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| 2. |
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| 3. |
- van Griensven, Martijn, et al.
(författare)
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PROTECTIVE EFFECTS OF THE COMPLEMENT INHIBITOR COMPSTATIN CP40 IN HEMORRHAGIC SHOCK
- 2019
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Ingår i: Shock. - Alphen aan den Rijn : LIPPINCOTT WILLIAMS & WILKINS. - 1073-2322 .- 1540-0514. ; 51:1, s. 78-87
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Tidskriftsartikel (refereegranskat)abstract
- Trauma-induced hemorrhagic shock (HS) plays a decisive role in the development of immune, coagulation, and organ dysfunction often resulting in a poor clinical outcome. Imbalanced complement activation is intricately associated with the molecular danger response and organ damage after HS. Thus, inhibition of the central complement component C3 as turnstile of both inflammation and coagulation is hypothesized as a rational strategy to improve the clinical course afterHS. Applying intensive care conditions, anaesthetized, monitored, and protectively ventilated nonhuman primates (NHP; cynomolgusmonkeys) received a pressure-controlled severe HS (60min at mean arterial pressure 30 mmHg) with subsequent volume resuscitation. Thirty minutes after HS, animals were randomly treated with either an analog of the C3 inhibitor compstatin (i.e., Cp40) in saline (n =4) or with saline alone (n =4). The observation period lasted 300 min after induction of HS. We observed improved kidney function in compstatin Cp40-treated animals after HS as determined by improved urine output, reduced damage markers and a tendency of less histopathological signs of acute kidney injury. Sham-treated animals revealed classical signs ofmucosal edema, especially in the ileum and colon reflected by worsened microscopic intestinal injury scores. In contrast, Cp40-treated HS animals exhibited only minor signs of organ edema and significantly less intestinal damage. Furthermore, early systemic inflammation and coagulation dysfunction were both ameliorated by Cp40. The data suggest that therapeutic inhibition of C3 is capable to significantly improve immune, coagulation, and organ function and to preserve organ-barrier integrity early after traumatic HS. C3-targeted complement inhibition may therefore reflect a promising therapeutic strategy in fighting fatal consequences of HS.
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| 4. |
- Ajithkumar, Thankamma, et al.
(författare)
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SIOPE - Brain tumor group consensus guideline on craniospinal target volume delineation for high-precision radiotherapy
- 2018
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Ingår i: Radiotherapy and Oncology. - : ELSEVIER IRELAND LTD. - 0167-8140 .- 1879-0887. ; 128:2, s. 192-197
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To develop a consensus guideline for craniospinal target volume (TV) delineation in children and young adults participating in SIOPE studies in the era of high-precision radiotherapy. Methods and materials: During four consensus meetings (Cambridge, Essen, Liverpool, and Marseille), conventional field-based TV has been translated into image-guided high-precision craniospinal TV by a group of expert paediatric radiation oncologists and enhanced by MRI images of liquor distribution. Results: The CTVcranial should include the whole brain, cribriform plate, most inferior part of the temporal lobes, and the pituitary fossa. If the full length of both optic nerves is not included, the dose received by different volumes of optic nerve should be recorded to correlate with future patterns of relapse (no consensus). The CTVcranial should be modified to include the dural cuffs of cranial nerves as they pass through the skull base foramina. Attempts to spare the cochlea by excluding CSF within the internal auditory canal should be avoided. The CTVspinal should include the entire subarachnoid space, including nerve roots laterally. The lower limit of the spinal CTV is at the lower limit of the thecal sac, best visible on MRI scan. There is no need to include sacral root canals in the spinal CTV. Conclusion: This consensus guideline has the potential to improve consistency of craniospinal TV delineation in an era of high-precision radiotherapy. This proposal will be incorporated in the RTQA guidelines of future SIOPE-BTG trials using CSI.
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| 5. |
- Alcorn, Sara, et al.
(författare)
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Practice Patterns of Stereotactic Radiotherapy in Pediatrics : Results From an International Pediatric Research Consortium
- 2018
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Ingår i: Journal of pediatric hematology/oncology (Print). - : Lippincott Williams & Wilkins. - 1077-4114 .- 1536-3678. ; 40:7, s. 522-526
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Tidskriftsartikel (refereegranskat)abstract
- Purpose/Objectives: There is little consensus regarding the application of stereotactic radiotherapy (SRT) in pediatrics. We evaluated patterns of pediatric SRT practice through an international research consortium. Materials and Methods: Eight international institutions with pediatric expertise completed a 124-item survey evaluating patterns of SRT use for patients 21 years old and younger. Frequencies of SRT use and median margins applied with and without SRT were evaluated. Results: Across institutions, 75% reported utilizing SRT in pediatrics. SRT was used in 22% of brain, 18% of spine, 16% of other bone, 16% of head and neck, and <1% of abdomen/pelvis, lung, and liver cases across sites. Of the hypofractionated SRT cases, 42% were delivered with definitive intent. Median gross tumor volume to planning target volume margins for SRT versus non-SRT plans were 0.2 versus 1.4 cm for brain, 0.3 versus 1.5 cm for spine/other bone, 0.3 versus 2.0 cm for abdomen/pelvis, 0.7 versus 1.5 cm for head and neck, 0.5 versus 1.7 cm for lung, and 0.5 versus 2.0 cm for liver sites. Conclusions: SRT is commonly utilized in pediatrics across a range of treatment sites. Margins used for SRT were substantially smaller than for non-SRT planning, highlighting the utility of this approach in reducing treatment volumes.
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| 6. |
- Alcorn, Sara R., et al.
(författare)
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Low-Dose Image-Guided Pediatric CNS Radiation Therapy : Final Analysis From a Prospective Low-Dose Cone-Beam CT Protocol From a Multinational Pediatrics Consortium
- 2020
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Ingår i: Technology in Cancer Research & Treatment. - : SAGE PUBLICATIONS INC. - 1533-0346 .- 1533-0338. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lower-dose cone-beam computed tomography protocols for image-guided radiotherapy may permit target localization while minimizing radiation exposure. We prospectively evaluated a lower-dose cone-beam protocol for central nervous system image-guided radiotherapy across a multinational pediatrics consortium.Methods: Seven institutions prospectively employed a lower-dose cone-beam computed tomography central nervous system protocol (weighted average dose 0.7 mGy) for patients <= 21 years. Treatment table shifts between setup with surface lasers versus cone-beam computed tomography were used to approximate setup accuracy, and vector magnitudes for these shifts were calculated. Setup group mean, interpatient, interinstitution, and random error were estimated, and clinical factors were compared by mixed linear modeling.Results: Among 96 patients, with 2179 pretreatment cone-beam computed tomography acquisitions, median age was 9 years (1-20). Setup parameters were 3.13, 3.02, 1.64, and 1.48 mm for vector magnitude group mean, interpatient, interinstitution, and random error, respectively. On multivariable analysis, there were no significant differences in mean vector magnitude by age, gender, performance status, target location, extent of resection, chemotherapy, or steroid or anesthesia use. Providers rated >99% of images as adequate or better for target localization.Conclusions: A lower-dose cone-beam computed tomography protocol demonstrated table shift vector magnitude that approximate clinical target volume/planning target volume expansions used in central nervous system radiotherapy. There were no significant clinical predictors of setup accuracy identified, supporting use of this lower-dose cone-beam computed tomography protocol across a diverse pediatric population with brain tumors.
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| 7. |
- Alcorn, Sara R, et al.
(författare)
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Practice patterns of photon and proton pediatric image guided radiation treatment : results from an International Pediatric Research consortium
- 2014
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Ingår i: Practical radiation oncology. - : Elsevier BV. - 1879-8500. ; 4:5, s. 336-341
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Image guided radiation therapy (IGRT) has become common practice for both photon and proton radiation therapy, but there is little consensus regarding its application in the pediatric population. We evaluated clinical patterns of pediatric IGRT practice through an international pediatrics consortium comprised of institutions using either photon or proton radiation therapy.METHODS AND MATERIALS: Seven international institutions with dedicated pediatric expertise completed a 53-item survey evaluating patterns of IGRT use in definitive radiation therapy for patients ≤21 years old. Two institutions use proton therapy for children and all others use IG photon therapy. Descriptive statistics including frequencies of IGRT use and means and standard deviations for planning target volume (PTV) margins by institution and treatment site were calculated.RESULTS: Approximately 750 pediatric patients were treated annually across the 7 institutions. IGRT was used in tumors of the central nervous system (98%), abdomen or pelvis (73%), head and neck (100%), lung (83%), and liver (69%). Photon institutions used kV cone beam computed tomography and kV- and MV-based planar imaging for IGRT, and all proton institutions used kV-based planar imaging; 57% of photon institutions used a specialized pediatric protocol for IGRT that delivers lower dose than standard adult protocols. Immobilization techniques varied by treatment site and institution. IGRT was utilized daily in 45% and weekly in 35% of cases. The PTV margin with use of IGRT ranged from 2 cm to 1 cm across treatment sites and institution.CONCLUSIONS: Use of IGRT in children was prevalent at all consortium institutions. There was treatment site-specific variability in IGRT use and technique across institutions, although practices varied less at proton facilities. Despite use of IGRT, there was no consensus of optimum PTV margin by treatment site. Given the desire to restrict any additional radiation exposure in children to instances where the exposure is associated with measureable benefit, prospective studies are warranted to optimize IGRT protocols by modality and treatment site.
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| 8. |
- Allard, Christina, et al.
(författare)
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Rasbiologiskt språkbruk i statens rättsprocess mot sameby
- 2015
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Ingår i: Dagens Nyheter. - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.
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| 9. |
- Baumann, Pia, et al.
(författare)
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Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy.
- 2009
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Ingår i: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 1527-7755 .- 0732-183X. ; 27:20, s. 3290-6
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The impact of stereotactic body radiotherapy (SBRT) on 3-year progression-free survival of medically inoperable patients with stage I non-small-cell lung cancer (NSCLC) was analyzed in a prospective phase II study. PATIENTS AND METHODS: Fifty-seven patients with T1NOMO (70%) and T2N0M0 (30%) were included between August 2003 and September 2005 at seven different centers in Sweden, Norway, and Denmark and observed up to 36 months. SBRT was delivered with 15 Gy times three at the 67% isodose of the planning target volume. RESULTS: Progression-free survival at 3 years was 52%. Overall- and cancer-specific survival at 1, 2, and 3 years was 86%, 65%, 60%, and 93%, 88%, 88%, respectively. There was no statistically significant difference in survival between patients with T1 or T2 tumors. At a median follow-up of 35 months (range, 4 to 47 months), 27 patients (47%) were deceased, seven as a result of lung cancer and 20 as a result of concurrent disease. Kaplan-Meier estimated local control at 3 years was 92%. Local relapse was observed in four patients (7%). Regional relapse was observed in three patients (5%). Nine patients (16%) developed distant metastases. The estimated risk of all failure (local, regional, or distant metastases) was increased in patients with T2 (41%) compared with those with T1 (18%) tumors (P = .027). CONCLUSION: With a 3-year local tumor control rate higher than 90% with limited toxicity, SBRT emerges as state-of-the-art treatment for medically inoperable stage I NSCLC and may even challenge surgery in operable instances.
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| 10. |
- Correia de Verdier, Maria, et al.
(författare)
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Magnetic resonance imaging detected radiation-induced changes in patients with proton radiation-treated arteriovenous malformations
- 2021
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Ingår i: Acta Radiologica Open. - : Sage Publications. - 2058-4601. ; 10:10
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTreatment of intracranial arteriovenous malformations (AVMs) includes surgery, radiation therapy, endovascular occlusion, or a combination. Proton radiation therapy enables very focused radiation, minimizing dose to the surrounding brain.PurposeTo evaluate the presence of radiation-induced changes on post-treatment MRI in patients with AVMs treated with proton radiation and to compare these with development of symptoms and nidus obliteration.Material and MethodsRetrospective review of pre- and post-treatment digital subtraction angiography and MRI and medical records in 30 patients with AVMs treated with proton radiation. Patients were treated with two or five fractions; total radiation dose was 20–35 physical Gy. Vasogenic edema (minimal, perinidal, or severe), contrast enhancement (minimal or annular), cavitation and nidus obliteration (total, partial, or none) were assessed.Results26 of 30 patients (87%) developed MRI changes. Vasogenic edema was seen in 25 of 30 (83%), abnormal contrast enhancement in 18 of 26 (69%) and cavitation in 5 of 30 (17%). Time from treatment to appearance of MRI changes varied between 5 and 25 months (median 7, mean 10). Seven patients developed new or deteriorating symptoms that required treatment with corticosteroids; all these patients had extensive MRI changes (severe vasogenic edema and annular contrast enhancement). Not all patients with extensive MRI changes developed symptoms. We found no relation between MRI changes and nidus obliteration.ConclusionRadiation-induced MRI changes are seen in a majority of patients after proton radiation treatment of AVMs. Extensive MRI changes are associated with new or deteriorating symptoms.
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| 11. |
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| 12. |
- Holmberg, Kristina, et al.
(författare)
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Cyborger och rhizom i förskolans musikverksamhet. Posthumanistiska begrepp i rörelse
- 2014
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Ingår i: Pedagogisk forskning i Sverige. - Malmö : Föreningen SWERA, Swedish Educational Research Association. - 1401-6788 .- 2001-3345. ; 19:2-3, s. 193-212
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Tidskriftsartikel (refereegranskat)abstract
- Arbetet med en pågående studie kring förskolans musikverksamhet, där surfplattans närvaro i de pedagogiska aktiviteterna är vital, har väckt vår nyfikenhet kring teorier som förmår fånga in tekniken och det materiella i den vetenskapliga förståelseramen. I linje med detta vittnar teorier om det moderna och posthumanistiska samhället om en post-antropocentrism där tron på människans överordning har övergivits. Detta skapar sammantaget behov av nya tankesystem som kan ledsagas av ett immanent och icke-hierarkiskt perspektiv. Avsikten med föreliggande artikel är också att bli ett bidrag i detta avseende. Syftet är att pröva posthumanistisk teori på specifika pedagogiska situationer i förskolans musikverksamhet och att utveckla metodologiska verktyg som kan hantera ett utvidgat subjekt, där även det materiella kan tilldelas aktörsskap. På så sätt är förhoppningen att etablerade vetenskapliga undersökningsmetoder och tillvägagångssätt kan radikaliseras. Videoobserverade aktiviteter i förskolan bearbetas utifrån ett posthumanistiskt perspektiv där de centrala begreppen Rhizom, Intensitet, Liv, Hopp, Flyktlije sätts i rörelse i förhållande till empirin. Resultaten skrivs fram i form av tre specifika och empirigenererade ingångar i rhizomet: Ingång-Låten, Ingång-Mästaren och Ingång-Ipadmannen.
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| 13. |
- Holmberg, Kristina, et al.
(författare)
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Music in preschool : ”A real f***ing hit song”
- 2013
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Ingår i: NZDC. - Auckland : Institute of Culture, Discourse & Communication, AUT University. ; , s. 35-35
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Konferensbidrag (refereegranskat)abstract
- During the last decades neoliberal ideas have increased its influence in society at large, as well as in education and preschool. Children’s freedom of doing and becoming what they want, and that everything is possible, become central issues in this perspective. However, this freedom could be a treacherous chimera as individual choice also is constrained by economic logics and the power of the market. The aim of this ongoing project is to study how children’s everyday music culture is related to activities in preschool and to discuss this in the light of neoliberal ideas and theories of modernity. Data consists of group conversations with preschool teachers and video observations of music activities during spring 2013. The theoretical framework is built on social constructionist and poststructuralist theory with discursive psychology and discourse theory as methodological approach.The result shows that the yearly TV-broadcasted song-contest in Sweden makes a great over all influence on children and adults. Our empirical result also indicates that preschool children are imitating the contest by staging their own song contest shows, while the preschool teachers are positioned as a passive audience by themselves and by the children. During group conversations the 1970th politicized education, with a clear upbringing goal according to preschool music, is discussed. Pedagogues explain that such governing would not be accepted in today’s preschool.The findings indicate that children’s initiatives are superior to teachers’ impact in preschool activities, but the content is simultaneously subordinated the laws of the market. At the same time the power of the market becomes legitimated by the idea of the independent child. This governing of preschool is considered to be in great need of further discussion and problematization.
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| 14. |
- Holmberg, Kristina, et al.
(författare)
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Perversity of enjoyment? Preschool music activities go neoliberal
- 2017
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Ingår i: Teachers and Teaching. - Abingdon, Oxon : Routledge. - 1354-0602 .- 1470-1278. ; 23:5, s. 583-595
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of empirical studies that examine the influence of neoliberal ideas in preschool music and teaching. Neoliberal ideas have primarily been studied in a broader educational perspective and related to preschool policy reforms. The aim of this paper is to study preschool teachers’ rhetoric concerning music contents and music activities related to neoliberal ideas. Data consist of group conversations with preschool teachers and of video observations of daily music activities, at one preschool in Sweden. Discursive psychology has been used as a micro-sociological methodological approach. The findings show that music in this preschool is characterized by popular music, and varied consequences for knowledge content and early childhood learning are highlighted and analyzed. Also, it is argued that neoliberal ideas, in varied ways, determine the establishment of music content. For many reasons, rhetoric concerning the choice of musical content is of great importance to the field of preschool education. For example, it is essential to music education research and to preschool teachers’ everyday work, as it can improve teaching and learning qualities and become a knowledge contribution in society at large. © 2016 informa UK Limited, trading as Taylor & Francis group
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| 15. |
- Holmberg, Kristina, et al.
(författare)
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Snacking on Knowledge and Feel Good : Challenging discourses on arts in education
- 2016
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Ingår i: European Journal of Philosophy in Arts Education. - 2002-4665. ; 1:1, s. 38-67
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to re-think the results of four larger studies conducted by the authors during the last decade, all with a discourse analytical approach. The studies are empirical and concern the Swedish field of arts in education and deal with a comprehensive material consisting of interviews, observations and field notes. In the results of these studies three prominent discourses emerges. A Curriculum discourse, where content knowledge is connected to traditions, norms and values of educational institutions, a Feel-good discourse that deals with content knowledge where social and personal aspects are essential, and a Snacking on knowledge discourse where content knowledge is portrayed as something students are able to pick and choose according to their own preference. Ideas of late modern society and arts in education are then used as a basis to carry out a critical discussion about the emerging discourses. Also different teacher and student positions are problematized.
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| 18. |
- Kilbo Edlund, Karl, et al.
(författare)
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Long-term ambient air pollution and coronary atherosclerosis : results from the Swedish SCAPIS study
- 2024
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Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484.
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis.Methods: We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders.Results: Median 10-year average PM2.5 exposure was 6.2 μg/m3 (range 3.5–13.4 μg/m3). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m3). Associations with significant stenoses were inconsistent.Conclusions: In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.
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| 19. |
- Kilbo Edlund, Karl, et al.
(författare)
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Long-term ambient air pollution and coronary atherosclerosis: Results from the Swedish SCAPIS study.
- 2024
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Ingår i: Atherosclerosis. - 1879-1484.
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Tidskriftsartikel (refereegranskat)abstract
- Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis.We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n=30154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5μm (PM2.5), <10μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders.Median 10-year average PM2.5 exposure was 6.2μg/m3 (range 3.5-13.4μg/m3). 51% of participants were women and 51% were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95% CI 1.13, 1.58, per 2.05μg/m3). Associations with significant stenoses were inconsistent.In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.
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| 20. |
- Labriere, C., et al.
(författare)
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Development and evaluation of cationic amphiphilic antimicrobial 2,5-diketopiperazines
- 2018
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Ingår i: Journal of Peptide Science. - : Wiley. - 1075-2617 .- 1099-1387. ; 24:7
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Tidskriftsartikel (refereegranskat)abstract
- Both pathogenic bacteria and fungi are developing resistance to common antimicrobial treatment at an alarming rate. To counteract this development, it is of essence to develop new classes of antimicrobial agents. One such class is antimicrobial peptides, most of which are derived from the innate immune system. In this study, a series of novel 2,5-diketopiperazines were designed, synthesized, and evaluated for their antimicrobial abilities. The compounds were designed to probe the pharmacophore dictated for short linear mimics of antimicrobial cationic peptides, and as such, the compounds contain a range of cationic and hydrophobic functionalities. Several of the prepared compounds displayed high antimicrobial activities toward bacteria and also against human pathogenic fungi. Of particular interest was the high activity toward fungal strains with an inherent increased resistance toward conventional antifungal agents. The most effective compounds displayed inhibition of Candida glabrata and Candida krusei growth at concentrations between 4 and 8 mu g/mL, which is comparable to commercial antifungal agents in use. Structure activity relationship studies revealed a similar dependence on cationic charge and the volume of the hydrophobic bulk as for linear cationic antimicrobial peptides. Finally, the hemolytic activity of selected compounds was evaluated, which revealed a potential to produce active compounds with attenuation of unwanted hemolysis. The findings highlight the potential of cyclic cationic amphiphilic peptidomimetics as a class of promising compounds for the treatment of infections caused by microorganisms with an increased resistance to conventional antimicrobial agents.
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| 21. |
- Marklund, Emelie, et al.
(författare)
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Longitudinal Follow Up of Immune Responses to SARS-CoV-2 in Health Care Workers in Sweden With Several Different Commercial IgG-Assays, Measurement of Neutralizing Antibodies and CD4+ T-Cell Responses.
- 2021
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Ingår i: Frontiers in immunology. - : Frontiers Media SA. - 1664-3224. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- The risk of SARS-CoV-2 infection among health care workers (HCWs) is a concern, but studies that conclusively determine whether HCWs are over-represented remain limited. Furthermore, methods used to confirm past infection vary and the immunological response after mild COVID-19 is still not well defined.314 HCWs were recruited from a Swedish Infectious Diseases clinic caring for COVID-19 patients. IgG antibodies were measured using two commercial assays (Abbot Architect nucleocapsid (N)-assay and YHLO iFlash-1800 N and spike (S)-assays) at five time-points, from March 2020 to January 2021, covering two pandemic waves. Seroprevalence was assessed in matched blood donors at three time-points. More extensive analyses were performed in 190 HCWs in September/October 2020, including two additional IgG-assays (DiaSorin LiaisonXL S1/S2 and Abbot Architect receptor-binding domain (RBD)-assays), neutralizing antibodies (NAbs), and CD4+ T-cell reactivity using an in-house developed in vitro whole-blood assay based on flow cytometric detection of activated cells after stimulation with Spike S1-subunit or Spike, Membrane and Nucleocapsid (SMN) overlapping peptide pools.Seroprevalence was higher among HCWs compared to sex and age-matched blood donors at all time-points. Seropositivity increased from 6.4% to 16.3% among HCWs between May 2020 and January 2021, compared to 3.6% to 11.9% among blood donors. We found significant correlations and high levels of agreement between NAbs and all four commercial IgG-assays. At 200-300 days post PCR-verified infection, there was a wide variation in sensitivity between the commercial IgG-assays, ranging from <30% in the N-assay to >90% in the RBD-assay. There was only moderate agreement between NAbs and CD4+ T-cell reactivity to S1 or SMN. Pre-existing CD4+ T-cell reactivity was present in similar proportions among HCW who subsequently became infected and those that did not.HCWs in COVID-19 patient care in Sweden have been infected with SARS-CoV-2 at a higher rate compared to blood donors. We demonstrate substantial variation between different IgG-assays and propose that multiple serological targets should be used to verify past infection. Our data suggest that CD4+ T-cell reactivity is not a suitable measure of past infection and does not reliably indicate protection from infection in naive individuals.
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| 22. |
- Marklund, Emelie, et al.
(författare)
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Serum-IgG responses to SARS-CoV-2 after mild and severe COVID-19 infection and analysis of IgG non-responders.
- 2020
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 15:10
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Tidskriftsartikel (refereegranskat)abstract
- To accurately interpret COVID-19 seroprevalence surveys, knowledge of serum-IgG responses to SARS-CoV-2 with a better understanding of patients who do not seroconvert, is imperative. This study aimed to describe serum-IgG responses to SARS-CoV-2 in a cohort of patients with both severe and mild COVID-19, including extended studies of patients who remained seronegative more than 90 days post symptom onset.SARS-CoV-2-specific IgG antibody levels were quantified using two clinically validated and widely used commercial serological assays (Architect, Abbott Laboratories and iFlash 1800, YHLO), detecting antibodies against the spike and nucleocapsid proteins.Forty-seven patients (mean age 49 years, 38% female) were included. All (15/15) patients with severe symptoms and 29/32 (90.6%) patients with mild symptoms of COVID-19 developed SARS-CoV-2-specific IgG antibodies in serum. Time to seroconversion was significantly shorter (median 11 vs. 22 days, P = 0.04) in patients with severe compared to mild symptoms. Of the three patients without detectable IgG-responses after >90 days, all had detectable virus-neutralizing antibodies and in two, spike-protein receptor binding domain-specific IgG was detected with an in-house assay. Antibody titers were preserved during follow-up and all patients who seroconverted, irrespective of the severity of symptoms, still had detectable IgG levels >75 days post symptom onset.Patients with severe COVID-19 both seroconvert earlier and develop higher concentrations of SARS-CoV-2-specific IgG than patients with mild symptoms. Of those patients who not develop detectable IgG antibodies, all have detectable virus-neutralizing antibodies, suggesting immunity. Our results showing that not all COVID-19 patients develop detectable IgG using two validated commercial clinical methods, even over time, are vital for the interpretation of COVID-19 seroprevalence surveys.
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| 23. |
- Nilsson, Kristina, et al.
(författare)
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Oxidative dissolution of ADOPT compared to standard UO2 fuel
- 2017
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Ingår i: Journal of Nuclear Materials. - : Elsevier B.V.. - 0022-3115 .- 1873-4820. ; 488, s. 123-128
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Tidskriftsartikel (refereegranskat)abstract
- In this work we have studied oxidative dissolution of pure UO2 and ADOPT (UO2 doped with Al and Cr) pellets using H2O2 and gammaradiolysis to induce the process. There is a small but significant difference in the oxidative dissolution rate of UO2 and ADOPT pellets, respectively. However, the difference in oxidative dissolution yield is insignificant. Leaching experiments were also performed on in-reactor irradiated ADOPT and UO2 pellets under oxidizing conditions. The results indicate that the U(VI) release is slightly slower from the ADOPT pellet compared to the UO2. This could be attributed to differences in exposed surface area. However, fission products with low UO2 solubility display a higher relative release from ADOPT fuel compared to standard UO2-fuel. This is attributed to a lower matrix solubility imposed by the dopants in ADOPT fuel. The release of Cs is higher from UO2 which is attributed to the larger grain size of ADOPT.
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| 24. |
- Nilsson, Kristina, 1967-, et al.
(författare)
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Pulmonary clearance of 99mTc--DTPA and 99mTc-albumin in rabbits with surfactant dysfunction and lung injury.
- 1992
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Ingår i: Clinical Physiology. - 0144-5979 .- 1365-2281. ; 12:5, s. 587-94
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Tidskriftsartikel (refereegranskat)abstract
- We measured the pulmonary clearance of inhaled 99mTc-DTPA and 99mTc-albumin in rabbits with surfactant dysfunction induced by dioctyl sodium sulphosuccinate and in rabbits with lung injury induced by oleic acid. The animals were tracheotomized and mechanically ventilated. After inhalation of 99mTc-albumin in ten animals, clearance of the tracer from the lungs was monitored for 90 min. The first 30 min was a control period. Dioctyl sodium sulphosuccinate was then administered in aerosol and after another 30 min oleic acid was injected intravenously. Ten other rabbits were given 99mTc-DTPA, and clearance was externally recorded for 60 min. Five animals inhaled detergent aerosol and five animals were given oleic acid intravenously after 30 min. Airway pressures, tidal volume, and arterial blood gases were measured before and after each intervention. The half-life of 99mTc-albumin in the lung was 442 +/- 123 min during the control period, 363 +/- 52 min after detergent administration, and 134 +/- 18 min after oleic acid administration (P less than 0.05 compared to control and P less than 0.01 compared to the period after detergent). The half-life of 99mTc-DTPA was 94 +/- 16 min before and 10 +/- 0.6 min (P less than 0.01) after detergent administration and 75 +/- 12 min before and 18 +/- 1.8 min (P less than 0.01) after oleic acid administration. Gas exchange was not affected by administration of dioctyl sodium sulphosuccinate but markedly impaired after injection of oleic acid. Compliance of the respiratory system remained unaffected by detergent but decreased after injection of oleic acid.(ABSTRACT TRUNCATED AT 250 WORDS)
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| 25. |
- Nilsson, Kristina, 1967-, et al.
(författare)
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Pulmonary clearance of tracers with different lipid and water solubility in experimental surfactant dysfunction.
- 1993
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Ingår i: European Respiratory Journal. - 0903-1936 .- 1399-3003. ; 6:4, s. 505-8
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Tidskriftsartikel (refereegranskat)abstract
- We measured the pulmonary clearance of inhaled 99mTc-diethylenetriamine penta-acetic acid (DTPA), 99mTc-sestamibi and 99mTc-dimethyliminodiacetic acid (HIDA) in normal rabbits, and rabbits with surfactant dysfunction induced by the detergent dioctyl sodium sulfosuccinate. The tracers differ widely in lipid/water partition coefficients, but have similar molecular radius and weight. Five animals in each group received the detergent in aerosol, and the other five a vehicle aerosol, before the administration of the tracer. Pulmonary clearance of the tracers was measured with a gamma camera. The half-life of 99mTc-DTPA was 94 +/- 16 min in normal lungs, and 10 +/- 1 min after detergent administration (p < 0.001). The half-life for 99mTc-sestamibi was 45 +/- 4 min and 39 +/- 4 min, respectively, (p < 0.05). There was no significant difference between the half-life of 99mTc-HIDA in normal lungs and in lungs with surfactant dysfunction. The half-life was 20 +/- 3 min and 17 +/- 2 min, respectively. The results indicate that the clearance rate limiting factors for the alveolocapillary transfer of water and lipid soluble substances are not the same. Surfactant dysfunction affects the transfer of water soluble substances (99mTc-DTPA) but not of substances with high lipid solubility (99mTc-HIDA).
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| 26. |
- Nilsson, Per, 1967-, et al.
(författare)
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Flexibility and coordination among acts of visualization and analysis in a pattern generalization activity
- 2011
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Ingår i: Journal of Mathematical Behavior. - : Elsevier BV. - 0732-3123 .- 1873-8028. ; 30:3, s. 194-205
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Tidskriftsartikel (refereegranskat)abstract
- This study aims at exploring processes of flexibility and coordination among acts of visualization and analysis in students’ attempt to reach a general formula for a three-dimensional pattern generalizing task.The investigation draws on a case-study analysis of two 15-year-old girls working together on a task in which they are asked to calculate the number of blocks in a three-dimensional tower of different heights. The students’ activity was video- and audio-taped, fully transcribed and lasted for 50 min.The analysis discloses several instances of how the students were linking acts of visualization and analysis to reach a general formula. However, regarding flexibility, we found that it was more natural for the students to change visual format than to change analytical position and direction in their attempts to generalize the three-dimensional pattern of the task in a closed formula.
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| 27. |
- Oscarsson, Jan, et al.
(författare)
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Effects of free omega-3 carboxylic acids and fenofibrate on liver fat content in patients with hypertriglyceridemia and non-alcoholic fatty liver disease : A double-blind, randomized, placebo-controlled study
- 2018
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Ingår i: Journal of Clinical Lipidology. - : Elsevier BV. - 1933-2874 .- 1876-4789. ; 12:6, s. 1390-1403
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Treatment with omega-3 fatty acids and fenofibrates reduces serum triglyceride levels, but few studies have compared the effect of these agents on liver fat. OBJECTIVE: The aim of the EFFECT I trial (NCT02354976) was to determine the effects of free omega-3 carboxylic acids (OM-3CA) and fenofibrate on liver fat in overweight or obese individuals with non-alcoholic fatty liver disease and hypertriglyceridemia. METHODS: Seventy-eight patients were randomized to receive oral doses of 4 g OM-3CA (n = 25), 200 mg fenofibrate (n = 27), or placebo (n = 26) for 12 weeks in a double-blind, parallel-group study. Liver proton density fat fraction (PDFF) and volume, pancreas volume, and adipose tissue volumes were assessed by magnetic resonance imaging. RESULTS: Changes in liver PDFF at 12 weeks were not significantly different across treatment groups (relative changes from baseline: placebo, +4%; OM-3CA, -2%; and fenofibrate, +17%). The common PNPLA3 genetic polymorphism (I148M) did not significantly influence the effects of OM-3CA or fenofibrate on liver PDFF. Fenofibrate treatment significantly increased liver and pancreas volumes vs placebo treatment, and the changes in liver and pancreas volumes were positively correlated (rho 0.45, P = .02). Total liver fat volume increased significantly in patients using fenofibrate vs OM-3CA (+23% vs 3%, P = .04). Compared with OM-3CA, fenofibrate increased total liver fat and liver volume. Serum triglycerides decreased with OM-3CA (-26%, P = .02) and fenofibrate (-38%, P < .001) vs placebo. In contrast to OM-3CA, fenofibrate reduced plasma docosahexaenoic acid levels and increased plasma acetylcarnitine and butyrylcarnitine levels, estimated delta-9 desaturase activity and the concentration of urine F2-isoprostanes. CONCLUSIONS: OM-3CA and fenofibrate reduced serum triglycerides but did not reduce liver fat. Fenofibrate increased total liver volume and total liver fat volume vs OM-3CA, indicating a complex effect of fenofibrate on human hepatic lipid metabolism.
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| 28. |
- Pivodic, Aldina, 1978, et al.
(författare)
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Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity
- 2022
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 106:11, s. 1573-1580
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Prematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights.METHODS: Data, including infants born at 24-30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6-14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions.RESULTS: ROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6-14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%.CONCLUSIONS: DIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24-30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.
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| 29. |
- Pivodic, Aldina, 1978, et al.
(författare)
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Prognostic Value of Parenteral Nutrition Duration on Risk of Retinopathy of Prematurity Development and Validation of the Revised DIGIROP Clinical Decision Support Tool
- 2023
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Ingår i: JAMA ophthalmology. - : AMER MEDICAL ASSOC. - 2168-6165 .- 2168-6173. ; 141:8, s. 716-724
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE The prognostic impact of parenteral nutrition duration (PND) on retinopathy of prematurity (ROP) is not well studied. Safe prediction models can help optimize ROP screening by effectively discriminating high-risk from low-risk infants. OBJECTIVE To evaluate the prognostic value of PND on ROP; to update and validate the Digital ROP (DIGIROP) 2.0 birth into prescreen and screen prediction models to include all ROP-screened infants regardless of gestational age (GA) and incorporate PND; and to compare the DIGIROP model with the Weight, IGF-1, Neonatal, and ROP (WINROP) and Postnatal Growth and ROP (G-ROP) models. DESIGN, SETTING, AND PARTICIPANTS This retrospective study included 11 139 prematurely born infants from 2007 to 2020 from the Swedish National Registry for ROP. Extended Poisson and logistic models were applied. Data were analyzed from August 2022 to February 2023. MAIN OUTCOMES AND MEASURES Any ROP and ROP requiring treatment were studied in relation to PND. ROP treatment was the outcome in DIGIROP models. Sensitivity, specificity, area under the receiver operating characteristic curve, and adjusted OR (aOR) with 95% CI were the main measures. Internal and external validations were performed. RESULTS Of 11 139 screened infants, 5071 (45.5%) were girls, and the mean (SD) gestational age was 28.5 (2.4) weeks. ROP developed in 3179 infants (29%), treatment was given in 599 (5%), 7228 (65%) had PND less than 14 days, 2308 (21%) had PND for 14 days or more, and 1603 (14%) had unknown PND. PND was significantly correlated with ROP severity (Spearman r = 0.45; P < .001). Infants with 14 days or more of PND vs less than 14 days had faster progression from any ROP to ROP treatment (adjusted mean difference, -0.9 weeks; 95% CI, -1.5 to -0.3; P = .004). Infants with PND for 14 days or more vs less than 14 days had higher odds of any ROP (aOR, 1.84; 95% CI, 1.62-2.10; P < .001) and of severe ROP requiring treatment (aOR, 2.20; 95% CI, 1.73-2.80; P < .001). Among all 11 139 infants, the DIGIROP 2.0 models had 100% sensitivity (95% CI, 99.4-100). The specificity was 46.6%(95% CI, 45.6-47.5) for the prescreen model and 76.9%(95% CI, 76.1-77.7) for the screen model. G-ROP as well as the DIGIROP 2.0 prescreen and screen models showed 100% sensitivity on a validation subset (G-ROP: sensitivity, 100%; 95% CI, 93-100; DIGIROP prescreen: sensitivity, 100%; 95% CI, 93-100; DIGIROP screen: sensitivity, 100%; 95% CI, 93-100), whereas WINROP showed 89% sensitivity (95% CI, 77-96). Specificity for each prediction model was 29% (95% CI, 22-36) for G-ROP, 38%(95% CI, 32-46) for DIGIROP prescreen, 53%(95% CI, 46-60) for DIGIROP screen at 10 weeks, and 46%(95% CI, 39-53) for WINROP. CONCLUSION AND RELEVANCE Based on more than 11 000 ROP-screened infants born in Sweden, PND of 14 days or more corresponded to a significantly higher risk of having any ROP and receiving ROP treatment. These findings provide evidence to support consideration of using the updated DIGIROP 2.0 models instead of the WINROP or G-ROP models in the management of ROP.
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| 30. |
- Rao, Avani Dholakia, et al.
(författare)
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Practice patterns of palliative radiation therapy in pediatric oncology patients in an international pediatric research consortium
- 2017
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 64:11
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric-specific clinical trials.Design/Methods:Six international institutions with pediatric expertise completed a 122-item survey evaluating patterns of palliative RT for patients 21 years old from 2010 to 2015. Two institutions use proton RT. Palliative RT was defined as treatment with the goal of symptom control or prevention of immediate life-threatening progression.Results:Of 3,225 pediatric patients, 365 (11%) were treated with palliative intent to a total of 427 disease sites. Anesthesia was required in 10% of patients. Treatment was delivered to metastatic disease in 54% of patients. Histologies included neuroblastoma (30%), osteosarcoma (18%), leukemia/lymphoma (12%), rhabdomyosarcoma (12%), medulloblastoma/ependymoma (12%), Ewing sarcoma (8%), and other (8%). Indications included pain (43%), intracranial symptoms (23%), respiratory compromise (14%), cord compression (8%), and abdominal distention (6%). Sites included nonspine bone (35%), brain (16% primary tumors, 6% metastases), abdomen/pelvis (15%), spine (12%), head/neck (9%), and lung/mediastinum (5%). Re-irradiation comprised 16% of cases. Techniques employed three-dimensional conformal RT (41%), intensity-modulated RT (23%), conventional RT (26%), stereotactic body RT (6%), protons (1%), electrons (1%), and other (2%). The most common physician-reported barrier to consideration of palliative RT was the concern about treatment toxicity (83%).Conclusion:There is significant diversity of practice in pediatric palliative RT. Combined with ongoing research characterizing treatment response and toxicity, these data will inform the design of forthcoming clinical trials to establish effective regimens and minimize treatment toxicity for this patient population.
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| 31. |
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| 32. |
- Rao, Avani D., et al.
(författare)
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Reirradiation for Recurrent Pediatric Central Nervous System Malignancies : A Multi-institutional Review
- 2017
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Ingår i: International Journal of Radiation Oncology, Biology, Physics. - : ELSEVIER SCIENCE INC. - 0360-3016 .- 1879-355X. ; 99:3, s. 634-641
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Reirradiation has been proposed as an effective modality for recurrent central nervous system (CNS) malignancies in adults. We evaluated the toxicity and outcomes of CNS reirradiation in pediatric patients.Methods and Materials: The data from pediatric patients <21 years of age at the initial diagnosis who developed a recurrent CNS malignancy that received repeat radiation therapy (RT) across 5 facilities in an international pediatric research consortium were retrospectively reviewed.Results: Sixty-seven pediatric patients underwent CNS reirradiation. The primary diagnoses included medulloblastoma/primitive neuroectodermal tumor (n = 20; 30%), ependymoma (n = 19; 28%), germ cell tumor (n = 8; 12%), high-grade glioma (n = 9; 13%), low-grade glioma (n = 5; 7%), and other (n = 6; 9%). The median age at the first course of RT was 8.5 years (range 0.5-19.5) and was 12.3 years (range 3.3-30.2) at reirradiation. The median interval between RT courses was 2.0 years (range 0.3-16.5). The median radiation dose and fractionation in equivalent 2-Gy fractions was 63.7 Gy (range 27.6-74.8) for initial RT and 53.1 Gy (range 18.6-70.1) for repeat RT. The relapse location was infield in 52 patients (78%) and surrounding the initial RT field in 15 patients (22%). Thirty-seven patients (58%) underwent gross or subtotal resection at recurrence. The techniques used for reirradiation were intensity modulated RT (n = 46), 3-dimensional conformal RT (n = 9), stereotactic radiosurgery (n = 4; 1213 Gy x 1 or 5 Gy x 5), protons (n = 4), combined modality (n = 3), 2-dimensional RT (n = 1), and brachytherapy (n = 1). Radiation necrosis was detected in 2 patients after the first RT course and 1 additional patient after reirradiation. Six patients (9%) developed secondary neoplasms after initial RT (1 hematologic, 5 intracranial). One patient developed a secondary neoplasm identified shortly after repeat RT. The median overall survival after completion of repeat RT was 12.8 months for the entire cohort and 20.5 and 8.4 months for patients with recurrent ependymoma and medulloblastoma after reirradiation, respectively.Conclusions: CNS reirradiation in pediatric patients could be a reasonable treatment option, with moderate survival noted after repeat RT. However, prospective data characterizing the rates of local control and toxicity are needed.
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| 33. |
- Stoppel, Gerhild, et al.
(författare)
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Lung toxicity after radiation in childhood : Results of the International Project on Prospective Analysis of Radiotoxicity in Childhood and Adolescence
- 2017
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Ingår i: Radiotherapy and Oncology. - : Elsevier. - 0167-8140 .- 1879-0887. ; 125:2, s. 286-292
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: This study presents the evaluation of acute and late toxicities of the lung in children and adolescents after irradiation in terms of dose-volume effects. Materials and methods: Irradiated children and adolescents in Germany have prospectively been documented since 2001 in the "Registry for the Evaluation of Side-Effects after Radiotherapy in Childhood and Adolescence (RiSK)"; in Sweden since 2008 in the RADTOX registry. Results: Up to April 2012, 1,392 children were recruited from RiSK, and up to June 2013, 485 from the RADTOX-registry. Of these patients, 295 were irradiated to the lung. Information about acute toxicity was available for 228 patients. 179 patients have been documented concerning late toxicity (>= grade 1: n = 28). The acute toxicity rate was noticeably higher in children irradiated with 5-20 Gy (p < 0.05). In the univariate analysis, a shorter time until late toxicity was noticeably associated with irradiation with 5-15 Gy (p < 0.05). Conclusion: Acute and late toxicities appear to be correlated with higher irradiation volumes and low doses. Our data indicate that similar to the situation in adult patients, V5, V10, V15 and V20 should be kept as low as possible (e.g., at least V5 < 50%, V10 and V15 < 35% and V20 < 30%) in children and adolescents to lower the risk of toxicity. (C) 2017 Elsevier B.V. All rights reserved.
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| 34. |
- Strömbergsson, S., et al.
(författare)
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Simulating Speech Error Patterns Across Languages and Different Datasets
- 2021
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Ingår i: Language and Speech. - : SAGE Publications. - 0023-8309 .- 1756-6053. ; , s. 1-38
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Tidskriftsartikel (refereegranskat)abstract
- Children’s speech acquisition is influenced by universal and language-specific forces. Some speech error patterns (or phonological processes) in children’s speech are observed in many languages, but the same error pattern may have different effects in different languages. We aimed to explore phonological effects of the same speech error patterns across different languages, target audiences and discourse modes, using a novel method for large-scale corpus investigation. As an additional aim, we investigated the face validity of five different phonological effect measures by relating them to subjective ratings of assumed effects on intelligibility, as provided by practicing speech-language pathologists. Six frequently attested speech error patterns were simulated in authentic corpus data: backing, fronting, stopping, /r/-weakening, cluster reduction and weak syllable deletion—each simulation resulting in a “misarticulated” version of the original corpus. Phonological effects were quantified using five separate metrics of phonological complexity and distance from expected target forms. Using Swedish child-speech data as a reference, phonological effects were compared between this reference and a) child speech in Norwegian and English, and b) data representing different modes of discourse (spoken/written) and target audiences (adults/children) in Swedish. Of the speech error patterns, backing—the one atypical pattern of those included—was found to cause the most detrimental effects, across languages as well as across modes and speaker ages. However, none of the measures reflects intuitive rankings as provided by clinicians regarding effects on intelligibility, thus corroborating earlier reports that phonological competence is not translatable into levels of intelligibility.
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| 35. |
- Toussaint, Laura, et al.
(författare)
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Inter-observer variation in target delineation and dose trade-off for radiotherapy of paediatric ependymoma
- 2022
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 61:2, s. 235-238
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Tidskriftsartikel (refereegranskat)abstract
- Postoperative radiotherapy for intracranial paediatric ependymoma is challenging both for target definition and treatment planning [1]. Delineation of the tumour bed is difficult, as structures in prior contact with the tumour will shift back into their original positions after surgery. In infratentorial cases, the target is adjacent to the brainstem and upper spinal cord, therefore the relatively high prescription dose and sparing of surrounding organs at risk (OARs) need to be balanced. Through the radiotherapy working-group of the Nordic Organization of Pediatric Hematology and Oncology (NOPHO) and in collaboration with the Westdeutsches Protonentherapizentrum Essen (WPE), a study was performed to quantify inter-centre variations in target delineation and treatment plans for these tumours.
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| 36. |
- Vlachogiannis, Pavlos, et al.
(författare)
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Hypofractionated high-energy proton-beam irradiation is an alternative treatment for WHO grade I meningiomas
- 2017
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Ingår i: Acta Neurochirurgica. - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 159:12, s. 2391-2400
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Tidskriftsartikel (refereegranskat)abstract
- Radiation treatment is commonly employed in the treatment of meningiomas. The aim of this study was to evaluate the effectiveness and safety of hypofractionated high-energy proton therapy as adjuvant or primary treatment for WHO grade I meningiomas. A total of 170 patients who received irradiation with protons for grade I meningiomas between 1994 and 2007 were included in the study. The majority of the tumours were located at the skull base (n = 155). Eighty-four patients were treated post subtotal resection, 42 at tumour relapse and 44 with upfront radiotherapy after diagnosis based on the typical radiological image. Irradiation was given in a hypofractionated fashion (3-8 fractions, usually 5 or 6 Gy) with a mean dose of 21.9 Gy (range, 14-46 Gy). All patients were planned for follow-up with clinical controls and magnetic resonance imaging scans at 6 months and 1, 2, 3, 5, 7 and 10 years after treatment. The median follow-up time was 84 months. Age, gender, tumour location, Simpson resection grade and target volume were assessed as possible prognostic factors for post-irradiation tumour progression and radiation related complications. The actuarial 5- and 10-year progression-free survival rates were 93% and 85% respectively. Overall mortality rate was 13.5%, while disease-specific mortality was 1.7% (3/170 patients). Older patients and patients with tumours located in the middle cranial fossa had a lower risk for tumour progression. Radiation-related complications were seen in 16 patients (9.4%), with pituitary insufficiency being the most common. Tumour location in the anterior cranial fossa was the only factor that significantly increased the risk of complications. Hypofractionated proton-beam radiation therapy may be used particularly in the treatment of larger World Health Organisation grade I meningiomas not amenable to total surgical resection. Treatment is associated with high rates of long-term tumour growth control and acceptable risk for complications.
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| 37. |
- Wikström, Kenneth, et al.
(författare)
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Evaluation of four surface surrogates for modeling lung tumor positions over several fractions in radiotherapy
- 2021
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Ingår i: Journal of Applied Clinical Medical Physics. - : Wiley. - 1526-9914. ; 22:9, s. 103-112
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Patient breathing during lung cancer radiotherapy reduces the ability to keep a sharp dose gradient between tumor and normal tissues. To mitigate detrimental effects, accurate information about the tumor position is required. In this work, we evaluate the errors in modeled tumor positions over several fractions of a simple tumor motion model driven by a surface surrogate measure and its time derivative. The model is tested with respect to four different surface surrogates and a varying number of surrogate and image acquisitions used for model training. Fourteen patients were imaged 100 times with cine CT, at three sessions mimicking a planning session followed by two treatment fractions. Patient body contours were concurrently detected by a body surface laser scanning system BSLS from which four surface surrogates were extracted; thoracic point TP, abdominal point AP, the radial distance mean RDM, and a surface derived volume SDV. The motion model was trained on session 1 and evaluated on sessions 2 and 3 by comparing modeled tumor positions with measured positions from the cine images. The number of concurrent surrogate and image acquisitions used in the training set was varied, and its impact on the final result was evaluated. The use of AP as a surface surrogate yielded the smallest error in modeled tumor positions. The mean deviation between modeled and measured tumor positions was 1.9 mm. The corresponding deviations for using the other surrogates were 2.0 mm (RDM), 2.8 mm (SDV), and 3.0 mm (TP). To produce a motion model that accurately models the tumor position over several fractions requires at least 10 simultaneous surrogate and image acquisitions over 1–2 minutes.
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| 38. |
- Wikström, Kenneth, et al.
(författare)
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Reproducibility of heart and thoracic wall position in repeated deep inspiration breath holds for radiotherapy of left-sided breast cancer patients
- 2018
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 57:10, s. 1318-1324
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Tidskriftsartikel (refereegranskat)abstract
- Background: Deep inspiration breath hold (DIBH) for radiotherapy of left-sided breast cancer patientscan effectively move the heart away from the target and reduce the heart dose compared to treatmentsin free breathing. This study aims to investigate the positional reproducibility of heart edge(HE) and thoracic wall (TW) during repeated DIBHs.Material and methods: At three occasions, 11 left-sided breast cancer patients were CT imaged during6 minutes of repeated DIBHs with 60 cine CT series. The series were evenly distributed over threebed positions and for each bed position, the heart edge associated maximum heart distance (MHD)and thoracic wall-associated maximum lung distance (MLD) from a reference line were retrospectivelyanalyzed. The high temporal resolution of the CT series enabled intrinsic heart movements to beresolved from breath hold variations. A body surface laser scanning system continuously extracted thethorax height and displayed it in a pair of goggles for patient feedback. To check for ‘fake-breathing’movements, e.g. that the patient lifts its back from the couch to reach DIBH, the couch-to-spine distancewas also measured in all CT series.Results: The analysis was done for 1432 cine CTs captured during 292 breath holds. The DIBH movedthe heart on average 15mm in medial direction compared with free breathing. For the three bed positionsstudied, the mean value of the max range, across all patients, was between 11–13mm for theMHD and 4–8mm for the MLD. The MHD variation due to breath hold variation was twice as large asthe MHD variation due to intrinsic heart movement. The couch-to-spine distance varied less than3mm for all fractions, i.e., no fake-breathing was discovered.Conclusions: The heart edge and thoracic wall reproducibility was high in relation to the medial heartdisplacement induced by the DIBH.
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| 39. |
- Zimmerman Nilsson, Marie-Helene, 1967-, et al.
(författare)
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Immanence, realism and construction : variations of posthumanistic subjects
- 2015
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Ingår i: Abstract book. - Gothenburg : University of Gothenburg. ; , s. 163-163
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Konferensbidrag (refereegranskat)abstract
- In recent years, posthumanist perspectives have become increasingly influential in the pedagogical research debate. The need for theories also capable of handling materialities as actors can be related to the increasing amount of technical devices present in everyday life, as in teaching contexts from preschool to university. Today, human´s use of different materialities is taken for granted, but materialities´ influence on the human has not been as obvious. From a posthumanist perspective characterized by anti-anthropocentrism where immanence and non-hierarchical approaches are emphasized, opportunities to understand materialities as acting subjects are created.Within this perspective, different ways of handling the subject have evolved which we find both interesting and important to further explore. The aim of the study is to analyze and problematize posthumanist subjects in pedagogical research. Thus, the ambition is to clarify subject formations and specify subjects that appear, which in turn contributes to visualizing different subject forms. Methodological tools from posthumanist theory are used to find different Entrances in the research Rhizome. The findings are presented as specific Entrances in the Rhizome. The Entrances show different subject formations, where subjects with similarities to poststructuralist perspectives, subjects in a critical framework, as well as more radical posthumanist subjects emerge. Finally, the subject variation that has appeared is further discussed and problematized.
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| 40. |
- Zimmerman Nilsson, Marie-Heléne, 1967-, et al.
(författare)
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Quality and Knowledge Content in Music Activities in Preschool : The Impact of Human Materiality Combinations
- 2017
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Ingår i: Journal of Research in Childhood Education. - Philadelphia, PA : Routledge. - 0256-8543 .- 2150-2641. ; 31:1, s. 103-112
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Tidskriftsartikel (refereegranskat)abstract
- Traditionally, pedagogical research has been child centered, where materialities often have been considered as objects and tools. However, in recent posthuman research, attempts have been made to consider human materiality combinations to have impact on pedagogical activities in preschool, but to a large extent music as an issue has been neglected. Therefore, the aim of this research study is to discuss pedagogical quality and knowledge content in music activities in preschool by focusing on combinations of human and materiality subjects as “cyborgs.” Particularly, this is essential for preschool, teacher education, and research, contributing alternative understandings of learning settings. A theoretical framework emanates from posthumanist theories, where the authors apply methodological concepts used in their earlier work to study music activities. The empirical material was produced in Spring 2013. The analysis of video observations identifies two different characters of a cyborg, the guitar-human, and the CD human having quite different impacts on the music activities. Nevertheless, they have in common that they create intensities with the children, where entanglements between human and materiality become the activity. Finally, the cyborgs are discussed, where issues and dilemmas related to pedagogical quality, knowledge content, agency, and competence are addressed.
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| 41. |
- Zimmerman Nilsson, Marie-Helene, 1967-, et al.
(författare)
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Students served at all costs and rescued from difficulties: consequences of neoliberal ideas in teacher education in Sweden
- 2014
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Ingår i: ICERI2014. - Valencia : The International Academy of Technology, Education and Development. - 9788461724840 ; , s. 867-873
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Konferensbidrag (refereegranskat)abstract
- During the last decades, neoliberal ideas have increased their influence in society at large, as well as in higher education. As teacher educators, we experience a growing trend that emphasizes the teacher's ability to be “liked” and “popular” at different levels of the educational system. Also, teacher education at large seems to profile through management, where a good reputation becomes weapon in the race to gain market shares. As a consequence of this emphasis is placed on quantification of students´ apprehensions, as it becomes a tool for success in the popularity-rankings, which in turn create possibilities to attract more students. For students already in the system, we have identified that they are more concerned about them selves and their own education than they are taking collective responsibility for a mutual education.This is in great need of further studying, enabling a more complex discussion, giving emphasis to varying consequences of neoliberal ideas in teacher education. Such a discussion opens up for issues as student freedom related to knowledge, teaching and becoming a teacher in a market-driven logic as well as issues related to the educational system at large and to society.Based on these considerations, the aim of this ongoing project is to study dialogues between students and teachers related to activities in teacher education and to discuss this in the light of neoliberal ideas. Data consists of written correspondence between teacher students and teachers produced during two months in 2014. The theoretical framework is built on social constructionist and poststructuralist theory, with discursive psychology and discourse theory as methodological approach.Findings show several aspects in the dialogues between teachers and student teachers, presented as different interpretative repertoires. From a student perspective, the repertoire of demands implies claiming to be served at all costs, while the repertoire of resignation implies appealing to be rescued from difficulties. The students are positioning themselves as consuming children in need of support whereas the teachers are positioned as helping facilitators. From a teacher perspective, the repertoire of adherence is characterized by responsiveness, whereas the repertoire of resistance means questioning students´ matter. Here, the teachers position themselves as facilitators or as critics, where the latter is seen as an expression of a competing idea, challenging the repertoires from a student perspective. From an educational perspective, several problematic aspects on education quality as well as on the supply of teachers to society appears. Finally, implications for teacher education settings are discussed in addition to neoliberalism as an influential tendency.
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| 42. |
- Zimmerman Nilsson, Marie-Heléne, 1967-, et al.
(författare)
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The Sounding iPad as a Resource for Teaching Children in Preschool
- 2014
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Ingår i: Minding the Sound – Sounding the Mind. - Halmstad : Halmstad University. ; , s. 6-6
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Konferensbidrag (refereegranskat)abstract
- In recent years, digital technologies have become more important in educational contexts in general and in preschool educational activities in particular. This paper is a part of a larger study focusing on every day activities in preschool where educators and children are using I-pads as musical and physical movement resources. More specifically, the aim in this paper is to study how musical activities with sounding I-pads in preschool are staged. The theoretical framework is built on discursive psychology, which emanates from social constructionist and poststructuralist ideas. Discursive psychology has been used in an extensive micro-analysis of video recorded I-pad related music activities in preschool. Data was collected during March/April 2013. Findings show that an increased space for children's participation and agency constructs an educator position that is challenged, transformed and opened up for negotiation. The educator position is questioned by the child's alternative music repertoire and prominent position related to the sounding I-Pad. At the expense of other sounding musical resources that enable the teacher to position him-/herself as a competent educator, the I-pad permeating the music activities implies a resource that both teachers and children have mutual access to. Hereby, the educator position becomes open to both teachers and children. Altogether, this legitimates a dismantled educator responsibility, Findings are considered problematic referred to quality and available knowledge formation in the music activities.
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| 43. |
- Ångström-Brännström, Charlotte, et al.
(författare)
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Parents’ experiences and responses to an intervention for psychological preparation of children and families during the child’s radiotherapy
- 2018
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Ingår i: Journal of Pediatric Oncology Nursing. - : Sage Publications. - 1043-4542 .- 1532-8457. ; 35:2, s. 132-148
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate parents’ experiences and responses to a systematic intervention for psychological preparation of children and families during the child’s radiotherapy (RT) treatment. In this case-control study at 3 pediatric RT centers, an intervention with a preparatory kit, including age-adjusted information on tablets, gift of a stuffed toy or a pair of headphones, a parent booklet, and toy models of the computed tomography and RT machines was implemented. For evaluation, a mixed methods data collection was conducted. A total of 113 parents of children undergoing RT were included—n = 59 in the baseline group and n = 54 in the intervention group. Health-related quality of life was rated low, but parents in the intervention group expressed less anxiety after the RT compared with the baseline group. They found information suitable for their young children, siblings, and friends were involved and the toy models were used for play. Parents expressed positive feelings due to close interaction with staff and each other within the family. The solutions developed within a human-centered design approach and shaped as a systematic family-centered strategy contributed to parents understanding and coping with the child’s RT.
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