| 1. |
- Hedman, Linnea, et al.
(författare)
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Receiving support to quit smoking and quit attempts among smokers with and without smoking related diseases : Findings from the EUREST-PLUS ITC Europe Surveys
- 2018
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Ingår i: Tobacco Induced Diseases. - Heraklion : European Publishing. - 1617-9625. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases.METHODS This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses.RESULTS Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts.CONCLUSIONS Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit.
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| 2. |
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| 3. |
- Lindberg, Sara, et al.
(författare)
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Expanded HILUS Trial: A Pooled Analysis of Risk Factors for Toxicity From Stereotactic Body Radiation Therapy of Central and Ultracentral Lung Tumors
- 2023
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Ingår i: INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS. - 0360-3016 .- 1879-355X. ; 117:5, s. 1222-1231
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Stereotactic body radiation therapy for tumors near the central airways implies high-grade toxic effects, as concluded from the HILUS trial. However, the small sample size and relatively few events limited the statistical power of the study. We therefore pooled data from the prospective HILUS trial with retrospective data from patients in the Nordic countries treated outside the prospective study to evaluate toxicity and risk factors for high-grade toxic effects. Methods and Materials: All patients were treated with 56 Gy in 8 fractions. Tumors within 2 cm of the trachea, the mainstem bronchi, the intermediate bronchus, or the lobar bronchi were included. The primary endpoint was toxicity, and the secondary endpoints were local control and overall survival. Clinical and dosimetric risk factors were analyzed for treatment-related fatal toxicity in univariable and multivariable Cox regression analyses.Results: Of 230 patients evaluated, grade 5 toxicity developed in 30 patients (13%), of whom 20 patients had fatal bronchopul-monary bleeding. The multivariable analysis revealed tumor compression of the tracheobronchial tree and maximum dose to the mainstem or intermediate bronchus as significant risk factors for grade 5 bleeding and grade 5 toxicity. The 3-year local control and overall survival rates were 84% (95% CI, 80%-90%) and 40% (95% CI, 34%-47%), respectively.Conclusions: Tumor compression of the tracheobronchial tree and high maximum dose to the mainstem or intermediate bronchus increase the risk of fatal toxicity after stereotactic body radiation therapy in 8 fractions for central lung tumors. Simi-lar dose constraints should be applied to the intermediate bronchus as to the mainstem bronchi.
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| 4. |
- Moro, Carlos Fernandez, et al.
(författare)
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An idiosyncratic zonated stroma encapsulates desmoplastic liver metastases and originates from injured liver
- 2023
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Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- A perimetastatic capsule is a strong positive prognostic factor in liver metastases, but its origin remains unclear. Here, we systematically quantify the capsule's extent and cellular composition in 263 patients with colorectal cancer liver metastases to investigate its clinical significance and origin. We show that survival improves proportionally with increasing encapsulation and decreasing tumor-hepatocyte contact. Immunostaining reveals the gradual zonation of the capsule, transitioning from benign-like NGFR(high) stroma at the liver edge to FAP(high) stroma towards the tumor. Encapsulation correlates with decreased tumor viability and preoperative chemotherapy. In mice, chemotherapy and tumor cell ablation induce capsule formation. Our results suggest that encapsulation develops where tumor invasion into the liver plates stalls, representing a reparative process rather than tumor-induced desmoplasia. We propose a model of metastases growth, where the efficient tumor colonization of the liver parenchyma and a reparative liver injury reaction are opposing determinants of metastasis aggressiveness.
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| 5. |
- Thomas, Kevin V, et al.
(författare)
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Comparing illicit drug use in 19 European cities through sewage analysis
- 2012
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Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 432, s. 432-439
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Tidskriftsartikel (refereegranskat)abstract
- The analysis of sewage for urinary biomarkers of illicit drugs is a promising and complementary approach for estimating the use of these substances in the general population. For the first time, this approach was simultaneously applied in 19 European cities, making it possible to directly compare illicit drug loads in Europe over a 1-week period. An inter-laboratory comparison study was performed to evaluate the analytical performance of the participating laboratories. Raw 24-hour composite sewage samples were collected from 19 European cities during a single week in March 2011 and analyzed for the urinary biomarkers of cocaine, amphetamine, ecstasy, methamphetamine and cannabis using in-house optimized and validated analytical methods. The load of each substance used in each city was back-calculated from the measured concentrations. The data show distinct temporal and spatial patterns in drug use across Europe. Cocaine use was higher in Western and Central Europe and lower in Northern and Eastern Europe. The extrapolated total daily use of cocaine in Europe during the study period was equivalent to 356kg/day. High per capita ecstasy loads were observed in Dutch cities, as well as in Antwerp and London. In general, cocaine and ecstasy loads were significantly elevated during the weekend compared to weekdays. Per-capita loads of methamphetamine were highest in Helsinki and Turku, Oslo and Budweis, while the per capita loads of cannabis were similar throughout Europe. This study shows that a standardized analysis for illicit drug urinary biomarkers in sewage can be applied to estimate and compare the use of these substances at local and international scales. This approach has the potential to deliver important information on drug markets (supply indicator).
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| 6. |
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| 7. |
- Andersson-Sköld, Yvonne, et al.
(författare)
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An integrated method for assessing climate-related risks and adaptation alternatives in urban areas
- 2015
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Ingår i: Climate Risk Management. - : Elsevier BV. - 2212-0963. ; 7, s. 31-50
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Tidskriftsartikel (refereegranskat)abstract
- © 2015 The Authors. The urban environment is a complex structure with interlinked social, ecological and technical structures. Global warming is expected to have a broad variety of impacts, which will add to the complexity. Climate changes will force adaptation, to reduce climate-related risks. Adaptation measures can address one aspect at the time, or aim for a holistic approach to avoid maladaptation. This paper presents a systematic, integrated approach for assessing alternatives for reducing the risks of heat waves, flooding and air pollution in urban settings, with the aim of reducing the risk of maladaptation. The study includes strategies covering different spatial scales, and both the current climate situation and the climate predicted under climate change scenarios. The adaptation strategies investigated included increasing vegetation; selecting density, height and colour of buildings; and retreat or resist (defend) against sea-level rise. Their effectiveness was assessed with regard to not only flooding, heat stress and air quality but also with regard to resource use, emissions to air (incl. GHG), soil and water, and people's perceptions and vulnerability. The effectiveness of the strategies were ranked on a common scale (from -3 to 3) in an integrated assessment. Integrated assessments are recommended, as they help identify the most sustainable solutions, but to reduce the risk of maladaptation they require experts from a variety of disciplines. The most generally applicable recommendation, derived from the integrated assessment here, taking into account both expertise from different municipal departments, literature surveys, life cycle assessments and publics perceptions, is to increase the urban greenery, as it contributes to several positive aspects such as heat stress mitigation, air quality improvement, effective storm-water and flood-risk management, and it has several positive social impacts. The most favourable alternative was compact, mid-rise, light coloured building design with large parks/green areas and trees near buildings.
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| 8. |
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| 9. |
- Axell, Emil, et al.
(författare)
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The role of shear forces in primary and secondary nucleation of amyloid fibrils
- 2024
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - 1091-6490. ; 121:25, s. 2322572121-2322572121
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Tidskriftsartikel (refereegranskat)abstract
- Shear forces affect self-assembly processes ranging from crystallization to fiber formation. Here, the effect of mild agitation on amyloid fibril formation was explored for four peptides and investigated in detail for Aβ42, which is associated with Alzheimer's disease. To gain mechanistic insights into the effect of mild agitation, nonseeded and seeded aggregation reactions were set up at various peptide concentrations with and without an inhibitor. First, an effect on fibril fragmentation was excluded by comparing the monomer-concentration dependence of aggregation kinetics under idle and agitated conditions. Second, using a secondary nucleation inhibitor, Brichos, the agitation effect on primary nucleation was decoupled from secondary nucleation. Third, an effect on secondary nucleation was established in the absence of inhibitor. Fourth, an effect on elongation was excluded by comparing the seeding potency of fibrils formed under idle or agitated conditions. We find that both primary and secondary nucleation steps are accelerated by gentle agitation. The increased shear forces facilitate both the detachment of newly formed aggregates from catalytic surfaces and the rate at which molecules are transported in the bulk solution to encounter nucleation sites on the fibril and other surfaces. Ultrastructural evidence obtained with cryogenic transmission electron microscopy and free-flow electrophoresis in microfluidics devices imply that agitation speeds up the detachment of nucleated species from the fibril surface. Our findings shed light on the aggregation mechanism and the role of detachment for efficient secondary nucleation. The results inform on how to modulate the relative importance of different microscopic steps in drug discovery and investigations.
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| 10. |
- Axelsson, Sara, et al.
(författare)
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Outcome of treatment with valacyclovir and prednisone in patients with Bell's Palsy
- 2003
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Ingår i: Annals of Otology, Rhinology & Laryngology. - 0003-4894. ; 112:3, s. 197-201
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Tidskriftsartikel (refereegranskat)abstract
- Idiopathic facial paralysis, or Bell's palsy, shows a nonepidemic pattern that might indicate reactivation of a latent microorganism such as herpes simplex type I as a causative agent. Thirty percent of patients with Bell's palsy given no treatment will not recover completely, and 5% will have severe sequelae. The aim of this study was to find out whether treatment with an antiviral drug in combination with corticosteroids is more effective than no medical treatment at all in patients with Bell's palsy. Fifty-six consecutive adult patients attending the otorhinolaryngology department of the University Hospital of Lund from 1997 to 1999 were treated with 1 g of valacyclovir hydrochloride 3 times per day for 7 days and 50 mg of prednisone daily for 5 days, with the dose being reduced by 10 mg daily for the next 5 days. Fifty-six adult patients with Bell's palsy attending the same department between 1995 and 1996 who were given no medical treatment were studied retrospectively and used as the control group. Forty-nine patients (87.5%) in the treatment group recovered completely, as compared with 38 patients (68%) in the control group (p < .05). One patient (1.8%) in the treatment group displayed severe sequelae, defined as a House-Brackmann score of IV or worse, as compared with 10 of 56 patients (18%) in the control group (p < .01). Among patients over 60 years old, 10 of 10 in the treatment group had complete recovery, as compared with 5 of 12 patients in the control group (p < .01). The present study showed a significantly better outcome in patients with Bell's palsy treated with valacyclovir and prednisone as compared with patients given no medical treatment. This difference in outcome was especially pronounced among elderly patients.
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| 11. |
- Backman, Max, et al.
(författare)
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Infiltration of NK and plasma cells is associated with a distinct immune subset in non‐small cell lung cancer
- 2021
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Ingår i: Journal of Pathology. - : John Wiley & Sons. - 0022-3417 .- 1096-9896. ; 255:3, s. 243-256
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Tidskriftsartikel (refereegranskat)abstract
- Immune cells of the tumor microenvironment are central but erratic targets for immunotherapy. The aim of this study was to characterize novel patterns of immune cell infiltration in non-small cell lung cancer (NSCLC) in relation to its molecular and clinicopathologic characteristics. Lymphocytes (CD3+, CD4+, CD8+, CD20+, FOXP3+, CD45RO+), macrophages (CD163+), plasma cells (CD138+), NK cells (NKp46+), PD1+, and PD-L1+ were annotated on a tissue microarray including 357 NSCLC cases. Somatic mutations were analyzed by targeted sequencing for 82 genes and a tumor mutational load score was estimated. Transcriptomic immune patterns were established in 197 patients based on RNA sequencing data. The immune cell infiltration was variable and showed only poor association with specific mutations. The previously defined immune phenotypic patterns, desert, inflamed, and immune excluded, comprised 30, 13, and 57% of cases, respectively. Notably, mRNA immune activation and high estimated tumor mutational load were unique only for the inflamed pattern. However, in the unsupervised cluster analysis, including all immune cell markers, these conceptual patterns were only weakly reproduced. Instead, four immune classes were identified: (1) high immune cell infiltration, (2) high immune cell infiltration with abundance of CD20+ B cells, (3) low immune cell infiltration, and (4) a phenotype with an imprint of plasma cells and NK cells. This latter class was linked to better survival despite exhibiting low expression of immune response-related genes (e.g. CXCL9, GZMB, INFG, CTLA4). This compartment-specific immune cell analysis in the context of the molecular and clinical background of NSCLC reveals two previously unrecognized immune classes. A refined immune classification, including traits of the humoral and innate immune response, is important to define the immunogenic potency of NSCLC in the era of immunotherapy. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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| 12. |
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| 13. |
- Bergstrand, Sara, et al.
(författare)
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Blood flow measurements at different depths using photoplethysmography and laser Doppler techniques
- 2009
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Ingår i: Skin research and technology. - : Wiley-Blackwell. - 0909-752X .- 1600-0846. ; 15:2, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Background/purpose: This study has evaluated a multi-parametric system combining laser Doppler flowmetry and photoplethysmography in a single probe for the simultaneous measurement of blood flow at different depths in the tissue. This system will be used to facilitate the understanding of pressure ulcer formation and in the evaluation of pressure ulcer mattresses.Methods: The blood flow in the tissue over the sacrum was measured before, during and after loading with 37.5 mmHg, respectively, 50.0 mmHg. The evaluation of the system consisted of one clinical part, and the other part focusing on the technicalities of the probe prototype.Results: An increase in blood flow while loading was the most common response, but when the blood flow decreased during loading it was most affected at the skin surface and the blood flow responses may be different due to depths of measurement. Reactive hyperaemia may occur more frequently in the superficial layers of the tissue.Conclusion: The study showed that the new system is satisfactory for measuring tissue blood flow at different depths. The laser Doppler complements the photoplethysmography, and further development of the system into a thin flexible probe with the ability to measure a larger area is required.
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| 14. |
- Bergstrand, Sara, et al.
(författare)
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Existence of Tissue Blood Flow in Response to External Pressure in the Sacral Region of Elderly Individuals - Using an Optical Probe Prototype
- 2010
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Ingår i: MICROCIRCULATION. - : Taylor and Francis. - 1073-9688 .- 1549-8719. ; 17:4, s. 311-319
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Tidskriftsartikel (refereegranskat)abstract
- Pandgt;Objective: The aim was to investigate the existence of sacral tissue blood flow at different depths in response to external pressure and compression in elderly individuals using a newly developed optical probe prototype. Methods: The tissue blood flow and tissue thickness in the sacral area were measured during load in 17 individuals using laser Doppler flowmetry and photoplethysmography in a combined probe, and digital ultrasound. Results: The mean age was 68.6 +/- 7.0 years. While loading, the mean compression was 60.3 +/- 11.9%. The number of participants with existing blood flow while loading increased with increased measurement depth. None had enclosed blood flow deep in the tissue and at the same time an existing more superficial blood flow. Correlation between tissue thickness and BMI in unloaded and loaded sacral tissue was shown: r = 0.68 (P = 0.003) and r = 0.68 (P = 0.003). Conclusions: Sacral tissue is highly compressed by external load. There seems to be a difference in responses to load in the different tissue layers, as occluded blood flow in deeper tissue layers do not occur unless the blood flow in the superficial tissue layers is occluded.
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| 15. |
- Bergstrand, Sara, et al.
(författare)
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Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
- 2014
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Ingår i: Microcirculation. - : John Wiley & Sons. - 1073-9688 .- 1549-8719. ; 21:8, s. 761-771
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To characterize pressure-induced vasodilatation and reactive hyperemia at different sacral tissue depths in different populations under clinically relevant pressure exposure.METHODS: Forty-two subjects (< 65 years), 38 subjects (≥ 65 years), and 35 patients (≥ 65 years) participated. Interface pressure, skin temperature, and blood flow at tissue depths of 1 mm, 2 mm, and 10 mm (using laser Doppler flowmetry and photoplethysmography) were measured in the sacral tissue before, during, and after load in a supine position.RESULTS: pressure-induced vasodilatation and reactive hyperemia were observed at three tissue depths. At 10 mm depth, the proportion of subjects with a lack of pressure-induced vasodilatation was higher compared to superficial depths. The patients had higher interface pressure during load than the healthy individuals, but there were no significant differences in blood flow. Twenty-nine subjects in all three study groups were identified with a lack of pressure-induced vasodilatation and reactive hyperemia.CONCLUSIONS: pressure-induced vasodilatation and reactive hyperemia can be measured at different tissue depths. A lack of these responses was found in healthy individuals as well as in patients indicating an innate susceptibility in some individuals, and are potential important factors to evaluate in order to better understand the etiology of pressure ulcers.
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| 16. |
- Bergstrand, Sara, 1978-
(författare)
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Preventing pressure ulcers by assessment of the microcirculation in tissue exposed to pressure
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to combine optical methods into a system with the ability to simultaneously measure blood flow changes at different tissue depths. The goal of such a system was to reveal vascular mechanisms relevant to pressure ulcer etiology under clinically relevant conditions and in relation to the evaluation of pressure-redistribution support surfaces.This thesis consists of four quantitative, cross-sectional studies measuring blood flow responses before, during, and after pressure exposure of the sacral tissue. Two optical methods – photoplethysmography and laser Doppler flowmetry – were combined in a newly developed system that has the ability to discriminate blood flows at different tissue depths. Studies I and II explored blood flow responses at different depths in 17 individuals. In Study I the blood flow was related to tissue thickness and tissue compression during pressure exposure of ≥ 220 mmHg. In Study II, the sacral tissue was loaded with 37.5 mmHg and 50.0 mmHg, and the variation in blood flow was measured. Studies III and IV included 42 healthy individuals < 65 years, 38 healthy individuals ≥ 65 years, and 35 patients ≥ 65 years. Study III included between-subject comparisons of blood flow and pressure between individuals in the three study groups lying in supine positions on a standard hospital mattress. Study IV added within-subject comparisons while the individual was lying on four different types of mattress. The studies explored the vascular phenomena pressure-induced vasodilation (PIV) and reactive hyperemia (RH).The most common blood flow response to tissue exposure in this thesis was PIV, although a decrease in blood flow (a lack of PIV) was observed in some individuals. The patients tended to have higher interface pressure during pressure exposure than the healthy groups but no differences in blood flow responses were seen. Our results showed that pressure levels that are normally considered to be harmless could have a significant effect on the microcirculation in different tissue structures. Differences in individual blood flow responses in terms of PIV and RH were seen, and a larger proportion of individuals lacked these responses in the deeper tissue structures compared to more superficial tissue structures.This thesis identified PIV and RH that are important vascular mechanisms for pressure ulcer development and revealed for the first time that PIV and RH are present at different depths under clinically relevant conditions. The thesis also identified a population of individuals not previously identified who lack both PIV and RH and seem to be particularly vulnerable to pressure exposure. Further, this thesis has added a new perspective to the microcirculation in pressure ulcer etiology in terms of blood flow regulation and endothelial function that are anchored in clinically relevant studies. Finally, the evaluation of pressureredistribution support surfaces in terms of mean blood flow during and after tissue exposure was shown to be unfeasible, but the assessment of PIV and RH could provide a new possibility for measuring individual physiological responses that are known to be related to pressure ulcer development.
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| 17. |
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| 18. |
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| 19. |
- Bergström, Pål, et al.
(författare)
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Firms' financial policy and labour demand : theory and evidence
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- We investigate the influence of financial leverage on firms' hiring decisions in the context of a hierarchy of finance model. The analysis is based on the Euler equation of employment in the presence of convex adjustment costs. We show the empirical implications of firms facing a hierarchy of financial costs, and estimate a linearised version of the model on a large panel of Swedish manufacturing firms. Bootstrap methods are utilised to alleviate some of the estimation problems involved. The empirical findings indicate that the influence of financial leverage on firms' hiring decisions differs significantly between firms in different financial regimes.
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| 20. |
- Bergström, Pål, et al.
(författare)
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Firms' financial policy and labour demand : theory and evidence
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- We investigate the influence of financial leverage on firms' hiring decisions in the context of a hierarchy of finance model. The analysis is based on the Euler equation of employment in the presence of convex adjustment costs. We show the empirical impli
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| 21. |
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| 22. |
- Bäck, Marcus, et al.
(författare)
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Design, synthesis and SAR of potent statine-based BACE-1 inhibitors : Exploration of P1 phenoxy and benzyloxy residues
- 2008
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Ingår i: Bioorganic & Medicinal Chemistry. - : Elsevier BV. - 0968-0896 .- 1464-3391. ; 16:21, s. 9471-9486
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Tidskriftsartikel (refereegranskat)abstract
- Several BACE-1 inhibitors with low nanomolar level activities, encompassing a statine-based core structure with phenyloxymethyl- and benzyloxymethyl residues in the P1 position, are presented. The novel P1 modi. cation introduced to allow the facile exploration of the S1 binding pocket of BACE-1, delivered highly promising inhibitors.
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| 23. |
- Claeson, Anna-Sara, 1974-, et al.
(författare)
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Feasibility and reliability of measures of bioactive lipids in human plasma and nasal mucosa
- 2022
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Ingår i: Journal of chromatography. B. - : Elsevier. - 1570-0232 .- 1873-376X. ; 1206
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Tidskriftsartikel (refereegranskat)abstract
- Analysis of bioactive lipids is increasingly useful in clinical studies, and there is a need for non-invasive and easy-to-use sampling methods that meet the demands of reliability. Samples that can be taken by a non-professional and that can be taken repeatedly so as to provide more detailed information about the inflammatory process are often desired. In this study, the feasibility of non-invasive sampling of nasal mucosa and saliva for the analysis of bioactive lipid mediators (e.g. oxylipins and endocannabinoids) was evaluated in a pilot study (n = 10). In a second study, the reliability (relative and absolute) of sampling of these lipid mediators derived from nasal mucosa and from plasma was assessed by calculation of the intraclass correlation coefficient and Bland–Altman’s limit of agreement. Samples were taken at the same time of day on two occasions from a cohort of individuals with and without building-related intolerance (n = 37). Nasal mucosa proved to be a suitable matrix for the analysis of bioactive lipids and was therefore included in the study on reliability together with the plasma samples. Relative reliability varied among the identified oxylipins and endocannabinoids. Arachidonic acid derivatives showed generally better reliability. Absolute reliability measures also varied indicating that only a subset of the oxylipins and endocannabinoids were suitable as biomarkers in either nasal mucosa or plasma and should therefore be used with caution for that purpose.
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| 24. |
- Creignou, Maria, et al.
(författare)
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Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS-M) prediction in myelodysplastic syndromes
- 2024
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Ingår i: Journal of Internal Medicine. - : WILEY. - 0954-6820 .- 1365-2796.
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Tidskriftsartikel (refereegranskat)abstract
- Background The Molecular International Prognostic Scoring System (IPSS-M) is the new gold standard for diagnostic outcome prediction in patients with myelodysplastic syndromes (MDS). This study was designed to assess the additive prognostic impact of dynamic transfusion parameters during early follow-up. Methods We retrieved complete transfusion data from 677 adult Swedish MDS patients included in the IPSS-M cohort. Time-dependent erythrocyte transfusion dependency (E-TD) was added to IPSS-M features and analyzed regarding overall survival and leukemic transformation (acute myeloid leukemia). A multistate Markov model was applied to assess the prognostic value of early changes in transfusion patterns. Results Specific clinical and genetic features were predicted for diagnostic and time-dependent transfusion patterns. Importantly, transfusion state both at diagnosis and within the first year strongly predicts outcomes in both lower (LR) and higher-risk (HR) MDSs. In multivariable analysis, 8-month landmark E-TD predicted shorter survival independently of IPSS-M (p < 0.001). A predictive model based on IPSS-M and 8-month landmark E-TD performed significantly better than a model including only IPSS-M. Similar trends were observed in an independent validation cohort (n = 218). Early transfusion patterns impacted both future transfusion requirements and outcomes in a multistate Markov model. Conclusion The transfusion requirement is a robust and available clinical parameter incorporating the effects of first-line management. In MDS, it provides dynamic risk information independently of diagnostic IPSS-M and, in particular, clinical guidance to LR MDS patients eligible for potentially curative therapeutic intervention.
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| 25. |
- Didriksson, Ingrid, et al.
(författare)
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Intensive care unit burden is associated with increased mortality in critically ill COVID-19 patients
- 2023
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 67:3, s. 329-338
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Traditional models to predict intensive care outcomes do not perform well in COVID-19. We undertook a comprehensive study of factors affecting mortality and functional outcome after severe COVID-19.METHODS: In this prospective multicentre cohort study, we enrolled laboratory-confirmed, critically ill COVID-19 patients at six ICUs in the Skåne Region, Sweden, between May 11, 2020, and May 10, 2021. Demographics and clinical data were collected. ICU burden was defined as the total number of ICU-treated COVID-19 patients in the region on admission. Surviving patients had a follow-up at 90 days for assessment of functional outcome using the Glasgow Outcome Scale-Extended (GOSE), an ordinal scale (1-8) with GOSE ≥5 representing a favourable outcome. The primary outcome was 90-day mortality; the secondary outcome was functional outcome at 90 days.RESULTS: Among 498 included patients, 74% were male with a median age of 66 years and a median body mass index (BMI) of 30 kg/m 2 . Invasive mechanical ventilation was employed in 72%. Mortality in the ICU, in-hospital and at 90 days was 30%, 38% and 39%, respectively. Mortality increased markedly at age 60 and older. Increasing ICU burden was independently associated with a two-fold increase in mortality. Higher BMI was not associated with increased mortality. Besides age and ICU burden, smoking status, cortisone use, P a CO 2 >7 kPa, and inflammatory markers on admission were independent factors of 90-day mortality. Lower GOSE at 90 days was associated with a longer stay in the ICU. CONCLUSION: In critically ill COVID-19 patients, the 90-day mortality was 39% and increased considerably at age 60 or older. The ICU burden was associated with mortality, whereas a high BMI was not. A longer stay in the ICU was associated with unfavourable functional outcomes at 90 days.
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| 26. |
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Digitalization and Digital Competence in Educational Contexts : A Nordic Perspective from Policy to Practice
- 2024
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Samlingsverk (redaktörskap) (refereegranskat)abstract
- This edited collection presents a Nordic perspective on intensified discussions concerning digitalization and digital competence in the current trends of educational work. Using a multidisciplinary and holistic approach, the book compares Nordic countries' attitudes towards the digitalization of education and demonstrates the Nordic region's position as digital front-runners in a European and global context. The book provides up-to-date cases and future-oriented perspectives on digitalization and digital competence in educational work. Chapters use empirical data gained from policy documents, interviews, and questionnaires to present nuanced discussions, theoretical perspectives, and implications for the future of digitalization in education. Ultimately, this book's reach far exceeds that of its Nordic contexts and will be of use to postgraduate students, researchers, and scholars across the globe involved with digital education, teacher education, and educational policy and politics more broadly . . .
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| 27. |
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| 28. |
- Elfversson, Emma, 1983-, et al.
(författare)
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Urban peacekeeping under siege : attacks on African Union peacekeepers in Mogadishu, 2007–2009
- 2019
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Ingår i: Third World Thematics. - : Informa UK Limited. - 2380-2014 .- 2379-9978. ; 4:2-3, s. 158-178
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Tidskriftsartikel (refereegranskat)abstract
- Peacekeepers in cities face particular challenges because cities are densely populated and heterogeneous, encompass multiple terrains and fluid features, and host key assets of political, economic and strategic importance. Attacks targeting peacekeepers in cities constitute a recurrent problem, but how do they affect a peace operation’s activities? We theorise the effects of such violence on three outcomes: patrolling and outreach, use of force, and the establishment of new bases. We explore these dynamics by analysing intra-city dynamics of violence and operational activity following attacks on African Union (AU) peacekeepers in Mogadishu, Somalia, from initial deployment in 2007 through 2009. We use the geo-referenced UCDP Peacemakers at Risk (PAR) dataset and extend it by coding specific city sub-locations for incidences of violence, allowing us to analyse the spatiality of violence involving peacekeepers in Mogadishu. The evidence suggests that during its first three years, attacks on AMISOM significantly hampered its ability to spread out in the city and operate effectively, but did not evidently alter wider patterns of violence in the city. Despite these challenges, AMISOM managed to fulfil the core element of its mandate: preventing the overthrow of the Somali Transitional Federal Government.
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| 29. |
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| 30. |
- Engert, Andreas, et al.
(författare)
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The European Hematology Association Roadmap for European Hematology Research : a consensus document
- 2016
-
Ingår i: Haematologica. - Pavia, Italy : Ferrata Storti Foundation (Haematologica). - 0390-6078 .- 1592-8721. ; 101:2, s. 115-208
-
Tidskriftsartikel (refereegranskat)abstract
- The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at (sic)23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology of blood disorders, and has improved diagnostics and treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap. The EHA Roadmap identifies nine 'sections' in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders. The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients.
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| 31. |
- Eriksson, Olaspers Sara, et al.
(författare)
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Identification of Cell-Penetrating Peptides That Are Bactericidal to Neisseria meningitidis and Prevent Inflammatory Responses upon Infection
- 2013
-
Ingår i: Antimicrobial Agents and Chemotherapy. - 0066-4804 .- 1098-6596. ; 57:8, s. 3704-3712
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Tidskriftsartikel (refereegranskat)abstract
- Meningococcal disease is characterized by a fast progression and a high mortality rate. Cell-penetrating peptides (CPPs), developed as vectors for cargo delivery into eukaryotic cells, share structural features with antimicrobial peptides. A screen identified two CPPs, transportan-10 (TP10) and model amphipathic peptide (MAP), with bactericidal action against Neisseria meningitidis. Both peptides were active in human whole blood at micromolar concentrations, while hemolysis remained negligible. Additionally, TP10 exhibited significant antibacterial activity in vivo. Uptake of SYTOX green into live meningococci was observed within minutes after TP10 treatment, suggesting that TP10 may act by membrane permeabilization. Apart from its bactericidal activity, TP10 suppressed inflammatory cytokine release from macrophages infected with N. meningitidis as well as from macrophages stimulated with enterobacterial and meningococcal lipopolysaccharide (LPS). Finally, incubation with TP10 reduced the binding of LPS to macrophages. This novel endotoxin-inhibiting property of TP10, together with its antimicrobial activity in vivo, indicates the possibility to design peptide-based therapies for infectious diseases.
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| 32. |
- Fallahi, Sara, 1985-, et al.
(författare)
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Recruitment Equality & Diversity Opportunities : Slutrapport för forskningsprojektet ’Rekrytering till sjöfarten – måste sjömän vara män?’
- 2021
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- När #metoo-rörelsen svepte över världen startade kvinnor i sjöfarten i Sverige ett eget upprop som lyfte ett stort antal frågor rörande den sociala arbetsmiljön ombord, detta blev under 2018 startskottet för initiativet Vågrätt.Vågrätt är ett samarbete mellan branschföreningar/arbetsgivarorganisationer, fackföreningar, akademi, myndigheter, studentföreningar och ideella organisationer inom den svenska sjöfartssektorn med målet att skapa en sjöfartssektor med arbetsmiljö i världsklass, med en nollvision om trakasserier och diskriminering för alla som arbetar inom sjöfartssektorn i Sverige.Med grund i detta startades forskningsprojektet REDO (Recruitment Equality & Diversity Opportunities) i januari 2020 som ett samarbetsprojekt mellan RISE Research Institutes of Sweden och Sjöfartsverket med en vision att förbättra den sociala arbetsmiljön ur ett jämställdhetsperspektiv.Syftet med REDO är att skapa en trygg och inkluderande sjöfartsindustri där fler kvinnor ska vilja söka jobb till sjöss, samt känna sig motiverade och inspirerade att stanna kvar. Detta är ett förhållningssätt som behöver omfatta alla, från högsta ledningen till varje medarbetare.I detta projekt har vi använt Design Thinking som den övergripande, användarcentrerade problemformuleringen och lösningsmetoden. För att identifiera drivkrafter och hinder för ökad mångfald och rekrytering av fler kvinnor inom sjöfarten har vi genomfört undersökningar, intervjuer och workshops med kvinnor som arbetar eller har arbetat i sjöfartsbranschen i olika roller. En benchmarkstudie av andra mansdominerade branscher och deras mångfaldsstrategier genom marknadsföring och kommunikation, mentorskap och nätverksinitiativ, samt förändring av befintliga normer och arbetskulturer, har gett inspiration till hur sjöfartsnäringen kan hantera jämlikhet och mångfald för att förbättra den sociala arbetsmiljön ombord.Denna rapport avser att sammanfatta de resultat och insikter som genererats genom detta projekt och att ge rekommendationer för hur sjöfartsnäringen kan fortsätta att främja mångfald genom att erbjuda en social arbetsmiljö som är byggd på tre hörnstenar av trygghet, inkludering och motivation. Mer detaljerad dokumentation av resultat från olika genomförda studier kompletterar denna rapport som fyra bilagor.
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| 33. |
- Fjelde, Hanne, et al.
(författare)
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Offsetting Losses : Bargaining Power and Rebel Attacks on Peacekeepers
- 2016
-
Ingår i: International Studies Quarterly. - : Oxford University Press (OUP). - 0020-8833 .- 1468-2478. ; 60:4, s. 611-623
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years, international third parties have increasingly sought to manage the dire consequences of civil war, often by deploying peacekeeping operations. However, peacekeepers sometimes face deliberate attacks by armed groups. These attacks hamper efforts to provide humanitarian relief and security. This raises a critical question: what factors lead rebel groups to target peacekeepers? We argue that internal conflict dynamics are important for explaining this phenomenon. Rebels attack peacekeepers as an alternative strategy to undermine incumbent regimes. They adopt this strategy as the balance of power turns against them in their struggle against governments. We evaluate our argument using a novel event data set on violent attacks on peacekeepers in sub-Saharan Africa from 1989 to 2009. We find a positive relationship between rebel losses and violent attacks on peacekeepers. These findings hold when controlling for mission-specific characteristics, time-invariant unobserved heterogeneity, and across different model specifications.
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| 34. |
- Hagblad, Jimmie, et al.
(författare)
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A technique based on laser Doppler flowmetry and photoplethysmography for simultaneously monitoring blood flow at different tissue depths
- 2010
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Ingår i: Medical and Biological Engineering and Computing. - : Springer Science Business Media. - 0140-0118 .- 1741-0444. ; 48:5, s. 415-422
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to validate a non-invasive optical probe for simultaneous blood flow measurement at different vascular depths combining three photoplethysmography (PPG) channels and laser Doppler flowmeter (LDF). Wavelengths of the PPG were near-infrared 810 nm with source-to-detector separation of 10 and 25 mm, and green 560 nm with source-to-detector separation of 4 mm. The probe is intended for clinical studies of pressure ulcer aetiology. The probe was placed over the trapezius muscle, and depths from the skin to the trapezius muscle were measured using ultrasound and varied between 3.8 and 23 mm in the 11 subjects included. A provocation procedure inducing a local enhancement of blood flow in the trapezius muscle was used. Blood flows at rest and post-exercise were compared. It can be concluded that this probe is useful as a tool for discriminating between blood flows at different vascular tissue depths. The vascular depths reached for the different channels in this study were at least 23 mm for the near-infrared PPG channel (source-to-detector separation 25 mm), 10-15 mm for the near-infrared PPG channel (separation 10 mm), and shallower than 4 mm for both the green PPG channel (separation 4 mm) and LDF.
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Huo, Langning, et al.
(författare)
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Analyzing the environmental risk factors of European spruce bark beetle damage at the local scale
- 2024
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Ingår i: European Journal of Forest Research. - 1612-4669 .- 1612-4677. ; 143, s. 985–1000-
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Tidskriftsartikel (refereegranskat)abstract
- The frequent outbreaks of European spruce bark beetle Ips typographus (L.) have destroyed huge amounts of Norway spruce Picea abies (L.) forests in central and Northern Europe. Identifying the risk factors and estimating the damage level is important for strategic damage control. The risk factors of forest damage by spruce bark beetles have mostly been analyzed on the landscape scale, while the in-stand risk factors have been less investigated. This study aims at exploring the local-scale risk factors in a flat area with spruce-dominated forest in southern Sweden. The investigated factors include four abiotic factors, i.e., soil wetness, solar radiation, slope gradient, and aspect, and three biotic factors, i.e., the number of deciduous trees and trees that died from attacks in previous years that remained (TreesLeft) and removed (TreesRemoved) from the forest stand. We put up 24 pheromone bags in six stands attacked by bark beetle in the previous years, resulting in different numbers of infested trees in each plot. We explored in which microenvironment a pheromone bag resulted in more colonization, the impact radius of each factor, and the necessary factors for a risk model. The environmental factors were obtained from remote sensing-based products and images. A generalized linear model (GLM) was used with the environmental factors as the explanatory variables and the damage levels as the response variables, i.e., the number of attacked trees for the plot scale, and healthy/infested for the single-tree scale. Using 50 m and 15 m radius of the environmental factors resulted in the best fit for the model at plot and individual tree scales, respectively. At those radii, the damage risk increased both at plot and individual tree level when spruce were surrounded by more deciduous trees, surrounded by dead trees that had been removed from the forest, and spruces located at the north and east slopes (315 degrees-135 degrees of aspect, > 2 degrees slope). Soil wetness, solar radiation, and remaining standing dead trees in the surrounding did not significantly impact the damage level in the microenvironment of the study area. The GLM risk model yielded an overall accuracy of 0.69 in predicting individual trees being infested or healthy. Our efforts to investigate the risk factors provide a context for wall-to-wall mapping in-stand infestation risks, using remote sensing-based data.
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| 39. |
- Ingvarsson, Sara, et al.
(författare)
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Strategies for de-implementation of low-value care—a scoping review
- 2022
-
Ingår i: Implementation Science. - : BioMed Central Ltd. - 1748-5908. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The use of low-value care (LVC) is a persistent problem that calls for knowledge about strategies for de-implementation. However, studies are dispersed across many clinical fields, and there is no overview of strategies that can be used to support the de-implementation of LVC. The extent to which strategies used for implementation are also used in de-implementing LVC is unknown. The aim of this scoping review is to (1) identify strategies for the de-implementation of LVC described in the scientific literature and (2) compare de-implementation strategies to implementation strategies as specified in the Expert Recommendation for Implementing Change (ERIC) and strategies added by Perry et al. Method: A scoping review was conducted according to recommendations outlined by Arksey and O’Malley. Four scientific databases were searched, relevant articles were snowball searched, and the journal Implementation Science was searched manually for peer-reviewed journal articles in English. Articles were included if they were empirical studies of strategies designed to reduce the use of LVC. Two reviewers conducted all abstract and full-text reviews, and conflicting decisions were discussed until consensus was reached. Data were charted using a piloted data-charting form. The strategies were first coded inductively and then mapped onto the ERIC compilation of implementation strategies. Results: The scoping review identified a total of 71 unique de-implementation strategies described in the literature. Of these, 62 strategies could be mapped onto ERIC strategies, and four strategies onto one added category. Half (50%) of the 73 ERIC implementation strategies were used for de-implementation purposes. Five identified de-implementation strategies could not be mapped onto any of the existing strategies in ERIC. Conclusions: Similar strategies are used for de-implementation and implementation. However, only a half of the implementation strategies included in the ERIC compilation were represented in the de-implementation studies, which may imply that some strategies are being underused or that they are not applicable for de-implementation purposes. The strategies assess and redesign workflow (a strategy previously suggested to be added to ERIC), accountability tool, and communication tool (unique new strategies for de-implementation) could complement the existing ERIC compilation when used for de-implementation purposes.
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| 40. |
- Jalakas, Mattis, et al.
(författare)
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A quick test of cognitive speed can predict development of dementia in Parkinson’s disease
- 2019
-
Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9:1
-
Tidskriftsartikel (refereegranskat)abstract
- Parkinson’s disease (PD) patients frequently develop cognitive impairment. There is a need for brief clinical assessments identifying PD patients at high risk of progressing to dementia. In this study, we look into predicting dementia in PD and underlying structural and functional correlates to cognitive decline in PD. We included 175 patients with PD, 30 with PD dementia, 51 neurologically healthy controls and 121 patients with Alzheimer’s disease (AD) from Skane University Hospital, BIOFINDER cohorts. All underwent cognitive tests, including MMSE, 10-word list delayed recall (ADAS-cog), A Quick Test of cognitive speed (AQT), Letter S fluency, Clock Drawing Test (CDT) and pentagon copying. In non-demented patients with PD, abnormal AQT and CDT results predicted an increased risk of subsequent development of dementia (hazard ratio 2.2 for both). When comparing the cognitive profile between PD and AD, decreased performance on AQT, which measures attention and processing speed, was more typical in PD. Lastly, we investigated the underlying structural and functional correlates for the PD-specific test AQT with magnetic resonance imaging. In PD patients, decreased performance on AQT was associated with i) cortical thinning in temporoparietal regions, ii) changes in diffusion MRI, especially in the cingulum tract, and iii) decreased functional connectivity in posterior brain networks.
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| 41. |
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| 42. |
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| 43. |
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| 44. |
- Jensen, Sara, et al.
(författare)
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Vilken effekt skulle sänkt temperatur i kylkedjan kunna få på matsvinnet?
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- arje år uppkommer ungefär en miljon ton matavfall i den svenska livsmedelskedjan. En del av detta är matsvinn, d.v.s. matavfall som hade kunnat undvikas, mat som slängs men som hade kunnat ätas om den hanterats annorlunda.Målet med detta projekt är att utreda hur matsvinnet i butiks- och konsumentledet skulle påverkas av en sänkt temperatur i kylkedjan. Projektet delas upp i tre delar, en beräkningsmodell, en litteratursammanställning och en intervjustudie. Beräkningsmodellen visar att hackad grönsallad i påse som lagras vid 4 °C har en hållbarhetstid på 12–13 dagar. Höjer man förvaringstemperaturen till 6 °C förkortas hållbarheten till 8–9 dagar, och vid konstant lagring vid 8 °C skulle hållbarhetstiden förkortas ytterligare till 6–7 dagar. Beräkningarna visar också att en ”normal” hemtransport på en dryg timma vid ca 12 °C (genomsnittliga värden) inte har någon påvisbar effekt på hållbarhetstiden. Litteraturstudien sammanställer information om lagar, matsvinn i butiker och hushåll samt kylförvaring i butiker och hushåll. Enligt gällande lagstiftning är livsmedelsproducenten skyldig att märka sin produkt med bäst-föredatum eller sista förbrukningsdag och en förvaringstemperatur. Produktens temperatur får aldrig, genom hela kylkedjan, överstiga den som angivits i anslutning till hållbarhetsmärkningen. Kylkedjan bryts dock ofta under transporten från butiken hem till konsumentens kylskåp. En studie om hur konsumenter förvarar mat i sitt kylskåp visar att i nästan hälften av fallen förvaras matvarorna i en temperatur som överstiger den på förpackningen märkta temperaturen. Undersökningen visar också att många konsumenter inte vet vilken temperatur de har i sina kylskåp, att temperaturen skiljer sig mellan olika hyllor eller hur de bör förvara olika matvaror på bästa sätt i kylskåpet. Andra studier visar att mycket av det onödiga matsvinnet från hushållen utgörs av mat som inte hunnits ätas upp i tid. Studier visar att temperaturmätning framför allt i öppna kylar i butik kan vara svårt och att det därför är lätt att varorna faktiskt håller annan temperatur än vad temperaturövervakningssystemet visar. Att sänka temperaturen i en kyldisk med ojämn temperatur skulle alltså i värsta fall kunna leda till högre andel svinn än förut pga. frostskadade varor. Det är därför av största vikt att den kylutrustning som används är av bra kvalitet och att butikerna är medvetna om riskerna.Intervjustudien baseras enbart på producenternas och butikschefernas svar, inga mätningar eller kontrollbesök har gjorts. En sänkt temperatur i livsmedelskedjan skulle enligt producenterna med största sannolikhet innebära förlängda hållbarhetstider för många kylda livsmedel. En stor del av den förlängda hållbarhetstiden skulle troligtvis komma livsmedelsbutikerna till godo och på så vis tror livsmedelsproducenterna att butikssvinnet skulle minska. Butikscheferna tror också att längre hållbarhetstid i kombination med ändrad datummärkning på varorna skulle minska butikernas svinn av packad sallad, packad chark, köttfärs och mjölk. Dessa fyra produkter är de som ingick i denna studie, svinnminskningen borde rimligen gälla fler produkter. Det är dock relevant att påpeka att alla produkter inte har en datummärkning men ändå stor andel svinn, t ex frukt och grönt. Nästan alla butikschefer säger att de nog skulle kunna sänka temperaturerna med sin befintliga kylutrustning, men de säger samtidigt att risken för frysskador på varorna skulle öka och att deras energianvändning skulle bli större.En sänkt temperatur i kylkedjan skulle kunna göra det möjligt för livsmedelsproducenterna att förlänga hållbarhetsdatumet på sina produkter. Längre hållbarhetstid i kombination med ändrad datummärkning på produkterna skulle kunna minska butikernas svinn av varor med datummärkning. Det skulle även kunna minska svinnet hos de konsumenter som inte äter mat vars datummärkning har passerats.
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| 45. |
- Jestin Hannan, Christine, et al.
(författare)
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Differences in multidisciplinary cancer conferences of esophageal and gastroesophageal junctional cancer regarding staging, resectability and treatment allocation – a multicenter study
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: There are differences in esophageal cancer care across different regions in Sweden. According to Swedish national guidelines, all patients diagnosed with these tumors should be individually evaluated by regional multidisciplinary cancer conferences (MCCs) to be recommended best possible treatment. The aim of the study was to investigate differences between the regional MCCs in Sweden regarding clinical staging and recommended treatment.Method: Representatives for all six regional MCCs were invited to contribute with ten retrospective consecutive cases each. After anonymization radiological investigations were presented, along with the original case-specific medical history, anew at all participating regional MCCs. Each MCCs’ clinical Tumor Nodal Metastasis classification (cTNM) and treatment recommendation (curative, palliative or best supportive care) were compared between MCCs as well as with the original assessment. Results: Five regional MCCs joined the study. Out of 50 available cases the majority were assessed anew in addition to the previous original assessment. There was not consensus among the regional MCCs regarding cT-stage in 42 cases (84%), cN-stage in 33 cases (66%), and for cM-stage in 16 cases (32%). Differences in appraisal were not associated with PET-CT availability. The MCCs agreed on treatment recommendations in 26/50 cases (52%). Discussion: The study shows differences, both in assessment of cTNM as well as treatment recommendations at different MCCs. A patient recommended curative treatment by one MCC could be suggested palliative care by another. To achieve more equal care for esophageal cancer patients in Sweden it is essential to increase consensus on cTNM and recommended treatment.
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| 46. |
- Jestin Hannan, Christine, et al.
(författare)
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Differences in multidisciplinary team assessment on esophageal cancer patients in Sweden : a multicentre study
- 2022
-
Ingår i: Diseases of the esophagus. - : Oxford University Press. - 1120-8694 .- 1442-2050. ; 35:Suppl. 2
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Tidskriftsartikel (refereegranskat)abstract
- There are differences in esophageal cancer care across different counties in Sweden. According to national guidelines, all patients should be offered equal care which should be administrated by regional multidisciplinary cancer conferences (MCCs). The aim of the study was to investigate differences between the six regional MCCs in Sweden regarding clinical stageing and recommended treatment.Ten consecutive cases per participating center, 60 cases in total, were planned for inclusion. After anonymization the radiological investigations were presented, along with the original case-specific medical history, anew at the six regional MCCs. Estimation of clinical TNM and treatment allocation (curative, palliative or best supportive care) were compared between MCCs as well as with the original assessment. Interim analysis was performed in April 2022 when ten cases had been presented at five of the six regional MCCs.All available cases were assessed at five MCCs in addition to the previous original assessment (60 assessments). The mean age for the first ten cases was 74.8 years (SD ± 9.8 years). Eight out of ten cases were men. In estimations of T- and N-stage the MCCs agreed in only one out of ten cases. In half of the cases more than three different estimations of N-stage were made. For clinical M-stage there was exact agreement in three cases. In determination of recommended treatment, all five MCCs were in agreement on half of the cases.Preliminary data show striking differences, both in assessment of TNM as well as treatment recommendation at different MCCs. One patient, recommended curative treatment by one MCC could be allocated to palliative care by another. Inclusion is ongoing and further analysis of these differences are warranted to achieve more equal care for esophageal cancer patients in Sweden.
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| 47. |
- Jiang, Yiwen, et al.
(författare)
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Glioblastoma Cell Malignancy and Drug Sensitivity Are Affected by the Cell of Origin
- 2017
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Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 18:4, s. 977-990
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Tidskriftsartikel (refereegranskat)abstract
- The identity of the glioblastoma (GBM) cell of origin and its contributions to disease progression and treatment response remain largely unknown. We have analyzed how the phenotypic state of the initially transformed cell affects mouse GBM development and essential GBM cell (GC) properties. We find that GBM induced in neural stem-cell-like glial fibrillary acidic protein (GFAP)-expressing cells in the subventricular zone of adult mice shows accelerated tumor development and produces more malignant GCs (mGC1GFAP) that are less resistant to cancer drugs, compared with those originating from more differentiated nestin- (mGC2NES) or 2,'3'-cyclic nucleotide 3'-phosphodiesterase (mGC3CNP)-expressing cells. Transcriptome analysis of mouse GCs identified a 196 mouse cell origin (MCO) gene signature that was used to partition 61 patient-derived GC lines. Human GC lines that clustered with the mGC1GFAP cells were also significantly more self-renewing, tumorigenic, and sensitive to cancer drugs compared with those that clustered with mouse GCs of more differentiated origin.
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| 48. |
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| 49. |
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| 50. |
- Kahanamoku, Sara, et al.
(författare)
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Twelve thousand recent patellogastropods from a northeastern Pacific latitudinal gradient
- 2018
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Ingår i: Scientific Data. - : Springer Science and Business Media LLC. - 2052-4463. ; 5, s. 170197-
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Tidskriftsartikel (refereegranskat)abstract
- Marine microfossils record the environmental, ecological, and evolutionary dynamics of past oceans in temporally expanded sedimentary archives. Rapid imaging approaches provide a means of exploiting the primary advantage of this archive, the vast number of fossils, for evolution and ecology. Here we provide the first large scale image and 2D and 3D shape dataset of modern planktonic foraminifera, a major microfossil group, from 34 Atlantic Ocean sediment samples. Information on more than 124,000 objects is provided, including general object classification for 4/5ths of the dataset (~ 99,000 objects). Of the ~ 99,000 classifications provided, more than 61,000 are complete or damaged planktonic foraminifera. Objects also include benthic foraminifera, ostracods, pteropods, spicules, and planktonic foraminifera test fragments, among others. This dataset is the first major microfossil output of a new high-throughput imaging method (AutoMorph) developed to extract 2D and 3D data from photographic images of fossils. Our sample preparation and imaging techniques are described in detail. The data provided here comprises the most extensive publically available archive of planktonic foraminiferal morphology and morphological variation to date.
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