1. |
- Demmelmaier, Ingrid, 1960-, et al.
(författare)
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Does exercise intensity matter for fatigue during (neo-)adjuvant cancer treatment? The Phys-Can randomized clinical trial
- 2021
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 31:5, s. 1144-1159
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Tidskriftsartikel (refereegranskat)abstract
- Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The 6-month exercise intervention included supervised resistance training and home-based endurance training. CRF was assessed by Multidimensional Fatigue Inventory (MFI, five subscales score range 4-20), and Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F, score range 0-52). Multiple linear regression for main factorial effects was performed according to intention-to-treat, with post-intervention CRF as primary endpoint. Overall, 577 participants (mean age 58.7 years) were randomized. Participants randomized to high- vs low-to-moderate-intensity exercise had lower physical fatigue (MFI Physical Fatigue subscale; mean difference −1.05 [95% CI: −1.85, −0.25]), but the difference was not clinically important (ie <2). We found no differences in other CRF dimensions and no effect of additional BCS. There were few minor adverse events. For CRF, patients undergoing (neo-)adjuvant treatment for breast, prostate or colorectal cancer can safely exercise at high- or low-to-moderate intensity, according to their own preferences. Additional BCS does not provide extra benefit for CRF in supervised, well-controlled exercise interventions.
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2. |
- Lysholm, Sara, et al.
(författare)
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Seroepidemiology of selected transboundary animal diseases in goats in Zambia
- 2022
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Ingår i: Preventive Veterinary Medicine. - : Elsevier. - 0167-5877 .- 1873-1716. ; 206
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Tidskriftsartikel (refereegranskat)abstract
- Transboundary pathogens of goats present significant constraints to the livelihoods of millions of farmers in countries such as Zambia. Consequently, this study aimed to investigate the seroprevalence of Mycoplasma capricolum subsp. capripneumoniae (Mccp), foot and mouth disease virus (FMDV), Brucella spp., Crimean Congo haemorrhagic fever virus (CCHFV), and Rift Valley fever virus (RVFV) in Zambian goats. Another aim was to identify associations between seroprevalence and different predictor variables, such as trade and border proximity. From September to October 2019, 962 serum samples were collected from goats in seven Zambian districts, four of which have an international border while the remaining three do not. A questionnaire survey was conducted with each household, focusing on trade routines, management strategies and herd disease history. Animal-level seroprevalence adjusted for herd-level clustering was 8.2 % (95 % confidence interval [CI] 7.5-9.0) for Mccp, 12.9% (95% CI 12.0-13.7) for FMDV, 13.0 % (95% CI 12.1-13.9) for Brucella spp., 3.3 % (95% CI 2.8-3.7) for CCHFV, and 0.4 % (95 % CI 0.3-0.7) for RVFV. The association between herd-level seroprevalence and border proximity and trade appeared negligible, with the exception of selling goats at least twice a year which was identified as a potential risk factor for Brucella spp. (OR 4.1, 95 % CI 1.1-16.0, p = 0.040). In addition, a positive association between herd-level seroprevalence of FMDV and a herd size of 21 goats or more (OR 3.3, 95 % CI 1.0-11.1, p = 0.049) was detected. Also, positive associations between animal-level seroprevalence of Brucella spp. and increasing age (OR 7.7, 95 % CI 1.5-40.7, p = 0.016), and CCHFV and keeping pigs in the household (OR 2.7, 95 % CI 1.0-7.1, p = 0.044), were found. For FMDV (OR 3.8, 95 % CI 1.4-10.9, p = 0.011) and Brucella spp. (OR 4.5, 95 % CI 1.2-17.3, p = 0.031) on the other hand, animal-level seroprevalence was significantly higher in households without pigs. To the best of the authors' knowledge, this is the first study to describe the presence of antibodies for CCPP and CCHF in the Zambian goat population. While the association between seroprevalence and trade and border proximity generally appeared negligible, it is recommended that their influence is further evaluated in future studies, preferably through in-depth longitudinal studies incorporating impacts of different biosecurity measures and trade variations, linked to for example seasonality and trade peaks.
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3. |
- Nilsson, Magnus, et al.
(författare)
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Neoadjuvant Chemoradiotherapy and Surgery for Esophageal Squamous Cell Carcinoma Versus Definitive Chemoradiotherapy With Salvage Surgery as Needed : The Study Protocol for the Randomized Controlled NEEDS Trial
- 2022
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Ingår i: Frontiers in Oncology. - : Frontiers Media S.A.. - 2234-943X. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: The globally dominant treatment with curative intent for locally advanced esophageal squamous cell carcinoma (ESCC) is neoadjuvant chemoradiotherapy (nCRT) with subsequent esophagectomy. This multimodal treatment leads to around 60% overall 5-year survival, yet with impaired post-surgical quality of life. Observational studies indicate that curatively intended chemoradiotherapy, so-called definitive chemoradiotherapy (dCRT) followed by surveillance of the primary tumor site and regional lymph node stations and surgery only when needed to ensure local tumor control, may lead to similar survival as nCRT with surgery, but with considerably less impairment of quality of life. This trial aims to demonstrate that dCRT, with selectively performed salvage esophagectomy only when needed to achieve locoregional tumor control, is non-inferior regarding overall survival, and superior regarding health-related quality of life (HRQOL), compared to nCRT followed by mandatory surgery, in patients with operable, locally advanced ESCC.Methods: This is a pragmatic open-label, randomized controlled phase III, multicenter trial with non-inferiority design with regard to the primary endpoint overall survival and a superiority hypothesis for the experimental intervention dCRT with regard to the main secondary endpoint global HRQOL one year after randomization. The control intervention is nCRT followed by preplanned surgery and the experimental intervention is dCRT followed by surveillance and salvage esophagectomy only when needed to secure local tumor control. A target sample size of 1200 randomized patients is planned in order to reach 462 events (deaths) during follow-up.
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4. |
- Weis, Erik, et al.
(författare)
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Merging Directed C-H Activations with High-throughput Experimentation : Development of Predictable Iridium-catalyzed C-H Aminations Applicable to Late-stage Functionalizations
- 2022
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Ingår i: JACS Au. - : American Chemical Society (ACS). - 2691-3704. ; 2:4, s. 906-916
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Tidskriftsartikel (refereegranskat)abstract
- Herein, we report an iridium-catalyzed directed C–H amination methodology developed using a high-throughput experimentation (HTE)-based strategy, applicable for the needs of automated modern drug discovery. The informer library approach for investigating the accessible directing group chemical space, in combination with functional group tolerance screening and substrate scope investigations, allowed for the generation of reaction application guidelines to aid future users. Applicability to late-stage functionalization of complex drugs and natural products, in combination with multiple deprotection protocols leading to the desirable aniline matched pairs, serve to demonstrate the utility of the method for drug discovery. Finally, reaction miniaturization to a nanomolar range highlights the opportunities for more sustainable screening with decreased material consumption.
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5. |
- Åkesson, Oscar, et al.
(författare)
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Surface microdialysis measures local tissue metabolism after Ivor Lewis esophagectomy; an attempt to predict anastomotic defect
- 2023
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Ingår i: Diseases of the esophagus. - : Oxford University Press. - 1120-8694 .- 1442-2050. ; 36:8
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Tidskriftsartikel (refereegranskat)abstract
- Anastomotic defect (AD) after esophagectomy can lead to severe complications with need for surgical or endoscopic intervention. Early detection enables early treatment and can limit the consequences of the AD. As of today, there are limited methods to predict AD. In this study, we have used microdialysis (MD) to measure local metabolism at the intrathoracic anastomosis. Feasibility and possible diagnostic use were investigated. Sixty patients planned for Ivor Lewis esophagectomy were enrolled. After construction of the anastomosis, surface MD (S-MD) probes were attached to the outer surface of the esophageal remnant and the gastric conduit in close vicinity of the anastomosis and left in place for 7 postoperative days (PODs). Continuous sampling of local tissue concentrations of metabolic substances (glucose, lactate, and pyruvate) was performed postoperatively. Outcome, defined as AD or not according to Esophagectomy Complications Consensus Group definitions, was recorded at discharge or at first postoperative follow up. Difference in concentrations of metabolic substances was analyzed retrospectively between the two groups by means of artificial neural network technique. S-MD probes can be attached and removed from the gastric tube reconstruction without any adverse events. Deviating metabolite concentrations on POD 1 were associated with later development of AD. In subjects who developed AD, no difference in metabolic concentrations between the esophageal and the gastric probe was recorded. The technical failure rate of the MD probes/procedure was high. S-MD can be used in a clinical setting after Ivor Lewis esophagectomy. Deviation in local tissue metabolism on POD 1 seems to be associated with development of AD. Further development of MD probes and procedure is required to reduce technical failure.
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6. |
- Ahl, Matilda, et al.
(författare)
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Inflammatory reaction in the retina after focal non-convulsive status epilepticus in mice investigated with high resolution magnetic resonance and diffusion tensor imaging
- 2021
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Ingår i: Epilepsy Research. - : Elsevier. - 0920-1211 .- 1872-6844. ; 176
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Tidskriftsartikel (refereegranskat)abstract
- Pathophysiological consequences of focal non-convulsive status epilepticus (fNCSE) have been difficult to demonstrate in humans. In rats fNCSE pathology has been identified in the eyes. Here we evaluated the use of high-resolution 7 T structural T1-weighted magnetic resonance imaging (MRI) and 9.4 T diffusion tensor imaging (DTI) for detecting hippocampal fNCSE-induced retinal pathology ex vivo in mice. Seven weeks post-fNCSE, increased number of Iba1+ microglia were evident in the retina ipsilateral to the hemisphere with fNCSE, and morphologically more activated microglia were found in both ipsi- and contralateral retina compared to non-stimulated control mice. T1-weighted intensity measurements of the contralateral retina showed a minor increase within the outer nuclear and plexiform layers of the lateral retina. T1-weighted measurements were not performed in the ipsilateral retina due to technical difficulties. DTI fractional anisotropy(FA) values were discretely altered in the lateral part of the ipsilateral retina and unaltered in the contralateral retina. No changes were observed in the distal part of the optic nerve. The sensitivity of both imaging techniques for identifying larger retinal alteration was confirmed ex vivo in retinitis pigmentosa mice where a substantial neurodegeneration of the outer retinal layers is evident. With MR imaging a 50 % decrease in DTI FA values and significantly thinner retina in T1-weighted images were detected. We conclude that retinal pathology after fNCSE in mice is subtle and present bilaterally. High-resolution T1-weighted MRI and DTI independently did not detect the entire pathological retinal changes after fNCSE, but the combination of the two techniques indicated minor patchy structural changes.
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7. |
- Anticona, Cynthia, 1983-, et al.
(författare)
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Exploring the possible impact of oral nutritional supplements on children's oral health : an in vitro investigation
- 2024
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Ingår i: Dentistry Journal. - : MDPI. - 2304-6767. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- Eight pediatric oral nutritional supplements (ONSs) and 0.5% fat bovine milk were examined in vitro regarding their effect on the adhesion of three caries-related bacteria, Streptococcus mutans (strain CCUG 11877T), Lactobacillus gasseri (strain CCUG 31451), and Scardovia wiggsiae (strain CCUG 58090), to saliva-coated hydroxyapatite, as well as their pH and capacity to withstand pH changes. Bacteria were cultivated and radiolabeled. The adhesion assays used synthetic hydroxyapatite coated with whole or parotid saliva. Measurements of pH and titration of the products with HCl and NaOH were conducted in triplicate. Three ONSs promoted the S. mutans adhesion to saliva-coated hydroxyapatite (increase from 35% to >200%), supporting caries risk enhancement. S. wigssiae and L. gasseri adhered only to one and no ONS, respectively. Most supplements had limited buffering capacity to counteract acidification changes, suggesting their low capacity to neutralize acids, and one ONS showed a significant capacity to counteract basic changes, suggesting a high erosive potential. S. mutans adhesion was influenced by the ONS pH and volume NaOH added to reach pH 10. L. gasseri and S. wiggsiae adhesion was influenced by the ONSs' carbohydrate and fat content. Interdisciplinary efforts are needed to increase awareness and prevent the possible negative impact of ONSs on children's oral health.
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8. |
- Bok, Gunilla, et al.
(författare)
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Microbial growth behind tiles in bathrooms
- 2020
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Ingår i: E3S Web of Conferences. Vollyme 172, 2020.. - : EDP Sciences.
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Konferensbidrag (refereegranskat)abstract
- Studies investigating microbial diversity in buildings have been performed mainly through the study of dust collected from e. g. floors and door frames and on moisture damaged building materials. A great diversity of mould fungi has been found and the fungus flora is dominated by the genera Aspergillus and Penicillium. The building materials targeted in this specific study were sampled on the back of ceramic tiles from bathroom walls and floors. Furthermore, two different analyses were used to investigate to which degree this specific environment was supportive of microbial growth. Microbial findings were detected in 48 % of the specimens from the spots exposed to liquid water in the bathrooms. To our knowledge, the microbial occurrence in this type of environment has not previously been investigated.. © The Authors.
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9. |
- Bolmsvik, A., et al.
(författare)
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Weather protection at the construction site : Work environment and conditions for moisture and mould growth on massive timber
- 2023
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Ingår i: Journal of Physics, Conference Series. - : Institute of Physics. - 1742-6588 .- 1742-6596. ; 2654:1
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Tidskriftsartikel (refereegranskat)abstract
- During the last decade, the use of timber (especially massive timber) has increased worldwide, mainly driven by anticipated environmental benefits. However, there is debate on how to handle the susceptibility against microbial growth for wooden constructions, especially during the construction phase. Sometimes full weather protection is used to avoid exposing the wooden material to outdoor conditions, but oftentimes the structures are fully exposed to precipitation. In an earlier study, one construction site using a full weather protection was studied, and the results showed promising results on the improved hygrothermal conditions and reduced risk of mould growth. Moreover, the site contractor also indicated improved work environment and productivity, however, this was not included in that study. This present study aims to investigate the effects of using full weather protection during construction in seven different construction projects to follow-up and broaden the earlier single project study. The studied aspects include the hygrothermal conditions, potential of mould growth, and influence on the work environment. Temperature and relative humidity were measured and analysed. Samples of cross-laminated timber (CLT) were analysed using a microscope, and the results are compared to theoretical mould growth potential. This is measured both inside the weather protection and outside at the seven construction projects. Furthermore, a work environment questionnaire is distributed to workers at the sites to collect the perceived work environment using a full weather protection. The results of the study partly confirm the conclusions from the earlier study, i.e., reducing the risk of mould growth and causing a slightly warmer and dryer conditions than outside. In addition, the results indicate an improved work environment. The majority of the interviewees wishes a weather protection in their next project regarding the work environment.
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10. |
- Divaris, K., et al.
(författare)
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Phenotype Harmonization in the GLIDE2 Oral Health Genomics Consortium
- 2022
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Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 101:11, s. 1408-1416
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Tidskriftsartikel (refereegranskat)abstract
- Genetic risk factors play important roles in the etiology of oral, dental, and craniofacial diseases. Identifying the relevant risk loci and understanding their molecular biology could highlight new prevention and management avenues. Our current understanding of oral health genomics suggests that dental caries and periodontitis are polygenic diseases, and very large sample sizes and informative phenotypic measures are required to discover signals and adequately map associations across the human genome. In this article, we introduce the second wave of the Gene-Lifestyle Interactions and Dental Endpoints consortium (GLIDE2) and discuss relevant data analytics challenges, opportunities, and applications. In this phase, the consortium comprises a diverse, multiethnic sample of over 700,000 participants from 21 studies contributing clinical data on dental caries experience and periodontitis. We outline the methodological challenges of combining data from heterogeneous populations, as well as the data reduction problem in resolving detailed clinical examination records into tractable phenotypes, and describe a strategy that addresses this. Specifically, we propose a 3-tiered phenotyping approach aimed at leveraging both the large sample size in the consortium and the detailed clinical information available in some studies, wherein binary, severity-encompassing, and “precision,” data-driven clinical traits are employed. As an illustration of the use of data-driven traits across multiple cohorts, we present an application of dental caries experience data harmonization in 8 participating studies (N = 55,143) using previously developed permanent dentition tooth surface–level dental caries pattern traits. We demonstrate that these clinical patterns are transferable across multiple cohorts, have similar relative contributions within each study, and thus are prime targets for genetic interrogation in the expanded and diverse multiethnic sample of GLIDE2. We anticipate that results from GLIDE2 will decisively advance the knowledge base of mechanisms at play in oral, dental, and craniofacial health and disease and further catalyze international collaboration and data and resource sharing in genomics research.
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11. |
- Dodhia, Serena A., et al.
(författare)
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Examining the causal association between 25-hydroxyvitamin D and caries in children and adults : A two-sample Mendelian randomization approach
- 2021
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Ingår i: Wellcome Open Research. - : F1000 Research Ltd. - 2398-502X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prior observational studies have reported that higher levels of vitamin D are associated with decreased caries risk in children. However, these studies are prone to bias and confounding so do not provide causal inference. Genetic variants associated with a risk factor of interest can be used as proxies, in a Mendelian randomization (MR) analysis, to test for causal association with an outcome. The objective was to estimate the causal association between serum 25-hydroxyvitamin D (25(OH)D) (the commonly measured vitamin D metabolite in blood) and dental caries using a two-sample MR approach which estimates the causal effect of an exposure on an outcome.Methods: A total of 79 genetic variants reliably associated with 25(OH)D were identified from genome-wide association studies and used as a proxy measure of 25(OH)D. The association of this proxy measure with three outcome measures was tested; specifically: caries in primary teeth (n=17,035, aged 3-12 years), caries in permanent teeth in childhood and adolescence (n=13,386, aged 6-18 years), and caries severity in adulthood proxied by decayed, missing and filled tooth surfaces (DMFS) counts (n=26,792, aged 18-93 years).Results: The estimated causal effect of a one standard deviation increase in natural log-transformed 25(OH)D could be summarized as an odds ratio of 1.06 (95%CI: 0.81, 1.31; P=0.66) for caries in primary teeth and 1.00 (95%CI: 0.76, 1.23; P=0.97) for caries in permanent teeth in childhood and adolescence. In adults, the estimated casual effect of a one standard deviation increase in natural log-transformed 25(OH)D was 0.31 fewer affected tooth surfaces (95%CI: from 1.81 fewer DMFS to 1.19 more DMFS; P=0.68)Conclusions: The MR-derived effect estimates for these three measures are small in magnitude with wide confidence intervals and do not provide evidence for a causal relationship between 25(OH)D and dental caries.
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12. |
- Eriksson, Linda, 1979-
(författare)
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Oral microbiota in relation to host traits, environment, and dental caries
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Dental caries still appears at high prevalence worldwide. Disease distribution is skewed with more disease in socio-economically weak groups. However, also in populations considered as “low caries” there is a significant fraction with continuous disease development. Caries develops when the hard tissues of the tooth is demineralized, which occurs when pH drops below approximately 5.5 for enamel and 6.2 for dentine. The pH drop follows fermentation and acid production by tooth colonising bacteria upon dietary carbohydrate exposure. Thus, understanding the interactions between oral bacteria, diet and host factors is essential for managing the disease. The overall aim of this thesis was to study the oral microbiota in relation to caries and its association with sugar intake and driving forces behind sugar intake.Material and method: Saliva and tooth biofilm samples, information on caries status, dietary habits and other lifestyle data were collected from 17-23 year old participants. The participants also carried out a tasting session for the tastes sour, sweet and bitter. Genomic DNA was extracted from saliva and tooth biofilm and analysed using 16S rDNA amplicon sequencing with two platforms. Taxa were classified against the eHOMD database. Taste gene genotyping was done by mass spectrometry. Data were compared by univariate and multivariate statistical methods.Results: Oral microbiota was analysed in 64 adolescents. Streptococcus mutans, Scardovia wiggsiae, Bifidobacterium longum and Lepotrichia sp. HOT 498 displayed strong association with having caries, whereas Corynebacterium matruchotii and tooth brushing were associated with being caries-free. It was also confirmed that S.mutans was not compulsory for having caries. The oral microbiota in caries affected adolescents without S. mutans in was evaluated, and found to be characterised by a wide panel of saccharolytic non-S.mutans species. In contrast, tooth biofilms in individuals with caries and S. mutans were enriched for relatively few saccharolytic species in addition to S.mutans. Further, the overall microbiota pattern fell into four distinct clusters with deviating caries prevalence. The association with a set of lifestyle factors was searched, and sugar intake was found to differ between the groups. In the cluster with the highest sugar intake, the microbiota was less diverse and low sugar intake was characterized by enumeration of C. durum, C. matruchotiiand S. sanguinis. To deepen the knowledge on mechanisms behind sweet food intake, single nucleotide polymorphisms (SNP) genotyping in genes reported to be associated with taste regulation or sugar intake was done. SNPs in four genes were associated with sensitivity and preference for sweet taste and in the SLC2A2 gene also with caries.Conclusions: This project confirmed that dental caries is not a single species disease, and in the present population S. mutans, S. wiggsiae, and B. longum were significant for having caries. It was also confirmed that S. mutans is not essential for having caries. Tooth biofilm microbiota in S. mutans free adolescents was characterised by a larger diversity of species than seen in those with caries and S. mutans. It may be hypothesised that sugar intake and associated pH drops alone or in interaction with host biology play a role in the differentiation of the microbiota into the distinct profiles. This was supported by the finding that sugar intake was related to microbiota clustering and less community diversity. In this perspective the genetically based influence on sugar preference should be taken into account in dietary counselling which is an important aspect in caries prevention and treatment.
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13. |
- Esberg, Anders, et al.
(författare)
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Corynebacterium matruchotii Demography and Adhesion Determinants in the Oral Cavity of Healthy Individuals
- 2020
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Ingår i: Microorganisms. - : MDPI. - 2076-2607. ; 8:11
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Tidskriftsartikel (refereegranskat)abstract
- Corynebacterium matruchotii may be key in tooth biofilm formation, but information about demographics, bacterial partners, and binding ligands is limited. The aims of this study were to explore C. matruchotii's demography by age and colonization site (plaque and saliva), in vitro bacterial-bacterial interactions in coaggregation and coadhesion assays, and glycolipids as potential binding ligands in thin-layer chromatogram binding assays. C. matruchotii prevalence increased from 3 months to 18 years old, with 90% and 100% prevalence in saliva and tooth biofilm, respectively. C. matruchotii aggregated in saliva in a dose-dependent manner but lacked the ability to bind to saliva-coated hydroxyapatite. In vivo, C. matruchotii abundance paralleled that of Actinomyces naeslundii, Capnocytophaga sp. HMT 326, Fusobacterium nucleatum subsp. polymorphum, and Tannerella sp. HMT 286. In vitro, C. matruchotii bound both planktonic and surface-bound A. naeslundii, Actinomyces odontolyticus, and F. nucleatum. In addition, C. matruchotii exhibited the ability to bind glycolipids isolated from human erythrocytes (blood group O), human granulocytes, rabbit intestine, human meconium, and rat intestine. Binding assays identified candidate carbohydrate ligands as isoglobotriaosylceramide, Gal alpha 3-isoglobotriaosylceramide, lactotriaosylceramide, lactotetraosylceramide, neolactotetraosylceramide, and neolactohexaosylceramide. Thus, C. matruchotii likely uses specific plaque bacteria to adhere to the biofilm and may interact with human tissues through carbohydrate interactions.
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14. |
- Esberg, Anders, et al.
(författare)
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Oral Microbiota Profile Associates with Sugar Intake and Taste Preference Genes
- 2020
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- Oral microbiota ecology is influenced by environmental and host conditions, but few studies have evaluated associations between untargeted measures of the entire oral microbiome and potentially relevant environmental and host factors. This study aimed to identify salivary microbiota cluster groups using hierarchical cluster analyses (Wards method) based on 16S rRNA gene amplicon sequencing, and identify lifestyle and host factors which were associated with these groups. Group members (n = 175) were distinctly separated by microbiota profiles and differed in reported sucrose intake and allelic variation in the taste-preference-associated genes TAS1R1 (rs731024) and GNAT3 (rs2074673). Groups with higher sucrose intake were either characterized by a wide panel of species or phylotypes with fewer aciduric species, or by a narrower profile that included documented aciduric- and caries-associated species. The inferred functional profiles of the latter type were dominated by metabolic pathways associated with the carbohydrate metabolism with enrichment of glycosidase functions. In conclusion, this study supported in vivo associations between sugar intake and oral microbiota ecology, but it also found evidence for a variable microbiota response to sugar, highlighting the importance of modifying host factors and microbes beyond the commonly targeted acidogenic and acid-tolerant species. The results should be confirmed under controlled settings with comprehensive phenotypic and genotypic data.
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15. |
- Esberg, Anders, et al.
(författare)
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Using Oral Microbiota Data to Design a Short Sucrose Intake Index
- 2021
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 13:5
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Tidskriftsartikel (refereegranskat)abstract
- Excessive sucrose consumption is associated with numerous health problems, including dental caries, and is considered to play a critical role in shaping the human microbiota. Here, we aimed to confirm the association between sucrose exposure and oral microbiota profile, develop a short food-based index capturing variation among sucrose consumers and validate it against oral microbiota and dental caries in a derivation cohort with 16- to 79-year-old participants (n = 427). Intake and food preferences were recorded by questionnaires and saliva microbiota by 16S rDNA sequencing. Taxonomic similarities clustered participants into five clusters, where one stood out with highest sucrose intake and predicted sugar related metabolic pathways but lowest species diversity in the microbiota. Multivariate modelling of food intake and preferences revealed foods suitable for a sucrose index. This, similarly to sucrose intake, was related to bacterial pattern and caries status. The validity of the sucrose index was replicated in the population-based Gene-Lifestyle Interactions in Dental Endpoints (GLIDE, n = 105,520 Swedish adults) cohort. This suggested that the index captured clinically relevant variation in sucrose intake and that FFQ derived information may be suitable for screening of sucrose intake in the clinic and epidemiological studies, although adjustments to local consumption habits are needed.
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16. |
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17. |
- Gormley, Alexander, et al.
(författare)
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Subtypes of early childhood caries predict future caries experience
- 2023
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 51:5, s. 966-975
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test whether postulated subtypes of early childhood caries (ECC) are predictive of subsequent caries experience in a population-based cohort of Swedish children.Methods: The study included children aged between 3 and 5 years at study entry with dental records available for at least 5 years of follow-up. Dental record data were retrieved from the Swedish Quality Registry for Caries and Periodontal disease (SKaPa) for the initial and follow-up visits. Participants who had ECC at study entry were assigned to one of five ECC subtypes (termed classes 1-5) using latent class modelling of tooth surface-level caries experience. Subsequent experience of caries was assessed using the decayed, missing and filled surfaces indices (dmfs/DMFS) at follow-up visits, and compared between ECC subtypes using logistic and negative binomial regression modelling.Results: The study included 128 355 children who had 3 or more dental visits spanning at least 5 years post-baseline. Of these children, 31 919 had caries at the initial visit. Baseline ECC subtype was associated with differences in subsequent disease experience. As an example, 83% of children who had a severe form of ECC at age 5 went on to have caries in the permanent dentition by the end of the study, compared to 51% of children who were caries-free at age 5 (adjusted odds ratio of 4.9 for new disease at their third follow-up).Conclusion: ECC subtypes assigned at a baseline visit are associated with differences in subsequent caries experience in both primary and permanent teeth. This suggests that the development and future validation of an ECC classification can be used in addition to current prediction tools to help identify children at high risk of developing new caries lesions throughout childhood and adolescence.
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18. |
- Gottlieb-Vedi, Eivind, et al.
(författare)
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Extent of Lymphadenectomy and Long-Term Survival in Esophageal Cancer
- 2023
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Ingår i: Annals of Surgery. - : Wolters Kluwer. - 0003-4932 .- 1528-1140. ; 277:3, s. 429-436
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the hypothesis that survival in esophageal cancer increases with more removed lymph nodes during esophagectomy up to a plateau, after which it levels out or even decreases with further lymphadenectomy.Summary of Background Data: There is uncertainty regarding the ideal extent of lymphadenectomy during esophagectomy to optimize long-term survival in esophageal cancer.Methods: This population-based cohort study included almost every patient who underwent esophagectomy for esophageal cancer in Sweden or Finland in 2000-2016 with follow-up through 2019. Degree of lymphadenectomy, divided into deciles, was analyzed in relation to all-cause 5-year mortality. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (95% CI) adjusted for all established prognostic factors.Results: Among 2,306 patients, the 2nd (4-8 nodes), 7th (21-24 nodes) and 8th decile (25-30 nodes) of lymphadenectomy showed the lowest all-cause 5-year mortality compared to the 1st decile (HR = 0.77, 95% CI 0.61-0.97, HR = 0.76, 95% CI 0.59-0.99, and HR = 0.73, 95% CI 0.57-0.93, respectively). In stratified analyses, the survival benefit was greatest in decile 7 for patients with pathological T-stage T3/T4 (HR = 0.56, 95% CI 0.40-0.78), although it was statistically improved in all deciles except decile 10. For patients without neoadjuvant chemotherapy, survival was greatest in decile 7 (HR = 0.60, 95% CI 0.41-0.86), although survival was also statistically significantly improved in deciles 2, 6, and 8.Conclusion: Survival in esophageal cancer was not improved by extensive lymphadenectomy, but resection of a moderate number (20-30) of nodes was prognostically beneficial for patients with advanced T-stages (T3/T4) and those not receiving neoadjuvant therapy.
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19. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Nurse assistants´ perceptions of developing person-centred communication
- 2021
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Konferensbidrag (refereegranskat)abstract
- Background: Communication is important for nurse assistants (NAs) when caring for older persons. There is limited research about how to improve the communication competence of NAs in home care. The aim was to describe NAs perception on learning in relation to an educational intervention on person-centred communication.Methods: A qualitative descriptive study was conducted. Data consisted of four group interviews, five individual in-depth interviews and written reflection assignments from participants gathered during the web-based intervention. In total 23 NAs at two home care units participated. The data were analysed using a phenomenographic approach. This is a qualitative method for analysis developed from Nordic traditions of phenomenology. Phenomenography aims to describe individual perceptions of a certain phenomenon.Preliminary findings points to the nurse assistants perceiving that the education supported their development of person-centred communication. They pointed out self-reflections as important for their learning as well as to get confirmation on what was already known. The NAs described that the intervention added to their knowledge and skills. Even though, there was more to learn and challenges that remained regarding communication in challenging situations such as caring for persons in end-of-life and supporting their relatives, caring for persons being aggressive or violent.Preliminary implications of research: This study can provide knowledge on participants’ perspective on their learning process, which may be important to consider when conducting educational interventions in home care as well as other health care contexts.
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20. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Process evaluation of the ACTION programme : a strategy for implementing person‐centred communication in home care
- 2021
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Ingår i: BMC Nursing. - : Springer Nature. - 1472-6955. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods: A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results: The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions: The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration: This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary (). © 2021, The Author(s).
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21. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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‘Sometimes you need an eye-opener’: A qualitative study on nursing assistants' experiences of developing communication skills through an educational intervention on person-centred communication
- 2023
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058.
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Tidskriftsartikel (refereegranskat)abstract
- AimTo explore nursing assistants' (NAs') experiences of developing communication skills while participating in an educational intervention on person-centred communication.DesignA descriptive qualitative study was conducted.MethodsData were collected from interviews and written assignments before, during and after an educational intervention on person-centred communication targeting NAs in home care services. The data were analysed using a phenomenological approach. A total of 25 NAs participated in the study.ResultsThe findings describe NAs' experiences concerning the communication skills needed for building relationships with older persons and handling emotionally challenging situations. The educational intervention increased their knowledge and awareness of the importance of communication skills and how such skills are developed and refined.
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22. |
- Hammarlund, Maria, et al.
(författare)
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The Alpha 7 Nicotinic Acetylcholine Receptor Does Not Affect Neonatal Brain Injury
- 2022
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Ingår i: Biomedicines. - : MDPI AG. - 2227-9059. ; 10:8
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Tidskriftsartikel (refereegranskat)abstract
- Inflammation plays a central role in the development of neonatal brain injury. The alpha 7 nicotinic acetylcholine receptor (alpha 7nAChR) can modulate inflammation and has shown promising results as a treatment target in rodent models of adult brain injury. However, little is known about the role of the alpha 7nAChR in neonatal brain injury. Hypoxic-ischemic (HI) brain injury was induced in male and female C57BL/6 mice, alpha 7nAChR knock-out (KO) mice and their littermate controls on postnatal day (PND) 9-10. C57BL/6 pups received i.p. injections of alpha 7nAChR agonist PHA 568487 (8 mg/kg) or saline once daily, with the first dose given directly after HI. Caspase-3 activity and cytokine mRNA expression in the brain was analyzed 24 h after HI. Motor function was assessed 24 and 48 h after HI, and immunohistochemistry was used to assess tissue loss at 24 h and 7 days after HI and microglial activation 7 days after HI. Activation of alpha 7nAChR with the agonist PHA 568487 significantly decreased CCL2/MCP-1, CCL5/RANTES and IL-6 gene expression in the injured brain hemisphere 24 h after HI compared with saline controls in male, but not female, pups. However, alpha 7nAChR activation did not alter caspase-3 activity and TNF alpha, IL-1 beta and CD68 mRNA expression. Furthermore, agonist treatment did not affect motor function (24 or 48 h), neuronal tissue loss (24 h or 7 days) or microglia activation (7 days) after HI in either sex. Knock-out of alpha 7nAChR did not influence neuronal tissue loss 7 days after HI. In conclusion, targeting the alpha 7nAChR in neonatal brain injury shows some effect on dampening acute inflammatory responses in male pups. However, this does not lead to an effect on overall injury outcome.
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23. |
- Haworth, Simon, et al.
(författare)
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Assessment and visualization of phenome-wide causal relationships using genetic data : an application to dental caries and periodontitis
- 2021
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Ingår i: European Journal of Human Genetics. - : Springer Nature. - 1018-4813 .- 1476-5438. ; 29, s. 300-308
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis-free Mendelian randomization studies provide a way to assess the causal relevance of a trait across the human phenome but can be limited by statistical power, sample overlap or complicated by horizontal pleiotropy. The recently described latent causal variable (LCV) approach provides an alternative method for causal inference which might be useful in hypothesis-free experiments across human phenome. We developed an automated pipeline for phenome-wide tests using the LCV approach including steps to estimate partial genetic causality, filter to a meaningful set of estimates, apply correction for multiple testing and then present the findings in a graphical summary termed causal architecture plot. We apply this pipeline to body mass index (BMI) and lipid traits as exemplars of traits where there is strong prior expectation for causal effects, and to dental caries and periodontitis as exemplars of traits where there is a need for causal inference. The results for lipids and BMI suggest that these traits are best viewed as contributing factors on a multitude of traits and conditions, thus providing additional evidence that supports viewing these traits as targets for interventions to improve health. On the other hand, caries and periodontitis are best viewed as a downstream consequence of other traits and diseases rather than a cause of ill health. The automated pipeline is implemented in the Complex-Traits Genetics Virtual Lab (https:// vl.genoma.io) and results are available in. We propose causal architecture plots based on phenome-wide partial genetic causality estimates as a new way visualizing the overall causal map of the human phenome.
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24. |
- Haworth, S., et al.
(författare)
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Heritability of Caries Scores, Trajectories, and Disease Subtypes
- 2020
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 99:3, s. 264-270
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies report that dental caries is partially heritable, but there is uncertainty in the magnitude of genetic effects and little understanding of how genetic factors might influence caries progression or caries subtypes. This study aimed to estimate the relative importance of genetic and environmental factors in the etiology of different caries outcomes using a twin-based design. Analysis included up to 41,678 twins in the Swedish Twin Register aged 7 to 97 y, and dental data were obtained from preexisting dental records. The outcome measures were 1) summary indices of caries experience, 2) parameters representing trajectory in caries progression derived from longitudinal modeling, and 3) caries scores in groups of biologically similar tooth surfaces derived from hierarchical clustering of tooth surfaces (termed caries clusters). Additive genetic factors explained between 49.1% and 62.7% of variation in caries scores and between 50.0% and 60.5% of variation in caries trajectories. Seven caries clusters were identified, which had estimates of heritability lying between 41.9% and 54.3%. Shared environmental factors were important for only some of these clusters and explained 16% of variation in fissure caries in molar teeth but little variation in other clusters of caries presentation. The genetic factors influencing these clusters were only partially overlapping, suggesting that different biological processes are important in different groups of tooth surfaces and that innate liability to some patterns of caries presentation may partially explain why groups of tooth surfaces form clusters within the mouth. These results provide 1) improved quantification of genetic factors in the etiology of caries and 2) new data about the role of genetics in terms of longitudinal changes in caries status and specific patterns of disease presentation, and they may help lay the foundations for personalized interventions in the future.
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25. |
- Haworth, Simon, et al.
(författare)
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Using national register data to estimate the heritability of periodontitis
- 2021
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Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 48:6, s. 756-764
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify whether periodontal traits derived from electronic dental records are biologically informative and heritable.Materials and methods: The study included 11,974 adult twins (aged 30–92 years) in the Swedish Twin Registry. Periodontal records from dental examinations were retrieved from a national register and used to derive continuous measures of periodontal health. A latent class approach was used to derive categorial measures of periodontal status. The correlation patterns in these traits were contrasted in monozygotic and dizygotic twin pairs using quantitative genetic models to estimate the heritability of the traits.Results: For continuous traits, heritability estimates ranged between 41.5% and 48.3% with the highest estimates for number of missing tooth surfaces and rate of change in number of deep periodontal pockets (≥6 mm). For categorial traits, the latent class approach identified three classes (good periodontal health, mild periodontitis signs and severe signs of periodontitis) and there was a clear difference in the hazard for subsequent tooth loss between these three classes. Despite this, the class allocations were only slightly more heritable than a conventional dichotomous disease definition (45.2% vs. 42.6%).Conclusions: Periodontitis is a moderately heritable disease. Quantitative periodontal traits derived from electronic records are an attractive target for future genetic association studies.
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26. |
- Hedberg, Jakob, et al.
(författare)
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Randomized controlled trial of nasogastric tube use after esophagectomy : study protocol for the kinetic trial
- 2024
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Ingår i: Diseases of the esophagus. - : John Wiley & Sons. - 1120-8694 .- 1442-2050. ; 37:6
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Tidskriftsartikel (refereegranskat)abstract
- Esophagectomy is a complex and complication laden procedure. Despite centralization, variations in perioparative strategies reflect a paucity of evidence regarding optimal routines. The use of nasogastric (NG) tubes post esophagectomy is typically associated with significant discomfort for the patients. We hypothesize that immediate postoperative removal of the NG tube is non-inferior to current routines. All Nordic Upper Gastrointestinal Cancer centers were invited to participate in this open-label pragmatic randomized controlled trial (RCT). Inclusion criteria include resection for locally advanced esophageal cancer with gastric tube reconstruction. A pretrial survey was undertaken and was the foundation for a consensus process resulting in the Kinetic trial, an RCT allocating patients to either no use of a NG tube (intervention) or 5 days of postoperative NG tube use (control) with anastomotic leakage as primary endpoint. Secondary endpoints include pulmonary complications, overall complications, length of stay, health related quality of life. A sample size of 450 patients is planned (Kinetic trial: https://www.isrctn.com/ISRCTN39935085). Thirteen Nordic centers with a combined catchment area of 17 million inhabitants have entered the trial and ethical approval was granted in Sweden, Norway, Finland, and Denmark. All centers routinely use NG tube and all but one center use total or hybrid minimally invasive-surgical approach. Inclusion began in January 2022 and the first annual safety board assessment has deemed the trial safe and recommended continuation. We have launched the first adequately powered multi-center pragmatic controlled randomized clinical trial regarding NG tube use after esophagectomy with gastric conduit reconstruction.
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27. |
- Hörbo, Moa, et al.
(författare)
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Experiences of Stress : A Focus Group Interview Study Among Swedish Adolescents During the COVID-19 Pandemic
- 2021
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Ingår i: Journal of School Nursing. - : SAGE Publications Inc.. - 1059-8405 .- 1546-8364. ; , s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Adolescence can be a stressful period in life. The period contains challenges associated with the transition from childhood to adulthood (body changes, changes in interpersonal relationships, and identity changes). The aim was to investigate experiences of stress among adolescents in addition to stress related to the COVID-19 pandemic. Focus group interviews (n = 8) were conducted with girls (n = 22) and boys (n = 19) aged 13–15 in southern Sweden. The transcribed interviews were analyzed with qualitative content analysis. Analysis of the collected material resulted in two categories with four sub-categories each of which highlights adolescents’ experiences of stress. The results show that adolescents’ have a variety of experiences of stress, i.e., what they mean are the sources of stress and how stress is manifested. The adolescents experienced how stress was manifested both physically and emotionally. This affected both their sleep and performance. The adolescents reflected on both positive and negative manifestations of stress.
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28. |
- Igra, Annachiara Malin, et al.
(författare)
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Early Life Environmental Exposure to Cadmium, Lead, and Arsenic and Age at Menarche : A Longitudinal Mother-Child Cohort Study in Bangladesh
- 2023
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Ingår i: Journal of Environmental Health Perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 131:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several metals act as endocrine disruptors, but there are few large longitudinal studies about associations with puberty onset.OBJECTIVES: We evaluated whether early life cadmium, lead, and arsenic exposure was associated with timing of menarche. METHODS: In a mother-child cohort in rural Bangladesh (n = 935), the exposure was assessed by concentrations in maternal erythrocytes in early pregnancy and in girls' urine at 5 and 10 years of age using inductively coupled plasma mass spectrometry. The girls were interviewed twice, at aver-age ages 13.3 [standard deviation eth SD THORN = 0.43] and 13.8 (SD = 0.43) y, and the date of menarche, if present, was recorded. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox regression.RESULTS: In total, 77% of the girls (n = 717) had reached menarche by the second follow-up. The median age of menarche among all girls was 13.0 y (25th-75th percentiles: 12.4-13.7 y). At 10 years of age, median urinary cadmium was 0.25 mu g/L (5th-95th percentiles: 0.087-0.72 mu g/L), lead 1.6 mu g/L (0.70-4.2 mu g/L), and arsenic 54 mu g/L (19-395 mu g/L). Given the same age, girls in the highest quartile of urinary cadmium at 5 and 10 years of age had a lower rate of menarche than girls in the lowest quartile, with an adjusted hazard ratio of (HR) 0.80 (95% CI: 0.62, 1.01) at 5 years of age, and 0.77 (95% CI: 0.60, 0.98) at 10 years of age. This implies that girls in the highest cadmium exposure quartile during childhood had a higher age at menarche. Comparing girls in the highest to the lowest quartile of urinary lead at 10 years of age, the former had a higher rate of menarche [adjusted HR = 1.23 (95% CI: 0.97, 1.56)], implying lower age at menarche, whereas there was no association with urinary lead at 5 years of age. Girls born to mothers in the highest quartile of erythrocyte arsenic during pregnancy were less likely to have attained menarche than girls born to mothers in the low-est quartile [adjusted HR = 0.79 (95% CI: 0.62, 0.99)]. No association was found with girls' urinary arsenic exposure.DISCUSSION: Long-term childhood cadmium exposure was associated with later menarche, whereas the associations with child lead exposure were inconclusive. Maternal exposure to arsenic, but not cadmium or lead, was associated with later menarche. https://doi.org/10.1289/EHP11121
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29. |
- Johansson, Anna, 1970-
(författare)
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Barns teaterskapande : En ämnesdidaktisk studie av drama och teater i kulturskolan
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The subject of this thesis is children’s theatre making in the Swedish School of Arts (Kulturskolan), which involves the creating work that children do on their own when they are asked to craft dramatic scenes without relying on a script or a story. Despite the fact that this is a common way of producing theatre in the Swedish School of Arts, little research has been done on the collective process when it is controlled by the children themselves. This thesis explores what children are actually doing when they collectively develop their own scene and what they need to master to make it comprehendible. The thesis is based on two empirical studies – a field study and a learning study – carried out in three drama groups with children aged 9–11 at a School of Arts in Sweden.In the field study, I observed a drama group during the process of creating their own play. By applying ethnographic methods and multimodal interaction analysis combined with theories about children's creative process and connections between play and drama/theatre the study explores what children do when they are set free to make scenes in small groups. The result shows a speedy, multi-layered, collaborative process in which they all, in different ways, responsively participate in designing roles and events through interactive verbal and bodily improvisation. The field study was followed by a learning study to explore how the multifaceted, simultaneous, and interactive activity of creating dramatic scenes could be specified and articulated as subject-specific knowledge. For this purpose, two other drama groups were chosen, and the subsequent study was conducted in collaboration with their respective drama teachers. A total of six lessons were designed and videotaped. The empirical material was analysed by using phenomenography. The result shows the skills divided into four subthemes: making the story logic, creating meaningful roles, coordinating the big picture, and adding relevant events. The co-creation of characters and events involves the ability to both talk about ideas and try them out through acting. When they create a scene, they use strategies similar to those children often use when role-playing; they alternate between being in and out of character, in and out of fiction. What essentially distinguishes theatre making in this sense from children’s ordinary role-play is the concern for and awareness of an imagined audience. Taking on the perspective of an audience includes the ability to design roles and events to make the play understandable from the outside: what I call aesthetic triangulation.
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30. |
- Johansson, Pernilla, et al.
(författare)
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Evaluation of cleaning products on the viability of mould growth on facades and decks
- 2023
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Ingår i: Journal of Physics, Conference Series. - : Institute of Physics. - 1742-6588 .- 1742-6596. ; 2654:1
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Tidskriftsartikel (refereegranskat)abstract
- Microfungi, algae and cyanobacteria may cause discolouration when growing on facades and deckings. When the extent of growth is such that it is no longer aesthetically acceptable, cleaning is often performed to make the façade or deck as similar to the original as possible. Different cleaning methods may have different effects. Choosing a cleaning method is difficult because one does not always know which works best for the current conditions. Also, the best cleaning method probably cannot remove all the growth. In this study, the effect of 15 different cleaning chemical products on the viability of mould growth on painted facade boards and impregnated wood deck boards was studied in the laboratory. Results showed varying results; the best products killed or removed almost all growth, while the worst had the same effect as clean water. The results can not be used to predict the efficiency of the different products on discolouration authentic facades or wooden decks over time. It will be investigated in other studies of the same project as this study belongs.
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31. |
- Johansson, Pernilla
(författare)
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Fukt, trä och mögelväxt – en översikt över litteratur inom området
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Preventing mould growth on building materials during construction requires understanding the conditions under which mould can grow. This study conducted an inventory of literature published in the field of moisture, wooden material, and mould growth, selected, documented and categorised relevant literature, and summarised the state of current research. The study is part of a bigger project working to produce a handbook for the moisture-proof production of wooden buildings. The criterium for selecting literature was whether it could provide information on the conditions under which mould growth can occur on wood and wood-based materials during the production stage. This information mainly covers limit values for humidity and temperature, how long these limit values can be exceeded without mould growth, and whether there are differences between different wood materials and between different wood-based products. Both laboratory tests and field studies are included in the material. Most published laboratory studies have been performed under high relative humidity (RH), very favourable to mould growth. Often in these conditions, mould growth begins within one week on all wooden material. Mould growth at lower, less favourable humidity conditions is less studied. However, there are indications that the lowest RH at which mould can grow varies between different qualities of wood. The laboratory studies use different methodologies, and it is not easy to compare results and make general conclusions to achieve the purpose of this study. For example, only discolouring growth is studied, resulting in misleading interpretations, as there may be extensive growth on a material without being visible to the naked eye. Outdoor field studies were evaluated first after several months. The results are difficult to apply to the construction of buildings, as these are not exposed for such long periods without weather protection. Additionally, the field studies only considered the development of discolouring growth. The report also summarises several studies performed at RISE using the same methodology. Some are yet unpublished. More information about the relationship between moisture, temperature, wood material, etc. can be obtained by additional analysis of the results from these studies.
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32. |
- Johansson, Pernilla, et al.
(författare)
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How well do mould models predict mould growth in buildings, considering the end-user perspective?
- 2021
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Ingår i: Journal of Building Engineering. - : Elsevier Ltd. - 2352-7102. ; 40
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Tidskriftsartikel (refereegranskat)abstract
- Mould growth results from a complex interaction between environmental factors, material properties, and mould fungi characteristics. These interactions must be considered during the design, construction and maintenance of a building to prevent growth. Mould prediction models aim to predict whether mould will grow on a specific material in a part of building with a known, or simulated, relative humidity and temperature. They are often used in the design phase. Several models are available. There is limited research on the performance of the models in real buildings. This study aimed to evaluate six different models, using data from five building parts. The predictions on whether mould growth was expected or not were compared to actual mould growth observations on five building materials. The study was performed as a round-robin. Most models underestimated the possibility for mould when humidity and temperature varied a lot by time. The outcome also depended on the end-user, who needs to make assumptions and parameter values choices on, for example, material susceptibility for mould growth. Therefore, using the same climate data, mould growth prediction may differ depending on who makes the prediction. One model, MOGLI model, where input data comes from laboratory tests and no such assumptions must be made, predicted correct in most cases. One conclusion of the study is that when predictions are made in practice, the results must be used cautiously. More knowledge is needed to understand, and more accurately model, the relationships between the moisture and temperature variations in buildings and the risk for mould growth.
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33. |
- Johansson, Pernilla, et al.
(författare)
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Kritiskt fukttillstånd för mögelpåväxt på byggnadsmaterial
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Critical moisture level for mould growth on building materials. Mould can grow on building materials in 75-100% relative humidity (RH) at room temperature. How sensitive materials are to mould growth varies. One way to describe this sensitivity is the critical moisture level, RHcrit, the lowest RH at which mould can grow on a material. The critical moisture level for different material groups was proposed based on the current research situation in 2005, in the report ” Microbiological growth on building materials – critical moisture levels. State of the art” (SP Rapport 2005: 11). Based on new research results, these values are no longer valid. This report provides a general overview of the conditions for mould growth on building materials, focusing on the critical moisture level and the new research results. The main conclusion is that RHcrit is a product-specific property. It is impossible to estimate RHcrit for a product based on that it belongs to a group of materials, such as plaster or wood-based boards. Instead, RHcrit must be determined by laboratory tests for each product. The report also discusses how the results of a laboratory test can be used to prevent mould growth in buildings with known RF and temperature and the benefits of using RHcrit instead of traditional mould resistance tests.
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34. |
- Johansson, Pernilla, et al.
(författare)
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Predicting mould growth on building materials- the PJ-model
- 2020
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Ingår i: E3S Web of Conferences. Volyme 172, 2020.. - : EDP Sciences.
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Konferensbidrag (refereegranskat)abstract
- Mould growth in buildings is a complex process, affected by moisture and temperature, the properties of the building material as well as characteristics of the mould fungi. The complexity poses challenges when assessing the risk of mould growth in buildings. Mathematical models are often used to predict whether mould will grow in a part of building with expected RH and temperature conditions. The models can be described as static or dynamic. In a previous round-robin study, comparing results from models with observations from field studies, the outcome of the dynamic models evaluated depended on the user of the model. Also, the models often underestimated the risk of mould growth. A better agreement was found for static models, especially for the PJ-model. It is a part of a standardised technical specification (SIS-TS 41:2014) and has not previously been described as a model. The critical moisture level (RHcrit), determined by tests according to the method, is used as input. Thus, the subjectivity in the predictions is reduced. RHcrit is the lowest moisture level at which mould can grow and is temperature-dependent. The PJ-model provides an equation to estimate RHcrit at typical temperatures in buildings. If RH in a building section exceeds the limit values at the current temperature, growth is predicted. This paper describes the PJ-model version 1.0, some of the extensive work performed during the development and validation of the model and the ongoing work to refine the model to include considering transient conditions and measurement uncertainties. © The Authors
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35. |
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36. |
- Johansson, Pernilla, et al.
(författare)
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Threshold values for mould growth : Critical moisture level of 21 different building materials
- 2020
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Ingår i: E3S Web of Conferences. Volume 172, 2020. - : EDP Sciences.
-
Konferensbidrag (refereegranskat)abstract
- The susceptibility for mould growth varies among different building materials. One way to describe the susceptibility is the lowest RH at which mould can grow on a specific material, the critical moisture level (RHcrit). Determining RHcrit for materials provide the basis for material choice in designs where moisture and temperature conditions are known. In this study, RHcrit of 21different products were determined according to SIS-TS 41:2014/SPMet 4927. This test method is developed based on the results of a variety of laboratory studies and validated by field studies. Test specimens were inoculated with a suspension containing spores from six different mould fungi and were then incubated in moisture chambers at four levels of RH at 22 °C. After 12 weeks specimens were analysed for mould growth. RHcrit was determined based on the lowest RH at which mould grew on the specimens. RHcrit varied among different products, even between product belonging to a similar group of material, for example, calcium silicate boards or gypsum boards. The results show, and confirm, previous findings that it is not possible to estimate RHcrit for a specific product based on material group. Instead, each product must be tested. © The Authors
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37. |
- Khalaf, Atika, et al.
(författare)
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Self-rated health in Swedish pregnant women : a comprehensive population register study
- 2022
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Ingår i: British Journal of Midwifery. - : MA Healthcare Ltd. - 0969-4900 .- 2052-4307. ; 30:6, s. 306-315
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Sociodemographic factors are associated with perceived overall health status or ‘self-rated health’. However, research using data from the comprehensive population register in Sweden to examine self-rated health in pregnant women is limited. This study aimed to examine sociodemographic factors associated with self-rated health before, during and after pregnancy in low-risk pregnant women, based on comprehensive population register data in Sweden. Methods: This was a retrospective analysis of the Swedish pregnancy register (Graviditets registret). Data from 167523 women were tested with group comparisons and ordinal regression analyses. Results: Women between the ages of 25 and 29 years and primiparas were less likely to self-rate their health lower.Women born outside Scandinavia, those whose education did not reach university level, jobseekers, those on parental leave and students were more likely to report lower self-rated health. Women with risky behaviours, such as alcohol consumption and those who smoked and/or snuffed were more likely to report lower self-rated health. Conclusions: The findings indicate that preventive and health promoting actions in the midwifery profession should build on awareness of possible associated sociodemographic factors.
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38. |
- Lif Holgerson, Pernilla, et al.
(författare)
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A longitudinal study of the development of the saliva microbiome in infants 2 days to 5 years compared to the microbiome in adolescents
- 2020
-
Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Understanding oral microbiota programming attracts increasing interest due to its importance for oral health and potential associations with systemic diseases. Here the oral microbiota was longitudinally characterized in children from 2 days (n = 206) to 5 years of age and in young adults (n = 175) by sequencing of the v3-v4 region of the 16S rRNA gene from saliva extracted DNA. Alpha diversity increased by age, with 2-day- and 3-month-old infants in one sub-group, and 18-month- and 3-year-old children in another. Firmicutes decreased up to 3 years of age, whereas Proteobacteria, Actinobacteria, Bacteroidetes and Fusobacteria abundances increased. Abiotrophia, Actinomyces, Capnocytophaga, Corynebacterium, Fusobacterium, Kingella, Leptotrichia, Neisseria and Porphyromonas appeared from 18-months of age. This was paralleled by expansions in the core microbiome that continued up to adulthood. The age-related microbiota transformation was paralleled by functional alterations, e.g., changed metabolic pathways that reflected e.g., breastfeeding and increasing proportions of anaerobic species. Oral microbiotas differed by feeding mode and weakly by mode of delivery, but not gender, pacifier use or cleaning method or probiotic intake. The study shows that the saliva microbiota is diverse 2 days after birth and under transformation up to 5 years of age and beyond, with fluctuations possibly reflecting age-related environmental influences.
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39. |
- Lif Holgerson, Pernilla, et al.
(författare)
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Genetic preference for sweet taste in mothers associates with mother-child preference and intake
- 2023
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 15:11
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Tidskriftsartikel (refereegranskat)abstract
- Taste perception is a well-documented driving force in food selection, with variations in, e.g., taste receptor encoding and glucose transporter genes conferring differences in taste sensitivity and food intake. We explored the impact of maternal innate driving forces on sweet taste preference and intake and assessed whether their children differed in their intake of sweet foods or traits related to sweet intake. A total of 133 single nucleotide polymorphisms (SNPs) in genes reported to associate with eating preferences were sequenced from saliva-DNA from 187 mother-and-child pairs. Preference and intake of sweet-, bitter-, sour-, and umami-tasting foods were estimated from questionnaires. A total of 32 SNP variants associated with a preference for sweet taste or intake at a p-value < 0.05 in additive, dominant major, or dominant minor allele models, with two passing corrections for multiple testing (q < 0.05). These were rs7513755 in the TAS1R2 gene and rs34162196 in the OR10G3 gene. Having the T allele of rs34162196 was associated with higher sweet intake in mothers and their children, along with a higher BMI in mothers. Having the G allele of rs7513755 was associated with a higher preference for sweets in the mothers. The rs34162196 might be a candidate for a genetic score for sweet intake to complement self-reported intakes.
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40. |
- Lif Holgerson, Pernilla, et al.
(författare)
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The breast milk and childhood gastrointestinal microbiotas and disease outcomes : a longitudinal study
- 2023
-
Ingår i: Pediatric Research. - : Springer Nature. - 0031-3998 .- 1530-0447. ; 93, s. 570-578
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We aimed to characterize breast milk microbiota and define associations with saliva and fecal microbiota and selected diseases in preschool children.METHODS: In a longitudinal cohort study, the microbiotas from breast milk, mouth, and fecal samples were characterized by 16S rRNA gene sequencing. Questionnaires and medical records provided information on demographics, medical, and dental data.RESULTS: The phylogeny in breast milk, saliva swabs, and feces differed at all levels (p < 0.0003), though all harbored species in Streptococcus, Veillonella, and Haemophilus. Species richness was highest in breast milk with increasing resemblance with the oral swab microbiota by increasing age. Caries-affected children at age 5 had been fed breast milk with tenfold higher abundance of caries-associated bacteria, e.g., Streptococcus mutans, than caries-free children (p < 0.002). At that age, taxa, e.g., Neisseria sicca were overrepresented in saliva swabs of children with otitis media (LDA score >2, p < 0.05). Gut symbionts, e.g., Bacteroides, were underrepresented in 3-month fecal samples in children later diagnosed with allergic disease (LDA score >2, p < 0.05).CONCLUSIONS: Distinct microbiotas for the three sources were confirmed, though resemblance between milk and oral swab microbiota increased by age. Future studies should evaluate if the observed associations with disease outcomes are causal.IMPACT: Few studies have studied the association between breast milk microbiota and gastrointestinal microbiota beyond early infancy. The present study confirms distinct microbiota profiles in breast milk, saliva swabs, and feces in infancy and indicates increasing resemblance between breast milk and the oral microbiota by increasing age. The fecal microbiota at 3 months was associated with later allergic disease; the saliva microbiota by age 5 differed between children with and without otitis media at the same age; and children with caries by age 5 had been fed breast milk with a higher abundance of caries-associated bacteria.
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41. |
- Malm, Joakim, et al.
(författare)
-
UTVÄRDERING AV SI-VERKSAMHETEN VID LUNDS UNIVERSITET 2019/20
- 2020
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Enkelt uttryckt är Samverkansinlärning (SI) en studiecirkel kopplat till en utmanande kurs. SI leds av en senior student som utformar läraktiviteter där studenterna arbetar i grupper med att förklara och förtydliga svårt kursmaterial. Målsättningen med SI, förutom förbättrade prestationer i den aktuella kursen, är att studenterna skall utveckla goda studiestrategier och bli mer självständiga i sitt lärande. Denna rapport behandlar SI-verksamheten vid Lunds universitet under läsåret 2019/20. Målsättningen är att läsaren skall få en god bild av hur SI bedrivs vid lärosätet och hur insatsen upplevs av deltagare och studentledare. Rapporten bygger dels på kvantitativa data – SI-närvaro samt närvaron kopplat till studenternas prestationer i SI-stödda kurser. Och dels på kvalitativa data från enkäter till deltagare och SI-ledare samt information frän metodhandledare och SI-koordinatorer.Under läsåret 2019/20 kompletterades undervisningen i 160 kurstillfällen av SI där totalt 235 studentledare ledde SI-pass. 4200 studenter vid universitetet deltog på passen under läsåret. Medelnärvaron var 25 % och 50 % av studenter med tillgång till SI provade på att besöka åtminstone ett pass. Dessa siffror betyder att SI-verksamheten vid Lunds universitet är en av de största vid lärosäten i Europa. SI-verksamheten följer också grundläggande SI-principer på ett bra sätt enligt deltagarna. Exempelvis på så sätt att deltagarna har ett stort inflytande över agendan på SI-passen och att arbetet med att förstå utmanande kursmaterial bedrivs genom arbete och diskussion i grupp. SI-ledaren ser till att arbetet går framåt genom att ställa frågor och uppmuntrardeltagarna att dela med sig av sina kunskaper till varandra. Studenternas drivkraft att gå på SI-passen är i huvudsak meningsorienterad genom att de vill få en bättre förståelse av ämnet och för att det är roligt att diskutera kursinnehåll med kurskamrater. Vad ger då deltagande på SI för närvarande studenter? Jämförelser av närvaro på SI och genomströmning på SI-stödd kurs antyder att chanserna att klara kursen vid ordinarie examination(er) ökar med ökad SI-närvaro. Deltagande studenter upplever dessutom i stor utsträckning att SI leder till att de bättre förstår vad som förväntas av dem i kursen, är ett effektivt stöd att ta sig fram i kursen, ökar intresset för ämnet och ger dem en djupare förståelse av kursinnehållet. Dessutom anser en stor andel avdeltagarna att de utvecklar generella färdigheter såsom problemlösning, kritiskt tänkande, lagarbete och presentation av akademiskt material inför andra. En betydande del av SI-deltagarna anger att de åtminstone till viss del de utvecklar sitt sätt att studera och förbättrar sitt akademiska självförtroende. Ca en fjärdedel av de svarande på enkäten anser att SI varit viktigt för att skaffa studiekamrater, vilket kan vara mycket betydelsefullt för att känna tillhörighet inom akademien och ge ytterligare motivation till fortsatta högre studier.De dominerande svarsteman på öppna enkätfrågor rörande vad som är bäst med SI samt vad som skiljer SI-pass från ordinarie undervisning är desamma för bägge frågorna. Det handlar om att deltagarna uppskattar diskussionen/samarbetet samt atmosfären och arbetsmiljön på passen. Vidare gillar studenterna fokus på djupare förståelse av kursinnehållet. På frågan vad man tycker kan förbättras med SI-passen anser en del av deltagarna att strukturen på passet ibland kan vara tydligare och att arbetet under passen ibland kan kännas ineffektivt.Aktiva SI-ledare och SI-ledaralumner i arbetslivet fick svara på enkäter rörande de färdigheter man tränar och utvecklar i sitt SI-arbete. Här framkom att de svarande generellt tyckte att de blivit bättre på ett flertal färdigheter inom områdena kommunikation, ledarskap och handhavande av grupper samt vissa personliga färdigheter. En stor majoritet av SI-ledaralumnerna ansåg dessutom SI-ledarskapet givit dem en fördel när de sökt jobb och att man haft god nytta av SI-färdigheterna i sitt yrkesverksamma liv. Enkätundersökningen avaktiva SI-ledare samt SI-ledaralumner vid Lunds Universitet var en del av en internationell undersökning där två andra SI-program vid North West University i Sydafrika och University of Missouri Kansas City ingick. Resultaten från enkäterna vid dessa lärosäten speglade resultaten från Lunds universitet. Således verkar SI-ledarna generellt vinna en hel del genom sin tjänstgöring, oavsett lärosäte och land, som de senare har nytta av i sitt yrkesverksamma liv.Under den andra hälften av vårterminen 2020 övergick SI-passen till att ges på distans pga Coronapandemin. Många metodhandledare och SI-ledare gjorde ett fantastiskt jobb med att snabbt ställa om verksamheten. Enkätsvar från deltagare på distans-SI visade att SI-passen var uppskattade och att fördelarna man fick från att delta motsvarade de som man får på reguljär sals-SI. Dock framträdde ett antal utmaningar. Närvaron var betydligt lägre på distans-SI jämfört med sals-SI. Mötena kändes ofta som lite mer tidsineffektiva när de gickpå distans, ledarna fick en svårare uppgift med att hålla reda på tekniken vid sidan av att leda SI-passet, och deltagarna/ledarna saknade den sociala dimensionen man får vid sals-SI med möjlighet att kunna snacka liteom annat och att kunna läsa av kroppsspråk. Möjligheten att prova på distans-SI vid Lunds universitet har varit berikande och gett inspiration till att utveckla konceptet. Distans SI bör även i mer normala tider kunna vara ett bra komplement till sals-SI vad gäller att stödja studenter i utmanande kurser. Speciellt vid distanskurser, men även för att stödja studenter som inte har möjlighet att delta på sals-SI, exempelvis pga föräldraskap, deltidsarbete, långa pendlingstider, mm mm.Under läsåret 2019/20 gjordes också en studie av läraktiviteter under SI-pass. Studien visade att de huvudsakliga aktiviteterna på SI-pass handlar om att förklara och tydliggöra det som är svårt i kursen. Men att man också avsätter betydande del av tiden för att få en djupare förståelse av det behandlade kursmaterialet genom analyserande och reflekterande aktiviteter.
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42. |
- Malm, Joakim, et al.
(författare)
-
Utvärdering av SI-verksamheten vid Lunds universitet 2022/23
- 2023
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Enkelt uttryckt är Samverkansinlärning (SI) en studiecirkel kopplat till en utmanande kurs. SI leds av en senior student som utformar läraktiviteter där studenterna arbetar i grupper med att förklara och förtydliga svårt kursmaterial. Målsättningen med SI, förutom förbättrade prestationer i den aktuella kursen, är att studenterna skall utveckla goda studiestrategier och bli mer självständiga i sitt lärande. Denna rapport behandlar SI-verksamheten vid Lunds universitet under läsåret 2022/23. Målsättningen är att läsaren skall få en god bild av hur SI bedrivs vid lärosätet och hur insatsen upplevs av deltagare och studentledare. Rapporten bygger dels på kvantitativa data – SI-närvaro, samt närvaron kopplat till studenternas prestationer i SI-stödda kurser. Och dels på kvalitativa data från enkäter till deltagare och SI-ledare, dels information frän metodhandledare och SI-koordinatorer. Under läsåret 2022/23 kompletterades undervisningen i 204 kurstillfällen av SI där totalt 266 studentledare ledde SI-pass. 5200 studenter vid universitetet deltog på passen under läsåret. Medelnärvaron var 23 % och 53% av studenter med tillgång till SI provade på att besöka åtminstone ett pass. Dessa siffror betyder att SI-verksamheten vid Lunds universitet är en av de största vid lärosäten i Europa (SI finns på 75+ högre lärosäten i Europa). SI-verksamheten följer också grundläggande SI-principer på ett bra sätt enligt deltagarna. Exempelvis på så sätt att deltagarna har ett stort inflytande över agendan på SI-passen och att arbetet med att förstå utmanande kursmaterial bedrivs genom arbete och diskussion i grupp. SI-ledaren ser till att arbetet gårframåt genom att ställa frågor och uppmuntrar deltagarna att dela med sig av sina kunskaper till varandra.Studenternas drivkraft att gå på SI-passen är i huvudsak meningsorienterad genom att de vill få en bättre förståelse av ämnet och för att det är roligt att diskutera kursinnehåll med kurskamrater. Vad ger då deltagande på SI för närvarande studenter? Jämförelser av närvaro på SI och genomströmning på SI-stödd kurs antyder att chanserna att klara kursen vid ordinarie examination(er) ökar med ökad SI-närvaro. Deltagande studenter upplever dessutom i stor utsträckning att SI leder till att de bättre förstår vad som förväntas av dem i kursen, är ett effektivt stöd att ta sig fram i kursen, ökar intresset för ämnet och ger dem en djupare förståelse av kursinnehållet. Dessutom anser en stor andel av deltagarna att de utvecklar generella färdigheter såsom problemlösning, kritiskt tänkande, lagarbete och presentation av akademiskt material införandra. En betydande del av SI-deltagarna anger att de åtminstone till viss del utvecklar sitt sätt att studera och förbättrar sitt akademiska självförtroende. Lite mer än en fjärdedel av de svarande på enkäten anser att SI varit viktigt för att skaffa studiekamrater, vilket kan vara mycket betydelsefullt för att känna tillhörighet inom akademien och ge ytterligare motivation till fortsatta högre studier.De dominerande svarsteman på öppna enkätfrågor rörande vad som är bäst med SI samt vad som skiljer SI-pass från ordinarie undervisning är desamma för bägge frågorna. Det handlar om att deltagarna uppskattar diskussionen/samarbetet samt atmosfären och arbetsmiljön på passen. Vidare gillar studenterna fokus på djupare förståelse av kursinnehållet. På frågan vad man tycker kan förbättras med SI-passen anser en del av deltagarna att strukturen på passet ibland kan vara tydligare och att arbetet under passen ibland kan kännas ineffektivt.Det är roligt att konstatera att de allra flesta SI-ledarna trivs i sin roll, känner sig nöjda med sitt jobb och upplever att de gör skillnad för sina deltagare, baserat på deras enkätsvar. Dessutom utvecklar de i hög grad i olika färdigheter som kommunikation, grupphantering och ledarskap.
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43. |
- Mensah, Tita, et al.
(författare)
-
Organisational models of health services for children and adolescents in out-of-home care : Health technology assessment
- 2020
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 109:2, s. 250-257
-
Forskningsöversikt (refereegranskat)abstract
- Aim: Decades of research confirm that children and adolescents in out‐of‐home care (foster family, residential care) have much greater health care needs than their peers. A systematic literature review was conducted to evaluate organisational health care models for this vulnerable group.Methods: A systematic literature search was undertaken of the following data‐bases: Academic Search Elite, CENTRAL, Cochrane Database of Systematic Reviews, Cinahl, DARE, ERIC, HTA, PsycInfo, Psychology and Behavioural Sciences Collection, PubMed, SocIndex. Randomised and non‐randomised controlled trials were to be included. Two pairs of reviewers independently assessed abstracts of the identified published papers. Abstracts meeting the inclusion criteria were ordered in full text. Each article was reviewed independently, by pairs of reviewers. A joint assessment was made based on the inclusion criteria and relevance. Cases of disagreement were resolved by consensus discussion.Results: No study with low or medium risk of bias was identified.Conclusion: In the absence of studies of acceptable quality, it is not possible to assess the impact of organisational models intended to ensure adequate health and dental care for children and adolescents in out‐of‐home care. Therefore, well‐designed follow‐up studies should be conducted following the implementation of such models.
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44. |
- Ohlsson, Jonas A., et al.
(författare)
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SPIRO : the automated Petri plate imaging platform designed by biologists, for biologists
- 2024
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Ingår i: The Plant Journal. - : John Wiley & Sons. - 0960-7412 .- 1365-313X. ; 118:2, s. 584-600
-
Tidskriftsartikel (refereegranskat)abstract
- Phenotyping of model organisms grown on Petri plates is often carried out manually, despite the procedures being time-consuming and laborious. The main reason for this is the limited availability of automated phenotyping facilities, whereas constructing a custom automated solution can be a daunting task for biologists. Here, we describe SPIRO, the Smart Plate Imaging Robot, an automated platform that acquires time-lapse photographs of up to four vertically oriented Petri plates in a single experiment, corresponding to 192 seedlings for a typical root growth assay and up to 2500 seeds for a germination assay. SPIRO is catered specifically to biologists' needs, requiring no engineering or programming expertise for assembly and operation. Its small footprint is optimized for standard incubators, the inbuilt green LED enables imaging under dark conditions, and remote control provides access to the data without interfering with sample growth. SPIRO's excellent image quality is suitable for automated image processing, which we demonstrate on the example of seed germination and root growth assays. Furthermore, the robot can be easily customized for specific uses, as all information about SPIRO is released under open-source licenses. Importantly, uninterrupted imaging allows considerably more precise assessment of seed germination parameters and root growth rates compared with manual assays. Moreover, SPIRO enables previously technically challenging assays such as phenotyping in the dark. We illustrate the benefits of SPIRO in proof-of-concept experiments which yielded a novel insight on the interplay between autophagy, nitrogen sensing, and photoblastic response.
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45. |
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46. |
- Palmqvist, Charlotte, et al.
(författare)
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Complications after advanced ovarian cancer surgery-A population-based cohort study
- 2022
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Ingår i: Acta Obstetricia Et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 101:7, s. 747-757
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Surgical complications after primary or interval debulking surgery in advanced ovarian cancer were investigated and associations with patient characteristics and surgical outcomes were explored. Material and methods A population-based cohort study including all women with ovarian cancer, FIGO III-IV, treated with primary or interval debulking surgery, 2013-2017. Patient characteristics, surgical outcomes and complications according to the Clavien-Dindo (CD) classification system <= 30 days postoperatively, were registered. Uni- and multivariable regression analyses were performed with severe complications (CD >= III) as endpoint. PFS in relation was analyzed using the Kaplan-Meier method. Results The cohort included 384 women, where 304 (79%) were treated with primary and 80 (21%) with interval debulking surgery. Complications CD I-V were registered in 112 (29%) patients and CD >= III in 42 (11%). Preoperative albumin was significantly lower in the CD >= III cohort compared with CD 0-II (P = 0.018). For every increase per unit in albumin, the risk of complications decreased by a factor of 0.93. There was no significant difference in completed chemotherapy between the cohorts CD 0-II 90.1% and CD >= III 83.3% (P = 0.236). In the univariable analysis; albumin <30 g/L, primary debulking surgery, complete cytoreduction and intermediate/high surgical complexity score (SCS) were associated with CD >= III. In the following multivariable analysis, only intermediate/high SCS was found to be an independent significant prognostic factor. Low (n = 180) vs intermediate/high SCS (n = 204) showed a median PFS of 17.2 months (95% confidence interval [CI] 15.2-20.7) vs 21.5 months (95% CI 18.2-25.7), respectively, with a significant log-rank; P = 0.038. Conclusions Advanced ovarian cancer surgery is associated with complications but no significant difference was seen in completion of adjuvant chemotherapy when severe complications occur. Importantly, our study shows that intermediate/high SCS is an independent prognostic risk factor for complications. Low albumin, residual disease and primary debulking surgery were found to be associated with severe complications. These results may facilitate forming algorithms in the decision-making procedure of surgical treatment protocols.
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47. |
- Palmqvist, Charlotte, et al.
(författare)
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Increased disease-free and relative survival in advanced ovarian cancer after centralized primary treatment
- 2020
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Ingår i: Gynecologic Oncology. - : Elsevier BV. - 0090-8258. ; 159:2, s. 409-417
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To analyze 5-year disease-free survival (DFS) and relative survival (RS) before and after the 2011 implementation of centralized primary treatment of patients with advanced ovarian cancer. Methods. A population-based cohort study using the Swedish Quality Registry for Gynecological Cancer (SQRGC). Women with FIGO stage III and IV epithelial ovarian and Fallopian tube cancers were divided into two cohorts: before and after centralization. We estimated RS using the Ederer II method, analyzed the difference in the excess mortality rate ratio (EMRR) and estimated 5-year DFS in a Cox proportional hazard regression model with centralization, age, primary treatment and complete cytoreduction as variables. Results. A total of 495 women were identified with 244 women before (2008-2010) and 251 after (2011-2013) centralization. An increased 5-year RS from 24% (95%CI:19-31) to 37% (95%CI:31-44) and an increased median RS from 27 months (95%CI:23-34) to 44 months (95%CI:40-52), p < 0.001 (log-rank), were observed in the total cohort regardless of primary treatment. EMRR was found to be 0.62 (95%CI:0.51-0.76) in 2011-2013 compared to 2008-2010 for all patients. After centralization, 5-year DFS was significantly longer, hazard ratio of 0.77 (95%CI:0.64-0.93) and centralization was found to be an independent significant factor for both survival and DFS. Complete cytoreduction was found to be a significant independent factor associated with increased RS and DFS. Conclusion. Centralization of primary treatment of advanced ovarian cancer was associated with significantly increased complete cytoreduction, 5-year RS and DFS, and was found to be a significant independent factor for both RS and DFS. (C) 2020 The Authors. Published by Elsevier Inc.
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48. |
- Palmqvist, Charlotte, et al.
(författare)
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Societal costs of ovarian cancer in a population-based cohort - a cost of illness analysis
- 2022
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 61:11, s. 1369-1376
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Tidskriftsartikel (refereegranskat)abstract
- Background The societal cost associated with ovarian cancer (OC) is not well known. Increasing costs for new treatments and/or the impact of organizational changes motivates these costs to be described and communicated. This study aims to evaluate the cost of illness of OC in a population-based cohort. Material and methods All patients diagnosed with ovarian, fallopian tube, primary peritoneal cancer, and serous cancer of undesignated primary site (UPS) in 2011-2012 were followed for six years. Direct costs, i.e., costs for health care expenditures, were gathered from the regional healthcare database. Information on indirect costs, i.e., costs of loss of production due to sick leave, was retrieved from Statistics Sweden. Sub-group analyses were conducted regarding stage, income levels, residential area, and diagnosis. Results The cost of illness for all stages during the six years of follow-up was euro201,086 per patient, where indirect costs constituted 43.7%. The mean cost of illness per year per patient for all stages was euro33,514. Direct costs were higher in advanced stages compared to early stages for every year from diagnosis. During the first two years, there were no differences in indirect costs between early and advanced stages. However, during the third year there was a difference with higher indirect costs in advanced stages. There was no difference in direct costs depending on income levels. Regarding residential area, there was a difference in the outpatient cost during the index and second year with higher costs when chemotherapy and follow-up were provided at county hospitals, compared to at the tertiary hospital. Conclusions Indirect costs constituted a large part of the cost of illness over 6 years from diagnosis. This could indicate that even though treatment costs can be expected to rise with the introduction of new therapies, the societal cost may decrease when survival increase.
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49. |
- Parrow, Albin, et al.
(författare)
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Drug solubilization in dog intestinal fluids with and without administration of lipid-rich formulations
- 2024
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Ingår i: Journal of Controlled Release. - : Elsevier. - 0168-3659 .- 1873-4995. ; 371
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Tidskriftsartikel (refereegranskat)abstract
- The use of animal experiments can be minimized with computational models capable of reflecting the simulated environments. One such environment is intestinal fluid and the colloids formed in it. In this study we used molecular dynamics simulations to investigate solubilization patterns for three model drugs (carvedilol, felodipine and probucol) in dog intestinal fluid, a lipid-based formulation, and a mixture of both. We observed morphological transformations that lipids undergo due to the digestion process in the intestinal environment. Further, we evaluated the effect of bile salt concentration and observed the importance of interindividual variability. We applied two methods of estimating solubility enhancement based on the simulated data, of which one was in good qualitative agreement with the experimentally observed solubility enhancement. In addition to the computational simulations, we also measured solubility in i) aspirated dog intestinal fluid samples and ii) simulated canine intestinal fluid in the fasted state, and found there was no statistical difference between the two. Hence, a simplified dissolution medium suitable for in vitro studies provided physiologically relevant data for the systems explored. The computational protocol used in this study, coupled with in vitro studies using simulated intestinal fluids, can serve as a useful prescreening tool in the process of drug delivery strategies development.
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50. |
- Rosendahl, Sara, et al.
(författare)
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CCR3 deficiency is associated with increased osteoclast activity and reduced cortical bone volume in adult male mice
- 2021
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Ingår i: Journal of Biological Chemistry. - : American Society for Biochemistry and Molecular Biology. - 0021-9258 .- 1083-351X. ; 296
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Tidskriftsartikel (refereegranskat)abstract
- Increasing evidence emphasizes the importance of chemokines and chemokine receptors as regulators of bone remodeling. The C–C chemokine receptor 3 (CCR3) is dramatically upregulated during osteoclastogenesis, but the role of CCR3 in osteoclast formation and bone remodeling in adult mice is unknown. Herein, we used bone marrow macrophages derived from adult male CCR3-proficient and CCR3-deficient mice to study the role of CCR3 in osteoclast formation and activity. CCR3 deficiency was associated with formation of giant hypernucleated osteoclasts, enhanced bone resorption when cultured on bone slices, and altered mRNA expression of related chemokine receptors and ligands. In addition, primary mouse calvarial osteoblasts isolated from CCR3-deficient mice showed increased mRNA expression of the osteoclast activator–related gene, receptor activator of nuclear factor kappa-B ligand, and osteoblast differentiation–associated genes. Microcomputed tomography analyses of femurs from CCR3-deficient mice revealed a bone phenotype that entailed less cortical thickness and volume. Consistent with our in vitro studies, the total number of osteoclasts did not differ between the genotypes in vivo. Moreover, an increased endocortical osteoid mineralization rate and higher trabecular and cortical bone formation rate was displayed in CCR3-deficient mice. Collectively, our data show that CCR3 deficiency influences osteoblast and osteoclast differentiation and that it is associated with thinner cortical bone in adult male mice.
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