Publikationer från Uppsala Universitet
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Biochemical osteomalacia reaffirmed by signs and symptoms and perinatal outcome : A prospective cohort study of women in Sweden
No full textBackground: Vitamin D deficiency-induced osteomalacia remains underexplored, despite the substantial migration to northern sun-deprived latitudes. In women, osteomalacia may impair smooth and striated muscle function and disrupt the birth canal. This study aimed to investigate the associations and effect estimates of biochemical osteomalacia on perinatal outcomes. Methods: A prospective cohort study was conducted to examine 71 Swedish and 52 Somali women during pregnancy and breastfeeding, addressing the heightened risk of severe vitamin D deficiency among Somali women. The baseline data comprised blood samples, questionnaires and clinical examination. Two years later, outcome variables were collected and comprised diagnostic codes for delivery methods. Women with miscarriage, stillbirth, or relocation from the region were excluded. Biochemical osteomalacia reaffirmed by signs and symptoms was diagnosed based on a non-invasive, non-radiation protocol. Associations between biochemical osteomalacia and delivery outcomes were analyzed using multinomial logistic regression, adjusted for a minimal set of confounders. Results: In the cohort 20 women, 19 Somali and one Swedish, were diagnosed with biochemical osteomalacia. Among women with biochemical osteomalacia, the adjusted odds ratio (aOR) for instrumental-assisted delivery was 4.92 (95 % CI 1.30-18.65) and the aOR for vacuum extractions was 16.16 (95 % CI 1.20-217.55). Conclusions: Biochemical osteomalacia was associated with a higher incidence of emergency instrumental delivery procedures, including an increased likelihood of vacuum-assisted delivery and emergency Caesarean sections. Primary healthcare staff play a vital role in screening for vitamin D deficiency during pregnancy and breastfeeding period, as well as initiating supplementation to mitigate the risk of adverse perinatal outcomes
Numerical solution of quantum Landau-Lifshitz-Gilbert equation
No full textThe classical Landau-Lifshitz-Gilbert (LLG) equation has long served as a cornerstone for modeling magnetization dynamics in magnetic systems, yet its classical nature limits its applicability to inherently quantum phenomena such as entanglement and nonlocal correlations. Inspired by the need to incorporate quantum effects into spin dynamics, recently a quantum generalization of the LLG equation is proposed [Phys. Rev. Lett. 133, 266704 (2024)] which captures essential quantum behavior in many-body systems. In this work, we develop a robust numerical methodology tailored to this quantum LLG framework that not only handles the complexity of quantum many-body systems but also preserves the intrinsic mathematical structures and physical properties dictated by the equation. We apply the proposed method to a class of quantum systems with a moderate number of spins that host host topological states of matter, and demonstrate rich quantum behavior, including the emergence of long-time entangled states. This approach opens a pathway toward reliable simulations of quantum magnetism beyond classical approximations, potentially leading to new discoveries.The authors contributed equally to this work</p
Effect of amino acids on the compaction behavior and stability of spray-dried trypsin/lactose powder
No full textAmino acids (AAs) have been employed as excipients in spray-dried (SD) protein formulations due to their stabilizing effects and particle engineering abilities. However, the research focusing on the influence of AAs on the tabletability of SD protein powders is still limited. The aim of this study was to investigate the effects of five diverse AAs, arginine hydrochloride (Arg & sdot;HCl), leucine (Leu), glycine (Gly), tryptophan (Trp) and sodium aspartate (Asp & sdot;Na), on the compaction behavior and stability of SD trypsin/lactose powders. The SD powders were characterized in terms of morphology, bulk powder properties, residual moisture content, and solid-state structure. Subsequently, the resulting powder compacts were characterized with respect to compressibility, compactability, and tabletability. Lastly, the conformational stability and enzymatic activity of trypsin in different SD formulations after compaction were assessed. The results showed that the SD trypsin/lactose/ Arg & sdot;HCl powder exhibited the poorest tabletability. Moreover, SD trypsin/lactose/Leu powder showed relatively poor tabletability, while SD trypsin/lactose/Trp powder showed a moderate tabletability. On the other hand, SD trypsin/lactose/Gly powder displayed the best compressibility, and the SD trypsin/lactose/Asp & sdot;Na tablets exhibited the highest tensile strengths at high compaction pressures. However, an altered conformation and reduced enzymatic activity of trypsin were observed in the SD trypsin/lactose/Asp & sdot;Na formulation upon compaction. In conclusion, the addition of five different AAs to the SD trypsin/lactose powder system resulted in distinct compaction behaviors and stabilizing effects, which can be attributed to the intrinsic properties of the original SD particles, such as hygroscopicity, morphology, and potential AAs' surface distribution
Smiling in the East and the West : Anatomical, cultural and sociological considerations in facial reanimation surgery
No full textThe importance of the smile as a means of communicative and metacommunicative signal in social engagement has been known and highlighted in studies dating back to the early 19th century. It remains a cornerstone of reconstructive surgeries for the paralyzed face. This paper calls attention to the differences between the Eastern and Western smile. Anatomical, cultural, and sociological peculiarities inform the way these populations smile and the way smiling itself is perceived. Reconstructive surgery of today would benefit from considering these aspects and allowing them to individualize the goals of reanimation procedures. (c) 2025 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/
Timing of MRI for early treatment response prediction of chemoradiotherapy in uterine cervical cancer
No full textAim: To explore the optimal use of MRI including time point to predict early treatment response during definitive chemoradiotherapy in cervical carcinoma. Methods: Pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) scheduled for chemoradiotherapy. All patients underwent four MRI examinations (at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment start). Maximum tumor size, size change (Delta size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) mean and change in ADC (Delta ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis" (PP) and the remaining 8/15 are referred to as "good prognosis" (GP). At all four time points, the tumors in the PP patients were larger than in the GP patients. Tumor size did change between the time point but this was not significant between the groups. Visible tumor on high b-value DWI reached a sensitivity and specificity for predicting prognostic group being highest at 5 weeks, 83 % (5/6) and 63 % (5/ 8), respectively. The combination of tumor size at baseline and visible tumor on DWI at 5 weeks, resulted in an area under the curve (AUC) = 0.83. At 12 weeks, no GP patients, but 2/7 PP patients showed visible tumor on DWI. Addition of ADC-values in the analysis did not improve the predictive value at any time point. Conclusion: This pilot study indicates that the tumor size on baseline MRI, combined with tumor visibility on DWI at 5 weeks, may predict outcome of chemoradiotherapy
Development and evaluation of AI chatbot tool for written communication training in self-care : Experiences of pharmacy students and faculty
No full textBackground: Effective communication is crucial in pharmacy practice, particularly in self-care counseling. As online pharmacies and chat-based consultations expand, training in digital written communication is increasingly important. Artificial intelligence (AI) systems based on large language models (LLMs) offer a structured and engaging environment to support skill development through conversational agents. This study explored the use of LLM-based chatbots to train pharmacy students in written synchronous communication for self-care consultations. Methods: Three chatbot-simulated patients and an LLM-based feedback system were developed to reflect common self-care scenarios and provide communication-focused feedback. Fourteen pharmacy students and faculty interacted with the chatbots and shared their experiences through semi-structured interviews. Thematic analysis was used to identify patterns in the data. Results: The analysis identified five main themes. Participants emphasized the authenticity of the simulated patient interactions, particularly their emotional realism. The AI-generated feedback was described as structured, detailed, and fair especially valued for its focus on communication skills. Faculty appreciated the consistency of the feedback and highlighted its added value to complement human assessment. Students discussed the cognitive and emotional demands of the experience, suggesting potential to tailor chatbot complexity to learners' needs. Conclusion: LLM-based chatbots represent a pedagogically grounded and scalable tool for developing pharmacy students' written communication skills in self-care consultations. This approach offers a foundation for building shared virtual patient infrastructures and integrating communication theory into digital education. It holds promise for broad implementation across pharmacy programs adapting to the demands of online and hybrid care
A Suitcase of Algae: Using PCRPresence-Absence to Determine MultipleTrebouxia Lineages in Thamnolia Lichen
No full textThe investigation of the relationship between autophagy and Huntington disease: A protocol optimization for Beclin 1 an important protein in autophagy and a Huntingtin interaction partner
No full textLong-acting nitrate use before and after revascularization to evaluate angina in chronic coronary syndrome : a case-crossover study from SCAAR
No full textBackground: The ORBITA and ORBITA-2 trials have valuable insights into the effects of coronary revascularization in chronic coronary syndrome (CCS). However, uncertainties remain regarding the efficacy of revascularization on symptoms in large real-world populations. To evaluate the efficacy of revascularization, we used dispensed long-acting nitrates as a proxy for the presence of angina. Methods: The Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to identify all patients with CCS and at least one stenosis >= 50% undergoing angiography between the 1st of January 2014 and the 16th of January 2020. Four groups were defined based on treatment strategy: coronary artery bypass graft (CABG) surgery, complete revascularization with percutaneous coronary intervention (PCI), incomplete revascularization with PCI, and no revascularization. As patients in these treatment arms are inherently different, we employed a case-crossover design where each patient served as their own control with data collected during two periods: 1 year before up until angiography and 1-2 years after. This study design inherently controls for time-invariant confounding. The primary outcome was the use of long-acting nitrates defined as a dispensed prescription during the studied periods. Conditional Poisson regression was used to analyse the data. Findings: For this study, 15,955 patients were eligible. CABG, complete revascularization with PCI, and incomplete revascularization with PCI were associated with a decrease in dispensed prescriptions of long-acting nitrates (from 989/2218 [30.8%] to 156/3207 [4.9%]; risk-ratio (RR): 0.16 [95% confidence interval (CI): 0.13-0.19]), (from 1676/ 7525 [22.3%] to 966/7525 [12.8%]; RR: 0.58 [95% CI: 0.53-0.62]), and (from 601/2180 [27.6%] to 495/2180 [22.7%]; RR: 0.82 [95% CI: 0.73-0.93]), respectively. No difference was observed for no revascularization (from 864/3043 [28.4%] to 856/3043 [28.1%]; RR: 0.99 [95% CI: 0.90-1.09]). Interpretation: Revascularization reduces the use of long-acting nitrates in patients with CCS, suggesting angina symptom improvement. CABG appears to provide a more significant effect than PCI, with complete PCI demonstrating greater effectiveness than incomplete revascularization. Funding: This work was supported by The Swedish Heart and Lung Foundation, ALF, Skane University Hospital funds, the Crafoord Foundation and the Swedish Medical Association. Copyright (c) 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Validation of the use of ToF-SIMS for analysis of glycosaminoglycans
No full textGlycosaminoglycans (GAGs) have a range of biological roles and are of particular interest for their pharmaceutical efficacy and their potential as biomarkers or drug targets. Heparin, used globally as an anticoagulant and an antithrombotic, is predominantly derived from porcine sources but bovine and ovine sources are increasingly being considered to reduce the substantial risk of reliance on a single animal species. However, high sensitivity chemical discrimination of heparins from different species is a significant analytical challenge. In this study ToF-SIMS analysis of GAGs is investigated as a methodology to achieve specific chemical discrimination between GAGs of different types and heparins from different animal sources. The ToF-SIMS data acquisition is relatively fast (ti1 min per sample) and requires minimal sample amounts (75 pg of sample analysed). Multivariate analysis (MVA) models enabled high selectivity between GAG type and animal source of heparin, and for the high sensitivity detection of GAG-contaminants within porcine derived heparin. Contaminants are detected down to 0.001 wt%, with the exception of ovine derived heparin where differences could be detected to 0.01 wt%. Assessments of specificity, precision, robustness and quantification limits are conducted to validate the approach for heparin analysis