Publikationer från Uppsala Universitet
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Dronedarone vs Sotalol Among Patients With Atrial Fibrillation : A Meta-Analysis of Retrospective Observational Databases
No full textBACKGROUND: Dronedarone and sotalol are antiarrhythmic drugs (AADs) recommended in similar populations per atrial fibrillation (AF) guidelines; however, comparative safety data are limited. OBJECTIVES: The goal of this study was to assess the safety of dronedarone vs sotalol for treatment of AF in AAD-naive patients. METHODS: This was a prespecified noninterventional meta-analysis of 4 retrospective observational cohort studies from 4 databases (Optum Clinformatics Data Mart, Merative MarketScan, Veterans Health Administration Electronic Health Record, and the Swedish National Patient Register) conducted by using one master protocol. Each analysis emulated the target trial using an active comparator (dronedarone vs sotalol), new user design with an as-treated approach. Primary outcomes were tested hierarchically for dronedarone vs sotalol: first for statistical significance of cardiovascular (CV) hospitalization, and then for statistical significance of ventricular arrhythmias. Propensity score matching (PSM) was used for confounding control, and negative control outcomes were used to assess residual confounding. Outcomes were evaluated by using Cox proportional hazards regression; meta-analysis was performed by using fixed effects models. RESULTS: The dronedarone and sotalol cohorts were well balanced within databases before and after PSM (after PSM mean age range: 62.5-70.9 years; mean CHA2DS2-VASc score range: 1.81-3.15). Negative control outcomes exhibited little-to-no evidence of residual confounding. Meta-analysis found significantly lower rates of CV hospitalization (pooled HR: 0.91; 95% CI: 0.85-0.97) and ventricular arrhythmias (pooled HR: 0.77; 95% CI: 0.69-0.85) with dronedarone vs sotalol. CONCLUSIONS: In this retrospective meta-analysis, dronedarone exhibited significantly lower rates of CV hospitalization and ventricular arrhythmias compared with sotalol. These findings provide real-world evidence to support selection of the most appropriate first-line AAD for rhythm control in patients with AF.
Epidemiology of patients with moderate-to-severe SLE in Sweden
No full textObjective SLE affects multiple organs and is associated with increased mortality and organ damage. While treatment recommendations for non-renal SLE stratify by disease activity, no standard approach to measuring severity exists. This study aimed to estimate the prevalence and incidence of SLE in Sweden, quantify patients with moderate-to-severe disease using register-based algorithms and examine associations between disease severity and survival. Methods We identified adult SLE patients in the Swedish National Patient Register with at least two SLE-coded visits between July 2005 and December 2019. Annual incidence and point prevalence were calculated. SLE patients were matched 5:1 with non-SLE comparators. SLE disease severity was classified annually postdiagnosis using an adapted algorithm based on prescriptions and comorbidities. Survival between SLE patients by each severity level in the year following diagnosis was compared with matched comparators using Cox regression models. Results In total, 10 186 SLE patients were identified, including 5076 incident cases. The average incidence of adult SLE in Sweden between 2015 and 2019 was 4.1 cases per 100 000, with a 2019 prevalence of 93.8 per 100 000. In the first year postdiagnosis, 61% of SLE patients had moderate-to-severe disease, stabilising at approximately 45% after 3–4 years among patients still in follow-up. Across all severity levels, SLE patients had poorer survival than comparators. High severity in the year following diagnosis was independently associated with increased mortality risk compared with mild disease, regardless of age, sex or prescribed treatments. Conclusions Using national register data, the estimated prevalence of SLE in Sweden is higher than published figures from previous years. This is the first Swedish register-based study characterising SLE severity and its survival impact. Mortality risk is particularly increased in patients with moderate or severe SLE at diagnosis, underscoring the need for targeted strategies to improve outcomes for this group
Relational Peace Among the Cypriot Youth : Experiences of participating in bicommunal activities in Cyprus
No full textThis study explores youths’ experiences of intergroup contact in Cyprus and how it is perceived to have affected the relationship between the two communities on the island. The experiences of bicommunal activities are mapped out through semi-structured, in-depth interviews with young Greek and Turkish Cypriots participating in such activities. This study builds on the contact hypothesis, focusing on intergroup contact, while using the relational peace framework to explore the experienced impacts on the relationship between the groups. The findings suggest that observing contact alone may be insufficient to understand how relationships evolve during contact and relationship-building. Thus, by examining experiences of intergroup contact through a relational lens, this study demonstrates how participating in bicommunal activities can have a positive influence on relationships. This thesis also contributes by highlighting the added value of exploring the relational aspects of peacebuilding activities. Similarly, focusing on the youth perspective, this study demonstrates how young people in both communities offer unique insights into relationship-building and contribute to peace practices in Cyprus, perspectives that are often overlooked in both research and practice.
Challenges of researching racism in healthcare
No full textThe unprecedented transnational protests following the killing of George Floyd highlighted the need to re-examine institutions that uphold various social injustices experienced by racialised minorities. Black Lives Matter protests thus created a serious reckoning with racism and facilitated global conversations. Against the backdrop of these protests, we evaluate our study of healthcare workers, exploring racialisation in Swedish healthcare including the design and implementation of an anti-racist initiative in healthcare education. We reflect on how the silencing of discussion around racism in Sweden led to difficulties in recruiting participants and the effect of the shift in public discourse following the Black Lives Matter uprising of 2020. The project was ultimately successful in recruitment and outreach to professional and regional authorities. However, this success is contrasted by the lack of structural change in embedding anti-racism as a core value in healthcare practice. We conclude by noting that conversations about anti-racism differ from implementing anti-racist practice in commissioning, evaluation, and service delivery
Face Reconstruction across different ages by ensuring identity preservation using GAN models
No full textThis thesis explores generative adversarial network (GAN) models, specifically Conditional GAN(CGAN) and StyleGAN, for the progression and regression of facial age. A key factor in this workis the selection of a suitable data set. The CGAN model conditions both the generator and thediscriminator on age labels, allowing age-specific synthesis. However, it produced low-resolutionimages with poor facial visibility because of limited control over the latent vectors. In contrast,the StyleGAN model introduces a style-based architecture with disentangled latent vectors andadaptive instance normalization (AdaIN), allowing for high-resolution and more realistic imagegeneration.Several datasets were evaluated, including AgeDB, UTKFace, Adience, IMDB, and Wiki. AgeDBwas initially selected for its balanced age distribution, but it proved unsuitable due to poor imagequality, a mix of grayscale and color images, and varied facial poses. Ultimately, the crop_part1subset of the UTKFace dataset was chosen for its better image quality and predominance offrontal face images, although it remained limited in size.The StyleGAN model successfully generated age progression and regression images using theUTKFace dataset, whereas the CGAN model failed to produce coherent facial outputs. DespiteStyleGAN’s architectural advantages, the generated images contained artifacts, primarily dueto poor image quality in the dataset. The state-of-the-art InsightFace model was employed forface detection and feature vector extraction from the generated images. Cosine similarity wascalculated on these vectors to assess identity preservation. StyleGAN achieved below 50% iden-tity retention across age transformations. These findings underscore the importance of datasetquality and architectural design in generative modeling for age-related facial synthesis
"We throw away an incredible amount of unused medicines" : Community pharmacy staff perspectives on environmental responsibility
No full textBackground: Pharmaceutical pollution is an increasing environmental concern. As key actors in the healthcare chain, community pharmacies play an important role in managing pharmaceuticals from an environmental perspective. Although environmental initiatives exist at the corporate level in Sweden, it remains unclear how well these are known to, or implemented by, pharmacy staff. Objectives: To explore how community pharmacy staff in Sweden perceive their role in reducing pharmaceutical pollution, and identify the opportunities and challenges they face in promoting environmentally friendly use of pharmaceuticals. Methods: Focus group discussions and individual semi-structured interviews were conducted with pharmacy staff in Sweden between May 2024 and February 2025. All focus group discussions and interviews were audio recorded, transcribed, and analysed using inductive qualitative content analysis. Results: Four focus group discussions and five individual interviews were conducted. The analysis resulted in three main categories. First, while there was an awareness of environmental issues, participants expressed a lack of concrete guidance and requested more information, such as lists of environmentally harmful pharmaceuticals. Second, pharmaceutical waste, originating both from households and pharmacies, was highlighted as a major concern. Third, there appeared to be a sense of limited agency and a wish for support from, for example, regulatory authorities to address pharmaceutical pollution. Conclusion: Swedish pharmacy staff view themselves as potential contributors to reducing pharmaceutical pollution, but struggle to identify concrete actions. They are concerned about pharmaceutical waste and responsibility is often shifted to other stakeholders
Motor expertise modulates cortical activation during imagery of simple and complex actions
No full textMotor imagery (MI) engages neural systems that overlap with actual movement and is widely used in sport and rehabilitation. Yet conflicting findings suggest that experts show either reduced (neural efficiency) or increased (vivid simulation) brain activation during MI. We hypothesized that task complexity moderates this effect. Using fNIRS, we compared experts and novices during MI of simple versus complex soccer actions. Experts showed lower activation for simple tasks but higher activation for complex ones, while novices showed the opposite pattern. These findings unify opposing accounts of expertise, revealing that expert brains adaptively scale simulation to task demands. This has practical implications for optimizing MI- based training across skill levels
Utifrån examensordningen för specialpedagoger, hur uppfattar lärare och specialpedagoger det specialpedagogiska uppdraget?
No full textDenna uppsats handlar om att ta reda på specialpedagogers och lärares uppfattningar om specialpedagogens uppdrag utifrån examensordningen för specialpedagoger. Uppsatsen tar upp hur specialpedagoger i grundskolan uppfattar sitt uppdrag utifrån examensordningen samt hur lärarna uppfattar specialpedagogens uppdrag utifrån examensordningen för specialpedagoger. Sedan görs en jämförelse mellan likheter och skillnader i informanternas uppfattningar. I litteratur och tidigare forskning finns det mycket att tillgå om uppfattningen av specialpedagogens yrkesroll. Det som gör fältet smalare är jämförelsen med examensordningen. Syftet med uppsatsen blev därför att ta reda på hur specialpedagoger och lärare upplever specialpedagogens uppdrag utifrån examensordningen för specialpedagoger. Undersökningen baseras på åtta semistrukturerade intervjuer vilka fördelas på fyra specialpedagoger och fyra grundskollärare. Resultatet presenteras i kategorier och analysen visade att specialpedagogerna upplevde att de arbetade utifrån examensordningen medan lärarna upplevde att specialpedagogers primära arbetsuppgift var att undervisa elever enskilt eller i mindre sammanhang. Det finns en önskan att specialpedagogerna ska visas mer tillgängliga i den ordinarie undervisningen och i rådgivande samtal utanför undervisningen. Resultaten analyserades med stöd av de tre begreppen makt, intersektion och kunskap. Detta teoretiska tillvägagångssätt ses också som ett bidrag till det specialpedagogiska fältet. This essay aims to investigate special educators’ and teachers’ perceptions of the special educators’ mission based on the degree ordinance for special educators. The essay explores how special educators in primary school perceive their mission based on their degree ordinance, as well as how teachers perceive the special educator's mission based on the degree ordinance for special educators. A comparison is then made between the similarities and differences in the informants’ perceptions. In the literature and previous research, there is a lot to draw from regarding the perception of the special educator’s professional role. What narrows down the field is the comparison with the degree ordinance. Therefore, the purpose of the essay was to investigate how special educators and teachers experience the special educators’ mission based on the degree ordinance for special educators. The study is based on eight semi-structured interviews with four special educators and four primary school teachers. The results are presented in categories, and the analysis showed that special educators perceived that they worked according to the degree ordinance to the extent that the workplace allowed and according to interest, while teachers perceived that that the primary task of special educators was to teach students individually or in small groups, there is a desire for special educators to be more accessible in regular classroom and in advisory conversations outside of teaching The results have then been analyzed by the three concepts power, intersection and knowledge. The theoretical take is also seen as a contribution to the special educational field.
Prenatal sugar exposure shapes late-life human capital and health
No full textMaternal sugar consumption during pregnancy may have a variety of effects on offspring. We exploit the abolishment of the rationing of sweet confectionery in the United Kingdom on 1949 April 24, and its subsequent reintroduction some months later, in an era of otherwise uninterrupted rationing of confectionery (1942-1953), sugar (1940-1953), and many other foods, and we consider effects on late-life cardiovascular disease, body mass index (BMI), height, type-2 diabetes, and the intake of sugar, fat, and carbohydrates, as well as cognitive outcomes and birth weight. We use individual-level data from the UK Biobank for cohorts born between April 1947 and May 1952. We also explore whether one's genetic "predisposition" to the outcome can moderate the effects of prenatal sugar exposure. We find that prenatal exposure to derationing increases education and reduces BMI and sugar consumption at higher ages, in line with the "developmental origins" explanatory framework, and that the sugar effects are stronger for those who are genetically "predisposed" to sugar consumption
ATLAS searches for additional scalars and exotic Higgs boson decays with the LHC Run 2 dataset
No full textThis report reviews the published results of searches for possible additional scalar particles and exotic decays of the Higgs boson performed by the ATLAS Collaboration using up to 140 fb−1 of 13 TeV proton–proton collision data collected during Run 2 of the Large Hadron Collider. Key results are examined, and observed excesses, while never statistically compelling, are noted. Constraints are placed on parameters of several models which extend the Standard Model, for example by adding one or more singlet or doublet fields, or offering exotic Higgs boson decay channels. Summaries of new searches as well as extensions of previous searches are discussed. These new results have a wider reach or attain stronger exclusion limits. New experimental techniques that were developed for these searches are highlighted. Search channels which have not yet been examined are also listed, as these provide insight into possible future areas of exploration.For complete list of authors see http://dx.doi.org/10.1016/j.physrep.2024.09.002</p