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- Flygt, Hjalmar, et al.
(författare)
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Successful tyrosine kinase inhibitor discontinuation outside clinical trials - data from the population-based Swedish chronic myeloid leukaemia registry
- 2021
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Ingår i: British Journal of Haematology. - : John Wiley & Sons. - 0007-1048 .- 1365-2141. ; 193:5, s. 915-921
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Tidskriftsartikel (refereegranskat)abstract
- Clinical trials show that tyrosine kinase inhibitor (TKI) treatment can be discontinued in selected patients with chronic myeloid leukaemia (CML). Although updated CML guidelines support such procedure in clinical routine, data on TKI stopping outside clinical trials are limited. In this retrospective study utilising the Swedish CML registry, we examined TKI discontinuation in a population-based setting. Out of 584 patients diagnosed with chronic-phase CML (CML-CP) in 2007-2012, 548 had evaluable information on TKI discontinuation. With a median follow-up of nine years from diagnosis, 128 (23%) discontinued TKI therapy (>= 1 month) due to achieving a DMR (deep molecular response) and 107 (20%) due to other causes (adverse events, allogeneic stem cell transplant, pregnancy, etc). Among those stopping in DMR, 49% re-initiated TKI treatment (median time to restart 4 center dot 8 months). In all, 38 patients stopped TKI within a clinical study and 90 outside a study. After 24 months 41 center dot 1% of patients discontinuing outside a study had re-initiated TKI treatment. TKI treatment duration pre-stop was longer and proportion treated with second-generation TKI slightly higher outside studies, conceivably affecting the clinical outcome. In summary we show that TKI discontinuation in CML in clinical practice is common and feasible and may be just as successful as when performed within a clinical trial.
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- Akil, Shahnaz, et al.
(författare)
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Influence of different time framings, reconstruction algorithms and post-processing methods on the quantification of myocardial blood flow from 13N-NH3 PET images
- 2024
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 44:2, s. 154-163
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to investigate to what extent the quantification of myocardial blood flow (MBF) from dynamic 13N-NH3 positron emission tomography (PET) images is affected by time frame schemes, time-of-flight (ToF), reconstruction algorithms, blood pool volume of interest (VOI) locations and compartment models in patients with suspected chronic coronary syndrome. Methods: A standard MBF value was determined from 25 patients' rest/stress 13N-NH3 PET/CT images reconstructed with ordered subset expectation maximization (OSEM), 5 s time frame for the first frames without ToF, subsequently analyzed using a basal VOI and the deGrado compartment model. MBFs calculated using 2 or 10 s for the first frames, ToF, block-sequential regularized expectation maximization (BSREM), apical or large VOI, Hutchins or Krivokapich compartment models were compared to MBFstandard in Bland–Altman plots (bias ± SD). Results: Good agreement in global rest/stress MBF (mL/min/g) was found when changing the time frame scheme or reconstruction algorithm (MBFstandard vs. MBF2s: −0.02 ± 0.06; MBF10s: 0.01 ± 0.07; MBFBSREM: 0.01 ± 0.07), while a lower level of agreement was found when altering the other factors (MBFstandard vs. MBFToF: −0.07 ± 0.10; MBFapical VOI: −0.27 ± 0.25; MBFlarge VOI: −0.11 ± 0.10; MBFHutchins: −0.08 ± 0.10; MBFKrivokapich: −0.47 ± 0.50). Conclusions: Quantification of MBF from 13N-NH3 PET images is more affected by choice of compartment models, ToF and blood pool VOIs than by different time frame schemes and reconstruction algorithms.
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- Alkan Olsson, Johanna, et al.
(författare)
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A model-supported participatory process for nutrient management: a socio-legal analysis of a bottom-up implementation of the EU Water Framework Directive
- 2011
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Ingår i: International Journal of Agricultural Sustainability. - : Informa UK Limited. - 1473-5903 .- 1747-762X. ; 9:2, s. 379-389
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Tidskriftsartikel (refereegranskat)abstract
- A methodology for local stakeholders' involvement in water management using a catchment model as a platform for dialogue has been developed and tested in the Kaggebo Bay drainage area in the southeast of Sweden. The process involved farmers, rural households not connected to municipal wastewater treatment facilities, local and regional authorities as well as different water and agricultural experts. This paper aims to assess whether and how the methodology has succeeded in encouraging social learning and promoting action and which barriers can be identified. The assessment shows that the methodology is able to create confidence in the process and increase the willingness to act as the methodology was able to adapt the form and content of the dialogue to better fit the cognitive and relational needs of involved stakeholders. It is also shown that the process may lead to a probable improvement of the eutrophication situation. However, if these types of processes are to serve not only as a basis for social learning and action at the local level, but also as the basis for a broader process of societal learning, then a mechanism to confer local ideas to the regional and national levels has to be clarified.
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- Alkan Olsson, Johanna, et al.
(författare)
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How participatory can participatory modeling be? Degrees of influence of stakeholder and expert perspectives in six dimensions of participatory modeling
- 2007
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Ingår i: Water Science and Technology. - : IWA Publishing. - 0273-1223 .- 1996-9732. ; 56:1, s. 207-214
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Tidskriftsartikel (refereegranskat)abstract
- The authors are involved in a project aiming at the development of a methodology for participatory modeling as a tool for public participation in water resource management. In this paper, some examples of different degrees of stakeholder influence in six key dimensions of participatory modeling are identified and discussed. Arnstein's (A ladder of citizen participation. Journal of the American Institute of Planners, 1969, 4, 216–224) critical discussion of different degrees of “real” decision-making power is taken as a point of departure to assess possible degrees of stakeholder influence. Can we as participatory modelers be sure that we are really inviting our research objects to an equal communicative relationship where local perspectives, knowledge and priorities are respected to the same extent as central and/or expert perspectives? This paper presents an approach that could be used as a tool for structured reflection to avoid unreflective tendencies towards expert knowledge dominance and low degree of stakeholders' real influence over the process.
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- Andersson, Lena, et al.
(författare)
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Hydrolysis of galactolipids by human pancreatic lipolytic enzymes and duodenal contents
- 1995
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Ingår i: Journal of Lipid Research. - 1539-7262. ; 36:6, s. 1392-1400
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Tidskriftsartikel (refereegranskat)abstract
- Monogalactosyldiacylglycerols (MGDG), digalactosyldiacylglycerols (DGDG) and sulfoquinovosyldiacylglycerols (SQDG) are major lipids in vegetable food. Their digestion and absorption are unknown. This study examines the hydrolysis of galactolipids in vitro with human duodenal contents, pancreatic juice, and purified human pancreatic lipases. Galactolipids were incubated with human duodenal contents, pancreatic juice, pure pancreatic carboxyl ester lipase (CEL), and colipase-dependent lipase with colipase (Lip-Col). Hydrolysis was estimated as release of free fatty acids and by the use of [3H]galactose or [3H]fatty acid-labeled DGDG. Pancreatic juice and duodenal contents hydrolyzed DGDG to fatty acids, digalactosylmonoacylglycerol (DGMG) and water-soluble galactose-containing compounds. The hydrolysis of DGDG was bile salt-dependent and had a pH optimum at 6.5-7.5. Human pancreatic juice released fatty acids from MGDG, DGDG, and SQDG. Purified CEL hydrolyzed all three substrates; the hydrolysis rate was MGDG > SQDG > DGDG. Pure Lip-Col had activity toward MGDG but had little activity against DGDG. Separation of pancreatic juice by Sephadex G100 gel filtration chromatography revealed two peaks with galactolipase activity that coincided with CEL (molecular mass 100 kD) and lipase (molecular mass 50 kD) peaks. In contrast to pure Lip-Col enzymes of the latter peak were as active against DGDG as against MGDG. Thus, DGDG is hydrolyzed both by CEL and by a pancreatic enzyme(s) with a molecular mass of 40-50 kD to fatty acids and lyso DGDG. MGDG, DGDG, and SQDG are all hydrolyzed by human pancreatic juice. Pure CEL hydrolyzed all three substrates.
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