| 1. |
- Bateman, Randall J., et al.
(författare)
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Two Phase 3 Trials of Gantenerumab in Early Alzheimer's Disease
- 2023
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 389:20, s. 1862-1876
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Tidskriftsartikel (refereegranskat)abstract
- Background: Monoclonal antibodies that target amyloid-beta (Aβ) have the potential to slow cognitive and functional decline in persons with early Alzheimer's disease. Gantenerumab is a subcutaneously administered, fully human, anti-Aβ IgG1 monoclonal antibody with highest affinity for aggregated Aβ that has been tested for the treatment of Alzheimer's disease. Methods: We conducted two phase 3 trials (GRADUATE I and II) involving participants 50 to 90 years of age with mild cognitive impairment or mild dementia due to Alzheimer's disease and evidence of amyloid plaques on positron-emission tomography (PET) or cerebrospinal fluid (CSF) testing. Participants were randomly assigned to receive gantenerumab or placebo every 2 weeks. The primary outcome was the change from baseline in the score on the Clinical Dementia Rating scale-Sum of Boxes (CDR-SB; range, 0 to 18, with higher scores indicating greater cognitive impairment) at week 116. Results: A total of 985 and 980 participants were enrolled in the GRADUATE I and II trials, respectively. The baseline CDR-SB score was 3.7 in the GRADUATE I trial and 3.6 in the GRADUATE II trial. The change from baseline in the CDR-SB score at week 116 was 3.35 with gantenerumab and 3.65 with placebo in the GRADUATE I trial (difference, -0.31; 95% confidence interval [CI], -0.66 to 0.05; P = 0.10) and was 2.82 with gantenerumab and 3.01 with placebo in the GRADUATE II trial (difference, -0.19; 95% CI, -0.55 to 0.17; P = 0.30). At week 116, the difference in the amyloid level on PET between the gantenerumab group and the placebo group was -66.44 and -56.46 centiloids in the GRADUATE I and II trials, respectively, and amyloid-negative status was attained in 28.0% and 26.8% of the participants receiving gantenerumab in the two trials. Across both trials, participants receiving gantenerumab had lower CSF levels of phosphorylated tau 181 and higher levels of Aβ42 than those receiving placebo; the accumulation of aggregated tau on PET was similar in the two groups. Amyloid-related imaging abnormalities with edema (ARIA-E) occurred in 24.9% of the participants receiving gantenerumab, and symptomatic ARIA-E occurred in 5.0%. Conclusions: Among persons with early Alzheimer's disease, the use of gantenerumab led to a lower amyloid plaque burden than placebo at 116 weeks but was not associated with slower clinical decline.
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| 2. |
- Chidambaram, Swathikan, et al.
(författare)
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Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer : a modified Delphi consensus process
- 2023
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Ingår i: Diseases of the esophagus. - : Oxford University Press. - 1120-8694 .- 1442-2050. ; 36:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients.METHODS: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set.RESULTS: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice.CONCLUSION: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.
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| 3. |
- Di Simplicio, Martina, et al.
(författare)
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An investigation of mental imagery in bipolar disorder : Exploring "the mind's eye"
- 2016
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Ingår i: Bipolar Disorders. - : WILEY-BLACKWELL. - 1398-5647 .- 1399-5618. ; 18:8, s. 669-683
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Mental imagery abnormalities occur across psychopathologies and are hypothesized to drive emotional difficulties in bipolar disorder (BD). A comprehensive assessment of mental imagery in BD is lacking. We aimed to test whether (i) mental imagery abnormalities (abnormalities in cognitive stages and subjective domains) occur in BD relative to non-clinical controls; and (ii) to determine the specificity of any abnormalities in BD relative to depression and anxiety disorders. Methods: Participants included 54 subjects in the BD group (depressed/euthymic; n=27 in each subgroup), subjects with unipolar depression (n=26), subjects with anxiety disorders (n=25), and non-clinical controls (n=27) matched for age, gender, ethnicity, education, and premorbid IQ. Experimental tasks assessed cognitive (non-emotional) measures of mental imagery (cognitive stages). Questionnaires, experimental tasks, and a phenomenological interview assessed subjective domains including spontaneous imagery use, interpretation bias, and emotional mental imagery. Results: (i) Compared to non-clinical controls, the BD combined group reported a greater impact of intrusive prospective imagery in daily life, more vivid and "real" negative images (prospective imagery task), and higher self-involvement (picture-word task). The BD combined group showed no clear abnormalities in cognitive stages of mental imagery. (ii) When depressed individuals with BD were compared to the depressed or anxious clinical control groups, no significant differences remained-across all groups, imagery differences were associated with affective lability and anxiety. Conclusions: Compared to non-clinical controls, BD is characterized by abnormalities in aspects of emotional mental imagery within the context of otherwise normal cognitive aspects. When matched for depression and anxiety, these abnormalities are not specific to BD-rather, imagery may reflect a transdiagnostic marker of emotional psychopathology.
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| 4. |
- Gallo-Cajiao, Eduardo, et al.
(författare)
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Implications of Russia’s invasion of Ukraine for the governance of biodiversity conservation
- 2023
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Ingår i: Frontiers in Conservation Science. - : Frontiers Media S.A.. - 2673-611X. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Maintaining peace and conserving biodiversity hinge on an international system of cooperation codified in institutions, but Russia’s invasion of Ukraine brings recent progress to a crossroads. Against this backdrop, we address some implications of Russia’s invasion of Ukraine for the governance of biodiversity conservation both within and beyond Russia. The Russian invasion of Ukraine threatens the governance system for biodiversity conservation, as it pertains to Russia and beyond, due to three interacting factors: (i) isolation of Russia from the international system, (ii) halt and delay of international cooperation, and (iii) changes in international and domestic policy priorities. We recommend making the existing international system of governance for conserving biodiversity more resilient and adaptable, while aligning security agendas with biodiversity conservation goals.
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| 5. |
- Huels, David J., et al.
(författare)
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E-cadherin can limit the transforming properties of activating beta-catenin mutations
- 2015
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Ingår i: EMBO Journal. - : EMBO. - 0261-4189 .- 1460-2075. ; 34:18, s. 2321-2333
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Tidskriftsartikel (refereegranskat)abstract
- Wnt pathway deregulation is a common characteristic of many cancers. Only colorectal cancer predominantly harbours mutations in APC, whereas other cancer types (hepatocellular carcinoma, solid pseudopapillary tumours of the pancreas) have activating mutations in beta-catenin (CTNNB1). We have compared the dynamics and the potency of beta-catenin mutations in vivo. Within the murine small intestine (SI), an activating mutation of beta-catenin took much longer to achieve Wnt deregulation and acquire a crypt-progenitor cell (CPC) phenotype than Apc or Gsk3 loss. Within the colon, a single activating mutation of beta-catenin was unable to drive Wnt deregulation or induce the CPC phenotype. This ability of beta-catenin mutation to differentially transform the SI versus the colon correlated with higher expression of E-cadherin and a higher number of E-cadherin: beta-catenin complexes at the membrane. Reduction in E-cadherin synergised with an activating mutation of beta-catenin resulting in a rapid CPC phenotype within the SI and colon. Thus, there is a threshold of beta-catenin that is required to drive transformation, and E-cadherin can act as a buffer to sequester mutated beta-catenin.
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| 6. |
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| 7. |
- Jung, Christian, et al.
(författare)
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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
- 2019
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Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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| 8. |
- Kroupa, Ales, et al.
(författare)
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Current problems and possible solutions in high-temperature lead-free soldering
- 2012
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Ingår i: Journal of materials engineering and performance (Print). - : Springer Science and Business Media LLC. - 1059-9495 .- 1544-1024. ; 21:5, s. 629-637
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Tidskriftsartikel (refereegranskat)abstract
- The substitution of lead in the electronics industry is one of the key issues in the current drive towards ecological manufacturing. Legislation has already banned the use of lead in solders for mainstream applications (T M≈220 °C), but the use of lead in the solders for high-temperature applications (>85% lead, T M≈250-350 °C) is still exempt in RoHS2. The search for proper substitutes has been ongoing among solder manufacturers only for a decade without finding a viable low cost alternative and is the subject of intensive research. This article tries to map the current situation in the field of high-temperature lead-free soldering, presenting a short review of current legislation, requirements for substitute alloys, and finally it describes some existing solutions both in the field of promising new materials and new technologies. Currently, there is no drop-in replacement for lead-containing solders and therefore both the new materials and the new technologies may be viable solutions for production of reliable lead-free joints for high-temperature applications.
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| 9. |
- Lehman, Joel, et al.
(författare)
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The Surprising Creativity of Digital Evolution: A Collection of Anecdotes from the Evolutionary Computation and Artificial Life Research Communities
- 2020
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Ingår i: Artificial Life. - : MIT Press - Journals. - 1530-9185 .- 1064-5462. ; 26:2, s. 274-306
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Tidskriftsartikel (refereegranskat)abstract
- Evolution provides a creative fount of complex and subtle adaptations that often surprise the scientists who discover them. However, the creativity of evolution is not limited to the natural world: Artificial organisms evolving in computational environments have also elicited surprise and wonder from the researchers studying them. The process of evolution is an algorithmic process that transcends the substrate in which it occurs. Indeed, many researchers in the field of digital evolution can provide examples of how their evolving algorithms and organisms have creatively subverted their expectations or intentions, exposed unrecognized bugs in their code, produced unexpectedly adaptations, or engaged in behaviors and outcomes, uncannily convergent with ones found in nature. Such stories routinely reveal surprise and creativity by evolution in these digital worlds, but they rarely fit into the standard scientific narrative. Instead they are often treated as mere obstacles to be overcome, rather than results that warrant study in their own right. Bugs are fixed, experiments are refocused, and one-off surprises are collapsed into a single data point. The stories themselves are traded among researchers through oral tradition, but that mode of information transmission is inefficient and prone to error and outright loss. Moreover, the fact that these stories tend to be shared only among practitioners means that many natural scientists do not realize how interesting and lifelike digital organisms are and how natural their evolution can be. To our knowledge, no collection of such anecdotes has been published before. This article is the crowd-sourced product of researchers in the fields of artificial life and evolutionary computation who have provided first-hand accounts of such cases. It thus serves as a written, fact-checked collection of scientifically important and even entertaining stories. In doing so we also present here substantial evidence that the existence and importance of evolutionary surprises extends beyond the natural world, and may indeed be a universal property of all complex evolving systems.
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| 11. |
- Smalley, Alexander J., et al.
(författare)
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Soundscapes, music, and memories : Exploring the factors that influence emotional responses to virtual nature content
- 2023
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Ingår i: Journal of Environmental Psychology. - : Elsevier. - 0272-4944 .- 1522-9610. ; 89
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Tidskriftsartikel (refereegranskat)abstract
- From walking through a park to sitting on a beach, much is known about the therapeutic potential of direct contact with natural environments. Yet routinely in the UK, millions of people encounter nature in a completely different way: through their television screens. Despite the ubiquity of natural history programming, little is understood about its impact on the restorative and affective experiences of audiences. Nowhere is this truer than in the bold orchestral scores that accompany almost all nature documentaries. Whilst considerable evidence suggests that separately, both nature and music can provide a range of psychological benefits, how their pairing might affect the wellbeing potential of virtual nature encounters remains largely unknown. Similarly, scant research has considered how viewers' own experiences, recalled through memories, might influence outcomes. To explore these areas, we formed a transdisciplinary broadcast initiative, called BBC Soundscapes for Wellbeing. Part of this project involved a randomized and controlled experiment that presented participants (n = 7636) with a dynamic nature scene accompanied by one of four acoustic tracks. Results demonstrated that whilst adding music to this scene led to increased feelings of excitement, it led to no other restorative or affective benefits when compared to silence. In contrast, the addition of natural sounds was associated with greater feelings of restorative potential, calmness, and excitement. Natural sounds also drove significant increases in the complex emotions of awe and nostalgia. Crucially, results showed the substantial moderating effects of participant memories. Those with positive memories stimulated by the experience reported significantly greater effects across all conditions and dependent variables. We find that although the acoustic design of virtual nature encounters can affect a range of emotional responses, the memories triggered by these experiences may be far more important for predicting viewer outcomes.
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| 12. |
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