at high risk of HIV infection, including sex workers and those with active genital inflammation, have molecular signatures of immune activation and epithelial barrier remodeling in samples of their genital mucosa. These alterations in the local immunological milieu are likely to impact HIV susceptibility. We here analyze host genital protein signatures in HIV uninfected women, with high frequency of condom use, living in HIV-serodiscordant relationships. Cervicovaginal secretions from women living in HIV-serodiscordant relationships (n = 62) were collected at three time points over 12 months. Women living in HIV-negative seroconcordant relationships (controls, n = 25) were sampled at one time point. All study subjects were examined for demographic parameters associated with susceptibility to HIV infection. The cervicovaginal samples were analyzed using a high-throughput bead-based affinity assay. Proteins involved in epithelial barrier function and inflammation were increased in HIV-serodiscordant women. By combining several methods of analysis, a total of five proteins (CAPG, KLK10, SPRR3, elafin/PI3, CSTB) were consistently associated with this study group. Proteins analyzed using the affinity set-up were further validated by label-free tandem mass spectrometry in a partially overlapping cohort with concordant results. Women living in HIV-serodiscordant relationships thus had elevated levels of proteins involved in epithelial barrier function and inflammation despite low prevalence of sexually transmitted infections and a high frequency of safe sex practices. The identified proteins are important markers to follow during assessment of mucosal HIV susceptibility factors and a high-throughput bead-based affinity set-up could be a suitable method for such evaluation.
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4. |
- Keefer, Laurie, et al.
(författare)
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Centrally Mediated Disorders of Gastrointestinal Pain.
- 2016
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Ingår i: Gastroenterology. - : Elsevier BV. - 1528-0012 .- 0016-5085. ; 150:6, s. 1408-1419
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Tidskriftsartikel (refereegranskat)abstract
- Centrally Mediated Abdominal Pain Syndrome (CAPS), formerly known as Functional Abdominal Pain Syndrome, can be distinguished from other functional GI disorders by its strong central component and relative independence from motility disturbances. CAPS is a result of central sensitization with disinhibition of pain signals rather than increased peripheral afferent excitability. A newly described condition, Narcotic Bowel Syndrome (NBS)/Opioid-Induced GI Hyperalgesia, is characterized by the paradoxical development of or increases in abdominal pain associated with continuous or increasing dosages of opioids. Patients only have relief when opioids are withdrawn. We define both conditions in the context of epidemiology, pathophysiology, clinical evaluation and treatment, emphasizing the importance of a physician-patient relationship in all aspects of care.
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5. |
- Mulligan, Joseph, et al.
(författare)
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An ‘engineer-client’ framework for community participation in infrastructure development projects
- 2011
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Ingår i: Proceedings of the Institution of Civil Engineers. - : Thomas Telford Ltd.. - 1478-4637 .- 1751-7664 .- 1478-4629 .- 1751-7680.
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Tidskriftsartikel (refereegranskat)abstract
- The importance of community participation in projects in the developing and developed world is widely recognised, despite considerable debate regarding what participation means in practice. In the developing world context, there is a distinct debate on how participation can achieve its stated goals of creating ‘ownership’ among targeted beneficiaries without becoming susceptible to elite capture or excluding marginalised groups. Projects that involve engineering analysis present a further challenge: to incorporate external technical expertise in decision-making so that project outcomes are improved, without compromising the participative process. The paper sets out a practical framework that reconciles the critical importance of early, meaningful community involvement in decision-making with the active role of the engineer as a technical adviser and facilitator. It is targeted for application in community-scale infrastructure development projects, where the community is the primary targeted beneficiary. The framework draws a parallel with a traditional engineer–client relationship, in which the client's (in this case the community's) needs and preferences drive the design process and in which final design approval rests with the client, but where the engineer plays an active role in helping to understand and interpret the client's needs and develops engineering responses through an iterative, responsive design process.
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