Publikationer från Umeå universitet
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Jämförelse av ballongguider och guidekatetrar utan ballong vid mekanisk trombektomi: en retrospektiv kohortanalys
No full textBackground: The use of balloon guide catheters (BGC) in mechanical thrombectomy is viewed as a method that offers patients improved post-procedural clinical and recovery outcomes. However, recent research suggests a possible negative effect contradicting earlier studies. Motive: A recent study from China found that using balloon guide catheters resulted in worse patient outcomes, which goes against the traditional understanding of why BCG is the method of choice. Aim: This study aimed to compare outcomes for two patient groups, those treated with BGC and those without. Methods: A retrospective cohort study utilized registry data from 596 patients treated for acute ischemic stroke between January 2023 and January 2025 at Karolinska University Hospital. The patient data was grouped according to BGC use. Outcomes such as reperfusion success (Tici Score), NIHSS at multiple time points, re-occlusion, and procedural complications were compared using descriptive statistics, t-tests, and Chi-square tests. Result: A total of 596 patients were included in the study. Of these, 190 underwent the treatment without a BGC, and 406 received treatment with the use of BGC. No statistically significant differences were found between the groups regarding NIHSS, TICI, clot-relocalisation, re-occlusion, hospital stay, or demographic differences (such as gender and age), with p > 0.05 for all comparisons. Conclusion: This study found no statistically significant difference in reperfusion outcomes, as measured by the TICI score, between the patient groups. These results suggest that, within the parameters of this study, BGC use did not appear to influence the degree of achieved reperfusion. Further prospective research is needed to clarify whether specific patient subgroups may benefit from BGC-assisted techniques. Bakgrund: Användningen av guidekatetrar med integrerade ballonger, s.k. ballongguider (BGC) vid mekanisk trombektomi har länge ansetts ge bättre kliniskt utfall. Ny forskning verkar dock ge motstridiga uppgifter och därför är ytterligare studier av intresse. Motiv: I en nyligen genomförd studie från Kina konstateras att användning av BGC gav sämre utfall för patienten vilket inte är i linje tidigare mindre studier där ballongstyrda katetrar gav bättre utfall. Syfte: Denna studie syftade till att jämföra utfallet för patienter behandlade med eller utan BGC.Metod: En retrospektiv kohortstudie genomfördes med registerdata innehållande 596 patienter behandlade för akut ischemisk stroke mellan januari 2023 och januari 2025 på Karolinska Universitetssjukhuset. Patientdata grupperades baserat på användning av BGC. Utfall som reperfusions framgång (TICI-poäng), NIHSS vid flera tidpunkter, re ocklusion och procedurkomplikationer jämfördes med hjälp av deskriptiv statistik, t-test och chi-Square. Resultat: Totalt ingick 596 patienter i denna studie, varav 190 behandlades utan ballongkatetern och 406 med. Det fanns inga statistiskt signifikanta skillnader mellan grupperna avseende NIHSS, TICI, propp migration, re-ocklusion, vistelse på sjukhuset eller demografiska skillnader (så som kön och ålder). Konklusion: Denna retrospektiva kohortstudie visade ingen statistisk signifikant skillnad i reperfusionsgrad, mätt med TICI-score, mellan patienter som behandlades med respektive utan BGC under mekanisk trombektomi. Resultaten antyder att ballonganvändning, inom denna studies ramar, inte påverkade graden av uppnådd reperfusion. Ytterligare prospektiv forskning krävs för att se om vissa patientgrupper kan ha nytta av ballongassisterad teknik.
Navigating productivity dilemmas and conflicting loyalties in activity-based flexible offices : a qualitative study of managers’ perspectives and coping strategies
No full textActivity-based Flexible Offices (AFOs) provide employees with a variety of workspaces to choose from based on their tasks, rather than having assigned desks. While the adoption of AFOs is increasing due to flexibility and cost-efficiency, there is limited research about the consequences of transitioning to AFOs from the perspective of staff managers. The purpose of this study is to explore how managers experience and cope with challenges that may arise in AFOs. Our qualitative descriptive study is based on two case studies that investigate the consequences of AFOs. Data collection involved semi-structured interviews with a total of 33 managers in two organisations, 12–18 months post-relocation. An inductive, bottom-up process was used for coding and thematization of the interview transcripts. Our results show that AFOs can enhance communication and collaboration depending on the units’ collaboration needs and prior geographical distribution. However, this effect was overshadowed by task-environment misalignments on within-team communication, distractions, and limitations on adjustments and recruitments. Additionally, managers faced conflicting loyalties between defending the organisation’s decision to implement AFOs while ensuring compliance with legal work environment requirements despite limited resources. There is a risk that the implementation of flexible offices will fragment and complicate managers’ tasks, such as ensuring that daily operations run smoothly, meeting legal responsibilities, and managing and recruiting staff. This poses a risk to managers’ productivity and health, and consequently, the achievement of organisational goals. The study uncovers managerial experiences, challenges, and coping strategies in AFOs, offering valuable insights for organisations considering this office type
Are routes aligned with the street network less complex? : a comprehensive analysis
No full textThe routes displayed on maps by navigation support systems are intended to help users to orient themselves towards reaching the destination and to infer information related to their navigation. Inferring how complex a route is, including how well you think you can remember it and the likelihood of getting lost, may influence expectations on how it is navigated. However, it is not well understood when and where a route displayed on a map is perceived as complex and why someone perceives it this way. Current methods for assessing complexity tend to focus either on (i) the complexity of the route or on (ii) the complexity of the environment as a static and global property. By taking inspiration from navigational map reading and how routes and street networks are perceived on a map, this paper investigates how environmental complexity influences route complexity and length.We developed a new approach to gauge the alignment between the orientation of a route’s origin and destination with respect to the orientation of the streets within the network, and we investigated how this measure relates to route complexity and length
Analysis of Immunoreactive Proteins in Filifactor alocis : Analysis of detection of serum antibodies against FtxA-positive and FtxA-negative strains of F. alocis in periodontitis patient sera
No full textABSTRACT Background: Aggregatibacter actinomycetemcomitans is an oral bacterium known to be associated with aggressive forms of periodontitis in adolescents. Studies suggest that Filifactor alocis might also correlate to periodontitis. A specific strain of F. alocis has been shown to express repeat-in-toxin (RTX) named FtxA, which may contribute to its virulence. Reports of potential synergistic interaction between FtxA and the non-JP2 genotype of A. actinomycetemcomitans highlight that further understanding of F. alocis and FtxA could be important for diagnosis of periodontitis. Aim: To investigate the presence of potential immunoreactive proteins expressed by FtxA-positive and FtxA-negative F. alocis strains. Methods: Sera from one periodontally healthy and three periodontally ill patients were used for Western blot analysis with loading of FtxA-positive and FtxA-negative strains. Results: Antibodies in sera from periodontitis patients immunoreacted with protein antigens in both Ftxa-positive and Ftxa-negative strains. A protein with a molecular weight of ~150 kDa in the FtxA-negative strain FA12 reacted strongly with antibodies in the sera of all three periodontitis patients, while a protein with a molecular weight of ~200 kDa in the FtxA-positive strain FA1 reacted with antibodies in the serum of one periodontitis patient. The identities of these proteins are unknown. Conclusion: Our findings suggest that antisera from periodontitis patients recognize different proteins in FtxA-positive and FtxA-negative strains of F. alocis. Thus, these two variants of F. alocis appear to induce differential patterns of immune reactions.
Nordic microalgae immobilized to a sulfur-cooking oil copolymer form a highly efficient, sustainable and reusable sorbent to remove heavy metals from complex mixtures
No full textHeavy metal contamination is of highest concern for the environment. Bioremediation, using microorganisms to adsorb and enrich heavy metals, offers an outstanding solution, especially when the pollutants appear at concentrations where physical/chemical methods are not efficient. This study presents a sustainable approach to heavy metal removal through the development of a microalgae-based sorbent supported on a copolymer produced entirely from recycled waste streams. The copolymer was synthesized by inverse vulcanization using sulfur recovered from petrochemical waste and waste cooking oil, demonstrating a circular use of industrial and household by-products. This sustainable, biobased sorbent was highly efficient in removing the heavy metals copper, cadmium and lead in a multi-element mixture at concentrations of industrial relevance. Kinetics and equilibrium parameters and even adsorption capacities improved drastically after immobilization of microalgae to the copolymer, compared to free-swimming microalgae or copolymer alone. The green microalga Chlorella vulgaris (13-1) immobilized to the copolymer removed more than 95% of the total Cu2+ and Cd2+ and 50% of the total Pb2+ within 8 h. Additionally, this sorbent is reusable; a desorption and regeneration step with 0.1M EDTA and CaCl2 allowed up to 98% recovery of the concentrated, bound heavy metals. Reusing the microalgal-copolymer sorbent in a second removal cycle resulted in removal rates of 75-99% of the initial ones. This novel sorbent allows not only sustainable and efficient removal of heavy metal mixtures from industrial wastewaters but also can be used in subsequent rounds during wastewater purification
Altered distribution of tissue galectins correlates with mucosal dysregulation in SIV infection
No full textThe intestinal mucosa in individuals with chronic human immunodeficiency virus (HIV) infection remains a site of viral persistence and immune dysregulation, even with prolonged suppressive antiretroviral therapy (ART). While biomarkers of mucosal damage and microbial translocation offer valuable correlative insights, the underlying mechanisms remain incompletely understood. Immunoregulatory galectins are implicated in HIV persistence and pathogenesis and play critical roles in intestinal inflammation and host-microbiome homeostasis. Here, we leveraged archival samples and data from an anti-alpha 4 beta 7 immunotherapy study of simian immunodeficiency virus (SIV)-infected rhesus macaques to investigate the relationships between circulating and gut mucosal galectins 1, 3, and 9, and barrier integrity, by tracking levels of tight junction proteins, and SIV viral load assessment of RNA and DNA levels in tissues. Elevated plasma levels of galectin-9 during peak viremia, ART suppression, ART interruption, and at necropsy were significantly correlated with SIVgag DNA levels in the ascending colon during necropsy. Several galectins were significantly reduced in the ascending colon and duodenum in ART-treated SIV-infected macaques compared to viremic animals and were related to tight junction disruptions. These findings suggest mucosal SIV burden and impaired gut integrity may be influenced by changes due to circulating and tissue galectins, making them potential therapeutic targets to restore gut homeostasis
Neurobehavioral outcomes at 10 years of age following delayed umbilical cord clamping : a follow-up study after a randomized trial
No full textIntroduction: The aim of this study was to explore long-term behavioral consequences of early versus delayed cord clamping (CC) in school-aged children. The hypothesis was that early CC would be associated with an increased risk of symptoms associated with attention deficit hyperactivity disorder (ADHD) due to the lower iron stores following early CC compared with delayed CC. Methods: Exploratory, long-term follow-up study of a randomized controlled trial in Sweden. Full-term, vaginally born, neonates to healthy mothers were originally included and randomized to either early (≤10 s) or delayed (≥180 s) CC. At 10 years of age, scores from the screening questionnaire Swanson, Nolan and Pelham Scale IV (SNAP-IV), that identifies symptoms suggestive of ADHD (but do not diagnose ADHD), were compared between groups of early and delayed CC. Results: We assessed 139/382 (36.4%) children, 64 early CC and 75 delayed CC. No significance in total score and subgroup scores of SNAP-IV was seen when comparing early and delayed CC. In the primary outcome, total scores, mean (standard deviation) of early CC was 14.64 (13.94) and for delayed CC 13.59 (13.41), p = 0.65. Conclusion: Timing of umbilical CC and iron status were not associated with symptoms associated with ADHD in 10-year-old children. Studies with higher follow-up rates and in populations with high prevalence of iron deficiency are needed to verify or discard the findings. Understanding if delayed CC has long-lasting neurobehavioral or neurodevelopmental effects can help develop guidelines and program about neonatal care
Organizational risks and the role of the work environment inmisconduct in elderly Care: A Scoping Review
No full textDenna studie är en scoping review som syftar till att kartlägga vilka organisatoriska och arbetsmiljömässiga faktorer som i tidigare forskning har kopplats till risken för missförhållanden inom äldreomsorgen, samt att belysa hur dessa faktorer påverkar personalens möjligheter att upprätthålla en trygg och värdig omsorg.Studien bygger på tio vetenskapligt granskade artiklar publicerade mellan 2015 och 2025, som identifierades genom systematiska sökningar i databasen Web of Science Core Collection. Materialet analyserades tematiskt utifrån återkommande mönster och samband mellan organisation, arbetsmiljö och omsorgskvalitet. Resultatet visar att missförhållanden sällan beror på individuella misstag utan uppstår i samspelet mellan organisatoriska strukturer, ledarskap och arbetsmiljömässiga villkor. Tre huvudteman identifierades: (1) organisation och ledarskap, (2) arbetsmiljö ocharbetsbelastning samt (3) personalfaktorer och omsorgskvalitet. Studien visar att höga krav i kombination med låg kontroll, otydliga rutiner och bristande stöd från chefer ökar risken för stress, utmattning och försämrad omsorgskvalitet. Samtidigt framhålls stödjande ledarskap, god kommunikation och personalens delaktighet som skyddande faktorer. Slutsatsen är att förbättringsarbete inom äldreomsorgen bör rikta sig mot de organisatoriskaförutsättningarna, inte enbart mot individuella insatser. En hållbar arbetsmiljö och ett närvarande ledarskap är avgörande för att förebygga missförhållanden och säkerställa en god och värdig omsorg
[Review] Review of The Ministry of Time
No full textReview of: Kaliane Bradley, The Ministry of Time. Simon and Schuster, 2024.</p
LRP8 is a receptor for tick-borne encephalitis virus
No full textTick-borne encephalitis virus (TBEV) causes tick-borne encephalitis (TBE), a severe and sometimes life-threatening disease characterized by viral invasion of the central nervous system with symptoms of neuroinflammation1,2. As with other orthoflaviviruses—enveloped, arthropod-borne RNA viruses—host factors required for TBEV entry remain poorly defined. Here we used a genome-scale CRISPR–Cas9-based screen to identify LRP8, an apolipoprotein E and reelin receptor with high expression in the brain, as a TBEV receptor. LRP8 downregulation reduced TBEV infection in human cells, and its overexpression enhanced infection. LRP8 bound directly to the TBEV E glycoprotein and mediated viral attachment and internalization into cells. An LRP8-based soluble decoy blocked infection of human cell lines and neuronal cells and protected mice from lethal TBEV challenge. LRP8’s role as a TBEV receptor has implications for TBEV neuropathogenesis and the development of antiviral countermeasures