| 1. |
- Bobjer, Johannes, et al.
(författare)
-
Location of retroperitoneal lymph node metastases in upper tract urothelial carcinoma : results from a prospective lymph node mapping study
- 2023
-
Ingår i: European Urology Open Science. - : Elsevier. - 2666-1691 .- 2666-1683. ; 57, s. 37-44
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is limited information on the distribution of retroperitoneal lymph node metastases (LNMs) in upper tract urothelial carcinoma (UTUC).Objective: To investigate the location of LNMs in UTUC of the renal pelvis or proximal ureter and short-term complications after radical nephroureterectomy (RNU) with lymph node dissection (LND).Design, setting, and participants: This was a prospective Nordic multicenter study (four university hospitals, two county hospitals). Patients with clinically suspected locally advanced UTUC (stage >T1) and/or clinical lymph node–positive (cN+) disease were invited to participate. Participants underwent RNU and fractionated retroperitoneal LND using predefined side-specific templates.Outcome measurements and statistical analysis: The location of LNMs in the LND specimen and retroperitoneal lymph node recurrences during follow-up was recorded. Postoperative complications within 90 d of surgery were ascertained from patient charts. Descriptive statistics were used.Results and limitations: LNMs were present in the LND specimen in 23/100 patients, and nine of 100 patients experienced a retroperitoneal recurrence. Distribution per side revealed LNMs in the LND specimen in 11/38 (29%) patients with right-sided tumors, for whom the anatomically larger, right-sided template was used, in comparison to 12/62 (19%) patients with left-sided tumors, for whom a more limited template was used. High-grade complications (Clavien grade ≥3) within 90 d of surgery were registered for 13/100 patients. The study is limited in size and not powered to assess survival estimates.Conclusions: The suggested templates that we prospectively applied for right-sided and left-sided LND in patients with advanced UTUC included the majority of LNMs. High-grade complications directly related to the LND part of the surgery were limited.Patient summary: This study describes the location of lymph node metastases in patients with cancer in the upper urinary tract who underwent surgery to remove the affected kidney and ureter. The results show that most metastases occur within the template maps for lymph node surgery that we investigated, and that this surgery can be performed with few severe complications.
|
|
| 2. |
- Brändstedt, Johan, et al.
(författare)
-
Urosymphyseal fistula after pelvic radiotherapy in a tertial referral centre : a rare entity with significant comorbidity requiring multidisciplinary management
- 2023
-
Ingår i: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 58, s. 4-10
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To report population-based clinical presentation and outcomes in patients with urosymphyseal fistula (USF) after pelvic radiotherapy (RT).Patients and methods: A retrospective chart review was performed in 33 consecutive patients diagnosed with suspicion of USF in a tertial referral center from 2014–2022 to ascertain information about diagnostic delay, clinical presentation, precipitating causes, treatments received and outcomes during the median 22 months follow-up. Out of 33 consecutive patients with suspicion of USF, one female with vesicovaginal fistula, one patient developing RT-associated bladder angiosarcoma, four patients with short follow-up (<3 months), and three patients that during chart review not were considered to have a USF were excluded.Results: In all, 24 males with a median age of 77 years were diagnosed with USF. Local pain was the predominating symptom in 17/24 (71%) patients. Endourologic manipulations preceded the diagnosis of USF in 16 patients. Five patients had a diagnostic delay of more than 3 months. At diagnosis, 20/24 patients had radiological signs of osteomyelitis, and five had a concomitant rectourethral fistula. Due to comorbidity, five patients were not amenable to any other interventions than urinary catheter or suprapubic tube in conjunction with long-term antibiotics, of which three died from infections related to the USF. Out of the remaining 19 patients receiving some form of urinary diversion, five had recurrent osteomyelitis, of which four did not undergo cystectomy in conjunction with surgery for the USF.Conclusions: Urethral endourologic interventions in patients previously subjected to pelvic RT should be performed cautiously.
|
|
| 3. |
- Ahlgren Cederlöf, Ebba
(författare)
-
The short, excited life of tellurium : Lifetime analysis of excited states in the Te midshell region
- 2024
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this licentiate thesis, lifetimes of low lying excited states in the midshell region of tellurium isotopes are discussed. The nuclear lifetimes are interesting properties to study, since they are inversely proportional to the transition probabilities, which contain information on the underlying structure of the nucleus. By measuring the lifetime of a transition, information can be gained on e.g. the collectivity of the state.The main results presented in this thesis are the lifetime measurements of the 2+ → 0+ and 4+ → 2+ transitions in 118Te described in Paper I. The principal aim of this paper was to reduce the relative uncertainty in the 2+ lifetime, to better see the trend of the 2+ → 0+ transition probabilities over the tellurium isotopic chain.The work presented in Paper I is based on data from an experiment conducted in 2017 at the JYFL accelerator facility in Jyväskylä, Finland. In this experiment, excited states of were populated in the fusion-evaporation reaction 100Mo(22Ne,4n)118Te at a beam energy of 75 MeV. The lifetimes were extracted using the Recoil Distance Doppler Shift (RDDS) technique, with the Jurogam II γ-ray spectrometer coupled to the Differential Plunger for Unbound Nuclear States (DPUNS). Data analysis was performed using the Differential Decay Curve Method (DDCM) in coincidence mode. The lifetimes were determined to be τ2+ = 7.46(19) ps and τ4+ = 4.25(23) ps, in agreement with previous measurements, but with reduced uncertainty. In the case of the 2+ lifetime, the new result reduces the relative uncertainty of the lifetime from 16% to 2.5%, allowing for more precise tests of theoretical predictions.In addition to 118Te, an analysis of lifetimes of low-lying excited states in the odd-A nuclei 117Te and 119Te is ongoing and an experiment aiming to measure lifetimes in 116Te has been accepted. These nuclides will also be discussed in this thesis.
|
|
| 4. |
- Atac Nyberg, Ayse, et al.
(författare)
-
Discrimination of gamma rays due to inelastic neutron scattering in AGATA
- 2009
-
Ingår i: Nuclear Instruments and Methods in Physics Research Section A. - : Elsevier BV. - 0168-9002 .- 1872-9576. ; 607:3, s. 554-563
-
Tidskriftsartikel (refereegranskat)abstract
- Possibilities of discriminating neutrons and gamma rays in the AGATA gamma-ray tracking spectrometer have been investigated with the aim of reducing the background due to inelastic scattering of neutrons in the high-purity germanium crystals. This background may become a serious problem especially in experiments with neutron-rich radioactive ion beams. Simulations using the GEANT4 toolkit and a tracking program based on the forward tracking algorithm were carried out by emitting neutrons and gamma rays from the center of AGATA. Three different methods were developed and tested in order to find "fingerprints" of the neutron interaction points in the detectors. In a simulation with simultaneous emission of six neutrons with energies in the range 1-5 MeV and 10 gamma rays with energies between 150 and 1450 keV, the peak-to-background ratio at a gamma-ray energy of 1.0 MeV was improved by a factor of 2.4 after neutron rejection with a reduction of the photopeak efficiency at 1.0 MeV of only a factor of 1.25. (C) 2009 Elsevier B.V. All rights reserved.
|
|
| 5. |
- Boutachkov, P., et al.
(författare)
-
High-spin isomers in 96Ag : excitations across the Z=38 and Z=50, N=50 closed shells
- 2011
-
Ingår i: Physical Review C. Nuclear Physics. - 0556-2813 .- 1089-490X. ; 84:4
-
Tidskriftsartikel (refereegranskat)abstract
- Excited states in (96)Ag were populated in fragmentation of an 850-MeV/u (124)Xe beam on a 4-g/cm(2) Be target. Three new high-spin isomers were identified and the structure of the populated states was investigated. The level scheme of (96)Ag was established, and a spin parity of (13(-)), (15(+)), and (19(+)) was assigned to the new isomeric states. Shell-model calculations were performed in various model spaces, including pi nu(p(1/2), g(9/2), f(5/2), p(3/2)) and the large-scale shell-model space pi nu(gds), to account for the observed parity changing M2 and E3 transitions from the (13(-)) isomer and the E2 and E4 transitions from the (19(+)) core-excited isomer, respectively. The calculated level schemes and reduced transition strengths are found to be in very good agreement with the experiment.
|
|
| 6. |
- Cederwall, Bo, et al.
(författare)
-
Evidence for a spin-aligned neutron-proton paired phase from the level structure of 92Pd
- 2011
-
Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 469:7328, s. 68-71
-
Tidskriftsartikel (refereegranskat)abstract
- Shell structure and magic numbers in atomic nuclei were generally explained by pioneering work(1) that introduced a strong spin-orbit interaction to the nuclear shell model potential. However, knowledge of nuclear forces and the mechanisms governing the structure of nuclei, in particular far from stability, is still incomplete. In nuclei with equal neutron and proton numbers (N = Z), enhanced correlations arise between neutrons and protons (two distinct types of fermions) that occupy orbitals with the same quantum numbers. Such correlations have been predicted to favour an unusual type of nuclear superfluidity, termed isoscalar neutron-proton pairing(2-6), in addition to normal isovector pairing. Despite many experimental efforts, these predictions have not been confirmed. Here we report the experimental observation of excited states in the N = Z = 46 nucleus Pd-92. Gamma rays emitted following the Ni-58(Ar-36,2n)Pd-92 fusion-evaporation reaction were identified using a combination of state-of-the-art high-resolution c-ray, charged-particle and neutron detector systems. Our results reveal evidence for a spin-aligned, isoscalar neutron-proton coupling scheme, different from the previous prediction(2-6). We suggest that this coupling scheme replaces normal superfluidity (characterized by seniority coupling(7,8)) in the ground and low-lying excited states of the heaviest N = Z nuclei. Such strong, isoscalar neutron-proton correlations would have a considerable impact on the nuclear level structure and possibly influence the dynamics of rapid proton capture in stellar nucleosynthesis.
|
|
| 7. |
- Cederwall, B., et al.
(författare)
-
Isospin Properties of Nuclear Pair Correlations from the Level Structure of the Self-Conjugate Nucleus Ru-88
- 2020
-
Ingår i: Physical Review Letters. - : AMER PHYSICAL SOC. - 0031-9007 .- 1079-7114. ; 124:6
-
Tidskriftsartikel (refereegranskat)abstract
- The low-lying energy spectrum of the extremely neutron-deficient self-conjugate (N = Z) nuclide Ru-88(44)44 has been measured using the combination of the Advanced Gamma Tracking Array (AGATA) spectrometer, the NEDA and Neutron Wall neutron detector arrays, and the DIAMANT charged particle detector array. Excited states in Ru-88 were populated via the Fe-54(Ar-36, 2n gamma)Ru-88* fusion-evaporation reaction at the Grand Accelerateur National d'Ions Lourds (GANIL) accelerator complex. The observed gamma-ray cascade is assigned to Ru-88 using clean prompt gamma-gamma-2-neutron coincidences in anticoincidence with the detection of charged particles, confirming and extending the previously assigned sequence of low-lying excited states. It is consistent with a moderately deformed rotating system exhibiting a band crossing at a rotational frequency that is significantly higher than standard theoretical predictions with isovector pairing, as well as observations in neighboring N > Z nuclides. The direct observation of such a "delayed" rotational alignment in a deformed N = Z nucleus is in agreement with theoretical predictions related to the presence of strong isoscalar neutron-proton pair correlations.
|
|
| 8. |
- Ciemala, M., et al.
(författare)
-
Testing ab initio nuclear structure in neutron-rich nuclei : Lifetime measurements of second 2(+) state in C-16 and O-20
- 2020
-
Ingår i: Physical Review C. - : AMER PHYSICAL SOC. - 2469-9985 .- 2469-9993. ; 101:2
-
Tidskriftsartikel (refereegranskat)abstract
- To test the predictive power of ab initio nuclear structure theory, the lifetime of the second 2(+) state in neutron-rich O-20, tau(2(2)(+)) = 150(-30)(+80) fs, and an estimate for the lifetime of the second 2(+) state in C-16 have been obtained for the first time. The results were achieved via a novel Monte Carlo technique that allowed us to measure nuclear state lifetimes in the tens-to-hundreds of femtoseconds range by analyzing the Doppler-shifted gamma-transition line shapes of products of low-energy transfer and deep-inelastic processes in the reaction O-18 (7.0 MeV/u) + Ta-181. The requested sensitivity could only be reached owing to the excellent performances of the Advanced gamma-Tracking Array AGATA, coupled to the PARIS scintillator array and to the VAMOS++ magnetic spectrometer. The experimental lifetimes agree with predictions of ab initio calculations using two- and three-nucleon interactions, obtained with the valence-space in-medium similarity renormalization group for O-20 and with the no-core shell model for C-16. The present measurement shows the power of electromagnetic observables, determined with high-precision gamma spectroscopy, to assess the quality of first-principles nuclear structure calculations, complementing common benchmarks based on nuclear energies. The proposed experimental approach will be essential for short lifetime measurements in unexplored regions of the nuclear chart, including r-process nuclei, when intense beams, produced by Isotope Separation On-Line (ISOL) techniques, become available.
|
|
| 9. |
- Ekblom Bak, Elin, 1981-, et al.
(författare)
-
Accelerometer derived physical activity patterns in 27.890 middle‐aged adults : The SCAPIS cohort study
- 2022
-
Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 32:5, s. 866-880
-
Tidskriftsartikel (refereegranskat)abstract
- The present study aims to describe accelerometer-assessed physical activity (PA) patterns and fulfillment of PA recommendations in a large sample of middle-aged men and women, and to study differences between subgroups of socio-demographic, socio-economic, and lifestyle-related variables. A total of 27 890 (92.5% of total participants, 52% women, aged 50–64 years) middle-aged men and women with at least four days of valid hip-worn accelerometer data (Actigraph GT3X+, wGT3X+ and wGT3X-BT) from the Swedish CArdioPulmonary bioImage Study, SCAPIS, were included. In total, 54.5% of daily wear time was spent sedentary, 39.1% in low, 5.4% in moderate, and only 0.1% in vigorous PA. Male sex, higher education, low financial strain, born in Sweden, and sedentary/light working situation were related to higher sedentary time, but also higher levels of vigorous PA. High BMI and having multiple chronic diseases associated strongly with higher sedentary time and less time in all three PA intensities. All-year physically active commuters had an overall more active PA pattern. The proportion fulfilling current PA recommendations varied substantially (1.4% to 92.2%) depending on data handling procedures and definition used. Twenty-eight percent was defined as having an “at-risk” behavior, which included both high sedentary time and low vigorous PA. In this large population-based sample, a majority of time was spent sedentary and only a fraction in vigorous PA, with clinically important variations between subgroups. This study provides important reference material and emphasizes the importance of a comprehensive assessment of all aspects of the individual PA pattern in future research and clinical practice.
|
|
| 10. |
- Ekström, Magnus, et al.
(författare)
-
Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women.
- 2024
-
Ingår i: Respiratory research. - : BioMed Central (BMC). - 1465-993X .- 1465-9921. ; 25:1
-
Tidskriftsartikel (refereegranskat)abstract
- Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population.Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50-64 years. Breathlessness (modified Medical Research Council [mMRC] ≥ 2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease.We included 25,948 people aged 57.5 ± [SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0-29.9), 21% obese (BMI ≥ 30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6-66.0%), stress (31.6-76.8%), respiratory disease (20.1-37.1%), depression (17.1-26.6%), cardiac disease (6.3-12.7%), anemia (0.8-3.3%), and peripheral arterial disease (0.3-0.8%). Stress was the main factor in women and current smokers.Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting-supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.
|
|
