| 1. |
- Beumer, B. R., et al.
(författare)
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Impact of muscle mass on survival of patients with hepatocellular carcinoma after liver transplantation beyond the Milan criteria
- 2022
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Ingår i: Journal of Cachexia, Sarcopenia and Muscle. - : Wiley. - 2190-5991 .- 2190-6009. ; 13:5, s. 2373-2382
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Tidskriftsartikel (refereegranskat)abstract
- Background: Access to the liver transplant waitlist for patients with hepatocellular carcinoma (HCC) depends on tumour presentation, biology, and response to treatments. The Milan Criteria (MC) represent the benchmark for expanded criteria that incorporate additional prognostic factors. The purpose of this study was to determine the added value of skeletal muscle index (SMI) in HCC patients beyond the MC. Method: Patients with HCC that were transplanted beyond the MC were included in this retrospective multicentre study. SMI was quantified using the Computed Tomography (CT) within 3months prior to transplantation. Cox regression models were used to identify predictors of overall survival (OS). The discriminative performance of SMI extended Metroticket 2.0 and AFP models was also assessed. Results: Out of 889 patients transplanted outside the MC, 528 had a CT scan within 3months prior to liver transplantation (LT), of whom 176 (33%) were classified as sarcopenic. The median time between assessment of the SMI and LT was 1.8months (IQR: 0.77–2.67). The median follow-up period was 5.1 95% CI [4.7–5.5] years, with a total of 177 recorded deaths from any cause. In a linear regression model with SMI as the dependent variable, only male gender (8.55 95% CI [6.51–10.59], P<0.001) and body mass index (0.74 95% CI [0.59–0.89], P<0.001) were significant. Univariable survival analysis of patients with sarcopenia versus patients without sarcopenia showed a significant difference in OS (HR 1.44 95% CI [1.07−1.94], P=0.018). Also the SMI was significant (HR 0.98 95% CI [0.96–0.99], P=0.014). The survival difference between the lowest SMI quartile versus the highest SMI quartile was significant (log-rank: P=0.005) with 5year OS of 57% and 71%, respectively. Data from 423 patients, describing 139 deaths, was used for multivariate analysis. Both sarcopenia (HR 1.45 95% CI [1.02−2.05], P=0.036) and SMI were (HR 0.98 95% CI [0.95–0.99], P=0.035) significant. On the survival scale this translates to a 5year OS difference of 11% between sarcopenia and no sarcopenia. Whereas for SMI, this translates to a survival difference of 8% between first and third quartiles for both genders. Conclusions: Overall, we can conclude that higher muscle mass contributes to a better long-term survival. However, for individual patients, low muscle mass should not be considered an absolute contra-indication for LT as its discriminatory performance was limited.
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| 2. |
- Tristao-Pereira, C., et al.
(författare)
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Longitudinal interplay between subclinical atherosclerosis, cardiovascular risk factors, and cerebral glucose metabolism in midlife: results from the PESA prospective cohort study
- 2023
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Ingår i: Lancet Healthy Longevity. - 2666-7568. ; 4:9
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Tidskriftsartikel (refereegranskat)abstract
- Background Cardiovascular disease and dementia often coexist at advanced stages. Yet, longitudinal studies examining the interplay between atherosclerosis and its risk factors on brain health in midlife are scarce. We aimed to characterise the longitudinal associations between cerebral glucose metabolism, subclinical atherosclerosis, and cardiovascular risk factors in middle-aged asymptomatic individuals. Methods The Progression of Early Subclinical Atherosclerosis (PESA) study is a Spanish longitudinal observational cohort study of 4184 asymptomatic individuals aged 40-54 years (NCT01410318). Participants with subclinical atherosclerosis underwent longitudinal cerebral [18F]fluorodeoxyglucose ([18F]FDG)-PET, and annual percentage change in [18F]FDG uptake was assessed (primary outcome). Cardiovascular risk was quantified with SCORE2 and subclinical atherosclerosis with three-dimensional vascular ultrasound (exposures). Multivariate regression and linear mixed effects models were used to assess associations between outcomes and exposures. Additionally, blood based biomarkers of neuropathology were quantified and mediation analyses were performed. Secondary analyses were corrected for multiple comparisons using the false discovery rate (FDR) approach. Findings This longitudinal study included a PESA subcohort of 370 participants (median age at baseline 49 & BULL;8 years [IQR 46 & BULL;1-52 & BULL;2]; 309 [84%] men, 61 [16%] women; median follow-up 4 & BULL;7 years [IQR 4 & BULL;2-5 & BULL;2]). Baseline scans took place between March 6, 2013, and Jan 21, 2015, and follow-up scans between Nov 24, 2017, and Aug 7, 2019. Persistent high risk of cardiovascular disease was associated with an accelerated decline of cortical [18F]FDG uptake compared with low risk (& beta;=-0 & BULL;008 [95% CI -0 & BULL;013 to -0 & BULL;002]; pFDR=0 & BULL;040), with plasma neurofilament light chain, a marker of neurodegeneration, mediating this association by 20% (& beta;=0 & BULL;198 [0 & BULL;008 to 0 & BULL;740]; pFDR=0 & BULL;050). Moreover, progression of subclinical carotid atherosclerosis was associated with an additional decline in [18F]FDG uptake in Alzheimer's disease brain regions, not explained by cardiovascular risk (& beta;=-0 & BULL;269 [95% CI -0 & BULL;509 to -0 & BULL;027]; p=0 & BULL;029). Interpretation Middle-aged asymptomatic individuals with persistent high risk of cardiovascular disease and subclinical carotid atherosclerosis already present brain metabolic decline, suggesting that maintenance of cardiovascular health during midlife could contribute to reductions in neurodegenerative disease burden later in life.
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| 3. |
- Huisman, J., et al.
(författare)
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ProSUM: Prospecting secondary Raw Materials in the Urban Mine and Mining Wastes
- 2017
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Ingår i: 2016 Electronics Goes Green 2016+, EGG 2016, Berlin, Germany, 6-9 September 2016.
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Konferensbidrag (refereegranskat)abstract
- ProSUM-Latin for 'I am useful'-aims to provide better information on raw materials from secondary origins. It focuses in particular on the content of Critical Raw Materials (CRMs) from Batteries (BATT), Waste Electrical and Electronic Equipment (WEEE), End of Life Vehicles (ELV) and Mining Wastes (MIN) available for processing in Europe. However, data for these products are usually very scattered amongst a variety of institutions, including government agencies, universities, NGOs and industry. This deficit is addressed in this H2020 funded project. ProSUM will establish a European network of expertise on secondary sources of CRMs, vital to today's high-tech society. It coordinates efforts to collect secondary CRM data and collate maps of stocks and flows for materials and products in the 'urban mine'. The project will construct a comprehensive inventory identifying and mapping CRM stocks and flows across the European Union (EU). Via a user-friendly, open-access Urban Mine Knowledge Data Platform (EU-UMKDP), it will combine and relate them to primary raw materials data from the EU-FP7 Minerals4EU project and communicate the results online through the future European Geological Data Infrastructure (EGDi) at large. It will also provide update protocols, standards and recommendations to maintain and expand the EU-UMKDP in the future.
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