Publikationer från Linköpings universitet
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Non-Autonomous Soliton Hierarchies
No full textA formalism for the systematic construction of integrable non-autonomous deformations of soliton hierarchies is presented. The theory is formulated as an initial value problem (IVP) for an associated Frobenius integrability condition on a Lie algebra. It is shown that this IVP has a formal solution, and within the framework of two particular subalgebras of the hereditary Lie algebra, the explicit forms of this formal solution are derived. Finally, this formalism is applied to the Korteveg-de Vries, dispersive water waves and Ablowitz-Kaup-Newell-Segur soliton hierarchies. The zero-curvature representations and Hamiltonian structures of the considered non-autonomous soliton hierarchies are also provided
Outcomes of the COVID-19 pandemic in chronic lymphocytic leukemia: focus on the very early period and Omicron era
No full textIndividuals with chronic lymphocytic leukemia (CLL) face an increased risk for severe COVID-19. This study from Sweden, a country that only had a few mandatory restrictions at the onset of the pandemic, used 10 nationwide registers to compare the risks for severe COVID-19 outcomes of polymerase chain reaction-verified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections through February 2023 in individuals with and those without CLL. From a population of 8 275 839 (6653 CLL) individuals born between 1930 and 2003, 2 088 163 first infections (1289 CLL) were included. The 90-day all-cause mortality rate and adjusted relative risk (aRR; 95% confidence interval) for individuals with CLL vs the general population was 24.8% (1.95; 1.58-2.41) during wild-type, 17.2% (2.38; 1.58-3.57) during Alpha, 4.1% (0.71; 0.24-2.08) during Delta, and 12.6% (1.49; 1.24-1.78) during Omicron infections. Their mortality during Omicron was 0.6% (&lt;65 years), 5.4% (65-74 years), and 19.7% (&gt;= 75 years). Small molecule inhibitors (1.56; 1.03-2.37) and corticosteroid usage (1.45; 1.04-2.02) was associated with increased mortality. Next, we analyzed the all-cause mortality in the capital (Stockholm), widely affected by SARS-CoV-2 at the onset of the pandemic. Mortality in individuals with CLL increased by 55% during the first 6 months of 2020 vs 2019, and the age- and sex-aRR by 30 June was 1.53 (1.09-2.15) for individuals with CLL (P = .02) and 1.29 (1.25-1.33) for the general population (P &lt; .001). Collectively, a significantly increased risk for severe COVID-19 and death was observed among individuals with CLL in Sweden, particularly at the onset of the pandemic when few national protective measures were introduced and also after Omicron emerged, emphasizing the need for a more pro-active pandemic strategy for CLL.Funding Agencies|Swedish Research Council [2021-04779_VR]; Swedish Cancer Society [22 0553 SCIA 03 H, 22 2220 Pj 01H]; Cancer Society in Stockholm [224143]; Region Stockholm (Centrum fr Innovativ MEDicin) [FoUI-963338]; Swedish government; Swedish county councils; Avtal om Lakarutbildning och Forskning [FoUI-987366]</p
Novel electrostatic dry lift-off and transfer route for vertically aligned nanocomposite oxide thin films
No full textHighly oriented oxide thin films hold substantial relevance to a wide range of fields. A major challenge is their integration with technological substrates, such as flexible polymers and silicon. While multiple strategies for the lift-off and transfer of high-quality oxide thin films have been widely explored, it remains a challenge to easily transfer films with low defect levels. In this work, we introduce a novel and effective strategy for achieving high-quality, freestanding perovskite oxide thin films. We first demonstrate that highly oriented perovskite oxides, as both single-phase films and vertically aligned nanocomposite (VAN) films, can be grown by pulsed laser deposition on single crystal NaCl, as not shown before. We next show that the VAN films, unlike single-phase films, can be readily, electrostatically, dry lifted-off the substrate. The success of the lift-off technique is enabled by (i) a high thermal expansion mismatch of the film, producing compression in the film, and (ii) lack of elastic strain relief in the out-of-plane direction in the VAN film. Finally, we show that a VAN cathode film can be incorporated into a proof-of-concept micro-solid oxide fuel cell structure, and that it is of good structural quality as demonstrated by performance comparable to equivalent VAN films grown on single crystal YSZ. Thus, we developed an entirely new way to lift-off and transfer highly oriented oxide thin films for use in a wide variety of electronic applications.Funding Agencies|H2020 European Research Council</p
Older Adults’ Experience of a Mobile Geriatric Team
No full textThe aim of this study is to examine older adults’ experience of receiving medical and care efforts from a Mobile Geriatric Team (MGT). A phenomenologically inspired approach guides this study to stay empirically close to the data while exploring the experiences of five older adults with comorbidity receiving medical and care efforts from a MGT. Three themes emerged from the interviews: The relief of integrated treatment, Reclaiming time from the emergency room, and Finding sanctuary at home. The findings reveal that older adults particularly valued the MGT’s comprehensive view of their medical history and medication, highlighting how this holistic approach provided significant comfort. Participants also emphasized the relief brought by staff continuity and the ability to receive acute medical treatments in the familiarity of their own homes, thereby avoiding the stress and inconvenience of emergency room visits. While reducing emergency room visits was a stated goal of the MGT, this study distinctively illuminates the profound positive impact of this outcome from the older adults’ perspective. These findings demonstrate a project successfully aligning with initiatives for good, close, and coordinated care, ultimately promoting health and well-being for older adults.Funding Agencies|Linkoping University</p
Changes in the sodium content of New Zealand packaged breads: 2013 to 2023
No full textWe aimed to compare the mean sodium content of New Zealand (NZ) packaged breads in 2013 and 2023 and assess compliance with the NZ Heart Foundation (HF) and World Health Organization (WHO) sodium reduction benchmarks. Sodium data were obtained from a supermarket food composition database. Mean differences between years were assessed using independent samples t-tests and chi-square tests. There was a significant reduction in the sodium content of all bread from 2013 (n=345) to 2023 (n=309) of 46 mg/100g (p&lt;0.001). In 2013, 20% (n=70/345) of breads met the HF benchmarks, and 10% (33/345) met the WHO benchmarks; corresponding values for 2023 were 45% (n=138/309) and 18% (n=57/309) (p&lt;0.001 for both). If continued, the modest reduction in sodium content and increase in the percentage of NZ breads meeting relevant sodium reduction benchmarks could positively affect public health, particularly if extended across the packaged food supply.Funding Agencies|Futurum; Region Jonkoping [FUTURUM-993791]; Swedish National Research School in General Practice; Svenska Saellskapet for Medicinsk Forskning [TG-23-0004]; Svenska Lakaresallskapet [SLS-993078]; Arthur Engels Fond; Heart Foundation of New Zealand [1843, 3728679]</p
Rättvist värde - Sektorns kraft : Sektoriella skillnader i prissättning vid börsintroduktioner och informationsasymmetri på de nordiska aktiemarknaderna
No full textBakgrund: Underprissättning vid börsintroduktioner är ett välkänt fenomen, däremot finns det en brist i tidigare forskning gällande hur detta skiljer sig mellan sektorer. Tidigare forskning har haft få observationer och få kontrollvariabler, vilket vår studie beaktar. Vidare är Norden en relativt outforskad och transparent marknad som är intressant och lämplig att studera. Forskningsfrågor: Hur varierar underprissättningen mellan olika sektorer inom Danmark, Finland, Norge och Sverige? Hur varierar underprissättningen inom samma sektor mellan Danmark, Finland, Norge och Sverige? Kvarstår en systematisk sektoreffekt på underprissättning efter kontroll för marknads- och emissionsrelaterade faktorer i Danmark, Finland, Norge och Sverige? Syfte: Syftet med studien är att kartlägga och analysera sambandet mellan sektortillhörighet och underprissättning vid börsintroduktioner på de nordiska marknaderna. Genom att jämföra mönster inom och mellan länder undersöks det om det finns en återkommande sektoreffekt som också består efter att hänsyn tagits till marknads- och emissionsförhållanden. Målet är att identifiera potentiella systematiska skillnader mellan sektorer och ge en fördjupad förståelse för hur sektorers informationsasymmetri kan bidra till en varierande grad av underprissättningen på de nordiska marknaderna. Resultat och kunskapsbidrag: Studien finner att det finns skillnader mellan sektorer i graden av underprissättning och att detta även varierar mellan de nordiska marknaderna. Vid regressionsanalys finner studien endast att hälsovårdssektorn i Finland och finansiella tjänstesektorn i Danmark har en sektorspecifik effekt när kontrollvariabler inkluderas, men de övriga sektorerna i länderna finner inga signifikanta samband och det finns därmed inte någon tydlig sektoreffekt. Studien är relevant för företag, investerare och beslutsfattare för att skapa en tydligare förståelse av förutsättningarna som finns vid kapitalmarknadsinträde. Vidare bidrar studien med teoretiska implikationer om informationsasymmetri på de nordiska aktiemarknaderna.Background: Underpricing in initial public offerings is a well-documented phenomenon. However, there is a lack of studies examining how underpricing differs across sectors. Prior research often includes few observations and limited control variables, which this study addresses. Furthermore, the Nordic region is a relatively unexplored and transparent market, making it an interesting and suitable area for investigation. Research Questions: How does underpricing vary between sectors within Denmark, Finland, Norway, and Sweden? How does underpricing vary within the same sector across Denmark, Finland, Norway, and Sweden? Does a systematic sector effect on underpricing remain after controlling for market and offering-related factors in Denmark, Finland, Norway, and Sweden? Purpose: The purpose of the study is to map and analyze how sector affiliation affects the underpricing of IPOs in the Nordic markets. By comparing patterns within and between countries, the study examines whether there is a recurring sector effect that persists even after accounting for market and issuance conditions. The aim is to identify potential systematic differences between sectors and to provide a deeper understanding of how sector-specific information asymmetry may contribute to varying levels of underpricing in the Nordic markets. Results and Contribution: The study finds that there are differences in the degree of underpricing between sectors, and that these also vary across the Nordic markets. In the regression analysis, only the healthcare sector in Finland and the financial services sector in Denmark show a sector-specific effect when control variables are included. For the remaining sectors and countries, no significant relationships were found, indicating thatthere is no clear sector effect. The study is relevant for companies, investors, and policymakers to better understand the conditions at market entry. It also contributes to theoretical insights into information asymmetry in the Nordic stock markets
Hur ser din skvader ut? : Lärares uppfattningar av bedömning av motsvarande kunskaper på folkhögskolans allmänna kurs
No full textThe aim of this study is to examine how folk high school general course teachers experience the concept corresponding, and in extension what impact it has on their planning, teaching and assessment. The study is based on a phenomenographic research approach. The empirical work consists of semi-structured interviews with fourteen general course teachers from nine different schools. Five different ways of understanding the concept corresponding where constituted. Corresponding is experienced as: (A) meaning the same knowledge as the content and requirements of the subject plans, (B) providing freedom to start from one's own ideas about the subjects, (C) providing the opportunity to start from the needs of the participants, (D) providing flexibility to deviate from certain parts of the subject plans and (E) providing the conditions for being able to work according to the distinctive character of the folk high school. The result was presented as a traditional outcome space and then deepened via themes of expanding awareness to provide further structure. The study has shown that different ways of understanding corresponding bring different didactic implications and different ways of realising the folk high school teacher's assignment. One idea behind the concept corresponding is that there should be room for teachers to work according to the distinctiveness of folk high schools. If the NCAE had demanded the same content and requirements as the NAE's subject plans, the word corresponding would not have been needed. The results of my study can contribute to providing a basis for teachers on general courses to reflect on how they relate to the concept corresponding, especially in relation to the qualification assessment as this also involves the exercise of authority, which in the long run can contribute to increased quality.Syftet med denna studie är att undersöka hur folkhögskolans allmän kurs-lärare uppfattar motsvarandebegreppet, och i förlängningen, vilken påverkan det får på deras planering, undervisning och bedömning. Studien bygger på en fenomenografisk forskningsansats. Empirin utgörs av semistrukturerade intervjuer med fjorton allmän kurs-lärare från nio olika skolor runt om i landet. Lärarna har olika utbildningar och har arbetat olika länge som folkhögskollärare. Fem olika uppfattningar av motsvarandebegreppet konstituerades, där motsvarande uppfattades: (A) betyda samma kunskaper som ämnesplanernas innehåll och krav, (B) ge frihet att utgå från egna föreställningar om ämnena, (C) ge möjlighet att utgå från deltagarnas behov, (D) ge flexibilitet att gå ifrån vissa delar av ämnesplanerna samt (E) ge förutsättningar för att kunna arbeta efter folkhögskolans särart. Resultatet presenterades först som ett traditionellt utfallsrum och fördjupades därefter via teman av expanderande medvetenhet för att ge ytterligare struktur och belysa skillnader och likheter. Studien har visat att olika uppfattningar av motsvarandebegreppet för med sig olika didaktiska implikationer och olika sätt att realisera folkhögskolläraruppdraget. En tanke med motsvarandebegreppet är att det ska finnas utrymme för lärarna att arbeta enligt folkhögskolans särart. Hade Folkbildningsrådet krävt samma innehåll och krav som Skolverkets ämnesplaner hade inte ordet motsvarande behövts. Resultatet av min studie kan bidra med underlag för lärare på allmän kurs att reflektera över hur de förhåller sig till motsvarandebegreppet, speciellt i relation till behörighetsbedömningen då denna också inbegriper ett myndighetsutövande, vilket i längden kan bidra till ökad kvalitet
Plasma carotenoids are inversely correlated with granulocyte counts and soluble inflammatory markers in a middle-aged population: a cross-sectional study with mediation analysis
No full textBackgroundHigh intake of fruits and vegetables is generally associated with reduced levels of inflammation. In line with this, plasma levels of carotenoids have shown inverse associations with inflammatory markers, in particular C-reactive protein (CRP) and leukocyte counts. However, it remains unclear to what extent carotenoids are associated with specific leukocyte subsets or other inflammatory markers. This study systematically assessed the inter-relationships among total and individual carotenoids, circulating leukocyte subsets, and soluble inflammatory markers in a middle-aged population.MethodsA subcohort of 1078 subjects, aged 50-64, was recruited from the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort. Leukocyte subsets were determined by whole blood flow cytometry. Five major carotenoids, namely lutein, beta-cryptoxanthin, lycopene, alpha-carotene and beta-carotene, and inflammatory markers including CRP, interleukin (IL)-6 and interleukin-18, matrix metalloproteinase (MMP)-9, and myeloperoxidase (MPO), were measured in plasma. Nutrient intake was estimated by validated food frequency questionnaires.ResultsAmong leukocyte subsets, only granulocytes showed independent and inverse associations with all carotenoids after adjustment. CRP, IL-18, and MMP-9 exhibited similar inverse relationships with most carotenoids. Mediation analysis revealed that the associations of carotenoids with CRP and MMP-9 were mediated by granulocyte counts. Lutein and beta-cryptoxanthin remained independently associated with MMP-9 after accounting for the mediation effects of granulocyte counts. No estimated nutrient intake showed comparable associations with leukocyte subsets or inflammatory markers.ConclusionsTo our knowledge, this is the largest population-based study investigating relationships between plasma carotenoids, leukocyte subsets, and soluble inflammatory markers. It provides evidence that low levels of carotenoids in plasma are linked to low-grade chronic inflammation and, furthermore, that this relationship is mediated by granulocyte numbers.Funding Agencies|Linkoeping University; Heart-Lung Foundation, Sweden [20180436]; Swedish Research Council [2018-03232]; Ake-Wibergs Foundation [M23-0074]; Stina and Birger Johansson Foundation [ROE-995110]; CirM strategic research network at Linkoping University; Vetenskapsradet [2018-03232]; Hjart-Lungfonden, Sweden [20180436]; Ake-Wibergs Foundation, Sweden [M23-0074]; Stina and BirgerJohansson Foundation [ROE-995110]; Vinnova [2018-03232] Funding Source: Vinnova; Swedish Research Council [2018-03232] Funding Source: Swedish Research Council</p
Carotenoids : Exploring Links with Inflammation and Optimizing Dietary Intake
No full textChronic low-grade inflammation is a key driver of lifestyle-related diseases like cancer, type 2 diabetes, and cardiovascular disease. While immunosuppressive therapies can reduce disease risk, serious side effects highlight the need for milder anti-inflammatory strategies. A high intake of fruits and vegetables is associated with reduced inflammation, potentially due to carotenoids, which are antioxidant pigments with anti-inflammatory properties. Plasma levels of carotenoids have consistently shown inverse associations with systemic markers of inflammation, mainly C-reactive protein (CRP) and circulating leukocyte counts. However, their relationship with specific leukocyte subsets and other inflammatory markers remains unclear. Furthermore, results from carotenoid intervention studies have been inconsistent, potentially due to the low absorption rates of carotenoids, which are heavily affected by food processing. In vitro studies have shown that preparing spinach as a smoothie can enhance carotenoid release. Yet, it remains unclear how co-consumed liquid components affect their absorption. The aim of this thesis was therefore to address these gaps by exploring the association between carotenoids and inflammation, and by developing strategies to optimize their dietary intake. In Paper I, we found that plasma carotenoids were inversely associated with circulating granulocytes, but not other immune cells, in a population-based cohort. Carotenoids were also associated with CRP, interleukin-18, and matrix metalloproteinase-9 (MMP-9). Mediation analysis revealed that granulocytes mediated the relationship between carotenoids and CRP, as well as MMP-9. In Papers II and III, we evaluated how co-consumed liquid components affected the release and absorption of carotenoids from spinach smoothies. Only four of the fourteen liquids enhanced release in vitro, while cow´s milk was the only liquid to significantly enhance in vivo absorption in humans. Overall, this thesis supports an inverse association between carotenoids and several inflammatory markers, particularly those involved in innate immunity. Furthermore, we developed a practical dietary strategy to optimize carotenoid intake by consuming spinach in smoothies with cow's milk. This offers a valuable tool for future studies evaluating the immunomodulatory effects of carotenoids and their potential to reduce chronic low-grade inflammation.Låggradig kronisk inflammation är en riskfaktor för vanliga folksjukdomar som hjärt-kärlsjukdom, typ 2 diabetes och cancer. Medicinska behandlingar som hämmar inflammation minskar risken för sjukdom, men kopplas samtidigt till allvarliga biverkningar. Ett mer fysiologiskt behandlingsalternativ skulle kunna vara förändrade kostvanor. Ett högt intag av frukt och grönt kopplas till lägre inflammation. Orsaken är inte klarlagd, men en förklaring är intag av karotenoider, som är antioxidanter och rikligt förekommande i vissa frukter och grönsaker. Flera studier har funnit att höga nivåer av karotenoider i blodet är kopplat till lägre inflammation. Men dessa studier har ofta använt generella mått och sambandet med specifika typer av immunceller eller inflammationsmarkörer är oklart. Samtidigt uppvisar kostinterventioner som syftat till att öka karotenoidintaget motstridiga resultat. Detta kan bero på att absorptionen av karotenoider är komplex, och att de lätt bryts ner vid uppvärmning. Som exempel är mängden karotenoider som kroppen kan ta upp från spenat mycket högre i en smoothie jämfört med när spenaten värms upp. Däremot vet vi inte hur olika drycker som används i en smoothie påverkar absorptionen. Syftet med denna avhandling var därför att dels undersöka sambandet mellan karotenoider och immunceller/inflammation i blodet, dels att utveckla en metod för att optimera upptag av karotenoider från spenat. I delarbete I, som var en befolkningsstudie såg vi ett starkt samband mellan karotenoidnivåer i blodet och specifika inflammationsmarkörer som kopplas till ökad risk för folksjukdomar. Vi såg också en koppling till en specifik typ av immuncell, granulocyter. Uppskattat karotenoidintag baserat på kostenkäter visade dock inget samband. I delarbete II och III undersökte vi vilka drycker som bäst kan användas i spenatsmoothies för att maximera upptaget av karotenoider. Av de fjorton drycker vi testade (mjölk- samt växtbaserade) var det endast fyra som ökade frisättningen av karotenoider från spenaten. När vi sedan testade hur upptaget i kroppen påverkades av dessa drycker, visade det sig att endast komjölk markant ökade absorptionen. Sammanfattningsvis visar denna avhandling att det finns ett tydligt samband mellan karotenoidintag och inflammation, vilket stärker potentialen för att karotenoider kan användas i sjukdomsförebyggande syfte. Vi visade också att man kan öka kroppens upptag av karotenoider avsevärt genom att använda komjölk i spenatsmoothie. En sådan smoothie skulle vara ett lättillgängligt verktyg i framtida behandlingsstudier för att se om ett högre intag av karotenoider kan sänka låggradig kronisk inflammation och på så sätt minska risken för sjukdom.Chronische ontsteking is een risicofactor voor veelvoorkomende ziektes zoals hart- en vaatziekten, diabetes type 2 en kanker. Medische behandelingen die ontstekingen remmen, verlagen weliswaar het risico op deze ziekten, maar hebben vaak ernstige bijwerkingen. Een meer fysiologisch alternatief zou een verandering van voedingsgewoonten kunnen zijn. Een hoog inname van groenten en fruit wordt namelijk geassocieerd met minder ontstekingen. De precieze reden hiervoor is nog onduidelijk, maar een mogelijke verklaring is de inname van carotenoïden, antioxidanten die rijkelijk aanwezig zijn in veel soorten groenten en fruit. Verschillende studies hebben al aangetoond dat hoge niveaus van carotenoïden in het bloed in verband staan met minder ontsteking. Deze studies maken echter vaak gebruik van algemene meetmethoden, waardoor de relatie met specifieke immuuncellen of ontstekingsmarkers onduidelijk is. Tegelijkertijd leveren voedingsinterventies om de inname van carotenoïden te verhogen inconsistente resultaten op. Een mogelijke reden is dat carotenoïden complex worden opgenomen en bovendien snel afbreken door verhitting. De hoeveelheid carotenoïden die het lichaam kan opnemen uit spinazie is bijvoorbeeld veel hoger in een smoothie dan in verhitte spinazie. Wat we echter nog niet weten, is hoe verschillende dranken in een smoothie de opname beïnvloeden. Het doel van dit proefschrift was daarom tweeledig: ten eerste het onderzoeken van het verband tussen carotenoïden en immuuncellen/ontsteking in het bloed, en ten tweede het ontwikkelen van een methode om de opname van carotenoïden uit spinazie te optimaliseren. In deelstudie I, een bevolkingsonderzoek, vonden we een sterk verband tussen de carotenoïdenniveaus in het bloed en specifieke ontstekingsmarkers die geassocieerd worden met een verhoogd risico op veelvoorkomende ziekten. Er werd ook een verband gevonden met een specifiek type immuuncel, granulocyten. De geschatte inname van carotenoïden op basis van voedingsenquêtes liet echter geen verband zien. In deelstudies II en III onderzochten we welke dranken het beste kunnen worden gebruikt in spinaziesmoothies om de opname van carotenoïden te maximaliseren. Van de veertien geteste dranken verhoogden slechts vier het carotenoïdegehalte uit de spinazie. Toen we vervolgens testten hoe de opname in het lichaam werd beïnvloed door deze dranken, bleek dat alleen koemelk de opname van carotenoïden aanzienlijk verhoogde. Samenvattend laat dit proefschrift zien dat er een duidelijk verband bestaat tussen carotenoïdeninname en ontsteking, wat het potentieel van carotenoïden voor ziektepreventie vergroot. Ons onderzoek toonde ook aan dat het gebruik van koemelk in een spinaziesmoothie de opname van carotenoïden aanzienlijk verhoogt. Een dergelijke smoothie zou een gemakkelijk hulpmiddel kunnen vormen voor toekomstig onderzoek. Daarin kan gekeken worden of een hogere inname van carotenoïden de chronische ontsteking en het risico op ziekte kan verlagen
Investigation of erythema migrans patients identifies Borrelia species and Neoehrlichia mikurensis with implications for clinical assessment
No full textEmerging tick-borne infections pose public health challenges and may complicate treatment decisions. The EMBio study, a multicenter observational study, aims to describe erythema migrans (EM), an early localized manifestation of Borrelia burgdorferi sensu lato (s.l.) infection, and investigate the occurrence of tick-borne co-infections among patients presenting with this skin lesion. Additionally, the study seeks to determine relations between EM morphology, other clinical manifestations, specific pathogens, and disease prognosis. Clinical characteristics, skin biopsies, and blood samples were analyzed from 26 patients to assess co-infections, quantity, Borrelia species, and spirochete load. Borrelia DNA was detected in 88% of EM skin lesions, with Borrelia afzelii as the predominant species. Two cases of co-infections were identified, one involving two Borrelia species and one involving Borrelia afzelii and the intracellular bacterium Neoehrlichia mikurensis. Notably, homogeneous EM lesions harbored significantly higher spirochete quantities in the central zone compared to annular lesions, suggesting that lesion morphology reflects local bacterial density. This supports the value of molecular diagnostics in detecting mixed infections and supports morphology-guided biopsy strategies in the clinical assessment of cutaneous infections. This study contributes to a better understanding of co-infection dynamics and may improve diagnostic accuracy and patient management in endemic settings.Funding Agencies|Linkoeping University; Medical Research Council of Southeast Sweden [FORSS-855141, FORSS-940983, FORSS-931010, FORSS-1012268]; Region Jonkopings County [FUTURUM-983017, FUTURUM-995198]; Region Otergotland [RO-990411, RO-979010, RO-937675]; EU-Interreg NSR programme NorthTick</p