KI News

At a degree ceremony on 17 May at Karolinska Institutet six doctors graduated from the Silvia programme, three of whom work in Sweden, one in Luxemburg, one in Germany and one in Japan. The ceremony took place in connection with the Silviahemmet’s 20th anniversary, and Her Majesty Queen Silvia handed out the diplomas to the new doctors. The two-year master’s programme in dementia care has been completed by the doctors in tandem with their clinical work. It is held in the form of a distance professional development course that they follow at their existing workplaces, which allows them to put what they learn into immediate practice. “This program has offered me the opportunity to study with colleagues from different countries, to gain new scientific insights, to deepen relevant knowledge for daily practice about dementia and demetia care,” says Ursula Sottong, physician at the Malteser Deutschland organisation in Germany, and one of the Silvia Doctors. “It has been especially interesting and beneficial for me and for my organisation to discuss patient cases. During the coming years we will profit from this experience.” Read more in a press release from Karolinska Institutet.

The city of Stockholm was at its best for Karolinska Institutet’s spring conferment ceremony, held on Friday, May 13, at Stockholm City Hall. A warm afternoon sun glistened off the water as elegantly clad evening attendants entered the cobblestone courtyard. As the clock approached 5 pm, the melody of “Puttin’ on the Ritz” filled the air inside. The bold sound of trumpets heralded the decent of scepters and flags slowly down the grand staircase, followed by the evening’s officiates.  KI’s Acting Vice-Chancellor, Karin Dahlman-Wright, warmly welcomed the promovendi, three honorary doctors, two jubilee gold medalists, and esteemed guests. “A PhD is clearly not a 9 to 5 job”, she addressed the new doctors, praising their new knowledge in the face of struggles and challenges that a PhD education involves. “A doctor thesis is not the end but the beginning. Never give up! Find a way through.”  She assured the promovendi that, despite today’s infamous date – Friday the 13th –  “we are in the business of science, not superstition. There’s no cause for concern.” Gold medals presented Karin Dahlman-Wright also presented two jubilee gold medals, an award of highest honor granted to individuals who have made significant contributions to the university. She praised the accomplishments of Rune Fransson, who served as University Director between 1995 and 2007, and Professor Emeritus Torsten Wiesel, winner of the 1981 Nobel Prize in Physiology or Medicine. An interlude followed, featuring the harmonious voices of the opera trio Divine, providing a moment of reflection on the award winners’ contributions and service to KI. Gazing upward as the radiant sounds filled the room, one’s attention was easily drawn to the flags of Zambia, the United States, and the United Kingdom. Their presence signified the nationalities of the evening’s distinguished honorary doctors – Alimuddin Zumla, Robert Langer, and Richard Peto. Marie Wahren-Herlenius, Pro-Dean of Research, began humbly, “Humankind is amazing…”, and acknowledged the great medical advances resulting from their respective discoveries.  Diplomas and doctor's hat Finally, the newest KI doctors, who had patiently awaited their turn, were welcomed to come forward by Anders Gustafsson, Dean of Doctoral Education and Acting Dean of Research.  Row by row, the promovendi ascended the grand staircase to receive their diplomas and their doctor’s hat. “A PhD entails a promise of change, development and improvement,” said Anders Gustafsson. “The truth is out there. Go out and show the world what a doctor from KI can do!” The ceremony concluded just before 7pm as the processional music accompanied the traditional parade of scepters, flags and banners up the grand staircase, followed by the Master of Ceremonies. The celebration could begin! Text: Megan Osler

The growth factor IGF-2 can prevent the death of human nerve cells in the incurable disease ALS, according to a study by researchers at Sweden´s Karolinska Institutet and the University of Milan in Italy. The study, which is published in the journal Scientific Reports, demonstrates that degeneration-resistant oculomotor neurons can be used as a tool to identify factors able to prevent the degeneration of vulnerable neurons caused by this deadly disease. Amyotrophic lateral sclerosis (ALS) is a lethal disease characterised by progressive loss of motor neurons and subsequent muscle atrophy, weakness and paralysis. However, certain motor neuron groups are, for unknown reasons, relatively resistant to degeneration in ALS. Among the most resistant are oculomotor neurons, which are located in the brain stem and control eye movement. Consequently, eye-tracking devices are used to enable paralyzed ALS patients to communicate through computers. Incurable disease The disease is currently incurable, but researchers are looking for genes that can be used to develop treatments able to arrest the progress of the disease and prevent the loss of motor neurons. To this end, Eva Hedlund’s team at Karolinska Institutet’s Department of Neuroscience has focused its attention on the oculomotor neurons. “We have now identified a factor, insulin-like growth factor 2, or IGF-2, within the resistant oculomotor neurons. We show that IGF-2 can rescue human motor neurons from degenerating,” explains Dr Hedlund, who has led the study with Stefania Corti at Milano University. The researchers used skin cells obtained from ALS patients. The skin cells were reprogrammed into stem cells and further developed into motor neurons.  Upon receiving IGF-2 the neurons fared better than normally under conditions harmful to motor neurons. Positive effect Since IGF-2 had a positive effect on cultivated neurons outside the body, the researchers proceeded to examine if it could also protect motor neurons in mice that develop ALS-like disease. When the researcher gave the ALS mice IGF-2 through gene therapy they lived longer.  “We can see that motor neurons are preserved and that IGF-2 treatment causes the axons to regenerate and recreate vital connections with muscles that were previously lost,” says Dr Hedlund. The closely related hormone IGF-1 has been clinically tested through administration under the skin to patients with ALS, but the results have been contradictory. So far IGF-2 has not been tested in a clinical setting. The new study supports the idea that administration of IGF-2 or IGF-1 directly to motor neurons through gene therapy could have a positive effect. The study was financed by grants from the Söderberg Foundation, the EU Joint Programme for Neurodegenerative Disease, the Birgit Backmark endowment for ALS research at Karolinska Institutet, the Thierry Latran Foundation, the Åhlen Foundation, the Swedish Research Council, the Swedish Society for Medical Research, the Swedish Brain Fund and the Swedish Society of Medicine. Publication Differential neuronal vulnerability identifies IGF-2 as a protective factor in ALS Ilary Allodi, Laura Comley, Susanne Nichterwitz, Monica Nizzardo, Chiara Simone, Julio Aguila Benitez, Ming Cao, Stefania Corti, Eva Hedlund Scientific Reports, published online 16 May 2016, doi: 10.1038/srep25960

The social transmission of fear, which can cause the development of phobias, can be prevented, according to a new study from Karolinska Institutet. The study, which is published in The Journal of Experimental Psychology: General, deepens our understanding of how best to develop practical strategies for preventing phobias and similar conditions in particularly vulnerable groups. Throughout its evolution, mankind has benefited from the ability to learn about emotionally charged situations by observing how other individuals behave. The phenomenon is called social learning and can be an efficient means for individuals to avoid danger. Babies, for example, can learn appropriate behaviour by observing what adults do. There is, however, a flipside to this. This kind of indirect experience can contribute to the transmission of fears and anxiety disorders between members of a family and people living in close proximity. Even though more is now understood about the mechanisms of social transmission for fear, researchers still know surprisingly little about the learning processes that counteract or reduce the transmission of fears between individuals. Transmission of fear In the present study, researchers at Karolinska Institutet found that the social transmission of fear can be counteracted. They had participants watch a video in which a “demonstrator” looked at images of two angry human faces. When one of the faces was shown, the demonstrator received an unpleasant electric shock to the wrist. In most cases, there was a transmission of fear from the demonstrator to the participants, who started to manifest fear reactions to the photograph that was associated with danger for the demonstrator. Safe situation The researchers then looked at what happened if the participants first saw a film of the demonstrator calmly looking at the same photographs, conveying that the situation was safe and the faces harmless, and found that it prevented the transmission of fear. However, if the participants were first shown a film of the same photographs but without the presence of the calming demonstrator, this effect was not achieved. “We found that an earlier safe experience in the presence of another person counteracted the social transmission of fear,” says co-researcher Armita Golkar at Karolinska Institutet’s Department of Clinical Neuroscience, Division of Psychology. In further experiments, the researchers observed that the effect remained when the circumstances changed, such as if the demonstrator was no longer present in a subsequent situation. In another version of the experiment, the “safe” and the “dangerous” demonstrators were different people, which cancelled the effect of safety learning. “This study extends our understanding of the basic learning processes governing social transmission of fear and safety, and connects these lines of work to clinical research by examining how prior safe experiences can reduce the transmission of fears between individuals,” says the other co-researcher Andreas Olsson from the same department. Publication Immunization against social fear learning Armita Golkar and Andreas Olsson  Journal of Experimental Psychology: General, published online 14 April 2016, doi 10.1037/xge0000173

Karolinska Institutet and the recently formed Sjöberg Foundation have today jointly signed a letter of intent describing the framework of a donation aimed at creating and managing a new cancer research centre located at Karolinska Institutet. “It is gratifying that we now have a new player who wants to support Swedish research and development and contribute to improved cancer therapies”, says Professor Henrik Grönberg, acting Pro-Vice-Chancellor of Karolinska Institutet. “We are honoured that Bengt Sjöberg and his new foundation have chosen Karolinska Institutet as a partner in these discussions.” Bengt Sjöberg, a Swedish businessman residing in Hong Kong, recently announced the creation of the Sjöberg Foundation, endowed with SEK 2 billion (approx. EUR 216 million), with the goal of “making a difference in cancer research and the treatment currently received by cancer patients”. This new foundation, among other things, will award the annual Sjöberg Prize to a prominent cancer researcher or cancer research group. The prize will be awarded in close cooperation with the Royal Swedish Academy of Sciences.

Docent Tore Curstedt at Karolinska Institutet’s Department of Molecular Medicine and Surgery has been nominated by the European Patent Office (EPO) for a Lifetime Achievement Award at the 2016 European Inventor Award ceremony for his work with Corosurf. Tore Curstedt is nominated for the work he and his colleague Bengt Robertsson have done on their innovative treatment for preterm babies with respiratory distress syndrome (RDS). The method, which was introduced in 1989, has now been administered to over three million infants. The drug developed by Dr Curstedt is marketed under the name Corosurf and is used in 80 countries, where it is estimated to have saved the lives of over half a million preterm babies. The nominations deadline is 31 May, and the prize ceremony will be held in Lisbon on 9 June 2016. Read more about the prize and Tore Curstedt’s nomination on the EPO website.

Wednesday 4 May,the former KI researcher and surgeon Paolo Macchiarini is interviewed in The Swedish Medical Association news magazine Läkartidningen and Swedish Television. In the interview in Läkartidningen, Paolo Macchiarini expresses that KI's decision to discharge him was ill-founded and further claims that KI's actions were media-driven. KI does not share this view. The decision to discharge Paolo Macchiarini was taken by the Staff Disciplinary Board at KI, and was preceeded by a thorough investigation exposing several circumstances rendering it impossible for KI to continue cooperating with him. These circumstances were described in a press release at the time of the decision. We do not have any further, new comments as we are awaiting the conclustions from several on-going investigations relating to this.

The Swedish Research Council has commissioned an audit of the large-scale biobank initiative BBMRI.se, in which Karolinska Institutet (KI) comes under fire on several counts as the host university. KI comments here on the report. We take full note of the criticism and have passed the report on to KI’s internal audit office for an examination of the financial issues. Karolinska Institutet has not handled the matter satisfactorily; for example, it took too long to establish a board and a strategic plan, and the project has not been managed clearly. There have also been internal collaborative problems that KI has not managed to sort out. There was, however, support for setting up the biobank at KI, as the SRC’s audit confirms. Granted, there was some formal obscurity surrounding how the decision was taken, but it was correct in substance. We were also criticised for supposedly having distributed resources in our favour. The report did, however, contain errors regarding investments in equipment: the amount for KI also includes staff costs, and the amount for other universities was SEK 4.6 million, not SEK 4.6 thousand, as incorrectly stated at the beginning of the report. Biobanks are a vital resource for medical research, and KI contends that BBMRI.se has represented an extremely important capacity improvement for Swedish epidemiological research that has contributed to scientific advances.

The spinal cord has its own system for sensing changes in pH, according to a study by researchers at Karolinska Institutet. The new findings, which are published in Current Biology, show that cells in the central canal of the spinal cord detect and regulate pH, if it deviates from normal levels. Such changes may in turn impair the function of the neural networks of the nervous system. The spinal cord conveys nerve signals between the different organs of the body and the brain, and it controls all our movements. Running in the midline through the cord is a thin tube called the central canal, which extends from the brain all the way down to the caudal vertebrae. The canal contains the cerebrospinal fluid (CSF), which flows around the brain and the spinal cord, and is coated with ciliated cells. The function of these cells has long eluded researchers and has been the object of much speculation. “We have now shown that they operate as sensors that detect the acidity – the pH, that is – of the CSF,” says Sten Grillner at Karolinska Institutet’s Department of Neuroscience. “These pH sensors in the central canal demonstrate an elegant mechanism of detecting fluctuations in pH.” Two types of molecules Each cell has two types of molecules in its cell membrane that detect pH levels, one reacting to acidic pH (called ASIC3) and the other to alkaline pH levels (called PKD2L1). The normal pH of the body is 7.4. These ciliated neurons are highly sensitive to even small deviations from the norm and disruption of the acid-base balance. The researchers behind the current study show that at a pH of 7.4, the cells have a very low level of activity, but as soon as the pH deviates from this value, in either the acidic or the alkaline direction, the activity level increases markedly through the activation of either the ASIC3 molecules (acidic) or the PKD2L1 molecules (alkaline). Deviations in pH lead to changes in the highly regulated micro-circuits of the nervous system, and an impairment of their normal function. It is therefore vital that it can sense pH levels. Inhibitory effect When the nerve system is active, it releases lactic acid metabolically, and at high levels of activity, such as during intense exercise or epilepsy, this causes the pH in the nerve system to become more acidic. Under certain circumstances that affect the metabolism, there can instead be an increase in pH in the alkaline direction. The researchers show that both a lower (more acidic) pH and a higher pH (alkaline) has an inhibitory effect on the motor activity in the spinal cord. This occurs through the secretion of a neurotransmitter called somatostatin from nerve terminals of the pH-sensing central canal cells distributed within the spinal cord itself. “When the central canal cells detect a change in pH, it thus gives rise to inhibition of the spinal cord’s motor circuits, which results in a depression of the motor activity,” says Professor Grillner. “This, in turn, helps the pH levels to return to normal.” The study was financed with grants from the Swedish Research Council, the EU’s Seventh Framework Programme, Karolinska Institutet’s research funds, the Centre National de la Recherche Scientifique and the Muséum National d´Historie Naturelle. Publication The Spinal Cord Has an Intrinsic System for the Control of pH Elham Jalalvand, Brita Robertson, Hervé Tostivint, Peter Wallén and Sten Grillner Current Biology, published online April 28 2016 doi: 10.1016/j.cub.2016.03.048

A diet of too much red meat and not enough fruit and vegetables could increase your body’s biological age and contribute to health problems. That is the result from research led by the University of Glasgow in cooperation with Karolinska Institutet, and published in the journal Aging. The researchers have found that a moderate increase in serum phosphate levels caused by red meat consumption, combined with a poor overall diet, increases the biological age in contrast to the chronological age. The study was led by researchers at the Institute of Cancer Sciences at University of Glasgow, in cooperation with researchers at the Department of Clinical Science, Intervention and Technology (CLINTEC) at Karolinska Institutet. It looked at participants from the most deprived to the least deprived in the NHS Greater Glasgow Health Board area, and also demonstrates that deprived males were the worst affected. Participating researcher from KI was Peter Stenvinkel. The research is part of the psychological, social, and biological determinants of ill health (pSoBid) study cohort, originally funded by the Glasgow Centre for Population Health. This news article is an edited version of a press release from University of Glasgow.   Publication: Accelerated ageing and renal dysfunction links lower socioeconomic status and dietary phosphate intake Ruth McClelland, Kelly Christensen, Suhaib Mohammed, Dagmara McGuinness, Josephine Cooney, Andisheh Bakshi, Evangelia Demou, Ewan MacDonald, Muriel Caslake, Peter Stenvinkel, and Paul G Shiels Aging, published online 26 April 2016.  

The Karolinska Institutet Jubilee Gold Medal is awarded to Nobel Laureate and neurophysiologist Torsten Wiesel and former university director Rune Fransson. The gold medal symbolises the special recognition given to people who have made an outstanding contribution to the university. Torsten Wiesel studied medicine and began his a career in neurophysiology at Karolinska Institutet. In 1955, he transferred to Johns Hopkins University in Baltimore, USA. In 1973 he was appointed chair of the Department of Neurobiology at Harvard Medical School in Boston, between 1991 and 1998 he was president of Rockefeller University, New York. In 1981, Torsten Wiesel and David Hubel were awarded the Nobel Prize in physiology or medicine for their innovative studies of visual sensory processing. From 2000 to 2009 Professor Wiesel was director of the Human Frontiers Science Programme in Strasbourg, and from 1994 to 2004 chair of the American Academy of Science’s human rights committee. He is also the patron and an honorary member of the Young Academy of Sweden. As a member of the Royal Swedish Academy of Sciences, he has also participated actively in its work. Torsten Wiesel has made many exceptional contributions to Sweden’s scientific community in general and to research at KI in particular. He has led advisory boards for the Department of Neuroscience and for the related strategic research area. In 2011 he carried out an analysis of KI’s research organisation and expressed opinions on it that remain relevant and the source of much discussion. “Through his unusual ability to conduct creative research and develop research environments, Torsten Wiesel has become an exemplar for several generations of medical researchers at Karolinska Institutet.” says acting vice-chancellor Karin Dahlman-Wright. Rune Fransson began his career at Karolinska Institutet in 1978 as financial director of the then School of Dentistry. In 1983 he was recruited to a central position as budget manager. In 1991 he ascended to the post of assistant administrative manager, becoming university director in 1995. After many years in this position he was made director in charge of infrastructure, innovations and overall financing in 2007. Rune Fransson led the KI93 project, a radical reorganisation of the university that, amongst other things, reduced the number of departments from 150 to just over 30.  This structure has remained essentially unchanged to this day and has made an invaluable contribution to KI’s strength and competitiveness. In the 1990s, during Rune Fransson’s leadership, KI introduced a cutting-edge and creative innovation process that has proved indispensible for researchers seeking to commercialise their discoveries ever since. Rune Fransson’s contributions have been absolutely crucial to the new building projects underway on the two KI campuses. In Solna, there is  the new world-class research centre Biomedicum, which will bring together 1,600 people in an innovative research environment; and in Huddinge the Neo block, which is located next to the hospital so that researchers can work with pressing disease issues and bring their results and improved treatment methods more quickly to where they are needed. “These buildings and the new spaces under completion at Karolinska University Hospital will make KI uniquely placed to grow and develop as a university.” says Karin Dahlman-Wright. “It is very much thanks to Rune Fransson that KI is the world-leading research institution it is today.” The medals will be presented to the recipients at Karolinska Institutets promotion ceremony on May 13. Previous winners

Rickard Sandberg, Professor at the Department of Cellular and Molecular Biology (CMB), has been awarded Eric K. Fernströms pris till yngre, särskilt lovande och framgångsrika forskare for 2016. In his research, Rickard Sandberg combines genome-wide experimental and computational techniques to study global aspects of gene regulation in development and disease. He receives the Eric K. Fernström Prize for pioneering single-cell technologies and his important discoveries of gene regulatory mechanisms in single cells. His lab developed a novel single-cell transcriptome method, which became an important breakthrough and is considered to have great potential for analyses of clinically relevant cells. He is awarded the prize, 100 000 SEK, at a ceremony in Lund at November 2. The Eric K. Fernström foundation annually awards one Nordic prize and six Swedish prizes to promising scientists in the medical sciences. Each one of the medical faculties designates its own prize winner.

A change of job could be a means of prolonging labour market participation for people on long-term sick leave, according to a thesis by Karin Nordström at Karolinska Institutet. The thesis also looks at differences in sick leave between workplaces. Many people on long-term sick leave become unemployed or retire due to disability. For her doctoral thesis, Karin Nordström, student at the Institute of Environmental Medicine, has examined if a change of job affects how likely it is that people who have been on long-term sick leave remain on the labour market. Registry data To do this, she used registry data from the Longitudinal Integration Database for Health Insurance and Labour Market Studies (LISA), which includes everyone in Sweden above the age of 16. “Amongst those with 180 days or more of absence by the base year who changed workplace for the coming year were more likely to be in work two to four years later,” says Ms Nordström. “A possible reason for this correlation is that it’s the healthier people who change job and who also are more likely to stay at work. However, the relationship holds regardless of the length of sick leave in the year before the base year. The study indicates that a change of job could be a way of prolonging labour market participation for individuals who have been on long-term sick leave. However, it is probable that individuals in this group might have some difficulties finding a new job.” Unreliable measure A workplace with a low rate of sickness absence is often seen as having healthy working conditions and sound leadership. However, a substudy in the thesis suggests that sick leave can be an unreliable measure of how healthy a workplace is. The findings show that workplaces with a high rate of sick leave are more likely than those with low rates to employ people with a high degree of sick leave the year before recruitment. “The results also suggest that people who have been on long-term sick leave and who change workplace risk ending up somewhere where the rate of sickness absence is high, which indicates, in turn, that changes of job for these groups occur within one and the same segment of the labour market,” explains Ms Nordström. “If someone is to have a successful change of job, the new job ought necessarily to involve some kind of new working conditions or tasks.” Publication Mobility on the labour market, work ability and sick leave Karin Nordström Karolinska Institutet (2016) ISBN: 978-91-7676-231-8

In an article on April 22, Expressen interviewed Acting Vice-Chancellor Karin Dahlman-Wright regarding the circumstances under which, in mid-March, the Swedish Research Council denied continued funding for BBMRI.se. In an article on April 22, Expressen interviewed Acting Vice-Chancellor Karin Dahlman-Wright regarding the circumstances under which, in mid-March, the Swedish Research Council denied continued funding for BBMRI.se. Within the scientific community, there are joint ventures for biobanks. Within Europe, there are, among other things, a common resource, which goes under the name Biobanking and Molecular Resource Infrastructure Europe (BBMRI). In Sweden, the Swedish Research Council (VR) funded a national biobank infrastructure, BBMRI.se, which includes a number of universities, and in which Karolinska Institutet coordinated operations through its role as host university. There have been different views on how the infrastructure cooperation should be managed. In a letter sent by directors from three of the nodes to VR and others, they voiced criticisms about how resources are used, the geographic placement of infrastructure, and how communication has been managed, among other issues. Due to the points raised in the letter, VR's Council for Research Infrastructures (RFI) decided on December 9, 2015, to postpone its decision regarding the financing of BBMRI’s funding application. VR informed KI in January that it would allow an external party to conduct an audit of the infrastructure’s finances. KI welcomes such an audit and stated that it is also preparing an internal review. KI is awaiting the results of the VR-initiated report, and will then address the possible need for additional external review. Pending the results of these reviews, KI will not comment further on the matter. KI's activities should be characterized by high quality and withstand external scrutiny. In its December decision, VR asked KI, as host university, to submit by March 1, 2016, an action plan for resolving the organizational issues, and that presents specific measures regarding the continued cooperation and organization of BBMRI.se. It is, of course, essential that the plan is approved and accepted by all BBMRI nodes. KI submitted such a plan, developed in collaboration with, and approved by, the university management for seven of the eight applying constituent universities (the University of Gothenburg chose not to participate in this additional work). RFI concluded that the action plan does not adequately address measures that could help to resolve the criticisms described in the letter submitted by the three node directors. Therefore, the Council for Research Infrastructures at the Swedish Research Council decided at its meeting on March 17-18, 2016, to reject the application from BBMRI.se.

Karolinska Institutet (KI) is investigating another case of suspected scientific misconduct involving Paolo Macchiarini. The case concerns a scientific article in which the researcher Paolo Macchiarini is one of the authors. The issue was discovered during a review that the university is conducting to detect research misconduct. The current case concerns a scientific article published in the journal Respiration in late November 2015. There are ambiguities in the article, including about ethical approvals, among other things. “I received the case on my desk last week. We have analyzed it and will demand answers from the researchers involved. After that, we will decide if we will submit the matter for external review,” says Henrik Grönberg, Pro-Vice-Chancellor of Karolinska Institutet. Karolinska University Hospital has been informed about the case. Read our press release. FACTS: How KI investigates cases of suspected scientific misconduct According to Sweden’s Higher Education Ordinance, it is the university at which the suspicion of scientific misconduct exists that investigates the issue. 1. A case is opened, for example, through a submitted complaint. 2. KI's lawyers receive the case for processing. 3. All parties involved are contacted and are given the opportunity to comment and respond to the complaint. 4. Based on the complaint and on the responses received, KI assesses whether the case should be sent for external expert review. This is done either by an external auditor appointed by the Vice-Chancellor or by the Central Ethical Review Board of the Swedish Research Council. 5. The conclusions of the external expert review are sent to those who submitted the complaint and to the subject of the complaint, who may submit comments. 6. The Vice-Chancellor makes a decision on whether or not scientific misconduct has taken place.

KI’s support system must be better at helping innovations intended to generate patient value rather than profit. So says Sophia Savage, who is working on a pack of cards to make people talk more about what is important for them at the end of their lives. “Being free from pain”, “Not losing my sense of humour,” “That my family’s prepared for my death”. The “DöBra” (literally: dead good/die well) pack of cards contains many such statements designed to get people talking about what matters to them as they reach the end of their lives. The cards have been developed in the USA and were introduced to Sweden by Carol Tishelman, professor of innovative care at the Department of Learning, Informatics, Management and Ethics, and by Olav Lindqvist, researcher and project coordinator at the same department. They have adapted the cards to Swedish circumstances for their research, and tested them with the help of patient and pensioner associations. To work with the cards, the researchers at KI needed an agreement with the American non-profit organisation that owns the copyright. Project coordinator Sophia Savage explains: “We’re not interested in selling the cards for a profit, as we just want to use them for research and maybe distribute them at cost price for research and for encouraging conversations on dying, death and grief. We needed an agreement to have the right to do this, but also to protect the cards in Sweden so that no one copies them and starts selling them.” For drugs and medical technology, there’s a more well-oiled machinery. Sophia Savage realised that she needed legal help and so contacted KI’s Innovation Office. She was put in touch with a lawyer at KI, who introduced her to a colleague at Uppsala University specialising in copyright. Now, after a protracted process of drafting and discussion back and forth between the researchers, the lawyer and the US organisation, the agreement has finally been approved. Sophia Savage is delighted, but says that things could have progressed more smoothly. In her experience, KI’s innovation system is not set up to deal with “social” innovations, which are more concerned about creating value for society or the patients than making money. “We were welcomed, but there wasn’t the know-how or any proper process in place,” she says. “For drugs and medical technology, there’s a more well-oiled machinery. If you ask me, social innovations must be given more space in discussions on innovation and in KI’s support system, so that researchers know that there are also ways to snap up and develop ideas that focus on, say, improving care processes. This is an important matter, especially for many young people today, and can create substantial and immediate social benefits.” Text: Sara Nilsson Translated by: Neil Betteridge Photo: Gustav Mårtensson Sophia’s tips for improving KI’s support system: 1) KI’s innovation system should expand its innovation expertise so that it also includes social entrepreneurship. 2) Identify the competence that already exists at the university on starting up or collaborating with non-profit associations. Many researchers and research networks have the necessary knowledge, but it’s hard to see the full picture since it’s neither valued nor pushed. 3) Create meeting spaces – physical and virtual – where people with similar ideas and aims can meet.

Heavy cannabis use at a young age increases the risk of early death, according to the longest follow-up study to date on cannabis use. The new study, which was done by researchers at Karolinska Institutet, is published in The American Journal of Psychology. Cannabis use increases the risk of developing schizophrenia and other psychotic disorders later in life, something that the researchers reported in a previous paper after having followed up all men who were enlisted for military service in 1969–70. At this time, the men answered questions on drug use; today, they are around 60, an age when any harmful long-time effects of cannabis use can start to show. New follow-up The researchers therefore made a new follow-up to find out if the mortality rate was higher amongst men who reported using cannabis in their youth. “A fresh WHO report has shown that cannabis has extensive effects on the health, even if the mental effects are the most salient,” says lead author Edison Manrique-Garcia at the Department of Public Health Sciences. Over 50,000 men were included in the study population, 4,000 of whom had died between 1970 and 2011. The researchers found that men who reported the heaviest cannabis use in their youth (over 50 occasions) ran a 40 per cent higher risk of death than those who reported lighter or no cannabis use (odds ratio 1.4; 95% confidence interval 1.1–1.8). They also found that the correlation remained even when controlling for other factors affecting mortality, such as alcohol use, mental illness and childhood/adolescent social problems. Treated for psychosis Since it is well-established that cannabis use increases the risk of psychotic disorders, the researchers studied if those who had suffered psychotic episodes had particularly high mortality rates and if cannabis use affects this. 683 people had been treated for psychosis. “For the men who had suffered psychosis, the mortality rate was roughly four times higher, but this was independent of earlier cannabis use,” says study leader Peter Allebeck, also at the Department of Public Health Sciences. “Our conclusion is that early cannabis use can contribute to premature death, particularly through injuries and suicide, and that this is unrelated to the increased risk of psychosis.” Since the study gave no details of cannabis use during the follow-up time, it is impossible to tell if the increased risk amongst heavy early cannabis users is attributable to strong effects of the drug in their youth or to continued use of cannabis later in life. The study was financed with grants from Swedish Research Council for Health, Working Life and Welfare and from Stockholm County Council. Publication Cannabis, Psychosis, and Mortality: A Cohort Study of 50,373 Swedish Men Edison Manrique-Garcia, Antonio Ponce de Leon, Christina Dalman, Sven Andréasson and Peter Allebeck  American Journal of Psychiatry, published online 22 April 2016, doi: 10.1176/appi.ajp.2016.14050637

The government has today decided on the members of the KI University Board (konsistoriet) whom it is to appoint. The new members were proposed by the nomination committee, comprising County Governor Christ Heister, former University Chancellor Lars Haikola and a student representative. The new board is to be in place by 1 May. Apart from the government-appointed members, the board consists of the vice-chancellor, pro-vice-chancellor and the university director along with three faculty representatives (appointed internally), three student representatives (appointed by the students’ unions) and three staff representatives. Government-appointed members: Lars Leijonborg, chair, returning Susana Borrás, returning Sofia Heidenberg, new Marianne Lundius, new Jonas Milton, new Torbjörn Rosdahl, returning Lisa Sennerby Forsse, new Charlotte Strömberg, returning Members to leave the board: Annika Andersson Dan Andersson Anders Blanck Eskil Franck More about konsistoriet Press release from the Government

When a missed patent application threw a spanner in the works for researcher Pernilla Videhult Pierre, she decided to learn more about commercialisation. As a doctoral student at Karolinska Institutet, Pernilla Videhult Pierre worked on developing methods for drug-based treatments of the cochlea. The human cochlea is the size of a pea and protected by the cranium and barrier systems; it is also difficult to reach with drugs. Pernilla Videhult Pierre, research associate at the Department of Clinical Sciences, Intervention and Technology, explored the possibility of injecting drugs via the ear drum, and found that the inner ear could be reached if the preparation was stabilised as a gel. Experiments using test tubes and an animal model for hearing disorders gave promising results, which the group quickly published. “As an academic, you want to – and have to – get published,” says Pernilla Videhult Pierre. “You hope that the article will get into a good journal and inspire others. It didn’t occur to us that we’d have to protect our discovery. Our group was made up of super-academics and clinicians, none of whom had any commercial nous.” She herself was rather sceptical of commercialisation. Difficult to find financiers “I think it wrong to want to earn money on your research, and once you start working with companies, you’re no longer free. I think many people in the medical world share this view.” After publication of the article, she applied for an ethical permit to test the method on patients. This she was granted, but then things ground to a halt. Financiers like the Swedish Research Council barely invest in clinical research, and without a patented discovery it was difficult to find other bodies willing to back the idea. “No one wants to invest if they believe they won’t get their money back, if someone can easily copy the product,” explains Pernilla Videhult Pierre. “It was really frustrating. We contacted the company that made the gel we used to see if it could sponsor us, but the wheels moved so slowly. They kept talking about patents and we didn’t really get it. Then I was advised to call KI Innovations.” Karolinska Innovations AB suggested she join Mentor4Research, a mentorship programme run by the Royal Academy of Engineering Sciences and funded by Vinnova (The Swedish governmental agency for innovation systems). The programme matches promising academic researchers with mentors in the corporate sector to help them commercialise their research. A research stipend of SEK 100,000 is awarded to the researcher who is deemed to have shown the greatest professional development over the almost one-year long programme. Pernilla Videhult Pierre applied, participated and won. New possibility of acquiring a patent Her new network brought her into contact with a small Swedish biotech company, which works with another potentially patentable gel-based carrier, and together they will test if it can be used instead. She also recently received a VINN Verification grant from Vinnova, which she will use for preclinical trials but mainly for testing to see if the original method can be made commercially viable: this involves creating a business plan and assessing the market potential and the possibility of acquiring a patent. I just want to be able to fund my research so that my results can benefit patients. Pernilla Videhult Pierre is pleased, but adds that much depends on having a good working relationship with the biotech company. Approaching a company is not that easy. She continues: “When my colleague and I have ideas about how to go forward with studying the method, we’re contractually bound to contact the company first. They might not say no, but the feeling of not being free isn’t satisfying. You need to have a good partnership so that you don’t end up doing contract research.” But when researchers apply for grants from bodies that finance basic research, they also have to adapt to the demand, she concedes. “It’s investments in nanotechnology one year, something else the next. If it takes partnering up with a company to get the method out to the patients, then it’s worth it. The ideal situation for me would be to commercialise my discoveries so I can get money back for them, money that I can then invest in more research. I wouldn’t then have to spend so much time applying for grants. I don’t want to be rich, I just want to be able to fund my research so that my results can benefit patients.” Pernilla’s advice to others with a business concept: 1) Remember that you might have to apply for a patent before publishing your results or describing them in grant applications. Without a patent it’s hard to attract financiers. 2) If you enter an agreement with a company, make sure that you’re entitled to publish, whatever the outcome of your research. 3) Get help from someone who understands the business world. I myself turned to KI Innovations. Text: Sara Nilsson Translated by: Neil Betteridge Photo: Gustav Mårtensson

Broken-heart syndrome is linked to other diseases, but the risk factors for cardiovascular disease are normally lower in these patients. This according to a large registry study of Swedish patients made by Karolinska Institutet. The results, which are published in The Journal of American College of Cardiology, provide confirmation that the prognosis for a broken heart is comparable to that for myocardial infarction. Interest in broken-heart syndrome, or stress cardiomyopathy, has increased dramatically since the turn of the 2000s, but to date knowledge of the condition has been largely based on clinical observations of relatively small groups of patients. The syndrome has also been named takotsubo, a Japanese word for an octopus trap, owing to the appearance of the heart when one of the ventricles, usually the left, expands and takes on a balloon-like form. It is very difficult to distinguish a broken heart from a myocardial infarction, so much so that two per cent of the latter eventually turn out to be the former. The condition is diagnosed through imaging tests showing that cardiac function is greatly impaired but the coronary vessels are normal. Triggered by stress The condition is often triggered by mental or physical stress. The prognosis was formally considered good, but more recent studies have indicated that broken-heart syndrome is more dangerous than once thought. In 2015 there were reports showing that the prognosis was similar to that of myocardial infarction, but the studies lacked healthy control groups. In this new large-scale registry study, the researchers examined 500 Swedish patients with broken-heart syndrome from the Swedish Coronary Angiography and Angioplasty Register (SCAAR). These patients, who did not have coronary stenosis, were compared with age and sex-matched infarction patients. The investigators also compared results with controls, who had had a coronary x-ray examination owing to chest pain but who did not have a stenosis. Data on education backgrounds, incomes, drug history and other diseases were sourced from different registers. “The study shows that a broken heart is associated with other diseases and their medication, particularly COPD, psychiatric diseases and migraine,” says cardiologist Per Tornvall, researcher at the Department of Clinical Science and Education. “But on the other hand, traditional risk factors for cardiovascular disease, such as smoking, high blood pressure, high blood lipids and diabetes, are less common.” Mostly women More than eighty per cent of those with a broken-heart diagnosis were women. The study also shows that patients with broken-heart syndrome are educated and have high incomes, particularly compared to infarction patients. The study provides confirmation that the prognosis is the same as for patients with myocardial infarction and worse than for patients with chest pain. “The study goes far towards helping doctors identify at-risk individuals,” says Dr Tornvall. “It also gives indications of causes that can be useful for treatment. For example, it supports the idea that beta-blockers could be given to patients with broken-heart syndrome.” The study was financed with a grant from the Swedish Heart and Lung Foundation. Publication A Case-Control Study of Risk Markers and Mortality in Takotsubo Stress Cardiomyopathy Per Tornvall, Olov Collste, Ewa Ehrenborg, Hans Järnbert-Petterson  Journal of American College of Cardiology, published online April 18 2016, doi: 10.1016/j.jacc.2016.02.029