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- André, Camilla, et al.
(författare)
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Recurrence and survival after standard versus oncoplastic breast-conserving surgery for breast cancer
- 2021
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Ingår i: BJS Open. - : Oxford University Press. - 2474-9842. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oncoplastic techniques in breast-conserving surgery (BCS) are used increasingly for larger tumours. This large cohort study aimed to assess oncological outcomes after oncoplastic BCS (OPS) versus standard BCS.Methods: Data for all women who had BCS in three centres in Stockholm during 2010-2016 were extracted from the Swedish National Breast Cancer Register. All patients with T2-3 tumours, all those receiving neoadjuvant treatment, and an additional random sample of women with T1 tumours were selected. Medical charts were reviewed for local recurrences and surgical technique according to the Hoffman-Wallwiener classification. Date and cause of death were retrieved from the Swedish Cause of Death Register.Results: The final cohort of 4178 breast cancers in 4135 patients was categorized into three groups according to surgical technique: 3720 for standard BCS, 243 simple OPS, and 215 complex OPS. Median duration of follow up was 64 (range 24-110) months. Node-positive and large tumours were more common in OPS than in standard BCS (P < 0.001). There were 61 local recurrences: 57 (1.5 per cent), 1 (0.4 per cent) and 3 (1.4 per cent) in the standard BCS, simple OPS and complex OPS groups respectively (P = 0.368). Overall, 297 patients died, with an unadjusted 5-year overall survival rate of 94.7, 93.1 and 92.6 per cent respectively (P = 0.350). Some 102 deaths were from breast cancer, with unadjusted 5-year cancer-specific survival rates of 97.9, 98.3 and 95.0 per cent respectively (P = 0.056).Discussion: Oncoplastic BCS is a safe surgical option, even for larger node-positive tumours, with low recurrence and excellent survival rates.
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- Appelgren, A, et al.
(författare)
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Impact of feedback on three phases of performance monitoring
- 2014
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Ingår i: Experimental psychology. - : Hogrefe Publishing Group. - 2190-5142 .- 1618-3169. ; 61:3, s. 224-233
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Tidskriftsartikel (refereegranskat)abstract
- We investigated if certain phases of performance monitoring show differential sensitivity to external feedback and thus rely on distinct mechanisms. The phases of interest were: the error phase (FE), the phase of the correct response after errors (FEC), and the phase of correct responses following corrects (FCC). We tested accuracy and reaction time (RT) on 12 conditions of a continuous-choice-response task; the 2-back task. External feedback was either presented or not in FE and FEC, and delivered on 0%, 20%, or 100% of FCC trials. The FCC20 was matched to FE and FEC in the number of sounds received so that we could investigate when external feedback was most valuable to the participants. We found that external feedback led to a reduction in accuracy when presented on all the correct responses. Moreover, RT was significantly reduced for FCC100, which in turn correlated with the accuracy reduction. Interestingly, the correct response after an error was particularly sensitive to external feedback since accuracy was reduced when external feedback was presented during this phase but not for FCC20. Notably, error-monitoring was not influenced by feedback-type. The results are in line with models suggesting that the internal error-monitoring system is sufficient in cognitively demanding tasks where performance is ∼ 80%, as well as theories stipulating that external feedback directs attention away from the task. Our data highlight the first correct response after an error as particularly sensitive to external feedback, suggesting that important consolidation of response strategy takes place here.
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- Appelgren, A., et al.
(författare)
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Relative fitness of a generalist parasite on two alternative hosts : a cross-infestation experiment to test host specialization of the hen flea Ceratophyllus gallinae (Schrank)
- 2016
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Ingår i: Journal of Evolutionary Biology. - : Wiley. - 1010-061X .- 1420-9101. ; 29:5, s. 1091-1101
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Tidskriftsartikel (refereegranskat)abstract
- Host range is a key element of a parasite's ecology and evolution and can vary greatly depending on spatial scale. Generalist parasites frequently show local population structure in relation to alternative sympatric hosts (i.e. host races) and may thus be specialists at local scales. Here, we investigated local population specialization of a common avian nest-based parasite, the hen flea Ceratophyllus gallinae (Schrank), exploiting two abundant host species that share the same breeding sites, the great tit Parus major (Linnaeus) and the collared flycatcher Ficedula albicollis (Temminck). We performed a cross-infestation experiment of fleas between the two host species in two distinct study areas during a single breeding season and recorded the reproductive success of both hosts and parasites. In the following year, hosts were monitored again to assess the long-term impact of cross-infestation. Our results partly support the local specialization hypothesis: in great tit nests, tit fleas caused higher damage to their hosts than flycatcher fleas, and in collared flycatcher nests, flycatcher fleas had a faster larval development rates than tit fleas. However, these results were significant in only one of the two studied areas, suggesting that the location and history of the host population can modulate the specialization process. Caution is therefore called for when interpreting single location studies. More generally, our results emphasize the need to explicitly account for host diversity in order to understand the population ecology and evolutionary trajectory of generalist parasites.
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| 21. |
- Appelgren, Daniel, et al.
(författare)
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Active NET formation in Libman–Sacks endocarditis without antiphospholipid antibodies : A dramatic onset of systemic lupus erythematosus
- 2018
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Ingår i: Autoimmunity. - : Informa UK Limited. - 0891-6934 .- 1607-842X. ; 51:6, s. 310-318
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Tidskriftsartikel (refereegranskat)abstract
- Although neutrophil extracellular traps (NETs) have been highlighted in several systemic inflammatory diseases, their clinical correlates and potential pathological role remain obscure. Herein, we describe a dramatic onset of systemic lupus erythematosus (SLE) with clear-cut pathogenic implications for neutrophils and NET formation in a young woman with cardiac (Libman–Sacks endocarditis) and central nervous system (psychosis and seizures) involvement. Despite extensive search, circulating antiphospholipid autoantibodies, a hallmark of Libman–Sacks endocarditis, could not be detected. Instead, we observed active NET formation in the tissue of the mitral valve, as well as in the circulation. Levels of NET remnants were significantly higher in serially obtained sera from the patient compared with sex-matched blood donors (p =.0011), and showed a non-significant but substantial correlation with blood neutrophil counts (r = 0.65, p =.16). The specific neutrophil elastase activity measured in serum seemed to be modulated by the provided immunosuppressive treatment. In addition, we found anti-Ro60/SSA antibodies in the cerebrospinal fluid of the patient but not NET remnants or increased elastase activity. This case illustrates that different disease mechanisms mediated via autoantibodies can occur simultaneously in SLE. NET formation with release of cytotoxic NET remnants is a candidate player in the pathogenesis of this non-canonical form of Libman–Sacks endocarditis occurring in the absence of traditional antiphospholipid autoantibodies. The case description includes longitudinal results with clinical follow-up data and a discussion of the potential roles of NETs in SLE.
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| 22. |
- Appelgren, Patrik, et al.
(författare)
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Modelling of a small helical magnetic flux compression generator
- 2007
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Ingår i: PPPS-2007 - Pulsed Power Plasma Science 2007. - 1424409144 - 9781424409143 ; , s. 1155-1158
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Konferensbidrag (refereegranskat)abstract
- Helical flux-compression generators convert the chemical energy bond in explosives into electric energy. This paper briefly presents a model of, implemented in Matlab-Simulink, and simulation results for such a device. The simulation results are compared to experimental data from two experiments with identical generators but with different seed currents, influencing the resistive losses and thus the current amplification. The model is used to analyse the performance of the generator.
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| 23. |
- Appelgren, Patrik, et al.
(författare)
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Parametric studies of an electrohydrodynamic plasma actuator for boundary layer flow control
- 2009
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Ingår i: PPC '09. IEEE Pulsed Power Conference, 2009. - : IEEE. - 9781424440658 ; , s. 1069-1074
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Konferensbidrag (refereegranskat)abstract
- An electrohydrodynamic plasma actuator can be used as an aerodynamic flow control device. A plasma actuator is realised as a surface-mounted dielectric barrier discharge (DBD) that transfers directed energy from ions in the discharge to the surrounding air. Parametric studies have been performed in order to investigate the relative efficiency in terms of electrical power into the actuator versus mechanical power in the generated boundary flow. The parametric study includes variations of the applied driving voltage and frequency as well as different electrode and dielectric materials. It is found that, within the range tested, for each value of electrical power into the actuator there exists an optimum driving frequency in terms of boundary layer flow velocity. It is also found that the same trend seems to be true when analyzing electric to mechanical efficiency of the device, i.e. for a given input power there exists an optimum driving frequency that produces the highest efficiency. However, this peak in efficiency of the actuator lies on the edge of the parametric space tested so that further experiments are needed to validate these results.
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| 24. |
- Bosman, Arthur D., et al.
(författare)
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A Potential Site for Wide-orbit Giant Planet Formation in the IM Lup Disk
- 2023
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Ingår i: Astrophysical Journal Letters. - : American Astronomical Society. - 2041-8205 .- 2041-8213. ; 944:2
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Tidskriftsartikel (refereegranskat)abstract
- The radial transport, or drift, of dust has taken a critical role in giant planet formation theory. However, it has been challenging to identify dust drift pileups in the hard-to-observe inner disk. We find that the IM Lup disk shows evidence that it has been shaped by an episode of dust drift. Using radiative transfer and dust dynamical modeling we study the radial and vertical dust distribution. We find that high dust drift rates exceeding 110 M ⊕ Myr−1 are necessary to explain both the dust and CO observations. Furthermore, the bulk of the large dust present in the inner 20 au needs to be vertically extended, implying high turbulence (α z ≳ 10−3) and small grains (0.2-1 mm). We suggest that this increased level of particle stirring is consistent with the inner dust-rich disk undergoing turbulence triggered by the vertical shear instability. The conditions in the IM Lup disk imply that giant planet formation through pebble accretion is only effective outside of 20 au. If such an early, high-turbulence inner region is a natural consequence of high dust drift rates, then this has major implications for understanding the formation regions of giant planets including Jupiter and Saturn.
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- Facanha, A L O, et al.
(författare)
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The endoplasmic reticulum cation P-type ATPase Cta4p is required for control of cell shape and microtubule dynamics
- 2002
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Ingår i: Journal of Cell Biology. - : Rockefeller University Press. - 0021-9525 .- 1540-8140. ; 157:6, s. 1029-1039
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Tidskriftsartikel (refereegranskat)abstract
- Here we describe the phenotypic characterization of the cta(4+) gene, encoding a novel member of the P4 family of P-type ATPases of fission yeast. The cta4Delta mutant is temperature sensitive and cold sensitive lethal and displays several morphological defects in cell polarity and cytokinesis. Microtubules are generally destabilized in cells lacking Cta4p. The microtubule length is decreased, and the number of microtubules per cell is increased. This is concomitant with an increase in the number of microtubule catastrophe events in the midzone of the cell. These defects are likely due to a general imbalance in cation homeostasis. Immunofluorescence microscopy and membrane fractionation experiments revealed that green fluorescent protein-tagged Cta4 localizes to the ER. Fluorescence resonance energy transfer experiments in living cells using the yellow cameleon indicator for Ca2+ indicated that Cta4p regulates the cellular Ca2+ concentration. Thus, our results reveal a link between cation homeostasis and the control of cell shape, microtubule dynamics, and cytokinesis, and appoint Ca2+ as a key ion in controlling these processes.
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| 27. |
- Fritzell, Peter, et al.
(författare)
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Cost-effectiveness of lumbar fusion and nonsurgical treatment for chronic low back pain in the Swedish lumbar spine study : A multicenter, randomized, controlled trial from the Swedish Lumbar Spine Study Group
- 2004
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Ingår i: Spine. - : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 29:4, s. 421-434
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. A cost-effectiveness study was performed from the societal and health care perspectives. Objective. To evaluate the costs-effectiveness of lumbar fusion for chronic low back pain (CLBP) during a 2-year follow-up. Summary of Background Data. A full economic evaluation comparing costs related to treatment effects in patients with CLBP is lacking. Patients and Methods. A total of 284 of 294 patients with CLBP for at least 2 years were randomized to either lumbar fusion or a nonsurgical control group. Costs for the health care sector ( direct costs), and costs associated with production losses ( indirect costs) were calculated. Societal total costs were identified as the sum of direct and indirect costs. Treatment effects were measured using patient global assessment of improvement, back pain ( VAS), functional disability (Owestry), and return to work. Results. The societal total cost per patient ( standard deviations) in the surgical group was significantly higher than in the nonsurgical group: Swedish kroner (SEK) 704,000 ( 254,000) vs. SEK 636,000 ( 208,000). The cost per patient for the health care sector was significantly higher for the surgical group, SEK 123,000 ( 60,100) vs. 65,200 ( 38,400) for the control group. All treatment effects were significantly better after surgery. The incremental cost-effectiveness ratio ( ICER), illustrating the extra cost per extra effect unit gained by using fusion instead of nonsurgical treatment, were for improvement: SEK 2,600 ( 600 - 5,900), for back pain: SEK 5,200 ( 1,100 - 11,500), for Oswestry: SEK 11,300 ( 1,200 - 48,000), and for return to work: SEK 4,100 ( 100 21,400). Conclusion. For both the society and the health care sectors, the 2-year costs for lumbar fusion was significantly higher compared with nonsurgical treatment but all treatment effects were significantly in favor of surgery. The probability of lumbar fusion being cost-effective increased with the value put on extra effect units gained by using surgery.
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| 28. |
- Karlsson, E., et al.
(författare)
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Breast cancer during follow-up and progression - A population based cohort on new cancers and changed biology
- 2014
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Ingår i: European Journal of Cancer. - : Elsevier. - 0959-8049 .- 1879-0852. ; 50:17, s. 2916-2924
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Tidskriftsartikel (refereegranskat)abstract
- Background: Emerging data indicate an important role for biopsies of clinically/radiologically defined breast cancer 'recurrences'. The present study investigates tumour related events (relapses, other malignancies, benign conditions) after a primary breast cancer diagnosis. Patients and methods: The cohort includes 2102 women, representing all patients, with primary invasive breast cancer during 2000-2011 in the county of Varmland, Sweden. A comparative analysis of oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and proliferation (Ki67) between the primary tumour and the relapse was performed and related to outcome. Results: With a mean follow-up time of 4.8 years, 1060 out of 2102 patients have had a biopsy taken after the initial breast cancer diagnosis demonstrating 177 recurrences, 93 other malignancies (colorectal, lung, skin), 40 cancer in situ (skin, breast) and 857 benign lesions. Approximately 70% (177 out of 245) of all cases of relapsed breast cancer underwent a biopsy during this time period. For patients with recurrences, ER (n = 127), PR (n = 101), HER2 (n = 73) and Ki67 (n = 55) status in both primary tumour and the corresponding relapse were determined. The discordance of receptor status was 14.2%, 39.6%, 9.6% and 36.3%, respectively. Loss of ER or PR in the relapse resulted in a significant increased risk of death (hazard ratio (HR) 3.62; 95% confidence interval (CI), 1.65-7.94) and (HR 2.34; 95% CI, 1.01-5.47) compared with patients with stable ER or PR positive tumours. The proportion of patients losing ER was bigger in the group treated with endocrine therapy alone or in combination with chemotherapy, 16.7% and 13.3%, respectively, compared with the group treated with chemotherapy alone or that which received no treatment 4.3% and 7.7%, respectively. Conclusion: Discordance of biomarkers between the primary tumour and the corresponding relapse was seen in 10-40% of the patients, adjuvant therapies seem to drive clonal selections. Patients with tumours losing ER or PR during progression have worse survival compared with patients with retained receptor expression. (C) 2014 Elsevier Ltd. All rights reserved.
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| 32. |
- Uppgard, Tomas, et al.
(författare)
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The Swedish newspaper industry's changing business strategies for multi-channel publishing 1995-2004
- 2004
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Ingår i: EADOPTION AND THE KNOWLEDGE ECONOMY. - AMSTERDAM : I O S PRESS. - 1586034707 ; , s. 499-506
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Konferensbidrag (refereegranskat)abstract
- The Swedish newspaper industry has gone through five major phases of multi channel business strategy from 1995 - 2004. The strategies have changed from "experimental learning" to "demands for profitability". Today's challenge is to understand the complex relationships between the different channels. Synergies can be achieved both for content delivery and advertising. During the spring of 2004, Swedish media have reported about several developments where the online advertising players gain ground at the expense of advertising in printed media. As a consequence of this development, major media companies in Sweden take considerable action to compete in this newborn online market. Other important challenges to handle over the years to come are; development of premium pay services, online classified advertising partnerships, display advertising packages in several channels and creation of an organization designed to promote change.
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