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  • 1. Agardh, Anette
    et al.
    Ross, Michael
    Östergren, Per-Olof
    Larsson, Markus
    Tumwine, Gilbert
    Månsson, Sven-Axel
    Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA). Malmö högskola, Centre for Sexology and Sexuality Studies (CSS).
    Simpson, Julie A
    Patton, George
    Health Risks in Same-Sex Attracted Ugandan University Students: Evidence from Two Cross-Sectional Studies2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 3, article id e0150627Article in journal (Refereed)
    Abstract [en]

    Widespread discrimination across much of sub-Saharan Africa against persons with same-sex sexuality, including recent attempts in Uganda to extend criminal sanctions against same-sex behavior, are likely to have profound effects on this group's health, health care access, and well-being. Yet knowledge of the prevalence of same-sex sexuality in this region is scarce. This study aimed to systematically examine prevalence of same-sex sexuality and related health risks in young Ugandan adults. We conducted two cross-sectional survey studies in south-western Uganda targeting student samples (n = 980, n = 1954) representing 80% and 72% of the entire undergraduate classes attending a university in 2005 and 2010, respectively. A questionnaire assessed items concerning same-sex sexuality (same-sex attraction/fantasies, same-sex sexual relations), mental health, substance use, experience of violence, risky sexual behavior, and sexual health counseling needs. Our findings showed that same-sex sexual attraction/fantasies and behavior were common among male and female students, with 10-25% reporting having sexual attraction/fantasies regarding persons of the same-sex, and 6-16% reporting same-sex sexual relations. Experiences of same-sex sexuality were associated with health risks, e.g. poor mental health (2010, AOR = 1.5; 95% CI: 1.0-2.3), sexual coercion (2010, AOR 2.9; CI: 1.9-4.6), and unmet sexual health counseling needs (2010, AOR 2.2; CI: 1.4-3.3). This first study of young adults in Uganda with same-sex sexuality found high levels of health needs but poor access to health care. Effective response is likely to require major shifts in current policy, efforts to reduce stigmatization, and reorientation of health services to better meet the needs of this vulnerable group of young people.

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  • 2.
    Arvidsson, Anna
    et al.
    Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
    Johnsdotter, Sara
    Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).
    Essen, Birgitta
    Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
    Views of Swedish Commissioning Parents Relating to the Exploitation Discourse in Using Transnational Surrogacy2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 5Article in journal (Refereed)
    Abstract [en]

    Transnational surrogacy, when people travel abroad for reproduction with the help of a surrogate mother, is a heavily debated phenomenon. One of the most salient discourses on surrogacy is the one affirming that Westerners, in their quest for having a child, exploit poor women in countries such as India. As surrogacy within the Swedish health care system is not permitted, Swedish commissioning parents have used transnational surrogacy, and the majority has turned to India. This interview study aimed to explore how commissioning parents negotiate the present discourses on surrogacy. Findings from the study suggest that the commissioning parents' views on using surrogacy are influenced by competing discourses on surrogacy represented by media and surrogacy agencies. The use of this reproductive method resulted, then, in some ambiguity. Although commissioning parents defy the exploitation discourse by referring to what they have learnt about the surrogate mother's life situation and by pointing at the significant benefits for her, they still had a request for regulation of surrogacy in Sweden, to better protect all parties involved. This study, then, gives a complex view on surrogacy, where the commissioning parents simultaneously argue against the exploitation discourse but at the same time are uncertain if the surrogate mothers are well protected in the surrogacy arrangements. Their responses to the situation endorse the need for regulation both in Sweden and India.

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  • 3.
    Berlin, Henrik
    et al.
    Malmö University, Faculty of Odontology (OD).
    Vall, Martina
    Malmö University, Malmö University Library.
    Bergenäs, Elisabeth
    Malmö University, Malmö University Library.
    Ridell, Karin
    Malmö University, Faculty of Odontology (OD).
    Brogårdh-Roth, Susanne
    Malmö University, Faculty of Odontology (OD).
    Lager, Elisabeth
    Malmö University, Faculty of Odontology (OD).
    List, Thomas
    Malmö University, Faculty of Odontology (OD).
    Davidson, Thomas
    Malmö University, Faculty of Odontology (OD).
    Klingberg, Gunilla
    Malmö University, Faculty of Odontology (OD).
    Effects and cost-effectiveness of postoperative oral analgesics for additional postoperative pain relief in children and adolescents undergoing dental treatment: Health technology assessment including a systematic review2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 12, article id e0227027Article, review/survey (Refereed)
    Abstract [en]

    Background There is an uncertainty regarding how to optimally prevent and/or reduce pain after dental treatment on children and adolescents. Aim To conduct a systematic review (SR) and health technology assessment (HTA) of oral analgesics administered after dental treatment to prevent postoperative pain in children and adolescents aged 3-19 years. Design A PICO-protocol was constructed and registered in PROSPERO (CRD42017075589). Searches were conducted in PubMed, Cochrane, Scopus, Cinahl, and EMBASE, November 2018. The researchers (reading in pairs) assessed identified studies independently, according to the defined inclusion and exclusion criteria, following the PRISMA-statement. Results 3,963 scientific papers were identified, whereof 216 read in full text. None met the inclusion criteria, leading to an empty SR. Ethical issues were identified related to the recognized knowledge gap in terms of challenges to conduct studies that are well-designed from methodological as well as ethical perspectives. Conclusions There is no scientific support for the use or rejection of oral analgesics administered after dental treatment in order to prevent or reduce postoperative pain in children and adolescents. Thus, no guidelines can be formulated on this issue based solely on scientific evidence. Well-designed studies on how to prevent pain from developing after dental treatment in children and adolescents is urgently needed.

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  • 4.
    Berthelsen, Hanne
    et al.
    Malmö University, Faculty of Odontology (OD). Malmö University, Centre for Work Life and Evaluation Studies (CTA).
    Hakanen, Jari J.
    Westerlund, Hugo
    Copenhagen Psychosocial Questionnaire: A validation study using the Job Demand-Resources model2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 4, article id e0196450Article in journal (Refereed)
    Abstract [en]

    Aim: This study aims at investigating the nomological validity of the Copenhagen Psychosocial Questionnaire (COPSOQ II) by using an extension of the Job Demands-Resources (JD-R) model with aspects of work ability as outcome. Material and methods: The study design is cross-sectional. All staff working at public dental organizations in four regions of Sweden were invited to complete an electronic questionnaire (75% response rate, n = 1345). The questionnaire was based on COPSOQ II scales, the Utrecht Work Engagement scale, and the one-item Work Ability Score in combination with a proprietary item. The data was analysed by Structural Equation Modelling. Results: This study contributed to the literature by showing that: A) The scale characteristics were satisfactory and the COPSOQ instrument could be integrated in the JD-R framework; B) Job resources arising from leadership may be a driver of the two processes included in the JD-R model; and C) Both the health impairment and motivational processes were associated with WA, and the results suggested that leadership may impact WA, in particularly by securing task resources. Conclusion: In conclusion, the nomological validity of COPSOQ was supported as the JD-R model can be operationalized by the instrument. This may be helpful for transferral of complex survey results and work life theories to practitioners in the field.

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  • 5.
    Berthelsen, Hanne
    et al.
    Malmö University, Faculty of Odontology (OD). Malmö University, Centre for Work Life and Evaluation Studies (CTA).
    Westerlund, Hugo
    Pejtersen, Jan Hyld
    Hadzibajramovic, Emina
    Construct validity of a global scale for Workplace Social Capital based on COPSOQ III2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 8, article id e0221893Article in journal (Refereed)
    Abstract [en]

    Background and aim: Workplace Social Capital has been suggested as a useful concept when addressing organizational and social factors of the work environment. The overall aim of the present study is to establish and evaluate the construct validity of a measure of Workplace Social Capital based on the operationalization suggested in the third version of the Copenhagen Psychosocial questionnaire. Methods: The present study is based on data collected as part of a validation and development project for the use of the Swedish version of COPSOQ at workplaces and includes responses from 1316 human service workers answering a workplace survey. Six items from scales for organizational justice, vertical trust and horizontal trust in COPSOQ III were included in the analyses. Rasch Analysis was used for scale validation. Results: The analyses showed that the psychometric properties of the suggested COPSOQ scale for Workplace Social Capital were satisfactory after accommodation for local dependency. Each individual item worked as intended, the scale was unidimensional and functioned invariantly for women and men, and for younger and older employees. The scale was furthermore found to be valid for use for distinguishing groups, not individuals. Conclusion: We have established that the scale for Workplace Social Capital measured by COPSOQ III is valid for distinguishing groups, e.g. work teams. The scale exhibits good construct validity as it satisfies the measurement criteria defined by the Rasch model.

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  • 6. Blankers, Matthijs
    et al.
    Frijns, Tom
    Belackova, Vendula
    Rossi, Carla
    Svensson, Bengt
    Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).
    Trautmann, Franz
    van Laar, Margriet
    Predicting Cannabis Abuse Screening Test (CAST) Scores: A Recursive Partitioning Analysis Using Survey Data from Czech Republic, Italy, the Netherlands and Sweden2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 9, article id 108298Article in journal (Refereed)
    Abstract [en]

    Cannabis is Europe's most commonly used illicit drug. Some users do not develop dependence or other problems, whereas others do. Many factors are associated with the occurrence of cannabis-related disorders. This makes it difficult to identify key risk factors and markers to profile at-risk cannabis users using traditional hypothesis-driven approaches. Therefore, the use of a data-mining technique called binary recursive partitioning is demonstrated in this study by creating a classification tree to profile at-risk users.

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  • 7.
    Carlsson, Linnea
    et al.
    The Västra Götaland Region Competence Centre on Intimate Partner Violence; The Sahlgrenska Academy.
    Lysell, Henrik
    The Västra Götaland Region Competence Centre on Intimate Partner Violence; Swedish National Board of Health and Welfare.
    Enander, Viveka
    he Västra Götaland Region Competence Centre on Intimate Partner Violence; University of Gothenburg.
    Örmon, Karin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). The Västra Götaland Region Competence Centre on Intimate Partner Violence.
    Lövestad, Solveig
    The Västra Götaland Region Competence Centre on Intimate Partner Violence; University of Gothenburg.
    Krantz, Gunilla
    The Västra Götaland Region Competence Centre on Intimate Partner Violence; University of Gothenburg.
    Socio-demographic and psychosocial characteristics of male and female perpetrators in intimate partner homicide: A case-control study from Region Västra Götaland, Sweden2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 8, article id e0256064Article in journal (Refereed)
    Abstract [en]

    Risk factor studies on male-perpetrated intimate partner homicide (IPH) are often compared with studies on intimate partner violence (IPV) or non-partner homicide perpetrators. This not only excludes female perpetrators, but also fails to take socio-demographic and psychosocial differences between perpetrators and the general population into consideration. The aim of this study was to examine male- and female-perpetrated IPH cases, and to compare socio-demographic factors in IPH perpetrators and in matched controls from the general population. Data were retrieved from preliminary inquiries, court records and national registers for 48 men and 10 women, who were perpetrators of IPH committed in 2000–2016 and residing in Region Västra Götaland, Sweden. The control group consisted of 480 men and 100 women matched for age, sex and residence parish. Logistic regression, yielding odds ratios (OR) with 95% confidence intervals (CI), was performed for male perpetrators and male controls to investigate associations for selected socio-demographic and psychosocial characteristics. This was not performed for females due to the small sample size. Female perpetrators were convicted of murder to a lesser extent than male perpetrators. No woman was sentenced to life imprisonment while five men were. Jealousy and separation were the most common motivational factors for male perpetration while the predominant factor for female perpetrators was subjection to IPV. Statistically significant differences were found between male perpetrators and male controls in unemployment rate (n = 47.9%/20.6%; OR 4.4; 95% CI 2.2–8.6), receiving benefits (n = 20.8%/4.8%; OR 5.2; 95% CI 2.3–11.7) and annual disposable income (n = 43.8%/23.3% low income; OR 5.2; 95% CI 1.9–14.2) one year prior to the crime. Female IPH perpetrators were less educated than female controls (≤ 9-year education 30%/12%) and were more often unemployed (70%/23%) one year before the crime. Male and female IPH perpetrators were socio-economically disadvantaged, compared with controls from the general population.

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  • 8.
    Cecchinato, Francesca
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Agha, Nezha Ahmad
    Martinez-Sanchez, Adela Helvia
    Luthringer, Berengere Julie Christine
    Feyerabend, Frank
    Willumeit-Roemer, Regine
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    Influence of Magnesium Alloy Degradation on Undifferentiated Human Cells2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 11, article id e0142117Article in journal (Refereed)
    Abstract [en]

    Background Magnesium alloys are of particular interest in medical science since they provide compatible mechanical properties with those of the cortical bone and, depending on the alloying elements, they have the capability to tailor the degradation rate in physiological conditions, providing alternative bioresorbable materials for bone applications. The present study investigates the in vitro short-term response of human undifferentiated cells on three magnesium alloys and high-purity magnesium (Mg). Materials and Methods The degradation parameters of magnesium-silver (Mg2Ag), magnesium-gadolinium (Mg10Gd) and magnesium-rare-earth (Mg4Y3RE) alloys were analysed after 1, 2, and 3 days of incubation in cell culture medium under cell culture condition. Changes in cell viability and cell adhesion were evaluated by culturing human umbilical cord perivascular cells on corroded Mg materials to examine how the degradation influences the cellular development. Results and Conclusions The pH and osmolality of the medium increased with increasing degradation rate and it was found to be most pronounced for Mg4Y3RE alloy. The biological observations showed that HUCPV exhibited a more homogeneous cell growth on Mg alloys compared to high-purity Mg, where they showed a clustered morphology. Moreover, cells exhibited a slightly higher density on Mg2Ag and Mg10Gd in comparison to Mg4Y3RE, due to the lower alkalinisation and osmolality of the incubation medium. However, cells grown on Mg10Gd and Mg4Y3RE generated more developed and healthy cellular structures that allowed them to better adhere to the surface. This can be attributable to a more stable and homogeneous degradation of the outer surface with respect to the incubation time.

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  • 9.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Albrektsson, Tomas
    Malmö högskola, Faculty of Odontology (OD).
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    Flapless versus conventional flapped dental implant surgery: a meta-analysis2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 6, article id e100624Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 23 publications. The I2 statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used for random-effects model or fixed-effects model, when indicated. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters. Sixteen studies were judged to be at high risk of bias, whereas two studies were considered of moderate risk of bias, and five studies of low risk of bias. The funnel plots indicated absence of publication bias for the three outcomes analyzed. The test for overall effect showed that the difference between the procedures (flapless vs. open flap surgery) significantly affect the implant failure rates (P = 0.03), with a RR of 1.75 (95% CI 1.07-2.86). However, a sensitivity analysis revealed differences when studies of high and low risk of bias were pooled separately. Thus, the results must be interpreted carefully. No apparent significant effects of flapless technique on the occurrence of postoperative infection (P = 0.96; RR 0.96, 95% CI 0.23-4.03) or on the marginal bone loss (P = 0.16; MD -0.07 mm, 95% CI -0.16-0.03) were observed.

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  • 10.
    De Silva, Kushan
    et al.
    Monash University, Clayton, Australia.
    Lim, Siew
    Monash University, Clayton, Australia.
    Mousa, Aya
    Monash University, Clayton, Australia.
    Teede, Helena
    Monash University, Clayton, Australia.
    Forbes, Andrew
    Monash University, Clayton, Australia.
    Demmer, Ryan T
    University of Minnesota, Minneapolis, Minnesota, United States of America; Columbia University, New York, New York, United States of America.
    Jönsson, Daniel
    Malmö University, Faculty of Odontology (OD).
    Enticott, Joanne
    Monash University, Clayton, Australia.
    Nutritional markers of undiagnosed type 2 diabetes in adults: Findings of a machine learning analysis with external validation and benchmarking.2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 5, article id e0250832Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Using a nationally-representative, cross-sectional cohort, we examined nutritional markers of undiagnosed type 2 diabetes in adults via machine learning.

    METHODS: A total of 16429 men and non-pregnant women ≥ 20 years of age were analysed from five consecutive cycles of the National Health and Nutrition Examination Survey. Cohorts from years 2013-2016 (n = 6673) was used for external validation. Undiagnosed type 2 diabetes was determined by a negative response to the question "Have you ever been told by a doctor that you have diabetes?" and a positive glycaemic response to one or more of the three diagnostic tests (HbA1c > 6.4% or FPG >125 mg/dl or 2-hr post-OGTT glucose > 200mg/dl). Following comprehensive literature search, 114 potential nutritional markers were modelled with 13 behavioural and 12 socio-economic variables. We tested three machine learning algorithms on original and resampled training datasets built using three resampling methods. From this, the derived 12 predictive models were validated on internal- and external validation cohorts. Magnitudes of associations were gauged through odds ratios in logistic models and variable importance in others. Models were benchmarked against the ADA diabetes risk test.

    RESULTS: The prevalence of undiagnosed type 2 diabetes was 5.26%. Four best-performing models (AUROC range: 74.9%-75.7%) classified 39 markers of undiagnosed type 2 diabetes; 28 via one or more of the three best-performing non-linear/ensemble models and 11 uniquely by the logistic model. They comprised 14 nutrient-based, 12 anthropometry-based, 9 socio-behavioural, and 4 diet-associated markers. AUROC of all models were on a par with ADA diabetes risk test on both internal and external validation cohorts (p>0.05).

    CONCLUSIONS: Models performed comparably to the chosen benchmark. Novel behavioural markers such as the number of meals not prepared from home were revealed. This approach may be useful in nutritional epidemiology to unravel new associations with type 2 diabetes.

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  • 11. Erturk, Gizem
    et al.
    Hedstrom, Martin
    Mattiasson, Bo
    Ruzgas, Tautgirdas
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Lood, Rolf
    Highly sensitive detection and quantification of the secreted bacterial benevolence factor RoxP using a capacitive biosensor: A possible early detection system for oxidative skin diseases2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 3Article in journal (Refereed)
    Abstract [en]

    The impact of the microbiota on our health is rapidly gaining interest. While several bacteria have been associated with disease, and others being indicated as having a probiotic effect, the individual biomolecules behind these alterations are often not known. A major problem in the study of these factors in vivo is their low abundance in complex environments. We recently identified the first secreted bacterial antioxidant protein, RoxP, from the skin commensal Propionibacterium acnes, suggesting its relevance for maintaining the redox homeostasis on the skin. In order to study the effect, and prevalence, of RoxP in vivo, a capacitive biosensor with a recognition surface based on molecular imprinting was used to detect RoxP on skin in vivo. In vitro analyses demonstrated the ability to detect and quantify RoxP in a concentration range of 1 x 10(-13) M to 1 x 10(-8) M from human skin swabs; with a limit of detection of 2.5 x 10(-19) M in buffer systems. Further, the biosensor was highly selective, not responding to any other secreted protein from P. acnes. Thus, it was possible to demonstrate the presence, and quantity, of RoxP on human skin. Therefore, the developed biosensor is a very promising tool for the detection of RoxP from clinical samples, offering a rapid, cost-effective and sensitive means of detecting low-abundant bacterial proteins in vivo in complex milieus.

  • 12. Falck Miniotis, Maria
    et al.
    Mukwaya, Anthonny
    Gjörloff Wingren, Anette
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Digital holographic microscopy for non-invasive monitoring of cell cycle arrest in L929 cells2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 1, article id e106546Article in journal (Refereed)
    Abstract [en]

    Digital holographic microscopy (DHM) has emerged as a powerful non-invasive tool for cell analysis. It has the capacity to analyse multiple parameters simultaneously, such as cell- number, confluence and phase volume. This is done while cells are still adhered and growing in their culture flask. The aim of this study was to investigate whether DHM was able to monitor drug-induced cell cycle arrest in cultured cells and thus provide a non-disruptive alternative to flow cytometry. DHM parameters from G1 and G2/M cell cycle arrested L929 mouse fibroblast cells were collected. Cell cycle arrest was verified with flow cytometry. This study shows that DHM is able to monitor phase volume changes corresponding to either a G1 or G2/M cell cycle arrest. G1-phase arrest with staurosporine correlated with a decrease in the average cell phase volume and G2/M-phase arrest with colcemid and etoposide correlated with an increase in the average cell phase volume. Importantly, DHM analysis of average cell phase volume was of comparable accuracy to flow cytometric measurement of cell cycle phase distribution as recorded following dose-dependent treatment with etoposide. Average cell phase volume changes in response to treatment with cell cycle arresting compounds could therefore be used as a DHM marker for monitoring cell cycle arrest in cultured mammalian cells.

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  • 13.
    Falk, Magnus
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Alcalde, Miguel
    Bartlett, Philip
    De Lacey, Antonio
    Gorton, Lo
    Gutierrez-Sanchez, Cristina
    Haddad, Raoudha
    Kilburn, Jeremy
    Leech, Donal
    Ludwig, Roland
    Magner, Edmond
    Mate, Diana
    Conghaile, Peter
    Ortiz, Roberto
    Pita, Marcos
    Poeller, Sascha
    Ruzgas, Tautgirdas
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Salaj-Kosla, Urszula
    Schuhmann, Wolfgang
    Sebelius, Fredrik
    Shao, Minling
    Stoica, Leonard
    Sygmund, Cristoph
    Tilly, Jonas
    Toscano, Miguel
    Vivekananthan, Jeevanthi
    Wright, Emma
    Shleev, Sergey
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Self-​powered wireless carbohydrate​/oxygen sensitive biodevice based on radio signal transmission2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 10, p. e109104/1-e109104/9, article id e109104Article in journal (Refereed)
    Abstract [en]

    Here for the first time, we detail self-​contained (wireless and self-​powered) biodevices with wireless signal transmission. Specifically, we demonstrate the operation of self-​sustained carbohydrate and oxygen sensitive biodevices, consisting of a wireless electronic unit, radio transmitter and sep. sensing bioelectrodes, supplied with elec. energy from a combined multi-​enzyme fuel cell generating sufficient current at required voltage to power the electronics. A carbohydrate​/oxygen enzymic fuel cell was assembled by comparing the performance of a range of different bioelectrodes followed by selection of the most suitable, stable combination. Carbohydrates (viz. lactose for the demonstration) and oxygen were also chosen as bioanalytes, being important biomarkers, to demonstrate the operation of the self-​contained biosensing device, employing enzyme-​modified bioelectrodes to enable the actual sensing. A wireless electronic unit, consisting of a micropotentiostat, an energy harvesting module (voltage amplifier together with a capacitor) and a radio microchip, were designed to enable the biofuel cell to be used as a power supply for managing the sensing devices and for wireless data transmission. The electronic system used required current and voltages greater than 44 μA and 0.57 V, resp. to operate; which the biofuel cell was capable of providing, when placed in a carbohydrate and oxygen contg. buffer. In addn., a USB based receiver and computer software were employed for proof-​of concept tests of the developed biodevices. Operation of bench-​top prototypes was demonstrated in buffers contg. different concns. of the analytes, showcasing that the variation in response of both carbohydrate and oxygen biosensors could be monitored wirelessly in real-​time as analyte concns. in buffers were changed, using only an enzymic fuel cell as a power supply.

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  • 14.
    Fernström, Johan
    et al.
    Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, Sweden..
    Ohlsson, Lars
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Asp, Marie
    Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, Sweden..
    Lavant, Eva
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Holck, Amanda
    Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, Sweden..
    Grudet, Cécile
    Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden..
    Westrin, Åsa
    Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.; Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, Sweden..
    Lindqvist, Daniel
    Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.; Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, Sweden..
    Plasma circulating cell-free mitochondrial DNA in depressive disorders2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 11, article id e0259591Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Plasma circulating cell-free mitochondrial DNA (ccf-mtDNA) is an immunogenic molecule and a novel biomarker of psychiatric disorders. Some previous studies reported increased levels of ccf-mtDNA in unmedicated depression and recent suicide attempters, while other studies found unchanged or decreased ccf-mtDNA levels in depression. Inconsistent findings across studies may be explained by small sample sizes and between-study variations in somatic and psychiatric co-morbidity or medication status.

    METHODS: We measured plasma ccf-mtDNA in a cohort of 281 patients with depressive disorders and 49 healthy controls. Ninety-three percent of all patients were treated with one or several psychotropic medications. Thirty-six percent had a personality disorder, 13% bipolar disorder. All analyses involving ccf-mtDNA were a priori adjusted for age and sex.

    RESULTS: Mean levels in ccf-mtDNA were significantly different between patients with a current depressive episode (n = 236), remitted depressive episode (n = 45) and healthy controls (n = 49) (f = 8.3, p<0.001). Post-hoc tests revealed that both patients with current (p<0.001) and remitted (p = 0.002) depression had lower ccf-mtDNA compared to controls. Within the depressed group there was a positive correlation between ccf-mtDNA and "inflammatory depression symptoms" (r = 0.15, p = 0.02). We also found that treatment with mood stabilizers lamotrigine, valproic acid or lithium was associated with lower ccf-mtDNA (f = 8.1, p = 0.005).

    DISCUSSION: Decreased plasma ccf-mtDNA in difficult-to-treat depression may be partly explained by concurrent psychotropic medications and co-morbidity. Our findings suggest that ccf-mtDNA may be differentially regulated in different subtypes of depression, and this hypothesis should be pursued in future studies.

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  • 15.
    Fritzell, Kaisa
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden; Hereditary Cancer Clinic, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.
    Hedberg, Berith
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Woudstra, Anke
    Team Advies en Onderzoek, Municipal Health Service (GGD) Kennemerland, Haarlem, the Netherlands.
    Forsberg, Anna
    Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
    Sventelius, Marika
    Regional Cancer Centre, Stockholm, Gotland, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jervaeus, Anna
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Making the BEST decision-the BESTa project development, implementation and evaluation of a digital Decision Aid in Swedish cancer screening programmes- a description of a research project2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 12, article id e0294332Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sweden has a long tradition of organized national population-based screening programmes. Participation rates differ between programmes and regions, being relatively high in some groups, but lower in others. To ensure an equity perspective on screening, it is desirable that individuals make an informed decision based on knowledge rather than ignorance, misconceptions, or fear. Decision Aids (DAs) are set to deliver information about different healthcare options and help individuals to visualize the values associated with each available option. DAs are not intended to guide individuals to choose one option over another. The advantage of an individual Decision Aid (iDA) is that individuals gain knowledge about cancer and screening by accessing one webpage with the possibility to communicate with health professionals and thereafter make their decision regarding participation. The objective is therefore to develop, implement and evaluate a digital iDA for individuals invited to cancer screening in Sweden.

    METHODS: This study encompasses a process-, implementation-, and outcome evaluation. Multiple methods will be applied including focus group discussions, individual interviews and the usage of the think aloud technique and self-reported questionnaire data. The project is based on The International Patient Decision Aid Standards (IPDAS) framework and the proposed model development process for DAs. Individuals aged 23-74, including women (the cervical-, breast- and CRC screening module) and men (the CRC screening module), will be included in the developmental process. Efforts will be made to recruit participants with self-reported physical and mental limitations, individuals without a permanent residence and ethnic minorities.

    DISCUSSION: To the best of our knowledge, the present study is the first attempt aimed at developing an iDA for use in the Swedish context. The iDA is intended to facilitate shared decision making about participation in screening. Furthermore, the iDA is expected to increase knowledge and raise awareness about cancer and cancer screening.

    PATIENT OR PUBLIC CONTRIBUTION: Lay people are involved throughout the whole development and implementation process of the digital DA.

    TRIAL REGISTRATION: NCT05512260.

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  • 16. Gajecki, Mikael
    et al.
    Berman, Anne H
    Sinadinovic, Kristina
    Andersson, Claes
    Malmö högskola, Faculty of Health and Society (HS), Department of Criminology (KR).
    Ljotsson, Brjann
    Hedman, Erik
    Ruck, Christian
    Lindefors, Nils
    Effects of Baseline Problematic Alcohol and Drug Use on Internet-Based Cognitive Behavioral Therapy Outcomes for Depression, Panic Disorder and Social Anxiety Disorder2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 8, article id e104615Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Patients' problematic substance use prevalence and effects were explored in relation to internet-based cognitive behavioral therapy (ICBT) outcomes for depression, panic disorder and social anxiety disorder. METHODS: At baseline and treatment conclusion, 1601 ICBT patients were assessed with self-rated measures for alcohol and drug use (AUDIT/DUDIT), depressive symptoms (MADRS-S), panic disorder symptoms (PDSS-SR) and social anxiety symptoms (LSAS-SR). RESULTS: Problematic substance use (AUDIT ≥ 8 for men, ≥ 6 for women; DUDIT ≥ 1) occurred among 32.4% of the patients; 24.1% only alcohol, 4.6% only drugs, and 3.7% combined alcohol and drug use. Hazardous alcohol use and probable alcohol dependence negatively affected panic disorder outcomes, and hazardous drug use led to worse social anxiety outcomes. Depression outcomes were not affected by substance use. Treatment adherence was negatively affected by problematic drug use among men and 25-34 year olds; combined substance use negatively affected adherence for women and 35-64 year olds. CONCLUSION: Problematic substance use does not preclude ICBT treatment but can worsen outcomes, particularly problematic alcohol use for panic disorder patients and hazardous drug use for social anxiety patients. ICBT clinicians should exercise particular caution when treating men and younger patients with problematic drug use, and women or older patients with combined substance use.

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  • 17. Gracia, Enrique
    et al.
    Martín-Fernández, Manuel
    Lila, Marisol
    Merlo, Juan
    Ivert, Anna-Karin
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Prevalence of intimate partner violence against women in Sweden and Spain: A psychometric study of the 'Nordic paradox'2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 5, article id e0217015Article in journal (Refereed)
    Abstract [en]

    The high prevalence of intimate partner violence against women (IPVAW) in countries with high levels of gender equality has been defined as the "Nordic paradox". In this study we compared physical and sexual IPVAW prevalence data in two countries exemplifying the Nordic paradox: Sweden (N = 1483) and Spain (N = 1447). Data was drawn from the European Union Agency for Fundamental Rights Survey on violence against women. To ascertain whether differences between these two countries reflect true differences in IPVAW prevalence, and to rule out the possibility of measurement bias, we conducted a set of analyses to ensure measurement equivalence, a precondition for appropriate and valid cross-cultural comparisons. Results showed that in both countries items were measuring two separate constructs, physical and sexual IPVAW, and that these factors had high internal consistency and adequate validity. Measurement equivalence analyses (i.e., differential item functioning, and multigroup confirmatory factor analysis) supported the comparability of data across countries. Latent means comparisons between the Spanish and the Swedish samples showed that scores on both the physical and sexual IPVAW factors were significantly higher in Sweden than in Spain. The effect sizes of these differences were large: 89.1% of the Swedish sample had higher values in the physical IPVAW factor than the Spanish average, and this percentage was 99.4% for the sexual IPVAW factor as compared to the Spanish average. In terms of probability of superiority, there was an 80.7% and 96.1% probability that a Swedish woman would score higher than a Spanish woman in the physical and the sexual IPVAW factors, respectively. Our results showed that the higher prevalence of physical and sexual IPVAW in Sweden than in Spain reflects actual differences and are not the result of measurement bias, supporting the idea of the Nordic paradox.

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  • 18.
    Gustafsson, Anna
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Boström, Anna-Karin
    Ljungberg, Börje
    Axelson, Håkan
    Dahlbäck, Björn
    Gas6 and the receptor tyrosine kinase Axl in clear cell renal cell carcinoma2009In: PLOS ONE, E-ISSN 1932-6203, Vol. 4, no 10, article id e7575Article in journal (Refereed)
    Abstract [en]

    Background The molecular biology of renal cell carcinoma (RCC) is complex and not fully understood. We have recently found that the expression of the receptor tyrosine kinase Axl in the RCC tumors independently correlates with survival of the patients. Principal Findings Here, we have investigated the role of Axl and its ligand Gas6, the vitamin-K dependent protein product of the growth arrest-specific gene 6, in clear cell RCC (ccRCC) derived cells. The Axl protein was highly expressed in ccRCC cells deficient in functional von Hippel-Lindau (VHL) protein, a tumor suppressor gene often inactivated in ccRCC. VHL reconstituted cells expressed decreased levels of Axl protein, but not Axl mRNA, suggesting VHL to regulate Axl expression. Gas6-mediated activation of Axl in ccRCC cells resulted in Axl phosphorylation, receptor down-regulation, decreased cell-viability and migratory capacity. No effects of the Gas6/Axl system could be detected on invasion. Moreover, in ccRCC tumor tissues, Axl was phosphorylated and Gas6 γ-carboxylated, suggesting these molecules to be active in vivo. Significance These results provide novel information regarding the complex function of the Gas6/Axl system in ccRCC.

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  • 19. Henssge, Uta
    et al.
    Do, Thuy
    Gilbert, Steven C.
    Cox, Steven
    Clark, Douglas
    Wickström, Claes
    Malmö högskola, Faculty of Odontology (OD).
    Ligtenberg, Antoon J. M.
    Radford, David R.
    Beighton, David
    Application of MLST and Pilus Gene Sequence Comparisons to Investigate the Population Structures of Actinomyces naeslundii and Actinomyces oris2011In: PLOS ONE, E-ISSN 1932-6203, Vol. 6, no 6, article id e21430Article in journal (Refereed)
    Abstract [en]

    Actinomyces naeslundii and Actinomyces oris are members of the oral biofilm. Their identification using 16S rRNA sequencing is problematic and better achieved by comparison of metG partial sequences. A. oris is more abundant and more frequently isolated than A. naeslundii. We used a multi-locus sequence typing approach to investigate the genotypic diversity of these species and assigned A. naeslundii (n=37) and A. oris (n=68) isolates to 32 and 68 sequence types (ST), respectively. Neighbor-joining and ClonalFrame dendrograms derived from the concatenated partial sequences of 7 house-keeping genes identified at least 4 significant subclusters within A. oris and 3 within A. naeslundii. The strain collection we had investigated was an under-representation of the total population since at least 3 STs composed of single strains may represent discrete clusters of strains not well represented in the collection. The integrity of these sub-clusters was supported by the sequence analysis of fimP and fimA, genes coding for the type 1 and 2 fimbriae, respectively. An A. naeslundii subcluster was identified with both fimA and fimP genes and these strains were able to bind to MUC7 and statherin while all other A. naeslundii strains possessed only fimA and did not bind to statherin. An A. oris subcluster harboured a fimA gene similar to that of Actinomyces odontolyticus but no detectable fimP failed to bind significantly to either MUC7 or statherin. These data are evidence of extensive genotypic and phenotypic diversity within the species A. oris and A. naeslundii but the status of the subclusters identified here will require genome comparisons before their phylogenic position can be unequivocally established.

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  • 20.
    Ivert, Anna-Karin
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Criminology (KR).
    Torstensson Levander, Marie
    Malmö högskola, Faculty of Health and Society (HS), Department of Criminology (KR).
    Merlo, Juan
    Adolescents' Utilisation of Psychiatric Care, Neighbourhoods and Neighbourhood Socioeconomic Deprivation: A Multilevel Analysis2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 8, article id e81127Article in journal (Refereed)
    Abstract [en]

    Mental health problems among adolescents have become a major public health issue, and it is therefore important to increase knowledge on the contextual determinants of adolescent mental health. One such determinant is the socioeconomic structure of the neighbourhood. The present study has two central objectives, (i) to examine if neighbourhood socioeconomic deprivation is associated to individual variations in utilisation of psychiatric care in a Swedish context, and (ii) to investigate if neighbourhood boundaries are a valid construct for identifying contexts that influence individual variations in psychiatric care utilization. Data were obtained from the Longitudinal Multilevel Analysis in Scania (LOMAS) database. The study population consists of all boys and girls aged 13–18 years (N=18,417), who were living in the city of Malmö, Sweden, in 2005. Multilevel logistic regression analysis was applied to estimate the probability of psychiatric care utilisation. The results from the study indicate that the neighbourhood of residence had little influence on psychiatric care utilisation. Although we initially found a variation between neighbourhoods, this general contextual effect was very small (i.e. 1.6 %). The initial conclusive association between the neighbourhood level of disadvantage and psychiatric care utilisation (specific contextual effect) disappeared following adjustment for individual and family level variables. Our results suggest the neighbourhoods in Malmö (at least measured in terms of SAMS-areas), do not provide accurate information for discriminating adolescents utilisation of psychiatric care. The SAMS-areas appears to be an inappropriate construct of the social environment that influences adolescent utilisation of psychiatric care. Therefore, public health interventions should be directed to the whole city rather than to specific neighbourhoods. However, since geographical, social or cultural contexts may be important for our understanding of adolescent mental health further research is needed to identify such contexts.

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  • 21.
    Jimbo, Ryo
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Tovar, Nick
    Janal, Malvin N.
    Mousa, Ramy
    Marin, Charles
    Yoo, Daniel
    Teixeira, Hellen S.
    Anchieta, Rodolfo B.
    Bonfante, Estevam A.
    Konishi, Akihiro
    Takeda, Katsuhiro
    Kurihara, Hidemi
    Coelho, Paulo G.
    The Effect of Brain-Derived Neurotrophic Factor on Periodontal Furcation Defects2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 1Article in journal (Refereed)
    Abstract [en]

    This study aimed to observe the regenerative effect of brain-derived neurotrophic factor (BDNF) in a non-human primate furcation defect model. Class II furcation defects were created in the first and second molars of 8 non-human primates to simulate a clinical situation. The defect was filled with either, Group A: BDNF (500 mu g/ml) in high-molecular weight-hyaluronic acid (HMW-HA), Group B: BDNF (50 mu g/ml) in HMW-HA, Group C: HMW-HA acid only, Group D: empty defect, or Group E: BDNF (500 mu g/ml) in saline. The healing status for all groups was observed at different time-points with micro computed tomography. The animals were euthanized after 11 weeks, and the tooth-bone specimens were subjected to histologic processing. The results showed that all groups seemed to successfully regenerate the alveolar buccal bone, however, only Group A regenerated the entire periodontal tissue, i.e., alveolar bone, cementum and periodontal ligament. It is suggested that the use of BDNF in combination with a scaffold such as the hyaluronic acid in periodontal furcation defects may be an effective treatment option.

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  • 22. Jounger, Sofia Louca
    et al.
    Christidis, Nikolaos
    Hedenberg-Magnusson, Britt
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Svensson, Peter
    Malmö högskola, Faculty of Odontology (OD).
    Schalling, Martin
    Ernberg, Malin
    Influence of Polymorphisms in the HTR3A and HTR3B Genes on Experimental Pain and the Effect of the 5-HT3 Antagonist Granisetron2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 12Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate experimentally if 5-HT3 single nucleotide polymorphisms (SNP) contribute to pain perception and efficacy of the 5-HT3-antagonist granisetron and sex differences. Sixty healthy participants were genotyped regarding HTR3A (rs1062613) and HTR3B (rs1176744). First, pain was induced by bilateral hypertonic saline injections (HS, 5.5%, 0.2 mL) into the masseter muscles. Thirty min later the masseter muscle on one side was pretreated with 0.5 mL granisetron (1 mg/mL) and on the other side with 0.5 mL placebo (isotonic saline) followed by another HS injection (0.2 mL). Pain intensity, pain duration, pain area and pressure pain thresholds (PPTs) were assessed after each injection. HS evoked moderate pain, with higher intensity in the women (P = 0.023), but had no effect on PPTs. None of the SNPs influenced any pain variable in general, but compared to men, the pain area was larger in women carrying the C/C (HTR3A) (P = 0.015) and pain intensity higher in women with the A/C alleles (HTR3B) (P = 0.019). Pre-treatment with granisetron reduced pain intensity, duration and area to a lesser degree in women (P < 0.05), but the SNPs did not in general influence the efficacy of granisetron. Women carrying the C/T & T/T (HTR3A) genotype had less reduction of pain intensity (P = 0.041) and area (P = 0.005), and women with the C/C genotype (HTR3B) had less reduction of pain intensity (P = 0.030), duration (P = 0.030) and area compared to men (P = 0.017). In conclusion, SNPs did not influence experimental muscle pain or the effect of granisetron on pain variables in general, but there were some sex differences in pain variables that seem to be influenced by genotypes. However, due to the small sample size further research is needed before any firm conclusions can be drawn.

  • 23.
    Kadir, Ayesha
    et al.
    Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Shenoda, Sherry
    Goldhagen, Jeffrey
    Effects of armed conflict on child health and development: A systematic review2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 1, article id e0210071Article, review/survey (Refereed)
    Abstract [en]

    Background Armed conflicts affect more than one in 10 children globally. While there is a large literature on mental health, the effects of armed conflict on children's physical health and development are not well understood. This systematic review summarizes the current and past knowledge on the effects of armed conflict on child health and development. Methods A systematic review was performed with searches in major and regional databases for papers published 1 January 1945 to 25 April 2017. Included studies provided data on physical and/or developmental outcomes associated with armed conflict in children under 18 years. Data were extracted on health outcomes, displacement, social isolation, experience of violence, orphan status, and access to basic needs. The review is registered with PROSPERO: CRD42017036425. Findings Among 17,679 publications screened, 155 were eligible for inclusion. Nearly half of the 131 quantitative studies were case reports, chart or registry reviews, and one-third were cross-sectional studies. Additionally, 18 qualitative and 6 mixed-methods studies were included. The papers describe mortality, injuries, illnesses, environmental exposures, limitations in access to health care and education, and the experience of violence, including torture and sexual violence. Studies also described conflict-related social changes affecting child health. The geographical coverage of the literature is limited. Data on the effects of conflict on child development are scarce. Interpretation The available data document the pervasive effect of conflict as a form of violence against children and a negative social determinant of child health. There is an urgent need for research on the mechanisms by which conflict affects child health and development and the relationship between physical health, mental health, and social conditions. Particular priority should be given to studies on child development, the long term effects of exposure to conflict, and protective and mitigating factors against the harmful effects of armed conflict on children.

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  • 24.
    Klingberg, Gunilla
    et al.
    Malmö University, Faculty of Odontology (OD).
    Benchimol, Daniel
    Karolinska Institutet, Sweden.
    Berlin, Henrik
    Malmö University, Faculty of Odontology (OD).
    Bring, Johan
    Statisticon AB, Uppsala.
    Gornitzki, Carl
    Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm.
    Odeberg, Jenny
    Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm.
    Tranæus, Sofia
    Malmö University, Faculty of Odontology (OD). Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm.
    Twetman, Svante
    Department of Odontology, University of Copenhagen, Copenhagen, Denmark.
    Wernersson, Emma
    Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm.
    Östlund, Pernilla
    Malmö University, Faculty of Odontology (OD). Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm.
    Domeij, Helena
    Malmö University, Faculty of Odontology (OD). Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm.
    How old are you?: a systematic review investigating the relationship between age and mandibular third molar maturity2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 5, p. 1-14, article id e0285252Article, review/survey (Refereed)
    Abstract [en]

    Introduction and objective: Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years.

    Methods: The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjian´s method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjian´s tooth stage H).

    Results: A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjian´s tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjian´s tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment.

    Conclusion: The identified literature does not provide scientific evidence for the relationship between Demirjian´s stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.

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  • 25. Kolbus, Daniel
    et al.
    Ljungcrantz, Irena
    Söderberg, Ingrid
    Alm, Ragnar
    Björkbacka, Harry
    Nilsson, Jan
    Nordin Fredrikson, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    TAP1-Deficiency Does Not Alter Atherosclerosis Development in Apoe−/− Mice2012In: PLOS ONE, E-ISSN 1932-6203, Vol. 3, no 7, article id e33932Article in journal (Refereed)
    Abstract [en]

    Antigen presenting cells (APC) have the ability to present both extra-cellular and intra-cellular antigens via MHC class I molecules to CD8+ T cells. The cross presentation of extra-cellular antigens is reduced in mice with deficient Antigen Peptide Transporter 1 (TAP1)-dependent MHC class I antigen presentation, and these mice are characterized by a diminished CD8+ T cell population. We have recently reported an increased activation of CD8+ T cells in hypercholesterolemic Apoe−/− mice. Therefore, this study included TAP1-deficient Apoe−/− mice (Apoe−/−Tap1−/−) to test the atherogenicity of CD8+ T cells and TAP1-dependent cross presentation in a hypercholesterolemic environment. As expected the CD8+ T cell numbers were low in Apoe−/−Tap1−/− mice in comparison to Apoe−/− mice, constituting ~1% of the lymphocyte population. In spite of this there were no differences in the extent of atherosclerosis as assessed by en face Oil Red O staining of the aorta and cross-sections of the aortic root between Apoe−/−Tap1−/− and Apoe−/− mice. Moreover, no differences were detected in lesion infiltration of macrophages or CD3+ T cells in Apoe−/−Tap1−/− compared to Apoe−/− mice. The CD3+CD4+ T cell fraction was increased in Apoe−/−Tap1−/− mice, suggesting a compensation for the decreased CD8+ T cell population. Interestingly, the fraction of CD8+ effector memory T cells was increased but this appeared to have little impact on the atherosclerosis development. In conclusion, Apoe−/−Tap1−/− mice develop atherosclerosis equal to Apoe−/− mice, indicating a minor role for CD8+ T cells and TAP1-dependent antigen presentation in the disease process.

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  • 26. Lind, Tania Kjellerup
    et al.
    Wacklin, Hanna
    Schiller, Jürgen
    Moulin, Martine
    Haertlein, Michael
    Günther Pomorski, Thomas
    Cárdenas, Marité
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö högskola, Biofilms Research Center for Biointerfaces.
    Formation and Characterization of Supported Lipid Bilayers Composed of Hydrogenated and Deuterated Escherichia coli Lipids2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 12, p. 10687-10694, article id e0144671Article in journal (Refereed)
    Abstract [en]

    Supported lipid bilayers are widely used for sensing and deciphering biomolecular interactions with model cell membranes. In this paper, we present a method to form supported lipid bilayers from total lipid extracts of Escherichia coli by vesicle fusion. We show the validity of this method for different types of extracts including those from deuterated biomass using a combination of complementary surface sensitive techniques; quartz crystal microbalance, neutron reflection and atomic force microscopy. We find that the head group composition of the deuterated and the hydrogenated lipid extracts is similar (approximately 75% phosphatidylethanolamine, 13% phosphatidylglycerol and 12% cardiolipin) and that both samples can be used to reconstitute high-coverage supported lipid bilayers with a total thickness of 41 ± 3 Å, common for fluid membranes. The formation of supported lipid bilayers composed of natural extracts of Escherichia coli allow for following biomolecular interactions, thus advancing the field towards bacterial-specific membrane biomimics.

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  • 27. Lira-Junior, Ronaldo
    et al.
    Akerman, Sigvard
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD).
    Bostrom, Elisabeth A.
    Gustafsson, Anders
    Salivary microbial profiles in relation to age, periodontal, and systemic diseases2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 3Article in journal (Refereed)
    Abstract [en]

    Background Analysis of saliva is emerging as a promising tool to diagnose and monitor diseases which makes determination of the salivary microbial profile in different scenarios essential. Objective To evaluate the effects of age, periodontal disease, sex, smoking, and medical conditions on the salivary microbial profile. Design A randomly selected sample of 441 individuals was enrolled (51% women; mean age 48.5 +/- 16.8). Participants answered a health questionnaire and underwent an oral examination. Stimulated saliva was collected and the counts of 41 bacteria were determined by checkerboard DNA-DNA hybridization. Results Elderly participants (>64 years old) presented a significant increase in 24 out of 41 bacterial species compared to adults (<= 64 years old). Eubacterium nodatum, Porphyromonas gingivalis, and Tannerella forsythia were significantly higher in participants with generalized bone loss compared to without. Males and non-smokers had higher bacteria counts in saliva. Individuals having mental disorders or muscle and joint diseases showed significantly altered microbial profiles whereas small or no differences were found for subjects with high blood pressure, heart disease, previous heart surgery, bowel disease, tumors, or diabetes. Conclusion Age, periodontal status, sex, smoking, and certain medical conditions namely, mental disorders and muscle and joint diseases, might affect the microbial profile in saliva.

  • 28.
    Mangrio, Elisabeth
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Sjöström, Karin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Grahn, Mathias
    Malmö Stad.
    Zdravkovic, Slobodan
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Risk for mental illness and family composition after migration to Sweden2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 5, article id e0251254Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present study is to determine how marital status and certain post-migration family structures are associated with the risk of mental illness among recently arrived Arabic- speaking refugees in Sweden. 

    Methods: A cross-sectional study was conducted during 2015 and 2016. The study population was recruited by inviting all adult refugees who participated in the mandatory public integration support programme. All refugees that participated had received refugee status. A total of 681 of the invited participants returned the GHQ-12 questionnaires, through which the risk for mental illness was measured and only Arabic- speaking refugees (N=638) were included in the analyses. 

    Results: Marital status per se was not associated with a risk for mental illness. However, for the whole study sample there was a statistical significant odds ratio of 1.72 (95% CI 1.03–2.86). For male Arabic-speaking refugees with a spouse or child left behind in the home country there was a borderline significant increased risk for mental illness, odds ratio = 1. 87 (95% CI 0.99–3.56). The risk for female Arabic-speaking refugees was non-significant, odds ratio = 1.35 (95% CI 0.55–3.33). 

    Conclusions: Arabic- speaking refugees who were separated from family members reported an increased risk for mental illness after arriving in the host country. Actions to facilitate family reunion after arriving as a refugee (in Sweden) seems to be an important factor to promote mental health among refugees. 

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  • 29. Mantani, Polyxeni T.
    et al.
    Duner, Pontus
    Bengtsson, Eva
    Alm, Ragnar
    Ljungcrantz, Irena
    Söderberg, Ingrid
    Sundius, Lena
    To, Fong
    Nilsson, Jan
    Björkbacka, Harry
    Nordin Fredrikson, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    IL-25 Inhibits Atherosclerosis Development in Apolipoprotein E Deficient Mice2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 1, article id e0117255Article in journal (Refereed)
    Abstract [en]

    Objective IL-25 has been implicated in the initiation of type 2 immunity and in the protection against autoimmune inflammatory diseases. Recent studies have identified the novel innate lymphoid type 2 cells (ILC2s) as an IL-25 target cell population. The purpose of this study was to evaluate if IL-25 has any influence on atherosclerosis development in mice. Methods and Results Administration of 1 mu g IL-25 per day for one week to atherosclerosis-prone apolipoprotein (apo) E deficient mice, had limited effect on the frequency of T cell populations, but resulted in a large expansion of ILC2s in the spleen. The expansion was accompanied by increased levels of anti-phosphorylcholine (PC) natural IgM antibodies in plasma and elevated levels of IL-5 in plasma and spleen. Transfer of ILC2s to apoE deficient mice elevated the natural antibody-producing B1a cell population in the spleen. Treatment of apoE/Rag-1 deficient mice with IL-25 was also associated with extensive expansion of splenic ILC2s and increased plasma IL-5, suggesting ILC2s to be the source of IL-5. Administration of IL-25 in IL-5 deficient mice resulted in an expanded ILC2 population, but did not stimulate generation of anti-PC IgM, indicating that IL-5 is not required for ILC2 expansion but for the downstream production of natural antibodies. Additionally, administration of 1 mu g IL-25 per day for 4 weeks in apoE deficient mice reduced atherosclerosis in the aorta both during initiation and progression of the disease. Conclusions The present findings demonstrate that IL-25 has a protective role in atherosclerosis mediated by innate responses, including ILC2 expansion, increased IL-5 secretion, B1a expansion and natural anti-PC IgM generation, rather than adaptive Th2 responses.

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  • 30. Mejàre, Ingegerd
    et al.
    Klingberg, Gunilla
    Malmö högskola, Faculty of Odontology (OD).
    Mowafi, Frida K
    Stecksén-Blicks, Christina
    Twetman, Svante H
    Tranæus, Sofia H
    A systematic map of systematic reviews in pediatric dentistry: what do we really know?2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 2, article id e0117537Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. METHODS: A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. RESULTS: Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. CONCLUSION: There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry

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  • 31. Naimi-Akbar, Aron
    et al.
    Hultin, Margareta
    Klinge, Anna
    Malmö University, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD).
    Tranæus, Sofia
    Malmö University, Faculty of Odontology (OD).
    Lund, Bodil
    Antibiotic prophylaxis in orthognathic surgery: A complex systematic review2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 1Article, review/survey (Refereed)
    Abstract [en]

    Objective In orthognathic surgery, antibiotics are prescribed to reduce the risk of postoperative infection. However, there is lack of consensus over the appropriate drug, the dose and duration of administration. The aim of this complex systematic review was to assess the effect of antibiotics on postoperative infections in orthognathic surgery. Methods Both systematic reviews and primary studies were assessed. Medline (OVID), The Cochrane Library (Wiley) and EMBASE (embase.com), PubMed (non-indexed articles) and Health Technology Assessment (HTA) publications were searched. The primary studies were assessed using GRADE and the systematic reviews by AMSTAR. Results Screening of abstracts yielded 6 systematic reviews and 36 primary studies warranting full text scrutiny. In total, 14 primary studies were assessed for risk of bias. Assessment of the included systematic reviews identified two studies with a moderate risk of bias, due to inclusion in the meta-analyses of primary studies with a high risk of bias. Quality assessment of the primary studies disclosed one with a moderate risk of bias and one with a low risk. The former compared a single dose of antibiotic with 24 hour prophylaxis using the same antibiotic; the latter compared oral and intravenous administration of antibiotics. Given the limited number of acceptable studies, no statistical analysis was undertaken, as it was unlikely to contribute any relevant information. Conclusion With respect to antibiotic prophylaxis in orthognathic surgery, most of the studies to date have been poorly conducted and reported. Thus scientific uncertainty remains as to the preferred antibiotic and the optimal duration of administration.

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  • 32. Nylander, Åsa
    et al.
    Svensäter, Gunnel
    Malmö högskola, Faculty of Odontology (OD).
    Senadheera, Dilani B.
    Cvitkovitch, Dennis G.
    Davies, Julia R
    Malmö högskola, Faculty of Odontology (OD).
    Persson, Karina
    Structural and functional analysis of the N-terminal domain of the Streptococcus gordonii adhesin Sgo07072013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 5, article id e63768Article in journal (Refereed)
    Abstract [en]

    The commensal Streptococcus gordonii expresses numerous surface adhesins with which it interacts with other microorganisms, host cells and salivary proteins to initiate dental plaque formation. However, this Gram-positive bacterium can also spread to non-oral sites such as the heart valves and cause infective endocarditis. One of its surface adhesins, Sgo0707, is a large protein composed of a non-repetitive N-terminal region followed by several C-terminal repeat domains and a cell wall sorting motif. Here we present the crystal structure of the Sgo0707 N-terminal domains, refined to 2.1 Å resolution. The model consists of two domains, N1 and N2. The largest domain, N1, comprises a putative binding cleft with a single cysteine located in its centre and exhibits an unexpected structural similarity to the variable domains of the streptococcal Antigen I/II adhesins. The N2-domain has an IgG-like fold commonly found among Gram-positive surface adhesins. Binding studies performed on S. gordonii wild-type and a Sgo0707 deficient mutant show that the Sgo0707 adhesin is involved in binding to type-1 collagen and to oral keratinocytes.

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  • 33.
    Ose, Solveig Osborg
    et al.
    SINTEF, Health Services Research group, Trondheim, Norway.
    Lohmann-Lafrenz, Signe
    NTNU Faculty of Medicine, Department of Public Health and Nursing, Trondheim, Norway.
    Bernstrøm, Vilde Hoff
    Oslo Metropolitan University, Centre for Welfare and Labour Research, Oslo, Norway.
    Berthelsen, Hanne
    Malmö University, Centre for Work Life and Evaluation Studies (CTA). Malmö University, Faculty of Odontology (OD).
    Marchand, Gunn Hege
    NTNU Faculty of Medicine, Department of Neuromedicine and Movement Science, Trondheim, Norway.
    The Norwegian version of the Copenhagen Psychosocial Questionnaire (COPSOQ III): Initial validation study using a national sample of registered nurses.2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 8, article id e0289739Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Employers are legally obligated to ensure the safety and health of employees, including the organizational and psychosocial working environment. The Copenhagen Psychosocial Questionnaire (COPSOQ III) covers multiple dimensions of the work environment. COPSOQ III has three parts: a) work environment b) conflicts and offensive behaviours and c) health and welfare. We translated all three parts into Norwegian and evaluated the statistical properties of the 28 work environment dimensions in part a), using a sample of registered nurses.

    METHODS: The original English version was translated into Norwegian and back translated into English; the two versions were compared, and adjustments made. In total, 86 of 99 items from the translated version were included in a survey to which 8804 registered nurses responded. Item response theory models designed for ordinal manifest variables were used to evaluate construct validity and identify potential redundant items. A standard confirmatory factor analysis was performed to verify the latent dimensionality established in the original version, and a more exploratory factor analysis without restrictions is included to determine dependency between items and to identify separable dimensions.

    RESULTS: The measure of sampling adequacy shows that the data are well suited for factor analyses. The latent dimensionality in the original version is confirmed in the Norwegian translated version and the scale reliability is high for all dimensions except 'Demands for Hiding Emotions'. In this homogenous sample, eight of the 28 dimensions are found not to be separate dimensions as items covering these dimensions loaded onto the same factor. Moreover, little information is provided at the low and high ends of exposure for some dimensions in this sample. Of the 86 items included, 14 are found to be potential candidates for removal to obtain a shorter Norwegian version.

    CONCLUSION: The established Norwegian translation of COPSOQ III can be used in further research about working environment factors and health and wellbeing in Norway. The extended use of the instrument internationally enables comparative studies, which can increase the knowledge and understanding of similarities and differences between labour markets in different countries. This first validation study shows that the Norwegian version has strong statistical properties like the original, and can be used to assess work environment factors, including relational and emotional risk factors and resources available at the workplace.

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  • 34.
    Qi, Haodong
    et al.
    Malmö University, Faculty of Culture and Society (KS), Department of Global Political Studies (GPS). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM). Stockholm University Demography Unit, Stockholm University, Stockholm, Sweden.
    Bircan, Tuba
    Department of Sociology, Vrije Universiteit Brussels, Brussels, Belgium.
    Modelling and predicting forced migration2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 4, article id e0284416Article in journal (Refereed)
    Abstract [en]

    Migration models have evolved significantly during the last decade, most notably the so-called flow Fixed-Effects (FE) gravity models. Such models attempt to infer how human mobility may be driven by changing economy, geopolitics, and the environment among other things. They are also increasingly used for migration projections and forecasts. However, recent research shows that this class of models can neither explain, nor predict the temporal dynamics of human movement. This shortcoming is even more apparent in the context of forced migration, in which the processes and drivers tend to be heterogeneous and complex. In this article, we derived a Flow-Specific Temporal Gravity (FTG) model which, compared to the FE models, is theoretically similar (informed by the random utility framework), but empirically less restrictive. Using EUROSTAT data with climate, economic, and conflict indicators, we trained both models and compared their performances. The results suggest that the predictive power of these models is highly dependent on the length of training data. Specifically, as time-series migration data lengthens, FTG's predictions can be increasingly accurate, whereas the FE model becomes less predictive.

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  • 35. Rathnayake, Nilminie
    et al.
    Gustafsson, Anders
    Norhammar, Anna
    Kjellstrom, Barbro
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Ryden, Lars
    Tervahartiala, Taina
    Sorsa, Timo
    Salivary Matrix Metalloproteinase-8 and-9 and Myeloperoxidase in Relation to Coronary Heart and Periodontal Diseases: A Subgroup Report from the PAROKRANK Study (Periodontitis and Its Relation to Coronary Artery Disease)2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 7, article id e0126370Article in journal (Refereed)
    Abstract [en]

    Background and Objective Matrix metalloproteinase (MMP) -8, -9 and myeloperoxidase (MPO) are inflammatory mediators. The potential associations between MMP-8, -9, MPO and their abilities to reflect cardiovascular risk remains to be evaluated in saliva. The objective of this study was to investigate the levels and associations of salivary MMP-8, -9, MPO and tissue inhibitors of metalloproteinase (TIMP)-1 in myocardial infarction (MI) patients and controls with or without periodontitis. Materials and Methods 200 patients with a first MI admitted to coronary care units in Sweden from May 2010 to December 2011 and 200 controls matched for age, gender, residential area and without previous MI were included. Dental examination and saliva sample collection was performed 6-10 weeks after the MI in patients and at baseline in controls. The biomarkers MMP -8, -9, MPO and TIMP-1 were analyzed by time-resolved immunofluorescence assay (IFMA), Western blot and Enzyme-Linked ImmunoSorbent Assay (ELISA). Results After compensation for gingivitis, gingival pockets and smoking, the mean salivary levels of MMP-8 (543 vs 440 ng/mL, p = 0.003) and MPO (1899 vs 1637 ng/mL, p = 0.02) were higher in non-MI subjects compared to MI patients. MMP-8, -9 and MPO correlated positively with clinical signs of gingival/periodontal inflammation while TIMP-1 correlated mainly negatively with these signs. The levels of latent and active forms of MMP-8 did not differ between the MI and non-MI groups. Additionally, MMP-8, MPO levels and MMP-8/TIMP-1 ratio were significantly higher in men compared to women with MI. Conclusions This study shows that salivary levels of the analyzed biomarkers are associated with periodontal status. However, these biomarkers could not differentiate between patients with or without a MI. These findings illustrate the importance to consider the influence of oral conditions when analyzing levels of inflammatory salivary biomarkers.

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  • 36. Rathnayake, Nilminie
    et al.
    Åkerman, Sigvard
    Malmö högskola, Faculty of Odontology (OD).
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Lundegren, Nina
    Malmö högskola, Faculty of Odontology (OD).
    Jansson, Henrik
    Malmö högskola, Faculty of Odontology (OD).
    Tryselius, Ylva
    Sorsa, Timo
    Gustafsson, Anders
    Salivary Biomarkers for Detection of Systemic Diseases2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 4, article id e61356Article in journal (Refereed)
    Abstract [en]

    Background and Objective Analysis of inflammatory biomarkers in saliva could offer an attractive opportunity for the diagnosis of different systemic conditions specifically in epidemiological surveys. The aim of this study was to investigate if certain salivary biomarkers could be used for detection of common systemic diseases. Materials and Methods A randomly selected sample of 1000 adults living in Skåne, a county in the southern part of Sweden, was invited to participate in a clinical study of oral health. 451 individuals were enrolled in this investigation, 51% women. All participants were asked to fill out a questionnaire, history was taken, a clinical examination was made and stimulated saliva samples were collected. Salivary concentrations of IL-1β, -6, -8, TNF-α, lysozyme, MMP-8 and TIMP-1 were determined using ELISA, IFMA or Luminex assays. Results Salivary IL-8 concentration was found to be twice as high in subjects who had experience of tumour diseases. In addition, IL-8 levels were also elevated in patients with bowel disease. MMP-8 levels were elevated in saliva from patients after cardiac surgery or suffering from diabetes, and muscle and joint diseases. The levels of IL-1β, IL-8 and MMP-8, as well as the MMP-8/TIMP-1 ratio were higher in subjects with muscle and joint diseases. Conclusion Biomarkers in saliva have the potential to be used for screening purposes in epidemiological studies. The relatively unspecific inflammatory markers used in this study can not be used for diagnosis of specific diseases but can be seen as markers for increased systemic inflammation.

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  • 37.
    Runnsjö, Anna
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö högskola, Biofilms Research Center for Biointerfaces.
    Dabkowska, Aleksandra P
    Sparr, Emma
    Kocherbitov, Vitaly
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö högskola, Biofilms Research Center for Biointerfaces.
    Arnebrant, Thomas
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö högskola, Biofilms Research Center for Biointerfaces.
    Engblom, Johan
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö högskola, Biofilms Research Center for Biointerfaces.
    Diffusion through Pig Gastric Mucin: Effect of Relative Humidity2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 6, article id e0157596Article in journal (Refereed)
    Abstract [en]

    Mucus covers the epithelium found in all intestinal tracts, where it serves as an important protecting barrier, and pharmaceutical drugs administrated by the oral, rectal, vaginal, ocular, or nasal route need to penetrate the mucus in order to reach their targets. Furthermore, the diffusion in mucus as well as the viscosity of mucus in the eyes, nose and throat can change depending on the relative humidity of the surrounding air. In this study we have investigated how diffusion through gels of mucin, the main protein in mucus, is affected by changes in ambient relative humidity (i.e. water activity). Already a small decrease in water activity was found to give rise to a significant decrease in penetration rate through the mucin gel of the antibacterial drug metronidazole. We also show that a decrease in water activity leads to decreased diffusion rate in the mucin gel for the fluorophore fluorescein. This study shows that it is possible to alter transport rates of molecules through mucus by changing the water activity in the gel. It furthermore illustrates the importance of considering effects of the water activity in the mucosa during development of potential pharmaceuticals.

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  • 38.
    Salinas Fredricson, Adrian
    et al.
    Department of Oral and Maxillofacial Surgery, Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Stockholm, Sweden; Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Stockholm, Sweden.
    Naimi-Akbar, Aron
    Malmö University, Faculty of Odontology (OD). Department of Oral and Maxillofacial Surgery, Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Stockholm, Sweden; Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Stockholm, Sweden.
    Adami, Johanna
    Sophiahemmet University, Stockholm, Sweden.
    Lund, Bodil
    Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Stockholm, Sweden; Medical Unit for Reconstructive Plastic- and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Rosén, Annika
    Department of Clinical Dentistry, Division of Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.
    Hedenberg-Magnusson, Britt
    Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Stockholm, Sweden; Department of Orofacial Pain and Jaw Function, Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Stockholm, Sweden.
    Fredriksson, Lars
    Department of Orofacial Pain and Jaw Function, Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Stockholm, Sweden.
    Krüger Weiner, Carina
    Department of Oral and Maxillofacial Surgery, Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Stockholm, Sweden; Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Stockholm, Sweden.
    Diseases of the musculoskeletal system and connective tissue in relation to temporomandibular disorders: A SWEREG-TMD nationwide case-control study2022In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 10, article id e0275930Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Temporomandibular disorders (TMD) are comprised by a heterogenous group of diagnoses with multifaceted and complex etiologies. Although diseases of the musculoskeletal system and connective tissue (MSD) have been reported as risk factors for developing TMD, no nationwide population-based registry studies have been conducted to investigate this possible link. The aim of this study was to investigate the association between MSD and TMD in a population-based sample using Swedish registry data, and to further investigate the difference in such association between patients diagnosed with TMD in a hospital setting and patients surgically treated for the condition.

    MATERIALS AND METHODS: Population based case-control study using Swedish nationwide registry data. Data was collected between 1998 and 2016 from 33 315 incident cases and 333 122 controls aged ≥18, matched for sex, age, and living area. Cases were stratified into non-surgical (NS), surgically treated once (ST1) and surgically treated twice or more (ST2). Information on MSD exposure (ICD-10 M00-M99) was collected between 1964 and 2016. Odds ratios were calculated using conditional logistic regression, adjusted for country of birth, educational level, living area, and mental health comorbidity.

    RESULTS: A significant association between MSD and the development of TMD was found for all diagnostic categories: arthropathies (OR 2.0, CI 1.9-2.0); systemic connective tissue disorders (OR 2.3, CI 2.1-2.4); dorsopathies (OR 2.2, CI 2.1-2.2); soft tissue disorders (OR 2.2, CI 2.2-2.3); osteopathies and chondropathies (OR 1.7, CI 1.6-1.8); and other disorders of the musculoskeletal system and connective tissue (OR 1.9, CI 1.8-2.1). The associations were generally much stronger for TMD requiring surgical treatment. The diagnostic group with the strongest association was inflammatory polyarthropathies, M05-M14 (OR 11.7, CI 8.6-15.9), which was seen in the ST2 group.

    CONCLUSIONS: Patients with MSD diagnoses have a higher probability of being diagnosed with TMD, in comparison to individuals without MSD. This association is even stronger for TMD that requires surgery. The results are in line with earlier findings, but present new population-based evidence of a possible causal relationship between MSD and TMD, even after adjusting for known confounders. Both dentists and physicians should be aware of this association and be wary of early signs of painful TMD among patients with MSD, to make early referral and timely conservative treatment possible.

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  • 39. Saxena, Amit
    et al.
    Björkbacka, Harry
    Ström, Åsa
    Rattik, Sara
    Berg, Katarina E.
    Gomez, Maria F.
    Nordin Fredrikson, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Nilsson, Jan
    Hultgårdh-Nilsson, Anna
    Mobilization of Regulatory T Cells in Response to Carotid Injury Does Not Influence Subsequent Neointima Formation2012In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 7, article id e51556Article in journal (Refereed)
    Abstract [en]

    Methods and Results A non-obstructive collar was introduced to inflict carotid artery injury in mice and subsequent activation of immune cells in draining lymph nodes and spleen were studied by flow cytometry. Carotid artery injury of wild type mice was associated with mobilization of both Th1 type CD4+IFNγ+ and regulatory CD4+CD25+FoxP3+ T cells in draining lymph nodes. Studies using FoxP3-green fluorescent protein (GFP) transgenic C57/Bl6 mice demonstrated scattered presence of regulatory T cells in the adventitial tissue of injured arteries as well as a massive emigration of regulatory T cells from the spleen in response to carotid injury. However, deletion of antigen presentation to CD4+ T cells (H20 mice), as well as deletion of regulatory T cells (through treatment with blocking anti-CD25 antibodies), did not affect neointima formation. Also deletion of antigen presentation to CD8+ T cells (Tap10 mice) was without effect on carotid collar-induced neointima formation. Conclusion The results demonstrate that carotid artery injury is associated with mobilization of regulatory T cells. Depletion of regulatory T cells does not, however, influence the subsequent repair processes leading to the formation of a neointima. The results also demonstrate that lack of CD8+ T cells does not influence neointima formation in presence of functional CD4+ T cells and B cells.

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  • 40. Schei, Berit
    et al.
    Lukasse, Mirjam
    Ryding, Elsa Lena
    Campbell, Jacquelyn
    Karro, Helle
    Kristjansdottir, Hildur
    Laanpere, Made
    Schroll, Anne-Mette
    Tabor, Ann
    Temmerman, Marleen
    Van Parys, An-Sofie
    Wangel, Anne-Marie
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    A history of abuse and operative delivery: results from a European multi-country cohort study2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 1, article id e87579Article in journal (Refereed)
    Abstract [en]

    Objective The main aim of this study was to assess whether a history of abuse, reported during pregnancy, was associated with an operative delivery. Secondly, we assessed if the association varied according to the type of abuse and if the reported abuse had been experienced as a child or an adult. Design The Bidens study, a cohort study in six European countries (Belgium, Iceland, Denmark, Estonia, Norway, and Sweden) recruited 6724 pregnant women attending routine antenatal care. History of abuse was assessed through questionnaire and linked to obstetric information from hospital records. The main outcome measure was operative delivery as a dichotomous variable, and categorized as an elective caesarean section (CS), or an operative vaginal birth, or an emergency CS. Non-obstetrically indicated were CSs performed on request or for psychological reasons without another medical reason. Binary and multinomial regression analysis were used to assess the associations. Results Among 3308 primiparous women, sexual abuse as an adult (≥18 years) increased the risk of an elective CS, Adjusted Odds Ratio 2.12 (1.28–3.49), and the likelihood for a non-obstetrically indicated CS, OR 3.74 (1.24–11.24). Women expressing current suffering from the reported adult sexual abuse had the highest risk for an elective CS, AOR 4.07 (1.46–11.3). Neither physical abuse (in adulthood or childhood <18 years), nor sexual abuse in childhood increased the risk of any operative delivery among primiparous women. Among 3416 multiparous women, neither sexual, nor emotional abuse was significantly associated with any kind of operative delivery, while physical abuse had an increased AOR for emergency CS of 1.51 (1.05–2.19). Conclusion Sexual abuse as an adult increases the risk of an elective CS among women with no prior birth experience, in particular for non-obstetrical reasons. Among multiparous women, a history of physical abuse increases the risk of an emergency CS.

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  • 41.
    Svensson, Robert
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Johnson, Björn
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Does it matter in what family constellations adolescents live? Reconsidering the relationship between family structure and delinquent behaviour.2022In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 4, article id e0265964Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study examines the associations between ten family structure types and delinquency, including four groups of symmetrical and asymmetrical living arrangements. We also adjust for attachment to parents and parental monitoring.

    METHODS: Data are drawn from four cross-sectional surveys conducted between 2016 and 2019 in southern Sweden. The sample consists of 3,838 adolescents, aged 14-15. Negative binomial models were used to calculate the associations between family structure and delinquency.

    RESULTS: The results show that those living in single-father, single-mother, father-stepmother, mother-stepfather families report significantly more delinquency than adolescents living with both their parents. Adolescents living in "symmetrical" family arrangements, i.e. both parents are single or have a new partner, reported lower levels of delinquency, whereas adolescents living in "asymmetrical" family arrangements, i.e. where either the mother or the father, but not both, have a new partner, reported higher levels of delinquency. Most of the associations between family structure and delinquency decline when adjusted for attachment to parents and parental monitoring.

    DISCUSSION: This study shows that it is important to move on to the use of more detailed categorisations of family structure in relation to delinquency. We need to increase our knowledge about the group of adolescents that moves between parents and especially about the different constellations of asymmetrical and symmetrical living arrangements.

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  • 42. Thybring, Emil Engelund
    et al.
    Digaitis, Ramunas
    Malmö University, Biofilms Research Center for Biointerfaces.
    Nord-Larsen, Thomas
    Beck, Greeley
    Fredriksson, Maria
    How much water can wood cell walls hold?: A triangulation approach to determine the maximum cell wall moisture content2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 8, article id e0238319Article in journal (Refereed)
    Abstract [en]

    Wood is a porous, hygroscopic material with engineering properties that depend significantly on the amount of water (moisture) in the material. Water in wood can be present in both cell walls and the porous void-structure of the material, but it is only water in cell walls that affects the engineering properties. An important characteristic of wood is therefore the capacity for water of its solid cell walls, i.e. the maximum cell wall moisture content. However, this quantity is not straight-forward to determine experimentally, and the measured value may depend on the experimental technique used. In this study, we used a triangulation approach to determine the maximum cell wall moisture content by using three experimental techniques based on different measurement principles: low-field nuclear magnetic resonance (LFNMR) relaxometry, differential scanning calorimetry (DSC), and the solute exclusion technique (SET). The LFNMR data were furthermore analysed by two varieties of exponential decay analysis. These techniques were used to determine the maximum cell wall moisture contents of nine different wood species, covering a wide range of densities. The results from statistical analysis showed that LFNMR yielded lower cell wall moisture contents than DSC and SET, which were fairly similar. Both of the latter methods include factors that could either under-estimate or over-estimate the measured cell wall moisture content. Because of this and the fact that the DSC and SET methods are based on different measurement principles, it is likely that they provide realistic values of the cell wall moisture content in the water-saturated state.

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  • 43. Ventorp, Filip
    et al.
    Gustafsson, Anna
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Träskman-Bendz, Lill
    Westrin, Åsa
    Ljunggren, Lennart
    Malmö högskola, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Increased Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in Plasma of Suicide Attempters2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 10, article id e0140052Article in journal (Refereed)
    Abstract [en]

    The soluble form of the urokinase receptor, suPAR, has been suggested as a novel biomarker of low-grade inflammation. Activation of the immune system has been proposed to contribute to the development of depression and suicidal behavior. In order to identify depressed and suicidal individuals who could benefit from an anti-inflammatory treatment, a reliable biomarker of low-grade inflammation is vital. This study evaluates plasma suPAR levels as a biomarker of low-grade inflammation in patients with major depressive disorder and in patients who recently attempted suicide. The plasma suPAR and an established biomarker, C reactive protein (CRP) of suicide attempters (n = 54), depressed patients (n = 19) and healthy controls (n = 19) was analyzed with enzyme-linked immunosorbent assays. The biomarker attributes of sensitivity and sensibility were evaluated using ROC curve analysis. Both the depressed patients and suicide attempters had increased plasma suPAR. The levels of suPAR discriminated better between controls and suicide attempters than did CRP. In the future, plasma suPAR might be a superior prognosticator regarding outcome of treatment applying conventional antidepressants in conjunction with anti-inflammatory drugs.

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  • 44. Wahlberg, Anna
    et al.
    Johnsdotter, Sara
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Ekholm Selling, Katarina
    Essén, Birgitta
    Shifting perceptions of female genital cutting in a Swedish migration context2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 12Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this paper was to investigate correlations between Somali Swedish own attitudes towards female genital cutting (FGC) and their perceptions about other Swedish Somalis attitudes. METHODS: In 2015, a cross-sectional study was conducted in four Swedish municipalities with 648 Somali men and women. To assess the level of agreement between the participants' approval of FGC and their perceptions about approval among other Swedish Somalis, Bangdiwala's B-statistic and Welch's t-test were used. RESULTS: We found a substantial agreement between an individual's own approval of FGC and their perceived approval of FGC among most other Swedish Somali men (B-statistic = 0.85) and women (B-statistic = 0.76). However, we also found a tendency for participants to report that other Swedish Somalis-and especially other Swedish Somali women-approved of FGC, while they themselves did not. Perceived percentage of Somali girls being circumcised in Sweden was significantly higher among Swedish Somalis who said they wanted tissue to be removed on their own daughter (mean 23%, 95% CI: 18.3-27.9) compared to those who said they opposed removal of tissue on their own daughter (mean 8%, 95% CI: 6.4-9.1). The majority of Swedish Somali men (92%) stated a preference to marry someone without FGC or with pricking, which was also the view of most of the Swedish Somali women (90%). CONCLUSIONS: Swedish Somalis motivation to continue or discontinue with the practice of FGC may be influenced by perceptions of what other Swedish Somalis prefer. How FGC is being portrayed, in for example media reports, could therefore have an impact on attitudes towards FGC.

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  • 45.
    Walde, Jonatan
    et al.
    Umeå University and Region Västerbotten, Umeå, Sweden.
    Andersson, Lisa
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Johnson, Björn
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA). Lund University, School of Social Work, Lund, Sweden.
    Håkansson, Anders
    Department of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden, Region Skåne, Malmö Addiction Center, Malmö, Sweden.
    Drug prescriptions preceding opioid-related deaths: a register study in forensic autopsy patients2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 5, p. e0285583-e0285583Article in journal (Refereed)
    Abstract [en]

    Background/Aim: Opioid overdose deaths have increased in Sweden and other developed countries in recentdecades, despite increased treatment efforts and harm-reduction interventions. Furtherknowledge in this field is needed if this trend is to be reversed. Previous research suggeststhat mental health and patterns of prescription of opioids and other prescription drugs areassociated with increased opioid-related mortality. The present study therefore aimed toinvestigate what drugs were prescribed during the last six months of life to individuals with ahistory of illicit substance use who died with opioids present in their blood, the relationshipbetween drugs prescribed and drugs found in blood at time of death, and if prescription ofspecific drugs was temporally associated with death.

    Methods: This was a retrospective, register-based observational study that utilized data from theNational Board of Forensic Medicine, the Prescribed Drug Registry, regional health careservices, and municipal social services. We used conditional logistic regression to findtemporal associations between the prescription and dispensing of drugs and time ofdeath.

    Results: Prescription and dispensing of alprazolam and diazepam were temporally associated withdeath. The most frequently dispensed drugs were zopiclone, pregabalin, methylphenidate,diazepam and oxycodone. Methadone, alprazolam, and buprenorphine were the drugsmost often found in the blood. Opioids and tranquilizers in combination were found in a vastmajority of deaths, and prescription data suggested that the use of these drugs was illicit in amajority of cases.

    Conclusion: Prescription of certain drugs, especially alprazolam and diazepam, should be made withgreat caution to patients with a history of illicit substance use or concurrent use of opioids.

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  • 46. Zambuzzi, Willian F.
    et al.
    Bonfante, Estevam A.
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Hayashi, Mariko
    Malmö högskola, Faculty of Odontology (OD).
    Andersson, Martin
    Alves, Gutemberg
    Takamori, Esther R.
    Beltrao, Paulo J.
    Coelho, Paulo G.
    Granjeiro, Jose M.
    Nanometer Scale Titanium Surface Texturing Are Detected by Signaling Pathways Involving Transient FAK and Src Activations2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 7, article id e95662Article in journal (Refereed)
    Abstract [en]

    Background: It is known that physico/chemical alterations on biomaterial surfaces have the capability to modulate cellular behavior, affecting early tissue repair. Such surface modifications are aimed to improve early healing response and, clinically, offer the possibility to shorten the time from implant placement to functional loading. Since FAK and Src are intracellular proteins able to predict the quality of osteoblast adhesion, this study evaluated the osteoblast behavior in response to nanometer scale titanium surface texturing by monitoring FAK and Src phosphorylations. Methodology: Four engineered titanium surfaces were used for the study: machined (M), dual acid-etched (DAA), resorbable media microblasted and acid-etched (MBAA), and acid-etch microblasted (AAMB). Surfaces were characterized by scanning electron microscopy, interferometry, atomic force microscopy, x-ray photoelectron spectroscopy and energy dispersive X-ray spectroscopy. Thereafter, those 4 samples were used to evaluate their cytotoxicity and interference on FAK and Src phosphorylations. Both Src and FAK were investigated by using specific antibody against specific phosphorylation sites. Principal Findings: The results showed that both FAK and Src activations were differently modulated as a function of titanium surfaces physico/chemical configuration and protein adsorption. Conclusions: It can be suggested that signaling pathways involving both FAK and Src could provide biomarkers to predict osteoblast adhesion onto different surfaces.

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