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  • 1.
    Abbey-Lee, Robin N.
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Kreshchenko, Anastasia
    Mechanical and Aeronautical Engineering Division L5, Department of Mechanical, Aerospace & Civil Engineering, Dalton Nuclear Institute, FSE Research Institutes,The University of Manchester, UK.
    Fernandez Sala, Xavier
    Linköping University, Faculty of Science & Engineering. Linköping University, Department of Physics, Chemistry and Biology, Biology.
    Petkova, Irina
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering. School of Biological Sciences, Centre for Ecology,Evolution and Behaviour, Royal Holloway University of London, Egham UK.
    Løvlie, Hanne
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Effects of monoamine manipulations on the personality and gene expression of three-spined sticklebacks2019In: Journal of Experimental Biology, ISSN 0022-0949, E-ISSN 1477-9145, Vol. 222, no 20, article id jeb211888Article in journal (Refereed)
    Abstract [en]

    Among-individual behavioral differences (i.e. animal personality) are commonly observed across taxa, although the underlying, causal mechanisms of such differences are poorly understood. Animal personality has been correlated with physiological functions as well as fitness-related traits. Variation in many aspects of monoamine systems, such as metabolite levels and gene polymorphisms, has been linked to behavioral variation. Therefore, here we experimentally investigated the potential role of monoamines in explaining individual variation in personality, using two common pharmaceuticals that respectively alter the levels of serotonin and dopamine in the brain: fluoxetine and ropinirole. We exposed three-spined sticklebacks, a species that shows animal personality, to either chemical alone or to a combination of the two chemicals, for 18 days. During the experiment, fish were assayed at four time points for the following personality traits: exploration, boldness, aggression and sociability. To quantify brain gene expression on short- and longer-term scales, fish were sampled at two time points. Our results show that monoamine manipulations influence fish behavior. Specifically, fish exposed to either fluoxetine or ropinirole were significantly bolder, and fish exposed to the two chemicals together tended to be bolder than control fish. Our monoamine manipulations did not alter the gene expression of monoamine or stress-associated neurotransmitter genes, but control, untreated fish showed covariation between gene expression and behavior. Specifically, exploration and boldness were predicted by genes in the dopaminergic, serotonergic and stress pathways, and sociability was predicted by genes in the dopaminergic and stress pathways. These results add further support to the links between monoaminergic systems and personality, and show that exposure to monoamines can causally alter animal personality.

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  • 2.
    Abbey-Lee, Robin N.
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Kreshchenko, Anastasia
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Fernandez Sala, Xavier
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Petkova, Irina
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Løvlie, Hanne
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Effects of monoamine manipulations on the personality and gene expression of three-spined sticklebacks2019Data set
    Abstract [en]

    Among-individual behavioral differences (i.e. animal personality) are commonly observed across taxa, although the underlying, causal mechanisms of such differences are poorly understood. Animal personality has been implicated in correlations with physiological functions as well as affecting fitness-related traits. Variation in many aspects of monoamine systems, such as metabolite levels and gene polymorphisms, has been linked to behavioral variation. Therefore, here we investigated the potential role of monoamines in explaining individual variation in personality, using two common pharmaceuticals that respectively alter the levels of serotonin and dopamine in the brain: fluoxetine and ropinirole. We exposed three- spined sticklebacks, a species that shows animal personality, to either chemical alone or to a combination of the two chemicals, for 18 days. During the experiment, fish were assayed at four time points for the following personality traits: exploration, boldness, aggression and sociability. To quantify brain gene expression on short- and longer-term scales, fish were sampled at two time points. Our results show that monoamine manipulations influence fish behavior. Specifically, fish exposed to either fluoxetine or ropinirole were significantly bolder, and fish exposed to the two chemicals together tended to be bolder than control fish. Our monoamine manipulations did not alter the gene expression of monoamine or stress-associated neurotransmitter genes, but control, untreated fish showed covariation between gene expression and behavior. Specifically, exploration and boldness were predicted by genes in the dopaminergic, serotonergic and stress pathways, and sociability was predicted by genes in the dopaminergic and stress pathways. These results add further support to the links between monoaminergic systems and personality, and show that exposure to monoamines can causally alter animal personality.

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  • 3.
    Abbey-Lee, Robin N.
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Uhrig, Emily
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Zidar, Josefina
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Favati, A.
    Department of Zoology, Stockholm University, Stockholm, Sweden.
    Almberg, J.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Dahlbom, J.
    Department of Neuroscience, Uppsala Biomedical Centre BMC, Uppsala University, Uppsala, Sweden.
    Winberg, S.
    Department of Neuroscience, Uppsala Biomedical Centre BMC, Uppsala University, Uppsala, Sweden.
    Løvlie, Hanne
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    The Influence of Rearing on Behavior, Brain Monoamines, and Gene Expression in Three-Spined Sticklebacks2018In: Brain, behavior, and evolution, ISSN 0006-8977, E-ISSN 1421-9743, Vol. 91, no 4, p. 201-213Article in journal (Refereed)
    Abstract [en]

    The causes of individual variation in behavior are often not well understood, and potential underlying mechanisms include both intrinsic and extrinsic factors, such as early environmental, physiological, and genetic differences. In an exploratory laboratory study, we raised three-spined sticklebacks <i>(Gasterosteus aculeatus)</i> under 4 different environmental conditions (simulated predator environment, complex environment, variable social environment, and control). We investigated how these manipulations related to behavior, brain physiology, and gene expression later in life, with focus on brain dopamine and serotonin levels, turnover rates, and gene expression. The different rearing environments influenced behavior and gene expression, but did not alter monoamine levels or metabolites. Specifically, compared to control fish, fish exposed to a simulated predator environment tended to be less aggressive, more exploratory, and more neophobic; and fish raised in both complex and variable social environments tended to be less neophobic. Exposure to a simulated predator environment tended to lower expression of dopamine receptor DRD4A, a complex environment increased expression of dopamine receptor DRD1B, while a variable social environment tended to increase serotonin receptor 5-HTR2B and serotonin transporter SLC6A4A expression. Despite both behavior and gene expression varying with early environment, there was no evidence that gene expression mediated the relationship between early environment and behavior. Our results confirm that environmental conditions early in life can affect phenotypic variation. However, the mechanistic pathway of the monoaminergic systems translating early environmental variation into observed behavioral responses was not detected.

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  • 4.
    Abbey-Lee, Robin
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Uhrig, Emily
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering. Southern Oregon Univ, OR 97520 USA.
    Garnham, Laura
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Lundgren, Kristoffer
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Child, Sarah
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering. Univ Manchester, England.
    Lovlie, Hanne
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Experimental manipulation of monoamine levels alters personality in crickets2018In: Scientific Reports, E-ISSN 2045-2322, Vol. 8, article id 16211Article in journal (Refereed)
    Abstract [en]

    Animal personality has been described in a range of species with ecological and evolutionary consequences. Factors shaping and maintaining variation in personality are not fully understood, but monoaminergic systems are consistently linked to personality variation. We experimentally explored how personality was influenced by alterations in two key monoamine systems: dopamine and serotonin. This was done using ropinirole and fluoxetine, two common human pharmaceuticals. Using the Mediterranean field cricket (Gryllus bimaculatus), we focused on the personality traits activity, exploration, and aggression, with confirmed repeatability in our study. Dopamine manipulations explained little variation in the personality traits investigated, while serotonin manipulation reduced both activity and aggression. Due to limited previous research, we created a dose-response curve for ropinirole, ranging from concentrations measured in surface waters to human therapeutic doses. No ropinirole dose level strongly influenced cricket personality, suggesting our results did not come from a dose mismatch. Our results indicate that the serotonergic system explains more variation in personality than manipulations of the dopaminergic system. Additionally, they suggest that monoamine systems differ across taxa, and confirm the importance of the mode of action of pharmaceuticals in determining their effects on behaviour.

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  • 5.
    Abbott, Rebecca
    et al.
    Northwestern Univ, IL 60611 USA.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    West, Janne
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Faculty of Medicine and Health Sciences.
    Elliott, James M.
    Northwestern Univ, IL 60611 USA; Univ Queensland, Australia; Zurich Univ Appl Sci, Switzerland.
    Åslund, Ulrika
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Karlsson, Anette
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Dahlqvist Leinhard, Olof
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    The qualitative grading of muscle fat infiltration in whiplash using fat and water magnetic resonance imaging2018In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 5, p. 717-725Article in journal (Refereed)
    Abstract [en]

    BACKGROUND CONTEXT: The development of muscle fat infiltration (MFI) in the neck muscles is associated with poor functional recovery following whiplash injury. Custom software and time-consuming manual segmentation of magnetic resonance imaging (MRI) is required for quantitative analysis and presents as a barrier for clinical translation. PURPOSE: The purpose of this work was to establish a qualitative MRI measure for MFI and evaluate its ability to differentiate between individuals with severe whiplash-associated disorder (WAD), mild or moderate WAD, and healthy controls. STUDY DESIGN/SETTING: This is a cross-sectional study. PATIENT SAMPLE: Thirty-one subjects with WAD and 31 age-and sex-matched controls were recruited from an ongoing randomized controlled trial. OUTCOME MEASURES: The cervical multifidus was visually identified and segmented into eighths in the axial fat/water images (C4-C7). Muscle fat infiltration was assessed on a visual scale: 0 for no or marginal MFI, 1 for light MFI, and 2 for distinct MFI. The participants with WAD were divided in two groups: mild or moderate and severe based on Neck Disability Index % scores. METHODS: The mean regional MFI was compared between the healthy controls and each of the WAD groups using the Mann-Whitney U test. Receiver operator characteristic (ROC) analyses were carried out to evaluate the validity of the qualitative method. RESULTS: Twenty (65%) patients had mild or moderate disability and 11 (35%) were considered severe. Inter- and intra-rater reliability was excellent when grading was averaged by level or when frequency of grade II was considered. Statistically significant differences (pamp;lt;.05) in regional MFI were particularly notable between the severe WAD group and healthy controls. The ROC curve, based on detection of distinct MFI, showed an area-under-the curve of 0.768 (95% confidence interval 0.59-0.94) for discrimination of WAD participants. CONCLUSIONS: These preliminary results suggest a qualitative MRI measure for MFI is reliable and valid, and may prove useful toward the classification of WAD in radiology practice. (C) 2017 Elsevier Inc. All rights reserved.

  • 6.
    Abdalla, Maie
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of General Surgery, Faculty of Medicine, Suez Canal University, Egypt.
    Norblad, Rickard
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Olsson, Malin
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Landerholm, Kalle
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Andersson, Peter
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Norrköping. Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Söderholm, Johan D.
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology.
    Andersson, Roland
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Surgery, Ryhov County Hospital, Jönköping, Sweden.
    Myrelid, Pär
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology.
    Anorectal Function After Ileo-Rectal Anastomosis Is Better than Pelvic Pouch in Selected Ulcerative Colitis Patients2020In: Digestive Diseases and Sciences, ISSN 0163-2116, E-ISSN 1573-2568, p. 250-259Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: With a lifelong perspective, 12% of ulcerative colitis patients will need a colectomy. Further reconstruction via ileo-rectal anastomosis or pouch can be affected by patients' perspective of their quality of life after surgery.

    AIM: To assess the function and quality of life after restorative procedures with either ileo-rectal anastomosis or ileal pouch-anal anastomosis in relation to the inflammatory activity on endoscopy and in biopsies.

    METHOD: A total of 143 UC patients operated with subtotal colectomy and ileo-rectal anastomosis or pouches between 1992 and 2006 at Linköping University Hospital were invited to participate. Those who completed the validated questionnaires (Öresland score, SF-36, Short Health Scale) were offered an endoscopic evaluation including multiple biopsies. Associations between anorectal function and quality of life with type of restorative procedure and severity of endoscopic and histopathologic grading of inflammation were evaluated.

    RESULTS: Some 77 (53.9%) eligible patients completed questionnaires, of these 68 (88.3%) underwent endoscopic evaluation after a median follow-up of 12.5 (range 3.5-19.4) years after restorative procedure. Patients with ileo-rectal anastomosis reported better overall Öresland score: median = 3 (IQR 2-5) for ileo-rectal anastomosis (n = 38) and 10 (IQR 5-15) for pouch patients (n = 39) (p < 0.001). Anorectal function (Öresland score) and endoscopic findings (Baron-Ginsberg score) were positively correlated in pouch patients (tau: 0.28, p = 0.006).

    CONCLUSION: Patients operated with ileo-rectal anastomosis reported better continence compared to pouches. Minor differences were noted regarding the quality of life. Ileo-rectal anastomosis is a valid option for properly selected ulcerative colitis patients if strict postoperative endoscopic surveillance is carried out.

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  • 7.
    Abdel-Halim, Adam
    et al.
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Danielsson, Max
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Arlitt, Martin
    Univ Calgary, Canada.
    Carlsson, Niklas
    Linköping University, Department of Computer and Information Science, Database and information techniques. Linköping University, Faculty of Science & Engineering.
    Temporal Analysis of X.509 Revocations and their Statuses2022In: 7TH IEEE EUROPEAN SYMPOSIUM ON SECURITY AND PRIVACY WORKSHOPS (EUROS&PW 2022), IEEE , 2022, p. 258-265Conference paper (Refereed)
    Abstract [en]

    Despite the X509 public key infrastructure (PKI) being essential for ensuring the trust we place in our communication with web servers, the revocation of the trust placed in individual X509 certificates is neither transparent nor well-studied, leaving many unanswered questions. In this paper, we present a temporal analysis of 36 million certificates, whose revocation statuses we followed for 120 days since first being issued. We characterize the revocation rates of different certificate authorities (CAs) and how the rates change over the lifetime of the certificates. We identify and discuss several instances where the status changes from "revoked" to "good", "unauthorized" or "unknown", respectively, before the certificates expiry. This complements prior work that has observed such inconsistencies in some CAs behavior after expiry but also highlight a potentially more severe problem. Our results highlight heterogeneous revocation practices among the CAs.

  • 8.
    Abdelrahman, Islam
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Vieweg, Rosa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US.
    Irschik, Stefan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Steinvall, Ingrid
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Sjöberg, Folke
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US.
    Elmasry, Moustafa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Development of delirium: Association with old age, severe burns, and intensive care2020In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 46, no 4, p. 797-803Article in journal (Refereed)
    Abstract [en]

    Background Delirium is defined as a disturbance of attention and awareness that develops over a short period of time, is a change from the baseline, and typically fluctuates over time. Burn care involves a high prevalence of known risk factors for delirium such as sedation, inflammation, and prolonged stay in hospital. Our aim was to explore the extent of delirium and the impact of factors associated with it for adult patients who have been admitted to hospital with burns. Methods In this retrospective study, all adult patients who had been admitted with burns during a four-year period were studied, including both those who were treated with intensive care and intermediate care only (no intensive care). Daily records of the assessment of delirium using the Nursing Delirium Screening Scale (Nu-DESC) were analysed together with age, sex, the percentage of total body surface area burned, operations, and numbers of wound care procedures under anaesthesia, concentrations of plasma C-reactive protein, and other clinical variables. Logistic regression was used to analyse factors that were associated with delirium and its effect on mortality, and linear regression was used to analyse its effect on the duration of hospital stay. Results Fifty-one patients (19%) of the total 262 showed signs of delirium (Nu-DESC score of 2 or more) at least once during their stay in hospital. Signs of delirium were recorded in 42/89 patients (47%) who received intensive care, and in 9/173 (5%) who had intermediate care. Independent factors for delirium in the multivariable regression were: age over 74 years; number of operations and wound care procedures under anaesthesia; and the provision of intensive care (area under the curve 0.940, 95% CI 0.899–0.981). Duration of hospital stay, adjusted for age and burn size, was 13.2 (95% CI 7.4–18.9, p < 0.001) days longer in the group who had delirium. We found no independent effects of delirium on mortality. Conclusion We found a strong association between delirium and older age, provision ofr intensive care, and number of interventions under anaesthesia. A further 5% of patients who did not receive intensive care also showed signs of delirium, which is a finding that deserves to be thoroughly investigated in the future.

  • 9.
    Abrahamsson, Annelie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Capodanno, Alessandra
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Rzepecka, Anna
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Dabrosin, Charlotta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Downregulation of tumor suppressive microRNAs in vivo in dense breast tissue of postmenopausal women2017In: Oncotarget, E-ISSN 1949-2553, Vol. 8, no 54, p. 92134-92142Article in journal (Refereed)
    Abstract [en]

    Women with dense breast tissue on mammography are at higher risk of developing breast cancer but the underlying mechanisms are not well understood. De-regulation of microRNAs (miRNAs) has been associated with the onset of breast cancer. miRNAs in the extracellular space participate in the regulation of the local tissue microenvironment. Here, we recruited 39 healthy postmenopausal women attending their mammography-screen that were assessed having extreme dense or entirely fatty breasts (nondense). Microdialysis was performed in breast tissue and a reference catheter was inserted in abdominal subcutaneous fat for local sampling of extracellular compounds. Three miRNAs, associated with tumor suppression, miR-193b, miR-365a, and miR-452 were significantly down-regulated in dense breast tissue compared with nondense breast tissue. In addition, miR-452 exhibited significant negative correlations with several pro-inflammatory cytokines in vivo, which was confirmed in vitro by overexpression of miR-452 in breast cancer cells. No differences were found of miR-21, -29a, -30c, 146a, -148a, -203, or -451 in breast tissue and no miRs were different in plasma. Extracellular miRNAs may be among factors that should be included in studies of novel prevention strategies for breast cancer.

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  • 10.
    Abrahamsson, Annelie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Rzepecka, Anna
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Dabrosin, Charlotta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Equal Pro-inflammatory Profiles of CCLs, CXCLs, and Matrix Metalloproteinases in the Extracellular Microenvironment In Vivo in Human Dense Breast Tissue and Breast Cancer2018In: Frontiers in Immunology, E-ISSN 1664-3224, Vol. 8, article id 1994Article in journal (Refereed)
    Abstract [en]

    The inflammatory microenvironment affects breast cancer progression. Proteins that govern the inflammatory response are secreted into the extracellular space, but this compartment still needs to be characterized in human breast tissues in vivo. Dense breast tissue is a major risk factor for breast cancer by yet unknown mechanisms and no non-toxic prevention for these patients exists. Here, we used the minimal invasive technique of microdialysis for sampling of extracellular proteins in live tissues in situ in breast cancers of women before surgery and in healthy women having dense or non-dense breast tissue on mammography. Proteins were profiled using a proximity extension assay. Out of the 32 proteins assessed, 26 exhibited similar profiles in breast cancers and dense breast tissues; CCL-4, -7, -8, -11, -15, -16, -22, -23, and -25, CXCL-5, -8, -9, -16 as well as sIL-6R, IL-18, vascular endothelial growth factor, TGF-a, fibroblast growth factor 19, matrix metalloproteinase (MMP)-1, -2, -3, and urokinase-type plasminogen activator were all increased, whereas CCL-3, CX3CL1, hepatocyte growth factor, and MMP-9 were unaltered in the two tissues. CCL-19 and -24, CXCL-1 and -10, and IL-6 were increased in dense breast tissue only, whereas IL-18BP was increased in breast cancer only. Our results provide novel insights in the inflammatory microenvironment in human breast cancer in situ and define potential novel therapeutic targets. Additionally, we show previously unrecognized similarities of the pro-inflammatory microenvironment in dense breast tissue and breast cancer in vivo suggesting that anti-inflammatory breast cancer prevention trials for women with dense breast tissue may be feasible.

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  • 11.
    Abrahamsson, Annelie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Rzepecka, Anna
    Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Dabrosin, Charlotta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Increased nutrient availability in dense breast tissue of postmenopausal women in vivo2017In: Scientific Reports, E-ISSN 2045-2322, Vol. 7, article id 42733Article in journal (Refereed)
    Abstract [en]

    Metabolic reprogramming is a hallmark of cancer. Nutrient availability in the tissue microenvironment determines cellular events and may play a role in breast carcinogenesis. High mammographic density is an independent risk factor for breast cancer. Whether nutrient availability differs in normal breast tissues with various densities is unknown. Therefore we investigated whether breast tissues with various densities exhibited differences in nutrient availability. Healthy postmenopausal women from the regular mammographic screening program who had either predominantly fatty breast tissue (nondense), n = 18, or extremely dense breast tissue (dense), n = 20, were included. Microdialysis was performed for the in vivo sampling of amino acids (AAs), analyzed by ultra-high performance liquid chromatography with tandem mass spectroscopy, glucose, lactate and vascular endothelial growth factor (VEGF) in breast tissues and, as a control, in abdominal subcutaneous (s.c.) fat. We found that dense breast tissue exhibited significantly increased levels of 20 proteinogenic AAs and that 18 of these AAs correlated significantly with VEGF. No differences were found in the s.c. fat, except for one AA, suggesting tissue-specific alterations in the breast. Glucose and lactate were unaltered. Our findings provide novel insights into the biology of dense breast tissue that may be explored for breast cancer prevention strategies.

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  • 12.
    Abtahi, Jahan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Malakuti, Iman
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Ajan, Aida
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Surgical Management of Granular Cell Tumor of the Orbit: Case Report and Literature Review2019In: The Open Dentistry Journal, E-ISSN 1874-2106, Vol. 13, p. 33-40Article, review/survey (Refereed)
    Abstract [en]

    Introduction: Granular Cell Tumors (GCTs) of the orbit are rare-entity soft-tissue tumors, and few reports have been published in the literature. The treatment of the choice is total excision. Early diagnosis prior to surgery is valuable for the distinction of malignant from benign tumor.

    Case presentation: We report a case of a 55-year-old woman with a solitary slow-growing mass in the right orbit with the involvement of the rectus inferior muscle, and present a review of the recent literature. The lesion had a diameter of 1 cm and was noticed 2 years before the examination. Excisional biopsy confirmed the diagnosis of GCT. The tumor was resected through a retroseptal transconjunctival approach. The final histological examination revealed findings characteristic of GCT, including positive reaction for protein S-100, SOX10, and calcitonin and negative reaction for desmin, myogenin, Smooth Muscle Antigen (SMA), Melan-A, and HMB-45. There were no signs of malignancy in this sample. Disturbance of motility was not noted by the patient after surgery.

    Conclusion: GCT should be included in the differential diagnosis of intraorbital lesions, particularly those that involve the orbit muscles. A biopsy is recommended before surgical resection, to exclude malignancy and prevent radical resection.

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  • 13.
    Abul-Kasim, Kasim
    et al.
    Lund Univ, Sweden.
    Persson, Erik
    Lund Univ, Sweden.
    Levinsson, Anders
    Lund Univ, Sweden.
    Strombeck, Anita
    Lund Univ, Sweden.
    Selariu, Eufrozina
    Lund Univ, Sweden.
    Ohlin, Acke
    Region Östergötland. Skane Univ Hosp, Sweden.
    Vertebral Hemangiomas: Prevalence, New Classification and Natural History. Magnetic Resonance Imaging-Based Retrospective Longitudinal Study2023In: The Neuroradiology Journal, ISSN 1971-4009, Vol. 36, no 1, p. 23-30Article in journal (Refereed)
    Abstract [en]

    Background and purpose: To determine the prevalence of vertebral hemangiomas (VHs), establish a new classification of VHs based on their MRI-signal pattern, and study their natural history. Methods: MRI of 1000 consecutive patients who underwent at least two MRI with an interval of at least 3 years. Growth rate and change of MRI-signal pattern during the follow-up period were the parameters included in studying the natural history of VHs. Results: The prevalence of VHs was 41%. VHs were classified as type I-IV with fat-rich VHs (type I), constituted 79% of all VHs. VHs were more common among females 43 degrees/o versus males 39%, p = .22. The most affected vertebra was L1. Occurrence rates for cervical (1%), thoracic (7%), and lumbar spine (10%) differed significantly (p &lt; .001). The prevalence of VHs increased with age regardless of gender or spinal part involved (p &lt; .001). Only 26% of VHs changed their size and 4 degrees/o changed their signal during the average follow-up of 7 years. All VHs were slowly growing lesions (average expected growth of &lt;3 mm/10 years). No significant difference between growth rate of VHs type I (0.25 mm/year) and other types of VHs. None of the VHs that were initially reported as "metastases cannot be rule out" showed alarming change in signal or size. Conclusions: VH can be classified into four types based on their MRI-signal pattern. Regardless of their type, VHs are slowly growing lesions. The presence of typical morphological pattern should enable radiologists to confidently differentiate them from vertebral metastases.

  • 14.
    Adams, Yvonne
    et al.
    Univ Copenhagen, Denmark.
    Clausen, Anne Skovsbo
    Copenhagen Univ Hosp, Denmark; Copenhagen Univ Hosp, Denmark.
    Jensen, Peter Ostrup
    Lager, Malin
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Natl Reference Lab Borrel, Div Clin Microbiol, Other Tick Borne Bacter, Lab Med, Reg Jonkoping Cty, Jonkoping, Sweden.
    Wilhelmsson, Peter
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Natl Reference Lab Borrel, Div Clin Microbiol, Other Tick Borne Bacter, Lab Med, Reg Jonkoping Cty, Jonkoping, Sweden.
    Jonsson Henningsson, Anna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Microbiology. Natl Reference Lab Borrel, Div Clin Microbiol, Other Tick Borne Bacter, Lab Med, Reg Jonkoping Cty, Jonkoping, Sweden.
    Lindgren, Per-Eric
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Natl Reference Lab Borrel, Div Clin Microbiol, Other Tick Borne Bacter, Lab Med, Reg Jonkoping Cty, Jonkoping, Sweden.
    Faurholt-Jepsen, Daniel
    Copenhagen Univ Hosp, Denmark.
    Mens, Helene
    Copenhagen Univ Hosp, Denmark.
    Kraiczy, Peter
    Goethe Univ Frankfurt, Germany.
    Kragh, Kasper Norskov
    Copenhagen Univ Hosp, Denmark; Univ Copenhagen, Denmark.
    Bjarnsholt, Thomas
    Copenhagen Univ Hosp, Denmark; Univ Copenhagen, Denmark.
    Kjaer, Andreas
    Copenhagen Univ Hosp, Denmark; Copenhagen Univ Hosp, Denmark.
    Lebech, Anne-Mette
    Copenhagen Univ Hosp, Denmark; Univ Copenhagen, Denmark.
    Jensen, Anja R.
    Univ Copenhagen, Denmark.
    3D blood-brain barrier-organoids as a model for Lyme neuroborreliosis highlighting genospecies dependent organotropism2023In: ISCIENCE, ISSN 2589-0042, Vol. 26, no 1, article id 105838Article in journal (Refereed)
    Abstract [en]

    Lyme neuroborreliosis (LNB), a tick-borne infection caused by spirochetes within the Borrelia burgdorferi sensu lato (s.L.) complex, is among the most prevalent bacterial central nervous system (CNS) infections in Europe and the US. Here we have screened a panel of low- passage B. burgdorferi s.l. isolates using a novel, human-derived 3D blood-brain barrier (BBB)-organoid model. We show that human-derived BBB-organoids support the entry of Borrelia spirochetes, leading to swelling of the organoids and a loss of their structural integrity. The use of the BBB-organoid model highlights the organotropism between B. burgdorferi s.l. genospecies and their ability to cross the BBB contributing to CNS infection.

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  • 15.
    Adedeji, Dickson O.
    et al.
    Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Norrköping. Karolinska Inst, Sweden.
    Holleman, Jasper
    Karolinska Inst, Sweden.
    Juster, Robert-Paul
    Univ Montreal, Canada.
    Udeh-Momoh, Chinedu T.
    Karolinska Inst, Sweden; Imperial Coll London, England.
    Kareholt, Ingemar
    Karolinska Inst, Sweden; Jonkoping Univ, Sweden; Stockholm Univ, Sweden.
    Hagman, Goran
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Aspo, Malin
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Adagunodo, Sofia
    Memory Clin Zentralschweiz, Switzerland.
    Hakansson, Krister
    Karolinska Inst, Sweden.
    Kivipelto, Miia
    Karolinska Inst, Sweden; Imperial Coll London, England; Karolinska Univ Hosp, Sweden; Univ Eastern Finland, Finland.
    Solomon, Alina
    Karolinska Inst, Sweden; Imperial Coll London, England; Karolinska Univ Hosp, Sweden; Univ Eastern Finland, Finland.
    Sindi, Shireen
    Karolinska Inst, Sweden; Imperial Coll London, England; Care Sci & Soc NVS, Sweden.
    Longitudinal study of Alzheimers disease biomarkers, allostatic load, and cognition among memory clinic patients2023In: Brain, Behavior, and Immunity - Health, E-ISSN 2666-3546, Vol. 28, article id 100592Article in journal (Refereed)
    Abstract [en]

    Background: Allostatic load (AL) is defined as the cumulative dysregulation of neuroendocrine, immunological, metabolic, and cardiovascular systems that increases the susceptibility to stress-related health problems. Several dementia and Alzheimers disease (AD) risk factors have been identified, yet little is known about the role of AL and its associations with AD biomarkers (e.g., beta-amyloid (A & beta;) or tau) and cognitive function among memory clinic patients. Hence, this study aims to assess the association between AL and AD biomarkers, cognitive performance, and cognitive decline after 3-years of follow-up.Methods: Data from 188 memory clinic patients were derived from the Cortisol and Stress in AD (Co-STAR) study in Sweden. Participants underwent baseline assessments including blood tests for AL measures (including cortisol, thyroid stimulating hormone, cobalamin, homocysteine, leukocytes, glycated hemoglobin, albumin, high-density and low-density lipoprotein cholesterol, triglycerides, and creatinine), cerebrospinal fluid (CSF) sampling for AD biomarkers and neuropsychological tests including five cognitive domains. Linear regressions were conducted, adjusting for age, sex, and education.Results: Higher AL was associated with lower CSF A & beta;1-42 levels (& beta; =-0.175, p = 0.025), reflecting higher brain levels of A & beta;1-42. Stratified analyses suggested a significant association among women but not men, although the AL-sex interaction was not statistically significant. AL was not significantly associated with T-tau level (& beta; =-0.030, p = 0.682) and P-tau level (& beta; = 0.091, p = 0.980). There were no significant associations between AL and cognition or cognitive decline after 3 years.Conclusion: This study showed that higher AL was associated with increased brain amyloid accumulation. This suggests that AL may play a role in AD/dementia pathophysiology. Potential sex-related differences should be assessed in further larger studies.

  • 16.
    Adham, Khalis Ibrahim
    Linköping University, Department of Education.
    Planning Higher Education in IRAQ I: Planning Medical Education1975Doctoral thesis, monograph (Other academic)
  • 17.
    Adil, Mohammed Yasin
    et al.
    Univ Oslo, Norway; Norwegian Dry Eye Clin, Norway.
    Xiao, Jiaxin
    Univ Oslo, Norway; Norwegian Dry Eye Clin, Norway.
    Olafsson, Jonatan
    Univ Oslo, Norway.
    Chen, Xiangjun
    Univ Oslo, Norway; Norwegian Dry Eye Clin, Norway; Arendal Hosp, Norway; Vestre Viken Hosp Trust, Norway; Univ Coll Southeast Norway, Norway.
    Lagali, Neil
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Raeder, Sten
    Norwegian Dry Eye Clin, Norway.
    Utheim, Oygunn A.
    Oslo Univ Hosp, Norway.
    Dartt, Darlene A.
    Harvard Med Sch, MA 02115 USA.
    Utheim, Tor P.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Univ Oslo, Norway; Vestre Viken Hosp Trust, Norway; Univ Coll Southeast Norway, Norway; Oslo Univ Hosp, Norway; Oslo Univ Hosp, Norway; Oslo Univ Hosp, Norway.
    Meibomian Gland Morphology Is a Sensitive Early Indicator of Meibomian Gland Dysfunction2019In: American Journal of Ophthalmology, ISSN 0002-9394, E-ISSN 1879-1891, Vol. 200, p. 16-25Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the relationship between meibomian gland (MG) morphology and clinical dry eye tests in patients with meibomian gland dysfunction (MGD). DESIGN: Cross-sectional study. SUBJECTS: Total 538 MGD patients and 21 healthy controls. METHODS: MG loss on meibography images of upper (UL) and lower lids (LL) was graded on a scale of 0 (lowest degree of MG loss) to 3. MG length, thickness, and interglandular space in the UL were measured. Clinical tests included meibum expression and quality, tear film break-up time, ocular staining, osmolarity, Schirmer I, blink interval timing, and Ocular Surface Disease Index (OSDI) questionnaire. RESULTS: Mean UL and LL meibogrades were significantly higher in MGD patients compared to controls (P amp;lt; .001 for UL and LL). The sensitivity and specificity of the meibograde as a diagnostic parameter for MGD was 96.7% and 85%, respectively. Schirmer I was significantly increased in MGD patients with meibograde 1 compared to patients with meibograde 0, 2, and 3 in the UL (P amp;lt; .05 ). MG thickness increased with higher meibograde (P amp;lt; .001). MG morphology correlated significantly but weakly with several clinical parameters (P amp;lt; .05). OSDI did not correlate with any MG morphologic parameter. CONCLUSIONS: Grading of MG loss using meibograde effectively diagnoses MGD. Compensatory mechanisms such as increased aqueous tear production and dilation of MGs make early detection of MGD difficult by standard clinical measures of dry eye, whereas morphologic analysis of MGs reveals an early stage of MGD, and therefore represents a complementary clinical parameter with diagnostic potential. (C) 2018 Elsevier Inc. All rights reserved.

  • 18.
    Adlers, Mikael
    Linköping University, Department of Mathematics. Linköping University, The Institute of Technology.
    Topics in Sparse Least Squares Problems2000Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This thesis addresses topics in sparse least squares computation. A stable method for solving the least squares problem, min ||Ax-b||2 is based on the QR factorization.Here we have addressed the difficulty for storing the orthogonal matrix Q. Using traditional methods, the number of nonzero elements in Q makes it in many cases not feasible to store. Using the multifrontal technique when computing the QR factorization,Q may be stored and used more efficiently. A new user friendly Matlab implementation is developed.

    When a row in A is dense the factor R from the QR factorization may be completely dense. Therefore problems with dense rows must be treated by special techniques. The usual way to handle dense rows is to partition the problem into one sparse and one dense subproblem. The drawback with this approach is that the sparse subproblem may be more ill-conditioned than the original problem or even not have a unique solution. Another method, useful for problems with few dense rows, is based on matrix stretching, where the dense rows are split into several less dense rows linked then together with new artificial variables. We give and analyze the conditioning of the matrix obtained by this method and show that no ill-conditioned subproblem arise.

    In many least squares problems upper and lower bounds on the variables have to be satisfied at the solution. This type of problem arises, for example, in reconstruction problems in geodesy and tomography. Here methods based on direct factorization methods for sparse matrix computation are explored. Two completely different approaches for solving the problem are discussed and compared, i.e. active set methods and primal-dual interior-point methods based on Mehrotra's predictor-corrector path following method. An active set block method suitable for sparse problems is developed and a convergence proof is presented. The choice of barrier parameter, multiple corrections and finite termination for the interior-point method are discussed. Numerical comparison is given of the active set method, the interior-point method, together with an trust region method based on the interior-reflective Newton implemented in the optimization toolbox for MATLAB. The numerical tests show that the block active set method is faster and gives better accuracy for both nondegenerate and degenerate problems.

  • 19.
    Adranno, Brando
    et al.
    Stockholm Univ, Sweden.
    Renier, Olivier
    Stockholm Univ, Sweden.
    Bousrez, Guillaume
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering. Stockholm Univ, Sweden.
    Paterlini, Veronica
    Stockholm Univ, Sweden.
    Baryshnikov, Glib
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Smetana, Volodymyr
    Stockholm Univ, Sweden.
    Tang, Shi
    Umea Univ, Sweden.
    agren, Hans
    Uppsala Univ, Sweden.
    Metlen, Andreas
    Queens Univ Belfast, North Ireland.
    Edman, Ludvig
    Umea Univ, Sweden.
    Anja-Verena, Mudring
    Stockholm Univ, Sweden; Aarhus Univ, Denmark.
    Rogers, Robin D.
    Stockholm Univ, Sweden; Queens Univ Belfast, North Ireland; Univ Alabama, AL 35487 USA.
    The 8-Hydroxyquinolinium Cation as a Lead Structure for Efficient Color-Tunable Ionic Small Molecule Emitting Materials2023In: ADVANCED PHOTONICS RESEARCH, ISSN 2699-9293, Vol. 4, no 3, article id 2200279Article in journal (Refereed)
    Abstract [en]

    Albeit tris(8-hydroxyquinolinato) aluminum (Alq(3)) and its derivatives are prominent emitter materials for organic lighting devices, and the optical transitions occur among ligand-centered states, the use of metal-free 8-hydroxyquinoline is impractical as it suffers from strong nonradiative quenching, mainly through fast proton transfer. Herein, it is shown that the problem of rapid proton exchange and vibration quenching of light emission can be overcome not only by complexation, but also by organization of the 8-hydroxyquinolinium cations into a solid rigid network with appropriate counter-anions (here bis(trifluoromethanesulfonyl)imide). The resulting structure is stiffened by secondary bonding interactions such as pi-stacking and hydrogen bonds, which efficiently block rapid proton transfer quenching and reduce vibrational deactivation. Additionally, the optical properties are tuned through methyl substitution from deep blue (455 nm) to blue-green (488 nm). Time-dependent density functional theory (TDFT) calculations reveal the emission to occur from which an unexpectedly long-lived S-1 level, unusual for organic fluorophores. All compounds show comparable, even superior photoluminescence compared to Alq(3) and related materials, both as solids and thin films with quantum yields (QYs) up to 40-50%. In addition, all compounds show appreciable thermal stability with decomposition temperatures above 310 degrees C.

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  • 20.
    af Geijerstam, Peder
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Cityhälsan Centrum.
    Janryd, Fredrik
    Region Östergötland, Primary Care Center, Primary Health Care Center Cityhälsan Centrum.
    Nyström, Fredrik
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Cityhälsan Centrum. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine.
    Smoking and cardiovascular disease in patients with type 2 diabetes: a prospective observational study2023In: Journal of Cardiovascular Disease, ISSN 2330-4596, E-ISSN 2330-460X, Vol. 24, no 11, p. 802-807Article in journal (Refereed)
    Abstract [en]

    Background

    Cigarette smoking is a major risk factor for cardiovascular disease. In type 2 diabetes mellitus (T2D), medications such as antihypertensives and statins can reduce the increased cardiovascular risk. The aim of this study was to evaluate the impact of cigarette smoking on major adverse cardiovascular event (MACE) and all-cause mortality in patients with T2D in a relatively well treated Swedish cohort.

    Methods

    Seven hundred and sixty-one patients with T2D aged 55–66 years were followed in the prospective observational CArdiovascular Risk factors in patients with DIabetes – a Prospective study in Primary care (CARDIPP) study. Baseline data included blood samples of markers of dysglycemia and inflammation, blood pressure as well as questionnaire responses regarding cigarette smoking. Participants were followed for incidence of MACE and all-cause mortality.

    Results

    Of the included 663 participants, the mean age was 60.6 (SD 3.1) years and 423 (63.8%) were men. Levels of C-reactive protein and vitamin D, as well as the proportion of participants treated with antihypertensives, acetylic salicylic acid, statins, and diabetes medications, were similar between smokers and nonsmokers. Median follow-up time was 11.9 (Q1–Q3 10.8–12.7) years. Cigarette smoking was associated with all-cause mortality [hazard ratio 2.24 (95% confidence interval, 95% CI 1.40–3.56), P < 0.001], but not MACE [hazard ratio 1.30 (95% CI 0.77–2.18), P = 0.328].

    Conclusion

    In patients with T2D, cigarette smoking was not associated with an increased risk of MACE. This raises the question of whether cardioprotective drugs in individuals with T2D to some degree mitigate the cardiovascular harm of smoking, even though they do not affect other dire consequences of smoking.

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  • 21.
    Agren, Martin
    et al.
    Prosthodont Specialist Clin, Sweden.
    Sahin, Christofer
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Dermatology and Venerology.
    Pettersson, Mattias
    Umea Univ, Sweden.
    The effect of botulinum toxin injections on bruxism: A systematic review2020In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 47, no 3, p. 395-402Article, review/survey (Refereed)
    Abstract [en]

    Objective To systematize evidence on the efficacy of botulinum toxin type A (BTA) in the treatment of bruxism measured through bite force or electromyography (EMG) at the masseter muscle. Method Identification of relevant articles through databases PubMed, Web of Science, SCOPUS, Ovid and EBSCO and manual search were performed for sources from review articles. Studies scoring less than 3 on the Jadad Scale were excluded. Results Four articles were included after an exclusion of 333 articles. 3 articles measured EMG and 1 bite force. 1 article did not record a significant drop of activity, 1 article recorded reduction midway and at final endpoint. 2 articles recorded initial reduction, but a non significant difference at later follow up. Conclusion The available research is inconclusive and does not show enough evidence that bruxism can be treated with BTA injections. However, promising results have been shown in individual studies and further research in this area is needed.

  • 22.
    Ahlbeck, Lars
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Allergy Center.
    Ahlberg, Emelie
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Björkander, Janne
    Acad Hlth & Care, Sweden.
    Aldén, Caroline
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Papapavlou, Georgia
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Palmberg, Laura
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Nyström Kronander, Ulla
    Region Östergötland, Medicine Center, Allergy Center.
    Retsas, Pavlos
    Region Östergötland, Medicine Center, Allergy Center.
    Nordenfelt, Patrik
    Cty Hosp Ryhov, Sweden.
    Togö, Totte
    Region Östergötland, Medicine Center, Allergy Center.
    Johansen, Pål
    Univ Zurich, Switzerland.
    Rolander, Bo
    Acad Hlth & Care, Sweden.
    Duchén, Karel
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Allergy Center. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Jenmalm, Maria
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Intralymphatic immunotherapy with one or two allergens renders similar clinical response in patients with allergic rhinitis due to birch and grass pollen2022In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 52, no 6, p. 747-759Article in journal (Refereed)
    Abstract [en]

    Introduction

    There is a need for a fast, efficient and safe way to induce tolerance in patients with severe allergic rhinitis. Intralymphatic immune therapy has been shown to be effective.

    Methods

    Patients with severe birch and timothy allergy were randomized and received three doses of 0.1 ml of birch and 5-grass allergen extracts (10,000 SQ units/ml, ALK-Abello), or birch and placebo or 5-grass and placebo by ultrasound-guided injections into inguinal lymph nodes at monthly intervals. Rhinoconjunctivitis total symptom score, medication score and rhinoconjunctivitis quality of life questionnaire were evaluated before treatment and after each birch and grass pollen season during three subsequent years. Circulating proportions of T helper subsets and allergen-induced cytokine and chemokine production were analysed by flow cytometry and Luminex.

    Results

    The three groups reported fewer symptoms, lower use of medication and improved quality of life during the birch and grass pollen seasons each year after treatment at an almost similar rate independently of treatment with one or two allergens. Mild local pain was the most common adverse event. IgE levels to birch decreased, whereas birch-induced IL-10 secretion increased in all three groups. IgG4 levels to birch and timothy and skin prick test reactivity remained mainly unchanged. Conjunctival challenge tests with timothy extract showed a higher threshold for allergen. In all three groups, regulatory T cell frequencies were increased 3 years after treatment.

    Conclusions

    Intralymphatic immunotherapy with one or two allergens in patients with grass and birch pollen allergy was safe, effective and may be associated with bystander immune modulatory responses.

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  • 23.
    Ahlbeck, Lars
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Allergy Center.
    Ahlberg, Emelie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Nyström Kronander, Ulla
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Allergy Center.
    Björkander, Janne
    Futurum, Academy of Health and Care, Jönköping, Sweden.
    Jenmalm, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Intralymphatic allergen immunotherapy against pollen allergy. A 3-year open follow-up study of 10 patients2018In: Annals of Allergy, Asthma & Immunology, ISSN 1081-1206, E-ISSN 1534-4436, Vol. 121, no 5, p. 626-627Article in journal (Refereed)
    Abstract [en]

    To date, allergen immunotherapy (AIT) is the only treatment that affects the long-term development of allergic rhinoconjunctivitis and induces clinical tolerance primarily by stimulating regulatory T (Treg) cells, attenuating T helper 2 (Th2) responses and synthesis of blocking antibodies1. Conventional AIT with subcutaneous injections, sublingual tablets or drops is effective, but consumes time and resources 2.

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  • 24.
    Ahlbeck, Lars
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Allergy Center.
    Ahlberg, Emelie
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Stuivers, Linn
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Bjorkander, Janne
    Futurum, Sweden.
    Nyström Kronander, Ulla
    Region Östergötland, Medicine Center, Allergy Center.
    Retsas, Pavlos
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Govindaraj, Dhanapal
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Jenmalm, Maria
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Duchén, Karel
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Allergy Center.
    Intralymphatic immunotherapy with birch and grass pollen extracts. A randomized double-blind placebo-controlled clinical trial2023In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 53, no 8, p. 809-820Article in journal (Refereed)
    Abstract [en]

    IntroductionThere is a need to evaluate the safety and efficacy of intralymphatic immunotherapy (ILIT) for inducing tolerance in patients with allergic rhinitis. MethodsThirty-seven patients with seasonal allergic symptoms to birch and grass pollen and skin prick test &gt;3 mm and/or IgE to birch and timothy &gt;0.35 kU/L were randomized to either ILIT, with three doses of 0.1 mL of birch pollen and 5-grass pollen allergen extracts on aluminium hydroxide (10,000 SQ-U/ml; ALK-Abello) or placebo using ultrasound-guided intralymphatic injections at monthly intervals. Daily combined symptom medical score and rhinoconjunctivitis total symptom score were recorded during the peak pollen seasons the year before and after treatment. Rhinoconjunctivitis total symptom score, medication score and rhinoconjunctivitis quality of life questionnaire were recorded annually starting 2 years after treatment. Circulating proportions of T helper cell subsets and allergen-induced cytokine and chemokine production were analysed using flow cytometry and ELISA. ResultsThere were no differences between the groups related to daily combined symptom medical score the year before and after treatment. Two years after ILIT (after unblinding), the actively treated group reported significantly fewer symptoms, lower medication use and improved quality of life than did the placebo group. After the pollen seasons the year after ILIT, T regulatory cell frequencies and grass-induced IFN-gamma levels increased only in the actively treated group. ConclusionIn this randomized controlled trial, ILIT with birch and grass pollen extract was safe and accompanied by immunological changes. Further studies are required to confirm or refute the efficacy of the treatment.

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  • 25.
    Ahlberg, Eva-Lena
    et al.
    Region Östergötland, Hälso- och sjukvårdens stab.
    Elfström, Johan
    Region Östergötland, Hälso- och sjukvårdens stab.
    Borgstedt Risberg, Madeleine
    Region Östergötland, Regionledningskontoret, Enheten för folkhälsa.
    Öhrn, Annica
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Övr Regionledningskontoret.
    Andersson, Christer
    Region Östergötland, Hälso- och sjukvårdens stab.
    Sjödahl, Rune
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Hälso- och sjukvårdens stab.
    Nilsen, Per
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Learning From Incident Reporting?: Analysis of Incidents Resulting in Patient Injuries in a Web-Based System in Swedish Health Care2020In: Journal of patient safety, ISSN 1549-8417, E-ISSN 1549-8425, Vol. 16, no 4, p. 264-268Article in journal (Refereed)
    Abstract [en]

    Objectives Incident reporting (IR) systems have the potential to improve patient safety if they enable learningfrom the reported risks and incidents. The aim of this study was to investigate incidents registered in an IR system in a Swedish county council.

    Methods The study was conducted in the County Council of Östergötland, Sweden. Data were retrieved from the IR system, which included 4755 incidents occurring in somatic care that resulted in patient injuries from 2004 to 2012. One hundred correctly classified patient injuries were randomly sampled from 3 injury severity levels: injuries leading to deaths, permanent harm, and temporary harm. Three aspects were analyzed: handling of the incident, causes of the incident, and actions taken to prevent its recurrence.

    Results Of the 300 injuries, 79% were handled in the departments where they occurred. The department head decided what actions should be taken to prevent recurrence in response to 95% of the injuries. A total of 448 causes were identified for the injuries; problems associated with procedures, routines, and guidelines were most common. Decisions taken for 80% of the injuries could be classified using the IR system documentation and root cause analysis. The most commonly pursued type of action was change of work routine or guideline.

    Conclusions The handling, causes, and actions taken to prevent recurrence were similar for injuries of different severity levels. Various forms of feedback (information, education, and dialogue) were an integral aspect of the IR system. However, this feedback was primarily intradepartmental and did not yield much organizational learning.

  • 26.
    Ahlstrand, Erik
    et al.
    Orebro Univ, Sweden.
    Samuelsson, Jan
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology.
    Lindgren, Marie
    Kalmar Cty Hosp, Sweden.
    Pettersson, Helna
    NU Hosp Grp, Sweden.
    Liljeholm, Maria
    Univ Hosp Nouthern Sweden, Sweden.
    Ravn-Landtblom, Anna
    Karolinska Inst, Sweden; Stockholm South Hosp, Sweden.
    Scheding, Stefan
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Andreasson, Bjorn
    NU Hosp Grp, Sweden.
    Highly reduced survival in essential thrombocythemia and polycythemia vera patients with vascular complications during follow-up2020In: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 104, no 3, p. 271-278Article in journal (Refereed)
    Abstract [en]

    Objective To explore the relative importance of risk factors, treatments, and blood counts for the occurrence of vascular complications and their impact on life expectancy in essential thrombocythemia (ET) and polycythemia vera (PV). Methods Nested case-control study within the Swedish MPN registry. From a cohort of 922 ET patients and 763 PV patients, 71 ET and 81 PV cases with vascular complications were compared with matched controls. Results Incidence of vascular complications was 2.0 and 3.4 events per 100 patient-years in ET and PV, respectively. At diagnosis, no significant risk factor differences were observed between cases and controls in neither of the diseases. At the time of vascular event, ET complication cases did not differ significantly from controls but in PV, cases had significantly higher WBCs and were to a lesser extent treated with anti-thrombotic and cytoreductive therapy. Life expectancy was significantly decreased in both ET and PV cases compared with controls. Conclusions The risk of vascular complications is high in both ET and PV, and these complications have a considerable impact on life expectancy. The protective effect of anti-thrombotic and cytoreductive therapy for vascular complications in PV underscores the importance of avoiding undertreatment.

  • 27.
    Ahlstrom, Christer
    et al.
    Swedish Natl Rd and Transport Res Inst VTI, Linkoping, Sweden.
    Anund, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Swedish Natl Rd and Transport Res Inst VTI, Linkoping, Sweden.
    Fors, Carina
    Swedish Natl Rd and Transport Res Inst VTI, Linkoping, Sweden.
    Akerstedt, Torbjorn
    Stockholm Univ, Sweden; Karolinska Inst, Sweden.
    The effect of daylight versus darkness on driver sleepiness: a driving simulator study2018In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 3, article id e12642Article in journal (Refereed)
    Abstract [en]

    Driver sleepiness studies are often carried out with alert drivers during daytime and sleep-deprived drivers during night-time. This design results in a mixture of different factors (e.g. circadian effects, homeostatic effects, light conditions) that may confound the results. The aim of this study was to investigate the effect of light conditions on driver sleepiness. Thirty young male drivers (23.6 +/- 1.7years old) participated in a driving simulator experiment where they drove on a rural road. A 2x2 design was used with the conditions daylight versus darkness, and daytime (full sleep) versus night-time (sleep deprived). The results show that light condition had an independent effect on the sleepiness variables. The subjective sleepiness measured by Karolinska Sleepiness Scale was higher, lateral position more left-oriented, speed lower, electroencephalogram alpha and theta higher, and blink durations were longer during darkness. The number of line crossings did not change significantly with light condition. The day/night condition had profound effects on most sleepiness indicators while controlling for light condition. The number of line crossings was higher during night driving, Karolinska Sleepiness Scale was higher, blink durations were longer and speed was lower. There were no significant interactions, indicating that light conditions have an additive effect on sleepiness. In conclusion, Karolinska Sleepiness Scale and blink durations increase primarily with sleep deprivation, but also as an effect of darkness. Line crossings are mainly driven by the need for sleep and the reduced alertness at the circadian nadir. Lane position is, however, more determined by light conditions than by sleepiness.

  • 28.
    Ahlström, Stina
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Natl Board Forens Med, Sweden.
    Ahlner, Johan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences.
    Jönsson, Anna K
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, S-58758 Linkoping, Sweden.
    Green, Henrik
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, S-58758 Linkoping, Sweden.
    The Importance of BHB Testing on the Post-Mortem Diagnosis of Ketoacidosis2022In: Biomolecules, E-ISSN 2218-273X, Vol. 12, no 1, article id 9Article in journal (Refereed)
    Abstract [en]

    Although beta-hydroxybutyrate (BHB) analysis has proved its importance in forensic pathology, its effects on cause-of-death diagnostics are unaddressed. Therefore, this study aims at evaluating the effects of BHB analysis on the number of deaths by DKA (diabetes ketoacidosis), AKA (alcoholic ketoacidosis), HHS (hyperosmolar hyperglycaemic state), hypothermia, diabetes, alcoholism, and acidosis NOS (not otherwise specified). All 2900 deaths from 2013 through 2019 in which BHB was analysed at the National Board of Forensic Medicine, and 1069 DKA, AKA, HHS, hypothermia, diabetes, alcoholism, and acidosis cases without BHB analysis were included. The prevalence of BHB-positive cases for each cause of death, and trends and proportions of different BHB concentrations, were investigated. The number of BHB analyses/year increased from 13 to 1417. AKA increased from three to 66 and acidosis from one to 20. The deaths from alcoholism, DKA, and hypothermia remained stable. It is unclear why death from alcoholism remained stable while AKA increased. The increase in unspecific acidosis deaths raises the question why a more specific diagnosis had not been used. In conclusion, BHB analysis is instrumental in detecting AKA and acidosis. The scientific basis for the diagnosis of DKA and hypothermia improved, but the number of cases did not change.

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  • 29.
    Ahlström, Stina
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Natl Board Forens Med, Sweden.
    Thiblin, Ingemar
    Natl Board Forens Med, Sweden; Uppsala Univ, Sweden.
    Jönsson, Anna K
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Linkoping, Sweden.
    Green, Henrik
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Linkoping, Sweden.
    Characteristics of post-mortem beta-hydroxybutyrate-positivet cases - A retrospective study on age, sex and BMI in 1407 forensic autopsies2021In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 325, article id 110878Article in journal (Refereed)
    Abstract [en]

    Background: Post-mortem biochemistry, including the analysis of beta-hydroxybutyrate (BHB), is increasingly employed in forensic medicine, especially in conditions such as diabetes and chronic alcoholism. However, not much is known about the associations between age, body mass index (BMI), and sex and BHB concentrations in ketoacidotic conditions. Aim: To retrospectively study the association between age, BMI and sex in several conditions, such as diabetic ketoacidosis (DKA), alcoholic ketoacidosis (AKA), and elevated post-mortem BHB concentrations. Methods: 1407 forensic autopsy cases analysed for BHB were grouped by diagnosis: DKA, AKA, HHS [hyperosmolar hyperglycaemic state], acidosis NOS [not otherwise specified], or hypothermia. Age, sex, BMI and the concentrations of blood alcohol, vitreous glucose and blood BHB were recorded. Results: Cases of AKA and DKA were most numerous (184 and 156, respectively). In DKA and in its male subgroup, cases with severe ketosis (BHB &gt; 1000 mu g/g) were younger and had a lower BMI than those with moderate ketosis (BHB 250-1000 mu g/g) and controls (P &lt; 0.001). In DKA and in its female subgroup, cases with moderate ketosis cases were older (P = 0.0218 and P = 0.0083) than controls. In AKA and in its male subgroup, cases with severe ketosis had a lower BMI than those with moderate ketosis (P = 0.0391 and P = 0.0469) and controls (P &lt; 0.001). Cases with moderate ketosis had a lower BMI than controls (P &lt; 0.001). Conclusions: BHB concentration is associated with BMI in DKA and AKA, and with both BMI and age in DKA. Constitutional factors should, therefore, be considered in potential AKA and DKA cases. (c) 2021 The Authors. Published by Elsevier B.V. CC_BY_4.0

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  • 30.
    Ahmad, Awais
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Brylid, Andre
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Dahle, Charlotte
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Saleh, Muna Atallah
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Rheumatology.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Enocsson, Helena
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Rheumatology.
    Sjöwall, Christopher
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Rheumatology.
    Doubtful Clinical Value of Subtyping Anti-U1-RNP Antibodies Regarding the RNP-70 kDa Antigen in Sera of Patients with Systemic Lupus Erythematosus2023In: International Journal of Molecular Sciences, ISSN 1661-6596, E-ISSN 1422-0067, Vol. 24, no 12, article id 10398Article in journal (Refereed)
    Abstract [en]

    The detection of antinuclear antibodies is central to the diagnosis and prognosis of systemic lupus erythematosus (SLE), primary Sjogrens syndrome (pSS) and mixed connective tissue disease (MCTD). Anti-U1-RNP and anti-RNP70 antibodies were assayed in the sera of patients with SLE (n = 114), pSS (n = 54) and MCTD (n = 12). In the SLE group, 34/114 (30%) were anti-U1-RNP positive, and 21/114 (18%) were both anti-RNP70 positive and anti-U1-RNP positive. In the MCTD group, 10/12 (83%) were anti-U1-RNP positive, and 9/12 (75%) were anti-RNP70 positive. Only one individual with pSS was antibody positive (for both anti-U1-RNP and anti-RNP70). All anti-RNP70-positive samples were also anti-U1-RNP positive. Anti-U1-RNP-positive subjects with SLE were younger (p &lt; 0.0001); showed lower concentrations of complement protein 3 (p = 0.03); had lower eosinophil (p = 0.0005), lymphocyte (p = 0.006) and monocyte (p = 0.03) counts; and had accrued less organ damage (p = 0.006) than the anti-U1-RNP-negative SLE patients. However, we observed no significant clinical or laboratory parameter differences between the anti-U1-RNP-positive individuals with/without anti-RNP70 in the SLE group. In conclusion, anti-RNP70 antibodies are not exclusive to MCTD but are rarely detected in pSS and healthy individuals. In SLE, anti-U1-RNP antibodies are associated with a clinical phenotype that resembles MCTD, with hematologic involvement and less damage accrual. Based on our results, the clinical value of subtyping anti-RNP70 in anti-U1-RNP-positive sera appears to be of limited value.

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  • 31.
    Ahmad, Awais
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Heijke, R.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Rheumatology.
    Eriksson, Per
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Rheumatology.
    Wirestam, Lina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Rheumatology.
    Kechagias, Stergios
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Mag- tarmmedicinska kliniken.
    Dahle, Charlotte
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Sjöwall, Christopher
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Rheumatology.
    Autoantibodies associated with primary biliary cholangitis are common among patients with systemic lupus erythematosus even in the absence of elevated liver enzymes2021In: Clinical and Experimental Immunology, ISSN 0009-9104, E-ISSN 1365-2249, Vol. 203, no 1, p. 22-31Article in journal (Refereed)
    Abstract [en]

    Knowledge of concomitant autoimmune liver diseases (AILD) is more detailed in primary Sjogrens syndrome (pSS) compared to systemic lupus erythematosus (SLE). Herein, the prevalence of autoantibodies associated with autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) was investigated in stored sera from patients with SLE (n = 280) and pSS (n = 114). Antibodies against mitochondria (AMA), liver-kidney microsomal (LKM) antigen, smooth muscle (SMA) and anti-nuclear antibodies (ANA) were analysed with immunofluorescence microscopy. In addition, AILD-associated autoantibodies were tested with immunoblot. Prior to sampling, eight SLE (2 center dot 9%) and three pSS (2 center dot 6%) cases were diagnosed with AILD. Among SLE-cases without known AILD (n = 272), 26 (9 center dot 6%) had PBC-associated autoantibodies, 15 (5 center dot 5%) AIH-associated autoantibodies (excluding ANA) and one serological overlap. Most subjects with PBC-associated autoantibodies had liver enzymes within reference limits (22 of 27, 81%) or mild laboratory cholestasis (two of 27, 7 center dot 4%), while one fulfilled the diagnostic PBC-criteria. AMA-M2 detected by immunoblot was the most common PBC-associated autoantibody in SLE (20 of 272, 7 center dot 4%). The prevalence of SMA (4 center dot 4%) was comparable with a healthy reference population, but associated with elevated liver enzymes in four of 12 (25%), none meeting AIH-criteria. The patient with combined AIH/PBC-serology had liver enzymes within reference limits. Among pSS cases without known AILD (n = 111), nine (8 center dot 1%) had PBC-associated, 12 (10 center dot 8%) AIH-associated autoantibodies and two overlapped. PBC-associated autoantibodies were found as frequently in SLE as in pSS but were, with few exceptions, not associated with laboratory signs of liver disease. Overall, AILD-associated autoantibodies were predominantly detected by immunoblot and no significant difference in liver enzymes was found between AILD autoantibody-negative and -positive patients.

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  • 32.
    Ahmad, Azeem
    et al.
    Linköping University, Department of Computer and Information Science, Software and Systems. Linköping University, Faculty of Science & Engineering.
    de Oliveira Neto, Francisco Gomes
    Chalmers & Univ Gothenburg, Sweden.
    Shi, Zhixiang
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Sandahl, Kristian
    Linköping University, Department of Computer and Information Science, Software and Systems. Linköping University, Faculty of Science & Engineering.
    Leifler, Ola
    Linköping University, Department of Computer and Information Science, Software and Systems. Linköping University, Faculty of Science & Engineering.
    A Multi-factor Approach for Flaky Test Detection and Automated Root Cause Analysis2021In: 2021 28TH ASIA-PACIFIC SOFTWARE ENGINEERING CONFERENCE (APSEC 2021), IEEE COMPUTER SOC , 2021, p. 338-348Conference paper (Refereed)
    Abstract [en]

    Developers often spend time to determine whether test case failures are real failures or flaky. The flaky tests, also known as non-deterministic tests, switch their outcomes without any modification in the codebase, hence reducing the confidence of developers during maintenance as well as in the quality of a product. Re-running test cases to reveal flakiness is resource-consuming, unreliable and does not reveal the root causes of test flakiness. Our paper evaluates a multi-factor approach to identify flaky test executions implemented in a tool named MDFlaker. The four factors are: trace-back coverage, flaky frequency, number of test smells, and test size. Based on the extracted factors, MDFlaker uses k-Nearest Neighbor (KNN) to determine whether failed test executions are flaky. We investigate MDFlaker in a case study with 2166 test executions from different open-source repositories. We evaluate the effectiveness of our flaky detection tool. We illustrate how the multi-factor approach can be used to reveal root causes for flakiness, and we conduct a qualitative comparison between MDFlaker and other tools proposed in literature. Our results show that the combination of different factors can be used to identify flaky tests. Each factor has its own trade-off, e.g., trace-back leads to many true positives, while flaky frequency yields more true negatives. Therefore, specific combinations of factors enable classification for testers with limited information (e.g., not enough test history information).

  • 33.
    Ahmad, Azeem
    et al.
    Linköping University, Department of Computer and Information Science, Software and Systems. Linköping University, Faculty of Science & Engineering.
    Held, Erik Norrestam
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Leifler, Ola
    Linköping University, Department of Computer and Information Science, Software and Systems. Linköping University, Faculty of Science & Engineering.
    Sandahl, Kristian
    Linköping University, Department of Computer and Information Science, Software and Systems. Linköping University, Faculty of Science & Engineering.
    Identifying Randomness related Flaky Tests through Divergence and Execution Tracing2022In: 2022 IEEE 15TH INTERNATIONAL CONFERENCE ON SOFTWARE TESTING, VERIFICATION AND VALIDATION WORKSHOPS (ICSTW 2022), IEEE COMPUTER SOC , 2022, p. 293-300Conference paper (Refereed)
    Abstract [en]

    Developers often spend time to determine whether test case failures are real failures or flaky. The flaky tests, known as non-deterministic tests, change their outcomes without any changes in the codebase, thus reducing the trust of developers during a software release as well as in the quality of a product. While rerunning test cases is a common approach, it is resource intensive, unreliable, and does not uncover the actual cause of test flakiness. Our paper evaluates an approach to identify randomness-related flaky. This paper used a divergence algorithm and execution tracing techniques to identify flaky tests, which resulted in the FLAKYPY prototype. In addition, this paper discusses the cases where FLAKYPY successfully identified the flaky test as well as those cases where FLAKYPY failed. The papers discuss how the reporting mechanism of FLAKYPY can help developers in identifying the root cause of randomness-related test flakiness. Thirty-two open-source projects were used in this. We concluded that FLAKYPY can detect most of the randomness-related test flakiness. In addition, the reporting mechanism of FLAKYPY reveals sufficient information about possible root causes of test flakiness.

  • 34.
    Ahmadpour, Doryaneh
    et al.
    Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala. Chalmers Univ Technol, Sweden.
    Kristoffersson, Anna
    Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Fredrikson, Mats
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences, Forum Östergötland.
    Link, Yumin
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Neurologiska kliniken i Linköping.
    Eriksson, Anne
    Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Iacobaeus, Ellen
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Landtblom, Anne-Marie
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Neurologiska kliniken i Linköping. Uppsala Univ, Sweden.
    Haghighi, Sara
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Neurologiska kliniken i Linköping. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Inventory study of an early pandemic COVID-19 cohort in South-Eastern Sweden, focusing on neurological manifestations2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 1, article id e0280376Article in journal (Refereed)
    Abstract [en]

    BackgroundNeurological manifestations in patients with COVID-19 have been reported previously as outcomes of the infection.The purpose of current study was to investigate the occurrence of neurological signs and symptoms in COVID-19 patients, in the county of ostergotland in southeastern Sweden. MethodsThis is a retrospective, observational cohort study. Data were collected between March 2020 and June 2020. Information was extracted from medical records by a trained research assistant and physician and all data were validated by a senior neurologist. ResultsSeventy-four percent of patients developed at least one neurological symptom during the acute phase of the infection. Headache (43%) was the most common neurological symptom, followed by anosmia and/or ageusia (33%), confusion (28%), hallucinations (17%), dizziness (16%), sleep disorders in terms of insomnia and OSAS (Obstructive Sleep Apnea) (9%), myopathy and neuropathy (8%) and numbness and tingling (5%). Patients treated in the ICU had a higher male presentation (73%). Several risk factors in terms of co-morbidities, were identified. Hypertension (54.5%), depression and anxiety (51%), sleep disorders in terms of insomnia and OSAS (30%), cardiovascular morbidity (28%), autoimmune diseases (25%), chronic lung diseases (24%) and diabetes mellitus type 2 (23%) founded as possible risk factors. ConclusionNeurological symptoms were found in the vast majority (74%) of the patients. Accordingly, attention to neurological, mental and sleep disturbances is warranted with involvement of neurological expertise, in order to avoid further complications and long-term neurological effect of COVID-19. Furthermore, risk factors for more severe COVID-19, in terms of possible co-morbidities that identified in this study should get appropriate attention to optimizing treatment strategies in COVID-19 patients.

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  • 35.
    Ahmed, Fareed
    et al.
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Ding, Penghui
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Ail, Ujwala
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Warczak, Magdalena
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Grimoldi, Andrea
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Ederth, Thomas
    Linköping University, Department of Physics, Chemistry and Biology, Biophysics and bioengineering. Linköping University, Faculty of Science & Engineering.
    Håkansson, Karl M. O.
    RISE Bioeconomy, Stockholm, Sweden.
    Vagin, Mikhail
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Gueskine, Viktor
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Berggren, Magnus
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Crispin, Xavier
    Linköping University, Department of Science and Technology, Laboratory of Organic Electronics. Linköping University, Faculty of Science & Engineering.
    Manufacturing Poly(3,4-Ethylenedioxythiophene) Electrocatalytic Sheets for Large-Scale H2O2 Production2022In: Advanced Sustainable Systems, E-ISSN 2366-7486, Vol. 6, no 1, article id 2100316Article in journal (Refereed)
    Abstract [en]

    Producing thick films of conducting polymers by a low-cost manufacturing technique would enable new applications. However, removing huge solvent volume from diluted suspension or dispersion (1-3 wt%) in which conducting polymers are typically obtained is a true manufacturing challenge. In this work, a procedure is proposed to quickly remove water from the conducting polymer poly(3,4-ethylenedioxythiophene:poly(4-styrene sulfonate) (PEDOT:PSS) suspension. The PEDOT:PSS suspension is first flocculated with 1 m H2SO4 transforming PEDOT nanoparticles (approximate to 50-500 nm) into soft microparticles. A filtration process inspired by pulp dewatering in a paper machine on a wire mesh with apertures dimension between 60 mu m and 0.5 mm leads to thick free-standing films (approximate to 0.5 mm). Wire mesh clogging that hinders dewatering (known as dead-end filtration) is overcome by adding to the flocculated PEDOT: PSS dispersion carbon fibers that aggregate and form efficient water channels. Moreover, this enables fast formation of thick layers under simple atmospheric pressure filtration, thus making the process truly scalable. Thick freestanding PEDOT films thus obtained are used as electrocatalysts for efficient reduction of oxygen to hydrogen peroxide, a promising green chemical and fuel. The inhomogeneity of the films does not affect their electrochemical function.

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  • 36.
    Ahrenberg, Lars
    et al.
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Merkel, Magnus
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Ridings, Daniel
    Department of Swedish Language, Goteborg University, Goteborg Sweden.
    Sågvall Hein, Anna
    Department of Linguistics, Uppsala University, Uppsala Sweden.
    Tiedemann, Jörg
    Department of Linguistics, Uppsala University, Uppsala Sweden.
    Automatic Processing of Parallel Corpora: A Swedish Perspective1999Report (Other academic)
    Abstract [en]

    As empirical methods have come to the fore in multilingual language technology and translation studies, the processing of parallel texts and parallel corpora have become a major research area in computational linguistics. In this article we review the state of the art in alignment and data extraction techniques for parallel texts, and give an overview of current work in Sweden in this area. In a final section, we summarize the results achieved so far and make some proposals for future research.

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  • 37.
    Ahrens, Peter
    et al.
    Statens Serum Inst, Denmark.
    Andersen, Lee OBrien
    Statens Serum Inst, Denmark.
    Lilje, Berit
    Statens Serum Inst, Denmark.
    Johannesen, Thor Bech
    Statens Serum Inst, Denmark.
    Gomez Dahl, Ebba
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Dermatology and Venerology. Statens Serum Inst, Denmark; Hlth Ctr Gullviksborg, Sweden.
    Baig, Sharmin
    Statens Serum Inst, Denmark.
    Jensen, Jorgen Skov
    Statens Serum Inst, Denmark.
    Falk, Lars
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Department of Dermatology and Venerology.
    Changes in the vaginal microbiota following antibiotic treatment forMycoplasma genitalium,Chlamydia trachomatisand bacterial vaginosis2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 7, article id e0236036Article in journal (Refereed)
    Abstract [en]

    The human vagina harbor a rich microbiota. The optimal state is dominated by lactobacilli that help to maintain health and prevent various diseases. However, the microbiota may rapidly change to a polymicrobial state that has been linked to a number of diseases. In the present study, the temporal changes of the vaginal microbiota in patients treated for sexually transmitted diseases or bacterial vaginosis (BV) and in untreated controls were studied for 26 days. The patients included 52 women treated with azithromycin, tetracyclines or moxifloxacin for present or suspected infection withChlamydia trachomatisorMycoplasma genitalium. Women with concurrent BV were also treated with metronidazole. The controls were 10 healthy women of matching age. The microbiota was analyzed by 16S rRNA gene deep sequencing, specific qPCRs and microscopy. There was generally good correlation between Nugent score and community state type (CST) and qPCR confirmed the sequencing results. By sequencing, more than 600 different taxa were found, but only 33 constituted more than 1 parts per thousand of the sequences. In both patients and controls the microbiota could be divided into three different community state types, CST-I, CST-III and CST-IV. Without metronidazole, the microbiota remained relatively stable regarding CST although changes were seen during menstrual periods. Administration of metronidazole changed the microbiota from CST-IV to CST-III in approximately 50% of the treated patients. In contrast, the CST was generally unaffected by azithromycin or tetracyclines. In 30% of the BV patients,Gardnerella vaginaliswas not eradicated by metronidazole. The majority of women colonized withUreaplasma parvumremained positive after azithromycin whileU.urealyticumwas eradicated.

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  • 38.
    Akerstrom, Finn
    et al.
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Hutter, Julie
    Kerckhoff Heart & Thorax Ctr, Germany.
    Charitakis, Emmanouil
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Tabrizi, Fariborz
    Arrhythm Ctr, Sweden.
    Asaad, Fahd
    Karolinska Univ Hosp, Sweden.
    Bastani, Hamid
    Karolinska Univ Hosp, Sweden.
    Bourke, Tara
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Braunschweig, Frieder
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Drca, Nikola
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Englund, Anders
    Arrhythm Ctr, Sweden.
    Friberg, Leif
    Karolinska Inst, Sweden.
    Insulander, Per
    Karolinska Inst, Sweden.
    Jonsson, Anders Hassel
    Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Kenneback, Goran
    Karolinska Univ Hosp, Sweden.
    Paul-Nordin, Astrid
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Sadigh, Bita
    Karolinska Univ Hosp, Sweden.
    Saluveer, Ott
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Saygi, Serkan
    Karolinska Univ Hosp, Sweden.
    Schwieler, Jonas
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Svennberg, Emma
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Tapanainen, Jari
    Danderyd Hosp, Sweden.
    Turkmen, Yusuf
    Karolinska Univ Hosp, Sweden.
    Jensen-Urstad, Mats
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Association between catheter ablation of atrial fibrillation and mortality or stroke2024In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 110, p. 163-169Article in journal (Refereed)
    Abstract [en]

    Objective Catheter ablation of atrial fibrillation effectively reduces symptomatic burden. However, its long-term effect on mortality and stroke is unclear. We investigated if patients with atrial fibrillation who undergo catheter ablation have lower risk for all-cause mortality or stroke than patients who are managed medically. Methods We retrospectively included 5628 consecutive patients who underwent first-time catheter ablation for atrial fibrillation between 2008 and 2018 at three major Swedish electrophysiology units. Control individuals with an atrial fibrillation diagnosis but without previous stroke were selected from the Swedish National Patient Register, resulting in a control group of 48 676 patients. Propensity score matching was performed to produce two cohorts of equal size (n=3955) with similar baseline characteristics. The primary endpoint was a composite of all-cause mortality or stroke. Results Patients who underwent catheter ablation were healthier (mean CHA(2)DS(2)-VASc score 1.4 +/- 1.4 vs 1.6 +/- 1.5, p&lt;0.001), had a higher median income (288 vs 212 1000 Swedish krona [KSEK]/year, p&lt;0.001) and had more frequently received university education (45.1% vs 28.9%, p&lt;0.001). Mean follow-up was 4.5 +/- 2.8 years. After propensity score matching, catheter ablation was associated with lower risk for the combined primary endpoint (HR 0.58, 95% CI 0.48 to 0.69). The result was mainly driven by a decrease in all-cause mortality (HR 0.51, 95% CI 0.41 to 0.63), with stroke reduction showing a trend in favour of catheter ablation (HR 0.75, 95% CI 0.53 to 1.07). Conclusions Catheter ablation of atrial fibrillation was associated with a reduction in the primary endpoint of all-cause mortality or stroke. This result was driven by a marked reduction in all-cause mortality.

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  • 39.
    Akhtar, Zubair
    et al.
    Univ New South Wales, Australia; Icddr B, Bangladesh; Univ New South Wales, Australia.
    Gotberg, Matthias
    Lund Univ, Sweden.
    Erlinge, David
    Lund Univ, Sweden.
    Christiansen, Evald H.
    Aarhus Univ Hosp, Denmark.
    Oldroyd, Keith G.
    Univ Glasgow, Scotland.
    Motovska, Zuzana
    Charles Univ Prague, Czech Republic; Univ Hosp Kralovske Vinohrady, Czech Republic.
    Erglis, Andrejs
    Univ Latvia, Latvia.
    Hlinomaz, Ota
    St Anne Univ Hosp, Czech Republic; Masaryk Univ, Czech Republic.
    Jakobsen, Lars
    Aarhus Univ Hosp, Denmark.
    Engstrom, Thomas
    Univ Copenhagen, Denmark.
    Jensen, Lisette O.
    Odense Univ Hosp, Denmark.
    Fallesen, Christian O.
    Odense Univ Hosp, Denmark.
    Jensen, Svend E.
    Aalborg Univ Hosp, Denmark; Aalborg Univ, Denmark.
    Angeras, Oskar
    Sahlgrens Univ Hosp, Sweden; Gothenburg Univ, Sweden.
    Calais, Fredrik
    Orebro Univ, Sweden.
    Karegren, Amra
    Vastmanlands Sjukhus Vasteras, Sweden.
    Lauermann, Jorg
    Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Reg Jonkoping Cty, Sweden.
    Mokhtari, Arash
    Lund Univ, Sweden.
    Nilsson, Johan
    Umea Univ, Sweden.
    Persson, Jonas
    Karolinska Inst, Sweden.
    Islam, Abu K. M. M.
    Natl Inst Cardiovasc Dis, Bangladesh.
    Rahman, Afzalur
    Natl Inst Cardiovasc Dis, Bangladesh.
    Malik, Fazila
    Natl Heart Fdn Hosp & Res Inst, Bangladesh.
    Choudhury, Sohel
    Natl Heart Fdn Hosp & Res Inst, Bangladesh.
    Collier, Timothy
    London Sch Hyg & Trop Med, England.
    Pocock, Stuart J.
    London Sch Hyg & Trop Med, England.
    Pernow, John
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Macintyre, Chandini R.
    Univ New South Wales, Australia; Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Frobert, Ole
    Orebro Univ, Sweden; Arizona State Univ, AZ USA; Aarhus Univ, Denmark; Aarhus Univ Hosp, Denmark; Aarhus Univ Hosp, Denmark.
    Optimal timing of influenza vaccination among patients with acute myocardial infarction - Findings from the IAMI trial2023In: Vaccine, ISSN 0264-410X, E-ISSN 1873-2518, Vol. 41, no 48, p. 7159-7165Article in journal (Refereed)
    Abstract [en]

    Influenza vaccination reduces the risk of adverse cardiovascular events. The IAMI trial randomly assigned 2571 patients with acute myocardial infarction (AMI) to receive influenza vaccine or saline placebo during their index hospital admission. It was conducted at 30 centers in 8 countries from October 1, 2016 to March 1, 2020. In this post-hoc exploratory sub-study, we compare the trial outcomes in patients receiving early season vaccination (n = 1188) and late season vaccination (n = 1344). The primary endpoint was the composite of all-cause death, myocardial infarction (MI), or stent thrombosis at 12 months. The cumulative incidence of the primary and key secondary endpoints by randomized treatment and early or late vaccination was estimated using the Kaplan-Meier method. In the early vaccinated group, the primary composite endpoint occurred in 36 participants (6.0%) assigned to influenza vaccine and 49 (8.4%) assigned to placebo (HR 0.69; 95% CI 0.45 to 1.07), compared to 31 participants (4.7%) assigned to influenza vaccine and 42 (6.2%) assigned to placebo (HR 0.74; 95% CI 0.47 to 1.18) in the late vaccinated group (P = 0.848 for interaction on HR scale at 1 year). We observed similar estimates for the key secondary endpoints of all-cause death and CV death. There was no statistically significant difference in vaccine effectiveness against adverse cardiovascular events by timing of vaccination. The effect of vaccination on all-cause death at one year was more pronounced in the group receiving early vaccination (HR 0.50; 95% CI, 0.29 to 0.86) compared late vaccination group (HR 0.75; 35% CI, 0.40 to 1.40) but there was no statistically significant difference between these groups (Interaction P = 0.335). In conclusion, there is insufficient evidence from the trial to establish whether there is a difference in efficacy between early and late vaccination but regardless of vaccination timing we strongly recommend influenza vaccination in all patients with cardiovascular diseases.

  • 40.
    Akinsete, Ebun
    et al.
    Int Ctr Res Environm & Econ ICRE8, Greece.
    Koundouri, Phoebe
    Athens Univ Econ & Business, Greece.
    Kartala, Xanthi
    Athens Univ Econ & Business, Greece.
    Englezos, Nikos
    Univ Piraeus, Greece.
    Lautze, Jonathan
    Int Water Management Inst, South Africa.
    Yihdego, Zeray
    Univ Aberdeen, Scotland.
    Gibson, Julie
    Univ Strathclyde, Scotland.
    Scholz, Geeske
    Osnabruck Univ, Germany.
    van Bers, Caroline
    Osnabruck Univ, Germany.
    Sodoge, Jan
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences.
    Sustainable WEF Nexus Management: A Conceptual Framework to Integrate Models of Social, Economic, Policy, and Institutional Developments2022In: Frontiers in Water, E-ISSN 2624-9375, Vol. 4, article id 727772Article, review/survey (Refereed)
    Abstract [en]

    Rapid population growth along with increased rates of economic growth around the globe are placing valuable natural resources, water in particular, under unprecedented stress; this in turn drives the pursuit of innovative tools to support integrated Water-Energy-Food (WEF) nexus management. This paper presents a framework for the integrated management of the WEF nexus, which brings together four separate models that address the less well-examined socio-anthropological aspects of the nexus. The proposed framework provides insight into the human element as part of the wider ecosystem in terms of socio-cultural and economic activities, the laws and policies that govern these activities, as well as their potential socio-economic impacts and consequences. This paper outlines each individual model, before going on to present a conceptual framework for the integration of the various models for the purpose of supporting more robust decision-making. The framework, which is grounded in systems thinking, adopts the principles of sustainable development as structural foci in order to position the various models in relation to one another; harmonizing their inputs as well as outputs.

  • 41.
    Aktaa, Suleman
    et al.
    Univ Leeds, England; Univ Leeds, England; Leeds Teaching Hosp NHS Trust, England.
    Batra, Gorav
    Uppsala Univ, Sweden; Uppsala Univ, Sweden.
    Cleland, John G. F.
    Univ Glasgow, Scotland; Univ Glasgow, Scotland; Imperial Coll London, England.
    Coats, Andrew
    Univ Warwick, England; European Soc Cardiol, Belgium.
    Lund, Lars H.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    McDonagh, Theresa
    Kings Coll Hosp London, England; Kings Coll London, England.
    Rosano, Giuseppe
    St Georges Hosp NHS Trust Univ London, England; IRCCS San Raffaele Pisana, Italy.
    Seferovic, Petar
    Univ Belgrade, Serbia.
    Vasko, Peter
    Region Östergötland, Heart Center, Department of Cardiology in Linköping. SWEDEHEART Swedish Web Syst Enhancement & Dev Evi, Sweden; SwedeHF Swedish Heart Failure Registry, Sweden.
    Wallentin, Lars
    Uppsala Univ, Sweden; Uppsala Univ, Sweden.
    Maggioni, Aldo P.
    Natl Assoc Hosp Cardiologists Res Ctr ANMCO, Italy.
    Casadei, Barbara
    Univ Oxford, England.
    Gale, Chris P.
    Univ Leeds, England; Univ Leeds, England; Leeds Teaching Hosp NHS Trust, England.
    Data standards for heart failure: the European Unified Registries for Heart Care Evaluation and Randomized Trials (EuroHeart)2022In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 43, no 23, p. 2185-2195Article in journal (Refereed)
    Abstract [en]

    Standardized data definitions are essential for assessing the quality of care and patient outcomes in observational studies and randomized controlled trials. The European Unified Registries for Heart Care Evaluation and Randomized Trials (EuroHeart) project of the European Society of Cardiology (ESC) aims to create contemporary pan-European data standards for cardiovascular diseases, including heart failure (HF). We followed the EuroHeart methodology for cardiovascular data standard development. A Working Group including experts in HF registries, representatives from the Heart Failure Association of the ESC, and the EuroHeart was formed. Using Embase and Medline (2016-21), we conducted a systematic review of the literature on data standards, registries, and trials to identify variables pertinent to HF. A modified Delphi method was used to reach a consensus on the final set of variables. For each variable, the Working Group developed data definitions and agreed on whether it was mandatory (Level 1) or additional (Level 2). In total, 84 Level 1 and 79 Level 2 variables were selected for nine domains of HF care. These variables were reviewed by an international Reference Group with the Level 1 variables providing the dataset for registration of patients with HF on the EuroHeart IT platform. By means of a structured process and interaction with international stakeholders, harmonized data standards for HF have been developed. In the context of the EuroHeart, this will facilitate quality improvement, international observational research, registry-based randomized trials, and post-marketing surveillance of devices and pharmacotherapies across Europe.

  • 42.
    Akyurek, Levent M.
    et al.
    Sahlgrens Univ Hosp, Sweden.
    Hussein, Aziz
    Sahlgrens Univ Hosp, Sweden.
    Nicholson, Andrew G.
    Imperial Coll, England; Imperial Coll, England.
    Mauritz, Nils-Johan
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Nephrology, Jönköping, Region Jönköping County, Sweden.
    Molne, Johan
    Sahlgrens Univ Hosp, Sweden.
    Pulmonary manifestations of systemic karyomegaly2020In: RESPIRATORY MEDICINE CASE REPORTS, ISSN 2213-0071, Vol. 29, article id 101032Article in journal (Refereed)
    Abstract [en]

    Over 40 years ago, abnormal enlargement of the nucleus of tubular epithelial cells was reported in a rare distinct hereditary chronic interstitial nephritis, karyomegalic interstitial nephritis (KIN). Here, we report the second case of systemic karyomegaly with pulmonary manifestations and present a detailed characterization of the karyomegalic cells in lung parenchyma. A 59-year-old woman who was diagnosed with KIN developed renal failure and eventually received a renal transplant later evaluated for chronic and progressive restrictive lung disease. The KIN diagnosis prompted us to carefully examine her lung parenchyma. Karyomegalic cells were identified in the alveolar epithelium, interstitium, as well as, in the vascular wall. Viral serological and biochemical blood analyses were negative. We consider that the pulmonary manifestations of karyomegaly expands the differential diagnosis of interstitial lung disease in patients with KIN.

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  • 43.
    Al Nimaa, Ali
    et al.
    Blekinge Ctr Competence, Sweden; Univ Gothenburg, Sweden.
    Cloninger, Kevin M.
    Blekinge Ctr Competence, Sweden; Anthropedia Fdn, MO USA.
    Persson, Bjorn N.
    Blekinge Ctr Competence, Sweden; Univ Turku, Finland.
    Sikstrom, Sverker
    Lund Univ, Sweden.
    Garcia, Danilo
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Blekinge Ctr Competence, Sweden; Univ Gothenburg, Sweden.
    Validation of Subjective Well-Being Measures Using Item Response Theory2020In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 10, article id 3036Article in journal (Refereed)
    Abstract [en]

    Background: Subjective well-being refers to the extent to which a person believes or feels that her life is going well. It is considered as one of the best available proxies for a broader, more canonical form of well-being. For over 30 years, one important distinction in the conceptualization of subjective well-being is the contrast between more affective evaluations of biological emotional reactions and more cognitive evaluations of ones life in relation to a psychologically self-imposed ideal. More recently, researchers have suggested the addition of harmony in life, comprising behavioral evaluations of how one is doing in a social context. Since measures used to assess subjective well-being are self-reports, often validated only using Classical Test Theory, our aim was to focus on the psychometric properties of the measures using Item Response Theory. Method: A total of 1000 participants responded to the Positive Affect Negative Affect Schedule. At random, half of the participants answered to the Satisfaction with Life Scale or to the Harmony in life Scale. First, we evaluate and provide enough evidence of unidimensionality for each scale. Next, we conducted graded response models to validate the psychometric properties of the subjective well-being scales. Results: All scales showed varied frequency item distribution, high discrimination values (Alphas), and had different difficulty parameters (Beta) on each response options. For example, we identified items that respondents found difficult to endorse at the highest/lowest point of the scales (e.g., "Proud" for positive affect; item 5, "If I could live my life over, I would change almost nothing," for life satisfaction; and item 3, "I am in harmony," for harmony in life). In addition, all scales could cover a good portion of the range of subjective well-being (Theta): -2.50 to 2.30 for positive affect, -1.00 to 3.50 for negative affect, -2.40 to 2.50 for life satisfaction, and -2.40 to 2.50 for harmony in life. Importantly, for all scales, there were weak reliability for respondents with extreme latent scores of subjective well-being. Conclusion: The affective component, especially low levels of negative affect, were less accurately measured, while both the cognitive and social component were covered to an equal degree. There was less reliability for respondents with extreme latent scores of subjective well-being. Thus, to improve reliability at the level of the scale, at the item level and at the level of the response scale for each item, we point out specific items that need to be modified or added. Moreover, the data presented here can be used as normative data for each of the subjective well-being constructs.

  • 44.
    Albadri, Zeyad
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    AL Bayati, Doua
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Habel, Henrike
    Karolinska Inst, Sweden.
    Jerkovic Gulin, Sandra
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Div Dermatol & Venereol, Sweden.
    Groenhagen, Carina
    Lund Univ, Sweden.
    Seifert, Oliver
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Incidence of Dermatitis Herpetiformis in Sweden 2005 to 2018: A Nationwide Retrospective Cohort Study2023In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 103, article id adv13210Article in journal (Refereed)
    Abstract [en]

    Dermatitis herpetiformis has been investigated in the past; however, only a limited number of studies have reported its incidence based on validated nationwide population-based registries. To address this gap, the aims of this study are to estimate the incidence of dermatitis herpetiformis in Sweden and to validate the National Patient Register (NPR) for diagnosis of dermatitis herpetiformis. A population-based open cohort study was conducted, including all patients diagnosed with dermatitis herpetiformis (International Classification of Diseases 10th revision; ICD-10 code L13.0) in Sweden from 2005 to 2018 (n = 1,724), identified from the NPR. The diagnosis of dermatitis herpetiformis in the NPR was validated using medical records, histopathological and immunopathological data, yielding a positive predictive value (PPV) of 62.5%. The mean annual incidence of dermatitis herpetiformis was 0.93/100,000 (95% confidence interval 0.79-1.08), female to male ratio 1:1, and mean age at diagnosis 60.9 years. In conclusion, this large nationwide cohort study showed a low validity for diagnosis of dermatitis herpetiformis in the NPR, and the adjusted incidence rate of dermatitis herpetiformis in Sweden was estimated to be 0.93/100,000, which is lower than that in previous Swedish studies.

  • 45.
    Albinsson, Pär-Anders
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Interacting with command and control systems: Tools for operators and designers2004Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Command and control is central in all distributed tactical operations such as rescue operations and military operations. It takes place in a complex system of humans and artefacts, striving to reach common goals. The command and control complexity springs from several sources, including dynamism, uncertainty, risk, time pressure, feedback delays and interdependencies. Stemming from this complexity, the thesis approaches two important and related problem areas in command and control research. On a general level, the thesis seeks to approach the problems facing the command and control operators and the problems facing the designers in the associated systems development process.

    We investigate the specific problem of operators losing sight of the overall perspective when working with large maps in geographical information systems with limited screen area. To approach this problem, we propose high-precision input techniques that reduce the need for zooming and panning in touch-screen systems, and informative unit representations that make better use of the screen area available. The results from an experimental study show that the proposed input techniques are as fast and accurate as state-of-the-art techniques without the need to resort to zooming. Furthermore, results from a prototype design show that the proposed unit representation reduces on-screen clutter and makes use of off-screen units to better exploit the valuable screen area.

    Developing command and control systems is a complex task with several pitfalls, including getting stuck in exhaustive analyses and overrated reliance on rational methods. In this thesis, we employ a design-oriented research framework that acknowledges creative and pragmatic ingredients to handle the pitfalls. Our approach adopts the method of reconstruction and exploration of mission histories from distributed tactical operations as a means for command and control analysis. To support explorative analysis of mission histories within our framework, we propose tools for communication analysis and tools for managing metadata such as reflections, questions, hypotheses and expert comments. By using these tools together with real data from live tactical operations, we show that they can manage large amounts of data, preserve contextual data, support navigation within data, make original data easily accessible, and strengthen the link between metadata and supporting raw data. Furthermore, we show that by using these tools, multiple analysts, experts, and researchers can exchange comments on both data and metadata in a collaborative and explorative investigation of a complex scenario.

    List of papers
    1. Visual Exploration of Communication in Command and Control
    Open this publication in new window or tab >>Visual Exploration of Communication in Command and Control
    2002 (English)In: Proceedings of the 6th International Conference on Information Visualization, July 10–12, London, England,ISSN 1093-9547, 2002, p. 141-146Conference paper, Published paper (Refereed)
    Abstract [en]

    Communication is a central activity in command and control. However, analysing communication using linear transcription of large amounts of sequential data is tedious and time consuming. This paper describes an alternative approach for communication analysis based on visual exploration of abstract representations of communication. It introduces a visualisation technique based on the Attribute Explorer. The technique was implemented in a visualisation component embedded in a framework for coordinated presentation of temporal data. It is demonstrated using authentic communication data from a military exercise and a rescue operation.

    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-14315 (URN)10.1109/IV.2002.1028769 (DOI)
    Available from: 2007-02-27 Created: 2007-02-27 Last updated: 2009-02-26
    2. High Precision Touch Screen Interaction
    Open this publication in new window or tab >>High Precision Touch Screen Interaction
    2003 (English)In: Proceedings of the ACM Conference on Human Factors Computing Systems, April 5–10, Fort Lauderdale, USA, 2003, p. 105–112-Conference paper, Published paper (Refereed)
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-14316 (URN)
    Available from: 2007-02-27 Created: 2007-02-27 Last updated: 2009-02-26
    3. Representing Military Units Using Nested Convex Hulls: Coping With Complexity in Command and Control
    Open this publication in new window or tab >>Representing Military Units Using Nested Convex Hulls: Coping With Complexity in Command and Control
    2002 (English)In: Proceedings of the 1st Swedish-American Workshop on Modeling and Simulation, October 30–31, Orlando, USA., 2002, p. 25-32Conference paper, Published paper (Refereed)
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-14317 (URN)
    Available from: 2007-02-27 Created: 2007-02-27 Last updated: 2009-02-26
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  • 46.
    Albinsson-Stenholm, Erina
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Bergsen, Johannes
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Ingues, Simon
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Vilhelmsson, Nathalie
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Guldbrand, Hans
    Region Östergötland, Local Health Care Services in West Östergötland, "Primary Health Care in Motala". Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Nyström, Fredrik H
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Cityhälsan Centrum, Norrköping.
    Subjects with high fasting insulin also have higher postprandial GLP-1 and glucagon levels than controls with lower insulin2019In: Nutrition Research, ISSN 0271-5317, E-ISSN 1879-0739, Vol. 72, p. 111-120Article in journal (Refereed)
    Abstract [en]

    Little is known about postprandial release of serum ghrelin, glucagon, and glucagon-like peptide-1 (GLP-1) in relation with differing fasting insulin levels. We hypothesized that these hormones are affected by insulin resistance, and hence, we compared different postprandial responses of GLP-1, glucagon, and ghrelin in subjects with relatively high (RHI) or relatively low (RLI) fasting insulin levels. The trial was a randomized crossover study with 4 different meal conditions. Fourteen nonobese or obese, healthy, men and 14 women were randomly assigned to the order of supervised intake of a 750 kcal drink with the same protein contents but with 20 energy-percent (E%) or 55 E% from carbohydrates, and the remaining energy from fat. Participants were also randomized to consume the drinks as 1 large beverage or as five 150-kcal portions every 30 minutes. The 28 subjects were divided into 2 equally sized groups based on fasting insulin levels. Statistics were done with general linear mixed model. Fasting insulin levels were 3-fold higher in the group with RHI compared with the RLI group (RHI: 1004 +/- 510 pg/mL, RLI: 324 +/- 123 pg/mL, P amp;lt; .0005). Serum GLP-1 was highest in the RHI group after both single meals and after 5 drinks and following high- and low-carbohydrate meals (both P amp;lt;= .002), and this was the case also for glucagon levels (both P amp;lt;= .018), whereas ghrelin levels did not differ between groups. Thus, subjects with RHI displayed both higher postprandial serum GLP-1 and glucagon than the participants with RLI, suggesting that glucagon could play a role in the advent of dysglycemia by insulin resistance. (C) 2019 Elsevier Inc. All rights reserved.

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  • 47.
    Albonico, Andrea
    et al.
    Human Vision and Eye Movement Laboratory, Departments of Medicine (Neurology), Ophthalmology and Visual Sciences, Psychology, University of British Columbia, Vancouver, Canada.
    Furubacke, Amanda
    Linköping University, Faculty of Medicine and Health Sciences. Human Vision and Eye Movement Laboratory, Departments of Medicine (Neurology), Ophthalmology and Visual Sciences, Psychology, University of British Columbia, Vancouver, Canada.
    Barton, Jason J. S.
    Human Vision and Eye Movement Laboratory, Departments of Medicine (Neurology), Ophthalmology and Visual Sciences, Psychology, University of British Columbia, Vancouver, Canada.
    Oruc, Ipek
    Department of Ophthalmology and Visual Sciences, University of British Columbia, Canada; Program in Neuroscience, University of British Columbia, Canada.
    Perceptual efficiency and the inversion effect for faces, words and houses2018In: Vision Research, ISSN 0042-6989, E-ISSN 1878-5646, Vol. 153, p. 91-97Article in journal (Refereed)
    Abstract [en]

    Face and visual word recognition are two key forms of expert visual processing. In the domain of object recognition, it has been suggested that expert processing is characterized by the use of different mechanisms from the ones involved in general object recognition. It has been suggested that one traditional marker of expert processing is the inversion effect. To investigate whether face and word recognition differ from general object recognition, we compared the effect of inversion on the perceptual efficiency of face and visual word recognition as well as on the recognition of a third, non-expert object category, houses. From the comparison of identification contrast thresholds to an ideal observer, we derived the efficiency and equivalent input noise of stimulus processing in both upright and inverted orientations. While efficiency reflects the efficacy in sampling the available information, equivalent input noise is associated with the degradation of the stimulus signal within the visual system. We hypothesized that large inversion effects for efficiency and/or equivalent input noise should characterize expert high-level processes, and asked whether this would be true for both faces and words, but not houses. However, we found that while face recognition efficiency was profoundly reduced by inversion, the efficiency of word and house recognition was minimally influenced by the orientation manipulation. Inversion did not affect equivalent input noise. These results suggest that even though faces and words are both considered expert processes, only the efficiency of the mechanism involved in face recognition is sensitive to orientation.

  • 48.
    Alenljung, Beatrice
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Decision-making in the requirements engineering process: a human-centered approach2005Licentiate thesis, monograph (Other academic)
    Abstract [en]

    Complex decision-making is a prominent aspect of requirements engineering and the need for improved decision support for requirements engineers has been identified by a number of authors. A first step toward better decision support in requirements engineering is to understand decision-makers- complex decision situations. To gain a holistic perspective of the decision situation from a decision-makers perspective, a decision situation framework has been created. The framework evolved through a literature analysis of decision support systems and decision-making theories. The decision situation of requirements engineers has been studied at Ericsson Microwave Systems and is described in this thesis. Aspects of decision situations are decision matters, decision-making activities, and decision processes. Another aspect of decision situations is the factors that affect the decision-maker. A number of interrelated factors have been identified. Each factor consists of problems and these are related to decision-making theories. The consequences of this for requirements engineering decision support, represented as a list that consists of desirable high-level characteristics, are also discussed.

  • 49.
    Alfredson, Jens
    et al.
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering. Saab Aeronaut, Linkoping, Sweden.
    Trabasso, Luís Gonzaga
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering. ITA, Brazil.
    Blomstrand, Niklas
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Eckerberg, Maria
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Klamer, Linda
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Ledin, Johanna
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Tarander, Jasmine
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Bång, Magnus
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    Engine Failure Induced Task Load Transient for Simulation Based Certification Aiding for Aircraft2018In: ADVANCES IN HUMAN ASPECTS OF TRANSPORTATION, SPRINGER INTERNATIONAL PUBLISHING AG , 2018, Vol. 597, p. 79-86Conference paper (Refereed)
    Abstract [en]

    This study is one of a series of studies, researching various aspects that all aim at enhanced simulation based certification aiding for aircraft. An experimental within-group design study was performed with 10 participants ( 5 male, and 5 female). The results showed a significant difference, F(2,16) = 5.11, p = 0.019, in mental workload between an engine failure condition and an normal condition for eye blink frequency. No effect of speed at the engine failure event on mental workload was found.

  • 50.
    Alfredsson, Joakim
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Region Östergötland, Heart Center, Department of Cardiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Omar, Kime
    Vastmanland Cty Hosp, Sweden.
    Csog, Jozsef
    Region Östergötland, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Venetsanos, Dimitrios
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Janzon, Magnus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Cardiology in Linköping.
    Ekstedt, Mattias
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Mag- tarmmedicinska kliniken.
    Bleeding complications with clopidogrel or ticagrelor in ST-elevation myocardial infarction patients: A real life cohort study of two treatment strategies2020In: IJC Heart & Vasculature, E-ISSN 2352-9067, Vol. 27, article id 100495Article in journal (Refereed)
    Abstract [en]

    Introduction

    Dual antiplatelet therapy (DAPT), including potent P2Y12 inhibition after ST-elevation myocardial infarction (STEMI) is recommended in clinical guidelines. However, bleeding complications are common, and associated with worse outcomes. The aim of this study was to assess incidence of bleeding events with a clopidogrel-based compared to a ticagrelor-based DAPT strategy, in a real world population. Secondary aims were to assess ischemic complications and mortality.

    Methods and Results

    We identified 330 consecutive STEMI patients with a clopidogrel-based and 330 with a ticagrelor-based DAPT strategy. Patientś medical records were searched for bleeding and ischemic complications, over 6 months follow-up.

    The two groups were well balanced in baseline characteristics, age (69 years inboth groups), sex (31% vs 32% females), history of diabetes (19% vs 21%), hypertension (43% in both) and MI (17% vs 15%). There was no difference in CRUSADE bleeding score (28 vs 29). After discharge, there were more than twice as many bleeding events with a ticagrelor-based compared with a clopidogrel-based strategy (13.3% vs. 6.5%, p = 0.005). Bleeding events included significantly more severe bleeding complications (TIMI major/minor [5.8 vs 1.0, p = 0.001]) during the ticagrelor-based period. There was no significant difference in the composite of death, MI or stroke (7.8% vs 7.1%, p = 0.76).

    Conclusions

    In this observational study, a ticagrelor-based DAPT strategy was associated with significantly more bleeding complications, without any significant change in death, MI or stroke. Larger studies are needed to determine whether bleeding complications off-sets benefits with a more potent DAPT strategy in older and more comorbid real-life patients.

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