KI News

How should we go about achieving the UN’s global sustainable development goals? In mid-September, the Department of Public Health Sciences cohosted an open house on this theme, concluding the day with a panel debate on how information – and myths – about vaccination can be managed.  The overall purpose of the UN’s 17 global sustainable development goals is to eradicate extreme poverty, reduce inequality and injustice and tackle climate change. These global goals were also the theme of an open house at the Widerström Building on 14 September, arranged in collaboration between the department of Public Health Sciences at Karolinska Institutet, Stockholm County Council’s (SLL) Centre for Epidemiology and Community Medicine and the Public Health Agency of Sweden.  During the afternoon, visitors were able to attend lectures in the fields of infectious diseases, inequality, policy, children and young people, and epidemiological surveillance. The day concluded with a panel debate at the Public Health Agency of Sweden, focusing on the third global goal – good health and well-being. The issue of the day was how to deal with people’s doubts about vaccination.  Important that the university promotes sustainability Vice-Chancellor of Karolinska Institutet Ole Petter Ottersen began by emphasising the universities responsibility to adopt the UN’s global sustainable development goals. “We educate the leaders of tomorrow, who will implement the goals which must be incorporated into KI and the universities,” he stated.  While emphasising KI’s important role in the vaccination debate, as a bearer of facts and scientific evidence, he also raises the importance of communicating the uncertainties.  “When it comes to vaccines, society craves facts. But what are the uncertainties and how can we communicate these? In certain cases, it is more important to explain what remains to be done,” says Ole Petter Ottersen. Panellists included Lucia Pastore Celentano, head of the vaccine-preventable disease programme at the European Centre for Disease Prevention and Control (ECDC), who stated that over 20,000 cases of measles have been reported in EU member states in the past year alone.  “This is the largest number we have ever seen,” she said.  Ann Lindstrand, head of the Vaccine and Register Unit at the Public Health Agency of Sweden, contributed a Swedish perspective, bearing witness to the country’s high and stable 97 percentage vaccination level.  “We have good control over our vaccine-preventable diseases and this is because our system of paediatric healthcare clinics allows nurses to build trust and long-term relationships with parents.”  A matter of solidarity? Sahar Nejat, paediatric public health advisor at Stockholm County Council, agreed with Ann Lindstrand that the Swedish system of paediatric healthcare is unique and creates trust. She also works at a paediatric clinic in Rinkeby, where nurses are under considerable pressure on the issue of vaccines. “The doubting groups vary. Some are well-read, well-educated people looking for help to sort through the available information; some of those we have trouble reaching have strong opinions about vaccination and others are afraid of the link between autism and the measles vaccine,” she says.  The panellists were united in believing that knowledge is generally low regarding the diseases for which vaccines are currently available.  “Many parents have never been exposed to these diseases, so we need to explain that they can be life threatening. We receive more questions about the risks associated with vaccination than their effects,” said Lucia Pastore Celentano, emphasising that we should be discussing vaccination at a societal rather than individual level. “If everyone thinks at the individual level, cases of disease will increase – something we’re already seeing with diphtheria. Vaccinating one’s is a service one performs for the community.  Collaboration important in making progress This is the third time that Karolinska Institutet, Stockholm County Council and the Public Health Agency of Sweden have arranged an event of this kind. “We do this in order to increase the scope of collaboration. It is just as much a social event as it is scientific and field-related, so it fulfils multiple functions,” explains Bo Burström, one of the organisers and a professor at the Department of Public Health Sciences.

Professor Jonas Frisén at Karolinska Institutet has been awarded the 2017 Eric K. Fernström Foundation Grand Nordic Prize of SEK 1 million in recognition of his research on how stem cells are transformed and renewed in adult organs. Jonas Frisén, professor at the Department of Cell and Molecular Biology at Karolinska Institutet, is an internationally renowned scientist and stem cell researcher who is interested in the formation of new stem cells, which are able to develop into specialised cells. Professor Frisén has concentrated mostly on the formation of new nerve cells, but has also conducted researches on the heart and cancer. Knowledge of stem cells is important to cancer, which often arises in stem cells, and to diseases caused by cell loss, such as Alzheimer’s. “I was surprised and overwhelmed when the prize committee called,” says Jonas Frisén in a press release from Lund University. Developed his own method of age-determining cells His interest in stem cells was born at a decisive moment in 1993 when he discovered something unexpected while looking at microscopic images of the rat spinal cord. The images were of a healthy and an injured cord, and he could see that while in the former the stem cells were inactive, in the latter they had been activated and had started to form new cells, seemingly around the precise area of damage. The discovery was revolutionary and made Professor Frisén drop all other lines of research. To find out if new nerve cells can be formed in an adult human, he has developed his own method of age-determining cells, inspired by the archaeological technique of carbon dating. “We made use of the nuclear tests that took place during the Cold War,” he explains. “Put simply, they put an enormous amount of radioactive matter into the atmosphere, which the cells absorbed. We then used this knowledge to date the neurons.” Reckless, curious and fearless What Professor Frisén loves about research is finding clever solutions, and he believes that a large dose of curiosity and fearlessness have contributed to his scientific success. “I guess I can be a little reckless,” he says. “I’m driven by the question – if there’s no way of answering it, I just have to find new ways. Using the nuclear tests was a long shot that no one else had tried. It sounded fun in theory but we had to learn a whole lot of new things to make it work in practice.” Jonas Frisén’s research group has shown that neuron formation in humans differs dramatically from other mammals. He has also studied new cell formation in the heart and demonstrated how we slowly replace our heart muscle cells. Every year, the Eric K. Fernström Foundation awards a Nordic prize to a medical researcher from one of the Nordic countries, and local prizes to junior researchers at medical faculties in Sweden. The Nordic Prize is worth SEK 1 million. The awards ceremony marks the end of the Science Day event in Lund, which this year is on 8 November. The Lund University medical faculty has been in partnership with the foundation since 1978, when honorary doctor of medicine Eric K Fernström made his endowment that first formed the Eric K. Fernström Foundation. This article is based on a press release from Lund University.

Hello there Jan Vesterbacka, researcher at Karolinska Institutet's Department of Medicine, Huddinge, who will soon be defending his thesis on the part played by gut flora in HIV patients’ immune systems. What has your research shown? "In untreated HIV patients, bacterial components leak out from the gut into the blood in a process called microbial translocation, which activates the immune system and contributes to inflammation. Such inflammation in HIV patients increases the risk of complications like cardiovascular disease and cognitive problems. I’ve been able to show that anti-retroviral drugs reduce the microbial translocation and that antibiotics can probably diminish the inflammation more effectively. I also observed that HIV patients who have not yet received anti-retroviral drugs have a gut flora, or microbiome, that is less species diverse than healthy controls and that the difference in the bacterial flora persisted even after a year of treatment.  Additionally, I investigated the gut flora of so-called “elite controllers”, who are HIV patients that can control their virus without drugs for 20 or 30 years with no impairment of their immune system. This rare group of HIV patients had the same species diversity in their microbiota as HIV negative people as well as some unique bacteria that were over-represented. When I examined how the gut flora of elite controllers works biologically, I found that there were proportionally fewer bacteria that break down carbohydrates and a higher percentage involved in fat metabolism. We hypothesize that their unique gut flora helps them control their virus." What does your research mean for HIV patients? "We hope that one day it will be possible to study the gut flora of HIV patients and adjust or modulate it using faecal transplantation to introduce a tailored, healthy microbiome. This is currently an established treatment for recurrent Clostridium difficile intestinal infection, which is caused by a microbiome dysbiosis. Faecal transplantation is also being tried for other diseases involving abnormal gut flora. Clinical trials have been performed on giving probiotics to HIV patients, although without significant effect. Maybe progress can be made here." What contribution do you hope your research will make? "I hope that what we learn about the gut flora and the immune system can also be useful to other diseases. In the past four or five years, scientists have correlated microbiome changes to several inflammatory and autoimmune diseases, such as MS (multiple sclerosis)." What interested you in the subject? "I’d been working for a few years with HIV patients at the infection clinic when it was found that microbial translocation was an important factor behind harmful HIV inflammation. This was in 2006 and I thought it was interesting, and figured that here was something long term that could be done for the patients." What will you do now? "I’ll continue to study our patients searching for bacterial metabolites as to explain the findings we’ve made investigating their microbiome. It’s still too early to start modulating the microbiome of HIV patients to any great degree since we don’t know exactly which bacteria to introduce or how to do it." Text: Maja Lundbäck Jan Vesterbacka is due to defend his thesis on “The role of microbial translocation and gut microbiota in HIV-1 infection” at Karolinska Institutet on 29 September 2017.

  How can research help a society handle matters connected to an ageing population? This issue was discussed at a workshop held to mark the start of a collaboration between three of Stockholm’s academic institutions and the University of Tokyo. Both in Sweden and Japan more and more people are living to an increasingly old age, and this raises important questions, like how to guarantee access to healthcare and how to finance pensions. Other important issues are how we can stay healthy for as long as possible and how homes for the elderly can best be designed. A workshop titled “Active ageing” was arranged on 21 September in KI’s Nobel Forum by KI, Stockholm University (SU), the Royal Institute of Technology (KTH) and the University of Tokyo. The event was part of the visit that a delegation from Tokyo is making to Stockholm in order to sign a collaboration agreement with KI, SU and KTH. Karolinska Institutet’s Vice-Chancellor, Ole Petter Ottersen, welcomed the delegates to this first official part of the programme. The University of Tokyo’s Executive Director and Vice President, Mamuro Mitsuishi, reminded participants that in 2018 Japan and Sweden will be celebrating 150 years of diplomatic relations, and that this new partnership serves to strengthen the bond between the countries and is a possible catalyst for new collaborations. The Queen of Sweden sees much potential for collaborations Queen Silvia opened the workshop with a speech in which she said that matters related to ageing, and how society handles them, are important to both Sweden and Japan. The Queen also mentioned her own commitment to such issues: for two decades, the Queen has worked to raise awareness of how to build a society that cares for its elderly citizens in the best way possible. Amongst the initiatives to which the Queen has contributed is Silviahemmet, which trains dementia care workers. Queen Silvia then concluded her address by saying that Sweden and Japan have much to learn from each other and that this new collaboration opens up considerable opportunities. The University of Tokyo prioritises Stockholm In 2014, the University of Tokyo adopted a strategy to establish strategic partnerships with leading academic institutions around the world, university Vice President Naoto Sekimura told the workshop participants. In addition to KI, SU and KTH, such priority partners include Berkeley, MIT and Cambridge.  The collaboration will centre on research and education under the watchwords excellence, interdisciplinarity and social relevance. The focus will be on three prioritised areas: health and medicine; energy, resource use and climate change; and economic equality. A rapidly ageing population The first researcher to speak was Livia Oláh, Associate Professor in Demography at SU, who stated that an ever-growing share of the global population is over the age of 65. Japan has one of the fastest ageing populations in the world, and also has a lower birth rate than Sweden.  The relatively high rate of childbirth in Sweden is linked to the large number of women who works, this made possible by the country’s family policy supporting the combination of work and family for both woman and men. One of the most important political measures that facilitates this combination lifestyle is childcare, Livia Oláh stated. She emphasised that a sustainable societal development requires a balanced age structure, with childbirth being a key part of maintaining this balance. Healthy ageing is possible Laura Fratiglioni, Professor at KI within the field of Medical Epidemiology specialising in dementia diseases, raised the issue that healthy ageing is possible and already a reality. The challenge, she said, is to make sure it stays this way. The population studies that have been conducted in Stockholm show that approximately 50 percent of the 90-year-olds say they are relativity healthy. Moreover, the statistics show that the risk of suffering from a cardiovascular condition or dementia has declined in recent decades. If this trend is to continue, it is important for people to, amongst other things, be physically active, maintain social relations and refrain from smoking. During the day, speakers from the four universities addressed different aspects of ageing from three general perspectives: the biophysical, the biomedical and the social scientific. The agreement will be signed on 25 September by the collaborators at a ceremony to be held at SU. Text: Per Larsson

This year’s KI race took place in somewhat overcast and chilly conditions. That may have been just as well, as the competitors gave it their all and were certainly warm enough by the time they reached the finish line. “The KI race is great for international students. We arrived here this semester but have already had an excellent introduction to KI through a range of events, and have been made to feel extremely welcome,” said Lena (Zombie) Schaller and Marianne (Mad Scientist) Brookman, both Master’s students in toxicology. They were two of the 210 participants – 170 individual entrants and 10 teams – participating in the race at Campus Flemingsberg on 20 September. The somewhat robust weather conditions that accompanied the race were almost certainly of benefit to the runners, the fastest of whom in the individual class was Joakim Eriksson, currently studying the first term of the physiotherapy programme.  “I finished on 14 minutes 23 seconds, a decent time for me. I do have some experience of running as I compete in distances between 5,000 and 10,000 metres,” explained the winner, catching his breath just after reaching the finish line.

Children who develop inflammatory bowel disease (ulcerative colitis or Crohn’s disease) run a higher risk of cancer, both in childhood and later in life, a study from Karolinska Institutet published in The BMJ reports. Adulthood onset inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease have been associated with an increased risk of bowel cancer. However, there have been no studies showing how the cancer risk is affected by childhood onset of the disease and whether it changes over time. Using data from the Swedish National Patient Register, researchers at Karolinska Institutet have now compared the incidence of cancer in 9,405 individuals who were diagnosed with inflammatory bowel disease as children, with 92,870 individuals from the general population. Doubled cancer risk Their results show that individuals who developed inflammatory bowel disease before the age of 18 had twice the cancer risk during childhood and adolescence as well as adulthood, compared with people who did not have such a diagnosis. The largest increase in risk was observed for bowel cancer, but there was also an increase in risk for other forms of cancer, such as blood and skin cancers. “We believe that the main cause is the chronic inflammation, which we know to be a driving factor for many different cancer types,” says principal investigator Ola Olén at Karolinska Institutet’s Clinical Epidemiology Unit at the Department of Medicine, Solna. “Early onset means that the body is exposed to inflammation for a longer time.” The study participants were diagnosed with inflammatory bowel disease between 1964 and 2014. “The treatment for inflammatory bowel disease improved considerably over these years, thanks in part to the introduction of new immunomodulating drugs, but unfortunately we can’t see that the relative incidence of cancer simultaneously declined,” says Dr Olén. Important to attend examinations Adult patients with inflammatory bowel disease are regularly invited to colonoscopy screenings, which can detect the presence of any cancer in the gut. The researchers believe that the knowledge of the cancer risk associated with the early onset of inflammatory bowel disease has to be factored into decisions on colonoscopy screening for children and adolescents, from both a healthcare and a patient perspective.” “Don’t forget that even if relative risks are high, the absolute risks are much more modest, and during childhood absolute risks are extremely small. Most young people don’t get cancer, and some of these forms of tumours are extremely rare,” explains Dr Olén. “But it’s probably important for individuals who develop inflammatory bowel disease in childhood to make sure to attend the examinations they’re invited to, especially those who have other strong risk factors for cancer, such as a family history of early cancer.” The research was financed by the Swedish Society of Medicine, Mag-tarmfonden, the Jane and Dan Olsson foundation, the Mjolkdroppen foundation, The Bengt Ihre research fellowship in gastroenterology, Karolinska Institutet foundations, the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet (ALF), the Swedish Cancer Society, the Swedish Research Council, and the Swedish Foundation for Strategic Research. Publication “Childhood-onset inflammatory bowel disease and risk of cancer – a Swedish nationwide cohort study 1964-2014” Ola Olén, Johan Askling, Michael Sachs, Paolo Frumento, Martin Neovius, Karin Ekström Smedby, Anders Ekbom, Petter Malmborg and Jonas F Ludvigsson The BMJ, online 21 September 2017, doi: 10.1136/bmj.j3951

By reprogramming skin cells into nerve cells, researchers at Karolinska Institutet are creating cell models of the human brain. In a new study published in Molecular Psychiatry the researchers describe how cells from patients with the severe developmental disease lissencephaly differ from healthy cells. The method can provide vital new knowledge on difficult-to-study congenital diseases. Lissencephaly is a rare congenital developmental disease that can be caused by, amongst other anomalies, a mutation of the DCX gene. Affected individuals are born with serious developmental disabilities and a brain that is smooth instead of folded. Uses award-winning technique The discovery that it is possible to reprogramme specialised cells such as skin cells in order to reverse their development back to stem cells was rewarded with the 2012 Nobel Prize. The resulting so-called iPS-cells (induced pluripotent stem cells) can then be turned into other specialised cell types. Anna Falk, docent at Karolinska Institutet’s Department of Neuroscience, uses this technique to build cell models of the human brain. In the present study, her team took skin cells from patients with lissencephaly and turned them into iPS cells, which they then cultivated under special conditions into neuronal stem cells and neurons that are copies of those in the patients’ brains. By examining the cell cultivation dishes, the researchers were able to observe how the patients’ cells behaved and developed from stem cells to nerve cells and compare them with cells from healthy controls. They found that the diseased cells matured much more slowly, sent out shorter projections and were much less mobile. “It’s already known that DCX affects the ability of neurons to migrate, but we can now show that DCX plays a much greater, broader part in brain development than that,” says Dr Falk. “Our hypothesis is that it’s this, the damaged nerve cells’ resistance to maturation that causes the disease.” No relevant animal models  Since there are no relevant animal models for lissencephaly, the reprogramming technique has been essential to the study of lissencephaly’s underlying pathogenesis. At Dr Falk’s laboratory, the method is used to also study other congenital diseases that affect the brain, such as autism and Down syndrome. In future projects, the researchers hope to study how diseased cells can be modified to act as healthy cells. “What many developmental diseases have in common seems to be the failure of brain cells to mature at the same rate as they do in healthy people,” says Dr Falk. “Trying to influence the cells so that they behave like healthy cells is the first step towards some kind of therapy for these diseases.” The study was a collaboration with Karolinska University Hospital, Uppsala University, SciLifeLab and the Salk Institute for Biological Studies in the USA. It was financed by several bodies, including the Swedish Foundation for Strategic Research, the Åke Wiberg Foundation, the Tore Nilson Foundation, the Jeansson Foundations, the Thuring Foundation and the Swedish Research Council, and through the KID and SFO funding schemes. Publication ”An in vitro model of lissencephaly: expanding the role of DCX during neurogenesis” M Shahsavani, R Pronk, R Falk, M Lam, M Moslem, S Linker, J Salma, K Day, J Schuster, B-M Anderlid, N Dahl, FH Gage, A Falk Molecular Psychiatry, online 19 September 2017. doi: 10.1038/MP.2017.175

This September, KI researcher Shervin Shahnavaz will be participating in two scientific conferences in Ljubljana and Vienna. In order to reduce his and KI’s negative environmental impact, he´s taking the train instead of flying for his official business travels, something he consider to be the responsibility of every KI co-worker who has the opportunity to choose. Anyone who believe in a scientific attitude also has a responsibility to take research findings seriously and use the knowledge that is developed, according to Shervin Shahnavaz, researcher at the Department of Dental Medicine, who chooses to travel climate-smart for both his private and his business travels. “In the research community we need to practise what we preach and by our actions show that we take results of climate research seriously. If we don’t change our travel habits for the better, we undermine research and its importance in general,” says Shervin Shahnavaz. The inspiration to travel by train on his upcoming trips came during March for Science last spring, a manifestation to underline the importance of science and research-based knowledge in society with an emphasis on climate research. But he has had an ambition to reduce his climate footprint in both his private and his business travels for a long time. “I’ve travelled by train to southern Europe with my family on holiday and discovered that it’s both pleasant and doable. At work, thanks to our head’s and the staff’s openness and interest in environmental issues, we have for several years had an ongoing dialogue about environmentally adapted travel, and when the section was to make a study visit to Denmark we chose to travel by train.”  Means of transport is important but also to plan ahead Shervin Shahnavaz tries to make all his domestic trips by train and as he says himself, hopefully also many trips in Europe. He is however aware that some international trips cannot be made by train and then advocates being restrictive and where possible cut down on unnecessary business travels. “Online conferences should be much more common than they are today. I also try to combine several activities during the same trip. In addition to attending the two congresses, this time I’ll also be networking, holding a seminar on children’s and young people’s healthcare together with colleagues from a sister section, and making study visits to colleagues. The trips to Ljubljana and Vienna will take two weeks, of which about two days will be spent travelling.  Wouldn’t it have been more time-efficient to fly?  “That depends on how we define ‘time-efficient’. Of course it would be faster to fly to southern Europe but that does not automatically mean that you get more out of the trip or that you use your working time more effectively. I’ll spend the night on the train and during the day I’ll be writing a scientific article and preparing my presentations. On my way home I’ll have my colleague Jonas Rafi with me and we’ll be able to have thorough discussions about how we can apply what we’ve learned during the congresses. And then of course I’m going to take the opportunity to look out of the window at the parts of Europe I pass through.” So what about the price? Shervin Shahnavaz says that on these particular trips, to fly is the more expensive choice. “The price is important but it’s also important to reduce one’s climate impact. KI’s business trips make up the university’s largest climate impact, with long-distance flights accounting for most of it. It´s therefore important that we as employees and our organisation raise awareness and take action on this issue, it affects us all,” says Shervin Shahnavaz. Environmental issues given greater prominence in KI’s travel guidelines International journeys by air are a prerequisite for KI’s activities and operations, but with its updated travel rules KI is encouraging employees to use more environment-friendly means of transport for short journeys, and to arrange travel-free meetings. The university’s action plan for the environment and sustainable development 2016-2018 also defines a goal of reducing the negative climate impact from KI’s business travel by three percent from the beginning of 2017 to the end of 2018. It is to be achieved by, among other things, educating employees in digital technology for travel-free meetings, favouring eco-labelled hotels and choosing means of transport with the least possible environmental impact.  “In our new rules and instructions for business travels, that came into effect in May, we have taken a holistic approach to our travelling that includes all means of transport. Wherever possible KI’s negative environmental impact is to be reduced, for example by travelling by public transport instead of by taxi or taking the train instead of flying,” says KI’s Travel Manager Kjell-Ove Lindgren.   He also says that we should always ask ourselves what the outcome of a meeting will be if we use modern technology such as video conferencing or webinars instead of travelling.  “If the outcome is the same, choose a travel-free meeting. There are extremely good technical solutions today for holding meetings at a distance so some business trips are totally unnecessary.” KI´s needs are still the deciding factor It should however be made clear that KI will not introduce measures that are not appropriate for its operations and activities, Kjell-Ove Lindgren emphasises.  “It is not a question of avoiding all travelling. Physical meetings are needed and cannot always be replaced. The focus is first and foremost on trips that are made across half the country for shorter meetings, and where a video conference might be a better alternative.” “Not needing to travel also makes our day easier; we don’t need to book transport, check with the family, stay at a hotel and so on. We can work efficiently, leave work on time and have our free time be just that,” Kjell-Ove Lindgren goes on. To learn from each other, universities in Sweden have started a network group consisting of the Royal Institute of Technology, Umeå University, Lund University, Uppsala University, the Swedish University of Agricultural Sciences, Stockholm University and Linköping University.  “We meet twice a year and exchange experience and discuss how we together can develop the best solutions for our colleagues regarding traveling and environmental impact,” says Kjell-Ove Lindgren. KI’s policy on business travel and the environment/sustainability KI’s travel rules state that university employees are to: • Always consider ways to hold a travel-free meeting • Take the train instead of flying to Gothenburg and for other short domestic trips • Choose eco-taxi • Rent an eco-car • Use the KI bus to travel between KI campuses • Use public transport • Choose hotels that are eco-labelled, eco-certified or that can in some other way prove that they work actively with environmental issues 1 flight = 74,000 travels by train A person who flies between Stockholm and Gothenburg contribute to the emission of as much carbon dioxide as 74,000 travels by train for the same route would result in. Source: SJ

For a little over a month, Ole Petter Ottersen has been on his new job as the vice-chancellor of Karolinska Institutet (KI). The time has been used wisely in getting to know the organisation and its employees. However, focus is already on a new KI strategy for 2030 and reorganisation, measures following the Heckscher inquiry and contacts with the Stockholm County Council (SLL), among lots of other things. How has your first month as KI’s vice-chancellor been? “It’s been fascinating, with an extremely steep learning curve. I’ve spoken with many KI employees, been to both the Flemingsberg and Solna campuses and met the Stockholm County Council and Karolinska University Hospital – all very important meetings. I have also had talks with all heads of departments. I’ve formed a very good first impression of KI and I'm impressed by all the research that’s being done here. I also see possibilities for KI to become an even stronger medical university in the future. Right now, I’m very happy. We’ve just had a first residential meeting with the Board of Karolinska Institutet, and the board strongly supported my idea that KI should institute a collegial council. Through this council, KI employees will be able to put their education and research ideas forward to the management and the board. It's important that all our employees get real influence. However, the decision hasn’t yet been formally taken.” What has made the greatest impression? “One of the strongest impressions was left by the meet and mingle with the new students who have come to KI full of expectations and inquisitiveness. Listening to them was very stimulating.” What has been your primary focus? “Thus far, getting to know KI’s organisation, listening, asking questions and forming ideas of the major challenges facing KI. Also, seeing all the great opportunities. Balance is important.” What has been most instructive? “Walking around the campuses and visiting various departments. I’ll be calling in at all of them in the future. Speaking with Karin Dahlman-Wright and learning about all the great work she and several others have done during the past one and a half very turbulent years, has also been instructive and useful.” Is there anything that you have already re-evaluated about KI? “I’ve followed KI throughout my entire career. Now that I see KI from the inside, I realise even more clearly how strong its research is. I can also see the potential for KI to be an even better university as regards to education.” What is your focus right now? “On top of the very important visits to the departments, we have been commissioned by the board to review KI’s organisation. The action plan following the Heckscher inquiry must also be seen through. Additionally, we must ensure that all the moving-in processes, for example Biomedicum and Neo, can be carried out optimally. Hard work is now also starting on KI’s strategy 2030. Such long-term work forces us to think very creatively and to put students and young researchers and their career paths in focus. And, not least, it will be possible to link the strategy to the UN's Agenda 2030 and the global goals for sustainable development. As a world-leading university, KI has an important responsibility to work for sustainable development, and particular in the field of public health. I also want to put a lot of energy into establishing good relations between KI and SLL and between KI and Karolinska University Hospital. This is perhaps one of the most important things.”   Text: Helena Mayer

Arvid Guterstam, postdoc at the Department of Neuroscience at Karolinska Institutet, has been awarded the Dimitris N. Chorafas Prize 2017 for his thesis on the neural mechanisms of the sense of bodily self. Arvid Guterstam receives the prize for his research on the neural and cognitive basis of bodily self-perception using a combination of human behavioural and neuroimaging approaches, including the use of functional magnetic resonance imaging (fMRI).   A key finding was that the sense of one’s own body is dependent on the integration of temporally and spatially congruent visual, tactile and proprioceptive signals in a spatial reference frame centred on the body. One piece of evidence for this arose from his discovery of the “invisible hand illusion” and the behavioural characterization of the perceptual rules that govern this striking perceptual phenomenon. Guterstam’s thesis was awarded an honorary distinction by the Thesis Examination Board; he has published 10 articles in international peer-reviewed journals. He was recently awarded the Wenner-Gren Fellowship and now plans to move the USA for a postdoc at Princeton University, where he will study the neural basis of awareness.

During this fall the Hagströmer Medico-Historical Library at Karolinska Institutet celebrates its 20th birthday, and extra guided tours are being held of the library's antique books and illustrations. The collections have grown steadily over the years, and today the library is well-known and internationally renowned. The Hagströmer Library in Hagaparken holds approximately 40,000 books, most of which were printed before 1870. Among other works the collection contains ten so-called incunabula, books printed before 1501, when the art of printing was in its infancy. One of the most valuable books is Carl Linnaeus’ personal copy of the first edition of his Systema Naturae, printed in 1735.  “I have had the honour of showing this Swedish national relic and world-famous book to Japanese Emperor Akihito in Tokyo, during the Linnaeus tercentenary celebrations in 2007, and also at the most prominent libraries in the USA,” says Ove Hagelin, the Hagströmer Library’s founder.  The basic idea 20 years ago was to bring together the old book collections from the Swedish Society of Medicine and Karolinska Institutet, but the library has grown over the years. Today many medical libraries have entrusted their collections of old books to the Hagströmer Library. Ove Hagelin’s vision has been, and continues to be, to bring to life these treasures that for centuries have stood unnoticed on library shelves.  Because the books are extremely valuable, the library cannot be permanently open to the public. For this reason, the library arranges guided tours and these have become increasingly popular over the years. Ove Hagelin estimates that about 10,000 people have visited the library. Visitors generally come from KI, associations, societies and foreign universities.  “During tours, visitors have the opportunity to see first editions of medical history’s classics but also the craftsmanship and artistry, which we think is so incredible today, that went into the production of a book in bygone centuries. After every visit it feels as if we’ve peeped through the door to a world that is totally unknown to most people,” Ove Hagelin says.   Limited space used to be a problem that was a constant struggle for the library but this was solved in 2010 when the National Property Board of Sweden offered KI the opportunity to lease the "k-listed" Haga Tingshus building in Solna.  “It was like a gift from Heaven. It’s fantastic to be able to invite people to such a beautiful building where we can display books in a worthy and appropriate setting,” Ove Hagelin continues.  Since a few years back, the library has been dependent on the Friends of the Hagströmer Library association. Doctor and writer Nils Uddenberg, the association’s vice-chair, met Ove Hagelin in 2002 and was fascinated by him as a person ad the unique collections he worked with. Since then he has been a frequent visitor to the library, whose materials he has used for research and inspiration in his writing. “I was spellbound immediately. All major breakthroughs in research can be seen all around on the walls and it’s a beautiful setting that seduces every visitor,” he says. Nils Uddenberg emphasises that it is a unique resource for a medical university that gives it a footing in the history of science.  “I hope it will be allowed to remain and that it is given a strong position at KI,” he goes on.  And the library continues to develop, not least through the association’s chair, financier Sven Hagströmer. He repeatedly finances new acquisitions to be kept at the Hagströmer Library, which takes its name from his great-great-great grandfather.     Text: Karin Montgomery Milestones in the Hagströmer Library’s history The Hagströmer Library takes its name from the Swedish Society of Medicine’s founder and Karolinska Institutet’s first inspector, Anders Johan Hagströmer (1753-1830).  The Hagströmer Library, which is a repository of medical history, has been built up in association with the Swedish Society of Medicine The Hagströmer Library is the core of the Medical History and Heritage Unit/Communications and Public Relations Office at Karolinska Insitutet, that takes care of and spreads information about KI’s medical heritage.  Milestones 1997 The Hagströmer Library is founded and Ove Hagelin is made Honorary Doctor of Medicine at KI. 2005 Exhibition at Nationalmuseum 2010 Relocation to existing premises in the Haga Tingshus building 2010 Exhibition at Valdemarudde, marking Karolinska Institutet's 200 years anniversary.   2017 The Hagströmer Library celebrates its 20th birthday and to mark the occasion three postage stamps are issued with illustrations from the library. The same year Ove Hagelin is awarded His Majesty the King’s Medal (earlier known as the Court Medal) for outstanding services as a bibliographer. Activities associated with the 20th anniversary The celebration began on 24 August with a lecture by First Librarian Hjalmar Fors, who held a lecture about medicinal plants from ancient times until today. The lecture was held at Postmuseum in connection with PostNord's release of three stamps with illustrations from Hagströmerbiblioteket. Anniversary Visions for KI staff will be held on three occasions: September 21, October 20 and November 28, 11-12. Pre-registration is required at: hagstromerlibrary@ki.se. A book exhibition, with medicinal plants illustrations, is on display throughout the fall in the large dining room at Haga Tingshus, and available for pre booked guided tours.. On 15 December, an open house will be held, mainly for KI's employees, researchers and students. During the day, short guided tours, lectures, book sales and coffee are on the agenda.

The Grand Silver Medal 2017 from Karolinska Institutet is awarded to Tore Curstedt and Marc Bygdeman in special recognition of the outstanding contributions they have made to medical research and Karolinska Institutet. Safe and effective abortion methods Professor Emeritus Marc Bygdeman has been awarded The Grand Silver Medal for outstanding contributions to research, education and healthcare and for significant involvement in the World Health Organisation’s work in fertility and family planning. He has dedicated his entire professional life to developing safer and more effective methods of abortion. During this time he has also worked unstintingly for the introduction and defence of the current abortion legislation. Under Professor Bygdeman’s leadership, research at Karolinska Institutet’s WHO centre has resulted in development of the medically-induced abortion, which today is well-established and is preferred by more than 90 percent of Swedish women as it minimizes the risks compared with surgical intervention. Every year, about 50,000 women around the world die as the result of unsafe abortions. Effective, safe and accepted abortion methods are essential for reproductive health. Changed abortion methods, which are more accessible, accepted and safe, thus have enormous importance for women’s health.  The medicine which has saved the lives of half a million children Associate Professor Tore Curstedt at the Department of Molecular Medicine and Surgery at Karolinska Institutet has been awarded the Grand Silver Medal for the work he and his colleague Bengt Robertson, who died in 2008, have done on their innovative treatment for preterm babies with respiratory distress syndrome (RDS). RDS has been the leading cause of death among preterm babies for decades.  It has been known since the 1950s that premature babies die due to the lack of surfactant, the substance which surrounds the inside of the lung alveoli. Attempts to synthesize the substance started in the 1960s, but these failed. However, when Pathologist Bengt Robertson and Clinical Chemist Tore Curstedt joined forces, they managed to extract the active ingredients from porcine lungs and develop a drug, Curosurf, which is used in more than 90 countries and is estimated to have saved more than half a million preterm babies.  Tore Curstedt has together with a colleague also developed a synthetic surfactant which is in clinical trials in United States and Europe. Unlike Curosurf the synthetic drug can be produced in large amounts and enables future treatment of adults suffering of lung diseases associated with inactive surfactant. He has received the Stockholm County Council Prize for Breakthrough in Clinical Research and His Majesty The King´s Gold Medal of the 12th size on a blue ribbon.

Folke Hammarqvist, Associate Professor in Surgery at Karolinska Institutet and Consultant at Karolinska University Hospital, has been awarded the Stipend for 2017 from the Håkan Mogren Foundation in recognition of and to support his efforts for human welfare.  “I am overwhelmed and happy! This award is of great importance, not least for the field in which I work, which is emergency surgery and traumatology, where assessment, interaction and empathy are all essential for providing the best quality care,” explains Folke Hammarqvist.  The award comprises a diploma and a personal prize to the winner of SEK 250,000.  To be eligible for the stipend, candidates must have established a reputation for looking after their patients with empathy and passion, and they should also be currently active, or planning to be active, in disseminating knowledge through lectures or the supervision of others. Folke Hammarqvist has been awarded the Stipend in honour of his professional skills and his empathic approach. Not only does he provide support and care for his patients and their relatives, he listens to his colleagues and creates a true team spirit. The justification for the award also highlights the fact that he is a role model within education where he is recognised for his major commitment and teaching skills. “Emergency surgery and traumatology require excellent team work, where optimal safety is achieved when patients, relatives and the entire team are all involved in the treatment. This is important within the modern health care, and cannot be replaced by technology. I have worked extensively in education, with practical medical work experience and together with others to reinforce the organisations involving emergency surgery and traumatology both in Sweden and abroad,” Folke Hammarqvist comments. Educated some 1,500 physicians and aims to continue Emergency surgery is an area that, together with traumatology, plays a central role in health care. Currently, the highest share of admitted patients arrive at hospital as emergency patients. Folke Hammarqvist is committed to education within the study programme in medicine and the education of younger physicians. He has been instrumental in developing national courses targeting emergency surgery and team and scenario training at emergency wards and operations involving trauma and emergency surgery.  “Working within education is so rewarding and you have the opportunity to keep abreast of developments. Every day, working in medicine involves elements of teaching, and we learn how to approach patients and their relatives in the way we work. Listening to the patients and their relatives is a natural part of medical work, and is necessary for us to be able to reach a diagnosis and provide help. One can gain important arguments by listening to what the patients and their relatives have to say, especially if the course of events has not been optimal, when making decisions about the structure of health care organisations that always in one way or another have an impact on our patients,” explains Folke Hammarqvist.  Over the years, around 1,500 younger physicians have taken part in courses held by Folke Hammarqvist, particularly within surgery. If we also count courses in for example team training, we find a further 2,000 students who have been able to benefit from Folke Hammarqvist’s knowledge. According to the man himself, this number is only set to increase. At the time of writing, he is teaching ATLS (Advanced Trauma and Life Support), a first-level course in the treatment of patients who have suffered accidents. He is also involved internationally in an accreditation programme for emergency and trauma surgeons in Europe. About the stipend The Håkan Mogren Foundation was established in 2012. Its purpose is partly to promote education and research within the medical field and partly to promote the education and training of classical musicians, particularly singers. The purpose of the stipend is to provide the opportunity for well-qualified, scientifically competent and clinically active physicians to improve themselves in a particular field of interest to them.

Surgery for severe heartburn has become less common after the turn of the millennium, due in part to the fear of relapse. Instead, most patients are treated with drugs that reduce the acidity of the stomach. However, a new study from Karolinska Institutet published in the distinguished journal JAMA shows that the risk of complications and relapse is not as high as feared, especially not in young, healthy males. Severe, recurrent heartburn, or reflux, affects between 10 and 20 per cent of the adult population. The most common treatment is medication that reduces the acidity of the stomach, which alleviate the symptoms for most people. Alternatively, sufferers can undergo antireflux surgery, whereby the contents of the stomach are prevented from entering the oesophagus by a mechanical valve implanted through keyhole surgery. However, such operations have declined since the turn of the 2000s due to the greater efficacy of the medications and to the risk of complications and relapse. Older studies of post-operative relapse have been small and provided conflicting results; some, however, have indicated a very high risk of relapse. Studied a large number of patients To obtain a clearer understanding of the risk of relapse after antireflux keyhole surgery, researchers at Karolinska Institutet have carried out a large study in which they followed up all adult reflux patients who underwent such an operation in Sweden between 2005 and 2014. They found that 18 per cent of the 2,655 patients had suffered a relapse, which is lower than in most of the earlier studies. Of these, 84 per cent were put on long-term medication, with the remainder having a second operation. Only 4 per cent of all included patients in the study suffered some form of complication, and those they did suffer were usually of low severity. The risk of reflux relapse was higher in women, elderly people and people with other diseases; the risk was lowest amongst healthy men below the age of 45. Possibly an under-used therapeutic alternative “This type of operation with a relatively low risk of complications is possibly an under-used therapeutic alternative, especially for young, healthy people with severe reflux,” says principal investigator Jesper Lagergren, professor at Karolinska Institutet’s Department of Molecular Medicine and Surgery. Medication is readily available and effective at alleviating symptoms, but does not treat the underlying disease. Medication is often lifelong, and long-standing treatment can eventually lead to complications such as osteoporosis, pneumonia and gastrointestinal infection. “The operation requires no lengthy hospitalisation and is a one-off, but it does carry a risk of complications and relapse,” says professor Lagergren. “Previous comparisons of medication and surgery have shown that life quality is better after surgery, and surgery is judged likely to be more cost-effective in the long run.” The study was financed by the Swedish Research Council. Publication “Association Between Laparoscopic Antireflux Surgery and Recurrence of Gastroesophageal Reflux” John Maret-Ouda, Karl Wahlin, Hashem B. El-Serag, Jesper Lagergren JAMA, online 12 September 2017, doi: 10.1001/jama.2017.10981

Sweden holds a strong position in the field of life science. While at the same time we are facing serious health challenges and need to adapt to changes in the world around us, not least rapid digitalisation. Players in the Life Science sector met for an afternoon at Karolinska Institutet to discuss the need for interaction to be able to meet the challenges. “One of the biggest challenges is how research and education are to keep pace with the extensive changes that are taking place, not only in Stockholm but around the world. That challenge is enormous and requires us to cooperate in order for our society to have the beast health services and health and medical care in the future,” said Karolinska Institutet’s new vice-chancellor Ole Petter Ottersen as he welcomed participants to the seminar on health and life science in the Samuelsson Hall on September 6th. The seminar is part of a nationwide series of seminars on societal challenges based on the research policy bill that the government put forward in 2016. Helene Hellmark Knutsson, Minister for Higher Education and Research, attends the seminars where concerned players from academia, trade and industry and other parts of society come together to discuss how the initiatives in the bill can be translated into practice and do the most good.  Ole Petter Ottersen said that Karolinska Institutet has listed six main points in the university’s strategies for interaction: development of university healthcare, regional and national cooperation, more interaction with trade and industry, incentives for and financing of innovation, strategic cooperation with trade and industry, and international collaborations. The major infrastructural changes currently taking place at Karolinska Institutet need well-developed forms of interaction with, among others, Stockholm County Council, Sweden’s trade and industry and other prominent universities, both in Sweden and in other countries. Professor Ottersen emphasised that all the ongoing initiatives and investments are taking place in interaction with the health and medical care services in order to further integrate research with clinical operations and activities.  The research policy bill turned into practical action In her introduction to the seminar, Helene Hellmark Knutsson emphasised that now is the time to turn the research policy into practical action. The new research funds and research programmes have just been set in motion and it is time to implement the research policy in reality. “It feels good to see so many of those who are to help us tackle societal challenges participating here,” Hellmark Knutsson told her audience. She emphasised that Sweden has traditionally been a country that has invested in research, which is for example evident in the Times Higher Education’s ranking of universities around the world where three Swedish universities can be found among the world’s top 100. The research policy bill’s starting point is to tackle societal challenges through collaboration, she went on. In order to achieve this, basic appropriations are being raised and particular initiatives will be put into effect with among other things ten-year research programmes and measures to promote collaboration and innovation. She emphasised, however, that more research funding does not always mean higher quality of the research results. “We must announce more career-development positions in international competition. Well-defined, transparent career paths are important in order to attract the best researchers. Today, many have time-limited positions and too many are recruited internally. We have traditionally favoured ‘home-grown sons’, that is to say men from one’s own university,” Helena Hellmark Knutsson said. More research linkage in education programmes, better conditions for doctoral students and quality assurance also of research are further examples from the research policy bill that Helena Hellmark Knutsson emphasised. “We have world-leading research in some areas of Life Science. We have health and medical care that covers all patients. We have good registers and bio-banks. All of these could put us even further ahead. I look forward to collaborating with you all to make Sweden a leading research nation in Life Science.” Helena Hellmark Knutsson also emphasised her support for the proposal that the European Medicines Agency should be located in Sweden, before handing over to moderator Göran Stiernstedt, senior lecturer and member of the University Senate Council at Karolinska Institutet. Research projects with social linkages Seminar participants then watched presentations on the theme of health challenges from four researchers at Karolinska Institutet. Professor Kristina Johnell, Division Head of the Aging Research Center, spoke about the challenges of drug treatment in elderly people. Among other things she said that elderly people are often excluded from clinical trials and that sensitivity to drugs increases the older we become. Ylva Trolle Lagerros, senior lecturer at the Department of Medicine, described how digital technology can be used to promote health. We can among other things use our smartphones to register the amount of exercise we do, share exercise data with our care provider and together set common goals for better health. “The exciting thing about this is that 70 percent of the participants in the research project are older men, a group that is usually difficult to reach when it comes to health promoting research. And the digital care plan makes a difference. Almost all take that extra evening walk to reach their goal,” she said. Christian Giske, senior lecturer at the Department of Laboratory Medicine, spoke about resistant intestinal bacteria and showed worrying figures of the proportion of resistant intestinal bacteria in various parts of the world. He pointed out, however, the importance of not scaring people and exaggerating the risks, which he said the media, among others, contributed to. Professor Jan-Olov Höög from the Department of Medical Biochemistry and Biophysics gave his views on how university education programmes in Life Science should be designed to equip students for the future. Karolinska Institutet offers for example global master’s programmes that are taught in English and free university courses via the Internet (MOOC). Professor Höög also emphasised the need for innovations in the health sector and said that programmes and courses must meet the particular skills needs and the possible clashes of culture that may occur between a medical and a technical organisation as technical innovations increasingly pervade health and medical care.  The seminar ended with a panel discussion on how interaction can be effective and what thresholds and obstacles can make successful interaction difficult, in which Ole Petter Ottersen, Eric Vänerlöv, secretary of the National Coordination for Life Science study, Anna Sandström, Science Relations Director at AstraZeneca, Jenni Nordborg, director and head of the Health Department at Vinnova, and Malin Frenning, County Council Director for Stockholm County Council, took part.

Is it less wrong to avoid tax if everyone else is doing it? A new study from Karolinska Institutet demonstrates that our view of what is morally right or wrong is shaped by how widespread a particular behaviour is. The results, which are presented in the Journal of Experimental Psychology: General, can improve our understanding of the psychological mechanisms behind attitudinal change in society. Social norms of right and wrong are vital to a well-functioning society. However, such moral standards are changeable and the psychological mechanisms driving this change are unknown. Now, researchers at Karolinska Institutet report that our view of selfish and altruistic behaviours changes depending on how common they are. The results are based on a combination of behavioural experiments, mathematical models and computer simulations. In the experiments, the participants first observed other people’s behaviour in a so-called “public goods game”, in which players receive a sum of money and then choose either to invest it to varying degrees so that it benefits everyone in the group, or to keep it for themselves. After every round, the participants were asked to judge the different choices as morally right or wrong, and whether the choices ought to be penalised with a reduction in how much the players gained. An idea based on flawed logic Altruistic behaviour was considered more morally right than selfish, but both behaviours were judged to be more moral and less deserving of penalty if the majority exhibited them than if they were uncommon. The commonness of the selfish behaviour also affected the participants’ willingness to themselves pay to punish selfishness. “Tolerance of selfish behaviour increased when the majority of the players kept the money for themselves, which surprised me,” says principal investigator Andreas Olsson, senior lecturer at Karolinska Institutet’s Department of Clinical Neuroscience. “The fact that a behaviour is common doesn’t automatically mean that it’s right – this idea is based on flawed logic that confuses facts with moral values.” The study shows our view of what is morally right and wrong has strong similarities with social conformity, in that we tend to adapt ourselves to the people around us and how they behave. This means that changes in our social environment can quickly alter our moral compass. Explains why moral attitudes change “This is interesting from several angles, and could explain why moral attitudes change over time, such as those towards public goods or legality,” says Björn Lindström, postdoc at University of Zürich and Karolinska Institutet’s Department of Clinical Neuroscience. The study was financed by Riksbankens Jubileumsfond, the European Research Council, the Knut and Alice Wallenberg Foundation and Forte. Publication Björn Lindström, Simon Jangard, Ida Selbing and Andreas Olsson “The role of a ‘common is moral’ heuristic in the stability and change of moral norms” Journal of Experimental Psychology: General, online 11 September 2017

In his new role as Vice-Dean for collaboration with Stockholm County Council (SCC) with particular focus on education at Karolinska University Hospital, Carl-Fredrik Wahlgren’s highest priority will be to try, in collaboration with others, to secure KI’s programmes and courses in the new healthcare landscape that is taking shape in Stockholm. Health and medical care in Stockholm is undergoing several extensive changes, where the reorganisation of Karolinska University Hospital is one of the things that will most impact KI’s possibilities to conduct clinical research and education. KI and SCC need to ensure that there are sufficient high-quality places for workplace-based education. “The question highest on my agenda is to try to secure the teaching and degree objectives that are under threat. This requires close cooperation between KI’s management team, the Board of Education, the unit for collaboration with the county council, representatives of the clinical departments, the education programmes and healthcare,” says Carl-Fredrik Wahlgren. An impact study, commissioned by the Vice-Chancellor and conducted by KI in spring 2017 as a result of Karolinska University Hospital’s new orientation, makes it clear that several degree and education goals are threatened. They concern for example medical students’ possibilities to meet patients with common diagnoses and several programmes’ possibilities to attain the goals in inter-professional learning.  Much of the outpatient care carried out at the hospital will be transferred outside, and new learning environments that enable inter-professional learning (meaning that students in different professions can learn from each other and together) and clinical training environments are needed. The availability of teachers and supervisors who are competent in both their subjects, science and pedagogics is also high on the list of priorities. Academic specialist centres a key issue As specialist outpatient care is moved out, an important issue will be to establish academic specialist centres, where clinical research and education can be carried on hand-in-hand with healthcare. For example, such a centre will be opened on Torsplan in December and will thereby be located close to KI and Karolinska University Hospital in Solna. Here, KI will collaborate with Stockholm Health Care services (an organization within the SCC) to develop and implement workplace-based education at basic level and advanced level. “The aim is to create a model for how education characterised by new approaches and innovative solutions with elements such as e-health and inter-professional learning can be carried on in specialist outpatient care. I believe that several such centres are needed if we are to ensure that places are available for KI’s workplace-based education”. Challenges but also opportunities In Carl-Fredrik Wahlgren’s opinion, collaboration should also be seen as a great opportunity to develop and improve clinical education still further. The aim is for the hospital to continue to be a central arena for KI’s clinical programmes and courses. There are still many research linkages with a great many researching teachers and good opportunities to, among other things, satisfy demands for inter-professional learning and internationalisation. “Transformation work at the hospital is also an investment intended to strengthen collaboration between care, research and education. A university hospital without students is not a university hospital. Close collaboration between the university and healthcare is a prerequisite for a quality-assured education where the students are happy and can achieve their learning and degree goals”.  Information meetings At two general information meetings, one in Flemingsberg on 11 September and one in Solna on 13 September, a summary will be given of KI’s impact study along with some proposed solutions. The meetings are open to everyone who is interested in the matter of education in collaboration with Karolinska University Hospital.

Representatives of Mayo Clinic are on a visit to Karolinska Institutet and Karolinska University Hospital to exchange knowledge and experiences on a number of subjects covering everything from research, education and innovation to administration. A conference has been arranged for all parties on 6 to 8 September at both the university and the hospital. The USA’s Mayo Clinic is considered an international role-model when it comes to integrating research and clinical activity. This has long interested Karolinska Institutet and Karolinska University Hospital, which this week is taking part in the annual conference that has formed part of the Karolinska Institutet-Mayo Clinic partnership for the past 25 years. “We need to exchange experiences and ways of thinking to achieve a swifter transition from research to clinic, where the results of our research can benefit healthcare provision,” says Vice-Chancellor Ole Petter Ottersen during his opening conference address. “Mayo Clinic excels in this field and can serve as an example to us in our collaboration with the healthcare sector.” Melvin Samsom, director of Karolinska University Hospital, stressed the importance of a sustained and advanced partnership between academy and clinic at a time of radical changes in how healthcare in Sweden, the USA and elsewhere is governed and organised: “We’re facing huge structural changes and have similar challenges in how we organise healthcare to make it more integrated, cost-effective and sustainable.” The main scientific lectures on the conference’s first day gave proof of groundbreaking research projects that have managed with the help of technological innovations to improve diagnostic and therapeutic procedures for patients with rare and difficult-to-treat diseases. Professors Eric Wieben and Martin Schalling, who are the scientific coordinators of the partnership at Mayo Clinic and Karolinska Institutet, respectively, hope that it can continue to be a platform for the development of clinical. Another goal is to create a career path with dual institutional affiliation, in which researchers from one can claim credit for the time spent and work done at the other. The partnership between Karolinska Institutet and Mayo Clinic began as a modest research collaboration on diabetes and metabolism in the 1990s and has since grown to include over a dozen research disciplines, such as psychology and psychiatry, autoimmune diseases, regenerative medicine, cancer and cardiovascular diseases. It also covers administration, education and innovation, which was identified as a success factor in a recent evaluation.   Text: Maissa Al-Adhami

Conducting plastics found in smartphone screens can be used to trick the metabolism of pathogenic bacteria, report scientists at Karolinska Institutet in the scientific journal npj Biofilms and Microbiomes. By adding or removing electrons from the plastic surface, bacteria may be tricked into growing more or less. The method may find widespread use in preventing bacterial infections in hospitals or improve effectiveness in wastewater management. When bacteria attach to a surface they grow quickly into a thick film known as a biofilm. These biofilms frequently occur in our surroundings but are especially dangerous in hospitals where they can cause life threatening infections. Researchers have now aimed to address this problem by producing coatings for medical devices made from a cheap conducting plastic called PEDOT, which is what makes smartphone screens respond to touch. By applying a small voltage, the PEDOT surface was either flooded with electrons or left almost empty, which in turn affected the growth of Salmonella bacteria. The bacteria cannot replicate “When the bacteria land on a surface full of electrons, they cannot replicate”, explains principal investigator Agneta Richter-Dahlfors, Professor at Karolinska Institutet’s Department of Neuroscience and Director of the Swedish Medical Nanoscience Center. “They have nowhere to deposit their own electrons which they need to do in order to respire.” On the other hand, if the bacteria encountered an empty PEDOT surface, the opposite happened, as they grew to a thick biofilm. “With the electrons being continually sucked out of the surface, bacteria could continually deposit their own electrons, giving them the energy they needed to grow quickly”, says Professor Richter-Dahlfors. Many implications for health and industry This left the research team in a position where, at the flick of a switch, they could either abolish bacterial growth or let it continue more effectively. This has many implications for both health and industry. “To begin with, we can coat medical devices with this material to make them more resistant to colonisation by bacteria”, says Professor Richter-Dahlfors. “However, if we look to industries like wastewater management that need a lot of beneficial biofilms to create clean water, we can produce surfaces that will promote biofilm production”, she continues. In the future the research team will work to integrate this technology into devices that could one day be implanted into patients to keep them safe when undergoing medical procedures or having devices implanted. The study was financed by the Swedish Research Council, Vinnova, Carl Bennet AB, and the Swedish Medical Nanoscience Center. Publication Salvador Gomez-Carretero, Ben Libberton, Mikael Rhen, and Agneta Richter-Dahlfors “Redox-active conducting polymers modulate Salmonella biofilm formation by controlling availability of electron acceptors” npj Biofilms and Microbiomes, online 4 September 2017. doi:10.1038/s41522-017-0027-0

KI researchers Erik Melén and Georgios Sotiriou have received starting grants from the European Research Council (ERC) for conducting their own independent research. The purpose of the ERC Starting Grants is to support talented early-career scientist, who have already produced excellent supervised work, into becoming independent researchers and the research leaders of tomorrow. The ERC Starting Grants are worth EUR 1.5 million, distributed over five years. In addition to that Georgios Sotiriou, who is the first KI grant recipient working within the field of physical science and engineering, receives EUR 312,500 to cover equipment costs. Read more in a press release from ERC New biomarkers for respiratory disease Erik Melén is a pediatric allergist and an Associate Professor at the Institute of Environmental Medicine (IMM). His ERC project, TRIBAL, aims to provide new knowledge for targeted prevention in children at risk of adult chronic lung disease, and to identify potential targets for new asthma and COPD (chronic obstructive pulmonary disease) drugs using omics-based biomarkers. In children, asthma is the most common chronic disease and more than 300 million people are affected globally. There is no curative treatment available. Persistence of childhood asthma into adult life is associated with lung function impairment and increased risk of COPD. “If you want to prevent adult chronic disease, you need to start early. I am extremely grateful for the opportunity to receive ERC funding for this important work. Also, going through the ERC application process has been a very enriching experience for me as a scientist,” says Erik Melén.  TRIBAL is a follow-up project using data and repeated bio-sampling from the Swedish BAMSE study, a world-leading population-based birth cohort of 4,089 participants, also led by Erik Melén. Fighting antimicrobial resistance with nanoengineering Georgios Sotiriou, Assistant Professor at the Department of Microbiology, Tumor and Cell Biology, conducts research with the overall mission to develop nanobiomaterials, tools and methods for medicine using core engineering sciences. The key focus lies on flame aerosol engineering of smart nanoscale materials and devices for biomedical applications. The aim of his ERC project, PROMETHEUS, is to employ flame nanoengineering and develop the next generation of antibacterial medical devices to fight infections and antimicrobial resistance. Antimicrobial resistance constitutes one of the most serious public health threats with estimations to become the leading cause of human deaths in 30 years “I am extremely delighted and honored to receive this grant that will enable me to work on the exciting field of nanoengineering for medicine and try to tackle tomorrow’s global health challenges”, says Georgios Sotiriou. The approach of his and his colleagues’ research is multidisciplinary, combining expertise from material and process engineering, bioengineering and health sciences. This allows for the design of biomaterials and devices that exhibit the desired functionality in applications ranging from diagnostics (biosensors) to therapeutic interventions. Text: Selma Wolofsky