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| 5. |
- 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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| 6. |
- 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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| 9. |
- 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. |
- Swillo, Marcin, et al.
(författare)
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Laser ablation in selected minerals for extracting fluid in inclusions
- 2011
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Ingår i: Conf. Lasers Electro-Opt. Europe Eur. Quantum Electron. Conf., CLEO EUROPE/EQEC. - 9781457705335
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Konferensbidrag (refereegranskat)abstract
- Fluid inclusions are naturally formed micro-containers in minerals that have been sealed since the mineral was formed. Analysis of inorganic and organic fluids from various inclusions is of particular interest for geologists, who are investigating environmental information and sometimes organic content. The inclusions are to a large extent prevented from contamination and many temporal changes as they are embedded within minerals. However, an essential part of the investigation procedure is the method of extracting fluids from such minerals. Since mechanical drilling or polishing involves a high risk for contamination of the sample, it is suggested to use a laser ablation technique to isolate the samples. In order to assess the potential of this technique, we have studied the parameters for laser ablation in quartz, calcite and apatite (the most common minerals containing fluid inclusions).
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| 15. |
- Andren, M., et al.
(författare)
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Coupling between mineral reactions, chemical changes in groundwater, and earthquakes in Iceland
- 2016
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Ingår i: Journal of Geophysical Research-Solid Earth. - : American Geophysical Union (AGU). - 2169-9313. ; 121:4, s. 2315-2337
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Tidskriftsartikel (refereegranskat)abstract
- Chemical analysis of groundwater samples collected from a borehole at Hafralaekur, northern Iceland, from October 2008 to June 2015 revealed (1) a long-term decrease in concentration of Si and Na and (2) an abrupt increase in concentration of Na before each of two consecutive M 5 earthquakes which occurred in 2012 and 2013, both 76km from Hafralaekur. Based on a geochemical (major elements and stable isotopes), petrological, and mineralogical study of drill cuttings taken from an adjacent borehole, we are able to show that (1) the long-term decrease in concentration of Si and Na was caused by constant volume replacement of labradorite by analcime coupled with precipitation of zeolites in vesicles and along fractures and (2) the abrupt increase of Na concentration before the first earthquake records a switchover to nonstoichiometric dissolution of analcime with preferential release of Na into groundwater. We attribute decay of the Na peaks, which followed and coincided with each earthquake to uptake of Na along fractured or porous boundaries between labradorite and analcime crystals. Possible causes of these Na peaks are an increase of reactive surface area caused by fracturing or a shift from chemical equilibrium caused by mixing between groundwater components. Both could have been triggered by preseismic dilation, which was also inferred in a previous study by Skelton et al. (2014). The mechanism behind preseismic dilation so far from the focus of an earthquake remains unknown.
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| 17. |
- Belliato, M., et al.
(författare)
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An experimental model of veno-venous arterial extracorporeal membrane oxygenation
- 2019
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Ingår i: International Journal of Artificial Organs. - : SAGE Publications Ltd. - 0391-3988 .- 1724-6040.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Veno-venous arterial extracorporeal membrane oxygenation is a hybrid-modality of extracorporeal membrane oxygenation combining veno-venous and veno-arterial extracorporeal membrane oxygenation. It may be applied to patients with both respiratory and cardio-circulatory failure. Aim: To describe a computational spreadsheet regarding an ex vivo experimental model of veno-venous arterial extracorporeal membrane oxygenation to determine the return of cannula pairs in a single pump–driven circuit. Methods: We developed an ex vivo model of veno-venous arterial extracorporeal membrane oxygenation with a single pump and two outflow cannulas, and a glucose solution was used to mimic the features of blood. We maintained a fixed aortic impedance and physiological pulmonary resistance. Both flow and pressure data were collected while testing different pairs of outflow cannulas. Six simulations of different cannula pairs were performed, and data were analysed by a custom-made spreadsheet, which was able to predict the flow partition at different flow levels. Results: In all simulations, the flow in the arterial cannula gradually increased differently depending on the cannula pair. The best cannula pair was a 19-Fr/18-cm arterial with a 17-Fr/50-cm venous cannula, where we observed an equal flow split and acceptable flow into the arterial cannula at a lower flow rate of 4 L/min. Conclusion: Our computational spreadsheet identifies the suitable cannula pairing set for correctly splitting the outlet blood flow into the arterial and venous return cannulas in a veno-venous arterial extracorporeal membrane oxygenation configuration without the use of external throttles. Several limitations were reported regarding fixed aortic impedance, central venous pressure and the types of cannulas tested; therefore, further studies are mandatory to confirm our findings.
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| 18. |
- Benedict, Christian, et al.
(författare)
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Acute Sleep Deprivation Enhances the Brain's Response to Hedonic Food Stimuli : An fMRI Study
- 2012
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 97:3, s. E443-447
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Tidskriftsartikel (refereegranskat)abstract
- Context:There is growing recognition that a large number of individuals living in Western society are chronically sleep deprived. Sleep deprivation is associated with an increase in food consumption and appetite. However, the brain regions that are most susceptible to sleep deprivation-induced changes when processing food stimuli are unknown.Objective:Our objective was to examine brain activation after sleep and sleep deprivation in response to images of food.Intervention:Twelve normal-weight male subjects were examined on two sessions in a counterbalanced fashion: after one night of total sleep deprivation and one night of sleep. On the morning after either total sleep deprivation or sleep, neural activation was measured by functional magnetic resonance imaging in a block design alternating between high- and low-calorie food items. Hunger ratings and morning fasting plasma glucose concentrations were assessed before the scan, as were appetite ratings in response to food images after the scan.Main Outcome Measures:Compared with sleep, total sleep deprivation was associated with an increased activation in the right anterior cingulate cortex in response to food images, independent of calorie content and prescan hunger ratings. Relative to the postsleep condition, in the total sleep deprivation condition, the activation in the anterior cingulate cortex evoked by foods correlated positively with postscan subjective appetite ratings. Self-reported hunger after the nocturnal vigil was enhanced, but importantly, no change in fasting plasma glucose concentration was found.Conclusions:These results provide evidence that acute sleep loss enhances hedonic stimulus processing in the brain underlying the drive to consume food, independent of plasma glucose levels. These findings highlight a potentially important mechanism contributing to the growing levels of obesity in Western society.
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| 21. |
- Broman, David, 1977-, et al.
(författare)
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Gradually typed symbolic expressions
- 2017
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Ingår i: PEPM 2018 - Proceedings of the ACM SIGPLAN Workshop on Partial Evaluation and Program Manipulation, Co-located with POPL 2018. - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450355872 ; , s. 15-29
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Konferensbidrag (refereegranskat)abstract
- Embedding a domain-specific language (DSL) in a general purpose host language is an efficient way to develop a new DSL. Various kinds of languages and paradigms can be used as host languages, including object-oriented, functional, statically typed, and dynamically typed variants, all having their pros and cons. For deep embedding, statically typed languages enable early checking and potentially good DSL error messages, instead of reporting runtime errors. Dynamically typed languages, on the other hand, enable flexible transformations, thus avoiding extensive boilerplate code. In this paper, we introduce the concept of gradually typed symbolic expressions that mix static and dynamic typing for symbolic data. The key idea is to combine the strengths of dynamic and static typing in the context of deep embedding of DSLs. We define a gradually typed calculus <*>, formalize its type system and dynamic semantics, and prove type safety. We introduce a host language called Modelyze that is based on <*>, and evaluate the approach by embedding a series of equation-based domain-specific modeling languages, all within the domain of physical modeling and simulation.
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| 22. |
- Broman, David, et al.
(författare)
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Modelyze : a Gradually Typed Host Language for Embedding Equation-Based Modeling Languages
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Equation-based modeling languages provide an effective means to simulate the physical part of a cyber-physical system. Such languages are complex domain-specific languages that enable model engineers, such as mechanical engineers, to declaratively model the dynamics of systems. However, these modeling languages do not support all modeling needs, which has lead to frequent revisions of state-of-the-art languages. In this article we explore a solution to this extensibility problem based on domain-specific embedded languages. We introduce a host language, named Modelyze, in which modeling languages may be easily embedded. The key features of Modelyze are first-class functions, which provide a mechanism to abstract components of a model, and symbolic expressions, to represent and manipulate equations. The type system for symbolic expressions supports model-level static error checking and provides an automatic lifting translation to provide seamless integration between the host language and the equations represented by symbolic expressions. The type system is based on gradual typing, enabling early static checking for model engineers while providing expressiveness for domain experts. We evaluate this approach by embedding a series of equation-based modeling languages in Modelyze and using them to develop models.
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| 25. |
- Broman, G, et al.
(författare)
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Older women's cardiovascular responses to deep-water running
- 2006
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Ingår i: Journal of aging and physical activity. - : Human Kinetics. - 1063-8652 .- 1543-267X. ; 14:1, s. 29-40
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to examine submaximal and maximal physiological responses and perceived exertion during deep-water running with a vest compared with the responses during treadmill running in healthy elderly women. Eleven healthy women 70 ± 2 years old participated. On two different occasions they performed a graded maximal exercise test on a treadmill on land and a graded maximal exercise test in water wearing a vest. At maximal work the oxygen uptake was 29% lower (p < .05), the heart rate was 8% lower (p < .05), and the ventilation was 16% lower (p < .05) during deep-water running than during treadmill running. During submaximal absolute work the heart rate was higher during deep-water running than during treadmill running for the elderly women. The participants had lower maximal oxygen uptake, heart rate, ventilation, respiratory-exchange ratio, and rate of perceived exertion during maximal deep-water running with a vest than during maximal treadmill running. These responses were, however, higher during submaximal deep-water running than during treadmill running.
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| 26. |
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| 27. |
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| 28. |
- Capo, Eric, et al.
(författare)
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Oxygen-deficient water zones in the Baltic Sea promote uncharacterized Hg methylating microorganisms in underlying sediments
- 2022
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Ingår i: Limnology and Oceanography. - : Wiley. - 1939-5590 .- 0024-3590. ; 67:1, s. 135-146
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Tidskriftsartikel (refereegranskat)abstract
- Human-induced expansion of oxygen-deficient zones can have dramatic impacts on marine systems and its resident biota. One example is the formation of the potent neurotoxic methylmercury (MeHg) that is mediated by microbial methylation of inorganic divalent Hg (HgII) under oxygen-deficient conditions. A negative consequence of the expansion of oxygen-deficient zones could be an increase in MeHg production due to shifts in microbial communities in favor of microorganisms methylating Hg. There is, however, limited knowledge about Hg-methylating microbes, i.e., those carrying hgc genes critical for mediating the process, from marine sediments. Here, we aim to study the presence of hgc genes and transcripts in metagenomes and metatranscriptomes from four surface sediments with contrasting concentrations of oxygen and sulfide in the Baltic Sea. We show that potential Hg methylators differed among sediments depending on redox conditions. Sediments with an oxygenated surface featured hgc-like genes and transcripts predominantly associated with uncultured Desulfobacterota (OalgD group) and Desulfobacterales (including Desulfobacula sp.) while sediments with a hypoxic-anoxic surface included hgc-carrying Verrucomicrobia, unclassified Desulfobacterales, Desulfatiglandales, and uncharacterized microbes. Our data suggest that the expansion of oxygen-deficient zones in marine systems may lead to a compositional change of Hg-methylating microbial groups in the sediments, where Hg methylators whose metabolism and biology have not yet been characterized will be promoted and expand.
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| 29. |
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| 30. |
- Cato, Ingemar, et al.
(författare)
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DIOXINS AND OTHER POPS IN THE BALTIC SEA – TRENDS AND CURRENT
- 2009
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Ingår i: 29th International Symposium on Halogenated Persistent Organic Pollutants (Dioxin 2009) in Bejing, China, August 25-30, 2009.
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Konferensbidrag (refereegranskat)abstract
- This paper summarizes a project that was initiated by the Swedish Environmental Protection Agency (EPA) in 2006. It involved several field studies and fate model calculations with the aim to better understand the present contamination situation of dioxins and other persistent organic pollutants (POPs) in the Baltic Sea region. Atmospheric inputs were found to be the dominant external source for all of the selected POPs (dioxins, PCBs and HCB). The model also predicted a significant decline of POP-levels in Baltic surface water if atmospheric concentrations are reduced. This issue is highly prioritized by the Swedish EPA since TEQ-levels of fatty fish exceed maximum residue limits set by the EU. Dioxin source regions were identified by air measurements and analysis of air mass origin. It was found that air that had passed over the European continent contained the highest concentrations, and the congener composition indicated that several major sources types may exist. This research has high relevance for the Swedish EPA, and continued efforts for resolving the dioxin issue of the Baltic Sea will follow.
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| 31. |
- Chi Fru, Ernest, et al.
(författare)
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Atmospheric weathering of Scandinavian alum shales and the fractionation of C, N and S isotopes
- 2016
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Ingår i: Applied Geochemistry. - : Elsevier BV. - 0883-2927 .- 1872-9134. ; 74, s. 94-108
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Tidskriftsartikel (refereegranskat)abstract
- Subaerial exposure and oxidation of organic carbon (C-org)-rich rocks is believed to be a key mechanism for the recycling of buried C and S back to Earth's surface. Importantly, processes coupled to microbial C-org oxidation are expected to shift new biomass delta C-13(org) composition towards more negative values relative to source. However, there is scarcity of information directly relating rock chemistry to oxidative weathering and shifting delta C-13(org) at the rock-atmosphere interface. This is particularly pertinent to the sulfidic, C-org-rich alum shale units of the Baltoscandian Basin believed to constitute a strong source of metal contaminants to the natural environment, following subaerial exposure and weathering. Consistent with independent support, we show that atmospheric oxidation of the sulfidic, C-org-rich alum shale sequence of the Cambrian-Devonian Baltoscandian Basin induces intense acid rock drainage at the expense of progressive oxidation of Fe sulfides. Sulfide oxidation takes priority over microbial organic matter decomposition, enabling quantitative massive erosion of C-org without producing a delta C-13 shift between acid rock drainage precipitates and shale. Moreover, C-13 enrichment in inorganic carbon of precipitates does not support microbial C-org oxidation as the predominant mechanism of rock weathering upon exposure. Instead, a Delta S-34 = delta S-34(shale) - delta S-34(precipitates) approximate to 0, accompanied by elevated S levels and the ubiquitous deposition of acid rock drainage sulfate minerals in deposited efflorescent precipitates relative to shales, provide strong evidence for quantitative mass oxidation of shale sulfide minerals as the source of acidity for chemical weathering. Slight delta N-15 depletion in the new surface precipitates relative to shale, coincides with dramatic loss of N from shales. Collectively, the results point to pyrite oxidation as a major driver of alum black shale weathering at the rock-atmosphere interface, indicating that quantitative mass release of C-org, N, S, and key metals to the environment is a response to intense sulfide oxidation. Consequently, large-scale acidic weathering of the sulfide-rich alum shale units is suggested to influence the fate and redistribution of the isotopes of C, N, and S from shale to the immediate environment.
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| 32. |
- 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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| 33. |
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| 34. |
- 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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| 35. |
- Farahmand, Bahman, et al.
(författare)
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Golf- a game of life and death : Reduced mortality in Swedish golf players
- 2009
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 19:3, s. 419-424
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Tidskriftsartikel (refereegranskat)abstract
- The specific health benefits achieved from different formsand patterns of leisure-time physical activity are not established.We analyzed the mortality in a cohort of Swedishgolf players. We used the Swedish Golf Federation’s membershipregistry and the nationwide Mortality Registry. Wecalculated standardized mortality ratios (SMR) with stratificationfor age, sex, and socioeconomic status. The cohortincluded 300 818 golfers, and the total number of deaths was1053. The overall SMR was 0.60 [95% confidence intervals(CIs): 0.57–0.64]. The mortality reduction was observed inmen and women, in all age groups, and in all socioeconomiccategories. Golfers with the lowest handicap (the mostskilled players) had the lowest mortality; SMR50.53(95% CI: 0.41–0.67) compared with 0.68 (95% CI: 0.61–0.75) for those with the highest handicap. While we cannotconclude with certainty that all the 40% decreased mortalityrates are explained by the physical activity associatedwith playing golf, we conclude that most likely this is part ofthe explanation. To put the observed mortality reduction incontext, it may be noted that a 40% reduction of mortalityrates corresponds to an increase in life expectancy of about5 years.
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| 36. |
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| 37. |
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| 38. |
- Ivarsson, Magnus, 1975-, et al.
(författare)
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Biogenic Mn-oxides in subseafloor basalts
- 2015
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:6
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Tidskriftsartikel (refereegranskat)abstract
- The deep biosphere of the subseafloor basalts is recognized as a major scientific frontier in disciplines like biology, geology, and oceanography. Recently, the presence of fungi in these environments has involved a change of view regarding diversity and ecology. Here, we describe fossilized fungal communities in vugs in subseafloor basalts from a depth of 936.65 metres below seafloor at the Detroit Seamount, Pacific Ocean. These fungal communities are closely associated with botryoidal Mn oxides composed of todorokite. Analyses of the Mn oxides by Electron Paramagnetic Resonance spectroscopy (EPR) indicate a biogenic signature. We suggest, based on mineralogical, morphological and EPR data, a biological origin of the botryoidal Mn oxides. Our results show that fungi are involved in Mn cycling at great depths in the seafloor and we introduce EPR as a means to easily identify biogenic Mn oxides in these environments.
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| 39. |
- Lundh, L-G, et al.
(författare)
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Alexithymia and insomnia
- 2006
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Ingår i: Pers Ind Diff. ; 40, s. 1615-1624
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Tidskriftsartikel (refereegranskat)
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| 40. |
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| 45. |
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| 46. |
- Manuel, A., et al.
(författare)
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Visuelle Wahrnehmung und sprachliche Beurteilung von Holzoberflächen durch Endverbraucher - Relevante Begrifflichkeiten untersucht am Beispiel von Kiefernholz-Dielenböden : [Visual perception and verbal assessment of wood surfaces by consumers - Relevant expressions on floors of pine wood boards as an example]
- 2017
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Ingår i: Allgemeine Forst und Jagdzeitung. - : J.D. Sauerländer’s Verlag. - 0002-5852. ; 188:9-10, s. 186-196
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Tidskriftsartikel (refereegranskat)abstract
- Interior design and flooring from wood are highly appreciated by consumers. Today's wood industries use mostly technical parameters to identify wood quality, whereas knowledge about consumer preferences is rarely taken into account. The exploration of terms consumers use in their day-to-day language characterising wood surfaces (Picture 1) can help to direct and focus the production and marketing of high valuable wood products according to consumers' appreciation and preferences. This study aims at (1) identifying relevant items which consumers use when assessing wood surfaces. (2) Relevant items are examined with regard to the construction of a practically feasible set of different Items and factors. The final number of items and factors should comprise the whole range of diverse aspects of the consumer's visual assessment of wood surfaces. A questionnaire in German language was used (1) to collect relevant terms and criteria in an open question. (2) A Set of 39 pre-set items, which have been found to be meaningful in earlier studies (in English language) was translated into German and offered to consumers (n = 102) to test their relevance in German language. This set of items was analysed in an exploratory factor analysis on the base of 96 answers. Two other questions requested terms (3) that were missing and (4) which were the most relevant. Out of the answers to the questions 1 and 4, objective and subjective Items (Table 1) were categorised. Based on the answers to question 2, the Kaiser-Gutttman criterion suggested a solution based on 12 factors, but further analysis revealed four factors the most appropriate solution (Table 2). Meaning and interpretation of the items and factors from this study need to be set in the context of the people's socio-demographic environment and so results cannot be generalised. The adjustment and validation of the items and factors identified in this study is recommended with regard to different panels of consumer groups and wood products, for which this study suggests adequate methods and tools for questionnaire design and data analysis. This may help to direct production and marketing of valuable wood products more effectively towards consumer's preferences with positive effects for a more efficient use of the raw material and added value.
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| 47. |
- Maskenskaya, Olga M., et al.
(författare)
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Source and character of syntaxial hydrothermal calcite veins in Paleoproterozoic crystalline rocks revealed by fine-scale investigations
- 2014
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Ingår i: Geofluids. - : Wiley. - 1468-8115 .- 1468-8123. ; 14:4, s. 495-511
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Tidskriftsartikel (refereegranskat)abstract
- Calcite veins in Paleoproterozoic granitoids on the Baltic Shield are the focus of this study. These veins are distinguished by their monomineralic character, unusual thickness and closeness to Neoproterozoic dolerite dykes and therefore have drawn attention. The aim of this study was to define the source of these veins and to unravel their isotopic and chemical nature by carrying out fine-scale studies. Seven calcite veins covering a depth interval of 50-420m below the ground surface and composed of breccias or crack-sealed fillings typically expressing syntaxial growth were sampled and analysed for a variety of physicochemical variables: homogenization temperature (T-h) and salinity of fluid inclusions, and stable isotopes (Sr-87/Sr-86, C-13/C-12, O-18/O-16), trace-element concentrations (Fe, Mn, Mg, Sr, rare earth elements) and cathodoluminescence (CL) of the solid phase. The fluid-inclusion data show that the calcites were precipitated mainly from relatively low-temperature (T-h=73-106 degrees C) brines (13.4-24.5wt.% CaCl2), and the Sr-87/Sr-86 is more radiogenic than expected for Rb-poor minerals precipitated from Neoproterozoic fluids. These features, together with the distribution of C-13 and O-18 values, provide evidence that the calcite veins are not genetic with the nearby Neoproterozoic dolerite dykes, but are of Paleozoic age and were precipitated from warm brines expressing a rather large variability in salinity. Whereas the isotopic and chemical variables express rather constant average values among the individual veins, they vary considerably on fine-scale across individual veins. This has implications for understanding processes causing calcite-rich veins to form and capture trace metals in crystalline bedrock settings.
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| 48. |
- Masucci, G, et al.
(författare)
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granulocyte/monocyte-colony Therapeutic efficacy by recombinant humanstimulating factor on mucositis occurring in patients with oral and oropharynx tumors treated with curative radiotherapy - A multicenter open randomized phase III study
- 2005
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Ingår i: Medical Oncology. - : Stockton. - 1357-0560 .- 1559-131X. ; 22:3, s. 247-256
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Tidskriftsartikel (refereegranskat)abstract
- Background. Previous studies suggested granulocyte-macrophage-colony stimulating factor (GM-CSF) might be beneficial for radiotherapy-induced mucositis. This trial examined the efficacy of GM-CSF in reducing mucositis of the oral cavity and/or oropharynx compared with conventional treatment. Methods. Mucositis, documented by a five-grade scale, was defined in patients with tumors of the head-neck. Centers were allowed to use their own preferred fractionation regimen. Randomization to treatment was decided before radiotherapy. Treatment with GM-CSF 4 mu g/kg/d subcutaneous, started when patients displayed a mucositis score greater than= 1.5. Results. Ninety-two patients entered the study according to intention-to-treat principle. Twenty did not reach a mucositis index of 1.5. Sixty-one patients were included in the statistical analysis. Forty-five percent of the patients randomized to receive GM-CSF had a significant reduction of the mucositis more than one grade compared to 9% of the conventional treated. Conclusions. In severe mucositis, GM-CSF is more effective than conventional treatment.
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| 49. |
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| 50. |
- Mouton, LJ, et al.
(författare)
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Lateral cervical nucleus projections to periaqueductal gray matter in cat
- 2004
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Ingår i: Journal of Comparative Neurology. - : Wiley. - 1096-9861 .- 0021-9967. ; 471:4, s. 434-445
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Tidskriftsartikel (refereegranskat)abstract
- The midbrain periaqueductal gray matter (PAG) integrates the basic responses necessary for survival of individuals and species. Examples are defense behaviors such as fight, flight, and freezing, but also sexual behavior, vocalization, and micturition. To control these behaviors the PAG depends on strong input from more rostrally located limbic structures, as well as from afferent input from the lower brainstem and spinal cord. Mouton and Holstege (2000, J Comp Neurol 428:389-410) showed that there exist at least five different groups of spino-PAG neurons, each of which is thought to subserve a specific function. The lateral cervical nucleus (LCN) in the upper cervical cord is not among these five groups. The LCN relays information from hair receptors and noxious information and projects strongly to the contralateral ventroposterior and posterior regions of thalamus and to intermediate and deep tectal layers. The question is whether the LCN also projects to the PAG. The present study in cat, using retrograde and anterograde tracing techniques, showed that neurons located in the lateral two-thirds of the LCN send fibers to the lateral part of the PAG, predominantly at rostrocaudal levels A0.6-P0.2. This part of the PAG is known to be involved in flight behavior. A concept is put forward according to which the LCN-PAG pathway alerts the animal about the presence of cutaneous stimuli that might represent danger, necessitating flight. (C) 2004 Wiley-Liss, Inc.
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