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Sirevåg K, Stavestrand SH, Sjøbø T, Endal TB, Nordahl HM, Andersson E, Nordhus IH, Rekdal Å, Specht K, Hammar Å, Halmøy A, Mohlman J, Hjelmervik H, Thayer JF, Hovland A. Correction to: Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial. Biopsychosoc Med 2023; 17:28. [PMID: 37542338 PMCID: PMC10401878 DOI: 10.1186/s13030-023-00284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Affiliation(s)
- Kristine Sirevåg
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway.
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway.
| | - S H Stavestrand
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
| | - T Sjøbø
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - T B Endal
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - H M Nordahl
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, NO-7030, Norway
| | - E Andersson
- The Swedish School of Sport and Health Sciences, GIH, Stockholm, 5626 SE-114 86, box, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, 171 177, Sweden
| | - I H Nordhus
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
- Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern, Oslo, NO-0316, Norway
| | - Å Rekdal
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - K Specht
- Faculty of humanities, social sciences and education, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway
| | - Å Hammar
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - A Halmøy
- Department of Psychiatry, Haukeland University Hospital, Kronstad DPS, P.O. Box 1400, Bergen, NO- 5021, Norway
- Department of Clinical Medicine, University of Bergen, P.O. Box 7804, Bergen, NO-5020, Norway
| | - J Mohlman
- Department of Psychology, William Paterson University, 300 Pomton Road, Wayne, NJ, 07470, USA
| | - H Hjelmervik
- School of Health Sciences, Kristiania University College, Kalfarveien 78c, Bergen, 5022, Norway
| | - J F Thayer
- Department of Psychological Science, The University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - A Hovland
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
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Sirevåg K, Stavestrand SH, Sjøbø T, Endal TB, Nordahl HM, Andersson E, Nordhus IH, Rekdal Å, Specht K, Hammar Å, Halmøy A, Mohlman J, Hjelmervik H, Thayer JF, Hovland A. Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial. Biopsychosoc Med 2023; 17:25. [PMID: 37468978 PMCID: PMC10357630 DOI: 10.1186/s13030-023-00280-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/04/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Generalised anxiety disorder (GAD) is a frequent and severe disorder among older adults. For older adults with GAD the effect of the recommended treatment, cognitive behaviour therapy (CBT), is reduced. Physical exercise (PE) may enhance the effect of CBT by improving cognitive function and increasing levels of brain-derived neurotrophic factor (BDNF), a predictor of the effect of CBT in patients with anxiety. The aim of the study was to assess the feasibility of a randomized controlled trial (RCT) investigating treatment effect of the combination of CBT and PE for GAD in a sample of older adults, including procedures for assessment and treatment. METHODS Four participants aged 62-70 years (M = 65.5, SD = 3.2) with a primary diagnosis of GAD were included. Participants received 15 weeks of PE in combination with 10 weeks of CBT. Participants completed self-report measures, and clinical, biological, physiological and neuropsychological tests at pre-, interim- and post-treatment. RESULTS Procedures, protocols, and results are presented. One participant dropped out during treatment. For the three participants completing, the total adherence to PE and CBT was 80% and 100%, respectively. An independent assessor concluded that the completers no longer fulfilled the criteria for GAD after treatment. Changes in self-report measures suggest symptom reduction related to anxiety and worry. The sample is considered representative for the target population. CONCLUSIONS The results indicate that combining CBT and PE for older adults with GAD is feasible, and that the procedures and tests are suitable and manageable for the current sample. TRIAL REGISTRATION ClinicalTrials.gov, NCT02690441. Registered on 24 February 2016, https://clinicaltrials.gov/ct2/show/NCT02690441 .
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Affiliation(s)
- Kristine Sirevåg
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway.
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway.
| | - S H Stavestrand
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
| | - T Sjøbø
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - T B Endal
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - H M Nordahl
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, NO-7030, Norway
| | - E Andersson
- The Swedish School of Sport and Health Sciences, GIH, Stockholm, 5626 SE-114 86, box, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, 171 177, Sweden
| | - I H Nordhus
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
- Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern, Oslo, NO-0316, Norway
| | - Å Rekdal
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
| | - K Specht
- Faculty of humanities, social sciences and education, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway
| | - Å Hammar
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - A Halmøy
- Department of Psychiatry, Haukeland University Hospital, Kronstad DPS, P.O. Box 1400, Bergen, NO- 5021, Norway
- Department of Clinical Medicine, University of Bergen, P.O. Box 7804, Bergen, NO-5020, Norway
| | - J Mohlman
- Department of Psychology, William Paterson University, 300 Pomton Road, Wayne, NJ, 07470, USA
| | - H Hjelmervik
- School of Health Sciences, Kristiania University College, Kalfarveien 78c, Bergen, 5022, Norway
| | - J F Thayer
- Department of Psychological Science, The University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - A Hovland
- Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway
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Siltari A, Lönnerbro R, Pang K, Shiranov K, Asiimwe A, Evans-Axelsson S, Franks B, Kiran A, Murtola TJ, Schalken J, Steinbeisser C, Bjartell A, Auvinen A, Smith E, N'Dow J, Plass K, Ribal M, Mottet N, Moris L, Lardas M, Van den Broeck T, Willemse PP, Gandaglia G, Campi R, Greco I, Gacci M, Serni S, Briganti A, Crosti D, Meoni M, Garzonio R, Bangma R, Roobol M, Remmers S, Tilki D, Visakorpi T, Talala K, Tammela T, van Hemelrijck M, Bayer K, Lejeune S, Taxiarchopoulou G, van Diggelen F, Senthilkumar K, Schutte S, Byrne S, Fialho L, Cardone A, Gono P, De Vetter M, Ceke K, De Meulder B, Auffray C, Balaur IA, Taibi N, Power S, Kermani NZ, van Bochove K, Cavelaars M, Moinat M, Voss E, Bernini C, Horgan D, Fullwood L, Holtorf M, Lancet D, Bernstein G, Omar I, MacLennan S, Maclennan S, Healey J, Huber J, Wirth M, Froehner M, Brenner B, Borkowetz A, Thomas C, Horn F, Reiche K, Kreux M, Josefsson A, Tandefekt DG, Hugosson J, Huisman H, Hofmacher T, Lindgren P, Andersson E, Fridhammar A, Vizcaya D, Verholen F, Zong J, Butler-Ransohoff JE, Williamson T, Chandrawansa K, Dlamini D, waldeck R, Molnar M, Bruno A, Herrera R, Jiang S, Nevedomskaya E, Fatoba S, Constantinovici N, Maass M, Torremante P, Voss M, Devecseri Z, Cuperus G, Abott T, Dau C, Papineni K, Wang-Silvanto J, Hass S, Snijder R, Doye V, Wang X, Garnham A, Lambrecht M, Wolfinger R, Rogiers S, Servan A, Lefresne F, Caseriego J, Samir M, Lawson J, Pacoe K, Robinson P, Jaton B, Bakkard D, Turunen H, Kilkku O, Pohjanjousi P, Voima O, Nevalaita L, Reich C, Araujo S, Longden-Chapman E, Burke D, Agapow P, Derkits S, Licour M, McCrea C, Payne S, Yong A, Thompson L, Lujan F, Bussmann M, Köhler I. How well do polygenic risk scores identify men at high risk for prostate cancer? Systematic review and meta-analysis. Clin Genitourin Cancer 2022; 21:316.e1-316.e11. [PMID: 36243664 DOI: 10.1016/j.clgc.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Genome-wide association studies have revealed over 200 genetic susceptibility loci for prostate cancer (PCa). By combining them, polygenic risk scores (PRS) can be generated to predict risk of PCa. We summarize the published evidence and conduct meta-analyses of PRS as a predictor of PCa risk in Caucasian men. PATIENTS AND METHODS Data were extracted from 59 studies, with 16 studies including 17 separate analyses used in the main meta-analysis with a total of 20,786 cases and 69,106 controls identified through a systematic search of ten databases. Random effects meta-analysis was used to obtain pooled estimates of area under the receiver-operating characteristic curve (AUC). Meta-regression was used to assess the impact of number of single-nucleotide polymorphisms (SNPs) incorporated in PRS on AUC. Heterogeneity is expressed as I2 scores. Publication bias was evaluated using funnel plots and Egger tests. RESULTS The ability of PRS to identify men with PCa was modest (pooled AUC 0.63, 95% CI 0.62-0.64) with moderate consistency (I2 64%). Combining PRS with clinical variables increased the pooled AUC to 0.74 (0.68-0.81). Meta-regression showed only negligible increase in AUC for adding incremental SNPs. Despite moderate heterogeneity, publication bias was not evident. CONCLUSION Typically, PRS accuracy is comparable to PSA or family history with a pooled AUC value 0.63 indicating mediocre performance for PRS alone.
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Kihlstedt Pasquier E, Andersson E. Pulmonary Recruitment Maneuver Reduces Shoulder Pain and Nausea After Laparoscopic Cholecystectomy: A Randomized Controlled Trial. World J Surg 2021; 45:3575-3583. [PMID: 34482412 PMCID: PMC8572840 DOI: 10.1007/s00268-021-06262-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 01/12/2023]
Abstract
Background Pain and nausea are common after laparoscopic surgery. This prospective, randomized, controlled trial aimed to investigate postoperative pain and as a secondary endpoint nausea, when performing a ventilator-piloted Pulmonary Recruitment Maneuvre (PRM) at the end of laparoscopic cholecystectomy. Method Patients having elective laparoscopic cholecystectomy were randomized to either ordinary exsufflation or ventilator-piloted PRM, to evacuate intra-abdominal carbon dioxide (CO2) before abdominal closure. A questionnaire with numeric rating scales (NRS) was utilized to evaluate pain and nausea at five occasions during 48 h following surgery. Analgesic and antiemetic treatment was also analyzed. Results 147 patients were analyzed, 76 receiving PRM and 71 controls. Overall pain was well controlled, with no significant difference between the groups regarding incidence (P=0.149) nor intensity (P=0.739). Incidence of shoulder pain was lower in the PRM group during the 48 postoperative hours, 44.7% versus 63.4% (P=0.023). The number needed to treat (NNT) to reduce shoulder pain was 6 (95% Confidence Interval, CI, 2.9–35.5) for the 48-h period. Incidence of nausea was lower in the PRM group during the 48-h period, 51.3% versus 70.4% (P=0.018). NNT was 6 (95% CI 2.9–27.4) for the 48-h period. Nausea intensity was lower in the PRM group during the 48 h (P=0.025). Fewer in the PRM population required antiemetics, 25.0% versus 42.3% (P=0.027). Conclusion A ventilator-piloted PRM at the end of laparoscopic cholecystectomy reduced incidence of shoulder pain, and incidence and intensity of nausea. Clinical trial registrationwww.clinicaltrials.gov. Identifier: NCT03026543. Supplementary Information The online version contains supplementary material available at 10.1007/s00268-021-06262-6.
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Affiliation(s)
- E Kihlstedt Pasquier
- Department of Surgery, Vrinnevi Hospital, Gamla Övägen 25, 603 79, Norrköping, Sweden. .,Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.
| | - E Andersson
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden
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Andersson E, Nazanin S, Estefania O, Small R. Swedish and Australian midwives' experiences of providing antenatal care for Somali-born women: A qualitative study. Sex Reprod Healthc 2021; 28:100607. [PMID: 33714846 DOI: 10.1016/j.srhc.2021.100607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 11/18/2020] [Accepted: 02/17/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Women from Somalia have increased risks of adverse pregnancy outcomes compared with destination country populations, but little is known about midwives' experiences of caring for Somali women in pregnancy, knowledge which might help to improve care and outcomes. This study aimed to explore how midwives in Melbourne and Stockholm experienced caring for Somali women. METHOD Eight midwives in Stockholm and ten midwives in Melbourne, all working in antenatal care clinics, were interviewed about caring for Somali women and the interviews were analysed using thematic analysis. FINDINGS Both the Swedish and Australian midwives highlighted lack of time and challenges in communication as impacting on their capacity to provide good care; and all wished they had a better understanding of Somali culture. Some differences in midwife attitudes and approaches to care were apparent in the two settings, particularly in how accepting of Somali women the midwives were and the flexibility with which care could be provided in order to meet the needs of the women. The Australian midwives appeared both more accepting and also more flexible. CONCLUSION Differences in the culture of care were apparent between midwives in Sweden and Australia, particularly in how flexible care could be in order to meet the needs of migrant women and how accepting and responsive the midwives were. More attention in antenatal care on developing mutual understanding between midwives and Somali women would improve their care, and possibly also their outcomes.
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Affiliation(s)
- E Andersson
- Department of Women's and Children's Health, Reproductive Health Karolinska Institutet, Stockholm, Sweden.
| | - S Nazanin
- Department of Women's and Children's Health, Reproductive Health Karolinska Institutet, Stockholm, Sweden
| | - O Estefania
- Department of Women's and Children's Health, Reproductive Health Karolinska Institutet, Stockholm, Sweden
| | - R Small
- Department of Women's and Children's Health, Reproductive Health Karolinska Institutet, Stockholm, Sweden; Judith Lumley Centre, La Trobe University, Melbourne, Australia
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Andersson E, Frössling J, Westin R, Algers B, Gunnarsson S. Associations between litter size and medical treatment of sows during farrowing and lactation. ACTA AGR SCAND A-AN 2020. [DOI: 10.1080/09064702.2020.1779800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- E. Andersson
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences (SLU), Skara, Sweden
| | - J. Frössling
- Department of Disease Control and Epidemiology, National Veterinary Institute, Uppsala, Sweden
| | - R. Westin
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences (SLU), Skara, Sweden
- Farm and Animal Health Service, Uddetorp Röda Huset, Skara, Sweden
| | - B. Algers
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences (SLU), Skara, Sweden
| | - S. Gunnarsson
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences (SLU), Skara, Sweden
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Arpaia R, Caprara S, Fumagalli R, De Vecchi G, Peng YY, Andersson E, Betto D, De Luca GM, Brookes NB, Lombardi F, Salluzzo M, Braicovich L, Di Castro C, Grilli M, Ghiringhelli G. Dynamical charge density fluctuations pervading the phase diagram of a Cu-based high- T c superconductor. Science 2020; 365:906-910. [PMID: 31467219 DOI: 10.1126/science.aav1315] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 07/30/2019] [Indexed: 11/02/2022]
Abstract
Charge density modulations have been observed in all families of high-critical temperature (T c) superconducting cuprates. Although they are consistently found in the underdoped region of the phase diagram and at relatively low temperatures, it is still unclear to what extent they influence the unusual properties of these systems. Using resonant x-ray scattering, we carefully determined the temperature dependence of charge density modulations in YBa2Cu3O7-δ and Nd1+ x Ba2- x Cu3O7-δ for several doping levels. We isolated short-range dynamical charge density fluctuations in addition to the previously known quasi-critical charge density waves. They persist up to well above the pseudogap temperature T*, are characterized by energies of a few milli-electron volts, and pervade a large area of the phase diagram.
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Affiliation(s)
- R Arpaia
- Dipartimento di Fisica, Politecnico di Milano, I-20133 Milano, Italy. .,Quantum Device Physics Laboratory, Department of Microtechnology and Nanoscience, Chalmers University of Technology, SE-41296 Göteborg, Sweden
| | - S Caprara
- Dipartimento di Fisica, Università di Roma "La Sapienza," I-00185 Roma, Italy.,CNR-ISC, I-00185 Roma, Italy
| | - R Fumagalli
- Dipartimento di Fisica, Politecnico di Milano, I-20133 Milano, Italy
| | - G De Vecchi
- Dipartimento di Fisica, Politecnico di Milano, I-20133 Milano, Italy
| | - Y Y Peng
- Dipartimento di Fisica, Politecnico di Milano, I-20133 Milano, Italy
| | - E Andersson
- Quantum Device Physics Laboratory, Department of Microtechnology and Nanoscience, Chalmers University of Technology, SE-41296 Göteborg, Sweden
| | - D Betto
- ESRF, European Synchrotron, F-38043 Grenoble, France
| | - G M De Luca
- Dipartimento di Fisica "E. Pancini," Università di Napoli Federico II, Complesso Monte Sant'Angelo, I-80126 Napoli, Italy.,CNR-SPIN, Complesso Monte Sant'Angelo, I-80126 Napoli, Italy
| | - N B Brookes
- ESRF, European Synchrotron, F-38043 Grenoble, France
| | - F Lombardi
- Quantum Device Physics Laboratory, Department of Microtechnology and Nanoscience, Chalmers University of Technology, SE-41296 Göteborg, Sweden
| | - M Salluzzo
- CNR-SPIN, Complesso Monte Sant'Angelo, I-80126 Napoli, Italy
| | - L Braicovich
- Dipartimento di Fisica, Politecnico di Milano, I-20133 Milano, Italy.,ESRF, European Synchrotron, F-38043 Grenoble, France
| | - C Di Castro
- Dipartimento di Fisica, Università di Roma "La Sapienza," I-00185 Roma, Italy.,CNR-ISC, I-00185 Roma, Italy
| | - M Grilli
- Dipartimento di Fisica, Università di Roma "La Sapienza," I-00185 Roma, Italy.,CNR-ISC, I-00185 Roma, Italy
| | - G Ghiringhelli
- Dipartimento di Fisica, Politecnico di Milano, I-20133 Milano, Italy. .,CNR-SPIN, Dipartimento di Fisica, Politecnico di Milano, I-20133 Milano, Italy
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Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr 2019; 108:2148-2156. [PMID: 31162723 PMCID: PMC6899754 DOI: 10.1111/apa.14884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/14/2019] [Accepted: 06/03/2019] [Indexed: 12/19/2022]
Abstract
Aim Recurrent pain of unknown origin is a major problem in children. The aim of the present review was to examine the hypothesis of negative stress as an aetiology of recurrent pain from different aspects. Methods and Results Epidemiological studies, clinical experience and hormonal data give support for such a hypothesis. Negative stress as a tentative aetiology for recurrent pain is reviewed. Stress, muscular tension, the startle reaction and its tentative relation to pain is illuminated. Deviations of hormonal secretion supporting a stress aetiology are mentioned. The role of central sensitisation for recurrent pain is discussed. Possible aetiological implications of recurrent pain as a local symptom or a general disorder are presented. Brain changes due to stress are shortly reviewed. Stress and pain in the clinic are highlighted. The importance of biological, psychological and social factors, as well as genetic elements, is discussed. Conclusion Stress elicits neurobiological mechanisms. They may lead to many neurophysiological deviances. Increase of muscle tension and neuromuscular excitability and enhanced startle reaction may be of importance for recurring pain. The identification of stress as a primary cause of recurrent pain can have huge implications for understanding signs and treatment in clinical practice.
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Affiliation(s)
- G Alfven
- Clintec Karolinska Institute Stockholm Sweden
| | - S Grillner
- Department of Neuroscience Karolinska institute Stockholm Sweden
| | - E Andersson
- Department of Neuroscience Karolinska institute Stockholm Sweden
- Swedish School of Sport and Health Sciences Stockholm Sweden
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Andersson E, Aralaguppe S, Thebo L, Sönnerborg A, Neogi U, Albert J. A5 Near full-length HIV-1 genome sequencing in newly diagnosed individuals in Sweden. Virus Evol 2019. [PMCID: PMC6735872 DOI: 10.1093/ve/vez002.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Swedish HIV-1 epidemic is characterized by a high diversity in HIV subtypes and recombinants as a result of migration. To study the time from infection through viral diversification, transmission patterns, and drug resistance in minor quasispecies, a robust protocol for pan-genotypic near full-length HIV-1 genome (HIV-NFLG) next-generation sequencing (NGS) is key. Our group has established two protocols for HIV-NFLG on the Illumina platform that we aim to compare and, if necessary, modify to find a method with optimized coverage, depth, and subtype inclusivity. Zanini et al. (https://doi.org/10.7554/eLife.11282.001) have developed a method with one-step RT-PCR with six overlapping primer sets, followed by NGS and quality filtering and assembly with in-house methods. Aralaguppe et al. (https://doi.org/10.1016/j.jviromet.2016.07.010) have designed amplification in two fragments, followed by multiplexed NGS and quality control and assembly with Iterative Virus Assembler and VICUNA. Both methods have high coverage per nucleotide and low error rates in amplification and sequencing and can reliably identify SNPs at 1 per cent of the viral population with linkage within the quasispecies. Subtype inclusivity remains a challenge even though both methods show success in amplifying and sequencing subtypes B, C, and the common recombinants 01_AE and 02_AG. Therefore, we aim to evaluate and optimize our NFLG NGS methods on a panel of patient samples that more completely reflects HIV-1 diversity in Sweden. Patient samples from fifty treatment-naïve viremic individuals representing the genotypic HIV-1 panorama in Sweden, including CRFs, are being amplified and sequenced by both protocols. Coverage of the genome, error rate, and possible depth of quasispecies analysis is being evaluated. We will compare number of reads, coverage across the HIV genome, and representation of minor single nucleotide variants as well as subtype inclusivity and impact of plasma RNA levels. To do this we will use an in-house bioinformatic pipeline. The NFLG sequences will also be analyzed with phylogenetic tools for determination of subtypes including CRFs and URFs.
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Affiliation(s)
- E Andersson
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - S Aralaguppe
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - L Thebo
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - A Sönnerborg
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - U Neogi
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - J Albert
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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Rackauskaite D, Svanborg E, Andersson E, Löwhagen K, Csajbok L, Nellgård B. Prospective study: Long-term outcome at 12-15 years after aneurysmal subarachnoid hemorrhage. Acta Neurol Scand 2018; 138:400-407. [PMID: 29963687 DOI: 10.1111/ane.12980] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with aneurysmal subarachnoid hemorrhage (aSAH) have poor outcome. Studies on outcome beyond 1 year post-aSAH are few, and late recovery is poorly investigated, initiating this prospective outcome study on patients 12-15 years after an aSAH. We hypothesized to find; functional improvement > 1 year post-ictus; increased long-term mortality in aSAH patients vs matched controls, and finally to present; predictors of long-term favorable outcome (GOS 4-5). METHODS We prospectively investigated patients, admitted 2000-2003 to the Sahlgrenska University Hospital, 1 year post-ictus using Glasgow Outcome Scale (GOS). The patients were revalidated 12-15 years post-aSAH by structured-telephone interviews (GOS), followed by statistical analysis. RESULTS A total of 158 patients were included, (women n = 114, men n = 44), with a mean age of 55 years at aSAH. Patients treated with surgical clipping had lower mortality. At the follow-up 12-15 years post-aSAH, all 103 survivors (65.2%) were categorized as having; good recovery (39.9%), moderate disability (15.2%), or severe disability (10.1%). Within the patient cohort, 23.6% improved GOS over time. Fifty-five patients died, median at 4 years post-ictus. aSAH patients had 3.5 times increased mortality 12-15 years post-ictus vs matched controls (P < .0001). Patients with favorable outcome at 1 year (67.3%, n = 101) had similar survival probability as control patients. Prognostic indicators of long-term favorable outcome were low age and high GOS at 1-year follow-up, (AUCROC, 0.79). CONCLUSIONS Individual functional improvement was found >1 year post-ictus. Patients with favorable outcome at 1 year had similar long-term life expectancy as the general population. Indicators of long-term favorable prognosis were low age at ictus and high GOS at 1-year follow-up.
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Affiliation(s)
- D. Rackauskaite
- Department of Anesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital; Mölndal Sweden
- Institution of clinical sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - E. Svanborg
- Department of Anesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital; Mölndal Sweden
| | - E. Andersson
- Department of Anesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital; Mölndal Sweden
- Institution of clinical sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - K. Löwhagen
- Department of Anesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital; Mölndal Sweden
- Institution of clinical sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - L. Csajbok
- Department of Anesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital; Mölndal Sweden
| | - B. Nellgård
- Department of Anesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital; Mölndal Sweden
- Institution of clinical sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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11
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Knutsson A, Hsiung S, Roxå A, Andersson E, Rattik S, Rauch U, Larsson J, Nilsson J, Hultgårdh-Nilsson A. IL-22 deficiency reduces progression of advanced atherosclerotic carotid plaques in apoe deficient mice. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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12
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Arvidsson Y, Rehammar A, Bergström A, Andersson E, Altiparmak G, Swärd C, Wängberg B, Kristiansson E, Nilsson O. miRNA profiling of small intestinal neuroendocrine tumors defines novel molecular subtypes and identifies miR-375 as a biomarker of patient survival. Mod Pathol 2018; 31:1302-1317. [PMID: 29487354 DOI: 10.1038/s41379-018-0010-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 12/30/2022]
Abstract
The aim of this study was to define the miRNA profile of small intestinal neuroendocrine tumors and to search for novel molecular subgroups and prognostic biomarkers. miRNA profiling was conducted on 42 tumors from 37 patients who underwent surgery for small intestinal neuroendocrine tumors. Unsupervised hierarchical clustering analysis of miRNA profiles identified two groups of tumor metastases, denoted cluster M1 and M2. The smaller cluster M1 was associated with shorter overall survival and contained tumors with higher grade (WHO grade G2/3) and multiple chromosomal gains including gain of chromosome 14. Tumors of cluster M1 had elevated expression of miR-1246 and miR-663a, and reduced levels of miR-488-3p. Pathway analysis predicted Wnt signaling to be the most significantly altered signaling pathway between clusters M1 and M2. Analysis of miRNA expression in relation to tumor proliferation rate showed significant alterations including downregulation of miR-137 and miR-204-5p in tumors with Ki67 index above 3%. Similarly, tumor progression was associated with significant alterations in miRNA expression, e.g. higher expression of miR-95 and miR-210, and lower expression of miR-378a-3p in metastases. Pathway analysis predicted Wnt signaling to be altered during tumor progression, which was supported by decreased nuclear translocation of β-catenin in metastases. Survival analysis revealed that downregulation of miR-375 was associated with shorter overall survival. We performed in situ hybridization on biopsies from an independent cohort of small intestinal neuroendocrine tumors using tissue microarrays. Expression of miR-375 was found in 578/635 (91%) biopsies and survival analysis confirmed that there was a correlation between downregulation of miR-375 in tumor metastases and shorter patient survival. We conclude that miRNA profiling defines novel molecular subgroups of metastatic small intestinal neuroendocrine tumors and identifies miRNAs associated with tumor proliferation rate and progression. miR-375 is highly expressed in small intestinal neuroendocrine tumors and may be used as a prognostic biomarker.
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Affiliation(s)
- Yvonne Arvidsson
- Sahlgrenska Cancer Center, Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Anna Rehammar
- Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden
| | - Anders Bergström
- Sahlgrenska Cancer Center, Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ellinor Andersson
- Sahlgrenska Cancer Center, Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Gülay Altiparmak
- Sahlgrenska Cancer Center, Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Christina Swärd
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Bo Wängberg
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Erik Kristiansson
- Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden
| | - Ola Nilsson
- Sahlgrenska Cancer Center, Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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13
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Ahrne M, Adan A, Schytt E, Andersson E, Small R, Flacking R, Byrskog U. 7.3-O6Antenatal care for Somali born women in Sweden – perspectives from mothers, fathers and midwives. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Ahrne
- Karolinska Institutet, Stockholm, Sweden
| | - A Adan
- Dalarna University, School of Education, Health and Social Studies, Sweden
| | - E Schytt
- Center for Clinical Research Dalarna/Uppsala University, Sweden
| | | | - R Small
- Judith Lumley Centre (formerly Mother and Child Health Research) La Trobe University, Melbourne, Australia
| | - R Flacking
- Dalarna University, School of Education, Health and Social Studies, Sweden
| | - U Byrskog
- Dalarna University, School of Education, Health and Social Studies, Sweden
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14
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Forsell K, Ljungkvist G, Nordlinder R, Andersson E, Nilsson R. 653 Benzene and work on deck on product tankers: exposures, benzene in exhaled air and urinary biomarkers of benzene exposure. Occup Med (Lond) 2018. [DOI: 10.1136/oemed-2018-icohabstracts.1114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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15
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Andersson E, Forsell K, Björ O, Nilsson R. 863 Cancer incidence among tanker crews in a cohort study of swedish seafarers. Occup Med (Lond) 2018. [DOI: 10.1136/oemed-2018-icohabstracts.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Lindborg T, Thorne M, Andersson E, Becker J, Brandefelt J, Cabianca T, Gunia M, Ikonen ATK, Johansson E, Kangasniemi V, Kautsky U, Kirchner G, Klos R, Kowe R, Kontula A, Kupiainen P, Lahdenperä AM, Lord NS, Lunt DJ, Näslund JO, Nordén M, Norris S, Pérez-Sánchez D, Proverbio A, Riekki K, Rübel A, Sweeck L, Walke R, Xu S, Smith G, Pröhl G. Climate change and landscape development in post-closure safety assessment of solid radioactive waste disposal: Results of an initiative of the IAEA. J Environ Radioact 2018; 183:41-53. [PMID: 29291453 DOI: 10.1016/j.jenvrad.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 06/07/2023]
Abstract
The International Atomic Energy Agency has coordinated an international project addressing climate change and landscape development in post-closure safety assessments of solid radioactive waste disposal. The work has been supported by results of parallel on-going research that has been published in a variety of reports and peer reviewed journal articles. The project is due to be described in detail in a forthcoming IAEA report. Noting the multi-disciplinary nature of post-closure safety assessments, here, an overview of the work is given to provide researchers in the broader fields of radioecology and radiological safety assessment with a review of the work that has been undertaken. It is hoped that such dissemination will support and promote integrated understanding and coherent treatment of climate change and landscape development within an overall assessment process. The key activities undertaken in the project were: identification of the key processes that drive environmental change (mainly those associated with climate and climate change), and description of how a relevant future may develop on a global scale; development of a methodology for characterising environmental change that is valid on a global scale, showing how modelled global changes in climate can be downscaled to provide information that may be needed for characterising environmental change in site-specific assessments, and illustrating different aspects of the methodology in a number of case studies that show the evolution of site characteristics and the implications for the dose assessment models. Overall, the study has shown that quantitative climate and landscape modelling has now developed to the stage that it can be used to define an envelope of climate and landscape change scenarios at specific sites and under specific greenhouse-gas emissions assumptions that is suitable for use in quantitative post-closure performance assessments. These scenarios are not predictions of the future, but are projections based on a well-established understanding of the important processes involved and their impacts on different types of landscape. Such projections support the understanding of, and selection of, plausible ranges of scenarios for use in post-closure safety assessments.
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Affiliation(s)
- T Lindborg
- Svensk Kärnbränslehantering AB, Evenemangsgatan 13, 169 79, Solna, Sweden.
| | - M Thorne
- Mike Thorne and Associates Limited, Quarry Cottage, Hamsterley, Bishop Auckland, DL13 3NJ, UK
| | - E Andersson
- Svensk Kärnbränslehantering AB, Evenemangsgatan 13, 169 79, Solna, Sweden
| | - J Becker
- National Cooperative for the Disposal of Radioactive Waste, Hardstrasse 73, Wettingen, Switzerland
| | - J Brandefelt
- Svensk Kärnbränslehantering AB, Evenemangsgatan 13, 169 79, Solna, Sweden
| | - T Cabianca
- Public Health England, Wellington House, 133-155 Waterloo Road, London, UK
| | - M Gunia
- Arbonaut Oy, Kaislakatu, 280130, Joensuu, Finland
| | - A T K Ikonen
- EnviroCase Ltd, Hallituskatu 1 D 4, 28100, Pori, Finland
| | - E Johansson
- Svensk Kärnbränslehantering AB, Evenemangsgatan 13, 169 79, Solna, Sweden
| | - V Kangasniemi
- EnviroCase Ltd, Hallituskatu 1 D 4, 28100, Pori, Finland
| | - U Kautsky
- Svensk Kärnbränslehantering AB, Evenemangsgatan 13, 169 79, Solna, Sweden
| | - G Kirchner
- Universität Hamburg - Carl Friedrich von Weizsäcker Centre for Science and Peace Research, Beim Schlump 83, 20144, Hamburg, Germany
| | - R Klos
- Aleksandria Sciences Limited, Unit 44a Avenue 2, Storforth Lane Trading Estate Hasland, Chesterfield, Derbyshire, UK
| | - R Kowe
- Radioactive Waste Management Ltd, Building 587, Curie Avenue, Harwell Oxford, Didcot, Oxfordshire, UK
| | - A Kontula
- Posiva Oy, Olkiluoto, 27160, Eurajoki, Finland
| | - P Kupiainen
- Fortum Power and Heat Oy, Keilaniementie 1, 02150, Espoo, Finland
| | - A-M Lahdenperä
- Saanio & Riekkola Oy, Laulukuja 4, FI-00420, Helsinki, Finland
| | - N S Lord
- School of Geographical Sciences, University of Bristol, University Road, Bristol, BS8 1SS, UK
| | - D J Lunt
- School of Geographical Sciences, University of Bristol, University Road, Bristol, BS8 1SS, UK
| | - J-O Näslund
- Svensk Kärnbränslehantering AB, Evenemangsgatan 13, 169 79, Solna, Sweden
| | - M Nordén
- Swedish Radiation Safety Authority, 171 16, Stockholm, Sweden
| | - S Norris
- Radioactive Waste Management Ltd, Building 587, Curie Avenue, Harwell Oxford, Didcot, Oxfordshire, UK
| | - D Pérez-Sánchez
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Avenida Complutense 40, Madrid, Spain
| | | | - K Riekki
- Posiva Oy, Olkiluoto, 27160, Eurajoki, Finland
| | - A Rübel
- Gesellschaft für Anlagen- und Reaktorsicherheit, Schwertnergasse 1, 50667, Köln, Germany
| | - L Sweeck
- Belgian Nuclear Research Center, Avenue Herrmann-Debrouxlaan 40, 1160, Brussels, Belgium
| | - R Walke
- Quintessa Limited, The Hub, 14 Station Road, Henley-on-Thames, Oxfordshire, UK
| | - S Xu
- Swedish Radiation Safety Authority, 171 16, Stockholm, Sweden
| | - G Smith
- GMS Abingdon Ltd, Tamarisk, Radley Road, Abingdon, Oxfordshire, UK
| | - G Pröhl
- International Atomic Energy Agency, Vienna International Centre, PO Box 100, 1400, Vienna, Austria
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17
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Hesser H, Hedman E, Lindfors P, Andersson E, Ljótsson B. The specific effect of systematic exposure in irritable bowel syndrome: complier average causal effect analysis using growth mixture modeling. Psychol Med 2017; 47:2653-2662. [PMID: 28464975 DOI: 10.1017/s0033291717001167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND We reanalyzed data from a previously published randomized component study that aimed to test the incremental effect of systematic exposure in an internet-delivered cognitive behavioral treatment (ICBT) for irritable bowel syndrome (IBS). METHODS Three hundred and nine individuals with IBS were randomly assigned to either the full treatment protocol (experimental condition) or the same treatment protocol without systematic exposure (control). Participants were assessed weekly for IBS symptoms over the active treatment phase. We used a complier average causal effect (CACE) analysis, in the growth mixture modeling framework, to (1) examine the specific effect of exposure among those who received the intervention (i.e. compliers), and (2) explore the associations of pre-treatment patient characteristics with compliance status and outcome changes. RESULTS Fifty-five per cent of those assigned to the experimental condition were classified as compliers. The CACE analysis that took into account compliance status demonstrated that the magnitude of the incremental effect of systematic exposure on IBS symptoms was larger than the effect observed in an intention-to-treat analysis that ignored compliance status (d = 0.81 v. d = 0.44). Patients with university education showed more improvement during the exposure phase of the treatment. Pre-treatment patient characteristics did not predict compliance status. CONCLUSIONS The effect of systematic exposure on IBS symptoms is of substantial magnitude among those individuals who actually receive the intervention (CACE). Studying the subsample of individuals who discontinue treatment prematurely and tailoring interventions to improve compliance may increase overall improvement rates in ICBT for IBS.
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Affiliation(s)
- H Hesser
- Department of Behavioural Sciences and Learning,Linköping University,Linköping,Sweden
| | - E Hedman
- Department of Clinical Neuroscience,Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - P Lindfors
- Department of Internal Medicine Sahlgrenska University Hospital,University of Gothenburg,Gothenburg,Sweden
| | - E Andersson
- Department of Clinical Neuroscience,Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - B Ljótsson
- Department of Clinical Neuroscience,Division of Psychology,Karolinska Institutet,Stockholm,Sweden
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18
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Roberts GL, Lucamarini M, Yuan ZL, Dynes JF, Comandar LC, Sharpe AW, Shields AJ, Curty M, Puthoor IV, Andersson E. Experimental measurement-device-independent quantum digital signatures. Nat Commun 2017; 8:1098. [PMID: 29061966 PMCID: PMC5653667 DOI: 10.1038/s41467-017-01245-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/30/2017] [Indexed: 11/09/2022] Open
Abstract
The development of quantum networks will be paramount towards practical and secure telecommunications. These networks will need to sign and distribute information between many parties with information-theoretic security, requiring both quantum digital signatures (QDS) and quantum key distribution (QKD). Here, we introduce and experimentally realise a quantum network architecture, where the nodes are fully connected using a minimum amount of physical links. The central node of the network can act either as a totally untrusted relay, connecting the end users via the recently introduced measurement-device-independent (MDI)-QKD, or as a trusted recipient directly communicating with the end users via QKD. Using this network, we perform a proof-of-principle demonstration of QDS mediated by MDI-QKD. For that, we devised an efficient protocol to distil multiple signatures from the same block of data, thus reducing the statistical fluctuations in the sample and greatly enhancing the final QDS rate in the finite-size scenario.
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Affiliation(s)
- G L Roberts
- Toshiba Research Europe Ltd, 208 Cambridge Science Park, Cambridge, CB4 0GZ, UK.,Cambridge University Engineering Department, Cambridge, CB3 0FA, UK
| | - M Lucamarini
- Toshiba Research Europe Ltd, 208 Cambridge Science Park, Cambridge, CB4 0GZ, UK.
| | - Z L Yuan
- Toshiba Research Europe Ltd, 208 Cambridge Science Park, Cambridge, CB4 0GZ, UK
| | - J F Dynes
- Toshiba Research Europe Ltd, 208 Cambridge Science Park, Cambridge, CB4 0GZ, UK
| | - L C Comandar
- Toshiba Research Europe Ltd, 208 Cambridge Science Park, Cambridge, CB4 0GZ, UK
| | - A W Sharpe
- Toshiba Research Europe Ltd, 208 Cambridge Science Park, Cambridge, CB4 0GZ, UK
| | - A J Shields
- Toshiba Research Europe Ltd, 208 Cambridge Science Park, Cambridge, CB4 0GZ, UK
| | - M Curty
- EI Telecomunicación, Department of Signal Theory and Communications, University of Vigo, Vigo, E-36310, Spain
| | - I V Puthoor
- SUPA, Institute of Photonics and Quantum Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - E Andersson
- SUPA, Institute of Photonics and Quantum Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK
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Skaftnesmo KO, Edvardsen RB, Furmanek T, Crespo D, Andersson E, Kleppe L, Taranger GL, Bogerd J, Schulz RW, Wargelius A. Integrative testis transcriptome analysis reveals differentially expressed miRNAs and their mRNA targets during early puberty in Atlantic salmon. BMC Genomics 2017; 18:801. [PMID: 29047327 PMCID: PMC5648517 DOI: 10.1186/s12864-017-4205-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Our understanding of the molecular mechanisms implementing pubertal maturation of the testis in vertebrates is incomplete. This topic is relevant in Atlantic salmon aquaculture, since precocious male puberty negatively impacts animal welfare and growth. We hypothesize that certain miRNAs modulate mRNAs relevant for the initiation of puberty. To explore which miRNAs regulate mRNAs during initiation of puberty in salmon, we performed an integrated transcriptome analysis (miRNA and mRNA-seq) of salmon testis at three stages of development: an immature, long-term quiescent stage, a prepubertal stage just before, and a pubertal stage just after the onset of single cell proliferation activity in the testis. RESULTS Differentially expressed miRNAs clustered into 5 distinct expression profiles related to the immature, prepubertal and pubertal salmon testis. Potential mRNA targets of these miRNAs were predicted with miRmap and filtered for mRNAs displaying negatively correlated expression patterns. In summary, this analysis revealed miRNAs previously known to be regulated in immature vertebrate testis (miR-101, miR-137, miR-92b, miR-18a, miR-20a), but also miRNAs first reported here as regulated in the testis (miR-new289, miR-30c, miR-724, miR-26b, miR-new271, miR-217, miR-216a, miR-135a, miR-new194 and the novel predicted n268). By KEGG enrichment analysis, progesterone signaling and cell cycle pathway genes were found regulated by these differentially expressed miRNAs. During the transition into puberty we found differential expression of miRNAs previously associated (let7a/b/c), or newly associated (miR-15c, miR-2184, miR-145 and the novel predicted n7a and b) with this stage. KEGG enrichment analysis revealed that mRNAs of the Wnt, Hedgehog and Apelin signaling pathways were potential regulated targets during the transition into puberty. Likewise, several regulated miRNAs in the pubertal stage had earlier been associated (miR-20a, miR-25, miR-181a, miR-202, let7c/d/a, miR-125b, miR-222a/b, miR-190a) or have now been found connected (miR-2188, miR-144, miR-731, miR-8157 and the novel n2) to the initiation of puberty. CONCLUSIONS This study has - for the first time - linked testis maturation to specific miRNAs and their inversely correlated expressed targets in Atlantic salmon. The study indicates a broad functional conservation of already known miRNAs and associated pathways involved in the transition into puberty in vertebrates. The analysis also reveals miRNAs not previously associated with testis tissue or its maturation, which calls for further functional studies in the testis.
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Affiliation(s)
- K O Skaftnesmo
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway.
| | - R B Edvardsen
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway
| | - T Furmanek
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway
| | - D Crespo
- Reproductive Biology group, Department of Biology, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH, Utrecht, The Netherlands
| | - E Andersson
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway
| | - L Kleppe
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway
| | - G L Taranger
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway
| | - J Bogerd
- Reproductive Biology group, Department of Biology, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH, Utrecht, The Netherlands
| | - R W Schulz
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway.,Reproductive Biology group, Department of Biology, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH, Utrecht, The Netherlands
| | - A Wargelius
- Institute of Marine Research, Postboks 1870 Nordnes, 5817, Bergen, Norway
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20
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Melero I, Segal N, Saro J, Ros W, Martinez-Garcia M, Argiles G, Moreno V, Ponce S, Marabelle A, Cleary J, Hurwitz H, Eder J, Jamois C, Andersson E, Bouseida S, Sandoval F, Bacac M, Nayak T, Karanikas V, Calvo E. Pharmacokinetics (PK) and pharmacodynamics (PD) of a novel carcinoembryonic antigen (CEA) T-cell bispecific antibody (CEA-CD3 TCB) for the treatment of CEA-positive solid tumors. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Steen Carlsson K, Andersson E, Berntorp E. Preference-based valuation of treatment attributes in haemophilia A using web survey. Haemophilia 2017; 23:894-903. [PMID: 28851125 DOI: 10.1111/hae.13322] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Clinical trials have shown promising results for extended half-life factor VIII concentrates but little is known about individuals' valuation of haemophilia treatment attributes. AIM To assess patient/caregiver and population valuation of treatment attributes of prophylactic regimens for people with severe haemophilia A. METHODS Members ≥16 years of the Swedish Haemophilia Society (FBIS) and of a web-panel representative of the Swedish population were invited to participate in a web-survey investigating preferences for haemophilia treatment attributes using the Time Trade-Off methodology which ranks health states on a scale 0 (dead) to 1 (full health). All respondents assessed the same four treatment scenarios for severe haemophilia A, each described by three stylized attributes: injection interval (every 2nd or 5th day); participation in physical activity (Y/N); annual risk of bleed (1-2 or 5-6 bleeds). RESULTS The survey had 1657 respondents (68% complete responses; 184/1233 from FBIS/web-panel gave informed consent; mean age 52 years, 51% men). Respondents from FBIS and from the web-panel had the same preference ranking of the four treatment scenarios, but members of FBIS consistently rated significantly higher health utilities; range 0.67-0.73 vs 0.54-0.60. Participation in physical activity implied +0.023 (95% confidence interval 0.015-0.030); a longer injection interval implied +0.038 (0.03; 0.45); and fewer bleeds implied +0.022 (0.015-0.029) utility points. CONCLUSIONS Patient/caregiver and population preferences indicate that treatment attributes such as frequency of injections and the possibility of participating in physical activity are important attributes impacting quality of life in addition to the control and prevention of bleeding episodes.
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Affiliation(s)
- K Steen Carlsson
- The Swedish Institute for Health Economics, Lund, Sweden.,Department of Clinical Sciences, Malmö, Health Economics Unit, Lund University, Lund, Sweden
| | - E Andersson
- The Swedish Institute for Health Economics, Lund, Sweden
| | - E Berntorp
- Centre for Thrombosis and Haemostasis, Skane University Hospital, Lund University, Malmö, Sweden
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22
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Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain 2017; 21:1561-1570. [PMID: 28474495 DOI: 10.1002/ejp.1057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Children with recurrent pain of negative chronic stress origin from different locations have a characteristic pattern of tender points in the temporal, trapezoid, great pectoral and abdominal muscles. We tested the hypothesis that the startle reaction is activated in these children and that some of the startle-activated muscles are related to the tender point pattern and the recurrent pain. METHODS In children/adolescents, aged 10-17 years, 19 with recurrent psychosomatic pain (PAIN) and 23 controls (CON) we measured and analysed resting activity and acoustic startle response with electromyography (EMG) for the muscles involved in the pattern of tender points and also the lumbar erector spinae. RESULTS The PAIN group showed higher resting activity and higher acoustic startle response values than the CON group for all six muscles together regarding the mean amplitude in the initial 200 ms, and during the burst of activity, and longer burst duration and shorter burst latency. For PAIN versus CON, all separate muscles showed generally higher values of EMG amplitudes and burst durations, and shorter latencies for the burst onset in all measures; with significance or strong trends for several parameters and muscles. CONCLUSION For the first time in children with recurrent psychosomatic pain, increased resting activity and potentiated startle response were demonstrated in the muscles involved in the stress tender point pattern. SIGNIFICANCE This study demonstrates in adolescents how recurrent pain of negative stress origin from the head, stomach, back and chest is related to increased startle reaction and increased muscular tension in these regions. This study contributes to the understanding of the mechanisms underlying the global burden of recurrent pain.
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Affiliation(s)
- G Alfvén
- Clintec, Karolinska Institute, Stockholm, Sweden
| | - S Grillner
- The Department of Neuroscience, Karolinska institute, Stockholm, Sweden
| | - E Andersson
- The Department of Neuroscience, Karolinska institute, Stockholm, Sweden.,Karolinska Institute and the Swedish School of Sport and Health Sciences, Stockholm, Sweden
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23
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Andersson E, Rackauskaite D, Svanborg E, Csajbók L, Öst M, Nellgård B. A prospective outcome study observing patients with severe traumatic brain injury over 10-15 years. Acta Anaesthesiol Scand 2017; 61:502-512. [PMID: 28374472 DOI: 10.1111/aas.12880] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 02/16/2017] [Accepted: 02/20/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Severe traumatic brain injury (sTBI) can be divided into primary and secondary injuries. Intensive care protocols focus on preventing secondary injuries. This prospective cohort study was initiated to investigate outcome, including mortality, in patients treated according to the Lund Concept after a sTBI covering 10-15 years post-trauma. METHODS Patients were included during 2000-2004 when admitted to the neurointensive care unit, Sahlgrenska University Hospital. Inclusion criteria were: Glasgow coma scale score of ≤8, need for artificial ventilation and intracranial monitoring. Glasgow Outcome Scale (GOS) was used to evaluate outcome both at 1-year and 10-15 years post-trauma. RESULTS Ninety-five patients, (27 female and 68 male), were initially included. Both improvement and deterioration were noted between 1- and 10-15 years post-injury. Mortality rate (34/95) was higher in the studied population vs. a matched Swedish population, (Standard mortality rate (SMR) 9.5; P < 0.0001). When dividing the cohort into Good (GOS 4-5) and Poor (GOS 2-3) outcome at 1-year, only patients with Poor outcome had a higher mortality rate than the matched population (SMR 7.3; P < 0.0001). Further, good outcome (high GOS) at 1-year was associated with high GOS 10-15 years post-trauma (P < 0.0001). Finally, a majority of patients demonstrated symptoms of mental fatigue. CONCLUSION This indicates that patients with severe traumatic brain injury with Good outcome at 1-year have similar survival probability as a matched Swedish population and that high Glasgow outcome scale at 1-year is related to good long-term outcome. Our results further emphasise the advantage of the Lund concept.
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Affiliation(s)
- E. Andersson
- Department of Anaesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital and Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - D. Rackauskaite
- Department of Anaesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital and Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - E. Svanborg
- Department of Anaesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital and Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - L. Csajbók
- Department of Anaesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital and Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - M. Öst
- Department of Anaesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital and Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - B. Nellgård
- Department of Anaesthesiology and Intensive Care Medicine; Sahlgrenska University Hospital and Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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24
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Andersson E, Björklund G, Holmberg HC, Ørtenblad N. Cover Image Volume 27, Issue 4. Scand J Med Sci Sports 2017. [DOI: 10.1111/sms.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Konovalenko L, Bradshaw C, Andersson E, Kautsky U. Application of an ecosystem model to evaluate the importance of different processes and food web structure for transfer of 13 elements in a shallow lake. J Environ Radioact 2017; 169-170:85-97. [PMID: 28110115 DOI: 10.1016/j.jenvrad.2016.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 12/25/2016] [Accepted: 12/29/2016] [Indexed: 06/06/2023]
Abstract
In environmental risk assessments of nuclear waste, there is need to estimate the potential risks of a large number of radionuclides over a long time period during which the environment is likely to change. Usually concentration ratios (CRs) are used to calculate the activity concentrations in organisms. However, CRs are not available for all radionuclides and they are not easily scalable to the varying environment. Here, an ecosystem transport model of elements, which estimates concentrations in organisms using carbon flows and food transfer instead of CR is presented. It is a stochastic compartment model developed for Lake Eckarfjärden at Forsmark in Sweden. The model was based on available data on carbon circulation, physical and biological processes from the site and identifies 11 functional groups of organisms. The ecosystem model was used to estimate the environmental transfer of 13 elements (Al, Ca, Cd, Cl, Cs, I, Ni, Nb, Pb, Se, Sr, Th, U) to various aquatic organisms, using element-specific distribution coefficients for suspended particles (Kd PM) and upper sediment (Kd sed), and subsequent transfer in the foodweb. The modelled CRs for different organism groups were compared with measured CRs from the lake and literature data, and showed good agreement for many elements and organisms, particularly for lower trophic levels. The model is, therefore, proposed as an alternative to measured CR, though it is suggested to further explore active uptake, assimilation and elimination processes to get better correspondence for some of the elements. The benthic organisms (i.e. bacteria, microphytobenthos and macroalgae) were identified as more important than pelagic organisms for transfer of elements to top predators. The element transfer model revealed that most of the radionuclides were channelled through the microbial loop, despite the fact that macroalgae dominated the carbon fluxes in this lake. Thus, element-specific adsorption of elements to the surface of aquatic species, that may be food sources for organisms at higher trophic levels, needs to be considered in combination with generic processes described by carbon fluxes.
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Affiliation(s)
- L Konovalenko
- Department of Ecology, Environment and Plant Sciences, (DEEP), Stockholm University, 10691 Stockholm, Sweden.
| | - C Bradshaw
- Department of Ecology, Environment and Plant Sciences, (DEEP), Stockholm University, 10691 Stockholm, Sweden.
| | - E Andersson
- Swedish Nuclear Fuel and Waste Management Co, (SKB), Box 250, 10124 Stockholm, Sweden.
| | - U Kautsky
- Swedish Nuclear Fuel and Waste Management Co, (SKB), Box 250, 10124 Stockholm, Sweden.
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26
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Abrahamsen R, Fell AKM, Svendsen MV, Andersson E, Torén K, Henneberger PK, Kongerud J. Association of respiratory symptoms and asthma with occupational exposures: findings from a population-based cross-sectional survey in Telemark, Norway. BMJ Open 2017; 7:e014018. [PMID: 28336744 PMCID: PMC5372104 DOI: 10.1136/bmjopen-2016-014018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES The aim of this study was to estimate the prevalence of respiratory symptoms and physician-diagnosed asthma and assess the impact of current occupational exposure. DESIGN Cross-sectional analyses of the prevalence of self-reported respiratory health and association with current occupational exposure in a random sample of the general population in Telemark County, Norway. SETTINGS In 2013, a self-administered questionnaire was mailed to a random sample of the general population, aged 16-50, in Telemark, Norway. The overall response rate was 33%, comprising 16 099 responders. OUTCOME MEASURES The prevalence for respiratory symptoms and asthma, and OR of respiratory symptoms and asthma for occupational groups and exposures were calculated. Occupational exposures were assessed using self-reported exposure and an asthma-specific job-exposure matrix (JEM). RESULTS The prevalence of physician-diagnosed asthma was 11.5%. For the occupational groups, the category with agriculture/fishery workers and craft/related trade workers was associated with wheezing and asthma attack in the past 12 months, showing OR 1.3 (1.1 to 1.6) and 1.9 (1.2 to 2.8), respectively. The group including technicians and associated professionals was also associated with wheezing OR 1.2 (1.0 to 1.3) and asthma attack OR 1.4 (1.1 to 1.9). The JEM data show that exposure to flour was associated with wheezing OR 3.2 (1.4 to 7.3) and woken with dyspnoea OR 3.5 (1.3 to 9.5), whereas exposures to diisocyanates, welding/soldering fumes and exposure to vehicle/motor exhaust were associated with dyspnoea OR 2.9 (1.5 to 5.7), 3.2 (1.6 to 6.4) and 1.4 (1.0 to 1.8), respectively. CONCLUSIONS The observed prevalence of physician-diagnosed asthma was 11.5%. The 'manual' occupations were associated with respiratory symptoms. Occupational exposure to flour, diisocyanates, welding/soldering fumes and vehicle/motor exhaust was associated with respiratory symptoms in the past 12 months and use of asthma medication. However, prospective data are needed to confirm the observed associations.
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Affiliation(s)
- R Abrahamsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - A K M Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - M V Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - E Andersson
- Department of Occupational and Environmental Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Torén
- Department of Occupational and Environmental Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - P K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Morgantown, West Virginia, USA
| | - J Kongerud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
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27
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Hothersall B, Whistance L, Zedlacher H, Algers B, Andersson E, Bracke M, Courboulay V, Ferrari P, Leeb C, Mullan S, Nowicki J, Meunier-Salaün MC, Schwarz T, Stadig L, Main D. Standardising the assessment of environmental enrichment and tail-docking legal requirements for finishing pigs in Europe. Anim Welf 2016. [DOI: 10.7120/09627286.25.4.499] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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28
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Konovalenko L, Bradshaw C, Andersson E, Lindqvist D, Kautsky U. Evaluation of factors influencing accumulation of stable Sr and Cs in lake and coastal fish. J Environ Radioact 2016; 160:64-79. [PMID: 27153476 DOI: 10.1016/j.jenvrad.2016.04.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 04/06/2016] [Accepted: 04/18/2016] [Indexed: 06/05/2023]
Abstract
As a result of nuclear accidents and weapons tests, the radionuclides Cs-137 and Sr-90 are common contaminants in aquatic ecosystems. Concentration ratios (CR) based on concentrations of stable Cs and Sr in biota and media are used for the estimation of transfer of their radioisotopes for radiation dose calculations in environmental and human safety assessments. Available element-specific CRs vary by over an order of magnitude for similar organisms, thus affecting the dose estimates proportionally. The variation could be reduced if they were based on a better understanding of the influence of the underlying data and how that affects accumulation and potential biomagnification of stable Cs and Sr in aquatic organisms. For fish, relationships have been identified between water concentrations of K and CR of Cs-137, and between water concentrations of Ca and CR of Sr-90. This has not been confirmed for stable Cs and Sr in European waters. In this study, we analysed an existing dataset for stable Cs and Sr, as well as K and Ca, in four Swedish lakes and three Baltic Sea coastal areas, in order to understand the behaviour of these elements and their radioisotopes in these ecosystems. We found significant seasonal variations in the water concentrations of Cs, Sr, K and Ca, and in electrical conductivity (EC), especially in the lakes. CR values based on measurements taken at single or few time points may, therefore, be inaccurate or introduce unnecessarily large variation into risk assessments. Instead, we recommend incorporating information about the underlying variation in water concentrations into the CR calculations, for example by using the variation of the mean. The inverse relationships between fish CR(Cs)-[K]water and fish CR(Sr)-[Ca]water, confirmed that stable Cs and Sr follow the same trends as their radioisotopes. Thus, they can be used as proxies when radioisotope data are lacking. EC was also strongly correlated with K and Ca concentrations in the water and could potentially be used as a quick and cost-effective method to estimate water chemistry to obtain less variable CR. We also recommend some simple improvements to data collection that would greatly enhance our ability to understand Cs and Sr uptake by fish.
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Affiliation(s)
- L Konovalenko
- Department of Ecology, Environment and Plant Sciences, (DEEP), Stockholm University, 10691 Stockholm, Sweden.
| | - C Bradshaw
- Department of Ecology, Environment and Plant Sciences, (DEEP), Stockholm University, 10691 Stockholm, Sweden.
| | - E Andersson
- Swedish Nuclear Fuel and Waste Management Co, (SKB), Box 250, 10124 Stockholm, Sweden.
| | - D Lindqvist
- Department of Environmental Science and Analytical Chemistry, (ACES), Stockholm University, 10691 Stockholm, Sweden.
| | - U Kautsky
- Swedish Nuclear Fuel and Waste Management Co, (SKB), Box 250, 10124 Stockholm, Sweden.
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29
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Fell AK, Abrahamsen R, Henneberger PK, Svendsen MV, Andersson E, Torén K, Kongerud J. Breath-taking jobs: a case-control study of respiratory work disability by occupation in Norway. Occup Environ Med 2016; 73:600-6. [PMID: 27365181 PMCID: PMC5013093 DOI: 10.1136/oemed-2015-103488] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/31/2016] [Indexed: 11/04/2022]
Abstract
Background The current knowledge on respiratory work disability is based on studies that used crude categories of exposure. This may lead to a loss of power, and does not provide sufficient information to allow targeted workplace interventions and follow-up of patients with respiratory symptoms. Objectives The aim of this study was to identify occupations and specific exposures associated with respiratory work disability. Methods In 2013, a self-administered questionnaire was mailed to a random sample of the general population, aged 16–50, in Telemark County, Norway. We defined respiratory work disability as a positive response to the survey question: ‘Have you ever had to change or leave your job because it affected your breathing?’ Occupational exposures were assessed using an asthma-specific job-exposure matrix, and comparison of risks was made for cases and a median of 50 controls per case. Results 247 workers had changed their work because of respiratory symptoms, accounting for 1.7% of the respondents ever employed. The ‘breath-taking jobs’ were cooks/chefs: adjusted OR 3.6 (95% CI 1.6 to 8.0); welders: 5.2 (2.0 to 14); gardeners: 4.5 (1.3 to 15); sheet metal workers: 5.4 (2.0 to 14); cleaners: 5.0 (2.2 to 11); hairdressers: 6.4 (2.5 to 17); and agricultural labourers: 7.4 (2.5 to 22). Job changes were also associated with a variety of occupational exposures, with some differences between men and women. Conclusions Self-report and job-exposure matrix data showed similar findings. For the occupations and exposures associated with job change, preventive measures should be implemented.
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Affiliation(s)
- A K Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - R Abrahamsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway Faculty Division Rikshospitalet, University of Oslo, Norway
| | - P K Henneberger
- National Institute for Occupational Safety and Health (NIOSH), Morgantown, West Virginia, USA
| | - M V Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - E Andersson
- Department of Occupational and Environmental Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Torén
- Department of Occupational and Environmental Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Kongerud
- Faculty Division Rikshospitalet, University of Oslo, Norway Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
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30
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Andersson E, Björklund G, Holmberg HC, Ørtenblad N. Energy system contributions and determinants of performance in sprint cross-country skiing. Scand J Med Sci Sports 2016; 27:385-398. [DOI: 10.1111/sms.12666] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/27/2022]
Affiliation(s)
- E. Andersson
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
| | - G. Björklund
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
| | - H-C. Holmberg
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
- Swedish Olympic Committee; Stockholm Sweden
| | - N. Ørtenblad
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
- Department of Sports Science and Clinical Biomechanics; SDU Muscle Research Cluster; University of Southern Denmark; Odense Denmark
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31
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Webster CS, Andersson E, Edwards K, Merry AF, Torrie J, Weller JM. Deviation from accepted drug administration guidelines during anaesthesia in twenty highly realistic simulated cases. Anaesth Intensive Care 2016; 43:698-706. [PMID: 26603793 DOI: 10.1177/0310057x1504300606] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Deviations from accepted practice guidelines and protocols are poorly understood, yet some deviations are likely to be deliberate and carry potential for patient harm. Anaesthetic teams practice in a complex work environment and anaesthetists are unusual in that they both prescribe and administer the drugs they use, allowing scope for idiosyncratic practise. We aimed to better understand the intentions underlying deviation from accepted guidelines during drug administration in simulated cases. An observer recorded events that may have increased the risk of patient harm ('Events of Interest' [EOIs]) during 20 highly realistic simulated anaesthetic cases. In semi-structured interviews, details of EOIs were confirmed with participating anaesthetic teams, and intentions and reasoning underlying the confirmed deviations were discussed. Confirmed details of EOIs were tabulated and we undertook qualitative analysis of interview transcripts. Twenty-four EOIs (69% of 35 recorded) were judged by participants to carry potential for patient harm, and 12 (34%) were judged to be deviations from accepted guidelines (including one drug administration error). Underlying reasons for deviations included a strong sense of clinical autonomy, poor clinical relevance and a lack of evidence for guidelines, ingrained habits learnt in early training, and the influence of peers. Guidelines are important in clinical practice, yet self-identified deviation from accepted guidelines was common in our results, and all but one of these events was judged to carry potential for patient harm. A better understanding of the reasons underlying deviation from accepted guidelines is essential to the design of more effective guidelines and to achieving compliance.
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Affiliation(s)
- C S Webster
- Centre for Medical and Health Sciences Education and Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | | | - K Edwards
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - A F Merry
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - J Torrie
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - J M Weller
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
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32
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Andersson E, Kuusanmäki H, Bortoluzzi S, Lagström S, Parsons A, Rajala H, van Adrichem A, Eldfors S, Olson T, Clemente MJ, Laasonen A, Ellonen P, Heckman C, Loughran TP, Maciejewski JP, Mustjoki S. Activating somatic mutations outside the SH2-domain of STAT3 in LGL leukemia. Leukemia 2015; 30:1204-8. [PMID: 26419508 DOI: 10.1038/leu.2015.263] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- E Andersson
- Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland.,Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - H Kuusanmäki
- Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - S Bortoluzzi
- Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland
| | - S Lagström
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - A Parsons
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - H Rajala
- Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland.,Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - A van Adrichem
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - S Eldfors
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - T Olson
- University of Virginia Cancer Center, University of Virginia, Charlottesville, VA, USA
| | - M J Clemente
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - A Laasonen
- Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - P Ellonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - C Heckman
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - T P Loughran
- University of Virginia Cancer Center, University of Virginia, Charlottesville, VA, USA
| | - J P Maciejewski
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - S Mustjoki
- Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland.,Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.,Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland
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33
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Henneberger PK, Liang X, Lillienberg L, Dahlman-Höglund A, Torén K, Andersson E. Occupational exposures associated with severe exacerbation of asthma. Int J Tuberc Lung Dis 2015; 19:244-50. [PMID: 25574926 DOI: 10.5588/ijtld.14.0132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The exacerbation of asthma by workplace conditions is common, but little is known about which agents pose a risk. OBJECTIVE We used data from an existing survey of adults with asthma to identify occupational exposures associated with severe exacerbation of asthma. DESIGN Questionnaires were completed by 557 working adults with asthma. Severe exacerbation of asthma in the past 12 months was defined as asthma-related hospitalization, or reports of both unplanned asthma care and treatment with a short course of oral corticosteroids. Occupational exposures for the same time period were assessed using an asthma-specific job exposure matrix. We modeled severe exacerbation to yield prevalence ratios (PRs) for exposures while controlling for potential confounders. RESULTS A total of 164 participants (29%) were positive for severe exacerbation, and 227 (40.8%) were assessed as being exposed to asthma agents at work. Elevated PRs were observed for several specific agents, notably the irritant subcategories of environmental tobacco smoke (PR 1.84, 95%CI 1.34-2.51) among all participants, inorganic dusts (PR 2.53, 95%CI 1.37-4.67) among men, and the low molecular weight subcategory of other highly reactive agents (PR 1.97, 95%CI 1.08-3.60) among women. CONCLUSION Among working adults with asthma, severe exacerbation was associated with several occupational agents.
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Affiliation(s)
- P K Henneberger
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - X Liang
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - L Lillienberg
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - A Dahlman-Höglund
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - K Torén
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - E Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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34
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Frank P, Andersson E, Pontén M, Ekblom B, Ekblom M, Sahlin K. Strength training improves muscle aerobic capacity and glucose tolerance in elderly. Scand J Med Sci Sports 2015; 26:764-73. [PMID: 26271931 DOI: 10.1111/sms.12537] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2015] [Indexed: 12/11/2022]
Abstract
The primary aim of this study was to investigate the effect of short-term resistance training (RET) on mitochondrial protein content and glucose tolerance in elderly. Elderly women and men (age 71 ± 1, mean ± SEM) were assigned to a group performing 8 weeks of resistance training (RET, n = 12) or no training (CON, n = 9). The RET group increased in (i) knee extensor strength (concentric +11 ± 3%, eccentric +8 ± 3% and static +12 ± 3%), (ii) initial (0-30 ms) rate of force development (+52 ± 26%) and (iii) contents of proteins related to signaling of muscle protein synthesis (Akt +69 ± 20 and mammalian target of rapamycin +69 ± 32%). Muscle fiber type composition changed to a more oxidative profile in RET with increased amount of type IIa fibers (+26.9 ± 6.8%) and a trend for decreased amount of type IIx fibers (-16.4 ± 18.2%, P = 0.068). Mitochondrial proteins (OXPHOS complex II, IV, and citrate synthase) increased in RET by +30 ± 11%, +99 ± 31% and +29 ± 8%, respectively. RET resulted in improved oral glucose tolerance measured as reduced area under curve for glucose (-21 ± 26%) and reduced plasma glucose 2 h post-glucose intake (-14 ± 5%). In CON parameters were unchanged or impaired. In conclusion, short-term resistance training in elderly not only improves muscular strength, but results in robust increases in several parameters related to muscle aerobic capacity.
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Affiliation(s)
- P Frank
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - E Andersson
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.,Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Pontén
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - B Ekblom
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - M Ekblom
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - K Sahlin
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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Fonvig C, Chabanova E, Andersson E, Hansen T, Pedersen O, Thomsen H, Holm JC. 1H MRS measured ectopic fat in liver and muscle in Danish lean and obese children and youths. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gejl KD, Hvid LG, Willis SJ, Andersson E, Holmberg HC, Jensen R, Frandsen U, Hansen J, Plomgaard P, Ørtenblad N. Repeated high-intensity exercise modulates Ca2+sensitivity of human skeletal muscle fibers. Scand J Med Sci Sports 2015; 26:488-97. [DOI: 10.1111/sms.12483] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 12/17/2022]
Affiliation(s)
- K. D. Gejl
- Department of Sports Science and Clinical Biomechanics; SDU Muscle Research Cluster; University of Southern Denmark; Odense Denmark
| | - L. G. Hvid
- Department of Sports Science and Clinical Biomechanics; SDU Muscle Research Cluster; University of Southern Denmark; Odense Denmark
| | - S. J. Willis
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
| | - E. Andersson
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
| | - H.-C. Holmberg
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
- Swedish Olympic Committee; Stockholm Sweden
| | - R. Jensen
- Department of Sports Science and Clinical Biomechanics; SDU Muscle Research Cluster; University of Southern Denmark; Odense Denmark
| | - U. Frandsen
- Department of Sports Science and Clinical Biomechanics; SDU Muscle Research Cluster; University of Southern Denmark; Odense Denmark
| | - J. Hansen
- Department of Infectious Diseases and CMRC; The Centre of Inflammation and Metabolism; Rigshospitalet; Copenhagen Denmark
- Department of Clinical Biochemistry; Rigshospitalet; Copenhagen Denmark
| | - P. Plomgaard
- Department of Infectious Diseases and CMRC; The Centre of Inflammation and Metabolism; Rigshospitalet; Copenhagen Denmark
- Department of Clinical Biochemistry; Rigshospitalet; Copenhagen Denmark
| | - N. Ørtenblad
- Department of Sports Science and Clinical Biomechanics; SDU Muscle Research Cluster; University of Southern Denmark; Odense Denmark
- Department of Health Sciences; Swedish Winter Sports Research Centre; Mid Sweden University; Östersund Sweden
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Sjökvist J, Sandbakk Ø, Willis SJ, Andersson E, Holmberg HC. The effect of incline on sprint and bounding performance in cross-country skiers. J Sports Med Phys Fitness 2015; 55:405-414. [PMID: 24921612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Aim of the present study was to investigate performance and kinematics of cross-country skiers during sprint running and bounding on different inclines, in relationship to maximal strength, power and skiing performance. METHODS On day one, the maximal strength of 14 elite skiers was tested using a mid-thigh isometric pull and maximal relative leg power determined using squat and countermovement jumps. Day two involved 15-m maximal sprints and 5-step bounding at 0º, 7.5° and 15º inclines. From video recordings sprint, step, contact and flight times; step length and frequency; total number of sprint steps and average bounding velocity were determined. Skiing performance was assessed using International Ski Federation (FIS) points from the preceding season and compared to strength, power, bounding and sprint performance, and kinematics. RESULTS On steeper inclines sprint time was higher and bounding distance shorter (both P<0.001), and step frequency during sprinting and bounding, reduced and increased respectively (P<0.001). Isometric maximal strength correlated strongly with bounding distance on the two steeper inclines (r=0.76 and 0.83). Squat and countermovement jump heights correlated moderately with sprint performance at both 7° and 15°, and bounding performance on all three inclines (r=0.55-0.65). The distance bounded uphill correlated moderately with FIS points (r=-0.55 and -0.67). CONCLUSION Incline influenced sprinting and bounding performance and kinematics. Maximal leg power is important for both sprinting and bounding uphill, while maximal strength is important for the latter. The skiers with better FIS rankings bounded farther on steeper inclines, suggesting that this capacity is beneficial for cross-country skiing performance.
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Affiliation(s)
- J Sjökvist
- Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden -
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Holm M, Torén K, Andersson E. Incidence of chronic bronchitis: a prospective study in a large general population. Int J Tuberc Lung Dis 2015; 18:870-5. [PMID: 24902568 DOI: 10.5588/ijtld.13.0652] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING A county in western Sweden. OBJECTIVE To prospectively investigate the incidence rate of chronic bronchitis (CB) in relation to smoking, age, sex, atopy and asthma in a large sample of the general population. DESIGN Subjects from a county in western Sweden born between 1943 and 1973, who had participated in our previous study in 1993, were mailed a new questionnaire in 2003. Altogether 11 463 (72%) answered the questionnaire, which comprised items about smoking, atopy, respiratory symptoms and age at onset of CB symptoms. CB was defined as chronic productive cough for at least 3 months per year for 2 consecutive years. RESULTS There were 98 new cases of CB during 1993-2003 in the study population aged 30-60 years at follow-up. The incidence rate was 0.9/1000 person-years (py); there was no significant difference between women and men or different age groups. However, CB incidence was higher in women in relation to smoking (incidence rate ratio 3.6, 95%CI 1.9-7.3) and in those with ever asthma (hazard ratio 5.6, 95%CI 3.5-9.0). CONCLUSION This prospective general population-based study shows an incidence rate of CB of 0.9/1000 py. Smoking and asthma were both associated with an increased risk of CB.
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Affiliation(s)
- M Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - K Torén
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - E Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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Andersson E, Steneby S, Karlsson K, Ljótsson B, Hedman E, Enander J, Kaldo V, Andersson G, Lindefors N, Rück C. Long-term efficacy of Internet-based cognitive behavior therapy for obsessive-compulsive disorder with or without booster: a randomized controlled trial. Psychol Med 2014; 44:2877-2887. [PMID: 25066102 DOI: 10.1017/s0033291714000543] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program. METHOD A total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT. RESULTS The entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58-2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan-Meier analysis also indicated a significantly slower relapse rate in the booster group. CONCLUSIONS The results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.
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Affiliation(s)
- E Andersson
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
| | - S Steneby
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
| | - K Karlsson
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
| | - B Ljótsson
- Department of Clinical Neuroscience, Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - E Hedman
- Department of Clinical Neuroscience, Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - J Enander
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
| | - V Kaldo
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
| | - G Andersson
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
| | - N Lindefors
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
| | - C Rück
- Department of Clinical Neuroscience, Division of Psychiatry,Karolinska Institutet,Stockholm,Sweden
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Hedman E, Ljótsson B, Rück C, Bergström J, Andersson G, Kaldo V, Jansson L, Andersson E, Andersson E, Blom K, El Alaoui S, Falk L, Ivarsson J, Nasri B, Rydh S, Lindefors N. Effectiveness of internet-based cognitive behaviour therapy for panic disorder in routine psychiatric care. Acta Psychiatr Scand 2013; 128:457-67. [PMID: 23406572 DOI: 10.1111/acps.12079] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Guided Internet-based cognitive behaviour therapy (ICBT) for panic disorder has been shown to be efficacious in several randomized controlled trials. However, the effectiveness of the treatment when delivered within routine psychiatric care has not been studied. The aim of this study was to investigate the effectiveness of ICBT for panic disorder within the context of routine psychiatric care. METHOD We conducted a cohort study investigating all patients (n = 570) who had received guided ICBT for panic disorder between 2007 and 2012 in a routine care setting at an out-patient psychiatric clinic providing Internet-based treatment. The primary outcome measure was the Panic Disorder Severity Scale-Self-report (PDSS-SR). RESULTS Participants made large improvements from screening and pretreatment assessments to posttreatment (Cohen's d range on the PDSS-SR = 1.07-1.55). Improvements were sustained at 6-month follow-up. CONCLUSION This study suggests that ICBT for panic disorder is as effective when delivered in a routine care context as in the previously published randomized controlled trials.
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Affiliation(s)
- E Hedman
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm
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Elsheikh E, Andersson E, Sylven C, Ericzon BG, Palmblad J, Mints M. Plasma levels of stromal cell-derived factor-1 (CXCL12) and circulating endothelial progenitor cells in women with idiopathic heavy menstrual bleeding. Hum Reprod 2013; 29:49-56. [DOI: 10.1093/humrep/det402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Muncaster S, Norberg B, Andersson E. Natural sex change in the temperate protogynous Ballan wrasse Labrus bergylta. J Fish Biol 2013; 82:1858-1870. [PMID: 23731141 DOI: 10.1111/jfb.12113] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 02/20/2013] [Indexed: 06/02/2023]
Abstract
Wild Ballan wrasse Labrus bergylta were sampled monthly over 2 years in western Norway to identify the natural process of sex change in this species. Light microscopy of standard histological-stained and immunohistochemistry-treated gonad tissue showed that spermatogonial germ cells tended to proliferate around the periphery of the lamellae before filling into the slowly receding, apoptotic central areas of the lamellae. Sex change occurred following the breeding season. From July to September, fish were most often in an early state of gonadal transition (ET), characterized by degenerating previtellogenic oocytes and pockets of proliferating spermatogonia in the germinative epithelia. The majority of fish with late transitional gonads, that were typically dominated by spermatogenic cells, developing efferent ducts and the beginning of lobule formation, were found between October and November. Sex steroid profiles of fish representing the different sexual phases showed that breeding females had the highest concentrations of 17β oestradiol (E2 ) and the lowest concentration of 11 ketotestosterone (11KT). Concentrations of E2 decreased greatly in ET fish at the beginning of sex change and remained low in all subsequent phases. The opposite trend was demonstrated in 11KT profiles. Initial-phase female fish had minimal concentrations of 11KT, but these increased during subsequent transitions. Sex change occurred most often in fish 34-41 cm total length (L(T)) and the median of fish in the size-frequency overlap of female and male fish was 36 cm L(T).
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Affiliation(s)
- S Muncaster
- Department of Biology, University of Bergen, Bergen, Norway.
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Hedman E, Andersson E, Lindefors N, Andersson G, Rück C, Ljótsson B. Cost-effectiveness and long-term effectiveness of internet-based cognitive behaviour therapy for severe health anxiety. Psychol Med 2013; 43:363-374. [PMID: 22608115 DOI: 10.1017/s0033291712001079] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Severe health anxiety is a common condition associated with functional disability, making it a costly disorder from a societal perspective. Internet-based cognitive behaviour therapy (ICBT) is a promising treatment but no previous study has assessed the cost-effectiveness or long-term outcome of ICBT for severe health anxiety. The aim of this study was to investigate the cost-effectiveness and 1-year treatment effects of ICBT for severe health anxiety. METHOD Cost-effectiveness and 1-year follow-up data were obtained from a randomized controlled trial (RCT) comparing ICBT (n = 40) to an attention control condition (CC, n = 41). The primary outcome measure was the Health Anxiety Inventory (HAI). A societal perspective was taken and incremental cost-effectiveness ratios (ICERs) were calculated using bootstrap sampling. RESULTS The main ICER was -£1244, indicating the societal economic gain for each additional case of remission when administering ICBT. Baseline to 1-year follow-up effect sizes on the primary outcome measure were large (d = 1.71-1.95). CONCLUSIONS ICBT is a cost-effective treatment for severe health anxiety that can produce substantial and enduring effects.
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Affiliation(s)
- E Hedman
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Andersson E, Stöggl T, Pellegrini B, Sandbakk O, Ettema G, Holmberg HC. Biomechanical analysis of the herringbone technique as employed by elite cross-country skiers. Scand J Med Sci Sports 2012. [PMID: 23206288 DOI: 10.1111/sms.12026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This investigation was designed to analyse the kinematics and kinetics of cross-country skiing at different velocities with the herringbone technique on a steep incline. Eleven elite male cross-country skiers performed this technique at maximal, high, and moderate velocities on a snow-covered 15° incline. They positioned their skis laterally (25 to 30°) with a slight inside tilt and planted their poles laterally (8 to 12°) with most leg thrust force exerted on the inside forefoot. Although 77% of the total propulsive force was generated by the legs, the ratio between propulsive and total force was approximately fourfold higher for the poles. The cycle rate increased with velocity (1.20 to 1.60 Hz), whereas the cycle length increased from moderate up to high velocity, but then remained the same at maximal velocity (2.0 to 2.3 m). In conclusion, with the herringbone technique, the skis were angled laterally without gliding, with the forces distributed mainly on the inside forefoot to enable grip for propulsion. The skiers utilized high cycle rates with major propulsion by the legs, highlighting the importance of high peak and rapid generation of leg forces.
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Affiliation(s)
- E Andersson
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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Abstract
AIM With fast track surgery and shorter hospital stay, discharge from hospital after cancer surgery is becoming more challenging for the individual patient. The aim of this study was to explore how patients perceive information after surgery for colorectal cancer, what their information needs are and to determine factors affecting received information. METHOD A hundred patients filled in the questionnaires QLQ-C30, CR38 and INFO25 created by the European Organization for Research and Treatment of Cancer, the Eastern Cooperative Oncology Group (ECOG) instrument and the SOC (sense of coherence) instrument and provided written comments within the first 2 weeks after discharge following surgery for colorectal cancer. The questionnaires were analysed using hierarchical cluster analysis and a multiple linear regression analysis. The written comments were analysed using content analysis. RESULTS In all, 49% of the patients expressed a need for more information. In the written comments they specified these areas of information: they lacked information concerning their surgery, how to handle symptoms and problems at home, someone to contact after discharge and prognostic information about their future. Patients reported most received information in areas of medical tests and disease but less on other services and support in outpatient care. The variation in INFO25 was best explained by gender (P = 0.045) and preoperative health status (American Society of Anesthesiologists score 3, P = 0.022). CONCLUSION The results from this study indicate that women and patients with a poorer preoperative health status scored less on information received and would need more time and support to prepare for discharge. The patients expressed a desire for more information about the surgery, how to handle symptoms at home and prognostic information about their future.
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Affiliation(s)
- M Lithner
- Department of Health Sciences, Lund University, and Skåne University Hospital, Sweden.
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Andersson E, Enander J, Andrén P, Hedman E, Ljótsson B, Hursti T, Bergström J, Kaldo V, Lindefors N, Andersson G, Rück C. Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial. Psychol Med 2012; 42:2193-2203. [PMID: 22348650 PMCID: PMC3435873 DOI: 10.1017/s0033291712000244] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 01/25/2012] [Accepted: 01/26/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive behaviour therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) but access to CBT is limited. Internet-based CBT (ICBT) with therapist support is potentially a more accessible treatment. There are no randomized controlled trials testing ICBT for OCD. The aim of this study was to investigate the efficacy of ICBT for OCD in a randomized controlled trial. METHOD Participants (n=101) diagnosed with OCD were randomized to either 10 weeks of ICBT or to an attention control condition, consisting of online supportive therapy. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) administered by blinded assessors. RESULTS Both treatments lead to significant improvements in OCD symptoms, but ICBT resulted in larger improvements than the control condition on the YBOCS, with a significant between-group effect size (Cohen's d) of 1.12 (95% CI 0.69-1.53) at post-treatment. The proportion of participants showing clinically significant improvement was 60% (95% CI 46-72) in the ICBT group compared to 6% (95% CI 1-17) in the control condition. The results were sustained at follow-up. CONCLUSIONS ICBT is an efficacious treatment for OCD that could substantially increase access to CBT for OCD patients. Replication studies are warranted.
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Affiliation(s)
- E Andersson
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
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Hedman E, Andersson E, Ljótsson B, Andersson G, Andersson E, Schalling M, Lindefors N, Rück C. Clinical and genetic outcome determinants of Internet- and group-based cognitive behavior therapy for social anxiety disorder. Acta Psychiatr Scand 2012; 126:126-36. [PMID: 22320999 DOI: 10.1111/j.1600-0447.2012.01834.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE No study has investigated clinical or genetic predictors and moderators of Internet-based cognitive behavior therapy (ICBT) compared with cognitive behavioral group therapy for (CBGT) for SAD. Identification of predictors and moderators is essential to the clinician in deciding which treatment to recommend for whom. We aimed to identify clinical and genetic (5-HTTLPR, COMTval158met, and BDNFval66met) predictors and moderators of ICBT and CBGT. METHOD We performed three types of analyses on data from a sample comprising participants (N = 126) who had undergone ICBT or CBGT in a randomized controlled trial. Outcomes were i) end state symptom severity, ii) SAD diagnosis, and iii) clinically significant improvement. RESULTS The most stable predictors of better treatment response were working full time, having children, less depressive symptoms, higher expectancy of treatment effectiveness, and adhering to treatment. None of the tested gene polymorphisms were associated with treatment outcome. Comorbid general anxiety and depression were moderators meaning that lower levels were associated with a better treatment response in ICBT but not in CBGT. CONCLUSION We conclude that demographic factors, symptom burden, adherence, and expectations may play an important role as predictors of treatment outcome. The investigated gene polymorphisms do not appear to make a difference.
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Affiliation(s)
- E Hedman
- Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Andersson E, Eldfors S, Koskela H, Ellonen P, Kallioniemi O, Porkka K, Loughran T, Maciejewski J, Heckman C, Mustjoki S. 825 Exome Sequencing of T-LGL Leukemia Patient Revealed ANGPT2 as a Possible Mutational Target. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thanabalasingham G, Shah N, Vaxillaire M, Hansen T, Tuomi T, Gašperíková D, Szopa M, Tjora E, James TJ, Kokko P, Loiseleur F, Andersson E, Gaget S, Isomaa B, Nowak N, Raeder H, Stanik J, Njolstad PR, Malecki MT, Klimes I, Groop L, Pedersen O, Froguel P, McCarthy MI, Gloyn AL, Owen KR. A large multi-centre European study validates high-sensitivity C-reactive protein (hsCRP) as a clinical biomarker for the diagnosis of diabetes subtypes. Diabetologia 2011; 54:2801-10. [PMID: 21814873 DOI: 10.1007/s00125-011-2261-y] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 06/30/2011] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS An accurate molecular diagnosis of diabetes subtype confers clinical benefits; however, many individuals with monogenic diabetes remain undiagnosed. Biomarkers could help to prioritise patients for genetic investigation. We recently demonstrated that high-sensitivity C-reactive protein (hsCRP) levels are lower in UK patients with hepatocyte nuclear factor 1 alpha (HNF1A)-MODY than in other diabetes subtypes. In this large multi-centre study we aimed to assess the clinical validity of hsCRP as a diagnostic biomarker, examine the genotype-phenotype relationship and compare different hsCRP assays. METHODS High-sensitivity CRP levels were analysed in individuals with HNF1A-MODY (n = 457), glucokinase (GCK)-MODY (n = 404), hepatocyte nuclear factor 4 alpha (HNF4A)-MODY (n = 54) and type 2 diabetes (n = 582) from seven European centres. Three common assays for hsCRP analysis were evaluated. We excluded 121 participants (8.1%) with hsCRP values >10 mg/l. The discriminative power of hsCRP with respect to diabetes aetiology was assessed by receiver operating characteristic curve-derived C-statistic. RESULTS In all centres and irrespective of the assay method, meta-analysis confirmed significantly lower hsCRP levels in those with HNF1A-MODY than in those with other aetiologies (z score -21.8, p < 5 × 10(-105)). HNF1A-MODY cases with missense mutations had lower hsCRP levels than those with truncating mutations (0.03 vs 0.08 mg/l, p < 5 × 10(-5)). High-sensitivity CRP values between assays were strongly correlated (r (2) ≥ 0.91, p ≤ 1 × 10(-5)). Across the seven centres, the C-statistic for distinguishing HNF1A-MODY from young adult-onset type 2 diabetes ranged from 0.79 to 0.97, indicating high discriminative accuracy. CONCLUSIONS/INTERPRETATION In the largest study to date, we have established that hsCRP is a clinically valid biomarker for HNF1A-MODY in European populations. Given the modest costs and wide availability, hsCRP could translate rapidly into clinical practice, considerably improving diagnosis rates in monogenic diabetes.
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Affiliation(s)
- G Thanabalasingham
- Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Headington, Oxford, OX3 7LJ, UK
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