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1.
  • Hibar, D. P., et al. (författare)
  • Cortical abnormalities in bipolar disorder: An MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group
  • 2018
  • Ingår i: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 23:4, s. 932-942
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen's d='0.293; P=1.71 × 10 '21), left fusiform gyrus (d='0.288; P=8.25 × 10 '21) and left rostral middle frontal cortex (d='0.276; P=2.99 × 10 '19). Longer duration of illness (after accounting for age at the time of scanning) was associated with reduced cortical thickness in frontal, medial parietal and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD. © 2018 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.
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2.
  • Thompson, Paul M., et al. (författare)
  • The ENIGMA Consortium : large-scale collaborative analyses of neuroimaging and genetic data
  • 2014
  • Ingår i: BRAIN IMAGING BEHAV. - : Springer Science and Business Media LLC. - 1931-7557 .- 1931-7565. ; 8:2, s. 153-182
  • Tidskriftsartikel (refereegranskat)abstract
    • The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium is a collaborative network of researchers working together on a range of large-scale studies that integrate data from 70 institutions worldwide. Organized into Working Groups that tackle questions in neuroscience, genetics, and medicine, ENIGMA studies have analyzed neuroimaging data from over 12,826 subjects. In addition, data from 12,171 individuals were provided by the CHARGE consortium for replication of findings, in a total of 24,997 subjects. By meta-analyzing results from many sites, ENIGMA has detected factors that affect the brain that no individual site could detect on its own, and that require larger numbers of subjects than any individual neuroimaging study has currently collected. ENIGMA's first project was a genome-wide association study identifying common variants in the genome associated with hippocampal volume or intracranial volume. Continuing work is exploring genetic associations with subcortical volumes (ENIGMA2) and white matter microstructure (ENIGMA-DTI). Working groups also focus on understanding how schizophrenia, bipolar illness, major depression and attention deficit/hyperactivity disorder (ADHD) affect the brain. We review the current progress of the ENIGMA Consortium, along with challenges and unexpected discoveries made on the way.
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3.
  • Hibar, D. P., et al. (författare)
  • Subcortical volumetric abnormalities in bipolar disorder
  • 2016
  • Ingår i: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 21:12, s. 1710-1716
  • Tidskriftsartikel (refereegranskat)abstract
    • Considerable uncertainty exists about the defining brain changes associated with bipolar disorder (BD). Understanding and quantifying the sources of uncertainty can help generate novel clinical hypotheses about etiology and assist in the development of biomarkers for indexing disease progression and prognosis. Here we were interested in quantifying case-control differences in intracranial volume (ICV) and each of eight subcortical brain measures: nucleus accumbens, amygdala, caudate, hippocampus, globus pallidus, putamen, thalamus, lateral ventricles. In a large study of 1710 BD patients and 2594 healthy controls, we found consistent volumetric reductions in BD patients for mean hippocampus (Cohen's d=-0.232; P=3.50 × 10 -7) and thalamus (d=-0.148; P=4.27 × 10 -3) and enlarged lateral ventricles (d=-0.260; P=3.93 × 10 -5) in patients. No significant effect of age at illness onset was detected. Stratifying patients based on clinical subtype (BD type I or type II) revealed that BDI patients had significantly larger lateral ventricles and smaller hippocampus and amygdala than controls. However, when comparing BDI and BDII patients directly, we did not detect any significant differences in brain volume. This likely represents similar etiology between BD subtype classifications. Exploratory analyses revealed significantly larger thalamic volumes in patients taking lithium compared with patients not taking lithium. We detected no significant differences between BDII patients and controls in the largest such comparison to date. Findings in this study should be interpreted with caution and with careful consideration of the limitations inherent to meta-analyzed neuroimaging comparisons. © 2016 Macmillan Publishers Limited, part of Springer Nature.
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5.
  • Gellanki, Jnaneswari, et al. (författare)
  • Characterization of Superdeformed Bands in 62Zn
  • 2009
  • Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 80:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Combined data from four fusion-evaporation reaction experiments were utilized to investigate deformed and superdeformed structures in Zn-62(30)32. Combination of the Gammasphere gamma-ray spectrometer and ancillary particle detection systems allowed for the connection of rotational bands to well-known, low-lying excited states in Zn-62, as well as spectroscopy of discrete high-spin states reaching excitation energies of E-x=42.5 MeV. Four well- or superdeformed bands in Zn-62 are characterized and described by means of cranked Nilsson-Strutinsky calculations.
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7.
  • Boy, M., et al. (författare)
  • Interactions between the atmosphere, cryosphere, and ecosystems at northern high latitudes
  • 2019
  • Ingår i: Atmospheric Chemistry and Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 19:3, s. 2015-2061
  • Tidskriftsartikel (refereegranskat)abstract
    • The Nordic Centre of Excellence CRAICC (Cryosphere-Atmosphere Interactions in a Changing Arctic Climate), funded by NordForsk in the years 2011-2016, is the largest joint Nordic research and innovation initiative to date, aiming to strengthen research and innovation regarding climate change issues in the Nordic region. CRAICC gathered more than 100 scientists from all Nordic countries in a virtual centre with the objectives of identifying and quantifying the major processes controlling Arctic warming and related feedback mechanisms, outlining strategies to mitigate Arctic warming, and developing Nordic Earth system modelling with a focus on short-lived climate forcers (SLCFs), including natural and anthropogenic aerosols. The outcome of CRAICC is reflected in more than 150 peer-reviewed scientific publications, most of which are in the CRAICC special issue of the journal Atmospheric Chemistry and Physics. This paper presents an overview of the main scientific topics investigated in the centre and provides the reader with a state-of-the-art comprehensive summary of what has been achieved in CRAICC with links to the particular publications for further detail. Faced with a vast amount of scientific discovery, we do not claim to completely summarize the results from CRAICC within this paper, but rather concentrate here on the main results which are related to feedback loops in climate change-cryosphere interactions that affect Arctic amplification.
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8.
  • Podolyák, Zs, et al. (författare)
  • Neutron-deficient N≈126 Nuclei Produced in 238U Fragmentation : Population of High-spin States
  • 2006
  • Ingår i: Frontiers in Nuclear Structure, Astrophysics, and Reactions - FINUSTAR. - : AIP. - 0735403236 - 9780735403239 ; 831, s. 114-118
  • Konferensbidrag (refereegranskat)abstract
    • The population of metastable states produced in relativistic-energy fragmentation of a 238U beam has been measured. For states with high angular momentum, I=17 and I=21.5, a higher population than expected has been observed, with the discrepancy increasing with angular momentum. By considering two sources for the angular momentum, related to single-particle and collective motions, a much improved description of the experimental results can be obtained. In addition, new results on the structure of 208Fr, 211Ra and 216Ac are reported.
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9.
  • Casar Borota, Olivera, et al. (författare)
  • Corticotroph Aggressive Pituitary Tumors and Carcinomas Frequently Harbor ATRX Mutations
  • 2021
  • Ingår i: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 106:4, s. 1183-1194
  • Tidskriftsartikel (refereegranskat)abstract
    • Context: Aggressive pituitary tumors (APTs) are characterized by unusually rapid growth and lack of response to standard treatment. About 1% to 2% develop metastases being classified as pituitary carcinomas (PCs). For unknown reasons, the corticotroph tumors are overrepresented among APTs and PCs. Mutations in the alpha thalassemia/mental retardation syndrome X-linked (ATRX) gene, regulating chromatin remodeling and telomere maintenance, have been implicated in the development of several cancer types, including neuroendocrine tumors. Objective: To study ATRX protein expression and mutational status of the ATRX gene in APTs and PCs. Design: We investigated ATRX protein expression by using immunohistochemistry in 30 APTs and 18 PCs, mostly of Pit-1 and T-Pit cell lineage. In tumors lacking ATRX immunolabeling, mutational status of the ATRX gene was explored. Results: Nine of the 48 tumors (19%) demonstrated lack of ATRX immunolabelling with a higher proportion in patients with PCs (5/18; 28%) than in those with APTs (4/30;13%). Lack of ATRX was most common in the corticotroph tumors, 7/22 (32%), versus tumors of the Pit-1 lineage, 2/24 (8%). Loss-of-function ATRX mutations were found in all 9 ATRX immunonegative cases: nonsense mutations (n = 4), frameshift deletions (n = 4), and large deletions affecting 22-28 of the 36 exons (n = 3). More than 1 ATRX gene defect was identified in 2 PCs. Conclusion: ATRX mutations occur in a subset of APTs and are more common in corticotroph tumors. The findings provide a rationale for performing ATRX immunohistochemistry to identify patients at risk of developing aggressive and potentially metastatic pituitary tumors.
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10.
  • Zannad, F., et al. (författare)
  • Clinical outcome endpoints in heart failure trials: a European Society of Cardiology Heart Failure Association consensus document
  • 2013
  • Ingår i: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 15:10, s. 1082-1094
  • Tidskriftsartikel (refereegranskat)abstract
    • Endpoint selection is a critically important step in clinical trial design. It poses major challenges for investigators, regulators, and study sponsors, and it also has important clinical and practical implications for physicians and patients. Clinical outcomes of interest in heart failure trials include all-cause mortality, cause-specific mortality, relevant non-fatal morbidity (e.g. all-cause and cause-specific hospitalization), composites capturing both morbidity and mortality, safety, symptoms, functional capacity, and patient-reported outcomes. Each of these endpoints has strengths and weaknesses that create controversies regarding which is most appropriate in terms of clinical importance, sensitivity, reliability, and consistency. Not surprisingly, a lack of consensus exists within the scientific community regarding the optimal endpoint(s) for both acute and chronic heart failure trials. In an effort to address these issues, the Heart Failure Association of the European Society of Cardiology (HFA-ESC) convened a group of expert heart failure clinical investigators, biostatisticians, regulators, and pharmaceutical industry scientists (Nice, France, 12-13 February 2012) to evaluate the challenges of defining heart failure endpoints in clinical trials and to develop a consensus framework. This report summarizes the group's recommendations for achieving common views on heart failure endpoints in clinical trials.
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11.
  • Andersson, Lise-Lotte, et al. (författare)
  • Extensive Gamma-ray Spectroscopy of Normally and Superdeformed Structures in 61Cu
  • 2008
  • Ingår i: European Physical Journal A. Hadrons and Nuclei. - : Springer Science and Business Media LLC. - 1434-6001. ; 36:3, s. 251-278
  • Tidskriftsartikel (refereegranskat)abstract
    • A largely extended experimental knowledge of the Cu-61(29)32 nucleus has been obtained from three experiments. Excited states in Cu-61 were produced via the fusion-evaporation reaction Si-28(Ar-36, 3p)Cu-61. In addition to the Ge array GAMMASPHERE, neutron and charged-particle detectors placed around the target position were used for high-performance particle spectroscopy. The constructed level scheme includes more than 160 energy levels and 320 gamma-ray transitions belonging to both normally deformed as well as superdeformed rotational structures. The multipolarities have been determined for the gamma-ray transitions and as a result spin-parity assignments are given for nearly all energy levels. Experimental results in the normally deformed region are compared with predictions from large-scale shell model calculations. The collective structures are compared with results from cranked Nilsson-Strutinsky calculations. The results reveal the need to modify the standard Nilsson parameters in the mass A similar to 60 region.
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12.
  • Bentley, M. A., et al. (författare)
  • Isospin symmetry of odd-odd mirror nuclei: Identification of excited states in N=Z-2 Mn-48
  • 2006
  • Ingår i: Physical Review Letters. - 1079-7114. ; 97:13: 132501
  • Tidskriftsartikel (refereegranskat)abstract
    • Excited states have been observed in the N=Z-2 odd-odd nucleus Mn-48 for the first time. Through comparison with the structure of V-48, a first high-spin study of an odd-odd mirror pair has been achieved. Differences between the T=1 analogue states in this pair have been interpreted in terms of Coulomb effects, with the aid of shell-model calculations in the full pf valence space. Unlike other mirror pairs, the energy differences have been interpreted almost entirely as due to a monopole effect associated with smooth changes in radius (or deformation) as a function of angular momentum. In addition, the large energy shift between analogue negative-parity states is interpreted in terms of the electromagnetic spin-orbit interaction in nuclei.
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14.
  • Johansson, Emma, et al. (författare)
  • Prompt Proton Decay and Deformed Bands in 56Ni
  • 2008
  • Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 77:6
  • Tidskriftsartikel (refereegranskat)abstract
    • High-spin states in the doubly magic N=Z nucleus Ni-56 have been investigated with three fusion-evaporation reaction experiments. New gamma-ray transitions are added, and a confirmation of a previously suggested prompt proton decay from a rotational band in Ni-56 into the ground state of Co-55 is presented. The rotational bands in Ni-56 are discussed within the framework of cranked Nilsson-Strutinsky calculations.
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15.
  • Torres, D. A., et al. (författare)
  • Deformations and Magnetic Rotations in the 60Ni Nucleus
  • 2008
  • Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 78:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Data from three experiments using the heavy-ion fusion evaporation-reaction Ar-36+Si-28 have been combined to study high-spin states in the residual nucleus Ni-60, which is populated via the evaporation of four protons from the compound nucleus Ge-64. The GAMMASPHERE array was used for all the experiments in conjunction with a 4 pi charged-particle detector arrays (MICROBALL, LUWUSIA) and neutron detectors (NEUTRON SHELL) to allow for the detection of. rays in coincidence with the evaporated particles. An extended Ni-60 level scheme is presented, comprising more than 270 gamma-ray transitions and 110 excited states. Their spins and parities have been assigned via directional correlations of gamma rays emitted from oriented states. Spherical shell-model calculations in the fp-shell characterize some of the low-spin states, while the experimental results of the rotational bands are analyzed with configuration-dependent cranked Nilsson-Strutinsky calculations.
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16.
  • Johansson, Emma, et al. (författare)
  • Thorough Gamma-ray and Particle Decay Investigations of 58Ni
  • 2009
  • Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 80:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The combined data from three fusion-evaporation reaction experiments have been utilized to investigate the semi-magic nucleus Ni-58(28)30. To detect gamma rays in coincidence with evaporated particles, the Ge-detector array Gammasphere was used in conjunction with the charged-particle detectors Microball and LuWuSiA (the Lund Washington University Silicon Array), and a neutron detector array. The results yield a significantly extended level scheme of Ni-58 comprising some 340 gamma-ray transitions and include a total of at least 14 discrete particle decays into excited states of the daughter nuclei Fe-54 and Co-57. The level scheme is compared with large-scale shell-model calculations and cranked Nilsson-Strutinsky calculations.
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17.
  • Liu, X., et al. (författare)
  • Toward a minimal representation of aerosols in climate models : description and evaluation in the Community Atmosphere Model CAM5
  • 2012
  • Ingår i: Geoscientific Model Development. - : Copernicus GmbH. - 1991-959X .- 1991-9603. ; 5:3, s. 709-739
  • Tidskriftsartikel (refereegranskat)abstract
    • A modal aerosol module (MAM) has been developed for the Community Atmosphere Model version 5 (CAM5), the atmospheric component of the Community Earth System Model version 1 (CESM1). MAM is capable of simulating the aerosol size distribution and both internal and external mixing between aerosol components, treating numerous complicated aerosol processes and aerosol physical, chemical and optical properties in a physically-based manner. Two MAM versions were developed: a more complete version with seven lognormal modes (MAM7), and a version with three lognormal modes (MAM3) for the purpose of long-term (decades to centuries) simulations. In this paper a description and evaluation of the aerosol module and its two representations are provided. Sensitivity of the aerosol lifecycle to simplifications in the representation of aerosol is discussed. Simulated sulfate and secondary organic aerosol (SOA) mass concentrations are remarkably similar between MAM3 and MAM7. Differences in primary organic matter (POM) and black carbon (BC) concentrations between MAM3 and MAM7 are also small (mostly within 10 %). The mineral dust global burden differs by 10 % and sea salt burden by 30-40 % between MAM3 and MAM7, mainly due to the different size ranges for dust and sea salt modes and different standard deviations of the log-normal size distribution for sea salt modes between MAM3 and MAM7. The model is able to qualitatively capture the observed geographical and temporal variations of aerosol mass and number concentrations, size distributions, and aerosol optical properties. However, there are noticeable biases; e.g., simulated BC concentrations are significantly lower than measurements in the Arctic. There is a low bias in modeled aerosol optical depth on the global scale, especially in the developing countries. These biases in aerosol simulations clearly indicate the need for improvements of aerosol processes (e.g., emission fluxes of anthropogenic aerosols and precursor gases in developing countries, boundary layer nucleation) and properties (e.g., primary aerosol emission size, POM hygroscopicity). In addition, the critical role of cloud properties (e. g., liquid water content, cloud fraction) responsible for the wet scavenging of aerosol is highlighted.
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18.
  • Sellgren, C. M., et al. (författare)
  • A genome-wide association study of kynurenic acid in cerebrospinal fluid: implications for psychosis and cognitive impairment in bipolar disorder
  • 2016
  • Ingår i: Molecular Psychiatry. - : Springer Science and Business Media LLC. - 1359-4184 .- 1476-5578. ; 21:10, s. 1342-1350
  • Tidskriftsartikel (refereegranskat)abstract
    • Elevated cerebrospinal fluid (CSF) levels of the glia-derived N-methyl-D-aspartic acid receptor antagonist kynurenic acid (KYNA) have consistently been implicated in schizophrenia and bipolar disorder. Here, we conducted a genome-wide association study based on CSF KYNA in bipolar disorder and found support for an association with a common variant within 1p21.3. After replication in an independent cohort, we linked this genetic variant-associated with reduced SNX7 expression-to positive psychotic symptoms and executive function deficits in bipolar disorder. A series of post-mortem brain tissue and in vitro experiments suggested SNX7 downregulation to result in a caspase-8-driven activation of interleukin-1 beta and a subsequent induction of the brain kynurenine pathway. The current study demonstrates the potential of using biomarkers in genetic studies of psychiatric disorders, and may help to identify novel drug targets in bipolar disorder.
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20.
  • Aad, G., et al. (författare)
  • Search for non-resonant Higgs boson pair production in the 2b+2ℓ+ETmiss final state in pp collisions at s = 13 TeV with the ATLAS detector
  • 2024
  • Ingår i: Journal of High Energy Physics. - : Springer Science and Business Media Deutschland GmbH. - 1029-8479 .- 1126-6708. ; 2024:2
  • Tidskriftsartikel (refereegranskat)abstract
    • A search for non-resonant Higgs boson pair (HH) production is presented, in which one of the Higgs bosons decays to a b-quark pair (bb¯) and the other decays to WW*, ZZ*, or τ+τ−, with in each case a final state with ℓ+ℓ−+ neutrinos (ℓ = e, μ). The analysis targets separately the gluon-gluon fusion and vector boson fusion production modes. Data recorded by the ATLAS detector in proton-proton collisions at a centre-of-mass energy of 13 TeV at the Large Hadron Collider, corresponding to an integrated luminosity of 140 fb−1, are used in this analysis. Events are selected to have exactly two b-tagged jets and two leptons with opposite electric charge and missing transverse momentum in the final state. These events are classified using multivariate analysis algorithms to separate the HH events from other Standard Model processes. No evidence of the signal is found. The observed (expected) upper limit on the cross-section for non-resonant Higgs boson pair production is determined to be 9.7 (16.2) times the Standard Model prediction at 95% confidence level. The Higgs boson self-interaction coupling parameter κλ and the quadrilinear coupling parameter κ2V are each separately constrained by this analysis to be within the ranges [−6.2, 13.3] and [−0.17, 2.4], respectively, at 95% confidence level, when all other parameters are fixed. © The Author(s) 2024.
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21.
  • Aad, G., et al. (författare)
  • Statistical Combination of ATLAS Run 2 Searches for Charginos and Neutralinos at the LHC
  • 2024
  • Ingår i: Physical Review Letters. - : American Physical Society. - 1079-7114 .- 0031-9007. ; 133:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Statistical combinations of searches for charginos and neutralinos using various decay channels are performed using 139 fb^{-1} of pp collision data at sqrt[s]=13 TeV with the ATLAS detector at the Large Hadron Collider. Searches targeting pure-wino chargino pair production, pure-wino chargino-neutralino production, or Higgsino production decaying via standard model W, Z, or h bosons are combined to extend the mass reach to the produced supersymmetric particles by 30-100 GeV. The depth of the sensitivity of the original searches is also improved by the combinations, lowering the 95% C.L. cross-section upper limits by 15%-40%.
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22.
  • Andersson, Lise-Lotte, et al. (författare)
  • Comprehensive Gamma-ray Spectroscopy of Rotational Bands in the N=Z+1 Nucleus 61Zn
  • 2009
  • Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 79:2
  • Tidskriftsartikel (refereegranskat)abstract
    • The Zn-61(30)31 nucleus has been studied via the combined data of two fusion-evaporation reaction experiments using a Ar-36 beam and a Si-28 target foil. The experimental setups involved the Ge array GAMMASPHERE and neutron and charged particle detectors placed around the target position. The resulting level scheme comprises about 120 excited states connected via some 180 gamma-ray transitions. In total, seven rotational structures were identified up to I similar to 25 or higher and compared with predictions from cranked Nilsson-Strutinsky calculations.
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24.
  • Ekman, S., et al. (författare)
  • Treatment (Tx) patterns and overall survival (OS) in patients (pts) with NSCLC in Sweden : A SCAN-LEAF study analysis from the I-O Optimise initiative
  • 2019
  • Ingår i: Annals of Oncology. - : Elsevier BV. - 0923-7534. ; 30:Suppl 2, s. 17-17
  • Konferensbidrag (refereegranskat)abstract
    • Background: As part of I-O Optimise, a multinational research platform providing real-world insights into the management of lung cancers, the SCAN-LEAF study aims to describe the epidemiology, clinical care and outcomes for pts with NSCLC in Scandinavia. We report initial Tx and OS for pts with NSCLC prior to the availability of immunotherapies in Sweden. Methods: The analysis includes all adult pts diagnosed with NSCLC at Uppsala and Karolinska (Stockholm) University Hospitals from 2012 to 2015 (follow-up to Dec 2016). Electronic medical record data were extracted using Pygargus CXP software and linked with national registries. Bespoke rule-based algorithms were applied to describe Tx patterns; Kaplan–Meier methods were used to estimate OS. Results: 2779 pts were diagnosed with incident NSCLC (median age, 70 yrs [range: 22–96; 14.2% ≥80]; male, 48.5%; histology: non-squamous (NSQ), 70.9%, squamous (SQ), 17.7%, other, 11.4%; stage distribution: I, 19.3%; II, 7.7%; IIIA, 12.3%; IIIB, 7.2%; IV, 51.2%). Initial Tx (≤6 months from diagnosis) by stage and yr of diagnosis is shown in the table. Median OS (months) for NSQ and SQ pts: not reached and 52.8 in stage I, 43.2 and 23.6 in stage II, 26.7 and 20.4 in stage IIIA, 12.5 and 12.9 in stage IIIB, and 7.6 and 6.1 in stage IV, respectively. Among stage IIIB–IV pts, 60.7% (NSQ) and 53.5% (SQ) had ≥1 line of systemic anti-cancer therapy (SACT); median OS was 12.2 (NSQ) and 10.4 (SQ) months in pts on SACT, and 3.1 (NSQ) and 3.7 (SQ) months in pts not on SACT. Ongoing analyses will assess factors associated with SACT receipt in stage IIIB–IV pts. Conclusions: Swedish pts with NSCLC had a high burden of disease, with most diagnosed at stage IV and a median OS of 1 yr in late-stage pts receiving SACT. There is also scope for improved prognosis in pts diagnosed at early stages, particularly in SQ pts. Future analyses will assess the potential impact of recent improvements in diagnostics and therapeutics on Tx patterns and OS in Swedish NSCLC pts.
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25.
  • Fjalldal, S., et al. (författare)
  • Detailed assessment of hypothalamic damage in craniopharyngioma patients with obesity
  • 2019
  • Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 43:3, s. 533-544
  • Tidskriftsartikel (refereegranskat)abstract
    • Background/objectives: Hypothalamic obesity (HO) occurs in 50% of patients with the pituitary tumor craniopharyngioma (CP). Attempts have been made to predict the risk of HO based on hypothalamic (HT) damage on magnetic resonance imaging (MRI), but none have included volumetry. We performed qualitative and quantitative volumetric analyses of HT damage. The results were explored in relation to feeding related peptides and body fat. Subjects/methods: A cross-sectional study of childhood onset CPs involving 3 Tesla MRI, was performed at median 22 years after first operation; 41 CPs, median age 35 (range: 17–56), of whom 23 had HT damage, were compared to 32 controls. After exclusions, 35 patients and 31 controls remained in the MRI study. Main outcome measures were the relation of metabolic parameters to HT volume and qualitative analyses of HT damage. Results: Metabolic parameters scored persistently very high in vascular risk particularly among HT damaged patients. Patients had smaller HT volumes compared to controls 769 (35–1168) mm3 vs. 879 (775–1086) mm3; P < 0.001. HT volume correlated negatively with fat mass and leptin among CP patients (rs = −0.67; P <.001; rs = −0.53; P = 0.001), and explained 39% of the variation in fat mass. For every 100 mm3 increase in HT volume fat mass decreased by 2.7 kg (95% CI: 1.5–3.9; P < 0.001). Qualitative assessments revealed HT damage in three out of six patients with normal volumetry, but HT damage according to operation records. Conclusions: A decrease in HT volume was associated with an increase in fat mass and leptin. We present a method with a high inter-rater reliability (0.94) that can be applied by nonradiologists for the assessment of HT damage. The method may be valuable in the risk assessment of diseases involving the HT.
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