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Article ; Online: Appearance of hexahydrocannabinols as recreational drugs and implications for cannabis drug testing - focus on HHC, HHC-P, HHC-O and HHC-H.

Helander, Anders / Johansson, Malin / Villén, Tomas / Andersson, Annika

Scandinavian journal of clinical and laboratory investigation

2024 Volume 84, Issue 2, Page(s) 125–132

Abstract: This study investigated the effects of hexahydrocannabinol (HHC) and other unclassified cannabinoids, which were recently introduced to the recreational drug market, on cannabis drug testing in urine and oral fluid samples. After the appearance of HHC in ...

Abstract	This study investigated the effects of hexahydrocannabinol (HHC) and other unclassified cannabinoids, which were recently introduced to the recreational drug market, on cannabis drug testing in urine and oral fluid samples. After the appearance of HHC in Sweden in 2022, the number of posts about HHC on an online drug discussion forum increased significantly in the spring of 2023, indicating increased interest and use. In parallel, the frequency of false positive screening tests for tetrahydrocannabinol (THC) in oral fluid, and for its carboxy metabolite (THC-COOH) in urine, rose from <2% to >10%. This suggested that HHC cross-reacted with the antibodies in the immunoassay screening, which was confirmed in spiking experiments with HHC, HHC-COOH, HHC acetate (HHC-O), hexahydrocannabihexol (HHC-H), hexahydrocannabiphorol (HHC-P), and THC-P. When HHC and HHC-P were classified as narcotics in Sweden on 11 July 2023, they disappeared from the online and street shops market and were replaced by other unregulated variants (e.g. HHC-O and THC-P). In urine samples submitted for routine cannabis drug testing, HHC-COOH concentrations up to 205 (mean 60, median 27) µg/L were observed. To conclude, cannabis drug testing cannot rely on results from immunoassay screening, as it cannot distinguish between different tetra- and hexahydrocannabinols, some being classified but others unregulated. The current trend for increased use of unregulated cannabinols will likely increase the proportion of positive cannabis screening results that need to be confirmed with mass spectrometric methods. However, the observed cross-reactivity also means a way to pick up use of new cannabinoids that otherwise risk going undetected.
MeSH term(s)	Humans ; Substance Abuse Detection/methods ; Illicit Drugs/urine ; Illicit Drugs/analysis ; Sweden ; Dronabinol/urine ; Dronabinol/analysis ; Dronabinol/analogs & derivatives ; Cannabis/chemistry ; Saliva/chemistry ; Cannabinoids/urine ; Cannabinoids/analysis ; Cannabinol/analysis ; Cannabinol/urine ; Cross Reactions ; Immunoassay/methods
Chemical Substances	Illicit Drugs ; Dronabinol (7J8897W37S) ; Cannabinoids ; Cannabinol (7UYP6MC9GH)
Language	English
Publishing date	2024-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	3150-1
ISSN	1502-7686 ; 0036-5513
ISSN (online)	1502-7686
ISSN	0036-5513
DOI	10.1080/00365513.2024.2340039
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Article ; Online: Goblet cells need some stress.

Johansson, Malin Ev / Hansson, Gunnar C

The Journal of clinical investigation

2022 Volume 132, Issue 17

Abstract: The intestinal tract is protected by epithelium-covering mucus, which is constantly renewed by goblet cells, a specialized type of epithelial cell. Mucus is largely composed of MUC2 mucin, an enormous molecule that poses a high demand on the endoplasmic ... ...

Abstract	The intestinal tract is protected by epithelium-covering mucus, which is constantly renewed by goblet cells, a specialized type of epithelial cell. Mucus is largely composed of MUC2 mucin, an enormous molecule that poses a high demand on the endoplasmic reticulum (ER) for proper folding and protein assembly, creating a challenge for the secretory machinery in goblet cells. In this issue of the JCI, Grey et al. reveal that the ER resident protein and folding sensor ERN2 (also known as IRE1β) was instrumental for goblet cells to produce sufficient amounts of mucus to form a protective mucus layer. In the absence of ERN2, mucus production was reduced, impairing the mucus barrier, which allowed bacteria to penetrate and cause an epithelial cell stress response. This study emphasizes the importance of a controlled unfolded protein response (UPR) for goblet cell secretion.
MeSH term(s)	Epithelial Cells/metabolism ; Goblet Cells/metabolism ; Intestinal Mucosa/metabolism ; Mucin-2/metabolism ; Mucins/metabolism ; Mucus/metabolism
Chemical Substances	Mucin-2 ; Mucins
Language	English
Publishing date	2022-09-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	3067-3
ISSN	1558-8238 ; 0021-9738
ISSN (online)	1558-8238
ISSN	0021-9738
DOI	10.1172/JCI162030
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Article ; Online: The need for flexibility in forest harvesting services – a case study on contractors’ workflow variations

Johansson, Malin / Erlandsson, Emanuel / Kronholm, Thomas / Lindroos, Ola

International Journal of Forest Engineering. 2023 Jan. 02, v. 34, no. 1 p.13-25

2023

Abstract: In many parts of the world, contractors account for the main share of harvesting work. Harvesting is characterized by innate complexity and volatility, and this can affect contractors’ workflow and ultimately their profitability. Thus, there is certainly ...

Abstract	In many parts of the world, contractors account for the main share of harvesting work. Harvesting is characterized by innate complexity and volatility, and this can affect contractors’ workflow and ultimately their profitability. Thus, there is certainly a need for flexibility in harvesting service provision and procedures, but our current knowledge about contractors’ workflow variations are limited. This study investigates workflow variations in harvesting services by comparing monthly variations between contractors’ workload in terms of harvested volumes and the time spent on operations. The data originates from 77 machines belonging to contractors and their harvesting of 6.6 million m³ of roundwood in Sweden during a two-year period. The results indicate differences between contractors’ workflow variations which can be attributed to the number of machines, machine sizes, and the workload in harvested volume and hours. These findings are relevant for guiding both the customer and contractor in this business relationship, and they could also serve as a basis for further research on the need for flexibility to effectively increase and decrease volume production in harvesting services.
Keywords	case studies ; forests ; profitability ; roundwood ; Sweden ; Contractor ; business relationship ; supply chain ; harvester ; forwarder
Language	English
Dates of publication	2023-0102
Size	p. 13-25.
Publishing place	Taylor & Francis
Document type	Article ; Online
ISSN	1913-2220
DOI	10.1080/14942119.2022.2071142
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Article ; Online: Interventions for return to work following work-related injuries among young adults: A systematic literature review.

Johansson, Malin K / Rissanen, Ritva

Work (Reading, Mass.)

2021 Volume 69, Issue 3, Page(s) 795–806

Abstract: Objective: To provide a review of current knowledge about interventions aimed to facilitate young adults to return to work following work-related injuries.: Methods: A systematic review of published literature from the year 2010 and onwards was ... ...

Abstract	Objective: To provide a review of current knowledge about interventions aimed to facilitate young adults to return to work following work-related injuries. Methods: A systematic review of published literature from the year 2010 and onwards was conducted to identify studies examining return to work interventions for young adults (aged 19-29) following work-related injuries using PubMed and Web of Science. Two reviewers conducted the screening process and assessed the study quality using the National Heart, Lung, and Blood Institute assessment tool for Observational Cohort and Cross-Sectional studies. Due to wide heterogeneity and small number of studies retained post-screening, a descriptive summary analysis of the included studies was conducted. Results: No studies were identified that focused exclusively on interventions for young adults. However, two studies, in which an age category of young adults was available, were included and assessed for quality. The study populations were primarily suffering from work-related injuries in the lower back or lower limbs. Both studies revealed that return to work interventions using a case manager coordinating and providing consultation, advice, and risk management to multidisciplinary teams was associated with lower sick leave days. Conclusions: Despite the emerging evidence that young adults have higher rates of work-related injuries compared to older colleagues, information concerning work-related injuries and return to work interventions specifically targeting young workers is still lacking. Further research is therefore needed to develop and evaluate return to work interventions for the population of young adults.
Language	English
Publishing date	2021-06-25
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1394194-x
ISSN	1875-9270 ; 1051-9815
ISSN (online)	1875-9270
ISSN	1051-9815
DOI	10.3233/WOR-205028
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Article ; Online: Surgical treatment of velopharyngeal dysfunction: Incidence and associated factors in the Swedish cleft palate population.

Schaar Johansson, Malin / Becker, Magnus / Eriksson, Marie / Stiernman, Mia / Klintö, Kristina

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2024 Volume 90, Page(s) 240–248

Abstract: Introduction: Speech in children with cleft palate can be affected by velopharyngeal dysfunction, which persists after primary palate repair. The incidence of surgery to correct velopharyngeal dysfunction in this patient group has previously been ... ...

Abstract	Introduction: Speech in children with cleft palate can be affected by velopharyngeal dysfunction, which persists after primary palate repair. The incidence of surgery to correct velopharyngeal dysfunction in this patient group has previously been reported as 2.6-37%. We aimed to investigate the incidence of velopharyngeal dysfunction surgery in Swedish children with cleft palate and to examine potential associations of independent variables with this incidence. Methods: In this cohort study, we analysed data from the Swedish cleft lip and palate quality registry for 1093 children with cleft palate with or without cleft lip. Kaplan-Meier analysis was used to estimate the risk of having velopharyngeal dysfunction surgery. Multivariable Cox proportional hazards models were used to estimate the associated effect of cleft subtype, additional diagnoses, gender, and age at and number of stages for primary palate repair on the primary outcome. Results: The risk of having velopharyngeal dysfunction surgery was 25.6%. Complete primary palate repair after the age of 18 months or in more than one stage was associated with a higher risk, but it could not be determined which of these was the more significant factor. Cleft soft palate was associated with a significantly lower risk than other cleft subtypes. Conclusions: Primary palate repair at a higher age or in more than one stage may increase the risk of having velopharyngeal dysfunction surgery. Further analysis of potential unknown confounding factors and the association between the incidence of velopharyngeal dysfunction and surgery to correct this condition is needed.
MeSH term(s)	Child ; Humans ; Infant ; Cleft Palate/complications ; Cleft Palate/surgery ; Cleft Lip/complications ; Cleft Lip/epidemiology ; Cleft Lip/surgery ; Cohort Studies ; Sweden/epidemiology ; Incidence ; Velopharyngeal Insufficiency/epidemiology ; Velopharyngeal Insufficiency/etiology ; Velopharyngeal Insufficiency/surgery ; Treatment Outcome ; Palate, Soft ; Speech
Language	English
Publishing date	2024-02-02
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2024.01.034
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Article ; Online: The role of goblet cells and mucus in intestinal homeostasis.

Gustafsson, Jenny K / Johansson, Malin E V

Nature reviews. Gastroenterology & hepatology

2022 Volume 19, Issue 12, Page(s) 785–803

Abstract: The intestinal tract faces numerous challenges that require several layers of defence. The tight epithelium forms a physical barrier that is further protected by a mucus layer, which provides various site-specific protective functions. Mucus is produced ... ...

Abstract	The intestinal tract faces numerous challenges that require several layers of defence. The tight epithelium forms a physical barrier that is further protected by a mucus layer, which provides various site-specific protective functions. Mucus is produced by goblet cells, and as a result of single-cell RNA sequencing identifying novel goblet cell subpopulations, our understanding of their various contributions to intestinal homeostasis has improved. Goblet cells not only produce mucus but also are intimately linked to the immune system. Mucus and goblet cell development is tightly regulated during early life and synchronized with microbial colonization. Dysregulation of the developing mucus systems and goblet cells has been associated with infectious and inflammatory conditions and predisposition to chronic disease later in life. Dysfunctional mucus and altered goblet cell profiles are associated with inflammatory conditions in which some mucus system impairments precede inflammation, indicating a role in pathogenesis. In this Review, we present an overview of the current understanding of the role of goblet cells and the mucus layer in maintaining intestinal health during steady-state and how alterations to these systems contribute to inflammatory and infectious disease.
MeSH term(s)	Humans ; Goblet Cells/pathology ; Goblet Cells/physiology ; Mucins/genetics ; Mucus ; Intestines ; Homeostasis ; Intestinal Mucosa/pathology
Chemical Substances	Mucins
Language	English
Publishing date	2022-09-12
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2493722-8
ISSN	1759-5053 ; 1759-5045
ISSN (online)	1759-5053
ISSN	1759-5045
DOI	10.1038/s41575-022-00675-x
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Article: Key drivers and obstacles for performance among forest harvesting service contractors – a qualitative case study from Sweden

Johansson, Malin / Erlandsson, Emanuel / Kronholm, Thomas / Lindroos, Ola

Scandinavian journal of forest research. 2021 Nov. 17, v. 36, no. 7-8

2021

Abstract: The extensive outsourcing of forest harvesting operations means that the operational performance of contractors has an immense impact on the forest industry supply chain. This study describes perceived drivers and obstacles for strong performance in ... ...

Abstract	The extensive outsourcing of forest harvesting operations means that the operational performance of contractors has an immense impact on the forest industry supply chain. This study describes perceived drivers and obstacles for strong performance in harvesting service based on semi-structured interviews with four production supervisors and eight contractors. The analysis of interview data revealed a wide array of factors considered to drive or hinder the performance. The factors were categorized into five types: Capability, Incentives, Commitment, Involvement and External factors. Factors concerning Capability, especially resources and competence, were most frequently considered by production supervisors as both drivers and hinders. The contractors considered most commonly Incentives to affect performance, especially motivation and strategy, as drivers and the economy as hinder. Both parties considered lack of resources as hinder to performance. For competence, relationship and collaboration interface, on the other hand, the two parties had different views on whether they acted as drivers or hinders. The knowledge presented in this paper is of interest to researchers or practitioners who wishes to understand the complexities underlying successful harvesting service performance. The insights can contribute to the reshaping of business practices to better target and leverage the mechanisms that most strongly affect performance.
Keywords	case studies ; forest industries ; forests ; motivation ; research ; supply chain ; Sweden
Language	English
Dates of publication	2021-1117
Size	p. 598-613.
Publishing place	Taylor & Francis
Document type	Article
ZDB-ID	2016344-7
ISSN	1651-1891 ; 0282-7581
ISSN (online)	1651-1891
ISSN	0282-7581
DOI	10.1080/02827581.2021.1981431
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Article ; Online: Return to work and sick leave patterns following a work injury among young adults: a study protocol of a Swedish multimodal study.

Johansson, Malin K / Hasselberg, Marie / Rissanen, Ritva

BMJ open

2021 Volume 11, Issue 6, Page(s) e045143

Abstract: Introduction: There is a lack of studies that focus exclusively on return to work (RTW) and sick leave patterns following a work injury among young adults. This study aims to close the gap by contributing with knowledge regarding young adults' sick ... ...

Abstract	Introduction: There is a lack of studies that focus exclusively on return to work (RTW) and sick leave patterns following a work injury among young adults. This study aims to close the gap by contributing with knowledge regarding young adults' sick leave pattern after a work injury and their experience of RTW after a work injury in Sweden. Methods and analysis: The present study is a multimodal study, which will use Swedish national register data and qualitative data collection by photovoice. Injuries classified as work injuries according to the Swedish injury classification were included. Registry data will be retrieved from the Swedish National-based registers of Swedish Information System on Occupational Accidents and Work-related diseases, the Swedish Social Insurance Agency's database MicroData for Analysis of Social Insurance and the Swedish Longitudinal Integration Database for Health Insurance and Labour Market Studies. Persons who have registered a work injury at the Swedish Work Environment Authority in 2012 will be included. Sick leave patterns will be analysed using group-based trajectory models and multivariate analyses to explore how sick leave patterns have developed over 5 years. Subsequently, a participatory approach using photovoice method will be conducted to explore young adults' perceptions of barriers and facilitators in RTW after a work injury. Results from the photovoice group sessions will be analysed using a grounded theoretical approach. Ethics and dissemination: The study has been reviewed and approved by the Ethical Review Board (case number 2019/028-6) in Sweden. Results of the study will be disseminated through peer-reviewed journals, print and media presentation, conferences and via reports to the funding agency.
MeSH term(s)	Humans ; Return to Work ; Sick Leave ; Social Security ; Sweden/epidemiology ; Workplace ; Young Adult
Language	English
Publishing date	2021-06-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2020-045143
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Article ; Online: An Analysis of Acceleration, Deceleration and High-Intensity Skating during Elite Bandy Match-Play: A Case Study.

Johansson, Malin / Ervasti, Per-Erik / Blomqvist, Sven

Sports (Basel, Switzerland)

2021 Volume 9, Issue 11

Abstract: Profiles of physical workload in sports are useful to optimize performance and reduce the risk of injury. The aim of the study was to investigate physical workload in 10 elite bandy players by describing acceleration, deceleration, and high-intensity ... ...

Abstract	Profiles of physical workload in sports are useful to optimize performance and reduce the risk of injury. The aim of the study was to investigate physical workload in 10 elite bandy players by describing acceleration, deceleration, and high-intensity skating during bandy match-play. During 13 home matches, 10 male elite bandy players wore a GPS unit to measure changes in the total distance, total distance skating in two speed zones, and total distance of acceleration and deceleration. A within-subject design was used to measure changes over time during match-play by comparing first and second halves as well as comparisons for consecutive 15 min intervals. No significant differences were observed for high-intensity or very high-intensity acceleration and deceleration for comparisons by halves or for 15-min intervals. For comparisons by halves, a significant time-dependent effect was observed on very fast skating (1337.6 m vs. 1160.9 m), sprint skating (300.0 m vs. 272.0 m), low-intensity acceleration (342.7 m vs. 333.0 m), and total distance covered (10,916.9 m vs. 10,450.3 m). These variables, along with low-intensity deceleration, were also significant for the 15 min interval comparisons. The results show that there is no time-dependent reduction in high-intensity acceleration and deceleration in elite bandy match-play. However, elite bandy players do not maintain the distance of high-intensity skating throughout a whole match.
Language	English
Publishing date	2021-11-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2704239-X
ISSN	2075-4663 ; 2075-4663
ISSN (online)	2075-4663
ISSN	2075-4663
DOI	10.3390/sports9110152
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Article ; Online: Analytical and medico-legal problems linked to the presence of delta-8-tetrahydrocannabinol (delta-8-THC): Results from urine drug testing in Sweden.

Helander, Anders / Johansson, Malin / Andersson, Annika / Villén, Tomas

Drug testing and analysis

2021 Volume 14, Issue 2, Page(s) 371–376

Abstract: During routine urine drug testing for cannabis use targeting delta-9-tetrahydrocannabinol carboxylic acid (delta-9-THC-COOH) at the Karolinska University Laboratory in Sweden, an unknown interfering peak was observed in the liquid-chromatographic-tandem ... ...

Abstract	During routine urine drug testing for cannabis use targeting delta-9-tetrahydrocannabinol carboxylic acid (delta-9-THC-COOH) at the Karolinska University Laboratory in Sweden, an unknown interfering peak was observed in the liquid-chromatographic-tandem mass-spectrometric (LC-MS/MS) confirmative analysis. The peak showed the same exact mass and most abundant fragments as delta-9-THC-COOH but a slightly shorter retention time, thereby not fulfilling all requirements for a positive identification. The analytical results suggested that it was a similar compound, and with access to reference material, it could be identified as the double bond isomer delta-8-THC-COOH. Delta-8-THC has recently become popular as a recreational drug, although its legality varies and is sometimes unclear. In Sweden, all THC isomers are classified substances. The slight difference in retention times was sufficient to distinguish the THC-COOH isomers in the routine LC-MS/MS method, but another LC method allowed better peak separation and individual quantification. At the Karolinska University Laboratory, delta-8-THC-COOH was first observed in April 2020, and the highest incidence was noted in June 2020 when it was present in 5.3% of all THC-COOH-positive samples. The incidence later decreased to today only occasional findings. Large differences in the relative presence of the isomers in the urine samples indicated different origin, for example, synthetically produced pure delta-8-THC, or mixtures of both THC isomers formed during combustion of cannabidiol (CBD). In conclusion, the appearance of delta-8-THC and other isomers on the recreational drug market risks causing analytical and medico-legal problems, due to confusion with delta-9-THC.
MeSH term(s)	Chromatography, Liquid/methods ; Dronabinol/analogs & derivatives ; Dronabinol/analysis ; Humans ; Sweden ; Tandem Mass Spectrometry/methods
Chemical Substances	delta-8-tetrahydrocannabinol (5957-75-5) ; Dronabinol (7J8897W37S)
Language	English
Publishing date	2021-11-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2462336-2
ISSN	1942-7611 ; 1942-7603
ISSN (online)	1942-7611
ISSN	1942-7603
DOI	10.1002/dta.3190
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