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Essner A, Hesbach AL, Igelström H, Kjellerstedt C, Svensson K, Westerlind H. Physical activity and sport-specific training patterns in Swedish sporting and working trial dogs-A questionnaire survey. Front Vet Sci 2022; 9:976000. [PMID: 36387412 PMCID: PMC9664515 DOI: 10.3389/fvets.2022.976000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/03/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To explore physical activity patterns, including conditioning exercise and sport-specific training, and management routines utilized by handlers of Swedish sporting and working dogs participating in agility, obedience, rally obedience and working trial disciplines. PROCEDURES Dog handlers provided information on competition-level dogs through an internet-based cross-sectional and descriptive survey on physical activity, sport-specific training and management. Results are reported overall and stratified by participation in specific disciplines. RESULTS We received 1615 replies to the questionnaire. After data cleaning, 1582 dogs (98%) remained for the analysis. Of these, 430 participated in agility, 790 in obedience, 596 in rally obedience, and 847 dogs had competed in a working trial, i.e., messenger, protection, search or tracking. Number of disciplines performed by each dog varied between one and five. Most common was participation in one (n = 767, 48%) or two (n = 541, 34%) disciplines. Out of the dogs competing in one discipline, 38% (n = 294) were considered to be specialized as they actively trained only that discipline for ≥10 months per year. The vast majority of the dogs (n = 1129, 71%) received more than 1 h of daily physical activity, e.g., walks, and only n = 51 (3%) were never exercised off-leash. Preferred self-selected gait was trot (n = 907, 57%) and gallop (n = 499, 32%). A fifth (n = 319, 20%) never played with other dogs. The majority (n = 1328, 84%) received more than 1 h of vigorous physical conditioning exercise per week. Almost three quarters (n = 1119, 71%) participated in physical conditioning exercise. Two thirds (n = 953, 60%) participated in at least 3 h of sport-specific training per week and only a very small portion (n = 35, 2%) trained their specific discipline less than once per week. Median total work load, i.e., all daily physical activity, vigorous physical conditioning exercise and sport-specific training, was 16.5 h per week. CONCLUSION AND CLINICAL RELEVANCE We observe physical activity at moderate to high durations and moderate to vigorous intensities among Swedish sporting and working trial dogs. Most dogs received physical conditioning exercise, but not all dogs were warmed up before training and competition. Our study provides veterinary professionals and dog trainers with valuable insights on the physical exposures and management routines of sporting and working trial dogs.
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Affiliation(s)
- Ann Essner
- Djurkliniken Gefle, IVC Evidensia, Gävle, Sweden,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden,*Correspondence: Ann Essner
| | | | - Helena Igelström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | | | - Helga Westerlind
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Klintö K, Eriksson M, Abdiu A, Brunnegård K, Cajander J, Hagberg E, Hakelius M, Havstam C, Mark H, Okhiria Å, Peterson P, Svensson K, Becker M. Inter-centre comparison of data on surgery and speech outcomes at 5 years of age based on the Swedish quality registry for patients born with cleft palate with or without cleft lip. BMC Pediatr 2022; 22:303. [PMID: 35606744 PMCID: PMC9125901 DOI: 10.1186/s12887-022-03367-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The objective of the Swedish cleft lip and palate registry (CLP registry) is to promote quality control, research and improvement of treatment, by the comparison of long-term results. The aim was to compare data from the CLP registry among the six treatment centres, regarding data on surgery and speech outcomes at 5 years of age. METHODS The participants were 430 children born in Sweden from 2009 to 2014, with cleft palate with or without cleft lip and without known syndromes and/or additional malformations. The number of primary and secondary palatal surgeries up to 5 years of age, timing of the last primary palatal surgery, percentage consonants correct, percentage non-oral speech errors and perceived velopharyngeal competence at 5 years were assessed. Multivariable binary logistic regression adjusted for sex and cleft type was used to compare results between the six centres. RESULTS At one centre (centre 4), the palate was closed in one to three stages, and at the remaining centres in one or two stages. At centre 4, more children underwent a higher number of palatal surgeries, and the last primary palatal surgery was performed at a higher age. Children in centre 4 were also less likely to achieve ≥86% correct consonants (OR = 0.169, P = < 0.001), have no non-oral speech errors (OR = 0.347, P = < 0.001), or have competent or marginally incompetent velopharyngeal competence (OR = 0.244, P = < 0.001), compared to the average results of the other centres. No clear association between patient volume and speech outcome was observed. CONCLUSIONS The results indicated the risk of a negative speech result if the last primary palatal surgery was performed after 25 months of age. Whether the cleft in the palate was closed in one or two stages did not affect speech outcome. The Swedish CLP registry can be used for open comparisons of treatment results to provide the basis for improvements of treatment methods. If deviating negative results are seen consistently at one centre, this information should be acted upon by further investigation and analysis, making changes to the treatment protocol as needed.
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Affiliation(s)
- Kristina Klintö
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
| | - Marie Eriksson
- Department of Statistics, USBE, Umeå University, Umeå, Sweden
| | - Avni Abdiu
- Department of Hand Surgery, Plastic Surgery and Burns and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Karin Brunnegård
- Department of Clinical Sciences, Speech and Language Pathology, Umeå University, Umeå, Sweden
| | - Jenny Cajander
- Department for Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Emilie Hagberg
- Medical Unit Speech and Language Pathology and Department of Plastic Surgery and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Hakelius
- Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Christina Havstam
- Department of Otorhinolaryngology, Division of Speech and Language Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hans Mark
- Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Okhiria
- Department of Speech-Language Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Petra Peterson
- Department of Plastic Surgery and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Svensson
- Speech and Language Therapy Unit, Linköping University Hospital, Linköping, Sweden
| | - Magnus Becker
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
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Essner A, Kjellerstedt C, Hesbach AL, Svensson K, Igelström H. Dog Handler Beliefs regarding Barriers and Facilitators to Canine Health Promotion and Injury Prevention in Swedish Working Dog Trials and Competitions. Vet Sci 2022; 9:242. [PMID: 35622770 PMCID: PMC9143433 DOI: 10.3390/vetsci9050242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
Dog trials and competitions involve various sport disciplines, e.g., obedience, agility, working dog trials and rally obedience. Dog handlers navigate their dogs through physically and mentally demanding tasks. The purpose of this study was to gain a better understanding of barriers and facilitators to canine health promotion and injury prevention described by dog handlers. METHODS Qualitative inductive content analysis was applied to systematically organize and interpret narrative data from 654 respondents' answers to open-ended questions in an anonymous online inquiry. RESULTS Two categories, with seven sub-categories, emerged from the analysis: (1) Challenges in applying the regulations in dog trials and competitions, and (2) Implementation of animal welfare and canine well-being approaches. Respondents described the challenges in applying regulations in dog trials and competitions and lack of scientific research as barriers to their intent to prevent injuries in their dogs. Implementation of animal welfare and canine well-being approaches were described as facilitators. CONCLUSION The findings imply that the stakeholders continuously need to work on bridging possible gaps between the canine welfare criteria and the scientific and empirical knowledge in canine sports and performance medicine.
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Affiliation(s)
- Ann Essner
- IVC Evidensia Djurkliniken Gefle, Norra Gatan 1, SE-803 21 Gavle, Sweden
- Department of Women’s and Children’s Health, Uppsala University, SE-751 24 Uppsala, Sweden;
| | | | | | | | - Helena Igelström
- Department of Women’s and Children’s Health, Uppsala University, SE-751 24 Uppsala, Sweden;
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Dehlin M, Scheepers L, Landgren AJ, Josefsson L, Svensson K, Jacobsson L. Lifestyle factors and comorbidities in gout patients compared to the general population in Western Sweden: results from a questionnaire study. Scand J Rheumatol 2022; 51:390-393. [PMID: 35266438 DOI: 10.1080/03009742.2022.2035952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aimed to identify lifestyle factors associated with gout in patients with prevalent gout compared to the general population. METHOD Adult patients with gout identified in primary and secondary care in Western Sweden between 2015 and 2017 were sent a questionnaire asking about demographics, lifestyle, and comorbidities. Five age- and gender-matched controls were identified in a random sample of 52 348 individuals aged 16-84 years who participated in the National Public Health survey in Sweden, year 2015. Logistic regression models were used to compare cases and controls with regard to lifestyle factors and comorbidities. RESULTS Of the 1589 invited gout patients, 868 (55%) responded. After matching for age and gender, 728 were included in the analysis (82.4% male; mean ± sd age 69.3 ± 10.5 years for men and 71.8 ± 9.9 years for women with gout). Male and female gout patients were significantly more likely to be overweight or obese (men 79% vs 66%; women 78.5% vs 65.3%), to have binge-drinking behaviour (men 29.9% vs 11%; women 13.7% vs 2.9%), and to be ex-smokers, compared to controls. Moreover, male gout patients reported lower levels of physical activity, while diabetes and hypertension were more common in both genders with gout than in controls. CONCLUSION In this questionnaire study, gout patients reported significantly more obesity and binge-drinking behaviour and less physical activity than controls. This suggests that there are great unmet needs for the management of lifestyle factors, particularly regarding overweight/obesity and binge drinking, in patients with gout.
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Affiliation(s)
- M Dehlin
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lejm Scheepers
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - A J Landgren
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Research and Development Primary Health Care, Gothenburg, Sweden
| | - L Josefsson
- Region Västra Götaland, Primary health care, Wästerläkarna AB, Gothenburg, Sweden
| | - K Svensson
- Department of Rheumatology, Skaraborg Hospital, Skövde, Sweden
| | - Lth Jacobsson
- Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Svensson K, Hagström J, Blomqvist M, Jormfeldt H. "Waiting in the Wings"-Next-of-Kin's Experiences of Lifestyle Interventions for People with Schizophrenia. Issues Ment Health Nurs 2020; 41:832-839. [PMID: 32421461 DOI: 10.1080/01612840.2020.1731026] [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: 10/24/2022]
Abstract
People with schizophrenia have an increased risk of experiencing physical ill health and thus risk premature death. It is important to gain knowledge about the next-of-kin's experiences of lifestyle interventions in order to increase the understanding of the development of health promotion. This study aimed to describe the experiences of next-of-kin of lifestyle interventions for people with schizophrenia. Ten next-of-kin to people diagnosed with schizophrenia were interviewed and content analysis was used to analyze the data. Three categories emerged in the analysis: Low prioritization of physical health, Patients' needs for motivational support and Next-of-kin's' limited and distant participation. Mental health nurses need a holistic view of human beings and to include the patients' physical health and the role of the family in their responsibilities. Further studies are needed that focus on the views of the next-of-kin and the staff from the mental health services about the care and support needs for promoting physical health in this patient group.
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Affiliation(s)
- Kristina Svensson
- Department of Psychiatry, Psychiatric Clinic in Varberg, Region Halland, Sweden
| | - Johanna Hagström
- Department of Psychiatry, Psychiatric Clinic in Varberg, Region Halland, Sweden
| | - Marjut Blomqvist
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Abstract
Background:Pegloticase is a PEGylated biologic therapy for patients with uncontrolled gout who have not improved on or could not tolerate conventional urate-lowering therapies.1All biologics have the ability to engender anti-drug antibodies (ADAs) and it is known that some patients given pegloticase develop ADAs that cause them to stop treatment prior to recieving a complete course of therapy.2-3In other rheumatic autoimmune diseases, DMARDs such as methotrexate or azathioprine are used as standard of care to prevent the development of ADAs to biologics. These DMARDs often allow patients to remain on biologic therapies longer and recieve the full therapeutic benefits while minimizing adverse events.4While pegloticase has been used traditionally as monotherapy, recent case series have demonstrated the therapeutic benefit of immunomodulator co-administration, allowing more patients to receive a full course of pegloticase therapy.5-6Little has been published on how widespread this practice is and whether it has changed over time.Objectives:To examine medical claims database from 2014-2019 for trends in immunomodulating therapies being co-prescribed with pegloticase.Methods:An IQVIA claims database (November 2014 to October 2019) representing 1.3 billion claims, covering 30 million patients diagnosed with gout or CKD, was utilized to search for patients who had received pegloticase. Patients who had recieved pegloticase were classified as having been on an immunomodulating co-therapy if they were prescribed methotrexate or azathioprine within 60 days before or after initiation of their first pegloticase infusion.Results:We found relatively steady low rates of immunomodulation co-therapy with pegloticase from 2014 through 2018 ranging from 1% in 2016 to 4% in 2018 (Figure 1). In 2019 however, the proportion of pegloticase patients that were co-treated with methotrexate or azathioprine therapy increased to 15%. Most patients were started on immunomodulating therapy 20 days before to 10 days after initiation of pegloticase. Methotrexate was the more frequently used immunomodulaton co-therapy as compared to azathioprine.Conclusion:We found evidence of a relatively dramatic increasing initiation of immunomodulation therapy with pegloticase beginning soon after a November 2018 presentation of a case series which demonstrated improved response rates of pegloticase when co-administered with methotrexate. These data indicate that clinicians began to more frequently employ a strategy of DMARD co-treatment with pegloticase in 2019 to improve response rates to this important gout medicine.References:[1]Sundy JS, et al.JAMA2011;306:711-20.[2]Abeles AM.Arthritis Research & Therapy2014, 16:112[3]Strand V, et al.BioDrugs2017; 31:299–316.[4]Krieckaert CL, et al.Arthritis Res Ther2010;12:217.[5]Botson J and Peterson J.Ann Rheum Dis.2019; 78: A1289.[6]Bessen SY, et al.Semin Arthritis Rheum.2019;49:56-61.Disclosure of Interests:Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Megan Francis-Sedlak Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Karl Svensson Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Robert Holt Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics
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Enroth H, Retz K, Andersson S, Andersson C, Svensson K, Ljungström L, Tilevik D, Pernestig AK. Evaluation of QuickFISH and maldi Sepsityper for identification of bacteria in bloodstream infection. Infect Dis (Lond) 2019; 51:249-258. [PMID: 30729840 DOI: 10.1080/23744235.2018.1554258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/24/2022] Open
Abstract
BACKGROUND Early detection of bacteria and their antibiotic susceptibility patterns are critical to guide therapeutic decision-making for optimal care of septic patients. The current gold standard, blood culturing followed by subculture on agar plates for subsequent identification, is too slow leading to excessive use of broad-spectrum antibiotic with harmful consequences for the patient and, in the long run, the public health. The aim of the present study was to assess the performance of two commercial assays, QuickFISH® (OpGen) and Maldi Sepsityper™ (Bruker Daltonics) for early and accurate identification of microorganisms directly from positive blood cultures. MATERIALS AND METHODS During two substudies of positive blood cultures, the two commercial assays were assessed against the routine method used at the clinical microbiology laboratory, Unilabs AB, at Skaraborg Hospital, Sweden. RESULTS The Maldi Sepsityper™ assay enabled earlier microorganism identification. Using the cut-off for definite species identification according to the reference method (>2.0), sufficiently accurate species identification was achieved, but only among Gram-negative bacteria. The QuickFISH® assay was time-saving and showed high concordance with the reference method, 94.8% (95% CI 88.4-98.3), when the causative agent was covered by the QuickFISH® assay. CONCLUSIONS The use of the commercial assays may shorten the time to identification of causative agents in bloodstream infections and can be a good complement to the current clinical routine diagnostics. Nevertheless, the performance of the commercial assays is considerably affected by the characteristics of the causative agents.
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Affiliation(s)
- Helena Enroth
- a Systems Biology Research Centre, School of Bioscience, University of Skövde , Skövde , Sweden.,b Department of Clinical Microbiology , Unilabs AB , Skövde , Sweden
| | - Karolina Retz
- a Systems Biology Research Centre, School of Bioscience, University of Skövde , Skövde , Sweden.,b Department of Clinical Microbiology , Unilabs AB , Skövde , Sweden
| | - Sofie Andersson
- b Department of Clinical Microbiology , Unilabs AB , Skövde , Sweden
| | - Carl Andersson
- a Systems Biology Research Centre, School of Bioscience, University of Skövde , Skövde , Sweden.,b Department of Clinical Microbiology , Unilabs AB , Skövde , Sweden
| | - Kristina Svensson
- b Department of Clinical Microbiology , Unilabs AB , Skövde , Sweden
| | - Lars Ljungström
- c Department of Infectious Diseases , Skaraborg Hospital , Skövde , Sweden
| | - Diana Tilevik
- a Systems Biology Research Centre, School of Bioscience, University of Skövde , Skövde , Sweden
| | - Anna-Karin Pernestig
- a Systems Biology Research Centre, School of Bioscience, University of Skövde , Skövde , Sweden
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Svensson K, LaBarge SA, Martins VF, Schenk S. Temporal overexpression of SIRT1 in skeletal muscle of adult mice does not improve insulin sensitivity or markers of mitochondrial biogenesis. Acta Physiol (Oxf) 2017; 221:193-203. [PMID: 28544355 DOI: 10.1111/apha.12897] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/23/2017] [Accepted: 05/11/2017] [Indexed: 12/23/2022]
Abstract
AIMS Activation of the NAD+ dependent protein deacetylase SIRT1 has been proposed as a therapeutic strategy to treat mitochondrial dysfunction and insulin resistance in skeletal muscle. However, lifelong overexpression of SIRT1 in skeletal muscle does not improve parameters of mitochondrial function and insulin sensitivity. In this study, we investigated whether temporal overexpression of SIRT1 in muscle of adult mice would affect skeletal muscle mitochondrial function and insulin sensitivity. METHODS To circumvent potential effects of germline SIRT1 overexpression, we utilized an inducible model of SIRT1 overexpression in skeletal muscle of adult mice (i-mOX). Insulin sensitivity was assessed by 2-deoxyglucose uptake, muscle maximal respiratory function by high-resolution respirometry and systemic energy expenditure was assessed by whole body calorimetry. RESULTS Although SIRT1 was highly, and specifically, overexpressed in skeletal muscle of i-mOX compared to WT mice, glucose tolerance and skeletal muscle insulin sensitivity were comparable between genotypes. Additionally, markers of mitochondrial biogenesis, muscle maximal respiratory function and whole-body oxygen consumption were also unaffected by SIRT1 overexpression. CONCLUSION These results support previous work demonstrating that induction of SIRT1 in skeletal muscle, either at birth or in adulthood, does not impact muscle insulin action or mitochondrial function.
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Affiliation(s)
- K. Svensson
- Department of Orthopaedic Surgery; University of California San Diego; La Jolla CA USA
| | - S. A. LaBarge
- Department of Orthopaedic Surgery; University of California San Diego; La Jolla CA USA
| | - V. F. Martins
- Department of Orthopaedic Surgery; University of California San Diego; La Jolla CA USA
| | - S. Schenk
- Department of Orthopaedic Surgery; University of California San Diego; La Jolla CA USA
- Biomedical Sciences Graduate Program; University of California San Diego; La Jolla CA USA
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10
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Svensson K, Eckerman M, Alricsson M, Magounakis T, Werner S. MUSCLE INJURIES OF THE DOMINANT OR NON-DOMINANT LEG IN MALE FOOTBALL PLAYERS AT ELITE LEVEL. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-096952.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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11
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Mérida-Ortega A, Hernández-Alcaraz C, García-Martínez A, Trejo-Valdivia B, Salinas-Rodríguez A, Svensson K, Cebrián M, López-Carrillo L. Phthalate exposure, flavonoid consumption and breast cancer risk among Mexican women. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.145] [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: 11/26/2022]
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12
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Westhovens R, van Vollenhoven RF, Boumpas DT, Brzosko M, Svensson K, Bjorneboe O, Meeuwisse CM, Srinivasan S, Gaudin P, Smolen JS, Rahman MU, Nelissen RL, Vastesaeger N. The early clinical course of infliximab treatment in rheumatoid arthritis: results from the REMARK observational study. Clin Exp Rheumatol 2014; 32:315-323. [PMID: 24529163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 11/14/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES We aimed to describe patterns of disease activity during infliximab plus methotrexate (MTX) treatment and explore C-reactive protein (CRP) as a potential marker of early response. METHODS REMARK was a phase IV, open-label, observational study of infliximab-naïve adults with rheumatoid arthritis (RA) who received infliximab 3 mg/kg plus MTX for 14 weeks. Treatment response was evaluated in 3 subgroups: patients with <1 year disease duration who were TNF-inhibitor (TNFi)-naïve, patients with ≥ 1 year disease duration who were TNFi-naïve, and patients who had previous TNFi failure or intolerance. In post hoc analyses, CRP kinetic profiles were analysed by EULAR response (good, moderate, non-response) in REMARK and in an independent replication with data from the ASPIRE study. RESULTS In the efficacy-evaluable population (n=662), median 28-joint disease activity score (DAS28) improved from baseline to Week 14 (5.2 vs. 3.6, p<0.0001). Regardless of disease history subgroup, most patients had good or moderate EULAR responses at Weeks 2 (64.9%), 6 (74.1%), and 14 (73.6%). DAS28 and its components did not differ across patient subgroups. Disease flare occurred in 16.2% of patients. CRP levels declined markedly at Week 2, but patients who were EULAR non-responders at Week 14 showed a CRP rebound at Weeks 6 and 14. This CRP pattern was independently replicated in data from ASPIRE. Adverse events were consistent with the known risk profile of infliximab. CONCLUSIONS Infliximab plus MTX treatment in patients with RA rapidly diminished disease activity. A unique pattern of CRP rebound was found in non-responders early in treatment.
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Affiliation(s)
- R Westhovens
- Skeletal Biology and Engineering Research Center, Department of Development and Regeneration KU Leuven; Rheumatology, University Hospitals Leuven, Belgium.
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13
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Wingfors H, Svensson K, Hägglund L, Hedenstierna S, Magnusson R. Emission factors for gases and particle-bound substances produced by firing lead-free small-caliber ammunition. J Occup Environ Hyg 2014; 11:282-291. [PMID: 24188168 DOI: 10.1080/15459624.2013.858821] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Lead-free ammunition is becoming increasingly popular because of the environmental and human health issues associated with the use of leaded ammunition. However, there is a lack of data on the emissions produced by firing such ammunition. We report emission factors for toxic gases and particle-bound compounds produced by firing lead-free ammunition in a test chamber. Carbon monoxide, ammonia, and hydrogen cyanide levels within the chamber were analysed by Fourier transform infrared spectroscopy, while total suspended particles and respirable particles were determined gravimetrically. The metal content of the particulate emissions was determined and the associated organic compounds were characterized in detail using a method based on thermal desorption coupled to gas chromatography and mass spectrometry. The particulate matter (∼30 mg/round) consisted primarily of metals such as Cu, Zn, and Fe along with soot arising from incomplete combustion. Nitrogen-containing heterocyclic aromatic compounds such as carbazole, quinolone, and phenazine were responsible for some of the 25 most significant chromatographic peaks, together with PAHs, diphenylamine, and phthalates. Emission factors were determined for PAHs and oxygenated PAHs; the latter were less abundant in the gun smoke particles than in domestic dust and diesel combustion smoke. This may be due to the oxygen-deficient conditions that occur when the gun is fired. By using an electrical low pressure impactor, it was demonstrated that more than 90% of the particles produced immediately after firing the weapon had diameters of less than 30 nm, and so most of the gun smoke particles belonged to the nanoparticle regime.
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Affiliation(s)
- H Wingfors
- a FOI Swedish Defence Research Agency, CBRN Defence and Security , Umeå , Sweden
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14
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E. Brumboiu I, Anselmo A, Brena B, Dzwilewski A, Svensson K, Moons E. Near-edge X-ray absorption fine structure study of the C60-derivative PCBM. Chem Phys Lett 2013. [DOI: 10.1016/j.cplett.2013.03.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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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15
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Jackman H, Krakhmalev P, Svensson K. Image formation mechanisms in scanning electron microscopy of carbon nanotubes, and retrieval of their intrinsic dimensions. Ultramicroscopy 2013; 124:35-9. [DOI: 10.1016/j.ultramic.2012.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 08/20/2012] [Indexed: 10/27/2022]
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16
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Svensson K, Andersson S. Desorption of H2, HD, and D2 through temporary negative ion formation. Phys Rev Lett 2012; 109:196102. [PMID: 23215407 DOI: 10.1103/physrevlett.109.196102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 09/07/2012] [Indexed: 06/01/2023]
Abstract
Physically adsorbed H(2), HD, and D(2) desorbs via the low-energy 2Σ(u)+ electron scattering resonance with characteristic electron energy dependent cross sections as we show by desorption and electron energy-loss measurements. Only H(2) and HD desorb, for energetic reasons, via excitation of the j = 0 → 2 rotational mode and its subsequent decay into free translational motion, while all three isotopes desorb by direct transitions to unbound continuum states, with a probability close to unity and an unexpectedly weak mass dependence ~m(-1/2).
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Affiliation(s)
- K Svensson
- Department of Physics and Electrical Engineering, Karlstad University, SE-651 88 Karlstad, Sweden
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17
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Abstract
The extent and depth of traumatic brain injury (TBI) remains a major determining factor together with the type of structural insult and its location, whether mild, moderate or severe, as well as the distribution and magnitude of inflammation and loss of cerebrovascular integrity, and the eventual efficacy of intervention. The influence of exercise intervention in TBI is multiple, ranging from anti-apoptotic effects to the augmentation of neuroplasticity. Physical exercise diminishes cerebral inflammation by elevating factors and agents involved in immunomodulatory function, and buttresses glial cell, cerebrovascular, and blood-brain barrier intactness. It provides unique non-pharmacologic intervention that incorporate different physical activity regimes, whether dynamic or static, endurance or resistance. Physical training regimes ought necessarily to be adapted to the specific demands of diagnosis, type and degree of injury and prognosis for individuals who have suffered TBI.
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Affiliation(s)
| | - K. Svensson
- School of Education; Psychology and Sport Science; Linnaeus University; Kalmar; Sweden
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18
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Juniper EF, Gruffydd-Jones K, Ward S, Svensson K. From the authors: The Asthma Control Questionnaire for children: still more questions than answers. Eur Respir J 2011. [DOI: 10.1183/09031936.00005311] [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: 11/05/2022]
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19
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Svensson K, Hernández-Ramírez R, Burguette A, Cebrian M, Claudio L, López-Carrillo L. Concentrations of urinary phthalates metabolites in Mexican women with and without diabetes. Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.224] [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: 12/01/2022]
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20
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Juniper EF, Gruffydd-Jones K, Ward S, Svensson K. Asthma Control Questionnaire in children: validation, measurement properties, interpretation. Eur Respir J 2010; 36:1410-6. [PMID: 20530041 DOI: 10.1183/09031936.00117509] [Citation(s) in RCA: 179] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Asthma Control Questionnaire (ACQ) has been validated in adults to measure the primary goal of management (minimisation of symptoms, activity limitations, short-acting β₂-agonist use and airway narrowing). The present study evaluated the validity, measurement properties and interpretability of the ACQ in children aged 6-16 yrs. 35 children attended clinic on three occasions (0, 1 and 4 weeks) and completed the ACQ, Mini Paediatric Asthma Quality of Life Questionnaire and the Royal College of Physicians' "Three Questions". Parents completed the Paediatric Asthma Caregiver's Quality of Life Questionnaire. Between visits, children completed the Asthma Control Diary and measured peak expiratory flow. At weeks 1 and 4, clinicians and parents completed Global Rating of Change Questionnaires. All patients completed the study. 19 children were stable between two assessments and provided evidence of good test-retest reliability (intraclass correlation coefficient 0.79). The ACQ was responsive to change in asthma control (p = 0.026) and the mean ± sd Minimal Important Difference was 0.52 ± 0.45. Both cross-sectional and longitudinal correlations between the ACQ and the other outcomes were close to predicted and provided evidence that the ACQ measures asthma control in children. The ACQ has strong measurement properties and is valid for use in children aged 6-16 yrs. In children aged 6-10 yrs, it must be administered by a trained interviewer.
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Affiliation(s)
- E F Juniper
- Dept of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
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21
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Andersson S, Svensson K. Dissociation of physisorbed H2 through low-energy electron scattering resonances. Phys Rev Lett 2010; 104:216101. [PMID: 20867118 DOI: 10.1103/physrevlett.104.216101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2010] [Indexed: 05/29/2023]
Abstract
Electron induced dissociation of physisorbed H2, HD, and D2 proceeds, as we observe in electron energy-loss measurements of the resulting atomic species, with a high quantum efficiency via the 2Σg(+) core excited electron scattering resonances. We find that the predominant decay of the temporary H2(-) state to the neutral excited 3Σu(+) parent state, which is intramolecularly antibonding, provides a sufficiently long-lived channel for dissociation to occur with high probability, even in the proximity of a metal surface.
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Affiliation(s)
- S Andersson
- Department of Physics, Göteborg University, SE-412 96 Göteborg, Sweden
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22
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Ohlsson R, Svensson K, Cui H, Malmikumpu H, Adam G. Allele-specific in situ hybridization (ASISH). Methods Mol Biol 2009; 181:153-67. [PMID: 12843448 DOI: 10.1385/1-59259-211-2:153] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
An unexpected outcome of the diploid genome is that evolutionary strategies have evolved to express only one of the alleles (1). The rapidly expanding list of genes that are expressed monoallelically fall into three main categories: random inactivation, allelic exclusion, and genomic imprinting. These categories are distinguished by whether the expressed and inactivated alleles are maintained from one cell division to the next (random inactivation occurs with each cell division, compared to stable propagation through subsequent cell divisions as seen for allelic exclusion and genomic imprinting) and whether allele inactivation or expression is determined by parent of origin of inheritance (this differentiates allelic exclusion from genomic imprinting). Genomically imprinted genes are currently more numerous than members of the other categories. This fact is likely to reflect that the persistent (in)activation of one allele in a parent of origin-specific manner has facilitated the detection of monoallelic expression patterns in RNA extracted from homogenized tissue. This crude approach does not take into account, however, different imprinted states within a tissue, or, indeed, random allelic (in)activation. It is not surprising, therefore, that well-known genes, such as Il2 (2), were only recently found to be monoallelically expressed in a random manner (1).
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Affiliation(s)
- R Ohlsson
- Department of Animal Development and Genetics, Uppsala University, Norbyvägen, Uppsala, Sweden
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23
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Partridge MR, Miravitlles M, Ståhl E, Karlsson N, Svensson K, Welte T. Development and validation of the Capacity of Daily Living during the Morning questionnaire and the Global Chest Symptoms Questionnaire in COPD. Eur Respir J 2009; 36:96-104. [PMID: 19897551 DOI: 10.1183/09031936.00123709] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This report concerns the development and validation of two patient-reported outcomes questionnaires developed to assess chronic obstructive pulmonary disease (COPD) patients' ability to perform morning activities and to evaluate their morning symptoms. Based on interviews with COPD patients, the Capacity of Daily Living during the Morning (CDLM) questionnaire and the Global Chest Symptoms Questionnaire (GCSQ) were developed, linguistically validated and incorporated into two multicentre, randomised trials involving a total of 1,100 COPD patients; those trials were registered at ClinicalTrials.gov (NCT00496470 and NCT00542880). Data from these trials were used to determine the reliability, validity and responsiveness of the questionnaires and to derive estimates of minimal important differences (MIDs). Both questionnaires displayed good-to-high reliability (Cronbach's alpha 0.75-0.93). Analysis of convergent validity showed that CDLM and GCSQ scores correlated significantly (p<0.001) with symptoms, health-related quality of life (HRQoL) and use of rescue medication. In both trials, CDLM and GCSQ scores discriminated between patients with different levels of HRQoL, as assessed by the St George's Respiratory Questionnaire for COPD patients (SGRQ-C), but not with disease severity, as assessed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. A significant improvement in CDLM and GCSQ scores occurred in response to treatment. Estimations of MID scores, corresponding to an SGRQ-C MID of 4, were 0.20 for the CDLM questionnaire and 0.15 for the GCSQ. Both the CDLM questionnaire and the GCSQ are easy-to-use, reliable, responsive, self-administered questionnaires that report on patients' symptoms and ability to perform morning activities.
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Affiliation(s)
- M R Partridge
- Faculty of Medicine, Imperial College, London, NHLI Division at Charing Cross, Hospital, St Dunstans Road, London W6 8RP, UK.
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Andersson S, Svensson K. Electron-induced desorption of physisorbed H2 via resonance vibrational excitation. Phys Rev Lett 2009; 102:156104. [PMID: 19518656 DOI: 10.1103/physrevlett.102.156104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Indexed: 05/27/2023]
Abstract
We show by electron energy-loss measurements that desorption of physisorbed H(2) and D(2) induced by low-energy electrons takes place with large cross sections, predominantly via resonance excitation of the molecule-surface vibrational mode. The observed H(2), D(2) cross-section ratio supports a picture where rotation-translation conversion of the resonance excited j = 0 --> 2 rotational transition contributes to the desorption of H(2), while this channel is energetically closed for D(2).
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Affiliation(s)
- S Andersson
- Department of Physics, Göteborg University, SE-412 96 Göteborg, Sweden
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25
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Ruprich J, Rehurkova I, Boon PE, Svensson K, Moussavian S, Van der Voet H, Bosgra S, Van Klaveren JD, Busk L. Probabilistic modelling of exposure doses and implications for health risk characterization: glycoalkaloids from potatoes. Food Chem Toxicol 2009; 47:2899-905. [PMID: 19286450 DOI: 10.1016/j.fct.2009.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Revised: 01/30/2009] [Accepted: 03/05/2009] [Indexed: 10/21/2022]
Abstract
Potatoes are a source of glycoalkaloids (GAs) represented primarily by alpha-solanine and alpha-chaconine (about 95%). Content of GAs in tubers is usually 10-100 mg/kg and maximum levels do not exceed 200 mg/kg. GAs can be hazardous for human health. Poisoning involve gastrointestinal ailments and neurological symptoms. A single intake of >1-3 mg/kg b.w. is considered a critical effect dose (CED). Probabilistic modelling of acute and chronic (usual) exposure to GAs was performed in the Czech Republic, Sweden and The Netherlands. National databases on individual consumption of foods, data on concentration of GAs in tubers (439 Czech and Swedish results) and processing factors were used for modelling. Results concluded that potatoes currently available at the European market may lead to acute intakes >1 mg GAs/kg b.w./day for upper tail of the intake distribution (0.01% of population) in all three countries. 50 mg GAs/kg raw unpeeled tubers ensures that at least 99.99% of the population does not exceed the CED. Estimated chronic (usual) intake in participating countries was 0.25, 0.29 and 0.56 mg/kg b.w./day (97.5% upper confidence limit). It remains unclear if the incidence of GAs poisoning is underreported or if assumptions are the worst case for extremely sensitive persons.
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Affiliation(s)
- J Ruprich
- NIPH - National Institute of Public Health, Prague, CHFCH Brno, Palackeho 3a, 61242 Brno, Czech Republic.
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Nygren A, Nyman L, Svensson K, Jahnke G. Cytological and biochemical studies in back-crosses between the hybrid Atlantic salmon X sea trout and its parental species. Hereditas 2009; 81:55-62. [PMID: 1194066 DOI: 10.1111/j.1601-5223.1975.tb01014.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Szende A, Leidy NK, Ståhl E, Svensson K. Estimating health utilities in patients with asthma and COPD: evidence on the performance of EQ-5D and SF-6D. Qual Life Res 2008; 18:267-72. [PMID: 19105049 DOI: 10.1007/s11136-008-9429-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2007] [Accepted: 11/26/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The objective of this study was to understand systematic differences in utility values derived from the EQ-5D and the SF-6D in two respiratory populations with heterogeneous disease severity. METHODS This study involved secondary analysis of data from two cross-sectional surveys of patients with asthma (N = 228; Hungary) and COPD (N = 176; Sweden). Disease severity was defined according to GINA and GOLD guidelines for asthma and COPD, respectively. EQ-5D and SF-6D scores and their distributional characteristics were compared across the two samples by disease severity level. RESULTS Within each patient population, mean EQ-5D and SF-6D scores were similar for the overall group and for those with moderate disease. Mean scores varied for patients with mild and severe disease. EQ-5D versus SF-6D scores in the asthma group by severity levels were 0.89 versus 0.80, 0.70 versus 0.73, 0.63 versus 0.64, and 0.51 versus 0.63, respectively. EQ-5D versus SF-6D scores in the COPD group by severity levels were 0.85 versus 0.80, 0.73 versus 0.73, 0.74 versus 0.73, and 0.53 versus 0.62, respectively. CONCLUSIONS Results suggest the EQ-5D and SF-6D do not yield consistent utility values in patients with asthma and COPD due to differences in underlying valuation techniques and the EQ-5D's limited response options relative to mild disease.
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Affiliation(s)
- A Szende
- Covance Market Access Services Inc., Springfield House, Hyde Street, Leeds, LS2 9LH, UK.
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Odlare M, Pell M, Svensson K. Changes in soil chemical and microbiological properties during 4 years of application of various organic residues. Waste Manag 2008; 28:1246-53. [PMID: 17697770 DOI: 10.1016/j.wasman.2007.06.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Revised: 04/25/2007] [Accepted: 06/19/2007] [Indexed: 05/16/2023]
Abstract
A 4-year field trial was established in eastern Sweden to evaluate the effects of organic waste on soil chemical and microbiological variables. A simple crop rotation with barley and oats was treated with either compost from household waste, biogas residue from household waste, anaerobically treated sewage sludge, pig manure, cow manure or mineral fertilizer. All fertilizers were amended in rates corresponding to 100kgNha(-1)year(-1). The effects of the different types of organic waste were evaluated by subjecting soil samples, taken each autumn 4 weeks after harvest, to an extensive set of soil chemical (pH, Org-C, Tot-N, Tot-P, Tot-S, P-AL, P-Olsen, K-AL, and some metals) and microbiological (B-resp, SIR, microSIR active and dormant microorganisms, PDA, microPDA, PAO, Alk-P and N-min) analyses. Results show that compost increased pH, and that compost as well as sewage sludge increased plant available phosphorus; however, the chemical analysis showed few clear trends over the 4 years and few clear relations to plant yield or soil quality. Biogas residues increased substrate induced respiration (SIR) and, compared to the untreated control amendment of biogas residues as well as compost, led to a higher proportion of active microorganisms. In addition, biogas residues increased potential ammonia oxidation rate (PAO), nitrogen mineralization capacity (N-min) as well as the specific growth rate constant of denitrifiers (microPDA). Despite rather large concentrations of heavy metals in some of the waste products, no negative effects could be seen on either chemical or microbiological soil properties. Changes in soil microbial properties appeared to occur more rapidly than most chemical properties. This suggests that soil microbial processes can function as more sensitive indicators of short-term changes in soil properties due to amendment of organic wastes.
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Affiliation(s)
- M Odlare
- Department of Public Technology, Mälardalen University, Box 883, SE-721 23 Västerås, Sweden.
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Abstract
Ortho-para conversion of H2 adsorbed at the step atoms of a Cu(510) surface proceeds with a short conversion time constant around 1 s as observed in electron-energy-loss measurements of rotational populations. We suggest that this rapid conversion is related to the special character of the adsorption state, which involves a short H2-Cu bond length of 1.8 A. On the flat Cu(100) surface, conversion is found to occur at active sites, most likely step atoms.
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Affiliation(s)
- K Svensson
- Department of Applied Physics, Chalmers University of Technology, SE-412 96 Göteborg, Sweden
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Raustorp A, Mattsson E, Svensson K, Ståhle A. Physical activity, body composition and physical self-esteem: a 3-year follow-up study among adolescents in Sweden. Scand J Med Sci Sports 2006; 16:258-66. [PMID: 16895531 DOI: 10.1111/j.1600-0838.2005.00483.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To measure physical activity by means of daily pedometer steps, body composition, expressed as body mass index (BMI) and bioelectrical impedance as percent body fat, and perceived physical self-esteem and additionally, to evaluate eventual predictors for a healthy lifestyle i.e., highly physically active, normal weighted and a high physical self-esteem in a follow-up group. METHODS During autumn 2000 physical activity level was assessed and BMI was calculated in 871 children aged 7-14 in south eastern Sweden and in 501 of these, physical self-esteem were also assessed. During autumn 2003 a total of 375 adolescents aged 15-18 were assessed using the same methodology and additionally percent body fat was measured. Ninety-three of these adolescents (46 girls), were also measured in 2000 and they formed the follow-up group. RESULTS In the follow-up group a significant increase in BMI and stability in physical self-esteem in boys and girls, and in boys a significant decrease in daily steps was found 3 years later. Strongest predictor to be highly physically active, maintain normal BMI and high self-esteem 3 years later, i.e., to have a healthy lifestyle, was for girls increased self-esteem and for boys a decreased BMI. CONCLUSION Consequently, for a healthy lifestyle, promoting physical self-esteem in girls and weight control in boys is of great importance in early adolescence.
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Affiliation(s)
- A Raustorp
- Department of Health and Behavioural Science, Division of Physical Education, University of Kalmar, Kalmar, Sweden.
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31
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Abstract
Using electron-energy-loss spectroscopy, we have measured preferential adsorption of molecular hydrogen at Cu and Au adatoms deposited on a cold Cu(100) surface. We show, with particular attention to the D(2)-Au system, that the molecules adsorb at the adatoms, with an enhanced binding energy. The adsorption state is not of chemisorption character, the D(2) rotational and internal vibrational transition energies are close to the corresponding gas phase values, a characteristic property of a physisorbed state. A revealing signature of the D(2)-Au interaction is an induced dipole activity of the rotational transition, which discriminates molecules adsorbed at the adatoms from those adsorbed on the bare substrate surface. The average number of molecules per Au atom depends on the Au coverage and increases at lower coverages, for example, at 4% of an adatom monolayer, there are approximately six D(2) molecules per Au adatom. In this limit, Au monomers prevail, and a cluster of six D(2) around a single Au adatom appears to be an optimal dense two-dimensional configuration.
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Affiliation(s)
- J Bellman
- Department of Applied Physics, Chalmers University of Technology, SE-412 96 Göteborg, Sweden
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32
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Calverley P, Pauwels Dagger R, Löfdahl CG, Svensson K, Higenbottam T, Carlsson LG, Ståhl E. Relationship between respiratory symptoms and medical treatment in exacerbations of COPD. Eur Respir J 2005; 26:406-13. [PMID: 16135720 DOI: 10.1183/09031936.05.00143404] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Exacerbations of chronic obstructive pulmonary disease (COPD) can be defined symptomatically or by healthcare contacts, yet the relationship between these events is unknown. Data were collected during a 1-yr study of the budesonide/formoterol combination in COPD patients, where exacerbations, defined by increases in treatment, were compared with daily records of respiratory symptoms, rescue medication use and peak expiratory flow (PEF). The relationship between changes in these variables and the medical event was examined using different modelling approaches. Data from the first exacerbation treated with oral corticosteroids and/or antibiotics and/or hospitalisation (event based) were available in 468 patients. Patients exacerbating were significantly more breathless and more likely to report cough than healthy patients, but did not differ in baseline spirometry. Exacerbations defined by changes in individual symptoms were only weakly related to event-based exacerbations; however, defined with 63% of such events being predicted from symptom changes. Changes in rescue medication use or PEF were poor predictors of event-based exacerbations. The mean peak change in symptoms was closely related to the onset of therapy. In conclusion, event-based exacerbations are a valid way of identifying acute symptom change in a chronic obstructive pulmonary disease population. However, daily symptom monitoring is too variable using the current diary cards to make individual management decisions.
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Affiliation(s)
- P Calverley
- The University Hospital Aintree, Liverpool Longmoor Lane, L9 7AL, UK.
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33
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Lindgren B, Sears MR, Campbell M, Villasante C, Huang S, Lindh A, Petermann W, Svensson K, Berggren F, Pauwels RA. Cost-effectiveness of formoterol and salbutamol as asthma reliever medication in Sweden and in Spain. Int J Clin Pract 2005; 59:62-8. [PMID: 15707467 DOI: 10.1111/j.1742-1241.2005.00347.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study aimed to evaluate the cost-effectiveness of formoterol (Oxis) Turbuhaler 4.5 microg and salbutamol 200 microg as reliever medications in Sweden and Spain. The study used data on effectiveness (exacerbations and symptom-free days) and resource utilisation from an open, 6-month, parallel-group, multicentre randomised trial with 18,124 asthma patients in 24 countries. Country-specific unit costs for Sweden and for Spain were used to transform resource utilisation data into costs. Total healthcare costs were not significantly different between formoterol and salbutamol dry powder inhalers in Sweden, whereas in Spain, the healthcare costs were 20% higher for formoterol vs. salbutamol pressurised metered dose inhalers. Total healthcare costs increased with disease severity, defined according to the Global Initiative for Asthma guidelines. Compared with salbutamol, formoterol produced statistically significant improvements in effectiveness, less reliever and maintenance medication usage, reduced healthcare resource utilisation, with no increase or a limited increase in healthcare cost.
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Affiliation(s)
- B Lindgren
- Lund University Centre for Health Economics,Lund University, Lund, Sweden.
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Bowden CL, Grunze H, Mullen J, Brecher M, Paulsson B, Jones M, Vågerö M, Svensson K. A randomized, double-blind, placebo-controlled efficacy and safety study of quetiapine or lithium as monotherapy for mania in bipolar disorder. J Clin Psychiatry 2005; 66:111-21. [PMID: 15669897 DOI: 10.4088/jcp.v66n0116] [Citation(s) in RCA: 224] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the efficacy and tolerability of quetiapine monotherapy versus placebo for the treatment of mania associated with bipolar disorder. METHOD In an international, multicenter, double-blind, parallel-group, 12-week study, patients with a DSM-IV diagnosis of bipolar I disorder (manic episode) were randomly assigned to treatment with quetiapine (flexibly dosed up to 800 mg/day), placebo, or lithium. The primary efficacy measure was change from baseline in Young Mania Rating Scale (YMRS) score at day 21. Data were gathered from April 2001 to May 2002. RESULTS More patients in the quetiapine (72/107) and lithium (67/98) groups completed the study compared with the placebo group (35/97). Improvement (reduction) in YMRS score was significantly greater for quetiapine than placebo at day 7 (-8.03 vs. -4.89; p < .01), and the difference between groups continued to increase over time to day 21 (-14.6 vs. -6.7; p < .001) and to endpoint at day 84 (-20.3 vs. -9.0; p < .001). Significantly more quetiapine patients compared with placebo patients fulfilled YMRS response criteria at day 21 (53.3% vs. 27.4%; p < .001) and at day 84 (72.0% vs. 41.1%; p < .001). Quetiapine was also superior to placebo in efficacy at day 21 and day 84 by all secondary measures. Lithium-treated patients improved significantly compared with placebo patients and similarly to quetiapine-treated patients on the primary efficacy measure. The most common adverse events for quetiapine were dry mouth, somnolence, and weight gain, while lithium was associated with tremor and insomnia. The quetiapine and placebo groups had similar, low levels of extrapyramidal symptom-related adverse events. CONCLUSIONS Quetiapine demonstrated superior efficacy to placebo in patients with bipolar mania and was well tolerated.
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Affiliation(s)
- Charles L Bowden
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX 78229-3900, USA.
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35
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Abstract
Here we demonstrate, for the first time experimentally, a nanopipette action for metals using multiwalled carbon nanotubes. The process relies on electromigration forces, created at high electron current densities, enabling the transport of material inside the hollow core of carbon nanotubes. In this way nanoparticles of iron were transported to and from electrically conducting substrates.
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Affiliation(s)
- K Svensson
- Department of Experimental Physics, Chalmers University of Technology and Göteborg University, Sweden
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Svensson K, Lange S, Lönnroth I, Widström AM, Hanson LA. Induction of anti-secretory factor in human milk may prevent mastitis. Acta Paediatr 2004; 93:1228-31. [PMID: 15384889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
AIM The aim of the study was to try to induce anti-secretory factor (AF) in human milk and possibly prevent mastitis. METHODS Forty mothers who had normal deliveries and healthy full-term infants were randomly divided into two groups, 3-7 days postpartum. The experimental group received a food inducing AF. The control group received the same type of food, without AF-inducing properties. Milk was tested for AF after the mothers had eaten the cereals for 4-5 wk. AF was determined by intravenous injection of milk samples into rats measuring their capacity to prevent secretion into a gut loop of the rat injected with cholera toxin. RESULTS The median levels of AF differed between the experimental (n = 12) and control groups (n = 16): 1.1 (0.7-1.25) units vs 0.1 (0.0-0.25) units, Z = -4.492, p < 0.0001 (11 mothers dropped out and one milk sample is missing from one of the control mothers). The frequency of mastitis in the experimental compared with the control group was reduced (p = 0.0086, permutation test). The median AF levels in mothers with or without mastitis differed; 0.0 (0.0-0.1) vs 0.5 (0.2-1.1), Z = -2.399, p = 0.017. CONCLUSION We suggest a specially treated cereal induces AF in human milk and protects against clinically manifested mastitis.
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Affiliation(s)
- K Svensson
- Division of Reproductive and Perinatal Health Care, Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden.
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Abstract
High levels of acrylamide have been found in foods heated at high temperatures, especially in carbohydrate rich foods. Several kinds of foods (industrially produced) representing different food/product groups available on the Swedish market have been analysed for acrylamide. A considerable variation in levels of acrylamide between single foodstuffs (different brands) within food categories were found, which also applies for levels in different food categories. Using recent Swedish food consumption data the dietary intake of acrylamide for the Swedish adult population was assessed based on foodstuffs with low to high levels of acrylamide (<30-2300 microg/kg), such as processed potato products, bread, breakfast cereals, biscuits, cookies, snacks and coffee. The estimated dietary intake of acrylamide per person (total population) given as the 5th, 50th and 95th percentile were 9.1, 27 and 62 microg/day respectively, from those food/product groups (mean 31 microg/day). No acrylamide was found in many other foodstuffs analysed and those were therefore not included in the dietary intake assessment of acrylamide. However, an additional minor contribution of a few microg/day of acrylamide from foods/products like poultry, meat, fish, cocoa powder and chocolates cannot be excluded. An average daily intake of 35 microg corresponds to 0.5 microg per kg body weight and day (body weight 70 kg). Risk assessments of acrylamide, made by US EPA and WHO, imply that this dietary intake of acrylamide could be associated with potential health risks.
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Affiliation(s)
- K Svensson
- National Food Administration, Box 622, SE 75126 Uppsala, Sweden.
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38
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Abstract
The aim was to compare health-related quality of life (HRQL) in patients with asthma from 4 countries, and to investigate the correlations between HRQL and clinical indices.341 patients; 140 (Sweden), 54 (Norway), 65 (the Netherlands) and 82 (Greece) were treated with formoterol fumarate 4.5 microg or with terbutaline sulphate 0.5mg for 12 weeks inhaled 'on demand' via Turbuhaler. The Asthma Quality of Life Questionnaire (AQLQ) and clinical indices were assessed. The mean baseline AQLQ overall scores in Sweden (4.97), in the Netherlands (5.04), in Norway (4.68) and in Greece (4.68) were in the same range, however, with a significant difference between the four countries (p=0.038). When comparing AQLQ, activity limitation and symptoms domains, the differences between the countries were not statistically significant. The cross-sectional correlations between AQLQ overall score and the clinical indices were similar in all four countries. The magnitude of change in AQLQ was consistent with the other clinical variables. The correlations between change in AQLQ overall score and change in clinical indices were low to medium in all countries. In conclusion, the consistency of cross-sectional correlations between the AQLQ overall and clinical indices across countries supports the validity of translations of the AQLQ used in this study. There were differences in baseline values between the countries. The treatment response in AQLQ differed to the same extent as other clinical indices. When combining HRQL data from different countries, there might be cultural, gender and socio-economic differences, explaining different responses to treatment.
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Affiliation(s)
- E Ståhl
- Department of Respiratory Medicine, University Hospital, Lund,
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39
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Chuchalin AG, Svensson K, Ståhl E, Ovcharenko SI, Goriachkina LA, Sidorenko IV, Tsoi AN. A health-related quality-of-life comparison of formoterol (Oxis) Turbuhaler plus budesonide (Pulmicort) Turbuhaler with budesonide Turbuhaler alone and noncorticosteroid treatment in asthma: a randomized clinical study in Russia. Respiration 2002; 69:427-33. [PMID: 12232450 DOI: 10.1159/000064022] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Russia, current therapy for the long-term management of asthma is mainly nonsteroidal. This situation provides the opportunity to evaluate new asthma treatments in a patient cohort with little previous exposure to inhaled corticosteroids. OBJECTIVES To compare the effect of formoterol (Oxis) Turbuhaler plus budesonide (Pulmicort) Turbuhaler with budesonide Turbuhaler alone, on the health-related quality of life (HRQL) of patients with mild to moderate asthma. METHODS A double-blind, parallel-group, randomized, 12-week study compared formoterol Turbuhaler plus budesonide Turbuhaler and budesonide Turbuhaler alone with an open control group of the investigator's choice of noncorticosteroid therapy. Patients completed the Short Form 36 (SF-36) and the Asthma Quality of Life Questionnaire (AQLQ). RESULTS The improvement in HRQL scores for patients treated with noncorticosteroids was significantly less (p < 0.05) than those treated with formoterol plus budesonide and budesonide alone in all domains of the SF-36 and AQLQ with one marginal exception (budesonide versus investigator's choice, SF-36, Mental Component Scale, p = 0.053). Improvements in HRQL scores of formoterol plus budesonide, compared with budesonide alone, although generally higher, were not significantly different. Formoterol plus budesonide was more effective in improving lung function and reducing both symptoms and the need for relief terbutaline inhalation. CONCLUSION Formoterol Turbuhaler plus budesonide Turbuhaler and budesonide Turbuhaler alone significantly improved the HRQL of patients with mild to moderate asthma compared with noncorticosteroid treatment.
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Affiliation(s)
- A G Chuchalin
- Russian Research Institute of Pulmonology, Moscow, Russia.
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40
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Velloso L, Svensson K, Schneider G, Pettersson RF, Lindqvist Y. Crystal structure of p58/ERGIC-53, a protein involved in glycoprotein export from the endoplasmic reticulum. Acta Crystallogr A 2002. [DOI: 10.1107/s0108767302096769] [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: 11/10/2022] Open
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41
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Stehr J, Müller T, Svensson K, Kamnerdpetch C, Scheper T. Basic examinations on chemical pre-oxidation by ozone for enhancing bioremediation of phenanthrene contaminated soils. Appl Microbiol Biotechnol 2001; 57:803-9. [PMID: 11778897 DOI: 10.1007/s00253-001-0840-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Biological treatment of polycyclic aromatic hydrocarbons (PAH) has been demonstrated to be a feasible and common remediation technology which has been successfully applied to the clean-up of contaminated soils. Because bioavailability of the contaminants is of great importance for a successful bioremediation, a chemical pre-oxidation step by ozone was tested to enhance the subsequent biodegradation steps. Oxidation of PAH by ozone should result in reaction products that have a better solubility in water and thus a better bioavailability. A major part of this work was done by examinations of the model substance phenanthrene as a typical compound of PAH. After initial ozonation of phenanthrene, analysis by GC-MS showed at least seven identified conversion-products of phenanthrene. In comparison with phenanthrene these conversion products were more efficiently biodegraded by Sphingomonas yanoikuyae or mixed cultures when the ozonation process resulted in monoaromatic compounds. Primary ozonation products with biphenylic structures were found not to be biodegradable. Investigations into the toxicity of contaminated and ozonated soils were carried out by well-established toxicity assays using Bacillus subtilis and garden cress. The ozonated soils surprisingly showed higher toxic or inhibitory effects towards different organisms than the phenanthrene or PAH itself. The microbial degradation of phenanthrene in slurry reactors by S. yanoikuyae was not enhanced significantly by preozonation of the contaminated soil.
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Affiliation(s)
- J Stehr
- Institut für Technische Chemie, Universität Hannover, Germany
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42
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Makino Y, Cao R, Svensson K, Bertilsson G, Asman M, Tanaka H, Cao Y, Berkenstam A, Poellinger L. Inhibitory PAS domain protein is a negative regulator of hypoxia-inducible gene expression. Nature 2001; 414:550-4. [PMID: 11734856 DOI: 10.1038/35107085] [Citation(s) in RCA: 454] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Alteration of gene expression is a crucial component of adaptive responses to hypoxia. These responses are mediated by hypoxia-inducible transcription factors (HIFs). Here we describe an inhibitory PAS (Per/Arnt/Sim) domain protein, IPAS, which is a basic helix-loop-helix (bHLH)/PAS protein structurally related to HIFs. IPAS contains no endogenous transactivation function but demonstrates dominant negative regulation of HIF-mediated control of gene expression. Ectopic expression of IPAS in hepatoma cells selectively impairs induction of genes involved in adaptation to a hypoxic environment, notably the vascular endothelial growth factor (VEGF) gene, and results in retarded tumour growth and tumour vascular density in vivo. In mice, IPAS was predominantly expressed in Purkinje cells of the cerebellum and in corneal epithelium of the eye. Expression of IPAS in the cornea correlates with low levels of expression of the VEGF gene under hypoxic conditions. Application of an IPAS antisense oligonucleotide to the mouse cornea induced angiogenesis under normal oxygen conditions, and demonstrated hypoxia-dependent induction of VEGF gene expression in hypoxic corneal cells. These results indicate a previously unknown mechanism for negative regulation of angiogenesis and maintenance of an avascular phenotype.
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Affiliation(s)
- Y Makino
- Department of Cell and Molecular Biology, Medical Nobel Institute, Karolinska Institutet, S-171 77 Stockholm, Sweden
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43
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Trollér U, Zeidman R, Svensson K, Larsson C. A PKCbeta isoform mediates phorbol ester-induced activation of Erk1/2 and expression of neuronal differentiation genes in neuroblastoma cells. FEBS Lett 2001; 508:126-30. [PMID: 11707282 DOI: 10.1016/s0014-5793(01)03043-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Protein kinase C (PKC) activation induces neuronal differentiation of SH-SY5Y neuroblastoma cells. This study examines the role of PKCbeta isoforms in this process. The PKCbeta-specific inhibitor LY379196 had no effect on 12-O-tetradecanoylphorbol 13-acetate (TPA)-induced neurite outgrowth from SH-SY5Y neuroblastoma cells. On the other hand, PKCbeta inhibition suppressed the TPA-stimulated increase in neuropeptide Y mRNA, activation of neuropeptide Y gene promoter elements, and phosphorylation of Erk1/2. The TPA-induced increase in neuropeptide Y expression was also inhibited by the MEK inhibitor PD98059. These data indicate that activation of a PKCbeta isoform, through a pathway involving Erk1/2, leads to increased expression of neuronal differentiation genes in neuroblastoma cells.
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Affiliation(s)
- U Trollér
- Lund University, Molecular Medicine, Malmö University Hospital, 205 02 Malmö, Sweden
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44
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O'Byrne PM, Barnes PJ, Rodriguez-Roisin R, Runnerstrom E, Sandstrom T, Svensson K, Tattersfield A. Low dose inhaled budesonide and formoterol in mild persistent asthma: the OPTIMA randomized trial. Am J Respir Crit Care Med 2001; 164:1392-7. [PMID: 11704584 DOI: 10.1164/ajrccm.164.8.2104102] [Citation(s) in RCA: 432] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The optimal treatment for mild asthma is uncertain. We assessed the effects of adding a long-acting inhaled beta-agonist, formoterol, to low doses of an inhaled corticosteroid, budesonide, for 1 yr in subjects with mild asthma, receiving no or only a small dose of inhaled corticosteroid. The 698 corticosteroid free patients (Group A) were assigned to twice daily treatment with 100 microg budesonide, 100 microg budesonide plus 4.5 microg formoterol, or placebo. The 1,272 corticosteroid-treated patients (Group B) were assigned to twice daily treatment with 100 microg budesonide, 100 microg budesonide plus 4.5 microg formoterol, 200 microg budesonide, or 200 microg budesonide plus 4.5 microg formoterol. The main outcome variables were time to the first severe asthma exacerbation and poorly controlled asthma days. In Group A, budesonide alone reduced the risk for severe exacerbations by 60% and poorly controlled days by 48%; adding formoterol increased lung function with no change in other end points. By contrast, in Group B, adding formoterol reduced the risk for the first severe exacerbation and for poorly controlled days by 43 and 30%, respectively. Thus, in corticosteroid-free patients, low dose inhaled budesonide alone reduced severe exacerbations and improved asthma control, and in patients already receiving inhaled corticosteroid, adding formoterol was more effective than doubling the corticosteroid dose.
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Affiliation(s)
- P M O'Byrne
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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45
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Abstract
The rate of respiration obtained in the substrate-induced respiration (SIR) method can be divided into the respiration rate of growing (r) and non-growing (K) microorganisms. The fraction of r is generally small (5-20%) in soils with no recent addition of substrates, but can be 100% in soils with high substrate availability. This suggests that substrate availability determines the proportion of biomass between these groups, and implies that transitions between them can take place reversibly. These hypotheses were tested by adding three different amounts of glucose which induced first-order, zero-order, and growth-associated respiration kinetics to three soils at four pre-incubation times (4, 12, 27, and 46 days) before the SIR measurement. An abiotic flush of CO(2) in the SIR measurement was detected and corrected for before data analysis. Accumulated CO(2)-C over 4 days after glucose addition, corrected for the respiration in unamended controls, corresponded to 41-50% mineralization of the glucose-C, and the relative amount mineralized by each soil was independent of the glucose amount added. The high glucose concentration gave an increased SIR, which reverted to the initial value within 27-46 days. In a specific sample, the maximum respiration rate induced during the pre-incubation, and the amount of organisms transformed from the K to the r state, as quantified in respiration rate units in the SIR measurement, were identical to each other, and these parameters were also highly correlated to the initial glucose concentration. The K-->r transition was very fast, probably concurrent with the instantaneous increase in the respiration rate obtained by the glucose amendment. Thereafter, a slow first-order back-transition from the r to the K state ensued, with half-lives of 12, 23, and 70 days for the three soils. The results suggest the existence of community-level controls by which growth within or of the whole biomass is inhibited until it has been completely transformed into the r state. The data also suggest that the microbial specific activity is not related to the availability of exogenous substrate in a continuous fashion, rather it responds as a sharp transition between dormant and fully active. Furthermore, the inherent physiological state of the microbial biomass is strongly related to its history. It is proposed that the normal dynamics of the soil microbial biomass is an oscillation between active and dormant physiological states, while significant growth occurs only at substantial substrate amendment.
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Affiliation(s)
- J Stenström
- Department of Microbiology, Swedish University of Agricultural Sciences, P.O. Box 7025, SE-750 07, Uppsala, Sweden
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Svensson K, Zeidman R, Trollér U, Schultz A, Larsson C. Protein kinase C beta1 is implicated in the regulation of neuroblastoma cell growth and proliferation. Cell Growth Differ 2000; 11:641-8. [PMID: 11149599] [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: 02/18/2023]
Abstract
To investigate a putative involvement of protein kinase C (PKC) isoforms in supporting neuroblastoma cell proliferation, SK-N-BE(2) neuroblastoma cells were transfected with expression vectors coding for the C2 and V5 regions from different PKC isoforms. These structures have been suggested to inhibit the activity of their corresponding PKC isoform. The PKC fragments were fused to enhanced green fluorescent protein to facilitate the detection of transfected cells. Expression of the C2 domain from a classical PKC isoform (PKCalpha), but not of C2 domains from novel PKCdelta or PKCepsilon, suppressed the number of neuroblastoma cells positive for cyclin A and bromodeoxyuridine incorporation. This indicates a role for a classical isoform in regulating proliferation of these cells. Among the V5 fragments from PKCalpha, PKCbetaI, and PKCbetaII, the PKCbetaI V5 had the most suppressive effect on proliferation markers, and this fragment also displaced PKCbetaI from the nucleus. Furthermore, a PKCbeta-specific inhibitor, LY379196, suppressed the phorbol ester- and serum-supported growth of neuroblastoma cells. There was a marked enhancement by LY379196 of the growth-suppressive and/or cytotoxic effects of paclitaxel and vincristine. These results indicate that PKCbetaI has a positive effect on the growth and proliferation of neuroblastoma cells and demonstrate that inhibition of PKCbeta may be used to enhance the effect of microtubule-interacting anticancer agents on neuroblastoma cells.
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Affiliation(s)
- K Svensson
- Lund University, Department of Laboratory Medicine, Molecular Medicine, Malmö University Hospital, Sweden
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Hammarling L, Gustavsson H, Svensson K, Oskarsson A. Migration of bisphenol-A diglycidyl ether (BADGE) and its reaction products in canned foods. Food Addit Contam 2000; 17:937-43. [PMID: 11271708 DOI: 10.1080/026520300750038126] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Bisphenol-A diglycidyl ether (BADGE) is used as an additive or starting agent in coatings for cans. The presence of hydrochloric acid in the organosol (PVC-based) lacquers results in formation of chlorohydroxy compounds of BADGE. These compounds, as well as BADGE itself, are potential migrants into the preserved food and are of toxicological concern. In the present investigation the presence of BADGE and the chlorohydroxy compounds (BADGE.HCl and BADGE.2HCl) in various kinds of canned foods from 30 brands have been determined by HPLC with fluorescence detection. BADGE was found in levels up to 5.1 mg/kg in the food and only in food from cans containing BADGE.HCl and BADGE.2HCl in the lacquers. BADGE was found both in fish in oil and in fish in tomato sauce, however, the highest amounts were found in the fatty foodstuffs. BADGE.HCl and BADGE.2HCl were found in concentrations up to 2.4 mg/kg and 8.3 mg/kg, respectively. Unlike BADGE, BADGE.2HCl was found in similar concentrations in fish in oil and in fish in tomato sauce. In aqueous and acidic foodstuffs BADGE readily hydrolyses into mono- and dihydrolysed products (BADGE.H2O and BADGE.2H2O). In this study BADGE.H2O was not found in any food sample, whereas BADGE.2H2O was found in levels up to 2.6 mg/kg. The Scientific Committee for Food (SCF) of the European Commission has proposed that a limit of restriction of 1 mg/kg food shall include BADGE itself and BADGE.H2O, BADGE.HCl, BADGE.2HCl and BADGE.HCL.H2O. The present results indicate that the migration of BADGE.HCl and BADGE.2HCl, compounds with almost no data on toxicity, implies a greater problem than BADGE.H2O and BADGE.2H2O.
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Affiliation(s)
- L Hammarling
- National Food Administration, Box 622, SE-751 26 Uppsala, Sweden.
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Osman H, Schmidt J, Svensson K, Palmer R, Shigeta Y, Wilcoxon J. STM studies of passivated Au nanocrystals immobilised on a passivated Au(111) surface: ordered arrays and single electron tunnelling. Chem Phys Lett 2000. [DOI: 10.1016/s0009-2614(00)01072-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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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Liang L, Kanduri C, Pilartz M, Svensson K, Song JH, Wentzel P, Eriksson U, Ohlsson R. Dynamic readjustment of parental methylation patterns of the 5'-flank of the mouse H19 gene during in vitro organogenesis. Int J Dev Biol 2000; 44:785-90. [PMID: 11128572] [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: 02/18/2023]
Abstract
Gametic marks are stably propagated in order to manifest parent of origin-specific expression patterns of imprinted genes in the developing conceptus. Although the character of the imprint has not yet been fully elucidated, there is compelling evidence that it involves a methylation mark. This is exemplified by a region upstream of the H19 gene, which is not only methylated in a parent of origin-specific manner, but also regulates the silencing of the maternal Igf2 and paternal H19 alleles, respectively. We show here that the parental-specific methylation patterns within the differentially methylated domain (DMD) are perturbed in the soma during in vitro organogenesis. Under these conditions, the paternal DMD allele becomes partially demethylated, whereas the maternal DMD allele gains methylation. Despite these effects, there were no changes in allelic Igf2 or H19 expression patterns in the embryo. Finally, we show that although TSA derepresses the paternal H19 allele in ectoplacental cone when in vitro developed, there is no discernible effect on the methylation status of the paternally inherited 5'-flank in comparison to control samples. Collectively, this data demonstrates that the parental mark is sensitive to a subset of environmental cues and that a certain degree of plasticity of the gametic mark is tolerated without affecting the manifestation of the imprinted state.
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Affiliation(s)
- L Liang
- Department of Development & Genetics, Uppsala University, Sweden
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van Vliet LA, Rodenhuis N, Wikström H, Pugsley TA, Serpa KA, Meltzer LT, Heffner TG, Wise LD, Lajiness ME, Huff RM, Svensson K, Haenen GR, Bast A. Thiazoloindans and thiazolobenzopyrans: a novel class of orally active central dopamine (partial) agonists. J Med Chem 2000; 43:3549-57. [PMID: 11000009 DOI: 10.1021/jm000087z] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The 2-aminothiazole moiety has proven its value in medicinal chemistry as a stable and lipophilic bioisosteric replacement of a phenol group. This approach has provided dopamine (DA) agonists with good oral availability. To further explore its use in the development of DA agonists, we have combined the 2-aminothiazole moiety with 2-aminoindans and 3-aminobenzopyrans, which are known templates for DA agonists. In this study we have synthesized 6-amino-3-(N,N-di-n-propylamino)-3,4-dihydro-2H-thiazolo[5, 4-f]-[1]benzopyran (12) and 6-amino-2-(N, N-di-n-propylamino)thiazolo[4,5-f]indan (20) and several analogues (13, 17, and 21). The affinity of the thiazolobenzopyrans and thiazoloindans for DA receptors was evaluated, which revealed compound 20 to have high affinity for DA D(3) receptors. In addition, the compounds were screened for their potential to inhibit lipid peroxidation, to determine their radical scavenging properties. Compounds 12, 20, and 21 were subjected to further pharmacological evaluation in a functional assay to determine intrinsic activity. Compound 20 was also studied with microdialysis (to determine effects on DA turnover in striatum) and in unilaterally 6-OH-DA lesioned rats (to determine their potential as DA agonists). These studies selected compound 20 (GMC 1111) as particularly interesting. Compound 20 caused a rotation activation in unilaterally 6-OH-DA lesioned rats and an increase in DA turnover in rat striatum. This dual agonist/antagonist action is best accounted for by its partial agonism at striatal DA D(2) receptors. Interestingly, 20 displayed long-lasting activity and excellent oral availability in 6-OH-DA lesioned rats, making this compound potentially useful for the treatment of Parkinson's disease.
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Affiliation(s)
- L A van Vliet
- Department of Pharmacology, Faculty of Medicine, University of Maastricht, Postbus 616, NL-6200 MD Maastricht, The Netherlands.
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