Journal Staff

A myelopoiesis gene signature in circulating leucocytes, exemplified by increased myeloperoxidase (MPO) and proteinase 3 (PR3) mRNA levels, has been reported in patients with active anti-neutrophil cytoplasm antibody associated vasculitis (AAV) and to a lesser extent during remission. We hypothesized that this signature could predict disease relapse. mRNA levels of PR3, MPO, selected myelopoiesis transcription factors (CEBPA, CEBPB, SPIB, SPI1) and microRNAs (miRNAs) from patient and control peripheral blood mononuclear cells (PBMCs) and polymorphonuclear cells (PMNs) were analyzed and associated with clinical data. Patients in stable remission had higher mRNA levels for PR3 (PBMCs, PMNs) and MPO (PBMCs). PR3 and SPIB mRNA correlated positively in control but negatively in patient PBMCs. Statistically significant correlations existed between PR3 mRNA and several miRNAs in controls, but not in patients. PR3/MPO mRNA levels were not associated with previous or future relapses but correlated to steroid treatment. Prednisolone doses were negatively linked to SPIB and miR-155-5p, miR-339-5p (PBMCs) and to miR-221, miR-361, miR-505 (PMNs). PR3 mRNA in PBMCs correlated with time since last flare, blood leucocyte count and estimated glomerular filtration rate. Our results show that elevated leucocyte PR3 mRNA levels in AAV patients in remission do not predict relapse. The origin seems multifactorial, but to an important part explainable by prednisolone action. Gene signatures in patients with AAV undergoing steroid treatment should therefore be interpreted accordingly

Phenolic compounds in oats

This research project examined how to treat raw oat material for oat-based food products in order to sustain or increase the levels of phenolic compounds. The focus was mainly on the avenanthramides, which are potentially health beneficial bioactive components found exclusively in oats. A proposed enzymatic decrease in avenanthramide levels when non heat-treated milled oats are steeped in water was investigated. The decrease was strongly suggested to be caused by a polyphenol oxidase. Although the avenanthramides are only found in oats, the polyphenol oxidase enzyme that acted on avenanthramides was also found to be present in wheat, barley and rye. The effects of a highly controlled steeping and germination process on levels of phenolic compounds and related enzyme activities in oats were studied. The process resulted in increased levels of avenanthramides and some unknown compounds to various extents depending on cultivar. This increase was suggested to be partly due to enzymatically catalysed de novo biosynthesis. Whether germination was the reason behind elevated levels of avenanthramides in one harvest year compared with another, in the same oat genotypes, were investigated. The differences in avenanthramide levels between the two years could not be explained by preharvest sprouting of the oat grains in the field. The content and location of tricin was studied in various oat samples. Tricin was found to be localised to oat hulls and was detected and quantified in a minority of all oat samples analysed. The overall conclusion was that germination of oats can be a good method to sustain or increase avenanthramides and other potentially health beneficial phenolic compounds. It is important to inactivate the polyphenol oxidase present in oats and other cereal grain ingredients included in oat-based food products, since it may otherwise decrease the levels of avenanthramides in these products. Oat hulls may be a good source of tricin if high-tricin cultivars are chosen

Att tillgodose ensamkommande barns individuella behov- en kvalitativ studie om HVB-personals arbete ur ett professionsperspektiv

The aim of this study was to examine how professionals on residential care for unaccompanied children worked with the youths needs. Due to the increase of refugees coming to Sweden and specially unaccompanied children it has become one of our present time most important political questions. In order to examine how the professionals are working with the unaccompanied children’s needs we believed that a qualitative study was necessary, and therefore we conducted six interviews. The theory of professional approach (Holm, 1995, 2001) was used to examined which approach the professionals used in their work with the youths, which need the professionals saw was the most important and if the personal put the youths needs before theirs. Our result showed that the needs the professionals saw were the most important with the youths, was the need of a safe relationship, being a participated in the decisions that involved them and the need of learning how to cope with their anxiety. Our result also showed that in their work with the youths needs the professionals had different approaches, an approach that was influenced by rules, an approach that saw the youths as responsible adults and an last approach there the professionals acted as a role model. We could also see that the professionals had an aptitude to see the youths need as a group and not as individual. The respondent expressed that achieving an individual work was hard when the youths all had different needs and different takes at what is important

Patterns of use, perceived benefits and reported effects of access to navigation support systems: an inter-European field operational test

The study presents findings regarding drivers’ patterns of use, attitude towards, and reported effects of access to mature nomadic navigation support systems. Three different systems were tested by 582 drivers in four-field operational tests for a period of six months. A majority of the participants used the support system for trips where the route/destination was unfamiliar but there were also other use scenarios. The main benefits entailed convenience and comfort. Reported effects involved increased possibilities to choose the route according to preferences; a decrease in the time it took to reach destinations and in the distance covered to reach the destination. One in four reported a decrease in fuel consumption attributed an increased compliance with speed limits and/or that driving around and searching for the correct route to reach the desired destination could be avoided. A majority reported ‘no change’ regarding the number of journeys made by car. Reported effects (whether increases or decreases) were however smaller than expected before the trial

Experiences and management strategies of Norwegian GPs during the COVID-19 pandemic: a longitudinal interview study

Objective: When the COVID-19 pandemic reached Norway, primary health care had to reorganize to ensure safe patient treatment and maintain infection control. General practitioners (GPs) are key health care providers in the municipalities. Our aim was to explore the experiences and management strategies of Norwegian GPs during the COVID-19 pandemic - over time, and in the context of a sudden organizational change. Design: Longitudinal qualitative interview study with two interview rounds. The first round of interviews was conducted from September–December 2020, the second round from January–April 2021. In the first interview round, we performed eight semi-structured interviews with GPs from eight municipalities in Norway. In the second round, five of the GPs were re-interviewed. Consecutive interviews were performed 2–4 months apart. To analyze the data, we used thematic analysis. Results: The COVID-19 pandemic required GPs to balance several concerns, such as continuity of care and their own professional efforts. Several GPs experienced challenges in the collaboration with the municipality and in relation to defining their own professional position. Guided by The Norwegian Association of General practitioners, The Norwegian College of General Practice and collegial support, they found viable solutions and ended up with a feeling of having adapted to a new normal. Conclusions: Although our study demonstrates that the GPs adapted to the changing conditions, the current municipal health care models are not ideal. There is a need for clarification of responsibilities between GPs and the municipality to facilitate a more coordinated future pandemic response

The experiences of patients ill with COVID-19-like symptoms and the role of testing for SARS-CoV-2 in supporting them: a qualitative study in eight European countries during the first wave of the pandemic

Background Access to testing during the first wave of the COVID-19 pandemic was limited, impacting patients with COVID-19-like symptoms. Current qualitative studies have been limited to one country or were conducted outside Europe. Objectives To explore - in eight European countries - the experiences of patients consulting in primary care with COVID-19-like symptoms during the first wave of the pandemic. Methods Sixty-six semi-structured interviews, informed by a topic guide, were conducted by telephone or in person between April and July 2020. Patients with COVID-19-like symptoms were purposively recruited in primary care sites in eight countries and sampled based on age, gender, and symptom presentation. Deductive and inductive thematic analysis techniques were used to develop a framework representing data across settings. Data adequacy was attained by collecting rich data. Results Seven themes were identified, which described the experiences of patients consulting. Two themes are reported in this manuscript describing the role of COVID-19 testing in this experience. Patients described significant distress due to their symptoms, especially those at higher risk of complications from COVID-19, and those with severe symptoms. Patients wanted access to testing to identify the cause of their illness and minimise the burden of managing uncertainty. Some patients testing positive for COVID-19 assumed they would be immune from future infection. Conclusion Patients experiencing novel and severe symptoms, particularly those with comorbidities, experienced a significant emotional and psychological burden due to concerns about COVID-19. Testing provided reassurance over health status and helped patients identify which guidance to follow. Testing positive for SARS-CoV-2 led to some patients thinking they were immune from future infection, thus influencing subsequent behaviour

Digital subtraction radiographic analysis of the combination of bioabsorbable membrane and bovine morphogenetic protein pool in human periodontal infrabony defects

Objectives: This study assessed the bone density gain and its relationship with the periodontal clinical parameters in a case series of a regenerative therapy procedure. Material and Methods: Using a split-mouth study design, 10 pairs of infrabony defects from 15 patients were treated with a pool of bovine bone morphogenetic proteins associated with collagen membrane (test sites) or collagen membrane only (control sites). The periodontal healing was clinically and radiographically monitored for six months. Standardized presurgical and 6-month postoperative radiographs were digitized for digital subtraction analysis, which showed relative bone density gain in both groups of 0.034 ± 0.423 and 0.105 ± 0.423 in the test and control group, respectively (p>0.05). Results: As regards the area size of bone density change, the influence of the therapy was detected in 2.5 mm2 in the test group and 2 mm2 in the control group (p>0.05). Additionally, no correlation was observed between the favorable clinical results and the bone density gain measured by digital subtraction radiography (p>0.05). Conclusions: The findings of this study suggest that the clinical benefit of the regenerative therapy observed did not come with significant bone density gains. Long-term evaluation may lead to a different conclusions

The experiences of patients ill with COVID-19-like symptoms and the role of testing for SARS-CoV-2 in supporting them: A qualitative study in eight European countries during the first wave of the pandemic

BACKGROUND: Access to testing during the first wave of the COVID-19 pandemic was limited, impacting patients with COVID-19-like symptoms. Current qualitative studies have been limited to one country or were conducted outside Europe. OBJECTIVES: To explore - in eight European countries - the experiences of patients consulting in primary care with COVID-19-like symptoms during the first wave of the pandemic. METHODS: Sixty-six semi-structured interviews, informed by a topic guide, were conducted by telephone or in person between April and July 2020. Patients with COVID-19-like symptoms were purposively recruited in primary care sites in eight countries and sampled based on age, gender, and symptom presentation. Deductive and inductive thematic analysis techniques were used to develop a framework representing data across settings. Data adequacy was attained by collecting rich data. RESULTS: Seven themes were identified, which described the experiences of patients consulting. Two themes are reported in this manuscript describing the role of COVID-19 testing in this experience. Patients described significant distress due to their symptoms, especially those at higher risk of complications from COVID-19, and those with severe symptoms. Patients wanted access to testing to identify the cause of their illness and minimise the burden of managing uncertainty. Some patients testing positive for COVID-19 assumed they would be immune from future infection. CONCLUSION: Patients experiencing novel and severe symptoms, particularly those with comorbidities, experienced a significant emotional and psychological burden due to concerns about COVID-19. Testing provided reassurance over health status and helped patients identify which guidance to follow. Testing positive for SARS-CoV-2 led to some patients thinking they were immune from future infection, thus influencing subsequent behaviour

The Beaker phenomenon and the genomic transformation of northwest Europe

From around 2750 to 2500 bc, Bell Beaker pottery became widespread across western and central Europe, before it disappeared between 2200 and 1800 bc. The forces that propelled its expansion are a matter of long-standing debate, and there is support for both cultural diffusion and migration having a role in this process. Here we present genome-wide data from 400 Neolithic, Copper Age and Bronze Age Europeans, including 226 individuals associated with Beaker-complex artefacts. We detected limited genetic affinity between Beaker-complex-associated individuals from Iberia and central Europe, and thus exclude migration as an important mechanism of spread between these two regions. However, migration had a key role in the further dissemination of the Beaker complex. We document this phenomenon most clearly in Britain, where the spread of the Beaker complex introduced high levels of steppe-related ancestry and was associated with the replacement of approximately 90% of Britain’s gene pool within a few hundred years, continuing the east-to-west expansion that had brought steppe-related ancestry into central and northern Europe over the previous centuries