| 1. |
- Asbun, H.J., et al.
(författare)
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The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection
- 2020
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Ingår i: Annals of Surgery. - : Lippincott Williams and Wilkins. - 0003-4932 .- 1528-1140. ; 271:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to develop and externally validate the first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019).Summary Background Data: MIPR has seen rapid development in the past decade. Promising outcomes have been reported by early adopters from high-volume centers. Subsequently, multicenter series as well as randomized controlled trials were reported; however, guidelines for clinical practice were lacking. Methods: The Scottisch Intercollegiate Guidelines Network (SIGN) methodology was used, incorporating these 4 items: systematic reviews using PubMed, Embase, and Cochrane databases to answer clinical questions, whenever possible in PICO style, the GRADE approach for assessment of the quality of evidence, the Delphi method for establishing consensus on the developed recommendations, and the AGREE-II instrument for the assessment of guideline quality and external validation. The current guidelines are cosponsored by the International Hepato-Pancreato-Biliary Association, the Americas Hepato-Pancreato-Biliary Association, the Asian-Pacific Hepato-Pancreato-Biliary Association, the European-African Hepato-Pancreato-Biliary Association, the European Association for Endoscopic Surgery, Pancreas Club, the Society of American Gastrointestinal and Endoscopic Surgery, the Society for Surgery of the Alimentary Tract, and the Society of Surgical Oncology. Results: After screening 16,069 titles, 694 studies were reviewed, and 291 were included. The final 28 recommendations covered 6 topics; laparoscopic and robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, as well as patient selection, training, learning curve, and minimal annual center volume required to obtain optimal outcomes and patient safety.Conclusion: The IG-MIPR using SIGN methodology give guidance to surgeons, hospital administrators, patients, and medical societies on the use and outcome of MIPR as well as the approach to be taken regarding this challenging type of surgery. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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| 2. |
- Korenblik, R., et al.
(författare)
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Dragon 1 Protocol Manuscript : Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy
- 2022
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Ingår i: Cardiovascular and Interventional Radiology. - : Springer. - 0174-1551 .- 1432-086X. ; 45, s. 1391-1398
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Tidskriftsartikel (refereegranskat)abstract
- Study Purpose The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. Methods The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. Results Not applicable. Conclusion DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR.
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| 3. |
- Pearce, Mark, et al.
(författare)
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PoGOLite : A balloon-borne soft gamma-ray polarimeter
- 2007
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Ingår i: Proceedings of the 30th International Cosmic Ray Conference, ICRC 2007. - : Universidad Nacional Autonoma de Mexico. ; , s. 479-482
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Konferensbidrag (refereegranskat)abstract
- Polarized gamma-rays are expected from a wide variety of sources including rotationpowered pulsars, accreting black holes and neutron stars, and jet-dominated active galaxies. Polarization measurements provide a powerful probe of the gamma-ray emission mechanism and the distribution of magnetic and radiation fields around the source. No measurements have been performed in the soft gamma-ray band where non-thermal processes are expected to produce high degrees of polarization. The PoGOLite experiment applies well-type phoswich detector technology to polarization measurements in the 25 - 80 keV energy range. The instrument uses Compton scattering and photoabsorption in an array of 217 phoswich detector cells made of plastic and BGO scintillators, and surrounded by active BGO shields. A prototype of the flight instrument has been tested with polarized gammarays and background generated with radioactive sources. The test results and computer simulations confirm that the instrument can detect 10% polarization of a 200 mCrab source in one 6 hour balloon observation. In flight, targets are constrained to within better than 5% of the field-of-view (~5 degrees squared) in order to maximize the effective detection area during observations. The pointing direction on the sky is determined by an attitude control system comprising star trackers, differential GPS receiver system, gyroscopes, accelerometers and magnetometers which provide correction signals to a reaction wheel and torque motor system. Additionally, the entire polarimeter assembly rotates around its viewing axis to minimize systematic bias during observations. Flights are foreseen to start in 2009- 2010 and will target northern sky sources including the Crab pulsar/nebula, Cygnus X-1, and Hercules X-1. These observations will provide valuable information about the pulsar emission mechanism, the geometry around the black hole, and photon transportation in the strongly magnetized neutron star surface, respectively. Future goals include a long duration balloon flight from the Esrange facility in Northern Sweden to Canada.
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| 4. |
- Burisch, J., et al.
(författare)
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Environmental factors in a population-based inception cohort of inflammatory bowel disease patients in Europe : An ECCO-EpiCom study
- 2014
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Ingår i: Journal of Crohn's & Colitis. - : Oxford University Press. - 1873-9946 .- 1876-4479. ; 8:7, s. 607-616
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe possibly due to changes in environmental factors towards a more "westernised" standard of Living. The aim of this study was to investigate differences in exposure to environmental factors prior to diagnosis in Eastern and Western European IBD patients.Methods: The EpiCom cohort is a population-based, prospective inception cohort of 1560 unselected IBD patients from 31 European countries covering a background population of 10.1 million. At the time of diagnosis patients were asked to complete an 87-item questionnaire concerning environmental factors.Results: A total of 1182 patients (76%) answered the questionnaire, 444 (38%) had Crohn's disease (CD), 627 (53%) ulcerative colitis (UC), and 111 (9%) IBD unclassified. No geographic differences regarding smoking status, caffeine intake, use of oral contraceptives, or number of first-degree relatives with IBD were found. Sugar intake was higher in CD and UC patients from Eastern Europe than in Western Europe while fibre intake was lower (p < 0.01). Daily consumption of fast food as well as appendectomy before the age of 20 was more frequent in Eastern European than in Western European UC patients (p < 0.01). Eastern European CD and UC patients had received more vaccinations and experienced fewer childhood infections than Western European patients (p < 0.01).Conclusions: In this European population-based inception cohort of unselected IBD patients, Eastern and Western European patients differed in environmental factors prior to diagnosis. Eastern European patients exhibited higher occurrences of suspected risk factors for IBD included in the Western lifestyle. (C) 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
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| 5. |
- Liu, Jimmy Z, et al.
(författare)
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Dense genotyping of immune-related disease regions identifies nine new risk loci for primary sclerosing cholangitis.
- 2013
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Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 45:6, s. 670-5
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Tidskriftsartikel (refereegranskat)abstract
- Primary sclerosing cholangitis (PSC) is a severe liver disease of unknown etiology leading to fibrotic destruction of the bile ducts and ultimately to the need for liver transplantation. We compared 3,789 PSC cases of European ancestry to 25,079 population controls across 130,422 SNPs genotyped using the Immunochip. We identified 12 genome-wide significant associations outside the human leukocyte antigen (HLA) complex, 9 of which were new, increasing the number of known PSC risk loci to 16. Despite comorbidity with inflammatory bowel disease (IBD) in 72% of the cases, 6 of the 12 loci showed significantly stronger association with PSC than with IBD, suggesting overlapping yet distinct genetic architectures for these two diseases. We incorporated association statistics from 7 diseases clinically occurring with PSC in the analysis and found suggestive evidence for 33 additional pleiotropic PSC risk loci. Together with network analyses, these findings add to the genetic risk map of PSC and expand on the relationship between PSC and other immune-mediated diseases.
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| 6. |
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| 7. |
- Mizuno, T., et al.
(författare)
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High sensitivity balloon-borne hard X-ray/soft Gamma-Ray Polarimeter PoGOLite
- 2007
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Ingår i: Nuclear Science Symposium Conference Record, 2007. NSS ’07. IEEE. - : IEEE. - 9781424409228 ; , s. 2538-2544
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Konferensbidrag (refereegranskat)abstract
- The Polarized Gamma-ray Observer - Lightweight version (PoGOLite) is a new balloon experiment capable of detecting 10% polarization from a 200 mCrab source in the 25-80 keV energy range in a single 6-hour flight for the first time. Polarization measurements of hard X-rays and soft gamma-rays are expected to provide a powerful probe into high-energy emission mechanisms as well as source geometries. PoGOLite uses Compton scattering and photo-absorption to measure polarization in an array of 217 well-type phoswich detector cells made of plastic and BGO scintillators. The adoption of a well-type phoswich counter concept and a thick polyethylene neutron shield provides a narrow field-of-view (1.25 msr), a large effective area ( gt; 250 cm2 at 40-50 keV), a high modulation factor (more than 25%) and the low background ( 100 mCrab) required to conduct high-sensitivity polarization measurements. Through tests in laboratories and accelerator facilities of a scaled-down prototype with the front-end electronics of flight design and an extensive study by Monte Carlo simulation, we have demonstrated high instrument performance. PoGOLite will be ready for a first engineering flight in 2009 and a science flight in 2010, during which polarization signals from the Crab Nebula/pulsar, Cygnus X-1 and other objects will be observed.
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| 8. |
- Arnason, T., et al.
(författare)
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Long-term rearing of Arctic charr Salvelinus alpinus under different salinity regimes at constant temperature
- 2014
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Ingår i: Journal of Fish Biology. - : Wiley. - 0022-1112. ; 85:4, s. 1145-1162
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Tidskriftsartikel (refereegranskat)abstract
- Arctic charr Salvelinus alpinus of the Holar strain (mean+/- s. e. body mass= 152.1+/-3.1g) were reared at four different salinity regimes at a constant temperature of 7.4 degrees C. Two groups were given a three-month acclimation in salinity 18 before the salinity was increased to either 25 or 29 (groups called A25 and A29), and two groups were reared in salinities 25 or 29 over the full experimental period of 409 days (groups called F25 and F29). In the first 3months, the A25 and A29 groups had the highest growth rates. By October 2011, there were no significant differences (two-way nested ANOVA, P> 0.05) in the mean body masses among A25, F25 and F29 (c. 1450 g), whereas A29 had a lower mean mass (1282 g). The growth in the last period from October 2011 to January 2012 was reduced by sexual maturation in the highest salinity regimes (A29 and F29), whereas fish in groups A25 and F25 showed high growth throughout the study. Males in all salinity groups had higher growth rates than females for the most part of the study, but the divergence between the sexes was most pronounced in the highest salinity regimes. All salinity groups showed distinct changes in Na+, K+-ATPase activity, with high activity in spring and summer, and lower activity in the autumn. Plasma sodium (Na+) levels were stable indicating that none of the experimental groups had problems in maintaining hydromineral balance during the study. While plasma leptin levels were not affected by salinity regimes, it was noted that these levels were 13-30% higher in fish with empty guts compared with those having food in their gut at the time of sampling. This suggests a link between leptin levels and food intake, indicating that this hormone may play a role in food intake and energy allocation in fishes.
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| 9. |
- Breves, J. P., et al.
(författare)
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Cortisol regulates insulin-like growth-factor binding protein (igfbp) gene expression in Atlantic salmon parr
- 2020
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Ingår i: Molecular and Cellular Endocrinology. - : Elsevier BV. - 0303-7207 .- 1872-8057. ; 518
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 Elsevier B.V. The growth hormone (Gh)/insulin-like growth-factor (Igf)/Igf binding protein (Igfbp) system regulates growth and osmoregulation in salmonid fishes, but how this system interacts with other endocrine systems is largely unknown. Given the well-documented consequences of mounting a glucocorticoid stress response on growth, we hypothesized that cortisol inhibits anabolic processes by modulating the expression of hepatic igfbp mRNAs. Atlantic salmon (Salmo salar) parr were implanted intraperitoneally with cortisol implants (0, 10, and 40 μg g−1 body weight) and sampled after 3 or 14 days. Cortisol elicited a dose-dependent reduction in specific growth rate (SGR) after 14 days. While plasma Gh and Igf1 levels were unchanged, hepatic igf1 mRNA was diminished and hepatic igfbp1b1 and -1b2 were stimulated by the high cortisol dose. Plasma Igf1 was positively correlated with SGR at 14 days. Hepatic gh receptor (ghr), igfbp1a, -2a, -2b1, and -2b2 levels were not impacted by cortisol. Muscle igf2, but not igf1 or ghr, levels were stimulated at 3 days by the high cortisol dose. As both cortisol and the Gh/Igf axis promote seawater (SW) tolerance, and particular igfbps respond to SW exposure, we also assessed whether cortisol coordinates the expression of branchial igfbps and genes associated with ion transport. Cortisol stimulated branchial igfbp5b2 levels in parallel with Na+/K+-ATPase (NKA) activity and nka-α1b, Na+/K+/2Cl--cotransporter 1 (nkcc1), and cystic fibrosis transmembrane regulator 1 (cftr1) mRNA levels. The collective results indicate that cortisol modulates the growth of juvenile salmon via the regulation of hepatic igfbp1s whereas no clear links between cortisol and branchial igfbps previously shown to be salinity-responsive could be established.
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| 10. |
- Eliasson, Björn, 1959, et al.
(författare)
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Hyperinsulinaemia impairs gastrointestinal motility and slows carbohydrate absorption
- 1995
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Ingår i: Diabetologia. - 0012-186X. ; 38:1, s. 79-85
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Tidskriftsartikel (refereegranskat)abstract
- Experimental euglycaemic hyperinsulinaemia (insulin levels 46 +/- 4 mU/l) impaired the post-absorptive gastrointestinal motility in healthy individuals; the effect being particularly pronounced in the upper gastrointestinal tract (stomach and proximal duodenum). The postprandial gastric emptying, measured with a standardized 99mTc labelled meal, was also significantly delayed (t50 increased by 38% or 32 min). This was combined with a slower carbohydrate absorption (delay in peak blood glucose level about 40 min). Furthermore, during experimental hyperinsulinaemia higher blood glucose levels were seen at 120 min than at 60 min after food ingestion. This was not seen in any subject in the control study where only 0.9% NaCl was infused. Blood levels of the motility-stimulating hormone, motilin, were significantly lower during experimental hyperinsulinaemia. Thus, experimental hyperinsulinaemia impairs the gastrointestinal motility in both the postabsorptive and postprandial states. This effect is combined with a delayed carbohydrate absorption. Hyperinsulinaemia per se may thus lead to alterations in carbohydrate absorption and can also contribute to the gastrointestinal disturbances in diabetes.
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