| 1. |
- Allard, Christina, et al.
(författare)
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Rasbiologiskt språkbruk i statens rättsprocess mot sameby : DN Debatt 2015-06-11
- 2015
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Annan publikation (populärvet., debatt m.m.)abstract
- Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.
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| 2. |
- Alvez, Maria Bueno, et al.
(författare)
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Next generation pan-cancer blood proteome profiling using proximity extension assay
- 2023
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Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- A comprehensive characterization of blood proteome profiles in cancer patients can contribute to a better understanding of the disease etiology, resulting in earlier diagnosis, risk stratification and better monitoring of the different cancer subtypes. Here, we describe the use of next generation protein profiling to explore the proteome signature in blood across patients representing many of the major cancer types. Plasma profiles of 1463 proteins from more than 1400 cancer patients are measured in minute amounts of blood collected at the time of diagnosis and before treatment. An open access Disease Blood Atlas resource allows the exploration of the individual protein profiles in blood collected from the individual cancer patients. We also present studies in which classification models based on machine learning have been used for the identification of a set of proteins associated with each of the analyzed cancers. The implication for cancer precision medicine of next generation plasma profiling is discussed.
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| 3. |
- Angelstam, Per, et al.
(författare)
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Evidence-Based Knowledge Versus Negotiated Indicators for Assessment of Ecological Sustainability : The Swedish Forest Stewardship Council Standard as a Case Study
- 2013
-
Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 42:2, s. 229-240
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Tidskriftsartikel (refereegranskat)abstract
- Assessing ecological sustainability involves monitoring of indicators and comparison of their states with performance targets that are deemed sustainable. First, a normative model was developed centered on evidence-based knowledge about (a) forest composition, structure, and function at multiple scales, and (b) performance targets derived by quantifying the habitat amount in naturally dynamic forests, and as required for presence of populations of specialized focal species. Second, we compared the Forest Stewardship Council (FSC) certification standards' ecological indicators from 1998 and 2010 in Sweden to the normative model using a Specific, Measurable, Accurate, Realistic, and Timebound (SMART) indicator approach. Indicator variables and targets for riparian and aquatic ecosystems were clearly under-represented compared to terrestrial ones. FSC's ecological indicators expanded over time from composition and structure towards function, and from finer to coarser spatial scales. However, SMART indicators were few. Moreover, they poorly reflected quantitative evidence-based knowledge, a consequence of the fact that forest certification mirrors the outcome of a complex social negotiation process.
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| 4. |
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| 5. |
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| 6. |
- Gaines, Hans, et al.
(författare)
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Six-week follow-up after HIV-1 exposure: a position statement from the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy
- 2016
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Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 48:2, s. 93-98
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Forskningsöversikt (refereegranskat)abstract
- In 2014 the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy (RAV) conducted a review and analysis of the state of knowledge on the duration of follow-up after exposure to human immunodeficiency virus (HIV). Up until then a follow-up of 12 weeks after exposure had been recommended, but improved tests and new information on early diagnosis motivated a re-evaluation of the national recommendations by experts representing infectious diseases and microbiology, county medical officers, the RAV, the Public Health Agency, and other national authorities. Based on the current state of knowledge the Public Health Agency of Sweden and the RAV recommend, starting in April 2015, a follow-up period of 6 weeks after possible HIV-1 exposure, if HIV testing is performed using laboratory-based combination tests detecting both HIV antibody and antigen. If point-of-care rapid HIV tests are used, a follow-up period of 8 weeks is recommended, because currently available rapid tests have insufficient sensitivity for detection of HIV-1 antigen. A follow-up period of 12 weeks is recommended after a possible exposure for HIV-2, since presently used assays do not include HIV-2 antigens and only limited information is available on the development of HIV antibodies during early HIV-2 infection. If pre- or post-exposure prophylaxis is administered, the follow-up period is recommended to begin after completion of prophylaxis. Even if infection cannot be reliably excluded before the end of the recommended follow-up period, HIV testing should be performed at first contact for persons who seek such testing.
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| 7. |
- Gustavsson, Per-Erik, et al.
(författare)
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Direct measurements of convective fluid velocities in superporous agarose beads
- 1998
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Ingår i: Journal of Chromatography A. - 0021-9673. ; 795:2, s. 199-210
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Tidskriftsartikel (refereegranskat)abstract
- Superporous agarose beads contain two sets of pores, diffusion pores and so-called superpores or flow pores, in which the chromatographic flow can transport substances to the interior of each individual bead [Gustavsson and Larsson, J. Chromatogr. A 734 (1996) 231]. The existence of pore flow may be proven indirectly by the chromatographic performance of beads but it has never been directly demonstrated in a chromatographic bed. In this report, pore flow was directly measured by following the movement of micro-particles (dyed yeast cells) in a packed bed. The passage of the micro-particles through the superpores and through the interstitial pores was followed by a microscope/video camera focused on beads which were situated four layers from the glass wall. The video recordings were subsequently used to determine the convective fluid velocities in both the superpores and the interstitial pores. Experiments were carried out with three different bead size ranges, all of which contained superporous beads having an average superpore diameter of 30 mu m. The superpore fluid velocity as % of interstitial fluid velocity was determined to be 2-5% for columns packed with 300-500-mu m beads (3% average value), 6-12% for columns packed with 180-300 mu m beads (7% average value) and 11-24% for columns packed with 106-180-mu m beads (17% average value). These data were compared to and found to agree with theoretically calculated values based on the Kozeny-Carman equation. In order to observe and accurately measure fluid velocities within a chromatographic bed, special techniques were adopted. Also, precautions were made to ensure that the experimental conditions used were representative of normal chromatography runs. (C) 1998 Elsevier Science B.V.
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| 8. |
- Gustavsson, Per-Erik, et al.
(författare)
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Superporous agarose beads as a hydrophobic interaction chromatography support
- 1999
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Ingår i: Journal of Chromatography A. - 0021-9673. ; 830:2, s. 275-284
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Tidskriftsartikel (refereegranskat)abstract
- Superporous agarose beads were used as a support for hydrophobic interaction chromatography. These beads have large connecting flow pores in addition to their normal diffusion pores. The flow pores, which are approximately one fifth of the overall diameter of the superporous agarose beads, were earlier shown to give the beads improved mass transfer properties relative to homogeneous agarose beads (Gustavsson and Larsson, J. Chromatogr. A, 734 (1996) 231-240). Superporous agarose beads and homogeneous agarose beads of the same particle size range (106-180 mu m) were derivatized with phenyl groups. The properties of the superporous beads were then compared with the homogeneous beads in the separation of a mixture of three model proteins (ribonuclease A, lysozyme and bovine serum albumin) at various superficial flow velocities from 30 to 600 cm/h. The superporous beads gave satisfactory separation at flow velocities five times higher than was possible for homogeneous beads. The performance of the two types of beads was also compared in the purification of lactate dehydrogenase from a beef heart extract at a superficial flow velocity of 150 cm/h. The superporous beads performed considerably better, leading to twice the purification factor and twice the concentration of the desired product. The results were interpreted using the theoretical treatment given by Carta and Rodrigues (Carta and Rodrigues, Chem. Eng. Sci., 48 (1993) 3927). (C) 1999 Elsevier Science B.V. All rights reserved.
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| 9. |
- Larsson, Per-Olof, et al.
(författare)
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Direct measurement of intraparticle fluid velocity in superporous agarose beads
- 1998
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Ingår i: Journal of Molecular Recognition. - 1099-1352. ; 11:1-6, s. 270-272
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Tidskriftsartikel (refereegranskat)abstract
- Superporous agarose beads contain both normal diffusion pores and special, very wide superpores through which part of the chromatographic flow is transported, a situation that may greatly improve the chromatographic performance. For the first time such pore flow was measured directly by following the movement of microparticles (dyed yeast cells) through superporous beads packed in a chromatographic bed. The passage of the microparticles through the superpores and through the interstitial pores was recorded by a microscope/video camera, The video recordings were subsequently used to determine flow paths as well as the convective fluid velocities in both the superpores and the interstitial pores. The superpore fluid velocity was found to be proportional to the ratio between the squares of the respective pore diameters, which is in agreement with the Kozeny-Carman equation, Values for two-dimensional and three-dimensional tortuosity of the flow paths were measured and calculated respectively. (C) 1998 John Wiley & Sons, Ltd.
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| 10. |
- Nygård, Per, et al.
(författare)
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Damage Mechanisms in Paper
- 2006
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Ingår i: 2006 Progress in Paper Physics.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 11. |
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| 12. |
- Abdo, A. A., et al.
(författare)
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A Population of Gamma-Ray Millisecond Pulsars Seen with the Fermi Large Area Telescope
- 2009
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 325:5942, s. 848-852
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Tidskriftsartikel (refereegranskat)abstract
- Pulsars are born with subsecond spin periods and slow by electromagnetic braking for several tens of millions of years, when detectable radiation ceases. A second life can occur for neutron stars in binary systems. They can acquire mass and angular momentum from their companions, to be spun up to millisecond periods and begin radiating again. We searched Fermi Large Area Telescope data for pulsations from all known millisecond pulsars (MSPs) outside of globular clusters, using rotation parameters from radio telescopes. Strong gamma-ray pulsations were detected for eight MSPs. The gamma-ray pulse profiles and spectral properties resemble those of young gamma-ray pulsars. The basic emission mechanism seems to be the same for MSPs and young pulsars, with the emission originating in regions far from the neutron star surface.
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| 13. |
- Abdo, A. A., et al.
(författare)
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Fermi LAT Observation of Diffuse Gamma Rays Produced Through Interactions Between Local Interstellar Matter and High-energy Cosmic Rays
- 2009
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Ingår i: Astrophysical Journal Supplement Series. - 0067-0049 .- 1538-4365. ; 703:2, s. 1249-1256
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Tidskriftsartikel (refereegranskat)abstract
- Observations by the Large Area Telescope (LAT) on the Fermi mission of diffuse γ-rays in a mid-latitude region in the third quadrant (Galactic longitude l from 200° to 260° and latitude |b| from 22° to 60°) are reported. The region contains no known large molecular cloud and most of the atomic hydrogen is within 1 kpc of the solar system. The contributions of γ-ray point sources and inverse Compton scattering are estimated and subtracted. The residual γ-ray intensity exhibits a linear correlation with the atomic gas column density in energy from 100 MeV to 10 GeV. The measured integrated γ-ray emissivity is (1.63 ± 0.05) × 10-26 photons s-1sr-1 H-atom-1 and (0.66 ± 0.02) × 10-26 photons s-1sr-1 H-atom-1 above 100 MeV and above 300 MeV, respectively, with an additional systematic error of ~10%. The differential emissivity from 100 MeV to 10 GeV agrees with calculations based on cosmic ray spectra consistent with those directly measured, at the 10% level. The results obtained indicate that cosmic ray nuclei spectra within 1 kpc from the solar system in regions studied are close to the local interstellar spectra inferred from direct measurements at the Earth within ~10%.
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| 14. |
- Abdo, A. A., et al.
(författare)
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Measurement of the Cosmic Ray e(+)+e(-) Spectrum from 20 GeV to 1 TeV with the Fermi Large Area Telescope
- 2009
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Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 102:Article number: 181101
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Tidskriftsartikel (refereegranskat)abstract
- Designed as a high-sensitivity gamma-ray observatory, the Fermi Large Area Telescope is also an electron detector with a large acceptance exceeding 2 m(2) sr at 300 GeV. Building on the gamma-ray analysis, we have developed an efficient electron detection strategy which provides sufficient background rejection for measurement of the steeply falling electron spectrum up to 1 TeV. Our high precision data show that the electron spectrum falls with energy as E-3.0 and does not exhibit prominent spectral features. Interpretations in terms of a conventional diffusive model as well as a potential local extra component are briefly discussed.
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| 15. |
- Abe, O, et al.
(författare)
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Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials
- 2005
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Ingår i: The Lancet. - 1474-547X. ; 365:9472, s. 1687-1717
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Tidskriftsartikel (refereegranskat)abstract
- Background Quinquennial overviews (1985-2000) of the randomised trials in early breast cancer have assessed the 5-year and 10-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival. Here, we report the 10-year and 15-year effects. Methods Collaborative meta-analyses were undertaken of 194 unconfounded randomised trials of adjuvant chemotherapy or hormonal therapy that began by 1995. Many trials involved CMF (cyclophosphamide, methotrexate, fluorouracil), anthracycline-based combinations such as FAC (fluorouracil, doxombicin, cyclophosphamide) or FEC (fluorouracil, epirubicin, cyclophosphamide), tamoxifen, or ovarian suppression: none involved taxanes, trastuzumab, raloxifene, or modem aromatase inhibitors. Findings Allocation to about 6 months of anthracycline-based polychemotherapy (eg, with FAC or FEC) reduces the annual breast cancer death rate by about 38% (SE 5) for women younger than 50 years of age when diagnosed and by about 20% (SE 4) for those of age 50-69 years when diagnosed, largely irrespective of the use of tamoxifen and of oestrogen receptor (ER) status, nodal status, or other tumour characteristics. Such regimens are significantly (2p=0 . 0001 for recurrence, 2p<0 . 00001 for breast cancer mortality) more effective than CMF chemotherapy. Few women of age 70 years or older entered these chemotherapy trials. For ER-positive disease only, allocation to about 5 years of adjuvant tamoxifen reduces the annual breast cancer death rate by 31% (SE 3), largely irrespective of the use of chemotherapy and of age (<50, 50-69, &GE; 70 years), progesterone receptor status, or other tumour characteristics. 5 years is significantly (2p<0 . 00001 for recurrence, 2p=0 . 01 for breast cancer mortality) more effective than just 1-2 years of tamoxifen. For ER-positive tumours, the annual breast cancer mortality rates are similar during years 0-4 and 5-14, as are the proportional reductions in them by 5 years of tamoxifen, so the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis. These results combine six meta-analyses: anthracycline-based versus no chemotherapy (8000 women); CMF-based versus no chemotherapy (14 000); anthracycline-based versus CMF-based chemotherapy (14 000); about 5 years of tamoxifen versus none (15 000); about 1-2 years of tamoxifen versus none (33 000); and about 5 years versus 1-2 years of tamoxifen (18 000). Finally, allocation to ovarian ablation or suppression (8000 women) also significantly reduces breast cancer mortality, but appears to do so only in the absence of other systemic treatments. For middle-aged women with ER-positive disease (the commonest type of breast cancer), the breast cancer mortality rate throughout the next 15 years would be approximately halved by 6 months of anthracycline-based chemotherapy (with a combination such as FAC or FEC) followed by 5 years of adjuvant tamoxifen. For, if mortality reductions of 38% (age <50 years) and 20% (age 50-69 years) from such chemotherapy were followed by a further reduction of 31% from tamoxifen in the risks that remain, the final mortality reductions would be 57% and 45%, respectively (and, the trial results could well have been somewhat stronger if there had been full compliance with the allocated treatments). Overall survival would be comparably improved, since these treatments have relatively small effects on mortality from the aggregate of all other causes. Interpretation Some of the widely practicable adjuvant drug treatments that were being tested in the 1980s, which substantially reduced 5-year recurrence rates (but had somewhat less effect on 5-year mortality rates), also substantially reduce 15-year mortality rates. Further improvements in long-term survival could well be available from newer drugs, or better use of older drugs.
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| 16. |
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| 17. |
- Akselsson, Roland, et al.
(författare)
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Multidisciplinary Research on Integration of Human Factors and Production Concepts such as TQM - A Participatory Discussion Session
- 1999
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Ingår i: Proceedings of the Conference on TQM and Human Factors. - 9172195207 ; 2, s. 439-448
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Konferensbidrag (refereegranskat)abstract
- A discussion session where the conference participants are invited to participate is planned. One topic for the session is to discuss experiences of multidisciplinary research on integration of human factors and different production concepts applied in change processes within Swedish companies. An important question that the discussion will focus on is: How to get high quality in multidisciplinary research? Another topic is to discuss how people from different disciplines in the companies interact with each other and with the researchers. Researchers from the centre Change@Work at Lund University in Sweden will present some of their experiences from several years of multidisciplinary research in companies. As a background the research questions within Change@Work are presented below. Discussions during the workshop will be performed according to methods used by the researchers in their research in the companies. All discussion will be documented and later sent to all workshop participants.
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| 18. |
- Al-Dury, Nooraldeen, 1986, et al.
(författare)
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Identifying the relative importance of predictors of survival in out of hospital cardiac arrest : a machine learning study
- 2020
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central. - 1757-7241. ; 28:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Studies examining the factors linked to survival after out of hospital cardiac arrest (OHCA) have either aimed to describe the characteristics and outcomes of OHCA in different parts of the world, or focused on certain factors and whether they were associated with survival. Unfortunately, this approach does not measure how strong each factor is in predicting survival after OHCA. Aim: To investigate the relative importance of 16 well-recognized factors in OHCA at the time point of ambulance arrival, and before any interventions or medications were given, by using a machine learning approach that implies building models directly from the data, and arranging those factors in order of importance in predicting survival. Methods: Using a data-driven approach with a machine learning algorithm, we studied the relative importance of 16 factors assessed during the pre-hospital phase of OHCA We examined 45,000 cases of OHCA between 2008 and 2016. Results: Overall, the top five factors to predict survival in order of importance were: initial rhythm, age, early Cardiopulmonary Resuscitation (CPR, time to CPR and CPR before arrival of EMS), time from EMS dispatch until EMS arrival, and place of cardiac arrest The largest difference in importance was noted between initial rhythm and the remaining predictors. A number of factors, including time of arrest and sex were of little importance. Conclusion: Using machine learning, we confirm that the most important predictor of survival in OHCA is initial rhythm, followed by age, time to start of CPR, EMS response time and place of OHCA. Several factors traditionally viewed as important e.g. sex, were of little importance.
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| 19. |
- Allard, Christina, et al.
(författare)
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Rasbiologiskt språkbruk i statens rättsprocess mot sameby
- 2015
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Ingår i: Dagens Nyheter. - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.
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| 20. |
- Almqvist, Helena, et al.
(författare)
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CETSA screening identifies known and novel thymidylate synthase inhibitors and slow intracellular activation of 5-fluorouracil
- 2016
-
Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Target engagement is a critical factor for therapeutic efficacy. Assessment of compound binding to native target proteins in live cells is therefore highly desirable in all stages of drug discovery. We report here the first compound library screen based on biophysical measurements of intracellular target binding, exemplified by human thymidylate synthase (TS). The screen selected accurately for all the tested known drugs acting on TS. We also identified TS inhibitors with novel chemistry and marketed drugs that were not previously known to target TS, including the DNA methyltransferase inhibitor decitabine. By following the cellular uptake and enzymatic conversion of known drugs we correlated the appearance of active metabolites over time with intracellular target engagement. These data distinguished a much slower activation of 5-fluorouracil when compared with nucleoside-based drugs. The approach establishes efficient means to associate drug uptake and activation with target binding during drug discovery.
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| 21. |
- Almroth, Gabriel, et al.
(författare)
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Increased Prevalence of Anti-Gliadin IgA-Antibodies with Aberrant Duodenal Histopathological Findings in Patients with IgA-Nephropathy and Related Disorders
- 2006
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 111:3, s. 339-352
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Tidskriftsartikel (refereegranskat)abstract
- Background: Antibodies present in coeliac disease may occur in IgA-nephropathy. This raises the question of food intolerance in the disease. Evidence for a true correlation between the two disorders has however been scarce.Design: Sera from 89 patients with IgA-nephropathy and 13 other patients with IgA deposits in the glomeruli of kidney biopsies were analysed for IgA-antibodies to gliadin, endomysium and tissue transglutaminase (92/102 patients).Results: Eleven out of 89 (12.4%) of the patients with IgA-nephropathy and five of the 13 others (38%) had elevated titres of IgA-antibodies to gliadin but, in all cases but one, normal IgA-antibodies to endomysium. Patients with IgA-nephropathy and elevated IgA-antibodies to gliadin had elevated total serum IgA more frequently than patients who had not (p<0.01). Two patients with IgA-nephropathy and one with Hennoch Schönlein's purpura had elevated IgA-antibodies to tissue transglutaminase.Small bowel biopsy in 7 out of 11 IgA-antibodies to gliadin positive patients with IgA-nephropathy was pathologic in three cases (two with Marsh I). One patient with chronic glomerulnephritis also had Marsh I.Conclusions: We found no increased frequency of verified coeliac disease in 89 patients with IgA-nephropathy. Two patients with IgA-nephropathy and one patient with chronic glomerulonephritis with IgA deposits in the kidney biopsy had a Marsh I histopathology. The findings suggest a possible link of celiac disease to IgA-nephropathy and a role for antibodies to food antigens in this disorder.
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| 22. |
- Amini, Hashem, et al.
(författare)
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Comparison of ultrasound and autopsy findings in pregnancies terminated due to fetal anomalies
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:10, s. 1208-1216
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To compare antenatal diagnoses with autopsy findings in pregnancies terminated after ultrasound detection of fetal anomalies. A second aim was to study the quality of antenatal fetal diagnosis over time. Design. Retrospective, multicenter study over two consecutive six-year periods in Uppsala and Stockholm. Setting. Cases were identified through fetal autopsy reports. Subjects. Three hundred and twenty-eight fetuses from pregnancies terminated between 1992 and 2003 because of ultrasonographically diagnosed anomalies. Main outcome measures. The findings at the last ultrasound examination were compared with the autopsy reports. Results. In 299 cases (91.2%) ultrasound findings either exactly matched or were essentially similar to the autopsy findings. In 23 cases (7%) ultrasound findings were not confirmed at autopsy, but the postnatal findings were at least as severe as the antenatal ones. In six cases (1.8%) termination was performed for an anomaly which proved to be less severe than was predicted by ultrasound. The number of such cases was the same in both six-year periods, while the total number of cases increased from 113 in the first to 215 in the second period. Fetal examination provided further diagnostic information in 47% of the cases. In 10% a syndrome was disclosed. Conclusion. Termination of pregnancy was not always based on a correct antenatal diagnosis. All fetuses but one from terminated pregnancies had evident anomalies. In six cases (1.8%) the decision to terminate was based on suboptimal prognostic and diagnostic information. Fetal autopsy by an experienced perinatal pathologist is essential to provide a definitive diagnosis.
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| 23. |
- Anderson, Ian, et al.
(författare)
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Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration) : a population study
- 2016
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 388:10040, s. 131-157
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Tidskriftsartikel (refereegranskat)abstract
- Background: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries.Methods: Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated.Findings: Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations.Interpretation: We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems.
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| 24. |
- Andersson, Kjell, et al.
(författare)
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Connecting Municipal and Regional Level Planning: Analysis and Visualization of Sustainability Indicators in Bergslagen, Sweden
- 2013
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Ingår i: European Planning Studies. - : Informa UK Limited. - 0965-4313 .- 1469-5944. ; 21, s. 1210-1234
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Tidskriftsartikel (refereegranskat)abstract
- Sustainable development as a process towards sustainability requires collaboration among societal actors and stakeholders at multiple levels. A key issue is to provide them with that they have comprehensive and transparent knowledge base representing the state and trends of different dimensions of sustainability. This study addresses the need to analyse and present data of sustainability as a foundation for the sustainable development process within municipalities, and among them. As a case study, we focus on 18 municipalities in the crisis-struck Bergslagen region in Sweden and compare them with 101 surrounding municipalities. Data from 2001 and 2006 on 15 indicators representing ecological, economic and social sustainability criteria were transformed to a common scale through normalization around the median, and summarized. Bergslagen region municipalities performed poorer than the surrounding ones for all dimensions in 2006. The change from 2001 to 2006 was positive for economic and social criteria, while the ecological dimension developed negatively in all municipalities. We stress the need for municipalities to collaborate with each other and other actors both at municipal and regional levels, and to use sustainability indicators as a base for informed planning processes. We propose visualization of indicators using maps to support decision-making and social learning.
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| 25. |
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| 26. |
- Andersson, Kjell, et al.
(författare)
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Green infrastructures and intensive forestry: Need and opportunity for spatial planning in a Swedish rural-urban gradient
- 2013
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Ingår i: Scandinavian Journal of Forest Research. - : Informa UK Limited. - 0282-7581 .- 1651-1891. ; 28, s. 143-165
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Tidskriftsartikel (refereegranskat)abstract
- There is a current industrial and societal interest in Europe to further intensify the yield of wood for the forest industry and biomass. At the same time, green infrastructures for ecological and sociocultural values in forest landscapes should be functional. Municipalities have exclusive responsibility for comprehensive planning in Sweden. We modelled the spatial distribution of green infrastructures in terms of three forest types with high ecological values, and three sociotopes with high sociocultural values in 119 municipalities in a ruralurban gradient in Sweden. Forest land without such values should be available for intensive forestry with lower conflict risk. We also estimated the municipalities' potential for physical planning in terms of financial and social capital, and ownership category structure. The area of functional green infrastructures varied considerably among municipalities. Municipalities with a high proportion of functional green infrastructure, thus less available for intensive forestry, were characterised by a stronger tax base, higher population density and lower demographic dependency ratio, and lower proportions of industrial and state forest ownership. We discuss the need for and opportunities of introducing collaborative physical planning to accommodate multiple demands on forest landscapes. We conclude that to accommodate both functional green infrastructures and intensive forestry, a landscape approach including knowledge-based collaboration is needed at multiple-levels of governance and management.
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| 27. |
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| 28. |
- Andersson, Kjell, 1956-2014, et al.
(författare)
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Limited GIS skills hamper spatial planning for green infrastructures in Sweden
- 2022
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Ingår i: Geografiska Notiser. - : Geografilärarnas Riksförening. - 0016-724X. ; 80:1, s. 16-35
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The term green infrastructure captures the need to conserve biodiversity and to sustain landscapes’ different ecosystem services. Maintaining green infrastructures through protected areas, management and landscape restoration requires knowledge in geography, spatial data about biophysical, anthropogenic and immaterial values, spatial comprehensive planning, and thus geographical information systems (GIS). To understand land use planning practices and planning education regarding GIS in Sweden we interviewed 43 planners and reviewed 20 planning education programmes. All planners used GIS to look at data but did not carry out spatial analyses of land covers. BSc programmes included more GIS than MSc programmes but very few taught analyses for spatial planning. As key spatial planning actors, municipalities’ barriers and bridges for improved GIS use for collaborative learning about green infrastructures are discussed. A concluding section presents examples of how GIS can support spatial planning for green infrastructures.
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| 29. |
- Andersson, Per, et al.
(författare)
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Förändringar i tjänstesamhället
- 2013
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Ingår i: Det mogna tjänstesamhällets förnyelse. - Lund : Studentlitteratur. - 9789144094304 ; , s. 25-60
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 30. |
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| 31. |
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| 32. |
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| 33. |
- Angelstam, Per, et al.
(författare)
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Knowledge production and learning for sustainable forest management on the ground: Pan-European landscapes as a time machine
- 2011
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Ingår i: Forestry. - : Oxford University Press (OUP). - 0015-752X .- 1464-3626. ; 84, s. 581-596
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Tidskriftsartikel (refereegranskat)abstract
- While sustainable forest management (SFM) policy processes are well developed, implementation on the ground remains a challenge. Given the diversity of biophysical conditions, economic histories and governance systems on the European continent, regionally and temporally adapted and adaptive solutions are needed for both social and ecological systems. To illustrate this, we apply (1) a biographic forest and woodland history approach to central Sweden's Bergslagen region, where boreal sustained yield forestry was widely applied first and (2) a comparative case study approach using five European landscapes that represent different forest history phases in Scotland, Germany, Ukraine and Russia. Additionally, we illustrate the need to learn from reference landscapes for natural forest and cultural woodland systems such as in economically remote regions in Romania, Russia and on the Iberian Peninsula. We conclude that there is great opportunity for innovative knowledge production about both governance and management for different SFM dimensions based on comparisons among concrete landscapes. In addition, there is a need to develop local place-based social learning processes that are characterized by a focus on a geographical area, commitment to SFM policy visions and collaborative approaches to development that include both ecological and social systems.
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| 34. |
- Angelstam, Per, et al.
(författare)
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Knowledge Production and Learning for Sustainable Landscapes: Forewords by the Researchers and Stakeholders
- 2013
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Ingår i: AMBIO: A Journal of the Human Environment. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 42, s. 111-115
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Tidskriftsartikel (refereegranskat)abstract
- This special issue of AMBIO presents a new approach to sustainability science that goes beyond interdisciplinary research. Using coupled natural and human systems, or landscapes, as multiple case studies in Europe's East and West knowledge production and learning toward transdisciplinary research was applied in Sweden, countries in Central and Eastern Europe, and Russia. First, the research group Forest-Landscape-Society summarizes the research program (2005-2012) behind this special issue of AMBIO and its development to participate in transdisciplinary research. Second, stakeholders at multiple levels provide their views on the new approach presented and reported.
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| 35. |
- Angelstam, Per, et al.
(författare)
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Knowledge Production and Learning for Sustainable Landscapes: Seven Steps Using Social-Ecological Systems as Laboratories
- 2013
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Ingår i: AMBIO: A Journal of the Human Environment. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 42, s. 116-128
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Tidskriftsartikel (refereegranskat)abstract
- There are multiple challenges regarding use and governance of landscapes' goods, functions and intangible values for ecosystem health and human well-being. One group of challenges is to measure and assess principal sustainability dimensions through performance targets, so stakeholders have transparent information about states and trends. Another group is to develop adaptive governance at multiple levels, and management of larger geographical areas across scales. Addressing these challenges, we present a framework for transdisciplinary research using multiple landscapes as place-based case studies that integrates multiple research disciplines and non-academic actors: (1) identify a suite of landscapes, and for each (2) review landscape history, (3) map stakeholders, use and non-use values, products and land use, (4) analyze institutions, policies and the system of governance, (5) measure ecological, economic, social and cultural sustainability, (6) assess sustainability dimensions and governance, and finally (7) make comparisons and synthesize. Collaboration, communication and dissemination are additional core features. We discuss barriers bridges and bridges for applying this approach.
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| 36. |
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| 37. |
- Angelstam, Per, et al.
(författare)
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Learning about the history of landscape use for the future : consequences for ecological and social systems in Swedish Bergslagen
- 2013
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 42:2, s. 146-159
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Tidskriftsartikel (refereegranskat)abstract
- Barriers and bridges to implement policies about sustainable development and sustainability commonly depend on the past development of social-ecological systems. Production of metals required integration of use of ore, streams for energy, and wood for bioenergy and construction, as well as of multiple societal actors. Focusing on the Swedish Bergslagen region as a case study we (1) describe the phases of natural resource use triggered by metallurgy, (2) the location and spatial extent of 22 definitions of Bergslagen divided into four zones as a proxy of cumulative pressure on landscapes, and (3) analyze the consequences for natural capital and society. We found clear gradients in industrial activity, stream alteration, and amount of natural forest from the core to the periphery of Bergslagen. Additionally, the legacy of top-down governance is linked to today's poorly diversified business sector and thus municipal vulnerability. Comparing the Bergslagen case study with other similar regions in Russia and Germany, we discuss the usefulness of multiple case studies.
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| 38. |
- Angelstam, Per, et al.
(författare)
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Measurement, Collaborative Learning and Research for Sustainable Use of Ecosystem Services: Landscape Concepts and Europe as Laboratory
- 2013
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Ingår i: AMBIO: A Journal of the Human Environment. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 42, s. 129-145
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Tidskriftsartikel (refereegranskat)abstract
- Policies at multiple levels pronounce the need to encompass both social and ecological systems in governance and management of natural capital in terms of resources and ecosystems. One approach to knowledge production and learning about landscapes as social-ecological systems is to compare multiple case studies consisting of large spaces and places. We first review the landscape concepts' biophysical, anthropogenic, and intangible dimensions. Second, we exemplify how the different landscape concepts can be used to derive measurable variables for different sustainability indicators. Third, we review gradients in the three dimensions of the term landscape on the European continent, and propose to use them for the stratification of multiple case studies of social-ecological systems. We stress the benefits of the landscape concepts to measure sustainability, and how this can improve collaborative learning about development toward sustainability in social-ecological systems. Finally, analyses of multiple landscapes improve the understanding of context for governance and management.
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| 39. |
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| 40. |
- Angelstam, Per, et al.
(författare)
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Protecting forest areas for biodiversity in Sweden 1991–2010: the policy implementation process and outcomes on the ground
- 2011
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Ingår i: Silva Fennica. - : Finnish Society of Forest Science. - 0037-5330 .- 2242-4075. ; 45, s. 1111-1133
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Tidskriftsartikel (refereegranskat)abstract
- Swedish forest and environmental policies imply that forests should be managed so that all naturally occurring species are maintained in viable populations. This requires maintenance of functional networks of representative natural forest and cultural woodland habitats. We first review the policy implementation process regarding protected areas in Sweden 1991-2010, how ecological knowledge was used to formulate interim short-term and strategic long-term biodiversity conservation goals, and the development of a hierarchical spatial planning approach. Second, we present data about the amount of formally protected and voluntarily set aside forest stands, and evaluate how much remains in terms of additional forest protection, conservation management and habitat restoration to achieve forest and environmental policy objectives in the long-term. Third, a case study in central Sweden was made to estimate the functionality of old Scots pine, Norway spruce and deciduous forest habitats, as well as cultural woodland, in different forest regions. Finally, we assess operational biodiversity conservation planning processes. We conclude that Swedish policy pronouncements capture the contemporary knowledge about biodiversity and conservation planning well. However, the existing area of protected and set-aside forests is presently too small and with too poor connectivity. To bridge this gap, spatial planning, management and restoration of habitat, as well as collaboration among forest and conservation planners need to be improved.
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| 41. |
- Angelstam, Per, et al.
(författare)
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Solving Problems in Social-Ecological Systems : Definition, Practice and Barriers of Transdisciplinary Research
- 2013
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 42:2, s. 254-265
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Tidskriftsartikel (refereegranskat)abstract
- Translating policies about sustainable development as a social process and sustainability outcomes into the real world of social-ecological systems involves several challenges. Hence, research policies advocate improved innovative problem-solving capacity. One approach is transdisciplinary research that integrates research disciplines, as well as researchers and practitioners. Drawing upon 14 experiences of problem-solving, we used group modeling to map perceived barriers and bridges for researchers' and practitioners' joint knowledge production and learning towards transdisciplinary research. The analysis indicated that the transdisciplinary research process is influenced by (1) the amount of traditional disciplinary formal and informal control, (2) adaptation of project applications to fill the transdisciplinary research agenda, (3) stakeholder participation, and (4) functional team building/development based on self-reflection and experienced leadership. Focusing on implementation of green infrastructure policy as a common denominator for the delivery of ecosystem services and human well-being, we discuss how to diagnose social-ecological systems, and use knowledge production and collaborative learning as treatments.
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| 42. |
- Angelstam, Per, et al.
(författare)
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Sustainable Bergslagen : a landscape approach initiative in Sweden
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bergslagen in south-central Sweden is an informal region with a long history of intensive land use. The legacies of than 2000 years of integrated use of ore, forests and water major national and international economic importance now involve several challenges for the maintenance of landscapes. This includes sustainability of rural and urban communities, of green infrastructures for natural capital and human well-being as well as of forests, river basins and mining. In response to this cross-sectoral integration necessary at multiple levels of public, private and civil as well as academia and schools. Landscapes need thus to be viewed as integrated socio-ecological systems. Collaboration and continuous learning among actors and stakeholders are needed for sustainable use and management of landscapes’ goods, services and values. To support this requires (1) data, monitoring and assessment of different aspects of sustainability, (2) continuous knowledge production about material and immaterial landscape values relevant for the management of ecological, economic, social and cultural dimensions, (3) information and communication using both traditional media, as well as (4) through art and culture. the vision to contribute to satisfying these requirements Sustainable Bergslagen initiative emerged gradually since 2004 as a multi-level partnership for sustainable landscapes (www.bergslagen.org). By joining the International Model Forest Network (IMFN), and the network for Long Term Socio-Economic and Ecological Research (LTSER), actors and stakeholders can learn from other regions’ sustainable development processes, and make Bergslagen more visible internationally.
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| 43. |
- Angelstam, Per, et al.
(författare)
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The Euroscapes network : learning for sustainable landscapes
- 2014
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Ingår i: Euroscapes Communication. - 2001-5801.
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Annan publikation (populärvet., debatt m.m.)abstract
- -Sustainable landscapes require evidence-based knowledge about multiple goods, services and values, as well as integrated place-based collaboration among actors and stakeholders at multiple levels. -EUROSCAPES is an international network of researchers, journalists and practitioners that supports sharing of knowledge about how to maintain and develop sustainable landscapes. --Euro... is about the diversity of places in the European continent’s East and West - from the Ural Mountains and Caucasus to the Atlantic Ocean. --...scapes links to the word landscape, which has biophysical, anthropogenic and perceived dimensions. -EUROSCAPES gathers and communicates knowledge using three series of publications: --EUROSCAPES News with short texts and illustrations that can be used by journalists. --EUROSCAPES Communication with popular summaries of peer-reviewed publications and reports. --EUROSCAPES Report with longer peer-reviewed comprehensive text. -EUROSCAPES uses the web site www.euroscapes.org to disseminate these publication series using five themes: People, Places, Practices, Projects, and Publications.
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| 44. |
- Antoni, Gunnar, et al.
(författare)
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In Vivo Visualization of Amyloid Deposits in the Heart with C-11-PIB and PET
- 2013
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Ingår i: Journal of Nuclear Medicine. - : Society of Nuclear Medicine. - 0161-5505 .- 1535-5667 .- 2159-662X. ; 54:2, s. 213-220
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Tidskriftsartikel (refereegranskat)abstract
- Cardiac amyloidosis is a differential diagnosis in heart failure and is associated with high mortality. There is currently no noninvasive imaging test available for specific diagnosis. N-[methyl-C-11]2-(4'-methylamino-phenyl)-6-hydroxybenzothiazole (C-11-PIB) PET is used in the evaluation of brain amyloidosis. We evaluated the potential use of C-11-PIB PET in systemic amyloidosis affecting the heart. Methods: Patients (n = 10) diagnosed with systemic amyloidosis-including heart involvement of either monoclonal immunoglobulin light-chain (AL) or transthyretin (ATTR) type- and healthy volunteers (n = 5) were investigated with PET/CT using C-11-PIB to study cardiac amyloid deposits and with C-11-acetate to measure myocardial blood flow to study the impact of global and regional perfusion on PIB retention. Results: Myocardial C-11-PIB uptake was visually evident in all patients 15-25 min after injection and was not seen in any volunteer. A significant difference in C-11-PIB retention in the heart between patients and healthy controls was found. The data indicate that myocardial amyloid deposits in patients diagnosed with systemic amyloidosis could be visualized with C-11-PIB. No correlation between C-11-PIB retention index and myocardial blood flow as measured with C-11-acetate was found on the global level, whereas a positive correlation on the segmental level was seen in a single patient. Conclusion: C-11-PIB and PET could be a method to study systemic amyloidosis of type AL and ATTR affecting the heart and should be investigated further both as a diagnostic tool and as a noninvasive method for treatment follow-up.
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| 45. |
- Arimoto, M., et al.
(författare)
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Performance assessment study of the balloon-borne astronomical soft gamma-ray polarimeter PoGOLite
- 2007
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Ingår i: Physica. E, Low-Dimensional systems and nanostructures. - : Elsevier BV. - 1386-9477 .- 1873-1759. ; 40:2, s. 438-441
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Tidskriftsartikel (refereegranskat)abstract
- Measurements of polarization play a crucial role in the understanding of the dominant emission mechanism of astronomical sources. Polarized Gamma-ray Observer-Light version (PoGOLite) is a balloon-borne astronomical soft gamma-ray polarimeter at the 25-80 keV band. The PoGOLite detector consists of a hexagonal close-packed array of 217 Phoswich detector cells (PDCs) and side anti-coincidence shields (SASs) made of BGO crystals surrounding PDCs. Each PDC consists of a slow hollow scintillator, a fast scintillator and a BGO crystal that connects to a photomultiplier tube at the end. To examine the PoGOLite's capability and estimate the performance, we conducted experiments with the PDC using radioisotope 241Am. In addition, we compared this result with performance expected by Monte Carlo simulation with Geant4. As a result, we found that the actual PDC has the capability to detect a 100 m Crab source until 80 keV.
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| 46. |
- Ashton, Nicholas J., et al.
(författare)
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A multicentre validation study of the diagnostic value of plasma neurofilament light
- 2021
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Increased cerebrospinal fluid neurofilament light (NfL) is a recognized biomarker for neurodegeneration that can also be assessed in blood. Here, we investigate plasma NfL as a marker of neurodegeneration in 13 neurodegenerative disorders, Down syndrome, depression and cognitively unimpaired controls from two multicenter cohorts: King's College London (n = 805) and the Swedish BioFINDER study (n = 1,464). Plasma NfL was significantly increased in all cortical neurodegenerative disorders, amyotrophic lateral sclerosis and atypical parkinsonian disorders. We demonstrate that plasma NfL is clinically useful in identifying atypical parkinsonian disorders in patients with parkinsonism, dementia in individuals with Down syndrome, dementia among psychiatric disorders, and frontotemporal dementia in patients with cognitive impairment. Data-driven cut-offs highlighted the fundamental importance of age-related clinical cut-offs for disorders with a younger age of onset. Finally, plasma NfL performs best when applied to indicate no underlying neurodegeneration, with low false positives, in all age-related cut-offs.
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| 47. |
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| 48. |
- Axelsson, Anders, et al.
(författare)
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”Alla vägar bär till Rom” eller ”Får man göra hur man vill”
- 2006
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Ingår i: [Host publication title missing].
-
Konferensbidrag (refereegranskat)abstract
- Projektet hade som mål att introducera ett simuleringsprogram redan i andra årskursen. Initiativet kom ursprungligen från utbildningsnämnden för Bioteknik och Kemiteknik, som startade ett antal beräkningsteknikprojekt för att stärka teknologerna färdigheter i beräkningsteknik. Projektet genomfördes av 11 frivilliga (av 108) ”testpiloter” i kursen Transportprocesser. Vi ersatte ett av de tre beräkningsprojekten, som normalt ingår i kursen, med ett Femlab-projekt (numera Comsol Multiphysics). Med detta kan man simulera tämligen avancerade strömningsförlopp. Projektet var mycket lyckosamt. De som gjorde detta projekt uppnådde samma insikt i strömningslära som övriga men på ett helt annat sätt – och dessutom genom att jobba helt på egen hand. Resultatet visar också att användningen av ”learning outcomes” eller ”läranderesultat”, som ett sätt att formulera kursmål, faktiskt kan innebära att vi kan se fler möjligheter att genomföra kurser på.
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| 49. |
- Axelsson, Anna, et al.
(författare)
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Patient reported long-term side effects from treatment on urinary and sexual function in anal cancer survivors-3-and 6-year results from the Swedish national ANCA study
- 2024
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Ingår i: COLORECTAL DISEASE. - 1462-8910 .- 1463-1318.
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The standard treatment for anal cancer is chemoradiotherapy. Most patients survive anal cancer but remain living with long-term side effects related to the treatment received. The aim of this study was to assess the occurrence of long-term impairment of urinary and sexual function at 3 and 6 years after diagnosis and to investigate the additive effect from chemotherapy in combined chemoradiotherapy on urinary incontinence, compared to radiotherapy alone. Method: The ANal CAncer study (ANCA) is based on a national Swedish cohort of patients diagnosed with anal cancer between 2011 and 2013. All identified patients within the study were invited to respond to a study-specific questionnaire at 3 and 6 years. Descriptive analyses for the primary endpoint were performed. To investigate a possible additional effect from chemotherapy logistic regression was used. Results: A total of 388 patients were included in the study. At 3 years 264 patients were alive and invited to respond to an anal cancer specific questionnaire. The 3- and 6 year response rates were 195 (74%) and 155 patients (67%), respectively. The patient reported urinary function impairment at 3 years were urgency (63%), incomplete bladder emptying (47%), and incontinence (46%) and there was an absolute increase of the prevalence of urinary dysfunction in about 10% at 6 years. Three years after diagnosis, 77% reported that intercourse was not part of their sex life; this percentage increased at 6 years to 83%. We found no negative effect of chemotherapy in combined chemoradiotherapy versus radiotherapy alone on patient reported urinary incontinence. Conclusion: For anal cancer survivors, urinary function was impaired after 3 years and continued to deteriorate as measured at 6 years after diagnosis. Anal cancer and its treatment negatively affected sexual function for both men and women. This may explain why patients reported that sexual activity and frequency of intercourse was not of importance in their life.
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| 50. |
- Axelsson, Anna, et al.
(författare)
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Patient reported long-term side effects on bowel function and anal pain in anal cancer survivors-3-and 6-year results from the Swedish national ANCA study
- 2023
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Ingår i: COLORECTAL DISEASE. - 1462-8910 .- 1463-1318.
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Tidskriftsartikel (refereegranskat)abstract
- AimThe primary therapeutic option for anal cancer treatment is chemoradiotherapy resulting in 80% survival. The aim of this study was to assess long-term bowel function impairment and anal pain at 3 and 6 years after anal cancer diagnosis, based on a hypothesis of an increase in impairment over time. A secondary aim was to investigate if chemoradiotherapy increased the risk for bowel impairment, compared to radiotherapy alone.MethodThe ANal CAncer study (ANCA) consists of a national Swedish cohort of patients diagnosed with anal cancer between 2011-2013. Patients within the study were invited to respond to a study-specific questionnaire at 3- and 6-years after diagnosis. Descriptive analyses for the primary endpoint and ordinal logistic regressions for secondary endpoint were performed.ResultsA total of 388 patients (84%) were included in the study. At 3 years of follow-up, 264 patients were alive. A total of 195 of these patients (74%) answered a study specific questionnaire, and at 6 years 154 patients (67%). Fifty-seven percent experienced bowel urgency at both 3 and 6 years. There was an increased risk for repeated bowel movement within 1 h (OR 2.44 [95% CI: 1.08-5.61, p = 0.03]) at 3 years in patients who had been treated by chemoradiation compared to radiotherapy alone.ConclusionsImpairment in bowel function and anal pain after anal cancer treatment should be expected and remains after 6 years. This suggests that long-term follow-up may be necessary in some form after customary follow-up. The addition of chemotherapy increases long-term side effects of bowel function.
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