| 1. |
- Ahlgren, Erik, 1962, et al.
(författare)
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Biokombi Rya - slutrapporter från ingående delprojekt
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Inom projektet Biokombi Rya har ett flertal olika forskargrupper samarbetat för att studera system¬effekterna av förgasning av biobränsle ur olika aspekter. Syftet med projektet är att öka kunskapen om biobränsleförgasning i Sverige samt att utreda förutsättningar för att sådana anläggningar ska vara ekonomiskt och miljömässigt intressanta. En referensgrupp har varit kopplad till projektet där förutsättningar, resultat och slutsatser har behandlats.I denna underlagsrapport har slutrapporterna från projektets delprojekt samlats. De beskriver förutsättningar, metodansatser, använda data och resultat utförligt och utgör på så sätt ett viktigt komplement till den mer övergripande beskrivningen i projektets syntesrapport. De delrapporter som ingår har valts för att täcka in samtliga delar av projektet som är av allmänt intresse. Projektresultat som publicerats på annat sätt berörs dock mer kortfattat.Projektet Biokombi Rya har pågått under två år (2005-2006) och drivits av Chalmers EnergiCentrum. Förutom de omfattande analysinsatser som författarna till denna rapport står för, har Avdelningen för kemisk teknologi vid KTH, Siemens Industrial Turbines AB och Göteborg Energi AB bidragit med expertstöd. CIT Industriell Energianalys, med undertecknad som projektledare, har stått för projektledning och koordination.Projektet har finansierats av Energimyndigheten, Göteborg Energis forsknings¬stiftelse samt Göteborg Energi AB.
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| 2. |
- Beal, Jacob, et al.
(författare)
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Robust estimation of bacterial cell count from optical density
- 2020
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Ingår i: Communications Biology. - : Springer Science and Business Media LLC. - 2399-3642. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data.
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| 3. |
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| 4. |
- Nyström, Ingrid, 1965, et al.
(författare)
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Biokombi Rya - Biobränsleförgasning satt i system
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Inom projekt Biokombi Rya har ett flertal olika forskargrupper gemensamt studerat systemeffekterna av att introducera förgasning av biobränsle i Göteborgs fjärrvärmesystem, i Västsverige som region och ur ett mer generellt och långsiktigt systemperspektiv. Syftet med projektet är att öka kunskapen inför eventuell framtida utbyggnad av biobränsleförgasning i Sverige samt att utreda vilka förutsättningar som är nödvändiga för att sådana anläggningar ska bli ekonomiskt och miljömässigt intressanta inom en relativt kort tidsrymd (ca 10 år). Fokus ligger på integration av anläggningar för förgasning av biobränsle med befintliga kraftvärmeverk med kombicykel samt med fjärrvärme. Projektet vänder sig till beslutsfattare inom området på nationell, regional och lokal nivå.Övergripande systemanalys inom projektet har särskilt fokuserat på biobränslemarknaden och framtida prisbildning för biobränsle samt på den långsiktiga konkurrenskraften för biodrivmedel via förgasning. Projektet i övrigt utgår från en tillämpad fallstudie av delvis konvertering av Rya Kraftvärmeverk (Rya KVV) i Göteborg till förgasat biobränsle, vilket alltså innebär integration mellan förgasningsanläggning och ett naturgaseldat gaskombikraftvärmeverk knutet till ett fjärrvärmesystem. I denna del ingår även en konceptuell studie över olika tekniska processalternativ för produktion av värme, el och drivmedel, inklusive ett mer långsiktigt alternativ för vätgasproduktion. Inom projektet används gemensamma scenarier för energimarknaderna ca år 2020.Några av projektets viktigaste slutsatser är:• Förgasning av biobränsle kan bli intressant för både el- och drivmedelsproduktion och bidra till reducerade CO2-utsläpp, förutsatt att nivån på priset på biobränsle inte är alltför hög relativt fossilbränslepriserna. I de flesta fall är också riktade styrmedel för att premiera förnybar el- och/eller drivmedelsproduktion (t ex certifikat) en förutsättning. Vid gynnsamma förutsättningar för både ”grön” el- och drivmedelsproduktion kan en konkurrenssituation om biobränsle uppstå.• Den långsiktiga konkurrenskraften för biodrivmedel från förgasning är i hög grad beroende av teknik- och kostnadsutveckling inom både transportsektorn och andra sektorer, t ex för lagring av el och väte, bränsleceller och uthållig CO2-fri elproduktion. Tillgängligheten för insamling och lagring av CO2 från fossila anläggningar ökar konkurrenskraften betydligt, men denna effekt neutraliseras om CO2 samlas in även från biobaserade anläggningar. Vilken typ av biodrivmedel som får bäst konkurrenskraft beror till stor del på distributions- och fordonskostnader.• Göteborgs fjärrvärmesystem, med en stor andel spillvärme, och Rya Kraftvärmeverk, med relativt andra kombicykler låg elverkningsgrad, har egentligen inte de optimala förutsättningarna för att förgasning av biobränsle ska vara ekonomiskt intressant.• I flera fall kan det trots detta vara ekonomiskt intressant att bygga en anläggning för förgasning av biobränsle i Göteborg. Av de förgasningsbaserade alternativ som studerats, visar sig produktion av syntetisk naturgas från flis för användning som fordonsbränsle var den ekonomiskt mest robusta lösningen, förutsatt att det finns riktade styrmedel för ”grön” drivmedelsproduktion, t ex drivmedelscertifikat. Ombyggnad av Rya Kraftvärmeverk till delvis biobränslebaserad kraftvärme via förgasning är även detta ekonomiskt intressant i flera fall. Kraftvärme baserad på biobränsleförgasning med högre elverkningsgrad än vad som är möjligt i Rya Kraftvärmeverk skulle dock kunna vara än mer intressant.• För att en förgasningsanläggning ska vara ekonomiskt intressant är det viktigt att uppnå så hög el- respektive drivmedelsverkningsgrad som möjligt samt att anläggningen får längsta möjliga drifttid. För drivmedelsproduktion finns det betydande fördelar med att kunna utnyttja värmeöverskottet från anläggningen i ett fjärrvärmesystem eller liknande.• För fjärrvärmesystemen i regionen som helhet finns det, enligt modellresultaten och för de scenarier som använts, starka drivkrafter att öka elproduktionen i kraftvärmeverk. Med gynnsamma förutsättningar för biobränslebaserad elproduktion har konventionell biobränslebaserad kraftvärme bäst ekonomi. Med drivmedelscertifikat eller liknande kan förgasningsanläggningar istället få en betydande roll för produktion av biodrivmedel, även knutet till medelstora fjärrvärmenät.• Produktion av biodrivmedel, som DME och vätgas, kan ske till kostnader som är konkurrenskraftiga gentemot dagens bensinpris, särskilt om produktionen blir möjlig att integrera med svartlutsförgasning (här studerat för vätgas). För vätgasproduktion är i samtliga fall ekonomin och den totala effekten på CO2-utsläppen dock starkt beroende av möjligheterna att samla in och lagra CO2.• För samtliga studerade tekniker och delsystem påverkar scenarieantaganden om utvecklingen av energimarknaderna och omvärldens energisystem i hög grad resultaten. För att utvärdera robustheten och de totala klimateffekterna för en enskild investering krävs därför systemanalys, som tar hänsyn till denna omvärld.
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| 5. |
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| 6. |
- Ahlgren, Christina, et al.
(författare)
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Gender analysis of musculoskeletal disorders and emotional exhaustion : interactive effects from physical and psychosocial work exposures and engagement in domestic work
- 2012
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Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 55:2, s. 212-228
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men. Practitioner Summary. The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.
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| 7. |
- Ahlgren, Christina, et al.
(författare)
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The meanings given to gender in studies on multimodal rehabilitation for patients with chronic musculoskeletal pain : a literature review
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:23, s. 2255-2270
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Forskningsöversikt (refereegranskat)abstract
- Purpose: The purpose of this study is to assess and describe the meanings given to "gender" in scientific publications that evaluate multidisciplinary, interdisciplinary or multimodal rehabilitation for patients with chronic musculoskeletal pain.Method: A systematic literature search for papers evaluating multimodal rehabilitation was conducted. The PubMed and EBSCO databases were searched from 1995 to 2015. Two or three researchers independently read each paper, performed a quality assessment and coded meanings of gender using qualitative content analysis.Results: Twenty-seven papers were included in the review. Gender was used very differently in the MMR studies investigated but primarily it referred to factual differences between men and women. Only one paper provided a definition of the concept of gender and how it had been used in that study. In the content analysis, the meaning of gender formed three categories: "Gender as a factual difference", "The man is the ideal" and "Gender as a result of social role expectations".Conclusions: The meaning of the concept of gender in multimodal rehabilitation is undefined and needs to be developed further. The way the concept is used should be defined in the design and evaluation of multimodal rehabilitation in future studies.Implications for rehabilitationHealthcare professionals should reflect on gender relations in encounters with patients, selection of patients into rehabilitation programs and design of programs. In rehabilitation for chronic pain the patients' social circumstances and cultural context should be given the same consideration as biological sex and pain symptoms.
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| 8. |
- Ahlgren, Eva Christina, et al.
(författare)
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Iron-induced oligomerization of human FXN81-210 and bacterial CyaY frataxin and the effect of iron chelators
- 2017
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:12
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Tidskriftsartikel (refereegranskat)abstract
- Patients suffering from the progressive neurodegenerative disease Friedreich’s ataxia have reduced expression levels of the protein frataxin. Three major isoforms of human frataxin have been identified, FXN42-210, FXN56-210 and FXN81-210, of which FXN81-210 is considered to be the mature form. Both long forms, FXN42-210 and FXN56-210, have been shown to spontaneously form oligomeric particles stabilized by the extended N-terminal sequence. The short variant FXN81-210, on other hand, has only been observed in the monomeric state. However, a highly homologous E. coli frataxin CyaY, which also lacks an N-terminal extension, has been shown to oligomerize in the presence of iron. To explore the mechanisms of stabilization of short variant frataxin oligomers we compare here the effect of iron on the oligomerization of CyaY and FXN81-210. Using dynamic light scattering, small-angle X-ray scattering, electron microscopy (EM) and cross linking mass spectrometry (MS), we show that at aerobic conditions in the presence of iron both FXN81-210 and CyaY form oligomers. However, while CyaY oligomers are stable over time, FXN81-210 oligomers are unstable and dissociate into monomers after about 24 h. EM and MS studies suggest that within the oligomers FXN81-210 and CyaY monomers are packed in a head-to-tail fashion in ring-shaped structures with potential iron-binding sites located at the interface between monomers. The higher stability of CyaY oligomers can be explained by a higher number of acidic residues at the interface between monomers, which may result in a more stable iron binding. We also show that CyaY oligomers may be dissociated by ferric iron chelators deferiprone and DFO, as well as by the ferrous iron chelator BIPY. Surprisingly, deferiprone and DFO stimulate FXN81-210 oligomerization, while BIPY does not show any effect on oligomerization in this case. The results suggest that FXN81-210 oligomerization is primarily driven by ferric iron, while both ferric and ferrous iron participate in CyaY oligomer stabilization. Analysis of the amino acid sequences of bacterial and eukaryotic frataxins suggests that variations in the position of the acidic residues in helix 1, β-strand 1 and the loop between them may control the mode of frataxin oligomerization.
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| 9. |
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| 10. |
- Ahlgren, Karin, et al.
(författare)
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De stora restaureringarna : Från Uppsala domkyrka till Skokloster
- 2004
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Rapport (populärvet., debatt m.m.)abstract
- De stora restaureringarna har varit årets tema. Genom att dokumentera och analysera teori och praktik i några av 1800- och 1900-talets största restaureringar - från genomgripande stilrestaureringar till ett mer återhållsamt och tekniskt skonsamt synsätt. Därmed får vi också ett bättre underlag även för dagens ställningstagande.Föremål för våra studier är Uppsala domkyrka, Gripsholms slott, Vreta klosterkyrka, Gustav 11I:s paviljong i Haga, Kungapalatset i Vadstena och Skoklosters slott. Vi hoppas att denna utställning skall bidra till en kritisk hållning och en ökad kunskap om restaureringskonsten, som kvalificerad yrkesuppgift, tidsspegel för historiesyn och som gestaltningsideal.
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| 11. |
- Ahlgren, Thorbjörn, 1959-
(författare)
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Institutionalisering på hemmaplan : En idés resa i den sociala barnavården
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes and analyses in three substudies how home-based measures for children are expanding and why an open care idea are established as part of the Swedish child welfare. The first substudy describes the national increment of what today can be considered as a treatment policy – non-institutional care in child welfare. The results are analysed with Kingdon's agenda setting theory and shows that the factors of what Kingdon describes as problems-, politics- and policyflow influenced the national increment. Significant mechanisms have primarily been, the profession, the society's concerns for socially disadvantaged children, negative experiences of institutionalisation and a political position to deinstitutionalise all care. The second substudy focuses on how knowledge and research contributes to ideological, professional, and organizational change in child welfare by analysis of Research & Developments reports and articles from the professional journal Socionomen. Based on the neo-institutional concepts of organisational fields and isoformism the study's results shows that a consequence of adaptation strategies and "rationalized myths" are a number of similarities in how home-based measures are organized and which measures that are used. The third substudy, a case study, analyses how we can understand a local development of ideas in social services for children with concepts from neo institutional theory. Interviews and municipal documents are analysed and shows that the local translation of an open care idea is characterized by discretion, personal preferences and action and affects the choice of method and organization. The study also shows a political mistrust of institutional care while there is at the same time political confidence in the individual social worker's ability to find solutions that allow non-institutional measures to be an alternative to institutional care.An overall conclusion of the thesis is that there is now a treatment policy in social services for the children, which involves extensive efforts at home and it has led to that more children receive support from social services. One result of non-institutional care increment is that it led to increased costs for municipalities for intervention for children and young people when out-of-home care has not decreased. Another general conclusion is that translation and adaptation of ideas to local contexts is something that generally fits street-level bureaucrats need for discretion.
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| 12. |
- Ahlgren, Thorbjörn, 1959-
(författare)
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Ungdomsbehandling : Hemmaplanslösning som idé och praktik
- 2007
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Title: Open-care Treatment of Youth. Home-ground Solutions in Theory and Practice This dissertation is a case study in two parts, which describes how ideas about open-care treatment of youth aged 13-20 years are interpreted and concretized in a local context. The study, i.a., aims at creating deeper knowledge about target group, content of treatment, and reported results concerning a form of treatment in social care which has hitherto been sparsely researched in Sweden. The results of the interview study demonstrate that the driving forces for developing local forms of open care treatments have first and foremost been to offer better care and to improve the professionalism of the social worker. Studies of the social welfare documents of 97 young people reveal that most of these youngsters are in bad need of treatment and that they have experiences of various kinds of treatment before the present efforts. The study also demonstrates that the efforts are rarely evaluated and lack systematic documentation. Finally, the study reveals that more than 60 per cent of the youth get some sort of continuous support by the social welfare system after the open-care treatment has come to an end. The results from both parts of the study are analysed by means of neo- institutional theory. According to this theory the local open-care treatment consists of an indistinct target group, family-oriented methods, and activities that have been legitimised by strong proponents, good timing, professional development, and by representing important political values. In conclusion, the author argues that open care treatment shows signs of a beginning institutionalisation, a taken-for-granted-ness, which he thinks is risky, as we still do not know if open-care treatment is more favourable to the young people than different kinds of 24-hour care. In addition, the author holds, that the future role of the social worker should include knowledge that decreases unfounded taken-for-granted ideas.
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| 13. |
- Atroshi, Isam, et al.
(författare)
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Collagenase treatment of Dupuytrens contracture using a modified injection method
- 2015
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Ingår i: Acta Orthopaedica. - : Informa Healthcare: Creative Commons Attribution Non-Commercial / Informa Healthcare. - 1745-3674 .- 1745-3682. ; 86:3, s. 310-315
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Treatment of Dupuytrens contracture (DC) with collagenase Clostridium histolyticum (CCH) consists of injection followed by finger manipulation. We used a modified method, injecting a higher dose than recommended on the label into several parts of the cord, which allows treatment of multiple joint contractures in 1 session and may increase efficacy. We studied the occurrence of skin tears and short-term outcome with this procedure. Patients and methods - We studied 164 consecutive hands with DC, palpable cord, and extension deficit of greater than= 20 degrees in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint (mean patient age 70 years, 82% men). A hand surgeon injected all the content of 1 CCH vial (approximately 0.80 mg) into multiple spots in the cord and performed finger extension under local anesthesia after 1 or 2 days. A nurse recorded skin tears on a diagram and conducted a standard telephone follow-up within 4 weeks. A hand therapist measured joint contracture before injection and at a median of 23 (IQR: 7-34) days after finger extension. Results - A skin tear occurred in 66 hands (40%). The largest diameter of the tear was less than= 5 mm in 30 hands and greater than 10 mm in 14 hands. Hands with skin tear had greater mean pretreatment MCP extension deficit than those without tear: 59 degrees (SD 26) as opposed to 32 degrees (SD 23). Skin tear occurred in 21 of 24 hands with MCP contracture of greater than= 75 degrees. All tears healed with open-wound treatment. No infections occurred. Mean improvement in total (MCP + PIP) extension deficit was 55 degrees (SD 28). Interpretation - Skin tears occurred in 40% of hands treated with collagenase injections, but only a fifth of them were larger than 1 cm. Tears were more likely in hands with severe MCP joint contracture. All tears healed without complications. Short-term contracture reduction was good.
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| 14. |
- Atroshi, Isam, et al.
(författare)
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Costs for collagenase injections compared with fasciectomy in the treatment of Dupuytren's contracture: a retrospective cohort study
- 2014
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:1, s. 004166-004166
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare collagenase injections and surgery (fasciectomy) for Dupuytren's contracture (DC) regarding actual total direct treatment costs and short-term outcomes. Design: Retrospective cohort study. Setting: Orthopaedic department of a regional hospital in Sweden. Participants: Patients aged 65 years or older with previously untreated DC of 30 degrees or greater in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joints of the small, ring or middle finger. The collagenase group comprised 16 consecutive patients treated during the first 6 months following the introduction of collagenase as treatment for DC at the study centre. The controls were 16 patients randomly selected among those operated on with fasciectomy at the same centre during the preceding 3 years. Interventions: Treatment with collagenase was given during two standard outpatient clinic visits (injection of 0.9 mg, distributed at multiple sites in a palpable cord, and next-day finger extension under local anaesthesia) followed by night-time splinting. Fasciectomy was carried out in the operating room (day surgery) under general or regional anaesthesia using standard technique, followed by therapy and splinting. Primary and secondary outcome measures: Actual total direct costs (salaries of all medical personnel involved in care, medications, materials and other relevant costs), and total MCP and PIP extension deficit (degrees) measured by hand therapists at 612 weeks after the treatment. Results: Collagenase injection required fewer hospital outpatient visits to a therapist and nurse than fasciectomy. Total treatment cost for collagenase injection was US$1418.04 and for fasciectomy US $2102.56. The post-treatment median (IQR) total extension deficit was 10 (0-30) for the collagenase group and 10 (0-34) for the fasciectomy group. Conclusions: Treatment of DC with one collagenase injection costs 33% less than fasciectomy with equivalent efficacy at 6 weeks regarding reduction in contracture.
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| 15. |
- Bydén, Moa, et al.
(författare)
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Cerebrovascular Reserve Capacity as a Predictor of Postoperative Delirium : A Pilot Study
- 2021
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Ingår i: Frontiers in Surgery. - : Frontiers Media S.A.. - 2296-875X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Postoperative delirium is a common complication after cardiac surgery with cardiopulmonary bypass (CPB). Compromised regulation of the cerebral circulation may be a predisposing factor for delirium. However, the potential relationship between cerebrovascular reserve capacity and delirium is unknown. The aim of this study was to investigate if impaired cerebrovascular reserve capacity was associated with postoperative delirium.Methods: Forty-two patients scheduled for cardiac surgery with CPB were recruited consecutively. All patients underwent preoperative transcranial Doppler (TCD) ultrasound with calculation of breath-hold index (BHI). BHI < 0.69 indicated impaired cerebrovascular reserve capacity. In addition, patients were examined with preoperative neuropsychological tests such as MMSE (Mini Mental State Examination) and AQT (A Quick Test of cognitive speed). Postoperative delirium was assessed using Nursing Delirium Screening Scale (Nu-DESC) in which a score of >= 2 was considered as delirium.Results: Six patients (14%) scored high for postoperative delirium and all demonstrated impaired preoperative cerebrovascular reserve capacity. Median (25th-75th percentile) BHI in patients with postoperative delirium was significantly lower compared to the non-delirium group [0.26 (-0.08-0.44) vs. 0.83 (0.57-1.08), p = 0.002]. Preoperative MMSE score was lower in patients who developed postoperative delirium (median, 25th-75th percentile; 26.5, 24-28 vs. 28.5, 27-29, p = 0.024). Similarly, patients with postoperative delirium also displayed a slower performance during the preoperative cognitive speed test AQT color and form (mean +/- SD; 85.8 s +/- 19.3 vs. 69.6 s +/- 15.8, p = 0.043).Conclusion: The present findings suggest that an extended preoperative ultrasound protocol with TCD evaluation of cerebrovascular reserve capacity and neuropsychological tests may be valuable in identifying patients with increased risk of developing delirium after cardiac surgery.
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| 16. |
- Cazzaniga, Walter, et al.
(författare)
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Population-based, nationwide registration of prostatectomies in Sweden
- 2019
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Ingår i: Journal of Surgical Oncology. - : Wiley. - 0022-4790 .- 1096-9098. ; 120:4, s. 803-812
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Radical prostatectomy (RP) is a common surgical procedure with a risk of postoperative erectile dysfunction and urinary incontinence. There is a need for data on RP as a basis for quality assurance and benchmarking. Methods In 2015, prostatectomies in Sweden (PiS) form was implemented in the National Prostate Cancer Register (NPCR) of Sweden with data on pre-, peri- and post-operative variables. Results Out of all radical prostatectomies performed in 2016 in Sweden, 3096/3881 (80%) were registered in PiS. A total of 2605 (84%) were robot-assisted radical prostatectomy (RARP) and 491 (16%) were RRP (retropubic radical prostatectomy). RARP was performed by 91 surgeons of whom 47% operated more than 25 RP/year; and RRP was performed by 69 surgeons of whom 10% performed more than 25 RP/year. RARP had a longer operative time (median operating time: RARP 155 minutes [IQR 124-190]; RRP 129 minutes [IQR 105-171]; P < .001) but was associated with smaller bleeding (median intraoperative blood loss: RARP 100 mL [IQR 50-200], RRP 700 mL [IQR 500-1100]; P < .001). Conclusions We report on a nationwide, population-based register with transparent reporting of data on the performance of radical prostatectomy. These data are needed as a basis for quality assurance with comparisons of results from individual surgeons and hospitals.
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| 17. |
- Eriksson, D, et al.
(författare)
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Extended exome sequencing identifies BACH2 as a novel major risk locus for Addison's disease
- 2016
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 286:6, s. 595-608
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Autoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addison's disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology.METHODS: To understand the genetic background of Addison's disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected set of 1853 genes and their potential regulatory elements, for the purpose of sequencing 479 patients with Addison's disease and 1394 controls.RESULTS: We identified BACH2 (rs62408233-A, OR = 2.01 (1.71-2.37), P = 1.66 × 10(-15) , MAF 0.46/0.29 in cases/controls) as a novel gene associated with Addison's disease development. We also confirmed the previously known associations with the HLA complex.CONCLUSION: Whilst BACH2 has been previously reported to associate with organ-specific autoimmune diseases co-inherited with Addison's disease, we have identified BACH2 as a major risk locus in Addison's disease, independent of concomitant autoimmune diseases. Our results may enable future research towards preventive disease treatment.
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| 18. |
- Fekry, Mostafa, et al.
(författare)
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SAXS and stability studies of iron-induced oligomers of bacterial frataxin CyaY
- 2017
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:9, s. 0184961-0184961
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Tidskriftsartikel (refereegranskat)abstract
- Frataxin is a highly conserved protein found in both prokaryotes and eukaryotes. It is involved in several central functions in cells, which include iron delivery to biochemical processes, such as heme synthesis, assembly of iron-sulfur clusters (ISC), storage of surplus iron in conditions of iron overload, and repair of ISC in aconitase. Frataxin from different organisms has been shown to undergo iron-dependent oligomerization. At least two different classes of oligomers, with different modes of oligomer packing and stabilization, have been identified. Here, we continue our efforts to explore the factors that control the oligomerization of frataxin from different organisms, and focus on E. coli frataxin CyaY. Using small-angle X-ray scattering (SAXS), we show that higher iron-to-protein ratios lead to larger oligomeric species, and that oligomerization proceeds in a linear fashion as a results of iron oxidation. Native mass spectrometry and online size-exclusion chromatography combined with SAXS show that a dimer is the most common form of CyaY in the presence of iron at atmospheric conditions. Modeling of the dimer using the SAXS data confirms the earlier proposed head-to-tail packing arrangement of monomers. This packing mode brings several conserved acidic residues into close proximity to each other, creating an environment for metal ion binding and possibly even mineralization. Together with negative-stain electron microscopy, the experiments also show that trimers, tetramers, pentamers, and presumably higher-order oligomers may exist in solution. Nano-differential scanning fluorimetry shows that the oligomers have limited stability and may easily dissociate at elevated temperatures. The factors affecting the possible oligomerization mode are discussed.
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| 19. |
- Gakh, Oleksandr, et al.
(författare)
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Architecture of the human mitochondrial iron-sulfur cluster assembly machinery
- 2016
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Ingår i: Journal of Biological Chemistry. - 0021-9258. ; 291:40, s. 21296-21321
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Tidskriftsartikel (refereegranskat)abstract
- Fe-S clusters, essential cofactors needed for the activity of many different enzymes, are assembled by conserved protein machineries inside bacteria and mitochondria. As the architecture of the human machinery remains undefined, we co-expressed in Escherichia coli the following four proteins involved in the initial step of Fe-S cluster synthesis: FXN42-210 (iron donor); [NFS1]·[ISD11] (sulfur donor); and ISCU (scaffold upon which new clusters are assembled). We purified a stable, active complex consisting of all four proteins with 1:1:1:1 stoichiometry. Using negative staining transmission EM and single particle analysis, we obtained a three-dimensional model of the complex with ∼14 Å resolution. Molecular dynamics flexible fitting of protein structures docked into the EM map of the model revealed a [FXN42-210]24·[NFS1]24·[ISD11]24·[ISCU]24 complex, consistent with the measured 1:1:1:1 stoichiometry of its four components. The complex structure fulfills distance constraints obtained from chemical cross-linking of the complex at multiple recurring interfaces, involving hydrogen bonds, salt bridges, or hydrophobic interactions between conserved residues. The complex consists of a central roughly cubic [FXN42-210]24·[ISCU]24 sub-complex with one symmetric ISCU trimer bound on top of one symmetric FXN42-210 trimer at each of its eight vertices. Binding of 12 [NFS1]2·[ISD11]2 sub-complexes to the surface results in a globular macromolecule with a diameter of ∼15 nm and creates 24 Fe-S cluster assembly centers. The organization of each center recapitulates a previously proposed conserved mechanism for sulfur donation from NFS1 to ISCU and reveals, for the first time, a path for iron donation from FXN42-210 to ISCU.
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| 20. |
- Godtman, Rebecka Arnsrud, 1981, et al.
(författare)
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Association of surgeon and hospital volume with short-term outcomes after robot-assisted radical prostatectomy: Nationwide, population-based study
- 2021
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 16:6
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP's registered in the National Prostate Cancer Register of Sweden (2015-2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group had shorter operative time; surgeon (OR 9.20, 95% CI 7.11-11.91), hospital (OR 2.16, 95% CI 1.53-3.06), less blood loss; surgeon (OR 2.58. 95% CI 2.07-3.21) hospital (no difference), more often nerve sparing intention; surgeon (OR 2.89, 95% CI 2.34-3.57), hospital (OR 2.02, 95% CI 1.66-2.44), negative margins; surgeon (OR 1.90, 95% CI 1.54-2.35), hospital (OR 1.28, 95% CI 1.07-1.53). There was wide range in outcome between hospitals and surgeons with similar volume that remained after adjustment. Conclusions High surgeon and hospital volume were associated with better outcomes. The range in outcome was wide in all volume groups, which indicates that factors besides volume are of importance. Registration of surgical performance is essential for quality control and improvement.
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| 21. |
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| 22. |
- Gunnlaugsson, Adalsteinn, et al.
(författare)
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A prospective phase II study of prostate-specific antigen-guided salvage radiotherapy and Ga-68-PSMA-PET for biochemical relapse after radical prostatectomy-The PROPER 1 trial
- 2022
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Ingår i: Clinical and Translational Radiation Oncology. - : Elsevier BV. - 2405-6308. ; 36, s. 77-82
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: The treatment of biochemical recurrence (BCR) after prostatectomy is challenging as the site of the recurrence is often undetectable. Our aim was to test a personalised treatment concept for BCR based on PSA kinetics during salvage radiotherapy (SRT) combined with prostate-specific membrane antigen positron emission tomography (PSMA-PET). Materials and methods: This phase II trial included 100 patients with BCR. PSMA-PET was performed at baseline. PSA was measured weekly during SRT. Initially, 70 Gy in 35 fractions was prescribed to the prostate bed. Radiotherapy was adapted after 50 Gy. Non-responders (PSA still >= 0.15 ng/mL) received sequential lymph node irradiation with a boost to PSMA-PET positive lesions, while responders (PSA < 0.15 ng/mL) continued SRT as planned. PET-findings were only taken into consideration for treatment planning in case of PSA non-response after 50 Gy. Results: Data from 97 patients were eligible for analysis. Thirty-four patients were classified as responders and 63 as non-responders. PSMA-PET was positive in 3 patients (9%) in the responder group and in 22 (35%) in the non-responder group (p = 0.007). The three-year failure-free survival was 94% for responders and 68% for non-responders (median follow-up 38 months). There were no significant differences in physician-reported urinary and bowel toxicity. Patient-reported diarrhoea at end of SRT was more common among non-responders. Conclusion: This new personalised treatment concept with intensified SRT based on PSA response demonstrated a high tumour control rate in both responders and non-responders. These results suggest a clinically significant effect with moderate side effects in a patient group with otherwise poor prognosis. PSMA-PET added limited value. The treatment approach is now being evaluated in a phase III trial.
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| 23. |
- Jaraj, D., et al.
(författare)
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Long-Term Prognostication for 20 114 Women With Small and Node-Negative Breast Cancer (T1abN0)
- 2021
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Ingår i: Jnci Cancer Spectrum. - : Oxford University Press (OUP). - 2515-5091. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although small, node-negative breast cancer (ie, T1abN0) constitutes 20% of all newly diagnosed breast cancers, data on prognosis and prognostic factors are limited. Methods: We conducted a population-based cohort study including 20 114 Swedish women treated for T1abN0 breast cancer from 1977 onward. Patient and tumor data were collected from Swedish breast cancer registries. Cohort subjects were followed through linkage to the Cause of Death Register. We calculated the cumulative incidence of breast cancer-specific and overall death and used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During a median follow-up of 9.1 years (range = 0-38), 915 women died of breast cancer and 5416 of any cause. The 10-, 20-, and 30-year cumulative incidences of breast cancer death were 3.4% (95% CI = 3.1% to 3.7%), 7.6% (95% CI = 7.1% to 8.2%), and 10.5% (95% CI = 9.6% to 11.4%), respectively. The multivariable hazard ratios and 95% confidence intervals of breast cancer death were 0.92 (95% CI = 0.88 to 0.97) for each additional calendar year of diagnosis, 4.38 (95% CI = 2.79 to 6.87) for grade 3 vs grade 1 tumors, 0.43 (95% CI = 0.31 to 0.62) for progesterone receptor-positive vs progesterone receptor-negative disease, and 2.01 (95% CI = 0.99 to 4.07) for HER2-positive vs HER2-negative disease. Women with grade 3 vs grade 1 tumors had a 56% increased risk of death from any cause (HR = 1.56, 95% CI = 1.30 to 1.88). Conclusions: The risk of breast cancer death in T1abN0 disease continues to increase steadily beyond 10 years after diagnosis, has improved over time, and varies substantially by tumor characteristics.
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| 24. |
- Jóhannesson, Vilberg, et al.
(författare)
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Adaptive sequential plan-on-plan optimization during prostate-specific antigen response guided radiotherapy of recurrent prostate cancer
- 2021
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Ingår i: Physics and imaging in radiation oncology. - : Elsevier BV. - 2405-6316. ; 18, s. 5-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Treatment adaptation based on tumour biomarker response during radiotherapy of prostate cancer, could be used for both escalation and de-escalation of radiation doses and volumes. To execute an adaptation involving extension of treatment volumes during radiation can however be restricted by the doses already delivered. The aim of this work was to develop a treatment planning method that addresses this challenge. Material and methods: A volumetric-modulated-arc-therapy (VMAT) planning method with sequential plan-on-plan optimization was developed for a prospective phase II trial including 100 patients on salvage radiotherapy (SRT) for prostate cancer recurrence. A treatment adaptation was performed after five weeks of SRT based on prostate-specific antigen response during this phase of the treatment. This involved extension of treatment volumes for non-responders (n = 64) to include pelvic lymph nodes and boost to 68Gallium-Prostate-Specific-Membrane-Antigen-Positron-Emission-Tomography positive lesions. This method was evolved by introducing an EQD2 (equivalent dose in 2.0 Gy fractions) correction of the base plan for improved dose coverage. Results: All dose-volume criteria for target coverage were met for the non-responders when based on physical dose. An EQD2 correction of the base plan for non-responders, implemented for the final 29 patients, led to a statistically significant improvement in dose coverage as compared to the 35 patients treated without EQD2 correction. Conclusions: This is to our knowledge the only study presented on biomarker-guided sequential VMAT radiotherapy using a plan-on-plan technique in the pelvis. By using a biologically adapted technique an improved target coverage was achieved without compromising doses to organs at risk.
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| 25. |
- Kimby, Eva, et al.
(författare)
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Two courses of four weekly infusions of rituximab with or without interferon-α2a : final results from a randomized phase III study in symptomatic indolent B-cell lymphomas
- 2015
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Ingår i: Leukemia and Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 56:9, s. 2598-2607
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Tidskriftsartikel (refereegranskat)abstract
- Patients with advanced CD20 + indolent lymphoma, requiring therapy, were randomized to rituximab (four weekly infusions of 375 mg/m(2)) or to rituximab combined with 5 weeks of interferon-α2a (IFN-α2a) (3-4.5 MIU daily) as priming. Responding patients were eligible for a second cycle with the same allocated treatment. In total, 156 patients were randomized to rituximab and 157 to rituximab + IFN-α2a. In the intention-to treat (ITT) population, 244 patients (78%) responded to cycle 1. After a second cycle the complete remission/complete remission unconfirmed (CR/CRu) rate was 41% with the combination versus 24% with monotherapy (p = 0.005). The median time to treatment failure (primary endpoint) in ITT patients was 28 vs. 21.5 months, respectively (p = 0.302). After a long median follow-up (61 months), 33% (42% of patients responding to cycle 1) were still failure-free with an overall survival rate of 88% and with no difference between the treatment groups. The trial was registered at ClinicalTrials.gov Identifier: NCT01609010.
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| 26. |
- Larson, Daniel, et al.
(författare)
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Bioaccumulation of microcystins in the food web : a field study of four Swedish lakes
- 2014
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Ingår i: Inland Waters. - 2044-2041 .- 2044-205X. ; 4:1, s. 91-104
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Tidskriftsartikel (refereegranskat)abstract
- The transfer of microcystins (MC) up the food chain was measured in 4 lakes in central Sweden; Ekoln, Lilla Ullfjärden, Valloxen, and Storsjön. In lakes Ekoln and Valloxen, Microcystis aeruginosa was the dominant cyanobacterium, while the oscillatorian species Planktothrix prolifica form dense blooms in Lake Lilla Ullfjärden. The cyanobacterial composition in Lake Storsjön was more diverse with several Microcystis andDolichospermum species. All dominant taxa are well-known producers of hepatotoxic MC. The highest recorded MC in the water samples from Lake Lilla Ullfjärden was measured in the bloom of P. prolifica (35 µg L−1). The highest MC content was measured in invertebrates; however, the MC concentration was usually low in fish. Maximum levels were 9 µg g−1 dry weight (dw) in zooplankton, 10 µg g−1 dw in benthos, and 2.7 µg g−1 dw in fish (smelt) liver. In fish muscle the highest recorded levels were 0.10–0.18 µg g−1 dw in bleak and smelt from Lake Lilla Ullfjärden and in pike-perch and roach from Lake Storsjön. Based on the World Health Organization’s tolerable daily intake value of 0.04 µg kg−1 body weight, we conclude that any risk related to MC from human consumption of fish from these lakes is minimal.
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| 27. |
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| 28. |
- Polesie, Sam, et al.
(författare)
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Discrimination Between Invasive and In Situ Melanomas Using Clinical Close-Up Images and a De Novo Convolutional Neural Network
- 2021
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Ingår i: Frontiers in Medicine. - : Frontiers Media SA. - 2296-858X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Melanomas are often easy to recognize clinically but determining whether a melanoma is in situ (MIS) or invasive is often more challenging even with the aid of dermoscopy. Recently, convolutional neural networks (CNNs) have made significant and rapid advances within dermatology image analysis. The aims of this investigation were to create a de novo CNN for differentiating between MIS and invasive melanomas based on clinical close-up images and to compare its performance on a test set to seven dermatologists. Methods: A retrospective study including clinical images of MIS and invasive melanomas obtained from our department during a five-year time period (2016-2020) was conducted. Overall, 1,551 images [819 MIS (52.8%) and 732 invasive melanomas (47.2%)] were available. The images were randomized into three groups: training set (n = 1,051), validation set (n = 200), and test set (n = 300). A de novo CNN model with seven convolutional layers and a single dense layer was developed. Results: The area under the curve was 0.72 for the CNN (95% CI 0.66-0.78) and 0.81 for dermatologists (95% CI 0.76-0.86) (P < 0.001). The CNN correctly classified 208 out of 300 lesions (69.3%) whereas the corresponding number for dermatologists was 216 (72.0%). When comparing the CNN performance to each individual reader, three dermatologists significantly outperformed the CNN. Conclusions: For this classification problem, the CNN was outperformed by the dermatologist. However, since the algorithm was only trained and validated on 1,251 images, future refinement and development could make it useful for dermatologists in a real-world setting.
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| 29. |
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| 30. |
- Segernäs Kvitting, Anna, et al.
(författare)
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Prediction of Postoperative Delirium After Cardiac Surgery with A Quick Test of Cognitive Speed, Mini-Mental State Examination and Hospital Anxiety and Depression Scale
- 2022
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Ingår i: Clinical Interventions in Aging. - : Dove Medical Press Ltd. - 1176-9092 .- 1178-1998. ; 17, s. 359-368
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate if preoperative assessment with A Quick Test of Cognitive Speed (AQT) could increase the accuracy of predicting delirium after cardiac surgery compared to Mini-Mental State Examination (MMSE), and examine if a composite of variables, including cognitive function and depressive symptoms, could be useful to predict delirium. Patients and Methods: Cardiac surgery was performed in 218 patients (mean age 72 years). Preoperative evaluation involved AQT, MMSE and Hospital Anxiety And Depression Scale (HADS). Postoperative delirium was assessed using Nursing Delirium Screening Scale (Nu-DESC) and Confusion Assessment Method-ICU (CAM-ICU). Logistic regression was performed to detect predictors of postoperative delirium and receiver operator characteristic curves (ROC) with area under the curve (AUC) to determine the accuracy. Results: Postoperative delirium occurred in 47 patients (22%) who had lower MMSE scores (median (range), 27 (19-30) vs 28 (20- 30), p=0.009) and slower AQT (median (range), 76 (48-181) vs 70 (40-182) seconds, p=0.030) than patients without delirium. Predictive power measured as AUC (95% CI) was 0.605 (0.51-0.70) for AQT and 0.623 (0.53-0.72) for MMSE. Logistic regression (OR, 95% CI) showed MMSE 27 points (2.72, 1.27-5.86), AQT 70 sec (2.26, 1.03-4.95), HADS-D >4 points (2.60, 1.21-5.58) and longer cardiopulmonary bypass-time (1.007, 1.002-1.013) to be associated with postoperative delirium. Combining these parameters yielded an AUC of 0.736 (0.65-0.82). Conclusion: The ability of predicting delirium using AQT was similar to MMSE, and only slightly higher by combining AQT and MMSE. Adding HADS-D and cardiopulmonary bypass-time to MMSE and AQT increased the predictive power to a borderline acceptable discriminatory value. Preoperative cognitive tests and screening for depressive symptoms may help identify patients at risk of postoperative delirium. Yet, there is still a need to establish useful preoperative tests.
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| 31. |
- Söderberg, Christopher, et al.
(författare)
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The molecular basis of iron-induced oligomerization of frataxin and the role of the ferroxidation reaction in oligomerization.
- 2013
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Ingår i: Journal of Biological Chemistry. - 1083-351X. ; 288:12, s. 8156-8167
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Tidskriftsartikel (refereegranskat)abstract
- The role of the mitochondrial protein frataxin in iron storage and detoxification, iron delivery to iron-sulfur cluster biosynthesis, heme biosynthesis and aconitase repair has been extensively studied during the last decade. However, still no general consensus exists on the details of the mechanism of frataxin function and oligomerization. Here, using small-angle X-ray scattering (SAXS) and X-ray crystallography, we describe the solution structure of the oligomers formed during the iron-dependent assembly of yeast (Yfh1) and E. coli (CyaY) frataxin. At an iron-to-protein ratio of 2, the initially monomeric Yfh1 is converted to a trimeric form in solution. The trimer in turn serves as the assembly unit for higher-order oligomers induced at higher iron-to-protein ratios. The X-ray crystallographic structure obtained from iron-soaked crystals demonstrates that iron binds at the trimer-trimer interaction sites, presumably contributing to oligomer stabilization. For the ferroxidation-deficient D79A;D82A variant of Yfh1, iron-dependent oligomerization may still take place, although more than 50% of the protein is found in the monomeric state at the highest iron-to-protein ratio used. This demonstrates that the ferroxidation reaction controls frataxin assembly and presumably the iron chaperone function of frataxin and its interactions with target proteins. For E. coli CyaY, the assembly unit of higher order oligomers is a tetramer, which could be an effect of the much shorter N-terminal region of this protein. The results show that understanding of the mechanistic features of frataxin function requires detailed knowledge of the interplay between the ferroxidation reaction, iron-induced oligomerization and the structure of oligomers formed during assembly.
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| 32. |
- Willen, Eva, et al.
(författare)
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Cyanotoxin production in seven Ethiopian Rift Valley lakes
- 2011
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Ingår i: Inland Waters. - 2044-2041 .- 2044-205X. ; 1:2, s. 81-91
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Tidskriftsartikel (refereegranskat)abstract
- We hypothesized that unusual deaths and illnesses in wild and domestic animals in lake areas of the Rift Valley south of Addis Ababa were caused by toxic cyanobacteria. In the first cyanotoxic analyses conducted in samples from Ethiopia, we found lakes Chamo, Abaya, Awassa, Chitu, Langano, Ziway, and Koka all had concentrations of microcystins (MC) ranging from trace to hazardous, whereas only traces less than limits of detection (LOD) of cylindrospermopsin (CYN) were found. In the December 2006 dry season we sampled the lakes for analyses of MC, CYN, species structures, and calculations of cyanobacteria biomass. We used the Utermol technique to analyse cyanobacterial biomass and monitored MC toxins using HPLC-DAD, LC-ESI-MS-MRM, and ELISA-test and CYN with HPLC-DAD and ELISA. The various toxicity tests coincided well. In 4 of the lakes (Chamo, Langano, Ziway, and Koka), the inter-lake range of total MC concentration was 1.3-48 mu g L-1; in 3 (Abaya, Awassa, and Chitu), we found only traces of MC. Microcystis aeruginosa was the dominant species, with Microcystis panniformis, Anabaena spiroides, and Cylindrospermopsis spp. as subdominants. The MC concentration, especially in Lake Koka, exceeded levels for serious health hazards for humans, cattle, and wildlife.
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| 33. |
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