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  • 1157701.
    Wuolikainen, Anna
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Neurology.
    Metabolomics studies of ALS: a multivariate search for clues about a devastating disease2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Amyotrophic lateral sclerosis (ALS), also known as Charcot’s disease, motor neuron disease (MND) and Lou Gehrig’s disease, is a deadly, adult-onset neurodegenerative disorder characterized by progressive loss of upper and lower motor neurons, resulting in evolving paresis of the linked muscles. ALS is defined by classical features of the disease, but may present as a wide spectrum of phenotypes. About 10% of all ALS cases have been reported as familial, of which about 20% have been associated with mutations in the gene encoding for CuZn superoxide dismutase (SOD1). The remaining cases are regarded as sporadic. Research has advanced our understanding of the disease, but the cause is still unknown, no reliable diagnostic test exists, no cure has been found and the current therapies are unsatisfactory. Riluzole (Rilutek®) is the only registered drug for the treatment of ALS. The drug has shown only a modest effect in prolonging life and the mechanism of action of riluzole is not yet fully understood. ALS is diagnosed by excluding diseases with similar symptoms. At an early stage, there are numerous possible diseases that may present with similar symptoms, thereby making the diagnostic procedure cumbersome, extensive and time consuming with a significant risk of misdiagnosis. Biomarkers that can be developed into diagnostic test of ALS are therefore needed. The high number of unsuccessful attempts at finding a single diseasespecific marker, in combination with the complexity of the disease, indicates that a pattern of several markers is perhaps more likely to provide a diagnostic signature for ALS. Metabolomics, in combination with chemometrics, can be a useful tool with which to study human disease. Metabolomics can screen for small molecules in biofluids such as cerebrospinal fluid (CSF) and chemometrics can provide structure and tools in order to handle the types of data generated from metabolomics. In this thesis, ALS has been studied using a combination of metabolomics and chemometrics. Collection and storage of CSF in relation to metabolite stability have been extensively evaluated. Protocols for metabolomics on CSF samples have been proposed, used and evaluated. In addition, a new feature of data processing allowing new samples to be predicted into existing models has been tested, evaluated and used for metabolomics on blood and CSF. A panel of potential biomarkers has been generated for ALS and subtypes of ALS. An overall decrease in metabolite concentration was found for subjects with ALS compared to their matched controls. Glutamic acid was one of the metabolites found to be decreased in patients with ALS. A larger metabolic heterogeneity was detected among SALS cases compared to FALS. This was also reflected in models of SALS and FALS against their respective matched controls, where no significant difference from control was found for SALS while the FALS samples significantly differed from their matched controls. Significant deviating metabolic patterns were also found between ALS subjects carrying different mutations in the gene encoding SOD1.

  • 1157702.
    Wuolikainen, Anna
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Acimovic, Jure
    Loevgren-Sandblom, Anita
    Parini, Paolo
    Andersen, Peter M.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Bjoerkhem, Ingemar
    Cholesterol, Oxysterol, Triglyceride, and Coenzyme Q Homeostasis in ALS. Evidence against the Hypothesis That Elevated 27-Hydroxycholesterol Is a Pathogenic Factor2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 11, p. e113619-Article in journal (Refereed)
    Abstract [en]

    High plasma levels of cholesterol have been suggested to be neuroprotective for the degenerative disease amyotrophic lateral sclerosis (ALS) and to be associated with increased survival time. The gene encoding cholesterol 27-hydroxylase, CYP27A1, was recently identified as a susceptibility gene for sporadic ALS. A product of this enzyme is 27-hydroxycholesterol. We investigated plasma samples from 52 ALS patients and 40 control subjects (spouses) regarding cholesterol homeostasis, lipid profiles, and coenzyme Q. Eleven of the patients carried mutations in C9orf72 and seven in SOD1. Plasma levels of 27-hydroxycholesterol were significantly lower in male patients with ALS than in controls. It was not possible to link the reduced levels to any specific mutation, and there was no significant correlation between 27-hydroxycholesterol and survival. With normalization for diet using the spouses, a correlation was found between survival and total cholesterol, very low density lipoprotein cholesterol, low density lipoprotein cholesterol, and coenzyme Q. We conclude that cholesterol, 24S-hydroxycholesterol, 25-hydroxycholesterol, 27-hydroxycholesterol and lipid profiles in plasma are of limited prognostic value in individual ALS patients.

  • 1157703.
    Wuolikainen, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology. Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Hedenström, Mattias
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Moritz, Thomas
    Marklund, Stefan
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Andersen, Peter
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Optimization of procedures for collecting and storing of CSF for studying the metabolome in ALS2009In: Amyotrophic Lateral Sclerosis, ISSN 1748-2968, Vol. 10, no 4, p. 229-236Article in journal (Refereed)
    Abstract [en]

    There is a need for biomarkers for early diagnosis, development and evaluation of treatment efficacy in amyotrophic lateral sclerosis (ALS). We aimed to investigate if pre-analytical factors induce artefacts in metabolomic data of cerebrospinal fluid (CSF) from patients with ALS. CSF from 16 patients was studied using a statistical experimental design protocol with the following parameters: storage temperature (-80 degrees C/ - 20 degrees C), type of collection tube (polypropylene/polystyrene), and time delay from collecting to freezing (0, 10, 30, 90, 150 min). Gas chromatography-mass spectrometry was used to analyse CSF from 12 of the patients while CSF from one patient was analysed with nuclear magnetic resonance spectroscopy. The extent of CO(2) evaporization from CSF collected in tubes of different sizes at different temperatures and with/without lid were studied in three addtional patients. We found that alterations in storage temperature affect the metabolite composition of CSF more than any other studied pre-analytical parameter. CO(2) evaporization may induce artefacts in the metabolome by increasing the pH. In conclusion, minimization of evaluated artefacts can be obtained by collecting the CSF directly into tubes with tightly sealed lids in N(2)(l) and after freezing transfer of the tubes to -80 degrees C to minimize evaporation of CO(2).

  • 1157704.
    Wuolikainen, Anna
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Jonsson, Pär
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Ahnlund, Maria
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Marklund, Stefan L.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Moritz, Thomas
    Forsgren, Lars
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Andersen, Peter M.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Trupp, Miles
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Multi-platform mass spectrometry analysis of the CSF and plasma metabolomes of rigorously matched amyotrophic lateral sclerosis, Parkinson's disease and control subjects2016In: Molecular Biosystems, ISSN 1742-206X, E-ISSN 1742-2051, Vol. 12, no 4, p. 1287-1298Article in journal (Refereed)
    Abstract [en]

    Amyotrophic lateral sclerosis (ALS) and Parkinson's disease (PD) are protein-aggregation diseases that lack clear molecular etiologies. Biomarkers could aid in diagnosis, prognosis, planning of care, drug target identification and stratification of patients into clinical trials. We sought to characterize shared and unique metabolite perturbations between ALS and PD and matched controls selected from patients with other diagnoses, including differential diagnoses to ALS or PD that visited our clinic for a lumbar puncture. Cerebrospinal fluid (CSF) and plasma from rigorously age-, sex- and sampling-date matched patients were analyzed on multiple platforms using gas chromatography (GC) and liquid chromatography (LC)-mass spectrometry (MS). We applied constrained randomization of run orders and orthogonal partial least squares projection to latent structure-effect projections (OPLS-EP) to capitalize upon the study design. The combined platforms identified 144 CSF and 196 plasma metabolites with diverse molecular properties. Creatine was found to be increased and creatinine decreased in CSF of ALS patients compared to matched controls. Glucose was increased in CSF of ALS patients and alpha-hydroxybutyrate was increased in CSF and plasma of ALS patients compared to matched controls. Leucine, isoleucine and ketoleucine were increased in CSF of both ALS and PD. Together, these studies, in conjunction with earlier studies, suggest alterations in energy utilization pathways and have identified and further validated perturbed metabolites to be used in panels of biomarkers for the diagnosis of ALS and PD.

  • 1157705.
    Wuolikainen, Anna
    et al.
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Neurology.
    Moritz, Thomas
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre.
    Marklund, Stefan L
    Umeå University, Faculty of Medicine, Medical Biosciences, Clinical chemistry.
    Andersen, Peter M
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Neurology.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Chemistry.
    Predictive metabolomics for detection, interpretation and validation of metabolite patterns in human cerebrospinal fluidArticle in journal (Other academic)
    Abstract [en]

    We here present our predictive metabolomics approach for screening and comparing metabolomics data from human cerebrospinal fluid (CSF) generated by gas chromatography-time of flight mass spectrometry (GC-TOFMS). The approach is based on a combination of hierarchical multivariate curve resolution (HMCR) and manual integration of the GC–TOFMS data for quantification and identification of metabolites in multiple CSF samples. Chemometric data analysis, orthogonal partial least squares (OPLS), for multiple CSF sample comparisons. We show how the predictive feature of both HMCR and OPLS can be used for biomarker detection and verification as well as for diagnostic modelling. To exemplify the capability of the method we have used human CSF from two test subjects aliquoted into 44 tubes stored at either -80 °C or -20 °C as a model system. A total of 170 potential metabolites were resolved from the GC-TOFMS data using HMCR. OPLS modelling revealed a clear separation of the samples according to storage temperature, with a prediction accuracy of 100% using a test set.

  • 1157706.
    Wuolikainen, Anna
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Moritz, Thomas
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre (UPSC).
    Marklund, Stefan L
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Andersen, Peter M
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    ALS patients with mutations in the SOD1 gene have an unique metabolomic profile in the cerebrospinal fluid compared with ALS patients without mutations2012In: Molecular Genetics and Metabolism, ISSN 1096-7192, E-ISSN 1096-7206, Vol. 105, no 3, p. 472-478Article in journal (Refereed)
    Abstract [en]

    A specific biochemical marker for early diagnosing and for monitoring disease progression in amyotrophic lateral sclerosis (ALS) will have important clinical applications. ALS is a heterogeneous syndrome with multiple subtypes with ill-defined borders. A minority of patients carries mutations in the Cu/Zn-superoxide dismutase (SOD1) gene but the disease mechanism remains unknown for all types of ALS. Using a GC-TOFMS platform we studied the cerebrospinal fluid (CSF) metabolome in 16 ALS patients with six different mutations in the SOD1 gene and compared with ALS-patients without such mutations. OPLS-DA was used for classification modeling. We find that patients with a SOD1 mutation have a distinct metabolic profile in the CSF. In particular, the eight patients homozygous for the D90A SOD1 mutation showed a distinctively different signature when modeled against ALS patients with other SOD1 mutations and sporadic and familial ALS patients without a SOD1 gene mutation. This was found irrespective of medication with riluzole and survival time. Among the metabolites that contributed most to the CSF signature were arginine, lysine, ornithine, serine, threonine and pyroglutamic acid, all found to be reduced in patients carrying a D90A SOD1 mutation. ALS-patients with a SOD1 gene mutation appear as a distinct metabolic entity in the CSF, in particular in patients with the D90A mutation, the most frequently identified cause of ALS. The findings suggest that metabolomic profiling using GC-TOFMS and multivariate data analysis may be a future tool for diagnosing and monitoring disease progression, and may cast light on the disease mechanisms in ALS.

  • 1157707.
    Wuolikainen, Anna
    et al.
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Neurology. Umeå University, Faculty of Science and Technology, Chemistry.
    Moritz, Thomas
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre.
    Marklund, Stefan L
    Umeå University, Faculty of Medicine, Medical Biosciences, Clinical chemistry.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Chemistry.
    Andersen, Peter M
    Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience, Neurology.
    Studies of the human cerebrospinal fluid metabolome reveal alterations associated with amyotrophic lateral sclerosis and subtypes of the diseaseArticle in journal (Other academic)
    Abstract [en]

    Background: The composition of the metabolome in the cerebrospinal fluid of patients with amyotrophic lateral sclerosis is unknown. Previous studies of single metabolites have shown conflicting results.

    Methods: Using GC-TOFMS and multivariate statistical modeling, we studied the metabolome signature of ~120 compounds in the cerebrospinal fluid of ALS patients stratified according to hereditary disposition and clinical subtypes of the disease.

    Findings: Sporadic ALS has a heterogeneous metabolite signature in the CSF, in some patients being almost identical to controls. Familial ALS without SOD1 gene mutation is less heterogeneous than sporadic ALS. The metabolome of the CSF of the 17 ALS patients with a SOD1 gene mutation appeared as a separate homogeneous group. Analysis of single metabolites revealed that glutamate, pyroglutamate and glutamine were all reduced, in particular in patients with a familial disposition.

    Interpretation: There are significant differences in the metabolite profile and composition among patients with familial ALS, sporadic ALS and patients carrying a mutation in the SOD1 gene suggesting that the neurodegenerative process in different subtypes of ALS may be different. Patients with a genetic predisposition to ALS have a more distinct signature than patients with a sporadic disease.

  • 1157708.
    Wuolikainen, Anna
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Moritz, Thomas
    Marklund, Stefan L
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Andersen, Peter Munch
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Disease-related changes in the cerebrospinal fluid metabolome in amyotrophic lateral sclerosis detected by GC/TOFMS2011In: PloS one, ISSN 1932-6203, Vol. 6, no 4, p. e17947-Article in journal (Refereed)
    Abstract [en]

    Background/Aim: The changes in the cerebrospinal fluid (CSF) metabolome associated with the fatal neurodegenerative disease amyotrophic lateral sclerosis (ALS) are poorly understood and earlier smaller studies have shown conflicting results.The metabolomic methodology is suitable for screening large cohorts of samples. Global metabolomics can be used for detecting changes of metabolite concentrations in samples of fluids such as CSF.

    Methodology: Using gas chromatography coupled to mass spectrometry (GC/TOFMS) and multivariate statistical modeling, we simultaneously studied the metabolome signature of, 120 small metabolites in the CSF of patients with ALS, stratified according to hereditary disposition and clinical subtypes of ALS in relation to controls.

    Principal Findings: The study is the first to report data validated over two sub-sets of ALS vs. control patients for a large set of metabolites analyzed by GC/TOFMS. We find that patients with sporadic amyotrophic lateral sclerosis (SALS) have a heterogeneous metabolite signature in the cerebrospinal fluid, in some patients being almost identical to controls. However, familial amyotrophic lateral sclerosis (FALS) without superoxide dismutase-1 gene (SOD1) mutation is less heterogeneous than SALS. The metabolome of the cerebrospinal fluid of 17 ALS patients with a SOD1 gene mutation was found to form a separate homogeneous group. Analysis of metabolites revealed that glutamate and glutamine were reduced, in particular in patients with a familial predisposition. There are significant differences in the metabolite profile and composition among patients with FALS, SALS and patients carrying a mutation in the SOD1 gene suggesting that the neurodegenerative process in different subtypes of ALS may be partially dissimilar.

    Conclusions/Significance: patients with a genetic predisposition to amyotrophic lateral sclerosis have a more distinct and homogeneous signature than patients with a sporadic disease.

  • 1157709.
    Wuopio, Amanda
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of Archaeology and Ancient History.
    Dödens uppluckrade identiteter: Gravar på gränsen mellan hedniskt och kristet2015Independent thesis Advanced level (degree of Master (Two Years)), 30 credits / 45 HE creditsStudent thesis
    Abstract [en]

    The Christianisation of Sweden is not much about religion. Instead, there is much to be gained by looking at it as a colonial situation with changing social identities and power structures. This is evident by the prevalence of hybridisations in the archaeological material.

    Some of the material categories that show the clearest example of changes are the burials from the 9th century up until about AD 1200. This is exemplified by two different Iron Age burial sites in Stockholm county, Uppland, Sweden: RAÄ 59, Valsta, in Norrsunda parish and RAÄ 40, Lilla Ullevi, in Bro parish; They both show hybridisation by involving older elements with newer ones during a time period when the church was not quite established in the region yet.

    The Christianisation of Sweden is a colonial situation, but the research tradition has often also used a colonial lens from the 19th and early 20th century in its approach to the period. This means that the same questions, interpretations and conclusions, often based on written sources, have been continuously reused for a long time, which has had consequences for the archaeology in Sweden.

  • 1157710.
    Wuopio, Christina
    Dalarna University, School of Technology and Business Studies, Material Science.
    Kylning av valsar vid spårvalsning2005Independent thesis Advanced level (degree of Master (Two Years))Student thesis
    Abstract [sv]

    Inom Ruukki Fundia Special Bar finns tre liknande förpar, ett i Smedjebacken och två i Boxholm varav ett i finverket och det andra i mediumverket. Valsarna levereras av Åkers Sweden AB och är av samma kvalité, (gjutna H-SG-P-Mo-48 värmebehandlat-segjärn-perlitisk struktur-molybdenlegerat och med hårdhet 48 Shore) det som skiljer är radien. I mediumverket utsätts valsarna för ett hårt slitage både genom sprickbildning och ojämn yta medan de två andra förparen inte slits lika hårt. Idag används en vals i cirka sex månader, under den tiden sker en omsvarvning. På grund den rikliga sprickbildningen kan bara en omsvarvning ske på grund av att de djupa sprickorna gör att 12-16mm på diametern svarvas bort vid varje tillfälle. En andra omsvarvning gör att valsens radie blir för liten. Företaget vill minimera sprickbildningen för att kunna svarva om valsarna ytterligare en gång och på det sättet förbättra valsekonomin. Syftet med detta examensarbete är att undersöka möjligheter till varför denna sprickbildning och ytojämnhet uppstår. Sprickbildning är en följd av bland annat termiska ojämnheter på valsytan som orsakas växlande uppvärmning från hetan och kylning från kylmedlet. En annan orsak till sprickbildning kan vara överbelastning av valsarna. Temperaturer på valsar, ämne och vatten kommer att undersökas för att få en förståelse för vart problemet kan ligga. Det har gjorts beräkningar på valskrafter och moment för undersökningar i fråga om överbelastning. Programmet Steeltemp har används för att studera temperatur- förändringar i valsen under valsning. Även jämförelser mellan förparen i Smedjebacken och finverket i Boxholm har studerats.

  • 1157711. Wuopio, Elin
    Kvantifiering av kornformsförändring vid materialkvalitetstestning av ballast2014Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Roads and railroads are important and essential transport systems for our everyday life. It is important to continue the development to create greater understanding of how these constructions are affected by degradation to not build long life constructions that are not fulfilling tomorrow’s changed demands. In constructions consisting of aggregates degradation caused by external loads is described by effects like changed properties of the soil mass. One step in the right direction when it comes to better understanding degradation is to describe the grain shape changes that occur. A number of grain shape describing variables are presented: soliditycircularity, aspect ratio, roundness and . These are measured with two dimensional digital image processing (DIP).The degradation is simulated by the material quality tests Los Angeles and micro Deval tests. A great number of grains from their samples are analyzed before and after the tests to compare the change of the grain shape. The results are analyzed to find the change of the grain shape and differences of the grain shape change of the two tests. The Los Angeles samples show a significant decrease in size indicating that fragmentation is the degradation mode. The samples also to some extent show more circular grains after testing. The micro Deval samples show smaller grains, but not to the same extent as for the Los Angeles samples. The micro Deval samples also show that the grains are more even and circular indicating the grains are exposed to wearing. These results verify the degradation modes for the micro Deval and Los Angeles tests. The data is also analyzed with factor analysis to identify connections between the measured variables’ results. A clear connection can be seen for Los Angeles and micro Deval tests both before and after testing. Circularity and solidity are varying alike and represents a shape factor, measuring a grain’s shape in two scales. Another analysis was completed for flakiness index to explore if there is a way to perform a similar grain shape test with two dimensional digital image processing. There is a great difference between the results from the laboratory test and the DIP. This is because of the fact that only two dimensions are identified with the DIP, and the data collected from the DIP does not represent the data from the flakiness index test. That one dimension is not identified with the two dimensional DIP can also affect the grain shape results. Despite this, it is possible that the great number of analyzed grains can counter this effect. Further investigation is necessary to verify this.

  • 1157712.
    Wuopio, Emilié
    et al.
    Mälardalen University, School of Education, Culture and Communication.
    Källman, Malin
    Mälardalen University, School of Education, Culture and Communication.
    "Matte är så mycket mer än att räkna tal i en bok" Lärares syn på att undervisa utan lärobok2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med detta arbete är att ta reda på lärares syn på att undervisa utan en lärobok i årskurs 1-3. Vårt arbete är en kvalitativ studie och vi har intervjuat åtta lärare som har erfarenhet av att undervisa utan lärobok och vi har undersökt vilka anledningar som de ser till att välja bort läroboken från undervisningen. Arbetets fokus ligger på planeringen innan själva genomförandet av matematikundervisningen, valet av material och vilka andra saker som kan tänkas påverka organiseringen av undervisningen. Därför har vi valt att utforma intervjufrågorna efter två huvudområden, först en mer allmän syn på området och sedan fördjupade vi oss i planeringen och organiseringen av undervisningen. Resultatet av vår undersökning är att läraren måste våga variera undervisningen och ge eleverna möjlighet att testa på flera olika arbetssätt. Läraren måste våga tro på sina egna kunskaper och inte alltid förlita sig på andra samtidigt så kan läroboken ses som ett hjälpmedel och en stöttning då läraren känner att man behöver det. Resultatet visar också att den största påverkan på organisering av undervisningen var tiden.      

  • 1157713.
    Wuopio, Jonas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna.
    Hilden, Jørgen
    Bring, Carl
    Kastrup, Jens
    Sajadieh, Ahmad
    Jensen, Gorm Boje
    Kjøller, Erik
    Kolmos, Hans Jørn
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Jakobsen, Janus Christian
    Winkel, Per
    Gluud, Christian
    Carlsson, Axel C
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Ärnlöv, Johan
    Cathepsin B and S as markers for cardiovascular risk and all-cause mortality in patients with stable coronary heart disease during 10 years: a CLARICOR trial sub-study.2018In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 278, p. 97-102Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: The lysosomal cysteine proteases cathepsin B and S have been implicated in the atherosclerotic process. The present paper investigates the association between serum levels of cathepsin B and S and cardiovascular events and mortality in patients with stable coronary heart disease.

    METHODS: The CLARICOR trial is a randomised, placebo-controlled trial investigating the effect of clarithromycin versus placebo in patients with stable coronary heart disease. The outcome was time to either a cardiovascular event or all-cause mortality. The placebo group was used as discovery sample and the clarithromycin group as replication sample: n = 1998, n = 1979; mean age (years) 65, 65; 31%, 30% women; follow-up for 10 years; number of composite outcomes n = 1204, n = 1220; respectively. We used a pre-defined multivariable Cox regression model adjusting for inflammation, established cardiovascular risk factors, kidney function, and use of cardiovascular drugs.

    RESULTS: Cathepsin B was associated with an increased risk of the composite outcome in both samples after multivariable adjustment (discovery: multivariable ratio (HR) per standard deviation increase 1.12, 95% confidence interval (CI) 1.05-1.19, p < 0.001, replication; HR 1.14, 95% CI 1.07-1.21, p < 0.001). There was no significant association between cathepsin S and the composite outcome in either the discovery or replication sample after multivariable adjustment (p>0.45). Secondary analyses suggest that cathepsin B was predominantly associated with mortality rather than specific cardiovascular events.

    CONCLUSIONS: Cathepsin B, but not serum cathepsin S, was associated with an increased risk of cardiovascular events in patients with stable coronary heart disease. The clinical implications of our findings remain to be established.

  • 1157714. Wuopio, Jonas
    et al.
    Hilden, Jørgen
    Bring, Carl
    Kastrup, Jens
    Sajadieh, Ahmad
    Jensen, Gorm Boje
    Kjøller, Erik
    Kolmos, Hans Jørn
    Larsson, Anders
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Cathepsin B and S as markers for cardiovascular risk and all-cause mortality in patients with stable coronary heart disease during 10 years: a CLARICOR trial sub-study2018In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 278, p. 97-102Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: The lysosomal cysteine proteases cathepsin B and S have been implicated in the atherosclerotic process. The present paper investigates the association between serum levels of cathepsin B and S and cardiovascular events and mortality in patients with stable coronary heart disease.

    METHODS: The CLARICOR trial is a randomised, placebo-controlled trial investigating the effect of clarithromycin versus placebo in patients with stable coronary heart disease. The outcome was time to either a cardiovascular event or all-cause mortality. The placebo group was used as discovery sample and the clarithromycin group as replication sample: n = 1998, n = 1979; mean age (years) 65, 65; 31%, 30% women; follow-up for 10 years; number of composite outcomes n = 1204, n = 1220; respectively. We used a pre-defined multivariable Cox regression model adjusting for inflammation, established cardiovascular risk factors, kidney function, and use of cardiovascular drugs.

    RESULTS: Cathepsin B was associated with an increased risk of the composite outcome in both samples after multivariable adjustment (discovery: multivariable ratio (HR) per standard deviation increase 1.12, 95% confidence interval (CI) 1.05-1.19, p < 0.001, replication; HR 1.14, 95% CI 1.07-1.21, p < 0.001). There was no significant association between cathepsin S and the composite outcome in either the discovery or replication sample after multivariable adjustment (p>0.45). Secondary analyses suggest that cathepsin B was predominantly associated with mortality rather than specific cardiovascular events.

    CONCLUSIONS: Cathepsin B, but not serum cathepsin S, was associated with an increased risk of cardiovascular events in patients with stable coronary heart disease. The clinical implications of our findings remain to be established.

  • 1157715.
    Wuopio, Jonas
    et al.
    Mora Cty Hosp, Sweden.
    Östgren, Carl Johan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Ödeshög.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Lind, Lars
    Uppsala Univ, Sweden.
    Ruge, Toralph
    Karolinska Univ Hosp, Sweden.
    Carlsson, Axel C.
    Karolinska Inst, Sweden.
    Larsson, Anders
    Uppsala Univ, Sweden.
    Nyström, Fredrik H
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Arnlov, Johan
    Karolinska Inst, Sweden; Dalarna Univ, Sweden.
    The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes2018In: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 27, no 4, p. 215-221Article in journal (Refereed)
    Abstract [en]

    Background: Endostatin, cleaved from collagen XVIII in the extracellular matrix, is a promising circulating biomarker for cardiovascular damage. It possesses anti-angiogenic and anti-fibrotic functions and has even been suggested to be involved in blood pressure regulation. Less is known if endostatin levels relate to circadian blood pressure patterns. In the present paper we studied the association between circulating levels of endostatin and nocturnal dipping in blood pressure.Methods: We used the CARDIPP-study, a cohort of middle aged, type 2 diabetics (n=593, 32% women), with data on both 24-hour and office blood pressure, serum-endostatin, cardiovascular risk factors, and incident major cardiovascular events. Nocturnal dipping was defined as a amp;gt;10% difference between day- and night-time blood pressures.Results: Two-hundred four participants (34%) were classified as non-dippers. The mean endostatin levels were significantly higher in non-dippers compared to dippers (meanstandard deviation: 62.6 +/- 1.8 mu g/l vs. 58.7 +/- 1.6 mu g/l, respectively, p=.007). Higher serum levels of endostatin were associated with a diminished decline in nocturnal blood pressure adjusted for age, sex, HbA1c, mean systolic day blood pressure, hypertension treatment, glomerular filtration rate, and prevalent cardiovascular disease (regression coefficient per SD increase of endostatin -0.01, 95% CI, -0.02-(-0.001), p=.03). Structural equation modelling analyses suggest that endostatin mediates 7% of the association between non-dipping and major cardiovascular events.Conclusion: We found an independent association between higher circulating levels of endostatin and a reduced difference between day- and night-time systolic blood pressure in patients with type 2 diabetes. Yet endostatin mediated only a small portion of the association between non-dipping and cardiovascular events arguing against a clinical utility of our findings.

  • 1157716. Wuopio, Jonas
    et al.
    Östgren, Carl Johan
    Länne, Toste
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Ruge, Toralph
    Carlsson, Axel C
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Nyström, Fredrik H
    Ärnlöv, Johan
    The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes.2018In: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 27, no 4, p. 215-221Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Endostatin, cleaved from collagen XVIII in the extracellular matrix, is a promising circulating biomarker for cardiovascular damage. It possesses anti-angiogenic and anti-fibrotic functions and has even been suggested to be involved in blood pressure regulation. Less is known if endostatin levels relate to circadian blood pressure patterns. In the present paper we studied the association between circulating levels of endostatin and nocturnal dipping in blood pressure.

    METHODS: We used the CARDIPP-study, a cohort of middle aged, type 2 diabetics (n = 593, 32% women), with data on both 24-hour and office blood pressure, serum-endostatin, cardiovascular risk factors, and incident major cardiovascular events. Nocturnal dipping was defined as a >10% difference between day- and night-time blood pressures.

    RESULTS: Two-hundred four participants (34%) were classified as non-dippers. The mean endostatin levels were significantly higher in non-dippers compared to dippers (mean ± standard deviation: 62.6 ± 1.8 µg/l vs. 58.7 ± 1.6 µg/l, respectively, p = .007). Higher serum levels of endostatin were associated with a diminished decline in nocturnal blood pressure adjusted for age, sex, HbA1c, mean systolic day blood pressure, hypertension treatment, glomerular filtration rate, and prevalent cardiovascular disease (regression coefficient per SD increase of endostatin -0.01, 95% CI, -0.02-(-0.001), p = .03). Structural equation modelling analyses suggest that endostatin mediates 7% of the association between non-dipping and major cardiovascular events.

    CONCLUSION: We found an independent association between higher circulating levels of endostatin and a reduced difference between day- and night-time systolic blood pressure in patients with type 2 diabetes. Yet endostatin mediated only a small portion of the association between non-dipping and cardiovascular events arguing against a clinical utility of our findings.

  • 1157717. Wuopio, Jonas
    et al.
    Östgren, Carl Johan
    Länne, Toste
    Lind, Lars
    Ruge, Toralph
    Carlsson, Axel C.
    Larsson, Anders
    Nyström, Fredrik H.
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska Institutet.
    The association between circulating endostatin and a disturbed circadian blood pressure pattern in patients with type 2 diabetes2018In: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 27, no 4, p. 215-221Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Endostatin, cleaved from collagen XVIII in the extracellular matrix, is a promising circulating biomarker for cardiovascular damage. It possesses anti-angiogenic and anti-fibrotic functions and has even been suggested to be involved in blood pressure regulation. Less is known if endostatin levels relate to circadian blood pressure patterns. In the present paper we studied the association between circulating levels of endostatin and nocturnal dipping in blood pressure.

    METHODS: We used the CARDIPP-study, a cohort of middle aged, type 2 diabetics (n = 593, 32% women), with data on both 24-hour and office blood pressure, serum-endostatin, cardiovascular risk factors, and incident major cardiovascular events. Nocturnal dipping was defined as a >10% difference between day- and night-time blood pressures.

    RESULTS: Two-hundred four participants (34%) were classified as non-dippers. The mean endostatin levels were significantly higher in non-dippers compared to dippers (mean ± standard deviation: 62.6 ± 1.8 µg/l vs. 58.7 ± 1.6 µg/l, respectively, p = .007). Higher serum levels of endostatin were associated with a diminished decline in nocturnal blood pressure adjusted for age, sex, HbA1c, mean systolic day blood pressure, hypertension treatment, glomerular filtration rate, and prevalent cardiovascular disease (regression coefficient per SD increase of endostatin -0.01, 95% CI, -0.02-(-0.001), p = .03). Structural equation modelling analyses suggest that endostatin mediates 7% of the association between non-dipping and major cardiovascular events.

    CONCLUSION: We found an independent association between higher circulating levels of endostatin and a reduced difference between day- and night-time systolic blood pressure in patients with type 2 diabetes. Yet endostatin mediated only a small portion of the association between non-dipping and cardiovascular events arguing against a clinical utility of our findings.

  • 1157718.
    Wuorenlinna, Stancy
    Stockholm University, Faculty of Law, Department of Law.
    Elektroniska skuldebrev2015Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 1157719.
    Wuorimaa, Olivia
    et al.
    KTH, School of Industrial Engineering and Management (ITM), Industrial Economics and Management (Dept.).
    Klimkeit, Katharina
    KTH, School of Industrial Engineering and Management (ITM), Industrial Economics and Management (Dept.).
    Preferred Approaches of Industrial Marketing by Innovative Technology Firms to Enhance the Diffusion of Innovation in the Financial Industry2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This paper will discuss the challenges that arise in the business-to-business marketing process in the area of highly technological and innovative solutions. The authors will depict the processes that are involved in the business-to-business marketing approach and portray the challenges that arise due to a number of factors, such as trust, customer value and early adoption, when it comes to selling new technology and innovative solutions, and innovations overall, that companies nowadays need, but not necessarily want. The Diffusion of Innovation theory as well as the concept of Relationship Management will be used to put this topic into theoretical frameworks. With the support of existing literature, the qualitative methodologies of this paper are chosen in order to gain knowledge of the preferred approaches of business-to-business marketing. In accordance to this, the authors aim to analyze the diffusion of innovation and how companies today can attain customers not only within the early adopters group, but also the early and later majority, thus increasing market value and share. This exact transition has been analyzed, however not in the exact field of industrial marketing with a focus on the financial industry, though innovation and digitalization is now more important than ever. 

    Firms need to establish personal and trustworthy relationships with potential and actual customers in order to generate more value and implement necessary innovative solutions. In a survey conducted within the scope of this thesis, respondents emphasize the perceived level of expertise suppliers need in order to initiate collaborations. The focus on innovation and increasing customer and market values through its implementation will be discussed in order to accelerate value generation for all parties involved in an ever-changing digital environment and to fill the research gap within innovation diffusion in industrial marketing. 

  • 1157720.
    Wuotila, Julia
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences.
    Ett yrke där hot och våld är vardag: En kvalitativ studie om polisers upplevelser av hot och våld i arbetet2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In this study, police vulnerability to threats and violence has been examined. The study is based on qualitative method and seven qualitative semi-structured interviews have been conducted with police officers who actively work as police officers in the external service as well as with police officers who have worked in external service. The aim of the study was to create a deeper understanding of police officers’ experiences of vulnerability to threats and violence at work. To fulfill the purpose, three issues were formulated: “What kind of threat and violence are police officers exposed to in the external service?”, How do police officers in external service experience their vulnerability to threats and violence?” and “What are the consequences of the vulnerability to threat and violence for police officers in external service?. The collected empirical data has been analyzed based on the study's theoretical framework consisted in previous research which examined which factors entail risks for police officers to be exposed to threats and violence, normalization of threats and violence as well as theory of demand, control and social support at work.

    The results of the study show that the definition of threat and violence is based on the police officer’s subjective perception of the concept. All police officers testify of events where they were exposed to threats, violence or both at work. There are different types of threat and varying degrees of violence, where violence that arises during commotion in interventions is seen as a lower degree of violence and violent acts made with intent were considered as more serious types of violence. Regarding threats, it was perceived to be dependent on who pronounces the threat, whether the threat is directed against them personally or their family who primarily determine whether it is considered serious or not. The police officers tend to normalize and to tone down threatening and aggressive actions based on the perception that it is to some extent included in the role of working as a police officer to be exposed to threats and violence. However, the police officers do not consider it being okay to be subjected to threats and violence at work regardless of the circumstances. Furthermore, the results show that there are demands for performance to intervene in situations where there is a risk of being exposed to threats and violence and that the police officers feel that they have a high degree of control in the work. The vulnerability to threats and violence at work is handled by good social support at work.

  • 1157721.
    Wur, Aleksandra
    KTH, School of Architecture and the Built Environment (ABE), Sustainable development, Environmental science and Engineering, Land and Water Resources Engineering.
    Factors increasing efficiency of deammonification process for nitrogen removal from mainstream wastewater.2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In recent years, the use of Anammox process for wastewater treatment has been thoroughly investigated. Currently, a major challenge is to use this process for the mainstream.

    The aim of this study is to find factors increasing efficiency of the deammonification process for nitrogen removal from mainstream wastewater in conditions of low ammonia concentration and low temperatures.

    Two types of lab-scale batch tests were done and obtained results were analysed separately. In the first lab-scale batch test suspended sludge was used and series of OUR tests were carried out. Inhibitors used during experiments were: FNA, FA, NaClO3, fresh UASB effluent and formic acid. The best results, after all tests obtained for using the free nitrous acid as an inhibitor. Results shows that NOB bacterial activity was inhibited, while AOB activity was still high. The second type of lab-scale batch test was used to check interactions between factors which have impact for the NOB suppression. Selected factors were: pH, DO and TAN and these factors were used to plan a series of experiments with MODDE application. After series of 34 experiments, results showed that this method is not effective for low concentrations of TAN and another, more efficient strategy is needed. New strategy should reduce the NOB activity or increase the activity of Anammox.

    It is difficult to find a good strategy to carry out this process because many factors are affecting it. Using the results, it is necessary to conduct further research, which will give indications to use the deammonification process for mainstream wastewater and will let to achieve good results.

  • 1157722. Wurdak, Mara
    et al.
    Ihle, Katharina
    Stürmer, Marco
    Dirnberger, Isabella
    Fischer, Uwe C.
    Funk, Tatjana
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Wolstein, Jörg
    Indikatoren für das Ausmaß jugendlichen Rauschtrinkens in Bayern2013In: SUCHT, ISSN 0939-5911, E-ISSN 1664-2856, Vol. 59, no 4, p. 225-233Article in journal (Refereed)
    Abstract [en]

    Aims: To research whether the rising number of hospital treatments of alcohol intoxication is an indicator of an increase in risky alcohol consumption among adolescents. Methods: This was investigated within the framework of two secondary analyses (examination of crimes committed and accidents caused under the influence of alcohol among 10 – 20-year-old adolescents, as well as the alcohol blood concentration (BAC) of adolescents treated in hospital, n = 1 020) and a field study (population survey, n = 285). Results: The number of hospital treatments was positively correlated with crimes, but not with accidents under the influence of alcohol. In a city with a high prevalence of hospital treatments related to alcohol intoxication, more people would primarily call an ambulance as compared to a city with a low prevalence. The average BAC continuously declined within a two-year-period. Conclusions: The number of hospital treatments and criminal offenses committed under the influence of alcohol is indicative of an increase in risky alcohol consumption. However, the number of hospital treatments is associated with a higher sensitivity of the population and is not supported by the number of accidents under the influence of alcohol.

  • 1157723. Wurdak, Mara
    et al.
    Kuntsche, Emmanuel
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, München, Germany.
    Wolstein, Jörg
    Effectiveness of a brief intervention with and without booster session for adolescents hospitalized due to alcohol intoxication2016In: Journal of Substance Use, ISSN 1465-9891, E-ISSN 1475-9942, Vol. 21, no 1, p. 72-77Article in journal (Refereed)
    Abstract [en]

    Background: The Hart-am-LimiT (HaLT) project is a brief intervention program for adolescents hospitalized due to alcohol intoxication in Germany.

    Objective: To test whether a booster session has an impact on participants’ drinking behavior compared with the standard HaLT program.

    Methods: On the morning after their admission due to alcohol intoxication, 411 adolescents in the Federal State of Bavaria were interviewed between October 2008 and January 2010 and socio-demographic data and information on previous drinking behavior were recorded (t1). Eleven to 25 months (M = 16.4) after their hospital treatment, 106 adolescents completed an online questionnaire (t2).

    Results: Subgroup analysis (ANOVA with repeated measurements) indicated that adolescents who took part in the booster session did not increase episodic heavy drinking (EHD; t1: M = 1.68 EHD d; t2: 1.59 EHD d) in contrast to the non-participating group (t1: M = 1.08 d EHD; t2: 2.66 d EHD; F = 4.383, p = 0.039).

    Conclusion: Considering the study’s limitations (e.g. no randomization, low response rate, etc.), the results indicate a positive effect of a booster session following a brief intervention for adolescents who have been treated in hospital due to alcohol intoxication. Adolescents should therefore be motivated and encouraged to participate in booster sessions.

  • 1157724.
    Wurm, Christian A.
    et al.
    Max Planck Inst Biophys Chem, Dept NanoBiophoton, Gottingen, Germany.;Abberior Instruments GmbH, Gottingen, Germany..
    Schwarz, Heinz
    Max Planck Inst Dev Biol, Tubingen, Germany..
    Jans, Daniel C.
    KTH, School of Engineering Sciences (SCI), Applied Physics. KTH, Centres, Science for Life Laboratory, SciLifeLab. Max Planck Inst Biophys Chem, Dept NanoBiophoton, Gottingen, Germany.;Univ Med Ctr Gottingen, Clin Neurol, Gottingen, Germany.
    Riedel, Dietmar
    Max Planck Inst Biophys Chem, Lab Electron Microscopy, D-37077 Gottingen, Germany..
    Humbel, Bruno M.
    Univ Lausanne, Electron Microscopy Facil, Lausanne, Switzerland.;Okinawa Inst Sci & Technol, Imaging, Onna Son, Okinawa, Japan..
    Jakobs, Stefan
    Max Planck Inst Biophys Chem, Dept NanoBiophoton, Gottingen, Germany.;Univ Med Ctr Gottingen, Clin Neurol, Gottingen, Germany..
    Correlative STED super-resolution light and electron microscopy on resin sections2019In: Journal of Physics D: Applied Physics, ISSN 0022-3727, E-ISSN 1361-6463, Vol. 52, no 37, article id 374003Article in journal (Refereed)
    Abstract [en]

    Correlative light and electron microscopy approaches can reveal the localisation of specific proteins while providing detailed information on the cellular context, thereby combining the strengths of both imaging modalities. The major challenge in combining fluorescence microscopy with electron microscopy is the different sample preparation requirements necessary for obtaining high quality data from both modalities. To overcome this limitation, we combined conventional sample preparation protocols for electron microscopy with post-embedding labelling on ultra-thin sections using antibodies and other specific ligands. We successfully employed STED super-resolution microscopy to image the subcellular distribution of several targets in various specimen including E. coli, T brucei, S. cerevisiae, human cancer cells and bovine sperm. Thus, we present widely applicable methods facilitating the use of antibodies for correlative super-resolution light and electron microscopy of post-embedding labelled targets.

  • 1157725.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Trans2017In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundberg, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur och kultur, 2017, 1, p. 137-152Chapter in book (Other (popular science, discussion, etc.))
  • 1157726.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Understanding Comorbid Pain and Emotions: A transdiagnostic approach2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Experiencing pain, including an emotional reaction, is part of being hu­man. Emotional comorbidity is common in pain patients, and corre­lated to higher symptomatology and worse treatment outcome. The shared vulnerability model suggests that many vulnerability and main­taining factors may be involved in both pain and emotional problems. Hence, they may be transdiagnostic. Since our knowledge about these shared factors is lacking, potential targets for risk assessment, preven­tion, and treatment are likely underutilized. The overarching aim of this dissertation was to further our understanding of comorbid musculo­skeletal pain and emotional problems by investigating the role of trans­diagnostic factors. Specifically, it was studied if levels of shared vulner­abilities (negative affect and anxiety sensitivity) and symptomatology covary in pain patients depending on the occurrence of comorbid social anxiety symptoms (Study I); if peer-related stress predicts musculoskel­etal pain problems over time in adolescents, and if this is mediated by worry and moderated by gender (Study II); and if symptomatology can be decreased in pain patients with comorbid emotional problems by using an internet delivered unified protocol for emotional disorders (Study III). Results show that vulnerabilities covaried with comorbid pain and social anxiety. Also, peer-related stress predicted musculoskel­etal pain problems in adolescents and was mediated by worry for girls. However, the internet-delivered unified protocol did not unequivocally decrease symptomatology. In sum, the studies in this dissertation pro­vide partial support for the role of transdiagnostic factors in comorbid musculoskeletal pain and emotional problems. A transdiagnostic ap­proach may offer a parsimonious understanding of the  development and maintenance of this comorbid symptomatology.

  • 1157727.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Anniko, Malin
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender2018In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 111, p. 76-82Article in journal (Refereed)
    Abstract [en]

    Objective: Adolescence is a time of change during which several health problems, such as pain problems, increase. Psychosocial mechanisms involved in this development, such as interpersonal stressors and worry, are still understudied, especially longitudinally. The first aim of this study was to investigate the prevalence of musculoskeletal pain in Swedish adolescents between the ages 13 and 15 using pain grades. The second aim was to study the role of peer-related stress, worry, and gender in the development of musculoskeletal pain problems over time.

    Methods: Adolescents in 18 public schools were followed from 7th to 9th grade (N=1181) and answered selfreport questionnaires at three time points. Prevalence was assessed at all three time points and a moderated mediation analysis investigated if peer-related stress in 7th grade predicted musculoskeletal pain two years later and if this relationship was mediated by worry in 8th grade. Gender was entered as a moderator.

    Results: In 7th grade, 8.4% of adolescents reported musculoskeletal pain with some functional impairment. In 8th and 9th grade around 10% of adolescents reported musculoskeletal pain problems, with girls reporting a higher prevalence than boys. Peer-related stress in 7th grade predicted musculoskeletal pain problems in 9th grade, mediated by worry in 8th grade. The mediation was moderated by gender: peer-related stress predicted worry for girls, but not for boys.

    Conclusion: Peer-related stress and worry seem to be involved in the development of pain over time. These factors should therefore be targeted in preventative interventions and during treatment.

  • 1157728.
    Wurm, Matilda
    et al.
    Örebro universitet.
    Anniko, Malin
    Örebro universitet.
    Tillfors, Maria
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Flink, Ida
    Örebro universitet.
    Boersma, Katja
    Örebro universitet.
    Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender2018In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 111, p. 76-82Article in journal (Refereed)
    Abstract [en]

    Objective: Adolescence is a time of change during which several health problems, such as pain problems, increase. Psychosocial mechanisms involved in this development, such as interpersonal stressors and worry, are still understudied, especially longitudinally. The first aim of this study was to investigate the prevalence of musculoskeletal pain in Swedish adolescents between the ages 13 and 15 using pain grades. The second aim was to study the role of peer-related stress, worry, and gender in the development of musculoskeletal pain problems over time. Methods: Adolescents in 18 public schools were followed from 7th to 9th grade (N = 1181) and answered self-report questionnaires at three time points. Prevalence was assessed at all three time points and a moderated mediation analysis investigated if peer-related stress in 7th grade predicted musculoskeletal pain two years later and if this relationship was mediated by worry in 8th grade. Gender was entered as a moderator. Results: In 7th grade, 8.4% of adolescents reported musculoskeletal pain with some functional impairment. In 8th and 9th grade around 10% of adolescents reported musculoskeletal pain problems, with girls reporting a higher prevalence than boys. Peer-related stress in 7th grade predicted musculoskeletal pain problems in 9th grade, mediated by worry in 8th grade. The mediation was moderated by gender: peer-related stress predicted worry for girls, but not for boys. Conclusion: Peer-related stress and worry seem to be involved in the development of pain over time. These factors should therefore be targeted in preventative interventions and during treatment.

  • 1157729.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Det senaste inom psykoterapi och smärta: Aktuellt från CHAMP: Unified Protocol online och Compassion Focused Therapy för smärtpatienter2016Conference paper (Other academic)
  • 1157730.
    Wurm, Matilda
    et al.
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Edlund, Sara
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Boersma, Katja
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Tillfors, Maria
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Comorbi social anxiety and pain: Relationship with transdiagnostic psychological processes2013Conference paper (Other academic)
  • 1157731.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Edlund, Sara
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Comorbi social anxiety and pain: Relationship with transdiagnostic psychological processes2013Conference paper (Other academic)
  • 1157732.
    Wurm, Matilda
    et al.
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Edlund, Sara
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Tillfors, Maria
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Boersma, Katja
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Characteristics and consequences of the co-occurence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment2016In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 12, p. 45-52Article in journal (Refereed)
    Abstract [en]

    Background and aims: Chronic pain problems are related to specific pain related fears and maladaptive pain-coping but also commonly co-occur with other anxiety problems. Shared emotional vulnerabil-ity factors may explain this comorbidity and may influence treatment outcome. Indeed, pain patients going through multimodal pain treatment are a heterogeneous group and treatment results vary. One understudied anxiety disorder co-occurring with pain is social anxiety. This may be relevant as many pain-related challenges are situated in social contexts. The aim of this study is to investigate the occur-rence of subgroups with differential patterns of social anxiety and pain related fear in a sample of chronic pain patients who receive multimodal pain treatment. The aim is also to study the characteristics of these potential subgroups and the consequences of different patterns of social anxiety and pain related fear.

    Methods: 180 patients with chronic musculoskeletal pain answered questionnaires before and after a multimodal pain treatment in a hospital rehabilitation setting in middle Sweden. A cluster analysis using pre-treatment scores on the Social Phobia Screening Questionnaire and the Tampa Scale of Kinesiophobia was performed. Subgroups were thereafter validated and compared on impairment due to social anxi-ety, pain catastrophizing, anxiety, and depression. Moreover, subgroups were described and compared on vulnerability factors (anxiety sensitivity, negative affect) and outcome factors (pain intensity, pain interference, and return to work self-efficacy).

    Results: Four distinct clusters emerged: (1) low scores, (2) pain-related fear only, (3) social concern only, and (4) high social anxiety and pain-related fear. Patients high on social anxiety and pain-related fear had significantly higher levels of anxiety sensitivity, negative affect, and higher general emotional symptomatology. They also had remaining problems posttreatment.

    Conclusions: A subgroup of patients with clinical levels of social anxiety has suboptimal rehabilitation results, with residual emotional problems and high levels of emotional vulnerability.

    Implications: These patients may be in need of additional treatment efforts that are not being met today. To prevent insufficient treatment results and prolonged work disability, these patients need to be detected during screening and may benefit from pain treatment that takes their emotional problems into account.

  • 1157733.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Edlund, Sara
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Characteristics and consequences of the co-occurence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment2016In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 12, p. 45-52Article in journal (Refereed)
    Abstract [en]

    Background and aims: Chronic pain problems are related to specific pain related fears and maladaptive pain-coping but also commonly co-occur with other anxiety problems. Shared emotional vulnerabil-ity factors may explain this comorbidity and may influence treatment outcome. Indeed, pain patients going through multimodal pain treatment are a heterogeneous group and treatment results vary. One understudied anxiety disorder co-occurring with pain is social anxiety. This may be relevant as many pain-related challenges are situated in social contexts. The aim of this study is to investigate the occur-rence of subgroups with differential patterns of social anxiety and pain related fear in a sample of chronic pain patients who receive multimodal pain treatment. The aim is also to study the characteristics of these potential subgroups and the consequences of different patterns of social anxiety and pain related fear.

    Methods: 180 patients with chronic musculoskeletal pain answered questionnaires before and after a multimodal pain treatment in a hospital rehabilitation setting in middle Sweden. A cluster analysis using pre-treatment scores on the Social Phobia Screening Questionnaire and the Tampa Scale of Kinesiophobia was performed. Subgroups were thereafter validated and compared on impairment due to social anxi-ety, pain catastrophizing, anxiety, and depression. Moreover, subgroups were described and compared on vulnerability factors (anxiety sensitivity, negative affect) and outcome factors (pain intensity, pain interference, and return to work self-efficacy).

    Results: Four distinct clusters emerged: (1) low scores, (2) pain-related fear only, (3) social concern only, and (4) high social anxiety and pain-related fear. Patients high on social anxiety and pain-related fear had significantly higher levels of anxiety sensitivity, negative affect, and higher general emotional symptomatology. They also had remaining problems posttreatment.

    Conclusions: A subgroup of patients with clinical levels of social anxiety has suboptimal rehabilitation results, with residual emotional problems and high levels of emotional vulnerability.

    Implications: These patients may be in need of additional treatment efforts that are not being met today. To prevent insufficient treatment results and prolonged work disability, these patients need to be detected during screening and may benefit from pain treatment that takes their emotional problems into account.

  • 1157734.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    Anniko, Malin
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over timeManuscript (preprint) (Other academic)
  • 1157735.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    External and internal social factors as risk factors for the development of back/neck pain in Swedish adolescents2017In: : Pain in Europe, 2017Conference paper (Other academic)
    Abstract [en]

    Background and aim: Back/neck pain is common in adolescents. Studies show correlations with social factors, such as bully victimization and individual social functioning (social anxiety). In adult pain populations, comorbid social anxiety has been correlated with higher symptomatology and worse treatment outcome. The aim of this study was to describe the prevalence of back/neck pain and to analyze the influence of bullying and social anxiety on back/neck pain over time in a general population sample of Swedish adolescents.

    Method: Data consisted at baseline of all pupils in 7’th grade attending public schools in three Swedish municipalities (N= 1453, Mage= 13.19, sd= .43, 52.6 % boys), followed up yearly. Pupils were categorized as having a pain-problem based on self-reported pain frequency, pain intensity, and functional limitation. A multivariate logistic regression was conducted with bullying victimization, social anxiety, back/neck pain and gender at time 1 as predictors for back/neck pain at time 3.

    Results: The prevalence of problematic back/neck pain was 8.4% (N= 122) at time 1, 10.5% (N=144) at time 2 and 9.9% (N=117) at time 3. The regression model was statistically significant (X² (4, N= 1181) = 84.46, p=.000). Gender, back/neck pain and bully victimization at time 1, but not social anxiety, significantly predicted pain problem at time 3.

    Conclusions: External social factors rather than individual social function predicted back/neck pain. Since studies have found correlations between bully victimization and social anxiety and social anxiety may be prevalent and influence treatment outcomes in adult pain populations, this relationship should be studied further.

  • 1157736.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Hanner, Hans
    Att möta samhället som hbtq+2017In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur & Kultur , 2017, p. 153-168Chapter in book (Other (popular science, discussion, etc.))
  • 1157737.
    Wurm, Matilda
    et al.
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Klein Strandberg, Ester
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Lorenz, Caroline
    Buhrman, Monica
    Uppsala University, Uppsala, Sweden.
    Holländare, Fredrik
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Tillfors, Maria
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Boersma, Katja
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Chronic pain and emotional problems: A replicated single case study of an internet based therapist guided treatment based on CBT principles and the Unified Protocol of transdiagnostic treatments2016Conference paper (Other academic)
  • 1157738.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Klein Strandberg, Ester
    Örebro University, School of Law, Psychology and Social Work.
    Lorenz, Caroline
    Buhrman, Monica
    Uppsala University, Uppsala, Sweden.
    Holländare, Fredrik
    Örebro University, School of Medical Sciences.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Chronic pain and emotional problems: A replicated single case study of an internet based therapist guided treatment based on CBT principles and the Unified Protocol of transdiagnostic treatments2016Conference paper (Other academic)
  • 1157739.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Klein Strandberg, Ester
    Örebro University, School of Law, Psychology and Social Work.
    Lorenz, Caroline
    Private person.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Buhrman, Monica
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Holländare, Fredrik
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Centre, Region Örebro County, Örebro, Sweden.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study2017In: Internet Interventions, ISSN 2214-7829, Vol. 10, p. 54-64Article in journal (Refereed)
    Abstract [en]

    In pain patients, comorbid emotional problems have been linked to negative outcomes, including suboptimaltreatment gains. Developing parsimonious and accessible treatment options is therefore important. The overarchingaim of this study was to test an internet delivered therapist guided transdiagnostic treatment withtelephone support. An adapted version of the Unified Protocol for Transdiagnostic Treatments of EmotionalDisorders was used as an intervention for pain patients with residual pain problems and comorbid emotionalproblems after having received a multimodal pain rehabilitation. The study used a replicated AB single caseexperimental design (N =5; 3 females). Outcome measures were depressive and general anxiety symptoms, painintensity, pain coping problems, and diagnostic status. Feasibility measures (completion and compliance) andpatient satisfaction were also assessed. Scores on Nonoverlap of All Pairs (NAP) indicate a decrease of anxiety forthree participants and a decrease of depression for four participants. Decreases were small and did not alwaysreach statistical significance. Also, Tau-U scores could only confirm a reliable trend for one participant. Two outof four patients who were diagnosed with psychiatric disorders before treatment did no longer fulfill diagnosticcriteria posttreatment. No improvements could be seen on pain problems. The treatment was feasible and patientsatisfaction was high. Hence, while an internet delivered transdiagnostic treatment with telephone support maybe a feasible and accepted secondary intervention for pain patients with comorbid emotional problems, theeffects are unclear. The gap between high patient satisfaction and small changes in symptomatology should beexplored further.

  • 1157740.
    Wurm, Matilda
    et al.
    Orebro Univ, CHAMP, Orebro, Sweden.
    Strandberg, Ester Klein
    Orebro Univ, CHAMP, Orebro, Sweden.
    Lorenz, Caroline
    Orebro Univ, CHAMP, Orebro, Sweden.
    Tillfors, Maria
    Orebro Univ, CHAMP, Orebro, Sweden.
    Buhrman, Monica
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Hollandare, Fredrik
    Orebro Univ, Univ Hlth Care Res Ctr, Fac Med & Hlth, Orebro, Sweden.
    Boersma, Katja
    Orebro Univ, CHAMP, Orebro, Sweden.
    Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study2017In: Internet Interventions, ISSN 2214-7829, Vol. 10, p. 54-64Article in journal (Refereed)
    Abstract [en]

    In pain patients, comorbid emotional problems have been linked to negative outcomes, including suboptimal treatment gains. Developing parsimonious and accessible treatment options is therefore important. The overarching aim of this study was to test an internet delivered therapist guided transdiagnostic treatment with telephone support. An adapted version of the Unified Protocol for Transdiagnostic Treatments of Emotional Disorders was used as an intervention for pain patients with residual pain problems and comorbid emotional problems after having received a multimodal pain rehabilitation. The study used a replicated AB single case experimental design (N = 5; 3 females). Outcome measures were depressive and general anxiety symptoms, pain intensity, pain coping problems, and diagnostic status. Feasibility measures (completion and compliance) and patient satisfaction were also assessed. Scores on Nonoverlap of All Pairs (NAP) indicate a decrease of anxiety for three participants and a decrease of depression for four participants. Decreases were small and did not always reach statistical significance. Also, Tau-U scores could only confirm a reliable trend for one participant. Two out of four patients who were diagnosed with psychiatric disorders before treatment did no longer fulfill diagnostic criteria posttreatment. No improvements could be seen on pain problems. The treatment was feasible and patient satisfaction was high. Hence, while an internet delivered transdiagnostic treatment with telephone support may be a feasible and accepted secondary intervention for pain patients with comorbid emotional problems, the effects are unclear. The gap between high patient satisfaction and small changes in symptomatology should be explored further.

  • 1157741.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Traczyk, Michal
    Riktlinjer2017In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur & Kultur , 2017, p. 333-338Chapter in book (Other (popular science, discussion, etc.))
  • 1157742. Wurm, Patrick
    et al.
    Adlarson, Patrik
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Calén, Hans
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Fransson, Kjell
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Gullström, Carl-Oscar
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Hejkenskjöld, Lena
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Höistad, Bo
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Jacewicz, Marek
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Johansson, Tord
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Kupsc, Andrzej
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Leupold, Stefan
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Marciniewski, Pawel
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Redmer, Christoph
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Wolke, Magnus
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Zlomanczuk, Jozef
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Nuclear Physics.
    Search for the η → e+ee+eˆ’ double Dalitz decay2011In: Journal of Physics: Conference Series, Vol. 312Article in journal (Refereed)
    Abstract [en]

    The Wide Angle Shower Apparatus (WASA) operated at the Cooler Synchrotron COSY-JÌlich is a 4p-spectrometer to study the decay channels of light mesons ranging up into the strange quark sector. A large number of η mesons is being produced in proton-deuteron and proton-proton reactions, permitting the study of very rare η -decay channels. One of the channels is the double Dalitz decay, where the η meson decays via two virtual photons into two electron-positron pairs. The coupling between the η meson and the two virtual photons can be described by the transition form factor. It depends on the squared invariant mass of the lepton pairs and allows to study the structure of the decay mechanism. Currently, there is only an experimental upper limit for the branching ratio. One objective of the WASA-at-COSY experiment is to reduce the upper limit for this decay channel or to determine a finite value of the branching ratio. The goal is to study the transition form factor. The status of the continuing analysis and preliminary results are presented.

  • 1157743. Wurnig, C
    et al.
    Schatz, K
    Noske, H
    Hemon, Y
    Dahlberg, G
    Josefsson, G
    Milbrink, J
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
    Hamard, C
    Subcutaneous low-dose epoetin beta for the avoidance of transfusion inpatients scheduled for elective surgery not eligible for autologous blooddonation.2001In: Eur Surg Res, Vol. 33, p. 303-Article in journal (Refereed)
  • 1157744. Wurst, Friedrich Martin
    et al.
    Kelso, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Weinmann, Wolfgang
    Pragst, Fritz
    Yegles, Michel
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Measurement of direct ethanol metabolites suggests higher rate of alcohol use among pregnant women than found with the AUDIT: a pilot study in a population-based sample of Swedish women2008In: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 198, no 4, p. 407.e1-Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objective of the study was to investigate whether biomarkers of alcohol consumption would provide additional information to the use of a validated alcohol questionnaire in pregnant women. STUDY DESIGN: One hundred three pregnant women were included in the study. The women completed the Alcohol Use Disorders Identification Test (AUDIT) questionnaire, and a urine and hair sample was collected. The urine samples were used for determination of ethyl glucuronide (EtG) and ethyl sulfate and the hair samples for EtG and fatty acid ethyl esters (FAEE). RESULTS: Twenty-six women (25.2%) were identified as possible alcohol consumers by the combined use of AUDIT and direct ethanol metabolites. Seven subjects had EtG or FAEE levels in hair highly suspicious of heavy drinking, but only 1 of these were positive according to the AUDIT questionnaire CONCLUSION: The combined use of the AUDIT questionnaire and direct ethanol metabolites appear to identify more potential alcohol consumers among pregnant women than does the sole use of the AUDIT questionnaire.

  • 1157745.
    Wursthorn, Amelie
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Determination of Call Graphs in Web Service Structures2012Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    This work is part of a project which addresses a detection of the most suitable Webservice for the needs of a particular end user within service oriented architecture (SOA).As of today a research group located at Karlsruhe University of Applied Sciences,Germany, and Linnæus University, Sweden developed a framework which obtainsknowledge about quality of services. Thereby this framework offers the possibility toregister several Web services and guarantees the routing of the communication betweenthem through an Enterprise Service Bus (ESB) implementation developed by this group.The project raises several issues that have to be solved in order to reach the aim ofproviding a framework which selects the most suitable services based on non-functionalcriteria like response time or reliability.Web services call each other to provide their own functionality.The first aim of this work is to redirect released requests (sub-requests) which areinitiated by previous requests (sub-requests), or to manipulate specific data,respectively. A sub-request should then call a specified service which had prior to thisbeen selected by the framework.The next and main part of this work deals with providing data which keepinformation about the relation between requests and those requests released by a Webservice as a reaction of these initial calls. This data is the basis input for later calculatingof call graphs. This issue leads to further questions: The information about Web servicecalls is not reported by the standard log output of the host server. The approach for asolution has to define a way to record the Web service requests and their dependenciesamong each other.For verifying the concept an implementation will demonstrate the successful result.

  • 1157746. Wurtz, Albrecht
    Boundary states in conformal field theory2004Licentiate thesis, monograph (Other academic)
    Abstract [en]

    This licentiate thesis discusses boundary states in conformal field theories related to WZW (Wess-Zumino-Witten) models. These models are used as building blocks to describe the compact extra dimensions of certain string theories. The focus of the first chapter is to give a flavor of conformal field theory. The second chapter treats WZW- and related models. Such models can be described from a geometric perspective, or from an algebraic perspective. The discussion in this text is mostly from the latter perspective, but some attention is being paid to the relation between the two approaches. The third and final chapter deals with boundary states in WZW- and related models. The physical application aimed at is the description of D-branes in string theory, subsets of space-time to which string end points are confined. The relation between the concept of D-branes and the concept of boundary states is not direct, as discussed in the beginning of chapter 3. It turns out that the boundary states, if interpreted in geometric language as D-branes, in many cases are ''smeared''. This was known already to Felder et al, together with the fact that 0- dimensional branes in WZW models do not exist. The first new result in this thesis is a concrete argument for the latter statement. An important class of models that are related to WZW models are the coset models. These are introduced in chapter 2, and some novel results on the geometric interpretation of their boundary states as D- branes can be found in chapter 3. Apart from the coset models, there are also geometric orbifold models related to WZW- models. Concrete examples of such models are the Lens space models, on which an article was published in collaboration with Pedro Bordalo. Results from this paper can be found in the final two sections of chapter 3.

  • 1157747.
    Wurtz, Albrecht
    Karlstad University, Faculty of Technology and Science.
    Conformal Field Theory and D-branes2006Doctoral thesis, monograph (Other scientific)
    Abstract [en]

    The main topic of this doctoral thesis is D-branes in string theory, expressed in the language of conformal field theory. The purpose of string theory is to describe the elementary particles and the fundamental interactions of nature, including gravitation as a quantum theory. String theory has not yet reached the status to make falsifiable predictions, thus it is not certain that string theory has any direct relevance to physics. On the other hand, string theory related research has led to progress in mathematics.

    We begin with a short introduction to conformal field theory and some of its applications to string theory. We also introduce vertex algebras and discuss their relevance to conformal field theory. Some classes of conformal field theories are introduced, and we discuss the relevant vertex algebras, as well as their interpretation in terms of string theory.

    In string theory, a D-brane specifies where the endpoint of the string lives. Many aspects of string theory can be described in terms of a conformal field theory, which is a field theory that lives on a two-dimensional space. The conformal field theory counterpart of a D-brane is a boundary state, which in some cases has a natural interpretation as constraining the string end point. The main focus of this thesis is on the interpretation of boundary states in terms of D-branes in curved target spaces.

  • 1157748. Wurz, Peter
    et al.
    Blomberg, Lars G.
    KTH, Superseded Departments, Alfvén Laboratory. KTH, School of Electrical Engineering (EES), Space and Plasma Physics.
    Particle populations in Mercury's magnetosphere2001In: Planetary and Space Science, ISSN 0032-0633, E-ISSN 1873-5088, Vol. 49, no 14-15, p. 1643-1653Article in journal (Refereed)
    Abstract [en]

    Observations by Mariner 10 during its first and third flybys showed that Mercury possesses an intrinsic magnetic field resulting in a small magnetosphere that can keep the solar wind from directly interacting with the planet's surface under usual conditions. Since Mercury occupies a large fraction of its magnetosphere, regions of trapped charged particles in the inner magnetosphere, the plasmasphere and the energetic radiation belts, would all be absent. During the first flyby, energetic particle bursts were detected and interpreted as hermean substroms analogous to the terrestrial magnetosphere. Moreover, during this flyby, ULF waves and field-aligned currents were detected in the data. Earth-based observations of Na, K, and Ca populations in the exosphere strongly suggest the existence of dynamic magnetospheric processes at high latitudes interacting with the planet's surface.

  • 1157749. Wurzbacher, Christian
    et al.
    Attermeyer, Katrin
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Ecology and Genetics, Limnology. Leibniz-Institute of Freshwater Ecology and Inland Fisheries, Stechlin, Germany.
    Kettner, Maria Therese
    Flintrop, Clara
    Warthmann, Norman
    Hilt, Sabine
    Grossart, Hans-Peter
    Monaghan, Michael T.
    DNA metabarcoding of unfractionated water samples relates phyto-, zoo- and bacterioplankton dynamics and reveals a single-taxon bacterial bloom2017In: Environmental Microbiology Reports, ISSN 1758-2229, E-ISSN 1758-2229, Vol. 9, no 4, p. 383-388Article in journal (Refereed)
    Abstract [en]

    Most studies of aquatic plankton focus on either macroscopic or microbial communities, and on either eukaryotes or prokaryotes. This separation is primarily for methodological reasons, but can overlook potential interactions among groups. We tested whether DNA metabarcoding of unfractionated water samples with universal primers could be used to qualitatively and quantitatively study the temporal dynamics of the total plankton community in a shallow temperate lake. We found significant changes in the relative proportions of normalized sequence reads of eukaryotic and prokaryotic plankton communities over a three-month period in spring. Patterns followed the same trend as plankton estimates measured using traditional microscopic methods. We characterized the bloom of a conditionally rare bacterial taxon belonging to Arcicella, which rapidly came to dominate the whole lake ecosystem and would have remained unnoticed without metabarcoding. Our data demonstrate the potential of universal DNA metabarcoding applied to unfractionated samples for providing a more holistic view of plankton communities.

  • 1157750.
    Wurzbacher, Christian
    et al.
    Leibniz-Institute of Freshwater Ecology and Inland Fisheries, Germany; Berlin Center for Genomics in Biodiversity Research, Germany; Department of Biological and Environmental Sciences, University of Gothenburg, Sweden.
    Fuchs, Andrea
    Carl-von-Ossietzky University Oldenburg, Germany; Leibniz-Institute of Freshwater Ecology and Inland Fisheries, Germany.
    Attermeyer, Katrin
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Ecology and Genetics, Limnology. Leibniz-InsLeibniz-Institute of Freshwater Ecology and Inland Fisheries, Germanytitute of Freshwater Ecology and Inland Fisheries, Alte Fischerhütte 2, 16775 Stechlin, Germany.
    Frindte, Katharina
    Leibniz-Institute of Freshwater Ecology and Inland Fisheries, 16775 Stechlin, Germany; Institute of Crop Science and Resource Conservation – Molecular Biology of the Rhizosphere, Bonn University, Germany.
    Grossart, Hans-Peter
    Leibniz-Institute of Freshwater Ecology and Inland Fisheries, Germany; Institute for Biochemistry and Biology, Potsdam University, Germany.
    Hupfer, Michael
    Leibniz-Institute of Freshwater Ecology and Inland Fisheries, Germany.
    Casper, Peter
    Leibniz-Institute of Freshwater Ecology and Inland Fisheries, Germany.
    Monaghan, Michael T.
    Leibniz-Institute of Freshwater Ecology and Inland Fisheries, Germany; Berlin Center for Genomics in Biodiversity Research, Germany.
    Shifts among Eukaryota, Bacteria, and Archaea define the vertical organization of a lake sediment2017In: Microbiome, ISSN 0026-2633, E-ISSN 2049-2618, Vol. 5, article id 41Article in journal (Refereed)
    Abstract [en]

    Background: Lake sediments harbor diverse microbial communities that cycle carbon and nutrients while being constantly colonized and potentially buried by organic matter sinking from the water column. The interaction of activity and burial remained largely unexplored in aquatic sediments. We aimed to relate taxonomic composition to sediment biogeochemical parameters, test whether community turnover with depth resulted from taxonomic replacement or from richness effects, and to provide a basic model for the vertical community structure in sediments.

    Methods: We analyzed four replicate sediment cores taken from 30-m depth in oligo-mesotrophic Lake Stechlin in northern Germany. Each 30-cm core spanned ca. 170 years of sediment accumulation according to 137Cs dating and was sectioned into layers 1–4 cm thick. We examined a full suite of biogeochemical parameters and used DNA metabarcoding to examine community composition of microbial Archaea, Bacteria, and Eukaryota.

    Results: Community β-diversity indicated nearly complete turnover within the uppermost 30 cm. We observed a pronounced shift from Eukaryota- and Bacteria-dominated upper layers (<5 cm) to Bacteria-dominated intermediate layers (5–14 cm) and to deep layers (>14 cm) dominated by enigmatic Archaea that typically occur in deep-sea sediments. Taxonomic replacement was the prevalent mechanism in structuring the community composition and was linked to parameters indicative of microbial activity (e.g., CO2 and CH4 concentration, bacterial protein production). Richness loss played a lesser role but was linked to conservative parameters (e.g., C, N, P) indicative of past conditions.

    Conclusions: By including all three domains, we were able to directly link the exponential decay of eukaryotes with the active sediment microbial community. The dominance of Archaea in deeper layers confirms earlier findings from marine systems and establishes freshwater sediments as a potential low-energy environment, similar to deep sea sediments. We propose a general model of sediment structure and function based on microbial characteristics and burial processes. An upper “replacement horizon” is dominated by rapid taxonomic turnover with depth, high microbial activity, and biotic interactions. A lower “depauperate horizon” is characterized by low taxonomic richness, more stable “low-energy” conditions, and a dominance of enigmatic Archaea.

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