A High-Precision Protocol for Identification of Preschool Children at Risk for Persisting Obesity

BACKGROUND:Recent studies suggest that adolescent adiposity is established already in preadolescence. Earlier studies have confirmed a strong tracking of obesity from adolescence to adulthood. Our aim was to examine the diagnostic accuracy of a population-derived protocol for identification of preschool children at risk for obesity in preadolescence. METHODOLOGY/PRINCIPAL FINDINGS:We analysed data obtained for child health surveillance up to age 5 from 5778 children born in a Swedish county in 1991. The basic data set included age, sex, and weight and height measurements from the regular checkups between ages 1.5 and 5. Data not routinely collected in the child health centre setting were disregarded. The children were at age 10 randomly assigned to protocol derivation and validation cohorts and assessed for obesity according to IOTF criteria. The accuracy of predicting obesity in the validation cohort was measured using decision precision, specificity, and sensitivity. The decision protocol selected 1.4% of preschool children as being at obesity risk. The precision of the protocol at age 10 was 82% for girls and 80% for boys, and the specificity was 100% for both boys and girls. The sensitivity was higher for girls (41%) than for boys (21%). The relative risk for obesity at age 10 estimated by the odds ratio for individuals selected by the protocol compared to non-selected peers was 212.6 (95% confidence interval 56.6 to 798.4) for girls and 120.3 (95% CI 24.5 to 589.9) for boys. CONCLUSION/SIGNIFICANCE:A simple and inexpensive decision protocol based on BMI values proved to have high precision and specificity for identification of preschool children at risk for obesity persisting into adolescence, while the sensitivity was low especially for boys. Implementation and further evaluations of the protocol in child health centre settings are warranted

Immunotherapy with tolerogenic apolipoprotein B-100–loaded dendritic cells attenuates atherosclerosis in hypercholesterolemic mice

BACKGROUND: Atherosclerosis is a chronic inflammatory disease characterized by a massive intimal accumulation of low-density lipoprotein that triggers chronic vascular inflammation with an autoimmune response to low-density lipoprotein components. METHODS AND RESULTS: To dampen the inflammatory component of atherosclerosis, we injected hypercholesterolemic huB100(tg) × Ldlr(-/-) mice (mice transgenic for human apolipoprotein B100 [ApoB100] and deficient for the low-density lipoprotein receptor) intravenously with dendritic cells (DCs) that had been pulsed with the low-density lipoprotein protein ApoB100 in combination with the immunosuppressive cytokine interleukin-10. DCs treated with ApoB100 and interleukin-10 reduced proliferation of effector T cells, inhibited production of interferon-γ, and increased de novo generation of regulatory T cells in vitro. Spleen cells from mice treated with DCs plus ApoB100 plus interleukin-10 showed diminished proliferative responses to ApoB100 and significantly dampened T-helper 1 and 2 immunity to ApoB100. Spleen CD4(+) T cells from these mice suppressed activation of ApoB100-reactive T cells in a manner characteristic of regulatory T cells, and mRNA analysis of lymphoid organs showed induction of transcripts characteristic of these cells. Treatment of huB100(tg) × Ldlr(-/-) mice with ApoB100-pulsed tolerogenic DCs led to a significant (70%) reduction of atherosclerotic lesions in the aorta, with decreased CD4(+) T-cell infiltration and signs of reduced systemic inflammation. CONCLUSIONS: Tolerogenic DCs pulsed with ApoB100 reduced the autoimmune response against low-density lipoprotein and may represent a novel possibility for treatment or prevention of atherosclerosis.Swedish Research CouncilFoundation for Strategic ResearchVinnovaSwedish Heart-Lung FoundationEuropean Union (AtheroRemo integrated project)Stockholm County CouncilPublishe

Esophageal perforation in South of Sweden: Results of surgical treatment in 125 consecutive patients

<p>Abstract</p> <p>Background</p> <p>For many years there has been a debate as to which is the method of choice in treating patients with esophageal perforation. The literature consists mainly of small case series. Strategies for aiding patients struck with this disease is changing as new and less traumatic treatment options are developing. We studied a relatively large consecutive material of esophageal perforations in an effort to evaluate prognostic factors, diagnostic efforts and treatment strategy in these patients.</p> <p>Methods</p> <p>125 consecutive patients treated at the University Hospital of Lund from 1970 to 2006 were studied retrospectively. Prognostic factors were evaluated using the Cox proportional hazards model.</p> <p>Results</p> <p>Pre-operative ASA score was the only factor that significantly influenced outcome. Neck incision for cervical perforation (n = 8) and treatment with a covered stent with or without open drainage for a thoracic perforation (n = 6) had the lowest mortality. Esophageal resection (n = 8) had the highest mortality. A CAT scan or an oesophageal X-ray with oral contrast were the most efficient diagnostic tools. The preferred treatment strategy changed over the course of the study period, from a more aggressive surgical approach towards using covered stents to seal the perforation.</p> <p>Conclusion</p> <p>Pre-operative ASA score was the only factor that significantly influenced outcome in this study. Treatment strategies are changing as less traumatic options have become available. Sealing an esophageal perforation with a covered stent, in combination with open or closed drainage when necessary, is a promising treatment strategy.</p

Inhibition of T cell response to native low-density lipoprotein reduces atherosclerosis

Immune responses to oxidized low-density lipoprotein (oxLDL) are proposed to be important in atherosclerosis. To identify the mechanisms of recognition that govern T cell responses to LDL particles, we generated T cell hybridomas from human ApoB100 transgenic (huB100tg) mice that were immunized with human oxLDL. Surprisingly, none of the hybridomas responded to oxidized LDL, only to native LDL and the purified LDL apolipoprotein ApoB100. However, sera from immunized mice contained IgG antibodies to oxLDL, suggesting that T cell responses to native ApoB100 help B cells making antibodies to oxLDL. ApoB100 responding CD4+ T cell hybridomas were MHC class II–restricted and expressed a single T cell receptor (TCR) variable (V) β chain, TRBV31, with different Vα chains. Immunization of huB100tgxLdlr−/− mice with a TRBV31-derived peptide induced anti-TRBV31 antibodies that blocked T cell recognition of ApoB100. This treatment significantly reduced atherosclerosis by 65%, with a concomitant reduction of macrophage infiltration and MHC class II expression in lesions. In conclusion, CD4+ T cells recognize epitopes on native ApoB100 protein, this response is associated with a limited set of clonotypic TCRs, and blocking TCR-dependent antigen recognition by these T cells protects against atherosclerosis

Eftersök av falsk guldskivlav Psora testacea på fastlandet och lavar på Fridö, Södermanland

Fyra medlemmar i expertkommittén för lavar besökte 26 april 2018 Fridö och Furholmens naturreservat i närheten av Tullgarns slott. Syftet var att klargöra statusen för falsk guldskivlav Psora testacea, som rapporterades från Furholmen 1895, vilket är det enda rapporterade fyndet av arten på fastlandet. Arten hittades inte och då det inte heller finns något belägg är vårt förslag att rapporten av denna art från Södermanland är alltför osäker för att kunna valideras. En artlista inkluderande de arter som noterades från Fridö presenteras. Elva arter rapporteras som nya för Södermanland, Briancoppinsia cytospora, Calogaya arnoldii, Catillaria cryptophila,Endocarpon pusillum, Gyalidea subscutellaris, Muellerella erratica, Rinodina lecanorina, Scytinium aragonii, Verrucaria dolosa, V. macrostoma och V. tectorum

Lavar på Fridö, Södermanland, del 2

En artlista inkluderande de arter som noterades vid en exkursion till Fridö i Södermanland 2018 presenterades tidigare i Lavbulletinen. Några arter var då ännu inte bestämda eller bara preliminärt bestämda. Här kompletteras artlistan med Bacidina egenula (ny för Södermanland) och Rinodina calcarea (första fyndet utanför Öland och Gotland) vilken nu är konfirmerad genom DNA-analys

Experiences from Applying the CDIO Standard for Sustainable Development in Institution-Wide Program Evaluations

In the CDIO standards 3.0, the original “core” CDIO standards have been updated regarding sustainable development. In addition, one of the new, so called “optional”, CDIO standards addresses sustainable development. This paper puts the new CDIO standard for sustainable development to test, in an institution-wide evaluation of engineering education programs at the KTH Royal Institute of Technology. First, the standard is operationalized by establishing a set of indicators and slightly modifying the standard rubrics. Then, it is used in the evaluation of a large number of programs on bachelor and master level. Examples are given of the evaluation outcomes, and the character of the integration of sustainable development in programs on different rubric levels are discussed. With the proposed indicators and rubric modifications, the new standard is concluded to be a useful tool for evaluating, promoting, and guiding, integration of sustainable development, not only in programs with particularly high ambitions regarding sustainable development, but in basically any engineering program. It is recommended that the new standard, with the here proposed modifications, is used for setting university-wide goals and for providing teachers and program directors with a framework for enhancing the future relevance of engineering education programs.QC 20210623</p

Blylav återfunnen i Padjelanta nationalpark efter 79 år

Padjelanta nationalpark har en exceptionellt artrik och fort­ farande till stor del okänd lavflora inklusive många sällsynta eller rödlistade arter. Lavforskaren Gunnar Degelius hittade 1941 den rödlistade blylaven på ett klippblock vid fjället Unna Duvgge på sydvästra stranden av Virihaure vilket är den nordligaste lokalen för arten i Sverige. Sommaren 2020 återfann vi blylaven efter 79 långa år, med stor sannolikhet på samma stenblock men totalt fanns det bara 18 cm2

Respiratory outcomes after a 1-year treatment of obstructive sleep apnoea with bibloc versus monobloc oral appliances : a multicentre, randomized equivalence trial

Objective: The benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that these types of appliances would be equally effective. Material and methods: In this multicentre, randomized equivalence trial, patients with OSA received one type of bibloc or one type of monobloc treatment. At baseline, a 1-night polygraphy study was done, and this was repeated after 1 year. The outcome was any change in the apnoea–hypopnoea index (AHI) and the limits of equivalence between the two devices were set at ±5 AHI units. Results: Of 302 patients, 146 were randomly assigned to bibloc and 156 to monobloc appliances. In 88 and 104 patients, respectively, there were significant reductions in the AHI (p &lt; .001) with a mean change of −16.7 (95% CI −19.4 to −14.1) in the bibloc and −11.8 (−14.9 to −8.7) in the monobloc groups. The proportions of responders defined as having an AHI &lt;10 were 68% and 65% for the bibloc and monobloc groups, respectively. Treatment-related adverse events were mild, transient and the dropouts were more frequent in the bibloc group. Conclusions: Both types of treatments positively and significantly reduced respiratory disturbances, but at the 1-year follow-up, they were not significantly different in treating OSA, with a numerically greater reduction of the AHI value with the bibloc appliance. However, the higher proportion of treatment-related adverse events and higher proportion of dropouts among bibloc users should be balanced against the advantage of a greater reduction in the AHI