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  • 1. Abzhandadze, Tamar
    et al.
    Reinholdsson, Malin
    Palstam, Annie
    Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg.
    Eriksson, Marie
    Sunnerhagen, Katharina S
    Transforming self-reported outcomes from a stroke register to the modified Rankin Scale: a cross-sectional, explorative study.2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 17215Article in journal (Refereed)
    Abstract [en]

    The aim was to create an algorithm to transform self-reported outcomes from a stroke register to the modified Rankin Scale (mRS). Two stroke registers were used: the Väststroke, a local register in Gothenburg, Sweden, and the Riksstroke, a Swedish national register. The reference variable, mRS (from Väststroke), was mapped with seven self-reported questions from Riksstroke. The transformation algorithm was created as a result of manual mapping performed by healthcare professionals. A supervised machine learning method-decision tree-was used to further evaluate the transformation algorithm. Of 1145 patients, 54% were male, the mean age was 71 y. The mRS grades 0, 1 and 2 could not be distinguished as a result of manual mapping or by using the decision tree analysis. Thus, these grades were merged. With manual mapping, 78% of the patients were correctly classified, and the level of agreement was almost perfect, weighted Kappa (Kw) was 0.81. With the decision tree, 80% of the patients were correctly classified, and substantial agreement was achieved, Kw = 0.67. The self-reported outcomes from a stroke register can be transformed to the mRS. A mRS algorithm based on manual mapping might be useful for researchers using self-reported questionnaire data.

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  • 2.
    Abzhandadze, Tamar
    et al.
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Westerlind, Emma
    rg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Palstam, Annie
    Dalarna University, School of Health and Welfare, Medical Science. Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Sunnerhagen, Katharina S
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Persson, Hanna C
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Sick leave one year after COVID-19 infection: a nationwide cohort study during the first wave in Sweden2024In: Scientific Reports, E-ISSN 2045-2322, Vol. 14, no 1, article id 572Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate the patterns of sick leave, as well as factors associated with sick leave due to COVID-19 during one year after the COVID-19 diagnosis, and sex-related aspects on sick leave. This nationwide study involved 11,902 individuals who received sickness benefits for COVID-19 during the first wave of the pandemic. Data from three Swedish registries were analyzed for sick leave that commenced between March 1 and August 31, 2020, with a follow-up period of 12 months. Sick leave due to COVID-19 was counted as the number of days with sickness benefits and required to include at least one registered COVID-19 diagnosis. The median duration of sick leave was 35 days, and 347 (2.9%) individuals continued their sick leave during the entire follow-up period. Furthermore, 1 year later, the cumulative incidence of sick leave was slightly higher in males (3.5%) compared to females (2.7%). Older age, being single with no children, diagnosed with the virus, medium income level, history of sick leave, and need for inpatient care were significantly associated with a higher duration of sick leave due to COVID-19, both in the total population and when stratified by sex. These results indicated that three out of 100 (3%) patients were still on sick leave 1 year after their COVID-19 diagnosis. Aspects regarding the importance of sick leave duration differed between males and females and comprised sociodemographic characteristics and need for inpatient care. The results indicated the complexity of sick leave due to COVID-19.

  • 3.
    Borneskog, Catrin
    et al.
    Dalarna University, School of Health and Welfare, Sexual Reproductive Perinatal Health. Northumbria University, Newcastle Upon Tyne, UK.
    Häggström-Nordin, Elisabet
    Stenhammar, Christina
    Tydén, Tanja
    Iliadis, Stavros I
    Changes in sexual behavior among high-school students over a 40-year period.2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 13963Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate sexual behavior, contraceptive use, risk factors as well as sources of sex information among first-year high-school students in Sweden. Secondly, to assess differences between genders and study programs as well as changes over a 40-year period. A repeated cross-sectional survey was conducted in two cities. A questionnaire comprising 77 items was used. The study population consisted of 415 students (63.4% females). The median age of sexual intercourse was 15 years. In total, 37% had had sexual intercourse, compared to 56.3% in 2009 and 45% in 1999 (p < 0.001), and the proportion of students who had their first sexual intercourse was not influenced by gender. More students in vocational programs (46.3%), compared to theoretical (33.3%), had experience of at least one sexual intercourse (p = 0.019). The same extend of contraception use at first and latest intercourse was reported, compared to previous studies. Forty-nine percent were mostly informed about sex from the internet, while in previous years, magazines, family and youth clinics were the main information sources. Comparing over time, students were in general less sexually experienced and less engaged in non-penetrative sex and physical intimacy. These findings call for a new approach, when designing sex and relationship education and health-care counseling in adolescents.

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  • 4.
    Hasselstrom, Linus
    et al.
    KTH Royal Inst Technol, Dept Sustainable Dev Environm Sci & Engn, Tekn Ringen 10B, SE-13331 Stockholm, Sweden.;Anthesis, Barnhusgatan 4, SE-11123 Stockholm, Sweden..
    Thomas, Jean-Baptiste
    KTH Royal Inst Technol, Dept Sustainable Dev Environm Sci & Engn, Tekn Ringen 10B, SE-13331 Stockholm, Sweden..
    Nordström, Jonas
    Univ Copenhagen, Dept Food & Resource Econ, Rolighedsvej 25, DK-1958 Frederiksberg C, Denmark.;Lund Univ, Sch Econ & Management, Agrifood Econ Ctr, Box 7080, SE-22007 Lund, Sweden..
    Cervin, Gunnar
    Univ Gothenburg, Dept Marine Sci Tjarno, Tjarno Marine Lab, SE-45296 Stromstad, Sweden..
    Nylund, Goran M.
    Univ Gothenburg, Dept Marine Sci Tjarno, Tjarno Marine Lab, SE-45296 Stromstad, Sweden..
    Pavia, Henrik
    Univ Gothenburg, Dept Marine Sci Tjarno, Tjarno Marine Lab, SE-45296 Stromstad, Sweden..
    Grondahl, Fredrik
    KTH Royal Inst Technol, Dept Sustainable Dev Environm Sci & Engn, Tekn Ringen 10B, SE-13331 Stockholm, Sweden..
    Socioeconomic prospects of a seaweed bioeconomy in Sweden2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 1610Article in journal (Refereed)
    Abstract [en]

    Seaweed cultivation is a large industry worldwide, but production in Europe is small compared to production in Asian countries. In the EU, the motivations for seaweed farming may be seen from two perspectives; one being economic growth through biomass production and the other being the provisioning of ecosystem services such as mitigating eutrophication. In this paper, we assess the economic potential of large-scale cultivation of kelp, Saccharina latissima, along the Swedish west coast, including the value of externalities. The findings suggest that seaweed farming has the potential of becoming a profitable industry in Sweden. Furthermore, large-scale seaweed farming can sequester a significant share of annual anthropogenic nitrogen and phosphorus inflows to the basins of the Swedish west coast (8% of N and 60% of P). Concerning the valuation of externalities, positive values generated from sequestration of nitrogen and phosphorus are potentially counteracted by negative values from interference with recreational values. Despite the large N and P uptake, the socioeconomic value of this sequestration is only a minor share of the potential financial value from biomass production. This suggests that e.g. payment schemes for nutrient uptake based on the socioeconomic values generated is not likely to be a tipping point for the industry. Additionally, seaweed cultivation is not a cost-efficient measure in itself to remove nutrients. Policy should thus be oriented towards industry development, as the market potential of the biomass will be the driver that may unlock these bioremediation opportunities.

  • 5. Helmersson-Karlqvist, J.
    et al.
    Lipcsey, M.
    Ärnlöv, Johan
    Dalarna University, School of Health and Welfare, Medical Science. Karolinska Institutet, Huddinge.
    Bell, M.
    Ravn, B.
    Dardashti, A.
    Larsson, A.
    Cystatin C predicts long term mortality better than creatinine in a nationwide study of intensive care patients2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 5882Article in journal (Refereed)
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  • 6.
    Hintze, Arend
    et al.
    Michigan State University, East Lansing, United States.
    Hertwig, R.
    The evolution of generosity in the ultimatum game2016In: Scientific Reports, E-ISSN 2045-2322, Vol. 6, article id 34102Article in journal (Refereed)
    Abstract [en]

    When humans fail to make optimal decisions in strategic games and economic gambles, researchers typically try to explain why that behaviour is biased. To this end, they search for mechanisms that cause human behaviour to deviate from what seems to be the rational optimum. But perhaps human behaviour is not biased; perhaps research assumptions about the optimality of strategies are incomplete. In the one-shot anonymous symmetric ultimatum game (UG), humans fail to play optimally as defined by the Nash equilibrium. However, the distinction between kin and non-kin - with kin detection being a key evolutionary adaption - is often neglected when deriving the "optimal" strategy. We computationally evolved strategies in the UG that were equipped with an evolvable probability to discern kin from non-kin. When an opponent was not kin, agents evolved strategies that were similar to those used by humans. We therefore conclude that the strategy humans play is not irrational. The deviation between behaviour and the Nash equilibrium may rather be attributable to key evolutionary adaptations, such as kin detection. Our findings further suggest that social preference models are likely to capture mechanisms that permit people to play optimally in an evolutionary context. Once this context is taken into account, human behaviour no longer appears irrational © The Author(s) 2016.

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  • 7.
    Hintze, Arend
    et al.
    Michigan State University, East Lansing, United States.
    Olson, R. S.
    Adami, C.
    Hertwig, R.
    Risk sensitivity as an evolutionary adaptation2015In: Scientific Reports, E-ISSN 2045-2322, Vol. 5, article id 8242Article in journal (Refereed)
    Abstract [en]

    Risk aversion is a common behavior universal to humans and animals alike. Economists have traditionally defined risk preferences by the curvature of the utility function. Psychologists and behavioral economists also make use of concepts such as loss aversion and probability weighting to model risk aversion. Neurophysiological evidence suggests that loss aversion has its origins in relatively ancient neural circuitries (e.g., ventral striatum). Could there thus be an evolutionary origin to risk aversion? We study this question by evolving strategies that adapt to play the equivalent mean payoff gamble. We hypothesize that risk aversion in this gamble is beneficial as an adaptation to living in small groups, and find that a preference for risk averse strategies only evolves in small populations of less than 1,000 individuals, or in populations segmented into groups of 150 individuals or fewer - numbers thought to be comparable to what humans encountered in the past. We observe that risk aversion only evolves when the gamble is a rare event that has a large impact on the individual's fitness. As such, we suggest that rare, high-risk, high-payoff events such as mating and mate competition could have driven the evolution of risk averse behavior in humans living in small groups.

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  • 8.
    Hintze, Arend
    et al.
    Michigan State University, East Lansing, United States.
    Phillips, N.
    Hertwig, R.
    The Janus face of Darwinian competition2015In: Scientific Reports, E-ISSN 2045-2322, Vol. 5, article id 13662Article in journal (Refereed)
    Abstract [en]

    Without competition, organisms would not evolve any meaningful physical or cognitive abilities. Competition can thus be understood as the driving force behind Darwinian evolution. But does this imply that more competitive environments necessarily evolve organisms with more sophisticated cognitive abilities than do less competitive environments? Or is there a tipping point at which competition does more harm than good? We examine the evolution of decision strategies among virtual agents performing a repetitive sampling task in three distinct environments. The environments differ in the degree to which the actions of a competitor can affect the fitness of the sampling agent, and in the variance of the sample. Under weak competition, agents evolve decision strategies that sample often and make accurate decisions, which not only improve their own fitness, but are good for the entire population. Under extreme competition, however, the dark side of the Janus face of Darwinian competition emerges: Agents are forced to sacrifice accuracy for speed and are prevented from sampling as often as higher variance in the environment would require. Modest competition is therefore a good driver for the evolution of cognitive abilities and of the population as a whole, whereas too much competition is devastating.

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  • 9.
    Hintze, Arend
    et al.
    Dalarna University, School of Technology and Business Studies, Microdata Analysis. Michigan State University, East Lansing, USA.
    Staudacher, Jochen
    Gelhar, Katja
    Pothmann, Alexander
    Rasch, Juliana
    Wildegger, Daniel
    Inclusive groups can avoid the tragedy of the commons2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 22392Article in journal (Refereed)
    Abstract [en]

    The public goods game is a famous example illustrating the tragedy of the commons (Hardin in Science 162:1243-1248, 1968). In this game cooperating individuals contribute to a pool, which in turn is distributed to all members of the group, including defectors who reap the same rewards as cooperators without having made a contribution before. The question is now, how to incentivize group members to all cooperate as it maximizes the common good. While costly punishment (Helbing et al. in New J Phys 12:083005, 2010) presents one such method, the cost of punishment still reduces the common good. The selfishness of the group members favors defectors. Here we show that including other members of the groups and sharing rewards with them can be another incentive for cooperation, avoiding the cost required for punishment. Further, we show how punishment and this form of inclusiveness interact. This work suggests that a redistribution similar to a basic income that is coupled to the economic success of the entire group could overcome the tragedy of the commons.

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  • 10. Lagali, Neil S
    et al.
    Badian, Reza A
    Liu, Xu
    Feldreich, Tobias R
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Utheim, Tor Paaske
    Dahlin, Lars B
    Rolandsson, Olov
    Dendritic cell maturation in the corneal epithelium with onset of type 2 diabetes is associated with tumor necrosis factor receptor superfamily member 92018In: Scientific Reports, E-ISSN 2045-2322, Vol. 8, no 1, article id 14248Article in journal (Refereed)
    Abstract [en]

    Type 2 diabetes mellitus is characterized by a low-grade inflammation; however, mechanisms leading to this inflammation in specific tissues are not well understood. The eye can be affected by diabetes; thus, we hypothesized that inflammatory changes in the eye may parallel the inflammation that develops with diabetes. Here, we developed a non-invasive means to monitor the status of inflammatory dendritic cell (DC) subsets in the corneal epithelium as a potential biomarker for the onset of inflammation in type 2 diabetes. In an age-matched cohort of 81 individuals with normal and impaired glucose tolerance and type 2 diabetes, DCs were quantified from wide-area maps of the corneal epithelial sub-basal plexus, obtained using clinical in vivo confocal microscopy (IVCM). With the onset of diabetes, the proportion of mature, antigen-presenting DCs increased and became organized in clusters. Out of 92 plasma proteins analysed in the cohort, tumor necrosis factor receptor super family member 9 (TNFRSF9) was associated with the observed maturation of DCs from an immature to mature antigen-presenting phenotype. A low-grade ocular surface inflammation observed in this study, where resident immature dendritic cells are transformed into mature antigen-presenting cells in the corneal epithelium, is a process putatively associated with TNFRSF9 signalling and may occur early in the development of type 2 diabetes. IVCM enables this process to be monitored non-invasively in the eye.

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  • 11. Lind, Lars
    et al.
    Sundström, Johan
    Ärnlöv, Johan
    Dalarna University, School of Health and Welfare, Medical Science. Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Risérus, Ulf
    Lampa, Erik
    A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases.2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 2978Article in journal (Refereed)
    Abstract [en]

    The impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90-4.05) at age 50 to 1.30 (95% CI 1.05-1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.

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  • 12. Nowak, Christoph
    et al.
    Hetty, Susanne
    Salihovic, Samira
    Castillejo-Lopez, Casimiro
    Ganna, Andrea
    Cook, Naomi L
    Broeckling, Corey D
    Prenni, Jessica E
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Ingelsson, Erik
    Glucose challenge metabolomics implicates medium-chain acylcarnitines in insulin resistance2018In: Scientific Reports, E-ISSN 2045-2322, Vol. 8, no 1, article id 8691Article in journal (Refereed)
    Abstract [en]

    Insulin resistance (IR) predisposes to type 2 diabetes and cardiovascular disease but its causes are incompletely understood. Metabolic challenges like the oral glucose tolerance test (OGTT) can reveal pathogenic mechanisms. We aimed to discover associations of IR with metabolite trajectories during OGTT. In 470 non-diabetic men (age 70.6 ± 0.6 years), plasma samples obtained at 0, 30 and 120 minutes during an OGTT were analyzed by untargeted liquid chromatography-mass spectrometry metabolomics. IR was assessed with the hyperinsulinemic-euglycemic clamp method. We applied age-adjusted linear regression to identify metabolites whose concentration change was related to IR. Nine trajectories, including monounsaturated fatty acids, lysophosphatidylethanolamines and a bile acid, were significantly associated with IR, with the strongest associations observed for medium-chain acylcarnitines C10 and C12, and no associations with L-carnitine or C2-, C8-, C14- or C16-carnitine. Concentrations of C10- and C12-carnitine decreased during OGTT with a blunted decline in participants with worse insulin resistance. Associations persisted after adjustment for obesity, fasting insulin and fasting glucose. In mouse 3T3-L1 adipocytes exposed to different acylcarnitines, we observed blunted insulin-stimulated glucose uptake after treatment with C10- or C12-carnitine. In conclusion, our results identify medium-chain acylcarnitines as possible contributors to IR.

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  • 13. Reinholdsson, Malin
    et al.
    Abzhandadze, Tamar
    Palstam, Annie
    Sahlgrenska Academy, University of Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Sunnerhagen, Katharina S
    A register-based study on associations between pre-stroke physical activity and cognition early after stroke (part of PAPSIGOT).2022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, no 1, article id 5779Article in journal (Refereed)
    Abstract [en]

    The objective was to investigate if pre-stroke physical activity is associated with intact cognition early after stroke. The study design was a cross-sectional, register-based study. The study sample included 1111 adults with first stroke (mild or moderate severity) admitted to three Swedish stroke units. The main outcome was cognition. The associations of pre-stroke physical activity, age, sex, smoking, diabetes, atrial fibrillation, previous TIA, statin treatment, hypertension treatment, reperfusion therapies, stroke severity, and education on the outcome cognition were analyzed using binary logistic regression. Physical activity was assessed within 48 h of admittance, and cognition was screened during stroke unit care. The results were: mean age 70 years, 40% women, 61% pre-stroke physically active, and 53% with post-stroke cognitive impairment. Patients with pre-stroke light or moderate physical activity have higher odds for intact cognition compared to inactive: odds ratio (95% confidence interval) 1.32 (0.97-1.80) and 2.04 (1.18-3.53), respectively. In addition to pre-stroke physical activity, people with younger age, a higher level of education, less severe stroke (more mild than moderate), being non-diabetic, and non-smoking have higher odds for intact cognition. In conclusion physical activity before stroke is associated with intact cognition in patients with mild and moderate stroke.

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  • 14. Salihovic, S.
    et al.
    Broeckling, C. D.
    Ganna, A.
    Prenni, J. E.
    Sundström, J.
    Berne, C.
    Lind, L.
    Ingelsson, E.
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska Institutet.
    Nowak, C.
    Non-targeted urine metabolomics and associations with prevalent and incident type 2 diabetes2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 16474Article in journal (Refereed)
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  • 15. Samrani, George
    et al.
    Marklund, Petter
    Engström, Lisa
    Broman, Daniel
    Dalarna University, School of Education, Health and Social Studies, Educational Work. Högskolan i Skövde.
    Persson, Jonas
    Behavioral facilitation and increased brain responses from a high interference working memory context.2018In: Scientific Reports, E-ISSN 2045-2322, Vol. 8, no 1, article id 15308Article in journal (Refereed)
    Abstract [en]

    Many real-life situations require flexible behavior in changing environments. Evidence suggests that anticipation of conflict or task difficulty results in behavioral and neural allocation of task-relevant resources. Here we used a high- and low-interference version of an item-recognition task to examine the neurobehavioral underpinnings of context-sensitive adjustment in working memory (WM). We hypothesized that task environments that included high-interference trials would require participants to allocate neurocognitive resources to adjust to the more demanding task context. The results of two independent behavioral experiments showed enhanced WM performance in the high-interference context, which indicated that a high-interference context improves performance on non-interference trials. A third behavioral experiment showed that when WM load was increased, this effect was no longer significant. Neuroimaging results further showed greater engagement of inferior frontal gyrus, striatum, parietal cortex, hippocampus, and midbrain in participants performing the task in the high- than in the low-interference context. This effect could arise from an active or dormant mode of anticipation that seems to engage fronto-striatal and midbrain regions to flexibly adjust resources to task demands. Our results extend the model of conflict adaptation beyond trial-to-trial adjustments by showing that a high interference context affects both behavioral and biological aspects of cognition.

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  • 16. Sheneman, L.
    et al.
    Hintze, Arend
    Michigan State University, East Lansing, United States.
    Evolving autonomous learning in cognitive networks2017In: Scientific Reports, E-ISSN 2045-2322, Vol. 7, no 1, article id 16712Article in journal (Refereed)
    Abstract [en]

    There are two common approaches for optimizing the performance of a machine: genetic algorithms and machine learning. A genetic algorithm is applied over many generations whereas machine learning works by applying feedback until the system meets a performance threshold. These methods have been previously combined, particularly in artificial neural networks using an external objective feedback mechanism. We adapt this approach to Markov Brains, which are evolvable networks of probabilistic and deterministic logic gates. Prior to this work MB could only adapt from one generation to the other, so we introduce feedback gates which augment their ability to learn during their lifetime. We show that Markov Brains can incorporate these feedback gates in such a way that they do not rely on an external objective feedback signal, but instead can generate internal feedback that is then used to learn. This results in a more biologically accurate model of the evolution of learning, which will enable us to study the interplay between evolution and learning and could be another step towards autonomously learning machines. © 2017 The Author(s).

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  • 17. Steubl, Dominik
    et al.
    Kumar, Santhosh V
    Tato, Maia
    Mulay, Shrikant R
    Larsson, Anders
    Lind, Lars
    Risérus, Ulf
    Renders, Lutz
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Anders, Hans-Joachim
    Circulating cathepsin-S levels correlate with GFR decline and sTNFR1 and sTNFR2 levels in mice and humans2017In: Scientific Reports, E-ISSN 2045-2322, Vol. 7, article id 43538Article in journal (Refereed)
    Abstract [en]

    Cardiovascular complications determine morbidity/mortality in chronic kidney disease (CKD). We hypothesized that progressive CKD drives the release of cathepsin-S (Cat-S), a cysteine protease that promotes endothelial dysfunction and cardiovascular complications. Therefore, Cat-S, soluble tumor-necrosis-factor receptor (sTNFR) 1/2 and glomerular filtration rate (GFR) were measured in a CKD mouse model, a German CKD-cohort (MCKD, n = 421) and two Swedish community-based cohorts (ULSAM, n = 764 and PIVUS, n = 804). Association between Cat-S and sTNFR1/2/GFR was assessed using multivariable linear regression. In the mouse model, Cat-S and sTNFR1/2 concentrations were increased following the progressive decline of GFR, showing a strong correlation between Cat-S and GFR (r = -0.746, p < 0.001) and Cat-S and sTNFR1/sTNFR2 (r = 0.837/0.916, p < 0.001, respectively). In the human cohorts, an increase of one standard deviation of estimated GFR was associated with a decrease of 1.008 ng/ml (95%-confidence interval (95%-CI) -1.576-(-0.439), p < 0.001) in Cat-S levels in MCKD; in ULSAM and PIVUS, results were similar. In all three cohorts, Cat-S and sTNFR1/sTNFR2 levels were associated in multivariable linear regression (p < 0.001). In conclusion, as GFR declines Cat-S and markers of inflammation-related endothelial dysfunction increase. The present data indicating that Cat-S activity increases with CKD progression suggest that Cat-S might be a therapeutic target to prevent cardiovascular complications in CKD.

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  • 18. Vavruch, Camilla
    et al.
    Nowak, C
    Rudholm Feldreich, Tobias
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Östgren, C J
    Sundström, J
    Söderberg, S
    Lind, L
    Nyström, F
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska Institutet.
    Using proximity extension proteomics assay to discover novel biomarkers associated with circulating leptin levels in patients with type 2 diabetes2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 13097Article in journal (Refereed)
    Abstract [en]

    We aimed to discover novel associations between leptin and circulating proteins which could link leptin to the development of cardiovascular disease in patients with type 2 diabetes (T2DM). In a discovery phase, we investigated associations between 88 plasma proteins, assessed with a proximity extension assay, and plasma leptin in a cohort of middle-aged patients with T2DM. Associations passing the significance threshold of a False discovery rate of 5% (corresponding to p < 0.0017) were replicated in patients with T2DM in an independent cohort. We also investigated if proteins mediated the longitudinal association between plasma leptin and the incidence of major cardiovascular events (MACE). One protein, adipocyte fatty acid binding protein (A-FABP), was significantly associated with leptin in both the discovery phase [95% CI (0.06, 0.17) p = 0.00002] and the replication cohort [95% CI (0.12, 0.39) p = 0.0003]. Multiplicative interaction analyses in the two cohorts suggest a stronger association between A-FABP and leptin in men than in women. In longitudinal analyses, the association between leptin and MACE was slightly attenuated after adding A-FABP to the multivariate model. Our analysis identified a consistent association between leptin and A-FABP in two independent cohorts of patients with T2DM, particularly in men.Trial registration: ClinicalTrials.gov identifier NCT01049737.

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  • 19. Westerlind, Emma
    et al.
    Persson, Hanna C
    Palstam, Annie
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Eriksson, Marie
    Norrving, Bo
    Sunnerhagen, Katharina S
    Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year.2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 13251Article in journal (Refereed)
    Abstract [en]

    Stroke is one of the most common diseases and has several potential consequences, such as psychological problems and pain. Return to work (RTW) after stroke in working-age individuals is incomplete. The present study aimed to investigate differences in self-perceived general health, pain, and depression between 1 and 5 years post-stroke related to RTW status. The study was nationwide, registry-based and the study population (n = 398) consisted of working-age people who had a stroke in 2011 and participated in 1-year and 5-year follow-up questionnaire surveys. Shift analyses with the Wilcoxon signed rank test and logistic regression were used. RTW within the first year post-stroke was associated with better self-perceived general health, less pain, and less depression both at 1 and 5 years post-stroke, compared with the no-RTW group. However, the RTW group had significant deterioration in general health and pain between 1 and 5 years, while the no-RTW group had no significant change. RTW was a significant predictor of lower odds of improvement in general health and pain between 1 and 5 years. This emphasizes the need for continued follow-up and support to ensure a balance between work and health for RTW individuals after stroke.

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  • 20. Yuan, Shuai
    et al.
    Xiong, Ying
    Michaëlsson, Madeleine
    Dalarna University, School of Teacher Education, Educational Work.
    Michaëlsson, Karl
    Larsson, Susanna C
    Genetically predicted education attainment in relation to somatic and mental health.2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 4296Article in journal (Refereed)
    Abstract [en]

    A deeper understanding of the causal links from education level to health outcomes may shed a light for disease prevention. In the present Mendelian randomization study, we found that genetically higher education level was associated with lower risk of major mental disorders and most somatic diseases, independent of intelligence. Higher education level adjusted for intelligence was associated with lower risk of suicide attempts, insomnia, major depressive disorder, heart failure, stroke, coronary artery disease, lung cancer, breast cancer, type 2 diabetes and rheumatoid arthritis but with higher risk of obsessive-compulsive disorder, anorexia nervosa, anxiety, bipolar disorder and prostate cancer. Higher education level was associated with reduced obesity and smoking, which mediated quite an extent of the associations between education level and health outcomes. These findings emphasize the importance of education to reduce the burden of common diseases.

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  • 21. Zalakeviciute, Rasa
    et al.
    Alexandrino, Katiuska
    Mejia, Danilo
    Bastidas, Marco G
    Oleas, Nora H
    Gabela, Diana
    Ngoc Phuong, Chau
    Dalarna University, School of Information and Engineering, Microdata Analysis.
    Bonilla-Bedoya, Santiago
    Diaz, Valeria
    Rybarczyk, Yves
    Dalarna University, School of Information and Engineering, Microdata Analysis.
    The effect of national protest in Ecuador on PM pollution.2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 17591Article in journal (Refereed)
    Abstract [en]

    Particulate matter (PM) accounts for millions of premature deaths in the human population every year. Due to social and economic inequality, growing human dissatisfaction manifests in waves of strikes and protests all over the world, causing paralysis of institutions, services and circulation of transport. In this study, we aim to investigate air quality in Ecuador during the national protest of 2019, by studying the evolution of PM2.5 (PM ≤ 2.5 µm) concentrations in Ecuador and its capital city Quito using ground based and satellite data. Apart from analyzing the PM2.5 evolution over time to trace the pollution changes, we employ machine learning techniques to estimate these changes relative to the business-as-usual pollution scenario. In addition, we present a chemical analysis of plant samples from an urban park housing the strike. Positive impact on regional air quality was detected for Ecuador, and an overall - 10.75 ± 17.74% reduction of particulate pollution in the capital during the protest. However, barricade burning PM peaks may contribute to a release of harmful heavy metals (tire manufacture components such as Co, Cr, Zn, Al, Fe, Pb, Mg, Ba and Cu), which might be of short- and long-term health concerns.

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  • 22. Zalakeviciute, Rasa
    et al.
    Alexandrino, Katiuska
    Rybarczyk, Yves
    Dalarna University, School of Technology and Business Studies, Microdata Analysis. Intelligent and Interactive Systems Lab (SI2 Lab) Universidad de Las Américas (UDLA), Quito, Ecuador.
    Debut, Alexis
    Vizuete, Karla
    Diaz, Maria
    Seasonal variations in PM10 inorganic composition in the Andean city2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 17049Article in journal (Refereed)
    Abstract [en]

    Particulate matter (PM) is one of the key pollutants causing health risks worldwide. While the preoccupation for increased concentrations of these particles mainly depends on their sources and thus chemical composition, some regions are yet not well investigated. In this work the composition of chemical elements of atmospheric PM10 (particles with aerodynamic diameters ≤ 10 µm), collected at the urban and suburban sites in high elevation tropical city, were chemically analysed during the dry and wet seasons of 2017-2018. A large fraction (~ 68%) of PM10 composition in Quito, Ecuador is accounted for by water-soluble ions and 16 elements analysed using UV/VIS spectrophotometer and Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES). Hierarchical clustering analysis was performed to study a correlation between the chemical composition of urban pollution and meteorological parameters. The suburban area displays an increase in PM10 concentrations and natural elemental markers during the dry (increased wind intensity, resuspension of soil dust) season. Meanwhile, densely urbanized area shows increased total PM10 concentrations and anthropogenic elemental markers during the wet season, which may point to the worsened combustion and traffic conditions. This might indicate the prevalence of cardiovascular and respiratory problems in motorized areas of the cities in the developing world.

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