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Brottet vållande till annans död kännetecknas av att en persons agerande lett till någons död utan att detta varit avsiktligt eller kontrollerat från start till slut. För att kunna konstatera att detta agerande varit så pass klandervärt att det faller under straffrättsligt ansvar har domstolen att ta ställning till huruvida en otillåten risk har företagits. Vad som utgör ett otillåtet risktagande inom sjukvården kan dock vara en svår avvägning mot bakgrund av att denna verksamhet både är riskfylld och önskvärd. Denna framställning syftar till att utreda vilket risktagande som tillåts inom sjukvården utan att detta faller under straffrättsligt ansvar för vållande till annans död. Detta utreds i två led, varav det första består i att kartlägga de faktorer som påverkar bedömningen av det otillåtna risktagandet generellt inom straffrätten. Detta utreds med hjälp av domstolspraxis och tillgänglig doktrin inom området. Därefter sätts dessa bedömningsgrunder i en hälso- och sjukvårdskontext genom en undersökning av hur Högsta domstolen och underrätterna tillämpat dessa när ett dödligt misstag skett inom sjukvården. Undersökningen visar att den medicinska normen vetenskap och beprövad erfarenhet tillmäts stor betydelse vid bedömningen av det otillåtna risktagandet. Detta kan te sig bekymmersamt mot bakgrund av dess stundtals vaga innebörd och dess förekomst inom en rad andra rättsområden än just straffrätten. Att hälso- och sjukvårdspersonalen många gånger befinner sig i en ansträngd och stressig arbetsmiljö uttrycks med sympatier från domstolarna, men är samtidigt inget som gör att ett risktagande tolereras. Av framställningen framgår också att gränsdragningen för det straffbara agerandet sker i ljuset av patienters förtroende för sjukvården. Härvid befinner sig sjukvårdspersonalen i en rättsligt utsatt situation. Med hänsyn till att det otillåtna risktagandet är knutet till de normer som råder i dagens samhälle kan dock denna utsatthet komma att ändras i respektive riktni, To cause someone’s death by mistake can bring criminal liability. For this mistake to be punishable, the court must decide whether an unacceptable risk has been taken. This assessment, however, is surrounded by difficulties when applied in the healthcare system. In medical decision-making, science and proven experience serve as a benchmark for acceptable actions. This essay aims to examine how the boundary between allowed risk-taking and criminal liability for causing a patient’s death is affected by the medical standard science and proven experience. This is investigated in two steps, the first of which consists of clarifying which factors affect the general assessment of the criminal risk-taking. This will be examined by consulting precedents and legal doctrine. Henceforth, these factors are examined in a healthcare context by consulting precedents, doctrine and lower case law. The essay shows that the medical standard of science and proven experience is given great importance when assessing the unauthorized risk-taking. This may seem alarming in light of its sometimes vague meaning and its occurrence in a number of other areas of law than just criminal law. The fact that the health care staff often find themselves in a strained and stressful work environment is expressed with sympathy from the courts, but at the same time it is not something that makes risk-taking tolerated. It is also clear from the courts that the distinction between the punishable action and the allowed risk-taking takes place in the light of patients' trust in the healthcare system. This puts the healthcare staff in a legally vulnerable situation. However, considering that the illicit risk-taking is tied to the norms that prevail in today's society, this exposure may change in the future.

Autoimmuna sjukdomar är en samling komplexa, kroniska, inflammatoriska sjukdomstillstånd som kännetecknas av dysreglering av immunsystemet, vilket resulterar i inflammation och skada av vävnader, celler och organ. Dessa sjukdomar har en betydande inverkan på individens livskvalitet och bidrar ofta till ökad dödsrisk där komorbiditeter föreligger. Emellertid medför den varierande symptombilden för olika autoimmuna sjukdomar betydande utmaningar för att uppnå noggrann diagnos, prognos och utvärdering av behandling. Det finns därför ett påtagligt behov av att upptäcka nya biomarkörer. I denna studie utfördes en omfattande analys av 944 plasmaprover med hjälp av OlinkR Explore-plattformen, vilket genererade data för 1463 unika proteiner. Baserat på uttrycksdata identifierades proteiner förknippade med de sex utvalda autoimmuna sjukdomarna multipel skleros, myosit, reumatoid artrit, systemisk skleros, Sjögrens sjukdom och systemisk lupus erythematosus samt några av deras definierade subgrupper. Dessa potentiella biomarkörer kommer eventuellt att underlätta tidig diagnos, sjukdomsdifferentiering och prognos. Flertalet av dessa proteiner har ännu aldrig kopplats till de här specifika sjukdomarna i litteraturen, särskilt inte från plasmaprover, vilket ger spännande nya perspektiv för biomarkörsutveckling. Det är dock av största vikt att genomföra robusta valideringsstudier i oberoende kohorter. Sammanfattningsvis belyser våra resultat den potentiella brukbarheten hos dessa proteomiska plasmabiomarkörer för att förbättra tidig sjukdomsdetektering, karakterisering av subgrupper och sjukdomsdifferentiering att stimulera. Förhoppningsvis kan dessa resultat stimulera till vidare forskning inom området för biomarkörer och potentiella framsteg inom individbaserad medicin., Autoimmune diseases are complex, chronic, inflammatory conditions characterized by dysregulation of the immune system, resulting in inflammation and damage to various tissues, cells and organs. These diseases significantly impact individuals’ quality of life and often contribute to increased mortality risk in the presence of comorbidities. However, due to the diverse array of symptoms associated with different autoimmune diseases, accurate diagnosis, prognosis, and treatment evaluation pose significant challenges. Thus, there is a pressing need for the discovery of novel biomarkers. In this study, a comprehensive analysis of 944 plasma samples using the OlinkR Explore platform was conducted, generating data on 1463 unique proteins. Based on the expression data, associated proteins were identified for six selected autoimmune diseases, namely multiple sclerosis, myositis, rheumatoid arthritis, systemic sclerosis, Sjögren’s syndrome, and systemic lupus erythematosus, as well as some of their defined subgroups. These are prospective biomarkers and have the potential to aid in early diagnosis, therapeutic intervention, subgroup identification, disease differentiation, and disease prognosis. Notably, some of these proteins have not been previously associated with the specific diseases in the existing literature, especially not in plasma samples, thereby offering intriguing new perspectives for biomarker development. However, it is of great importance to conduct robust validation studies in independent cohorts to confirm the outcomes of this study. In summary, our findings highlight the potential utility of these proteomic plasma biomarkers in improving the early detection, subgroup characterization, and disease differentiation of autoimmune diseases. The identification of these proteins will hopefully stimulate further investigation in the field of biomarker research and potential advancements in personalized medicine.

In this study a sample of particles in a size region of 0.05-10 μm were run through a centrifugation process with the ambition to make it monodisperse. The product requirements were stated as follows, particles within the size range of 2 to 3.8 μm should be isolated and separated from the sample with a D90/D10 < 1.4 where the D90/D50/D10 values should be approximately 3.8 μm/2.5 μm/2 μm. It was found that two layers of sucrose with a 50/50 volume distribution of 45w% sucrose solution and 60w% sucrose solution respectively, was the most efficient density gradient arrangement for separation of this particular sample. The optimal time and RPM combination was found to be 5 min 3000 RPM with a fast acceleration and slower deceleration, ratio 9:6. Two centrifugation rounds on the same sample improved D90/D10 drastically. The effect of centrifugation rounds on D90/D10 was not investigated further than 3 rounds, however this would be a good starting point for further studies. The upscaled test runs indicated a positive result, i.e. the yields with respect to both mass and purity were reproducible. It is worth mentioning that the upscale was only in the volume, sample load volume and surface area factors. The gradient height or particle travel distance remained the same.

Transcriptional studies of the human heart provide insight into physiological and pathophysiological mechanisms, essential for understanding the fundamental mechanisms of normal cardiac function and how they are altered by disease. To improve the understanding of why men and women may respond differently to the same therapeutic treatment it is crucial to learn more about sex-specific transcriptional differences. In this study the transcriptome of right atrium and left ventricle was compared across sex and regional location. Paired biopsies from five male and five female patients undergoing aortic valve replacement or coronary artery bypass grafting were included. Gene expression analysis identified 620 differentially expressed transcripts in atrial and ventricular tissue in men and 471 differentially expressed transcripts in women. In total 339 of these transcripts overlapped across sex but notably, 281 were unique in the male tissue and 162 in the female tissue, displaying marked sex differences in the transcriptional machinery. The transcriptional activity was significantly higher in atrias than in ventricles as 70% of the differentially expressed genes were upregulated in the atrial tissue. Furthermore, pathway- and functional annotation analyses performed on the differentially expressed genes showed enrichment for a more heterogeneous composition of biological processes in atrial compared with the ventricular tissue, and a dominance of differentially expressed genes associated with infection disease was observed. The results reported here provide increased insights about transcriptional differences between the cardiac atrium and ventricle but also reveal transcriptional differences in the human heart that can be attributed to sex., Copyright © 2020 the American Physiological Society

Studies of expressed genes in human heart provide insight into both physiological and pathophysiological mechanisms. This is of importance for extended understanding of cardiac function as well as development of new therapeutic drugs. Heart tissue for gene expression studies is generally hard to obtain, particularly from the ventricles. Since different parts of the heart have different functions, expression profiles should likely differ between these parts. The aim of the study was therefore to compare the global gene expression in cardiac tissue from the more accessible auricula of the right atrium to expression in tissue from the left ventricle. Tissue samples were collected from five men undergoing aortic valve replacement or coronary artery bypass grafting. Global gene expression analysis identified 542 genes as differentially expressed between the samples extracted from these two locations, corresponding to similar to 2% of the genes covered by the microarray; 416 genes were identified as abundantly expressed in right atrium, and 126 genes were abundantly expressed in left ventricle. Further analysis of the differentially expressed genes according to available annotations, information from curated pathways and known protein interactions, showed that genes with higher expression in the ventricle were mainly associated with contractile work of the heart. Transcription in biopsies from the auricula of the right atrium on the other hand indicated a wider area of functions, including immunity and defense. In conclusion, our results suggest that biopsies from the auricula of the right atrium may be suitable for various genetic studies, but not studies directly related to muscle work.

In this article, recent progress in cardiotoxicity testing based on the use of immortalized cell lines or human embryonic stem cell (hESC) derived cardiomyocytes in combination with state-of-the-art bioanalytical methods and sensors is reviewed. The focus is on hESC-derived cells and their refinement into competent testing cells, but the access and utility of other relevant cell types are also discussed. Recent developments in sensor techniques and bioanalytical approaches for measuring critical cardiotoxicity parameters are highlighted, together with aspects of data evaluation and validation. Finally, recommendations for further research are given.