| 1011. |
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| 1012. |
- Mahindra, Anuj, et al.
(författare)
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New Cancers after Autotransplantations for Multiple Myeloma
- 2015
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Ingår i: Biology of blood and marrow transplantation. - : Elsevier BV. - 1083-8791 .- 1523-6536. ; 21:4, s. 738-745
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Tidskriftsartikel (refereegranskat)abstract
- We describe baseline incidence and risk factors for new cancers in 4161 persons receiving autotransplants for multiple myeloma in the United States from 1990 to 2010. Observed incidence of invasive new cancers was compared with expected incidence relative to the US population. The cohort represented 13,387 person-years at-risk. In total, 163 new cancers were observed, for a crude incidence rate of 1.2 new cancers per 100 person-years and cumulative incidences of 2.6% (95% confidence interval [CI], 2.09 to 3.17), 4.2% (95% CI, 3.49 to 5.00), and 6.1% (95% CI, 5.08 to 7.24) at 3, 5, and 7 years, respectively. The incidence of new cancers in the autotransplantation cohort was similar to age-, race-, and gender-adjusted comparison subjects with an observed/expected (O/E) ratio of 1.00 (99% CI, .81 to 1.22). However, acute myeloid leukemia and melanoma were observed at higher than expected rates with O/E ratios of 5.19 (99% CI, 1.67 to 12.04; P = .0004), and 3.58 (99% CI, 1.82 to 6.29; P < .0001), respectively. Obesity, older age, and male gender were associated with increased risks of new cancers in multivariate analyses. This large data set provides a baseline for comparison and defines the histologic type specific risk for new cancers in patients with MM receiving postautotransplantation therapies, such as maintenance.
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| 1013. |
- Mak, Jonathan K. L., et al.
(författare)
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Development of an Electronic Frailty Index for Hospitalized Older Adults in Sweden
- 2022
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Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press. - 1079-5006 .- 1758-535X. ; 77:11, s. 2311-2319
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Tidskriftsartikel (refereegranskat)abstract
- Background Frailty assessment in the Swedish health system relies on the Clinical Frailty Scale (CFS), but it requires training, in-person evaluation, and is often missing in medical records. We aimed to develop an electronic frailty index (eFI) from routinely collected electronic health records (EHRs) and assess its association with adverse outcomes in hospitalized older adults. Methods EHRs were extracted for 18 225 patients with unplanned admissions between 1 March 2020 and 17 June 2021 from 9 geriatric clinics in Stockholm, Sweden. A 48-item eFI was constructed using diagnostic codes, functioning and other health indicators, and laboratory data. The CFS, Hospital Frailty Risk Score, and Charlson Comorbidity Index were used for comparative assessment of the eFI. We modeled in-hospital mortality and 30-day readmission using logistic regression; 30-day and 6-month mortality using Cox regression; and length of stay using linear regression. Results Thirteen thousand one hundred and eighty-eight patients were included in analyses (mean age 83.1 years). A 0.03 increment in the eFI was associated with higher risks of in-hospital (odds ratio: 1.65; 95% confidence interval: 1.54-1.78), 30-day (hazard ratio [HR]: 1.43; 1.38-1.48), and 6-month mortality (HR: 1.34; 1.31-1.37) adjusted for age and sex. Of the frailty and comorbidity measures, the eFI had the highest area under receiver operating characteristic curve for in-hospital mortality of 0.813. Higher eFI was associated with longer length of stay, but had a rather poor discrimination for 30-day readmission. Conclusions An EHR-based eFI has robust associations with adverse outcomes, suggesting that it can be used in risk stratification in hospitalized older adults.
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| 1014. |
- Mak, Jonathan K. L., et al.
(författare)
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Two Years with COVID-19 : The Electronic Frailty Index Identifies High-Risk Patients in the Stockholm GeroCovid Study
- 2023
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Ingår i: Gerontology. - : S. Karger. - 0304-324X .- 1423-0003. ; 69:4, s. 396-405
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Frailty, a measure of biological aging, has been linked to worse COVID-19 outcomes. However, as the mortality differs across the COVID-19 waves, it is less clear whether a medical record-based electronic frailty index (eFI) that we have previously developed for older adults could be used for risk stratification in hospitalized COVID-19 patients. Objectives: The aim of the study was to examine the association of frailty with mortality, readmission, and length of stay in older COVID-19 patients and to compare the predictive accuracy of the eFI to other frailty and comorbidity measures. Methods: This was a retrospective cohort study using electronic health records (EHRs) from nine geriatric clinics in Stockholm, Sweden, comprising 3,980 COVID-19 patients (mean age 81.6 years) admitted between March 2020 and March 2022. Frailty was assessed using a 48-item eFI developed for Swedish geriatric patients, the Clinical Frailty Scale, and the Hospital Frailty Risk Score. Comorbidity was measured using the Charlson Comorbidity Index. We analyzed in-hospital mortality and 30-day readmission using logistic regression, 30-day and 6-month mortality using Cox regression, and the length of stay using linear regression. Predictive accuracy of the logistic regression and Cox models was evaluated by area under the receiver operating characteristic curve (AUC) and Harrell's C-statistic, respectively. Results: Across the study period, the in-hospital mortality rate decreased from 13.9% in the first wave to 3.6% in the latest (Omicron) wave. Controlling for age and sex, a 10% increment in the eFI was significantly associated with higher risks of in-hospital mortality (odds ratio = 2.95; 95% confidence interval = 2.42-3.62), 30-day mortality (hazard ratio [HR] = 2.39; 2.08-2.74), 6-month mortality (HR = 2.29; 2.04-2.56), and a longer length of stay (beta-coefficient = 2.00; 1.65-2.34) but not with 30-day readmission. The association between the eFI and in-hospital mortality remained robust across the waves, even after the vaccination rollout. Among all measures, the eFI had the best discrimination for in-hospital (AUC = 0.780), 30-day (Harrell's C = 0.733), and 6-month mortality (Harrell's C = 0.719). Conclusion: An eFI based on routinely collected EHRs can be applied in identifying high-risk older COVID-19 patients during the continuing pandemic.
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| 1015. |
- Malarstig, A., et al.
(författare)
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Plasma CD93 concentration is a potential novel biomarker for coronary artery disease
- 2011
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 270:3, s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. A common nonsynonymous single nucleotide polymorphism (SNP) in the CD93 gene (rs3746731, Pro541Ser) has been associated with risk of coronary artery disease (CAD). CD93 is a transmembrane glycoprotein, which is detectable in soluble form in human plasma. We investigated whether the concentration of soluble CD93 in plasma is related to risk of myocardial infarction (MI) and CAD, using a case-control study of premature MI (n = 764) and a nested case-control analysis of a longitudinal cohort study of 60-year-old subjects (analysis comprising 844 of 4232 subjects enrolled at baseline). In addition, SNPs in the CD93 gene were studied in relation to plasma CD93 concentration and CD93 mRNA expression. Methods and Results. A sensitive and specific enzyme-linked immunosorbent assay was established for determination of the plasma CD93 concentration. Subjects were divided into three groups according to tertiles of the distribution of CD93 concentration. Lower odds ratios for risk of MI and incidence of CAD were observed in the middle CD93 tertile (142-173 mu g L(-1)): odds ratio (95% confidence interval), 0.69 (0.49-0.97) and 0.61 (0.40-0.94), respectively. These associations were independent of traditional CAD risk factors. The minor allele of a SNP in the 3' untranslated region of CD93(rs2749812) was associated with increased plasma CD93 concentrations (P = 0.03) and increased CD93 mRNA expression levels (P = 0.02). Conclusion. The results of the present study suggest that the concentration of soluble CD93 in plasma is a potential novel biomarker for CAD, including MI.
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| 1016. |
- Malerba, L., et al.
(författare)
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Comparison of empirical interatomic potentials for iron applied to radiation damage studies
- 2010
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Ingår i: Journal of Nuclear Materials. - : Elsevier BV. - 0022-3115 .- 1873-4820. ; 406:1, s. 19-38
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Tidskriftsartikel (refereegranskat)abstract
- The performance of four recent semi-empirical interatomic potentials for iron, developed or used within the FP6 Perfect Project, is evaluated by comparing them between themselves and with available experimental or, more often, density functional theory data. The quantities chosen for the comparison are of specific interest for radiation damage studies, i.e. they concern mainly properties of point-defects and their clusters, as well as dislocations. For completeness, an earlier, widely used (also within the Project) iron potential is included in the comparison exercise as well. This exercise allows conclusions to be drawn about the reliability of the available potentials, while providing a snapshot of the state-of-the-art concerning fundamental properties of iron, thereby being also useful as a kind of handbook and as a framework for the validation of future semi-empirical interatomic potentials for iron. It is found that Mendelev-type potentials are currently the best choice in order to "extend density functional theory" to larger scales and this justifies their widespread use, also for the development of iron alloy potentials. However, a fully reliable description of self-interstitial atom clusters and dislocations with interatomic potentials remains largely an elusive objective, that calls for further effort within the concerned scientific community.
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| 1017. |
- Malerba, L., et al.
(författare)
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Modelling of Radiation Damage in Fe-Cr Alloys
- 2008
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Ingår i: EFFECTS OF RADIATION ON MATERIALS. - 9780803134218 ; , s. 159-176
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Konferensbidrag (refereegranskat)abstract
- High-Cr ferritic/martensitic steels are being considered as structural materials for a large number of future nuclear applications, from fusion to accelerator-driven systems and GenIV reactors. Fe-Cr alloys can be used as model materials to investigate some of the mechanisms governing their microstructure evolution under irradiation and its correlation to changes in their macroscopic properties. Focusing on these alloys, we show an example of how the integration of computer simulation and theoretical models can provide keys for the interpretation of a host of relevant experimental observations. In particular we show that proper accounting for two basic features of these alloys, namely, the existence of a fairly strong attractive interaction between self-interstitials and Cr atoms and of a mixing enthalpy that changes sign from negative to positive around 8 to 10 % Cr, is a necessary and, to a certain extent, sufficient condition to rationalize and understand their behavior under irradiation. These features have been revealed by ab initio calculations, are supported by experimental evidence, and have been adequately transferred into advanced empirical interatomic potentials, which have been and are being used for the simulation of damage production, defect behavior, and phase transformation in these alloys. The results of the simulations have been and are being used to parameterize models capable of extending the description of radiation effects to scales beyond the reach of molecular dynamics. The present paper intends to highlight the most important achievements and results of this research activity.
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| 1018. |
- Malerba, L., et al.
(författare)
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Modelling of radiation damage in Fe-Cr alloys
- 2007
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Ingår i: Journal of ASTM International. - 1546-962X. ; 4:6
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Tidskriftsartikel (refereegranskat)abstract
- High-Cr ferritic/martensitic steels are being considered as structural materials for a large number of future nuclear applications, from fusion to accelerator-driven systems and GenIV reactors. Fe-Cr alloys can be used as model materials to investigate some of the mechanisms governing their microstructure evolution under irradiation and its correlation to changes in their macroscopic properties. Focusing on these alloys, we show an example of how the integration of computer simulation and theoretical models can provide keys for the interpretation of a host of relevant experimental observations. In particular we show that proper accounting for two basic features of these alloys, namely, the existence of a fairly strong attractive interaction between self-interstitials and Cr atoms and of a mixing enthalpy that changes sign from negative to positive around 8 to 10% Cr, is a necessary and, to a certain extent, sufficient condition to rationalize and understand their behavior under irradiation. These features have been revealed by ab initio calculations, are supported by experimental evidence, and have been adequately transferred into advanced empirical interatomic potentials, which have been and are being used for the simulation of damage production, defect behavior, and phase transformation in these alloys. The results of the simulations have been and are being used to parameterize models capable of extending the description of radiation effects to scales beyond the reach of molecular dynamics. The present paper intends to highlight the most important achievements and results of this research activity.
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| 1019. |
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| 1020. |
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