Direct hollow fibre liquid phase membrane extraction and LC-MS determination of selective serotonin reuptake inhibitors in fish tissue

Selective serotonin reuptake inhibitors (SSRIs) have been found in waste water treatment plant effluents and surface water at detectable concentrations. Although the medical effects and side effects of pharmaceuticals and personal care products are investigated through safety and toxicology studies the potential environmental impacts are less studied, and information concerning ecotoxicological risks and the distribution in sludge, surface water and water living organisms is rather scarce. In this thesis, sertraline (SER), fluoxetine (FLU) and its N-desmethyl metabolite norfluoxetine (norFLU) were chosen as model substances to develop a method for detection. Fish was chosen as the model matrix because fish is a top predator with possible high analyte concentrations because of biomagnification. Hollow fibre liquid-phase membrane extraction (HF-LPME) was used as the extraction, clean-up and enrichment technique and LC-MS was used to detect the SSRIs in fish muscle tissue. This analytical method showed enrichment factors ranging 1500-1800 for fish samples and 3000-6300 for water samples. The R2-values of the linearity were 0.936, 0.990, 0.966 for norFLU, FLU and SER, respectively. The detection limits of the method for norFLU, FLU and SER were in the range of 130-280 ng L-1. The method was successfully applied to detect the analytes in exposed crucian carp; 1.7 μg g-1 FLU and 2.8 μg g-1 SER were found after exposure to a 51 μg L-1-mixture for 3 days. The FLU metabolite norFLU was not added in the exposure solution and it was not formed in detectable concentrations during the exposure. In unexposed crucian carp, none of the analytes were detected. The developed analytical method might be extended to estimate the distribution or the fate of norFLU, FLU and SER in other biota or human beings.Spår av antidepressiva läkemedel i fisk Läkemedel hjälper till att behandla och förebygga sjukdomar hos både djur och människor. Rigorösa utredningar krävs för att kartlägga deras effekter och bieffekter, men när de inte bryts ner helt i kroppen hamnar de i sjöar och vattendrag. Här är deras påverkan på djur och natur inte alls lika kartlagd. Depression är bland de äldsta sjukdomarna kända för människan. Sedan den antidepressiva läkemedelsgruppen selektiva serotoninåterupptagshämmare (SSRI) introducerades behandlas även mildare former av depression med medicin. Detta har gjort SSRI-mediciner till de mest utskrivna psykofarmakan. Då forskning har visat att psykofarmaka inte helt bryts ner i kroppen är det av största vikt att hitta sätt att analysera denna typ av läkemedel i vattenlevande organismer. Förutom låg koncentration är det alltid komplicerat att analysera ämnen i biologiska prover på grund av mängden andra, oönskade, ämnen som ofta skymmer sikten. Forskning har dock utvecklat metoder som är selektiva och högt anrikande av de önskade molekylerna. En sådan teknik är hålfiberteknik, eller Hollow Fibre Liquid Phase Membrane Extraction (HF-LPME). Med hjälp av en tunn, porös slang (hålfiber), koncentreras de önskade molekylerna tusenfalt. Detta för också med sig att endast små mängder lösningsmedel behöver användas, vilket gör metoden miljövänlig. I ett arbete utfört på Centrum för analys och syntes vid Lunds universitet, användes tekniken för att analysera SSRI i ruda från Revingehed. Arbetet visade att då fiskarna exponerades för SSRI i vattnet, kunde de antidepressiva läkemedlen även hittas i fiskvävnaden

Upload or not to upload

The use of cloud computing is increasing in many different areas, and one of these areas is education. As using cloud in education becomes standard in many schools, some ethical concern regarding student information arises. This thesis aims to identify the issues that Swedish schools in the region of Skåne are facing regarding the use of cloud computing. This is achieved by creating a theoretical framework based on literature on issues with cloud computing. This framework consists of four components: cloud in education, stakeholders, contracts and regulations and PAPAM framework (privacy, accuracy, property, access and motivation) Thereafter is a qualitative research conducted, based on interviews with the stakeholders in education that are in contact with cloud computing. These stakeholders are identified to be teachers, principals and IT-professionals. By understanding how these stakeholders manage the ethical issues of cloud computing, and comparing this with the theoretical framework, several guidelines and propositions are reached. The guidelines are advised to be applied by the stakeholders for them to manage cloud in education in a way that avoids any ethical concerns. The guidelines concern policies for cloud use, clearer laws from the government, and solid contracts with the cloud providers and clear responsibility distribution

Missing: Understanding the Reception of a Serious Game by Analyzing App Store Data

The focus of this paper is the design and player reception of a serious game called Missing released on Google Play with the intention of spreading awareness of trafficking and its impact on individuals and society. The aim of the paper is to investigate how the game has been received by its players, focusing on its trafficking theme, by analyzing player metrics and app store data available from the Google Play digital distribution system. The paper presents results focusing on three main knowledge contributions: the identification and characterization of the tension between the designer’s intention with a game’s mechanics and how they help to convey the message of the game, the identification of the complexity of finding relevant reviews relating to the serious theme of the game and the identification and characterization of the tension between the star rating and the content of the reviews. One of the conclusions is that even a negative review can mirror a positive result in terms of fulfillment of the purpose

How does comorbidity influence healthcare costs? A population-based cross-sectional study of depression, back pain and osteoarthritis

Objectives To analyse how comorbidity among patients with back pain, depression and osteoarthritis influences healthcare costs per patient. A special focus was made on the distribution of costs for primary healthcare compared with specialist care, hospital care and drugs. Design Population-based cross-sectional study. Setting The County of Östergötland, Sweden. Patients Data on diagnoses and healthcare costs for all 266 354 individuals between 20 and 75 years of age, who were residents of the County of Östergötland, Sweden, in the year 2006, were extracted from the local healthcare register and the national register of drug prescriptions. Main outcome measures The effects of comorbidity on healthcare costs were estimated as interactions in regression models that also included age, sex, number of other health conditions and education. Results The largest diagnosed group was back pain (11 178 patients) followed by depression (7412 patients) and osteoarthritis (5174 patients). The largest comorbidity subgroup was the combination of back pain and depression (772 patients), followed by the combination of back pain and osteoarthritis (527 patients) and the combination of depression and osteoarthritis (206 patients). For patients having both a depression diagnosis and a back pain diagnosis, there was a significant negative interaction effect on total healthcare costs. The average healthcare costs among patients with depression and back pain was SEK 11 806 lower for a patient with both diagnoses. In this comorbidity group, there were tendencies of a positive interaction for general practitioner visits and negative interactions for all other visits and hospital days. Small or no interactions at all were seen between depression diagnoses and osteoarthritis diagnoses. Conclusions A small increase in primary healthcare visits in comorbid back pain and depression patients was accompanied with a substantial reduction in total healthcare costs and in hospital costs. Our results can be of value in analysing the cost effects of comorbidity and how the coordination of primary and secondary care may have an impact on healthcare costs

Experimental and theoretical lifetimes and transition probabilities in Sb I

We present experimental atomic lifetimes for 12 levels in Sb I, out of which seven are reported for the first time. The levels belong to the 5p$^2$($^3$P)6s $^{2}$P, $^{4}$P and 5p$^2$($^3$P)5d $^{4}$P, $^{4}$F and $^{2}$F terms. The lifetimes were measured using time-resolved laser-induced fluorescence. In addition, we report new calculations of transition probabilities in Sb I using a Multiconfigurational Dirac-Hartree-Fock method. The physical model being tested through comparisons between theoretical and experimental lifetimes for 5d and 6s levels. The lifetimes of the 5d $^4$F$_{3/2, 5/2, 7/2}$ levels (19.5, 7.8 and 54 ns, respectively) depend strongly on the $J$-value. This is explained by different degrees of level mixing for the different levels in the $^4$F term.Comment: 10 page

Patterns of local recurrence and dose fractionation of adjuvant radiation therapy in 462 patients with soft tissue sarcoma of extremity and trunk wall

Purpose To study the impact of dose fractionation of adjuvant radiation therapy (RT) on local recurrence (LR) and the relation of LR to radiation fields. Methods and Materials LR rates were analyzed in 462 adult patients with soft tissue sarcoma who underwent surgical excision and adjuvant RT at five Scandinavian sarcoma centers from 1998 to 2009. Medical records were reviewed for dose fractionation parameters and to determine the location of the LR relative to the radiation portals. Results Fifty-five of 462 patients developed a LR (11.9%). Negative prognostic factors included intralesional surgical margin (hazard ratio [HR]: 7.83, 95% confidence interval [CI]: 3.08-20.0), high malignancy grade (HR: 5.82, 95% CI: 1.31-25.8), age at diagnosis (HR per 10 years: 1.27, 95% CI: 1.03-1.56), and malignant peripheral nerve sheath tumor histological subtype (HR: 6.66, 95% CI: 2.56-17.3). RT dose was tailored to margin status. No correlation between RT dose and LR rate was found in multiple Cox regression analysis. The majority (65%) of LRs occurred within the primary RT volume. Conclusions No significant dose–response effect of adjuvant RT was demonstrated. Interestingly, patients given 45-Gy accelerated RT (1.8 Gy twice daily/2.5 weeks) had the best local outcome. A total dose of 50 Gy in 25 fractions seemed adequate following wide margin surgery. The risk of LR was associated with histopathologic subtype, which should be included in the treatment algorithm of adjuvant RT in soft tissue sarcoma.publishedVersio

Associations between sleep quality and biomarkers for neurodegeneration - A longitudinal one-year case-control study of patients with bipolar disorder and healthy control individuals

Disturbed sleep during affective episodes may impact levels of cerebrospinal fluid (CSF)-amyloid-beta (Aβ)42 and other biomarkers of neurodegeneration in patients with bipolar disorder (BD). The study aimed to investigate the correlations between sleep and biomarkers for Alzheimer's disease (AD) and neurodegeneration in BD and healthy controls (HC). We present a prospective, longitudinal case-control study of euthymic patients with BD (N ​= ​86) and HC (N ​= ​44). All participants were evaluated with clinical assessments at baseline, and after a year. The patients’ affective states were recorded weekly as euthymic, subthreshold level, major depression, or (hypo)mania. Patients were re-assessed during and after an episode if it occurred during follow-up. Total sleep scores based on three Hamilton-17 Depression Scale items were analyzed in relation to concentrations of CSF-Aβ42, CSF-Aβ40, CSF-Aβ38, CSF-Aβ42/40 and 42/38 ratios, CSF-soluble amyloid-precursor proteins α+β, plasma-Aβ42, plasma-Aβ40, CSF-phosphorylated-tau, CSF-total-tau, plasma-total-tau, CSF-neurofilament-light, plasma-neurofilament-light, CSF-neurogranin, serum-S100B, CSF-8-oxo-7,8-dihydro-guanosine, CSF-8-oxo-7,8-dihydro-2′-deoxyguanosine, urine-8-oxo-7,8-dihydro-guanosine, and urine-8-oxo-7,8-dihydro-2′-deoxyguanosine. The primary outcome was the association between total sleep scores and levels of CSF-Aβ42 at baseline and follow-up estimated by the regression coefficient in a linear mixed model. We found no statistically significant associations between sleep and CSF-Aβ42 (−2.307 ​pg/ml (95% CI: -9.525–4.911; p ​= ​0.523)) or any other biomarkers. However, higher sleep scores appeared to be associated with higher CSF-Aβ42/40 and CSF-Aβ42/38 ratios, and lower CSF-total-tau concentration, but were not statistically significant after correction for multiple testing. In conclusion attenuated sleep during an affective episode was not associated with changes in biomarkers for AD and neurodegeneration in BD, but larger prospective studies are needed

Consensus statement from the 2014 International Microdialysis Forum.

Microdialysis enables the chemistry of the extracellular interstitial space to be monitored. Use of this technique in patients with acute brain injury has increased our understanding of the pathophysiology of several acute neurological disorders. In 2004, a consensus document on the clinical application of cerebral microdialysis was published. Since then, there have been significant advances in the clinical use of microdialysis in neurocritical care. The objective of this review is to report on the International Microdialysis Forum held in Cambridge, UK, in April 2014 and to produce a revised and updated consensus statement about its clinical use including technique, data interpretation, relationship with outcome, role in guiding therapy in neurocritical care and research applications.We gratefully acknowledge financial support for participants as follows: P.J.H. - National Institute for Health Research (NIHR) Professorship and the NIHR Biomedical Research Centre, Cambridge; I.J. – Medical Research Council (G1002277 ID 98489); A. H. - Medical Research Council, Royal College of Surgeons of England; K.L.H.C. - NIHR Biomedical Research Centre, Cambridge (Neuroscience Theme; Brain Injury and Repair Theme); M.G.B. - Wellcome Trust Dept Health Healthcare Innovation Challenge Fund (HICF-0510-080); L. H. - The Swedish Research Council, VINNOVA and Uppsala Berzelii Technology Centre for Neurodiagnostics; S. M. - Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; D.K.M. - NIHR Senior Investigator Award to D.K.M., NIHR Cambridge Biomedical Research Centre (Neuroscience Theme), FP7 Program of the European Union; M. O. - Swiss National Science Foundation and the Novartis Foundation for Biomedical Research; J.S. - Fondo de Investigación Sanitaria (Instituto de Salud Carlos III) (PI11/00700) co-financed by the European Regional Development; M.S. – NIHR University College London Hospitals Biomedical Research Centre; N. S. - Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s00134-015-3930-