| 1. |
- Boman, Krister K., et al.
(författare)
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Long-term outcomes of childhood cancer survivors in Sweden : a population-based study of education, employment, and income
- 2010
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Ingår i: Cancer. - : Wiley. - 0008-543X .- 1097-0142. ; 116:5, s. 1385-1391
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies of different national populations were indispensable for estimating the impact of illness-related disability on social outcomes in adult childhood cancer survivors. The effects of childhood cancer on educational attainment, employment, and income in adulthood in a Swedish setting were studied. METHODS: The study population was a national cohort of 1.46 million Swedish residents, including 1716 survivors of childhood cancer diagnosed before their 16th birthday, followed up in 2002 in registries at >25 years of age. Main outcomes were educational attainment, employment, and net income. Markers of persistent disability were considered, and outcomes were analyzed with multivariate linear and logistic regression models adjusted for age, sex, and socioeconomic indicators of the childhood households. RESULTS: Non-central nervous system (CNS) cancer survivors had similar education, employment, and income as the general population in adjusted models, whereas survivors of CNS tumors more often had no more than basic (< or =9 years) education (relative risk [RR], 1.80 [95% confidence interval (95% CI), 1.45-2.23]), less often attained education beyond secondary school (RR, 0.69 [95% CI, 0.58-0.81]), and less often were employed (RR, 0.85 [95% CI, 0.77-0.94]). Predicted net income from work was lower in CNS tumor survivors (P <.001) than in the general population, even after the exclusion of individuals who received economic disability compensation. CONCLUSIONS : CNS tumor survivors had poorer social outcomes compared with the general population, whereas outcomes for survivors of other childhood cancers were similar to the general population. Established late effects highlighted the importance of improved, safer pediatric CNS tumor treatment protocols and surveillance that identified individual needs for preventive and remedial measures.
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| 2. |
- Brown, Jamie S., et al.
(författare)
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Clinical, patient-reported, radiographic and magnetic resonance imaging findings 11 years after acute posterior cruciate ligament injury treated non-surgically
- 2023
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Ingår i: BMC Musculoskeletal Disorders. - 1471-2474. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term consequences of posterior cruciate ligament (PCL) injury such as persistent posterior tibial translation and risk of osteoarthritis development are unclear. Additionally, little data is available describing the natural history of structural morphology of the ruptured PCL. The purpose of the study was to determine the long-term outcome after non-operatively treated PCL injury. Methods: Over 6-years, all acute knee injuries were documented by subacute MRI (median 8 days [5–15, 25th − 75th percentile] from injury to MRI). Twenty-six patients with acute PCL injury were identified of whom 18 (69%) participated in the long-term follow-up after 11 years. Follow-up included radiographic posterior tibial translation (RPTT) determined using the Puddu axial radiograph. weight-bearing knee radiographs, MRI and KOOS (Knee injury and Osteoarthritis Outcome Score). Results: On subacute MRI, 11 knees displayed total and 7 partial ruptures. At 11 (SD 1.9) years, the median RPTT was 3.7 mm (1.5–6.3, 25th − 75th percentile). Seven knees displayed radiographic osteoarthritis approximating Kellgren-Lawrence grade ≥ 2. All follow-up MRIs displayed continuity of the PCL. Patients with more severe RPTT (> 3.7 mm), had worse scores in the KOOS subscales for symptoms (mean difference 14.5, 95% CI 7–22), sport/recreation (30, 95% CI 0–65) and quality of life (25, 95% CI 13–57) than those with less severe RPTT (≤ 3.7 mm). This was also the case for the KOOS4 (22, 95% CI 9–34). Conclusion: Acute PCL injuries treated non-surgically display a high degree of PCL continuity on MR images 11 years after injury. However, there is a large variation of posterior tibial translation with higher values being associated with poorer patient-reported outcomes.
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| 3. |
- Gribenski, Natacha, 1986-
(författare)
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Comparison of dating methods for paleoglacial reconstruction in Central Asia
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Reconstruction of former Central Asian glaciers extents can provide valuable information about past atmospheric circulation variations. These extents, often marked by terminal moraines, need to be chronologically constrained. Cosmogenic nuclide exposure (CNE) dating is widely used to directly date moraines. In addition, there is increasing interest on using optically stimulated luminescence (OSL) techniques for dating glacial landforms. This thesis focuses on the methodological aspects of directly dating glacial landforms to perform paleoglacial reconstructions in Central Asia, with an emphasis on OSL dating.For OSL dating of sediments from glacial settings, it is important to measure the luminescence signal at the single grain scale, because the sediments are likely affected by partial bleaching due to short light exposure during glacial or glaciofluvial transport. The use of an Electron Multiplying Charges Coupled Device (EMCCD)-based imaging system for single grain OSL measurements would offer larger flexibility in light stimulation and sediment type, compared to the current Single Grain Risø reader. An automated image processing procedure has been developed to compensate for sample carrier displacement over repeated measurements and for attributing pixels to each grain for signal integration when using this imaging system. However, significant cross talk contamination, demonstrated by laboratory and simulation experiments, prohibits accurate single grain luminescence measurements. Preliminary experiments using a basic image processing algorithm show good potential for software correction solutions.Paleoglacial reconstructions conducted in the Altai Mountains, Central Asia, using both CNE and OSL dating demonstrate that luminescence measurements of glaciofluvial sediments performed at the multi-grain scale result in large age overestimates, and that single grain measurements allow for more accurate dating of glacial landforms. However, uncertainties remain that are related to the model used for extracting equivalent doses for well-bleached grains and to fading corrections when using feldspar minerals. The timing of glaciation can be inferred from scattered CNE moraine boulder ages if most of the ages are concentrated within a few thousand years, with only few ages clearly older or younger. Overall, combining CNE and OSL techniques for dating a glacial landform is a powerful approach for producing robust glacial chronologies, despite uncertainties inherent to each technique.Paleoglacial reconstructions from the Altai Mountains indicate Marine Isotope Stage (MIS) 2 and MIS 4/late MIS 5 local Last Glacial Maximums. In Central Asia, in addition to a regional MIS 2 glaciation, previous studies indicate a period of major glacial advances during MIS 3 that is out of phase with global ice volume records. However, most MIS 3 glacial chronologies from Central Asia are based on too few or too heavily scattered CNE data sets, or on OSL or Electron Spin Resonance (ESR) ages for which partial bleaching has not been properly investigated. Hence, at this stage, chronological evidence is insufficient to demonstrate a regional MIS 3 glaciation in Central Asia.Surge-related glacial features identified in the Russian Altai also highlight the importance of conducting detailed geomorphology and sedimentology studies to understand former ice dynamics, which is essential for inferring appropriate paleoclimate information from paleoglacial reconstructions.
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| 4. |
- Gribenski, Natacha, 1986-, et al.
(författare)
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Major glaciation in Central Asia during MIS 3: reality or dating artefact?
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Previous investigations have concluded that a period of major glacial advances occurred during Marine Isotope Stage (MIS) 3 (57-29 ka) in Central Asia, out of phase with global ice volume records. We have re-examined the Kanas moraine complex in the Altai Mountains, where an MIS 3 glaciation has been previously inferred. New cosmogenic exposure and single grain luminescence ages indicate that the Kanas complex was formed during MIS 2 (29-12 ka); we regard the initial MIS 3 interpretation as a result of dating artefacts. Building on this example, we reanalyze chronological data associated with proposed major MIS 3 glacial advances in Central Asia (24 sites). We find that chronological data do not allow glaciation timing inferences for most of the sites, and that chronological evidence for major MIS 3 glacial advance only exists at one site.
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| 5. |
- Hjern, Anders, et al.
(författare)
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Disability in adult survivors of childhood cancer : a Swedish national cohort study.
- 2007
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Ingår i: J Clin Oncol. - 1527-7755 .- 0732-183X. ; 25:33, s. 5262-6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Disability in adult survivors of childhood cancer: a Swedish national cohort study.Hjern A, Lindblad F, Boman KK.Karolinska Institutet, Childhood Cancer Research Unit, Astrid Lindgren Children's Hospital Q6:05, 171 76 Stockholm, Sweden.PURPOSE: We studied the effects of childhood or adolescent cancer and cancer treatment on disability as indicated by persistent aid needs in adult life. PATIENTS AND METHODS: A group of 2,503 survivors of childhood cancer diagnosed before their 16th birthday were studied with data from registers in a national cohort of 1.91 million Swedish residents. Disability indicators were created from information in national registers about income (sickness pension, handicap allowance), personal assistance, and family situation in 2002. Multivariate logistic regression on the log scale was used to estimate relative risk (RR) ratios. RESULTS: A total of 7.6% of survivors received handicap allowance indicating permanent disability, including brain tumors (14.0%), other solid tumors (6.3), and leukemias/lymphomas (2.9%), compared with 0.6% in the general population. Twenty-six percent of survivors of CNS tumor and 10% of survivors of solid tumors had at least one indication of a disability. Younger age at diagnosis suggested a higher risk for disability. CNS tumor survivors had an RR of 10.7 (95% CI, 9.3 to 12.8) for having at least one disability indication compared with the noncancer population, whereas leukemia and lymphoma survivors had an RR of 3.0, and survivors of other cancers had an RR of 3.8. Survivors of CNS tumor only had an increased RR for living in the parental household (RR = 1.6; 95% CI, 1.4 to 1.9). CONCLUSION: Childhood cancer survivors more often have persistent needs of supportive measures provided by community and/or the parental household. The survivors of CNS tumors were at particular risk, indicating a need of safer treatment protocols, and tailored follow-up, prevention, and rehabilitation to address this persistent social disability.PMID: 18024873 [PubMed - indexed for MEDLINE]
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