Publikationer från Umeå universitet
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Captive bolt guns and suicides : a 15-year Swedish retrospective study
No full textBackground: The captive bolt gun is a tool for stunning animals in the meat industry and is not considered a firearm under the Swedish firearm legislation. This study aimed to explore the involvement of such devices in human fatalities, with an emphasis on suicides. Epidemiological characteristics from a longitudinal perspective, as well as risk factors and injury patterns were analyzed. Method: Suicides involving captive bolt guns in Sweden 2009–2023 were studied. Data, including demographics, circumstances of the incident, and autopsy reports, were collected from the National Board of Forensic Medicine. Results: During the 15-year study period, there were 39 suicides involving captive bolt guns, accounting for an annual average of 2.6 suicides, or 0.3 suicides/1,000,000 living people. The incidence was relatively stable over the period. The county-level suicide rate increased with decreasing population density. Older males with mental health issues represented a high-risk group. Four cases were complex suicides, and in two cases, a victim sustained two separate bolt gun injuries in consecutive attempts. Injuries caused by modern captive bolt guns exhibited typical characteristics and could be distinguished from those involving older devices with projectiles. Brain injuries predominated as cause of death. Conclusion: Suicides involving captive bolt guns are rare. Older males in rural areas, especially those with mental health issues and access to such devices, represented a high-risk group. Since access to these devices is unrestricted, prevention efforts should address individual risk factors, restriction of means and systemic measures aimed at promoting better mental health in rural communities
Sjuksköterskors erfarenhet av palliativ vård inom hemsjukvård i glesbygd : En kvalitativ intervjustudie
No full textBakgrund: Palliativ vård fokuserar på att lindra lidande och främja livskvalitet när bot inte längre är möjligt. Vården bygger på symtomlindring, samarbete inom teamet och stöd till både personen och anhöriga. I glesbygd har distriktsköterskan en nyckelroll, där självständighet och bred kompetens är väsentligt på grund av långa avstånd och många gånger begränsade resurser. Motiv: Allt fler personer uttrycker en önskan att få vistats i sitt hem i livets slut, vilket ställer krav på att palliativ vård kan erbjudas i hemmet. För att förbättra omhändertagandet av personer i palliativ vård behövs ökad kunskap om erfarenhet av palliativ vård inom hemsjukvård i glesbygd. I denna studie intervjuades sjuksköterskor då distriktssköterskor saknades i området. Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenhet av palliativ vård inom hemsjukvård i glesbygd. Metod: Studien har en kvalitativ design med induktiv ansats. Semistrukturerade intervjuer genomfördes med sjuksköterskor verksamma inom hemsjukvård i glesbygd i Västerbotten och Norrbotten. Resultatet analyserades med kvalitativ innehållsanalys. Resultat: Resultatet visade sjuksköterskornas erfarenheter av palliativ vård inom hemsjukvård i glesbygd. Tre kategorier framkom: Att arbeta personcentrerat i livets slut, Att ge jämlikvård en utmaning i glesbygd samt Att få göra skillnad i livets slut. Utifrån kategorierna framkom sex subkategorier. Konklusion: Sjuksköterskornas erfarenheter speglar en vilja att skapa jämlik, personcentrerad och trygg palliativ vård i hemmet, dygnets alla timmar, oavsett geografiska förutsättningar. Utifrån detta blir det tydligt att mer forskning och utvecklingsarbete behövs för att säkerställa att palliativ vård i hemmet kan erbjudas på likvärdiga villkor i hela landet
Occupational risk factors for surgically treated lumbar disc herniation - a 33-year follow-up
No full textOBJECTIVES: This study aimed to assess the associations between occupational biomechanical factors and occurrence of surgically treated lumbar disc herniation (LDH) and describe the consequences in terms of early exit from the labor market. METHODS: A cohort of 262 850 male construction workers participating in a national occupational health surveillance program was followed prospectively for 33 years (1987-2019). Occupational biomechanical exposures were assessed by a job exposure matrix (JEM) based on specific occupational groups. Workers who underwent surgical treatment for LDH were identified from the national patient register and data on disability pension from the Swedish Social Insurance Agency. Poisson regression models were used to estimate relative risks (RR) and 95% confidence intervals (CI) for biomechanical exposures, adjusted for age, body mass index, smoking status, height and time period. RESULTS: There were 2451 cases of surgical treatment for LDH and the incidence peaked at age 40-45 years. Increased risks were found for often lifting >25 kg (RR 1.77, 95% CI 1.06-2.94), extreme lumbar flexion/extension (RR 1.60, 95% CI 1.37-1.88) and high exposure to whole-body vibration (RR 1.32, 95% CI 1.05-1.65). Among cases, the mean age for exiting the labor market due to disability pension was 55.9 years for white-collar workers and 51.7 years for construction workers. CONCLUSIONS: Occupational exposure to heavy lifting and working in non-neutral back postures was associated with increased risk of surgical treatment for LDH. Construction workers who have had surgery for LDH exited the labor market with disability pension earlier than white-collar workers
Glycoalkaloid-free starch potatoes generated by CRISPR/Cas9-mediated mutations of genes in the glycoalkaloid biosynthesis pathway enable more sustainable uses of by-products from starch production
No full textSteroidal glycoalkaloids (SGAs) are toxic cholesterol-derived secondary metabolites present in several Solanaceae species. In potato, tuber SGA levels are for reasons of toxicity of concern in both table and starch cultivars. In the latter, SGAs bind to proteins and fibres in starch production side-streams and prevent their further uses as food and feed. To enable more sustainable uses of starch by-products, we have here reduced SGA biosynthesis in a starch potato cultivar using DNA-free CRISPR/Cas9. Six SGA genes were targeted, encoding enzymes acting either before cholesterol (SMO1-L, DWF1-L, DWF7-L), or after (16DOX, CYP88B1, TAMiso2). Editing efficiencies varied between 20% and 49%, and generated mutants were investigated under greenhouse and field conditions. Target mass-spectrometric analyses confirmed reduced SGA levels and alterations of sterol metabolism in mutated events. Plant height and tuber yield were reduced in several events, although this was not correlated to low SGA levels. Several knockout mutants had almost SGA-free leaves and tubers, the latter also under two SGA-inducing conditions. Similarly, both fibre and protein fractions isolated from side-streams in the starch production process from mutant tubers had very low SGA levels. By contrast, the corresponding wild-type SGA levels were almost 10-fold and, respectively, 40-fold higher than the recommended upper safe limit. The results demonstrate that glycoalkaloid-free mutants can be generated and grown with moderate yield reductions under both greenhouse and field conditions. This suggests a potential for sustainable production of high-value products, e.g., food-grade protein and fibre, from starch production side-streams of SGA knockout tubers
10-year longitudinal dopamine D2-receptor losses are associated with cognitive decline in healthy aging
No full textAging-related dopamine decline has been suggested as a key factor behind individual differences in cognitive decline at older ages. Thus far, the hypothesized age-dopamine-cognition triad has been extrapolated from cross-sectional studies, which cannot uncover change associations. Using data from the longitudinal Cognition, Brain, and Aging (COBRA) study, we examined whether dopamine D2-receptor availability changes are correlated with cognitive changes across individuals in old age. At the first wave, 181 healthy adults aged 64 to 68 years underwent positron emission tomography with 11C-raclopride, magnetic resonance imaging, multiple cognitive tests assessing episodic memory, working memory, and perceptual speed, and mapping of health-related factors. The returnees (n = 129 after 5 years; n = 93 after 10 years) were representative of the parent sample regarding gender composition, educational attainment, cognitive performance, and dopamine D2-receptor status at baseline. Bayesian structural equation modeling revealed mean decline and individual differences in decline for striatal dopamine D2-receptor availability (approximately-5% per decade) and for all three cognitive abilities. Changes in dopamine D2-receptor and a factor of general cognition were positively correlated (r = 0.31, P(r > 0.00) > 0.95). Taken together, these longitudinal findings support that striatal dopamine decline is associated with cognitive aging, possibly reflecting dopamine influences via striato-Thalamo-cortical loops on general cognitive functions
Att förutspå det kliniska utfallet vid Subarachnoidalblödning med hjälp av biomarkörer
No full textBackground: Aneurysmal subarachnoid haemorrhage (SAH) is a complex form of stroke affecting approximately 10 per 100,000 individuals in Western populations. In addition to the damage caused by the initial haemorrhage, secondary complications such as rebleeding, hydrocephalus and delayed cerebral ischemia may further contribute to the overall extentof brain injury. Long-term outcomes range widely, from death to full recovery. Predicting functional outcomes during theacute phase of the disease remains challenging, and currently, no blood-based biomarkers are routinely used in clinical practice. Aim: This thesis investigates whether the biochemical biomarkers myo-inositol (MI), neurofilament light chain (NFL), and S100-beta (S100B) measured in venous blood are associated with secondary complications and long-term functional outcomes. The focus is also on characterizing their trajectories during the acute phase of SAH. The main hypothesis is that levels of the biomarkers are associated with functional outcome 12 months after the haemorrhage. Method: This work is based on four studies; all derived from a single observational cohort. The cohort included patients aged 18 years or older who were treated for SAH at Umeå University Hospital between 2014 and 2018. Serum samples were collected at multiple time points during hospitalization. Demographic and clinical data were recorded, including neurological status upon admission according to the World Federation of Neurosurgical Societies and Hunt and Hessscores, the amount of subarachnoid blood on the initial CT scan as classified by the Fisher grade, the presence of delayed cerebral ischemia and angiographic vasospasm, as well as the treatment modality used for aneurysm occlusion. Functional status was assessed one year after disease onset using the Glasgow Outcome Scale Extended and the modified Rankin Scale. Outcomes were dichotomized into favourable (Glasgow Outcome Scale 5-8, modified Rankin Scale 0-3) and unfavourable (Glasgow Outcome Scale 1-4, modified Rankin Scale 4-6) groups. In one study, health-related quality of life was also evaluated using the EuroQoL 5-Dimension Index. Biomarker levels were compared between groups, and multivariable logistic regression was applied to assess their predictive value for long-term outcomes. Results: For MI, levels at admission did not correlate with World Federation of Neurosurgical Societies score, nor did they differ between favourable and unfavourable outcome groups. However, by day seven, significant differences in MI levels emerged between outcome groups, and the change in MI levels over this period also differed significantly. For NFL, levelswere significantly associated with both World Federation of Neurosurgical Societies score at admission and outcome group,with differences observed at admission and throughout follow-up. S100B values obtained during the first days after SAH onset correlated significantly with both modified Rankin Scale and EuroQoL 5-Dimension Index with peak S100B levels showing the strongest association with functional outcome. All three biomarkers were significant predictors of long-termfunctional outcome in univariate analyses. When combined with established predictors, these biomarkers improved the performance of multivariable regression models. Conclusions: The biomarkers MI, NFL, and S100B are associated with long-term functional outcomes in patients with SAH. Incorporating them into predictive models may provide a valuable tool for outcome prognostication. However, external validation in larger cohorts is required before these biomarkers can be considered for routine clinical implementation. The main hypothesis of this thesis has therefore to be accepted
Quantization compensator network : server-side feature reconstruction in partitioned IoT systems
No full textWith the growing number of IoT devices generating data at the edge, there is a rising demand to run machine learning (ML) models directly on these resource-constrained nodes. To overcome hardware limitations, a common approach is to partition the model between the node and a more capable edge or cloud server. However, this introduces a communication bottleneck, especially for transmitting intermediate feature maps. Extreme quantization, such as 1-bit quantization, drastically reduces communication cost but causes significant accuracy degradation. Existing solutions like full-model retraining offer limited recovery, while methods such as autoencoders shift computational burden to the IoT node. In this work, we propose Quantization Compensator Network (QCNet)—a lightweight, server-side module that reconstructs high-fidelity feature maps directly from 1-bit quantized data. QCNet is used alongside fine-tuning of the server-side model and introduces no additional computation on the IoT node. We evaluate QCNet across diverse vision models (ResNet50, ViT-B/16, ConvNeXt Tiny, and YOLOv3 Tiny) and tasks (classification, detection), showing that it consistently outperforms standard dequantization, autoencoder-based, and Quantization-Aware Training (QAT) approaches. Remarkably, QCNet achieves accuracy close to—or even surpassing—that of the original unpartitioned models, while maintaining a favorable accuracy–latency trade-off. QCNet offers a practical and efficient solution for enabling accurate distributed intelligence on communication- and compute-limited IoT platforms
Towards collaborative planning for health promotion through person-tailored storytelling and argumentation
No full textThe aim of this research is to explore collaborative AI systems to promote healthy lifestyle changes. With a focus onolder adults, a participatory design process was initiated, involving a team of researchers in occupational therapywith expertise in engagement in meaningful activities such as among older adults, human-agent interaction,and artificial intelligence. The scenario of collaboratively assessing past activities and planning activities of thecoming week - between the human and AI agent -guided the development of a novel, person-tailored storytellingsystem, based on argumentation theory. A framework was developed, integrating semantic user models, dialoguetypes, and structured argumentation to guide personalised story generation towards motivational and reflectivegoals. The formative evaluation highlighted critical challenges, including narrative inconsistency and hallucinatedcontent, motivating the future inclusion of reflective AI components. This work contributes to the methodologicalfoundations of designing trustworthy, purpose-driven storytelling systems that can be extended for futureHuman-AI collaboration
Mapping CAD education in architecture : a critical review and survey of bachelor programmes in Europe
No full textThis study examines the current state of computer-aided design (CAD) in architectural education, revisiting early 2000s debates on digital design integration in Bachelor of Architecture programmes. Using a mixed-methods approach, the study analyzes curricula from 50 European architecture schools and reviews foundational scholarship on CAD education. The study examines how, when, and what aspects of digital design are taught, considering rapid advances in AI and the growing emphasis on sustainable design. Two main methods of CAD integration are identified: through dedicated courses and integrated into existing courses, with schools split between these approaches. Most dedicated digital design courses occur in the first years, suggesting a shift toward early integration. However, CAD remains largely framed as a representational tool since it is frequently embedded in drawing courses. Despite growing scholarly interest in early integration of advanced topics such as parametric design, current curricula primarily emphasize general digital design methodologies
Thyroid hormone receptor beta signaling is a targetable driver of prostate cancer growth
No full textThyroid hormone (TH) signaling plays a major role in the development, energy homeostasis, and metabolism of most tissues. Recent studies have identified THs as drivers of prostate cancer (PCa) development and progression. We reported that the T3-scavenger protein µ-crystallin (CRYM) regulates the development and progression of PCa and that this involved crosstalk with androgen receptor (AR) signaling. However, the mechanisms remain incompletely understood. Here, we explored the role of thyroid hormone receptor β (TRβ), which is the main effector of TH signaling, in the context of PCa. The use of the TRβ-selective antagonist NH-3 inhibited PCa cell proliferation in vitro and reduced tumor size in PCa xenograft models in vivo. Notably, NH-3 was highly effective in the engrafted 22Rv1 cell line, a model for castration-resistant PCa (CRPC). Mechanistic studies revealed that NH-3 downregulates AR and the AR target genes Nkx3.1 and KLK3 (PSA). NH-3 was a more effective anticancer agent than enzalutamide, and their combined use was synergistic. Evidence from human datasets corroborates our findings, whereby elevated TRβ expression and mutations in the TH signaling pathway are associated with the onset of PCa. Collectively, these results establish TRβ as a mediator of tumorigenesis in PCa and identify NH-3 as a promising therapeutic agent for targeting AR signaling, particularly in CRPC