| 1. |
- Henricsson, Marianne, et al.
(författare)
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The incidence of retinopathy 10 years after diagnosis in young adult people with diabetes: results from the nationwide population-based Diabetes Incidence Study in Sweden (DISS).
- 2003
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 26:2, s. 349-354
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE—To estimate the prevalence and severity of diabetic retinopathy (DR) 10 years after diagnosis in a nationwide population-based cohort study of young adult diabetic patients in Sweden. RESEARCH DESIGN AND METHODS—The Diabetes Incidence Study in Sweden (DISS) aims to register all incident cases of diabetes aged 15–34 years in Sweden. In 1987–1988, 806 cases were reported, and 627 (78%) of them were followed up with regard to retinopathy 8–10 years later. The assessment was based on retinal photographs in most cases (86%). RESULTS—Ten years after diagnosis, retinopathy was found in 247 patients (39%). The retinopathy was mild in 206 (33%), whereas 30 (4.8%) patients had moderate nonproliferative DR (NPDR) and 11 (1.8%) had proliferative DR (PDR). Patients with retinopathy had worse glycemic control during the years than patients without (HbA1c 8.1 ± 1.5% and 6.8 ± 1.2%, respectively; P < 0.001). In a Cox regression analysis, time to retinopathy was related to high HbA1c (P < 0.001) and high BMI (P = 0.001). Patients with type 2 diabetes had an increased prevalence of severe retinopathy (NPDR or PDR) compared with those with type 1 diabetes (14 of 93 [15%] versus no or mild 24 of 471 [5%], respectively; P < 0.001). CONCLUSIONS—Despite modern diabetes management, 39% of young adult diabetic patients developed retinopathy within the first 10 years of the disease. Nevertheless, compared with the prevalence of retinopathy (63%), after a similar duration of diabetes before the Diabetes Control and Complications Trial, this prevalence was clearly lower. Current treatment aimed to achieve strict glycemic control has reduced the risk for developing retinopathy.
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| 2. |
- Lembrechts, Jonas J., et al.
(författare)
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SoilTemp : A global database of near-surface temperature
- 2020
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 26:11, s. 6616-6629
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Tidskriftsartikel (refereegranskat)abstract
- Current analyses and predictions of spatially explicit patterns and processes in ecology most often rely on climate data interpolated from standardized weather stations. This interpolated climate data represents long-term average thermal conditions at coarse spatial resolutions only. Hence, many climate-forcing factors that operate at fine spatiotemporal resolutions are overlooked. This is particularly important in relation to effects of observation height (e.g. vegetation, snow and soil characteristics) and in habitats varying in their exposure to radiation, moisture and wind (e.g. topography, radiative forcing or cold-air pooling). Since organisms living close to the ground relate more strongly to these microclimatic conditions than to free-air temperatures, microclimatic ground and near-surface data are needed to provide realistic forecasts of the fate of such organisms under anthropogenic climate change, as well as of the functioning of the ecosystems they live in. To fill this critical gap, we highlight a call for temperature time series submissions to SoilTemp, a geospatial database initiative compiling soil and near-surface temperature data from all over the world. Currently, this database contains time series from 7,538 temperature sensors from 51 countries across all key biomes. The database will pave the way toward an improved global understanding of microclimate and bridge the gap between the available climate data and the climate at fine spatiotemporal resolutions relevant to most organisms and ecosystem processes.
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| 3. |
- Littorin, Bengt, et al.
(författare)
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Family characteristics and life events before the onset of autoimmune type 1 diabetes in young adults : A nationwide study
- 2001
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 24:6, s. 1033-1037
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE - To elucidate whether family characteristics and stressful life events were associated with onset of autoimmune type 1 diabetes in young adults. RESEARCH DESIGN AND METHODS - This investigation was based on a nationwide study (Diabetes Incidence Study in Sweden) of newly diagnosed patients aged 15-34 years. Patients clinically classified as type 1 diabetic with antibodies to islet cells and/or to GAD65 were compared with age- and sex-matched control subjects via questionnaire. The questionnaire covered diabetes heredity, social environment, educational level, and life events experienced during the 12 months before diagnosis. RESULTS - The rate of response was 82% for the diabetic patients and 65% for the control subjects. Questionnaires from 349 diabetic patients and 979 control subjects were considered. Diabetes in relatives was more frequent in the patients (odds ratio [OR] 2.6) who were born in Sweden and whose mothers were of Swedish origin. No major stress factors were detected in the diabetic patients, however, in comparison with the control subjects, the diabetic patients had experienced fewer conflicts with their parents and had less often broken contacts with friends. CONCLUSIONS - Young adults with recent-onset type 1 diabetes were more exposed to heredity for diabetes, but no major prediabetic stress factors were detected. Our study does not directly support the concept that psychosocial stressful life events are involved in the development of autoimmune type 1 diabetes in young adults.
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| 4. |
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| 5. |
- Svensson, Maria, et al.
(författare)
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Signs of nephropathy may occur early in young adults with diabetes despite modern diabetes management : Results from the nationwide population-based Diabetes Incidence Study in Sweden (DISS)
- 2003
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 26:10, s. 2903-2909
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE - To estimate the occurrence of early-onset renal involvement in a nationwide population-based cohort of young adults with diabetes in Sweden and relate the findings to glycemic control, type of diabetes, sex, smoking, and blood pressure. RESEARCH DESIGN AND METHODS - The Diabetes Incidence Study in Sweden aims to register all incident cases of diabetes in the age-group 15-34 years. In 1987-1988, 806 patients were reported and invited to participate in a follow-up study focusing on microvascular complications. Of them, 469 subjects participated. The assessment was based on questionnaires (n = 469), blood samples (n = 424), urine samples (n = 251) and, when appropriate, medical records (n = 186). RESULTS - During the follow-up time, median 9 years (range 6-12), 31 of 469 patients (6.6%) with incipient or overt diabetic nephropathy (i.e., micro- or macroalbuminuria) were found, 24 of 426 (5.6%) in type 1 and 7 of 43 (16%) in type 2 diabetic subjects (P = 0.016). Additionally, 24 of 31 patients (77%) had microalbuminuria and 7 (23%) had macroalbuminuria, which mainly occurred in patients with type 2 diabetes. In a Cox regression analysis, high mean HbA1c during the follow-up period and high blood pressure at follow-up increased the risk of developing signs of nephropathy (P = 0.020 and P = 0.003, respectively). Compared with patients with type 1 diabetes, those with type 2 diabetes tended to have an increased risk of renal involvement (P = 0.054) when adjusting for sex, tobacco use, glycemic control, and blood pressure. CONCLUSIONS - Despite modern treatment and self-monitoring of blood glucose, young adult patients with diabetes may still develop renal involvement during the first 10 years of diabetes duration. Inadequate HbA 1c high blood pressure, and type 2 diabetes appear to be risk markers for early occurrence of diabetic nephropathy.
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| 6. |
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| 7. |
- Törn, Carina, et al.
(författare)
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Glutamic acid decarboxylase antibodies (GADA) is the most important factor for prediction of insulin therapy within 3 years in young adult diabetic patients not classified as Type 1 diabetes on clinical grounds
- 2000
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Ingår i: Diabetes/Metabolism Research and Reviews. - 1520-7552 .- 1520-7560. ; 16:6, s. 442-447
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Tidskriftsartikel (refereegranskat)abstract
- Background Differentiation between Type 1 and Type 2 diabetes in adults is difficult at diagnosis. In this study we tested the hypothesis that autoantibodies at diagnosis are predictive for insulin treatment within 3 years in patients initially not classified as Type 1 diabetes. Methods In a nationwide population-based study, blood samples were obtained from 764 patients, all diagnosed with diabetes during a 2-year period. At diagnosis, 583 (76%) were classified as Type 1, 110 (14%) as Type 2 and 71 (9.3%) could not be classified. Results Among patients not classified as Type 1 diabetes, 52 (47%) of Type 2 and 42 (59%) of unclassified patients were positive for islet cell antibodies CICA), glutamic acid decarboxylase antibodies (GADA) or tyrosine phosphatase antibodies (IA-2A). These patients (n=94) had lower body mass index (BMI) (p<0.001) and lower C-peptide (p<0.001) compared to the autoantibody negative patients (n=87). Compared to clinically classified Type 1 diabetes patients positive for autoantibodies (n=477), they have higher BMI (p<0.001), higher C-peptide (p<0.001) and the same levels of ICA, GADA and IA-2A. After 3 years, 93% of autoantibody positive patients initially not classified as Type 1 were on insulin. When ICA, GADA, IA-2A, BMI and C-peptide were tested in a multiple logistic regression, only GADA was signiificant for insulin treatment within 3 years (OR = 18.8; 95% CI 1.8-191) in patients treated with diet or oral drugs at diagnosis. Conclusions A correct classification is difficult in adult diabetic patients. The presence of pancreatic autoantibodies, especially GADA, at diagnosis of diabetes are highly predictive for insulin therapy within 3 years from diagnosis.
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| 8. |
- Björk, Jan, et al.
(författare)
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Periampullary adenomas and adenocarcinomas in familial adenomatous polyposis : Cumulative risks and APC gene Mutations
- 2001
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Ingår i: Gastroenterology. - : Elsevier. - 0016-5085 .- 1528-0012. ; 121:5, s. 1127-1135
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Patients with familial adenomatous polyposis (FAP) have a high prevalence of duodenal adenomas, and the region of the ampulla of rater is the predilection site for duodenal adenocarcinomas. This study assessed the risk of stage IV periampullary adenomas according to the Spigelman classification and periampullary adenocarcinomas in Swedish FAP patients screened by esophagogastroduodenoscopy (EGD). The genotype of patients with stage IV periampullary adenomas and periampullary adenocarcinomas was also investigated. Methods: A retrospective study of 180 patients screened by EGD in 1982-1999 was undertaken. Kaplan-Meier analysis was performed to evaluate cumulative risk. Mutation analysis was carried out in patients with periampullary adenocarcinomas diagnosed outside the screening program, in addition to patients in the screening group with stage IV periampullary adenomas and adenocarcinomas. Results: Periampullary adenoma stage IV was diagnosed in 14 patients (7.8%), with a cumulative risk of 20% at age 60 years. Periampullary adenocarcinoma was diagnosed in 5 patients (2.8%), with a cumulative risk of 10% at age 60. Three of the adenocarcinomas occurred in patients with stage IV periampullary adenomas compared with 2 in patients with less severe periampullary adenomatosis at screening (odds ratio, 31; 95% confidence interval, 4.6-215). Fifteen (88%) of the APC gene mutations were detected; 12 of these were located downstream from codon 1051 in exon 15. Conclusions: The life time risk of severe periampullary lesions in FAP patients is high, and an association between stage IV periampullary adenomas and a malignant course of the periampullary adenomatosis is strongly suggestive. Mutations downstream from codon 1051 seem to be associated with severe periampullary lesions.
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| 9. |
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| 10. |
- Eriksson, Carl, 1981-, et al.
(författare)
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Long-term effectiveness of vedolizumab in inflammatory bowel disease : a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
- 2017
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 52:6-7, s. 722-729
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw index<5 in Crohn's disease (CD) and Patient Simple Clinical Colitis Activity index<3 in ulcerative colitis (UC).Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (p<.0001 in both groups). Faecal-calprotectin decreased in CD (p<.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.
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| 11. |
- Kanter-Smoler, Gunilla, et al.
(författare)
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Novel findings in Swedish patients with MYH-associated polyposis: mutation detection and clinical characterization
- 2006
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Ingår i: Clin Gastroenterol Hepatol. - : Elsevier BV. - 1542-3565. ; 4:4, s. 499-506
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Biallelic mutations in the base-excision repair gene MYH have recently been associated with recessive inheritance of multiple colorectal adenomas. An investigation and characterization of MYH mutations in Swedish patients were therefore carried out. METHODS: A set of 15 unrelated adenomatous polyposis coli (APC)-mutation negative patients from the Swedish Polyposis Registry was screened for germline mutations in the MYH gene. The patients were clinically characterized and compared with 43 APC-mutation positive probands diagnosed during the same period. RESULTS: Disease-causing biallelic MYH mutations were identified in 6 patients (40%). The mean age at diagnosis was 47.8 years versus 34.1 years in APC-mutation positive patients (P = .015). Colorectal cancer at diagnosis of polyposis was present in 67% (4/6) of the patients, and all were right-sided, compared with only 19% versus 12.5% right-sided cancer in APC-mutation positive patients. Upper gastrointestinal manifestations were diagnosed in 1 of 5 compared with 23 of 27 in APC-mutation positive patients (odds ratio, 23; 95% confidence interval, 2-263; P = .0086). One family exhibited apparent dominant inheritance of colorectal adenomatous polyposis. Two new pathogenic mutations, MYH p.G175E and p.P391L, were identified. The mutations are argued to introduce profound changes in substrate-recognizing domains of the protein. CONCLUSIONS: Biallelic MYH mutations, including 2 novel mutations, were found in a substantial number of the patients with multiple colorectal adenomas who were negative for APC-mutation. The examined MYH-mutation positive patients were found to have higher risks of colorectal cancer at diagnosis, right-sided location of cancers, and a significantly lower incidence of upper gastrointestinal manifestations, compared with APC-mutation positive patients.
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| 12. |
- Lembrechts, Jonas J., et al.
(författare)
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Global maps of soil temperature
- 2022
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 28:9, s. 3110-3144
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Tidskriftsartikel (refereegranskat)abstract
- Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0–5 and 5–15cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean=3.0±2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6±2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (−0.7±2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications.
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| 13. |
- Meuller, Johan, et al.
(författare)
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Identification of genomic deletions of the APC gene in familial adenomatous polyposis by two independent quantitative techniques.
- 2004
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Ingår i: Genetic testing. - : Mary Ann Liebert Inc. - 1090-6576 .- 1557-7473. ; 8:3, s. 248-56
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Tidskriftsartikel (refereegranskat)abstract
- Large deletions in the APC (adenomatous polyposis coli) gene, causing familial adenomatous polyposis (FAP), cannot easily be detected by conventional mutation-detection techniques. Therefore, we have developed two independent quantitative methods for the detection of large deletions, encompassing one or more exons, of APC. Multiplex ligation-dependent probe amplification (MLPA) is performed in one reaction for the initial quantification of all APC exon copy numbers. Subsequently, quantitative real-time PCR (QRT-PCR) is used to verify the results obtained in the MLPA reaction. The identification of a deletion of the whole APC gene in a patient with classical FAP is described. The mutation was detected with the two quantitative methods and further verified on chromosomal level by the use of FISH (fluorescence in situ hybridization) on metaphase spreads. Furthermore, a large deletion covering exons 11-13 of the APC gene was detected in two apparently unrelated families. This deletion was further verified and characterized with long-range PCR. The MLPA test ensures a sensitive high-throughput screening for large deletions of the APC gene and can easily be implemented in the diagnostic testing for FAP.
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| 14. |
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| 15. |
- Rohlin, Anna, et al.
(författare)
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GREM1 and POLE variants in hereditary colorectal cancer syndromes
- 2016
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Ingår i: Genes, Chromosomes and Cancer. - : Wiley. - 1045-2257 .- 1098-2264. ; 55:1, s. 95-106
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Tidskriftsartikel (refereegranskat)abstract
- Hereditary factors are thought to play a role in at least one third of patients with colorectal cancer (CRC) but only a limited proportion of these have mutations in known high-penetrant genes. In a relatively large part of patients with a few or multiple colorectal polyps the underlying genetic cause of the disease is still unknown. Using exome sequencing in combination with linkage analyses together with detection of copy-number variations (CNV), we have identified a duplication in the regulatory region of the GREM1 gene in a family with an attenuated/atypical polyposis syndrome. In addition, 107 patients with colorectal cancer and/or polyposis were analyzed for mutations in the candidate genes identified. We also performed screening of the exonuclease domain of the POLE gene in a subset of these patients. The duplication of 16 kb in the regulatory region of GREM1 was found to be disease-causing in the family. Functional analyses revealed a higher expression of the GREM1 gene in colorectal tissue in duplication carriers. Screening of the exonuclease domain of POLE in additional CRC patients identified a probable causative novel variant c.1274A>G, p.Lys425Arg. In conclusion a high penetrant duplication in the regulatory region of GREM1, predisposing to CRC, was identified in a family with attenuated/atypical polyposis. A POLE variant was identified in a patient with early onset CRC and a microsatellite stable (MSS) tumor. Mutations leading to increased expression of genes can constitute disease-causing mutations in hereditary CRC syndromes. © 2015 The Authors. Genes, Chromosomes & Cancer Published by Wiley Periodicals, Inc.
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| 16. |
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| 17. |
- Shchyrba, Aneliia, et al.
(författare)
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Controlling the dimensionality of on-surface coordination polymers via endo- or exoligation
- 2014
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Ingår i: Journal of the American Chemical Society. - : American Chemical Society (ACS). - 0002-7863 .- 1520-5126. ; 136:26, s. 9355-9363
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Tidskriftsartikel (refereegranskat)abstract
- The formation of on-surface coordination polymers is controlled by the interplay of chemical reactivity and structure of the building blocks, as well as by the orientating role of the substrate registry. Beyond the predetermined patterns of structural assembly, the chemical reactivity of the reactants involved may provide alternative pathways in their aggregation. Organic molecules, which are transformed in a surface reaction, may be subsequently trapped via coordination of homo- or heterometal adatoms, which may also play a role in the molecular transformation. The amino-functionalized perylene derivative, 4,9-diaminoperylene quinone-3,10-diimine (DPDI), undergoes specific levels of dehydrogenation (-1 H-2 or -3 H-2) depending on the nature of the present adatoms (Fe, Co, Ni or Cu). In this way, the molecule is converted to an endo- or an exoligand, possessing a concave or convex arrangement of ligating atoms, which is decisive for the formation of either ID or 2D coordination polymers.
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| 18. |
- Zackrisson, Björn, et al.
(författare)
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Two-year results from a Swedish study on conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma - The ARTSCAN study
- 2011
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Ingår i: Radiotherapy and Oncology. - : Elsevier. - 0167-8140 .- 1879-0887. ; 100:1, s. 41-48
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Studies on accelerated fractionation (AF) in head and neck cancer have shown increased local control and survival compared with conventional fractionation (CF), while others have been non-conclusive. In 1998 a national Swedish group decided to perform a randomised controlled clinical study of AF. Materials and methods: Patients with verified squamous cell carcinoma of the oral cavity, oropharynx, larynx (except glottic T1-T2, N0) and hypopharynx were included. Patients with prior chemotherapy or surgery were excluded. Patients were randomised to either CF (2Gy/day, 5days/week for 7 weeks, total dose 68Gy) or to AF (1.1Gy+2.0Gy/day, 5days/week for 4.5weeks, total dose 68Gy). An extensive quality assurance protocol was followed throughout the study. The primary end point was loco-regional tumour control (LRC) at two years after treatment. RESULTS: The study was closed in 2006 when 750 patients had been randomised. Eighty-three percent of the patients had stages III-IV disease. Forty eight percent had oropharyngeal, 21% laryngeal, 17% hypopharyngeal and 14% oral cancers. There were no significant differences regarding overall survival (OS) or LRC between the two regimens. The OS at two years was 68% for AF and 67% for CF. The corresponding figures for LRC were 71% and 67%, respectively. There was a trend towards improved LRC for oral cancers treated (p=0.07) and for large tumours (T3-T4) (p=0.07) treated with AF. The AF group had significantly worse acute reactions, while there was no significant increase in late effects. Conclusion: Overall the AF regimen did not prove to be more efficacious than CF. However, the trend towards improved results in AF for oral cancers needs to be further investigated.
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| 19. |
- Abel, Edvard, 1970, et al.
(författare)
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Fatigue in Patients With Head and Neck Cancer Treated With Radiation Therapy: A Prospective Study of Patient-Reported Outcomes and Their Association With Radiation Dose to the Cerebellum
- 2022
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Ingår i: Advances in Radiation Oncology. - : Elsevier BV. - 2452-1094. ; 7:5
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Although fatigue is a known side effect in patients with head and neck cancer (HNC) receiving radiation therapy, knowledge regarding long-term fatigue and dose-response relationships to organs at risk is scarce. The aim of this prospective study was to analyze patient-reported fatigue in patients with HNC receiving radiation therapy and to explore any possible association with organ-at-risk doses. Methods and Materials: Patients with HNC referred for curative radiation therapy were eligible for inclusion in the study. To assess patient-reported fatigue, quality of life questionnaires (European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-FA12) were distributed before treatment and 1, 3, 6, 12, 24, and 60 months after the start of treatment. Mean dose (Dmean) and near maximum dose (D2%) of the cerebellum and brain stem were evaluated in relation to baseline-adjusted fatigue scores at 3 months. Results: One hundred twenty-six patients treated with intensity modulated radiation therapy between 2008 and 2010 were available for final analysis. Female sex and age <60 years were associated with higher fatigue at baseline, whereas patients also treated with chemotherapy had reduced physical and emotional fatigue at 6 months. Physical fatigue (QLQ-FA12 scale) increased from baseline up to 3 months (29 vs 59; P < .0001) but showed no difference compared with baseline from 1 to 5 years. Emotional fatigue was significantly lower at 5 years compared with baseline (14 vs 28; P < .0001). Patients with cerebellum Dmean > 3.5 Gy had higher mean physical fatigue scores at 3 months (38 vs 27; P = .036). Conclusions: Although there is a significant increase in fatigue scores for patients with HNC up to 1 year after radiation therapy, this study showed a return to baseline levels at 5 years. A possible association was found between physical fatigue and a higher mean dose to the cerebellum.
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| 20. |
- Abel, Edvard, 1970, et al.
(författare)
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Impact on quality of life of IMRT versus 3-D conformal radiation therapy in head and neck cancer patients: A case control study
- 2017
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Ingår i: Advances in Radiation Oncology. - : Elsevier BV. - 2452-1094. ; 2:3, s. 346-353
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Tidskriftsartikel (refereegranskat)abstract
- Objective The purpose of this study was to prospectively and longitudinally compare the health-related quality of life (HRQOL) outcomes between head and neck (HN) cancer patients treated with parotid-sparing intensity modulated radiation therapy (IMRT) and patients treated with 3-dimensional conventional radiation therapy (3D-CRT). Methods and materials Before and up to 12 months after treatment, HRQOL was recorded in patients with HN cancer who were referred to the Department of Oncology at Sahlgrenska University Hospital for curative IMRT. The study group's HRQOL was compared with a matched group of patients from previous descriptive HRQOL studies treated with 3D-CRT. Both groups' HRQOL was measured by the European Organization for Research and Treatment for Cancer QLQ-C30 and European Organization for Research and Treatment for Cancer QLQ-HN35 at 6 time points in the first year after diagnosis. Results Two hundred and seven patients were included, 111 treated with IMRT and 96 matched controls treated with 3D-CRT. Both groups' HRQOL deteriorated during and after treatment. Just after treatment, worse HRQOL scores were observed in the IMRT group regarding insomnia (38 vs 27; P = .032), appetite loss (64 vs 50; P = .019), senses (54 vs 41; P = .017), and coughing (39 vs 26, P = .009). At 12 months, however, significantly better HRQOL scores were observed in the IMRT group regarding problems with dry mouth (72 vs 62; P = .018), pain (28 vs 20; P = .018), sexuality (37 vs 23; P = .016), social contacts (10 vs 6; P = .026), cognitive functioning (79 vs 87; P = .0057), and financial difficulties (12 vs 20; P = .0019). Conclusions This study further supports the hypothesis that the introduction of IMRT has improved the long-term quality of life of HN cancer patients who have been treated with radiation therapy, but might cause more acute side effects. Longer follow-up is needed to study late complications.
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| 21. |
- Abel, Edvard, 1970, et al.
(författare)
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Long-Term Aspects of Quality of Life in Head and Neck Cancer Patients Treated With Intensity Modulated Radiation Therapy: A 5-Year Longitudinal Follow-up and Comparison with a Normal Population Cohort
- 2020
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Ingår i: Advances in Radiation Oncology. - : Elsevier BV. - 2452-1094. ; 5:1, s. 101-110
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Author(s) Purpose: Knowledge of long-term health-related quality of life (HRQOL) in patients with advanced head and neck cancer treated with intensity modulated radiation therapy is scarce. Methods and Materials: HRQOL in 126 patients with advanced head and neck cancer treated with intensity modulated radiation therapy was followed longitudinally from diagnosis to 5 years after treatment with the European Organization for Research and Treatment of Cancer's QLQ-C30, the European Organization for Research and Treatment of Cancer's Head and Neck Cancer Module, and the M.D. Anderson Dysphagia Inventory. The survivors' HRQOL was compared with an age- and sex-matched normal population cohort. Results: At 5 years, 73 of the 95 surviving patients had completed the study. Significant reductions in general pain (29 vs 12), head and neck (HN) pain (22 vs 14), and feeling ill (20 vs 10) were found, and emotional functioning (70 vs 83) and global quality of life (67 vs 74) improved, compared with baseline values. Conversely, dry mouth (19 vs 56), senses (8 vs 27), teeth problems (10 vs 22), opening mouth (19 vs 56), and sticky saliva (15 vs 40) were markedly worse, although significant improvements had occurred over time after treatment. Anderson Dysphagia Inventory scores >80 at 5 years indicated good swallowing function. In a subgroup analysis, dry mouth and senses were significantly better in patients treated with chemoradiotherapy. Comparison to a normal population cohort's HRQOL shows that the study group experienced a wide array of symptoms affecting their quality of life. Conclusions: The results of this large, long-term follow-up study show that a majority of patients report a reasonable quality of life 5 years after treatment and that there seems to be continuous improvement over time. Comparison with a normal population cohort, however, underlines the fact that classical side effects remain, even with improved radiation techniques. Additional emphasis on normal-tissue-sparing radiation therapy is warranted, with close attention devoted to HRQOL outcomes.
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| 22. |
- af Klintberg, Tord, 1951-, et al.
(författare)
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Riksbyggens renoveringsverkstad 2 : Energieffektivisering i samband med renovering hos bostadsrättsföreningar
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta projektet ”Riskbyggens renoveringsverkstad 2” har, med utgångspunkt från bostadsrättsföreningarna och den omvärld de möter, analyserat hinder för mer långtgående energisparprocesser och hur dessa kan överbryggas.Projektets resultat visar på att det främsta hindret är rent ekonomiskt. Om man inte räknar med realt stigande energipriser är det svårt att motivera insatser som t.ex. tilläggsisolering av fasader eller värmeåtervinning av ventilationsluft. De enskilda fallen kan dock naturligtvis avvika och det är viktigt att undersöka lönsamheten för denna typ investeringar i samband med planering av större underhållsåtgärder och ombyggnationer. Det finns också en pågående teknikutveckling som kan göra denna typ av insatser mer intressanta framöver. Däremot bekräftas bilden från ett tidigare projektet att driftoptimerande åtgärder (t.ex. injustering av värmesystemet) ofta är mycket lönsamma. Ekonomin skulle naturligtvis kunna påverkas genom styrmedel. Det är dock ganska tveksamt att prioritera styrmedel för minskad användning av värme eftersom denna till stor del, när det gäller flerbostadshusen, baseras på förnyelsebara energislag (jämfört med t.ex. trafiken).Projektet har även studerat hur bank-och försäkringsbranscherna skulle kunna medverka till att mer energieffektivisering blir verklighet hos bostadsrättsföreningarna. Slutsatsen är att dessa branscher har en ganska marginell möjlighet till påverkan. Det kan dock finnas en möjlig ”trigger-effekt” om det finns specialerbjudanden på marknaden för föreningar som arbetar aktivt med sin energieffektivisering. Arbetet fortsätter här för att undersöka olika möjligheter inom området.Projektet har studerat Riksbyggens nuvarande utbud av tjänster inom energiområdet och har flera förslag på kompletterande tjänster och processer. Det gäller dels den långsiktiga finansiella planeringen som utgör en viktig faktor för att föreningarna beredskap att genomföra motiverade investeringar, dels den mer kortsiktiga/operativa när föreningen närmar sig beslut om större underhållsåtgärder. Kopplat till detta kan olika former av kompetensutveckling, framförallt av styrelser ha stor betydelse. Projektet föreslår bl.a. en bred utbildningsinsats byggt på rollspel. Riksbyggen kan också utveckla sin roll som diskussionspart för att bedöma olika alternativa insatser/investeringar och även för att skapa nätverk med andra bostadsrättsföreningar som kan underlätta informationsspridning och kanske till och med samordning av insatser.Detta projekt är en direkt fortsättning på Riksbyggens renoveringsverkstad och följaktligen har vi valt att döpa det till Riksbyggen renoveringsverkstad 2.Projektet Riksbyggens renoveringsverkstad drevs som ett gemensamt projekt av Riksbyggen, KTH och Sustainable Innovation under 2010-2012 med syfte att lyfta fram goda exempel på renoveringsinsatser hos bostadsrättsföreningar som kan bidra till att minska energianvändningen. Projektet visade att det finns goda ekonomiska potentialer till energibesparingar framförallt genom driftoptimering och mindre omfattande åtgärder.
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| 23. |
- Afrasiabi, Roodabeh, et al.
(författare)
-
Effect of microwave-assisted silanization on sensing properties of silicon nanoribbon FETs
- 2015
-
Ingår i: Sensors and actuators. B, Chemical. - : Elsevier B.V.. - 0925-4005 .- 1873-3077. ; 209, s. 586-595
-
Tidskriftsartikel (refereegranskat)abstract
- An important concern with using silicon nanoribbon field-effect transistors (SiNR FET) for ion-sensing is the pH-response of the gate oxide surface. Depending on the application of the FET sensor, this response has to be chemically manipulated. Thus in silicon oxide-gated pH-sensors with integrated sensor and reference FETS, a surface with high pH-sensitivity, compared to the bare gate oxide, is required in the sensor FETs (SEFET), whereas in the reference FETs (REFET) the surface has to be relatively pH-insensitive. In order to control the sensitivity and chemistry of the oxide surface of the nanoribbons, a silanization reagent with a functional group is often self-assembled on the SiNR surface. Choice of a silanization reaction that results in a self-assembled layer on a silicon oxide surface has been studied extensively over the past decades. However, the effect of various self-assembled layers such as monolayers or mixed layers on the electrical response of SiNR FETs in aqueous solution needs to be exploited further, especially for future integrated SEFET/REFET systems. In this work, we have performed a comprehensive study on 3-aminopropyltriethoxysilane (APTES) silanization of silicon oxide surfaces using microwave (MW) heating as a new biocompatible route to conventional methods. A set of complementary surface characterization techniques (ellipsometry, AFM and ATR-FTIR) was used to analyze the properties of the APTES layer deposited on the silicon surface. We have found that a uniform monolayer can be achieved within 10 min by heating the silanization solution to 75 °C using MW heating. Furthermore, electrical measurements suggest that little change in device performance is observed after exposure to MW irradiation. Real-time pH measurements indicate that a uniform APTES monolayer not only reduces the pH sensitivity of SiNR FET by passivating the surface silanol groups, but also makes the device less sensitive to cation concentration in the background electrolyte. Our silanization route proves promising for future chemical surface modification of on-chip REFETs.
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| 24. |
- Afrasiabi, Roodabeh, et al.
(författare)
-
Integration of a droplet-based microfluidic system and silicon nanoribbon FET sensor
- 2016
-
Ingår i: Micromachines. - : MDPI AG. - 2072-666X. ; 7:8
-
Tidskriftsartikel (refereegranskat)abstract
- We present a novel microfluidic system that integrates droplet microfluidics with a silicon nanoribbon field-effect transistor (SiNR FET), and utilize this integrated system to sense differences in pH. The device allows for selective droplet transfer to a continuous water phase, actuated by dielectrophoresis, and subsequent detection of the pH level in the retrieved droplets by SiNR FETs on an electrical sensor chip. The integrated microfluidic system demonstrates a label-free detection method for droplet microfluidics, presenting an alternative to optical fluorescence detection. In this work, we were able to differentiate between droplet trains of one pH-unit difference. The pH-based detection method in our integrated system has the potential to be utilized in the detection of biochemical reactions that induce a pH-shift in the droplets.
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| 25. |
- Ahlberg, Erik, et al.
(författare)
-
"Vi klimatforskare stödjer Greta och skolungdomarna"
- 2019
-
Ingår i: Dagens nyheter (DN debatt). - 1101-2447.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- DN DEBATT 15/3. Sedan industrialiseringens början har vi använt omkring fyra femtedelar av den mängd fossilt kol som får förbrännas för att vi ska klara Parisavtalet. Vi har bara en femtedel kvar och det är bråttom att kraftigt reducera utsläppen. Det har Greta Thunberg och de strejkande ungdomarna förstått. Därför stödjer vi deras krav, skriver 270 klimatforskare.
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| 26. |
- Al Abdulaali, Ahmad Khalid, 1981-
(författare)
-
On the Extension and Wedge Product of Positive Currents
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation is concerned with extensions and wedge products of positive currents. Our study can be considered as a generalization for classical works done earlier in this field. Paper I deals with the extension of positive currents across different types of sets. For closed complete pluripolar obstacles, we show the existence of such extensions. To do so, further Hausdorff dimension conditions are required. Moreover, we study the case when these obstacles are zero sets of strictly k-convex functions. In Paper II, we discuss the wedge product of positive pluriharmonic (resp. plurisubharmonic) current of bidimension (p,p) with the Monge-Ampère operator of plurisubharmonic function. In the first part of the paper, we define this product when the locus points of the plurisubharmonic function are located in a (2p-2)-dimensional closed set (resp. (2p-4)-dimensional sets), in the sense of Hartogs. The second part treats the case when these locus points are contained in a compact complete pluripolar sets and p≥2 (resp. p≥3). Paper III studies the extendability of negative S-plurisubharmonic current of bidimension (p,p) across a (2p-2)-dimensional closed set. Using only the positivity of S, we show that such extensions exist in the case when these obstacles are complete pluripolar, as well as zero sets of C2-plurisubharmoinc functions.
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| 27. |
- Almlöf, Jonas
(författare)
-
Quantum error correction
- 2016
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Quantum error correction is the art of protecting quantum states from the detrimental influence from the environment. To master this art, one must understand how the system interacts with the environment and gives rise to a full set of quantum phenomena, many of which have no correspondence in classical information theory. Such phenomena include decoherence, an effect that in general destroys superpositions of pure states as a consequence of entanglement with the environment. But decoherence can also be understood as “information leakage”, i.e., when knowledge of an encoded code block is transferred to the environment. In this event, the block’s information or entanglement content is typically lost.In a typical scenario, however, not all types of destructive events are likely to occur, but only those allowed by the information carrier, the type of interaction with the environment, and how the environment “picks up” information of the error events. These characteristics can be incorporated into a code, i.e., a channel-adapted quantum error-correcting code.Often, it is assumed that the environment’s ability to distinguish between error events is small, and I will denote such environments “memory-less”. But this assumption is not always valid, since the ability to distinguish error events is related to the temperature of the environment, and in the particular case of information coded onto photons, kBTR «ℏω typically holds, and one must then assume that the environment has a “memory”. In the thesis I describe a short quantum error-correction code adapted for photons interacting with a “cold” reservoir, i.e., a reservoir which continuously probes what error occurred in the coded state.I also study other types of environments, and show how to distill meaningful figures of merit from codes adapted for these channels, as it turns out that resource-based figures reflecting both information and entanglement can be calculated exactly for a well-studied class of channels: the Pauli channels. Starting from these resource-based figures, I establish the notion of efficiency and quality and show that there will be a trade-off between efficiency and quality for short codes. Finally I show how to incorporate, into these calculations, the choices one has to make when handling quantum states that have been detected as incorrect, but where no prospect of correcting them exists, i.e., so-called detection errors.
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| 28. |
- Almlöf, Jonas, 1973-
(författare)
-
Quantum error correction
- 2012
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis intends to familiarise the reader with quantum error correction, and also show some relations to the well known concept of information - and the lesser known quantum information. Quantum information describes how information can be carried by quantum states, and how interaction with other systems give rise to a full set of quantum phenomena, many of which have no correspondence in classical information theory. These phenomena include decoherence, as a consequence of entanglement. Decoherence can also be understood as "information leakage", i.e., knowledge of an event is transferred to the reservoir - an effect that in general destroys superpositions of pure states.It is possible to protect quantum states (e.g., qubits) from interaction with the environment - but not by amplification or duplication, due to the "no-cloning" theorem. Instead, this is done using coding, non-demolition measurements, and recovery operations. In a typical scenario, however, not all types of destructive events are likely to occur, but only those allowed by the information carrier, the type of interaction with the environment, and how the environment "picks up" information of the error events. These characteristics can be incorporated into a code, i.e., a channel-adapted quantum error-correcting code. Often, it is assumed that the environment's ability to distinguish between error events is small, and I will denote such environments "memory-less". This assumption is not always valid, since the ability to distinguish error events is related to the \emph{temperature} of the environment, and in the particular case of information coded onto photons, typically holds, and one must then assume that the environment has a "memory". In this thesis, I describe a short quantum error-correcting code (QECC), adapted for photons interacting with a cold environment, i.e., this code protects from an environment that continuously records which error occurred in the coded quantum state.Also, it is of interest to compare the performance of different QECCs - But which yardstick should one use? We compare two such figures of merit, namely the quantum mutual information and the quantum fidelity, and show that they can not, in general, be simultaneously maximised in an error correcting procedure. To show this, we have used a five-qubit perfect code, but assumed a channel that only cause bit-flip errors. It appears that quantum mutual information is the better suited yardstick of the two, however more tedious to calculate than quantum fidelity - which is more commonly used.
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| 29. |
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| 30. |
- Bjerke, Axel, et al.
(författare)
-
Onset of the degradation of CVD alpha-Al2O3 coating during turning of Ca-treated steels
- 2021
-
Ingår i: Wear. - : Elsevier BV. - 0043-1648 .- 1873-2577. ; 477
-
Tidskriftsartikel (refereegranskat)abstract
- The ability to control the shape, distribution and composition of non-metallic inclusions has had an important impact on many aspects of steel making. One such impact is on the machinability. Ca-treatments have shown to be able to reduce the abrasiveness of oxide inclusions, improve chip-breaking and lead to formation of deposits that reduce tool wear. However, machining Ca-treated steels with Al2O3 coated cemented carbide tools has not been as advantageous as expected. This study investigates the mechanisms behind the anomalous wear of Al2O3 coatings when turning soft Ca-treated steels. Longitudinal turning tests at a range of speeds (vc = 100-600 m/min) show rapid localized degradation of the Al2O3 coating limited to the sliding zone. Detailed analysis of the degradation mechanisms was performed using scanning and transmission electron microscopy. The results demonstrate a presence of chemical interactions between the alumina coating and non-metallic inclusions. The interaction resulted in the formation of mainly calcium aluminates and partly alumina-magnesia spinel. In-operando infrared thermography measurements indicate cutting temperatures of 850-1000 degrees C. Thermodynamic calculations give that CaO and MgO readily reacts with Al2O3, while the reaction with CaS requires presence of additional oxygen at these cutting conditions. Additional turning experiments investigate the influence of oxygen by controlling the cutting environment by adding oxygen (compressed air) or removing oxygen (supply argon). These additional tests show that the presence of additional oxygen has a limited impact on the possible Ca-Al2O3 interaction. This demonstrat a potential for further machinability improvements by controlling the chemical interaction between Ca and Mg based non-metallic inclusions and alumina coatings.
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| 31. |
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| 32. |
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| 33. |
- Björk, Folke, 1958-, et al.
(författare)
-
Dränering av fukt i betong genom elektrokemisk metodik (elektroosmos)
- 2018
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med detta projekt är att studera funktionen av elektroosmos som åtgärd mot fukt-problem i byggnader i Sverige samt att utifrån detta ge rekommendationer kring om och i så fall när det är lämpligt/olämpligt att använda metodiken under de varierande fuktighets-förhållanden som vanligtvis råder i Sverige.I projektet har vi gjort en litteraturstudie, en modellering av fysikaliska processer, studie-besök i byggnader med installationer för elektroosmos och mätningar av fukt i en källarvägg där en installation för elektroosmos blivit gjord.Vi ser metoden elektroosmos som en möjlighet för att hantera fuktproblem i grunder. Det behövs dock en del av utveckling både kring tekniken för metoden och kring vad som ska kunna förväntas av den.Det behövs bättre möjligheter att kunna förutsäga att metoden kommer att fungera i ett visst fall. Att inte kunna förutsäga detta bör vara ett bekymmer för dem som marknadsför metoden.Elektroosmos kräver höga fuktnivåer för att fungera. Torkning ned till under kritiska fuktnivåer kräver komplettering med andra torkmetoder. Det krävs en tydlighet kring hur detta ska lösas.Det behövs en bättre förståelse kring hur elektroderna ska placeras för bästa funktion.Fuktvandring i jorden kan ha stor betydelse för processen i praktiken. Det är idé att undersöka om detta kan användas för att utveckla metoden.Det behövs klara regler kring hur elinstallationen ska utformas på ett säkert sätt.Eftersom jontransporten i betongen är av ganska liten omfattning så tror vi inte att elektroosmos kommer att påverka, eller skada, betongens egenskaper på lång sikt.
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| 34. |
- Björk, Folke, et al.
(författare)
-
Electroosmosis - A method applied for handling of moisture in foundations
- 2020
-
Ingår i: E3S Web of Conferences. Volyme 172, 2020. - : EDP Sciences.
-
Konferensbidrag (refereegranskat)abstract
- Electroosmosis is an electrokinetic phenomena which is applied in some technical fields. It is also applied large scale for transport of moisture out of basements. We see the method of electroosmosis as an opportunity for solving moisture problems in basements. However, there is a need to develop both the technology for the method and the understanding about what to expect out of it. Better methods are needed to predict whether the method will work in a particular case. © The Authors.
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| 35. |
- Björk, Göran, 1956, et al.
(författare)
-
Bathymetry and deep-water exchange across the central Lomonosov Ridge at 88°-89°N
- 2007
-
Ingår i: Deep-Sea Research I. - : Elsevier BV. ; 54, s. 1197-1208
-
Tidskriftsartikel (refereegranskat)abstract
- Seafloor mapping of the central Lomonosov Ridge using a multibeam echo-sounder during the Beringia/Healy–Oden Trans-Arctic Expedition (HOTRAX) 2005 shows that a channel across the ridge has a substantially shallower sill depth than the 2500 m indicated in present bathymetric maps. The multibeam survey along the ridge crest shows a maximum sill depth of about 1870 m. A previously hypothesized exchange of deep water from the Amundsen Basin to the Makarov Basin in this area is not confirmed. On the contrary, evidence of a deep-water flow from the Makarov to the Amundsen Basin was observed, indicating the existence of a new pathway for Canadian Basin Deep Water toward the Atlantic Ocean. Sediment data show extensive current activity along the ridge crest and along the rim of a local Intra Basin within the ridge structure.
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| 36. |
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| 37. |
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| 38. |
- Björk, Jan-Erik, et al.
(författare)
-
Regularizations of residue currents
- 2010
-
Ingår i: Journal fur die reine und angewandte Mathematik. ; 649, s. 33-54
-
Tidskriftsartikel (refereegranskat)
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| 39. |
- Björk, Jens, et al.
(författare)
-
Lean Product Development in Early Stage Startups
- 2013
-
Ingår i: CEUR Workshop Proceedings. - 1613-0073. ; 1095, s. 19-32
-
Konferensbidrag (refereegranskat)abstract
- Software startups are more popular than ever and growing innumbers. They operate under conditions of extreme uncertainty and face plentyof challenges, underlined by their high failure rate. Using Design ScienceResearch, these challenges were investigated. A literaturestudy showed that inrecent years, several authors have suggested ways to increase the odds ofsucceeding as a startup, such as customer focused development, fact baseddecision making, pivoting and agile/lean thinking. Interviews with industryprofessionals showed that few usedtheseLean Startup practices: many foundthem difficult to implement in practice. In response, we developed the EarlyStage Software Startup Development Model (ESSSDM) for managing earlystage software startups by applying Lean Startup principles. The modelis novelin that itsupports managing a portfolio of product ideas and provides clearcriteria for when to move forward with product ideas, when to abandon productideasas well asrecommends whatconcrete techniques that can be used andwhen, in order to achieve this. The process was instantiated and evaluated on astartup project in an incubator setting.
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| 40. |
- Björk, Jan, et al.
(författare)
-
Sporadiska kolorektala polyper. Uppdaterade riktlinjer for endoskopikontroller
- 2003
-
Ingår i: Läkartidningen. - 0023-7205. ; 100:34, s. 2584-2584
-
Tidskriftsartikel (refereegranskat)abstract
- No surveillance is recommended after radical excision of low-risk adenomas (pedunculated adenoma irrespective of size, sessile adenoma < or = 10 mm, number < or = 2. An endoscopic check-up is recommended 3-6 months after radical excision of high-risk adenomas (sessile adenoma > 10 mm, number > or = 3), as well as after excision of a pedunculated or a sessile adenoma with an unclear resection margin. All above is irrespective of histopathological adenoma classification. An endoscopic check-up is recommended 3 months after radical excision of a highly or moderately differentiated malignant polyp with no sign of invasion into blood or lymph vessels and with a maximum invasion depth stage T1-sm1. Surgical resection is necessary if the malignant polyp is poorly differentiated, and/or invades into blood or lymph vessels, and/or is stage T1-sm3, or is excised with unclear resection margins. Treatment for stage T1-sm2 polyps may be individualized. Individuals with low-risk adenomas and a first degree relative with colorectal cancer, individuals having high-risk adenomas or malignant polyps removed, as well as individuals operated on for colorectal cancer should be subjected to colonoscopy after three years and then every fifth year when < or = 75 years of age.
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| 41. |
- Björk, Jan
(författare)
-
Studies on familial adenomatous polyposis
- 2000
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Familial adenomatous polyposis (FAP) is a hereditary disorder caused by mutations in the adenomatous polyposis coli (APC) gene, which leads to adenoma formation and subsequently to cancer, predominantly in the colon and the rectum but also in the duodenum. The cancer morbidity and mortality can be decreased by presymtomatic screening and surgical treatment. We have therefore studied the epidemiology of the disease in the Swedish population over time and the effect of family screening. Data was obtained from the Swedish Polyposis Registry, which was set up in the late 1950s. The registry included 431 patients in 145 families at the end of 1996. The risk of having colorectal cancer (CRC) at diagnosis was very low in patients detected by screening. Moreover, females were diagnosed with symptoms and CRC significantly earlier than males. The most common surgical treatment for FAP has been colectomy and ileorectal anastomosis (IRA), but since the early 1980s, restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has been an alternative to IRA. Patients with IRA remain at risk of rectal cancer. Therefore, we investigated the risk of rectal cancer and rectal amputation after IRA and searched for risk factors that could predict the fate of the rectal stump. We also compared the surgical and functional outcome of IRA and IPAA. Rectal cancer occurred in almost 10% of IRA operated patients despite a high rectal excision rate. Dense polyposis was shown to be a risk factor for a malignant trait. However, the functional outcome was better after IRA, compared to IPAA. Duodenal cancer has become the second most common cause of death in FAP patients as screening and prophylactic treatment of CRC have improved. We assessed the risk of premalignant and malignant lesions in the periampullary region of the duodenum in 180 patients screened by upper endoscopy. The cumulative risk at age 60 of periampullary advanced adenomas and adenocarcinomas was 20% and 10%, respectively. We also investigated the APC gene mutations in families with these lesions. Mutations were found in 14 out of 16 families accessible for analysis and they were clustered between codons 1051- 1309 in exon 15 of the APC gene. The pathogenesis of intestinal adenomatosis in FAP is still unknown. Thus, we studied tenascin and alkaline sphingomyelinase, factors that have been implicated in the regulation of epithelial cell growth regulation. Tenascin, an extracellular matrix constituent, was found to be differently expressed in dysplastic and hyperplastic mucosa of rectal adenomas in FAP patients compared to surrounding normal mucosa and mucosa from controls. The sphingomyelinase activity was decreased both in adenomas and surrounding normal mucosa from FAP patients. In conclusion, a national screening program for FAP efficiently reduces the risk of CRC although patients operated with IRA are still at risk of rectal cancer, especially those with a high number of polyps at operation. It also demonstrates the influence of gender on the course of the disease. IPAA, although more radical than IRA, has the disadvantage of a poorer functional outcome. Duodenal cancer is an increasing clinical problem and advanced periampullary adenomas together with genotype seem to be predictive of prognosis. Tenascin and alkaline sphingomyelinase may be involved in the pathogenesis of adenoma formation in FAR.
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| 42. |
- Björk, Klara, 1973, et al.
(författare)
-
Paradise is an island and so is hell
- 2023
-
Ingår i: ELIA Academy 2023: Exploring Situatedness, 10 – 12 May Évora, Portugal..
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Performance lecture at the ELIA Academy 2023. Björk and Nåls guides the audience on a journey through the Norwegian island of Vega, a place of extraordinary beauty and wonder, and at the same time, a place of deep ecological and historical trauma. The promise of utopia and the threat of dystopia is ever-present on any island. Their performance lecture will include sensory exercises that will give the participants an embodied experience of the island of Vega — the smells, the sounds, and the sights — but also evoke its history and forgotten stories. In their lecture, they will also speak to theories, persons, and the non-humans that have helped them understand the islands they have visited.
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| 43. |
- Björk, Petra, et al.
(författare)
-
Intranuclear binding in space and time of exon junction complex and NXF1 to premRNPs/mRNPs in vivo
- 2015
-
Ingår i: Journal of Cell Biology. - : Rockefeller University Press. - 0021-9525 .- 1540-8140. ; 211:1, s. 63-75
-
Tidskriftsartikel (refereegranskat)abstract
- Eukaryotic gene expression requires the ordered association of numerous factors with precursor messenger RNAs (premRNAs)/messenger RNAs (mRNAs) to achieve efficiency and regulation. Here, we use the Balbiani ring (BR) genes to demonstrate the temporal and spatial association of the exon junction complex (EJC) core with gene-specific endogenous premRNAs and mRNAs. The EJC core components bind cotranscriptionally to BR premRNAs during or very rapidly after splicing. The EJC core does not recruit the nonsense-mediated decay mediaters UPF2 and UPF3 until the BR messenger RNA protein complexes (mRNPs) enter the interchromatin. Even though several known adapters for the export factor NXF1 become part of BR mRNPs already at the gene, NXF1 binds to BR mRNPs only in the interchromatin. In steady state, a subset of the BR mRNPs in the interchromatin binds NXF1, UPF2, and UPF3. This binding appears to occur stochastically, and the efficiency approximately equals synthesis and export of the BR mRNPs. Our data provide unique in vivo information on how export competent eukaryotic mRNPs are formed.
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| 44. |
- Björk, Petra, et al.
(författare)
-
Specific combinations of SR proteins associate with single pre-messenger RNAs in vivo and contribute different functions
- 2009
-
Ingår i: Journal of Cell Biology. - : Rockefeller University Press. - 0021-9525 .- 1540-8140. ; 184:4, s. 555-568
-
Tidskriftsartikel (refereegranskat)abstract
- Serine/arginine-rich (SR) proteins are required for messenger RNA (mRNA) processing, export, surveillance, and translation. We show that in Chironomus tentans, nascent transcripts associate with multiple types of SR proteins in specific combinations. Alternative splicing factor (ASF)/SF2, SC35, 9G8, and hrp45/SRp55 are all present in Balbiani ring (BR) pre-messenger ribonucleoproteins (mRNPs) preferentially when introns appear in the pre-mRNA and when cotranscriptional splicing takes place. However, hrp45/SRp55 is distributed differently in the pre-mRNPs along the gene compared with ASF/SF2, SC35, and 9G8, suggesting functional differences. All four SR proteins are associated with the BR mRNPs during export to the cytoplasm. Interference with SC35 indicates that SC35 is important for the coordination of splicing, transcription, and 3' end processing and also for nucleocytoplasmic export. ASF/SF2 is associated with polyribosomes, whereas SC35, 9G8, and hrp45/SRp55 cosediment with mono-ribosomes. Thus, individual endogenous pre-mRNPs/mRNPs bind multiple types of SR proteins during transcription, and these SR proteins accompany the mRNA and play different roles during the gene expression pathway in vivo.
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| 45. |
- Björk Skuladottir, Edda, et al.
(författare)
-
Translation and validation of Assessment of Work Performance (AWP) into the Icelandic language and culture
- 2021
-
Ingår i: Work. - : IOS PRESS. - 1875-9270 .- 1051-9815. ; 69:4, s. 1305-1316
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Evidence-based services in vocational rehabilitation call for valid and reliable assessments of work performance for intervention planning and safe return to work for individuals with illness or injuries. Assessments that are easy to use, culturally adapted, and in a language professionals and clients understand is important for their utility. Translation and adaption of assessments to new languages and cultures are of importance to maintain high standards of assessments and the quality of services in the vocational rehabilitation setting. OBJECTIVE:The aim of this study was to translate and adapt the Assessment of Work Performance (AWP), into the Icelandic language and culture. Furthermore, to investigate the content validity and utility of the evaluation instrument. METHODS:The study was conducted in two phases. The first phase, based on the Dual-Panel translation method, included two expert panels performing translation and cultural adaption of the original Swedish AWP. In the second phase field testing of the translated instrument was followed by an online survey among vocational rehabilitation professionals for content validation and utility. RESULTS:The results of the study showed satisfactory opinions from experienced professionals toward the content validity, translation, cultural adaption, and utility of the Icelandic version of the AWP. CONCLUSIONS:The study indicates that the Dual-Panel translation method is a valid method when translating instruments from one language and culture to another. Furthermore, the results of the study imply that the AWP can be regarded as content valid up to an acceptable degree for implementation in vocational rehabilitation services in Iceland.
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| 48. |
- Borg, Henrik, et al.
(författare)
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Evaluation of the new ADA and WHO criteria for classification of diabetes mellitus in young adult people (15-34 yrs) in the Diabetes Incidence Study in Sweden (DISS)
- 2003
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 46:2, s. 173-181
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis. We aimed to evaluate how an aetiology-based classification, as recommended in the ADA and WHO guidelines for classification of diabetes mellitus, matches clinical judgement in the Diabetes Incidence Study in Sweden (DISS), a study covering incident cases of diabetic patients aged 15 to 34 years. Methods. During a 1-year period (1998), blood samples were taken at diagnosis and 4 months (median) thereafter. Patients were classified according to clinical judgement by the reporting physicians and assessments of islet antibodies (ICA, GADA, and IA-2A) and plasma C-peptide. Results. In 1998, 422 patients were registered in DISS. Among the 313 patients participating in the follow-up, most with clinical Type 1 diabetes (185/218, 85%, 95% CI 79-89%) were islet antibody positive (ab+) at diagnosis. In addition, 14 out of 58 (24%, 14-37%) with clinical Type 2 diabetes and 21 out of 37 (57%, 40-73%) with unclassifiable diabetes were antibody positive at diagnosis. Further to this, 4 out of 33 (12%, 3-28%) were antibody negative with clinical Type 1 diabetes and 4 out of 44 (9%, 3-22%) with Type 2 had converted to antibody positive at follow-up. Among those who were constantly antibody negative, 10 out of 29 (34%, 18-54%) with clinical Type 1 and 1 out of 16 (6%, 0-30%) with unclassifiable diabetes had fasting plasma C-peptide concentrations below the normal range (<0.25 nmol/l) at follow-up. Conclusion/interpretation. Most young adults with clinical Type 1 diabetes (199/218, 91%) had objective Type 1 (ab+ at diagnosis/follow-up and/or low fasting plasma C-peptide concentrations at follow-up), as did one third (18/58, 31%) with clinical Type 2 diabetes and more than half (22/37, 59%) with unclassifiable diabetes. About 10% of those who were antibody negative converted to antibody positive. Our study underlines that a classification considering aetiology is superior to clinical judgement.
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| 49. |
- Bosch, Jan, et al.
(författare)
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The Early Stage Software Startup Development Model : A Framework for Supporting Lean Principles in Software Startups
- 2013
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Ingår i: Lean Enterprise Software and Systems. LESS 2013.. - Berlin, Heidelberg : Springer. ; , s. 1-15
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Konferensbidrag (refereegranskat)abstract
- Software startups are more popular than ever and growing in numbers. They operate under conditions of extreme uncertainty and face many challenges. Often, agile development practices and lean principles are suggested as ways to increase the odds of succeeding as a startup, as they both advocate close customer collaboration and short feedback cycles focusing on delivering direct customer value. However, based on an interview study we see that despite guidance and support in terms of well-known and documented development methods, practitioners find it difficult to implement and apply these in practice. To explore this further, and to propose operational support for software startup companies, this study aims at investigating (1) what are the typical challenges when finding a product idea worth scaling, and (2) what solution would serve to address these challenges. To this end, we propose the ‘Early Stage Software Startup Development Model’ (ESSSDM). The model extends already existing lean principles, but offers novel support for practitioners for investigating multiple product ideas in parallel, for determining when to move forward with a product idea, and for deciding when to abandon a product idea. The model was evaluated in a software startup project, as well as with industry professionals within the software startup domain.
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| 50. |
- Bosch, Jan, 1967, et al.
(författare)
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The Early Stage Software Startup Development Model: A Framework for Operationalizing Lean Principles in Software Startups
- 2013
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Ingår i: Lecture Notes in Business Information Processing. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 1865-1356 .- 1865-1348. ; 167, s. 1-15
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Konferensbidrag (refereegranskat)abstract
- Software startups are more popular than ever and growing in numbers. They operate under conditions of extreme uncertainty and face many challenges. Often, agile development practices and lean principles are suggested as ways to increase the odds of succeeding as a startup, as they both advocate close customer collaboration and short feedback cycles focusing on delivering direct customer value. However, based on an interview study we see that despite guidance and support in terms of well-known and documented development methods, practitioners find it difficult to implement and apply these in practice. To explore this further, and to propose operational support for software startup companies, this study aims at investigating (1) what are the typical challenges when finding a product idea worth scaling, and (2) what solution would serve to address these challenges. To this end, we propose the ‘Early Stage Software Startup Development Model’ (ESSSDM). The model extends already existing lean principles, but offers novel support for practitioners for investigating multiple product ideas in parallel, for determining when to move forward with a product idea, and for deciding when to abandon a product idea. The model was evaluated in a software startup project, as well as with industry professionals within the software startup domain.
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