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Dos Santos Dias M, Biniskos N, Dos Santos FJ, Schmalzl K, Persson J, Bourdarot F, Marzari N, Blügel S, Brückel T, Lounis S. Topological magnons driven by the Dzyaloshinskii-Moriya interaction in the centrosymmetric ferromagnet Mn 5Ge 3. Nat Commun 2023; 14:7321. [PMID: 37951946 PMCID: PMC10640582 DOI: 10.1038/s41467-023-43042-3] [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] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023] Open
Abstract
The phase of the quantum-mechanical wave function can encode a topological structure with wide-ranging physical consequences, such as anomalous transport effects and the existence of edge states robust against perturbations. While this has been exhaustively demonstrated for electrons, properties associated with the elementary quasiparticles in magnetic materials are still underexplored. Here, we show theoretically and via inelastic neutron scattering experiments that the bulk ferromagnet Mn5Ge3 hosts gapped topological Dirac magnons. Although inversion symmetry prohibits a net Dzyaloshinskii-Moriya interaction in the unit cell, it is locally allowed and is responsible for the gap opening in the magnon spectrum. This gap is predicted and experimentally verified to close by rotating the magnetization away from the c-axis with an applied magnetic field. Hence, Mn5Ge3 realizes a gapped Dirac magnon material in three dimensions. Its tunability by chemical doping or by thin film nanostructuring defines an exciting new platform to explore and design topological magnons. More generally, our experimental route to verify and control the topological character of the magnons is applicable to bulk centrosymmetric hexagonal materials, which calls for systematic investigation.
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Affiliation(s)
- M Dos Santos Dias
- Peter Grünberg Institut and Institute for Advanced Simulation, Forschungszentrum Jülich & JARA, D-52425, Jülich, Germany.
- Faculty of Physics, University of Duisburg-Essen and CENIDE, D-47053, Duisburg, Germany.
- Scientific Computing Department, STFC Daresbury Laboratory, Warrington, WA4 4AD, UK.
| | - N Biniskos
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science at MLZ, Lichtenbergstr. 1, D-85748, Garching, Germany.
- Charles University, Faculty of Mathematics and Physics, Department of Condensed Matter Physics, Ke Karlovu 5, 121 16, Praha, Czech Republic.
| | - F J Dos Santos
- Laboratory for Materials Simulations, Paul Scherrer Institut, 5232, Villigen, PSI, Switzerland.
- Theory and Simulation of Materials (THEOS), and National Centre for Computational Design and Discovery of Novel Materials (MARVEL), École Polytechnique Fédérale de Lausanne, 1015, Lausanne, Switzerland.
| | - K Schmalzl
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science at ILL, 71 Avenue des Martyrs, F-38000, Grenoble, France
| | - J Persson
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science (JCNS-2) and Peter Grünberg Institut (PGI-4), JARA-FIT, D-52425, Jülich, Germany
| | - F Bourdarot
- Université Grenoble Alpes, CEA, IRIG, MEM, MDN, F-38000, Grenoble, France
| | - N Marzari
- Laboratory for Materials Simulations, Paul Scherrer Institut, 5232, Villigen, PSI, Switzerland
- Theory and Simulation of Materials (THEOS), and National Centre for Computational Design and Discovery of Novel Materials (MARVEL), École Polytechnique Fédérale de Lausanne, 1015, Lausanne, Switzerland
| | - S Blügel
- Peter Grünberg Institut and Institute for Advanced Simulation, Forschungszentrum Jülich & JARA, D-52425, Jülich, Germany
| | - T Brückel
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science (JCNS-2) and Peter Grünberg Institut (PGI-4), JARA-FIT, D-52425, Jülich, Germany
| | - S Lounis
- Peter Grünberg Institut and Institute for Advanced Simulation, Forschungszentrum Jülich & JARA, D-52425, Jülich, Germany
- Faculty of Physics, University of Duisburg-Essen and CENIDE, D-47053, Duisburg, Germany
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2
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Palmér C, Wallin A, Persson J, Aronsson M, Blennow K. Effective communications on invasive alien species: Identifying communication needs of Swedish domestic garden owners. J Environ Manage 2023; 340:117995. [PMID: 37100004 DOI: 10.1016/j.jenvman.2023.117995] [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] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/12/2023]
Abstract
Invasive alien species threaten biodiversity with domestic gardens acting as a major pathway for the introduction of alien species. Even though the Nordic region is not currently a hotspot for biological invasions, the number of invasions in the Nordic area has been predicted to increase due to climate change. Given a time lag between introduction and invasion, many non-invasive horticultural alien species already introduced into gardens may become invasive in the future. This study aimed to identify the communication needs of Swedish garden owners regarding their management of invasive alien species. A survey among domestic garden owners, informed by topic specialists and local area experts, and interviews with garden owners were conducted in three different bio-climatic areas in a latitudinal gradient across Sweden. The questions targeted invasive alien species and their relations to biodiversity loss and climate change, as well as measures taken to control these species. Analysing the survey data collected in relation to measures taken to control invasive species, Bayesian Additive Regression Tree (BART) modelling was used to identify geographically varying communication needs of the domestic garden owners. In all study areas, the garden owners' measures taken to control invasive alien species were correlated with their strength of beliefs in having experienced local biodiversity loss. A majority of the garden owners were, moreover, uncertain about the impact of climate change on the invasiveness of alien species. In addition, the garden owners' capacity for identifying invasive alien species was often in need of improvement, in particular with respect to the species Impatiens glandulifera, Reynoutria japonica and Rosa rugosa. The results suggest that the evidence-based guidelines for effective communications we developed, have the potential to help communicators meet the local communication needs of garden owners across Sweden, in relation to the management of invasive alien garden species.
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Affiliation(s)
- C Palmér
- Department of Landscape Architecture, Planning and Management, Swedish University of Agricultural Sciences, Sweden
| | - A Wallin
- Division of Cognitive Science, Department of Philosophy, Lund University, Sweden
| | - J Persson
- Department of Philosophy, Lund University, Sweden
| | - M Aronsson
- Swedish Species Information Centre, Swedish University of Agricultural Sciences, Sweden
| | - K Blennow
- Department of Landscape Architecture, Planning and Management, Swedish University of Agricultural Sciences, Sweden; Department of Physical Geography and Ecosystem Science, Lund University, Sweden.
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3
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Sharma T, Maehara A, Ben-Yehuda O, Maeng M, Kjoller-Hansen L, Engstrom T, Matsumura M, Frobert O, Persson J, Wiseth R, Larsen AI, James SK, Ali ZA, Stone GW, Erlinge D. Biomarkers associated with vulnerable plaques. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1292] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiovascular heart disease is the leading cause of mortality worldwide, with the rupture or thrombosis of an atherosclerotic plaque being the main reason behind an acute coronary syndrome. It has already been established that the morphology of atherosclerotic plaques determine their stability. A lipid rich lesion with a thin fibrous cap is more prone to rupture compared to solid fibrous lesions. In the PROSPECTII study we used Near infrared spectroscopy (NIRS) and Intravascular ultrasound (IVUS) to identify atherosclerotic plaques in the coronary arteries; NIRS-derived lipid core burden index (LCBI) and IVUS-derived plaque burden (PB) identified plaques that caused adverse cardiovascular events.
Purpose
Our aim is to find biomarkers associated with LCBI or PB, to understand the development of vulnerable plaques.
Methods
902 patients were enrolled in this study after successful percutaneous coronary intervention (PCI). A combined NIRS-IVUS catheter was then used to analyze approximately 200m of coronary arteries. Blood samples for biomarker analysis were taken before the PCI procedure and plasma levels of 182 proteins associated with cardiovascular disease were assessed using a novel method for measuring proximity extension assay. Adjusted linear regression models were calculated between the biomarkers and the outcomes of interest, followed by a false discovery rate (FDR) correction.
Results
We found 24 proteins associated with plaque burden and 28 proteins associated with LCBI after using a cut off of two tailed P value <0.05. An overlap of 8 biomarkers could be seen between the two groups. After adjusting the P values with FDR, Angiopoeitin like 3 (ANGPTL3) retained its association to LCBI, and Interleukin 18 receptor 1 (IL18R1) and colony stimulating factor 1 (CSF-1) to plaque burden.
Conclusion
We were able to identify different biomarker patterns associated with plaque burden compared to lipid rich vulnerable plaques. ANGPTL3 was shown to only have an association with lipid rich plaques and not with solid fibrous lesions which further supports its role in vulnerable plaques.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Abbott Vascular, Infraredx, and The Medicines Company
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Affiliation(s)
| | - A Maehara
- Columbia University Medical Center , New York , United States of America
| | - O Ben-Yehuda
- Cardiovascular Research Foundation , New York , United States of America
| | - M Maeng
- Aarhus University Hospital , Aarhus , Denmark
| | | | - T Engstrom
- University of Copenhagen , Copenhagen , Denmark
| | - M Matsumura
- Cardiovascular Research Foundation , New York , United States of America
| | - O Frobert
- Orebro University, Faculty of Health , Orebro , Sweden
| | - J Persson
- Danderyd University Hospital , Stockholm , Sweden
| | - R Wiseth
- St Olavs Hospital , Trondheim , Norway
| | - A I Larsen
- Stavanger University Hospital , Stavanger , Norway
| | - S K James
- Uppsala University Hospital and Uppsala Clinical Research Center , Uppsala , Sweden
| | - Z A Ali
- Columbia University Medical Center , New York , United States of America
| | - G W Stone
- The Zena and Michael A. Wiener Cardiovascular Institute , New York , United States of America
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Loerstad S, Shekarestan S, Tehrani S, Jernberg T, Astrand P, Gille-Johnson P, Persson J. First sampled plasma troponin T is associated with one-year mortality in sepsis and septic shock, independent of age, gender, comorbidities, and clinically relevant biomarkers. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1486] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with sepsis and septic shock often have elevated troponin T levels indicating acute myocardial injury. Studies investigating the relationship between troponin T levels as a predictor for mortality in sepsis have been contradictory.
Purpose
To investigate if the first in-hospital sampled plasma troponin T value is associated with one-year mortality in sepsis and septic shock independent of comorbidities, Sequential Organ Failure Assessment (SOFA)-score, Clinical Frailty Scale, Charlson Comorbidity Index (including age) and clinical biomarkers (e.g., serum lactate, creatinine, C-reactive protein).
Methods
Patients with sepsis and sepsis shock were included if they were admitted to the intermediate and intensive care units at our institution between 1st of March 2012 and 30th of September 2021, and if at least one troponin T value was recorded within the first two calendar days from symptom onset. Variables were collected from medical records. Normal troponin-T was defined as <15 ng/L. Elevated troponin T values were divided into quartiles (Q): Q1 15–35.9 ng/L, Q2 36–61.9 ng/L, Q3 62–125.9 ng/L and Q4 ≥126 ng/L. Kaplan-Meier stratified survival curves were plotted for normal levels and Qs of elevated troponin T. Multivariate Cox regression was used for multivariate analysis.
Results
586 patients were included and 529 (90%) had a first sampled troponin T ≥15 ng/L. 523 (89%) met the Sepsis-3 criteria for septic shock, the remainder met the criteria for sepsis. The mean age was 71 years and 220 (38%) were women. One-year mortality was 45% (n=264). Increasing levels of first sampled plasma troponin T were associated with higher hazard ratios (HR) for one-year mortality compared to normal levels (<15 ng/L): Q1 HR 5.29 (95% confidence interval [CI] 1.9–14.7); Q2 HR 7.47 (95% CI 2.71–20.6); Q3 HR 12.81 (95% CI 4.7–35.0); Q 4 HR 13.82 (95% CI 5.06–37.7) (Figure 1). Troponin T was independently associated with one-year mortality after adjustment for gender, plasma lactate, plasma CRP, prior atrial fibrillation, in-hospital onset atrial fibrillation, SOFA-score, CFS, and CCI (including age) (Table 1).
Conclusions
Elevated first sampled plasma troponin T in patients with sepsis and septic shock was associated with higher one-year mortality, independent of age, gender, comorbidities, and clinically relevant biomarkers. There was a risk gradient across the Qs of elevated troponin T with increasingly higher risk of death at one year per higher Q. Further studies are needed to ascertain whether elevated troponin T levels and clinical assessment scores can be used together in the clinical setting to identify patients for more aggressive treatment and cardiac work-up.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Region Stockholm
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Affiliation(s)
- S Loerstad
- Karolinska Institutet Danderyd Hospital , Stockholm , Sweden
| | | | - S Tehrani
- Karolinska Institutet Danderyd Hospital , Stockholm , Sweden
| | - T Jernberg
- Karolinska Institutet Danderyd Hospital , Stockholm , Sweden
| | - P Astrand
- Danderyd University Hospital , Stockholm , Sweden
| | | | - J Persson
- Karolinska Institutet Danderyd Hospital , Stockholm , Sweden
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Winbo A, Diamant U, Persson J, Jensen SM, Rydberg A. To Modify or Not to Modify: Allele‐Specific Effects of 3'UTR‐
KCNQ1
Single Nucleotide Polymorphisms on Clinical Phenotype in a Long QT 1 Founder Population Segregating a Dominant‐Negative Mutation. J Am Heart Assoc 2022; 11:e025981. [DOI: 10.1161/jaha.122.025981] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
There are conflicting reports with regard to the allele‐specific gene suppression effects of single nucleotide polymorphisms (SNPs) in the 3'untranslated region (3'UTR) of the
KCNQ1
gene in long QT syndrome type 1 (LQT1) populations. Here we assess the allele‐specific effects of 3 previously published 3'UTR‐
KCNQ1
's SNPs in a LQT1 founder population segregating a dominant‐negative mutation.
Methods and Results
Bidirectional sequencing of the
KCNQ1
'
s
3'UTR was performed in the p.Y111C founder population (n=232, 147 genotype positive), with a minor allele frequency of 0.1 for SNP1 (rs2519184) and 0.6 for linked SNP2 (rs8234) and SNP3 (rs107980). Allelic phase was assessed in trios aided by haplotype data, revealing a high prevalence of derived SNP2/3
in cis
with p.Y111C (89%). Allele‐specific association analyses, corrected using a relatedness matrix, were performed between 3'UTR‐
KCNQ1
SNP genotypes and clinical phenotypes. SNP1
in trans
was associated with a significantly higher proportion of symptomatic phenotype compared with no derived SNP1 allele
in trans
(58% versus 32%, corrected
P
=0.027). SNP2/3
in cis
was associated with a significantly lower proportion of symptomatic phenotype compared with no derived SNP2/3 allele
in cis
(32% versus 69%, corrected
P
=0.010).
Conclusions
Allele‐specific modifying effects on symptomatic phenotype of 3'UTR‐
KCNQ1
SNPs rs2519184, rs8234, and rs107980 were seen in a LQT1 founder population segregating a dominant‐negative mutation. The high prevalence of suppressive 3'UTR‐
KCNQ1
SNPs segregating with the founder mutation could contribute to the previously documented low incidence of cardiac events in heterozygous carriers of the p.Y111C
KCNQ1
mutation.
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Affiliation(s)
- Annika Winbo
- Department of Clinical Sciences, Pediatrics Umeå University Umeå Sweden
- Department of Physiology University of Auckland Auckland New Zealand
| | - Ulla‐Britt Diamant
- Department of Public Health and Clinical Medicine Heart Centre, Umeå University Umeå Sweden
| | - Johan Persson
- Department of Clinical Sciences, Pediatrics Umeå University Umeå Sweden
| | - Steen M. Jensen
- Department of Public Health and Clinical Medicine Heart Centre, Umeå University Umeå Sweden
| | - Annika Rydberg
- Department of Clinical Sciences, Pediatrics Umeå University Umeå Sweden
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6
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Shahed H, Sharma N, Angst M, Voigt J, Persson J, Gildenast H, Englert U, Chernyshov D, Tornroos K, Grzechnik A, Friese K. Elucidation of barocaloric effect in spin crossover compounds. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322092932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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7
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Bodén R, Bengtsson J, Thörnblom E, Struckmann W, Persson J. Dorsomedial prefrontal theta burst stimulation to treat anhedonia, avolition, and blunted affect in schizophrenia or depression - a randomized controlled trial. J Affect Disord 2021; 290:308-315. [PMID: 34020205 DOI: 10.1016/j.jad.2021.04.053] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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] [Received: 11/25/2020] [Revised: 01/12/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intermittent theta burst stimulation (iTBS) over the dorsomedial prefrontal cortex (DMPFC) has shown promise in open-label trials of depression. METHODS In this randomized, double-blind, sham controlled trial we evaluate iTBS over the DMPFC for anhedonia, avolition, and blunted affect in patients with schizophrenia or depression. Active iTBS was delivered over the DMPFC with 1200 pulses per session, twice daily over ten weekdays at target intensity with an angled figure-of eight coil. Sham condition comprised the magnetically shielded side of the coil and simultaneous transcutaneous electrical nerve stimulation. Primary outcome was change on the Clinical Assessment Interview for Negative Symptoms (CAINS). RESULTS Twenty-eight patients were randomized to active iTBS and 28 to sham. Mean (standard deviation) change in CAINS score from baseline to the day after last treatment was -5.3 (8.1) in active iTBS and -2.1 (7.1) in sham. A linear model showed no significant effect of treatment, accounting for baseline scores p=.088. Sub analyses per diagnostic group showed a significant effect in patients with depression, p=.038, but not in the schizophrenia group, p=.850. However, overall depressive symptoms did not change significantly in patients with depression. There were three serious adverse events, all in the sham group. LIMITATIONS Possibly too short treatment course and few patients with schizophrenia. CONCLUSION In this first transdiagnostic randomized controlled trial of iTBS over DMPFC for anhedonia, avolition, and blunted affect it can be concluded that it was generally tolerable and safe but only more effective than sham in the subgroup of patients with depression.
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Affiliation(s)
- R Bodén
- Department of Neuroscience, Pychiatry, Uppsala University, Entrance 10, ground floor, Brain Stimulation Unit, SE- 751 85, Uppsala, Sweden.
| | - J Bengtsson
- Department of Neuroscience, Pychiatry, Uppsala University, Entrance 10, ground floor, Brain Stimulation Unit, SE- 751 85, Uppsala, Sweden
| | - E Thörnblom
- Department of Neuroscience, Pychiatry, Uppsala University, Entrance 10, ground floor, Brain Stimulation Unit, SE- 751 85, Uppsala, Sweden
| | - W Struckmann
- Department of Neuroscience, Pychiatry, Uppsala University, Entrance 10, ground floor, Brain Stimulation Unit, SE- 751 85, Uppsala, Sweden
| | - J Persson
- Department of Neuroscience, Pychiatry, Uppsala University, Entrance 10, ground floor, Brain Stimulation Unit, SE- 751 85, Uppsala, Sweden
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8
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Zhai Q, Freund-Levi Y, Horn A, Fridenberger AC, Lager E, Montgomery S, Persson J. Physical training for patients with depression and anxiety - a randomized controlled study. Eur Psychiatry 2021. [PMCID: PMC9480390 DOI: 10.1192/j.eurpsy.2021.1828] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPharmaceutical treatment and psychotherapy constitute the most common treatment methods for depression and anxiety. Physical training has been shown to have comparable effect to cognitive behavioral therapy in treatment of mild to moderate depression and anxiety. Physically active individuals also show lower risks to develop depression and relapse in depression.ObjectivesThe objectives are to evaluate how physical activity can affect depressive and anxiety symptoms, by examining biomarkers in the blood and from the gut and also by measuring cognitive functions. Hopefully, this can lead to new treatment strategies for patients with depression and anxiety.Methods102 patients are randomized to two groups and undergo 12 weeks intervention as add-on to standard outpatient psychiatric treatment. The first group will participate in physical training three times per week and the other group will receive relaxation therapy on a weekly basis. Daily activity intensity will be measured before and at the last week of intervention with an accelerometer. Blood and faeces sample collection, symptom grading by clinician together with self-rating scales and cognitive screening will be performed at baseline, week 12 and one year of follow-up. The cognitive screenings are performed digitally in cooperation with Mindmore.ResultsThe RCT is currently recruiting patients at the Department of Psychiatry of Örebro University Hospital.Conclusions
The project aims to be holistic in its approach, combining the defining clinical psychiatric symptoms in patients who have both depression and anxiety with the finding and evaluation of new biomarkers from blood and gut to improve cognitive functions.DisclosureNo significant relationships.
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Bengtsson J, Bodén R, Olsson EMG, Mårtensson J, Gingnell M, Persson J. Autonomic modulation networks in schizophrenia: The relationship between heart rate variability and functional and structural connectivity in the brain. Psychiatry Res Neuroimaging 2020; 300:111079. [PMID: 32283474 DOI: 10.1016/j.pscychresns.2020.111079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Received: 10/02/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 12/30/2022]
Abstract
Heart rate variability (HRV), a measurement of autonomic nervous system (ANS) activity, has been found reduced in schizophrenia. The anterior cingulate cortex (ACC), which is important in regulating the ANS, is structurally and functionally affected in schizophrenia. We investigate the relationship between HRV and functional and structural connectivity of the ACC in patients with schizophrenia and healthy controls. Ten patients with a diagnosis of schizophrenia and ten healthy controls were recruited. Heart rate was monitored in a naturalistic out-of-clinic setting. Magnetic resonance imaging (MRI) was performed, including resting-state functional MRI and diffusion tensor imaging. Patients with schizophrenia had significantly lower HRV compared to controls. A positive correlation between ACC connectivity with the bilateral cerebellum and HRV was found in the patients. HRV was also positively correlated with amplitude of low frequency fluctuations (ALFF) in the cerebellum, and with axial diffusivity in the middle cerebellar peduncle, in the patients. There was a significant negative relationship between antipsychotic medication dosage, HRV and all neuroimaging measures related to HRV. We conclude that ACC connectivity seems to be affected in schizophrenia, both structurally and functionally, and that the ACC-cerebellum connectivity, as well as cerebellar function, is associated with ANS regulation in patients with schizophrenia.
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Affiliation(s)
- J Bengtsson
- Dept. of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
| | - R Bodén
- Dept. of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - E M G Olsson
- Dept. of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - J Mårtensson
- Dept. of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden; Dept. of Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - M Gingnell
- Dept. of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - J Persson
- Dept. of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
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10
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Young R, Bekele T, Gunn A, Chapman N, Chowdhary V, Corrigan K, Dahora L, Martinez S, Permar S, Persson J, Rodriguez B, Schäferhoff M, Schulman K, Singh T, Terry RF, Yamey G. Developing new health technologies for neglected diseases: a pipeline portfolio review and cost model. Gates Open Res 2020; 2:23. [PMID: 30234193 PMCID: PMC6139384 DOI: 10.12688/gatesopenres.12817.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Funding for neglected disease product development fell from 2009-2015, other than a brief injection of Ebola funding. One impediment to mobilizing resources is a lack of information on product candidates, the estimated costs to move them through the pipeline, and the likelihood of specific launches. This study aimed to help fill these information gaps. Methods: We conducted a pipeline portfolio review to identify current candidates for 35 neglected diseases. Using an adapted version of the Portfolio to Impact financial modelling tool, we estimated the costs to move these candidates through the pipeline over the next decade and the likely launches. Since the current pipeline is unlikely to yield several critical products, we estimated the costs to develop a set of priority “missing” products. Results: We found 685 neglected disease product candidates as of August 31, 2017; 538 candidates met inclusion criteria for input into the model. It would cost about $16.3 billion (range $13.4-19.8B) to move these candidates through the pipeline, with three-quarters of the costs incurred in the first 5 years, resulting in about 128 (89-160) expected product launches. Based on the current pipeline, there would be few launches of complex new chemical entities; launches of highly efficacious HIV, tuberculosis, or malaria vaccines would be unlikely. Estimated additional costs to launch one of each of 18 key missing products are $13.6B assuming lowest product complexity or $21.8B assuming highest complexity ($8.1B-36.6B). Over the next 5 years, total estimated costs to move current candidates through the pipeline and develop these 18 missing products would be around $4.5B (low complexity missing products) or $5.8B/year (high complexity missing products). Conclusions: Since current annual global spending on product development is about $3B, this study suggests the annual funding gap over the next 5 years is at least $1.5-2.8B.
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Affiliation(s)
- Ruth Young
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Tewodros Bekele
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Alexander Gunn
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Nick Chapman
- Policy Cures Research, Sydney, NSW, 2010, Australia
| | | | | | - Lindsay Dahora
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA
- Department of Immunology, Duke University, Durham, NC, 27710, USA
| | | | - Sallie Permar
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA
- Children’s Health and Discovery Institute; Department of Pediatrics, Duke University, Durham, NC, 27710, USA
| | | | - Bill Rodriguez
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | | | - Kevin Schulman
- Duke Clinical Research Institute, Duke University, Durham, NC, 27715, USA
| | - Tulika Singh
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, 27710, USA
| | - Robert F Terry
- The Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, CH-1211, Switzerland
| | - Gavin Yamey
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
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11
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Cederström S, Lundman P, Folkersen L, Paulsson-Berne G, Karadimou G, Eriksson P, Caidahl K, Gabrielsen A, Jernberg T, Persson J, Tornvall P. New candidate genes for ST-elevation myocardial infarction. J Intern Med 2020; 287:66-77. [PMID: 31589004 DOI: 10.1111/joim.12976] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Despite extensive research in atherosclerosis, the mechanisms of coronary atherothrombosis in ST-elevation myocardial infarction (STEMI) patients are undetermined. OBJECTIVES Our aim was to find candidate genes involved in STEMI by analysing leucocyte gene expression in STEMI patients, without the influence of secondary inflammation from innate immunity, which was assumed to be a consequence rather than the cause of coronary atherothrombosis. METHODS Fifty-one patients were included at coronary angiography because of STEMI. Arterial blood was sampled in the acute phase (P1), at 24-48 h (P2) and at 3 months (P3). Leucocyte RNA was isolated and gene expression analysis was performed by Affymetrix Human Transcriptome Array 2.0. By omission of up- or downregulated genes at P2, secondary changes from innate immunity were excluded. Genes differentially expressed in P1 when compared to the convalescent sample in P3 were determined as genes involved in STEMI. RESULTS Three genes were upregulated at P1 compared to P3; ABCG1 (P = 5.81 × 10-5 ), RAB20 (P = 3.69 × 10-5 ) and TMEM2 (P = 7.75 × 10-6 ) whilst four were downregulated; ACVR1 (P = 9.01 × 10-5 ), NFATC2IP (P = 8.86 × 10-5 ), SUN1 (P = 3.87 × 10-5 ) and TTC9C (P = 7.18 × 10-6 ). These genes were also highly expressed in carotid atherosclerotic plaques. CONCLUSIONS We found seven genes involved in STEMI. The study is unique regarding the blood sampling in the acute phase and omission of secondary expressed genes from innate immunity. However, the results need to be replicated by future studies.
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Affiliation(s)
- S Cederström
- Division of Cardiovascular medicine, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital (KI DS), Stockholm, Sweden
| | - P Lundman
- Division of Cardiovascular medicine, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital (KI DS), Stockholm, Sweden
| | - L Folkersen
- Sankt Hans Hospital, Capital Region Hospitals, Roskilde, Denmark
| | - G Paulsson-Berne
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
| | - G Karadimou
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
| | - P Eriksson
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
| | - K Caidahl
- Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, Stockholm, Sweden.,Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Gabrielsen
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
| | - T Jernberg
- Division of Cardiovascular medicine, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital (KI DS), Stockholm, Sweden
| | - J Persson
- Division of Cardiovascular medicine, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital (KI DS), Stockholm, Sweden
| | - P Tornvall
- Division of Cardiovascular medicine, Department of Clinical Science and Education, Södersjukhuset (KI SÖS), Karolinska Institutet, Stockholm, Sweden
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12
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Persson J, Engström C, Bergquist H, Johnsson E, Smedh U. Validation of instruments for the assessment of dysphagia due to malignancy of the esophagus. Dis Esophagus 2019; 32:5267100. [PMID: 30596966 DOI: 10.1093/dote/doy125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Received: 09/21/2018] [Revised: 11/27/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022]
Abstract
The aim of the study was to validate the Watson scale, the Ogilvie scale, and the Goldschmid scale for assessment of dysphagia due to malignancy of the esophagus. After translation of the scales to Swedish, 35 patients with dysphagia due to esophageal malignancy were asked to participate. On day 1, patients were asked to fill in the questionnaires. The patients also kept a food diary for 4 consecutive days, for assessment of actual swallowing ability. On day 10, the patients were asked to fill in the scales again, to control for individual variability. As an external control group, 29 healthy volunteers were asked to fill in the questionnaires once. External validation was done against actual swallowing ability, and against the European Organization for Research and Treatment of Cancer scales QLQ-C30 and QLQ-OG25, which are already validated quality of life scales for malignancy. Reliability in the categorical variables (Ogilvie and Goldschmid) showed weighted kappa values of 0.52 and 0.54, respectively. For the Watson scale and the Dysphagia module of QLQ-OG25, the intraclass correlation coefficients were 0.68 and 0.80, respectively. Correlations between all scales were good to excellent with values of correlation coefficients (rs) between 0.69 and 0.88, with the strongest correlations between the Ogilvie score and the dysphagia module in QLQ-OG25. These latter two scales had the strongest correlation to the food diary (rs = 0.72). Although the Ogilvie scale was superior, all the three scales showed good reliability and are thus judged to have good validity for assessment of dysphagia due to esophageal malignancy.
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Affiliation(s)
- J Persson
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital
| | - C Engström
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital
| | - H Bergquist
- Department of ENT, Head and Neck Surgery, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - E Johnsson
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital
| | - Ulrika Smedh
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital
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13
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Tengbom J, Cederstrom S, Verouhis D, Sorensson P, Bohm F, Saleh N, Jernberg T, Lundman P, Eriksson P, Gabrielsen A, Caidahl K, Persson J, Folkersen L, Tornvall P, Pernow J. P6599Upregulation of protein and gene expression of arginase-1 in patients with ST elevation myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1187] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The mechanisms underlying rupture of a coronary atherosclerotic plaque and development of myocardial ischemia-reperfusion injury in ST-elevation myocardial infarction (STEMI) remain unknown. Increased arginase-1 activity leads to reduced nitric oxide production and increased formation of reactive oxygen species due to uncoupling of the endothelial nitric oxide synthase (eNOS). These events lead to endothelial dysfunction, plaque instability and increased susceptibility to ischemia-reperfusion injury in acute myocardial infarction. Experimental studies have shown that arginase-1 expression and activity are increased in atherosclerosis and during myocardial ischemia-reperfusion. Accordingly, inhibition of arginase-1 reduces atherosclerotic lesion development and limits the extent of infarct size during ischemia-reperfusion via an eNOS-dependent mechanism. Furthermore, arginase-1 inhibition improves endothelial function in patients with coronary artery disease but the potential role of arginase-1 in patients with STEMI is poorly understood.
Purpose
The purpose of the current study was to test the hypothesis that arginase-1 is upregulated and correlate to infarct size in STEMI patients.
Methods and results
Two independent cohorts of STEMI patients were included. In cohort 1, plasma and buffy coat leukocytes were collected from 53 STEMI patients at the time of arterial puncture for percutaneous coronary intervention, at 24–48 hours post STEMI and at 3 months post STEMI. Gene expression in leukocytes was determined in 51 patients with Affymetrix Human Transcriptome Array 2.0. In cohort 2, plasma was collected from 82 STEMI patients at admission and at 6 months for determination of plasma arginase-1. These patients underwent cardiac magnetic resonance imaging performed at day 4–7 and at 6 months post STEMI. Plasma arginase-1 levels were quantified with ELISA. Control blood samples were collected from 56 healthy age matched subjects. In cohort 1, ARG1 gene expression was four-fold higher in STEMI patients at admission compared to controls (Figure A). This expression returned to control levels within 3 months. Plasma arginase-1 levels were two times higher in STEMI patients at admission compared to controls, and remained elevated at 24–48 hours and at 3 months post STEMI (Figure B). The increase in plasma arginase-1 in STEMI patients was confirmed in cohort 2 (Figure C). Arginase-1 levels did not correlate with infarct size.
Conclusions
STEMI patients demonstrate increased gene expression and plasma levels of arginase-1 in the acute setting. In contrast to gene expression plasma arginase-1 levels remain significantly elevated over time. The markedly increased expression of arginase-1 already at admission may suggest a mechanistic role of arginase-1 in the development of STEMI. Further studies are needed to elucidate whether increased expression, induction and activity of arginase-1 are contributing factors for the development of STEMI.
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Affiliation(s)
- J Tengbom
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - S Cederstrom
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - D Verouhis
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - P Sorensson
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - F Bohm
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - N Saleh
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - T Jernberg
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - P Lundman
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - P Eriksson
- Karolinska Institute, Department of Medicine, Solna (MedS), Karolinska University Hospital, Stockholm, Sweden
| | - A Gabrielsen
- Karolinska Institute, Department of Medicine, Solna (MedS), Karolinska University Hospital, Stockholm, Sweden
| | - K Caidahl
- Karolinska Institute, Department of Molecular Medicine and Surgery (MMK), Stockholm, Sweden
| | - J Persson
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | | | - P Tornvall
- Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset (KI SÖS), Stockholm, Sweden
| | - J Pernow
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
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14
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Kirkegård J, Aahlin EK, Al-Saiddi M, Bratlie SO, Coolsen M, de Haas RJ, den Dulk M, Fristrup C, Harrison EM, Mortensen MB, Nijkamp MW, Persson J, Søreide JA, Wigmore SJ, Wik T, Mortensen FV. Multicentre study of multidisciplinary team assessment of pancreatic cancer resectability and treatment allocation. Br J Surg 2019; 106:756-764. [PMID: 30830974 DOI: 10.1002/bjs.11093] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/09/2018] [Accepted: 11/26/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Multidisciplinary team (MDT) meetings have been adopted widely to ensure optimal treatment for patients with cancer. Agreements in tumour staging, resectability assessments and treatment allocation between different MDTs were assessed. METHODS Of all patients referred to one hospital, 19 patients considered to have non-metastatic pancreatic cancer for evaluation were selected randomly for a multicentre study of MDT decisions in seven units across Northern Europe. Anonymized clinical information and radiological images were disseminated to the MDTs. All patients were reviewed by the MDTs for radiological T, N and M category, resectability assessment and treatment allocation. Each MDT was blinded to the decisions of other teams. Agreements were expressed as raw percentages and Krippendorff's α values, both with 95 per cent confidence intervals. RESULTS A total of 132 evaluations in 19 patients were carried out by the seven MDTs (1 evaluation was excluded owing to technical problems). The level of agreement for T, N and M categories ranged from moderate to near perfect (46·8, 61·1 and 82·8 per cent respectively), but there was substantial variation in assessment of resectability; seven patients were considered to be resectable by one MDT but unresectable by another. The MDTs all agreed on either a curative or palliative strategy in less than half of the patients (9 of 19). Only fair agreement in treatment allocation was observed (Krippendorff's α 0·31, 95 per cent c.i. 0·16 to 0·45). There was a high level of agreement in treatment allocation where resectability assessments were concordant. CONCLUSION Considerable disparities in MDT evaluations of patients with pancreatic cancer exist, including substantial variation in resectability assessments.
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Affiliation(s)
- J Kirkegård
- Department of Surgery, Hepatopancreatobiliary (HPB) Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - E K Aahlin
- Department of Gastrointestinal and HPB Surgery, University Hospital of Northern Norway, Breivika, Norway
| | - M Al-Saiddi
- Department of Radiology, Stavanger University Hospital, Stavanger, Norway
| | - S O Bratlie
- Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M Coolsen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - R J de Haas
- Department of Radiology, University Medical Centre Groningen, Groningen, the Netherlands
| | - M den Dulk
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Surgery, RWTH University Hospital, Aachen, Germany
| | - C Fristrup
- Odense Pancreas Centre, Department of Surgical Gastroenterology, Odense University Hospital, Odense, Denmark
| | - E M Harrison
- Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - M B Mortensen
- Odense Pancreas Centre, Department of Surgical Gastroenterology, Odense University Hospital, Odense, Denmark
| | - M W Nijkamp
- Department of Surgery, University Medical Centre Groningen, Groningen, the Netherlands
| | - J Persson
- Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - J A Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - S J Wigmore
- Department of Clinical Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - T Wik
- Department of Radiology, University Hospital of Northern Norway, Breivika, Norway
| | - F V Mortensen
- Department of Surgery, Hepatopancreatobiliary (HPB) Research Unit, Aarhus University Hospital, Aarhus, Denmark
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15
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Persson J, Struckmann W, Gingnell M, Bodén R. Depressive symptoms reduction following intermittent theta burst stimulation over dorsomedial prefrontal cortex is related to resting-state connectivity modulation: Preliminary findings from a double blinded sham controlled trial. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.630] [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: 11/16/2022] Open
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16
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Ueda P, Bodil Svennblad B, James S, Alfredsson J, Erlinge D, Omerovic E, Persson J, Ravn-Fischer A, Tornvall P, Jernberg T, Varenhorst C. 1400External validation of the DAPT score in nationwide real-world data: ischemic and bleeding events following coronary stent implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/13/2022] Open
Affiliation(s)
- P Ueda
- Karolinska Institute, Clinical Epidemiology Unit, Department of Medicine, Stockholm, Sweden
| | | | - S James
- Uppsala Clinical Research Center, Uppsala, Sweden
| | - J Alfredsson
- Linkoping University Hospital, Linkoping, Sweden
| | - D Erlinge
- Skane University Hospital, Lund, Sweden
| | | | - J Persson
- Danderyd University Hospital, Stockholm, Sweden
| | | | - P Tornvall
- South Hospital Stockholm, Stockholm, Sweden
| | - T Jernberg
- Danderyd University Hospital, Stockholm, Sweden
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17
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Young R, Bekele T, Gunn A, Chapman N, Chowdhary V, Corrigan K, Dahora L, Martinez S, Permar S, Persson J, Rodriguez B, Schäferhoff M, Schulman K, Singh T, Terry RF, Yamey G. Developing new health technologies for neglected diseases: a pipeline portfolio review and cost model. Gates Open Res 2018; 2:23. [PMID: 30234193 DOI: 10.12688/gatesopenres.12817.2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 08/15/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Funding for neglected disease product development fell from 2009-2015, other than a brief injection of Ebola funding. One impediment to mobilizing resources is a lack of information on product candidates, the estimated costs to move them through the pipeline, and the likelihood of specific launches. This study aimed to help fill these information gaps. Methods: We conducted a pipeline portfolio review to identify current candidates for 35 neglected diseases. Using an adapted version of the Portfolio to Impact financial modelling tool, we estimated the costs to move these candidates through the pipeline over the next decade and the likely launches. Since the current pipeline is unlikely to yield several critical products, we estimated the costs to develop a set of priority "missing" products. Results: We found 685 neglected disease product candidates as of August 31, 2017; 538 candidates met inclusion criteria for input into the model. It would cost about $16.3 billion (range $13.4-19.8B) to move these candidates through the pipeline, with three-quarters of the costs incurred in the first 5 years, resulting in about 128 (89-160) expected product launches. Based on the current pipeline, there would be few launches of complex new chemical entities; launches of highly efficacious HIV, tuberculosis, or malaria vaccines would be unlikely. Estimated additional costs to launch one of each of 18 key missing products are $13.6B assuming lowest product complexity or $21.8B assuming highest complexity ($8.1B-36.6B). Over the next 5 years, total estimated costs to move current candidates through the pipeline and develop these 18 missing products would be around $4.5B (low complexity missing products) or $5.8B/year (high complexity missing products). Conclusions: Since current annual global spending on product development is about $3B, this study suggests the annual funding gap over the next 5 years is at least $1.5-2.8B.
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Affiliation(s)
- Ruth Young
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Tewodros Bekele
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Alexander Gunn
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Nick Chapman
- Policy Cures Research, Sydney, NSW, 2010, Australia
| | | | | | - Lindsay Dahora
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA.,Department of Immunology, Duke University, Durham, NC, 27710, USA
| | | | - Sallie Permar
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA.,Children's Health and Discovery Institute; Department of Pediatrics, Duke University, Durham, NC, 27710, USA
| | | | - Bill Rodriguez
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | | | - Kevin Schulman
- Duke Clinical Research Institute, Duke University, Durham, NC, 27715, USA
| | - Tulika Singh
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA.,Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, 27710, USA
| | - Robert F Terry
- The Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, CH-1211, Switzerland
| | - Gavin Yamey
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
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18
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Young R, Bekele T, Gunn A, Chapman N, Chowdhary V, Corrigan K, Dahora L, Martinez S, Permar S, Persson J, Rodriguez B, Schäferhoff M, Schulman K, Singh T, Terry RF, Yamey G. Developing new health technologies for neglected diseases: a pipeline portfolio review and cost model. Gates Open Res 2018. [PMID: 30234193 DOI: 10.12688/gatesopenres.12817.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 01/26/2023] Open
Abstract
Background: Funding for neglected disease product development fell from 2009-2015, other than a brief injection of Ebola funding. One impediment to mobilizing resources is a lack of information on product candidates, the estimated costs to move them through the pipeline, and the likelihood of specific launches. This study aimed to help fill these information gaps. Methods: We conducted a pipeline portfolio review to identify current candidates for 35 neglected diseases. Using an adapted version of the Portfolio to Impact financial modelling tool, we estimated the costs to move these candidates through the pipeline over the next decade and the likely launches. Since the current pipeline is unlikely to yield several critical products, we estimated the costs to develop a set of priority "missing" products. Results: We found 685 neglected disease product candidates as of August 31, 2017; 538 candidates met inclusion criteria for input into the model. It would cost about $16.3 billion (range $13.4-19.8B) to move these candidates through the pipeline, with three-quarters of the costs incurred in the first 5 years, resulting in about 128 (89-160) expected product launches. Based on the current pipeline, there would be few launches of complex new chemical entities; launches of highly efficacious HIV, tuberculosis, or malaria vaccines would be unlikely. Estimated additional costs to launch one of each of 18 key missing products are $13.6B assuming lowest product complexity or $21.8B assuming highest complexity ($8.1B-36.6B). Over the next 5 years, total estimated costs to move current candidates through the pipeline and develop these 18 missing products would be around $4.5B (low complexity missing products) or $5.8B/year (high complexity missing products). Conclusions: Since current annual global spending on product development is about $3B, this study suggests the annual funding gap over the next 5 years is at least $1.5-2.8B.
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Affiliation(s)
- Ruth Young
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Tewodros Bekele
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Alexander Gunn
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
| | - Nick Chapman
- Policy Cures Research, Sydney, NSW, 2010, Australia
| | | | | | - Lindsay Dahora
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA.,Department of Immunology, Duke University, Durham, NC, 27710, USA
| | | | - Sallie Permar
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA.,Children's Health and Discovery Institute; Department of Pediatrics, Duke University, Durham, NC, 27710, USA
| | | | - Bill Rodriguez
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | | | - Kevin Schulman
- Duke Clinical Research Institute, Duke University, Durham, NC, 27715, USA
| | - Tulika Singh
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710, USA.,Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, 27710, USA
| | - Robert F Terry
- The Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, CH-1211, Switzerland
| | - Gavin Yamey
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27710, USA
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19
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Cederstrom S, Lundman P, Folkersen L, Paulsson-Berne G, Eriksson P, Caidahl K, Gabrielsen A, Jernberg T, Persson J, Tornvall P. P3674New candidate genes for plaque rupture in myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3674] [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: 11/15/2022] Open
Affiliation(s)
- S Cederstrom
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital (KI DS), Stockholm, Sweden
| | - P Lundman
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital (KI DS), Stockholm, Sweden
| | - L Folkersen
- Karolinska Institute, Department of Medicine, Solna (MedS), Karolinska University Hospital, Stockholm, Sweden
| | - G Paulsson-Berne
- Karolinska Institute, Department of Medicine, Solna (MedS), Karolinska University Hospital, Stockholm, Sweden
| | - P Eriksson
- Karolinska Institute, Department of Medicine, Solna (MedS), Karolinska University Hospital, Stockholm, Sweden
| | - K Caidahl
- Karolinska Institute, Department of Molecular Medicine and Surgery (MMK), Stockholm, Sweden
| | - A Gabrielsen
- Karolinska Institute, Department of Medicine, Solna (MedS), Karolinska University Hospital, Stockholm, Sweden
| | - T Jernberg
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital (KI DS), Stockholm, Sweden
| | - J Persson
- Karolinska Institute, Department of Clinical Sciences, Danderyd Hospital (KI DS), Stockholm, Sweden
| | - P Tornvall
- Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset (KI SÖS), Stockholm, Sweden
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20
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Biniskos N, Schmalzl K, Raymond S, Petit S, Steffens P, Persson J, Brückel T. Spin Fluctuations Drive the Inverse Magnetocaloric Effect in Mn_{5}Si_{3}. Phys Rev Lett 2018; 120:257205. [PMID: 29979049 DOI: 10.1103/physrevlett.120.257205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Indexed: 06/08/2023]
Abstract
Inelastic neutron scattering measurements are performed on single crystals of the antiferromagnetic compound Mn_{5}Si_{3} in order to investigate the relation between the spin dynamics and the magnetothermodynamics properties. It is shown that, among the two stable antiferromagnetic phases of this compound, the high temperature one has an unusual magnetic excitation spectrum where propagative spin waves and diffuse spin fluctuations coexist. Moreover, it is evidenced that the inverse magnetocaloric effect of Mn_{5}Si_{3}, the cooling by adiabatic magnetization, is associated with field induced spin fluctuations.
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Affiliation(s)
- N Biniskos
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science at ILL, 71 avenue des Martyrs, 38000 Grenoble, France
- Université Grenoble Alpes, CEA, INAC, MEM, 38000 Grenoble, France
| | - K Schmalzl
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science at ILL, 71 avenue des Martyrs, 38000 Grenoble, France
| | - S Raymond
- Université Grenoble Alpes, CEA, INAC, MEM, 38000 Grenoble, France
| | - S Petit
- Laboratoire Léon Brillouin, CEA, CNRS, Université Paris-Saclay, CE-Saclay, F-91191 Gif sur Yvette, France
| | - P Steffens
- Institut Laue-Langevin, 71 avenue des Martyrs, 38000 Grenoble, France
| | - J Persson
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science (JCNS-2) and Peter Grünberg Institut (PGI-4), JARA-FIT, 52425 Jülich, Germany
| | - T Brückel
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science (JCNS-2) and Peter Grünberg Institut (PGI-4), JARA-FIT, 52425 Jülich, Germany
- Forschungszentrum Jülich GmbH, Jülich Centre for Neutron Science at MLZ, Lichtenbergstrasse 1, 85748 Garching, Germany
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La Fleur L, Boura VF, Alexeyenko A, Berglund A, Pontén V, Mattsson JSM, Djureinovic D, Persson J, Brunnström H, Isaksson J, Brandén E, Koyi H, Micke P, Karlsson MCI, Botling J. Expression of scavenger receptor MARCO defines a targetable tumor-associated macrophage subset in non-small cell lung cancer. Int J Cancer 2018; 143:1741-1752. [PMID: 29667169 DOI: 10.1002/ijc.31545] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/14/2018] [Accepted: 03/28/2018] [Indexed: 12/14/2022]
Abstract
Tumor-associated macrophages (TAMs) are attractive targets for immunotherapy. Recently, studies in animal models showed that treatment with an anti-TAM antibody directed against the scavenger receptor MARCO resulted in suppression of tumor growth and metastatic dissemination. Here we investigated the expression of MARCO in relation to other macrophage markers and immune pathways in a non-small cell lung cancer (NSCLC) cohort (n = 352). MARCO, CD68, CD163, MSR1 and programmed death ligand-1 (PD-L1) were analyzed by immunohistochemistry and immunofluorescence, and associations to other immune cells and regulatory pathways were studied in a subset of cases (n = 199) with available RNA-seq data. We observed a large variation in macrophage density between cases and a strong correlation between CD68 and CD163, suggesting that the majority of TAMs present in NSCLC exhibit a protumor phenotype. Correlation to clinical data only showed a weak trend toward worse survival for patients with high macrophage infiltration. Interestingly, MARCO was expressed on a distinct subpopulation of TAMs, which tended to aggregate in close proximity to tumor cell nests. On the transcriptomic level, we found a positive association between MARCO gene expression and general immune response pathways including strong links to immunosuppressive TAMs, T-cell infiltration and immune checkpoint molecules. Indeed, a higher macrophage infiltration was seen in tumors expressing PD-L1, and macrophages residing within tumor cell nests co-expressed MARCO and PD-L1. Thus, MARCO is a potential new immune target for anti-TAM treatment in a subset of NSCLC patients, possibly in combination with available immune checkpoint inhibitors.
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Affiliation(s)
- Linnéa La Fleur
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Vanessa F Boura
- Department of Microbiology, Tumor and Cell biology, Karolinska institutet, Stockholm, Sweden
| | - Andrey Alexeyenko
- Department of Microbiology, Tumor and Cell biology, Karolinska institutet, Stockholm, Sweden.,Science for Life Laboratory, National Bioinformatics Infrastructure Sweden, Solna, Sweden
| | | | - Victor Pontén
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Johanna S M Mattsson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Dijana Djureinovic
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Johan Persson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Hans Brunnström
- Division of Pathology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Johan Isaksson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden.,Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden.,County Council of Gävleborg, Centre for Research and Development, Uppsala University, Uppsala, Sweden
| | - Eva Brandén
- Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden.,County Council of Gävleborg, Centre for Research and Development, Uppsala University, Uppsala, Sweden
| | - Hirsh Koyi
- Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden.,County Council of Gävleborg, Centre for Research and Development, Uppsala University, Uppsala, Sweden
| | - Patrick Micke
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Mikael C I Karlsson
- Department of Microbiology, Tumor and Cell biology, Karolinska institutet, Stockholm, Sweden
| | - Johan Botling
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
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22
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Persson J, Helgason B, Engqvist H, Ferguson SJ, Persson C. Stiffness and strength of cranioplastic implant systems in comparison to cranial bone. J Craniomaxillofac Surg 2018; 46:418-423. [DOI: 10.1016/j.jcms.2017.11.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 11/17/2017] [Accepted: 11/28/2017] [Indexed: 11/17/2022] Open
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23
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Grindefjord M, Persson J, Jansson L, Tsilingaridis G. Dental treatment and caries prevention preceding treatment under general anaesthesia in healthy children and adolescents: a retrospective cohort study. Eur Arch Paediatr Dent 2018; 19:99-105. [PMID: 29480502 PMCID: PMC5893663 DOI: 10.1007/s40368-018-0332-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 09/19/2017] [Indexed: 12/29/2022]
Abstract
AIM This was to examine healthy children and adolescents treated under general anaesthesia (GA) and a matched control group not receiving GA to compare treatment and preventive care received prior to GA treatment. METHODS This retrospective cohort study included 71 healthy subjects and 213 age- and gender-matched control subjects. The treatment group had been consecutively referred from the Public Dental Health Service (PDS) in Stockholm to the Department of Paediatric Dentistry, Eastman Institute, Stockholm during 2006-2007. Data was extracted from the patient records at the PDS, including variables such as number of dental visits, treatment/prophylaxis prior to GA, number of missed and cancelled appointments, and number of decayed teeth. RESULTS On average, the treatment group had significantly more decayed teeth (p < 0.001) than the control group. Furthermore, the treatment group had significantly more restorations (p < 0.01), had visited the dentist significantly more often (p < 0.001), and had undergone significantly more behaviour management treatment and preventive treatment (p < 0.001). In the treatment group 65% of the children and adolescents, had received no behaviour management treatment and 48%, no preventive treatment. CONCLUSIONS In the Stockholm PDS, over half of the children and adolescents referred by general dentists to paediatric specialists had no behaviour management treatment and nearly half, no preventive treatment, despite receiving significantly more operative treatment compared with matched controls. General dentists should target high caries-risk patients for additional behaviour management and preventive care to reduce the need for treatment under GA.
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Affiliation(s)
- M Grindefjord
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden.,Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - J Persson
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - L Jansson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Department of Periodontology, Public Dental Health Services, Eastmaninstitutet, Stockholm, Sweden
| | - G Tsilingaridis
- Department of Pediatric Dentistry, Public Dental Health Services, Eastmaninstitutet, Dalagatan 11, 113 24, Stockholm, Sweden. .,Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Center of Pediatric Oral Health, Stockholm, Sweden.
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Wigertz O, Persson J, Ahlfeldt H. Teaching Medical Informatics to Biomedical Engineering Students: Experiences over 15 Years. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636807] [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] [Indexed: 10/17/2022]
Abstract
Abstract:The Departments of Biomedical Engineering and Medical Informatics at Linkoping University in Sweden were established in 1972-1973. The main purpose was to develop and offer courses in medicine, biomedical engineering and medical informatics to students in electrical engineering and computer science, for a specialization in biomedical engineering and medical informatics. The courses total about 400 hours of scheduled study in the subjects of basic cell biology, basic medicine (terminology, anatomy, physiology), biomedical engineering and medical informatics. Laboratory applications of medical computing are mainly taught in biomedical engineering courses, whereas clinical information systems, knowledge based decision support and computer science aspects are included within the medical informatics courses.
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Lagesson A, Brodin T, Fahlman J, Fick J, Jonsson M, Persson J, Byström P, Klaminder J. No evidence of increased growth or mortality in fish exposed to oxazepam in semi-natural ecosystems. Sci Total Environ 2018; 615:608-614. [PMID: 28988097 DOI: 10.1016/j.scitotenv.2017.09.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 06/26/2017] [Revised: 09/07/2017] [Accepted: 09/07/2017] [Indexed: 05/14/2023]
Abstract
An increasing number of short-term laboratory studies on fish reports behavioral effects from exposure to aquatic contaminants or raised carbon dioxide levels affecting the GABAA receptor. However, how such GABAergic behavioral modifications (GBMs) impact populations in more complex natural systems is not known. In this study, we induced GBMs in European perch (Perca fluviatilis) via exposure to a GABA agonist (oxazepam) and followed the effects on growth and survival over one summer (70days) in replicated pond ecosystems. We hypothesized that anticipated GBMs, expressed as anti-anxiety like behaviors (higher activity and boldness levels), that increase feeding rates in laboratory assays, would; i) increase growth and ii) increase mortality from predation. To test our hypotheses, 480 PIT tagged perch of known individual weights, and 12 predators (northern pike, Esox lucius) were evenly distributed in 12 ponds; six control (no oxazepam) and six spiked (15.5±4μgl-1 oxazepam [mean±1S.E.]) ponds. Contrary to our hypotheses, even though perch grew on average 16% more when exposed to oxazepam, we found no significant difference between exposed and control fish in growth (exposed: 3.9±1.2g, control: 2.9±1g [mean±1S.E.], respectively) or mortality (exposed: 26.5±1.8individuals pond-1, control: 24.5±2.6individuals pond-1, respectively). In addition, we show that reduced prey capture efficiency in exposed pike may explain the lack of significant differences in predation. Hence, our results suggest that GBMs, which in laboratory studies impact fish behavior, and subsequently also feeding rates, do not seem to generate strong effects on growth and predation-risk in more complex and resource limited natural environments.
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Affiliation(s)
- A Lagesson
- Department of Ecology and Environmental Science, Umeå University, 90187 Umeå, Sweden.
| | - T Brodin
- Department of Ecology and Environmental Science, Umeå University, 90187 Umeå, Sweden
| | - J Fahlman
- Department of Ecology and Environmental Science, Umeå University, 90187 Umeå, Sweden
| | - J Fick
- Department of Chemistry, Umeå University, 90187 Umeå, Sweden
| | - M Jonsson
- Department of Ecology and Environmental Science, Umeå University, 90187 Umeå, Sweden
| | - J Persson
- Department of Ecology and Environmental Science, Umeå University, 90187 Umeå, Sweden
| | - P Byström
- Department of Ecology and Environmental Science, Umeå University, 90187 Umeå, Sweden
| | - J Klaminder
- Department of Ecology and Environmental Science, Umeå University, 90187 Umeå, Sweden
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Rosén H, Persson J, Rantala A, Behm L. “A call for a clear assignment” – A focus group study of the ambulance service in Sweden, as experienced by present and former employees. Int Emerg Nurs 2018; 36:1-6. [DOI: 10.1016/j.ienj.2017.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/25/2017] [Accepted: 07/01/2017] [Indexed: 11/26/2022]
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Backman M, Kurppa P, Djureinovic D, La Fleur L, Persson J, Mattsson J, Botling J, Branden E, Koyi H, Ponten F, Micke P. MA 06.01 Cancer Testis Antigens and Mutational Load in Relation to the Immune Landscape of Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.490] [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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28
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La Fleur L, Boura V, Berglund A, Mattsson J, Djureinovic D, Persson J, Brunnström H, Isaksson J, Branden E, Koyi H, Micke P, Karlsson M, Botling J. MA 05.13 Scavenger Receptor MARCO Defines a Targetable Tumor-Associated Macrophage Subset in Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.488] [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: 10/18/2022]
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29
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Winbo A, Stattin EL, Westin IM, Norberg A, Persson J, Jensen SM, Rydberg A. Sex is a moderator of the association between NOS1AP sequence variants and QTc in two long QT syndrome founder populations: a pedigree-based measured genotype association analysis. BMC Med Genet 2017; 18:74. [PMID: 28720088 PMCID: PMC5516337 DOI: 10.1186/s12881-017-0435-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/06/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Sequence variants in the NOS1AP gene have repeatedly been reported to influence QTc, albeit with moderate effect sizes. In the long QT syndrome (LQTS), this may contribute to the substantial QTc variance seen among carriers of identical pathogenic sequence variants. Here we assess three non-coding NOS1AP sequence variants, chosen for their previously reported strong association with QTc in normal and LQTS populations, for association with QTc in two Swedish LQT1 founder populations. METHODS This study included 312 individuals (58% females) from two LQT1 founder populations, whereof 227 genotype positive segregating either Y111C (n = 148) or R518* (n = 79) pathogenic sequence variants in the KCNQ1 gene, and 85 genotype negatives. All were genotyped for NOS1AP sequence variants rs12143842, rs16847548 and rs4657139, and tested for association with QTc length (effect size presented as mean difference between derived and wildtype, in ms), using a pedigree-based measured genotype association analysis. Mean QTc was obtained by repeated manual measurement (preferably in lead II) by one observer using coded 50 mm/s standard 12-lead ECGs. RESULTS A substantial variance in mean QTc was seen in genotype positives 476 ± 36 ms (Y111C 483 ± 34 ms; R518* 462 ± 34 ms) and genotype negatives 433 ± 24 ms. Female sex was significantly associated with QTc prolongation in all genotype groups (p < 0.001). In a multivariable analysis including the entire study population and adjusted for KCNQ1 genotype, sex and age, NOS1AP sequence variants rs12143842 and rs16847548 (but not rs4657139) were significantly associated with QT prolongation, +18 ms (p = 0.0007) and +17 ms (p = 0.006), respectively. Significant sex-interactions were detected for both sequent variants (interaction term r = 0.892, p < 0.001 and r = 0.944, p < 0.001, respectively). Notably, across the genotype groups, when stratified by sex neither rs12143842 nor rs16847548 were significantly associated with QTc in females (both p = 0.16) while in males, a prolongation of +19 ms and +8 ms (p = 0.002 and p = 0.02) was seen in multivariable analysis, explaining up to 23% of QTc variance in all males. CONCLUSIONS Sex was identified as a moderator of the association between NOS1AP sequence variants and QTc in two LQT1 founder populations. This finding may contribute to QTc sex differences and affect the usefulness of NOS1AP as a marker for clinical risk stratification in LQTS.
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Affiliation(s)
- Annika Winbo
- Department of Clinical Sciences, Pediatrics, Umeå University, 90187, Umeå, Sweden. .,Department of Physiology, University of Auckland, Auckland, New Zealand.
| | - Eva-Lena Stattin
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ida Maria Westin
- Department of Medical Biosciences, Medical and Clinical Genetics, Umeå University, Umeå, 90185, Sweden
| | - Anna Norberg
- Department of Medical Biosciences, Medical and Clinical Genetics, Umeå University, Umeå, 90185, Sweden
| | - Johan Persson
- Department of Clinical Sciences, Pediatrics, Umeå University, 90187, Umeå, Sweden
| | - Steen M Jensen
- Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, Umeå, 90185, Sweden
| | - Annika Rydberg
- Department of Clinical Sciences, Pediatrics, Umeå University, 90187, Umeå, Sweden
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Mölder AL, Persson J, El-Schich Z, Czanner S, Gjörloff-Wingren A. Supervised classification of etoposide-treated in vitro adherent cells based on noninvasive imaging morphology. J Med Imaging (Bellingham) 2017; 4:021106. [PMID: 28382315 DOI: 10.1117/1.jmi.4.2.021106] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 02/20/2017] [Indexed: 11/14/2022] Open
Abstract
Single-cell studies using noninvasive imaging is a challenging, yet appealing way to study cellular characteristics over extended periods of time, for instance to follow cell interactions and the behavior of different cell types within the same sample. In some cases, e.g., transplantation culturing, real-time cellular monitoring, stem cell studies, in vivo studies, and embryo growth studies, it is also crucial to keep the sample intact and invasive imaging using fluorophores or dyes is not an option. Computerized methods are needed to improve throughput of image-based analysis and for use with noninvasive microscopy such methods are poorly developed. By combining a set of well-documented image analysis and classification tools with noninvasive microscopy, we demonstrate the ability for long-term image-based analysis of morphological changes in single cells as induced by a toxin, and show how these changes can be used to indicate changes in biological function. In this study, adherent cell cultures of DU-145 treated with low-concentration (LC) etoposide were imaged during 3 days. Single cells were identified by image segmentation and subsequently classified on image features, extracted for each cell. In parallel with image analysis, an MTS assay was performed to allow comparison between metabolic activity and morphological changes after long-term low-level drug response. Results show a decrease in proliferation rate for LC etoposide, accompanied by changes in cell morphology, primarily leading to an increase in cell area and textural changes. It is shown that changes detected by image analysis are already visible on day 1 for [Formula: see text] etoposide, whereas effects on MTS and viability are detected only on day 3 for [Formula: see text] etoposide concentration, leading to the conclusion that the morphological changes observed occur before and at lower concentrations than a reduction in cell metabolic activity or viability. Three classifiers are compared and we report a best case sensitivity of 88% and specificity of 94% for classification of cells as treated/untreated.
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Affiliation(s)
- Anna Leida Mölder
- Manchester Metropolitan University , School of Computing, Mathematics and Digital Technology, Faculty of Science and Engineering, Manchester, United Kingdom
| | - Johan Persson
- Malmö University , Department of Biomedical Science, Health and Society, Malmö, Sweden
| | - Zahra El-Schich
- Malmö University , Department of Biomedical Science, Health and Society, Malmö, Sweden
| | - Silvester Czanner
- Manchester Metropolitan University , School of Computing, Mathematics and Digital Technology, Faculty of Science and Engineering, Manchester, United Kingdom
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Bodén R, Persson J, Wall A, Lubberink M, Ekselius L, Larsson EM, Antoni G. Striatal phosphodiesterase 10A and medial prefrontal cortical thickness in patients with schizophrenia: a PET and MRI study. Transl Psychiatry 2017; 7:e1050. [PMID: 28267149 PMCID: PMC5416662 DOI: 10.1038/tp.2017.11] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/16/2016] [Indexed: 11/09/2022] Open
Abstract
The enzyme phosphodiesterase 10A (PDE10A) is abundant in striatal medium spiny neurons and has been implicated in the pathophysiology of schizophrenia in animal models and is investigated as a possible new pharmacological treatment target. A reduction of prefrontal cortical thickness is common in schizophrenia, but how this relates to PDE10A expression is unknown. Our study aim was to compare, we believe for the first time, the striatal non-displaceable binding potential (BPND) of the new validated PDE10A ligand [11C]Lu AE92686 between patients with schizophrenia and healthy controls. Furthermore, we aimed to assess the correlation of PDE10A BPND to cortical thickness. Sixteen healthy male controls and 10 male patients with schizophrenia treated with clozapine, olanzapine or quetiapine were investigated with positron emission tomography (PET) and magnetic resonance imaging (MRI). Striatal binding potential (BPND) of [11C]Lu AE92686 was acquired through dynamic PET scans and cortical thickness by structural MRI. Clinical assessments of symptoms and cognitive function were performed and the antipsychotic dosage was recorded. Patients with schizophrenia had a significantly lower BPND of [11C]Lu AE92686 in striatum (P=0.003) than healthy controls. The striatal BPND significantly correlated to cortical thickness in the medial prefrontal cortex and superior frontal gyrus across patients with schizophrenia and healthy controls. No significant correlation was observed between the BPND for [11C]Lu AE92686 in striatum and age, schizophrenia symptoms, antipsychotic dosage, coffee consumption, smoking, duration of illness or cognitive function in the patients. In conclusion, PDE10A may be important for functioning in the striato-cortical interaction and in the pathophysiology of schizophrenia.
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Affiliation(s)
- R Bodén
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - J Persson
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - A Wall
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - M Lubberink
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - L Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - E-M Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - G Antoni
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden,Department of Medicinal Chemistry, Uppsala University PET Centre, Uppsala University Hospital, Uppsala SE-751 85, Sweden. E-mail:
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Schwieler Å, Sjögren LH, Törnqvist H, Sandberg C, Westin T, Persson J, Stalfors J, Melén I, Wiberg A. Head and neck cancer videoconferences. J Telemed Telecare 2016. [DOI: 10.1258/1357633001934889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Å Schwieler
- Spri, Swedish Institute for Health Services Development
| | - L H Sjögren
- Spri, Swedish Institute for Health Services Development
| | - H Törnqvist
- Spri, Swedish Institute for Health Services Development
| | - C Sandberg
- Spri, Swedish Institute for Health Services Development
| | - T Westin
- †Western Health-Care Region, Sweden
| | | | | | - I Melén
- †Western Health-Care Region, Sweden
| | - A Wiberg
- †Western Health-Care Region, Sweden
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Aronsson M, Persson J. Mismatch between goals and the scale of actions constrains adaptive carnivore management: the case of the wolverine in Sweden. Anim Conserv 2016. [DOI: 10.1111/acv.12310] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Aronsson
- Grimsö Wildlife Research Station; Department of Ecology; Swedish University of Agricultural Sciences; Riddarhyttan Sweden
| | - J. Persson
- Grimsö Wildlife Research Station; Department of Ecology; Swedish University of Agricultural Sciences; Riddarhyttan Sweden
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Keplinger M, Grifone R, Greil J, Kriegner D, Persson J, Lugstein A, Schülli T, Stangl J. Strain distribution in single, suspended germanium nanowires studied using nanofocused x-rays. Nanotechnology 2016; 27:055705. [PMID: 26753909 DOI: 10.1088/0957-4484/27/5/055705] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Within the quest for direct band-gap group IV materials, strain engineering in germanium is one promising route. We present a study of the strain distribution in single, suspended germanium nanowires using nanofocused synchrotron radiation. Evaluating the probed Bragg reflection for different illumination positions along the nanowire length results in corresponding strain components as well as the nanowire's tilting and bending. By using these findings we determined the complete strain state with the help of finite element modelling. The resulting information provides us with the possibility of evaluating the validity of the strain investigations following from Raman scattering experiments which are based on the assumption of purely uniaxial strain.
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Affiliation(s)
- Mario Keplinger
- Institut für Halbleiter- und Festkörperphysik, Johannes Kepler Universität Linz, Altenbergerstraße 69, 4040 Linz, Austria
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Beyer I, van Rensburg R, Strauss R, Li Z, Wang H, Persson J, Yumul R, Feng Q, Song H, Bartek J, Fender P, Fehm T, Lieber A. Kombinationstherapie mit dem epithelialen „junction opener“ JO-1 verbessert die Wirksamkeit von monoklonalen Antikörpern oder Chemotherapeutika bei Karzinomen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0035-1570040] [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: 10/22/2022] Open
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Winbo A, Fosdal I, Lindh M, Diamant UB, Persson J, Wettrell G, Rydberg A. Third Trimester Fetal Heart Rate Predicts Phenotype and Mutation Burden in the Type 1 Long QT Syndrome. Circ Arrhythm Electrophysiol 2015; 8:806-14. [DOI: 10.1161/circep.114.002552] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 05/08/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Annika Winbo
- From the Department of Clinical Sciences, Pediatrics (A.W., M.L., J.P., A.R.) and Department of Public Health and Clinical Medicine, Heart Centre (U.-B.D.), Umeå University, Umeå, Sweden; Pediatric Clinic, Visby Hospital, Visby, Sweden (I.F.); Department of Pediatrics and Pediatric Cardiology, University of Lund, Lund, Sweden (G.W.); and Department of Physiology, University of Auckland, Auckland, New Zealand (A.W.)
| | - Inger Fosdal
- From the Department of Clinical Sciences, Pediatrics (A.W., M.L., J.P., A.R.) and Department of Public Health and Clinical Medicine, Heart Centre (U.-B.D.), Umeå University, Umeå, Sweden; Pediatric Clinic, Visby Hospital, Visby, Sweden (I.F.); Department of Pediatrics and Pediatric Cardiology, University of Lund, Lund, Sweden (G.W.); and Department of Physiology, University of Auckland, Auckland, New Zealand (A.W.)
| | - Maria Lindh
- From the Department of Clinical Sciences, Pediatrics (A.W., M.L., J.P., A.R.) and Department of Public Health and Clinical Medicine, Heart Centre (U.-B.D.), Umeå University, Umeå, Sweden; Pediatric Clinic, Visby Hospital, Visby, Sweden (I.F.); Department of Pediatrics and Pediatric Cardiology, University of Lund, Lund, Sweden (G.W.); and Department of Physiology, University of Auckland, Auckland, New Zealand (A.W.)
| | - Ulla-Britt Diamant
- From the Department of Clinical Sciences, Pediatrics (A.W., M.L., J.P., A.R.) and Department of Public Health and Clinical Medicine, Heart Centre (U.-B.D.), Umeå University, Umeå, Sweden; Pediatric Clinic, Visby Hospital, Visby, Sweden (I.F.); Department of Pediatrics and Pediatric Cardiology, University of Lund, Lund, Sweden (G.W.); and Department of Physiology, University of Auckland, Auckland, New Zealand (A.W.)
| | - Johan Persson
- From the Department of Clinical Sciences, Pediatrics (A.W., M.L., J.P., A.R.) and Department of Public Health and Clinical Medicine, Heart Centre (U.-B.D.), Umeå University, Umeå, Sweden; Pediatric Clinic, Visby Hospital, Visby, Sweden (I.F.); Department of Pediatrics and Pediatric Cardiology, University of Lund, Lund, Sweden (G.W.); and Department of Physiology, University of Auckland, Auckland, New Zealand (A.W.)
| | - Göran Wettrell
- From the Department of Clinical Sciences, Pediatrics (A.W., M.L., J.P., A.R.) and Department of Public Health and Clinical Medicine, Heart Centre (U.-B.D.), Umeå University, Umeå, Sweden; Pediatric Clinic, Visby Hospital, Visby, Sweden (I.F.); Department of Pediatrics and Pediatric Cardiology, University of Lund, Lund, Sweden (G.W.); and Department of Physiology, University of Auckland, Auckland, New Zealand (A.W.)
| | - Annika Rydberg
- From the Department of Clinical Sciences, Pediatrics (A.W., M.L., J.P., A.R.) and Department of Public Health and Clinical Medicine, Heart Centre (U.-B.D.), Umeå University, Umeå, Sweden; Pediatric Clinic, Visby Hospital, Visby, Sweden (I.F.); Department of Pediatrics and Pediatric Cardiology, University of Lund, Lund, Sweden (G.W.); and Department of Physiology, University of Auckland, Auckland, New Zealand (A.W.)
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Kander T, Tanaka KA, Norström E, Persson J, Schött U. The effect and duration of prophylactic platelet transfusions before insertion of a central venous catheter in patients with bone marrow failure evaluated with point-of-care methods and flow cytometry. Anesth Analg 2014; 119:882-890. [PMID: 24854870 DOI: 10.1213/ane.0000000000000259] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Patients with bone marrow failure and severe thrombocytopenia are frequently given prophylactic platelet transfusion before interventions. The clinical effects of such transfusions, however, are poorly defined. We performed a prospective observational study on patients with bone marrow failure scheduled for prophylactic platelet transfusion before the insertion of a central venous catheter. The objectives were to evaluate the effect and duration of prophylactic platelet transfusions on central venous catheter insertion in thrombocytopenic patients with bone marrow failure. METHODS Thirty-nine adult patients with bone marrow failure and platelet counts below 50 × 10/L were consecutively enrolled before prophylactic platelet transfusion for subclavian central venous catheter insertion. Blood samples were drawn from the patients before platelet transfusion, 1 hour, and 4 hours after completion of the transfusion. The coagulation profile was assessed by conventional hematological tests, thromboelastometry (ROTEM) assays (EXTEM and FIBTEM), multiple electrode aggregometry (Multiplate) assays including adenosine diphosphate, collagen, and thrombin receptor agonist peptide, and by flow cytometry for the platelet expression of P-selectin (CD62P) and activated glycoprotein IIb-IIIa (PAC-1). Bleeding complications were classified with a 5-grade scale, according to the Common Terminology Criteria for Adverse Events. RESULTS Seventeen women and 22 men were included in the study. Platelet count was increased from 24 × 10/L (18-32) before to 42 × 10/L (31-50) 1 hour after transfusion (P < 0.0001) and was not significantly different 4 hours after transfusion (40 × 10/L (29-50), P = 0.047). Maximal clot firmness EXTEM was increased from 38 mm (32-45) before to 46 mm (41-52) 1 hour after transfusion (P < 0.0001) and did not change 4 hours after transfusion. Clotting time EXTEM was decreased from 58.5 seconds (50-78) beforehand to 53 seconds (45-61) 1 hour after transfusion (P = 0.0006) and was not significantly different 4 hours after transfusion (57 seconds (52-70, P = 0.025). FIBTEM results were all unchanged after transfusion. All Multiplate analyses were significantly increased after 1 hour and were not diminished 4 hours after transfusion. Four grade 1 bleeding episodes occurred, but no grade 2 to 5 bleeding could be detected. Flow cytometry analyses showed mixed results with no overall trend. CONCLUSIONS Prophylactic platelet transfusions in thrombocytopenic patients with bone marrow failure improve hemostatic parameters on ROTEM and Multiplate by increasing the number of platelets, and not through enhancement of platelet function. Improved clotting parameters on ROTEM and platelet aggregation on Multiplate appear to persist between 1 and 4 hours after transfusion.
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Affiliation(s)
- Thomas Kander
- From the *Department of Intensive and Perioperative Care, Skåne University Hospital and Lund University, Lund, Sweden; †Department of Anesthesiology, Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; ‡Clinical Chemistry, Malmö, Laboratory Medicine, Skåne, Sweden
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Ovchinnikova OA, Folkersen L, Persson J, Lindeman JHN, Ueland T, Aukrust P, Gavrisheva N, Shlyakhto E, Paulsson-Berne G, Hedin U, Olofsson PS, Hansson GK. The collagen cross-linking enzyme lysyl oxidase is associated with the healing of human atherosclerotic lesions. J Intern Med 2014; 276:525-36. [PMID: 24588843 DOI: 10.1111/joim.12228] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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] [Indexed: 12/17/2022]
Abstract
BACKGROUND Acute clinical complications of atherosclerosis such as myocardial infarction (MI) and ischaemic stroke are usually caused by thrombus formation on the ruptured plaque surface. Collagen, the main structural protein of the fibrous cap, provides mechanical strength to the atherosclerotic plaque. The integrity of the fibrous cap depends on collagen fibre cross-linking, a process controlled by the enzyme lysyl oxidase (LOX). METHODS AND RESULTS We studied atherosclerotic plaques from human carotid endarterectomies. LOX was strongly expressed in atherosclerotic lesions and detected in the regions with ongoing fibrogenesis. Higher LOX levels were associated with a more stable phenotype of the plaque. In the studied population, LOX mRNA levels in carotid plaques predicted the risk for future MI. Within the lesion, LOX mRNA levels correlated positively with levels of osteoprotegerin (OPG) and negatively with markers of immune activation. The amount of LOX-mediated collagen cross-links in plaques correlated positively also with serum levels of OPG. CONCLUSIONS Lysyl oxidase may contribute to the healing of atherosclerotic lesions and to the prevention of its lethal complications. Mediators of inflammation may control LOX expression in plaques and hence plaque stability.
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Affiliation(s)
- O A Ovchinnikova
- Department of Medicine, Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden; Almazov Federal Heart, Blood and Endocrinology Centre, St. Petersburg, Russia
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Kurzeder C, Persson J, du Bois A, Kannisto P, Bossmar T, Borgfeldt C, Heitz F, El Khalfaoui K, Traut A, Harter P. Robot assisted gynaecologic procedures in morbidly obese patients. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388284] [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: 10/24/2022] Open
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Winbo A, Stattin EL, Nordin C, Diamant UB, Persson J, Jensen SM, Rydberg A. Phenotype, origin and estimated prevalence of a common long QT syndrome mutation: a clinical, genealogical and molecular genetics study including Swedish R518X/KCNQ1 families. BMC Cardiovasc Disord 2014; 14:22. [PMID: 24552659 PMCID: PMC3942207 DOI: 10.1186/1471-2261-14-22] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 11/12/2013] [Accepted: 02/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The R518X/KCNQ1 mutation is a common cause of autosomal recessive (Jervell and Lange Nielsen Syndrome- JLNS) and autosomal dominant long QT syndrome (LQTS) worldwide. In Sweden p.R518X accounts for the majority of JLNS cases and is the second most common cause of LQTS. Here we investigate the clinical phenotype and origin of Swedish carriers of the p.R518X mutation. METHODS The study included 19 Swedish p.R518X index families, ascertained by molecular genetics methods (101 mutation-carriers, whereof 15 JLNS cases and 86 LQTS cases). In all families analyses included assessment of clinical data (symptoms, medications and manually measured electrocardiograms), genealogy (census records), haplotype (microsatellite markers) as well as assessment of mutation age and associated prevalence (ESTIAGE and DMLE computer software). RESULTS Clinical phenotype ranged from expectedly severe in JLNS to surprisingly benign in LQTS (QTc 576 ± 61 ms vs. 462 ± 34 ms, cumulative incidence of (aborted) cardiac arrest 47% vs. 1%, annual non-medicated incidence rate (aborted) cardiac arrest 4% vs. 0.04%).A common northern origin was found for 1701/1929 ancestors born 1650-1950. Historical geographical clustering in the coastal area of the Pite River valley was shown. A shared haplotype spanning the KCNQ1 gene was seen in 17/19 families. Mutation age was estimated to 28 generations (95% CI 19;41). A high prevalence of Swedish p.R518X heterozygotes was suggested (~1:2000-4000). CONCLUSIONS R518X/KCNQ1 occurs as a common founder mutation in Sweden and is associated with an unexpectedly benign phenotype in heterozygous carriers.
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Affiliation(s)
- Annika Winbo
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
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Williams J, Ondrus M, Kitzinger M, Persson J, Popescu M, Valjakka R. EPA-0716 – An international study of the grid-hamd: has it fulfilled its promise. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78074-5] [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: 10/25/2022] Open
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Mattisson J, Arntsen GB, Nilsen EB, Loe LE, Linnell JDC, Odden J, Persson J, Andrén H. Lynx predation on semi‐domestic reindeer: do age and sex matter? J Zool (1987) 2013. [DOI: 10.1111/jzo.12084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Mattisson
- Norwegian Institute for Nature Research (NINA) Trondheim Norway
| | - G. B. Arntsen
- Department of Ecology and Natural Resource Management Norwegian University of Life Sciences Ås Norway
| | - E. B. Nilsen
- Norwegian Institute for Nature Research (NINA) Trondheim Norway
| | - L. E. Loe
- Department of Ecology and Natural Resource Management Norwegian University of Life Sciences Ås Norway
| | | | - J. Odden
- Norwegian Institute for Nature Research (NINA) Trondheim Norway
| | - J. Persson
- Department of Ecology Swedish University of Agricultural Science, Grimsö Wildlife Research Station Riddarhyttan Sweden
| | - H. Andrén
- Department of Ecology Swedish University of Agricultural Science, Grimsö Wildlife Research Station Riddarhyttan Sweden
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Sjövall F, Morota S, Persson J, Hansson MJ, Elmér E. Patients with sepsis exhibit increased mitochondrial respiratory capacity in peripheral blood immune cells. Crit Care 2013; 17:R152. [PMID: 23883738 PMCID: PMC4056763 DOI: 10.1186/cc12831] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 07/09/2013] [Indexed: 12/13/2022]
Abstract
Introduction In sepsis, mitochondria have been associated with both initial dysfunction and subsequent upregulation (biogenesis). However, the evolvement of mitochondrial function in sepsis over time is largely unknown, and we therefore investigated mitochondrial respiration in peripheral blood immune cells (PBICs) in sepsis patients during the first week after admission to the intensive care unit (ICU). Methods PBICs from 20 patients with severe sepsis or septic shock were analyzed with high-resolution respirometry 3 times after admission to the ICU (within 48 hours, days 3 to 4 and days 6 to 7). Mitochondrial DNA (mtDNA), cytochrome c (Cyt c), and citrate synthase (CS) were measured as indicators of cellular mitochondrial content. Results In intact PBICs with endogenous substrates, a gradual increase in cellular respiration reached 173% of controls after 1 week (P = 0.001). In permeabilized cells, respiration using substrates of complex I, II, and IV were significantly increased days 1 to 2, reaching 137%, 130%, and 173% of controls, respectively. In parallel, higher levels of CS activity, mtDNA, and Cyt c content in PBICs (211%, 243%, and 331% of controls for the respective indicators were found at days 6 to 7; P < 0.0001). No differences in respiratory capacities were noted between survivors and nonsurvivors at any of the time points measured. Conclusions PBICs from patients with sepsis displayed higher mitochondrial respiratory capacities compared with controls, due to an increased mitochondrial content, as indicated by increased mitochondrial DNA, protein content, and enzyme activity. The results argue against mitochondrial respiratory dysfunction in this type of cells in sepsis.
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Dumas RK, Iacocca E, Bonetti S, Sani SR, Mohseni SM, Eklund A, Persson J, Heinonen O, Åkerman J. Spin-wave-mode coexistence on the nanoscale: a consequence of the Oersted-field-induced asymmetric energy landscape. Phys Rev Lett 2013; 110:257202. [PMID: 23829755 DOI: 10.1103/physrevlett.110.257202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Indexed: 06/02/2023]
Abstract
It has been argued that if multiple spin wave modes are competing for the same centrally located energy source, as in a nanocontact spin torque oscillator, that only one mode should survive in the steady state. Here, the experimental conditions necessary for mode coexistence are explored. Mode coexistence is facilitated by the local field asymmetries induced by the spatially inhomogeneous Oersted field, which leads to a physical separation of the modes, and is further promoted by spin wave localization at reduced applied field angles. Finally, both simulation and experiment reveal a low frequency signal consistent with the intermodulation of two coexistent modes.
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Affiliation(s)
- Randy K Dumas
- Physics Department, University of Gothenburg, 412 96 Gothenburg, Sweden.
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Mohseni SM, Sani SR, Persson J, Nguyen TNA, Chung S, Pogoryelov Y, Muduli PK, Iacocca E, Eklund A, Dumas RK, Bonetti S, Deac A, Hoefer MA, Akerman J. Spin Torque-Generated Magnetic Droplet Solitons. Science 2013; 339:1295-8. [DOI: 10.1126/science.1230155] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Lönnerfors C, Persson J. Implementation and applications of robotic surgery within gynecologic oncology and gynecology; analysis of the first thousand cases. Ceska Gynekol 2013; 78:12-19. [PMID: 23607378] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To describe the effects of implementing a robotic surgical program within gynecologic oncology and gynecology at a tertiary referral hospital. DESIGN Prospective study. SETTING University Hospital, Lund and Lund University, Sweden. METHODS Based on prospective data retrieved for all patients, we evaluated intraoperative times, estimated blood loss, rate of conversion and rate of intraoperative complications in the first 1000 robotic surgeries to describe the effects of implementing the technology and the applications of robotic surgery over time. RESULTS Between the years 2005-2011, 606 women were operated on for a malignant disease and 394 for a benign disorder. The median age was 49 years (14-89 years) and the median BMI 25,2 kg/m2 (14.7-61.7 kg/m2). The median blood loss was 100 ml (range 0-1300 ml). Nineteen (1.9%) intraoperative complications occurred. Conversion to laparotomy was necessary in 37 patients (3.7%) primarily due to excessive adhesions (n = 15) or unexpected disseminated cancer (n = 11). The proportion of minimally invasive surgery for cervical, endometrial, and early ovarian cancer increased from 26% in 2005 to 81% in 2011. A wide variety of procedures including rare and very complex surgery, otherwise operated by laparotomy, were gradually introduced. Overall, the total OR time per procedure decreased by 159 minutes between the first and last two-year periods, mainly due to a reduction in surgical time by 132 minutes, mainly seen in oncology cases. CONCLUSION Robotic surgery enables minimally invasive surgery for a larger proportion of patients with malignant and select benign gynecological disorders with low rates of conversions and intraoperative complications. The effort and time needed to build a successful robotic team should not be underestimated. An adequate surgical volume with a large proportion of complex cases is necessary to motivate a robotic program.
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Affiliation(s)
- C Lönnerfors
- Department of Obstetrics and Gynecology, Skåne University Hospital, Sweden
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Karlsson K, Nyman J, Baumann P, Wersäll P, Gagliardi G, Johansson K, Persson J, Rutkowska E, Tullgren O, Lax I. A Retrospective Study of Bronchial Doses and Radiation-induced Atelectasis After SBRT of Lung Tumors Located Close to the Bronchial Tree. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.089] [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: 11/16/2022]
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Winbo A, Stattin EL, Diamant UB, Persson J, Jensen SM, Rydberg A. Prevalence, mutation spectrum, and cardiac phenotype of the Jervell and Lange-Nielsen syndrome in Sweden. Europace 2012; 14:1799-806. [PMID: 22539601 DOI: 10.1093/europace/eus111] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIMS To explore the national prevalence, mutation spectrum, cardiac phenotype, and outcome of the uncommon Jervell and Lange-Nielsen syndrome (JLNS), associated with a high risk of sudden cardiac death. METHODS AND RESULTS A national inventory of clinical JLNS cases was performed. Genotype and area of origin were ascertained in index families. Retrospective clinical data were collected from medical records and interviews. We identified 19 cases in 13 Swedish families. A JLNS prevalence >1:200 000 was revealed (five living cases <10 years of age). The mutation spectrum consisted of eight KCNQ1 mutations, whereof p.R518X in 12/24 alleles. Geographic clustering of four mutations (20/24 alleles) and similarities to Norway's mutation spectrum were seen. A high prevalence of heterozygotes was suggested. Three paediatric cases on β-blockers since birth were as yet asymptomatic. Seven symptomatic cases had suffered an aborted cardiac arrest and four had died suddenly. QTc prolongation was significantly longer in symptomatic cases (mean 605 ± 62 vs. 518 ± 50 ms, P = 0.016). β-Blockers reduced, but did not abolish, cardiac events in any previously symptomatic case. β-Blocker type, dosage, and compliance probably affect outcome significantly. Implantable cardioverter-defibrillator therapy (ICD, n = 6) was associated with certain complications; however, no case of sudden death. CONCLUSION Founder effects could explain 83% of the Swedish JLNS mutation spectrum and probably contribute to the high JLNS prevalence found in preadolescent Swedish children. Due to the severe cardiac phenotype in JLNS, the importance of stringent β-blocker therapy and compliance, and consideration of ICD implantation in the case of therapy failure is stressed.
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Affiliation(s)
- Annika Winbo
- Division of Pediatrics, Department of Clinical Sciences, Pediatrics, Umeå University, 90185 Umeå, Sweden.
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Persson J, Pudas S, Lind J, Kauppi K, Nilsson LG, Nyberg L. Longitudinal Structure-Function Correlates in Elderly Reveal MTL Dysfunction with Cognitive Decline. Cereb Cortex 2011; 22:2297-304. [DOI: 10.1093/cercor/bhr306] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Winbo A, Diamant UB, Rydberg A, Persson J, Jensen SM, Stattin EL. Origin of the Swedish long QT syndrome Y111C/KCNQ1 founder mutation. Heart Rhythm 2011; 8:541-7. [DOI: 10.1016/j.hrthm.2010.11.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 11/26/2010] [Indexed: 10/18/2022]
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