Publikationer från Uppsala Universitet
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On metal-organic framework isomers, and the SF6 sorption and fluorescence of an In and a Zr MOF with a tritopic linker
No full textThe concept of framework isomers by network topology analysis is illustrated by a new rod-MOF isomer of In3+ and the tritopic linker 4,4′,4′′-(benzene-1,3,5-triyl-tris(oxy))tribenzoic acid (H3bttb), CTH-41, with a unique 3- and 4-connected net different from 437-MOF. CTH-41 shows affinity for SF6 with a Langmuir area of 1587 m2 g−1 while the new Zr4+ dot-MOF with the same linker [Zr6(bttb)4(O)4(OH)4] CTH-42, forms the 3-, 12-connected llj-net based on a different conformation of the flexible bttb linker
Uncertainty estimation for trust attribution to speed-of-sound reconstruction with variational networks
No full textPurpose Speed-of-sound (SoS) is a biomechanical characteristic of tissue, and its imaging can provide a promising biomarker for diagnosis. Reconstructing SoS images from ultrasound acquisitions can be cast as a limited-angle computed-tomography problem, with variational networks being a promising model-based deep learning solution. Some acquired data frames may, however, get corrupted by noise due to, e.g., motion, lack of contact, and acoustic shadows, which in turn negatively affects the resulting SoS reconstructions. Methods We propose to use the uncertainty in SoS reconstructions to attribute trust to each individual acquired frame. Given multiple acquisitions, we then use an uncertainty-based automatic selection among these retrospectively, to improve diagnostic decisions. We investigate uncertainty estimation based on Monte Carlo Dropout and Bayesian Variational Inference. Results We assess our automatic frame selection method for differential diagnosis of breast cancer, distinguishing between benign fibroadenoma and malignant carcinoma. We evaluate 21 lesions classified as BI-RADS 4, which represents suspicious cases for probable malignancy. The most trustworthy frame among four acquisitions of each lesion was identified using uncertainty-based criteria. Selecting a frame informed by uncertainty achieved an area under curve of 76% and 80% for Monte Carlo Dropout and Bayesian Variational Inference, respectively, superior to any uncertainty-uninformed baselines with the best one achieving 64%. Conclusion A novel use of uncertainty estimation is proposed for selecting one of multiple data acquisitions for further processing and decision making
Altered breathing pattern and thoracic mobility in women with fibromyalgia : A case-control study
No full textThe objective of this study was to investigate respiratory parameters, including minute ventilation, tidal volume,and respiratory rate, and the role of thoracic mobility in women with FM compared to healthy controls. Thiscase-control study included 38 women with fibromyalgia and 44 age-matched healthy women. Respiratory ratewas measured using a portable monitor and tidal volume was assessed through spirometry. The minute venti-lation was calculated by multiplying tidal volume by respiratory rate. Thoracic mobility was evaluated bymeasuring chest expansion. Pressure pain threshold was assessed over paraspinal muscles between C7-T7 byalgometry to evaluate pain sensitivity. Perceived stress was assessed using the questionnaire Perceived StressScale 10. Women with fibromyalgia exhibited significantly higher minute ventilation (p<0.032), respiratoryrate (p<0.001), and lower tidal volume (p<0.001) compared to healthy controls. Thoracic mobility was reducedin participants with fibromyalgia. Group differences in minute ventilation disappeared when adjusting forperceived stress, suggesting a psychological influence on respiratory parameters. However, differences in res-piratory rate and tidal volume were still significant. Fibromyalgia is associated with altered breathing function,including higher respiratory rate and lower tidal volume. Thoracic mobility and stress may contribute to thesechanges.Perspective: Compared to healthy controls, women with fibromyalgia exhibit an altered breathing pattern whichconsists of higher minute ventilation due to increased respiratory rate. Reduced thoracic mobility and perceivedstress may contribute to this condition. Including the respiratory system in the evaluation and treatment mayoptimize the effects of rehabilitation.Trial registration number: ClinicalTrials.gov: NCT04098731
The Devil is in the Details(?): Age-based Discrimination of Children in the Context of Migration
No full textForthcoming 2025Treated Like a Chil
‘I wish there was a f*** it app’ : creative strategies of digital un-use in family settings
No full textFamilies creatively negotiate many different types of digitally mediated communication to do social family work – sometimes playfully and sometimes due to urgent need. This negotiation can manifest in numerous ways, reflecting the dynamic nature of modern family life. Such creative acts are performed across a multitude of interfaces and media forms and serve to maintain family intimacy and cohesion. In this study, we combine the concept of creative un-use with the study of family life and digital technology. We analyse in-depth interviews with Swedish extended family members who are curating, cutting, reducing, or modifying their uses to ‘do family’. Our results show that these social and creative acts are constantly negotiated and shifting as new technologies are adopted and uses, norms, routines, habits, and expectations change. We show how acts of creative un-use, always oscillating between use and non-use, and as small or sometimes quirky they may be, are deeply entangled with family work and used as a means to support both within and between household family ties. The study finally explores what creative family appropriation of digital communication technology means for how these very systems are designed
Using causal loop diagrams to examine the interrelationships between factors influencing family planning utilisation in urban east central Uganda
No full textIntroduction Despite progress in reducing Uganda’s unmet need for family planning (FP), particularly in urban areas, it remains high with notable intraurban disparities. FP services in urban settings are delivered in a complex health system, which impacts service delivery and utilisation. Acknowledging the complexity of FP utilisation in these contexts, this study adopted a systems thinking approach, using causal loop diagrams (CLDs), to examine the interrelationships between the factors influencing FP uptake in urban east central Uganda. Methods This qualitative study, conducted in Jinja city and Iganga municipality, used community-based system dynamic modelling to create CLDs to visualise the interrelationships between the different factors. The CLDs were developed through two group model building workshops, involving 14 community members and other key stakeholders. Initial model building was based on themes derived from analysis of data from eight focus group discussions, eight key informant interviews and four indepth interviews. The resulting CLDs were subsequently validated in a separate meeting with the participants. Results The study identified 30 key factors influencing FP utilisation mediated through five mechanisms: reproductive autonomy, service access, client satisfaction, perceptions of FP as important and perceived susceptibility to sexually transmitted infections among women. It highlighted the role of self-regulating feedback loops related to side effects, commodity and supply availability and provider workload, which moderate FP use. Additionally, the study emphasised the positive reinforcing effects of enhanced access to FP information on service access and uptake. Conclusion Effective FP intervention designs should account for the complex interplay of factors affecting utilisation. Key leverage points include addressing the underlying negative religious and sociocultural beliefs that shape system behaviour, improving information flow and data use for better commodity management and human resource sustainability, enhancing contraceptive pharmacovigilance systems, improving the management of side effects and increasing access to FP information
Catheter ablation of arrhythmias : 15 years of development: data from the Swedish Catheter Ablation Registry
No full textAims: The number of patients undergoing catheter ablation is continuously growing, and techniques are improving. However, studies reporting contemporary data on catheter ablations from large real-world populations are scarce. This study aims to report characteristics and outcomes of catheter ablation from 2006 to 2020, using a nationwide registry with virtually complete coverage. Methods and results: From the Swedish Catheter Ablation Registry, patients >18 years of age undergoing catheter ablation from 2006 to 2020 were included. Periprocedural data and baseline characteristics were recorded retrospectively. A total of 61 243 procedures were included. There was an overall increase in the number of catheter ablations performed. From 2006, the number of atrial fibrillation (AF) ablations performed increased from 352 procedures in 2006 to 2609 procedures in 2020. Decreased procedural times were seen in catheter ablation of accessory pathway/Wolff-Parkinson-White syndrome, atrial tachycardia (AT), atrioventricular nodal reentry tachycardia, cavotricuspid isthmus (CTI), AF, and atrioventricular junction. Between the time periods 2006-15 and 2016-20, median procedural time in AF ablations decreased from 180 to 140 min (P < 0.001). There was a decreased trend in fluoroscopy time and median dose area product for all ablation procedures (P < 0.001). For AT, CTI, and AF, the cumulative probability of requiring a repeat ablation was significantly lower for procedures performed after January 2016 (P < 0.001). Conclusion: With a yearly increase in the number of ablations performed, there was a reduction in the need for repeat ablations for AF, AT, and CTI, along with reduced procedural times and lower fluoroscopy levels.
Estimated health impact, cost, and cost-effectiveness of taxation on unhealthy packaged foods in the Philippines : a modelling study
No full textBackground: In 2018, the Philippines implemented a tax on sugar-sweetened beverages. A broader tax on unhealthy foods is being considered. We aimed to estimate the effect of a tax on unhealthy packaged foods. Methods: In this modelling study, we used a multiple-cohort, proportional multistate life table model to estimate the effect of a 20% tax on packaged foods exceeding WHO thresholds for sodium or sugar, excluding beverages already taxed. Using nationally representative nutrition, sales, and Global Burden of Diseases, Injuries, and Risk Factors Study data, we projected changes in sodium and sugar intake and related health outcomes (cardiovascular disease and type 2 diabetes) and economic outcomes (health-care costs, tax revenue, and implementation costs) over 20 years, comparing Filipino adults aged 25 years and older in 2020 (reference population) with the same population under the intervention with reduced intakes from the tax, assuming 100% pass-through to prices. Cost-effectiveness was estimated from extended health-care and government perspectives and stratified by wealth quintile. Findings: Compared with the base-case scenario (ie, the status quo), the tax was estimated to avert 2775 deaths (95% uncertainty interval 2685-2853), 13 632 incident ischaemic heart disease events (13 153-14 029), 5287 ischaemic strokes (5090-5445), and 21 763 type 2 diabetes cases (21 532-22 006) over 20 years, generating 326 253 health-adjusted life-years (321 577-330 434). The tax could be cost saving from the government perspective and cost-effective from the health-care perspective, with an estimated 2·37 billion Philippine pesos (PHP; 2·32-2·42) in health-care savings, PHP 647·99 billion (646·42-649·45) in tax revenue, and PHP 12·96 billion (12·93-12·99) in implementation costs over 20 years. Estimated health gains were concentrated among people in middle-income groups, whereas tax revenue increased with income. Interpretation: A nutrient-based tax on unhealthy packaged foods could reduce diet-related disease burden and generate sustained tax revenue in the Philippines. These findings support nutrient-based food taxes as a cost-effective strategy to reduce disease burden, and raise revenue in low-income and middle-income countries.
Circularity in the European Battery Regulation : A 9R framework analysis
No full textTransportation is one of the largest emitting sectors in the European Union and electrifying the transportation fleet is a monumental step towards achieving carbon neutrality by 2050. As global demand for electric vehicles rises, so does the demand for lithium-ion batteries. More circularity in the battery sector could be an avenue both for increased sustainability and supply security, as battery materials such as lithium are scarce in nature and subject to environmental, social and geopolitical pressures. This thesis examines the circularity potential of the European Battery Regulation through the lens of the 9R framework. The study applied a mixed-method content analysis, combining a quantitative mapping of R-strategies in the European Battery Regulation with a qualitative assessment of their enabling functions. The results suggest that while the European Battery Regulation engages several R-strategies, it prioritizes recycling through set targets on recycling efficiency, material recovery and share of recycled contents in batteries. In contrast, higher-order strategies such as reduce, reuse or remanufacture are mainly enabled through information disclosure and general sustainability requirements, leaving their uptake dependent on market actors. This imbalance risks placing circularity into end-of-pipe solutions, with recycling supported for economic and political reasons, while more transformative circularity strategies remain underdeveloped. These findings reflect broader debates on the concept of circular economy, highlighting both its promise and limits. The European Battery Regulation strengthens Europe’s recycling industry and is framed as a response to supply security and competitiveness concerns, yet it falls short of addressing systemic drivers on resource demand. By bridging technical and policy perspectives, this study demonstrates how circularity frameworks can be operationalized in regulatory contexts and underscores the importance of aligning legislative language with genuine circular economy objectives
Delpazolid in combination with bedaquiline, delamanid, and moxifloxacin for pulmonary tuberculosis (PanACEA-DECODE-01) : a prospective, randomised, open-label, phase 2b, dose-finding trial
No full textBackground: Linezolid plays a crucial role in the first-line treatment of drug-resistant tuberculosis globally. Its prolonged use can lead to neurological and haematological toxicity, highlighting the need for safer oxazolidinones. Delpazolid, a novel oxazolidinone, might be safer. We aimed to evaluate the safety and efficacy of delpazolid and identify an optimal dose. Methods: PanACEA-DECODE-01 was a prospective, randomised, open-label, phase 2b, multicentre, dose-finding trial done in five tuberculosis trial sites in Tanzania and South Africa. Adults aged 18-65 years, who weighed 40-90 kg, and had newly diagnosed, smear positive pulmonary tuberculosis were randomly assigned (1:1:1:1:1) through centralised allocation, using a probabilistic minimisation algorithm to receive no delpazolid (D0), delpazolid 400 mg once daily (D400), delpazolid 800 mg once daily (D800), delpazolid 1200 mg once daily (D1200), or delpazolid 800 mg twice daily (D800BD), all administered orally for 16 weeks with follow-up to week 52. All participants received bedaquiline (400 mg orally once daily for the first 14 days, then 200 mg orally thrice weekly), delamanid (100 mg orally twice daily), and moxifloxacin (400 mg orally once daily). Randomisation was stratified based on bacterial load in sputum as measured by GeneXpert cycle threshold (<16 vs ≥ 16), site, and HIV status. The primary efficacy objective was to establish an exposure-response model with the primary endpoint, measured in the modified intention-to-treat population, of change in mycobacterial load measured by time to positivity using the liquid culture mycobacterial growth indicator tube system. A secondary outcome was the time on treatment to sustained conversion to negative sputum culture in liquid media. The primary safety outcome was the occurrence of oxazolidinone class toxicities defined as peripheral or optical neuropathy, incident leukopenia, anaemia or thrombocytopenia, or adverse events in line with tyramine pressor response, all of grade 2 or higher, possibly, probably or definitely related to delpazolid. This study was registered with ClinicalTrials.gov, NCT04550832. Findings: Between Oct 28, 2021, and Aug 31, 2022, 156 individuals were screened for eligibility, 76 of whom were enrolled and randomly assigned to D0 (n=15), D400 (n=15), D800 (n=15), D1200 (n=16), or D800BD (n=15). 60 (79%) of 76 participants were male and 16 (21%) were female. Population pharmacokinetic-pharmacodynamic modelling suggests maximal microbiological activity at a daily total exposure of delpazolid (area under the concentration curve from 0 h to 24 h [AUC0-24]) of 50 mg/L per h; close to the median exposure observed after a 1200 mg dose. This maximal effect was estimated at a 38% (95% CI 4-83; p=0·025) faster decline in bacterial load compared with no delpazolid. In the secondary time-to-event analysis, there was no significant difference in time to culture conversion between treatment arms or exposure tertile. When all delpazolid-containing groups were combined, the hazard ratio for the time to sustained culture conversion to negative, comparing all delpazolid-containing groups with the group without delpazolid was 1·53 (95% CI 0·84-2·76). Two drug-related serious adverse events (one gastritis and one anaemia) occurred in the D800BD group, with high individual AUC0-24. Apart from the anaemia and one event of brief, moderate neutropenia observed at only one visit in the D800 group not in line with the characteristics of oxazolidinone class toxicity, no oxazolidinone class toxicities occurred. Interpretation: The pharmacokinetic-pharmacodynamic modelling results suggest that delpazolid adds efficacy on top of bedaquiline, delamanid, and moxifloxacin; and that a dose of 1200 mg once daily would result in exposures with maximum efficacy. That dose was shown to be safe, raising hope that linezolid toxicities could be averted in long-term treatment. Delpazolid is a promising drug for future tuberculosis treatment regimens and could be widely usable if safety and efficacy are confirmed in larger trials