| 1. |
- Kumarathunge, Dushan P., et al.
(författare)
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Acclimation and adaptation components of the temperature dependence of plant photosynthesis at the global scale
- 2019
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Ingår i: New Phytologist. - : John Wiley & Sons. - 0028-646X .- 1469-8137. ; 222:2, s. 768-784
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Tidskriftsartikel (refereegranskat)abstract
- The temperature response of photosynthesis is one of the key factors determining predicted responses to warming in global vegetation models (GVMs). The response may vary geographically, owing to genetic adaptation to climate, and temporally, as a result of acclimation to changes in ambient temperature. Our goal was to develop a robust quantitative global model representing acclimation and adaptation of photosynthetic temperature responses.We quantified and modelled key mechanisms responsible for photosynthetic temperature acclimation and adaptation using a global dataset of photosynthetic CO2 response curves, including data from 141 C3 species from tropical rainforest to Arctic tundra. We separated temperature acclimation and adaptation processes by considering seasonal and common-garden datasets, respectively.The observed global variation in the temperature optimum of photosynthesis was primarily explained by biochemical limitations to photosynthesis, rather than stomatal conductance or respiration. We found acclimation to growth temperature to be a stronger driver of this variation than adaptation to temperature at climate of origin.We developed a summary model to represent photosynthetic temperature responses and showed that it predicted the observed global variation in optimal temperatures with high accuracy. This novel algorithm should enable improved prediction of the function of global ecosystems in a warming climate.
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| 2. |
- Abraham-Nordling, Mirna, et al.
(författare)
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Incidence of hyperthyroidism in Stockholm, Sweden, 2003-2005
- 2008
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Ingår i: European Journal of Endocrinology. - 1479-683X. ; 158:6, s. 823-827
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the incidence of hyperthyroidism in Stockholm County in those patients who were diagnosed with hyperthyroidism for the First time during the years 2003-2005. Design: All new cases of hyperthyroidism >= 18 years of age were prospectively registered to calculate the total incidence of hyperthyroidism, as well as the incidence of the subgroups: Graves' disease (GD), toxic multinodular goitre and solitary toxic adenoma (STA). Eight specialized units/hospitals in Stockholm County participated in the registration. The participating physicians were all specialists in medical endocrinology. oncology, nuclear medicine or surgery. Results: Duringa 3-year period, 1431 new patients of hyperthyroidism were diagnosed in a well-defined adult population (>18 years of age) of in average 1 457 036 inhabitants. This corresponds to a mean annual incidence of hyperthyroidism of 32.7/100 000. The incidence of GD was 24.5/100 000 per year. toxic nodular goitre was 3.3/100 000 per year and STA was 4.9/100 000 per year. Conclusions: The total incidence of hyperthyroidism in Stockholm County was found to be 32.7/100 000 per year. of which 75% had GD. There were a higher percentage of smokers among the patients with hyperthyroidism compared with the overall population in Stockholm, but no difference in the frequency of smoking between patients with GD and toxic nodular goitre.
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| 3. |
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| 4. |
- Ahlberg, Erik, et al.
(författare)
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"Vi klimatforskare stödjer Greta och skolungdomarna"
- 2019
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Ingår i: Dagens nyheter (DN debatt). - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- DN DEBATT 15/3. Sedan industrialiseringens början har vi använt omkring fyra femtedelar av den mängd fossilt kol som får förbrännas för att vi ska klara Parisavtalet. Vi har bara en femtedel kvar och det är bråttom att kraftigt reducera utsläppen. Det har Greta Thunberg och de strejkande ungdomarna förstått. Därför stödjer vi deras krav, skriver 270 klimatforskare.
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| 5. |
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| 6. |
- Jakobsson, Martin, 1966-, et al.
(författare)
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An Arctic Ocean ice shelf during MIS 6 constrained by new geophysical and geological data
- 2010
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Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 29:25-26, s. 3505-3517
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Tidskriftsartikel (refereegranskat)abstract
- The hypothesis of floating ice shelves covering the Arctic Ocean during glacial periods was developed in the 1970s. In its most extreme form, this theory involved a 1000 m thick continuous ice shelf covering the Arctic Ocean during Quaternary glacial maxima including the Last Glacial Maximum (LGM). While recent observations clearly demonstrate deep ice grounding events in the central Arctic Ocean, the ice shelf hypothesis has been difficult to evaluate due to a lack of information from key areas with severe sea ice conditions. Here we present new data from previously inaccessible, unmapped areas that constrain the spatial extent and timing of marine ice sheets during past glacials. These data include multibeam swath bathymetry and subbottom profiles portraying glaciogenic features on the Chukchi Borderland, southern Lomonosov Ridge north of Greenland, Morris Jesup Rise, and Yermak Plateau. Sediment cores from the mapped areas provide age constraints on the glaciogenic features. Combining these new geophysical and geological data with earlier results suggests that an especially extensive marine ice sheet complex, including an ice shelf, existed in the Amerasian Arctic Ocean during Marine Isotope Stage (MIS) 6. From a conceptual oceanographic model we speculate that the cold halocline of the Polar Surface Water may have extended to deeper water depths during MIS 6 inhibiting the warm Atlantic water from reaching the Amerasian Arctic Ocean and, thus, creating favorable conditions for ice shelf development. The hypothesis of a continuous 1000 m thick ice shelf is rejected because our mapping results show that several areas in the central Arctic Ocean substantially shallower than 1000 m water depth are free from glacial influence on the seafloor.
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| 7. |
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| 8. |
- Träisk, Frank, et al.
(författare)
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Thyroid-Associated Ophthalmopathy after Treatment for Graves´Hyperthyroidism with Antithyroid Drugs or lodine-131
- 2009
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 94:10, s. 3700-3707
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Tidskriftsartikel (refereegranskat)abstract
- Context: Previous randomized trials have suggested an association between radioiodine treatment for Graves' hyperthyroidism and thyroid-associated ophthalmopathy (TAO). Objectives: The aim of the study was to compare the occurrence of worsening or development of TAO in patients who were treated with radioiodine or antithyroid drugs. Design: We conducted a randomized trial (TT 96) with a follow-up of 4 yr. Patients, Setting, and Intervention: Patients with a recent diagnosis of Graves' hyperthyroidism were randomized to treatment with iodine-131 (163 patients) or 18 months of medical treatment (150 patients). Early substitution with T-4 was given in both groups. Main Outcome Measure: Worsening or development of TAO was significantly more common in the iodine-131 treatment group (63 patients; 38.7%) compared with the medical treatment group (32 patients; 21.3%) (P < 0.001). Results: The risk for de novo development of TAO was greater in patients treated with iodine-131 (53 patients) than with medical treatment(23patients). However, worsening of TAO in the 41 patients who had ophthalmopathy already before the start of treatment was not more common in the radioiodine group (10 patients) than in the medical group (nine patients). Smoking was shown to influence the risk of worsening or development of TAO, and smokers treated with radioiodine had the overall highest risk for TAO. However, in the group of smokers, worsening or development of TAO was not significantly associated with the choice of treatment for hyperthyroidism. Conclusions: Radioiodine treatment is a significant risk factor for development of TAO in Graves' hyperthyroidism. Smokers run the highest risk for worsening or development of TAO irrespective of treatment modality.
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| 9. |
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| 10. |
- Wallin, Paul, 1961-, et al.
(författare)
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Re-dating Ahu Nau Nau and the Settlement at 'Anakena, Rapa Nui
- 2010
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Ingår i: The Gotland Papers. - Visby : Gotland University. - 9789186343071 ; , s. 37-46
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The building phase and early use of Ahu Nau Nau have been re-dated by nine charcoal and rat bone samples. The new dates in comparison with earlier data suggest that the ahu was constructed around 650-550 BP. It is also suggested that a settlement dated to c. 950-900 BP preceded the ahu-building phase. A new question in light of recent research might be raised: Is the earliest settlement on Rapa Nui found at ´Anakena or should we look elsewhere?
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| 11. |
- Abraham-Nordling, Mirna, et al.
(författare)
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Incidence of hyperthyroidism in Sweden
- 2011
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Ingår i: European Journal of Endocrinology. - 0804-4643 .- 1479-683X. ; 165:6, s. 899-905
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The incidence of hyperthyroidism has been reported in various countries to be 23-93/100000 inhabitants per year. This extended study has evaluated the incidence for similar to 40% of the Swedish population of 9 million inhabitants. Sweden is considered to be iodine sufficient country. Methods:All patients including children, who were newly diagnosed with overt hyperthyroidism in the years 2003-2005, were prospectively registered in a multicenter study. The inclusion criteria are as follows:clinical symptoms and/or signs of hyperthyroidism with plasma TSH concentration below 0.2 mIE/l and increased plasma levels of free/total triiodothyronine and/or free/total thyroxine. Patients with relapse of hyperthyroidism or thyroiditis were not included. The diagnosis of Graves' disease (GD), toxic multinodular goiter (TMNG) and solitary toxic adenoma (STA), smoking, initial treatment, occurrence of thyroid-associated eye symptoms/signs, and demographic data were registered. Results:A total of 2916 patients were diagnosed with de novo hyperthyroidism showing the total incidence of 27.6/100 000 inhabitants per year. The incidence of GD was 21.0/100 000 and toxic nodular goiter (TNG=STA+TMNG) occurred in 692 patients, corresponding to an annual incidence of 6.5/100 000. The incidence was higher in women compared with men (4.2:1). Seventy-five percent of the patients were diagnosed with GD, in whom thyroid-associated eye symptoms/signs occurred during diagnosis in every fifth patient. Geographical differences were observed. Conclusion:The incidence of hyperthyroidism in Sweden is in a lower range compared with international reports. Seventy-five percent of patients with hyperthyroidism had GD and 20% of them had thyroid-associated eye symptoms/signs during diagnosis. The observed geographical differences require further studies.
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| 12. |
- af Ekenstam, Angelica, et al.
(författare)
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Leaf respiration rates are increased by warm season as well as by elevated temperature treatment in Eucalyptus globulus
- 2014
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Ingår i: EGU General Assembly 2014, held 27 April - 2 May, 2014 in Vienna, Austria.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Plant leaf respiration is one of the major CO2 fluxes between terrestrial biosphere and the atmosphere, and its responses to elevated CO2 and temperature thus have important implications for the carbon cycle and rate on ongoing climate change. Non-photorespiratory leaf respiration is reduced in light, Rlight, compared with the rate in the dark, Rdark. It is therefore important to consider both Rlight and Rdark when estimating the exchange of CO2 between the biosphere and the atmosphere, during current and future climates. This study was conducted at the Hawkesbury Forest Experiment, HFE, in Richmond, NSW, Australia. Trees of Tasmanian Blue Gum (Eucalyptus globulus Labill.) were exposed in whole tree chambers (WTC) to a complete factorial combination of ambient and elevated temperature and CO2 (+3 °C and +240 ppm CO2, respectively). The measurements of Rlight and Rdark were made in 2011 after 15 month exposure in the WTCs. The measurements were made in March (after the year’s hottest months) and October (after the coldest period). Rlight was determined at four temperatures ranging between 20 and 40 °C on attached leaves using a portable gas exchange system (LI-6400XT). Rdark was measured at 20-40 °C in October and at 25 °C in March. Rdark was measured after dark acclimation for at least 30 min and Rlight was determined from the intersection of the photosynthetic CO2 responses measured at three different light intensities using the Laisk metod. Trees grown in elevated temperature had a considerably higher Rdark (+53% across all measurement temperatures in October). However, Rlight did not respond significantly to either CO2 or temperature. In October, the Rlight to Rdark ratio indicated an overall light inhibition of respiration of 31% across all temperatures and in March the light inhibition was 22 % at 25 °C. The seasonal comparisons showed that both Rlight and Rdark were considerably higher after the warm compared to cold season, especially when measured at high temperature. These results points out the importance to account for Rlight as well as seasonal thermal respiratory acclimation when improving predictions of the carbon exchange between tree canopies and the atmosphere. If not taking light inhibition into account, leaf respiration is being overestimated and if not taking the seasonal acclimation into account the errors are potentially very large.
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| 13. |
- Ahl, Rebecka, 1987-, et al.
(författare)
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Does beta-blockade reduce the risk of depression in patients with isolated severe extracranial injuries?
- 2017
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Ingår i: World Journal of Surgery. - New York : Springer. - 0364-2313 .- 1432-2323. ; 41:7, s. 1801-1806
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without significant brain injury.METHODS: Patients were identified by retrospectively reviewing the trauma registry at an urban university hospital between 2007 and 2011. Severe extracranial injuries were defined as extracranial injuries with Abbreviated Injury Scale score ≥3, intracranial Abbreviated Injury Scale score <3 and an Injury Severity Score ≥16. In-hospital deaths and patients prescribed antidepressant therapy ≤1 year prior to admission were excluded. Patients were stratified into groups based on pre-admission beta-blocker status. The primary outcome was post-traumatic depression, defined as receiving antidepressants ≤1 year following trauma.RESULTS: Five hundred and ninety-six patients met the inclusion criteria with 11.4% prescribed pre-admission beta-blockade. Patients receiving beta-blockers were significantly older (57 ± 18 vs. 42 ± 17 years, p < 0.001) with lower Glasgow Coma Scale score (12 ± 3 vs. 14 ± 2, p < 0.001). The beta-blocked cohort spent significantly longer in hospital (21 ± 20 vs. 15 ± 17 days, p < 0.01) and intensive care (4 ± 7 vs. 3 ± 5 days, p = 0.01). A forward logistic regression model was applied and predicted lack of beta-blockade to be associated with increased risk of depression (OR 2.7, 95% CI 1.1-7.2, p = 0.04). After adjusting for group differences, patients lacking beta-blockers demonstrated an increased risk of depression (AOR 3.3, 95% CI 1.2-8.6, p = 0.02).CONCLUSIONS: Pre-admission beta-blockade is associated with a significantly reduced risk of depression following severe traumatic injury. Further investigation is needed to determine the beneficial effects of beta-blockade in these instances.
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| 14. |
- Ahl, Rebecka, 1987-, et al.
(författare)
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Effects of beta-blocker therapy on mortality after elective colon cancer surgery : a Swedish nationwide cohort study
- 2020
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Colon cancer surgery remains associated with substantial postoperative morbidity and mortality despite advances in surgical techniques and care. The trauma of surgery triggers adrenergic hyperactivation which drives adverse stress responses. We hypothesised that outcome benefits are gained by reducing the effects of hyperadrenergic activity with beta-blocker therapy in patients undergoing colon cancer surgery. This study aims to test this hypothesis.DESIGN: Retrospective cohort study.SETTING AND PARTICIPANTS: This is a nationwide study which includes all adult patients undergoing elective colon cancer surgery in Sweden over 10 years. Patient data were collected from the Swedish Colorectal Cancer Registry. The national drugs registry was used to obtain information about beta-blocker use. Patients were subdivided into exposed and unexposed groups. The association between beta-blockade, short-term and long-term mortality was evaluated using Poisson regression, Kaplan-Meier curves and Cox regression.PRIMARY AND SECONDARY OUTCOMES: Primary outcome of interest was 1-year all-cause mortality. Secondary outcomes included 90-day all-cause and 5-year cancer-specific mortality.RESULTS: The study included 22 337 patients of whom 36.1% were prescribed preoperative beta-blockers. Survival was higher in patients on beta-blockers up to 1 year after surgery despite this group being significantly older and of higher comorbidity. Regression analysis demonstrated significant reductions in 90-day deaths (IRR 0.29, 95% CI 0.24 to 0.35, p<0.001) and a 43% risk reduction in 1-year all-cause mortality (adjusted HR 0.57, 95% CI 0.52 to 0.63, p<0.001) in beta-blocked patients. In addition, cancer-specific mortality up to 5 years after surgery was reduced in beta-blocked patients (adjusted HR 0.80, 95% CI 0.73 to 0.88, p<0.001).CONCLUSION: Preoperative beta-blockade is associated with significant reductions in postoperative short-term and long-term mortality following elective colon cancer surgery. Its potential prophylactic effect warrants further interventional studies to determine whether beta-blockade can be used as a way of improving outcomes for this patient group.
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| 15. |
- Ahl, Rebecka, 1987-
(författare)
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The Association Between Beta-Blockade and Clinical Outcomes in the Context of Surgical and Traumatic Stress
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Traumatic injury and major abdominal surgery are areas in general surgery associated with high rates of morbidity and mortality. The overall colorectal cancer surgery mortality rate is around 4%, with that for emergency surgery more than twice as high as for planned. Surgical morbidity varies between 25% and 45%. Around half of trauma patients develop low mood. In one quarter of patients this becomes permanent. Depression is known to impede physical rehabilitation and recovery. The onset of physiological stress, driven by adrenergic hyperactivity following traumatic and surgical injury is hypothesized to contribute to these adverse outcomes. Interest has therefore been sparked into blocking adrenergic receptor activation.Papers I and II investigated the role of beta-blocker therapy in preventing post-traumatic depression following severe traumatic brain injury (Paper I) and severe extracranial injury (Paper II). The Karolinska University Hospital Trauma Registry was used to identify patients admitted between 2007 and 2011. In Paper I (n = 545), patients on pre-injury beta-blocker therapy were matched to beta-blocker naïve patients with equivalent injury burden. Results revealed that beta-blocked patients exhibited a 60% reduced risk of needing antidepressant therapy within one year of trauma. In Paper II (n = 596), the lack of beta-blocker use before extracranial trauma was linked to a three-fold increase in the risk of antidepressant initiation.Papers III-V explored the role of pre-operative beta-blocker therapy in patients undergoing surgery for colorectal cancer between 2007 and 2016, identified using the nationwide Swedish Colorectal Cancer Registry. Paper III (n = 3,187) identified a 69% reduction in the risk of 30-day mortality in beta-blocked patients. Paper IV (n = 22,337) outlined long-term survival benefits for patients on beta-blocker therapy prior to undergoing elective surgery for colon cancer. Beta-blocked patients showed a risk reduction of 42% for 1-year all-cause mortality and 18% for 5-year cancerspecific mortality. Similarly, patients on beta-blocker therapy who underwent surgery for rectal cancer demonstrated improved survival up to one year after surgery with a risk reduction of 57% and a reduction in anastomotic failure and infectious complications in Paper V (n = 11,966).
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| 16. |
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| 17. |
- Aktypis, Charalampos, et al.
(författare)
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Cardiovascular Toxicities Secondary to Biotherapy and Molecular Targeted Therapies in Neuroendocrine Neoplasms : A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.
- 2021
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Ingår i: Cancers. - : MDPI. - 2072-6694. ; 13:9
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Forskningsöversikt (refereegranskat)abstract
- A broad spectrum of novel targeted therapies with prime antitumor activity and/or ample control of hormonal symptoms together with an overall acceptable safety profile have emerged for patients with metastatic neuroendocrine neoplasms (NENs). In this systematic review and quantitative meta-analysis, the PubMed, EMBASE, Cochrane Central Register of Controlled Trials and clinicaltrials.gov databases were searched to assess and compare the safety profile of NEN treatments with special focus on the cardiovascular adverse effects of biotherapy and molecular targeted therapies (MTTs). Quality/risk of bias were assessed using GRADE criteria. Placebo-controlled randomized clinical trials (RCTs) in patients with metastatic NENs, including medullary thyroid cancer (MTC) were included. A total of 3695 articles and 122 clinical trials registered in clinicaltrials.gov were screened. We included sixteen relevant RCTs comprising 3408 unique patients assigned to different treatments compared with placebo. All the included studies had a low risk of bias. We identified four drug therapies for NENs with eligible placebo-controlled RCTs: somatostatin analogs (SSAs), tryptophan hydroxylase (TPH) inhibitors, mTOR inhibitors and tyrosine kinase inhibitors (TKI). Grade 3 and 4 adverse effects (AE) were more often encountered in patients treated with mTOR inhibitors and TKI (odds ratio [OR]: 2.42, 95% CI: 1.87-3.12 and OR: 3.41, 95% CI: 1.46-7.96, respectively) as compared to SSAs (OR:0.77, 95% CI: 0.47-1.27) and TPH inhibitors (OR:0.77, 95% CI: 0.35-1.69). MTOR inhibitors had the highest risk for serious cardiac AE (OR:3.28, 95% CI: 1.66-6.48) followed by TKIs (OR:1.51, 95% CI: 0.59-3.83). Serious vascular AE were more often encountered in NEN patients treated with mTOR inhibitors (OR: 1.72, 95% CI: 0.64-4.64) and TKIs (OR:1.64, 95% CI: 0.35-7.78). Finally, patients on TKIs were at higher risk for new-onset or exacerbation of pre-existing hypertension (OR:3.31, 95% CI: 1.87-5.86). In conclusion, SSAs and TPH inhibitors appear to be safer as compared to mTOR inhibitors and TKIs with regards to their overall toxicity profile, and cardiovascular toxicities in particular. Special consideration should be given to a patient-tailored approach with anticipated toxicities of targeted NEN treatments together with assessment of cardiovascular comorbidities, assisting clinicians in treatment selection and early recognition/management of cardiovascular toxicities. This approach could improve patient compliance and preserve cardiovascular health and overall quality of life.
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| 18. |
- Alevroudis, Emmanouil, et al.
(författare)
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Clinical utility of 18f-fdg pet in neuroendocrine tumors prior to peptide receptor radionuclide therapy : A Systematic Review and Meta-Analysis
- 2021
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Ingår i: Cancers. - : MDPI. - 2072-6694. ; 13:8
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Forskningsöversikt (refereegranskat)abstract
- The role of 18F-FDG PET in patients with variable grades of neuroendocrine tumors (NETs) prior to peptide receptor radionuclide therapy (PRRT) has not been adequately elucidated. We aimed to evaluate the impact of 18F-FDG PET status on disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) in neuroendocrine tumor (NET) patients receiving PRRT. We searched the MEDLINE, Embase, Cochrane Library, and Web of Science databases up to July 2020 and used the Newcastle-Ottawa scale (NOS) criteria to assess quality/risk of bias. A total of 5091 articles were screened. In 12 studies, 1492 unique patients with NETs of different origins were included. The DCR for patients with negative 18F-FDG PET status prior to PRRT initiation was 91.9%, compared to 74.2% in patients with positive 18F-FDG PET status (random effects odds ratio (OR): 4.85; 95% CI: 2.27–10.36). Adjusted analysis of pooled hazard ratios (HRs) confirmed longer PFS and OS in NET patients receiving PRRT with negative 18F-FDG PET (random effects HR:2.45; 95%CIs: 1.48–4.04 and HR:2.25; 95% CIs:1.55–3.28, respectively). In conclusion, 18F-FDG PET imaging prior to PRRT administration appears to be a useful tool in NET patients to predict tumor response and survival outcomes and a negative FDG uptake of the tumor is associated with prolonged PFS and OS.
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| 19. |
- Ali, Fathalla, 1963-, et al.
(författare)
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Effect of the SARS-CoV-2 pandemic on planned and emergency hernia repair in Sweden : a register-based study
- 2023
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Ingår i: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; 27:5, s. 1103-1108
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The COVID-19 has had a profound impact on the health care delivery in Sweden, including deprioritization of benign surgeries during the COVID-19 pandemic. The aim of this study was to assess the effect of COVID-19 pandemic on emergency and planned hernia repair in Sweden.METHODS: Data on hernia repairs from January 2016 to December 2021 were retrieved from the Swedish Patient Register using procedural codes. Two groups were formed: COVID-19 group (January 2020-December 2021) and control group (January 2016-December 2019). Demographic data on mean age, gender, and type of hernia were collected.RESULTS: This study showed a weak negative correlation between the number of elective hernia repairs performed each month during the pandemic and the number of emergency repairs carried out during the following 3 months for inguinal hernia repair (p = 0.114) and incisional hernia repair (p = 0.193), whereas there was no correlation for femoral or umbilical hernia repairs.CONCLUSION: The COVID-19 pandemic had a great impact on planned hernia surgeries in Sweden, but our hypothesis that postponing planned repairs would increase the risk of emergency events was not supported.
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| 20. |
- Ali, Fathalla, 1963-, et al.
(författare)
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Laparoscopic ventral and incisional hernia repair using intraperitoneal onlay mesh with peritoneal bridging
- 2022
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Ingår i: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; 26:2, s. 635-646
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to assess the feasibility and safety of a novel IPOM procedure with peritoneal bridging (IPOM-pb) for laparoscopic ventral hernia repair, and to compare the outcomes of this procedure with IPOM with- (IPOM-plus) and IPOM without (sIPOM) defect closure.Method: A single-centre retrospective study comparing a novel IPOM technique with peritoneal bridging (IPOM-pb) with the two commonly used IPOM techniques, IPOM with defect closure (IPOM-plus) and without defect closure (sIPOM). The intraoperative and postoperative data of patients who underwent laparoscopic IPOM ventral hernia repair were reviewed. Preoperative data, recurrence, and postoperative seroma, surgical site infection, and pain, were compared.Results: From January 2017 to June 2020, a total of 213 patients underwent laparoscopic ventral and incisional hernia repair with IPOM technique. The mean length and width of the ventral hernia was 4.4 +/- 1.8 cm and 3.6 +/- 1.4 cm, respectively, and the mean BMI was 30.1 +/- 5.2 kg/m(2). The mean operating time was 67 +/- 28 min and was longer for IPOM-pb (71 +/- 27 min), less for IPOM-plus (63 +/- 28 min), and least for sIPOM (61 +/- 26 min). The incidence of early postoperative seroma was least in IPOM-pb (1/98, 1%), and similar in the IPOM-plus (4/94, 4%) and sIPOM (1/21, 5%) group. Late postoperative seroma was found only in IPOM-plus (2, 2%). The incidence of early and late postoperative pain was relatively higher in sIPOM (3, 14%; 1, 5%, respectively) compared to IPOM-pb and IPOM-plus in the early (5, 5% and 6, 6%) and late (2, 2% and 1, 1%) postoperative period, respectively. Surgical site infection was higher in sIPOM group (3, 14%), compared to IPOM-pb (1, 1%), and IPOM-plus (3, 3%). Recurrence rates were similar in IPOM-pb group (3/98, 3%) and IPOM-plus (3/94, 3%), and none in sIPOM (0/21).Conclusion: IPOM with peritoneal bridging is as feasible and safe as conventional IPOM with defect closure and simple non-defect closure. However, a large randomised controlled trial is required to confirm this finding.
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| 21. |
- Ali, Fathalla, 1963-, et al.
(författare)
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Peritoneal bridging versus fascial closure in laparoscopic intraperitoneal onlay ventral hernia mesh repair : a randomized clinical trial
- 2020
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Ingår i: BJS Open. - : John Wiley & Sons. - 2474-9842. ; 4:4, s. 587-592
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many patients develop seroma after laparoscopic ventral hernia repair. It was hypothesized that leaving the hernial sac in situ may cause this complication.METHODS: In this patient- and outcome assessor-blinded, parallel-design single-centre trial, patients undergoing laparoscopic intraperitoneal onlay mesh ventral hernia repair were randomized (1 : 1) to either conventional fascial closure or peritoneal bridging. The primary endpoint was the incidence of seroma 12 months after index surgery detected by CT, evaluated in an intention-to-treat analysis.RESULTS: Between September 2017 and May 2018, 62 patients were assessed for eligibility, of whom 25 were randomized to conventional closure and 25 to peritoneal bridging. At 3 months, one patient was lost to follow-up in the conventional and peritoneal bridging groups respectively. No seroma was detected at 6 or 12 months in either group. The prevalence of clinical seroma was four of 25 (16 (95 per cent c.i. 2 to 30) per cent) versus none of 25 patients in the conventional fascial closure and peritoneal bridging groups respectively at 1 month after surgery (P = 0·110), and two of 24 (8 (0 to 19) per cent) versus none of 25 at 3 months (P = 0·235). There were no significant differences between the groups in other postoperative complications (one of 25 versus 0 of 25), rate of recurrent hernia within 1 year (none in either group) or postoperative pain.CONCLUSION: Conventional fascial closure and peritoneal bridging did not differ with regard to seroma formation after laparoscopic ventral hernia repair.TRIAL REGISTRATION: ClinicalTrials.gov (NCT03344575).
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| 22. |
- Ali, Fathalla, 1963-, et al.
(författare)
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Peritoneal Bridging Versus Nonclosure in Laparoscopic Ventral Hernia Repair
- 2023
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Ingår i: Annals of Surgery Open. - : Wolters Kluwer. - 2691-3593. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Postoperative seroma and pain are common problems following laparoscopic intraperitoneal onlay mesh (IPOM) repair of ventral hernias. These advers outcomes may be avoided by dissecting and using the peritoneum in the hernial sac to bridge the hernia defect.Methods: This was a patient- an and outcome assesor-blinded, parallel-design, randomized controlled trial compairing nonclosure and peritoeal bridging approaches in patients schedueled for elective midline ventral hernia repair. The primary end point was seroma volume on ultrasonography. The secondary end points were postoperative pain, recurrence, and complications.Results: Between November 2018 and December 2020, 112 patients were randomized of whom 60 were in the nonclosure group and 52 were in the peritoneal bridging group. The seroma volume in the nonclosure and peritoneal bridging groups were 17cm3(6-53cm3) versus 0cm3(0-26cm3) at 1-moth follow-up (P=0.013). The median volume was zero at 3-, 6-, and 12-month follow-ups in both groups. No significant differences were observed in early postoperative pain (P=0.447) and in recurrencerate (P=0.684). There were 4(7%) and 1(2%) perioperative complictions that lead to reoperations in simple IPOM(sIPOM) and IPOM with peritoneal bridging (IPOM-pb), respectively.Conclusion: Seroma was less prevalent after IPOM-pb at 1-month follow-up compaired with sIPOM, with simillar posoperative pain 1 week after index of surgery in both groups. At subsequent follow-ups, the differences in seroma were not statiscally significant. Further studies are required to confirm these results. Trial registration (NCT04229940)Keywords: epigastric hernia, incisional hernia, IPOM with fascia closure, IPOM with peritoneal bridging, laparoscopic hernia repair, simple IPOM, umblical hernia, ventral hernia
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| 23. |
- Aloysie, Manishimwe, et al.
(författare)
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Warming Responses of Leaf Morphology Are Highly Variable among Tropical Tree Species
- 2022
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Ingår i: Forests. - : MDPI AG. - 1999-4907. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Leaf morphological traits vary along climate gradients, but it is currently unclear to what extent this results from acclimation rather than adaptation. Knowing so is important for predicting the functioning of long-lived organisms, such as trees, in a rapidly changing climate. We investigated the leaf morphological warming responses of 18 tropical tree species with early (ES) abd late (LS) successional strategies, planted at three sites along an elevation gradient from 2400 m a.s.l. (15.2 °C mean temperature) to 1300 m a.s.l. (20.6 °C mean temperature) in Rwanda. Leaf size expressed as leaf area (LA) and leaf mass per area (LMA) decreased, while leaf width-to-length ratio (W/L) increased with warming, but only for one third to half of the species. While LA decreased in ES species, but mostly not in LS species, changes in LMA and leaf W/L were common in both successional groups. ES species had lower LMA and higher LA and leaf W/L compared to LS species. Values of LMA and LA of juvenile trees in this study were mostly similar to corresponding data on four mature tree species in another elevation-gradient study in Rwanda, indicating that our results are applicable also to mature forest trees. We conclude that leaf morphological responses to warming differ greatly between both successional groups and individual species, with potential consequences for species competitiveness and community composition in a warmer climate. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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| 24. |
- Annebäck, Matilda, et al.
(författare)
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Validating the risk of hypoparathyroidism after total thyroidectomy in a population-based cohort : plea for improved follow-up
- 2024
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Ingår i: British Journal of Surgery. - : Oxford University Press. - 0007-1323 .- 1365-2168. ; 111:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA previous nationwide study from Sweden showed that the rate of permanent hypoparathyroidism is high and under-rated in the Swedish Quality Register. This retrospective population-based study aimed to validate the rate and diagnosis of permanent hypoparathyroidism found in the previous study. A secondary aim was to assess the relationship between the rate of low parathyroid hormone (PTH) levels within 24 h after surgery and the rate of permanent hypoparathyroidism.MethodsAll patients who underwent total thyroidectomy from 2005 to 2015 in a region of Sweden were included. Data were retrieved from local health records, the National Patient Registry, the Swedish Prescribed Drug Registry, and the Swedish Quality Register. A strict definition of permanent hypoparathyroidism was used, including biochemical data and attempts to stop the treatment.ResultsA total of 1636 patients were included. Altogether, 143 patients (8.7 per cent) developed permanent hypoparathyroidism. Of these, 102 (6.2 per cent) had definitive permanent hypoparathyroidism, whereas 41 (2.5 per cent) had possible permanent hypoparathyroidism, because attempts to stop the treatment were lacking (28) or patients were lost to follow-up (13). The agreement between the Swedish Quality Register and the chart review was 29.3 per cent. A proportion of 23.2 per cent with a PTH level below the reference value corresponded to a 6.7 per cent rate of permanent hypoparathyroidism.ConclusionThe risk of permanent hypoparathyroidism after total thyroidectomy is high. Some patients are overtreated because attempts to stop the treatment are lacking. Quality registers might underestimate the risk of permanent hypoparathyroidism. Approximately one-quarter of all patients with low PTH levels immediately after surgery developed permanent hypoparathyroidism.
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| 25. |
- Apel, Jan, et al.
(författare)
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Early Holocene human population events on the island of Gotland in the Baltic Sea (9200-3800 cal. BP)
- 2018
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Ingår i: Quaternary International. - : Elsevier BV. - 1040-6182 .- 1873-4553. ; 465, s. 276-286
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Tidskriftsartikel (refereegranskat)abstract
- The summed probability distribution of 162 radiocarbon dates from Gotland was analysed with reference to archaeological and environmental data in order to evaluate possible variations in settlement intensity on the island. The data indicated variations in demographic development on the island, with probably several different colonization events and external influences; the pioneer settlement reached the island around 9200 cal. BP. After the initial colonization, the radiocarbon dates were rather evenly distributed until around 7700–7600 cal. BP, then there was a drop in the number of dates between 8300 and 8000 cal. BP that may be associated with the 8200 cold event. A marked decline in the number of dates between 7600 and 6000 cal. BP may be associated initially with the Littorina I transgression, but this transgression cannot explain why the Late Mesolithic period is not well represented on Gotland: the climatic development was favourable but did not result in increased human activity. The number of radiocarbon dates indicated that the population size remained low until around 6000 cal. BP, after which there was a gradual increase that reached a first ‘threshold’ after 5600 cal. BP and a second ‘threshold’ after 4500 cal. BP. The first apparent population increase was associated with the appearance of the Funnel Beaker Culture (FBC) and the second with Pitted Ware Culture (PWC) complexes. A decline in the number of dates occurred after 4300 cal. BP, i.e. towards the Late Neolithic. There was an association between the frequency distributions of the radiocarbon dates and the number of stray finds from different time periods but any correlation was not straightforward.
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| 26. |
- Bergenfelz, Anders, et al.
(författare)
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Impact of modern techniques on short-term outcome after surgery for primary hyperparathyroidism: a multicenter study comprising 2,708 patients.
- 2009
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Ingår i: Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie. - : Springer Science and Business Media LLC. - 1435-2451 .- 1435-2443. ; 394:5, s. 851-60
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Tidskriftsartikel (refereegranskat)abstract
- Preoperative localization procedures and the use of intraoperative parathyroidism (iOPTH) have led to a shift of paradigm from bilateral neck exploration to focused parathyroidectomy in primary hyperparathyroidism (pHPT). However, only a small number of randomized trials from specialized centers have been published. The main purpose of the study was to analyze the impact of localization procedures and iOPTH on short-term outcome after pHPT surgery in a multi-institutional setting.
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| 27. |
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| 28. |
- Betson, N. R., et al.
(författare)
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No diurnal variation in rate or carbon isotope composition of soil respiration in a boreal forest
- 2007
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Ingår i: Tree Physiology. - 0829-318X. ; 27:5, s. 749-756
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Tidskriftsartikel (refereegranskat)abstract
- Characterization of soil respiration rates and delta(13C) values of soil-respired CO2 are often based on measurements at a particular time of day. A study by Gower et al. (2001) in a boreal forest demonstrated diurnal patterns of soil CO2 flux using transparent measurement chambers that included the understory vegetation. It is unclear whether these diurnal patterns were solely the result of photosynthetic CO2 uptake during the day by the understory or whether there were underlying trends in soil respiration, perhaps driven by plant root allocation, as recently demonstrated in Mediterranean oak savannah. We undertook intensive sampling campaigns in a boreal Picea abies L. Karst. forest to investigate whether diurnal variations in soil respiration rate and stable carbon isotope ratio (delta C-13) exist in this ecosystem when no understory vegetation is present in the measurement chamber. Soil respiration rates and delta C-13 were measured on plots in which trees were either girdled (to terminate the fraction of soil respiration directly dependent on recent photosynthate from the trees), or not girdled, every 4 h over two 48-hour cycles during the growth season of 2004. Shoot photosynthesis and environmental parameters were measured concurrently. No diurnal patterns in soil respiration rates and delta C-13 were observed in either treatment, despite substantial variations in climatic conditions and shoot photosynthetic rates in non-girdled trees. Consequently, assessment of daily soil respiration rates and delta C-13 in boreal forest systems by single, instantaneous daily measurements does not appear to be confounded by substantial diurnal variation.
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| 29. |
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| 30. |
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| 31. |
- Boukharta, Lars, et al.
(författare)
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Computer Simulations of Structure-Activity Relationships for hERG Channel Blockers
- 2011
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Ingår i: Biochemistry. - : American Chemical Society (ACS). - 0006-2960 .- 1520-4995. ; 50:27, s. 6146-6156
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Tidskriftsartikel (refereegranskat)abstract
- The hERG potassium channel is of major pharmaceutical importance, and its blockade by various compounds, potentially causing serious cardiac side effects, is a major problem in drug development. Despite the large amounts of existing biochemical data on blockade of hERG by drugs and druglike compounds, relatively little is known regarding the structural basis of binding of blockers to the channel. Here, we have used a recently developed homology model of hERG to conduct molecular docking experiments with a series of channel blockers, followed by molecular dynamics simulations of the complexes and evaluation of binding free energies with the linear interaction energy method. The calculations yield a remarkably good agreement with experimental binding affinities and allow for a rationalization of three-dimensional structure-activity relationships in terms of a number of key interactions. Two main interaction regions of the channel are thus identified with implications for further mutagenesis experiments and design of new compounds.
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| 32. |
- Calissendorff, Jan, et al.
(författare)
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Long-Term Outcome of Graves' Disease : A Gender Perspective
- 2023
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Ingår i: Women's Health Reports. - : Mary Ann Liebert. - 2688-4844. ; 4:1, s. 487-496
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: In gender-skewed conditions such as Graves' disease (GD), the outcome naturally becomes dominated by the majority. This may lead to gender-biased misunderstandings regarding treatment outcomes. This especially holds true when complications, such as depression, are unevenly distributed. We have, therefore, studied the long-term outcome of GD from a gender perspective.Materials and Methods: A cohort of 1186 patients with GD was included in a follow-up 6-10 years after inclusion. Choice of treatment, the feeling of recovery, long-term treatment, comorbidity, and quality of life were investigated with questionnaires. All results were studied sex-divided.Results: We included 973 women and 213 men. There was no difference between men and women in the choice of treatment. At follow-up, women scored significantly worse in the general questionnaire 36-item Short-Form Health Status (SF-36) domain bodily pain and in the thyroid-specific Thyroid-Related Patient-Reported Outcome (ThyPRO) domains depression, impaired sex life, and cosmetic complaints, all p < 0.05. Women were twice as likely (29.5%) to be treated with levothyroxine after successful treatment with antithyroid drugs (ATD) compared with men (14.9%, p < 0.05).Conclusion: After treatment for GD, women were more affected by depression, impaired sex life, cosmetic issues, and bodily pain despite successful cure of hyperthyroidism. The prevalence of hypothyroidism was also doubled in women. Whether these observed gender differences reflect a worse outcome of GD in women or a natural consequence of a higher prevalence of these symptoms and autoimmunity in the female population is difficult to disentangle. Nevertheless, several years after GD, women reveal more persistent symptoms.
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| 33. |
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| 34. |
- Crouse, Kristine, et al.
(författare)
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Acclimation of light and dark respiration to experimental and seasonal warming are mediated by changes in leaf nitrogen in Eucalyptus globulus
- 2017
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Ingår i: Tree Physiology. - : Oxford University Press (OUP). - 0829-318X .- 1758-4469. ; 37:8, s. 1069-1083
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Tidskriftsartikel (refereegranskat)abstract
- Quantifying the adjustments of leaf respiration in response to seasonal temperature variation and climate warming is crucial because carbon loss from vegetation is a large but uncertain part of the global carbon cycle. We grew fast-growing Eucalyptus globulus Labill. trees exposed to +3 °C warming and elevated CO2 in 10-m tall whole-tree chambers and measured the temperature responses of leaf mitochondrial respiration, both in light (RLight) and in darkness (RDark), over a 20–40 °C temperature range and during two different seasons. RLight was assessed using the Laisk method. Respiration rates measured at a standard temperature (25 °C – R25) were higher in warm-grown trees and in the warm season, related to higher total leaf nitrogen (N) investment with higher temperatures (both experimental and seasonal), indicating that leaf N concentrations modulated the respiratory capacity to changes in temperature. Once differences in leaf N were accounted for, there were no differences in R25 but the Q10 (i.e., short-term temperature sensitivity) was higher in late summer compared with early spring. The variation in RLight between experimental treatments and seasons was positively correlated with carboxylation capacity and photorespiration. RLight was less responsive to short-term changes in temperature than RDark, as shown by a lower Q10 in RLight compared with RDark. The overall light inhibition of R was ∼40%. Our results highlight the dynamic nature of leaf respiration to temperature variation and that the responses of RLight do not simply mirror those of RDark. Therefore, it is important not to assume that RLight is the same as RDark in ecosystem models, as doing so may lead to large errors in predicting plant CO2 release and productivity.
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| 35. |
- Cuni-Sanchez, Aida, et al.
(författare)
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High aboveground carbon stock of African tropical montane forests
- 2021
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 596:7873, s. 536-542
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Tidskriftsartikel (refereegranskat)abstract
- Tropical forests store 40–50per cent of terrestrial vegetation carbon. However, spatial variations in aboveground live tree biomass carbon (AGC) stocks remain poorly understood, in particular in tropical montane forests. Owing to climatic and soil changes with increasing elevation, AGC stocks are lower in tropical montane forests compared with lowland forests. Here we assemble and analyse a dataset of structurally intact old-growth forests (AfriMont) spanning 44 montane sites in 12 African countries. We find that montane sites in the AfriMont plot network have a mean AGC stock of 149.4megagrams of carbon per hectare (95% confidence interval 137.1–164.2), which is comparable to lowland forests in the African Tropical Rainforest Observation Network4 and about 70per cent and 32per cent higher than averages from plot networks in montane and lowland forests in the Neotropics, respectively. Notably, our results are two-thirds higher than the Intergovernmental Panel on Climate Change default values for these forests in Africa8. We find that the low stem density and high abundance of large trees of African lowland forests is mirrored in the montane forests sampled. This carbon store is endangered: we estimate that 0.8 million hectares of old-growth African montane forest have been lost since 2000. We provide country-specific montane forest AGC stock estimates modelled from our plot network to helpto guide forest conservation and reforestation interventions. Our findings highlight the need for conserving these biodiverse and carbon-rich ecosystems.
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| 36. |
- Dahle, B., et al.
(författare)
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Predation on adult moose Alces alces by European brown bears Ursus arctos
- 2013
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Ingår i: Wildlife Biology. - : Wiley. - 0909-6396 .- 1903-220X. ; 19:2, s. 165-169
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Tidskriftsartikel (refereegranskat)abstract
- Several North American studies have reported significant predation rates on moose Alces alces by brown bears Ursus arctos. We documented predation on moose by brown bears in south-central Sweden, where brown bears and moose occurred at estimated densities of 10-30 and 400-1,340/1,000 km(2), respectively. Bears killed 0.8% of radio-collared adult female moose (i.e. >= 1 year old) annually and no male moose (>= 1 year old). Bear predation was the least important mortality factor we documented. Based on tracking brown bears on snow during spring we recorded one successful hunt for every 372 km of tracks and documented attacks only by adult bears and successful attacks only by adult males. Autopsy of moose older than calves that were killed by brown bears revealed that yearlings were more prone to predation than older moose, and that older (i.e. >= 2 years) cows were more vulnerable to predation than older bulls. Our study suggests a lower tendency for Scandinavian brown bears to prey on moose compared to most of the North American studies.
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| 37. |
- Dammeyer, Pascal, et al.
(författare)
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Cisplatin and oxaliplatin are toxic to cochlear outer hair cells and both target thioredoxin reductase in organ of Corti cultures
- 2014
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 134:5, s. 448-454
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Tidskriftsartikel (refereegranskat)abstract
- Conclusion: Inhibition of thioredoxin reductase (TrxR) may be a contributing factor in cisplatin- induced ototoxicity. Direct exposure of organ of Corti to cisplatin and oxaliplatin gives equal loss of hair cells. Objectives: Platinum- containing drugs are known to target the anti- oxidant selenoprotein TrxR in cancer cells. Two such anti- cancer, platinum- containing drugs, cisplatin and oxaliplatin, have different side effects. Only cisplatin induces hearing loss, i.e. has an ototoxic side effect that is not seen after treatment with oxaliplatin. The objective of this study was to evaluate if TrxR is a target in the cochlea. Loss of outer hair cells was also compared when cisplatin and oxaliplatin were administered directly to the organ of Corti. Methods: Organ of Corti cell culture was used for direct exposure to cisplatin and oxaliplatin. Hair cells were evaluated and the level of TrxR was assessed. Immunohistochemical staining for TrxR was performed. An animal model was used to evaluate the effect on TrxR after treatment with cisplatin and oxaliplatin in vivo. Results: Direct exposure of cochlear organotypic cultures to either cisplatin or oxaliplatin induced comparable levels of outer hair cell loss and inhibition of TrxR, demonstrating that both drugs are similarly ototoxic provided that the cochlea becomes directly exposed.
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| 38. |
- Daskalakis, Kosmas, 1979-, et al.
(författare)
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Modified Histopathological Grading Optimizes Prediction of Survival Outcomes in Small Intestinal Neuroendocrine Tumours
- 2024
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197.
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: One of the major prognostic indices in neuroendocrine tumours (NETs) is Ki67 proliferation index.OBJECTIVE: To identify optimal grading Ki-67 cut-offs to delineate differences in prognosis of patients with small intestinal NETs (SI-NETs).DESIGN, SETTING, PARTICIPANTS: Multicentre retrospective cohort analysis of 551 SI-NET patients diagnosed from 1993 through 2021 at five European referral centres with a mean(±SD) follow-up time of 51.5(±52.9) months.MAIN OUTCOME MEASURES: Overall- and event-free survival (OS and EFS) rates.RESULTS: Median age at baseline was 62.3(range:17-90) years; 252(45.7%) patients were female. All SI-NETs were well-differentiated with 326 being grade 1(G1; 59.2%), 169G2(30.7%), and only 8G3(1.5), while 48 tumours were of unspecified grade (8.7%). The median Ki67 was 2%(range:1-70%). Two-hundred forty-seven patients (44.8%) had distant metastases at baseline (stage IV), 217 locoregional disease (41.1%; stage III), whereas 29(7.1%) and 25(4.5%) presented at stages II and I, respectively. The median OS was 214.7(95%CI:152.7-276.6) months and the median EFS was 79.8(95%CI:68.2-91.5) months, respectively. In multivariable Cox-regression OS analysis, the proposed modified histopathological Ki67 grading system (K67:5-10% group: HR=2.2, 95%CI:1.15-4.31; p=0.018 and K67≥10% group: HR=5.11, 95%CI:2.87-9.09; p<0.001), age (HR=1.07, 95%CI:1.04-1.09; p<0.001), Charlson Comorbidity Index (HR=1.08, 95%CI:1-1.16; p=0.028) and TNM stage (HR=1.79, 95%CI:1.05-3.06; p=0.034) were independent predictors for death. Pertinent EFS analysis, confirmed the proposed modified histopathological Ki67 grading system (K67≥10% group: HR=4.01, 95%CI:2.6-6.37; p<0.001) and age (HR=1.04, 95%CI:1.02-1.05; p<0.001) as independent predictors for recurrence, progression and/or death.CONCLUSIONS: Ki-67 proliferation index was a strong and independent predictor of OS and EFS. A modified histopathological grading system applying Ki-67 cut-offs of 5 and 10% could be superior to predict differences in SI-NET patient survival outcomes.
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| 39. |
- Daskalakis, Kosmas, 1979-, et al.
(författare)
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MODIFIED HISTOPATHOLOGICAL GRADING OPTIMIZES PREDICTION OF SURVIVAL OUTCOMES IN SMALL INTESTINAL NEUROENDOCRINE TUMOURS
- 2024
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Ingår i: British Journal of Surgery. - : Oxford University Press. - 0007-1323 .- 1365-2168. ; 111:Suppl. 4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: We aimed to identify optimal grading Ki-67 cut-offs to delineate differences in prognosis of patients with small intestinal neuroendocrine tumours (SI-NETs) in terms of overall- and event-free survival rates.Methods: We included 551 patients with SI-NETs diagnosed from June 15th, 1993, through March 8th, 2021, identified using the SI-NET databases from five European referral centers.Results: Median age at baseline was 62.3(17-90) years; 252 patients were women (45.7%). All tumours were well-differentiated; 326 were G1 tumours (59.2%), 169 G2(30.7%), only 8 G3(1.5%), while 48 tumourswere of unspecified grade (8.7%). The median Ki67 was 2%(1-70%). 247 patients(44.8%) had distant metastases at baseline (stage IV), 217locoregional disease (41.1%; stage III), whereas 29(7.1%) and 25(4.5%) presented at stages II and I, respectively. Within a mean(SD) follow-up of 51.5(52.9) months, 94 patients(17.1%) died, whereas overall 188 experienced disease recurrence, progression and/or death(34.1%). The median OS was 214.7(95%CI: 152.7-276.6) months and the median EFS was 79.8(95%CI: 68.2-91.5) months, respectively. In multivariable Cox-regression OS analysis, age (HR=1.07, 95%CI: 1.04-1.09; p<0.001), Charlson Comorbidity Index(HR=1.1, 95%CI: 1.03-1.17; p=0.006) and the proposed modified histopathological Ki67 grading system(K67:5-10% group: HR=2.4, 95%CI: 1.3-4.5; p=0.007 and K67≥10% group: HR=5.1, 95%CI: 2.9-9.2; p<0.001) were independent predictors for death. Pertinent EFS analysis, confirmed age(HR=1.04, 95%CI: 1.02-1.05;p<0.001) and the proposed modified histopathological Ki67 grading system(K67≥10% group: HR=4; 95%CI:2.5-6.2;p<0.001) as independent predictors for recurrence, progression and/or death.Conclusions: Ki-67 proliferation index is an independent predictor of EFS and OS. A modified site-specific histopathological grading system applying Ki-67 cut-offs of 5% and 10% seems more optimal to predict differences in SI-NET patient prognosis
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| 40. |
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| 41. |
- Dehlaghi Jadid, Kaveh, 1985-
(författare)
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Long-term outcome, socioeconomic aspects and postoperative inflammatory response in minimally invasive rectal cancer surgery
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In Sweden, more than 2,200 individuals are diagnosed with rectal cancer each year and surgical resection is the cornerstone of treatment. Minimally invasive surgery (MIS) was introduced for abdominal rectal cancer resection in the 1990s. Proven advantages of MIS in the short term include less intraoperative bleeding, less postoperative pain, faster postoperative mobilization, and shorter hospital stay. Large randomized studies have also shown that MIS is not inferior to OPEN with regard to the oncological short-term or long-term outcome.The aim of this thesis was to increase the knowledge of MIS from a Swedish perspective regarding long-term oncological outcome, socioeconomic aspects, and the postoperative inflammatory response in curative abdominal rectal cancer surgery.Study I included all patients who were diagnosed with clinical stage I-III rectal cancer during 2010-2016. More than 8,300 patients were identified via the Swedish Colorectal Cancer Registry (SCRCR). The study had a so-called non-inferiority design and investigated overall 5-year survival. The results showed that survival was not worse in patients who underwent minimally invasive surgery in comparison to patients who underwent open surgery.Study II included all patients who were diagnosed with pathological stage I-III cancer of the colon 2010-2016. More than 11,000 patients were identified via the SCRCR. The study was designed in the same way as Study I. The results demonstrated that minimally invasive surgery was not inferior to open surgery.Study III analysed the potential impact of socioeconomic status, measured as level of education and household income, regarding the likelihood of receiving minimally invasive surgery. All patients who underwent curative abdominal rectal resection surgery during 2010-2016 were included. More than 8,000 patients were identified. The results showed that patients with the highest level of education and those in the highest income quartile were more likely to be operated on with minimally invasive technique.Study IV analysed the inflammatory response, measured as serum C-reactive protein during postoperative days 1-5, in all 520 patients undergoing abdominal rectal resection in Örebro between 2011 and 2021. Following exclusions based on postoperative adverse events, 382 patients remained for final analysis. The study demonstrated a trend for a less pronounced inflammatory response in patients operated with robot-assisted laparoscopy compared with conventional laparoscopy.
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| 42. |
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| 43. |
- Dewar, R. C., et al.
(författare)
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Why does leaf nitrogen decline within tree canopies less rapidly than light? An explanation from optimization subject to a lower bound on leaf mass per area
- 2012
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Ingår i: Tree Physiology. - : Oxford University Press (OUP). - 0829-318X .- 1758-4469. ; 32:5, s. 520-534
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Tidskriftsartikel (refereegranskat)abstract
- A long-established theoretical result states that, for a given total canopy nitrogen (N) content, canopy photosynthesis is maximized when the within-canopy gradient in leaf N per unit area (N-a) is equal to the light gradient. However, it is widely observed that N-a declines less rapidly than light in real plant canopies. Here we show that this general observation can be explained by optimal leaf acclimation to light subject to a lower-bound constraint on the leaf mass per area (m(a)). Using a simple model of the carbon-nitrogen (C-N) balance of trees with a steady-state canopy, we implement this constraint within the framework of the MAXX optimization hypothesis that maximizes net canopy C export. Virtually all canopy traits predicted by MAXX (leaf N gradient, leaf N concentration, leaf photosynthetic capacity, canopy N content, leaf-area index) are in close agreement with the values observed in a mature stand of Norway spruce trees (Picea abies L. Karst.). An alternative upper-bound constraint on leaf photosynthetic capacity (A(sat)) does not reproduce the canopy traits of this stand. MAXX subject to a lower bound on m(a) is also qualitatively consistent with co-variations in leaf N gradient, m(a) and A(sat) observed across a range of temperate and tropical tree species. Our study highlights the key role of constraints in optimization models of plant function.
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| 44. |
- Donadio, V., et al.
(författare)
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Muscle sympathetic response to arousal predicts neurovascular reactivity during mental stress
- 2012
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Ingår i: Journal of Physiology-London. - : Wiley. - 0022-3751. ; 590:12, s. 2885-2896
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Tidskriftsartikel (refereegranskat)abstract
- Key points Mental stress (MS) is often initiated by a sensory or cognitive stimulus, which induces a brief arousal reaction followed by a longer stress phase. Both phases induce blood pressure (BP) increases whereas effects on muscle sympathetic nerve activity (MSNA) vary: in approximately 50% of healthy subjects (responders) arousal induces a brief MSNA reduction, which is absent in the remaining 50% (non-responders). We now report a link between the arousal response and neurovascular effects of MS in healthy males. Our data show that during MS, responders to arousal exhibited a significant decrease of MSNA and a lesser BP increase compared to non-responders. The whole material displayed a positive correlation between MSNA responses induced by arousal and MS. In addition, arousal induced MSNA changes correlated positively with BP changes during MS. We conclude that the MSNA response to arousal predicts MSNA and BP responses to MS.
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| 45. |
- Dusenge, Mirindi Eric, 1986, et al.
(författare)
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Limited thermal acclimation of photosynthesis in tropical montane tree species
- 2021
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 27:19, s. 4860-4878
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Tidskriftsartikel (refereegranskat)abstract
- The temperature sensitivity of physiological processes and growth of tropical trees remains a key uncertainty in predicting how tropical forests will adjust to future climates. In particular, our knowledge regarding warming responses of photosynthesis, and its underlying biochemical mechanisms, is very limited. We grew seedlings of two tropical montane rainforest tree species, the early-successional species Harungana montana and the late-successional species Syzygium guineense, at three different sites along an elevation gradient, differing by 6.8℃ in daytime ambient air temperature. Their physiological and growth performance was investigated at each site. The optimum temperature of net photosynthesis (ToptA) did not significantly increase in warm-grown trees in either species. Similarly, the thermal optima (ToptV and ToptJ) and activation energies (EaV and EaJ) of maximum Rubisco carboxylation capacity (Vcmax) and maximum electron transport rate (Jmax) were largely unaffected by warming. However, Vcmax, Jmax and foliar dark respiration (Rd) at 25℃ were significantly reduced by warming in both species, and this decline was partly associated with concomitant reduction in total leaf nitrogen content. The ratio of Jmax/Vcmax decreased with increasing leaf temperature for both species, but the ratio at 25℃ was constant across sites. Furthermore, in H. montana, stomatal conductance at 25℃ remained constant across the different temperature treatments, while in S. guineense it increased with warming. Total dry biomass increased with warming in H. montana but remained constant in S. guineense. The biomass allocated to roots, stem and leaves was not affected by warming in H. montana, whereas the biomass allocated to roots significantly increased in S. guineense. Overall, our findings show that in these two tropical montane rainforest tree species, the capacity to acclimate the thermal optimum of photosynthesis is limited while warming-induced reductions in respiration and photosynthetic capacity rates are tightly coupled and linked to responses of leaf nitrogen.
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| 46. |
- Dusenge, Mirindi Eric, 1986, et al.
(författare)
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Photosynthetic capacities of mature tropical forest trees in Rwanda are linked to successional group identity rather than to leaf nutrient content
- 2014
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Ingår i: EGU General Assembly 2014, held 27 April - 2 May, 2014 in Vienna, Austria.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Tropical forests are crucial in the global carbon balance, yet information required to estimate how much carbon that enter these ecosystems through photosynthesis is very limited, in particular for Africa and for tropical montane forests. In order to increases the knowledge of natural variability of photosynthetic capacities in tropical tree species in tropical Africa, measurements of leaf traits and gas exchange were conducted on sun and shade leaves of ten tree species growing in two tropical forests in Rwanda in central Africa. Seven species were studied in Ruhande Arboretum, a forest plantation at mid altitude (ca 1700 m), and six species in Nyungwe National Park, a cooler and higher altitude (at ca 2500 m) montane rainforest. Three species were common to both sites. At Nyungwe, three species each belonged to the successional groups pioneer and climax species. Climax species had considerably lower maximum rates of photosynthetic carboxylation (Vcmax) and electron transport (Jmax) than pioneer species. This difference was not related to leaf nutrient content, but rather seemed to be caused by differences in within-leaf N allocation between the two successional groups. With respect to N, leaves of climax species invested less N into photosynthetic enzymes (as judged by lower Vcmax and Jmax values) and more N into chlorophyll (as judged by higher SPAD values). Photosynthetic capacities, (i.e., Jmax and Vcmax), Jmax:Vcmax ratio and P content were significantly higher in Nyungwe than in Arboretum. Sun leaves had higher photosynthetic capacities and nutrient content than shade leaves. Across the entire dataset, variation in photosynthetic capacities among species was not related to leaf nutrient content, although significant relationships were found within individual species. This study contributes critical tropical data for global carbon models and suggests that, for montane rainforest trees of different functional types, successional group identity is a better predictor of photosynthetic capacities than leaf nutrient content.
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| 47. |
- Dusenge, Mirindi Eric, 1986, et al.
(författare)
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Photosynthetic capacity of tropical montane tree species in relation to leaf nutrients, successional strategy and growth temperature
- 2015
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Ingår i: Oecologia. - : Springer Science and Business Media LLC. - 0029-8549 .- 1432-1939. ; 177:4, s. 1183-1194
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Tidskriftsartikel (refereegranskat)abstract
- Photosynthetic capacity of tree leaves is typically positively related to nutrient content and little affected by changes in growth temperature. These relationships are, however, often poorly supported for tropical trees, for which interspecific differences may be more strongly controlled by within-leaf nutrient allocation than by absolute leaf nutrient content, and little is known regarding photosynthetic acclimation to temperature. To explore the influence of leaf nutrient status, successional strategy and growth temperature on the photosynthetic capacity of tropical trees, we collected data on photosynthetic, chemical and morphological leaf traits of ten tree species in Rwanda. Seven species were studied in a forest plantation at mid-altitude (~1,700 m), whereas six species were studied in a cooler montane rainforest at higher altitude (~2,500 m). Three species were common to both sites, and, in the montane rainforest, three pioneer species and three climax species were investigated. Across species, interspecific variation in photosynthetic capacity was not related to leaf nutrient content. Instead, this variation was related to differences in within-leaf nitrogen allocation, with a tradeoff between investments into compounds related to photosynthetic capacity (higher in pioneer species) versus light-harvesting compounds (higher in climax species). Photosynthetic capacity was significantly lower at the warmer site at 1,700 m altitude. We conclude that (1) within-leaf nutrient allocation is more important than leaf nutrient content per se in controlling interspecific variation in photosynthetic capacity among tree species in tropical Rwanda, and that (2) tropical montane rainforest species exhibit decreased photosynthetic capacity when grown in a warmer environment.
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| 48. |
- Dusenge, Mirindi Eric, 1986, et al.
(författare)
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Photosynthetic capacity of tropical montane tree species in relation to leaf nutrients, successional strategy and growth temperature
- 2015
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Ingår i: 2015 Canadian Society of Plant Biologist/Eastern Regional meeting; University of Toronto, St George Campus, November 21-22nd, 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Photosynthetic capacity of tree leaves is typically positively related to nutrient content and little affected by changes in growth temperature. These relationships are, however, often poorly supported for tropical trees, for which interspecific differences may be more controlled by within-leaf nutrient allocation than by absolute leaf nutrient content, and little is known regarding photosynthetic acclimation to temperature. To explore the influence of leaf nutrient status, successional strategy and growth temperature on the photosynthetic capacity of tropical trees, we collected data on photosynthetic, chemical and morphological leaf traits of ten tree species in Rwanda. Seven species were studied in a forest plantation at mid-altitude, whereas six species were studied in a cooler montane rainforest at higher altitude. Three species were common to both sites, and, in the montane rainforest, three pioneer species and three climax species were investigated. Across species, interspecific variation in photosynthetic capacity was not related to leaf nutrient content. Instead, this variation was related to differences in within-leaf nitrogen allocation, with a tradeoff between investments into compounds related to photosynthetic capacity (higher in pioneer species) versus light-harvesting compounds (higher in climax species). Photosynthetic capacity was significantly lower at the warmer site. We conclude that (1) within-leaf nutrient allocation is more important than leaf nutrient content per se in controlling interspecific variation in photosynthetic capacity among tree species in tropical Rwanda, and that (2) tropical montane rainforest species exhibit decreased photosynthetic capacity when grown in a warmer environment.
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| 49. |
- Eckerström, Carl, et al.
(författare)
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Small baseline volume of left hippocampus is associated with subsequent conversion of MCI into dementia. The Göteborg MCI study.
- 2008
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Ingår i: Journal of the Neurological Sciences. - : Elsevier BV. - 0022-510X .- 1878-5883. ; 272:1-2, s. 48-59
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Tidskriftsartikel (refereegranskat)abstract
- Background: Earlier studies have reported that hippocampal atrophy can to some extent predict which patients with mild cognitive impairment (MCI) will subsequently convert to dementia, and that converters have an enhanced rate of hippocampal volume loss. Objective: To further validate the hypothesis that hippocampal atrophy predicts conversion from MCI to dementia, to relate baseline hippocampal volume to different forms of dementia, and to investigate the role of hippocampal side differences and rate of volume loss over time. Patients: The subjects (N = 68) include patients with MCI at baseline and progression to dementia at the two-year follow-up (N = 21), stable MCI patients (N = 21), and controls (N = 26). Among the progressing patients, 13 were diagnosed as having AD. Methods: The Göteborg MCI study is a clinically based longitudinal study with biannual clinical assessments. Hippocampal volumetry was performed manually on the MRI investigations at baseline and at the two-year follow-up. Results: Hippocampal volumetry could predict conversion to dementia in both the AD and the non-AD subgroup of converters. Left hippocampal volume in particular discriminated between converting and stable MCI. Cut off points for individual discrimination were shown to be potentially useful. The converting MCI group had a significantly higher rate of hippocampal volume loss as compared to the stable MCI group. Conclusions: In MCI patients, hippocampal volumetry at baseline gives prognostic information about possible development of AD and non-AD dementia. Contrary to earlier studies, we found that left hippocampal volume has the best predictive power. Reliable predictions appear to be possible in many individual cases.
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| 50. |
- Ekblom, Maria, 1974-, et al.
(författare)
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Device-Measured Sedentary Behavior, Physical Activity and Aerobic Fitness Are Independent Correlates of Cognitive Performance in Healthy Middle-Aged Adults-Results from the SCAPIS Pilot Study.
- 2019
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:24
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Tidskriftsartikel (refereegranskat)abstract
- High aerobic fitness, more moderate to vigorous physical activity (MVPA) and less sedentary behavior (SED) have all been suggested to promote cognitive functions, but it is unclear whether they are independent predictors of specific cognitive domains. This study aimed to investigate to what extent aerobic fitness MVPA and SED are independently associated with cognitive performance among middle-aged Swedish adults. We acquired device-based measures of aerobic fitness, cognitive performance and percent daily time spent in MVPA and SED in Swedish adults (n = 216; 54-66 years old). Aerobic fitness was associated with better performance at one out of two tests of speed/attention and one out of four tests of executive attention, and with worse performance at one of seven tests of memory. Increasing %MVPA was associated with better performance at one out of seven tests of memory and two out of three tests of verbal ability, whereas increasing %SED was associated with better performance at all four tests of executive attention and four out of seven tests of memory. These findings suggest that aerobic fitness, %MVPA and %SED are partly independent correlates of cognitive performance. To fully understand the association between SED and performance at several tests of cognitive function, future investigations might attempt to investigate intellectually engaging SED (such as reading books) separately from mentally undemanding SED (such as watching TV).
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