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| 2. |
- Broman, K. K., et al.
(författare)
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Surveillance of Sentinel Node-Positive Melanoma Patients with Reasons for Exclusion from MSLT-II: Multi-Institutional Propensity Score Matched Analysis
- 2021
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Ingår i: Journal of the American College of Surgeons. - : Ovid Technologies (Wolters Kluwer Health). - 1072-7515. ; 232:4, s. 424-431
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In sentinel lymph node (SLN)-positive melanoma, two randomized trials demonstrated equivalent melanoma-specific survival with nodal surveillance vs completion lymph node dissection (CLND). Patients with microsatellites, extranodal extension (ENE) in the SLN, or >3 positive SLNs constitute a high-risk group largely excluded from the randomized trials, for whom appropriate management remains unknown. STUDY DESIGN: SLN-positive patients with any of the three high-risk features were identified from an international cohort. CLND patients were matched 1:1 with surveillance patients using propensity scores. Risk of any-site recurrence, SLN-basin-only recurrence, and melanoma specific mortality were compared. RESULTS: Among 1,154 SLN-positive patients, 166 had ENE, microsatellites, and/or >3 positive SLN. At 18.5 months median follow-up, 49% had recurrence (vs 26% in patients without high-risk features, p < 0.01). Among high-risk patients, 52 (31%) underwent CLND and 114 (69%) received surveillance. Fifty-one CLND patients were matched to 51 surveillance patients. The matched cohort was balanced on tumor, nodal, and adjuvant treatment factors. There were no significant differences in any-site recurrence (CLND 49%, surveillance 45%, p = 0.99), SLN-basin-only recurrence (CLND 6%, surveillance 14%, p = 0.20), or melanoma-specific mortality (CLND 14%, surveillance 12%, p = 0.86). CONCLUSIONS: SLN-positive patients with microsatellites, ENE, or >3 positive SLN constitute a high-risk group with a 2-fold greater recurrence risk. For those managed with nodal surveillance, SLN-basin recurrences were more frequent, but all-site recurrence and melanoma-specific mortality were comparable to patients treated with CLND. Most recurrences were outside the SLN-basin, supporting use of nodal surveillance for SLN-positive patients with microsatellites, ENE, and/or >3 positive SLN. Crown Copyright (C) 2020 Published by Elsevier Inc. on behalf of the American College of Surgeons. All rights reserved.
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| 3. |
- Broman, K. K., et al.
(författare)
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Active surveillance of patients who have sentinel node positive melanoma: An international, multi-institution evaluation of adoption and early outcomes after the Multicenter Selective Lymphadenectomy trial II (MSLT-2)
- 2021
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Ingår i: Cancer. - : Wiley. - 0008-543X .- 1097-0142. ; 127:13, s. 2251-2261
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Tidskriftsartikel (refereegranskat)abstract
- Background For patients with sentinel lymph node (SLN)-positive cutaneous melanoma, the Second Multicenter Selective Lymphadenectomy trial demonstrated equivalent disease-specific survival (DSS) with active surveillance using nodal ultrasound versus completion lymph node dissection (CLND). Adoption and outcomes of active surveillance in clinical practice and in adjuvant therapy recipients are unknown. Methods In a retrospective cohort of SLN-positive adults treated at 21 institutions in Australia, Europe, and the United States from June 2017 to November 2019, the authors evaluated the impact of active surveillance and adjuvant therapy on all-site recurrence-free survival (RFS), isolated nodal RFS, distant metastasis-free survival (DMFS), and DSS using Kaplan-Meier curves and Cox proportional hazard models. Results Among 6347 SLN biopsies, 1154 (18%) were positive and had initial negative distant staging. In total, 965 patients (84%) received active surveillance, 189 (16%) underwent CLND. Four hundred thirty-nine patients received adjuvant therapy (surveillance, 38%; CLND, 39%), with the majority (83%) receiving anti-PD-1 immunotherapy. After a median follow-up of 11 months, 220 patients developed recurrent disease (surveillance, 19%; CLND, 22%), and 24 died of melanoma (surveillance, 2%; CLND, 4%). Sixty-eight patients had an isolated nodal recurrence (surveillance, 6%; CLND, 4%). In patients who received adjuvant treatment without undergoing prior CLND, all isolated nodal recurrences were resectable. On risk-adjusted multivariable analyses, CLND was associated with improved isolated nodal RFS (hazard ratio [HR], 0.36; 95% CI, 0.15-0.88), but not all-site RFS (HR, 0.68; 95% CI, 0.45-1.02). Adjuvant therapy improved all-site RFS (HR, 0.52; 95% CI, 0.47-0.57). DSS and DMFS did not differ by nodal management or adjuvant treatment. Conclusions Active surveillance has been adopted for most SLN-positive patients. At initial assessment, real-world outcomes align with randomized trial findings, including in adjuvant therapy recipients. Lay Summary For patients with melanoma of the skin and microscopic spread to lymph nodes, monitoring with ultrasound is an alternative to surgically removing the remaining lymph nodes. The authors studied adoption and real-world outcomes of ultrasound monitoring in over 1000 patients treated at 21 centers worldwide, finding that most patients now have ultrasounds instead of surgery. Although slightly more patients have cancer return in the lymph nodes with this strategy, typically, it can be removed with delayed surgery. Compared with up-front surgery, ultrasound monitoring results in the same overall risk of melanoma coming back at any location or of dying from melanoma.
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| 4. |
- Eroglu, Z., et al.
(författare)
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Outcomes with adjuvant anti-PD-1 therapy in patients with sentinel lymph node-positive melanoma without completion lymph node dissection
- 2022
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Ingår i: Journal for Immunotherapy of Cancer. - : BMJ. - 2051-1426. ; 10:8
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Tidskriftsartikel (refereegranskat)abstract
- Until recently, most patients with sentinel lymph node-positive (SLN+) melanoma underwent a completion lymph node dissection (CLND), as mandated in published trials of adjuvant systemic therapies. Following multicenter selective lymphadenectomy trial-II, most patients with SLN+ melanoma no longer undergo a CLND prior to adjuvant systemic therapy. A retrospective analysis of clinical outcomes in SLN+ melanoma patients treated with adjuvant systemic therapy after July 2017 was performed in 21 international cancer centers. Of 462 patients who received systemic adjuvant therapy, 326 patients received adjuvant anti-PD-1 without prior immediate (IM) CLND, while 60 underwent IM CLND. With median follow-up of 21 months, 24-month relapse-free survival (RFS) was 67% (95% CI 62% to 73%) in the 326 patients. When the patient subgroups who would have been eligible for the two adjuvant anti-PD-1 clinical trials mandating IM CLND were analyzed separately, 24-month RFS rates were 64%, very similar to the RFS rates from those studies. Of these no-CLND patients, those with SLN tumor deposit >1 mm, stage IIIC/D and ulcerated primary had worse RFS. Of the patients who relapsed on adjuvant anti-PD-1, those without IM CLND had a higher rate of relapse in the regional nodal basin than those with IM CLND (46% vs 11%). Therefore, 55% of patients who relapsed without prior CLND underwent surgery including therapeutic lymph node dissection (TLND), with 30% relapsing a second time; there was no difference in subsequent relapse between patients who received observation vs secondary adjuvant therapy. Despite the increased frequency of nodal relapses, adjuvant anti-PD-1 therapy may be as effective in SLN+ pts who forego IM CLND and salvage surgery with TLND at relapse may be a viable option for these patients.
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| 12. |
- Berglund, Olof, et al.
(författare)
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Organochlorine accumulation and stable isotope ratios in an Atlantic salmon (Salmo salar) population from the Baltic Sea
- 2001
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Ingår i: Science of the Total Environment. - 1879-1026. ; 281:1-3, s. 141-151
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- We investigated the organochlorine accumulation (p,p′-DDE and ∑PCB) and stable isotope ratios (N and C) in a migrating salmon (Salmo salar) population in the Baltic Sea. ∂15N in the entire population ranged from 11.7 to 13.7‰ and ∂13C ranged from −22.0 to −19.6‰. In the entire population, ∂15N were weakly related to p,p′-DDE and ∑PCB concentrations (r2=0.20 and 0.14, respectively). However, lipid content was a better predictor of organochlorine (OC) concentrations (r2=0.48 and 0.50, respectively). Lipid adjusted ∑PCB concentrations were not related to ∂15N, and lipid adjusted p,p′-DDE concentrations were only weakly related (r2=0.12). We divided the salmon population into three groups representing reproductive strategies: small males <5 kg (SM); large males >5 kg (LM); and females (F). ∂15N varied between the three reproductive strategies. The mean ∂15N for SM was 12.7±0.3‰, for F was 12.9±0.3‰, and for LM equalled 13.2±0.3‰. Lipid adjusted OC concentrations differed between the three reproductive strategies, with the females having the highest concentrations. We conclude that the ∂15N varied between reproductive strategies indicating differences in prey choice, but the lipid content was better able to predict OC concentrations than the trophic position of the salmon.
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| 13. |
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| 15. |
- Broman, D., et al.
(författare)
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A clinician-friendly test battery with a passing rate similar to a ‘gold standard’ return-to-sport test battery 1 year after ACL reconstruction: Results from a rehabilitation outcome registry
- 2023
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Ingår i: Physical Therapy in Sport. - : Elsevier BV. - 1466-853X. ; 59, s. 144-150
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To 1) present passing rates for different clinician-friendly (CF) test batteries and 2) determine the relationship between passing CF test batteries and passing gold standard (GS) return-to-sport (RTS) muscle function testing, 1 year after ACL reconstruction. Study design: Cross-sectional registry study, level of evidence: 3. Setting: Primary care. Participants: Data from 588 patients (52% women, mean age 29.3 ± 9.8 years) were extracted from the Project ACL registry. Main outcome measures: The passing rates for the different test batteries. Results: The passing rate for GS test battery was 28% (95% CI, 24–32%) and the passing rate for the CF test battery with the lowest passing rate was 27% (95% CI 24–31%). The two CF test batteries with the strongest relationships with passing GS test battery showed that 51% (95% CI 43–59%) and 49% (95% CI 44–55%) of the patients who passed the respective CF test battery also passed the GS test battery. Conclusion: A CF test battery can be as demanding to pass as a GS test battery, 1 year after ACL reconstruction. However, passing a CF test battery only gives patients a chance similar to a “coin flip” of also passing a GS RTS test battery.
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| 16. |
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| 18. |
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| 19. |
- Broman, J., et al.
(författare)
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Long-term risk of recurrent vascular events and mortality in young stroke patients: Insights from a multicenter study
- 2023
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Ingår i: European Journal of Neurology. - 1351-5101. ; 30:9, s. 2675-2683
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although the incidence of stroke in the young is rising, data on long-term outcomes in these patients are scarce. We thus aimed to investigate the long-term risk of recurrent vascular events and mortality in a multicenter study. Methods: We followed 396 consecutive patients aged 18-55 years with ischemic stroke (IS) or transient ischemic attack (TIA) enrolled in three European centers during the period 2007-2010. A detailed outpatient clinical follow-up assessment was performed between 2018 and 2020. When an in-person follow- -up visit was not possible, outcome events were assessed using electronic records and registry data. Results: During a median follow-up of 11.8 (IQR 10.4-12.7) years, 89 (22.5%) patients experienced any recurrent vascular event, 62 (15.7%) had any cerebrovascular event, 34 (8.6%) had other vascular events, and 27 (6.8%) patients died. Cumulative 10-year incidence rate per 1000 person-years was 21.6 (95% CI 17.1-26.9) for any recurrent vascular event and 14.9 (95% CI 11.3-19.3) for any cerebrovascular event. The prevalence of cardiovascular risk factors increased over time, and 22 (13.5%) patients lacked any secondary preventive medication at the in-person follow-up. After adjustment for demographics and comorbidities, atrial fibrillation at baseline was found to be significantly associated with recurrent vascular events. Conclusions: This multicenter study shows a considerable risk of recurrent vascular events in young IS and TIA patients. Further studies should investigate whether detailed individual risk assessment, modern secondary preventive strategies, and better patient adherence may reduce recurrence risk.
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| 20. |
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| 21. |
- Broman, S. L., et al.
(författare)
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Dihydroazulene Photoswitch Operating in Sequential Tunneling Regime: Synthesis and Single-Molecule Junction Studies
- 2012
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Ingår i: Advanced Functional Materials. - : Wiley. - 1616-3028 .- 1616-301X. ; 22:20, s. 4249-4258
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Tidskriftsartikel (refereegranskat)abstract
- Molecular switches play a central role for the development of molecular electronics. In this work it is demonstrated that the reproducibility and robustness of a single-molecule dihydroazulene (DHA)/vinylheptafulvene (VHF) switch can be remarkably enhanced if the switching kernel is weakly coupled to electrodes so that the electron transport goes by sequential tunneling. To assure weak coupling, the DHA switching kernel is modified by incorporating p-MeSC6H4 end-groups. Molecules are prepared by Suzuki cross-couplings on suitable halogenated derivatives of DHA. The synthesis presents an expansion of our previously reported brominationeliminationcross-coupling protocol for functionalization of the DHA core. For all new derivatives the kinetics of DHA/VHF transition has been thoroughly studied in solution. The kinetics reveals the effect of sulfur end-groups on the thermal ring-closure of VHF. One derivative, incorporating a p-MeSC6H4 anchoring group in one end, has been placed in a silver nanogap. Conductance measurements justify that transport through both DHA (high resistivity) and VHF (low resistivity) forms goes by sequential tunneling. The switching is fairly reversible and reenterable; after more than 20 ON-OFF switchings, both DHA and VHF forms are still recognizable, albeit noticeably different from the original states.
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| 23. |
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| 24. |
- Chapman, Colin D., et al.
(författare)
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Acute sleep deprivation increases food purchasing in men
- 2013
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Ingår i: Obesity. - : Wiley. - 1930-7381 .- 1930-739X. ; 21:12
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate if acute sleep deprivation affects food purchasing choices in a mock supermarket. Design and Methods On the morning after one night of total sleep deprivation (TSD) or after one night of sleep, 14 normal-weight men were given a fixed budget (300 SEKapproximately 50 USD). They were instructed to purchase as much as they could out of a possible 40 items, including 20 high-caloric foods (>2 kcal/g) and 20 low-caloric foods (<2 kcal/g). The prices of the high-caloric foods were then varied (75%, 100% (reference price), and 125%) to determine if TSD affects the flexibility of food purchasing. Before the task, participants received a standardized breakfast, thereby minimizing the potential confound produced by hunger. In addition, morning plasma concentrations of the orexigenic hormone ghrelin were measured under fasting conditions. Results Independent of both type of food offered and price condition, sleep-deprived men purchased significantly more calories (+9%) and grams (+18%) of food than they did after one night of sleep (both P<0.05). Morning plasma ghrelin concentrations were also higher after TSD (P<0.05). However, this increase did not correlate with the effects of TSD on food purchasing. Conclusions This experiment demonstrates that acute sleep loss alters food purchasing behavior in men.
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| 25. |
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| 26. |
- Cornelissen, G, et al.
(författare)
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Black carbon-dominated PCDD/Fs sorption to soils at a former wood impregnation site
- 2008
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Ingår i: Chemosphere. - : Elsevier. - 0045-6535 .- 1879-1298. ; 72:10, s. 1455-1461
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Tidskriftsartikel (refereegranskat)abstract
- The influence of black carbon (BC) on the sorption of 17 native polychlorinated-p-dibenzodioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) was studied in five soil samples from a sawmill site where wood used to be impregnated with chlorophenol preservatives. The presence of BC caused measured total organic carbon (TOC)-water distribution ratios (KTOC) to be a median factor of 51 (interquartile range 18-68, n = 85) higher than modeled amorphous organic carbon (AOC)-water distribution ratios (KAOC). KTOC was a factor of 73 ± 27 above KAOC for PCDFs (n = 10) and a factor of 20 ± 13 (n = 7) for PCDDs. The reason for this difference is probably that attaining a planar configuration after sorption to BC is less thermodynamically favorable for PCDDs than for PCDFs. BC-water distribution ratios were calculated from KTOC, KAOC and BC contents, and ranged from 109.9 (2,3,7,8-Tetra-CDD) to 1011.5 l kg-1 (Octa-CDF). More than 90% of the PCDD/Fs in the soil was calculated to be BC-sorbed. Dissolved organic carbon (DOC)-water distribution ratios were measured to be in the same order of magnitude as KAOC. This study shows that strong sorption to BC should be included when assessing ecotoxicological risk or modeling transport to groundwater of PCDD/Fs in soil.
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| 27. |
- Cvetkovic, M, et al.
(författare)
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International survey of neuromonitoring and neurodevelopmental outcome in children and adults supported on extracorporeal membrane oxygenation in Europe
- 2023
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Ingår i: Perfusion. - : SAGE Publications. - 1477-111X .- 0267-6591. ; 38:2, s. 245-260
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Tidskriftsartikel (refereegranskat)abstract
- Adverse neurological events during extracorporeal membrane oxygenation (ECMO) are common and may be associated with devastating consequences. Close monitoring, early identification and prompt intervention can mitigate early and late neurological morbidity. Neuromonitoring and neurocognitive/neurodevelopmental follow-up are critically important to optimize outcomes in both adults and children. Objective: To assess current practice of neuromonitoring during ECMO and neurocognitive/neurodevelopmental follow-up after ECMO across Europe and to inform the development of neuromonitoring and follow-up guidelines. Methods: The EuroELSO Neurological Monitoring and Outcome Working Group conducted an electronic, web-based, multi-institutional, multinational survey in Europe. Results: Of the 211 European ECMO centres (including non-ELSO centres) identified and approached in 23 countries, 133 (63%) responded. Of these, 43% reported routine neuromonitoring during ECMO for all patients, 35% indicated selective use, and 22% practiced bedside clinical examination alone. The reported neuromonitoring modalities were NIRS ( n = 88, 66.2%), electroencephalography ( n = 52, 39.1%), transcranial Doppler ( n = 38, 28.5%) and brain injury biomarkers ( n = 33, 24.8%). Paediatric centres (67%) reported using cranial ultrasound, though the frequency of monitoring varied widely. Before hospital discharge following ECMO, 50 (37.6%) reported routine neurological assessment and 22 (16.5%) routinely performed neuroimaging with more paediatric centres offering neurological assessment (65%) as compared to adult centres (20%). Only 15 (11.2%) had a structured longitudinal follow-up pathway (defined followup at regular intervals), while 99 (74.4%) had no follow-up programme. The majority ( n = 96, 72.2%) agreed that there should be a longitudinal structured follow-up for ECMO survivors. Conclusions: This survey demonstrated significant variability in the use of different neuromonitoring modalities during and after ECMO. The perceived importance of neuromonitoring and follow-up was noted to be very high with agreement for a longitudinal structured follow-up programme, particularly in paediatric patients. Scientific society endorsed guidelines and minimum standards should be developed to inform local protocols.
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| 28. |
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| 29. |
- Engwall, Magnus, 1965-, et al.
(författare)
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Biological and chemical determination of contaminant levels in settling particulate matter and sediments : a Swedish river system before, during, and after dredging of PCB-contaminated lake sediments
- 1998
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Ingår i: Ambio. - 0044-7447 .- 1654-7209. ; 27:5, s. 403-410
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Tidskriftsartikel (refereegranskat)abstract
- A sensitive bioassay, based on EROD induction in cultured chicken embryo livers, was used together with chemical analysis to determine levels of dioxin-like contaminants in particulate matter in Eman. Extracts of sediment and settling particulate matter (SPM) collected in the river system before, during, and after dredging of a PCB contaminated lake, Lake Jarnsjon, were separated into three fractions containing a) monoaromatic/aliphatic; b) diaromatic (e.g., PCBs and polychlorinated dibenzodioxins and dibenzofurans); and c) polyaromatic compounds (e.g., polycyclic aromatic hydrocarbons). The samples from Lake Jarnsjon contained the highest PCB concentrations and the diaromatic extracts from Lake Jarnsjon samples showed the highest activities of EROD-inducing diaromatic compounds. The dioxin-like activity of the diaromatic fraction in sediment collected after the dredging of Jarnsjon had only around 1% of the activity of the pre-dredging sediment, showing that the remediation was successful in terms of removal of the PCB-contaminated sediment from the lake. In SPM collected immediately downstream from Jarnsjon, levels of diaromatic dioxin-like compounds were elevated during the dredging, and decreased after that. The post-dredging concentrations were however higher than in SPM from lakes upstream of Jarnsjon, showing that elevated levels of dioxin-like diaromatic compounds were still present in the water System downstream of Jarnsjon a couple of years after the dredging.
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| 31. |
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| 35. |
- Forsvall, Andreas, et al.
(författare)
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Prostate biopsy quality and patient experience with the novel Forsvall biopsy needle - a randomized controlled non-inferiority trial
- 2021
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 55:3, s. 235-241
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Tidskriftsartikel (refereegranskat)abstract
- Background Transrectal prostate biopsy (TRbx) carries an increasing risk of infection. The Forsvall Needle Prototype (FNP) is a novel biopsy needle that reduces bacterial load brought across the rectum and may therefore reduce infection risk. The objective of this study was to compare biopsy length, quality and patient experience for the FNP Version 2 (FNP2) versus a standard Tru-Cut needle. Methods We conducted a randomized, parallel-group, non-inferiority trial with twenty consecutive patients eligible for TRbx. Participants were randomized to undergo TRbx using either FNP2 or a standard Tru-Cut needle. The primary outcome was difference in mean biopsy lengths measured by the pathologist. FNP2 biopsy lengths <= 1.35 mm of the standard needle length were considered non-inferior. Secondary outcomes were biopsy length in the needle chamber and immediately after removal, biopsy quality, biopsy fragmentation, patient discomfort/pain, and complications (immediate and after 14 and 30 days). Results Mean pathologist-measured FNP2 biopsy length was non-inferior compared to the standard Tru-Cut needle (0.02 mm longer, 95%CI-0.73 to 0.76 mm). Biopsy length in the needle chamber and immediately after removal were also non-inferior. Biopsy quality and patient discomfort were not significantly different for the FNP2 and the standard Tru-Cut needle. Biopsy fragmentation was more common in the FNP2 group. Conclusions The FNP2 biopsy needle is non-inferior to the Tru-Cut needle in terms of biopsy length and not significantly different in terms of biopsy quality and patient experience. Future studies will evaluate the Forsvall needle design's effect on post-biopsy infection risk.
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| 36. |
- Gustafsson, Ö., et al.
(författare)
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Evaluation of the collection efficiency of upper ocean sub-photic-layer sediment traps : A 24-month in situ calibration in the open Baltic Sea using 234Th
- 2004
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Ingår i: Limnology and Oceanography. - : Wiley. - 1541-5856. ; 2:2, s. 62-74
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Tidskriftsartikel (refereegranskat)abstract
- The collection efficiency of cylindrical sediment traps of common design was assessed in situ for more than 2 y in an offshore shelf regime using the 234Th proxy and simultaneously collected hydrological and biogeochemical parameters. The traps were found to systematically record an undertrapping bias of 234Th by, on average, a factor of three (range 0.8 to 10). Seasonal variations in trapping efficiency were related to the seasonally varying ballasting properties of the settling particle pool. Sediment trap 234Th fluxes agreed within a factor of two of the estimated 234Th export from the overlying surface waters in the winter-spring periods in both 1999 and 2000 and appeared related to a particle pool that included, presumably rapidly sinking, mineral particles and diatom tests acting as ballast. In contrast, discrimination against slowly settling organic-rich aggregates of apparent exudate origin resulted in undertrapping of 234Th by factors of three to ten throughout the summerfall seasons. These data are consistent with hydrodynamic predictions that the collection efficiency of sinking particles is inversely related to their intrinsic settling velocities. Recognition of changing particle composition along a settling velocity spectrum combine with carbon mass balance restrictions to suggest that these 234Th-based collection efficiencies, ranging from 0.1 to 1, may not be directly applicable to "correct" sediment trap fluxes of other components, such as organic carbon. However, the 234Th-derived insights of settling-velocity-related undertrapping may beneficially be taken into account when interpreting trap records both in studies of biogeochemical element fluxes and in phytoplankton ecology
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| 37. |
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| 38. |
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| 39. |
- Hogenkamp, Pleunie S, et al.
(författare)
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Acute sleep deprivation increases portion size and affects food choice in young men.
- 2013
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 38:9, s. 1668-1674
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Tidskriftsartikel (refereegranskat)abstract
- Acute sleep loss increases food intake in adults. However, little is known about the influence of acute sleep loss on portion size choice, and whether this depends on both hunger state and the type of food (snack or meal item) offered to an individual. The aim of the current study was to compare portion size choice after a night of sleep and a period of nocturnal wakefulness (a condition experienced by night-shift workers, e.g. physicians and nurses). Sixteen men (age: 23±0.9 years, BMI: 23.6±0.6kg/m(2)) participated in a randomized within-subject design with two conditions, 8-h of sleep and total sleep deprivation (TSD). In the morning following sleep interventions, portion size, comprising meal and snack items, was measured using a computer-based task, in both fasted and sated state. In addition, hunger as well as plasma levels of ghrelin were measured. In the morning after TSD, subjects had increased plasma ghrelin levels (13%, p=0.04), and chose larger portions (14%, p=0.02), irrespective of the type of food, as compared to the sleep condition. Self-reported hunger was also enhanced (p<0.01). Following breakfast, sleep-deprived subjects chose larger portions of snacks (16%, p=0.02), whereas the selection of meal items did not differ between the sleep interventions (6%, p=0.13). Our results suggest that overeating in the morning after sleep loss is driven by both homeostatic and hedonic factors. Further, they show that portion size choice after sleep loss depend on both an individual's hunger status, and the type of food offered.
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| 40. |
- Hogenkamp, Pleunie S, et al.
(författare)
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Sweet taste perception not altered after acute sleep deprivation in healthy young men.
- 2013
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Ingår i: Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine. - : Springer Science and Business Media LLC. - 1432-9123 .- 1439-054X. ; 17:2, s. 111-114
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Tidskriftsartikel (refereegranskat)abstract
- We hypothesized that acutely sleep-deprived participants would rate ascending concentrations of sucrose as more intense and pleasant, than they would do after one night of normal sleep. Such a finding would offer a potential mechanism through which acute sleep loss could promote overeating in humans.
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| 41. |
- Holmberg, Carl Jacob, et al.
(författare)
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The efficacy of immune checkpoint blockade for melanoma in-transit with or without nodal metastases - A multicenter cohort study
- 2022
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Ingår i: EUROPEAN JOURNAL OF CANCER. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 40:16
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Guidelines addressing melanoma in-transit metastasis (ITM) recommend immune checkpoint inhibitors (ICI) as a first-line treatment option, despite the fact that there are no efficacy data available from prospective trials for exclusively ITM disease. The study aims to analyze the outcome of patients with ITM treated with ICI based on data from a large cohort of patients treated at international referral clinics. Methods: A multicenter retrospective cohort study of patients treated between January 2015 and December 2020 from Australia, Europe, and the USA, evaluating treatment with ICI for ITM with or without nodal involvement (AJCC8 N1c, N2c, and N3c) and without distant disease (M0). Treatment was with PD-1 inhibitor (nivolumab or pembrolizumab) and/or CTLA-4 inhibitor (ipilimumab). The response was evaluated according to the RECIST criteria modified for cutaneous lesions. Results: A total of 287 patients from 21 institutions in eight countries were included. Immunotherapy was first-line treatment in 64 (22%) patients. PD-1 or CTLA-4 inhibitor monotherapy was given in 233 (81%) and 23 (8%) patients, respectively, while 31 (11%) received both in combination. The overall response rate was 56%, complete response (CR) rate was 36%, and progressive disease (PD) rate was 32%. Median PFS was ten months (95% CI 7.4-12.6 months) with a one-, two-, and five-year PFS rate of 48%, 33%, and 18%, respectively. Median MSS was not reached, and the one-, two-, and five-year MSS rates were 95%, 83%, and 71%, respectively. Conclusion: Systemic immunotherapy is an effective treatment for melanoma ITM. Future studies should evaluate the role of systemic immunotherapy in the context of multimodality therapy, including locoregional treatments such as surgery, intralesional therapy, and regional therapies.
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| 42. |
- Högberg, Johan, 1994, et al.
(författare)
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Is absolute or relative knee flexor strength related to patient- reported outcomes in patients treated with ACL reconstruction with a hamstring tendon autograft? An analysis of eccentric Nordic hamstring strength and seated concentric isokinetic strength
- 2023
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Ingår i: Knee. - : Elsevier BV. - 0968-0160. ; 41, s. 161-170
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a need for better understanding of how knee flexor strength influence patient-reported outcomes (PROs) after anterior cruciate ligament (ACL) reconstruction. Our aim was to investigate the relationship between the eccentric NordBord test and the seated concentric Biodex test with PROs, during the first year of rehabilitation after ACL reconstruction with hamstring tendon (HT) autograft.Methods: Patients with an index ACL reconstruction with an HT autograft participating in a rehabilitation registry were screened for inclusion. Outcomes of interest were the correla-tion between absolute (N/kg or Nm/kg) and relative (limb symmetry index) knee flexor strength measured in the NordBord and Biodex with the results of PROs. The significance level was set at p < 0.05 and Pearson's correlation coefficient was used.Results: 137 patients were included (47% women) with a mean age of 24.8 +/- 8.4 years. There were non-significant and weak correlations between relative strength for all PROs. Significant and weak correlations between absolute strength in the Biodex with the Knee Self-Efficacy Scale18 (K-SES18) present at 4 and 8 months, and for the ACL-Return to Sport after Injury scale (ACL-RSI) at 12 months was observed, accounting for 8.4-15.7% of the variance. Significant and weak correlations between absolute strength in the Nordbord with the Knee injury and Osteoarthritis Outcome Scale subscale Sports and Recreation at 4 months, the K-SES18 present and the ACL-RSI at 8 months were observed, accounting for 9.4-14.4% of the variance.
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- Jung, T. D., et al.
(författare)
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Quality of life in Swedish patients with post-polio syndrome with a focus on age and sex
- 2014
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Ingår i: International Journal of Rehabilitation Research. - : Ovid Technologies (Wolters Kluwer Health). - 0342-5282. ; 37:2, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the health-related quality of life (QOL) in Swedish patients with post-polio syndrome (PPS), with a focus on sex and age. A total of 364 patients were recruited from five Swedish post-polio clinics. Analysis was carried out using SF-36 and data were compared with those of a normal population. QOL was significantly lower in PPS patients for all eight subdomains and the two main scores (physical compound score and mental compound score) when compared with the controls. Male patients had a significantly higher QOL than female patients for all subdomains and also for mental compound score and physical compound score, a phenomenon also observed in the normal population. There was a decrease in QOL in the physical domains and an increase in vitality with age. PPS decreases health-related QOL in both sexes, more in female patients. QOL for physical domains decreases whereas vitality increases with age in both sexes. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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- Larsson, Per, et al.
(författare)
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Persistent organic pollutants (POPs) in pelagic systems
- 2000
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Ingår i: Ambio: a Journal of the Human Environment. - 0044-7447. ; 29:4-5, s. 202-209
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Tidskriftsartikel (refereegranskat)abstract
- Several studies show that there are interactive processes between eutrophication and uptake of persistent organic pollutants (POPs) in aquatic biota. The main concept is that the increased biomass and production in aquatic ecosystems, due to excess discharge of nutrients, causes a chain event that results in reduced uptake of POPs in primary producers (phytoplankton). This effect is then transferred to consumers at different trophic levels. The chain event may work in an indirect way by increasing the sedimentation of organic matter and, thereby, increasing the downward flux of pollutants to the bottoms, where they are caught in the organic sediment matrix. The chain event may also work in a direct way; the uptake of POPs in the fast growing phytoplankton is decreased as a result of "growth-dilution", and lower amounts of pollutants are transported in the food-web. The effect seen may also be a result of changed food-web structures that differ considerably from nutrient-poor to nutrient-rich ecosystems. In this paper, we use the existing knowledge of POPs behavior in aquatic systems of different nutrient status, to discuss possible interactive processes of eutrophication and contaminants in the Baltic Sea. The Baltic is known to be highly contaminated with POPs and exposed to ongoing eutrophication. Results from investigations in lakes are compared to laboratory and field studies of the Baltic Sea.
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