Publikationer från Uppsala Universitet
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Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation : Does Speeding Up Neutrophil Engraftment Make a Difference?
No full textBackground. Despite decades of post–allogeneic hematopoietic cell transplantation (HCT) growth factor utilization, its role remains undefined, leading to ongoing debates and research. The theoretical impacts of growth factors have been challenged in numerous studies. Methods. In this retrospective cohort study conducted at the Princess Margaret Cancer Centre, we analyzed the clinical outcomes of 509 patients who underwent allogeneic HCT between May 1, 2019, and May 31, 2022. This study aimed to assess the impact of granulocyte colony-stimulating factor (G-CSF) administration posttransplantation on neutrophil and platelet engraftment, incidence of bloodstream infections (BSIs), graft-versus-host disease, engraftment syndrome (ES), and survival metrics including overall survival, nonrelapse mortality, and graft-versus-host disease–free/relapse-free survival. Results. Our findings indicate that G-CSF administration expedited neutrophil engraftment (16 versus 18 d, P = 0.009) and was associated with a decreased incidence of BSI (9.4% versus 31.3%, P = 0.014). However, this benefit was counterbalanced by a significant delay in platelet engraftment (21 versus 17 d, P < 0.001). Multivariate logistic regression analysis identified mismatched donors (odds ratio, 1.72; 95% confidence interval, 1.03-2.88; P = 0.038) and the duration of G-CSF therapy (odds ratio, 1.04; 95% confidence interval, 1.00-1.09; P = 0.038) as independent predictors for the development of ES. Despite these hematological impacts, there was no observed advantage in overall survival, nonrelapse mortality, or graft-versus-host disease–free/relapse-free survival among patients who received G-CSF compared with those who did not. Conclusions. Although G-CSF post-HCT expedited neutrophil engraftment and reduced BSI risk, it did not result in a survival advantage. The association with ES necessitates careful consideration
Highly viable gastrointestinal Chlamydia trachomatis in women abstaining from receptive anal intercourse
No full textChlamydia trachomatis (CT) may employ persistence to evade antimicrobial clearance, possibly residing in the gastrointestinal tract. This study assessed the reliability of droplet digital PCR (ddPCR) in CT detection, its functionality in viability assessment, and predictions on CT transmission dynamics by combining viability PCR (vPCR) and clinical data from 52 infected women. The ddPCR showed 94% positive and 100% negative agreement with Abbott Alinity STI-M for endocervical samples, and 92% positive and 87% negative agreement in rectal samples. Viability was higher in endocervical samples (89.1%) than in rectal samples (69.4%). Samples from participants not engaging in anal intercourse, and with non-concordant multi-locus sequence typing between rectum and endocervix, had on average the highest viability in rectum, indicating a persistent population residing in the gastrointestinal tract. This study demonstrates the effectiveness of ddPCR in detecting CT, especially in samples with high inhibition or low bacterial load, suggesting its superiority over quantitative real- time PCR. These findings support that rectal CT infection can occur independently of anal intercourse, possibly through vaginorectal contamination or oral routes. High rectal CT viability, independent of endocervical infection, indicates potential gastrointestinal establishment. Understanding CT dynamics in various infection sites can provide insights into the epidemiology and pathogenesis of CT
Glömdes kusten bort i visionen om ett ekologiskt hållbart samhälle? : En kvalitativ studie över Göteborgs kommuns planering för en ekologiskt hållbar kustzon
No full textStudien baseras på en problembild av planeringen för hållbar utveckling för kustzoner. Genom att undersöka Göteborgs kommuns styrande dokument syftar den här studien till att analysera hur kommunen uttrycker sig om ekologisk hållbarhet för sin kommun, samt vilka målsättningar för ekologisk hållbarhet för sin kustzon som presenteras. Vidare avser studien att analysera hur väl dessa målsättningar förhåller sig till Sveriges miljömål ”Hav i balans samt levande kust och skärgård”. Det genomförs genom en fallstudie av Göteborgs kommun och genom en dokumentanalys av tre styrande dokument från kommunen. Utifrån dokumentanalysen framgår det att Göteborgs kommun har en tydlig målsättning om ekologisk hållbarhet för deras kustzon. Det fanns mer konkreta mål, men i många fall saknades detta. Vidare fanns det ett tydligt fokus på mål som berörde biologisk mångfald och ekosystemtjänster. Studiens resultat fann även att kommunens planering avsåg att planera för att uppfylla Sveriges miljömål, men att de faktiskt uppfyllde dem gick inte att fastställa
Njurar utanför kroppen : Upplevelser av livet hos personer med en hemodialysbehandling
No full textIntroduktion: Akut njurskada och kronisk njursvikt är ett växande problem. Det anses varaett av de största folkhälsoproblemen i världen. Vid njursvikt upphör njurarnas funktion ochindividen är i behov av en hemodialysbehandling för att överleva. Behandlingen har sentidigare förknippats med en försämrad livskvalitet. Det är en stor livsförändring att genomgåen hemodialysbehandling. Därför är det av stor betydelse att hälso-och sjukvårdspersonal haren förståelse vilken påverkan hemodialysbehandlingen har. Syfte: Syftet med litteraturöversikten var att belysa hur personer upplevde hur livetpåverkades när de genomgick en hemodialysbehandling på en vårdenhet. Metod: Arbetet genomfördes som en litteraturöversikt med deskriptiv design och kvalitativansats. Litteraturöversikten baserades på tolv kvalitativa artiklar. Resultat: Deltagare med en hemodialysbehandling upplevde en påverkan på flera aspekter ilivet. I samband med behandlingen kunde det uppstå både fysiska och psykiska symtom.Deltagare kunde uppleva en förändring i sina relationer och ekonomi. Restriktionerna somförknippades med behandlingen ansågs även begränsa livet. Inställningen till behandlingvarierade utifrån hur nackdelar och fördelar med hemodialysbehandlingen upplevdes. Slutsats: Denna litteraturöversikt visade att personer som genomgick enhemodialysbehandling upplevde att behandlingen påverkade livet, då det ledde tillförändringar i flera av livets aspekter. Förutom fysiska och psykiska symtom upplevde deäven en socialbegränsning samt en ekonomisk påverkan. En begränsad vardag var ytterligareen påföljd som upplevdes i samband med behandlingen. Då livet påverkades kunde ett lidandehos personerna uppstå. För att lindra lidandet skulle det kunna vara av betydelse om hälso-ochsjukvårdpersonalen erhöll en ökad förståelse, om den påverkan en hemodialysbehandlingskulle kunna medföra
BRICS: building blocs in a changing world : A decade of environmental discourse: How BRICS frames ecological sustainability 2014-2024
No full textThis study examines how the discourse on ecological sustainability evolves over time in the BRICS and BRICS+ summit statements between 2014-2024. While BRICS as a trade bloc and its economic role have been studied, limited research has applied discourse analysis to understand how BRICS communicates environmental concerns. This thesis addresses this research gap by employing discourse analysis guided by an analytical framework based on three environmental discourses: economic rationalism, sustainable development and ecological modernization alongside the “What’s the problem represented to be”-approach. The findings reveal that economic rationalism dominates the discourse throughout the decade, however both sustainable development and ecological modernization emerge in various degrees in the summit statements. The main findings also includes the “securitization” of climate change which has materialized in the recent summit statement, framing it as a security concern that is intertwined with geopolitical agendas. This study contributes to affirming BRICS’ dual role as both a participant in and a challenger to the global world order, not only in terms of economic participation but environmental as well
Högre utbildning som norm : Nya sätt att bli vuxen och självständig i en tidigare bruksort
No full textThis study investigates the perception and navigation of higher education among young adults in a former industrial community in Sweden. Similar to other countries, the Swedish system of higher education has expanded considerably since the 1960s, to include more students and institutions. Alongside this expansion, a process of de-industrialisation has taken place since the 1970s. The thesis focuses on a locality severely affected by the diminishing of manufacturing industries, where higher education was unusual due to the prevalence of working-class occupations. The study asks how higher education is managed in a context where educational levels are comparatively low and where labour market participation did not previously require tertiary qualifications. The thesis is designed as a single-case study of Söderhamn, Sweden. The main method used is in-depth interviews with young adults and parents. Through the study of how young adults reason about education in general, and a potential entry into tertiary education in particular, the thesis analyses how higher education is viewed within this social context. Using social class, gender, and dispositions to interpret the interviewees’ reasoning, the thesis arrives at the conclusion that there exists a higher education norm among young adults in Söderhamn today. Far from everyone will or want to attend university, yet, the study points to the fact that young adults are required to negotiate the norm of higher education, even if they prefer a different path. A significant conclusion is that this newly established norm of higher education is intertwined with older norms tied to the locality’s industrial past. Young adults and parents share the view that higher education is necessary for a stable position in the labour market today. Thus, tertiary education is perceived as an instrument for becoming employable, thereby upholding values of independence and adulthood that have existed for longer. The thesis concludes that the processes of de-industrialisation and the expansion of higher education both sustain and create new social norms that affect young adults’ perceptions and navigations of a potential entry into higher education
Classification of skin cancer in darker complexions : A case study
No full textSkin cancer detection models using AI have attained exceptional standards, but frequently exhibit bias due to the insufficient representation of darker skin tones in datasets, which results in diagnostic inconsistency. Therefore, this study aims to improve the performance of an AI model for the classification of skin cancer in darker complexions with the help of transfer learning and data augmentation. Utilizing the Fitzpatrick17K dataset, which includes annotations of skin types, we trained and fine-tuned a neural network to maximize the classification accuracy for skin cancer in darker complexions. The results of our study is that detection of skin cancer in diverse data improved. The findings from our study is that transfer learning based on a model pre-trained on a generic dataset can improve model performance in darker complexions
Establishing a Pan-European, multi-disciplinary taphonomic research Infrastructure : The ‘UK-Netherlands decomposition experimental research (UNDER) Group’
No full textThis study unveils the establishment of the United Kingdom-Netherlands Decomposition Experimental Research (UNDER) working group, marking a pioneering initiative in practical Forensic Taphonomy within the UK. Our primary objective was to craft a cohesive multidisciplinary framework, designed to ethically orchestrate, execute, and assess human decomposition. Concurrently, we aimed to amass data through human burials, fostering collaboration among diverse forensic experts across Europe. The compilation of data collected over the year, elucidates the comprehensive utilisation of cadavers through a multifaceted scientific methodology. This paper discusses the triumphs, challenges, and innovative solutions encountered during this undertaking, providing a blueprint for forthcoming European research in Forensic Taphonomy. Our efforts support the comparability of longitudinal studies and give strategies to address the challenges posed by the scarcity and diversity of human donors in forensic science. Moreover, we propose the adoption of a dynamic scientific research management framework, which includes thorough identification, measurement, analysis, and application of solutions. Emphasis is also placed on adeptly managing business processes to ensure sustained relevance in both research and other stakeholders
Exploring nutritional risks of the specific carbohydrate diet: food and nutrient intake in children with juvenile idiopathic arthritis
No full textDiet is considered a key research priority for juvenile idiopathic arthritis (JIA), garnering considerable interest from affected families. Despite this, research studies focusing on dietary interventions remain scarce. The specific carbohydrate diet (SCD) has shown potential, however, its nutritional consequences and risks are not well understood. This study aims to describe and evaluate food and nutrient intakes in children with JIA adhering to the SCD and contextualize the results relative to recommendations and intakes in the general population. In a secondary analysis, food and nutrient intakes from three-day dietary records of ten children, following a four-week SCD intervention, were evaluated against the Nordic Nutrition Recommendations 2023 and Riksmaten Adolescents data (RMA) (n = 1282). All children following the SCD met the recommended minimum intake of fruit and vegetables of 500g/day, a stark contrast to the 6% in RMA. Median dietary fibre intake for the SCD was 26g/d, (IQR 21-33), compared to 16g/d (IQR 12-22) in RMA. Elevated saturated fatty acid (SFA) intake was observed in both groups, with the SCD group also consuming high amounts of red meat. Calcium was the sole nutrient for which the standard diet surpassed the SCD, as 9 out of 10 participants had inadequate intake. While children on the SCD showed a lower likelihood of nutrient inadequacy compared to the general population, inadequate calcium intake and elevated SFA and red meat consumption are concerning given known comorbidities in JIA. These results highlight the importance of disease-specific dietary guidance to ensure optimal support for patients and parents
Communication-Efficient Object Detection for Vehicular Applications
No full textThe increasing adoption of edge devices in vehicular applications underscores the critical role of real-time object detection in enhancing vehicular safety and efficiency. Traditional centralized training approaches for object detection models pose significant challenges, particularly regarding data privacy, communication latency, and scalability in distributed vehicular networks. Federated Learning (FL) offers a promising alternative by enabling collaborative training without requiring data centralization, preserving privacy, and enhancing security. This thesis investigates the integration of model compression techniques, specifically Quantized Stochastic Gradient Descent (QSGD), within the FL framework for vehicular object detection tasks. By focusing on YOLOv8, a state-of-the-art real-time object detection model, this research explores the impact of QSGD on communication efficiency, detection accuracy, and overall model performance in scenarios characterized by non-independent and identically distributed (Non-IID) data. Comprehensive experiments were conducted on automotive datasets, including the KITTI and Zenseact Open Dataset (ZOD), to evaluate the effectiveness of the proposed approach. The results demonstrate that integrating QSGD significantly reduces communication overhead while maintaining competitive detection accuracy, even under challenging data distribution scenarios. This research highlights the feasibility of combining federated learning and model compression, offering valuable insights for developing scalable, communication-efficient, and privacy-preserving solutions in the future of vehicular technology