| 1. |
- Abuhasanein, Suleiman, et al.
(författare)
-
Standardized care pathways for patients with suspected urinary bladder cancer: the Swedish experience
- 2022
-
Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 56:3, s. 227-232
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To compare time intervals to diagnosis and treatment, tumor characteristics, and management in patients with primary urinary bladder cancer, diagnosed before and after the implementation of a standardized care pathway (SCP) in Sweden. Materials and methods Data from the Swedish National Register of Urinary Bladder Cancer was studied before (2011-2015) and after (2016-2019) SCP. Data about time from referral to transurethral resection of bladder tumor (TURBT), patients and tumor characteristics, and management were analyzed. Subgroup analyses were performed for cT1 and cT2-4 tumors. Results Out of 26,795 patients, median time to TURBT decreased from 37 to 27 days after the implementation of SCP. While the proportion of cT2-T4 tumors decreased slightly (22-21%, p < 0.001), this change was not stable over time and the proportions cN + and cM1 remained unchanged. In the subgroups with cT1 and cT2-4 tumors, the median time to TURBT decreased and the proportions of patients discussed at a multidisciplinary team conference (MDTC) increased after SCP. In neither of these subgroups was a change in the proportions of cN + and cM1 observed, while treatment according to guidelines increased after SCP in the cT1 group. Conclusion After the implementation of SCP, time from referral to TURBT decreased and the proportion of patients discussed at MDTC increased, although not at the levels recommended by guidelines. Thus, our findings point to the need for measures to increase adherence to SCP recommendations and to guidelines.
|
|
| 2. |
- Adestam, Johan, 1982-, et al.
(författare)
-
Associationsrättens grunder
- 2022. - 1
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- En betydande del av näringslivet och civilsamhället bedrivs av och i olika slags associationer. Associationsrätt handlar om de regler som möjliggör och styr verksamheten i associationerna. Associationsrättens grunder ger en systematisk överblick över rättsområdet och dess centrala problem. Fokus ligger på allmänna bolags- och föreningsformer, men boken redogör även för regleringen av stiftelser. I boken diskuteras frågor om juridisk personlighet, ansvar för förpliktelser, beslutsfattande, företrädarskap, medlemsskydd, borgenärsskydd och redovisning och revision. Utöver detta behandlas vissa straffrättsliga regler av betydelse för bedrivande av verksamhet i företag och företagsbot som särskild sanktion. Boken placerar associationsrätten i en samhällelig kontext, bland annat mot bakgrund av de hållbarhetssträvanden som sker inom EU och internationellt. Associationsrättens grunder vänder sig i första hand till studenter inom juridikutbildningar men kan också användas som vägledning för den som är praktiskt verksam inom området.
|
|
| 3. |
- Adestam, Johan, 1982-, et al.
(författare)
-
Avtalsrättsligt medhjälparansvar
- 2022
-
Ingår i: Svensk Juristtidning. - 0039-6591. ; 2022:1, s. 98-123
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Det inomobligatoriska medhjälparansvaret har länge ansetts bygga på oskrivna tillräknanderegler. Anta att B anlitar C för att utföra något som uppfyller B:s avtalsförpliktelse mot A och att C orsakar A skada genom handlingen eller underlåtelsen H. Frågan om B:s skadeståndsansvar mot A ska enligt dessa regler avgöras på samma sätt som om B själv hade företagit H. De centrala frågorna blir då om H strider mot någon avtalsförpliktelse som B har mot A och om C har företagit H på ett sådant sätt att den i relationen mellan A och B tillämpliga ansvarsgrunden (t.ex. oaktsamhet) är uppfylld. Den traditionella bilden har emellertid utmanats i litteraturen och även i prejudikatet NJA 2018 s. 301. Artikeln argumenterar för att de konkurrerande beskrivningarna är omotiverade och att gällande rätt alltjämt svarar mot den traditionella bilden.
|
|
| 4. |
- Adestam, Johan, 1982-, et al.
(författare)
-
Nytt prejudikat om tidpunkten för uppkomsten av en förpliktelse att ersätta rättegångskostnader vid tillämpning av medansvarsreglerna i 25 kap. ABL
- 2020
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- De senaste åren har det kommit många prejudikat rörande medansvar vid kritisk kapitalbrist i 25 kap. aktiebolagslagen (ABL). I ett nytt prejudikat klargör Högsta domstolen när ett aktiebolags förpliktelse att lämna ersättning för rättegångskostnader ska anses ha uppkommit vid tillämpning av 25 kap. 18 § ABL. Trots den ofta upprepade utgångspunkten att reglernas ändamål är att verka handlingsdirigerande genom att medansvaret verkar som ett påtryckningsmedel för styrelseledamöterna har det delvis varit oklart vilken betydelse detta haft för utgången i tidigare fall. Det nya prejudikatet klarlägger och kompletterar bilden genom att även lägga vikt vid reglernas funktion av att skydda enskilda borgenärer mot riskökningar. Prejudikatet analyseras av jur. dr Johan Adestam, lektor i rättsvetenskap och jur. dr och docent Niklas Arvidsson.
|
|
| 5. |
- Ahlstrand, Erik, 1974-, et al.
(författare)
-
Highly Reduced Survival in Essential Thrombocythemia and Polycythemia Vera Patients with Vascular Complications during Follow-up
- 2020
-
Ingår i: European Journal of Haematology. - : Munksgaard Forlag. - 0902-4441 .- 1600-0609. ; 104:3, s. 271-278
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore the relative importance of risk factors, treatments and blood counts for the occurrence of vascular complications and their impact on life expectancy in Essential Thrombocythemia (ET) and Polycythemia Vera (PV).METHODS: Nested case-control study within the Swedish MPN registry. From a cohort of 922 ET patients and 763 PV patients, 71 ET and 81 PV cases with vascular complications were compared to matched controls.RESULTS: Incidence of vascular complications were 2.0 and 3.4 events per 100 patient-years in ET and PV, respectively. At diagnosis, no significant risk factor differences were observed between cases and controls in neither of the diseases. At the time of vascular event, ET complication cases did not differ significantly from controls but in PV, cases had significantly higher WBCs and were to a lesser extent treated with antithrombotic and cytoreductive therapy. Life expectancy was significantly decreased in both ET and PV cases compared to controls.CONCLUSIONS: The risk of vascular complications is high in both ET and PV and these complications have a considerable impact on life expectancy. The protective effect of antithrombotic and cytoreductive therapy for vascular complications in PV underscores the importance of avoiding undertreatment.
|
|
| 6. |
- Ahlström, Gerd, et al.
(författare)
-
A Psychometric Evaluation of the Family Collaboration Scale and an Investigation of How the Close Family of Frail Older Patients Perceive the Collaboration with Healthcare Professionals on Acute Medical Wards at Hospitals in Sweden
- 2022
-
Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 10:3
-
Tidskriftsartikel (refereegranskat)abstract
- The inclusion of family members in the acute care of older persons with complex needs results in better coordination of care and reduces the frequency and/or duration of rehospitalisation. Therefore, healthcare professionals need a tool to assess the collaboration with family members on acute hospital wards. The aims were to test the psychometric properties of the Swedish version of the Family Collaboration Scale (FCS), to investigate family members' perception of collaboration with healthcare professionals on acute medical wards in Sweden and to compare the data with the corresponding Danish results. Three hundred and sixty family members of frail patients aged 65 or older from 13 acute medical wards answered the FCS questionnaire. In addition to descriptive statistics, psychometric methods were applied. The internal consistency of the Swedish version of the FCS was excellent, and confirmatory factor analysis revealed that its factor structure was equivalent to that of the original Danish FCS. The respondents' ratings indicated better perceived collaboration than in the Danish case. Older age than 60 was associated with worse collaboration with healthcare professionals regarding Influence on discharge than younger respondents. Those with compulsory and health or nursing education showed better collaboration. The Swedish version of the FCS should be further evaluated for its retest reliability and as an outcome measure in intervention studies.
|
|
| 7. |
- Ahmadi, Zainab, et al.
(författare)
-
Agreement of the modified Medical Research Council and New York Heart Association scales for assessing the impact of self-rated breathlessness in cardiopulmonary disease
- 2022
-
Ingår i: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The functional impact of breathlessness is assessed using the modified Medical Research Council (mMRC) scale for chronic respiratory disease and with the New York Heart Association Functional Classification (NYHA) scale for heart failure. We evaluated agreement between the scales and their concurrent validity with other clinically relevant patient-reported outcomes in cardiorespiratory disease.Methods: Outpatients with stable chronic respiratory disease or heart failure were recruited. Agreement between the mMRC and NYHA scales was analysed using Cramér's V and Kendall's tau B tests. Concurrent validity was evaluated using correlations with clinically relevant measures of breathlessness, anxiety, depression, and health-related quality of life. Analyses were conducted for all participants and separately in chronic obstructive pulmonary disease (COPD) and heart failure.Results: In a total of 182 participants with cardiorespiratory disease, the agreement between the mMRC and NYHA scales was moderate (Cramér's V: 0.46; Kendall's tau B: 0.57) with similar results for COPD (Cramér's V: 0.46; Kendall's tau B: 0.66) and heart failure (Cramér's V: 0.46; Kendall's tau B: 0.67). In the total population, the scales correlated in similar ways to other patient-reported outcomes.Conclusion: In outpatients with cardiorespiratory disease, the mMRC and NYHA scales show moderate to strong correlations and similar associations with other patient-reported outcomes. This supports that the scales are comparable when assessing the impact of breathlessness on function and patient-reported outcomes.
|
|
| 8. |
- Alfredsson, Joakim, 1962-, et al.
(författare)
-
Randomized comparison of early supplemental oxygen versus ambient air in patients with confirmed myocardial infarction : Sex-related outcomes from DETO2X-AMI
- 2021
-
Ingår i: American Heart Journal. - : Mosby Inc.. - 0002-8703 .- 1097-6744. ; 237, s. 13-24
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study is to investigate the impact of oxygen therapy on cardiovascular outcomes in relation to sex in patients with confirmed myocardial infarction (MI).Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction trial randomized 6,629 patients to oxygen at 6 L/min for 6-12 hours or ambient air. In the present subgroup analysis including 5,010 patients (1,388 women and 3,622 men) with confirmed MI, we report the effect of supplemental oxygen on the composite of all-cause death, rehospitalization with MI, or heart failure at long-term follow-up, stratified according to sex.Results: Event rate for the composite endpoint was 18.1% in women allocated to oxygen, compared to 21.4% in women allocated to ambient air (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.65-1.05). In men, the incidence was 13.6% in patients allocated to oxygen compared to 13.3% in patients allocated to ambient air (HR 1.03, 95% CI 0.86-1.23). No significant interaction in relation to sex was found (P=.16). Irrespective of allocated treatment, the composite endpoint occurred more often in women compared to men (19.7 vs 13.4%, HR 1.51; 95% CI, 1.30-1.75). After adjustment for age alone, there was no difference between the sexes (HR 1.06, 95% CI 0.91-1.24), which remained consistent after multivariate adjustment.Conclusion: Oxygen therapy in normoxemic MI patients did not significantly affect all-cause mortality or rehospitalization for MI or heart failure in women or men. The observed worse outcome in women was explained by differences in baseline characteristics, especially age
|
|
| 9. |
- Alhamdow, Ayman, et al.
(författare)
-
Fluorene exposure among PAH-exposed workers is associated with epigenetic markers related to lung cancer
- 2020
-
Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 77:7, s. 488-495
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives Exposure to high-molecular-weight polycyclic aromatic hydrocarbons (PAHs) may cause cancer in chimney sweeps and creosote-exposed workers, however, knowledge about exposure to low-molecular-weight PAHs in relation to cancer risk is limited. In this study, we aimed to investigate occupational exposure to the low-molecular-weight PAHs phenanthrene and fluorene in relation to different cancer biomarkers. Methods We recruited 151 chimney sweeps, 19 creosote-exposed workers and 152 unexposed workers (controls), all men. We measured monohydroxylated metabolites of phenanthrene and fluorene in urine using liquid chromatography coupled to tandem mass spectrometry. We measured, in peripheral blood, the cancer biomarkers telomere length and mitochondrial DNA copy number using quantitative PCR; and DNA methylation ofF2RL3andAHRRusing pyrosequencing. Results Median PAH metabolite concentrations were higher among chimney sweeps (up to 3 times) and creosote-exposed workers (up to 353 times), compared with controls (p<0.001; adjusted for age and smoking). n-ary sumation OH-fluorene (sum of 2-hydroxyfluorene and 3-hydroxyfluorene) showed inverse associations with percentage DNA methylation ofF2RL3andAHRRin chimney sweeps (B (95% CI)=-2.7 (-3.9 to -1.5) forF2RL3_cg03636183, and -7.1 (-9.6 to -4.7) forAHRR_cg05575921: adjusted for age and smoking), but not in creosote-exposed workers. In addition, n-ary sumation OH-fluorene showed a 42% mediation effect on the inverse association between being a chimney sweep and DNA methylation ofAHRRCpG2. Conclusions Chimney sweeps and creosote-exposed workers were occupationally exposed to low-molecular-weight PAHs. Increasing fluorene exposure, among chimney sweeps, was associated with lower DNA methylation ofF2RL3andAHRR, markers for increased lung cancer risk. These findings warrant further investigation of fluorene exposure and toxicity.
|
|
| 10. |
- Almeida, Juan Pablo, et al.
(författare)
-
Phosphorus regulates ectomycorrhizal fungi biomass production in a Norway spruce forest
- 2023
-
Ingår i: Biogeosciences. - : Copernicus Publications. - 1726-4170 .- 1726-4189. ; 20:7, s. 1443-1458
-
Tidskriftsartikel (refereegranskat)abstract
- Ectomycorrhizal fungi (EMF) are important components of soil microbial communities, and EMF biomass can potentially increase carbon (C) stocks by accumulating in the soils as necromass and producing recalcitrant structures. EMF growth depends on the C allocated belowground by the host trees, and the nutrient limitation on tree growth is expected to influence this allocation. Therefore, studying EMF production and understanding the factors that regulates it in natural soils are important to understand C cycling in forests.Fungal mycelium collected from ingrowth mesh bags is commonly used to estimate EMF biomass, but these measurements might not reflect the total EMF production since turnover rates of the hyphae are not considered. Here we estimated EMF production and turnover in response to P fertilization (applied as superphosphate) in a Norway spruce forest where nitrogen (N) deposition has resulted in phosphorus (P) limitation of plant production by using a combination of mesh bags with different incubation periods and with Bayesian inferences. To test how localized patches of N and P influence EMF production and turnover we amended some bags with a nitrogen source (methylene urea) or P source (apatite). Additionally, the Bayesian model tested the effect of seasonality (time of mesh-bag harvesting) on EMF production and turnover.We found that turnover of EMF was not affected by P fertilization or mesh-bag amendment. P fertilization had a negative effect on EMF production in all the mesh-bag amendments, suggesting a reduced belowground C allocation to the EMF when P limitation is alleviated. Apatite amendment significantly increased EMF biomass production in comparison with the pure quartz bags in the control plots but not in the P-fertilized plots. This indicates that P-rich patches enhance EMF production in P-limited forests, but not when P is not limiting. Urea amendment had a generally positive effect on EMF production, but this was significantly reduced by P fertilization, suggesting that a decrease in EMF production due to the alleviated P limitation will affect N foraging. Seasonality had a significant effect on EMF production, and the differences registered between the treatments were higher during the warmer months and disappeared at the end of the growing season.Many studies highlight the importance of N for regulating belowground C allocation to EMF in northern coniferous forests, but here we show that the P status of the forest can be equally important for belowground carbon allocation to EMF production in areas with high N deposition.
|
|
