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- Ancelle-Park, R., et al.
(författare)
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Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet
- 2012
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Ingår i: Journal of Medical Screening. - : SAGE Publications. - 0969-1413 .- 1475-5793. ; 19, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women. Methods From the studies reviewed, the primary benefit of screening, breast cancer mortality reduction, was compared with the main harms, over-diagnosis and false-positive screening results (FPRs). Results Pooled estimates of breast cancer mortality reduction among invited women were 25% in incidence-based mortality studies and 31% in case-control studies (38% and 48% among women actually screened). Estimates of over-diagnosis ranged from 1% to 10% of the expected incidence in the absence of screening. The combined estimate of over-diagnosis for screened women, from European studies correctly adjusted for lead time and underlying trend, was 6.5%. For women undergoing 10 biennial screening tests, the estimated cumulative risk of a FPR followed by non-invasive assessment was 17%, and 3% having an invasive assessment. For every 1000 women screened biennially from age 50-51 until age 68-69 and followed up to age 79, an estimated seven to nine lives are saved, four cases are over-diagnosed, 170 women have at least one recall followed by non-invasive assessment with a negative result and 30 women have at least one recall followed by invasive procedures yielding a negative result. Conclusions The chance of saving a woman's life by population-based mammographic screening of appropriate quality is greater than that of over-diagnosis. Service screening in Europe achieves a mortality benefit at least as great as the randomized controlled trials. These outcomes should be communicated to women offered service screening in Europe.
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- Melin, Anna K., Assistant Professor, 1965-, et al.
(författare)
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Energy availability and the female athlete triad in elite endurance athletes
- 2015
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 25:5, s. 610-622
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Tidskriftsartikel (refereegranskat)abstract
- The female athlete triad (Triad), links low energy availability (EA), with menstrual dysfunction (MD), and impaired bone health. The aims of this study were to examine associations between EA/MD and energy metabolism and the prevalence of Triad-associated conditions in endurance athletes. Forty women [26.2 +/- 5.5 years, body mass index (BMI) 20.6 +/- 2.0 kg/m(2), body fat 20.0 +/- 3.0%], exercising 11.4 +/- 4.5 h/week, were recruited from national teams and competitive clubs. Protocol included gynecological examination; assessment of bone health; indirect respiratory calorimetry; diet and exercise measured 7 days to assess EA; eating disorder (ED) examination; blood analysis. Subjects with low/reduced EA (< 45 kcal/kg FFM/day), had lower resting metabolic rate (RMR) compared with those with optimal EA [28.4 +/- 2.0 kcal/kg fat-free mass (FFM)/day vs 30.5 +/- 2.2 kcal/kg FFM/day, P < 0.01], as did subjects with MD compared with eumenorrheic subjects (28.6 +/- 2.4 kcal/kg FFM/day vs 30.2 +/- 1.8 kcal/kg FFM/day, P < 0.05). 63% had low/reduced EA, 25% ED, 60% MD, 45% impaired bone health, and 23% had all three Triad conditions. 53% had low RMR, 25% hypercholesterolemia, and 38% hypoglycemia. Conclusively, athletes with low/reduced EA and/or MD had lowered RMR. Triad-associated conditions were common in this group of athletes, despite a normal BMI range. The high prevalence of ED, MD, and impaired bone health emphasizes the importance of prevention, early detection, and treatment of energy deficiency.
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- Melin, Anna K., Assistant Professor, 1965-, et al.
(författare)
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Low-energy density and high fiber intake are dietary concerns in female endurance athletes
- 2016
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 26:9, s. 1060-1071
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Tidskriftsartikel (refereegranskat)abstract
- Low or reduced energy availability (LEA) is linked to functional hypothalamic oligomenorrhea/amenorrhea (FHA), which is frequently reported in weight-sensitive sports. This makes LEA a major nutritional concern for female athletes. The aim of this study was to describe dietary characteristics of athletes with LEA and/or FHA. Endurance athletes (n=45) were recruited from national teams and competitive clubs. Protocols included gynecological examination, body composition, eating disorder evaluation, and 7-day dietary intake and EA assessment. Athletes with disordered eating behavior/eating disorders (n=11), menstrual dysfunction other than FHA (n=5), and low dietary record validity (n=4) were excluded. Remaining subjects (n=25) were characterized by EA [optimal:45kcal (188kJ)/kg fat-free mass (FFM)/day (n=11), LEA:<45kcal (188kJ)/kg FFM/day (n=14)] and reproductive function [eumenorrhea (EUM; n=10), FHA (n=15)]. There was no difference in EA between FHA and EUM subjects. However, FHA and LEA subjects shared the same dietary characteristics of lower energy density (ED) [(P=0.012; P=0.020), respectively], and fat content [(P=0.047; P=0.027), respectively]. Furthermore, FHA subjects had a lower intake of carbohydrate-rich foods (P=0.019), higher fiber content (P<0.001), and drive for thinness score (P=0.003). Conclusively, low ED together with high fiber content may constitute targets for dietary intervention in order to prevent and treat LEA and FHA in female athletes.
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- Andersen, SB, et al.
(författare)
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Measuring the burden of interval cancers in long-standing screening mammography programmes
- 2015
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Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 22:2, s. 83-92
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Tidskriftsartikel (refereegranskat)abstract
- Mammography screening programme sensitivity is evaluated by comparing the interval cancer rate (ICR) with the expected breast cancer incidence without screening, ie. the proportional interval cancer rate (PICR). The PICR is usually found by extrapolating pre-screening incidence rates, whereas ICR is calculated from data available in the screening programmes. As there is no consensus regarding estimation of background incidence, we seek to validate the ICR measure against the PICR. Methods Screening data from the three mammography screening programmes of Stockholm, Copenhagen, and Funen in the period 1989-2011 provided data to calculate the ICR. The most commonly described methods of extrapolating pre-screening incidence rates to calculate the PICR were illustrated and PICRs were calculated by year and programme using these different methods and compared with the ICRs. Results PICRs varied greatly, reaching a difference of 32–34% in Stockholm, 79% in Copenhagen, and 100–106% in Funen between the highest and the lowest value, depending on which method was applied. PICRs exhibited large variations yearly and from programme to programme. ICRs did not vary to the same extent, ranging on average from 0.100 to 0.136 in the first 12-months and between 0.201 and 0.225 in the last 12-months of the two-year period after a negative screen across the three programmes. Conclusion The value of the PICR is hugely influenced by which method is applied, whereas the ICR is calculated purely on data available within programmes. We find that the PICR, the establishing indicator for sensitivity, could preferably be replaced by the ICR.
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- Bishop, Lev S., et al.
(författare)
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Proposal for generating and detecting multi-qubit GHZ states in circuit QED
- 2009
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Ingår i: New Journal of Physics. - : IOP Publishing. - 1367-2630. ; 11, s. 073040-
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Tidskriftsartikel (refereegranskat)abstract
- We propose methods for the preparation and entanglement detectionof multi-qubit Greenberger–Horne–Zeilinger (GHZ) states in circuit quantumelectrodynamics. Using quantum trajectory simulations appropriate for thesituation of a weak continuous measurement, we show that the joint dispersivereadout of several qubits can be utilized for the probabilistic production ofhigh-fidelity GHZ states. When employing a nonlinear filter on the recordedhomodyne signal, the selected states are found to exhibit values of theBell–Mermin operator exceeding 2 under realistic conditions. We discuss thepotential of the dispersive readout to demonstrate a violation of the Merminbound, and present a measurement scheme avoiding the necessity for fulldetector tomography.
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- Chow, J.M., et al.
(författare)
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Randomized benchmarking and process tomography for gate errors in a solid-state qubit
- 2009
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Ingår i: Physical Review Letters. - 1079-7114 .- 0031-9007. ; 102:9
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Tidskriftsartikel (refereegranskat)abstract
- We present measurements of single-qubit gate errors for a superconducting qubit. Results from quantum process tomography and randomized benchmarking are compared with gate errors obtained from a double pulse experiment. Randomized benchmarking reveals a minimum average gate error of 1.1±0.3% and a simple exponential dependence of fidelity on the number of gates. It shows that the limits on gate fidelity are primarily imposed by qubit decoherence, in agreement with theory.
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- Dent, T, et al.
(författare)
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Stratified cancer screening: the practicalities of implementation
- 2013
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Ingår i: Public health genomics. - : S. Karger AG. - 1662-8063 .- 1662-4246. ; 16:3, s. 94-99
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Improving understanding of the genetic basis of disease susceptibility enables us to estimate individuals' risk of developing cancer and offer them disease prevention, including screening, stratified to reflect that risk. Little attention has so far been given to the implementation of stratified screening. This article reviews the issues that would arise in delivering such tailored approaches to prevention in practice. <b><i>Results:</i></b> Issues analysed include the organisational context within which implementation of stratified prevention would occur, how the offer of screening would be made, making sure consent is adequately informed, how individuals' risk would be assessed, the age at which risk estimation should occur, and the potential use of genetic data for other purposes. The review also considers how management might differ depending on individuals' risk, how their results would be communicated and their follow-up arranged, and the different issues raised by modification of an existing screening programme, such as that for breast cancer, and the establishment of a new one, for example for prostate cancer. <b><i>Conclusion:</i></b> Stratified screening based on genetic testing is a radically new approach to prevention. Various organisational issues would need to be considered before it could be introduced, and a number of questions require further research.
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