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| 3. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 4. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 5. |
- Glasbey, JC, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Chavatza, K, et al.
(författare)
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EULAR RECOMMENDATION-BASED QUALITY INDICATORS (QIS) FOR SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): ELABORATION, FINAL SET, PERFORMANCE AND INITIAL VALIDATION
- 2021
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 80, s. 635-636
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Targets of therapy and quality of care are receiving increased attention in systemic lupus erythematosus (SLE).Objectives:To develop Quality Indicators (QIs) for the care of SLE patients based on the EULAR recommendations, and assess their performance.Methods:Using the published EULAR recommendations for SLE, we developed 44 candidate QIs. These were independently rated for validity and feasibility by 12 experts, analysed by a modified RAND/UCLA model and further scrutinized based on the scorings and expert opinion. (Fig.1) Adherence to the final set of QIs was tested in a cohort of 220 SLE patients combined with an assessment on its impact on disease outcomes such as flares, hospitalizations and organ damage.Results:The panel rated 18 QIs as valid and feasible. These involve diagnosis; disease and damage assessment; monitoring for lupus nephritis and drug toxicity; therapy and targets of therapy; fertility and pregnancy; and adjunct therapy (preventive measures for osteoporosis, vaccination, cardiovascular disease). On average, SLE patients received 54% (95%CI 52–56%) of the indicated care with adherence ranging from 41% for QIs related to monitoring to 88% for treatment-related QIs. Regarding targets of therapy, sustained remission or low disease activity were achieved in 27%, while 94% of patients received low-dose glucocorticoids, and 92% the recommended hydroxychloroquine dose. Dependent upon individual QI tested, adherence for lupus nephritis-related QIs was 88% for receiving appropriate adjunct therapy (ACE inhibitors) to 100% for being treated with the indicated immunosuppressive treatment. In contrast, adherence to QIs related to preventive measures and other adjunct therapies was moderate to low. Notably, patients who were eligible for cardiovascular risk modification, vaccination, and osteoporosis management received lower quality of care (40.5%, 47.7% and 45.5% respectively) while 91.4% had sunscreen protection. In reference to laboratory work-up and monitoring, complete laboratory work-up at diagnosis was performed in 48%, while disease activity and damage, were fully assessed only in 14.1% (in three consecutive visits) and 28.6% (annually) respectively, Similarly, reproductive health and pregnancy counselling adherence rates were modest estimated at 50% and 62% respectively. Higher adherence to the indicated care during follow-up (monitoring QIs) was associated with reduced risk for adverse outcomes during the last year of observation (OR 0.97, 95%CI 0.96-0.99). Patients who achieved sustained remission or LLDAS, exhibited fewer flares (OR=0.15, p-value<0.001) and damage accrual (OR=0.35, p-value<0.001). Of interest, patients who received low-dose of GCs or were appropriately vaccinated, had a lower risk of experiencing a flare (OR=0.23 and 0.46 respectively).Conclusion:A set of 18 QIs based on the EULAR recommendations for SLE was developed to be used towards improving care in SLE. Initial real-life data suggest variable degree of adherence with higher adherence resulting in reduced adverse outcomes.References:[1]Fanouriakis, et al., 2019 Update of the EULAR recommendations for the management of systemic lupus erythematosus. In Annals of the Rheumatic Diseases (Vol. 78, Issue 6, pp. 736–745). BMJ Publishing Group. https://doi.org/10.1136/annrheumdis-2019-215089.[2]Nikolopoulos, D., et al., Evolving phenotype of systemic lupus erythematosus in Caucasians: low incidence of lupus nephritis, high burden of neuropsychiatric disease and increased rates of late-onset lupus in the ‘Attikon’ cohort. Lupus, 29(5), 514–522. https://doi.org/10.1177/0961203320908932.Acknowledgements:This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 742390)Disclosure of Interests:None declared
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| 11. |
- Cheng, J. C., et al.
(författare)
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Adolescent idiopathic scoliosis
- 2015
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Ingår i: Nature Reviews Disease Primers. - : Springer Science and Business Media LLC. - 2056-676X. ; 1
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent idiopathic scoliosis (AIS) is the most common form of structural spinal deformities that have a radiological lateral Cobb angle - a measure of spinal curvature - of >= 10 degrees. AIS affects between 1% and 4% of adolescents in the early stages of puberty and is more common in young women than in young men. The condition occurs in otherwise healthy individuals and currently has no recognizable cause. In the past few decades, considerable progress has been made towards understanding the clinical patterns and the three-dimensional pathoanatomy of AIS. Advances in biomechanics and technology and their clinical application, supported by limited evidence-based research, have led to improvements in the safety and outcomes of surgical and non-surgical treatments. However, the definite aetiology and aetiopathogenetic mechanisms that underlie AIS are still unclear. Thus, at present, both the prevention of AIS and the treatment of its direct underlying cause are not possible.
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- Vázquez-Córdova, S. A., et al.
(författare)
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Spectroscopy of erbium-doped potassium double tungstate waveguides
- 2017
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Ingår i: Integrated Optics. - : SPIE - International Society for Optical Engineering. - 9781510606531
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Konferensbidrag (refereegranskat)abstract
- We report the spectroscopy of crystalline waveguide amplifiers operating in the telecom C-band. Thin films of erbiumdoped gadolinium lutetium potassium double tungstate, KGdxLuyEr1-x-y (WO4)2, are grown by liquid-phase epitaxy onto undoped potassium yttrium double tungstate (KYW) substrates and micro-structured by Ar+-beam etching. Channel waveguides with erbium concentrations between 0.45-6.35 × 1020 cm-3 are characterized. The transition cross-sections of interest are estimated. The effect of energy-transfer up-conversion (ETU) is experimentally investigated. Microscopic and macroscopic ETU parameters are extracted from a simultaneous analysis of 20 decay curves of luminescence on the transition 4I13/2 → 4I15/2. The correlation between ETU and the doping concentration is studied. Pump excited-state absorption (ESA) on the transition 4I11/2 → 4F7/2 is investigated via a direct ESA measurement using a double-modulation pump-probe technique. The effect of ESA is studied for different pump wavelengths. The pump wavelength of 984.5 nm is found to be favorable for the complete range of erbium concentrations.
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| 22. |
- Björk, Malin
(författare)
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Synthesis of sulfur and selenium heterocycles, including derivatives of imidazopyridine and benzimidazole
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The chemistry developed in this thesis can be divided into two parts. The first part, which is the major part of the thesis, contains syntheses towards analogues to mutagenic heterocyclic amines found in e.g. meat fried at high temperatures. The second part concentrates on the palladium-(0)catalyzed cross-coupling reactions of 4- and 5-substituted 2,1,3-benzoselenadiazoles. The heterocyclic amines described can be divided into the linear and the angular compounds. Five linear imidazo[4,5-b]pyridines were synthesised via the Friedländer reaction: 2-amino-1 - methylbenzothieno[2,3-e]imidazo[4,5-b]pyridine, 2-amino-1-methy-benzothieno [3,2-e] imidazo[4,5-b] pyridine, 2-amino-1-methylthieno[2,3-elimidazo[4,5-b]-pyridine, 2-amino-1methylthieno[3,2-e]imidazo[4,5-b]pyridine and the sulfur analogue to the cooked-food mutagen IFP, 2-amino- 1,6-dimethylthieno[2,3-e]imidazo[4,5-b]pyridine. Attempts were made to form three thienoimidazo[4,5-b]pyridines via stepwise condensation. The first condensation between creatinine and 2-nitro-3-thiophene-carbaldehyde, 3-amino-2thiophenecarbaldehyde and 4-azido3-thiophenecarbaldehyde yielded thenylidenomethyleneimidazolinones, but only one of these gave the ring closed compound 2-amino-1-methylthieno[2,3-e]imidazo[4,5-b]pyridine by a second condensation. In addition, 2-amino- 1 methyl benzoth ieno[3,2-e] imidazo[4,5 -b] pyridine was transformed into the 2-nitro- and 2-hydroxy derivative. The last linear isomer 2-amino-1methylimidazo[4,5-b]benzothiophene, was synthesized by a different route. The series of angular compounds are considered analogues to the food-mutagen IQx. A series of six homologues of 7-amino-imidazo[4,5-e]-2,1,3-benzoselenadiazoles. Four ring systems were obtained by treating 4-methylamino-3-nitro-phenylenedianmine with a range of biselectrophiles, namely: 2-amino-1-methylbenzo-thiadiazole, -triazole, -diazepinone and 2amino1-methylimidazobenzimidazole. Among the palladium-(0)-catalyzed cros s- couplings, the Suzuki, Stille, Fleck and Sonogashira reactions were used. These were applied to 4-, or 5-bromo-2,1,3-benzoselenadiazoles. In addition, the 4- and 5-trimethyltin-2,1,3-benzoselenadiazole were synthesized.
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| 23. |
- Powles, T, et al.
(författare)
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Plain language summary of results from the JAVELIN Bladder 100 study: avelumab maintenance treatment for advanced urothelial cancer
- 2022
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Ingår i: Future oncology (London, England). - : Future Medicine Ltd. - 1744-8301 .- 1479-6694. ; 18:19, s. 2361-2371
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Tidskriftsartikel (refereegranskat)abstract
- This is a plain language summary of an article originally published in The New England Journal of Medicine. It is about initial results (collected in October 2019) from the JAVELIN Bladder 100 study (a clinical trial), which looked at avelumab maintenance treatment in people with advanced urothelial cancer. Urothelial cancer is the most common type of bladder cancer. People with advanced urothelial cancer often receive chemotherapy. If this is the first treatment people with advanced disease are given, it is called first-line treatment. If the cancer stops growing or shrinks with first-line chemotherapy, people can be given different treatment to try to prevent the cancer from growing again. This is called maintenance treatment. It may help people live longer. What happened in the JAVELIN Bladder 100 study? In the JAVELIN Bladder 100 study, researchers wanted to find out if maintenance treatment with avelumab would help people with advanced urothelial cancer live longer. Avelumab is a type of medicine called immunotherapy. Immunotherapy helps the body's immune system fight cancer. 700 people took part in the study. To take part, they must have already been treated with first-line chemotherapy. Also, their cancer must have shrunk or not grown with this treatment. They were then treated with either avelumab maintenance treatment plus best supportive care or best supportive care alone. Best supportive care means treatments that help improve symptoms and quality of life. These treatments do not affect the cancer directly and can include medicines to relieve pain. What were the results? Researchers found that people treated with avelumab maintenance treatment plus best supportive care lived, on average, 7 months longer than people who received best supportive care alone. People treated with avelumab had more side effects than those not treated with avelumab, but most were not severe. Common side effects with avelumab included persistent tiredness, itchy skin, urinary tract infection, and diarrhea. What do the results of the study mean? Results from the JAVELIN Bladder 100 study support the use of avelumab as maintenance treatment for people with advanced urothelial cancer whose cancer has shrunk or not grown with first-line chemotherapy. ClinicalTrials.gov NCT number: NCT02603432
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| 26. |
- Vazquez-Cordova, Sergio A., et al.
(författare)
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High gain in erbium-doped channel waveguides
- 2017
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Ingår i: 2017 CONFERENCE ON LASERS AND ELECTRO-OPTICS EUROPE & EUROPEAN QUANTUM ELECTRONICS CONFERENCE (CLEO/EUROPE-EQEC). - : IEEE.
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Konferensbidrag (refereegranskat)abstract
- Summary form only given. Integration of multiple functions on an optical micro-chip is going to revolutionize the exploitation of optics for various applications such as communication, optical sensing, and biomedicine. One of the enabling functions is amplification at 1.5 μm [1]. Rare-earth-doped amplifiers typically deliver a net gain per unit length of only a few dB/cm [2]. In spiral-shaped channel waveguides a total internal net gain of 20 dB was demonstrated [3].The rare-earth-doped potassium double tungstates KY(WO 4 ) 2 , KGd(WO 4 ) 2 , and KLu(WO 4 ) 2 are widely investigated laser materials [4]. They are especially suited for optical amplification due to the high transition cross-sections of rare-earth ions in these materials. Moreover, the large inter-ionic distance between neighboring rare-earth sites may allow for higher erbium concentrations without the detrimental effect of energy-transfer upconversion (ETU). Recently an internal net gain of ~1000 dB/cm was demonstrated in ytterbium-doped channel waveguides [2]. Here we report optical gain at 1.53 μm in KGd x Lu y Er 1-x-y (WO 4 ) 2 channel waveguides doped with five different Er 3+ concentrations. When pumping the Er 3+ ions at 980 nm, a record-high internal net gain of 13 dB/cm is experimentally demonstrated, despite the fact that the intrinsic propagation losses in these surface waveguides were as high as 4 dB/cm. Using buried channel waveguides, which typically exhibit intrinsic propagation losses of only 0.2 dB/cm, and optimizing the erbium concentration and waveguide length, for a reasonable 500 mW of launched pump power a high total gain of ~40 dB can be achieved.
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| 27. |
- Vazquez-Cordova, Sergio A., et al.
(författare)
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High optical gain in erbium-doped potassium double tungstate channel waveguide amplifiers
- 2018
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Ingår i: Optics Express. - : Optical Society of America. - 1094-4087. ; 26:5, s. 6260-6266
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Tidskriftsartikel (refereegranskat)abstract
- We report on the optical-gain properties of channel waveguides patterned into lattice-matched KGdxLuyEr1-x-y(WO4)(2) layers grown onto undoped KY(WO4)(2) substrates by liquid phase epitaxy. A systematic investigation of gain is performed for five different Er3+ concentrations in the range of 0.75 to 10at.% and different pump powers and signal wavelengths. In pump-probe-beam experiments, relative internal gain, i.e., signal enhancement minus absorption loss of light propagating in the channel waveguide, is experimentally demonstrated, with a maximum value of 12 +/- 5 dB/cm for signals at the peak-emission wavelength of 1534.7 nm.
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| 28. |
- Wit, Esther M K, et al.
(författare)
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Sentinel Node Procedure in Prostate Cancer : A Systematic Review to Assess Diagnostic Accuracy
- 2017
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838. ; 71:4, s. 596-605
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Forskningsöversikt (refereegranskat)abstract
- Context: Extended pelvic lymph node dissection (ePLND) is the gold standard for detecting lymph node (LN) metastases in prostate cancer (PCa). The benefit of sentinel node biopsy (SNB), which is the first draining LN as assessed by imaging of locally injected tracers, remains controversial. Objective: To assess the diagnostic accuracy of SNB in PCa. Evidence acquisition: A systematic literature search of Medline, Embase, and the Cochrane Library (1999-2016) was undertaken using PRISMA guidelines. All studies of SNB in men with PCa using PLND as reference standard were included. The primary outcomes were the nondiagnostic rate (NDR), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false positive (FP) and false negative (FN) rates. Relevant sensitivity analyses based on SN definitions, ePLND as reference standard, and disease risk were undertaken, including a risk of bias (RoB) assessment. Evidence synthesis: Of 373 articles identified, 21 studies recruiting a total of 2509 patients were eligible for inclusion. Median cumulative percentage (interquartile range) results were 4.1% (1.5-10.7%) for NDR, 95.2% (81.8-100%) for sensitivity, 100% (95.0-100%) for specificity, 100% (87.0-100%) for PPV, 98.0% (94.3-100%) for NPV, 0% (0-5.0%) for the FP rate, and 4.8% (0-18.2%) for the FN rate. The findings did not change significantly on sensitivity analyses. Most studies (17/22) had low RoB for index test and reference standard domains. Conclusions: SNB appears to have diagnostic accuracy comparable to ePLND, with high sensitivity, specificity, PPV and NPV, and a low FN rate. With a low FP rate (rate of detecting positive nodes outside the ePLND template), SNB may not have any additional diagnostic value over and above ePLND, although SNB appears to increase nodal yield by increasing the number of affected nodes when combined with ePLND. Thus, in high-risk disease it may be prudent to combine ePLND with SNB. Patient summary: This literature review showed a high diagnostic accuracy for sentinel node biopsy in detecting positive lymph nodes in prostate cancer, but further studies are needed to explore the effect of sentinel node biopsy on complications and oncologic outcome. The accuracy of sentinel node biopsy (SNB) in detecting positive lymph nodes in prostate cancer appears to have diagnostic accuracy comparable to that of extended pelvic lymph node dissection (ePLND). However, SNB may not have any additional diagnostic value over and above ePLND.
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