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Meyer E, Kruglov D, Krivic M, Tanveer M, Argaez-Ramirez R, Zhang Y, Briseno Ojeda A, Smirnova K, Alekseev K, Safari Mugisho M, Cimbili B, Farid N, Dang Y, Shahid M, Ensan M, Banar J, Bao H, Matters-Kammerer M, Gustavsson U, Demuynck F, Zwick T, Acar M, Fager C, van der Heijden M, Ivashina M, Caratelli D, Hasselblad M, Ulusoy C, Smolders A, Eriksson K, Johannson M, Maaskant R, Quay R, Floriot D, Bao M, Bronckers L, Fridén J, van Beurden M, de Hon B, Kolitsidas C, Blanco D, Willems F, Eriksson T, Filippi A, Ponzini F, Johannsen U. The state of the art in beyond 5G distributed massive multiple-input multiple-output communication system solutions. Open Res Eur 2022; 2:106. [PMID: 37982077 PMCID: PMC10654493 DOI: 10.12688/openreseurope.14501.1] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/21/2023]
Abstract
Beyond fifth generation (5G) communication systems aim towards data rates in the tera bits per second range, with improved and flexible coverage options, introducing many new technological challenges in the fields of network architecture, signal pro- cessing, and radio frequency front-ends. One option is to move towards cell-free, or distributed massive Multiple-Input Multiple-Output (MIMO) network architectures and highly integrated front-end solutions. This paper presents an outlook on be- yond 5G distributed massive MIMO communication systems, the signal processing, characterisation and simulation challenges, and an overview of the state of the art in millimetre wave antennas and electronics.
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Affiliation(s)
- E. Meyer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - D. Kruglov
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. Krivic
- Keysight Technologies, Kortrijksesteenweg 1093B, 9051 Gent, Belgium
| | - M. Tanveer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - R. Argaez-Ramirez
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - Y. Zhang
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | | | - K. Smirnova
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - K. Alekseev
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Safari Mugisho
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - B. Cimbili
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - N. Farid
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - Y. Dang
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Shahid
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - M. Ensan
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - J. Banar
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - H. Bao
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. Matters-Kammerer
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - U. Gustavsson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - F. Demuynck
- Keysight Technologies, Kortrijksesteenweg 1093B, 9051 Gent, Belgium
| | - T. Zwick
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - M. Acar
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - C. Fager
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - M. van der Heijden
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - M. Ivashina
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - D. Caratelli
- The Antenna Company, High Tech Campus 29, 5656 AE Eindhoven, The Netherlands
| | - M. Hasselblad
- Gapwaves, Nellickevagen 22, 412 63 Gothenburg, Sweden
| | - C. Ulusoy
- Karlsruhe Institute of Technology, 6131 Karlsruhe, Germany
| | - A.B. Smolders
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - K. Eriksson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - M. Johannson
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - R. Maaskant
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - R. Quay
- Fraunhofer Institute for Applied Solid State Physics, IAF, Tullastraße 72, 79108 Freiburg, Germany
| | - D. Floriot
- United Monolithic Semiconductors SAS, Bâtiment Charmille, Mosaic parc de Courtaboeuf, 10 avenue du Québec, 91140, Villebon-sur-Yvette, France
| | - M. Bao
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - L.A. Bronckers
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - J. Fridén
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - M.C. van Beurden
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - B.P. de Hon
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - C. Kolitsidas
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - D. Blanco
- Ericsson AB, Lindholmspiren 11, 417 56 Göteborg, Sweden
| | - F.M.J. Willems
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
| | - T. Eriksson
- Chalmers University of Technology, Chalmersplatsen 4, 412 96 Göteborg, Sweden
| | - A. Filippi
- NXP Semiconductors, High Tech Campus 60, 5656 AG Eindhoven, The Netherlands
| | - F. Ponzini
- Ericsson Telecomunicazioni SpA, Via Anagnina 203, 00118 Rome, Italy
| | - U. Johannsen
- Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands
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Sabouri P, Andersson S, Nilsson R, Eriksson K, Mossahebi S. Using CBCT to Monitor Treatment Dose Delivery Accuracy in Head and Neck Proton Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ödén J, Eriksson K, Traneus E, Dasu A, Nyström PW, Toma-Dasu I. OC-0699: Relative biological effectiveness in proton therapy: accounting for variability and uncertainties. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00721-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Stefanski AL, Eriksson K, Zbinden A, Villiger P, Förger F. AB0105 CHECKPOINT MOLECULES AND PREGNANCY: ENHANCED SPD-L1 PREDICTS FLARE IN RA PREGNANCY AND POSTPARTUM. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a female-predominant autoimmune disease that may affect women in childbearing age, making family planning an important issue for their life. There is a need for better understanding the mechanisms modulating RA in pregnancy and develop prognostic marker regarding adverse pregnancy outcome such as reduced birth weight and preterm delivery. As a crucial organ for peripheral tolerance during pregnancy, the placenta is expressing constitutively programmed cell death ligand 1 (PD-L1), major ligand of the inhibitory receptor PD-1 (Zhang et al, 2015). We hypothesize that the PD-1 pathway plays a central inhibitory role in regulating the course of the disease and pregnancy outcome in RA.Objectives:To investigate the relationship between PD-1 pathway, disease activity during pregnancy/postpartum and pregnancy outcome in RA.Methods:We measured soluble PD-1 and PD-L1 levels by ELISA in serum samples of 27 pregnant RA patients and 25 healthy pregnant controls at different time points during pregnancy and postpartum. As for pregnancy controls, we analyzed serum samples from 28 non-pregnant RA patients and 18 non-pregnant healthy controls. The data was analyzed in correlation with disease activity (measured by DAS28-CRP) and pregnancy outcome (defined as preterm delivery and birth weight). Statistics were calculated by Mann-Whitney U test and Wilcoxon test, correlations by Spearman rank test.Results:In healthy pregnancy, sPD-L1 increases significantly in the 1sttrimester (p = 0,0198) and decreases significantly postpartum (p = 0,0029). sPD-L1 values are higher in non-pregnant RA patients compared to non-pregnant healthy controls (p = 0,047) and there are no significant changes during RA pregnancy. Postpartum sPD-L1 values are significantly higher in RA patients compared to healthy controls (p = 0,0014), Fig. 1. Notably, regarding disease activity, we noticed a significant positive correlation between the overall sPD-L1 values in RA and DAS28-CRP (p= 0.0104), Fig. 2. No significant correlation was seen between sPD-L1, birth weight and preterm delivery. For sPD-1 we focused on 3rdtrimester and postpartum, however, there was no difference between healthy controls and RA patients and no correlation with disease activity or pregnancy outcome.Conclusion:In healthy pregnancy, we observed an increase of sPD-L1, which decreases after delivery. This supports the hypothesis, that PD-1 pathway may be involved in shaping the physiological fetal-maternal tolerance. In RA higher sPD-L1 values are measured already in non-pregnant patients compared to healthy controls and there is no physiological decrease postpartum. Intriguing, sPD-L1 correlates positively with RA disease activity, reflecting a possible functional antagonism towards the inhibitory function of membrane bound PD-L1 molecules. However, the detailed function of sPD-L1 need to be further delineated. Nevertheless, sPD-L1 may have the potential to serve as prognostic marker for flares in RA pregnancy. Regarding the rather rarely observed adverse pregnancy outcome, larger cohorts need to be investigated.References:[1]Zhang YH, Tian M, Tang MX et al. Recent Insight into the Role of the PD-1/PD-L1 Pathway in Feto-Maternal Tolerance and Pregnancy. Am J Reprod Immunol. 2015 Sep;74(3):201-8.Disclosure of Interests:Ana-Luisa Stefanski: None declared, Klara Eriksson: None declared, Astrid Zbinden: None declared, Peter Villiger Consultant of: MSD, Abbvie, Roche, Pfizer, Sanofi, Speakers bureau: Roche, MSD, Pfizer, Frauke Förger Grant/research support from: Unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK
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Zbinden A, Eriksson K, Förger F. AB1294-HPR LOW CONCENTRATIONS OF BIOLOGIC DMARDS IN BREASTMILK OF PATIENTS TREATED DURING LACTATION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:There is very limited information about the passage of biologics into breast milk and into the peripheral blood of breastfed infants. However, based on pharmacological properties of biologic DMARDs (bDMARDs) lactation may not be discouraged in patients with chronic inflammatory rheumatic disease to treat or prevent postpartum relapses. We here report two cases treated with bDMARDs during lactation: one woman with Muckle-Wells syndrome (MWS) treated with canakinumab and one woman with microscopic polyangiitis (MPA) treated with rituximab.Objectives:To determine the level of rituximab and canakinumab in breast milk, in sera of breastfed infants as well as in sera of the mother and to calculate the average daily infant dose and the relative infant dose.Methods:Serum and milk levels of Rituximab were measured by ELISA using commercially available coating and detection antibodies. For Canakinumab an ELISA was established by coating of plates with recombinant human IL-1beta and detection of Canakinumab in samples by a polyclonal anti-human IgG coupled to HRP. In both cases separate standard curves for serum and milk were established. Serum samples and milk samples of unexposed healthy controls were used to determine the lower limit of quantification.Results:One patient with MWS received canakinumab 150 mg s.c. to treat a worsening of her disease ten days postpartum. She continued to breastfeed her child. The average concentration of canakinumab in milk samples collected on 10 consecutive days was 15.8 ng/ml. The average daily infant dose was 0.002 mg/kg/day. The relative infant dose, which refers infant to maternal exposure on a dose/weight basis, was 0.11%. There was no detectable canakinumab in the serum of the infant.One patient with MPA received rituximab 500 mg i.v. as a remission maintenance therapy four months postpartum. She continued to breastfeed her child. The average concentration of rituximab in milk samples collected on 4 consecutive days was 3.71 ng/ml. The average daily infant dose was 0.001 mg/kg/day. The relative infant dose was 0.01%. There was no detectable rituximab in the serum of the infant.Conclusion:Only minimal concentrations of canakinumab and rituximab can be detected in breastmilk. For both bDMARDs, the relative infant dose was below 1% of the maternal dose, which is considered unlikely to be of clinical concern. The lack of detectable levels of canakinumab and rituximab in the infants’ sera supports the notion of low oral bioavailability of large monoclonal antibodies. Together, the results are similar to those seen in TNF inhibitors which are regarded to be compatible with breastfeeding, yet more data are needed (1, 2, 3).References:[1]Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016 May;75(5):795-810. doi: 10.1136/annrheumdis-2015-208840. Epub 2016 Feb 17.[2]Clowse ME, Förger F, Hwang C, Thorp J, Dolhain RJ, van Tubergen A, Shaughnessy L, Simpson J, Teil M, Toublanc N, Wang M, Hale TW. Minimal to no transfer of certolizumab pegol into breast milk: results from CRADLE, a prospective, postmarketing, multicentre, pharmacokinetic study. Ann Rheum Dis. 2017 Nov;76(11):1890-1896. doi: 10.1136/annrheumdis-2017-211384. Epub 2017 Aug 16.[3]Matro R, Martin CF, Wolf D, Shah SA, Mahadevan U. Exposure Concentrations of Infants Breastfed by Women Receiving Biologic Therapies for Inflammatory Bowel Diseases and Effects of Breastfeeding on Infections and Development.Gastroenterology. 2018;155(3):696–704. doi:10.1053/j.gastro.2018.05.040Disclosure of Interests:Astrid Zbinden: None declared, Klara Eriksson: None declared, Frauke Förger Grant/research support from: Unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK
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Ödén J, Eriksson K, Toma-Dasu I. Simultaneously Integrated Boost and Variable Relative Biological Effectiveness Effects on Normal Tissue Complication Probability-Based Patient Selection for Proton Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Engberg L, Eriksson K, Forsgren A. EP-1893: Automated planning through explicit optimization of plan quality. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hirvonen M, Ojala R, Korhonen P, Haataja P, Eriksson K, Rantanen K, Gissler M, Luukkaala T, Tammela O. Intellectual disability in children aged less than seven years born moderately and late preterm compared with very preterm and term-born children - a nationwide birth cohort study. J Intellect Disabil Res 2017; 61:1034-1054. [PMID: 28699168 DOI: 10.1111/jir.12394] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 06/12/2017] [Accepted: 06/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Prematurity has been shown to be associated with an increased risk of intellectual disability (ID). METHOD The aim was to establish whether the prevalence of ID, defined as significant limitations in both intellectual (intelligence quotient below 70) and adaptive functioning among moderately preterm (MP; 32+0 -33+6 weeks) and late preterm (LP; 34+0 -36+6 weeks) infants, is increased compared with that in term infants (≥37+0 weeks). Antenatal and neonatal risk factors for ID among gestational age groups were sought. The national register study included all live-born infants in Finland in 1991-2008, excluding those who died before one year age, or had any major congenital anomaly or missing data. A total of 1 018 256 infants (98.0%) were analysed: very preterm (VP; <32+0 weeks, n = 6329), MP (n = 6796), LP (n = 39 928) and term (n = 965 203). RESULTS By the age of seven years, the prevalence of ID was 2.48% in the VP group, 0.81% in the MP group, 0.55% in the LP group and 0.35% in the term group. Intracranial haemorrhage increased the ID risk in all groups. Male sex and born small for gestational age predicted an increased risk in all but the MP group. CONCLUSIONS The prevalence of ID decreased with increasing gestational age. Prevention of intracranial haemorrhages may have a beneficial effect on the neurodevelopmental outcomes of neonates.
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Affiliation(s)
- M Hirvonen
- Department of Pediatrics, Central Finland Central Hospital, Jyväskylä, Finland
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - R Ojala
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - P Korhonen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - P Haataja
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - K Eriksson
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - K Rantanen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- School of Social Sciences and Humanities, Psychology Clinic, University of Tampere, Tampere, Finland
| | - M Gissler
- Information Services Department, National Institute for Health and Welfare, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - T Luukkaala
- Science Center, Pirkanmaa Hospital District, Tampere, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - O Tammela
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
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Odén J, Eriksson K, Flejmer A, Dasu A, Toma-Dasu I. PO-0832: The impact of variable RBE and breathing control in proton radiotherapy of breast cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31269-0] [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: 11/17/2022]
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Schueler E, Eriksson K, Hynning E, Loo B, Maxim P. TU-H-BRC-03: Evaluation of Very High-Energy Electron (VHEE) Beams in Comparison to VMAT and PBS Treatment Plans. Med Phys 2016. [DOI: 10.1118/1.4957610] [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: 11/07/2022] Open
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Engberg L, Eriksson K, Forsgren A, Hardemark B. WE-AB-209-07: Explicit and Convex Optimization of Plan Quality Metrics in Intensity-Modulated Radiation Therapy Treatment Planning. Med Phys 2016. [DOI: 10.1118/1.4957776] [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: 11/07/2022] Open
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Boeck M, Eriksson K, Forsgren A, Hardemark B. TU-H-CAMPUS-JeP3-01: Towards Robust Adaptive Radiation Therapy Strategies. Med Phys 2016. [DOI: 10.1118/1.4957699] [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: 11/07/2022] Open
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Burghelea M, Poels K, Gevaert T, Collen C, Dhont J, Hung C, Eriksson K, Simon V, De Ridder M, Verellen D. Preliminary Dosimetric Evaluation of Dynamic Wave Arc for SBRT Treatments. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Burghelea M, Poels K, Gevaert T, Tournel K, Dhont J, Hung C, Eriksson K, Simon V, De Ridder M, Verellen D. TU-CD-304-03: Dosimetric Verification and Preliminary Comparison of Dynamic Wave Arc for SBRT Treatments. Med Phys 2015. [DOI: 10.1118/1.4925572] [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: 11/07/2022] Open
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Pettersson S, Boström C, Eriksson K, Svenungsson E, Gunnarsson I, Henriksson EW. Lifestyle habits and fatigue among people with systemic lupus erythematosus and matched population controls. Lupus 2015; 24:955-65. [PMID: 25697772 DOI: 10.1177/0961203315572716] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/21/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of this paper is to identify clusters of fatigue in patients with systemic lupus erythematosus (SLE) and matched controls, and to analyze these clusters with respect to lifestyle habits, health-related quality of life (HRQoL), anxiety and depression. METHODS Patients with SLE (n = 305) and age- and gender-matched population controls (n = 311) were included. Three measurements of fatigue (Fatigue Severity Scale (FSS), Vitality (VT, from SF-36) and Multidimensional Assessment of Fatigue scale (MAF) and hierarchic cluster analysis were used to define clusters with different degrees of fatigue. Lifestyle habits were investigated through questionnaires. HRQoL was assessed with the SF-36 and anxiety/depression with the Hospital Anxiety and Depression Scale. RESULTS Three clusters, denominated "High," "Intermediate" and "Low" fatigue clusters, were identified. The "High" contained 80% patients, and 20% controls (median; VT 25, FSS 5.8, MAF 37.4). These had the most symptoms of depression (51%) and anxiety (34%), lowest HRQoL (p < 0.001) and they exercised least frequently. The "Intermediate" (48% patients and 52% controls) (median; VT 55, FSS 4.1, MAF 23.5) had similarities with the "Low" regarding sleep/rest whereas social status and smoking were closer to the "High." The"Low" contained 22% patients and 78% controls (median; VT 80, FSS 2.3, MAF 10.9). They had the highest perceived HRQoL (p < 0.001), least symptoms of anxiety (10%), no depression, smoked least (13%) and reported the highest percentage (24%) of exercising ≥ 3 times/week. CONCLUSION Fatigue is common, but not a general feature of SLE. It is associated with depression, anxiety, low HRQoL and less physical exercise. Patients with SLE and population controls with a healthy lifestyle reported lower levels of fatigue. Whether lifestyle changes can reduce fatigue, which is a major problem for a majority of SLE patients, needs to be further explored.
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Affiliation(s)
- S Pettersson
- Rheumatology Clinic, Karolinska University Hospital, Stockholm, Sweden Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - C Boström
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - K Eriksson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - E Svenungsson
- Department of Medicine, Unit of Rheumatology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - I Gunnarsson
- Department of Medicine, Unit of Rheumatology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - E Welin Henriksson
- Rheumatology Clinic, Karolinska University Hospital, Stockholm, Sweden Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Gelvez-Zapata S, D'Oliveiro R, Eriksson K, Bracken J, Pontin M, Jones N. INTRODUCTION OF WEEKLY MULTIDISCIPLINARY TEAM MEETINGS IN A TERTIARY CARDIOTHORACIC CRITICAL CARE UNIT: EVALUATION OF STAFF SATISFACTION AND IMPACT ON CLINICAL OUTCOMES. Intensive Care Med Exp 2015. [PMCID: PMC4798074 DOI: 10.1186/2197-425x-3-s1-a862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kharlamova N, Sherina N, Quirke AM, Eriksson K, Israelsson L, Potempa J, Venables P, Lindberg TL, Lundberg K. A6.8 Elevated antibody levels to porphyromonas gingivalis detected in rheumatoid arthritis patients with a specific anti-citrullinated protein/peptide antibody profile. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-205124.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Slavica L, Nurkkala-Karlsson M, Karlson T, Ingelsten M, Nyström J, Eriksson K. Indoleamine 2,3-dioxygenase expression and functional activity in dendritic cells exposed to cholera toxin. Scand J Immunol 2012; 76:113-22. [PMID: 22519828 DOI: 10.1111/j.1365-3083.2012.02713.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Indoleamine 2,3-dioxygenase (IDO), a tryptophan-metabolizing enzyme expressed by dendritic cells (DC), has the potential to inhibit T cell responses and to promote tolerance. In contrast, cholera toxin (CT), the enterotoxin produced by Vibrio cholerae, promotes T cell responses, partly through its ability to induce DC maturation and promote antigen presentation. We hypothesized that the adjuvant activity of CT is associated with a lack of induction of IDO in DC. To test this hypothesis, monocyte-derived DC were pulsed with CT, and the IDO mRNA expression, IDO functional activity and cytokine production were measured as well as the ability of DC to induce T cell responses in vitro. Cholera toxin exposure induced enhanced levels of IDO mRNA in DC but no functional IDO protein activity. Cholera toxin pulsing however primed DC for CD40L-induced IDO protein activity. CD40L stimulation of CT-pulsed DC induced a modest IL-12p40 production, but not IL-12p70 or IL-23 secretion. Furthermore, CT-pulsed DC induced strong allogeneic and autologous T cell responses in vitro, which were not affected by the IDO-specific inhibitor 1-methyl tryptophan. Our results show that CT per se does not induce the expression of functional IDO protein, although it primes DC for CD40L-mediated IDO production and IL-12p40 secretion. Furthermore, CT-treated DC were equally powerful in their T cell stimulatory capacity as cytokine-matured DC.
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Affiliation(s)
- L Slavica
- Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
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Rantanen K, Eriksson K, Nieminen P. Social competence in children with epilepsy--a review. Epilepsy Behav 2012; 24:295-303. [PMID: 22595143 DOI: 10.1016/j.yebeh.2012.04.117] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [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: 01/02/2012] [Revised: 04/05/2012] [Accepted: 04/07/2012] [Indexed: 11/30/2022]
Abstract
This systematic review focuses on definitions of social competence and assessment methods and provides an overview of the main findings in childhood epilepsy. A total of 45 studies drawn from MEDLINE and PsycINFO (1998-2010) and their reference lists met the selection criteria. Social competence was not defined in the studies reviewed. The study samples varied and consisted mostly of school-aged children. The majority of the studies focused on social adjustment and addressed problems in this area. Little is known about other aspects of social competence, namely social skills or social performance. A broader perspective on and definition of the assessment of social competence in children with epilepsy are proposed. More studies of the abilities underlying social competence, such as social and socio-cognitive skills, are needed in order to gain insight into the developmental pathways of social competence and protective factors for later development.
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Affiliation(s)
- K Rantanen
- University of Tampere, School of Social Sciences and Humanities, Psychology Clinic, Finland.
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Eriksson K, Svenungsson E, Karreskog H, Gunnarsson I, Gustafsson J, Möller S, Pettersson S, Boström C. Physical activity in patients with systemic lupus erythematosus and matched controls. Scand J Rheumatol 2012; 41:290-7. [DOI: 10.3109/03009742.2011.624117] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Svensson A, Nordström I, Rudin A, Bergström T, Eriksson K. Enveloped virus but not bacteria block IL-13 responses in human cord blood T cells in vitro. Scand J Immunol 2012; 75:409-18. [PMID: 22229804 PMCID: PMC7190188 DOI: 10.1111/j.1365-3083.2012.02676.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Infections that occur early in life may have a beneficial effect on the immune system and thereby reduce the risk of allergen sensitization and/or allergic disease. It is not yet clear to what extent specific virus and/or bacteria can mediate this effect. The purpose of this study was to assess the role of virus and bacteria in CD4+ T cell‐derived cytokine production in newborns. We compared the effects of five bacteria (Staphlococcus aureus, Escherichia coli, Clostridium difficile, Lactobacillus rhamnosus and Bifidobacterium bifidus) and seven virus (adenovirus, coronavirus, cytomegalovirus, herpes simplex virus, influenza virus, morbillivirus and poliovirus) on the Th1/Th2 cytokine production in mixed lymphocyte reactions using CD4+ T cells from cord blood cocultured with allogenic myeloid or plasmacytoid dendritic cells. When comparing the baseline cytokine production prior to microbial stimulation, we observed that cord plasmacytoid DC were stronger inducers of Th2 cytokines (IL‐5 and IL‐13) compared with cord myeloid DC and to adult DC. When adding microbes to these cultures, bacteria and virus differed in two major respects; Firstly, all enveloped viruses, but none of the bacteria, blocked Th2 (IL‐13) production by cord CD4+ cells. Secondly, all Gram‐positive bacteria, but none of the virus, induced IL‐12p40 responses, but the IL‐12p40 responses did not affect Th1 cytokine production (IFN‐γ). Instead, Th1 responses were correlated with the capacity to induce IFN‐α secretion, which in cord cells were induced by S. aureus and influenza virus alone. These data imply that enveloped virus can deviate Th2 responses in human cord T cells.
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Affiliation(s)
- A Svensson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Ahlqvist E, Turrini F, Lang ST, Taneera J, Zhou Y, Almgren P, Hansson O, Isomaa B, Tuomi T, Eriksson K, Eriksson JG, Lyssenko V, Groop L. A common variant upstream of the PAX6 gene influences islet function in man. Diabetologia 2012; 55:94-104. [PMID: 21922321 DOI: 10.1007/s00125-011-2300-8] [Citation(s) in RCA: 17] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 08/09/2011] [Indexed: 10/17/2022]
Abstract
AIMS/HYPOTHESIS Impaired glucose tolerance and impaired insulin secretion have been reported in families with PAX6 mutations and it is suggested that they result from defective proinsulin processing due to lack of prohormone convertase 1/3, encoded by PCSK1. We investigated whether a common PAX6 variant would mimic these findings and explored in detail its effect on islet function in man. METHODS A PAX6 candidate single nucleotide polymorphism (rs685428) was associated with fasting insulin levels in the Diabetes Genetics Initiative genome-wide association study. We explored its potential association with glucose tolerance and insulin processing and secretion in three Scandinavian cohorts (N = 8,897 individuals). In addition, insulin secretion and the expression of PAX6 and transcriptional target genes were studied in human pancreatic islets. RESULTS rs685428 G allele carriers had lower islet mRNA expression of PAX6 (p = 0.01) and PCSK1 (p = 0.001) than AA homozygotes. The G allele was associated with increased fasting insulin (p (replication) = 0.02, p (all) = 0.0008) and HOMA-insulin resistance (p (replication) = 0.02, p (all) = 0.001) as well as a lower fasting proinsulin/insulin ratio (p (all) = 0.008) and lower fasting glucagon (p = 0.04) and gastric inhibitory peptide (GIP) (p = 0.05) concentrations. Arginine-stimulated (p = 0.02) insulin secretion was reduced in vivo, which was further reflected by a reduction of glucose- and potassium-stimulated insulin secretion (p = 0.002 and p = 0.04, respectively) in human islets in vitro. CONCLUSIONS/INTERPRETATION A common variant in PAX6 is associated with reduced PAX6 and PCSK1 expression in human islets and reduced insulin response, as well as decreased glucagon and GIP concentrations and decreased insulin sensitivity. These findings emphasise the central role of PAX6 in the regulation of islet function and glucose metabolism in man.
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Affiliation(s)
- E Ahlqvist
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, CRC at Skåne University Hospital, 205 02 Malmö, Sweden.
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Fu F, Nordlander M, Ponzer S, Tidermark J, Eriksson K, Fu F. Anterior cruciate ligament reconstruction with semitendinosus graft provided similar stability and knee function and fewer problems with kneeling compared with the bone-patellar tendon-bone graft. J Bone Joint Surg Am 2011; 93:969. [PMID: 21593374 DOI: 10.2106/jbjs.9310ebo371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Freddie Fu
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Bokrantz R, Eriksson K, Hardemark B. 252 oral DOES DOSE RATE AND GANTRY SPEED PROVIDE SUFFICIENT DEGREES OF FREEDOM TO ALLOW FOR MULTI-CRITERIA VMAT PLANNING? Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70374-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jonsson H, Bergdahl IA, Akerblom G, Eriksson K, Andersson K, Kagstrom L, Jarvholm B, Damber L. Lung cancer risk and radon exposure in a cohort of iron ore miners in Malmberget, Sweden. Occup Environ Med 2010; 67:519-25. [DOI: 10.1136/oem.2009.047449] [Citation(s) in RCA: 16] [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: 11/04/2022]
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Bergdahl IA, Jonsson H, Eriksson K, Damber L, Jarvholm B. Lung cancer and exposure to quartz and diesel exhaust in Swedish iron ore miners with concurrent exposure to radon. Occup Environ Med 2010; 67:513-8. [DOI: 10.1136/oem.2009.047456] [Citation(s) in RCA: 15] [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: 11/04/2022]
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Nordström I, Rudin A, Adlerberth I, Wold A, Saalman R, Hesselmar B, Åberg N, Liljeqvist JÅ, Eriksson K. Infection of infants with human herpesvirus type 6 may be associated with reduced allergic sensitization and T-helper type 2 development. Clin Exp Allergy 2010; 40:882-90. [DOI: 10.1111/j.1365-2222.2010.03491.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rendell L, Boyd R, Cownden D, Enquist M, Eriksson K, Feldman MW, Fogarty L, Ghirlanda S, Lillicrap T, Laland KN. Why copy others? Insights from the social learning strategies tournament. Science 2010; 328:208-13. [PMID: 20378813 PMCID: PMC2989663 DOI: 10.1126/science.1184719] [Citation(s) in RCA: 345] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Social learning (learning through observation or interaction with other individuals) is widespread in nature and is central to the remarkable success of humanity, yet it remains unclear why copying is profitable and how to copy most effectively. To address these questions, we organized a computer tournament in which entrants submitted strategies specifying how to use social learning and its asocial alternative (for example, trial-and-error learning) to acquire adaptive behavior in a complex environment. Most current theory predicts the emergence of mixed strategies that rely on some combination of the two types of learning. In the tournament, however, strategies that relied heavily on social learning were found to be remarkably successful, even when asocial information was no more costly than social information. Social learning proved advantageous because individuals frequently demonstrated the highest-payoff behavior in their repertoire, inadvertently filtering information for copiers. The winning strategy (discountmachine) relied nearly exclusively on social learning and weighted information according to the time since acquisition.
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Affiliation(s)
- L Rendell
- Centre for Social Learning and Cognitive Evolution, School of Biology, University of St. Andrews, Queen's Terrace, St. Andrews, Fife KY16 9TS, UK.
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Liljelind I, Norberg C, Egelrud L, Westberg H, Eriksson K, Nylander-French LA. Dermal and inhalation exposure to methylene bisphenyl isocyanate (MDI) in iron foundry workers. ACTA ACUST UNITED AC 2009; 54:31-40. [PMID: 19783835 DOI: 10.1093/annhyg/mep067] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Diisocyanates are a group of chemically reactive agents, which are used in the production of coatings, adhesives, polyurethane foams, and parts for the automotive industry and as curing agents for cores in the foundry industry. Dermal and inhalation exposure to methylene bisphenyl isocyanate (MDI) is associated with respiratory sensitization and occupational asthma. However, limited research has been performed on the quantitative evaluation of dermal and inhalation exposure to MDI in occupationally exposed workers. The objective of this research was to quantify dermal and inhalation exposure levels in iron foundry workers. Workers involved in mechanized moulding and mechanized production of cores were monitored: 12 core makers, 2 core-sand preparers, and 5 core installers. Personal breathing-zone levels of MDI were measured using impregnated filter sampling. Dermal exposure to MDI was measured using a tape-strip technique. Three or five consecutive tape-strip samples were collected from five exposed skin areas (right and left forefingers, left and right wrists, and forehead). The average personal air concentration was 0.55 microg m(-3), 50-fold lower than the Swedish occupational exposure limit of 30 microg m(-3). The core makers had an average exposure of 0.77 microg m(-3), which was not significantly different from core installers' and core-sand preparers' average exposure of 0.16 microg m(-3) (P = 0.059). Three core makers had a 10-fold higher inhalation exposure than the other core makers. The core makers' mean dermal exposure at different skin sites varied from 0.13 to 0.34 microg while the two other groups' exposure ranged from 0.006 to 0.062 microg. No significant difference was observed in the MDI levels between the skin sites in a pairwise comparison, except for left forefinger compared to left and right wrist (P < 0.05). In addition, quantifiable but decreasing levels of MDI were observed in the consecutive tape strip per site indicating MDI penetration into the skin. This study indicates that exposure to MDI can be quantified on workers' skin even if air levels are close to unquantifiable. Thus, the potential for uncured MDI to deposit on and penetrate into the skin is demonstrated. Therefore, dermal exposure along with inhalation exposure to MDI should be measured in the occupational settings where MDI is present in order to shed light on their roles in the development of occupational isocyanate asthma.
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Affiliation(s)
- I Liljelind
- Department of Public Health and Clinical Medicine, Umeå University, SE-901 87 Umeå, Sweden.
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Abstract
Sixty patients with hyperthyroidism were treated with standard doses of 131I during 1969-83 in our department. The doses were 10-25 mCi (370-920 MBq), mostly 15 mCi (550 MBq). 38 of the patients have become hypothyroid, mostly within one year after treatment. There were 3 early relapses of hyperthyroidism; these patients became hypothyroid within one year after an additional dose of radioiodine. All hypothyroid patients had early substitution with l-thyroxine before overt clinical symptoms and signs had developed. There were no late relapses of hyperthyroidism. 15 patients had died during the follow-up; all were euthyroid or hypothyroid with adequate substitution. 28 of the 60 patients have been followed for 5-14 years, 14 for 2-5 years, 7 for 1-2 years and 10 for less than one year. Standard dose 131I treatment offers certain advantages compared with attempted individualized treatment. Late hypothyroidism after individualized dosage may be difficult to anticipate and detect, whereas early hypothyroidism after ablative standard dose treatment is easy to detect and control. Generally speaking, hypothyroidism is not to be regarded as a complication of radioiodine treatment for hyperthyroidism, but as its natural end result. The fixed dose schedule is especially well suited for regions where hyperthyroidism with no goitre or a small goitre is common.
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Abstract
People with parenchymal iron overload exhibit an elevated serum iron concentration and a raised transferrin (TIBC) saturation early in the course of the disease. They can therefore be detected by simple laboratory tests before organ damage has occurred. In this study running for 2 months, 10512 samples from approximately 8750 patients and blood donors were examined in a county hospital in Central Sweden. Abnormal TIBC saturation (greater than 70%) was found in 1.7% of the samples. This abnormality was caused by physiological fluctuations in serum iron in 44%, liver disease in 22%, blood disorder in 10%, iron therapy in 10.5% and parenchymal iron overload in 11.5%. The diagnosis of iron overload was confirmed by measuring the serum ferritin concentration and by performing the desferrioxamine test, liver biopsy, quantitative phlebotomy and family studies including HLA typing. We found a prevalence of iron overload of 0.24%. This figure is almost certainly too low because some affected patients were probably lost because of TIBC desaturation induced by inflammatory conditions.
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Rantanen K, Timonen S, Hagström K, Hämäläinen P, Eriksson K, Nieminen P. Social competence of preschool children with epilepsy. Epilepsy Behav 2009; 14:338-43. [PMID: 19027086 DOI: 10.1016/j.yebeh.2008.10.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [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: 08/31/2008] [Revised: 10/22/2008] [Accepted: 10/31/2008] [Indexed: 11/25/2022]
Abstract
The aims of this study were to describe the social competence of 3- to 6-year-old children with epilepsy (n=26) compared with that of age- and gender-matched healthy controls (n=26). Social competence was assessed with the Vineland Social Maturity Scale, Conners' Parent Rating Scales-Revised, and the Child Behavior Checklist. The results indicate that the children with epilepsy, especially with complicated epilepsy, had fewer age-appropriate social skills and more attention and behavior problems than the healthy children, as reported by parents. It is possible that the lack of age-appropriate social skills and the presence of attention problems predispose to behavioral problems. Also, epilepsy-related factors impaired the achievement of social competence. This study shows that the preschool children with complicated, early-onset epilepsy are at increased risk of difficulties in social competence.
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Affiliation(s)
- K Rantanen
- Department of Psychology, University of Tampere, Tampere, Finland.
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Abstract
Papanicolaou-stained cervicovaginal smears (Pap smears) are used to screen for cervical cancer. Since there is a lack of consensus in published reports respecting the efficacy of Pap-stained smears in BV diagnostics, there is a need to validate their use for diagnosis of BV. Slides from the international BV00 workshop were Pap stained and independently analyzed by four investigators under a phase-contrast microscope. All workshop slides--whether Pap-stained, Gram-stained or rehydrated air-dried smears--were scored according to the same Nugent classification. The diagnostic accuracy of Pap smears for diagnosis of BV had a sensitivity of 0.85 and a specificity of 0.92, with a positive and negative predictive value of 0.84 and 0.93, respectively. The interobserver weighted kappa index was 0.86 for Pap-stained smears compared to 0.81 for Gram-stained smears, and 0.70 for rehydrated air-dried smears using the mean Nugent score as the criterion standard. Provided that the samples are taken from equivalent locations (the vaginal fornix) and analyzed according to the same scoring criteria, there is no discernable difference in the diagnostic accuracy of the three smear-staining methods. The Pap-stained vaginal smears can be used as a wholly adequate alternative to Gram-stained smears for BV diagnosis.
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Affiliation(s)
- K Eriksson
- Department of Obstetrics and Gynecology, Alands Centralsjukhus, Finland.
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Kälviäinen R, Eriksson K, Losekoot M, Sorri I, Harvima I, Santavuori P, Järvelä I, Autti T, Vanninen R, Salmenperä T, van Diggelen OP. Juvenile-onset neuronal ceroid lipofuscinosis with infantile CLN1 mutation and palmitoyl-protein thioesterase deficiency. Eur J Neurol 2007; 14:369-72. [PMID: 17388982 DOI: 10.1111/j.1468-1331.2007.01668.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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: 11/30/2022]
Abstract
Accurate diagnosis, especially in progressive hereditary diseases, is essential for the treatment and genetic counseling of the patient and the family. Neuronal ceroid lipofuscinoses (NCL) are amongst the most common groups of neurodegenerative diseases. Infantile, juvenile, and adult-onset types with multiple genotype-phenotype associations have been described. A fluorimetric enzyme assay for palmitoyl protein thioesterase (PPT) from leukocytes and fibroblasts has been previously developed to confirm the diagnosis of infantile NCL. We describe a patient with juvenile-onset NCL phenotype with a new CLN1 mutation and deficient PPT activity. Over 40 different mutations have been found in patients with PPT deficiency, indicating that screening for known mutations is not an efficient way to diagnose this disorder. Therefore, PPT enzyme analysis should precede mutation analysis in suspected PPT deficiency, particularly in patients with granular osmiophilic deposits (GROD) or in patients who have negative ultrastructural data. The use of enzyme assay led to the diagnosis of this patient with juvenile-onset Finnish variant NCL with PPT deficiency, and we expect that greater awareness of the utility of the enzymatic assay may lead to identification of other similar cases awaiting a definitive diagnosis.
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Affiliation(s)
- R Kälviäinen
- Department of Neurology, Kuopio Epilepsy Center, Kuopio University Hospital and University of Kuopio, Kuopio, Finland.
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Blomfeldt R, Törnkvist H, Eriksson K, Söderqvist A, Ponzer S, Tidermark J. A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. ACTA ACUST UNITED AC 2007; 89:160-5. [PMID: 17322427 DOI: 10.1302/0301-620x.89b2.18576] [Citation(s) in RCA: 269] [Impact Index Per Article: 15.8] [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: 01/11/2023]
Abstract
The best treatment for the active and lucid elderly patient with a displaced intracapsular fracture of the femoral neck is still controversial. Randomised controlled trials have shown that a primary total hip replacement is superior to internal fixation as regards the need for secondary surgery, hip function and health-related quality of life. Despite good results achieved with total hip replacement in this group, most orthopaedic surgeons still advocate hemiarthroplasty for this injury. We studied 120 patients with a mean age of 81 years (70 to 90) with an acute displaced intracapsular fracture of the femoral neck. They were randomly allocated to be treated with either a bipolar hemiarthroplasty or total hip replacement. Outcome measurements included peri-operative data, general and hip-specific complications, hip function and health-related quality of life. The patients were reviewed at four and 12 months. The duration of surgery was longer in the total hip replacement group (102 minutes (70 to 151)) versus 78 minutes (43 to 131) (p < 0.001), and the intra-operative blood loss was increased 460 ml (100 to 1100) versus 320 ml (50 to 850) (p < 0.001), but there were no differences between the groups regarding any complications or mortality. There were no dislocations in either group. Hip function measured by the Harris hip score was significantly better in the total hip replacement group at both follow-up periods (p = 0.011 and p < 0.001, respectively). The health-related quality of life measure was in favour of the total hip replacement group but did not reach statistical significance (p = 0.818 at four months and p = 0.636 at 12 months). These results indicate that a total hip replacement provides better function than a bipolar hemiarthroplasty as soon as one year post-operatively, without increasing the complication rate. We recommend total hip replacement as the primary treatment for this group of patients.
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Affiliation(s)
- R Blomfeldt
- Department of Orthopedics, Karolinska Institutet, Stockholm Söder Hospital, Stockholm S-11883, Sweden.
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Abstract
The purpose of this study was to investigate possible differences in age, gender, Tegner activity level prior to injury, knee joint laxity and the variables evaluated with knee osteoarthritis outcome score (KOOS) between patients who chose non-operative treatment (NT), early reconstruction (ER) and late reconstruction (LR). A second aim was to study whether patients who choose ER choose surgical treatment for the same reasons as patients who choose LR. Seventy-two patients with an acute (< 1 month) anterior cruciate ligament (ACL) tear, who had not yet decided to have surgery, were included in this study. They filled out the Tegner activity score, assessing preinjury activity level, KOOS and underwent KT-1000 arthrometer examination. The 36 subjects who later chose reconstruction were questioned about reasons for their decision. A high preinjury activity level was associated with the choice of ACL reconstruction, but the choice of treatment was not associated with age, gender or the outcome variables measured with KOOS or KT-1000. Fifteen out of the 20 (75%) subjects who chose ER based their decision on assumptions of future problems and not on experience of knee function. Fourteen out of 16 (88%) subjects, who chose reconstructive surgery later, based their decision on experience of knee function.
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Affiliation(s)
- L R Swirtun
- Department of Surgical Sciences, Section of Sports Medicine, Karolinska Institutet, Stockholm, Sweden.
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Sadr Azodi O, Bellocco R, Eriksson K, Adami J. The impact of tobacco use and body mass index on the length of stay in hospital and the risk of post-operative complications among patients undergoing total hip replacement. ACTA ACUST UNITED AC 2006; 88:1316-20. [PMID: 17012420 DOI: 10.1302/0301-620x.88b10.17957] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.4] [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: 11/05/2022]
Abstract
We carried out a retrospective cohort study of 3309 patients undergoing primary total hip replacement to examine the impact of tobacco use and body mass index on the length of stay in hospital and the risk of short term post-operative complications. Heavy tobacco use was associated with an increased risk of systemic post-operative complications (p = 0.004). Previous and current smokers had a 43% and 56% increased risk of systemic complications, respectively, when compared with non-smokers. In heavy smokers, the risk increased by 121%. A high body mass index was significantly associated with an increased mean length of stay in hospital of between 4.7% and 7%. The risk of systemic complications was increased by 58% in the obese. Smoking and body mass index were not significantly related to the development of local complications. Greater efforts should be taken to reduce the impact of preventable life style factors, such as smoking and high body mass index, on the post-operative course of total hip replacement.
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Affiliation(s)
- O Sadr Azodi
- Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden.
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41
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Rehbinder H, Andersson J, Ericson S, Eriksson K, Forsgren C, Hårdemark B, Korevaar E, Larsson M, Liander A, Lundin A, Riddersporre J, Rosseau D, Sundgren C, Uhrdin J, Löf J. TH-C-230A-10: A General Software Framework for Investigations in Radiation Therapy Planning. Med Phys 2006. [DOI: 10.1118/1.2241873] [Citation(s) in RCA: 5] [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: 11/07/2022] Open
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42
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Abstract
The aim of the present study was to assess the association between socio-economic status and impaired respiratory health in a 10-yr follow-up of a population-based postal survey in Northern Sweden. Multiple logistic regression was used to estimate odds ratios in relation to socio-economic class, using age, sex, a family history of asthma, smoking habits, and occupational exposures to dust, gases and fumes as possible confounders. The study comprised 2,341 males and 2,413 females. Cumulative incidences were generally lowest in professionals, including executives and civil servants at intermediate and higher levels, who were chosen as reference group. Manual workers in industry showed a significantly increased risk of developing asthma, recurrent wheeze, attacks of shortness of breath or a combination of the two, and chronic productive cough. Manual workers in service showed a similar pattern for attacks of shortness of breath, recurrent wheeze, or a combination of the two, and chronic productive cough. The corresponding population attributable risks were approximately 10%. Low socio-economic status was a risk factor for the development of asthma, symptoms common in asthma and chronic productive cough.
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Affiliation(s)
- U Hedlund
- The Obstructive Lung Disease in Northern Sweden Studies, Dept of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden
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43
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Abstract
Factors contributing to the duration of a single convulsive seizure > 5 minutes were analyzed in 157 children. The medically treated episodes were compared with seizure episodes resolving without treatment (n = 27). Major differences were in age (p = 0.016) and etiology (p = 0.003), and the association between treatment delay and response became significant after 30 minutes when this was analyzed as a single variable (p = 0.003) in Cox regression analysis.
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Affiliation(s)
- K Eriksson
- Pediatric Research Centre, Medical School, University of Tampere, Tampere, Finland.
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Eriksson K, Rehbinder H, Siddiqi M, Lind B. MO-D-T-6E-05: Biological Optimization of Fractionated IMRT Using Fraction Groups. Med Phys 2005. [DOI: 10.1118/1.1998275] [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: 11/07/2022] Open
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45
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Bellner L, Löwhagen GB, Tunbäck P, Nordström I, Liljeqvist JA, Eriksson K. Characterization of T-cell reactive epitopes in glycoprotein G of herpes simplex virus type 2 using synthetic peptides. Arch Virol 2005; 150:1393-406. [PMID: 15750862 DOI: 10.1007/s00705-005-0497-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2004] [Accepted: 01/09/2005] [Indexed: 10/25/2022]
Abstract
We have previously shown that the CD4+ T-cell response to herpes simplex virus type 2 glycoprotein G-2 is type-specific and can thus be used to evaluate herpes simplex virus type 2-specific T-cell responses in individuals with a concomitant herpes simplex virus type 1 infection. In this study we have followed the glycoprotein G-2-specific T-cell responses over time, and also tried to identify T-cell epitopes in the membrane bound portion and the secreted portion of glycoprotein G-2 using synthetic peptides spanning the whole amino acid sequence of glycoprotein G-2. We found that the magnitude of the glycoprotein G-2-specific response varied considerably in infected individuals over time, even though all patients responded to at least one of the two glycoproteins at all time-points examined. We could also document strong T-cell responses to synthetic peptides from the secreted glycoprotein G-2 but only low responses to synthetic peptides corresponding to sequences from the heavily glycosylated membrane-bound glycoprotein G-2. We were able to map an immunogenic region (amino acid 31-125) within the secreted glycoprotein G-2. This region of the glycoprotein induced proliferative responses in 47% of the herpes simplex virus type 2-infected individuals. However, we were not able to identify any universal T-cell epitope.
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Affiliation(s)
- L Bellner
- Department of Rheumatology and Inflammation Research, Göteborg University, Göteborg, Sweden
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46
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Gadjeva M, Paludan SR, Thiel S, Slavov V, Ruseva M, Eriksson K, Löwhagen GB, Shi L, Takahashi K, Ezekowitz A, Jensenius JC. Mannan-binding lectin modulates the response to HSV-2 infection. Clin Exp Immunol 2004; 138:304-11. [PMID: 15498041 PMCID: PMC1809223 DOI: 10.1111/j.1365-2249.2004.02616.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Viruses have developed numerous strategies to escape recognition by the immune system. However, some viruses such as herpes simplex virus-2 (HSV-2) are recognized by initiators of the complement system, e.g. mannan-binding lectin (MBL). To study the effects of MBL deficiency during viral infection we have chosen a model of generalized HSV-2 infection. We infected MBL-A and MBL-C double knock-out mice (DKO) with HSV-2 via the intraperitoneal (i.p.) route. DKO mice cleared HSV-2 from the liver less efficiently than the comparable wild-type animals. The impairment to effectively neutralize HSV-2 correlated with compromised liver function as measured by increased plasma levels of alanine-amino transferase. No differences in the viral burden were found in other organs such as spleen or brain. Thus, MBL-mediated protection was limited to the effects of preservation of liver homeostasis. Reconstitution with recombinant human MBL before and during the HSV-2 infection dramatically lowered the viral titres in the liver. Taken together, the data show that MBL modulates the response to HSV-2 in mice by affecting neutralization of the virus. To analyse if MBL plays a role in establishment and progression of human HSV-2 infection we analysed MBL levels in the serum samples from asymptomatic (virus-exposed people who have never displayed symptoms of HSV-2 infection) and symptomatic HSV-2 patients (people with recurrent HSV-2 infections). We found that the frequency of the MBL deficiency (<100 ng/ml) was higher in the symptomatic group and significantly different from that in the asymptomatic group (P = 0.0369). This suggests that lack of MBL-mediated complement activation increases susceptibility to viral infection.
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Affiliation(s)
- M Gadjeva
- Department of Medical Microbiology and Immunology, University of Aarhus, Aarhus, Denmark.
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Sun JB, Eriksson K, Li BL, Lindblad M, Azem J, Holmgren J. Vaccination with dendritic cells pulsed in vitro with tumor antigen conjugated to cholera toxin efficiently induces specific tumoricidal CD8+ cytotoxic lymphocytes dependent on cyclic AMP activation of dendritic cells. Clin Immunol 2004; 112:35-44. [PMID: 15207780 DOI: 10.1016/j.clim.2004.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2003] [Accepted: 03/01/2004] [Indexed: 10/26/2022]
Abstract
We investigated the development of CD8+ tumor-specific cytotoxic lymphocytes (CTL) and protection against tumor growth after vaccination with bone marrow-derived dendritic cells (DC) pulsed with a model protein ovalbumin conjugated to cholera toxin (OVA-CT) in B6 mice using E.G7 tumor cells expressing OVA(257-264) peptide (SIINFEKL) as target cells in vitro and in vivo. Vaccination with OVA-CT-pulsed DC concurrently induced strong CTL in vitro activity and anti-E.G7 tumor protection in vivo in WT, NK-depleted and CD4-deficient mice as well as in IL-12-/- and IFN-gamma-/- mice but not in CD8-deficient mice. Importantly, activation of CTL by OVA-CT-pulsed DC was dependent on CT-induced activation of adenylate cyclase and increased cAMP production by DC associated with increased expression of MHC class I and co-stimulatory molecules (CD80, CD86 and CD40). These results show that vaccination with DC pulsed with antigens (Ag) conjugated to CT induces a strong CTL response and suggest that conjugation of tumor Ag to CT for DC vaccination represents a promising approach for tumor vaccination and immunotherapy.
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MESH Headings
- Adjuvants, Immunologic/pharmacology
- Animals
- Antigens, Neoplasm/immunology
- Antigens, Neoplasm/pharmacology
- Cholera Toxin/immunology
- Cholera Toxin/pharmacology
- Cyclic AMP/immunology
- Cytotoxicity Tests, Immunologic
- Dendritic Cells/immunology
- Egg Proteins/immunology
- Egg Proteins/pharmacology
- Flow Cytometry
- Immunologic Memory
- Immunotherapy, Adoptive/methods
- Immunotoxins/immunology
- Immunotoxins/pharmacology
- Interferon-gamma/immunology
- Lymphocyte Activation/immunology
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Neoplasms, Experimental/immunology
- Neoplasms, Experimental/therapy
- Ovalbumin/immunology
- Ovalbumin/pharmacology
- Peptide Fragments
- Specific Pathogen-Free Organisms
- T-Lymphocytes, Cytotoxic/immunology
- Vaccination
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Affiliation(s)
- J-B Sun
- Department of Medical Microbiology and Immunology, and Göteborg University Vaccine Research Institute (GUVAX), Göteborg University, S-405 30, Göteborg, Sweden.
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48
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Bergdahl IA, Torén K, Eriksson K, Hedlund U, Nilsson T, Flodin R, Järvholm B. Increased mortality in COPD among construction workers exposed to inorganic dust. Eur Respir J 2004; 23:402-6. [PMID: 15065829 DOI: 10.1183/09031936.04.00034304] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.2] [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: 11/05/2022]
Abstract
The aim of this study was to find out if occupational exposure to dust, fumes or gases, especially among never-smokers, increased the mortality from chronic obstructive pulmonary disease (COPD). A cohort of 317,629 Swedish male construction workers was followed from 1971 to 1999. Exposure to inorganic dust (asbestos, man-made mineral fibres, dust from cement, concrete and quartz), gases and irritants (epoxy resins, isocyanates and organic solvents), fumes (asphalt fumes, diesel exhaust and metal fumes), and wood dust was based on a job-exposure matrix. An internal control group with "unexposed" construction workers was used, and the analyses were adjusted for age and smoking. When all subjects were analysed, there was an increased mortality from COPD among those with any airborne exposure (relative risk 1.12 (95% confidence interval (CI) 1.03-1.22)). In a Poisson regression model, including smoking, age and the major exposure groups, exposure to inorganic dust was associated with an increased risk (hazard ratio (HR) 1.10 (95% CI 1.06-1.14)), especially among never-smokers (HR 2.30 (95% CI 1.07-4.96)). The fraction of COPD among the exposed attributable to any airborne exposure was estimated as 10.7% overall and 52.6% among never-smokers. In conclusion, occupational exposure among construction workers increases mortality due to chronic obstructive pulmonary disease, even among never-smokers.
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Affiliation(s)
- I A Bergdahl
- Occupational Medicine, Dept of Clinical Medicine and Public Health, Umeå University, Umeå, Sweden
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49
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Rajan-Sithamparanadarajah R, Roff M, Delgado P, Eriksson K, Fransman W, Gijsbers JHJ, Hughson G, Mäkinen M, van Hemmen JJ. Patterns of Dermal Exposure to Hazardous Substances in European Union Workplaces. ACTA ACUST UNITED AC 2004; 48:285-97. [PMID: 15059805 DOI: 10.1093/annhyg/meh025] [Citation(s) in RCA: 17] [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: 11/15/2022]
Abstract
Workplace dermal exposure assessment is a complex task that aims to understand the dynamic interaction between the skin and the hazardous substances present in the surrounding environment. A European project known as RISKOFDERM gathered dermal exposure data in 85 workplaces (industrial and other types) in five countries in Europe. In order to optimize data collection and to develop a representative picture of dermal exposure, scenarios (tasks made up of a series of activities) were grouped together into dermal exposure operation units (DEOs). The allocation of scenarios to relevant DEOs was achieved on the basis of similarities of exposure routes, tasks and professional judgement. Sampling and quantification procedures were based on the approaches recommended by the OECD protocol. The laboratories involved in the analysis of the samples participated in quality assurance programmes. This exercise resulted in 419 body measurements and 437 measurements on hands expressed in terms of formulation (product) in use. Exposures for a given scenario varied by several orders of magnitude. The extent and patterns of exposure were found to be dependent on various exposure determinants, including inter- and intra-scenario variations. Hands were found to be the most contaminated parts of the body. Exposure patterns for liquid and solid contaminants were different. On the basis of the analysis of the data presented here, the averaged results (median and 95th percentile) for a given DEO unit should not be used as a representative measure of dermal exposure for all scenarios within that DEO without taking the exposure determinants into account. However, the data could be used to develop an exposure matrix (indicative exposure distributions) for different types of scenario and workplace, using determinants of exposure and a Bayesian approach to integrating expert opinion.
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50
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Gyllenhammar E, Thoren-Todoulos E, Strang P, Ström G, Eriksson K, Kinch M. Palliative home care and dying at home is an option for patients living alone. Palliat Med 2003; 17:644-5. [PMID: 14594159 DOI: 10.1177/026921630301700714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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