Public access to lakeshores in Iceland

The study to assess the current state of public access to lakeshores in Iceland was done as little has been written on the subject and landowners and the public are not well-informed about their rights. The objective was to gather information about laws and regulations concerning accessibility, investigate the current situation at two particular locations regarding access to lakeshores and whether municipalities and landowners are fulfilling their obligations to allow and facilitate certain access to these areas. A lakeshore area by lake Elliðavatn was investigated as well as the lakeshore area Þorsteinsvík by lake Þingvallavatn. Methods used were the same as landscape architects and planners use to analyse and design areas, whether in rural or urban landscapes; document and landscape analysis as well as accessibility and visual analysis. Expectations turned out to be exaggerated as the areas were far from being used to their full potential. Conclusions include a need for evaluating every location separately as conditions vary greatly and the laws and regulations must be clearer to better serve the interest of the public. Municipalities and landowners were not doing fulfilling their obligations to allow and facilitate access to the study areas

Profibrinolytic effect of the epigenetic modifier valproic acid in man.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.The aim of the study was to test if pharmacological intervention by valproic acid (VPA) treatment can modulate the fibrinolytic system in man, by means of increased acute release capacity of tissue plasminogen activator (t-PA) as well as an altered t-PA/Plasminogen activator inhibitor -1 (PAI-1) balance. Recent data from in vitro research demonstrate that the fibrinolytic system is epigenetically regulated mainly by histone deacetylase (HDAC) inhibitors. HDAC inhibitors, including VPA markedly upregulate t-PA gene expression in vitro.The trial had a cross-over design where healthy men (n = 10), were treated with VPA (Ergenyl Retard) 500 mg depot tablets twice daily for 2 weeks. Capacity for stimulated t-PA release was assessed in the perfused-forearm model using intra-brachial Substance P infusion and venous occlusion plethysmography. Each subject was investigated twice, untreated and after VPA treatment, with 5 weeks wash-out in-between. VPA treatment resulted in considerably decreased levels of circulating PAI-1 antigen from 22.2 (4.6) to 10.8 (2.1) ng/ml (p<0.05). It slightly decreased the levels of circulating venous t-PA antigen (p<0.05), and the t-PA:PAI-1 antigen ratio increased (p<0.01). Substance P infusion resulted in an increase in forearm blood flow (FBF) on both occasions (p<0.0001 for both). The acute t-PA release in response to Substance P was not affected by VPA (p = ns).Valproic acid treatment lowers plasma PAI-1 antigen levels and changes the fibrinolytic balance measured as t-PA/PAI-1 ratio in a profibrinolytic direction. This may in part explain the reduction in incidence of myocardial infarctions by VPA treatment observed in recent pharmacoepidemiological studies.The EU Clinical Trials Register 2009-011723-31.Swedish Heart-Lung Foundation Swedish Research Council Emelle Foundatio

Lung Transplantation in Icelanders

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Inngangur: Lungnaígræðsla er valkostur við meðferð á langt gengnum lungnasjúkdómum, öðrum en krabbameinum, þegar lífslíkur eru mjög skertar og lífsgæði léleg, þrátt fyrir bestu mögulegu meðferð. Í flestum tilvikum batna lungnapróf og heilsutengd lífsgæði mikið við lungnaígræðslu. Sýkingar og stíflumyndandi berkjungabólga, einnig kallað langvinn höfnun, eru algengustu fylgikvillarnir eftir lungnaígræðslu. Efniviður og aðferðir: Hér er sagt frá íslenskum sjúklingum sem farið hafa í lungnaígræðslu frá febrúar 1988 til janúar 2015. Gagnagrunnur var unninn afturskyggnt úr sjúkraskrám. Safnað var upplýsingum um bakgrunn sjúklinga, ígræðsluaðgerð, ónæmisbælingu og hafnanir, fylgikvilla og lifun. Niðurstöður: Alls hefur verið gerð 21 lungnaígræðsla á 20 einstaklingum en einn sjúklingur hefur tvisvar farið í aðgerð. Um var að ræða 9 konur og 11 karla og meðalaldur við ígræðslu var 45 ár (20-61 ár). Flestar aðgerðirnar hafa verið gerðar á Sahlgrenska-sjúkrahúsinu í Gautaborg. Flestir fengu ígrædd bæði lungu. Langvinn lungnateppa var algengasta ábendingin. Algengustu fylgikvillar eftir lungnaígræðslu voru hafnanir og sýkingar. Átta af 20 sjúklingum hafa fengið bráðahöfnun og helmingur sjúklinga langvinna höfnun. Alls eru 6 af 20 sjúklingum látnir, af þeim létust þrír vegna langvinnrar höfnunar á ígræddu líffæri. Miðgildi lifunar er 8,5 ár. Fimm ára lifun er 74%. Ályktanir: Lungnaígræðslur á Íslendingum eru nú framkvæmdar á Sahlgrenskasjúkrahúsinu í Gautaborg en eftirfylgni er á vegum sérhæfðra lungnalækna á Landspítala. Fylgikvillar og lifun íslenskra sjúklinga er sambærilegt við það sem gerist á stærri stofnunum. Náin samskipti og samstarf við stofnunina þar sem ígræðsla fer fram er lykilatriði.Introduction: Lung transplantation is a treatment option for end-stage lung diseases, excluding lung cancer, when life expectancy is short and quality of life is poor. In most instances pulmonary function and quality of life improves after lung transplantation. Infections and rejection are the most common complications and limit the feasibility of lung transplantation. Materials and methods: Retrospective analysis of lung transplantations performed on Icelanders from February 1988 to January 2015. Clinical information was obtained from medical records and a database was created. Information on demographics, underlying lung disease, type of transplantation, immunosuppression, rejection and other complications was collected. Results: A total of 21 lung transplantations were performed, one of which was a retransplantation. There were 9 females and 11 males and the mean age was 45 years (20-61 years). Most of the operations were done at the Sahlgrenska hospital in Gothenburg. Bilateral lung transplantion was the most common operation. COPD was the most common indication. Rejection and infections were the most common complications. Eight of 20 patients have had acute rejection and half of the patients chronic rejection. Six of 20 patients are deceased, three died from chronic rejection. Median survival is 8,5 years. Five-year survival is 74%. Conclusions: Lung transplantations are currently performed at the Sahlgrenska hospital in Gothenburg but follow-up is in the hands of specialized pulmonologists in Iceland. Complications and survival for Icelandic patients is similar to larger centers. Close cooperation with the transplanting center is essential

Improving unbiased left/right training of rats and use of physostigmine to counteract scopolamine-induced short-term memory impairment

Rationale: The DNMTP task measures short-term / working memory uncontaminated by learning capacity,  spatial abilities, motor performance or general motivational and arousal factors. However, DNMTP training  of rats can take two months, and we aimed to reduce this. Methods: Two experiments were conducted on rats  in an operant DNMTP task. Improvements were made on the training procedure. The method was validated  by replicating the effect of scopolamine on working memory. The experiments also explored the influence  of physostigmine in reversing impairment induced by scopolamine. Thus in experiment 1, ten Lewis rats  were trained in an operant DNMTP task (1, 2, 4 and 8 s delay intervals) before 9 of them received vehicle,  scopolamine, saline or combinations of scopolamine and physostigmine. In experiment 2, ten Lewis rats (5  old and 5 young) were trained in the same task (1, 2, 4, 8 and 16 s delay intervals). There were six treatments:  0.05 mg/kg scopolamine, 0.1 mg/kg physostigmine or 0.15 mg/kg physostigmine, control involving  saline or involving no injection and no handling, and finally a combined treatment of 0.05mg/kg scopolamine  and 0.15 mg/kg physostigmine. In both experiments scopolamine significantly reduced correct  responses, nose-pokes and lever presses compaired to control conditions. Furthermore, in experiment 2,  there was insignificant difference between saline and combined scopolamine/physostigmine for correct  responses and for delay prior to pressing the sample lever. As expected, there was significant difference  between scopolamine and combined scopolamine/physostigmine for correct responses, for delay prior to  pressing the sample lever and for delay prior to pressing the non-matching lever. As a result, the animals  were ready for drug injection after 17 days from habituation and the method ensured that there were no dropouts  due to left or right lever preference. This is a shorter training period than previously thought necessary.  The brief training method was validated by replicating the effect of scopolamine on working memory.

Physical activity and sleep in Icelandic adolescents

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesInngangur: Hreyfing og svefn eru mikilvægir áhrifaþættir heilsufars. Alþjóðlegar ráðleggingar mæla með því að börn og unglingar hreyfi sig að lágmarki 60 mínútur daglega af miðlungs eða mikilli ákefð og sofi í 8 til 10 klukkustundir á sólarhring. Tengsl hreyfingar og svefns meðal ungmenna eru ekki vel þekkt. Markmið rannsóknarinnar voru að meta: a) hversu hátt hlutfall 16 ára reykvískra ungmenna uppfyllir viðmið um hreyfingu og svefn, b) hvort tengsl séu milli hreyfingar og svefns og c) kynjamun á hreyfingu og svefni. Efniviður og aðferðir: Alls var 411 nemendum 10. bekkjar 6 grunnskóla í Reykjavík boðin þátttaka í rannsókninni vorið 2015. Gild gögn fengust frá 106 drengjum og 160 stúlkum. Hlutlægar og huglægar mælingar á hreyfingu og svefni voru gerðar með hröðunarmælum og spurningalistum. Niðurstöður: Um helmingur þátttakenda náði viðmiðum um hreyfingu samkvæmt niðurstöðum spurningalista. Þrátt fyrir að 51,9% teldu sig sofa nógu mikið náðu þó einungis 22,9% viðmiðum um ráðlagða svefnlengd samkvæmt hröðunarmælum. Engin tengsl fundust milli svefnlengdar og hreyfingar samkvæmt spurningalistum. Stúlkur hreyfðu sig marktækt meira en drengir á frídögum (p<0,01) samkvæmt hröðunarmælum en ekki var marktækur munur á meðaltali hreyfingar stúlkna og drengja yfir vikuna. Hvorki var marktækur kynjamunur á svefnlengd mældri með hröðunarmælum né spurningalista. Ályktun: Lífsstíll íslenskra ungmenna virðist ekki endurspegla viðmið opinberra aðila um daglega hreyfingu og svefn. Einungis 22,9% náðu viðmiðum um ráðlagðan svefntíma, og 11,3% uppfylltu bæði viðmið um hreyfingu og svefn.Introduction: Physical activity and sleep are major determinants of overall health. According to international recommendations, adolescents should engage in moderate to vigorous physical activity for at least 60 min each day and sleep eight to ten hours each night. The association between physical activity and sleep in adolescents is not well known. The aim of the study was to estimate a) the proportion of Icelandic adolescents that achieves recommended physical activity and sleep, b) if there is an association between physical activity and sleep patterns, and c) sex differences in physical activity and sleep. Material and methods: A total of 411 adolescents from the 10th grade in six schools in Reykjavik were invited to participate in a cross-sectional study in the spring of 2015. Valid data was obtained from 106 boys and 160 girls. Objective and subjective measures of physical activity and sleep were made by wrist-worn accelerometers and a questionnaire. Results: Almost half of the participants fulfilled the physical activity recommendations according to the questionnaire. Although 51.1% reported usually getting enough sleep, only 22.9% achieved the recommended sleep length according to objective assessment. No associations were observed between sleep and subjective physical activity. Girls had higher accelerometer-measured physical activity than boys on non-school days (p<0.01), but weekly averages were not different between sexes. Girls and boys did not differ in subjective or objective measures of sleep. Conclusion: The behavior of Icelandic adolescents does not reflect recommended amount of sleep and physical activity. Only 22.9% obtained the recommended sleep length and just 11.3% fulfilled recommendations of both sleep and physical activity.Ranní

Prevention, Detection, and Management of Heart Failure in Patients Treated for Breast Cancer

Purpose of Review: Long-term survival has increased significantly in breast cancer patients, and cardiovascular side effects are surpassing cancer-related mortality. We summarize risk factors, prevention strategies, detection, and management of cardiotoxicity, with focus on left ventricular dysfunction and heart failure, during breast cancer treatment. Recent Findings: Baseline treatment of cardiovascular risk factors is recommended. Anthracycline and trastuzumab treatment constitute a substantial risk of developing cardiotoxicity. There is growing evidence that this can be treated with beta blockers and angiotensin antagonists. Early detection of cardiotoxicity with cardiac imaging and circulating cardiovascular biomarkers is currently evaluated in clinical trials. Chest wall irradiation accelerates atherosclerotic processes and induces fibrosis. Immune checkpoint inhibitors require consideration for surveillance due to a small risk of severe myocarditis. Cyclin-dependent kinases4/6 inhibitors, cyclophosphamide, taxanes, tyrosine kinase inhibitors, and endocrine therapy have a lower-risk profile for cardiotoxicity. Summary: Preventive and management strategies to counteract cancer treatment–related left ventricular dysfunction or heart failure in breast cancer patients should include a comprehensive cardiovascular risk assessment and individual clinical evaluation. This should include both patient and treatment-related factors. Further clinical trials especially on early detection, cardioprevention, and management are urgently needed. © 2020, The Author(s).Peer reviewe

Novel self-epitopes derived from aggrecan, fibrillin, and matrix metalloproteinase-3 drive distinct autoreactive T-cell responses in juvenile idiopathic arthritis and in health

Juvenile idiopathic arthritis (JIA) is a heterogeneous autoimmune disease characterized by chronic joint inflammation. Knowing which antigens drive the autoreactive T-cell response in JIA is crucial for the understanding of disease pathogenesis and additionally may provide targets for antigen-specific immune therapy. In this study, we tested 9 self-peptides derived from joint-related autoantigens for T-cell recognition (T-cell proliferative responses and cytokine production) in 36 JIA patients and 15 healthy controls. Positive T-cell proliferative responses (stimulation index ≥2) to one or more peptides were detected in peripheral blood mononuclear cells (PBMC) of 69% of JIA patients irrespective of major histocompatibility complex (MHC) genotype. The peptides derived from aggrecan, fibrillin, and matrix metalloproteinase (MMP)-3 yielded the highest frequency of T-cell proliferative responses in JIA patients. In both the oligoarticular and polyarticular subtypes of JIA, the aggrecan peptide induced T-cell proliferative responses that were inversely related with disease duration. The fibrillin peptide, to our knowledge, is the first identified autoantigen that is primarily recognized in polyarticular JIA patients. Finally, the epitope derived from MMP-3 elicited immune responses in both subtypes of JIA and in healthy controls. Cytokine production in short-term peptide-specific T-cell lines revealed production of interferon-γ (aggrecan/MMP-3) and interleukin (IL)-17 (aggrecan) and inhibition of IL-10 production (aggrecan). Here, we have identified a triplet of self-epitopes, each with distinct patterns of T-cell recognition in JIA patients. Additional experiments need to be performed to explore their qualities and role in disease pathogenesis in further detail

Less physical activity and more varied and disrupted sleep is associated with a less favorable metabolic profile in adolescents

Publisher's version (útgefin grein)Background: Sleep and physical activity are modifiable behaviors that play an important role in preventing overweight, obesity, and metabolic health problems. Studies of the association between concurrent objective measures of sleep, physical activity, and metabolic risk factors among adolescents are limited. Objective: The aim of the study was to examine the association between metabolic risk factors and objectively measured school day physical activity and sleep duration, quality, onset, and variability in adolescents. Materials and methods: We measured one school week of free-living sleep and physical activity with wrist actigraphy in 252 adolescents (146 girls), aged 15.8±0.3 years. Metabolic risk factors included body mass index, waist circumference, total body and trunk fat percentage, resting blood pressure, and fasting glucose and insulin levels. Multiple linear regression adjusted for sex, parental education, and day length was used to assess associations between metabolic risk factors and sleep and activity parameters. Results: On average, participants went to bed at 00:22±0.88 hours and slept 6.2±0.7 hours/night, with 0.83±0.36 hours of awakenings/night. However, night-to-night variability in sleep duration was considerable (mean ± interquartile range) 0.75±0.55 hours) and bedtime (0.64±0.53 hours) respectively. Neither average sleep duration nor mean bedtime was associated with any metabolic risk factors. However, greater night-to-night variability in sleep duration and bedtime was associated with higher total body and trunk fat percentage, and less physical activity was associated with higher trunk fat percentage and insulin levels. Conclusion: Greater nightly variation in sleep duration and in bedtime and less physical activity were associated with a less favorable metabolic profile in adolescents. These findings support the idea that, along with an adequate amount of physical activity, a regular sleep schedule is important for the metabolic health of adolescents.VR had financial support by The Icelandic Centre for Research (RANNIS) The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer Reviewe

Longitudinal Change in Adolescent Bedtimes Measured by Self-Report and Actigraphy

Introduction: Sleep is often quantified using self-report or actigraphy. Self-report is practical and less technically challenging, but prone to bias. We sought to determine whether these methods have comparable sensitivity to measure longitudinal changes in adolescent bedtimes. Methods: We measured one week of free-living sleep with wrist actigraphy and usual bedtime on school nights and non-school nights with self-report questionnaire in 144 students at 15 y and 17 y. Results: Self-reported and actigraphy-measured bedtimes were correlated with one another at 15 y and 17 y (p 30 minutes, p  ±106 minutes). Mean inter-method discrepancy did not differ on school nights at 15 y and 17 y but was greater at 17 y on non-school nights (p = .002). Inter-method discrepancy at 15 y was not correlated to that at 17 y. Mean change in self-reported school night bedtime from 15 y to 17 y did not differ from that by actigraphy, but self-reported bedtime changed less on non-school nights (p = .002). Two-year changes in self-reported bedtime did not correlate with changes measured by actigraphy. Conclusions: Although methods were correlated, consistently earlier self-reported bedtime suggests report-bias. More varied non-school night bedtimes challenge the accuracy of self-report and actigraphy, reducing sensitivity to change. On school nights, the methods did not differ in group-level sensitivity to changes in bedtime. However, lack of correlation between bedtime changes by each method suggests sensitivity to individual-level change was different. Methodological differences in sensitivity to individual- and group-level change should be considered in longitudinal studies of adolescent sleep patterns.Peer Reviewe