| 1. |
- Bergemalm, Daniel, 1977-, et al.
(författare)
-
Systemic Inflammation in Preclinical Ulcerative Colitis
- 2021
-
Ingår i: Gastroenterology. - : AGA Institute. - 0016-5085 .- 1528-0012. ; 161:5, s. 1526-1539.e9
-
Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Preclinical ulcerative colitis is poorly defined. We aimed to characterize the preclinical systemic inflammation in ulcerative colitis, using a comprehensive set of proteins.Methods: We obtained plasma samples biobanked from individuals who developed ulcerative colitis later in life (n = 72) and matched healthy controls (n = 140) within a population-based screening cohort. We measured 92 proteins related to inflammation using a proximity extension assay. The biologic relevance of these findings was validated in an inception cohort of patients with ulcerative colitis (n = 101) and healthy controls (n = 50). To examine the influence of genetic and environmental factors on these markers, a cohort of healthy twin siblings of patients with ulcerative colitis (n = 41) and matched healthy controls (n = 37) were explored.Results: Six proteins (MMP10, CXCL9, CCL11, SLAMF1, CXCL11 and MCP-1) were up-regulated (P < .05) in preclinical ulcerative colitis compared with controls based on both univariate and multivariable models. Ingenuity Pathway Analyses identified several potential key regulators, including interleukin-1β, tumor necrosis factor, interferon-gamma, oncostatin M, nuclear factor-κB, interleukin-6, and interleukin-4. For validation, we built a multivariable model to predict disease in the inception cohort. The model discriminated treatment-naïve patients with ulcerative colitis from controls with leave-one-out cross-validation (area under the curve = 0.92). Consistently, MMP10, CXCL9, CXCL11, and MCP-1, but not CCL11 and SLAMF1, were significantly up-regulated among the healthy twin siblings, even though their relative abundances seemed higher in incident ulcerative colitis.Conclusions: A set of inflammatory proteins are up-regulated several years before a diagnosis of ulcerative colitis. These proteins were highly predictive of an ulcerative colitis diagnosis, and some seemed to be up-regulated already at exposure to genetic and environmental risk factors.
|
|
| 2. |
- Bajc, Marika, et al.
(författare)
-
Assessment of Ventilation and Perfusion in Patients with COVID-19 Discloses Unique Information of Pulmonary Function to a Clinician : Case Reports of V/P SPECT
- 2021
-
Ingår i: Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine. - : SAGE Publications. - 1179-5484. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- V/P SPECT from 4 consecutive patients with COVID-19 suggests that ventilation and perfusion images may be applied to diagnose or exclude pulmonary embolism, verify nonsegmental diversion of perfusion from the ventilated areas (dead space ventilation) that may represent inflammation of the pulmonary vasculature, detect the reversed mismatch of poor ventilation and better preserved perfusion (shunt perfusion) in bilateral pulmonary inflammation and indicate redistribution of lung perfusion (antigravitational hyperperfusion) due to cardiac congestion. V/P mismatch and reversed mismatch may be extensive enough to diminish dramatically preserved matching ventilation/perfusion and to induce severe hypoxemia in COVID-19.
|
|
| 3. |
- Bergström, Göran, 1964, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
|
|
| 4. |
- Bergström, Göran, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
|
|
| 5. |
|
|
| 6. |
- Dimander, Josefin, et al.
(författare)
-
Documented nutritional therapy in relation to nutritional guidelines post burn injury : a retrospective observational study
- 2023
-
Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 56, s. 222-229
-
Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Intensive nutritional therapy is an essential component of burn care. Regardingpost-minor burn injuries, the literature is lacking. The aim of this study was to evaluate documentednutritional therapy in relation to international guidelines after both minor and major burn injuries. The secondary aim of this study was to evaluate the adequacy of energy and protein intake compared toindividual nutritional goals post-burn injury.Methods: A retrospective observational single-centre study including patients admitted between 2017and 2019 at a burn centre in Sweden was performed. The patients included in the study were >18 years old and in need of hospital care for > 72 h post-burn injury. Information about patients' demographics,nutritional therapy, and clinical characteristics of burn injury was collected. The patients were dividedaccording to total body surface area burnt (TBSA %) into minor burn injuries (TBSA <20%) and major burninjuries (TBSA >20%). Descriptive statistics were used to analyse data. Adherence to guidelines wasestablished by comparing 24 nutritional therapy recommendations to documented treatment. If documented nutritional treatment were in accordance with guidelines, adherence was considered high(>80%), moderate (60-79.9%) or low (<59.9%).Results: One hundred thirty-four patients were included, 90 patients with minor burn injuries and 44patients with major burn injuries. Documented adherence to the nutritional guideline was overall low.After minor burn injury, 8% (2/24) of nutritional therapy recommendations had a high adherence (fatintake <35% of total energy intake and enteral nutrition as prioritized feeding route), 17% (4/24) amoderate adherence, and 75% (18/24) a low adherence. In patients treated after a major burn injury,there were two recommendations with documented high adherence (Vitamin C and Zinc); 25% (6/24)had moderate adherence, and 67% (16/24) had low adherence. In addition, quite a large amount ofmissing data was found.Adequacy of documented nutritional intake, compared to the individual documented goal, was 78%(±23%) for energy and 66% (±22%) for protein after minor burn injury. After major burn injury, the adequacy was 89% (±21%) for energy and 78% (±19%) for protein, respectively.Conclusions: This study revealed low adherence to nutritional guidelines in patients treated for minorand major burn injuries. Compared to major burn injuries, lower documented adequacy for both energyand proteins was found in minor burn injuries. Given the disparity between guidelines and documentednutritional therapy, and the lack of specific guidelines for minor burn injuries, there could be aconsiderable risk of inadequate nutritional therapy post-burn injury.
|
|
| 7. |
- Fridén, Michael
(författare)
-
Role of Fatty Acid Composition in Non-Alcoholic Fatty Liver Disease: a Dietary Perspective : Results from Interventional and Observational Studies
- 2024
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this doctoral thesis was to investigate the role of circulating, liver and dietary fatty acids in non-alcoholic fatty liver disease (NAFLD). For circulating and liver fatty acids, special emphasis was given to fatty acids reflecting diet.In paper I, circulating cholesteryl ester (CE) linoleic acid (18:2n-6), which is considered a good biomarker of dietary intake of 18:2n-6, was cross-sectionally inversely associated with liver fat in n=308 50-year old men and women. Several fatty acids reflecting both exogenous intake and endogenous metabolism were associated with liver fat, basal fat oxidation and resting energy expenditure (REE). No association between fatty acids and liver fat, except for docosahexaenoic acid (22:6n-3) and liver fat, were attenuated after adjusting for REE. In paper II, phospholipid (PL) 22:6n-3 in liver tissue, a potential biomarker of dietary intake of 22:6n-3, was cross-sectionally inversely associated with liver fibrosis in n=60 men and women with biopsy-verified NAFLD. This finding was not replicated in plasma. Several other fatty acids reflecting both exogenous intake and endogenous metabolism were associated with fibrosis. Pooled saturated fatty acids (SFA) were generally positively associated whereas monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) were inversely associated with fibrosis. In paper III, no clear (i.e. imprecise) associations were observed for any of the nutrient or food substitutions with incidence NAFLD cirrhosis or hepatocellular carcinoma (HCC), over a median follow-up of 24 years in n>77 000 middle-aged to elderly men and women. In paper IV, a 12-month randomized controlled trial (RCT) was conducted to investigate the effects of a low-carbohydrate high PUFA (LCPUFA) diet and a healthy Nordic diet (HND) on liver fat in men and women with type 2 diabetes (T2D) or prediabetes. The comparator diet (usual care (UC)) aligned with the Nordic Nutrition Recommendations. Liver fat decreased more in the LCPUFA diet and the HND versus UC. No difference in liver fat was observed between LCPUFA and HND. The LCPUFA diet and the HND improved several other cardiometabolic markers compared to UC, with more favorable improvements in the HND group.In conclusion, findings from this thesis suggest that higher intakes of dietary unsaturated fatty acids (in particular PUFA) and lower intakes of SFA may be of importance for the prevention and treatment of NAFLD (at least for liver fat and fibrosis). Findings from this thesis also suggest that fatty acids reflecting both diet and endogenous metabolism may play a role in NAFLD.
|
|
| 8. |
- Hagberg, Cecilia, et al.
(författare)
-
Lättviktsgrindar av höghållfast stål för säkrare djurhantering och arbetsmiljö
- 2021
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Lightweight gates of high-strength steel for improved worker safety and cattle handling This report presents the work with developing a lightweight gate of high-strength steel for the handling of cattle. The project was conducted as a European Innovation Partnership (EIP) project. The project group consisted of co-workers from the unit of Agriculture and Horticulture and the unit of Process and Environmental Engineering at Research Institutes of Sweden (RISE Jordbruk och trädgård och RISE Kretsloppsteknik), Parsteel AB (former Nilssons Plåtindustri AB), SSAB EMEA AB, Sophie Atkinson at Smart Animal Handling, Swedish University of Agricultural Sciences (SLU) in Skara and the cattle farmer Lars Olsson. The main objectives of the project were to develop a lightweight gate weighing at least 50% less and being three times as strong as a traditional gate for cattle handling. The main motive was to improve the ergonomic conditions and working environment for the animal handlers. Additionally, for the safety of both animals and handlers, the gate must withstand the loads from cattle. Other objectives were to design and construct a gate that does not exceed the price of a high-quality gate and not contribute to increased negative environmental impact. A lightweight gate can be made of various materials such as plastic, fiberglass or steel. Regarding the project group's participants and their competencies, in addition to the numerous requirements placed on a lightweight gate, the choice fell on high-strength steel. High-strength steel is characterized by having high yield strengths, up to 1300 MPa, in comparison with traditional construction steel with yield strength of 355 MPa. For the specific lightweight gate, steel pipes with a yield strength of approximately 750 MPa were chosen. These pipes are mainly used in the automotive and engine industry, where high demands are placed on strength while at the same time a light construction is desired. The gate itself was designed during the project and several details were examined and developed in regard to functionality and safety for both cattle and handlers. The work environment legislation states that gates must be dimensioned and anchored so that the animals cannot break out (AFS 2008:17). The gates must also not pose a risk of injury to the cattle. In order to work safely with cattle, knowledge of cattle behavior is essential and consequently the report contains a chapter describing cattle senses and behavior. Both the lightweight gates and the handling system, built up by the gates, must be adapted to the cattle. In the project, the bud box handling system was tested. The handling system was originally developed to make use of the behavioral characteristics of cattle to encourage forward movement in the desired direction. In the project the handling system's functionality and safety, by using lightweight gates and additional equipment and components, were further designed. The handling system was tested in two groups of heifers at the SLU Götala Beef and Lamb Research Centre. The lightweight gates were also tested in a dairy herd and a beef herd, while hoof trimming, and at a small-scale abattoir. Generally, the light weight of the gates was considered an advantage as the handling of the gates is simplified also resulting in more frequent use of the gates, increasing safety for both animals and humans. During the project, several strength tests were performed by building unique test rigs. In one test rig, the weld of the pipes of the lightweight gate was tested. In another test rig, the strength of lightweight gates, compared with traditional gates on the market, were tested. The outcome of the tests confirmed the original aim of the project, a lightweight gate made of high-strength steel, about 50% lighter and at least three times as strong as traditional gates, had been developed and designed during the project period.
|
|
| 9. |
- Hatcher, Robert L., et al.
(författare)
-
Psychometric evaluation of the Working Alliance Inventory—Therapist version : Current and new short forms
- 2020
-
Ingår i: Psychotherapy Research. - : Informa UK Limited. - 1050-3307 .- 1468-4381. ; 30:6, s. 706-717
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The Working Alliance Inventory (WAI) and its short forms are widely used, although the properties of the therapists? versions have been little studied. Method: We examined the psychometric properties of two short forms (WAI-S-T, WAI-SR-T), and explored the creation of a psychometrically stronger short form using contemporary measure development techniques. Well-fitting items from the full 36-item WAI were identified in a development sample (131 therapists, 688 patients) using multi-level Bayesian Structural Equation Modeling, accounting for therapist rated effects. Multi-level Item Response Theory (IRT) methods aided creation of a revised short form (WAI-S-T-IRT). Factor structures of the three forms were assessed using multi-level ML estimation with robust standard errors. Results: Collinearity problems for the Goal and Task dimensions led to testing a two-factor model (Goal?Task, Bond). All three measures showed satisfactory fit; the WAI-S-T-IRT fit slightly better but differences were minor. Testing the structures in an independent sample (N?=?1117) yielded essentially the same results. No version showed strong measurement invariance. Discussion: Continued use of current therapist forms is supported; differentiation of theoretical dimensions is difficult with current measures, and may not be possible with self-report forms.
|
|
| 10. |
- Klysing, Amanda, et al.
(författare)
-
Stereotype Content at the Intersection of Gender and Sexual Orientation
- 2021
-
Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- According to the Stereotype Content Model (SCM), the content of stereotypes differs on two dimensions: communion and agency. Research shows that for stereotypes about the general gender categories of “women” and “men,” there is an ambivalent pattern of communion and agency, where high levels on one dimension are associated with low levels on the other. For sexual minority stereotypes, a gender inversion has been found, whereas homosexual women are seen as more similar to men in general than to women in general, whereas homosexual men are seen as more similar to women in general than to men in general. However, there is limited research on how stereotype content for general groups relate to stereotype content for subgroups with intersecting category memberships. This research addresses this gap by investigating stereotype content at the intersection of gender and sexual orientation, including stereotype content for general gender groups, heterosexual groups, homosexual groups, and bisexual groups. In Study 1, a community sample from Sweden (N = 824) rated perceived communion and agency for women and men in general, as well as hetero-, homo-, and bisexual women and men. In Study 2, a nationally representative Swedish sample (N = 424) performed the same rating task, and in addition completed Single-Category IATs (SC-IATs) for warmth and competence. Results from both studies show that the stereotype content for the general categories “women” and “men” overlap with the stereotype content for heterosexual same-gender targets. Homosexual and bisexual groups were rated as more similar to their non-congruent gender category than same gender heterosexual categories were, but stereotype content for sexual minority groups did not overlap with either general gender categories, thus showing only incomplete gender inversion of stereotype content. Implicit associations between “women” and “warmth” were significantly stronger than associations between “men” and “warmth.” There were no other significant relations between implicit associations to warmth/competence and gender or sexual orientation. Theoretical and methodological implications for future research into intersectional stereotype content are presented, including how the findings inform the co-dependent relationship between a binary gender structure and a heteronormative ideology.
|
|
