| 1. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Danielsson, Pernilla, et al.
(författare)
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Sustainable Value Co-Creation in Welfare Service Ecosystems : Transforming temporary collaboration projects into permanent resource integration
- 2023
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Ingår i: Re-imagining service to enhance human life and society : QUIS18 Proceedings, VinUniversity, Hanoi June 20-23,2023 - QUIS18 Proceedings, VinUniversity, Hanoi June 20-23,2023. - 9798891218680 ; QUIS18, s. 211-224
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Konferensbidrag (refereegranskat)abstract
- The aim of this paper is to discuss the unexploited forces of user-orientation and shared responsibility to promote sustainable value co-creation during service innovation projects in welfare service ecosystems. The framework is based on the theoretical field of public service logic (PSL) and our thesis is that service innovation seriously requires a user-oriented approach, and that such an approach enables resource integration based on the service-user’s needs and lifeworld. In our findings, we identify prerequisites and opportunities of collaborative service innovation projects in order to transform these projects into sustainable resource integration once they have ended.
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| 3. |
- Hu, Cheng, et al.
(författare)
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On the steady-state workpiece flow mechanism and force prediction considering piled-up effect and dead metal zone formation
- 2021
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Ingår i: Journal of Manufacturing Science and Engineering. - : ASME International. - 1087-1357 .- 1528-8935. ; 143:4
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Tidskriftsartikel (refereegranskat)abstract
- The manufacturing of miniaturized components is indispensable in modern industries, where the uncut chip thickness (UCT) inevitably falls into a comparable magnitude with the tool edge radius. Under such circumstances, the ploughing phenomenon between workpiece and tool becomes predominant, followed by the notable formation of dead metal zone (DMZ) and piled-up chip. Although extensive models have been developed, the critical material flow status in such microscale is still confusing and controversial. In this study, a novel material separation model is proposed for the demonstration of workpiece flow mechanism around the tool edge radius. First, four critical positions of workpiece material separation are determined, including three points characterizing the DMZ pattern and one inside considered as stagnation point. The normal and shear stresses as well as friction factors along the entire contact region are clarified based on slip-line theory. It is found that the friction coefficient varies symmetrically about the stagnation point inside DMZ and remains constant for the rest. Then, an analytical force prediction model is developed with Johnson-Cook constitutive model, involving calibrated functions of chip-tool contact length and cutting temperature. The assumed tribology condition and morphologies of material separation including DMZ are clearly observed and verified through various finite element (FE) simulations. Finally, comparisons of cutting forces from cutting experiments and predicted results are adopted for the validation of the predictive model.
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| 4. |
- Hu, Kejia, et al.
(författare)
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Aspirin and other non-steroidal anti-inflammatory drugs and depression, anxiety, and stress-related disorders following a cancer diagnosis : a nationwide register-based cohort study
- 2020
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Ingår i: BMC Medicine. - : BioMed Central. - 1741-7015. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cancer patients have a highly increased risk of psychiatric disorders following diagnosis, compared with cancer-free individuals. Inflammation is involved in the development of both cancer and psychiatric disorders. The role of non-steroidal anti-inflammatory drugs (NSAIDs) in the subsequent risk of psychiatric disorders after cancer diagnosis is however unknown.METHODS: We performed a cohort study of all patients diagnosed with a first primary malignancy between July 2006 and December 2013 in Sweden. Cox proportional hazards models were used to assess the association of NSAID use during the year before cancer diagnosis with the risk of depression, anxiety, and stress-related disorders during the first year after cancer diagnosis.RESULTS: Among 316,904 patients identified, 5613 patients received a diagnosis of depression, anxiety, or stress-related disorders during the year after cancer diagnosis. Compared with no use of NSAIDs, the use of aspirin alone was associated with a lower rate of depression, anxiety, and stress-related disorders (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.81 to 0.97), whereas the use of non-aspirin NSAIDs alone was associated with a higher rate (HR, 1.24; 95% CI, 1.15 to 1.32), after adjustment for sociodemographic factors, comorbidity, indications for NSAID use, and cancer characteristics. The association of aspirin with reduced rate of depression, anxiety, and stress-related disorders was strongest for current use (HR, 0.84; 95% CI, 0.75 to 0.93), low-dose use (HR, 0.88; 95% CI, 0.80 to 0.98), long-term use (HR, 0.84; 95% CI, 0.76 to 0.94), and among patients with cardiovascular disease (HR, 0.81; 95% CI, 0.68 to 0.95) or breast cancer (HR, 0.74; 95% CI, 0.56 to 0.98).CONCLUSION: Pre-diagnostic use of aspirin was associated with a decreased risk of depression, anxiety, and stress-related disorders during the first year following cancer diagnosis.
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| 5. |
- Hu, Kejia, et al.
(författare)
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Neuroendocrine pathways and breast cancer progression : a pooled analysis of somatic mutations and gene expression from two large breast cancer cohorts
- 2022
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Ingår i: BMC Cancer. - : BioMed Central. - 1471-2407 .- 1471-2407. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Experimental studies indicate that neuroendocrine pathways might play a role in progression of breast cancer. We aim to test the hypothesis that somatic mutations in the genes of neuroendocrine pathways influence breast cancer prognosis, through dysregulated gene expression in tumor tissue.METHODS: We conducted an extreme case-control study including 208 breast cancer patients with poor invasive disease-free survival (iDFS) and 208 patients with favorable iDFS who were individually matched on molecular subtype from the Breast Cancer Cohort at West China Hospital (WCH; N = 192) and The Cancer Genome Atlas (TCGA; N = 224). Whole exome sequencing and RNA sequencing of tumor and paired normal breast tissues were performed. Adrenergic, glucocorticoid, dopaminergic, serotonergic, and cholinergic pathways were assessed for differences in mutation burden and gene expression in relation to breast cancer iDFS using the logistic regression and global test, respectively.RESULTS: In the pooled analysis, presence of any somatic mutation (odds ratio = 1.66, 95% CI: 1.07-2.58) of the glucocorticoid pathway was associated with poor iDFS and a two-fold increase of tumor mutation burden was associated with 17% elevated odds (95% CI: 2-35%), after adjustment for cohort membership, age, menopausal status, molecular subtype, and tumor stage. Differential expression of genes in the glucocorticoid pathway in tumor tissue (P = 0.028), but not normal tissue (P = 0.701), was associated with poor iDFS. Somatic mutation of the adrenergic and cholinergic pathways was significantly associated with iDFS in WCH, but not in TCGA.CONCLUSION: Glucocorticoid pathway may play a role in breast cancer prognosis through differential mutations and expression. Further characterization of its functional role may open new avenues for the development of novel therapeutic targets for breast cancer.
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| 6. |
- Hu, Kejia
(författare)
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Psychological distress and breast cancer : a bidirectional link
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psychological distress is one of the six vital signs among patients with cancer. An increased risk of psychiatric disorders has also been reported among cancer patients, compared with the general population. On the other hand, psychological distress might also influence the initiation and progression of cancer. As breast cancer is the most common cancer, and females are more vulnerable to psychiatric disorders than men, we further investigated the bidirectional link between psychological distress and breast cancer. The potential mechanisms linking together psychological distress and breast cancer include inflammation, neuroendocrine pathways, behavioral factors, and reproductive and hormonal factors. In this thesis, we studied various response processes and consequences of psychological distress in relation to the risk, prognosis, and diagnostic workup of breast cancer, including stress coping ability, anti-inflammatory drug use, and genetic determinants of different stress pathways, to comprehensively investigate such a link. In Study I, we examined whether sense of coherence (SoC), as a measure of resilience to psychological distress, reduced the risk of breast cancer. We included all women who had answered the SoC-13 questionnaire when enrolled in the Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA) cohort, and identified incident cases of breast cancer after enrollment of these women through cross-linkages with Swedish national registers. We used the SoC score measured at enrollment as the main exposure because SoC is believed to be stable. We estimated the hazard ratio (HR) and 95% confidence interval (CI) of breast cancer in relation to SoC, based on Cox proportional hazards models, after adjustment for potential confounders. We found no evidence to support an association between SoC and risk of breast cancer (HR: 1.08; 95% CI: 0.90-1.29). In Study II, considering that inflammation is a critical component in both cancer development and stress response (especially chronic stress response), we assessed whether use of non-steroidal anti-inflammatory drugs (NSAIDs) reduced the risk of breast cancer. We used a nested case-control design within the general female population of Sweden as well as within the KARMA cohort. Conditional logistic regression models were used to estimate HRs and 95% CIs, adjusted for potential confounders. We did not find use of aspirin to be associated with the risk of breast cancer. However, use of non-aspirin NSAIDs was associated with a slightly increased risk of early-stage breast cancer (HR: 1.05; 95% CI: 1.02-1.08), a decreased risk of advanced-stage breast cancer (HR: 0.80; 95% CI: 0.73-0.88), and a decreased risk of breast cancer in general among women with dense breasts (HR: 0.72; 95% CI: 0.59-0.89). In study III, we aim to understand the potential genetic determinants of the link between psychological distress and breast cancer prognosis. We assessed whether somatic mutations and gene expression of the neuroendocrine pathways, namely the adrenergic, cholinergic, dopaminergic, glucocorticoid, and serotonergic pathways, which are directly involved in stress response, were associated with breast cancer prognosis. We used a matched extreme case-control design based on two cohorts of breast cancer patients from China, US, and other countries. Somatic mutations and gene expression data were derived from whole exome sequencing (WES) and RNA sequencing on tumor and paired normal breast tissues. Logistic regression was used to estimate the odds ratio of invasive disease-free survival (iDFS). A two-fold increase of somatic mutation burden in genes of the glucocorticoid pathway was associated with a 17% (95% CI: 2%-35%) elevated odds of reaching iDFS endpoints. This association might be regulated through differential gene expression of the glucocorticoid pathway in tumor tissue. In Study IV, we compared the risk of psychiatric disorders potentially related to psychological distress among cancer patients with or without pre-diagnostic use of NSAIDs. We conducted a cohort study including all cancer patients diagnosed during July 2006 to December 2013 in Sweden and followed them for an incident diagnosis of anxiety, depression, or stress-related disorders. Cox proportional hazards models were used to estimate the HR and 95% CI, adjusted for potential confounders. We found a reduced risk of anxiety, depression, and stress-related disorders among cancer patients with pre-diagnostic use of aspirin (HR: 0.88; 95% CI: 0.81-0.97) and contrastingly an increased risk of these psychiatric disorders among patients with pre-diagnostic use of non-aspirin NSAIDs (HR: 1.24; 95% CI: 1.15-1.32). A more prominent risk decreased in relation to aspirin use was found among females and patients with breast cancer. Taken together, the knowledge gained through this thesis work helps to improve our understanding on the role of psychological distress in the risk and prognosis of cancer and supports intervention of severe psychological distress subsequent to a cancer diagnosis. In the long run, such knowledge should also help pave the way for the development of innovative measures for the prevention of cancer and cancer-related morbidity and mortality.
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| 7. |
- Hu, Kejia, et al.
(författare)
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Risk of Psychiatric Disorders Among Spouses of Patients With Cancer in Denmark and Sweden
- 2023
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Ingår i: JAMA Network Open. - : American Medical Association. - 2574-3805. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: There is emerging evidence that spouses of patients with cancer may have a higher prevalence of mental illness, but these studies have been limited by pre-post designs, focus on a single mental illness, and short follow-up periods. OBJECTIVES: To assess the overall burden of psychiatric disorders among spouses of patients with cancer vs spouses of individuals without cancer and to describe possible changes in this burden over time.DESIGN, SETTING, AND PARTICIPANTS: This population based cohort study included spouses of patients with cancer (diagnosed 1986-2016 in Denmark and 1973-2014 in Sweden; exposed group) and spouses of individuals without cancer (unexposed group). Members of the unexposed group were individually matched to individuals in the exposed group on the year of birth, sex, and country. Spouses with and without preexisting psychiatric morbidity were analyzed separately. Data analysis was performed between May 2021 and January 2022. EXPOSURES: Being spouse to a patient with cancer.MAIN OUTCOMES AND MEASURES: The main outcome was a clinical diagnosis of psychiatric disorders through hospital-based inpatient or outpatient care. Flexible parametric models and Cox models were fitted to estimate hazard ratios (HRs) with 95% CIs, adjusted for sex, age and year at cohort entry, country, household income, and cancer history.RESULTS: Among 546 321 spouses in the exposed group and 2 731 574 in the unexposed group who had no preexisting psychiatry morbidity, 46.0% were male participants, with a median (IQR) age at cohort entry of 60 (51-68) years. During follow-up (median, 8.4 vs 7.6 years), the incidence rate of first-onset psychiatric disorders was 6.8 and 5.9 per 1000 person-years for the exposed and unexposed groups, respectively (37 830 spouses of patients with cancer [6.9%]; 153 607 of spouses of individuals without cancer [5.6%]). Risk of first-onset psychiatric disorders increased by 30% (adjusted HR, 1.30; 95% CI, 1.25-1.34) during the first year after cancer diagnosis, especially for depression (adjusted HR, 1.38; 95% CI, 1.30-1.47) and stress-related disorders (adjusted HR, 2.04; 95% CI, 1.88-2.22). Risk of first-onset psychiatric disorders increased by 14% (adjusted HR, 1.14; 95% CI, 1.13-1.16) during the entire follow-up, which was similar for substance abuse, depression, and stress-related disorders. The risk increase was more prominent among spouses of patients diagnosed with a cancer with poor prognosis (eg, pancreatic cancer: adjusted HR, 1.41; 95% CI, 1.32-1.51) or at an advanced stage (adjusted HR, 1.31; 95% CI, 1.26-1.36) and when the patient died during follow-up (adjusted HR, 1.29; 95% CI, 1.27-1.31). Among spouses with preexisting psychiatric morbidity, the risk of psychiatric disorders (first-onset or recurrent) increased by 23% during the entire follow-up (adjusted HR, 1.23; 95% CI, 1.20-1.25).CONCLUSIONS AND RELEVANCE: In this cohort study of 2 populations in Denmark and Sweden, spouses of patients with cancer experienced increased risk of several psychiatric disorders that required hospital-based specialist care. Our results support the need for clinical awareness to prevent potential mental illness among the spouses of patients with cancer.
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| 8. |
- Hu, Kejia, et al.
(författare)
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Use of antibiotics and risk of psychiatric disorders in newly diagnosed cancer patients : a population-based cohort study in Sweden
- 2022
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Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - : American Association for Cancer Research. - 1055-9965 .- 1538-7755. ; 31:3, s. 528-535
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Antibiotic-induced dysbiosis is associated with an increased risk of depression and anxiety in the general populations. A diagnosis of cancer is associated with an immediately and dramatically elevated risk of psychiatric disorders, but the potential influence of pre-diagnostic antibiotic-induced dysbiosis is unknown.METHODS: Based on a national cohort of cancer patients in Sweden, we included 309,419 patients who were diagnosed with a first primary malignancy between July 2006 and December 2013. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of first-onset psychosis, depression, anxiety, or stress-related disorders during the first year after cancer diagnosis for antibiotic use during the year before cancer diagnosis.RESULTS: Compared with no antibiotic use, use of antibiotics was associated with a higher rate of the aforementioned psychiatric disorders (HR, 1.23; 95% CI, 1.16-1.30) after adjustment for sociodemographic factors, comorbidity, potential indications for antibiotics, cancer stage and type. The magnitude of the association was higher for broad-spectrum antibiotics (HR, 1.27; 95% CI, 1.18-1.37), higher doses (HR, 1.33; 95% CI, 1.22-1.44), more frequent (HR, 1.33; 95% CI, 1.21-1.46) and recent use (HR, 1.26; 95% CI, 1.17-1.35).CONCLUSIONS: Use of antibiotics, especially of broad-spectrum type, of high dose and frequency, with recent use, was associated with an aggravated risk of psychiatric disorders, compared with no antibiotic use.IMPACT: A better understanding of the microbiota-gut-brain axis may open up a wide avenue for the prevention and treatment of psychiatric disorders in cancer patients.
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| 9. |
- Wang, Chengshi, et al.
(författare)
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Cardiovascular mortality among cancer survivors who developed breast cancer as a second primary malignancy
- 2020
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Ingår i: Cancer Research. - : American Association for Cancer Research. - 0008-5472 .- 1538-7445. ; 80:16
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Patients with breast cancer are at increased risk of cardiovascular diseases and cardiovascular mortality, potentially due to treatment-related cardiotoxicity, early menopause, and psychological distress. Cancer survivors who developed breast cancer as a second malignancy (BCa-2) are common and may experience cancer treatment and distress for a second time. It is however unknown whether BCa-2 patients have increased risk of cardiovascular mortality compared to patients with breast cancer as the first malignancy (BCa-1) and the cancer-free female population.Methods: Using the Surveillance, Epidemiology, and End Results database, we conducted a cohort study including 1,024,047 patients with BCa-1 and 41,744 with BCa-2 diagnosed at age of 30 years and older during 1975-2016, and the corresponding female population of 994,415,911 person-years in the U.S.. Compared with patients with BCa-1 and the general population, we calculated incidence rate ratios (IRRs) of cardiovascular deaths among patients with BCa-2 by using multivariable Poisson regression.Results: During the median follow-up of 5.9 years (interquartile range, 2.4-11.3 years), 3,550 and 71,298 cardiovascular deaths were observed in BCa-2 and BCa-1 patients. Overall, BCa-2 patients had a mildly increased risk of cardiovascular mortality compared with the general population (IRR 1.07, 95% CI 1.03-1.10) and BCa-1 patients (IRR 1.13, 95% CI 1.10-1.17) with the adjustment of demographic factors. When comparing BCa-2 with BCa-1, the association was further independent of tumor characteristics and treatment modes (IRR 1.15, 95% CI 1.11-1.19). The elevated risk of cardiovascular mortality was mostly pronounced at age of follow-up between 30 and 79 years (IRR 1.31, 95% CI 1.23-1.40 compared with the general population; IRR 1.34, 95% CI 1.25-1.43 compared with BCa-1), whereas the risk was mildly increased, if any, at age of 80+ years compared with BCa-1 (IRR 1.07, 95% CI 1.02-1.11). The increased risk at age of 30-79 years in BCa-2 was particularly greater within the first month after cancer diagnosis compared with the general population (IRR 3.20, 95% CI 2.34-4.38). In contrast, cardiovascular mortality rate in BCa-2 was comparable to that in BCa-1 within the first month (IRR 0.87, 95% CI 0.63-1.21).Conclusions: Our findings suggest that patients with BCa-2, particularly in patients younger than 80 years, are at increased risk of cardiovascular mortality, compared with the general population and patients with BCa-1.
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| 10. |
- Wang, Chengshi, et al.
(författare)
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Cardiovascular mortality among cancer survivors who developed breast cancer as a second primary malignancy
- 2021
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Ingår i: British Journal of Cancer. - : Nature Publishing Group. - 0007-0920 .- 1532-1827. ; 125:10, s. 1450-1458
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To assess the risk of cardiovascular mortality among cancer survivors who developed breast cancer as a second malignancy (BCa-2) compared with patients with first primary breast cancer (BCa-1) and the general population.METHODS: Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study including 1,024,047 BCa-1 and 41,744 BCa-2 patients diagnosed from the age 30 between 1975 and 2016, and the corresponding US female population (994,415,911 person-years; 5,403,551 cardiovascular deaths). Compared with the general population and BCa-1 patients, we calculated incidence rate ratios (IRRs) of cardiovascular deaths among BCa-2 patients using Poisson regression. To adjust for unmeasured confounders, we performed a nested, case-crossover analysis among BCa-2 patients who died from cardiovascular disease.RESULTS: Although BCa-2 patients had a mildly increased risk of cardiovascular mortality compared with the population (IRR 1.08) and BCa-1 patients (IRR 1.15), the association was pronounced among individuals aged 30-49 years (BCa-2 vs. population: IRR 6.61; BCa-2 vs. BCa-1: IRR 3.03). The risk elevation was greatest within the first month after diagnosis, compared with the population, but comparable with BCa-1 patients. The case-crossover analysis confirmed these results.CONCLUSION: Our findings suggest that patients with BCa-2 are at increased risk of cardiovascular mortality.
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