Publikationer från Uppsala Universitet
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Fetal and postnatal growth following natural conception and IVF treatment
No full textAbnormal fetal growth is closely related to adverse short-term outcomes as well as negative long-term health consequences. Fetal growth restriction is a common pregnancy complication, and for the detection of fetuses small for gestational age, a reliable reference is vital. Increasing evidence supports that mode of conception has implications for growth. Fresh embryo transfer (ET) is associated with small for gestational age, and frozen ET with large for gestational age. The overall aim of this thesis was to describe optimal fetal growth, as well as pre-and postnatal growth after ART, trying to isolate the direct effects of ART from related factors. Study I was a prospective multicentre study aiming to construct updated population-based references for fetal growth for the Swedish population from a cohort of 583 low-risk pregnancies. Comparisons were also made with other relevant growth charts. In Study II, a population-based retrospective cohort study including 10 970 fresh ET, 6520 frozen ET, and 178 518 natural conception (NC) pregnancies, fetal growth after ART was explored with longitudinal statistics. Study III, a prospective longitudinal multicentre study of 82 fresh ET, 175 frozen ET and the 583 NC from Study I as reference, had similar aims. Fetuses after ART in general tended to be larger than NC in early pregnancy and thereafter growing at a slower rate than NC. This was more pronounced after fresh ET and at term mean fetal weight was lower than NC. Frozen ET remained heavier than NC in Study II but in Study III there were no significant differences. Study IV was a population-based retrospective cohort study of 517 fresh ET, 284 frozen ET and 17 214 NC, examining growth from birth to five years of age. At birth, children after fresh ET were smaller, and those after frozen ET were larger than NC. Most differences were attenuated by 18 months of age. The new references will in future studies be evaluated for the intended population. Our results support that there is a direct effect of ART on fetal growth. Although differences diminish with age, the differences in growth are known risk factors for future cardiometabolic disease
EU - Samhällskunskapsämnet som faller mellan stolarna : En kvalitativ studie om samhällskunskapslärares EU-undervisning i årskurs 7–9 och på gymnasiet
No full textStudien syftar till att kartlägga vilka ämnesområden inom EU-undervisningen samhällskunskapslärare väljer att undervisa om, och hur de prioriterar dessa ämnesområden. Vidare syftar även studien till att identifiera vilka undervisningsmetoder samhällskunskapslärare använder sig av för att undervisa om EU. Syftet med undersökningen är även att skapa en förståelse för lärarnas motiveringar till deras val av ämnesinnehåll och undervisningsmetoder. Studien använder sig av Peter Walls avhandling från 2011 och hans användning av teorier om vilka ämnesområden och undervisningsmetoder som skapar europeisk deltagarkompetens. Det grundar sig i att skapa en förståelse för hur EU-undervisning utformas av lärare för att kunna resonera kring om undervisningen ger eleverna förutsättningar för att skapa intresse och tillgodose sig kunskap om EU. Studien använder sig av en kvalitativ metod med semi-strukturerade intervjuer där sju samhällskunskapslärare intervjuats. Intervjuerna visade på ett brett spektrum av vad samhällskunskapslärare undervisar om inom EU och vilka undervisningsmetoder som lärarna använde sig av. [ma1] Vidare fann studien att lärarna ansåg att deras EU-undervisning påverkades av en mängd olika faktorer inom flera områden. Dessa har studien kategoriserat som fyra övergripande områden vilket lärarna ansåg påverkade deras EU-undervisning. Dessa var [ma2] samhället, aktörer i skolan, läraren, samt elever. Sammanfattningsvis visade studies resultat att det finns en stor variation i hur lärare undervisar om EU, vilket indikerar på att det inte existerar något förutbestämt sätt att närma sig EU-undervisningen som samhällskunskapslärare. Vidare finner studien brister i lärarnas förutsättningar för att kunna ha en EU-undervisning som samstämmer med skolans övergripande uppdrag och syftet med samhällskunskapsämnet, utifrån lärarnas motiveringar till varför deras undervisning ser ut som den gör. Avslutningsvis framkom det av studien att lärarna i undersökningen utformar sin EU-undervisning i hög grad utifrån egna motiveringar och tankar om vad de anser som centralt i EU-undervisningen
Föräldrars upplevelser av att ha ett barn som vårdas palliativt i hemmet
No full textIntroduktion: Syftet med palliativ vård är att lindra lidande och förbättra livskvalitén hos den individen som är drabbad av en obotlig sjukdom. Föräldrar som har ett barn som vårdas palliativt i hemmet möter dagligen många emotionella, fysiska, psykiska och sociala utmaningar. Sjuksköterskan har en central och viktig roll i att stödja och stötta dessa familjer med de utmaningar som de ställs inför. Syfte: Syftet var att beskriva föräldrars upplevelser av att ha ett barn som vårdas palliativt i hemmet. Metod: En litteraturstudie med deskriptiv design användes. Elva kvalitativa artiklar från databaserna PubMed och CINAHL har granskats. Resultat: Tre huvudkategorier identifierades: Strävan efter kontroll och trygghet, Påverkan på identitet och relationer, samt Ett förändrat liv. Föräldrarna upplevde en strävan efter att få någon slags kontroll och trygghet i deras värld full av kaos, vikten av vårdpersonalens emotionella stöd, samt en stark vilja av att själva vara delaktiga i barnets vårdplaneringen. De upplevde också en känsla av förlust, både gällande sin egen identitet, sociala relationer, men också familjens samanhållning. De upplevde att de behövde acceptera en ny verklighet och lära sig att leva i den. Existentiella frågor och reflektion kring liv och död var en del av deras nya vardag, och många föräldrar ville hitta en mening och en fin sista tid med deras sjuka barn. Slutsats: Föräldrarna till barn som vårdas palliativt i hemmet möter stora utmaningar dagligen, men genom ett stöd från sjuksköterskan där personcentrerad vård är en grundpelare så hjälper det föräldrarna att hantera denna svåra tid. Sjuksköterskans roll är central för att ge fysiskt, emotionellt och existentiellt stöd till hela familjen
Reduced order modeling of wave energy systems via sequential Bayesian experimental design and machine learning
No full textMarine energy technologies face significant challenges in ensuring their survivability under extreme ocean conditions. Quantifying extreme load statistics on marine energy structures is essential for reliable structural design; however, this is a challenging task due to the scarcity of high-quality data and the inherent uncertainties associated with predicting rare events. While computational fluid dynamics (CFD) simulations can accurately capture the nonlinear dynamics and loads in extreme wave–structure interactions, providing high-fidelity data, extracting statistical information through these models is computationally impractical. This study proposes a reduced-order modeling framework for marine energy systems, enabling efficient analysis across diverse scenarios, and facilitating the quantification of extreme load statistics with significantly reduced computational cost. Specifically, a hybrid reduced-order or surrogate model for a wave energy converter is developed to map extreme sea states and design parameters to the resulting loads in the mooring system. The term ”hybrid” refers to the combination of Gaussian Process Regression (GPR) and Long Short-Term Memory (LSTM) neural networks. The model is developed using two distinct approaches: (1) a baseline approach that relies on existing CFD data for training and validation, and (2) an active learning approach that strategically selects the most informative CFD samples from regions of the input space associated with extreme mooring loads. This procedure iteratively refines the model while minimizing prediction uncertainty, making it particularly effective for real-world applications where obtaining each sample requires substantial time and resources. The developed model demonstrates its exceptional ability to efficiently predict complex load time series, including instantaneous peaks, at speeds significantly faster than traditional modeling methods. Subsequently, the model is utilized to effectively evaluate Monte Carlo samples, providing accurate estimates of the probability of extreme mooring loads. Understanding the expected extreme loads is essential during the design phase of marine energy systems, enabling cost reduction by optimizing strength margins, refining overly conservative safety factors, and enhancing overall system reliability
The impact of patient and public involvement in healthcare services: A conceptual review spanning social sciences and health sciences
No full textTo understand patient and public involvement (PPI) and its potential impact in the healthcare services more comprehensively, the social science literature on public participation in governing public services must be integrated with the health science literature. To facilitate planning and evaluation of PPI-activities, the aim of this article is to review conceptual discussions of involvement/participation and impact, and summarize and integrate these in a way that advances the conceptual understanding of impact of PPI in healthcare services. Based on the review, we present a conceptual integration chart of impact areas, categories and types. There are three overarching areas: (i) impact on individuals; (ii) impact on the health system; and (iii) impact on decision-making processes and society. The overarching areas contain the categories: (i) citizens, patients, and decision-makers; (ii) service provision, and public health; and (iii) decision-making, policy and state, and public and society. Under these categories, the most commonly encountered impact types are presented
Ohm's Law, the Reconnection Rate, and Energy Conversion in Collisionless Magnetic Reconnection
No full textMagnetic reconnection is a ubiquitous plasma process that transforms magnetic energy into particle energy during eruptive events throughout the universe. Reconnection not only converts energy during solar flares and geomagnetic substorms that drive space weather near Earth, but it may also play critical roles in the high energy emissions from the magnetospheres of neutron stars and black holes. In this review article, we focus on collisionless plasmas that are most relevant to reconnection in many space and astrophysical plasmas. Guided by first-principles kinetic simulations and spaceborne in-situ observations, we highlight the most recent progress in understanding this fundamental plasma process. We start by discussing the non-ideal electric field in the generalized Ohm's law that breaks the frozen-in flux condition in ideal magnetohydrodynamics and allows magnetic reconnection to occur. We point out that this same reconnection electric field also plays an important role in sustaining the current and pressure in the current sheet and then discuss the determination of its magnitude (i.e., the reconnection rate), based on force balance and energy conservation. This approach to determining the reconnection rate is applied to kinetic current sheets with a wide variety of magnetic geometries, parameters, and background conditions. We also briefly review the key diagnostics and modeling of energy conversion around the reconnection diffusion region, seeking insights from recently developed theories. Finally, future prospects and open questions are discussed
A registry study on nonsyndromic craniosynostosis: Long-term associations with academic achievement
No full textObjective: To assess the association between nonsyndromic craniosynostosis (NSC) and academic achievement. Methods: Registry data were analyzed on demographic background, presence of craniosynostosis and other comorbidities, grades, and results on national standardized tests (NSTs) across primary and upper secondary school, as well as the presence of academic degrees. The analysis used regression modeling on a sample of N = 1110 individuals with NSC and a matched cohort of N = 10,654 individuals. Results: There was a significant negative association between NSC and NST scores in third grade for both mathematics (aOR 0.76, 95% CI 0.60–0.99, p = .020) and Swedish (aOR 0.69, 95% CI 0.54–0.89, p = .004). The association seemed to primarily be carried by females with NSC (aORs for the interaction term 0.26–0.45, all ps <.05). Further, a slightly stronger negative association was observed in individuals with psychiatric comorbidities (aOR 0.44, 95% CI 0.22–0.90, p = .025 for mathematics; aOR 0.45, 95% CI 0.21–0.98, p = .045 for Swedish). No statistically significant association was found between NSC and NST scores or grades in later school years, or with academic degrees. Conclusions: There is evidence for a limited temporary negative association between NSC and academic achievement. A stronger negative association between NSC and academic achievement seems to be present in girls, and for individuals with psychiatric comorbidities. This has important implications for clinical management and provision of support in educational contexts
Cardio-metabolic-related plasma proteins reveal biological links between cardiovascular diseases and fragility fractures : a cohort and Mendelian randomisation investigation
No full textBackground How cardiovascular diseases (CVD) predispose to a higher risk of fragility fractures is not well understood. Both contribute to significant components of disease burden and health expenditure. Poor bone quality, central obesity, sarcopenia, falls, and low grip strength are independent risk factors for hip and other fragility fractures and also for CVD and early death. Methods We used proteomics and a cohort design combined with Mendelian randomisation analysis to understand shared mechanisms for developing CVD and fragility fractures, two significant sources of disease burden and health expenditure. We primarily aimed to discover and replicate the association of 274 cardio-metabolic-related proteins with future rates of hip and any fracture in two separate population-based cohorts, with a total of 12,314 women and men. Findings The average age at baseline was 68 years in the discovery cohort of women and 74 years in the mixed-sex replication cohort. During 100,619 person-years of follow-up, 2168 had any fracture, and 538 had a hip fracture. Our analysis resulted in 24 cardiometabolic proteins associated with fracture risk: 20 with hip fracture, 9 with any fracture, and 5 with both. The associations remained even if protein concentrations were measured from specimens taken during preclinical stages of cardio-metabolic diseases, and 19 associations remained after adjustment for bone mineral density. Twenty-two of the proteins were associated with total body fat mass or lean body mass. Mendelian randomisation (MR) analysis supported causality since genetically predicted levels of SOST (Sclerostin), CCDC80 (Coiled-coil domain-containing protein 80), NT-proBNP (N-terminal prohormone brain natriuretic peptide), and BNP (Brain natriuretic peptide) were associated with risk of hip fracture. MR analysis also revealed a possible negative impact on bone mineral density (BMD) by genetically predicted higher levels of SOST, CCDC80, and TIMP4 (Metalloproteinase inhibitor 4). The MR association with BMD was positive for PTX3 (Pentraxin-related protein) and SPP1 (Osteopontin). Genetically predicted higher concentrations of SOST and lower concentrations of SPP1 also conferred a higher risk of falls and lowered grip strength. The genetically determined concentration of nine proteins influenced fat mass, and one influenced lean body mass. Interpretation These data reveal biological links between cardiovascular diseases and fragility fractures. The proteins should be further evaluated as shared targets for developing pharmacological interventions to prevent fractures and cardiovascular disease
Horn och aska: Kammar från Valsgärdes brandgravar : Kronologi och jämförelse av kamstilistiska element
No full textThis thesis focuses on the examination of the combs of the Valsgärde cremations burials, that span the Vendel Period and Viking Age. The analysis looks at seventeen, previously unpublished Valsgärde combs derived from a database of female cremation burials in Sweden. The Valsgärde combs are stylistically compared to combs from the Lovö parish, focusing on the designs and motifs of the connecting plates, end plates, and top edge of the combs. The study highlights the relationship between different stylistic elements of combs and burial chronology, suggesting that combs can serve as chronological markers in artefact dating. The aim is to identify common stylistic elements that can be seen in fragmented combs that may contribute to the creation of a typological system for artefact dating. Key findings indicate that combs, prevalent in burials across gender and social boundaries, have a chronological evolution of stylistic elements. This research uses the comparative analysis to expand a previously established typological system with the aim of laying the groundwork for future typological systems methods that can be used for artefact dating with combs.Uppsatsen behandlar sjutton, tidigare opublicerade kammar från gravfältet Valsgärdes vendeltida och vikingatida kremeringsgravar. Genom att undersöka kammarnas olika stilistiska element i förhållande till gravarnas kronologi, visar studien att kammar kan fungera som kronologiska markörer vid artefaktdatering. Kammar är återkommande fynd i gravar oavsett genus och social status. Genom att identifiera vanliga stilistiska element, som även syns på fragmenterade kammar, konstrueras ett typologiskt system som gör det möjligt att datera gravar där andra daterande föremål saknas.
Different sensory dimensions in infancy are associated with separable etiological influences and with autistic traits in toddlerhood
No full textBackground Infants vary significantly in the way they process and respond to sensory stimuli, and altered sensory processing has been reported among infants later diagnosed with autism. Previous work with adolescents and adults suggests that variability in sensory processing may have a strong genetic basis. Yet, little is known about the etiological factors influencing sensory differences in infancy, when brain circuits supporting social and non-social cognition are sculpted and learning about the world via sensory input largely occurs in interaction with caregivers. Methods We analysed data from a community sample of monozygotic (MZ) and dizygotic (DZ) 5-month-old same-sex twins (n = 285 pairs, n = 158 MZ pairs, n = 150 male pairs) from the BabyTwins Study in Sweden (BATSS) using exploratory factor analysis, generalised estimating equations and multivariate twin models to delineate the phenotypic and etiological structure of individual variability across different sensory processing dimensions, as measured by the Infant/Toddler Sensory Profile. Developmental links to later autistic traits were also assessed, as measured by total scores from the Quantitative Checklist for Autism in Toddlers at 36 months. Results Results suggested separability between sensory processing dimensions (i.e. sensation seeking, sensation avoiding, sensory sensitivity and low registration) at a phenotypic and etiological level, with significant contributions from additive genetics and family environment that were unique to each sensory dimension and significant but smaller contributions from shared influences. Sensory domains also showed etiological separability, with unique genetic influences to each domain, while contributions from shared environment were in part shared across domains. A higher incidence of tactile-related behaviours and behaviours associated with sensory sensitivity, sensation avoiding, and low registration were significantly associated with higher levels of autistic traits in toddlerhood. Conclusions This study provides a map of the phenotypic and etiological structure of sensory processing in infancy, which will be informative for studies of both typical and atypical development