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  • Kanai, M, et al. (författare)
  • 2023
  • swepub:Mat__t
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  • Abe, O, et al. (författare)
  • Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials
  • 2005
  • Ingår i: The Lancet. - 1474-547X. ; 365:9472, s. 1687-1717
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Quinquennial overviews (1985-2000) of the randomised trials in early breast cancer have assessed the 5-year and 10-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival. Here, we report the 10-year and 15-year effects. Methods Collaborative meta-analyses were undertaken of 194 unconfounded randomised trials of adjuvant chemotherapy or hormonal therapy that began by 1995. Many trials involved CMF (cyclophosphamide, methotrexate, fluorouracil), anthracycline-based combinations such as FAC (fluorouracil, doxombicin, cyclophosphamide) or FEC (fluorouracil, epirubicin, cyclophosphamide), tamoxifen, or ovarian suppression: none involved taxanes, trastuzumab, raloxifene, or modem aromatase inhibitors. Findings Allocation to about 6 months of anthracycline-based polychemotherapy (eg, with FAC or FEC) reduces the annual breast cancer death rate by about 38% (SE 5) for women younger than 50 years of age when diagnosed and by about 20% (SE 4) for those of age 50-69 years when diagnosed, largely irrespective of the use of tamoxifen and of oestrogen receptor (ER) status, nodal status, or other tumour characteristics. Such regimens are significantly (2p=0 . 0001 for recurrence, 2p<0 . 00001 for breast cancer mortality) more effective than CMF chemotherapy. Few women of age 70 years or older entered these chemotherapy trials. For ER-positive disease only, allocation to about 5 years of adjuvant tamoxifen reduces the annual breast cancer death rate by 31% (SE 3), largely irrespective of the use of chemotherapy and of age (<50, 50-69, &GE; 70 years), progesterone receptor status, or other tumour characteristics. 5 years is significantly (2p<0 . 00001 for recurrence, 2p=0 . 01 for breast cancer mortality) more effective than just 1-2 years of tamoxifen. For ER-positive tumours, the annual breast cancer mortality rates are similar during years 0-4 and 5-14, as are the proportional reductions in them by 5 years of tamoxifen, so the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis. These results combine six meta-analyses: anthracycline-based versus no chemotherapy (8000 women); CMF-based versus no chemotherapy (14 000); anthracycline-based versus CMF-based chemotherapy (14 000); about 5 years of tamoxifen versus none (15 000); about 1-2 years of tamoxifen versus none (33 000); and about 5 years versus 1-2 years of tamoxifen (18 000). Finally, allocation to ovarian ablation or suppression (8000 women) also significantly reduces breast cancer mortality, but appears to do so only in the absence of other systemic treatments. For middle-aged women with ER-positive disease (the commonest type of breast cancer), the breast cancer mortality rate throughout the next 15 years would be approximately halved by 6 months of anthracycline-based chemotherapy (with a combination such as FAC or FEC) followed by 5 years of adjuvant tamoxifen. For, if mortality reductions of 38% (age <50 years) and 20% (age 50-69 years) from such chemotherapy were followed by a further reduction of 31% from tamoxifen in the risks that remain, the final mortality reductions would be 57% and 45%, respectively (and, the trial results could well have been somewhat stronger if there had been full compliance with the allocated treatments). Overall survival would be comparably improved, since these treatments have relatively small effects on mortality from the aggregate of all other causes. Interpretation Some of the widely practicable adjuvant drug treatments that were being tested in the 1980s, which substantially reduced 5-year recurrence rates (but had somewhat less effect on 5-year mortality rates), also substantially reduce 15-year mortality rates. Further improvements in long-term survival could well be available from newer drugs, or better use of older drugs.
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  • Richards, Stephen, et al. (författare)
  • Genome Sequence of the Pea Aphid Acyrthosiphon pisum
  • 2010
  • Ingår i: PLoS biology. - : Public Library of Science (PLoS). - 1544-9173 .- 1545-7885. ; 8:2, s. e1000313-
  • Tidskriftsartikel (refereegranskat)abstract
    • Aphids are important agricultural pests and also biological models for studies of insect-plant interactions, symbiosis, virus vectoring, and the developmental causes of extreme phenotypic plasticity. Here we present the 464 Mb draft genome assembly of the pea aphid Acyrthosiphon pisum. This first published whole genome sequence of a basal hemimetabolous insect provides an outgroup to the multiple published genomes of holometabolous insects. Pea aphids are host-plant specialists, they can reproduce both sexually and asexually, and they have coevolved with an obligate bacterial symbiont. Here we highlight findings from whole genome analysis that may be related to these unusual biological features. These findings include discovery of extensive gene duplication in more than 2000 gene families as well as loss of evolutionarily conserved genes. Gene family expansions relative to other published genomes include genes involved in chromatin modification, miRNA synthesis, and sugar transport. Gene losses include genes central to the IMD immune pathway, selenoprotein utilization, purine salvage, and the entire urea cycle. The pea aphid genome reveals that only a limited number of genes have been acquired from bacteria; thus the reduced gene count of Buchnera does not reflect gene transfer to the host genome. The inventory of metabolic genes in the pea aphid genome suggests that there is extensive metabolite exchange between the aphid and Buchnera, including sharing of amino acid biosynthesis between the aphid and Buchnera. The pea aphid genome provides a foundation for post-genomic studies of fundamental biological questions and applied agricultural problems.
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  • Adibekyan, V., et al. (författare)
  • Sun-like stars unlike the Sun : Clues for chemical anomalies of cool stars
  • 2017
  • Ingår i: Astronomical Notes - Astronomische Nachrichten. - : WILEY-V C H VERLAG GMBH. - 0004-6337 .- 1521-3994. ; 338:4, s. 442-452
  • Tidskriftsartikel (refereegranskat)abstract
    • We present a summary of the splinter session Sun-like stars unlike the Sun that was held on June 9, 2016, as part of the Cool Stars 19 conference (Uppsala, Sweden), in which the main limitations (in the theory and observations) in the derivation of very precise stellar parameters and chemical abundances of Sun-like stars were discussed. The most important and most debated processes that can produce chemical peculiarities in solar-type stars were outlined and discussed. Finally, in an open discussion between all the participants, we tried to identify new pathways and prospects toward future solutions of the currently open questions.
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  • Allesøe, Rosa Lundbye, et al. (författare)
  • Discovery of drug–omics associations in type 2 diabetes with generative deep-learning models
  • 2023
  • Ingår i: Nature Biotechnology. - : Springer Nature. - 1087-0156 .- 1546-1696. ; 41:3, s. 399-408
  • Tidskriftsartikel (refereegranskat)abstract
    • The application of multiple omics technologies in biomedical cohorts has the potential to reveal patient-level disease characteristics and individualized response to treatment. However, the scale and heterogeneous nature of multi-modal data makes integration and inference a non-trivial task. We developed a deep-learning-based framework, multi-omics variational autoencoders (MOVE), to integrate such data and applied it to a cohort of 789 people with newly diagnosed type 2 diabetes with deep multi-omics phenotyping from the DIRECT consortium. Using in silico perturbations, we identified drug–omics associations across the multi-modal datasets for the 20 most prevalent drugs given to people with type 2 diabetes with substantially higher sensitivity than univariate statistical tests. From these, we among others, identified novel associations between metformin and the gut microbiota as well as opposite molecular responses for the two statins, simvastatin and atorvastatin. We used the associations to quantify drug–drug similarities, assess the degree of polypharmacy and conclude that drug effects are distributed across the multi-omics modalities.
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  • Bottger, P, et al. (författare)
  • Glutamate-system defects behind psychiatric manifestations in a familial hemiplegic migraine type 2 disease-mutation mouse model
  • 2016
  • Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6, s. 22047-
  • Tidskriftsartikel (refereegranskat)abstract
    • Migraine is a complex brain disorder, and understanding the complexity of this prevalent disease could improve quality of life for millions of people. Familial Hemiplegic Migraine type 2 (FHM2) is a subtype of migraine with aura and co-morbidities like epilepsy/seizures, cognitive impairments and psychiatric manifestations, such as obsessive-compulsive disorder (OCD). FHM2 disease-mutations locate to the ATP1A2 gene encoding the astrocyte-located α2-isoform of the sodium-potassium pump (α2Na+/K+-ATPase). We show that knock-in mice heterozygous for the FHM2-associated G301R-mutation (α2+/G301R) phenocopy several FHM2-relevant disease traits e.g., by mimicking mood depression and OCD. In vitro studies showed impaired glutamate uptake in hippocampal mixed astrocyte-neuron cultures from α2G301R/G301R E17 embryonic mice, and moreover, induction of cortical spreading depression (CSD) resulted in reduced recovery in α2+/G301R male mice. Moreover, NMDA-type glutamate receptor antagonists or progestin-only treatment reverted specific α2+/G301R behavioral phenotypes. Our findings demonstrate that studies of an in vivo relevant FHM2 disease knock-in mouse model provide a link between the female sex hormone cycle and the glutamate system and a link to co-morbid psychiatric manifestations of FHM2.
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  • Casagrande, L., et al. (författare)
  • Strömgren Survey for Asteroseismology and Galactic Archaeology: Let the SAGA Begin.
  • 2014
  • Ingår i: Astrophysical Journal. - 0004-637X. ; 787:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Asteroseismology has the capability of precisely determining stellar properties that would otherwise be inaccessible, such as radii, masses, and thus ages of stars. When coupling this information with classical determinations of stellar parameters, such as metallicities, effective temperatures, and angular diameters, powerful new diagnostics for Galactic studies can be obtained. The ongoing Stromgren survey for Asteroseismology and Galactic Archaeology has the goal of transforming the Kepler field into a new benchmark for Galactic studies, similar to the solar neighborhood. Here we present the first results from a stripe centered at a Galactic longitude of 74 degrees and covering latitude from about 8 degrees to 20 degrees, which includes almost 1000 K giants with seismic information and the benchmark open cluster NGC 6819. We describe the coupling of classical and seismic parameters, the accuracy as well as the caveats of the derived effective temperatures, metallicities, distances, surface gravities, masses, and radii. Confidence in the achieved precision is corroborated by the detection of the first and secondary clumps in a population of field stars with a ratio of 2 to 1 and by the negligible scatter in the seismic distances among NGC 6819 member stars. An assessment of the reliability of stellar parameters in the Kepler Input Catalog is also performed, and the impact of our results for population studies in the Milky Way is discussed, along with the importance of an all-sky Stromgren survey.
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  • de Boniface, J., et al. (författare)
  • Omitting axillary dissection in breast cancer with sentinel-node metastases
  • 2024
  • Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 390:13, s. 1163-1175
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND Trials evaluating the omission of completion axillary-lymph-node dissection in patients with clinically node-negative breast cancer and sentinel-lymph-node metastases have been compromised by limited statistical power, uncertain nodal radiotherapy target volumes, and a scarcity of data on relevant clinical subgroups.METHODS We conducted a noninferiority trial in which patients with clinically node-negative primary T1 to T3 breast cancer (tumor size, T1, ≤20 mm; T2, 21 to 50 mm; and T3, >50 mm in the largest dimension) with one or two sentinel-node macrometastases (metastasis size, >2 mm in the largest dimension) were randomly assigned in a 1:1 ratio to completion axillary-lymph-node dissection or its omission (sentinel-node biopsy only). Adjuvant treatment and radiation therapy were used in accordance with national guidelines. The primary end point was overall survival. We report here the per-protocol and modified intention-to-treat analyses of the prespecified secondary end point of recurrence-free survival. To show noninferiority of sentinel-node biopsy only, the upper boundary of the confidence interval for the hazard ratio for recurrence or death had to be below 1.44.RESULTS Between January 2015 and December 2021, a total of 2766 patients were enrolled across five countries. The per-protocol population included 2540 patients, of whom 1335 were assigned to undergo sentinel-node biopsy only and 1205 to undergo completion axillary-lymph-node dissection (dissection group). Radiation therapy including nodal target volumes was administered to 1192 of 1326 patients (89.9%) in the sentinel-node biopsy–only group and to 1058 of 1197 (88.4%) in the dissection group. The median follow-up was 46.8 months (range, 1.5 to 94.5). Overall, 191 patients had recurrence or died. The estimated 5-year recurrence-free survival was 89.7% (95% confidence interval [CI], 87.5 to 91.9) in the sentinel-node biopsy–only group and 88.7% (95% CI, 86.3 to 91.1) in the dissection group, with a country-adjusted hazard ratio for recurrence or death of 0.89 (95% CI, 0.66 to 1.19), which was significantly (P<0.001) below the prespecified noninferiority margin.CONCLUSIONS The omission of completion axillary-lymph-node dissection was noninferior to the more extensive surgery in patients with clinically node-negative breast cancer who had sentinel-node macrometastases, most of whom received nodal radiation therapy. (Funded by the Swedish Research Council and others; SENOMAC ClinicalTrials.gov number, NCT02240472.).
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  • Olafsdottir, P., et al. (författare)
  • Body Dysmorphic Symptoms in Youth with Obsessive-compulsive Disorder: Prevalence, Clinical Correlates, and Cognitive Behavioral Therapy Outcome
  • 2022
  • Ingår i: Child Psychiatry & Human Development. - : Springer Science and Business Media LLC. - 0009-398X .- 1573-3327. ; 54:4, s. 939-48
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of the study were to estimate the prevalence of body dysmorphic symptoms in a sample of children and adolescents with obsessive-compulsive disorder, possible clinical correlates and whether BDD symptoms predict poorer treatment outcomes after cognitive behavioral therapy. The study included 269 children and adolescents with OCD, aged 7-17 years, from Denmark, Sweden, and Norway, who were treated with 14 weekly sessions of manualized, exposure-based CBT. Twenty-one patients (7.8%) had BDD symptoms. BDD symptoms were associated with older age (p = 0.003) and a higher prevalence of comorbid anxiety disorders (p = 0.025). In addition, patients with BDD symptoms endorsed a greater number of OCD symptoms than did those without BDD symptoms. Having symptoms of BDD did not affect the CBT outcome on OCD. The results of the study suggest that CBT for OCD is equally effective for those with and without comorbid BDD symptoms.
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  • Amarsi, Anish, et al. (författare)
  • 3D non-LTE iron abundances in FG-type dwarfs
  • 2022
  • Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 668
  • Tidskriftsartikel (refereegranskat)abstract
    • Iron is one of the most important elements in-stellar astrophysics. However, spectroscopic measurements of its abundance are prone to systematic modelling errors. We present three dimensional non-local thermodynamic equilibrium (3D non-LTE) calculations across 32 STAGGER-grid models with effective temperatures from 5000 K to 6500 K, surface gravities of 4.0 dex and 4.5 dex, and metallicities from −3 dex to 0 dex, and we study the effects on 171 Fe I and 12 Fe II optical lines. In warm metal-poor stars, the 3D non-LTE abundances are up to 0.5 dex larger than 1D LTE abundances inferred from Fe I lines of an intermediate excitation potential. In contrast, the 3D non-LTE abundances can be 0.2 dex smaller in cool metal-poor stars when using Fe I lines of a low excitation potential. The corresponding abundance differences between 3D non-LTE and 1D non-LTE are generally less severe but can still reach ±0.2 dex. For Fe II lines, the 3D abundances range from up to 0.15 dex larger to 0.10 dex smaller than 1D abundances, with negligible departures from 3D LTE except for the warmest stars at the lowest metallicities. The results were used to correct 1D LTE abundances of the Sun and Procyon (HD 61421), and of the metal-poor stars HD 84937 and HD 140283, using an interpolation routine based on neural networks. The 3D non-LTE models achieve an improved ionisation balance in all four stars. In the two metal-poor stars, they removed excitation imbalances amounting to 250 K to 300 K errors in effective temperature. For Procyon, the 3D non-LTE models suggest [Fe/H] = 0.11 ± 0.03, which is significantly larger than literature values based on simpler models. We make the 3D non-LTE interpolation routine for FG-type dwarfs publicly available, in addition to 1D non-LTE departure coefficients for standard MARCS models of FGKM-type dwarfs and giants. These tools, together with an extended 3D LTE grid for Fe II from 2019, can help improve the accuracy of stellar parameter and iron abundance determinations for late-type stars.
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  • Amarsi, A. M., et al. (författare)
  • Carbon and oxygen in metal-poor halo stars
  • 2019
  • Ingår i: Astronomy and Astrophysics. - : EDP SCIENCES S A. - 0004-6361 .- 1432-0746. ; 622
  • Tidskriftsartikel (refereegranskat)abstract
    • Carbon and oxygen are key tracers of the Galactic chemical evolution; in particular, a reported upturn in [C/O] towards decreasing [O/H] in metal-poor halo stars could be a signature of nucleosynthesis by massive Population III stars. We reanalyse carbon, oxygen, and iron abundances in 39 metal-poor turn-off stars. For the first time, we take into account 3D hydrodynamic effects together with departures from local thermodynamic equilibrium (LTE) when determining both the stellar parameters and the elemental abundances, by deriving effective temperatures from 3D non-LTE H beta profiles, surface gravities from Gaia parallaxes, iron abundances from 3D LTE Fe ii equivalent widths, and carbon and oxygen abundances from 3D non-LTE C-I and O-I equivalent widths. We find that [C/Fe] stays flat with [Fe/H], whereas [O/Fe] increases linearly up to 0.75 dex with decreasing [Fe/H] down to -3.0 dex. Therefore [C/O] monotonically decreases towards decreasing [C/H], in contrast to previous findings, mainly because the non-LTE e ff ects for O i at low [Fe/H] are weaker with our improved calculations.
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  • Bentley, Blair P., et al. (författare)
  • Divergent sensory and immune gene evolution in sea turtles with contrasting demographic and life histories
  • 2023
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences (PNAS). - 0027-8424 .- 1091-6490. ; 120:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Sea turtles represent an ancient lineage of marine vertebrates that evolved from terrestrial ancestors over 100 Mya. The genomic basis of the unique physiological and ecological traits enabling these species to thrive in diverse marine habitats remains largely unknown. Additionally, many populations have drastically declined due to anthropogenic activities over the past two centuries, and their recovery is a high global conservation priority. We generated and analyzed high-quality reference genomes for the leatherback (Dermochelys coriacea) and green (Chelonia mydas) turtles, representing the two extant sea turtle families. These genomes are highly syntenic and homologous, but localized regions of noncollinearity were associated with higher copy numbers of immune, zinc-finger, and olfactory receptor (OR) genes in green turtles, with ORs related to waterborne odorants greatly expanded in green turtles. Our findings suggest that divergent evolution of these key gene families may underlie immunological and sensory adaptations assisting navigation, occupancy of neritic versus pelagic environments, and diet specialization. Reduced collinearity was especially prevalent in microchromosomes, with greater gene content, heterozygosity, and genetic distances between species, supporting their critical role in vertebrate evolutionary adaptation. Finally, diversity and demographic histories starkly contrasted between species, indicating that leatherback turtles have had a low yet stable effective population size, exhibit extremely low diversity compared with other reptiles, and harbor a higher genetic load compared with green turtles, reinforcing concern over their persistence under future climate scenarios. These genomes provide invaluable resources for advancing our understanding of evolution and conservation best practices in an imperiled vertebrate lineage.
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  • Briley, M. M., et al. (författare)
  • Abundances of RGB Stars in the Globular Cluster NGC 6752
  • 2001
  • Ingår i: American Astronomical Society, 199th AAS Meeting, #56.17; Bulletin of the American Astronomical Society. ; 199, s. 1386-1386
  • Konferensbidrag (refereegranskat)abstract
    • Abundances of O, Fe, Al, Mg, Na and Li determined from high-resolutionand high signal-to-noise VLT spectra from the atmospheric UV cutoff to6800Å of 21 red giant branch (RGB) stars in the globular clusterNGC 6752 are presented. We demonstrate that the previously observedstar-to-star scatter in the Strömgren c1 index is due todifferences in uv NH band strengths caused by significant variations inN abundances. The c1 values also correlate extremely wellwith the measured CN indicies and anticorrelate with CH. Furthermore, weshow that the well known relations between O - Na and Mg - Al (as wellas with CN, CH, and NH) are also present in these stars, some of whichare fainter than the RGB luminosity function bump. We find that the Li(6708Å) equivalent width becomes too small to be measured as theluminosity of the stars increases above the luminosity of the RGB bump,which we interpret as the onset of deep mixng. Taken together, thesedata enforce the results of Gratton et al. (2001, A&A 369, 87) forturnoff and sub--giant branch stars, and suggest that in this clusterthe bulk of the abundance correlations observed among the brightergiants are in place prior to appreciable RGB ascent and likely due to a''primordial'' source, rather than due to mixing. Based on observationsobtained with the ESO Very Large Telescope. Partial support provided bythe NSF under grant AST-0098489 (to MMB).
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  • Duholm, C. S., et al. (författare)
  • Specific Contamination Symptoms are Associated with Experiencing a Limited Response of Cognitive-Behavioral Therapy in Pediatric Patients with OCD
  • 2022
  • Ingår i: Child Psychiatry & Human Development. - : Springer Science and Business Media LLC. - 0009-398X .- 1573-3327.
  • Tidskriftsartikel (refereegranskat)abstract
    • A recent study identified three distinct treatment-response trajectories in pediatric OCD where higher levels of contamination symptoms predicted a limited response to cognitive-behavioral therapy (CBT). This study extends these findings by examining which specific symptoms characterize limited CBT response from baseline to 3-year follow-up, with an emphasis on contamination symptoms. The study sample comprised 269 pediatric patients with OCD, all receiving stepped-care treatment with manualized CBT. Differences in single item-reporting between the three trajectory groups were examined using linear mixed-effect modeling. Limited responders displayed a higher symptom load across all OCD symptom categories at 3-year follow-up, dominated by contamination symptoms. Five of these (obsessions about dirt and germs, about bodily fluids, about the feeling of contamination and compulsions regarding handwashing and showering) showed persistence from baseline to 3-year follow-up. The results indicate that presence of specific contamination symptoms may influence long-term symptom severity trajectories in young patients with OCD.
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  • Georgiadis, S, et al. (författare)
  • CAN SINGLE IMPUTATION TECHNIQUES FOR BASDAI COMPONENTS RELIABLY CALCULATE THE COMPOSITE SCORE IN AXIAL SPONDYLOARTHRITIS PATIENTS?
  • 2022
  • Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 81, s. 212-213
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • In axial spondyloarthritis (axSpA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a key patient-reported outcome. However, one or more of its components may be missing when recorded in clinical practice.ObjectivesTo determine whether an individual patient’s BASDAI at a given timepoint can be reliably calculated with different single imputation techniques and to explore the impact of the number of missing components and/or differences between missingness of individual components.MethodsReal-life data from axSpA patients receiving tumour necrosis factor inhibitors (TNFi) from 13 countries in the European Spondyloarthritis (EuroSpA) Research Collaboration Network were utilized [1]. We studied missingness in BASDAI components based on simulations in a complete dataset, where we applied and expanded the approach of Ramiro et al. [2]. After introducing one or more missing components completely at random, BASDAI was calculated from the available components and with three different single imputation techniques: possible middle value (i.e. 50) of the component and mean and median of the available components. Differences between the observed (original) and calculated scores were assessed and correct classification of patients as having BASDAI<40 mm was additionally evaluated. For the setting with one missing component, differences arising between missing one of components 1-4 versus 5-6 were explored. Finally, the performance of imputations in relation to the values of the original score was investigated.ResultsA total of 19,894 axSpA patients with at least one complete BASDAI registration at any timepoint were included. 59,126 complete BASDAI registrations were utilized for the analyses with a mean BASDAI of 38.5 (standard deviation 25.9). Calculating BASDAI from the available components and imputing with mean or median showed similar levels of agreement (Table 1). When allowing one missing component, >90% had a difference of ≤6.9 mm between the original and calculated scores and >95% were correctly classified as BASDAI<40 (Table 1). However, separate analyses of components 1-4 and 5-6 as a function of the BASDAI score suggested that imputing any one of the first four BASDAI components resulted in a level of agreement <90% for specific BASDAI values while imputing one of the stiffness components 5-6 always reached a level of agreement >90% (Figure 1, upper panels). As expected, it was observed that regardless of the BASDAI component set to missing and the imputation technique used, correct classification of patients as BASDAI<40 was less than 95% for values around the cutoff (Figure 1, lower panels).Table 1.Level of agreement between the original and calculated BASDAI and correct classification for BASDAI<40 mmLevel of agreement with Dif≤6.9 mm* (%)Correct classification for BASDAI<40 mm** (%)1 missing componentAvailable93.996.9Value 5073.996.3Mean94.296.8Median93.196.82 missing componentsAvailable83.794.8Value 5040.792.8Mean83.594.8Median82.894.73 missing componentsAvailable71.992.6Value 5028.187.3Mean72.292.6Median69.792.2* The levels of agreement with a difference (Dif) of ≤6.9 mm between the original and calculated scores were based on the half of the smallest detectable change. Agreement of >90% was considered as acceptable. ** Correct classification of >95% was considered as acceptable.Figure 1.Level of agreement between the original and calculated BASDAI and correct classification for BASDAI<40 mm as a function of the original scoreConclusionBASDAI calculation with available components gave similar results to single imputation of missing components with mean or median. Only when missing one of BASDAI components 5 or 6, single imputation techniques can reliably calculate individual BASDAI scores. However, missing any single component value results in misclassification of patients with original BASDAI scores close to 40.References[1]Ørnbjerg et al. (2019). Ann Rheum Dis, 78(11), 1536-1544.[2]Ramiro et al. (2014). Rheumatology, 53(2), 374-376.AcknowledgementsNovartis Pharma AG and IQVIA for supporting the EuroSpA collaboration.Disclosure of InterestsStylianos Georgiadis Grant/research support from: Novartis, Myriam Riek Grant/research support from: Novartis, Christos Polysopoulos Grant/research support from: Novartis, Almut Scherer Grant/research support from: Novartis, Daniela Di Giuseppe: None declared, Gareth T. Jones Speakers bureau: Janssen, Grant/research support from: AbbVie, Pfizer, UCB, Amgen, GSK, Merete Lund Hetland Grant/research support from: Abbvie, Biogen, BMS, Celltrion, Eli Lilly, Janssen Biologics B.V, Lundbeck Fonden, MSD, Medac, Pfizer, Roche, Samsung Biopies, Sandoz, Novartis, Mikkel Østergaard Speakers bureau: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, UCB, Consultant of: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, UCB, Grant/research support from: Abbvie, BMS, Merck, Celgene, Novartis, Simon Horskjær Rasmussen Grant/research support from: Novartis, Johan K Wallman Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Novartis, Bente Glintborg Grant/research support from: Pfizer, Abbvie, BMS, Anne Gitte Loft Speakers bureau: AbbVie, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Consultant of: AbbVie, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Karel Pavelka Speakers bureau: Pfizer, MSD, BMS, UCB, Amgen, Egis, Roche, AbbVie, Consultant of: Pfizer, MSD, BMS, UCB, Amgen, Egis, Roche, AbbVie, Jakub Zavada Speakers bureau: Abbvie, Elli-Lilly, Sandoz, Novartis, Egis, UCB, Consultant of: Abbvie, Elli-Lilly, Sandoz, Novartis, Egis, UCB, Merih Birlik: None declared, Ayten Yazici Grant/research support from: Roche, Brigitte Michelsen Grant/research support from: Novartis, Eirik kristianslund: None declared, Adrian Ciurea Speakers bureau: AbbVie, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Consultant of: AbbVie, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Michael J. Nissen Speakers bureau: AbbVie, Eli Lilly, Janssens, Novartis, Pfizer, Consultant of: AbbVie, Eli Lilly, Janssens, Novartis, Pfizer, Ana Maria Rodrigues Speakers bureau: Abbvie, Amgen, Consultant of: Abbvie, Amgen, Grant/research support from: Novartis, Pfizer, Amgen, Maria Jose Santos Speakers bureau: Abbvie, AstraZeneca, Lilly, Novartis, Pfizer, Gary Macfarlane Grant/research support from: GSK, Anna-Mari Hokkanen Grant/research support from: MSD, Heikki Relas Speakers bureau: Abbvie, Celgene, Pfizer, UCB, Viatris, Consultant of: Abbvie, Celgene, Pfizer, UCB, Viatris, Catalin Codreanu Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Ewopharma, Lilly, Novartis, Pfizer, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Ewopharma, Lilly, Novartis, Pfizer, Corina Mogosan: None declared, Ziga Rotar Speakers bureau: Abbvie, Novartis, MSD, Medis, Biogen, Eli Lilly, Pfizer, Sanofi, Lek, Janssen, Consultant of: Abbvie, Novartis, MSD, Medis, Biogen, Eli Lilly, Pfizer, Sanofi, Lek, Janssen, Matija Tomsic Speakers bureau: Abbvie, Amgen, Biogen, Eli Lilly, Janssen, Medis, MSD, Novartis, Pfizer, Sanofi, Sandoz-Lek, Consultant of: Abbvie, Amgen, Biogen, Eli Lilly, Janssen, Medis, MSD, Novartis, Pfizer, Sanofi, Sandoz-Lek, Björn Gudbjornsson Speakers bureau: Amgen, Novartis, Consultant of: Amgen, Novartis, Arni Jon Geirsson: None declared, Pasoon Hellamand Grant/research support from: Novartis, Marleen G.H. van de Sande Speakers bureau: Eli Lilly, Novartis, UCB, Janssen, Abbvie, Consultant of: Eli Lilly, Novartis, UCB, Janssen, Abbvie, Grant/research support from: Eli Lilly, Novartis, UCB, Janssen, Abbvie, Isabel Castrejon: None declared, Manuel Pombo-Suarez Consultant of: Abbvie, MSD, Roche, Bruno Frediani: None declared, Florenzo Iannone Speakers bureau: Abbvie, Amgen, AstraZeneca, BMS, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Consultant of: Abbvie, Amgen, AstraZeneca, BMS, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, UCB, Lykke Midtbøll Ørnbjerg Grant/research support from: Novartis
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33.
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34.
  • Grundahl, F, et al. (författare)
  • Abundances of RGB stars in NGC 6752
  • 2002
  • Ingår i: Astronomy & Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 385, s. 14-17
  • Tidskriftsartikel (refereegranskat)abstract
    • Abundances of O, Fe, Al, Mg, Na and Li determined from high-resolutionand high signal-to-noise spectra of 21 red giant branch (RGB) stars inthe globular cluster NGC 6752 are presented. We demonstrate that theStrömgren c1 index correlates extremely well with themeasured NH, CH and CN indices and that variations in c1 aredue to differences in UV NH band strengths. As shown by Grundahl et al.(cite{grundahl02}), the RGB stars in all 20 globular clusters surveyedpossess large star-to-star variations in their c1 index,which we interpret as significant inhomogeneities in N abundances. Thewell known relations among O and Na and Mg and Al as well as with CN,CH, and NH are also present in these stars, some of which are fainterthan the RGB bump. We find that the Li (6708 Å) equivalent widthbecomes too small to be measured as the luminosity of the stars increaseabove the luminosity of the RGB bump. Taken together, these data enforcethe results of Gratton et al. (cite{gratton01}) for turnoff andsub-giant branch stars, and suggest that in this cluster the abundancecorrelations observed among the brighter giants are in place prior toappreciable RGB ascent and likely due to previous generation(s) ofstars, rather than due to mixing in the observed stars. Based onobservations obtained with the ESO Very Large Telescope UVESspectrograph for programme 65.L-0165(A). Based on observations obtainedwith the Danish 1.5 m telescope at the European Southern Observatory, LaSilla, Chile.
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36.
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37.
  • Jensen, S., et al. (författare)
  • Distinct trajectories of long-term symptom severity in pediatric obsessive-compulsive disorder during and after stepped-care treatment
  • 2020
  • Ingår i: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 61:9, s. 969-978
  • Tidskriftsartikel (refereegranskat)abstract
    • Background First-line treatments for pediatric obsessive-compulsive disorder (OCD) include exposure-based cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs). No studies have thus far identified distinct classes and associated predictors of long-term symptom severity during and after treatment. Yet, these could form the basis for more personalized treatment in pediatric OCD. Method The study included 269 OCD patients aged 7-17 years from the Nordic Long-term OCD Treatment Study (NordLOTS). All participants received stepped-care treatment starting with 14 weekly sessions of manualized CBT. Nonresponders were randomized to either prolonged CBT or SSRIs. Symptom severity was assessed using the Children's Yale-Brown Obsessive-Compulsive Scale at seven time points from pre- to post-treatment and over a three-year follow-up. Latent class growth analysis (LCGA) was performed to identify latent classes of symptom severity trajectories. Univariate and multivariate analyses were used to detect differences between classes and identify predictors of trajectory class membership including several clinical and demographic variables. Trial registry: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; ; ISRCTN66385119. Results Three LCGA classes were identified: (a) acute, sustained responders (54.6%); (b) slow, continued responders (23.4%); and (c) limited long-term responders (21.9%). Class membership was predicted by distinct baseline characteristics pertaining to age, gender, symptom presentation, insight, avoidance, and comorbidity. Conclusions The LCGA suggests three distinct trajectory classes of long-term symptom severity during and after treatment in pediatric OCD with different clinical profiles at pretreatment. The results point to required clinical attention for adolescent patients with contamination/cleaning symptoms and reduced insight who do not show convincing responses to first-line treatment even though they may have reached the established cutoff for treatment response.
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38.
  • Jensen, S., et al. (författare)
  • Long- term remission status in pediatric obsessive-compulsive disorder: Evaluating the predictive value of symptom severity after treatment
  • 2022
  • Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781. ; 317
  • Tidskriftsartikel (refereegranskat)abstract
    • It is unknown if long-term remission for pediatric obsessive-compulsive disorder (OCD) patients is associated with post-treatment OCD symptom severity. The aim of the present study was to evaluate if post-treatment symptom severity cut-offs can discriminate remitters from non-remitters in pediatric OCD patients during three years of follow-up. All participants (N = 269) from the Nordic Long-term OCD Treatment Study (Nor-dLOTS) undergoing stepped-care treatment were included. Patients were rated with the Clinical Global Impression - Severity Scale (CGI-S) one (n = 186), two (n = 167), and three years (n = 166) after first-line cognitive-behavioral therapy. Post-treatment symptom severity scores as well as percentage reductions during treatment evaluated with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were analyzed using receiver operating characteristics according to the CGI-S remission scores (< 2) at follow-up. Post-treatment CY-BOCS severity scores acceptably discriminated remitters from non-remitters at one-year follow-up, but poorly for the two-and three-year follow-up. Severity percentage reduction during treatment did not discriminate remis-sion status acceptably at any follow-up point. Post-treatment OCD symptom severity status seems to have little discriminative value for long-term remission status in pediatric patients. Further research is warranted to detect post-treatment factors of prognostic value.
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39.
  • Jensen, S., et al. (författare)
  • Quality of life in pediatric patients with obsessive-compulsive disorder during and 3 years after stepped-care treatment
  • 2022
  • Ingår i: European Child & Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 31:9, s. 1377-1389
  • Tidskriftsartikel (refereegranskat)abstract
    • The present study aimed to investigate the long-term quality of life (QoL) in a large sample of pediatric obsessive-compulsive disorder (OCD) patients. The study included 220 pediatric OCD patients from the Nordic Long-term OCD Treatment Study (NordLOTS) who were evaluated at seven time points before, during, and after stepped-care treatment over a 3-year follow-up period. Data from three symptom severity trajectory classes formed the basis of the QoL evaluation: acute (n = 127, N = 147), slow (n = 46, N = 63), and limited responders (n = 47, N = 59). Patients' QoL was assessed using parent and child ratings of the revised Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). QoL was analyzed by trajectory class using a random mixed effects model. The association between pre-treatment factors and long-term QoL was investigated across classes in a multivariate model. Three years after treatment, the acute responder class had reached QoL levels from a general population, whereas the limited responder class had not. The slow responder class reached norm levels for the child-rated QoL only. Higher levels of co-occurring externalizing symptoms before treatment were associated with lower parent-rated QoL during follow-up, while adolescence and higher levels of co-occurring internalizing symptoms were associated with lower child-rated QoL during follow-up. For some patients, residual OCD symptoms in the years after treatment, even at levels below assumed clinical significance, are associated with compromised QoL. Co-occurring symptoms could be part of the explanation. Assessing QoL after OCD treatment, beyond the clinician-rated symptom severity, could detect patients in need of further treatment and/or assessment. Trial registry: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; ; ISRCTN66385119.
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40.
  • Jonas, W., et al. (författare)
  • Short- and long-term decrease of blood pressure in women during breastfeeding
  • 2008
  • Ingår i: Breastfeeding Medicine. - New Rochelle : Mary Ann Liebert Inc. - 1556-8253 .- 1556-8342. ; 3:2, s. 103-109
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: The benefits of breastfeeding for infants are well known. Recently data have started to emerge showing that breastfeeding may also induce positive effects in the mother. This study aimed to investigate the pattern of maternal blood pressure before, during, and after a breastfeed 2 days postpartum. Additionally, blood pressure during the following 25-week breastfeeding period was investigated. Methods: Sixty-six primiparae with normal deliveries were consecutively recruited. Blood pressure was measured at -5, 10, 30, and 60 minutes in connection with a morning breastfeed. Thirty-three women continued to measure blood pressure before and after breastfeeding for 25 weeks. Results: Blood pressure fell significantly in response to breastfeeding 2 days after birth. The fall in systolic and diastolic blood pressure amounted to 8.8 (SD = 11.00) and 7.7 (SD = 9.3) mm Hg, respectively. During the 25-week follow-up period a significant fall of basal blood pressure (systolic, df = 3, F = 7.843, p < 0.001; diastolic, df = 3, F = 5.453, p = 0.002) was observed. The total fall in systolic and diastolic blood pressure amounted to a mean of 15 (SD = 10.4) mm Hg and 10 (SD = 9.7) mm Hg, respectively. In addition, blood pressure fell significantly in response to individual breastfeeding sessions during the entire observation period. Conclusions: In conclusion, both systolic and diastolic blood pressures fall during a breastfeeding session, and pre-breastfeeding blood pressure decreases during at least the first 6 months of a breastfeeding period in a homelike environment. This study lends further support to the health-promoting effects of breastfeeding. © 2008 Mary Ann Liebert, Inc.
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41.
  • Jönsson, Henrik, et al. (författare)
  • Sulphur abundances in halo giants from the [S I] line at 1082 nm and the [S I] triplet around 1045 nm
  • 2011
  • Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 530, s. A144-
  • Tidskriftsartikel (refereegranskat)abstract
    • Context. It is still debated whether or not the Galactic chemical evolution of sulphur in the halo follows the flat trend with [Fe/H] that is ascribed to the result of explosive nucleosynthesis in type II SNe. It has been suggested that the disagreement between different investigations of sulphur abundances in halo stars might be owing to problems with the diagnostics used, that a new production source of sulphur might be needed in the early Universe, like hypernovae, or that the deposition of supernova ejecta into the interstellar medium is time-delayed. Aims. The aim of this study is to try to clarify this situation by measuring the sulphur abundance in a sample of halo giants using two diagnostics: the S I triplet around 1045 nm and the [S I] line at 1082 nm. The latter of the two is not believed to be sensitive to non-LTE effects. We can thereby minimize the uncertainties in the diagnostic used and estimate the usefulness of the triplet for the sulphur determination in halo K giants. We will also be able to compare our sulphur abundance differences from the two diagnostics with the expected non-LTE effects in the 1045 nm triplet previously calculated by others. Methods. High-resolution near-infrared spectra of ten K giants were recorded using the spectrometer CRIRES mounted at VLT. Two standard settings were used, one covering the S I triplet and one covering the [S I] line. The sulphur abundances were individually determined with equivalent widths and synthetic spectra for the two diagnostics using tailored 1D model atmospheres and relying on non-LTE corrections from the litterature. Effects of convective inhomogeneities in the stellar atmospheres are investigated. Results. The sulphur abundances derived from both the [S I] line and the non-LTE corrected 1045 nm triplet favor a flat trend for the evolution of sulphur. In contrast to some previous studies, we saw no "high" values of [S/Fe] in our sample. Conclusions. We corroborate the flat trend in the [S/Fe] vs. [Fe/H] plot for halo stars found in some previous studies but do not find a scatter or a rise in [S/Fe] as obtained in other works. We find the sulphur abundances deduced from the non-LTE corrected triplet to be somewhat lower than the abundances from the [S I] line, possibly indicating too large non-LTE corrections. Considering 3D modeling, however, they might instead be too small. Moreover, we show that the [S I] line can be used as a sulphur diagnostic down to [Fe/H] similar to - 2.3 in giants.
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42.
  • Lawniczak, Mara K. N., et al. (författare)
  • Standards recommendations for the Earth BioGenome Project
  • 2022
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences (PNAS). - 0027-8424 .- 1091-6490. ; 119:4
  • Tidskriftsartikel (refereegranskat)abstract
    • A global international initiative, such as the Earth BioGenome Project (EBP), requires both agreement and coordination on standards to ensure that the collective effort generates rapid progress toward its goals. To this end, the EBP initiated five technical standards committees comprising volunteer members from the global genomics scientific community: Sample Collection and Processing, Sequencing and Assembly, Annotation, Analysis, and IT and Informatics. The current versions of the resulting standards documents are available on the EBP website, with the recognition that opportunities, technologies, and challenges may improve or change in the future, requiring flexibility for the EBP to meet its goals. Here, we describe some highlights from the proposed standards, and areas where additional challenges will need to be met.
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45.
  • Lindström, Ulf, et al. (författare)
  • Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration
  • 2021
  • Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 80, s. 1410-1418
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy. Methods: Patients with PsA from 13 European countries who initiated a first TNFi in 2006-2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not significant. Secondary analyses stratified according to TNFi subtype (adalimumab/infliximab/etanercept) and restricted to methotrexate as comedication were performed. Results: In total, 15 332 patients were included (62% comedication, 38% monotherapy). TNFi retention varied across countries, with significant heterogeneity precluding a combined estimate. Comedication was associated with better remission rates, pooled OR 1.25 (1.12-1.41). Methotrexate comedication was associated with improved remission for adalimumab (OR 1.45 (1.23-1.72)) and infliximab (OR 1.55 (1.21-1.98)) and improved retention for infliximab. No effect of comedication was demonstrated for etanercept. Conclusion: This large observational study suggests that, as used in clinical practice, csDMARD and TNFi comedication are associated with improved remission rates, and specifically, comedication with methotrexate increases remission rates for both adalimumab and infliximab. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
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48.
  • Melander, Eva, et al. (författare)
  • Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties.
  • 2003
  • Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 1432-1041 .- 0031-6970. ; 59:4, s. 331-335
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Antibiotic utilisation varies profoundly among and within countries, and the extent of antibiotic utilisation correlates with the frequency of bacterial resistance, particularly among children. Hence, it is important to assess which factors may influence prescribing. In addition to variations in morbidity, health-care organisation, drug regulatory and supply systems, prescriber's attitudes, parents' behaviour, attitudes and socio-economic positions seem important. We compared socio-economic position (educational level of adults) and antibiotic utilisation in children in the municipalities within a Danish and a Swedish county which are geographically close, have similar social and economic development, and similar drug regulatory and supply systems. Methods. Data on antibiotic utilisation (1998), expressed in defined daily doses per 1000 inhabitants per day (DDD/TID), were obtained from the Copenhagen County Health Insurance register and from the National Corporation of Swedish Pharmacies. Data on municipal educational levels were obtained from Statistics Denmark and Statistics Sweden. Results. The utilisation of antibiotics in 0- to 6-year-old children was higher in the Swedish than in the Danish county but varied between the municipalities within both the Swedish (9.6-17.7 DDD/TID) and the Danish (8.0-12.9 DDD/TID) counties. Most notably, utilisation rates correlated negatively with the education levels in the Danish (r=-0.539, P=0.021) but positively in the Swedish (r=+0.390, P=0.025) municipalities. Conclusion. The observed variations in antibiotic prescribing may reflect different parental and/or prescriber attitudes towards use of antibiotics and they emphasise that antibiotic prescribing is influenced by factors other than the prevalence of bacterial infections. Relationships between socio-economic position (educational level) and drug utilisation should not be generalised from one area to another.
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