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Sökning: WFRF:(Gill Michael)

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  • Föregående 12345[6]7Nästa
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51.
  • Jankovic, Momcilo, et al. (författare)
  • Long-term survivors of childhood cancer : cure and care—the Erice Statement (2006) revised after 10 years (2016)
  • 2018
  • Ingår i: Journal of Cancer Survivorship. - Springer. - 1932-2259. ; 12:5, s. 647-650
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The number of persons who have successfully completed treatment for a cancer diagnosed during childhood and who have entered adulthood is increasing over time, and former patients will become aging citizens. Methods: Ten years ago, an expert panel met in Erice, Italy, to produce a set of principles concerning the cure and care of survivors of childhood and adolescent cancer. The result was the Erice Statement (Haupt et al. Eur J Cancer 43(12):1778–80, 2007) that was translated into nine languages. Ten years on, it was timely to review, and possibly revise, the Erice Statement in view of the changes in paediatric oncology and the number and results of international follow-up studies conducted during the intervening years. Results: The long-term goal of the cure and care of a child with cancer is that he/she becomes a resilient and autonomous adult with optimal health-related quality of life, accepted in society at the same level as his/her age peers. “Cure” refers to cure from the original cancer, regardless of any potential for, or presence of, remaining disabilities or side effects of treatment. The care of a child with cancer should include complete and honest information for parents and the child. Conclusions and implication for cancer survivors: Some members of the previous expert panel, as well as new invited experts, met again in Erice to review the Erice Statement, producing a revised version including update and integration of each of the ten points. In addition, a declaration has been prepared, by the Childhood Cancer International Survivors Network in Dublin on October 2016 (see Annex 1).
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52.
  • Kotecha, Dipak, et al. (författare)
  • Impact of Renal Impairment on Beta-Blocker Efficacy in Patients With Heart Failure.
  • 2019
  • Ingår i: Journal of the American College of Cardiology. - 1558-3597. ; 74:23, s. 2893-2904
  • Tidskriftsartikel (refereegranskat)abstract
    • Moderate and moderately severe renal impairment are common in patients with heart failure and reduced ejection fraction, but whether beta-blockers are effective is unclear, leading to underuse of life-saving therapy.This study sought to investigate patient prognosis and the efficacy of beta-blockers according to renal function using estimated glomerular filtration rate (eGFR).Analysis of 16,740 individual patients with left ventricular ejection fraction <50% from 10 double-blind, placebo-controlled trials was performed. The authors report all-cause mortality on an intention-to-treat basis, adjusted for baseline covariates and stratified by heart rhythm.Median eGFR at baseline was 63 (interquartile range: 50 to 77) ml/min/1.73 m2; 4,584 patients (27.4%) had eGFR 45 to 59 ml/min/1.73 m2, and 2,286 (13.7%) 30 to 44 ml/min/1.73 m2. Over a median follow-up of 1.3 years, eGFR was independently associated with mortality, with a 12% higher risk of death for every 10 ml/min/1.73 m2 lower eGFR (95% confidence interval [CI]: 10% to 15%; p < 0.001). In 13,861 patients in sinus rhythm, beta-blockers reduced mortality versus placebo; adjusted hazard ratio (HR): 0.73 for eGFR 45 to 59 ml/min/1.73 m2 (95% CI: 0.62 to 0.86; p < 0.001) and 0.71 for eGFR 30 to 44 ml/min/1.73 m2 (95% CI: 0.58 to 0.87; p = 0.001). The authors observed no deterioration in renal function over time in patients with moderate or moderately severe renal impairment, no difference in adverse events comparing beta-blockers with placebo, and higher mortality in patients with worsening renal function on follow-up. Due to exclusion criteria, there were insufficient patients with severe renal dysfunction (eGFR <30 ml/min/1.73 m2) to draw conclusions. In 2,879 patients with atrial fibrillation, there was no reduction in mortality with beta-blockers at any level of eGFR.Patients with heart failure, left ventricular ejection fraction <50% and sinus rhythm should receive beta-blocker therapy even with moderate or moderately severe renal dysfunction.
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53.
  • López-Ballesteros, Ana, et al. (författare)
  • Towards a feasible and representative pan-African research infrastructure network for GHG observations
  • 2018
  • Ingår i: Environmental Research Letters. - IOP Publishing. - 1748-9326. ; 13:8
  • Tidskriftsartikel (refereegranskat)abstract
    • There is currently a lack of representative, systematic and harmonised greenhouse gas (GHG) observations covering the variety of natural and human-altered biomes that occur in Africa. This impedes the long-term assessment of the drivers of climate change, in addition to their impacts and feedback loops at the continental scale, but also limits our understanding of the contribution of the African continent to the global carbon (C) cycle. Given the current and projected transformation of socio-economic conditions in Africa (i.e. the increasing trend of urbanisation and population growth) and the adverse impacts of climate change, the development of a GHG research infrastructure (RI) is needed to support the design of suitable mitigation and adaptation strategies required to assure food, fuel, nutrition and economic security for the African population. This paper presents the initial results of the EU-African SEACRIFOG project, which aims to design a GHG observation RI for Africa. The first stages of this project included the identification and engagement of key stakeholders, the definition of the conceptual monitoring framework and an assessment of existing infrastructural capacity. Feedback from stakeholder sectors was obtained through three Stakeholder Consultation Workshops held in Kenya, Ghana and Zambia. Main concerns identified were data quality and accessibility, the need for capacity building and networking among the scientific community, and adaptation to climate change, which was confirmed to be a priority for Africa. This feedback in addition to input from experts in the atmospheric, terrestrial and oceanic thematic areas, facilitated the selection of a set of 'essential variables' that need to be measured in the future environmental RI. An inventory of 47 existing and planned networks across the continent allowed for an assessment of the current RIs needs and gaps in Africa. Overall, the development of a harmonised and standardised pan-African RI will serve to address the continent's primary societal and scientific challenges through a potential cross-domain synergy among existing and planned networks at regional, continental and global scales.
54.
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55.
  • Nordin, Sara, 1972-, et al. (författare)
  • Destination governance transitions in skiing destinations : A perspective on resortisation
  • 2019
  • Ingår i: Tourism Management Perspectives. - 2211-9736 .- 2211-9744. ; 31, s. 24-37
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>While destination governance has grown into a mature research field, the dynamic analysis of destination governance transitions remains in its infancy. Therefore, this paper analyses and compares the destination governance transitions in the successful skiing destinations of Åre (Sweden), Whistler (Canada) and Dolomites (Italy). This multiple case study unveils development patterns in governance transitions and investigates the factors that trigger such transitions. In particular, the paper investigates whether leading skiing destinations get increasingly corporatised and ‘resortisised’. It also scrutinises what could trigger processes of ‘resortisation’ and focuses on the impact of crises. The study finds that governance is an adaptive phenomenon that transforms over time, but no strictly uniform transition pattern is detected. While differences arise from varying starting conditions and crises, the commonality is to be found in an apparent convergence of destination governance towards an intermediate stage of ‘socially licensed resorts’ with a minimum of community acceptance. </p>
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56.
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57.
  • Pfreundschuh, Michael, et al. (författare)
  • CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma : a randomised controlled trial by the Mab Thera International Trial (MlnT) Group
  • 2006
  • Ingår i: The Lancet Oncology. - 1470-2045 .- 1474-5488. ; 7:5, s. 379-391
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background</p> <p>The role of rituximab in combination with different CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like chemotherapy regimens in young patients with good-prognosis diffuse large-B-cell lymphoma remains to be defined. We aimed to compare CHOP-like chemotherapy and rituximab with CHOP-like chemotherapy alone in these patients.</p> <p>Methods</p> <p>824 patients who were from 18 countries; aged 18–60 years; and who had no risk factors or one risk factor according to age-adjusted International Prognostic Index (IPI), stage II–IV disease, or stage I disease with bulk were enrolled. These patients were randomly assigned to six cycles of CHOP-like chemotherapy and rituximab (n=413) or to six cycles of CHOP-like chemotherapy alone (n=411). Bulky and extranodal sites received additional radiotherapy. The primary endpoint was event-free survival; secondary endpoints were response, progression under therapy, progression-free survival, overall survival, and frequency of toxic effects. Analyses were done by intention to treat and per protocol. This trial is registered at http://www.clinicaltrials.gov, NCT 00064116.</p> <p>Findings</p> <p>After a median follow-up of 34 months (range 0·03–61), patients assigned chemotherapy and rituximab had increased 3-year event-free survival compared with those assigned chemotherapy alone (79% [95% CI 75–83] <em>vs</em> 59% [54–64]; difference between groups 20% [13–27], log-rank p&lt;0·0001), and had increased 3-year overall survival (93% [90–95] <em>vs</em> 84% [80–88]; difference between groups 9% [3–13], log-rank p=0·0001). Event-free survival was affected by treatment group, presence of bulky disease, and age-adjusted IPI: after chemotherapy and rituximab, a favourable subgroup (ie, IPI=0, no bulk) could be defined from a less-favourable subgroup (ie, IPI=1 or bulk, or both). Groups did not differ in the frequency of adverse events.</p> <p>Interpretation</p> <p>Rituximab added to six cycles of CHOP is an effective treatment for young patients with good-prognosis diffuse large-B-cell lymphoma. The definition of two prognostic subgroups allows for a more refined therapeutic approach for these patients.</p> Background <p>The role of rituximab in combination with different CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-like chemotherapy regimens in young patients with good-prognosis diffuse large-B-cell lymphoma remains to be defined. We aimed to compare CHOP-like chemotherapy and rituximab with CHOP-like chemotherapy alone in these patients.</p> Methods <p>824 patients who were from 18 countries; aged 18–60 years; and who had no risk factors or one risk factor according to age-adjusted International Prognostic Index (IPI), stage II–IV disease, or stage I disease with bulk were enrolled. These patients were randomly assigned to six cycles of CHOP-like chemotherapy and rituximab (n=413) or to six cycles of CHOP-like chemotherapy alone (n=411). Bulky and extranodal sites received additional radiotherapy. The primary endpoint was event-free survival; secondary endpoints were response, progression under therapy, progression-free survival, overall survival, and frequency of toxic effects. Analyses were done by intention to treat and per protocol. This trial is registered at http://www.clinicaltrials.gov, NCT 00064116.</p> Findings <p>After a median follow-up of 34 months (range 0·03–61), patients assigned chemotherapy and rituximab had increased 3-year event-free survival compared with those assigned chemotherapy alone (79% [95% CI 75–83] <em>vs</em> 59% [54–64]; difference between groups 20% [13–27], log-rank p&lt;0·0001), and had increased 3-year overall survival (93% [90–95] <em>vs</em> 84% [80–88]; difference between groups 9% [3–13], log-rank p=0·0001). Event-free survival was affected by treatment group, presence of bulky disease, and age-adjusted IPI: after chemotherapy and rituximab, a favourable subgroup (ie, IPI=0, no bulk) could be defined from a less-favourable subgroup (ie, IPI=1 or bulk, or both). Groups did not differ in the frequency of adverse events.</p> Interpretation <p>Rituximab added to six cycles of CHOP is an effective treatment for young patients with good-prognosis diffuse large-B-cell lymphoma. The definition of two prognostic subgroups allows for a more refined therapeutic approach for these patients.</p>
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58.
  • Purcell, Shaun M., et al. (författare)
  • Common polygenic variation contributes to risk of schizophrenia and bipolar disorder
  • 2009
  • Ingår i: Nature. - 0028-0836 .- 1476-4687. ; 460:7256, s. 748-752
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Schizophrenia is a severe mental disorder with a lifetime risk of about 1%, characterized by hallucinations, delusions and cognitive deficits, with heritability estimated at up to 80%(1,2). We performed a genome-wide association study of 3,322 European individuals with schizophrenia and 3,587 controls. Here we show, using two analytic approaches, the extent to which common genetic variation underlies the risk of schizophrenia. First, we implicate the major histocompatibility complex. Second, we provide molecular genetic evidence for a substantial polygenic component to the risk of schizophrenia involving thousands of common alleles of very small effect. We show that this component also contributes to the risk of bipolar disorder, but not to several non-psychiatric diseases.</p>
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59.
60.
  • Rolffs, R., et al. (författare)
  • Reversal of infall in SgrB2(M) revealed by Herschel/HIFI observations of HCN lines at THz frequencies
  • 2010
  • Ingår i: Astronomy and Astrophysics. - 0004-6361 .- 1432-0746. ; 521:1, s. Article Number: L46
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims. To investigate the accretion and feedback processes in massive star formation, we analyze the shapes of emission lines from hot molecular cores, whose asymmetries trace infall and expansion motions. Methods. The high-mass star forming region SgrB2(M) was observed with Herschel/HIFI (HEXOS key project) in various lines of HCN and its isotopologues, complemented by APEX data. The observations are compared to spherically symmetric, centrally heated models with density power-law gradient and different velocity fields (infall or infall+expansion), using the radiative transfer code RATRAN. Results. The HCN line profiles are asymmetric, with the emission peak shifting from blue to red with increasing J and decreasing line opacity (HCN to (HCN)-C-13). This is most evident in the HCN 12-11 line at 1062 GHz. These line shapes are reproduced by a model whose velocity field changes from infall in the outer part to expansion in the inner part. Conclusions. The qualitative reproduction of the HCN lines suggests that infall dominates in the colder, outer regions, but expansion dominates in the warmer, inner regions. We are thus witnessing the onset of feedback in massive star formation, starting to reverse the infall and finally disrupting the whole molecular cloud. To obtain our result, the THz lines uniquely covered by HIFI were critically important.
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