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It will soon be time to select the winner of the work environment and health prize that was founded at Karolinska Institutet last year. One of the main aims of the prize is to promote a healthy psychosocial work environment, says Professor Karin Dahlman-Wright, who nominated the very first winner. New candidates can be put forward by KI employees up until 21 October. The 2014 prize winner was toxicologist Dan Segerbäck, now retired from the Department of Biosciences and Nutrition. Back then, Professor Karin Dahlman-Wright was head of department there, but she is now vice dean of infrastructure at KI. Why did you nominate Dan Segerbäck? “The work environment is one of the most important issues facing a department, and having a person with the necessary commitment and competence able to take his own initiative, like him, was a great support for me when I was head of department. As a toxicologist Dan Segerbäck, who’s retired now, was very knowledgeable about issues relating to the physical laboratory environment, but he also worked a lot with psychosocial matters.” What have you done with the SEK 30,000 prize money that the department was awarded? “We’ve been discussing a more advanced further training programme for the work environment group because the people working with these issues need to update their knowledge and because it’s stimulating to meet others involved in the same issues. Another idea is a course in heart and lung resuscitation for the staff. A third proposal is to put the money into health promotion lectures in English so that we can also engage the many English speakers we have working here.” Have you checked out other work environment role models at KI who deserve this year’s prize? “Not specifically, but I think people who are really passionate about these issues and take their own initiatives, preferably with a focus on the psychosocial work environment, are worth looking at.” What’s your greatest wish right now? “I’d like to see the work environment treated with the status it deserves and be an attractive area to work in. We can’t just conduct excellent research and education, we have to look after the work environment too. The one needs the other.” Text: Karin Söderlund Leifler   To all employees: Find out more about how to nominate candidates for KI’s Work Environment Prize.  

A new service has opened up in the Wallenberg laboratory: called Karolinska Institutet Mouse Models (KIMM), it has been set up for researchers conducting research on mice that have been genetically modified to develop certain medical conditions, such as diabetes, cancer or depression. The new service offers scientists an opportunity to buy haematological, physiological and pathological health checks of the animals, which can also be examined behaviourally. All such checks are made on order from the researchers and are conducted at certain ages and using methods that accord with international standards. This means that the animals can be compared with an international database, making it easier for new links between genes and diseases to be discovered. “Genes operate globally throughout the body,” says Brun Ulfhake, operations manager at Comparative Medicine and initiator of the KIMM concept. “Studying how a specific gene affects a specific function requires a very narrow focus. If we monitor the animal’s health through a wider-angled lens, we can discover new diseases and disease correlations, and understand the gene under study better.” KIMM also operates an “open access” service whereby scientists can conduct research on the mice themselves with their own or rented equipment, and offers bacteria-free mice for research purposes. Mice are the most widely used mammal for research. According to Professor Ulfhake this is mainly because the mouse genome is the most thoroughly mapped, with 5,000 genes identified of the estimated 23,000 total. “As we continue to do research on mice, we help to map the genome of a mammal and learn more about the part played by individual genes in the context of the entire genome,” says Professor Ulfhake. “When this has been done, the mouse genome will form a reference library for other mammals, including humans. We have roughly the same number of genes.” Text: Annika Lund Photo: Ulf Sirborn Find out more on ki.se/kimm.

Dr. Katrin Willig, junior research group leader at the Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB) with affiliation at the Max Planck Institute for Experimental Medicine in Göttingen, Germany, is the recipient of the Lennart Nilsson Award 2015 for her groundbreaking contribution to the super-resolution microscopy of living cells. In her research she uses technology for studying cell structures at nanoscale to understand how our brains work. Fluorescent Light Microscopy was long inhibited by the limited resolution caused by the light’s wavelength. The technology was revolutionised twenty years ago with the development of Stimulated Emission Depletion (STED), which enabled researchers to study living cells in tiniest molecular detail. The method involves using a laser beam to illuminate fluorescent molecules while a second customised laser beam deactivates parts of the fluorescence, leaving only a nano-sized area at the focal point that emits a signal. STED is one of the technologies collectively known as super-resolution microscopy. In 2014 Eric Betzig, Stefan W. Hell and William E. Moerner shared the Nobel Prize for Chemistry for developing super-resolution fluorescence microscopy. This year’s recipient of the Lennart Nilsson Award, Katrin Willig, pioneered the use of fluorescent proteins for the nanoscale imaging of living cells. She has developed STED microscopy for imaging tissue inside living organs, known as Deep Tissue Imaging, and her special area of interest is the processes in the contact points between the nerve cells that are known as the synapses. She has demonstrated the strength of these technologies by in vivo-imaging inside a living mouse brain the tiny protrusions (dendritic spines) on the nerve cell dendrites found in the synapses, which are believed to be the basis of memory in the brain. Katrin Willig studied Physics at Würzburg University before joining Stefan W. Hell’s research team at the Max Planck Institute for Biophysical Chemistry in Göttingen. She graduated with a PhD in 2006 with a thesis on STED microscopy. Since 2014 she has been leading her own research team at the Göttingen Cluster of Excellence and DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB) at the Max Planck Institute of Experimental Medicine in Göttingen. The Lennart Nilsson Award is the world’s top accolade in scientific and medical photography. The award was inaugurated in 1998 in honour of Swedish medical photographer Lennart Nilsson, who achieved worldwide recognition for his images. The SEK 100,000 prize money is awarded each year to individuals who make an outstanding contribution to scientific photography “in the spirit of Lennart Nilsson”. The prize is awarded at Karolinska Institutet's inauguration ceremony on 15 October.

The announcement that dangerous goods were no longer allowed on the Solna-Huddinge shuttle bus drew howls of protest from KI’s labs. But now researchers can transport their material on the “slingbilen” (the Scientific Sample Shuttle) instead – completely free. The minibus shuttle stops outside the Centre for Molecular Medicine in Solna at ten on the dot. Driver Peter Lundevall waits ten minutes, during which time a researcher shows up needing to transport blood samples and biopsies from two gastroscopies. The samples were taken that morning and need taking to Huddinge. “I only heard about the minibus recently and this is the first time I’ve used it,” says Takami Ichiya, researcher at the Centre for Infection Medicine. “It’s a bit frustrating that it leaves at ten, though. If it left later, we’d be able to transport more samples taken in the morning and afternoon.” Anna-Lee Cöster Jansén, main safety delegate at Karolinska Institutet and one of the drivers – figuratively speaking – behind the shuttle bus, is standing with us and is all ears: “It’s good to hear comments like that,” she says. “If it’s needed we’ll try to change the timetable. The bus has to be of use to the researchers.” Just over a year ago, a new contract was signed for the staff shuttle bus between Solna and Huddinge, and the new operator made it quite clear that no dangerous goods were to be allowed on board – and scientific samples are often hazardous, as is dry ice and liquid nitrogen. “This drew howls of protest from the labs,” says Ms Cöster Jansén. “But we figured there was a risk that samples would be transported on the bus anyway. One option was for the researchers to order couriers, but the money for that would have to come out of their own research funds.” So now, since May, there is a free minibus service for researchers between Solna and Huddinge. It will run until November, when the scheme will be evaluated. “We won’t be able to keep the service if it’s not used,” says Ms Cöster Jansén. “But I know the need exists, so we hope that people will start to discover it.” Text: Annika Lund Photo: Gustav Mårtensson How to catch the bus: read more on internwebben.ki.se.

There is no association between coffee consumption and an increased risk of atrial fibrillation, according to a new study by researchers from the Institute of Environmental Medicine at Karolinska Institutet. The study also includes a meta-analysis of four other research articles, making it the largest of its kind to investigate a possible link between a common irregular-heartbeat condition and drinking coffee “Our study results shows that people who like coffee can safely continue to consume it, at least in moderation, without the risk of developing this condition”, says lead author Susanna Larsson, PhD, Associate professor at the Institute of Environmental Medicine. Moderate coffee consumption has been associated with a reduced risk of coronary heart disease and stroke. Its association with atrial fibrillation (AF), a heart condition that causes an irregular and often abnormally fast heart rate substantially increasing the risk of stroke, heart failure and all-cause mortality, has been unclear. However, it has sometimes been speculated that high coffee consumption may increase the risk of developing this disorder. The current study, which is being published in the online journal BMC Medicine, included 41,881 men and 34,594 women who, in 1997, reported how many cups of coffee they consumed and were followed up for 12 years. There were 4,311 and 2,730 incident AF cases in men and women, respectively, in the two cohorts. The median daily coffee consumption was three cups among both men and women. Extreme levels of coffee consumption In their analysis of the two cohorts, the research team found no evidence that high consumption of coffee increases the risk of atrial fibrillation, not even in more extreme levels of coffee consumption. This lack of association was then confirmed in a follow-up meta-analysis that included the present two cohorts and four other prospective studies, giving a total of 10,406 cases of AF diagnosed among 248,910 individuals. “However, in sex-specific analyses of this larger follow-up material, coffee consumption was associated with a non-significant increased risk of AF in men, but a non-significant decreased risk of AF in women”, says Susanna Larsson. “Whether men may be more sensitive to a high coffee or caffeine intake warrants further study.” Although available evidence does not indicate that coffee consumption increases the risk of developing AF specifically, coffee may still trigger other forms of irregular heartbeat. Data in the study suggests that some individuals with AF at the start of the study may have quit drinking coffee or lowered their consumption because of an arrhythmic-triggering effect. While the authors adjusted for major AF risk factors, they warn of possible bias and confounding factors that may have influenced their results, and highlight the limits of self-reported data. All studies were conducted in either Sweden or the US, thus reducing the generalizability of the results. The study was funded by the Swedish Research Council, and the Strategic Research Area in Epidemiology (SfoEpi) at Karolinska Institutet. This news article is an edited version of a press release from BioMed Central. Publication Coffee consumption is not associated with increased risk of atrial fibrillation: results from two prospective cohorts and a meta-analysis Susanna C. Larsson, Nikola Drca, Mats Jensen-Urstad and Alicja Wolk BMC Medicine , online 23 September 2015,  doi:10.1186/s12916-015-0447-8  

In the decisive battle against Ebola, it has become harder and harder for Doctors Without Borders to find international aid workers. While many of those active out in the field have started to tire, there are some who still have the energy to carry on. One of them is Dr Helena Nordenstedt, who recently travelled to Guinea, where her prompt action made it possible to start a treatment programme against Ebola. Last autumn, Dr Helena Nordenstedt attended the emergency crash course that KI set up for Ebola fieldworkers. As soon as her two-day training was over, she set off for Liberia. “When I first entered the high-risk zone at the centre, it was really scary and I felt so nervous,” she recalls. “But once there, you realise that you have a role to play, and you don’t have time to feel worried. You feel that it’s ‘us versus the virus’, which gives you a sense of unity that only an emergency like this can create.” On her return from Liberia she continued to combine her job as resident physician at Danderyd Hospital with a research associateship at the Department of Public Health Sciences, where one of her responsibilities is KI’s Global Health course. A sudden request But early this autumn she received a call from Doctors Without Borders asking her if she could travel back to West Africa the very next day, this time Guinea. “My spontaneous reaction was to say no, it’s impossible, I’m busy with my patients and the course planning,” she says. “But then I gave it a bit more thought and decided that my work here at home could not take precedence.” Two days later she was in the Guinean capital of Conakry, this time as the only foreign doctor at the Nongo Ebola centre. Dr Nordenstedt’s skills as a research-qualified clinician were an asset in a new treatment programme using Favipiravir, a drug that has yet to be approved for use against Ebola. Preliminary results have shown, however, that the drug reduces the mortality rate of Ebola by 30 to 15 per cent in people with a moderate virus infection. The Doctor Without Borders’ Nongo centre is what Dr Nordenstedt calls a “State of the Art- centre”, with its superior layout, monitoring facilities and, above all, own laboratory. At the time of this interview, she has been back in Sweden for just three days. “For me personally, it was really rewarding to see how far we’ve come. Last autumn when I was in Liberia it was frustrating that we couldn’t do more for each patient. We dreamt about being able to give blood plasma from survivors and would say, ‘Imagine if we at least had a blood pressure cuff’.” Ebola on the decline Another big difference from last autumn is that the number of Ebola cases has dropped sharply. Nongo had 30 beds and during Dr Nordenstedt’s stint there, there were about two confirmed cases a week. Even though the number of Ebola patients is low, they still have to be screened out from the influx of malaria and typhoid cases, both of which are very prevalent in Guinea and produce symptoms similar to Ebola. This means that everyone must be considered an Ebola patient until proven otherwise. “Another complicating factor is that more and more recently admitted patients have been given a vaccine, which can cause fever and joint and muscle pain, symptoms that are just like those you see in early-phase Ebola,” she says. The last patients come from the most marginalised groups. Paradoxically, rumour-mongering, aggression and irrelevant interventions are more common during the protracted closing phase of the epidemic than during its more chaotic peak. One such rumour is that the vaccine causes Ebola, since it is given to newly identified contacts, who start off at higher risk of contracting the disease over the coming few days. We have been taken by surprise before. Despite this, Dr Nordenstedt is optimistic about West Africa’s future when it comes to Ebola. “At present there’s only one case in Conakry, a thirteen-year-old girl. She could be the last case in Guinea, but you can’t be too sure – we are talking about Ebola, after all. We’ve been taken by surprise before.” Last week, the virus was found in a dead body in Sierra Leone in an area that had not had Ebola for six months, and it gave rise to five new cases. And in Liberia, which was declared Ebola-free in March, six people fell ill in June. “The important thing is that systems and routines are in place and are there in case new outbreaks occur,” says Dr Nordenstedt. “Now, unlike before, the local community has the necessary knowledge and skills, and the WHO rushes in to inoculate everyone who’s been in contact with the infected people, and even people who’ve been in contact with these people.” Text: Jenny Ryltenius Photo: Gunnar Ask and Doctors Without Borders

The Håkan Mogren Foundation has awarded its 2015 medical stipend to the cancer specialist Elisabet Lidbrink in recognition of her outstanding contributions to alleviating human suffering. Elisabet Lidbrink, oncology consultant at Karolinska University Hospital, is awarded the prize for her strong commitment to women with breast cancer, and for her support of younger colleagues. She sets an example with her humane patient approach. Elisabet Lidbrink has 30 years’ experience as an oncologist. During this time, she has been relentless in her efforts to ensure that women with breast cancer receive the best care and treatment possible, and that they are treated with dignity and empathy. The doctor-patient relationship is an important part of the caring process. Elisabet Lidbrink often receives the most difficult cases, those whose treatments have failed and whose cancer has spread to other organs. In the midst of sadness and despair, Elisabet Lidbrink manages to find hope and to share it with her patients. Her commitment is that every patient will receive the best care and treatment available and that when all options are exhausted, the patient's remaining days will be as healthy as possible. “Elisabet Lidbrink puts the patient first and always from a place of passion and empathy. She is an amazing mentor to the next generation of oncologists and a role model who exemplifies what true cancer care is all about”, says Håkan Mogren. The Håkan Mogren Foundation was established in 2012. Its dual purpose is to promote education and research within the medical field and to promote the education and training of classical musicians, particularly singers. Within the medical field, the purpose of the stipend is as follows: to provide the opportunity for well-qualified, scientifically competent and clinically active physicians to improve themselves professionally, or to carry out research in a particular field of interest to them. To be eligible for the stipend from The Håkan Mogren Foundation, candidates must have established a reputation for caring for 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. The award includes a diploma and a personal prize of SEK 250,000. Elisabet Lidbrink will receive the Prize in conjunction with Karolinska Institutet's installation ceremony on 15 October 2015.  Previous award winners

Being able to teach in English is not the only thing a teacher has to think about, because the international classroom is also about culture and values. Newly employed Jennifer Valcke will now be opening doors at KI to a bigger world. On 30 September she is one of the speakers at the “Lärardagen” event.  On 7 September, Jennifer Valcke stepped into a brand new role at KI, created at the initiative of the Board of Higher Education, in which for the next three years she will be helping Karolinska Institutet’s teachers and supervisors adapt their teaching methods to the multicultural classroom. Dr Valcke has over ten years’ experience as a pedagogical developer at the Université Libre de Bruxelles in Belgium, where neither the teachers nor the students had English as their first language. “It was in many ways like the situation here at KI,” she says. “The main difference is that here I’ll only be working with medical education. The teachers I worked with before taught finance, multilingual communication, law and medicine. I think the teachers here have a much more clearly defined identity.” Jennifer Valcke is looking forward to working with teachers on KI’s different study programmes, where human health is the focus and effective communication a precondition. “When you teach in a foreign language, you’re not just dealing with words but with cultural awareness too. The students will need a greater understanding of culture in their future careers, as they’ll need to be able to talk to their patients about highly sensitive medical matters.” A plan for internationalisation This new post is part of KI’s efforts to make teaching more international and strengthen its competitiveness. One of the objectives in the university’s strategy plan for internationalisation is for all study programmes to have at least one course held in English by next year. Another important aim is to bring more intercultural awareness and global health issues into the programmes than is currently the case. But this is not just about English being necessary for academic communication; the teachers have also expressed an interest in learning more about teaching in multicultural contexts. As pedagogical developer Jennifer Valcke will be in close, regular contact with teachers and supervisors, and working with strategies for internationalisation at management level. Not only will she be on hand to help the various programme directors weave international and intercultural perspectives into the courses and their intended learning outcomes, but she will be arranging workshops and offering personal advice for pedagogical leaders, teachers and supervisors too. An online tool for teachers will be developed. Teaching in another language “I think we’ll reach many teachers through an interactive website where they can watch interviews with colleagues that have done something interesting, find information, network and link with other people,” she says. “There might also be a discussion forum where they can exchange ideas and experiences. The challenge will be to help teachers expand their notions of what it means to teach in English. It’s not the same as teaching in your mother tongue. You also have to make sure that your students are aware of each other’s culture and how it influences their communication and values.” Jennifer Valcke believes that teaching in another language is very much about making it possible for the students to absorb what the teacher is trying to convey. This can involve apparently trivial matters, such as the fact that it can be so tiring to listen to someone speaking in another language, that no matter how interested students might be in what their teacher is saying, their concentration can start to wane. Jennifer Valcke can help teachers to tackle this aspect of teaching in English too, and give them tips on how to hold their students’ attention. She, for one, likes to use group activities: “I’m inspired by the playful side of teaching. I like engaging the participants in a way that helps then learn things without being aware that they’re doing so.” Text: Karin Söderlund Leifler Photo: Daniel Roos Read more about the speakers and the programme on the “Lärardagen” event on 30 September 2015: ”KI Goes Global – Intercultural & International Perspectives on Teaching and Learning”.  

Insensitivity to insulin, also called insulin resistance, is associated with type 2 diabetes and affects several cell types and organs in the body. Now, scientists from Sweden’s Karolinska Institutet have discovered a mechanism that explains how insulin-producing cells can be insulin resistant and insulin sensitive at the same time. The findings are being published in the journal Cell Reports, and may lead to future novel treatment strategies for type 2 diabetes. Insulin is critical in lowering blood glucose concentration. Individuals with type 2 diabetes suffer from insulin resistance and this means that their cells/organs are insensitive to insulin. In type 2 diabetes the body tries to compensate by producing more insulin, and also by increasing the number of insulin-producing cells. Finding new treatment strategies is only possible by gaining a greater understanding of what happens in the body of a diabetic patient. One scientific challenge is to explain how a cell/organ at the same time can be insulin resistant in one biological function and insulin sensitive in another. Drs Barbara Leibiger and Ingo Leibiger, both members of Professor Per-Olof Berggren’s research group at the Department of Molecular Medicine and Surgery, Karolinska Institutet, are particularly interested in the insulin-producing beta cells. “The beta cell must have insulin to work properly”, says Barbara Leibiger, PhD, Associate Professor, and lead author of the current study. “In a person with diabetes, the beta cells become insensitive to insulin.” The researchers have previously shown that the beta cell has two receptors with different biological functions, insulin receptor A and insulin receptor B. In the current study, they found that under diabetic conditions, even though insulin receptor B is insulin insensitive for one signalling pathway, insulin can under these conditions instead activate a different signalling pathway, leading to beta cell proliferation. The researchers also identified the factor, PI3K-C2α, that caused the switch from one signalling pathway to another. A proliferative state “The results are important since it explains how the beta cell can go from a differentiated state to a proliferative state”, says Ingo Leibiger, PhD, Associate Professor, who co-supervised the current study with Professor Berggren. “This means that the cells change from being glucose-responsive to instead increase in number.” According to the study authors, also including researchers from the Pohang University of Science and Technology, Republic of Korea, factors involved in the re-routing of the insulin signal represent tentative therapeutic targets in the treatment of diabetes. This research was supported by funds the Swedish Research Council, the Family Erling-Persson Foundation, the Novo Nordisk Foundation, the Stichting af Jochnick Foundation, the Swedish Diabetes Association, the Skandia Insurance Company Ltd., the Diabetes Research and Wellness Foundation, Berth von Kantzow’s Foundation, the Strategic Research Program in Diabetes at Karolinska Institutet, the European Research Council, and the Knut and Alice Wallenberg Foundation. View our press release about this study Publication PI3K-C2α Knockdown Results in Rerouting of Insulin Signaling and Pancreatic Beta Cell Proliferation Barbara Leibiger, Tilo Moede, Meike Paschen, Na-Oh Yunn, Jong Hoon Lim, Sung Ho Ryu, Teresa Pereira, Per-Olof Berggren, and Ingo B. Leibiger Cell Reports, October 06, 2015 paper issue, online first September 17, 2015

The Grand Silver Medal 2015 from Karolinska Institutet is awarded to Gunnel Biberfeld, Britta Wahren and SGO Johansson in special recognition of the outstanding contributions they have made to medical research and Karolinska Institutet. The medals will be presented at the installation ceremony on 15 October 2015. The medal committee's citations for Karolinska Institutet's Grand Silver Medals in 2015 are as follows: Gunnel Biberfeld, professor emerita of infectious disease control, especially clinical immunology, is awarded the Grand Silver Medal for her outstanding contribution to research and doctoral education in the area of HIV at Karolinska Institutet. She is one of the pioneers in HIV research, at KI and globally. At a very early stage, she realised the urgent need for research on HIV, and since the beginning of the HIV pandemic she has remained active in this area of research. She has fostered a generation of young HIV researchers at Karolinska Institutet, of which many are now leaders in the field. Gunnel Biberfeld's research into HIV focuses on a global perspective, especially considering her clinical vaccine studies in Tanzania. The research collaboration with Tanzania also includes a comprehensive doctoral program. In addition, Gunnel Biberfeld's studies on the prevention of HIV transmission from mother to child in Dar es Salaam, shows the importance of using antiretroviral therapy during both pregnancy and the postnatal period. The results of these studies have formed the basis for Tanzania's national guidelines for the prevention of HIV transmission from mother to child, and they have also contributed to WHO's recommendations in the area. Britta Wahren, professor emerita of clinical virology, is awarded the Grand Silver Medal for her outstanding contribution to research and doctoral education in the area of HIV and cancer research at Karolinska Institutet. Britta Wahren is one of the pioneers in HIV research and particularly in designing HIV vaccines, at KI and globally. At a very early stage, she realised the urgent need for research on immune responses and protection against HIV. She has fostered a generation of young researchers at Karolinska Institutet, of which many are now leaders in the field. Britta Wahren was the first person in the world to show that a genetic vaccine that expresses early genes/antigens of HIV could induce new cell mediated responses to HIV in already infected individuals. These finding were taken forward to perform experimental and clinical HIV vaccine studies against the many types of HIV that prevail in the world. She designed novel genetic HIV vaccines that induce cell-mediated and humoral immunity of prolonged nature in healthy individuals. Together with the National Institutes of Health and the US Army, a new prime-boost vaccine schedule has been proposed for prophylactic vaccination against HIV. Britta Wahren´s focus has been on translational research, from molecular studies of HIV, tumour viral immunogens and immune responses to the development of novel vaccine prototypes to HIV. S Gunnar O Johansson, professor emeritus of clinical immunology, especially allergology, is awarded the Grand Silver Medal for his outstanding contribution to the area of allergy research. He identified, in 1967, together with Hans Bennisch, a new class of immunoglobulins, IgE, and showed that these are associated with allergic responses. He has established and grown the research area of allergy at Karolinska Institutet, and his successful research has contributed to making Karolinska Institutet into a world leader in the area. SGO Johansson’s groundbreaking discovery of IgE and the development of allergy tests have improved the health and quality of life for a large proportion of the worldwide population. Previous winners

A new Swedish study suggests that when considering overall costs of healthcare, obese patients with type 2 diabetes should be prioritised for obesity surgery over those who do not suffer from this disease. Many patients see a reversal of diabetes after surgery, and therefor do not need expensive diabetes medications or treatment for future complications.  The findings are being published in the journal The Lancet Diabetes & Endocrinology. The research is based on the Swedish Obese Subjects (SOS) study from Sahlgrenska Academy in Gothenburg and performed in collaboration with Dr Martin Neovius, Karolinska Institutet, Dr Lena Carlsson, Chief SOS Investigator, University of Gothenburg, and Dr Catherine Keating, Deakin University and Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Currently most healthcare systems prioritise access to obesity surgery based on a person’s body-mass index (BMI), and in general, those with the highest BMI are prioritised. Patients with lower BMIs and comorbidities such as type 2 diabetes can also be considered eligible for surgery, but different countries have different guidelines. Several groups have recommended that a person’s diabetes status (rather than BMI alone), be used to prioritise obese patients to receive bariatric surgery. But so far, the long-term effect of bariatric surgery (relative to conventional therapy) on healthcare costs in obese patients according to their diabetes status has not been assessed using real-world data. Accumulated drug costs The data used from the SOS study included 2010 adults who underwent obesity surgery and 2037 matched controls recruited between 1987 and 2001. The analysis showed that accumulated drug costs over 15 years did not differ between the surgery and control group in patients without diabetes at the time of surgery, but were lower in surgery patients who had prediabetes (on average, -US$3329 per patient) or diabetes (-$5487 per patient). However, hospital costs were higher in all patients who had surgery.  No differences in outpatient costs were observed.  Compared with patients treated conventionally, total healthcare costs (accounting for costs of surgery, inpatient and outpatient hospital care and prescription drugs) were higher in surgery patients who did not have diabetes at the beginning of the study (by $22,390 per patient) or who had prediabetes ($26,292), but not in patients with diabetes, most likely because the remission of diabetes that often occurs after bariatric surgery means that patients need fewer diabetes medications and hospital appointments in the subsequent years. Remission of diabetes also means that diabetes complications are lessened, further reducing future healthcare costs. The study was funded by AFA Försäkring, the Swedish Research Council, and Diabetesfonden, amongst others. This news article is an edited version of a press release from The Lancet Diabetes & Endocrinology. Publication Health-care costs over 15 years after bariatric surgery for patients with different baselina glucose statuses: results from the Swedish Obese Subjects study Catherine Keating, Martin Neovius, Kajsa Sjöholm, Markku Peltonen, Kristina Narbro, Jonas K. Eriksson, Lars Sjöström, Lena M.S. Carlsson Lancet Diabetes & Endocrinology online 17 September 2015, http://dx.doi.org/10.1016/ S2213-8587(15)00290-9. 

The use of antidepressant SSRIs is modestly associated with violent crime in adolescents and young adults, according to a new study published in the journal PLOS Medicine. The cohort study by researchers from Karolinska Institutet and the University of Oxford showed in subgroup analysis that this association was evident in participants aged 15-24, but not significant for individuals aged 25 and older. Selective serotonin reuptake inhibitors (SSRI) are widely prescribed, and effectively used to treat for example depression and anxiety syndrome. Inconclusive evidence, however, links SSRI use with violent behaviour. In the current study, Dr Seena Fazel of Oxford University and colleagues compared the rate of violent crime while individuals were prescribed SSRIs with the rate of violent crime in the same individuals while not receiving medication, using matched data from the Swedish Prescribed Drug Register and the Swedish national crime register. During the 4-year study period (2006-2009), about 850,000 individuals were prescribed SSRIs, and 1% of these individuals were convicted of a violent crime. In age-stratified analysis, associations between SSRI use and convictions for violent crimes were significant for individuals aged 15 to 24 years but not for older individuals. Increased risks were also found in individuals aged 15-24 years for violent arrests, non-violent convictions and arrests, non-fatal accidental injuries and emergency contacts for alcohol-related problems. Do not prove causation According to the study-authors, these findings do not prove causation, as possible time-varying confounding by one or more unidentified factors linked to both SSRI use and violent crime may explain the results. Any change to the advice given to young persons prescribed with SSRIs will need to be carefully considered, and should not be based on one study alone. Lead study-author was Dr Yasmina Molero Samuelson at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. The research has been funded with grants from the Wellcome Trust, Karolinska Institutet, and the Swedish Research Council. This news article is an edited version of a press release from PLOS Medicine. Publication Selective Serotonin Reuptake Inhibitors and Violent Crime: A Cohort Study Yasmina Molero, Paul Lichtenstein, Johan Zetterqvist, Clara Hellner Gumpert, Seena Fazel PLoS Med 12(9): e1001875, online 15 September 2015, doi:10.1371/journal.pmed.1001875

KI is number nine in the world in the Faculty Ranking Life Sciences and Medicine in the 2015 QS World University Rankings. Each year, QS presents an universal university ranking, as well as so called faculty rankings in different areas. The universal ranking only includes multi-faculty universities and KI is thus not featured in the universal ranking. In the Faculty Ranking Life Sciences and Medicine, KI is ranked number nine in the world and number three in Europe. Last year, KI was number eight in the world. The highest ranked university on the "Sciences and Medicine" list is Harvard University. The universal ranking list is topped by the same university as last year, MIT. Sweden is represented in the top100 by KTH and Lund University. Six months after the universal ranking, QS publishes area-specific rankings. In the area-specific rankings that were announced in March 2015 KI is ranked nine in "Medicine" and six in "Pharmacy&Pharmacology". KI tops the recently introduced ranking list in "Dentistry", in which Gothenburg University and Malmö University also ranked high. The QS rankings have been criticised for statistical uncertainty due to small subject areas, and lack of use of field-normalised bibliometry indicators. Starting with the 2015 ranking, QS uses field-normalised bibliometry data.  Read more at topuniversities.com.

The government decided today to appoint Professor Kerstin Tham, pro-vice-chancellor at KI, as vice-chancellor of Malmö University commencing 1 November 2015. Kerstin Tham has been professor of occupational therapy at the Department of Neurobiology, Care Science and Society since 2009 and the pro-vice-chancellor of Karolinska Institutet Since January 2013. Last May, the nomination committee at Malmö University decided to present Kerstin Tham as the only candidate for the post. She had also been selected for recommendation by the consultative assembly and union representatives out of the three shortlisted names. This means that Professor Tham will be vacating the office of pro-vice-chancellor at KI after over two and a half years, and that a replacement must now be found. The post of vice-chancellor at Malmö will last until 31 July 2021. Her predecessor at Malmö University, Stefan Bengtsson, left on August to become president and CEO of Chalmers in Gothenburg. For more on the recruitment of the new pro-vice-chancellor, see internwebben.ki.se.

A low resting heart rate in late adolescence is associated with increased risk for violent criminality in men later in life, according to a new study by researchers at Karolinska Institutet and University of Helsinki, Finland. The findings are being published online in the journal JAMA Psychiatry. Low resting heart rate (RHR) has been viewed either as an indicator of a chronically low level of psychological arousal, which may lead some people to seek stimulating experiences, or as a marker of weakened responses to aversive and stressful stimuli, which can lead to fearless behaviour and risk taking. However, not much is known about RHR as a predictor of severe violence. A better understanding of individual-level biological risk factors in the cause of violence could help prevention and intervention efforts. In the current study, the research team examined the association of RHR in late adolescence to predict violent criminality later in life using data on 710,264 Swedish men born from 1958 to 1991 with up to 35.7 years of follow-up. RHR and blood pressure were measured at mandatory military conscription testing when the men were an average age of 18 years old. There were 40,093 men convicted of a violent crime during nearly 12.9 million person-years of follow-up. Beats per minute The researchers found that compared with 139,511 men with the highest RHR (greater than or equal to 83 beats per minute), the 132, 595 men with the lowest RHR (less than or equal to 60 beats per minute) had a 39 percent higher chance of being convicted of violent crimes and a 25 percent higher chance of being convicted of nonviolent crimes when the analysis models accounted for an assortment of variables. The study was supervised by Drs Paul Lichtenstein and Henrik Larsson at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and funded with grants from the Swedish Research Council for Health, Working Life and Welfare, the Swedish Research Council, the Academy of Finland, the Alfred Kordelin Foundation, and the European Union Seventh Framework Programme. This news article is and edited version of a press release from JAMA Network. Publication A Longitudinal Study of Resting Heart Rate and Violent Criminality in More Than 700 000 Men Antti Latvala,  Ralf Kuja-Halkola,  Catarina Almqvist,  Henrik Larsson, Paul Lichtenstein,  JAMA Psychiatry, published online September 09, 2015. doi:10.1001/jamapsychiatry.2015.1165

Continued smoking after a diagnosis of multiple sclerosis (MS) appears to be associated with accelerated disease progression compared with those patients who quit smoking, according to a new study by researchers from Karolinska Institutet. The findings are being published online in JAMA Neurology. “There are of course a number of health risks connected to smoking, but for people diagnosed with a such a severe disease as MS, it is especially important to quit smoking immediately”, says study leader Jan Hillert, MD, PhD, Professor of Neurology at Karolinska Institutet’s Department of Clinical Neuroscience. MS is a neurogenerative disease and smoking is one of its known risk factors. While MS begins with an initial course of irregular and worsening relapses, it usually changes after about 20 years into secondary progressive (SP) disease. The time that passes from onset to conversion to SPMS is a frequently used measure of disease progression. The current study included 728 patients in Sweden with MS who smoked at diagnosis, of whom 216 converted to SP. Among the smokers, 332 were classified as 'continuers' who smoked continuously from the year after diagnosis, and 118 were 'quitters' who stopped smoking the year after diagnosis. Data on 1,012 never smokers also were included. Nearly 60 percent of patients with MS were smokers in the present study cohort and in a Swedish cohort of new cases, according to study background. Each additional year Analysis by the authors suggests each additional year of smoking after diagnosis accelerated the time to SP conversion by 4.7 percent. Other analysis suggested that those patients who continued to smoke each year after diagnosis converted to SP faster (at age 48) than those who quit (at age 56). Funding this study was provided by Neuroförbundet, the Swedish Research Council, the Knut and Alice Wallenberg Foundation, the AFA foundation, the Swedish Brain Foundation, Margareta af Ugglas Stiftelse, EU FP7 Neurinox, the Bibby and Nils Jensen Foundation, and the Karolinska Institutet Research fund. This news article is an edited version of a press release from JAMA Network. Publication Effect of Smoking Cessation on Multiple Sclerosis Prognosis Ryan Ramanujam, Anna-Karin Hedström, Ali Manouchehrinia, Lars Alfredsson, Tomas Olsson, Matteo Bottai, Jan Hillert JAMA Neurology, doi:10.1001/jamaneurol.2015.1788, online September 8, 2015

The Sven and Ebba-Christina Hagberg prize in medicine 2014 is awarded to Emma Andersson, Senior researcher at the Department of Biosciences and Robert Månsson, Assistant professor at the Department of Laboratory Medicine. Emma Andersson is awarded the prize for her work concerning how the Wnt and Notch signalling pathways control differentiation and morphogenesis during embryonic development. It is important to gain an understanding of these signalling pathways, since a range of diseases can arise when they do not function properly during development. Dr Andersson is doing important research into Alagille syndrome, a genetic disorder that arises in early childhood and affects the liver, heart and kidney.  Robert Månsson is awarded the prize for his work concerning early haematopoiesis and three-dimensional genomic architecture, and the relationship between this higher order genomic organization of genes and transcriptional regulation. He is particularly interested in genes that are involved in the development of blood cells. The overall aim of his work is to gain a greater understanding of normal blood cell development why some genetic mutations cause blood cancers. About the prize: The Sven and Ebba-Christina Hagberg Prize awards a personal prize and research funding to especially outstanding junior researchers at Karolinska Institutet. This year, the prizewinners will be awarded SEK 150,000 each as well as research funding to the sum of SEK 175,000 each. The prize will be awarded at Karolinska Institutet’s Installation Ceremony on 15 October 2015.

A new molecular test, which can indicate the unique rate at which a person is ageing, could transform the way ageing is approached in medical research by assessing a person’s ‘biological age’ rather than the number of years one has lived. The findings, published the journal Genome Biology, could help manage age-related disease by identifying people most at risk of diseases affected by age, as well as improve the way anti-ageing treatments are evaluated. The seven-year collaborative study at King’s College London, Karolinska Institutet and Uppsala University in Sweden, and Duke University in the USA, used a process called RNA-profiling to measure and compare gene expression in thousands of human tissue samples. Rather than look for genes associated with disease or extreme longevity, the researchers discovered that the ‘activation’ of 150 genes in the blood, brain and muscle tissue were a hallmark of good health at 65 years of age. After discovering that it was the levels of the exact same genes that were regulated in very different types of tissue, the researchers were able to create a formula for ‘healthy ageing’, and use this test to tell how well a person is ageing when compared to others born the same year. The extensive range in ‘biological age’ scores of people born at the same time indicates that a person’s biological age is separate and distinct to his/her chronological age. Lower cognitive status Importantly, a low score was found to reflect lower cognitive status, with low levels of gene expression measured in the blood also reflecting regulation of the same genes in brain regions involved with neurodegeneration. These findings imply that the molecular test could translate into a simple blood test to predict those most at risk of Alzheimer’s disease and suitable for taking part in prevention trials. The Swedish part of this study was supervised by Dr Thomas Gustafsson, MD, PhD, Associate Professor at the Department of Laboratory Medicine, Karolinska Institutet. The project was funded by the Swedish Research Council, the Wallenberg Foundation, Sweden, the Medical Research Council (MRC), UK, National Institutes of Health (NIH), US, and the Innovative Medicines Initiative (IMI), a joint undertaking between the European Union and the pharmaceutical industry association EFPIA. This news article is an abbreviation of a press release from MRC.   Publication A novel multi-tissue RNA diagnostic of healthy ageing relates to cognitive health status Sanjana Sood, Iain J Gallagher, Katie Lunnon, Eric Rullman, Aoife Keohane, Hannah Crossland, Bethan E Phillips, Tommy Cederholm, Thomas Jensen, Luc JC van Loon, Lars Lannfelt, William E Kraus, Philip J Atherton, Robert Howard, Thomas Gustafsson, Angela Hodges and James A Timmons Genome Biology 2015, 16:185, online 7 September 2015,  doi:10.1186/s13059-015-0750-x

Mosquito mesh can prevent malaria, but also be used to reduce the suffering of millions of poor people in other ways. Through a collaboration of researchers at Umeå University, Karolinska Institutet and Makerere University in Uganda, it has been shown that mosquito mesh can be used safely in groin hernia surgery. The findings are being presented in a new doctoral thesis. “Mosquito mesh with the purpose of catching mosquitoes can now be used to prevent the intestines from falling through the hole in the abdominal wall”, says Jenny Löfgren, a doctoral student at the Department of Surgical and Perioperative Sciences, Umeå University, and author of the thesis. “This progress means that even the poor can benefit from the network-based surgical technique used in high-income countries.” Over 200 million people suffer from groin hernia worldwide. Without surgery, groin hernias can cause much suffering and about 40 000 people die from this condition every year. Groin hernia repair is among the most commonly performed surgical procedures on the planet. Around 20 million hernia repairs are performed every year – but over 180 million are not operated. The majority of those who do not benefit from surgery are poor and live in Low and Middle Income Countries. In Uganda, for instance, over six per cent of adult men have a groin hernia but less than one in a hundred groin hernia patients are operated per year. Instead of the expensive mesh In western countries, hernias are mostly repaired using a synthetic commercial mesh. Mesh repairs have proven unequalled compared to previous surgical methods, but the mesh costs 100 US Dollars or more. Such an expense is insurmountable to the world’s poor. According to Jenny Löfgren, this is where the mosquito mesh has its potential, as it can be used instead of the expensive mesh. Mosquito mesh is already used in groin hernia surgery in some places but the safety and effectiveness of this practice has hardly been evaluated. The current research project compared expensive commercial mesh with mosquito mesh. Almost all the 300 patients were followed for one year and there were no differences in terms of complications, hernia recurrence or patient satisfaction. “Therefore, our study provides solid evidence that the mosquito mesh can be safely used for the treatment of groin hernia”, says Jenny Löfgren. “Now, a superior surgical method can also be provided for poor patients at a fraction of the cost of the expensive mesh. These findings may benefit the many millions of groin hernia patients living in Low and Middle Income Countries.”   This doctoral thesis will be presented at Umeå university on September 17th, 2015. Supervisor has been Dr Andreas Wladis, MD, PhD, at the Department of Clinical Science and Education, Södersjukhuset at Karolinska Institutet. Learn more in a press release from Umeå University More about Karolinska Institutet's collaborations in Uganda Doctoral thesis Groin hernias and unmet need for surgery in Uganda - epidemiology, mosquito nets and cost effectiveness Jenny Löfgren, Umeå University 2015, ISBN: 978-91-7601-316-8

Professor Endre Alexander Balazs, physician, scientist, innovator and entrepreneur, died August 29 in France, aged 95. Earlier this year, professor Balazs and his wife, Dr Janet L. Denlinger, donated 4 million dollars for the establishment of a Professorship in Innovation and Entrepreneurship at Karolinska Institutet. The couple visited Karolinska Institutet in May to attend the ceremony at which the deed of gift was signed. Professor Balazs, called “Bandi”, dedicated his life to research on the structure and biological activity of the polysaccharide hyaluronan. In the 1940s, he successfully extracted the substance in large volumes from cockscombs. He was the founder of companies that contributed to the development of the therapeutic application of hyaluronan in cataract operations, which as of today have improved the eyesight of hundreds of millions of patients. Hyaluronan is also used in the treatment of osteoarthritis and facial wrinkles. The Endre A. Balazs Professorship in Innovation and Entrepreneurship made possible by the donation will contribute to the development and commercialisation of research discoveries for the benefit of society. Read more about the donation on KI News, May 13, 2015: “Karolinska Institutet creates a new professorship in innovation and entrepreneurship“