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Central venous catheter misplacement is common (approximately 7%) after right subclavian vein catheterisation. To avoid it, ultrasound-guided tip navigation may be used during the catheterisation procedure to help direct the guidewire towards the lower superior vena cava. We aimed to determine the number of central venous catheter misplacements when using the right supraclavicular fossa ultrasound view to aid guidewire positioning in right infraclavicular subclavian vein catheterisation. We hypothesised that the incidence of catheter misplacements could be reduced to 1% when using this ultrasound technique. One -hundred and three adult patients were prospectively included. After vein puncture and guidewire insertion, we used the right supraclavicular fossa ultrasound view to confirm correct guidewire J-tip position in the lower superior vena cava and corrected the position of misplaced guidewires using real-time ultrasound guidance. Successful catheterisation of the right subclavian vein was achieved in all patients. The guidewire J-tip was initially misplaced in 15 patients, either in the ipsilateral internal jugular vein (n = 8) or in the left brachiocephalic vein (n = 7). In 12 patients it was possible to adjust the guidewire J-tip to a correct position in the lower superior vena cava. All ultrasound-determined final guidewire J-tip positions were consistent with the central venous catheter tip positions on chest X-ray. Three out of 103 catheters were misplaced, corresponding to an incidence (95%CI) of 2.9 (0.6–8.3) %. Although the hypothesis could not be confirmed, this study demonstrated the usefulness of the right supraclavicular fossa ultrasound view for real-time confirmation and correction of the guidewire position in right infraclavicular subclavian vein catheterisation. (Less)

Listeria monocytogenes causes the foodborne illness listeriosis, which exhibits high fatality among people in risk groups. The incidence of listeriosis has increased in Europe, which raises concerns about L. monocytogenes occurrence in foodstuffs. Ready-to-eat seafood products are considered particularly risky vehicles. Poor hygiene at processing facilities predisposes them to L. monocytogenes contamination, which can be controlled by stringent self-checking system measures. We examined the association of fish-processing plant operational and hygiene practices with the occurrence of L. monocytogenes in vacuum-packaged gravad (cold-salted) and cold-smoked salmon and rainbow trout products. Product sampling of 21 fish-processing plants was carried out, and operational procedures relating to L. monocytogenes control were surveyed using an in-depth risk assessment questionnaire. L. monocytogenes occurred only in sliced and mainly in gravad products of seven fish-processing plants. Shortages in preventive measures were discovered predominantly among the L. monocytogenes positive fish-processing plants. Using generalized linear modeling, we identified the following features associated with L. monocytogenes product contamination: the number of processing machines, deficiencies in the processing environment and machinery sanitation, and staff movement from areas of low toward high hygiene. Furthermore, performing frequent periodic thorough sanitation alongside everyday sanitation practices associated with a decreased risk of product contamination.

Cell replacement is a long-standing and realistic goal for the treatment of Parkinsonʼs disease (PD). Cells for transplantation can be obtained from fetal brain tissue or from stem cells. However, after transplantation, dopamine (DA) neurons are seen to be a minor component of grafts, and it has remained difficult to determine the identity of other cell types. Here, we report analysis by single-cell RNA sequencing (scRNA-seq) combined with comprehensive histological analyses to characterize intracerebral grafts from human embryonic stem cells (hESCs) and fetal tissue after functional maturation in a pre-clinical rat PD model. We show that neurons and astrocytes are major components in both fetal and stem cell-derived grafts. Additionally, we identify a cell type closely resembling a class of recently identified perivascular-like cells in stem cell-derived grafts. Thus, this study uncovers previously unknown cellular diversity in a clinically relevant cell replacement PD model. What happens to cells on engrafting into the brain in animal models to treat Parkinson’s disease is unclear. Here, the authors use scRNA-seq to examine ventral midbrain (VM)-patterned human embryonic stem cells after functional maturation in a pre-clinical rat model for Parkinson’s disease and identify perivascular-like cells.

Analyses of gene expression in cells affected by neurodegenerative disease can provide important insights into disease mechanisms and relevant stress response pathways. Major symptoms in Parkinson’s disease (PD) are caused by the degeneration of midbrain dopamine (mDA) neurons within the substantia nigra. Here we isolated neuromelanin-positive dopamine neurons by laser capture microdissection from post-mortem human substantia nigra samples recovered at both early and advanced stages of PD. Neuromelanin-positive cells were also isolated from individuals with incidental Lewy body disease (ILBD) and from aged-matched controls. Isolated mDA neurons were subjected to genome-wide gene expression analysis by mRNA sequencing. The analysis identified hundreds of dysregulated genes in PD. Results showed that mostly non-overlapping genes were differentially expressed in ILBD, subjects who were early after diagnosis (less than five years) and those autopsied at more advanced stages of disease (over five years since diagnosis). The identity of differentially expressed genes suggested that more resilient, stably surviving DA neurons were enriched in samples from advanced stages of disease, either as a consequence of positive selection of a less vulnerable long-term surviving mDA neuron subtype or due to up-regulation of neuroprotective gene products.

Insomnia is highly prevalent among adolescents with psychiatric conditions and is known to aggravate psychiatric symptoms. Research on cognitive behaviour therapy for adolescents with comorbid insomnia (CBT-I) is still limited. The aim of this study was to investigate feasibility and preliminary effects of internet-delivered CBT for adolescents with insomnia comorbid to a psychiatric condition. Twenty-one patients (13–17 years) with comorbid insomnia were recruited from Child and Adolescent Psychiatry. All patients received 7 weeks of internet-delivered CBT-I with therapist support. Outcomes were assessed at baseline, post-treatment, and at a 4-month follow-up. The proportion of completed assessments was overall acceptable. Participants on average completed 4.48 ( sd = 1.97) of the seven treatment modules and therapists on average spent 12.80 minutes ( sd = 6.23) per patient and week. Results showed large statistically significant improvements on insomnia severity, sleep efficiency, sleep onset latency and sleep quality. Medium to large improvements were also seen on the psychiatric symptoms of depression, obsessive-compulsive symptoms, interpersonal sensitivity, paranoid ideation and psychoticism. These findings indicate that internet-delivered CBT is feasible and potentially promising for improving sleep and reducing psychiatric symptoms in adolescent psychiatric patients with insomnia and co-morbid psychiatric disorders. A larger randomised trial is warranted to verify these preliminary results.

The long-term time trends of atmospheric pollutants at eight Arctic monitoring stations are reported. The work was conducted under the Arctic Monitoring and Assessment Programme (AMAP) of the Arctic Council. The monitoring stations were: Alert, Canada; Zeppelin, Svalbard; Stórhöfði, Iceland; Pallas, Finland; Andøya, Norway; Villum Research Station, Greenland; Tiksi and Amderma, Russia. Persistent organic pollutants (POPs) such as α- and γ-hexachlorocyclohexane (HCH), polychlorinated biphenyls (PCBs), α-endosulfan, chlordane, dichlorodiphenyltrichloroethane (DDT) and polybrominated diphenyl ethers (PBDEs) showed declining trends in air at all stations. However, hexachlorobenzene (HCB), one of the initial twelve POPs listed in the Stockholm Convention in 2004, showed either increasing or non-changing trends at the stations. Many POPs demonstrated seasonality but the patterns were not consistent among the chemicals and stations. Some chemicals showed winter minimum and summer maximum concentrations at one station but not another, and vice versa. The ratios of chlordane isomers and DDT species showed that they were aged residues. Time trends of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) were showing decreasing concentrations at Alert, Zeppelin and Andøya. The Chemicals of Emerging Arctic Concern (CEAC) were either showing stable or increasing trends. These include methoxychlor, perfluorohexane sulfonic acid (PFHxS), 6:2 fluorotelomer alcohol, and C9-C11 perfluorocarboxylic acids (PFCAs). We have demonstrated the importance of monitoring CEAC before they are being regulated because model calculations to predict their transport mechanisms and fate cannot be made due to the lack of emission inventories. We should maintain long-term monitoring programmes with consistent data quality in order to evaluate the effectiveness of chemical control efforts taken by countries worldwide.

Aims and objectives To describe potential risks for patient safety incidents in the radiology department from a radiographer's perspective. Background A radiology department is a high-tech environment with high communication activity between different healthcare systems in combination with a large patient flow. Risks for patient safety incidents exist in every phase of a radiological examination. Due to the nature of the activity, a radiology department needs to have its own range of measures to prevent risks linked to radiology. Design A qualitative descriptive design. Methods Semi-structured interviews were carried out with 17 radiographers during the period September 2015 to February 2016. The data were analysed using conventional content analysis. This study followed the COREQ checklist criteria for the reporting of qualitative research. Results The analysis yielded 20 different patient safety incidents that could result in the following six types of healthcare-associated harm: Patients could be exposed to unnecessary radiation; patients could receive an inaccurate diagnosis; patients could incur drug-induced damage; patients could suffer direct physical injury; or, their examination and treatment could be delayed or not carried out; or, their general health condition could deteriorate. Conclusion Lack of communication and knowledge, both internally and externally, can increase risks for patient safety incidents. The study describes a complex chain of activities that represent risks in the radiology department. It needs to be pointed out that it is not always the activities in the radiology department that cause the harm. Relevance to clinical practice To carry out preventive patient safety work, a comprehensive analysis of the entire care chain is required. Patient safety work should also focus on improvement in communication both internally, within the radiology department, and externally. Standardised methodological guidelines, consistent prescriptions of method from the radiologist and a good working environment are internal success factors for patient safety at the radiology department.

The article follows the journey of one text, Thirst (1948), a modernist short story composite or cycle by Birgit Tengroth, into Ingmar Bergman’s 1949 film of the same title, and further into the no ...

Polychlorinated biphenyls (PCBs) can be used as chemical sentinels for the assessment of anthropogenic influences on Arctic environmental change. We present an overview of studies on PCBs in the Arctic and combine these with the findings from ArcRisk—a major European Union-funded project aimed at examining the effects of climate change on the transport of contaminants to and their behaviour of in the Arctic—to provide a case study on the behaviour and impact of PCBs over time in the Arctic. PCBs in the Arctic have shown declining trends in the environment over the last few decades. Atmospheric long-range transport from secondary and primary sources is the major input of PCBs to the Arctic region. Modelling of the atmospheric PCB composition and behaviour showed some increases in environmental concentrations in a warmer Arctic, but the general decline in PCB levels is still the most prominent feature. ‘Within-Arctic’ processing of PCBs will be affected by climate change-related processes such as changing wet deposition. These in turn will influence biological exposure and uptake of PCBs. The pan-Arctic rivers draining large Arctic/sub-Arctic catchments provide a significant source of PCBs to the Arctic Ocean, although changes in hydrology/sediment transport combined with a changing marine environment remain areas of uncertainty with regard to PCB fate. Indirect effects of climate change on human exposure, such as a changing diet will influence and possibly reduce PCB exposure for indigenous peoples. Body burdens of PCBs have declined since the 1980s and are predicted to decline further., Environmental Science and Pollution Research, ISSN:0944-1344, ISSN:1614-7499

Animal products are highly nutritious, but also highly perishable. In India milk is an important source of animal protein, but problems with low quality of the milk, high degrees of adulterated milk on the market, high bacterial loads, and sometimes presence of zoonotic pathogens persist. Most dairy farmers in India are resource-poor small-holders, often with limited knowledge about the importance of food safety and hygiene. Milk quality problems including adulteration and bacterial contamination is common in the country. This paper describes a training intervention for improved food safety in Guwahati, Assam, India, conducted in 2009–2013. The training was designed to be short, simple and customized, cheap to deliver, easily accessible, and accompanied by incentives to bring change in knowledge, attitude and practices (KAP). In 2014 three outcomes were assessed: changed KAP; milk production; and, mastitis prevalence. Selected food safety hazards were also assessed, although their management had not been included in training. We found evidence of improved KAP among trained farmers, 14% higher milk production, and a tendency towards less mastitis, but no effects on food safety hazard levels. This study shows that a training intervention can have a medium-term impact, while the issue of food safety is more complex and cannot be assumed to automatically follow from even successful training.

Introduction Breast cancer is the leading cause of death for middle-aged women in Sweden. Approximately 600,000 women are surveyed annually within the national screening program. However, 20% of Swedish women do not participate in mammography screening. Participation in mammography screening is a complex phenomenon that has many dimensions. The aim of this study was to explore the reasons why women refrain from mammography screening from the perspective of non-attending women. Method A qualitative approach was chosen, and 10 women were interviewed. The interviews were analysed using qualitative content analysis. Results Two categories were identified: individual needs and absence of active promotion. "Non-personalized system" was the main theme that emerged from the analysis. Conclusion The mammography screening does not adapt to the needs of each individual. This may be the reason why some women refrain from mammography screening.

Vacuum-packaged cold-salted and cold-smoked fish products are considered typical vehicles for Listeria monocytogenes, the causative agent of the food-borne disease listeriosis, which is increasingly prevalent in the European Union. Efficacy of both the fish processing plant self-checking system and official food control conducted by authorities are crucial for L. monocytogenes prevention in the processing of these risky products. However, the impact of official control on L. monocytogenes prevention in the processing of fish products has not been extensively studied. We investigated the occurrence, control measures, and correction of non-compliances predisposing to L. monocytogenes in Finnish fish processing plants. The following features were associated with L. monocytogenes occurrence: (a) frequency of non-compliances concerning processing machinery, (b) recurrence of non-compliances, and (c) frequency of non-compliances for which official control measures were requested by inspecting authorities. Official control of fish processing plants had focused on risky areas, but non-compliances were common and their correction exhibited deficiencies. We conclude that L. monocytogenes prevention in fish processing can be enhanced by strengthening official food control measures and processing plant compliance. In particular, timely correction of all food safety violations must be improved.

Introduction The expansion of the radiography profession in recent decades has widened the scope of radiographic practice. This has raised questions about which trends have had an impact on the profession over the years. The study aim was to explore trends that have influenced the radiography profession over the last four decades. Methods A qualitative design was used. Eleven focus group interviews inspired by the Scenario Planning Method were conducted at 11 diagnostic radiology departments in public hospitals in Sweden. The target group consisted of 48 registered radiographers. To analyse the data, qualitative content analysis was used. Results Thematic data analysis revealed three broad categories; technological development and radiation doses, current status of the radiography profession and specialisation leading to expert knowledge. Each category derived from two or three sub-categories. Conclusion The results demonstrate significant trends of influences on the radiography profession in Sweden over the last four decades. New methods and technology and control of radiation doses have had a favourable effect on the development of the radiography profession. Nevertheless, current status such as shortage of radiographers has had an adverse way. Specialisation leading to expert knowledge has an influence on career advancement and a specialist education regulated by the law, might be a prerequisite for the development of the radiography profession.

Since the pioneering studies using fetal cell transplants in Parkinson’s disease (PD), brain repair by cell replacement has remained a long-standing and realistic goal for the treatment of neurodegenerative disorders including PD. Authentic and functional midbrain dopamine (DA) neurons can now be generated from human pluripotent stem cells (hPSCs) via a floor plate intermediate1,2, and these cell preparations are both safe and functional when transplanted to animal models of PD3. However, although resulting grafts from fetal brain tissue and hPSCs contain large numbers of desired DA neurons, these therapeutic cells are a minor component of the grafts. Moreover, the cellular composition of the graft has remained difficult to assess due to limitations in histological methods that rely on pre-conceived notions concerning cell types. Here, we used single cell RNA sequencing (scRNA-seq) combined with comprehensive histological analyses to characterize intracerebral grafts from ventral midbrain (VM)-patterned human embryonic stem cells (hESCs) and VM fetal tissue after long-term survival and functional maturation in a pre-clinical rat model of PD. The analyses revealed that while both cell preparations gave rise to neurons and astrocytes, oligodendrocytes were only detected in grafts of fetal tissue. On the other hand, a cell type closely resembling a class of newly identified perivascular-like cells was identified as a unique component of hESC-derived grafts. The presence of these cells was confirmed in transplants from three different hESC lines, as well as from iPSCs. Thus, these experiments have addressed one of the major outstanding questions in the field of cell replacement in neurological disease by revealing graft composition and differences between hESC- and fetal cell-derived grafts, which can have important implications for clinical trials.

Aims and objectives The overall aim of the study was to illuminate the patients' lived experiences of waiting for and undergoing an endovascular aortic repair (EVAR) in a hybrid operating room (OR). Background The hybrid OR is an example of the technological advancements within hospitals. The environmental impact on humans is well recognised but is rarely taken into account when hospitals are designed or rebuilt. The patient's experience of a hybrid OR is not earlier described. Design A qualitative design based on hermeneutic phenomenology was implemented. Methods Interviews were conducted with 18 patients. A thematic interpretation based on van Manen's approach was then used to analyse the findings. The consolidated criteria for reporting qualitative studies (COREQ) were used (Data S1). Results The following three themes emerged from the interviews: (a) being scheduled for surgery induced both anxiety and hopefulness; (b) feeling watched over and surrendering to others in the technology intense environment and (c) feeling relief but unexpected exhaustion after surgery. In the discussion, the results were additionally reflected upon out from the four lifeworld existentials: lived body, lived space, lived time and lived others. Conclusions The hybrid OR technology did not frighten the patients, but it was also not an environment that promoted or was conductive to having a dialogue with the staff. The disease and surgery brought feelings of anxiety, which was largely associated with the uncertainty of the situation. We suggest that continuity in contact with staff and patient-centred information could be solutions to further calm the patients. Relevance to clinical practice The hybrid OR environment itself did not seem to frighten the patient, but the way the high-tech environment increased the distance between the patient and the multiple staff members needs further investigation.

High power laser pulses can be a threat to optical sensors, including the human eye. Traditionally this threat has been alleviated by colour filters that block radiation in chosen wavelength ranges ...

Norovirus (NoV) gastroenteritis outbreaks appear frequently in food service operations (FSOs), such as in restaurants and canteens. In this study the presence of NoV and adenovirus (AdV) genomes was investigated on the surfaces of premises, especially in kitchens, of 30 FSOs where foodborne gastroenteritis outbreaks were suspected. The objective was to establish a possible association between the presence of virus genomes on surfaces and a visual hygienic status of the FSOs. NoV genome was found in 11 and AdV genome in 8 out of 30 FSOs. In total, 291 swabs were taken, of which 8.9% contained NoV and 5.8% AdV genome. The presence of NoV genomes on the surfaces was not found to associate with lower hygiene level of the premises when based on visual inspection; most (7/9) of the FSOs with NoV contamination on surfaces and a completed evaluation form had a good hygiene level (the best category). Restaurants had a significantly lower proportion of NoV-positive swabs compared to other FSOs (canteens, cafeteria, schools etc.) taken together (p = 0.00014). The presence of a designated break room for the workers was found to be significantly more common in AdV-negative kitchens (p = 0.046). Our findings suggest that swabbing is necessary for revealing viral contamination of surfaces and emphasis of hygiene inspections should be on the food handling procedures, and the education of food workers on virus transmission. Electronic supplementary material The online version of this article (doi:10.1007/s12560-017-9291-7) contains supplementary material, which is available to authorized users.

Introduction Early use of automated external defibrillators (AED) increases survival in cases of out-of-hospital cardiac arrest (OHCA). Dispatchers play important roles in identifying OHCA, dispatching ambulances and providing callers with telephone-assisted cardiopulmonary resuscitation. Guidelines recommend that AED registries be linked to dispatch centres as tools to refer callers to nearby AED. Aim The aim of this study was to investigate to what extent dispatchers, when provided with a tool to display AED locations and accessibility, referred callers to nearby AED. Methods An application providing real-time visualization of AED locations and accessibility was implemented at four dispatch centres in Sweden. Dispatchers were instructed to refer callers to nearby AED when OHCA was suspected. Such cases were prospectively collected, and geographic information systems were used to identify those located ≤100 m from an AED. Audio recordings of emergency calls were assessed to evaluate the AED referral rate. Results Between February and August 2014, 3009 suspected OHCA calls were received. In 6.6% of those calls (200/3009), an AED was ≤100 m from the suspected OHCA. The AED was accessible and the caller was not alone on scene in 24% (47/200) of these cases. In two of those 47 cases (4.3%), the dispatcher referred the caller to the AED. Conclusion Despite a tool for dispatchers to refer callers to a nearby AED, referral was rare. Only a minority of the suspected OHCA cases occurred ≤100 m from an AED. We identified AED accessibility and callers being alone on scene as obstacles for AED referral.

Cell replacement is a long-standing and realistic goal for the treatment of Parkinsonʼs disease (PD). Cells for transplantation can be obtained from fetal brain tissue or from stem cells. However, after transplantation, dopamine (DA) neurons are seen to be a minor component of grafts, and it has remained difficult to determine the identity of other cell types. Here, we report analysis by single-cell RNA sequencing (scRNA-seq) combined with comprehensive histological analyses to characterize intracerebral grafts from human embryonic stem cells (hESCs) and fetal tissue after functional maturation in a pre-clinical rat PD model. We show that neurons and astrocytes are major components in both fetal and stem cell-derived grafts. Additionally, we identify a cell type closely resembling a class of recently identified perivascular-like cells in stem cell-derived grafts. Thus, this study uncovers previously unknown cellular diversity in a clinically relevant cell replacement PD model., What happens to cells on engrafting into the brain in animal models to treat Parkinson’s disease is unclear. Here, the authors use scRNA-seq to examine ventral midbrain (VM)-patterned human embryonic stem cells after functional maturation in a pre-clinical rat model for Parkinson’s disease and identify perivascular-like cells.

This study aimed to set up methodology to monitor parasite-specific T-cell activation in vitro using Eimeria tenella-infected chickens. A sonicated E. tenella sporozoite protein preparation was used for the activation of chicken spleen cell cultures. Proliferation assessed by 3H-thymidin incorporation or blast transformation of T-cells assessed by immunofluorescence labelling and flow cytometry were used as read-outs for activation. Results showed that E. tenella-specific proliferation was detected in cultures of spleen cells collected in a ‘window’ between 8 and 14 days after primary infection. However, due to high variation in proliferative responses between individuals and to high background proliferation, large numbers of observations were needed to obtain significant results. Moreover, the outcome was not improved by increasing the infection dose to chickens or by depletion of T-cell receptor (TCR) γ/δ expressing cells from cultures. An E. tenella-specific blast transformation response was observed for TCRα/β expressing cells within the same ‘window’, confirming the identity of the responding cells as classic T-cells. Thus, it is possible to study the kinetics of E. tenella-specific T-cell responses in vitro. However, more in-depth phenotypic identification of the responding T-cells could improve the methodology.

The advancement in high-throughput sequencing technology and bioinformatics tools has spurred a new age of viral discovery. Arthropods is the largest group of animals and has shown to be a major reservoir of different viruses, including a group known as insect-specific viruses (ISVs). The majority of known ISVs have been isolated from mosquitoes and shown to belong to viral families associated with animal arbovirus pathogens, such as Flaviviridae, Togaviridae and Phenuiviridae. These insect-specific viruses have a strict tropism and are unable to replicate in vertebrate cells, these properties are interesting for many reasons. One is that these viruses could potentially be utilised as biocontrol agents using a similar strategy as for Wolbachia. Mosquitoes infected with the viral agent could have inferior vectorial capacity of arboviruses resulting in a decrease of circulating arboviruses of public health importance. Moreover, insect-specific viruses are thought to be ancestral to arboviruses and could be used to study the evolution of the switch from single-host to dual-host. In this review, we discuss new discoveries and hypothesis in the field of arboviruses and insect-specific viruses.

Background: Radiography as a concept has mainly been associated with the functional role of the radiographer. The concept has been studied from a theoretical point of view. However, there is a lack of a theoretical foundation and research on the actual substance of the term radiography used in education. It is therefore important to undertake an investigation in order to determine how students after three years education understand the subject of radiography. Aim: The aim of this study was to analyse how students in the Swedish radiographers' degree program understand the concept of radiography. Method: A concept analysis was made according to the hybrid model, which combines theoretical, fieldwork and analytical phases. A summative content analysis was used to identify the number and content of statements. The empirical data were collected from questionnaires answered by radiography students at four universities in Sweden. Findings: All radiography students' exemplified radiography with statements related to the practical level although some of them also identified radiography at an abstract level, as a subject within a discipline. The attribute ‘An interdisciplinary area of knowledge’ emerged, which is an attribute on the

Background Peripheral Arterial Disease (PAD) often caused by atherosclerosis is a major health care issue worldwide. Percutaneous Transluminal Angioplasty (PTA) on the lower limb is a common procedure used to enhance peripheral circulation. With an increasing number of individuals acquiring peripheral PTA treatment and with an increased focus on patient centred care, there is a need to find out more about patients' feelings and thoughts of undergoing PTA. Aim The aim was to identify patients who are predominantly anxious or calm during and after peripheral PTA and to explore reasons for these feelings. Method The study includes 51 patients who received PTA treatment in western Sweden. Findings Seventy-eight percent of the patients rated themselves as calm after the PTA. The analysed interviews resulted in two themes: reasons for feelings of calmness and reasons for feelings of anxiety. Conclusion In order to feel calm during and after the PTA, information given prior to the PTA needs to be comprehensive and consistent with the actual situation at the angiography suite. The dialogue with the physician and the radiographers was considered valuable, as was the ability to follow the procedure on the image screen. It is concluded that a thorough dialogue with the physician in a calm setting after the PTA is important for the patients' ability to foresee and plan for the future. Moreover, there is a need to find ways to improve analgesic routines regarding assessment and evaluation in connection with PTA treatment as pain is shown to increase anxiety.

We present our latest experimental results on V-agent Raman scattering in the middle UV. The Raman scattering was examined using a pulsed tunable laser based spectrometer system. Neat droplets of the agents were placed on a silicon surface and irradiated with sequences of laser pulses. The Raman scattering was examined as a function of laser wavelength and accumulated exposure with a reduced level of exposure per pulse compared to our earlier investigations.

The rapid development within Interventional Radiology presents new challenges. Hybrid operating rooms consist of interventional radiology, open surgery, computed tomography, magnetic resonance imaging and other techniques. This means that several disciplines and professionals need to work in new constellations creating a multidisciplinary team around the patient. In accordance with this development, higher professional education must provide new pedagogic strategies to successfully address the knowledge expected in today's complex working life.To explore the use of Applied Drama as a learning medium, focusing on the use of Forum Theatre, to foster team work and collaboration in the field of radiography and learning.A qualitative approach, closely related to Ethnography, was utilized.The Drama Workshop utilising Forum Theatre created a dynamic learning environment and enabled the participants from three professions to understand each other's priorities better. The use of drama within health care education allows the students to take different roles in order to find the best way to co-operate.Forum Theatre is a useful learning medium in order to promote teamwork and collaboration in the radiological intervention field. By choosing a personal working experience, Forum Theatre seem to engage the participants at a deeper level and to experience various communication strategies and how the outcome changed depending on the approach. This can lead to improved teamwork and collaboration.

Summary The purpose of this study was to monitor local cytokine responses to Dictyocaulus viviparus in calves during primary infection and re-infection. Bronchoalveolar lavage fluid (BALF) was collected weekly from experimentally infected calves and interleukin-2 (IL-2), IL-4, IL-5, IL-10 and IFN-γ mRNA expression was quantified in BALF cells. The major finding was a prominent transient increase in IL-4 mRNA expression, compared with that of uninfected calves, observed in BALF cells collected 2–3 weeks post-primary D. viviparus infection. At 2 weeks post-infection, macroscopic worms were also first observed in BALF. Calves re-infected after 10 weeks were partially immune which was evident at slaughter 5 weeks post-infection as a lower worm burden than in previously naive calves infected at the same time. IL-4 mRNA expression in BALF cells 2 weeks post-re-infection was increased compared with that of uninfected animals but not as high as that of primarily infected calves. BALF cell expression of the other cytokines tested for was not as clearly effected by the D. viviparus infection. It seems likely that the strong IL-4 response observed during primary infection reflects an innate response to the worms that may initiate an ensuing Th2 response, which confers protective immunity.

Temporal trends of Persistent Organic Pollutants (POPs) measured in Arctic air are essential in understanding long-range transport to remote regions and to evaluate the effectiveness of national and international chemical control initiatives, such as the Stockholm Convention (SC) on POPs. Long-term air monitoring of POPs is conducted under the Arctic Monitoring and Assessment Programme (AMAP) at four Arctic stations: Alert, Canada; Stórhöfði, Iceland; Zeppelin, Svalbard; and Pallas, Finland, since the 1990s using high volume air samplers. Temporal trends observed for POPs in Arctic air are summarized in this study. Most POPs listed for control under the SC, e.g. polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethanes (DDTs) and chlordanes, are declining slowly in Arctic air, reflecting the reduction of primary emissions during the last two decades and increasing importance of secondary emissions. Slow declining trends also signifies their persistence and slow degradation under the Arctic environment, such that they are still detectable after being banned for decades in many countries. Some POPs, e.g. hexachlorobenzene (HCB) and lighter PCBs, showed increasing trends at specific locations, which may be attributable to warming in the region and continued primary emissions at source. Polybrominated diphenyl ethers (PBDEs) do not decline in air at Canada's Alert station but are declining in European Arctic air, which may be due to influence of local sources at Alert and the much higher historical usage of PBDEs in North America. Arctic air samples are screened for chemicals of emerging concern to provide information regarding their environmental persistence (P) and long-range transport potential (LRTP), which are important criteria for classification as a POP under SC. The AMAP network provides consistent and comparable air monitoring data of POPs for trend development and acts as a bridge between national monitoring programs and SC's Global Monitoring Plan (GMP).

The contribution of three candidate genes to the variation in meat tenderness was tested in muscle samples from 243 pure-bred, young, beef bulls of Angus, Charolais, Hereford, Limousin and Simmental breeds, raised in Swedish commercial herds. The animals were genotyped for single nucleotide polymorphisms (SNPs) in the calpain 1 (CAPN1), calpastatin (CAST) and leptin genes. The frequent calpain 1 CAPN1:c.947G>C G allele showed an unfavourable association with tenderness. The calpastatin CAST:c.155C>T T allele, which was the most common allele, showed a favourable association with Warner–Bratzler shear force (WBSF) and compression tests. An association was observed between the leptin UASMS2C>T SNP and compression tests.

Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format.Ninety-nine participants (mean age = 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n = 32), ACT (n = 35), or a control condition (monitored Internet discussion forum; n = 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up.Mixed-effects linear regression analysis of all randomized participants showed significant effects on the primary outcome (Tinnitus Handicap Inventory) for CBT and for ACT compared with control at posttreatment (95% CI [-17.03, -2.94], d = 0.70, and 95% CI [-16.29, -2.53], d = 0.68, respectively). Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments (95% CI [-44.65, -20.45], d = 1.34), with no significant difference between treatments (95% CI [-14.87, 11.21], d = 0.16).Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus. The Internet can improve access to psychological interventions for tinnitus.

A wide range is carried out in catheterization laboratories in radiological departments everyday. In Sweden, the nurse radiographers are usually responsible for patient care, medical technical equipment, and sterility during interventional radiology. The competence of a nurse radiographer is mainly equated with that of registered nurses. The aim of this qualitative study was to describe nurse radiographers' experiences of caring for patients undergoing radiological interventions at the catheterization laboratories. The study is based on individual interviews analyzed using a hermeneutic approach. "Sensing and responding to the patient" was the main theme that appeared in this study from the radiographers' descriptions of their encounters with patients undergoing radiological intervention. The meaning of this main theme is based on four themes; creating a trusting atmosphere, creating a dialogue, dealing with unpredictable outcomes, and dealing with pain and agony.

BACKGROUND: Obesity is associated with accumulation of macrophages in white adipose tissue (WAT), which contribute to the development of insulin resistance. Germ-free (GF) mice have reduced adiposity and are protected against diet-induced obesity, OBJECTIVE: To investigate whether the gut microbiota and, specifically, gut-derived lipopolysaccharide (LPS) promote WAT inflammation and contribute to impaired glucose metabolism. METHOD: Macrophage composition and expression of proinflammatory and anti-inflammatory markers were compared in WAT of GF, conventionally raised and Escherichia coli-monocolonised mice. Additionally, glucose and insulin tolerance in these mice was determined. RESULTS: The presence of a gut microbiota resulted in impaired glucose metabolism and increased macrophage accumulation and polarisation towards the proinflammatory M1 phenotype in WAT. Monocolonisation of GF mice for 4 weeks with E.coli W3110 or the isogenic strain MLK1067 (which expresses LPS with reduced immunogenicity) resulted in impaired glucose and insulin tolerance and promoted M1 polarisation of CD11b cells in WAT. However, colonisation with E.coli W3110 but not MLK1067 promoted macrophage accumulation and upregulation of proinflammatory and anti-inflammatory gene expression as well as JNK phosphorylation. CONCLUSION: Gut microbiota induced LPS-dependent macrophage accumulation in WAT, whereas impairment of systemic glucose metabolism was not dependent on LPS. These results indicate that macrophage accumulation in WAT does not always correlate with impaired glucose metabolism.

Summary The aims of this study were to investigate the presence of genetic variation for susceptibility to pathogen-specific mastitis and to examine whether haplotypes of an identified quantitative trait locus with effect on unspecific mastitis resistance had different effects on specific mastitis pathogens. Bacteriological data on mastitis pathogens were obtained from the diagnostic laboratory at the Swedish National Veterinary Institute. The data were mainly from subclinical cases of mastitis but also clinical cases were included. Variance components were estimated for incidence of the six most frequent pathogens using Markov Chain Monte Carlo methodology via Gibbs sampling. Genetic variation for susceptibility to pathogen-specific mastitis was higher compared to estimates of general resistance to clinical mastitis in most other studies. However, because of the non-random nature of data collection, comparisons to other studies should be made by caution. The effect of haplotype on the risk of being infected by a given mastitis pathogen, relative to other pathogens, was studied using an allele substitution model. Although there were no significant haplotype substitution effects on the resistance to any of the six mastitis pathogens, there was a significant difference between the effects of two of the haplotypes regarding the risk of acquiring a Streptococcus dysgalactiae infection.

Knowledge of the prevalence of different human papillomavirus (HPV) types in young girls is important for the early detection of changes in HPV prevalence, e.g. due to HPV vaccines. The purpose of this study was to obtain information on the prevalence of 24 different genital HPV types in a group of sexually active young women (aged 15-23 y) attending a major youth healthcare centre in Stockholm, before the introduction of public HPV vaccination of young women in the autumn of 2010. A total of 615 women were analyzed for 24 different, mainly high-risk HPV (HR-HPV) types using multiplex polymerase chain reaction and Luminex technology. A high HPV prevalence in this cohort was demonstrated, particularly with regard to HPV16, but also to all included HR-HPV types. Of the 544 successfully analyzed samples from non-vaccinated individuals, 70% were positive for the HPV types assayed for, and 62% were positive for HR-HPV types. Over a third (34.7%) of the women were infected with HPV16, and a high frequency of infections with HR-HPV types 51 (10.7%), 18 (10.1%), 52 (9.9%) and 73 (9.4%) was also observed. At least 9 different non-vaccine HR-HPV types were present with a prevalence of6% in this selected group of young women.

Ninety-nine individual milk samples from 37 cows in lactation week 10–35, selected for producing well or poorly/non-coagulating milk, were compared regarding protein composition, total calcium content, casein micelle size, pH, and coagulating properties after addition of 0·05% CaCl2. The results showed that a low κ-casein concentration in milk was a risk factor for non-coagulation. CaCl2 addition improved coagulating properties (coagulation time, curd firmness) of nearly all samples and eliminated differences between poorly/non-coagulating and well-coagulating milk, particularly regarding curd firmness. A second, independent data set with 18 non-coagulating or well-coagulating milk samples were analysed for protein composition, where indications of a similar association with κ-casein was observed.

The oxidative process in milk fat, resulting in spontaneous oxidized off-flavour (SOF), is commonly assumed to depend on contents of pro- and antioxidants in milk and availability of fatty acids acting as their substrate. An important antioxidant in milk is α-tocopherol whereas the most potent prooxidant is the metal ion copper. The separate effects of α-tocopherol, copper, and milk fatty acid profile, and their combined effect on SOF development were examined in milk from 44 multiparous cows fed different roughage types and different amounts of dietary, unsaturated fat. A clear association between concentrations of copper and poly-unsaturated fatty acids in milk and the risk for developing SOF was found. Heritability estimates suggest that occurrence of SOF is partly under genetic control which indicates that milk quality may be compromised if breeding bulls are selected that carry genotypes predisposing for milk prone to develop SOF.

The incidence of spontaneous oxidized flavor (SOF) is commonly assumed to be dependent on the combination of substrate supply and contents of pro- and anti-oxidants in milk. A total of 142 cows in the experimental herd at the Swedish University of Agricultural Sciences were included, 87 of the Swedish Red breed and 55 of the Swedish Holstein breed. Altogether 893 milk samples were analyzed for milk composition, copper content, and milk flavor. Milk copper concentration was highest in early lactation and during the spring period. Oxidative off-flavor was most common during the first 3 weeks of lactation. However, when adjusting for copper concentration the odds ratio for incidence of SOF was instead highest in lactation weeks 14–39. The higher incidence of SOF during the first 3 weeks of lactation is proposed to be a consequence of the high copper concentration in milk during this period.

Purpose Bladder exstrophy is a congenital malformation of the bladder occurring in about 1 in 35 000 newborns. A few cases of bladder exstrophy patients have been described to carry chromosomal aberrations and in addition the recurrence risk in higher among relatives of bladder exstrophy cases than in the general population. This speaks in favour of a genetic contribution to the pathogenesis of bladder exstrophy. Material and Methods We have performed array-CGH analysis of 36 Swedish bladder exstrophy patients in order to look for submicroscopic chromosomal aberrations. Results The analysis revealed a 22q11.21 microduplication in two unrelated cases with bladder exstrophy and hearing impairment consistent with the recently described 22q11.2 microduplication syndrome. This finding was confirmed by multiplex ligation-dependent probe amplification (MLPA) and FISH analysis. Subsequent MLPA analysis of this chromosomal region in 33 bladder exstrophy patients did not reveal any deletion/duplication within this region. MLPA analysis of 171 anonymous control individuals revealed one individual carrying this microduplication. Conclusions Chromosomal rearrangements of 22q11.2 are implicated in several genomic disorders i.e. DiGeorge/velocardiofacial- and cat-eye syndrome. Deletions within this chromosomal region are relatively common while duplications of 22q11.2 are much less frequently observed. An increasing number of reports of microduplications of this region describe a highly variable phenotype. This is the first report of 22q11.2 microduplication associated with bladder exstrophy and hearing impairment. The finding of one carrier among a cohort of normal controls further highlights the variable phenotype linked to this microduplication syndrome.

Hypoxia-induced modifications of HSPG may be of relevance for the development of atherosclerotic lesions and tumor progression. Macrophages are recruited and retained in hypoxic sites in atherosclerotic lesions and tumors. Furthermore, macrophages are suggested to be a major source of HSPG synthesis in atherosclerotic lesions. HSPG are, among other things, known to regulate cell motility, cell adhesion, and receptor interaction. The aim of this study was to investigate the effect of hypoxia on HSPG expression and macrophage motility. We also explored the potential regulation of HSPG by the transcription factor HIF-1α. The nondirected cell motility was increased in HMDM after 24 h exposure to hypoxia (0.5% O2) compared with normal cell culture condition (21% O2). Enzymatic degradation of HS GAG further increased the motility of the HMDM in hypoxia, indicating a role of reduced cell-associated HSPG in the increased HMDM motility. HMDM exposed to 24 h of hypoxia had lower mRNA expressions of syndecan-1 and −4 compared with cells exposed to normal cell culture conditions. Protein levels of syndecan-1 were also decreased significantly in response to hypoxia, and cells subjected to hypoxia had lower mRNA expression for key enzymes involved in HS biosynthesis. In addition, hypoxia was found to reduce the relative content of HS GAG. Transfecting THP-1 cells with siHIF-1α indicated that this transcription factor was not involved in the hypoxia-induced modifications of HSPG expression. Given the documented multiple functions of HSPG in macrophage behavior, the hypoxia-induced modifications of HSPG may be of relevance for the development of atherosclerotic lesions and tumor progression.

Adult Dictyocaulus viviparus homogenate induced proliferation of lymphocytes from naïve cattle. We characterized the responding cells by carboxyfluorescein diacetate succinimidyl ester (CFSE) loading, for detection of proliferation, and antibody labelling for cell surface molecules. Lymphocytes expressing CD4, CD8 and gamma/delta TCR, rather than Ig expressing cells, proliferated after in vitro stimulation with D. viviparus homogenate. Of gamma/delta TCR expressing cells, both CD8, WC1.1 and WC1.2 co-expressing cells proliferated. Moreover, gamma/delta T cells expressing MHC class II proliferated to a higher extent than those negative for MHC class II. Of CD4 and CD8 expressing lymphocytes, both those co-expressing CD45R and CD45R0 proliferated. Among CD4 expressing lymphocytes, those that were CD45R0 positive had a larger proportion of proliferated cells than did CD45R positive cells. Compared to stimulation with Con A, the proportion of dividing cells after D. viviparus stimulation was smaller although the cells had divided more times. Furthermore, we also compared in vitro responses of peripheral blood mononuclear cells collected before and after two subsequent infections with D. viviparus, but no clear acquired responses could be detected. Overall, this suggests that most T lymphocytes are stimulated by the D. viviparus homogenate rather than any particular lymphocyte subpopulation.

Acyl-CoA:diacylglycerol acyltransferase 1 (DGAT1) is a key enzyme in triacylglycerol synthesis in the mammary gland, and the corresponding gene has emerged as a strong candidate for the variation in milk fat percentage. In this study, the allele frequencies and effects of the DGAT1 K232A variants in the Swedish dairy breeds Swedish Red and Swedish Holstein were investigated. A total of 239 cows, 143 of the Swedish Red breed and 96 of the Swedish Holstein breed, in the experimental herd at the Swedish University of Agricultural Sciences were genotyped for the DGAT1 polymorphism. The Swedish Red cows in the herd belonged to 1 of 2 selection lines with high or low milk fat percentage, respectively, but with similar high total milk energy production. The frequency of the K variant was found to be significantly greater in the high-fat line than in the low-fat line. The average frequency of the K variant in the 2 lines of the Swedish Red cows was 0.09 compared with 0.12 among the Swedish Holstein cows. Mixed model analysis was used to estimate the effect of the DGAT1 K232A polymorphism based on 16,866 test-day records for milk production traits. In accordance with previous studies, the most pronounced effects were found for fat and protein percentages and milk yield; and the K variant was associated with an increase in milk fat and protein percentages but less milk yield compared with the A variant. Less pronounced effects were found for yields of fat and protein for which the K variant was associated with greater fat yield but less protein yield.

Aims: Acid and heat tolerance of 17 persistent and 23 nonpersistent Listeria monocytogenes strains, recovered from three meat-processing plants, were investigated. Methods and Results: The isolates were genotyped by pulsed-field gel electrophoresis and categorized into persistent strains according to the frequency of the strain and duration of the contamination. The persistent and nonpersistent strains were challenged to acidic conditions (pH 2·4 for 2 h, 1 mol l−1 HCl were used to acidify the suspension) and to heat (55°C for 40 min) to receive a reduction in cell count. Listeria monocytogenes strains showed large variation in acid tolerance (over 6 log units) and in heat tolerance (3 log units). The persistent strains showed higher tolerance to acidic conditions than the nonpersistent strains (Student’s t-test, P = 0·02), but significant differences in heat tolerance between persistent and nonpersistent strains were not observed. Conclusions: The results indicate that acid tolerance may have an effect on the persistence of L. monocytogenes contamination. Significance and Impact of the Study: This study highlights the fact that there are great differences in acid and heat tolerances between L. monocytogenes strains, and the preventive measures should be designed to be effective against the most tolerant strains.