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  • 1.
    Abada, Mariam
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Vilka problem finns det med förfalskade läkemedel?2014Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Världsmarknaden för läkemedlen beräknades år 2011 till 900 miljarder US$ enligt IMS-health. Marknaden för illegala läkemedel uppskattas vara värd mellan 75-200 miljarder dollar. I Sverige uppskattas den illegala läkemedelsmarknaden till motsvarande ≤0,5 %. Straffet för insmuggling av läkemedel till Sverige är böter eller max 2 års fängelse. Tullverket räknar med att man endast hittar 10 % av det som smugglas in. I andra länder kan straffet variera mellan böter (ekonomisk brottslighet i Afrika) till dödsstraff i Kina.

    I Utvecklingsländerna uppskattas 10-30 % av alla läkemedel som säljs vara förfalskade, jmf 1 % I-länderna. l. Förekomsten av förfalskade läkemedel har många allvarliga konsekvenser på människor som exempelvis, utebliven effekt, toxiska reaktioner, förgiftningar, som kan i värsta fall leda till döden. Ett annat alvarligt problem är resistensutveckling, ökad spridning av smittsamammasjukdomar som exempel, tuberkulos och/ eller HIV/AIDS.

    Syftet med detta examensarbete är att besvara frågan: Vilka problem ger den ökande förekomsten av förfalskade läkemedel i samhället. Undersökningen fokuserar på livstidsläkemedel, dvs ett läkemedel en person måste ta resten av sitt liv för behandling av sin kroniska sjukdom.

    För att komma till rätta med de problem, som förfalskade läkemedel, skapar krävs ett mer utvecklat samarbete mellan olika läkemedelsmyndigheter, läkemedelsföretag, internationella polisorganisationer, tull m.fl. Arbetet med att utveckla förpackningar som är svåra att förfalska bör intensifieras. Straffsatser bör kanske ses över. Det är viktigt att öka medvetandet bland allmänheten om risker med att köpa läkemedel utanför apotek (t ex via nätet).

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  • 2.
    Abbas, Mirna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Finns det ett samband mellan behandling av akne med läkemedlet isotretinoin och uppkomst av psykiatriska symptom samt självmord?: En litteraturstudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Acne or pimples is an inflammatory skin reaction that occurs when the sebaceous glands or hair follicles become inflamed. This skin reaction is seen as a rash on or under the skin and mainly involves the face. Acne is most common in adolescence but can affect people of all ages. Acne is considered a contributing factor to social isolation, low self-esteem, depression, and suicidal thoughts.

    During the 1950s, a new acne drug containing the active substance isotretinoin was developed. The drug began to be used in the early 1980s and is today the most effective drug in treating severe acne. Isotretinoin is a vitamin A acid derivative (13-cis-retonic-acid) that belongs to the drug group retinoids. Isotretinoin is intended for the treatment of severe scarring acne, as well as where the treatment of acne with other drugs such as antibiotics or topical treatment has not given the desired result. Isotretinoin is an effective drug in treating severe acne, but unfortunately also a drug that can cause troublesome and severe side effects. As isotretinoin crosses the blood-brain barrier, studies have been performed on whether there is a link between treatment with isotretinoin and mental reactions. There is a high incidence of psychiatric symptoms and suicidal ideation in people suffering from acne. It is difficult to distinguish whether the mental symptoms are drug-related or not.

    The purpose of this literature review was to investigate whether there may be an association between the treatment of acne with the drug isotretinoin and the onset of psychiatric symptoms as well as suicide. To find relevant articles for this work, a search was performed in the PubMed database through Linnaeus University's library, which resulted in six relevant studies. Different self-assessment scales evaluated depression, anxiety, and quality of life in selected studies. The results of the studies are unequivocal, where none of the studies showed a connection between the occurrence of psychiatric symptoms and suicidal thoughts when treating acne with the drug isotretinoin. On the contrary, it indicated an improvement in psychiatric conditions reflected in acne reduction. However, there is insufficient evidence that these results can rule out the emergence of psychiatric symptoms and suicidal thoughts during treatment.

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    Ex-arbete 2022
  • 3.
    Abdo, Jasmin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Tidig insulinbehandling för typ II diabetiker2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Diabetes mellitus är en av de vanligaste endokrina sjukdomarna och de vanligaste formerna är typ I och typ II. Idag har ca 350 000 personer i Sverige diabetes och av dessa har 85-90% diabetes typ II. Typ II diabetes börjar med insulinresistens och så småningom blir det avtagande funktion av β- cellerna vilket leder till nedsatt insulinkänslighet och främsta orsakerna till typ II diabetes är övervikt och fetma. Det finns olika behandlingsrekommendationer för att behandla typ II diabetiker för att minska att sena komplikationer uppstår. Främst genom livsstilsförändringar som kost och fysisk aktivitet, men då dessa inte räcker till kan perorala läkemedel komma i efterhand och om inte det heller ger tillräcklig effekt kan insulinbehandling sättas in. Ca 50 % av typ II diabetiker får insulin efter 10 års sjukdom.

    Syftet med arbetet är att undersöka om det finns en god implikation av att sätta in insulin tidigare än det som redan är rekommenderat.

    Denna litteraturstudie är baserad på artiklar hämtade från databasen PubMed. Sammanlagt har fem randomiserade kontrollerade studier granskats.

    Resultaten visar att en HbA1c-sänkning med ca 1,5 - 2,0 % kan erhållas samt också en bibehållen β- cellfunktion vid insättning av insulin. Insulinbehandlingen bör sättas in så snart HbA1c går över 7,5 % istället för att vänta en viss tid. Den kan sättas in hos behandlingsnaiva personer med framträdande symtom eftersom insulin fortfarande sänker HbA1c och det finns inget som tyder på att insulin inte kan sättas in tidigare än det som är rekommenderat.

    Slutsatsen som dras är att stödja intensiv behandling som gör att HbA1c hålls på en så låg nivå det är möjligt och när målvärden för HbA1c inte kan hållas kan insulin med fördel sättas in hos typ II diabetiker som behandlats med perorala antidiabetika.

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  • 4.
    Abdoulkader, Souha
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Undersökning av en ny agitationsmetod för trombocytframställning: En jämförelse mellan Trombomixer 307 och trombocytvagga (Helmer)2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Platelet transfusion is a treatment to prevent or stop bleeding. Platelets for transfusion (platelet-concentrate) are produced by separating the blood into erythrocyte-unit, plasma, leukocyte-unit, and interim platelet-unit (IPU). The IPUs are then placed on an agitation method. Platelet-concentrate is prepared by pooling 4–6 IPUs with platelet additive solution (PAS). The purpose of this study was to examine Trombomixer 307 as new agitation method for producing platelet-concentrate, and compare it with the current agitation method, the platelet-rocker. It is also investigated whether the implantation of the Trombomixer 307 can reduce the number of aggregated IPUs. The study was performed by placing 100 IPUs on the platelet-rocker and 100 IPUs on the Trombomixer 307. Additionally, 56 platelet-concentrates were prepared (28 from the Trombomixer 307 and 28 from the platelet-rocker), which then examined through quality control of the platelet yield index sum (PYI value), volume, leukocyte particle concentration (LPK) and platelet particle concentration (TPK). The results showed that 31 out of the 100 IPUs from Trombomixer and 47 of the 100 IPUs from the platelet-rocker were aggregated. IPUs from the Trombomixer had a significantly lower number of aggreged IPUs compared to IPUs from the platelet rocker (p = 0.029). The results also showed that platelet-concentrate from Trombomixer had lower LPK and TPK, while Platelet-concentrate from platelet-rocker showed better correlation between PYI sum and TPK. In conclusion, Trombomixer 307 fulfills requirements as an agitation method to produce platelet-concentrates and reduces the percentage of aggregated IPUs. However, platelet-rocker leads to better quality of platelet-concentrate.

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  • 5.
    Abdul Hadi, Roza
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Avvikelser i receptlistan: En intervjustudie med patienter på apotek2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Medications are used to treat, cure, or relieve symptoms of diseases, but there is a risk with the use of medications. Drug-related-problems are known to increase morbidity and mortality. Incorrect medical list and discrepancies in these lists can lead to drug-related problems as side effects, hospitalization, non-compliance, drug interactions and overtreated or undertreated patients. Discrepancies can be for example: more prescriptions than necessary, outdated prescriptions, i.e., medicines that will not be used, prescriptions with incorrect dosing and missing prescriptions i.e., medicines used by patients that cannot be seen in the medication list.

    Purpose:  The aim of this study was to investigate discrepancies in the Swedish prescription list "My saved prescriptions at the pharmacy". The secondary aim was to investigate how common it is to use this prescription list or the dosage label on the medicine packaging to know which medicines to use and which dosage.

    Methods: The data collection was performed by four pharmacy students at seven pharmacies in Sweden over a period of three weeks during Jan-Feb. 2021 where the prescription list was investigated together with patients to identify any discrepancies. The study included patients who was over 18 years old, spoke Swedish, had three or more prescribed drugs, and agreed to participate. 

    Results A total of 215 patients were interviewed, where 61% had one or more discrepancies in their medication list. A total of 1717 prescriptions were analyzed, of which 10% were double prescriptions (n = 167), 8% outdated prescriptions (n = 141) and 3% prescriptions with the wrong dosage (n = 42). When analyzing the primary sources of information used by patients to know which medicine to use, the printout of the list "my saved prescriptions at the pharmacy” dominated (n = 72).  Most used information source to know drug dosage was the dosage label on the medicine packaging (n = 112).

    Conclusions: It is important to have an updated and correct information in the medication list, to prevent drug-related-problems caused by discrepancies. It becomes even more important when we see that the medication list "My saved prescriptions at the pharmacy" and dosage label (containing the same information in the medication list), are the most used primary sources by patients to know which drug to use and in what dosage. Finally, results show a relationship between the number of prescribed drugs and the number of discrepancies that occur, and therefore we see more discrepancies in elderly patients who are usually ill and are being treated for several diseases. 

    There are opportunities for further research to study e.g., which drug-related-problems are caused by discrepancies in the medication list as well as the degree of danger in these problems. 

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  • 6.
    Abdul Rahim, Ranya
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Kommunikationsproblem på svenska apotek: Förekomst och orsak2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The word communication originates from the Latin word communicare that means to do something in common. When human beings communicate with each other, we share thoughts, emotions, values and actions. The foundation in communication is found within the interpersonal communication, which is the act of communication between two persons. All types of communications include of verbal and nonverbal acts of communication.

    The verbal communication consists of words either in speech or writing, the nonverbal act implies gestures, frequency of the tone and facial expressions.

    Within the pharmaceutical profession, good communication between the pharmacist and the customer is important and can affect the customer’s health and quality of life in both direct as well as indirect ways. In recent years, the pharmacist's role in the pharmacy has drastically changed. Nowadays the care of the customer has gained more significance than before. To improve customer health and quality of life it is important that the pharmacist acts to promote a good relationship with the customer and the foundation for this relationship should be built on good terms of communication.

    The purpose of this study was to study how common it is with communication errors between pharmacist and customer, and to demonstrate probable underlying causes. Secondary questions were, how is the drug advice the pharmacist provides affected by communication errors?

    Collection of data for the study was done with structured observation charts, where the customer and pharmacist were strictly observed. A total of 316 meetings were observed and the data collected referred to prescriptions. In more than one-third of the observed meetings, there were communication errors between the pharmacist and the customer. Communication errors that arose concerned lack of eye contact, language barriers, choice of questions, background noise from colleagues and customers and discussions from generic exchanges. To reduce future communication errors, the pharmacist's actions should be strengthened, such as eye contact, clear follow-up questions and improved feedback.

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  • 7.
    Abdulsalam Muhammednouri, Hevi
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Kan Entresto ersätta ACE-hämmare vid hjärtsvikt och är den behandlingen optimal med avseende på farmakogenetiken?2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Around 200,000–250,000 people suffer from heart failure in Sweden. Heart failure is a condition of impaired heart pumping capacity. The condition results in reduced quality of life, high morbidity and mortality and there have been many attempts to find suitable drug targets to minimize these consequences. Neurohormonal compensatory mechanisms, such as renin–angiotensin–aldosterone system, aim to restore blood pressure to normal levels again but in the long-term it also increases the stress on the heart. The hormone angiotensin II gets activated through this mechanism and is the reason behind the increased stress. Therefore, the hormone has been an important drug target for ACE inhibitors (ACEI) and AT1 blockers (ARB) to prevent antihypertensive effects. The enzyme neprilysin is another drug target whose inhibition is accomplished by using neprilysin inhibitors. Entresto® is a new medication that contains a neprilysin inhibitor and an ARB. The neprilysin inhibitory component, sacubitril, is activated by carboxylesterase 1 (CES1) but mutations in the gene encoding CES1 may cause a non-therapeutic effect. Additionally, patients with wild-type CES1 may risk unacceptable side effects such as rhabdomyolysis and Alzheimer's disease. The objective of this study is to investigate whether replacement of ACE inhibitors with Entresto is optimal in heart failure with regard to pharmacogenetics.

    This study is organized as a literature study in which five scientific articles (I-V) were analyzed and selected from PubMed database and through Linnaeus University's search engine, OneSearch. The studies show that Entresto is superior to enalapril in reducing the risk for cardiovascular death or hospitalization for heart failure. However, the effects of Entresto is dependent on a functioning CES1 gene because mutations like G143E cause a non-therapeutic effect. Enalapril has shown to be independent of such mutations.

    Theoretically, inhibition of neprilysin may cause accumulation of amyloid-β peptides (Aβ), which associates with Alzheimer's disease. Study IV, with the purpose to investigate the effect of Entresto on Aβ isoforms, showed no significant change in Aβ concentrations in cerebrospinal fluid. However, further studies with longer duration were suggested. On the other hand, study V shows that a combination of Entresto and statins increases the plasma concentration of statins. That in turn would increase the risk of a development of rhabdomyolysis. The conclusion is that it is not optimal to replace enalapril with Entresto in heart failure with regard to pharmacogenetics.

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  • 8.
    Abellan-Flos, Marta
    et al.
    Univ Namur, Belgium;PSL Univ, France.
    Timmer, Brian J. J.
    KTH Royal Institute of Technology, Sweden.
    Altun, Samuel
    Attana AB, Sweden.
    Aastrup, Teodor
    Attana AB, Sweden.
    Vincent, Stephane P.
    Univ Namur, Belgium.
    Ramström, Olof
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. KTH Royal Institute of Technology, Sweden;Univ Massachusetts, USA.
    QCM sensing of multivalent interactions between lectins and well-defined glycosylated nanoplatforms2019In: Biosensors & bioelectronics, ISSN 0956-5663, E-ISSN 1873-4235, Vol. 139, article id 111328Article in journal (Refereed)
    Abstract [en]

    Quartz crystal microbalance (QCM) methodology has been adopted to unravel important factors contributing to the "cluster glycoside effect" observed in carbohydrate-lectin interactions. Well-defined, glycosylated nanostructures of precise sizes, geometries and functionalization patterns were designed and synthesized, and applied to analysis of the interaction kinetics and thermodynamics with immobilized lectins. The nanostructures were based on Borromean rings, dodecaamine cages, and fullerenes, each of which carrying a defined number of carbohydrate ligands at precise locations. The synthesis of the Borromeates and dodecaamine cages was easily adjustable due to the modular assembly of the structures, resulting in variations in presentation mode. The binding properties of the glycosylated nanoplatforms were evaluated using flow-through QCM technology, as well as hemagglutination inhibition assays, and compared with dodecaglycosylated fullerenes and a monovalent reference. With the QCM setup, the association and dissociation rate constants and the associated equilibrium constants of the interactions could be estimated, and the results used to delineate the multivalency effects of the lectin-nanostructure interactions.

  • 9.
    Abiib, Amina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Probiotika som behandling vid IBS2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: IBS (Irritable Bowel Syndrome) is a functional gastrointestinal disorder, with an unclear etiology and pathophysiology. IBS is a common disorder in the Western population and is characterized by recurrent abdominal pain/ discomfort, bloating, flatulence, diarrhea and/ or constipation. There is currently no cure for IBS, but the interest in probiotics as an option of treatment has recently increased. Probiotics have been defined as live microorganisms that, when administered in adequate amounts, provide a health benefit on the host, and are believed to have a symptomatic effect in IBS. Probiotics have therefore been of interest for the treatment in IBS.

    Purpose: The purpose of this study is to examine whether probiotics have a therapeutic effect and if it could be used as a treatment for IBS.

    Method: Five randomized, double-blind, placebo-controlled studies were reviewed that examined the therapeutic effect of different probiotics in the IBS-patients. Articles were obtained through searches in the medical database PubMed, during the month of February 2016.

    Results: Four of the five studies showed a significant improvement of symptoms especially in abdominal pain/ discomfort. The best results were seen in a study that investigated the probiotic Lactobacillus plantarum 299v. Three of the five studies showed a significant improvement in quality of life (QOL) of the subjects in the study. One of the five studies which examined the effect of Escherichia coli Nissle 1917, there was no significant difference between E.coli (probiotics) and placebo.

    Conclusion: There is reasonable evidence that treatment with certain probiotics might provide improvement in symptoms of abdominal pain/ discomfort, and increase patients quality of life based on the five studies. Further studies are required to determine the most effective probiotic, dose and duration of IBS-treatment.

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  • 10.
    Acuña, Ulyana Muñoz
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Ohio State Univ, USA.
    Ezzone, Nathan
    Ohio State Univ, USA.
    Rakotondraibe, L. Harinantenaina
    Ohio State Univ, USA.
    De Blanco, Esperanza J. Carcache
    Ohio State Univ, USA.
    Activity in MCF-7 Estrogen-sensitive Breast Cancer Cells of Capsicodendrin from Cinnamosma fragrans2021In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 41, no 12, p. 5935-5944Article in journal (Refereed)
    Abstract [en]

    Background/Aim: Effect of capsicodendrin on the NF-KB pathway was studied in MCF-7 cancer cells. Materials and Methods: The transcription factor assay was used to screen for NF-KB activity. The effect on IKK beta, ICAM-1, and caspase-7 were studied using western blot. Caspase-1 was studied using Promega Caspase-Glo (R) assay. Reactive oxygen species (ROS) were detected using the fluorescent probe DCFH-DA. The potentiometric dye JC-1 was used to assess mitochondrial membrane potential (Delta psi m) and the cell cycle was examined using a fluorescence-activated cell sorter. Results: NF-kappa B p65 inhibitory effect was IC50=8.6 mu M and cytotoxic activity was IC50=7.5 mu M. The upstream IKK and the downstream ICAM-1 were down-regulated. Sub G1-phase population increased to 81% after 12 h of treatment with capsicodendrin (10 mu M) and there was no loss of Delta psi M. Conclusion: Increased levels of intracellular ROS promoted activity of caspase-1 and induced cell death in MCF-7 cells. Capsicodendrin may be a future anticancer agent that prevents the progression of metastatic breast cancer.

  • 11.
    Adel Ali, Sura
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Kan manuell analys av Csv-EPK ersättas med automatiserad analys på Sysmex XN-1000?2016Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Determination of erythrocyte count in cerebrospinal fluid (CSF-EPC) is used to exclude various intracranial hemorrhage, especially subarachnoid hemorrhage (SAH). SAH means a bleeding between the pia mater and arachnoidea which occurs due to rupture of an aneurysm in the subarachnoid space. Manual counting of erythrocytes in the cerebrospinal fluid with Bürkers chamber and microscopy has been the gold standard for the past decades, but the manual method is time consuming and requires great experience. The purpose of this study was to evaluate if manual analysis of  CSF-EPC with counting chamber, and light microscopy can be replaced by automated analysis of CSF-EPC with Hematology Analyzer XN-1000 (Sysmex). Fortyeight cerebrospinal fluid samples with various concentrations of erythrocytes ware prepared by diluting known concentration of erythrocytes in cell-free CSF. Prepared CSF-samples with added erythrocytes were analyzed first on the XN-1000. Thereafter, manual counting of erythrocytes was performed using Bürkers counting chamber. A linear regression was established to describe the correlation between the automated analysis of the CSF-EPC and manual analysis of the CSF-EPC. Imprecision in the analysis of the CSF-EPC on the XN-1000 (Sysmex) was assessed by within-run imprecision. A very good correlation (r = 0.999) was found between the XN-1000 and manual counting. For results in the lower range, 100 - 5000 (106/L), correlation was also good (r = 0.997). The coefficient of variation was 19,8 % at CSF-EPC of 370 x 106/L and 3.1 % at CSF-EPC of 25 950 x 106/L. The sensitivity for analysis of CSF-EPC on XN-1000 was 370 x 106/L. The conclusion is that the analysis of Csv-EPC on XN-1000 can be used for clinical diagnostics of CSF- samples. However, it should be noted that XN-1000 has poor sensitivity for low CSF-EPC values < 370 x 106/L. To ensure high diagnostic quality even in CSF-samples with low erythrocyte counts are recommended a reference limit of < 500 x 106/L as a practical cut off for supplemental microscopic counting in routine healthcare laboratories.

     

     

     

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    Sura Adel Ali
  • 12.
    Adell, Jenny
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Isolering och identifiering av bakterie som orsakar missfärgning på kött2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Meat is skeletal muscle from different animals, such as pigs, cattle or sheep. Pseudomonas are bacteria that may cause food spoilage. The bacteria live in our environment and can cause problems due to biofilm formation in hospitals and industries. The slaughterhouse KLS Ugglarps has found that some pig cuttings have become discolored with at blue color and they wanted to find out what caused it. Pseudomonas aeruginosa had previously been found in the production area and was suspected as the cause.Meat, with and without discoloration, was investigated using various microbiological methods to see which bacterium cause the blue color. Different colonies were isolated and identified. The methods used were API 20NE, gram staining and oxidation test. A reference isolate was used as control. It was found that it was not P. aeruginosa but instead Pseudomonas fluorescens that caused the blue color. This was confirmed by applying the isolated bacteria to sterile meat and the blue color did appear after incubation. A screening for the source of contamination was performed in the production area to see if the bacterium could be found before start-up and during production. The samples taken showed that there were bacteria at both time points and that the production surfaces at the beginning of the production line were more prone to contamination than the other surfaces.

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    Isolering och identifiering av bakterie som orsakar missfärgning på kött
  • 13.
    Adler, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Är det säkert att byta från originalläkemedlet för inflixmab, Remicade®, till CT-P13 och är CT-P13 ekvivalent med Remicade® med avseende på effekt, säkerhet, immunogenicitet och farmakokinetik?2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Biologic drugs are effective against numerous diseases but they are very expensive. The European Medicines Agency approved sales of biosimilars in 2006. Biosimilars are copies of already approved biologic drugs, but they are not considered to be exact copies like generic drugs are. Only living organisms can produce substances with the complexity of biologic drugs. Differences in pH, enviroment, and the purification process during the production of biologic drugs can affect the structure of the final product. Differences in the production processes can affect properties like the glycosylation pattern of the molecules which in turn can influence the effect of the drug. This is the reason biosimilars are not considered as exact copies of the original drug. The patent for Remicade® a TNF inhibitor expired in 2015 which led to the introduction of the first biosimilar for monoclonal antibodies (CT-P13) on the European market. The aim of this study was to investigate the efficacy, safety profile, immunogenicity and pharmacokinetics equivalence between CT-P13 and the original drug for infliximab, Remicade®. And to investigate if it was safe to switch from Remicade to CT-P13.

     

    The articles for the study were collected from PubMed, a medical and bioscientific database, and five studies were chosen for further analysis. The articles were not limited to a specific indication for infliximab, so the studies included patients with rhematoid arthritis (RA), ankylosing spondylitis (AS) and inflammatory bowel disease (IBD). The short-term equivalence between Remicade® and CT-P13 was analysed in the studies but more studies including long-term equivalence are needed. Based on the primary endpoints in the studies it seems to be safe to switch from Remicade® to CT-P13 and short-term equivalence seems to exist between CT-P13 and Remicade® considering the efficacy, safety profile, immunogenicity and pharmacokinetics equivalence in patients with RA, AS and IBD.

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  • 14.
    Adler, Anna
    et al.
    Uppsala University, Sweden.
    Fritsch, Marlene
    Uppsala University, Sweden.
    Fromell, Karin
    Uppsala University, Sweden.
    Leneweit, Gero
    ABNOBA GmbH, Germany;Assoc Promot Canc Therapy, Germany.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University, Sweden.
    Nilsson, Bo
    Uppsala University, Sweden.
    Teramura, Yuji
    Uppsala University, Sweden;Cellular & Mol Biotechnol Res Inst CMB, Japan;Univ Tsukuba, Japan.
    Regulation of the innate immune system by fragmented heparin-conjugated lipids on lipid bilayered membranes in vitro2023In: Journal of materials chemistry. B, ISSN 2050-750X, E-ISSN 2050-7518, Vol. 11, no 46, p. 11121-11134Article in journal (Refereed)
    Abstract [en]

    Surface modification with heparin is a powerful biomaterial coating strategy that protects against innate immunity activation since heparin is a part of the proteoglycan heparan sulfate on cell surfaces in the body. We studied the heparinization of cellular and material surfaces via lipid conjugation to a heparin-binding peptide. In the present study, we synthesized fragmented heparin (fHep)-conjugated phospholipids and studied their regulation of the innate immune system on a lipid bilayered surface using liposomes. Liposomes have versatile applications, such as drug-delivery systems, due to their ability to carry a wide range of molecules. Owing to their morphological similarity to cell membranes, they can also be used to mimic a simple cell-membrane to study protein-lipid interactions. We investigated the interaction of complement-regulators, factor H and C4b-binding protein (C4BP), as well as the coagulation inhibitor antithrombin (AT), with fHep-lipids on the liposomal surface. Herein, we studied the ability of fHep-lipids to recruit factor H, C4BP, and AT using a quartz crystal microbalance with dissipation monitoring. With dynamic light scattering, we demonstrated that liposomes could be modified with fHep-lipids and were stable up to 60 days at 4 degree celsius. Using a capillary western blot-based method (Wes), we showed that fHep-liposomes could recruit factor H in a model system using purified proteins and assist in the degradation of the active complement protein C3b to iC3b. Furthermore, we found that fHep-liposomes could recruit factor H and AT from human plasma. Therefore, the use of fHep-lipids could be a potential coating for liposomes and cell surfaces to regulate the immune system on the lipid surface.

  • 15.
    Adler, Anna
    et al.
    Uppsala University, Sweden.
    Inoue, Yuuki
    The University of Tokyo, Japan.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Baba, Teruhiko
    National Institute of Advanced Industrial Science and Technology, Japan.
    Ishihara, Kazuhiko
    The University of Tokyo, Japan.
    Nilsson, Bo
    Uppsala University, Sweden.
    Teramura, Yuji
    Uppsala University, Sweden;National Institute of Advanced Industrial Science and Technology, Japan.
    Effect of liposome surface modification with water-soluble phospholipid polymer chain-conjugated lipids on interaction with human plasma proteins2022In: Journal of materials chemistry. B, ISSN 2050-750X, E-ISSN 2050-7518, Vol. 10, no 14, p. 2512-2522Article in journal (Refereed)
    Abstract [en]

    Alternative liposome surface coatings for PEGylation to evade the immune system, particularly the complement system, have garnered significant interest. We previously reported poly(2-methacryloyloxyethyl phosphorylcholine) (MPC)-based lipids (PMPC-lipids) and investigated the surface modification of liposomes. In this study, we synthesize PMPC-lipids with polymerization degrees of 10 (MPC10-lipid), 20 (MPC20-lipid), 50 (MPC50-lipid), and 100 (MPC100-lipid), and coated liposomes with 1, 5, or 10 mol% PMPC-lipids (PMPC-liposomes). Non-modified and PEGylated liposomes are used as controls. We investigate the liposome size, surface charge, polydispersity index, and adsorption of plasma proteins to the liposomes post incubation in human plasma containing N,N,N′,N′-ethylenediamine tetraacetic acid (EDTA) or lepirudin by some methods such as sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), western blotting, and automated capillary western blot, with emphasis on the binding of complement protein C3. It is shown that the coating of liposome PMPC-lipids can suppress protein adsorption more effectively with an increase in the molecular weight and molar ratio (1-10 mol%). Apolipoprotein A-I is detected on PMPC-liposomes with a higher molecular weight and higher molar ratio of PMPC-lipids, whereas α2-macroglobulin is detected on non-modified, PEGylated, and PMPC-liposomes with a shorter polymer chain. In addition, a correlation is shown among the PMPC molecular weight, molar ratio, and C3 binding. The MPC10-lipid cannot inhibit C3 binding efficiently, whereas surface modifications with 10 mol% MPC20-lipid and 5 mol% and 10 mol% MPC50-lipid suppress both total protein and C3 binding. Hence, liposome modification with PMPC-lipids can be a possible strategy for avoiding complement activation.

  • 16.
    Adler, Anna
    et al.
    Uppsala University, Sweden.
    Inoue, Yuuki
    Univ Tokyo, Japan.
    Sato, Yuya
    Univ Tokyo, Japan.
    Ishihara, Kazuhiko
    Univ Tokyo, Japan.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Linnaeus University, Linnaeus Knowledge Environments, Advanced Materials. Uppsala University, Sweden.
    Nilsson, Bo
    Uppsala University, Sweden.
    Teramura, Yuji
    Uppsala University, Sweden;Univ Tokyo, Japan;Natl Inst Adv Ind Sci & Technol, Japan.
    Synthesis of poly(2-methacryloyloxyethyl phosphorylcholine)-conjugated lipids and their characterization and surface properties of modified liposomes for protein interactions2021In: Biomaterials Science, ISSN 2047-4830, E-ISSN 2047-4849, Vol. 9, no 17, p. 5854-5867Article in journal (Refereed)
    Abstract [en]

    Poly(ethylene glycol) (PEG) is frequently used for liposomal surface modification. However, as PEGylated liposomes are cleared rapidly from circulation upon repeated injections, substitutes of PEG are being sought. We focused on a water-soluble polymer composed of 2-methacryloyloxyethyl phosphorylcholine (MPC) units, and synthesized poly(MPC) (PMPC)-conjugated lipid (PMPC-lipid) with degrees of MPC polymerization ranging from 10 to 100 (calculated molecular weight: 3 to 30 kDa). In addition, lipids with three different alkyl chains, myristoyl, palmitoyl, and stearoyl, were applied for liposomal surface coating. We studied the interactions of PMPC-lipids with plasma albumin, human complement protein C3 and fibrinogen using a quartz crystal microbalance with energy dissipation, and found that adsorption of albumin, C3 and fibrinogen could be suppressed by coating with PMPC-lipids. In particular, the effect was more pronounced for PMPC chains with higher molecular weight. We evaluated the size, polydispersity index, surface charge, and membrane fluidity of the PMPC-lipid-modified liposomes. We found that the effect of the coating on the dispersion stability was maintained over a long period (98 days). Furthermore, we also demonstrated that the anti-PEG antibody did not interact with PMPC-lipids. Thus, our findings suggest that PMPC-lipids can be used for liposomal coating.

  • 17.
    Adler, Anna
    et al.
    Uppsala University, Sweden.
    Manivel, Vivek Anand
    Uppsala University, Sweden.
    Fromell, Karin
    Uppsala University, Sweden.
    Teramura, Yuji
    Uppsala University, Sweden;Cellular & Mol Biotechnol Res Inst CMB, Japan.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University, Sweden.
    Nilsson, Bo
    Uppsala University, Sweden.
    A Robust Method to Store Complement C3 With Superior Ability to Maintain the Native Structure and Function of the Protein2022In: Frontiers in Immunology, E-ISSN 1664-3224, Vol. 13, article id 891994Article in journal (Refereed)
    Abstract [en]

    Complement components have a reputation to be very labile. One of the reasons for this is the spontaneous hydrolysis of the internal thioester that is found in both C3 and C4 (but not in C5). Despite the fact that approximate to 20,000 papers have been published on human C3 there is still no reliable method to store the protein without generating C3(H2O), a fact that may have affected studies of the conformation and function of C3, including recent studies on intracellular C3(H2O). The aim of this work was to define the conditions for storage of native C3 and to introduce a robust method that makes C3 almost resistant to the generation of C3(H2O). Here, we precipitated native C3 at the isoelectric point in low ionic strength buffer before freezing the protein at -80 degrees C. The formation of C3(H2O) was determined using cation exchange chromatography and the hemolytic activity of the different C3 preparations was determined using a hemolytic assay for the classical pathway. We show that freezing native C3 in the precipitated form is the best method to avoid loss of function and generation of C3(H2O). By contrast, the most efficient way to consistently generate C3(H2O) was to incubate native C3 in a buffer at pH 11.0. We conclude that we have defined the optimal storage conditions for storing and maintaining the function of native C3 without generating C3(H2O) and also the conditions for consistently generating C3(H2O).

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  • 18.
    Adolfsson, Matilda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Anthelmintika mot hästens inälvsparasiter: en studie av effekt, resistensförekomst och försäljning2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 19.
    Adowan, Mohmad
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Verifiering av metoden för PCT-analys på Alinity i-serie Abbot2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Procalcitonin (PCT) is a precursor protein of the hormone calcitonin and is encoded by the gene Calcitonin-1. In the Blekinge Regional, P-PCT is only analyzed in Karlskrona. The analysis is performed in the department of clinical chemistry on the Alinity i-series instrument. PCT indicates bacterial infections and therefore, it is important to have a backup method for the analysis when the instrument in the city of Karlskrona is out of order. The aim of this work was to verify the analysis method of P-PCT on the instrument Alinity i-series in the city of Karlshamn. Analysis method verification means to confirm and prove that the method meets the specified requirements. Verification was performed by analyzing 35 samples with different concentration of PCT on the master instrument in Karlskrona and on “Alinity 1” and “Alinity 2” in Karlshamn. The method was compared by studying correlation coefficient and bias. The precision was measured only on “Alinity 1” which would be the master instrument in Karlshamn. Precision was measured by analyzing 25 replicates at two control levels and then was 5 replicates of each control level analyzed over 5 days. The correlation was good and no significant bias between results from Karlskrona and “Alinity 1” and between results from “Alinity 1” and “Alinity 2”. Precision on “Alinity 1” meets the requirements. The conclusion was that verification of PCT on master instrument “Alinity 1” and slave instrument “Alinity 2” was approved and the backup method for the PCT analysis in Karlshamn was verified.

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  • 20.
    Adowan, Ola
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Flödescytometrisk utvärdering av inbindning mellan transferrinsreceptor 1 och rekombinanta proteiner uttryckta på cellytan i Saccharomyces cerevisiae genom ”yeast surface display”2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 21.
    Aeinehband, Shahin
    et al.
    Karolinska Institutet.
    Lindblom, Rickard P. F.
    Karolinska Institutet.
    Al Nimer, Faiez
    Karolinska Institutet.
    Vijayaraghavan, Swetha
    Karolinska Institutet.
    Sandholm, Kerstin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Khademi, Mohsen
    Karolinska Institutet.
    Olsson, Tomas
    Karolinska Institutet.
    Nilsson, Bo
    Uppsala University.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University.
    Darreh-Shori, Taher
    Karolinska Institutet.
    Piehl, Fredrik
    Karolinska Institutet.
    Complement Component C3 and Butyrylcholinesterase Activity Are Associated with Neurodegeneration and Clinical Disability in Multiple Sclerosis2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 4, article id e0122048Article in journal (Refereed)
    Abstract [en]

    Dysregulation of the complement system is evident in many CNS diseases but mechanisms regulating complement activation in the CNS remain unclear. In a recent large rat genomewide expression profiling and linkage analysis we found co-regulation of complement C3 immediately downstream of butyrylcholinesterase (BuChE), an enzyme hydrolyzing acetylcholine (ACh), a classical neurotransmitter with immunoregulatory effects. We here determined levels of neurofilament-light (NFL), a marker for ongoing nerve injury, C3 and activity of the two main ACh hydrolyzing enzymes, acetylcholinesterase (AChE) and BuChE, in cerebrospinal fluid (CSF) from patients with MS (n = 48) and non-inflammatory controls (n = 18). C3 levels were elevated in MS patients compared to controls and correlated both to disability and NFL. C3 levels were not induced by relapses, but were increased in patients with >= 9 cerebral lesions on magnetic resonance imaging and in patients with progressive disease. BuChE activity did not differ at the group level, but was correlated to both C3 and NFL levels in individual samples. In conclusion, we show that CSF C3 correlates both to a marker for ongoing nerve injury and degree of disease disability. Moreover, our results also suggest a potential link between intrathecal cholinergic activity and complement activation. These results motivate further efforts directed at elucidating the regulation and effector functions of the complement system in MS, and its relation to cholinergic tone.

  • 22.
    Affan, Yara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    En jämförande litteraturstudie över säkerheten av behandling av insulin degludec och insulin glargin hos diabetes typ-2 patienter med risk för hypoglykemi: En jämförande litteraturstudie över säkerheten av behandling av insulin degludec och insulin glargin hos diabetes typ-2 patienter med risk för hypoglykemi2023Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

    Bakgrund: Typ 2-diabetes är en kronisk sjukdom som innebär att kroppen har svårt att reglera blodsockernivån. Det beror på att insulinresistens har utvecklats viket innebär att insulinet som produceras inte fungerar som det ska. Insulinresistens kan leda till minskad betacellsfunktion vilket ytterligare gör att den blodsockerreglerande förmågan försämras. Denna sjukdom är vanligare hos äldre individer och kan ha ärftliga orsaker, men risken ökar också vid övervikt och låg fysisk aktivitet. Typ 2- diabetes behandlas ofta med livsstilsförändringar, beteendeförändringar och läkemedel som t.ex metformin, natriumglukoskopplad transportör 2(SGLT-2) hämmare, glitazoner, dipeptidylpeptidas-4 (DPP4) hämmare, GLP analoger, sulfonylurea och insulin. Insulin degludec och insulin glargin används vid behandling av typ 2 diabetes.

     

    Syfte: Syftet med detta examensarbete är att undersöka effekten av insulin degludec och jämföra den med insulin glargin hos T2D- patienter med risk för hypoglykemi och se om degludec ger mindre uttalad hypoglykemi.

     

    Metod: Litteratursökningen genomfördes via pubmed med sökorden ”insulin degludec, insulin glargine in type 2 diabetes”. Begränsningarna som valdes vid sökningsfallen var randomiserad kontrollerad studie, 5 år. Detta gav 30 artiklar och av dessa inkluderades 5 artiklar.

     

     

    Resultat: Insulin degludec har jämfört med insulin glargin visat statistisk signifikant lägre risk för både symtomatiska hypoglykemiska episoder och nattliga symtomatiska hypoglykemiska episoder under behandlingsperioden. Effekten av de två behandlingarna när det gäller genomsnittliga procentandelen av tid inom målglukosintervallet 70-180mg/dl, ger ingen skillnad mellan glargin och degludec. När det gäller genomsnittliga procentandelen av tid med hypoglykemi <70 mg/dL var den lägre med insulin glargin än med insulin degludec. Svår symtomatisk hypoglykemi och nattliga hypoglykemihändelser var ovanligare hos både de yngre och äldre deltagarna som tog degludec än glargin. Degludec gav en lägre risk för svår och nattlig hypoglykemi jämfört med glargin hos de äldre patienterna.

     

     

    Slutsats: Slutsatsen är att insulin degludec visat sig vara effektivare än insulin glargin för att minska förekomsten av symtomatiska hypoglykemiska episoder, nattliga symtomatiska hypoglykemiska episoder och svår hypoglykemi hos patienter med typ 2 diabetes som hade risk för hypoglykemi. Detta har fastställts genom att studier har visat att insulin degludec har statistiskt signifikant lägre värden jämfört med insulin glargin i dessa sammanhang.

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  • 23.
    Agell, Blenda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Effect of Antibacterial Mouthwash on Basal Metabolic Rate in Humans: A Randomized, Double-blinded, Cross-over Study2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The use of mouthwash is a common complement to oral care. However, the physiological implication of this use, besides of effects on oral hygiene, is poorly known. The research of the gut micro flora and its implications on the host is a very active area of research today. Many important connections between the gut micro flora and obesity and diabetes have been found. These billions of bacteria are part of the immune system, they produce essential vitamins and they make inaccessible polysaccharides more digestible to the host, just to mention a few of their symbiotic roles for the host.

    A less explored area is the micro flora in the oral cavity. On the back of the tongue, anaerobic bacteria can reduce dietary nitrate to nitrite which then further can be reduced to nitric oxide, NO. NO is important in several important biological functions, e.g. as a signal substance, vasoregulation, mucus production and antibacterial effects. Vegetables as beetroot and spinach are dietary sources with a high nitrate content. Also drinking water and processed meats can be of relevance. Nitrite is added to processed meat for the prevention of botulism but also adds taste and color.  

    Experiments on humans indicate that mitochondrial efficiency increases after nitrate load, manifested as a decreased oxygen demand during physical exercise. This can also be relevant under conditions where the mitochondrial function is impaired, such as in diabetes and cardiovascular diseases.

    First a pilot study was made to evaluate the nitrate reducing effect from the antibacterial mouthwash. The mouthwash proved very effective. The concentrations of nitrate and nitrite in saliva was analyzed by HPLC and saliva from the antibacterial treatment showed greatly reduced concentrations of nitrite and high concentrations of nitrate. Saliva from placebo mouthwash showed high concentrations of nitrite and low concentrations of nitrate as expected.

    To study the importance of oral bacteria on metabolism, we performed a randomized, cross-over double-blinded study with 19 healthy males between 22-43 years. During two separate three-day periods they used an antibacterial and placebo mouthwash, respectively. On the fourth day their basal metabolic rate (BMR) was measured with an indirect calorimetric system. Moreover, samples from saliva, urine and blood were collected but these results are not included in this thesis. An earlier, unpublished study has demonstrated that nitrate administration reduces the basal metabolic rate. Accordingly, our aim was to study potential effects on the basal metabolic rate following reduction of the number of oral bacteria by aid of antibacterial mouthwash. Our hypothesis was that the reduced availability of nitrite would decrease the availability of NO in the body and manifest as an increased basal metabolic rate.

    The results from indirect calorimetry measurements showed no significant difference between placebo and antibacterial mouthwash, but there may be confounding factors. Further study is needed to assess the potential effects on host metabolism by these bacteria.

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  • 24.
    Ahlgren, Madeleine
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Food intake, diet-related attitudes and information sources among university students2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    A series of food surveys suggest that the dietary intake among the Swedish population has changed substantially in recent years. Fat intake has increased whereas carbohydrate intake has decreased. The reason for this change is not clear but it has been suggested to be an effect of the public breakthrough of high-fat diets such as LCHF (Low Carbohydrate High Fat).

    In this study we attempt to shed light on the associations between food intake, attitudes to different diets and the information sources with regard to food, nutrition and health.

    The study is based on data collected from 311 students at the Linnaeus University, from 2015 through 2017. Food intake was identified through three-day food records using Dietist Net software. Opinions about diets, and the degree to which different sources of information were used to obtain diet-related information, were evaluated through questionnaires. Where applicable, Pearson’s correlation tests were performed in SPSS.

    In general, the students reported a low intake of iron, carbohydrates and alcohol as well as a high intake of dietary fiber, folate and selenium, relative to Nordic Nutrition Recommendations and national food surveys. Out of ten selected diets, the students ranked Nordic Nutrition Recommendations and the Mediterranean diet as the healthiest diets and the LCHF and Atkins diets as the least healthy diets. The correlation tests identified a number of associations between dietary intake and opinions about diets. Similar diets were associated to each other, such as Paleo, LCHF and Atkins diet on one hand, and Nordic Nutrition Recommendations, Vegan, Low-fat and Weight Watchers diet on the other hand. However, the Mediterranean diet, Gluten-free and 5:2 diets were associated with both low-carbohydrate diets and high-carbohydrate diets. As previous research has suggested, an association between media use and attitudes to diets which is reflected in dietary intake, can be observed. The main conclusion is that there are associations between and within reported dietary intake, information sources regarding cooking, diets and health and reported opinions regarding different diets. However, causality cannot be elucidated by this analysis.

  • 25.
    Ahlin, Ellen
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Utvärdering av dricksvattenkvaliteten i Bjuv: Kartläggning av klagomål och eftersökning av orsak2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vid bytet från grundvattentäkt till ytvattentäkt i Bjuvs kommun började klagomål om dricksvattnets kvalitet att strömma in till Nordvästra Skånes Vatten och Avlopp (NSVA), ansvarig för vattenverksamheten i kommunen. Syftet med denna studie är att kartlägga klagomålen kring dricksvattnet, ringa in problemet och eftersöka orsaken. Detta har skett genom intervjuer med konsumenter liksom vattenprovtagningar hos dessa. En geografisk spridning låg till grund vid valet av provtagningspunkterna. Utöver mikrobiologiska, kemiska och fysikaliska parametrar som inkluderas i Livsmedelsverkets föreskrifter om dricksvatten har vattnet analyserats för innehåll av geosmin, 2-metylisoborneol och 2,4,6-trikloranisol då dessa föreningar är kända för att orsaka dålig lukt och bismak på dricksvatten. Analysresultaten visar generellt på ett vatten med god kvalitet. Av de intervjuer som gjorts hos de utvalda konsumenterna framgår det dock att vattenkvaliteten inte är tillfredsställande. Det är i huvudsak vattnets lukt och smak som kritiseras där unken och mögel är den vanligaste beskrivningen. Vad denna lukt och smak beror på har inte kunnat fastställas. En kartläggning av klagomålen och definiering av problemet har dock påbörjats vilket underlättar för fortsatta studier och eventuella åtgärder.

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  • 26.
    Ahlstrand, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Metal ions in life: towards accurate computer-aided studies ofprotein-ion interactions2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The importance of ions in life sciences can not be overstated. The interaction betweenmetal ions and proteins is vital because it is involved in a variety of biological processes.The ions contribute to stability and function of proteins. Moreover, they are relevant indisease progression.Realistic computer simulations pave the way for drug development, through providingdetailed insights into the dynamics of proteins and various biological processes thatoccur in the body. Such information can be impossible to achieve through experimentsof living subjects in vivo or from test tube experiments in vitro alone. However,theoretical methods have to result in accurate predictions. In my thesis, I studieddifferent ways to handle the ions in simulations. Since the systems contain thousands ofatoms the calculations are demanding. Despite the availability of computer clusters, thecom putational capacity is not sufficient. I have examined the simplified models used insimulations of larger systems (e.g., whole proteins) to pave the way for improvements ofthe simulation models.Different ions have different effects on biochemical systems and it is important to beable to distinguish between them. Thus, from a biochemical point of view, it is centralto be able to describe their unique characteristics. Their difference can be from vital totoxic to the body. Zinc is essential and present in more than 3000 proteins in our bodyand has a very flexible interaction with proteins. This property has proved to be hard toreproduce in computer simulations. Cadmium can replace zinc, but is toxic because itdoes not have the same catalytic ability. From a modelling perspective do these ions havesimilar characteristics as they have the same ionic charge. Inclusion of more realisticelectron effects may be necessary to be able to simulate the difference.With my studies, I have contributed towards a better understanding of the interactionsbetween metal ions and proteins. I have pointed out a direction for further improvementof methods for simulations of large systems.For the same purpose, I have also studied the frequently occurring ions sodium andpotassium found as salts in all body fluids, but also lithium belonging to the same groupin the periodic table and used in therapeutic purposes. The results show that potassiumand sodium can be simulated by a commonly used computational approach, whereasmore advanced methods are required to study lithium ions accurately.Overall, the work within this thesis has explored ion-protein interactions and providedinformation about methods for energy calculations and models for molecular dynamicssimulations for some of the most important ions within biochemistry.

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  • 27.
    Ahlstrand, Emma
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Buetti-Dinh, Antoine
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Universita’ della Svizzera Italiana, Switzerland;Swiss Institute of Bioinformatics, Switzerland.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    An interactive computer lab of the galvanic cell for students in biochemistry2018In: Biochemistry and molecular biology education, ISSN 1470-8175, E-ISSN 1539-3429, Vol. 46, no 1, p. 58-65Article in journal (Refereed)
    Abstract [en]

    We describe an interactive module that can be used to teach basic concepts in electrochemistry and thermodynamics to first year natural science students. The module is used together with an experimental laboratory and improves the students’ understanding of thermodynamic quantities such as ΔrG, ΔrH, and ΔrS that are calculated but not directly measured in the lab. We also discuss how new technologies can substitute some parts of experimental chemistry courses, and improve accessibility to course material. Cloud computing platforms such as CoCalc facilitate the distribution of computer codes and allow students to access and apply interactive course tools beyond the course's scope. Despite some limitations imposed by cloud computing, the students appreciated the approach and the enhanced opportunities to discuss study questions with their classmates and instructor as facilitated by the interactive tools. 

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  • 28.
    Ahlstrand, Emma
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Hermansson, Kersti
    Uppsala University.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Interaction Energies in Complexes of Zn and Amino Acids: A Comparison of Ab Initio and Force Field Based Calculations2017In: Journal of Physical Chemistry A, ISSN 1089-5639, E-ISSN 1520-5215, Vol. 121, no 13, p. 2643-2654Article in journal (Refereed)
    Abstract [en]

    Zinc plays important roles in structural stabilization of proteins, eniyine catalysis, and signal transduction. Many Zn binding sites are located at the interface between the protein and the cellular fluid. In aqueous solutions, Zn ions adopt an octahedral coordination, while in proteins zinc can have different coordinations, with a tetrahedral conformation found most frequently. The dynainics of Zn binding to proteins and the formation of complexes that involve Zn are dictated by interactions between Zn and its binding partners. We calculated the interaction energies between Zn and its ligands in complexes that mimic protein binding sites and in Zn complexes of water and one or two amino acid moieties, using quantum mechanics (QM) and molecular mechanics (MM). It was found that MM calculations that neglect or only approximate polarizability did not reproduce even the relative order of the QM interaction energies in these complexes. Interaction energies calculated with the CHARMM-Diode polarizable force field agreed better with the ab initio results,:although the deviations between QM and MM were still rather large (40-96 kcallmol). In order to gain further insight into Zn ligand interactions, the free energies of interaction were estimated by QM calculations with continuum solvent representation, and we performed energy decomposition analysis calculations to examine the characteristics of the different complexes. The ligand-types were found to have high impact on the relative strength of polarization and electrostatic interactions. Interestingly, ligand ligand interactions did not play a significant role in the binding of Zn. Finally) analysis of ligand exchange energies suggests that carboxylates could be exchanged with water molecules, which explains the flexibility in Zn:binding dynamics. An exchange between earboxylate (Asp/Glii) and imidazole (His) is less likely.

  • 29.
    Ahlstrand, Emma
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Spångberg, Daniel
    Uppsala University.
    Hermansson, Kersti
    Uppsala University.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Interaction energies between metal ions (Zn2+ and Cd2+) and biologically relevant ligands2013In: International Journal of Quantum Chemistry, ISSN 0020-7608, E-ISSN 1097-461X, Vol. 113, no 23, p. 2554-2562Article in journal (Refereed)
    Abstract [en]

    Interactions between the group XII metals Zn2+ and Cd2+ and amino acid residues play an important role in biology due to the prevalence of the first and the toxicity of the second. Estimates of the interaction energies between the ions and relevant residues in proteins are however difficult to obtain. This study reports on calculated interaction energy curves for small complexes of Zn2+ or Cd2+ and amino acid mimics (acetate, methanethiolate, and imidazole) or water. Given that many applications and models (e.g., force fields, solvation models, etc.) begin with and rely on an accurate description of gas-phase interaction energies, this is where our focus lies in this study. Four density functional theory (DFT)-functionals and MP2 were used to calculate the interaction energies not only at the respective equilibrium distances but also at a relevant range of ion–ligand separation distances. The calculated values were compared with those obtained by CCSD(T). All DFT-methods are found to overestimate the magnitude of the interaction energy compared to the CCSD(T) reference values. The deviation was analyzed in terms of energy components from localized molecular orbital energy decomposition analysis scheme and is mostly attributed to overestimation of the polarization energy. MP2 shows good agreement with CCSD(T) [root mean square error (RMSE) = 1.2 kcal/mol] for the eight studied complexes at equilibrium distance. Dispersion energy differences at longer separation give rise to increased deviations between MP2 and CCSD(T) (RMSE = 6.4 kcal/mol at 3.0 Å). Overall, the results call for caution in applying DFT methods to metalloprotein model complexes even with closed-shell metal ions such as Zn2+ and Cd2+, in particular at ion–ligand separations that are longer than the equilibrium distances.

  • 30.
    Ahlstrand, Emma
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Zukerman Schpector, Julio
    Universidade Federal de São Carlos, Brazil.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Computer simulations of alkali-acetate solutions: Accuracy of the forcefields in difference concentrations2017In: Journal of Chemical Physics, ISSN 0021-9606, E-ISSN 1089-7690, Vol. 147, p. 1-10, article id 194102Article in journal (Refereed)
    Abstract [en]

    When proteins are solvated in electrolyte solutions that contain alkali ions, the ions interact mostlywith carboxylates on the protein surface. Correctly accounting for alkali-carboxylate interactionsis thus important for realistic simulations of proteins. Acetates are the simplest carboxylates thatare amphipathic, and experimental data for alkali acetate solutions are available and can be comparedwith observables obtained from simulations. We carried out molecular dynamics simulations of alkali acetate solutions using polarizable and non-polarizable forcefields and examined the ionacetateinteractions. In particular, activity coefficients and association constants were studied in a range of concentrations (0.03, 0.1, and 1M). In addition, quantum-mechanics (QM) based energy decomposition analysis was performed in order to estimate the contribution of polarization, electrostatics, dispersion, and QM (non-classical) effects on the cation-acetate and cation-water interactions. Simulations of Li-acetate solutions in general overestimated the binding of Li+ and acetates. In lower concentrations, the activity coefficients of alkali-acetate solutions were too high, which is suggested to be due to the simulation protocol and not the forcefields. Energy decomposition analysis suggested that improvement of the forcefield parameters to enable accurate simulations of Li-acetate solution scan be achieved but may require the use of a polarizable forcefield. Importantly, simulations with some ion parameters could not reproduce the correct ion-oxygen distances, which calls for caution in thechoice of ion parameters when protein simulations are performed in electrolyte solutions.

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  • 31.
    Ahlstrom, Christina A. A.
    et al.
    US Geol Survey, USA.
    Woksepp, Hanna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Kalmar County Region, Sweden.
    Sandegren, Linus
    Uppsala University, Sweden.
    Ramey, Andrew M. M.
    US Geol Survey, USA.
    Bonnedahl, Jonas
    Linköping University, Sweden;Kalmar County Region, Sweden.
    Exchange of Carbapenem-Resistant Escherichia coli Sequence Type 38 Intercontinentally and among Wild Bird, Human, and Environmental Niches2023In: Applied and Environmental Microbiology, ISSN 0099-2240, E-ISSN 1098-5336, Vol. 89, no 6, article id e0031923Article in journal (Refereed)
    Abstract [en]

    Carbapenem-resistant bacteria are a threat to public health globally and have been found in the environment as well as the clinic. Some bacterial clones are associated with carbapenem resistance genes, such as Escherichia coli sequence type 38 (ST38) and the carbapenemase gene bla(OXA-48). Carbapenem-resistant Enterobacteriaceae (CRE) are a global threat to human health and are increasingly being isolated from nonclinical settings. OXA-48-producing Escherichia coli sequence type 38 (ST38) is the most frequently reported CRE type in wild birds and has been detected in gulls or storks in North America, Europe, Asia, and Africa. The epidemiology and evolution of CRE in wildlife and human niches, however, remains unclear. We compared wild bird origin E. coli ST38 genome sequences generated by our research group and publicly available genomic data derived from other hosts and environments to (i) understand the frequency of intercontinental dispersal of E. coli ST38 clones isolated from wild birds, (ii) more thoroughly measure the genomic relatedness of carbapenem-resistant isolates from gulls sampled in Turkey and Alaska, USA, using long-read whole-genome sequencing and assess the spatial dissemination of this clone among different hosts, and (iii) determine whether ST38 isolates from humans, environmental water, and wild birds have different core or accessory genomes (e.g., antimicrobial resistance genes, virulence genes, plasmids) which might elucidate bacterial or gene exchange among niches. Our results suggest that E. coli ST38 strains, including those resistant to carbapenems, are exchanged between humans and wild birds, rather than separately maintained populations within each niche. Furthermore, despite close genetic similarity among OXA-48-producing E. coli ST38 clones from gulls in Alaska and Turkey, intercontinental dispersal of ST38 clones among wild birds is uncommon. Interventions to mitigate the dissemination of antimicrobial resistance throughout the environment (e.g., as exemplified by the acquisition of carbapenem resistance by birds) may be warranted.IMPORTANCE Carbapenem-resistant bacteria are a threat to public health globally and have been found in the environment as well as the clinic. Some bacterial clones are associated with carbapenem resistance genes, such as Escherichia coli sequence type 38 (ST38) and the carbapenemase gene bla(OXA-48). This is the most frequently reported carbapenem-resistant clone in wild birds, though it was unclear if it circulated within wild bird populations or was exchanged among other niches. The results from this study suggest that E. coli ST38 strains, including those resistant to carbapenems, are frequently exchanged among wild birds, humans, and the environment. Carbapenem-resistant E. coli ST38 clones in wild birds are likely acquired from the local environment and do not constitute an independent dissemination pathway within wild bird populations. Management actions aimed at preventing the environmental dissemination and acquisition of antimicrobial resistance by wild birds may be warranted.

  • 32.
    Ahlstrom, Christina A.
    et al.
    US Geol Survey, USA.
    Scott, Laura C.
    US Geol Survey, USA.
    Woksepp, Hanna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Region Kalmar County, Sweden.
    Bonnedahl, Jonas
    Linköping University, Sweden;Region Kalmar County, Sweden.
    Ramey, Andrew M.
    US Geol Survey, USA.
    Environmental antimicrobial resistance gene detection from wild bird habitats using two methods: A commercially available culture-independent qPCR assay and culture of indicator bacteria followed by whole-genome sequencing2023In: Journal of Global Antimicrobial Resistance, ISSN 2213-7165, E-ISSN 2213-7173, Vol. 33, p. 186-193Article in journal (Refereed)
    Abstract [en]

    Objectives: A variety of methods have been developed to detect antimicrobial resistance (AMR) in differ-ent environments to better understand the evolution and dissemination of this public health threat. Com-parisons of results generated using different AMR detection methods, such as quantitative PCR (qPCR) and whole-genome sequencing (WGS), are often imperfect, and few studies have analysed samples in parallel to evaluate differences. In this study, we compared bacterial culture and WGS to a culture-independent commercially available qPCR assay to evaluate the concordance between methods and the utility of each in answering research questions regarding the presence and epidemiology of AMR in wild bird habitats.Methods: We first assessed AMR gene detection using qPCR in 45 bacterial isolates from which we had existing WGS data. We then analysed 52 wild bird faecal samples and 9 spatiotemporally collected water samples using culture-independent qPCR and WGS of phenotypically resistant indicator bacterial isolates.Results: Overall concordance was strong between qPCR and WGS of bacterial isolates, although concor-dance differed among antibiotic classes. Analysis of wild bird faecal and water samples revealed that more samples were determined to be positive for AMR via qPCR than via culture and WGS of bacterial isolates, although qPCR did not detect AMR genes in two samples from which phenotypically resistant isolates were found.Conclusions: Both qPCR and culture followed by sequencing may be effective approaches for characteris-ing AMR genes harboured by wild birds, although data streams produced using these different tools may have advantages and disadvantages that should be considered given the application and sample matrix.Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

  • 33.
    Ahlström, Felicia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Säkerhet och effektivitet av hormonella preventivmedel för män2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Hormonal contraceptives for men are currently not available, the only available contraceptives for male use are currently condoms and vasectomy which are both non-hormonal. The supply for women is greater, the first hormonal contraceptive for women was approved as early as the 1960s. Several side effects have been reported since the launch. Common adverse events are weight gain, nausea, decreased libido, acne and depression. In the 1970s, studies began to be issued on male hormonal contraceptives, although there is currently no approved such product on the market. Potential hormonal contraceptives for men contain exogenous androgens as monotherapy or in combination with progestins. The goal of these contraceptives is to inhibit male spermatogenesis. A normal sperm concentration is ≥15 million spermatozoa / ml of ejaculation. To achieve contraceptive protection equivalent to that of female contraceptives, the sperm concentration should be ≤1 million spermatozoa / ml of ejaculation.

    Aim: The aim of this literature study was to investigate the efficacy and safety of potential male hormonal contraceptives.

    Method: To answer the study question, a literature study was conducted in which six articles were selected and reviewed. All articles were retrieved from the PubMed database. Of the studies selected, five were randomized and double-blind and one study was single-armed. All six studies examined the efficacy and safety of hormonal contraceptives intended for male use.

    Results: All studies included in this study show that gonadotropin levels are inhibited by the use of hormonal contraceptives. Adverse events reported were mild in all but one study which reported eight serious side effects that were thought to be related to themedication that was used in that specific study.

    Conclusion: All male hormonal contraceptives that uses exogenous androgens as monotherapy or in combination with progestins inhibit follicle-stimulating hormone (FSH) and luteinizing hormone (LH) effectively and reversibly. Further studies need to be done and these studies should preferably have a longer span than 28 days, to check how the hormonal drugs affect the sperm concentration. Treatment in all studies except one did not produce any serious side effects, indicating that hormonal contraceptives for men are safe to use. Side effects that occur in women were also common for men in these studies. However, there are several more serious side effects with female use. Longer studies with more participants are required to investigate side effects that male hormonal contraceptives may have on a long-time basis.

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  • 34.
    Ahmad Ghafour, Soz
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Kan behandling med antidepressiva läkemedel påverka sjukdomens svårighetsgrad och självmordstankar/självmordshändelser hos barn och ungdomar med egentlig depression?2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Suicide is a public health problem that, in addition to loss of human life, leads to extensive psychological suffering and impairment of the health of relatives. It is common that suicide occurs under the influence of mental illness such as personality disorders and depression. Depression is a serious condition that often causes severe suffering. Depression can affect all ages, i.e. children, adolescents, adults and the elderly and it is as costly as heart disease. In Sweden, depression is one of the most common psychiatric diagnoses. About 19 percent of the population (16-84 years) have been diagnosed with depression at least once in their lifetime.  Of these, almost one in three have been diagnosed more than once. The affected individual performs poorly in daily activities such as school, work and in social settings. Additionally, there is increased risk of suicide in depressed individuals. Accordingly, it is important to treat depression to reduce suffering. Depression in children was accepted as the same disease as in adults since 1980. Today, depression is treated primarily with first-line therapy SSRIs. The aim of this work was to examine the effect and safety of antidepressants in the treatment of major depresive disorder in chlidren and adolescents with special reference to suicidal activity and self-injury. To implement this study, scientific articles were obtained in Pubmed, and five articles were selected. Study 1 showed that the combination of fluoxetine and CBT, cognitive behavior therapy, had better effect than treatment with only flouxetin or with only CBT. Study 2 showed that suicidal events and ideation were least among the group treated with the combination of fluoxetine and CBT compared to the treatment with only fluoxetine or only CBT. Study 3 showed that more suicide-related events occurred among the group with previous non-suicidal self-injury, NSSI. Study 4 resulted in greater medical response and better remission in escitalopram patients compared to placebo. Study 5 showed that treatment with venlafaxine caused serious adverse events that led to many discontinuing treatment. Treatment with antidepressants, especially in combination with CBT, can reduce the severity of depression in children and adolescents and reduce suicidal ideation and suicide attempts in some patients. In cases of treatment failure a risk of suicide and self-injury remains. Previous self-injury increases the risk of future self-injury as well as the risk of future suicide attempts.

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  • 35.
    Airey, John
    et al.
    Stockholm University, Sweden.
    Patron, Emelie
    Linnaeus University, Faculty of Social Sciences, Department of Education and Teacher's Practice. Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Wikman, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Making the Invisible Visible: The role of undergraduate textbooks in the teaching and learning of physics and chemistry2023In: Designing futures: The 11th International Conference on Multimodality; Book of abstracts, London Conference, London: UCL , 2023Conference paper (Refereed)
    Abstract [en]

    As disciplines, undergraduate physics and chemistry leverage a particularly wide range of semiotic systems (modes) in order to create and communicate their scientific meanings. Examples of the different semiotic systems employed are: spoken and written language, mathematics, chemical formulae, graphs, diagrams, sketches, computer simulations, hands-on work with experimental apparatus, computer simulations, etc. Individual semiotic resources within this range of semiotic systems are coordinated in specific constellations (Airey & Linder, 2009) in order to mediate scientific knowledge. In this Swedish Research Council project, we are interested in the representation of scientific phenomena that cannot be seen. The question we pose is: How is scientific knowledge mediated when we cannot directly interact with the phenomena in question through our senses?  We adopt a social semiotic approach (Airey & Linder, 2017; van Leeuwen, 2005), to investigate the ways in which two phenomena—electromagnetic fields and chemical bonds—are presented in undergraduate textbooks. To do this we carried out a semiotic audit (Airey & Erikson, 2019) of eight textbooks (four in each discipline). We note that the individual resources used have a mixture of affordances—whilst the majority retain high disciplinary affordance, others are unpacked (Patron et al. 2021) providing higher pedagogical affordance. We discuss the ways in which the resources have been combined and orchestrated (Bezemer & Jewitt, 2010) in order to attempt to make visible that which is invisible, and identify a number of potential problems. In earlier work, Volkwyn et al. (2019) demonstrated how experimental work with physics devices can make the Earth’s magnetic field accessible to students through chains of transduction. Thus, we propose that encouraging transductions across the semiotic resource systems provided in textbooks may help students to experience the invisible.

    References

    Airey, J. (2006). Physics students' experiences of the disciplinary discourse encountered in lectures in English and Swedish (Licentiate dissertation, Department of Physics, Uppsala University).

    Airey, J. (2009). Science, language, and literacy: Case studies of learning in Swedish university physics (Doctoral dissertation, Acta Universitatis Upsaliensis).

    Airey, J. (2015). Social Semiotics in Higher Education: Examples from teaching and learning in undergraduate physics. In In: SACF Singapore-Sweden Excellence Seminars, Swedish Foundation for International Cooperation in Research in   Higher Education (STINT) , 2015 (pp. 103). 

    Airey, J., & Eriksson, U. (2019). Unpacking the Hertzsprung-Russell diagram: A social semiotic analysis of the disciplinary and pedagogical affordances of a central resource in astronomy. Designs for Learning, 11(1), 99-107.

    Goodwin, C. (2015). Professional vision. In Aufmerksamkeit: Geschichte-Theorie-Empirie (pp. 387-425). Wiesbaden: Springer Fachmedien Wiesbaden.

    O’Halloran, K. (2007). Mathematical and scientific forms of knowledge: A systemic functional multimodal grammatical approach. language, Knowledge and pedagogy: functional linguistic and sociological perspective, 205-236.

    Patron, E. (2022). Exploring the role that visual representations play when teaching and learning chemical bonding: An approach built on social semiotics and phenomenography(Doctoral dissertation, Linnaeus University Press).

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  • 36.
    Al Hamami, Albatol
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Har barn med autism mer magbesvär? Hur effektivt är glutenfri-diet och probiotikatillskott på autismspektrumsymtom? 2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inom begreppet autismspektrumtillståndet (AST) ingår de tre diagnoserna: Aspergers syndrom, autistiskt syndrom och atypisk autism/autismliknande tillstånd. Den rapporterade prevalensen avdessa har ökat senaste tiden och i Sverige har 1-2% en autismdiagnos. Gemensamt för individermed tillståndet är att de bearbetar information på ett annorlunda sätt. Kognitiva funktioner, socialtsamspel och kommunikation påverkas bland annat. De bakomliggande orsakerna till AST ärfortfarande oklara. En effektiv behandling för AST finns inte i nuläget. Det har rapporterats att barn med autismspektrumtillståndet har skillnader i mikrobiotisk sammansättning jämfört med individersom inte har AST. Det finns även en del studier som tyder på att näringsrelaterade faktorer kan haen effekt på dess symtom. Syftet med denna litteraturstudien var att med vetenskapliga artiklar delsundersöka om barn med AST lider mer av gastrointestinala (GI) besvär än andra barn, samt attundersöka vilken effekt en glutenfri-diet och probiotikatillskott har på AST-symtom. Den härstudien avser jämföra och utvärdera hur effektiva dessa två behandlingsalternativ är på att behandla AST-symtom. Resultaten i denna litteraturstudie visade att GI-symtom förekom mer hos barn medAST. Glutenfri-diet hade effekt på en del barn och skillnader observerades i stereotypa beteenden,kommunikation och social interaktion före och efter intervention. Probiotikatillskott hade viss effekt på en del barn på autismsymtom. Resultatet visade bland annat nominell reduktion i problemrelaterade till kommunikation och social interaktion och beteenden som hyperaktivitet och ångestmed probiotiska tillskottet PS128. Slutsatsen är att observerade GI-symtom inte är autismspecifika och det finns inte tillräckligt med bevis för att en glutenfri-diet gynnar barn inom spektrumet och probiotikatillskott kan ge olika effekter enligt de undersökta studierna.

  • 37.
    Al-Asafi, Zainab
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Förekomst av Mycobacterium avium i vattenprover från barns närmiljö: med fokus på badleksaker2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Mycobacteria are gram-positive bacteria belonging to the Mycobacteriaceae family. There are more than 50 different species of the mycobacteria which can cause diseases in humans, the most important one being M. tuberculosis. Non-tuberculous mycobacteria are also called environmental mycobacteria. Some species can survive in areas with very low amounts of nutrients along with aquatic areas, such as water, dirt, swamps, and marshes. Some environmental mycobacteria are pathogenic and can cause diseases in humans and animals. They are mostly opportunistic pathogens, i.e. they infect humans with an already weakened immune system or humans who suffer from chronic diseases. Two species of mycobacteria named Mycobacterium avium avium and Mycobacterium avium hominissuis belong to the subgroup Mycobacterium avium complex (MAC). Healthy children between the ages of 1 and 5 are an exposed group to MAC-infections. When these children are infected with MAC, they develop an inflammation in the lymph nodes (Lymphadenitis) in the neck area. Since no direct transmission between humans has been established, it has been speculated that the MAC-bacteria take a different route to reach and infect adults and children with lymphadenitis. It has been hypothesized that MAC infect humans through nature and drinking water.

    The purpose of this study was to develop a method to detect the occurrence of M. avium bacteria in tap water from Öland, Kalmar, and Hultsfred, incubated in rubber ducks. The purpose was also to investigate experimentally if M. avium can survive and/or thrive in a rubber duck environment. The methods which have been evaluated in the study were cultivation followed by detection by MALDI-TOF and also triplex q-PCR.  

    The study was done on clean (new) and contaminated (used) rubber ducks with tap water from Öland, Kalmar, and Hultsfred, where some rubber ducks were injected with known strains from M. avium avium and M. avium hominissuis and incubated for five weeks. DNA was extracted from the water and biofilm samples from each rubber duck, for further analysis with q-PCR. Furthermore, a culture from the same water samples was made on nutritious agar for later detection by MALDI-TOF.

    The results of this study using q-PCR showed detection of the bacteria M. avium avium and M. avium hominissuis in all the samples. A possible, and believable, reason for this could be that the extraction solutions used in this study were contaminated. However, the study show that the mycobacteria survive in rubber duck environment.

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  • 38.
    Al-Assadi, Obaidah
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Järnbristanemi och behandlingsmetoder: Jämförelse av effektivitet och säkerhet av intravenösa och orala järnbehandlingar av järnbristanemi vid graviditet och postpartum hos kvinnor.2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Oxygen is transported in the body from the lungs to tissues while bound to hemoglobin in erythrocytes. Specifically in hemoglobin it is the iron atom that binds the oxygen. Synthesis of erythrocytes place iron, folic acid and vitamin B12. A lack of these compounds leads to anemia.

    Anemia affects about 1/3 of the world's population. It is defined as lower-than-normal levels of healthy erythrocytes and deprives the body's tissues of oxygen. The most common form of anemia is caused by iron deficiency. Iron deficiency occurs in two forms, absolute or functional iron deficiency. Absolute iron deficiency is central for this study. Absolute iron deficiency implies low or empty iron storages which can cause iron deficiency anemia. This occurs in the event of, among other factors, increased demand for iron, reduced iron content in the food, malabsorption or chronic bleedings. Approximately 1.2 billion people have iron deficiency anemia worldwide. The most common side effects are headache, paleness, fatigue and dyspnea. During pregnancy the need for iron triples to be able to support the mother's increase of blood plasma, erythrocytes, the growth of the fetus and the placenta and to compensate for the blood loss during childbirth. If you have low or empty iron stores before pregnancy, you are at risk for iron deficiency anemia. Iron deficiency anemia in pregnant women increases the risk of prematurity, low birth weight and miscarriage. The risk of maternal mortality has a direct correlation with the severity of iron deficiency anemia. If iron deficiency anemia is left untreated, the newborn has an increased risk of suffering from iron deficiency anemia and also a negative impact on the cognitive development. When treating iron deficiency anemia, oral iron is the primarily treatment but in more severe cases intravenous iron is given.

    The objective of this study was to compare the efficacy and safety of intravenous and oral iron treatment for iron deficiency anemia in pregnancy and postpartum women.

    The method used consists of several searches on Pubmed where six clinical studies that fit the aim of this report were chosen.

    The results from all these articles indicate that intravenous treatment of iron deficiency anemia is more effective at increasing Hb values ​​and iron storages with increased compliance and fewer side effects. The iron preparation that was most promising was ferric carboxymaltose.

    Although this study had several limitations that could have been improved by using more homogeneous clinical studies, the results from all six studies favored the intravenous treatment over the oral treatment. However, all pregnant women should take oral iron supplements early on as a preventive measure in the first trimester to avoid developing iron deficiency anemia. Intravenous iron should be used as a last resort in more severe types of anemia, malabsorption and to increase compliance.

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    Järnbristanemi och behandlingsmetoder
  • 39.
    Al-Dires, Hanoaf
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Graviditet i samband med underfunktion i sköldkörteln2022Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Backgrond: The thyroid is a hormone-producing endocrine gland which is located in the front of the throat. The thyroid gland tissue contains several microscopic and spherical cavities called follicles. Thyroid hormones thyroxine (T4) and triiodothyronine (T3) are produced from the follicle cells and regulated by a so-called three-hormone sequence. Thyroid stimulating hormone (TSH) is the second hormone in the sequence and is produced from the pituitary gland. During pregnancy, the thyroid gland produces a greater amount of hormone to cater the needs of the mother and her offspring. When the gland produces too little hormone, it is called hypothyroidism. The disease causes symptoms such as chills, dryness, depression, and hair loss. The disease is divided into different types depending on the underlying cause of the disease. It is called primary hypothyroidism when disorders are in the thyroid gland itself and secondary when the problem is elsewhere in the body, usually in the hypothalamus. Hypothyroidism during pregnancy increases the risk of obstetric complications and can also lead to reduced IQ development in the fetus. Levothyroxine is a synthetic T4 and is used as a first-line drug in the treatment of hypothyroidism.

    Aim: The aim of this study was to investigate whether treatment with levothyroxine in subclinical hypothyroidism in pregnancy reduces the risk of pregnancy complications and also to analyze how thyroid autoimmunity and subclinical hypothyroidism affect the pregnant woman.

    Method: The work is a literature study conducted using six relevant published articles retrieved from the medical database and the search engine PubMed.

    Results: The studies 2,4,5 concluded that subclinical hypothyroidism and thyroid autoimmunity increase the risk of pregnancy complications. Studies 1 and 6 could not show any connection between these groups. Levothyroxine treatment in pregnancy with TSH value greater than 4 mIU/L is effective and leads to reduced risk of miscarriage, admission to neonatal wards and premature birth. In addition, the studies showed that the levothyroxine treatment in patients with TSH value less than 4mIU/L is without any significant effect.

     

    Conclusion: The evidence at present, is unclear and there is insufficient data to determine the efficacy of treatment in patients with TSH levels below 2.5 mIU / L. More and larger clinical randomized controlled trials in pregnant women with subclinical hypothyroidism and positive for thyroperoxidase antibodies are needed to increase the validity of the treatment. In contrast, levothyroxine treatment in mothers with a TSH level in serum greater than 4 mIU / L is effective and of significant importance for both the woman and her offspring. 

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  • 40.
    Aldén, Erik
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Livsstilsförändringar vid fetma: En litteraturstudie som undersöker livsstilsförändringar samt hur täta kontakter påverkar följsamheten2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Obesity has become one of our times most endemic disease on a global scale and changes to lifestyle is the most cost-effective way to treat patients, when the cost for healthcare related treatment is staggeringly high for obesity and sequela diseases NAFLD, diabetes typ 2, dyslipidaemia and metabolic syndrome.The problem with this remedy is that it requires work and dedication. But changes require hard work, and in this patient group- low compliance, weight gain after treatment, dropping out of programs and small desire to change are the most common problems. Motivational studies report that readiness in obese patients is low and the best way to help patients to move forward is by motivational conversations. The obesity sequela disease NAFLD is an asymptomatic disease it displays no symptoms until very late stages. Therefore it’s a problem to get patients make the patient understand his illness and the seriousness of it.

    Aim: This literature work was aimed at investigating compliance in lifestyle changes in obese subject and to see if close contact with healthcare staff affected the achieved results.

    Method: In this literature study, the databases Pubmed, Science Direct, Medline and Sportdiscus were used to find information. Article inclusion criteria were that the articles were not older than 10 years and were in English.

    Result: Frequent and regular contacts between participants and professional staff provided good results both with regard to weight loss, biochemical response, and the participants' willingness to change. Also it shows that return visits at least every three months will improve weight loss if the participant is motivated to implement a change to lifestyle.

    Conclusion: Overall, this literature study shows the difficulties with lifestyle changes in people with obesity and sequela NAFLD. Close contacts of the patients with healthcare staff has proven to have a positive impact on treatment compliance, but there are other lifestyle difficulties in these patient groups which hamper compliance. 

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    Erik Aldén examensarbete
  • 41.
    Alexandersson, Sandra
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Akutpreventivmedel: Hur skiljer sig effektivitet och säkerhet för de tre godkända metoderna levonorgestrel, ulipristal och kopparspiral?2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I Sverige är abort en laglig rättighet och det finns flera godkända metoder för regelbunden antikonception. Ändå finns ett behov av akutmetoder för att förhindra oönskad graviditet.  Det finns tre godkända akutpreventivmedelsmetoder; levonorgestrel, ulipristal och kopparspiral. Detta arbetes syfte var att undersöka effektivitet och säkerhet för dessa tre godkända metoder. En litteratursökning gjordes i databasen PubMed,  7 artiklar valdes ut för analys. Artikel 1och 2 undersökte levonorgestrels effektivitet och säkerhet och kunde redovisa graviditetsfrekvenser på 0, 57%  och 0,67 % , samt en graviditetsförebyggande effektivitet på 68 %. Artikel 3 jämförde ulipristal och levonorgestrel och redovisade graviditetsfrekvenser på 1,8 % för ulipristal och 2,6 % för levonorgestrel. Även ”non-inferiority” konstaterades med OR på 0,68. Artikel 4 undersökte levonorgestrels effektivitet och redovisade graviditetsfrekvenser på 2,0 % (12 h- gruppen) och 1,9 % (24 h- gruppen), dessutom redovisades en graviditetsförebyggande effektivitet på 72 % (12 h- gruppen) och 75 % (24 h- gruppen). Artikel 5 jämförde ulipristal och levonorgestrel och fann att ulipristalbehandling  är ”non-inferiority” till levonorgestrelbehandling. Artikel 6 undersökte ulipristals effektivitet och redovisade en graviditetsfrekvens på 2, 1 % och en graviditetsförebyggande effektivitet på  62, 3%. Artikel 7 undersökte kopparspiralens effektivitet och kunde redovisa 100 % graviditetsförebyggande effektivitet. Akutpreventivmedel fungerar inte alltid, men förhindrar oönskade graviditeter. Slutsatsen är att resultaten ger stöd för gällande behandlingsrekommendationer.

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  • 42.
    Alfawaz, Maya
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Akne: Kan dosreduktion av isotretinoin minskabiverkningar och samtidigt ge god effekt mot olikasvårighetsgrader till akne?2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Isotretinoin är en av de mest använda vid behandling av medelsvår till svår akne. Läkemedlet används främst när mildare behandlingar såsom lokalbehandling och antibiotika inte är tillräckligt aktiva vid behandling av akne. Nittio procent av alla tonåringar i världen lider av akne som kallas just för akne vulgaris. En tredjedel av tonåringar lider av just måttlig och svår akne och behöver därför behandlas med ett effektivt behandling.

    Flera vetenskapliga studier har bekräftat att standarddos (0,5 -1,0 mg/kg/dag) av isotretinoin är den mest effektiva behandling vid akne. Däremot har studierna bekräftat att behandlingen med standarddos isotretinoin leder till allvarliga biverkningar såsom teratogena effekter (fosterskador) och därför väljer en stor del av patienterna att inte behandlas med standarddos isotretinoin.

    Syftet med detta arbete var att undersöka om ersättning av standarddos isotretinoin (0,5-1,0 mg/kg/dag) med lågdos isotretinoin (0,2-0,4mg/kg/dag) som monoterapi eller i kombination med en annan behandling såsom laser som kan minska svårighetsgraden av akne och samtidigt minska av biverkningar. 

    Fem vetenskapliga studier som besvarar studiens frågeställningar har valts med hjälp av databasen Pubmed. Alla fem studier visade att lågdos isotretinoin är effektiv behandling vid måttlig till svår akne. Färre biverkningar noterades vid användning av lågdos isotretinoin (0,25-0,5 mg/kg/dag) jämfört med standarddoser (0,5-1 mg/kg/dag).

    Slutsatsen som dras från detta litteraturarbete är att lågdos isotretinoin (< 0,5 mg/kg/dag) är en effektiv och säker behandling vid mild till svår akne. Färre biverkningar noterades vid användning av låg dos isotretinoin jämfört med standard dos isotretinoin (0,5-1 mg/kg/dag) som ger allvarliga biverkningar. Lågdos isotretinoin, både som monoterapi och som kombinationsbehandling har visat sig vara lika effektiv som standarddos. 

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  • 43.
    Alhasan, Reem
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Effekter av ketamin i behandling av depression2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Depression is a mental illness that can affect young people, adults and the elderly population. The disease is characterized by one or more episodes with negative thoughts and reduced cognitive function. Other symptoms that are also common can include feelings of worthlessness, sleep disorders and suicidal thoughts. Depression occurs in three different degrees of severity; mild-, moderate – and severe depression. The condition can be treated with psychological-, pharmacological – or ECT-treatment depending on the severity and type of symptoms. About one third of patients are still diagnosed as suffering from depression despite trying the different available treatment methods. These patients have treatment-resistant depression (TRD), and they have a higher risk of committing suicide. The drug ketamine belongs to the group of anesthetic drugs, but later it has been discovered that it can act as an antidepressant in low doses. It occurs as two enantiomers, (S)-ketamine and (R)-ketamine. The (S)-enantiomer is the isomer with the highest potency and the (R)-enantiomer is the one with the lower potency. (S)-ketamine (esketamine) leads to less hallucinations compared to (R)-ketamine. Ketamine is an N-methyl-D-aspartate (NMDA)-receptor antagonist. It acts by blocking NMDA receptors in the brain. Previous studies have shown that ketamine can provide a rapid antidepressant effect in the treatment of people with TRD. The purpose of this study was to investigate whether ketamine is effective enough in the treatment of people with TRD. Randomized controlled trials (RCTs) were searched for in the Pubmed database. Five RCTs was selected to be further analyzed in order to answer the question. Two studies were dose-response tests, one study examined the effect of intravenous ketamine in comparison with another drug, midazolam, one study examined the effect of intranasal esketamine with placebo and one study compared intravenous esketamine with placebo. In summary, the results showed statistically significant improvement and the severity of the depression in patient with TRD was reduced after 24 hours compared with placebo. The treatment response was defined as > 50 % reduction in symptom score using the MADRS. The effect of the treatment with ketamine and esketamine was compared with placebo, and the results were statistically significant in the five selected studies. The proportion of patients that showed response to treatment varied between 38 % - 67 %. This was compared to the response in the placebo group that varied between 0 % - 18 %, and with the response for midazolam that was 28 %. In addition, a lower dose of ketamine or esketamine was better in terms of tolerance and caused fewer side effects compared to higher doses. According to the results, ketamine was shown to have a good treatment effect against TRD, but more research is needed with a larger number of participants and for longer periods of time in order to be able to more reliably assess its antidepressant effects and to be able to answer the question regarding the effectiveness of treatment. (R)-ketamine has a certain antidepressant effects but can lead to higher incidence of hallucinations compared to (S)-ketamine, which seems to be a better alternative as racemic ketamine contains 50 % (R)-ketamine which also has a narcotic effect. 

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  • 44.
    Ali Ghani, Hawraa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Funktionella studier av VEGFR2-bindande affibody-molekyler kovalent konjugerade till spindelsilke2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Spider silk and its mechanical properties are today well-recognized. Obtaining sufficient amount of spider silk from spiders is complicated, therefore a method to produce recombinant spider silk fusion protein (4RepCT) has been developed. 4RepCT has biocompatible properties and can be used as a scaffold for cell cultures. Fibronectin, (FN) is a glycoprotein found in the extracellular matrix containing peptides that stimulate cell adherence. 4RepCT can be genetically coupled to a FN-peptide (FN-4RepCT). The vascular endothelial growth factor receptor-2 (VEGFR-2) is found on endothelial cell which are activated by VEGF-polypeptides. This initiates growth of existing blood vessels which can be observed in cancerous diseases and therefore VEGFR-2 is an attractive and promising target in cancer research. During this study transgenic cells that overexpress VEGFR-2, 293/KDR were used.

    The aim of the study is to examine the functionality and bioactivity of VEGFR-2-binding affibody molecules after their conjugation with 4RepCT and FN-4RepCT.

    Alamar Blue and the biochemical assay ELISA were used to examine cell proliferation/viability and phosphorylation respectively. Cell proliferation of 293/KDR was analyzed in wells coated initially with 4RepCT followed by one extra coating of the following affibody molecules: Zdimer-4RepCT, Ztetramer-4RepCT, FN-4RepCT, ZDimer-FN, Ztetramer-FN-4RepCT and 4RepCT. Phosphorylation was examined of 293/KDRs VEGFR-2 cultures on the mentioned coatings using ELISA.

    293/KDRs highest proliferation value was obtained on Ztetramer-FN-4RepCT. Zdimer-FN-4RepCT had a lower cell proliferation than Ztetramer-FN-4RepCT. The phosphorylation results showed that the affibody-molecule Ztetramer-4RepCT has a stronger effect on VEGFR-2 in comparison to the Zdimer-4RepCT. The conclusion was drawn that Ztetramer coupled to 4RepCT with or without FN may impose an inducive effect upon VEGFR-2 although further studies need to be conducted.

  • 45.
    Ali, Lara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Metadon eller buprenorfin vid farmakologisk behandling av opioidberoende?: Effekt och säkerhetsaspekter2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Opioids are the general term for substances with affinity for opioid receptors that produce morphine-like effects including sedation, pain relief, muscle relaxation and euphoria. All opioids have addictive effects that account for a global substance abuse problem. Development of opioid dependence is associated with three neurobiological changes; positive effects of the drug such as euphoria, negative effects such as abstinence and cravings which cause a continuously drug intake. With continuously intake of opioids, an imbalance occurs in the physiological balance created by the brain reward system and anti-reward system, which results in opioid dependence. At diagnosis, ICD-10 and DSM-V are used and the treatment consists of pharmacological substitution treatment with buprenorphine or methadone combined with psychological and psychosocial treatment. Buprenorphine is a partial opioid agonist and methadone is an opioid agonist, and both reduce cravings and withdrawal symptoms. Substitution treatment with methadone includes risk of overdose, respiratory depression and leakage to illegal drug sales. In comparison, buprenorphine includes a lower risk of respiratory depression and developing drug dependence. 

    Aim: In this literature study, the aim was to evaluate and compare the clinical efficacy and safety of buprenorphine and methadone as maintenance treatment for diagnosed opioid dependence. 

    Method: The present study was based on five clinical trials obtained from the PubMed database with the keywords “opioid dependence”, “buprenorphine” and “methadone”. Retention, substance use and adverse effects were evaluated for all five clinical trials.

    Results: The results showed that all drugs effectively decreased substance use. Patients receiving higher doses of methadone or buprenorphine were more likely to obtain at least 12 consecutive opioid negative urine samples than patients receiving lower doses. Both drugs effectively retained patients in treatment, however, methadone was seen to retain patients more effectively. Several cases of detoxification occurred during treatment with buprenorphine. Otherwise, the drugs were well tolerated and no serious adverse effects occurred. 

    Conclusion: All drugs effectively decreased opioid use, managed to retain patients in treatment and were well tolerated. Due to the fact that buprenorphine has a better safety profile than methadone, buprenorphine should be given as a first-line drug in the substitution treatment of opioid dependence. Initially, the dosage of buprenorphine should be adjusted according to the patient’s clinical status, as this is considered important for retention to treatment. Transition to methadone should be possible for patients who have not been successfully stabilized by buprenorphine. This treatment strategy is in accordance with current used guidelines. Most detoxification cases occurred in the buprenorphine treatment group probably due to insufficient dosing of buprenorphine. Further studies are needed to evaluate the relationship between dosage and retention, substance use and adverse effects. 

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  • 46.
    Ali, Najma Suad
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Metodverifiering av fria lätta kedjor (kappa och lambda) i humant serum, S-FLC.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Immunoglobulins are proteins produced by plasma cells and humans normally produce five different immunoglobulin classes of IgG, IgA, IgM, IgD and IgE. The basic function of the immunoglobulins is to counteract the invasion of pathogenic organisms by their antibody activity and to protect against its toxic products. The basic structure of the immunoglobulins is made up of two identical heavy chains and two light chains, kappa and lambda. In healthy subjects, normal plasma cell contents of the bone marrow are 1-3 %, in patients with multiple myeloma (MM), concentrations increase to over 90 % and are comprised of a malignant transplanted plasma cell clone. This clone of cells produces a kind of immunoglobulin that can be detected using various laboratory methods in both serum and urine. Analysis of free light immunoglobulin chains (kappa and lambda) in human serum occurs in the diagnosis and follow-up of MM and provides a simpler and faster alternative to daily urine collection for the analysis of light immunoglobulin chains in the urine.

    The purpose of the study was to carry out a method verification of free light chains in serum using an automated immunochemical instrument, BN Prospec II from Siemens, which uses the nephelometric measuring principle (antigen-antibody complex). The calibration concentrations of kappa and lambda assigned by Siemens were met. The method's stability and precision were measured by analyzing high and low controls for both analytes in each of the internal and total series. Within the series received CV 1,47 % for SL1 kappa and 2,57 % for SL2 kappa, and 1,77 % for SL1 lambda and 2,57 % for SL2 lambda. The total series was obtained CV 1,58 % for SL1 kappa and 2,81 % for SL2 kappa and CV 2,05 % for SL1 lambda and 2,30 % for SL2 lambda. The correctness of the method was studied through a patient comparison where 64 patient samples previously analyzed in Lund were analyzed in Kalmar. The study showed good precision and repeatability, the results of the patient comparison showed good correspondence with corresponding methods performed in Lund when the coefficient of determination for S-FLC-kappa was 0, 999 and 0, 958 for S-FLC-lambda. The conclusion is that analysis of free light chains in serum can be used in routine operation in the laboratory for clinical chemistry and transfusion medicine at the county hospital in Kalmar.

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    S-FLC i humant serum
  • 47.
    Alimjanova, Aziza
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Hur vanligt är det med terapimisslyckande med SSRI-preparat?2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 48.
    Alizadeh, Seddike
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Association mellan långtidsbehandling av takrolimus och ökad risk för cancer vid atopisk dermatit2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Background: Tacrolimus (Tac) is mainly used as an immunosuppressive drug through oral treatment after organ transplantation, especially liver transplantation and kidney transplantation. Tac is administered as a second-line treatment for moderate and severe atopic dermatitis through topical treatment with two different strengths 0.1% and 0.03%. It has long been controversial whether Tac is carcinogenic and whether it can affect the cell cycle.

    The aim: The study intends to report if the occurrence of cancer cases is linked to the long-term use of Tac for the treatment of atopic dermatitis

    Method and material: The degree project was carried out as a literature study where four clinical studies were analyzed. The four scientific studies were retrieved from the PubMed database with the keywords "tacrolimus cancer development" and "tacrolimus atopic dermatitis".

    Results: The results from the four clinical studies that investigated the cancer risk after exposure to Tac in the treatment of atopic dermatitis showed that Tac slightly increases the risk of skin cancer. One of the studies showed that Tac increases the risk of T-cell lymphoma, use of Tac and T-cell lymphoma resulted in HR=3.13 (95%CI, 1.41 to 6.94), (P = 0.005). Study number three conducted in children showed that Tac did not increase the risk of cancer among children. In study number four, it appeared that incidence rate (IR) increased for all lymphomas and cutaneous T-cell lymphoma (CTCL) increased as the Tac dose increased. In study number one, 13 study participants were diagnosed with non-melanoma skin cancer (NMSC) among 4761 adults. Patients with fair skin and aged over 50 years had a higher potential to suffer from NMSC.  

    Conclusion: The selected studies showed that the cancer risk with topical application of Tac for atopic dermatitis treatment is low, but there is still a small risk because the systemic exposure increases as the body surface and area of application increases.  

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    Takrolimus
  • 49.
    Alkadour, Nesren
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Har högdos, intradermalt influensavaccintillräckligt god effekt, immunogenicitet ochsäkerhet hos äldre?: En litteraturstudie om effekten, immunogeniciteten och säkerhetav högdos influensavaccin och intradermal injektion hos äldre.2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    There are four different types of influenza virus: A, B, C and D which cause influenza.Generally, influenza virus A, B and C infects humans. Rarely, influenzavirus D occursin humans, but it often infects animals. The influenza virus consists of a viral RNAenclosed in a capsid surrounded by an envelope, which has different surface structures,hemagglutinin (H) and neuramindase (N). Based on these surface structures,influenzavirus is classified into different subtypes.Vaccination is the most effective way to fight influenza. Although influenza affectsindividuals of all ages, the elderly are most vulnerable to serious complications.The intradermal (ID) administration of a high-dose inactivated trivalentinfluenzavaccine (IIV3-HD), is a new strategy that could improve the antibody responsein the elderly.This study examined whether a IIV3-HD vaccine might give higher safety,immunogenicity and efficacy compared to a standard-dose (IIV3-SD) vaccine for theprevention of laboratory-confirmed influenza illness in older adults, and examinedwhether HD-ID is a suitable vaccination strategy for the elderly compared to SD orstandard dose intramuscular (SD-IM) vaccine.The PubMed database was used to search for studies.The chosen studies weremulticenter, randomized, controlled trials. Three of them aimed to assess IIV3-HDcompared to IIV3-SD, and two evaluated the administration of the vaccine via the IDroute. 

    The results from the five studies showed that Hemagglutination Inhibition (HAI) titersand seroprotection rates were significantly higher in the IIV3-HD group than in theIIV3-SD group. No major difference was demonstrated as regards to the safety profilebetween the two groups. In addition, the number of patients who had laboratoryconfirmed influenza illness was less in the IIV3-HD compared to the IIV3-SD group.Both HD and ID administration are presented as suitable vaccination strategies for theelderly compared to SD or standard dose intramuscular (SD-IM) vaccines.The conclusion from the first three studies is that high-dose, inactivated trivalentinfluenza vaccine has better efficacy, immunogenicity and safety in the elderlycompared to standard dose of trivalent influenza vaccine, further from the last twostudies that intradermal administration of vaccine and high-dose vaccine had betterimmunogenicity and tolerance when used compared with the SD-IM vaccine.

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  • 50.
    Alkashaf, Zeinab
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Kognitiv beteendeterapi som behandlingsmetod vid Anorexia nervosa2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Anorexia nervosa is characterized by a strong focus on body weight and a strong desire to lose weight. The disease leads to extreme anxiety and constant thoughts about diet and body weight. Currently, there are still no clear guidelines and scientific evidence for the treatment of Anorexia Nervosa with a special method. The evidence for the effectiveness of different treatments is weak and lacks empirical support. Therefore, there is a need to document and study the effectiveness of existing treatment methods for Anorexia Nervosa. Aim: The study aims to study the efficacy of CBT in the treatment of Anorexia nervosa. Method: A literature study was conducted where five studies about CBT as treatment and it’s efficacy for Anorexia nervosa was studied. Result: CBT as a single treatment at Anorexia Nervosa leads to an increase in BMI and a decrease in the eating disorder's psychopathology. Conclusion: CBT is a potent treatment that can be used advantageously in the treatment of Anorexia nervosa, but further research is needed in the field with, among other things, several studies comparing CBT with other treatment methods.

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