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| 2. |
- McKay, James D., et al.
(författare)
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Lung cancer susceptibility locus at 5p15.33
- 2008
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 40:12, s. 1404-1406
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Tidskriftsartikel (refereegranskat)abstract
- We carried out a genome-wide association study of lung cancer (3,259 cases and 4,159 controls), followed by replication in 2,899 cases and 5,573 controls. Two uncorrelated disease markers at 5p15.33, rs402710 and rs2736100 were detected by the genome-wide data (P - 2 x 10(-7) and P = 4 x 10(-6)) and replicated by the independent study series (P = 7 x 10(-5) and P = 0.016). The susceptibility region contains two genes, TERT and CLPTM1L, suggesting that one or both may have a role in lung cancer etiology.
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| 3. |
- Aggett, Peter J, et al.
(författare)
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Feeding preterm infants after hospital discharge : a commentary by the ESPGHAN Committee on Nutrition.
- 2006
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Ingår i: Journal of pediatric gastroenterology and nutrition. - : Ovid Technologies (Wolters Kluwer Health). - 1536-4801 .- 0277-2116. ; 42:5, s. 596-603
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Tidskriftsartikel (refereegranskat)abstract
- Survival of small premature infants has markedly improved during the last few decades. These infants are discharged from hospital care with body weight below the usual birth weight of healthy term infants. Early nutrition support of preterm infants influences long-term health outcomes. Therefore, the ESPGHAN Committee on Nutrition has reviewed available evidence on feeding preterm infants after hospital discharge. Close monitoring of growth during hospital stay and after discharge is recommended to enable the provision of adequate nutrition support. Measurements of length and head circumference, in addition to weight, must be used to identify those preterm infants with poor growth that may need additional nutrition support. Infants with an appropriate weight for postconceptional age at discharge should be breast-fed when possible. When formula-fed, such infants should be fed regular infant formula with provision of long-chain polyunsaturated fatty acids. Infants discharged with a subnormal weight for postconceptional age are at increased risk of long-term growth failure, and the human milk they consume should be supplemented, for example, with a human milk fortifier to provide an adequate nutrient supply. If formula-fed, such infants should receive special postdischarge formula with high contents of protein, minerals and trace elements as well as an long-chain polyunsaturated fatty acid supply, at least until a postconceptional age of 40 weeks, but possibly until about 52 weeks postconceptional age. Continued growth monitoring is required to adapt feeding choices to the needs of individual infants and to avoid underfeeding or overfeeding
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| 5. |
- Akerstedt, Torbjörn, et al.
(författare)
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Accounting for partial sleep deprivation and cumulative sleepiness in the Three-Process Model of alertness regulation.
- 2008
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Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 309-19
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Tidskriftsartikel (refereegranskat)abstract
- Accounting for partial sleep deprivation and cumulative sleepiness in the Three-Process Model of alertness regulation.Akerstedt T, Ingre M, Kecklund G, Folkard S, Axelsson J.Stress Research Institute, University of Stockholm, Stockholm, Sweden. torbjorn.akerstedt@ki.seMathematical models designed to predict alertness or performance have been developed primarily as tools for evaluating work and/or sleep-wake schedules that deviate from the traditional daytime orientation. In general, these models cope well with the acute changes resulting from an abnormal sleep but have difficulties handling sleep restriction across longer periods. The reason is that the function representing recovery is too steep--usually exponentially so--and with increasing sleep loss, the steepness increases, resulting in too rapid recovery. The present study focused on refining the Three-Process Model of alertness regulation. We used an experiment with 4 h of sleep/night (nine participants) that included subjective self-ratings of sleepiness every hour. To evaluate the model at the individual subject level, a set of mixed-effect regression analyses were performed using subjective sleepiness as the dependent variable. These mixed models estimate a fixed effect (group mean) and a random effect that accounts for heterogeneity between participants in the overall level of sleepiness (i.e., a random intercept). Using this technique, a point was sought on the exponential recovery function that would explain maximum variance in subjective sleepiness by switching to a linear function. The resulting point explaining the highest amount of variance was 12.2 on the 1-21 unit scale. It was concluded that the accumulation of sleep loss effects on subjective sleepiness may be accounted for by making the recovery function linear below a certain point on the otherwise exponential function.
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| 6. |
- Akerstedt, Torbjörn, et al.
(författare)
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Effects of context on sleepiness self-ratings during repeated partial sleep deprivation.
- 2008
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Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 271-8
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Tidskriftsartikel (refereegranskat)abstract
- Effects of context on sleepiness self-ratings during repeated partial sleep deprivation.Akerstedt T, Kecklund G, Axelsson J.Stress Research Institute, Stockholm University, Stockholm, Sweden. torbjorn.akerstedt@ki.seRatings of subjective sleepiness are often used in laboratory and field studies of sleep loss and shifted sleep hours. Some studies suggest that such ratings might fail to reflect sleepiness as shown in physiology or performance. One reason for this may be the influence of the context of the rating. Social interaction or physical activity may mask latent sleepiness. The present study attempted to approach this question. Nine subjects participated in a partial sleep-deprivation experiment (five days of 4 h of time in bed [TIB]), preceded by two baseline days (8 h TIB) and followed by three recovery days (8 h TIB). Sleepiness was self-rated on the Karolinska Sleepiness Scale (KSS; scores of 1-9) after a period of relaxation, after a reaction-time test, and after 30 min of free activities. The results showed a strong increase in subjective sleepiness during sleep restriction and a significant difference between conditions. Free activity reduced the self-rated subjective sleepiness by 1.1 KSS units compared to the level of sleepiness self-rated at the end of the reaction-time test. Thus, the results of this study indicate that the context of a sleepiness rating affects the outcome of the rating.
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| 7. |
- Akerstedt, Torbjörn, et al.
(författare)
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Sleep homeostasis during repeated sleep restriction and recovery : support from EEG dynamics.
- 2009
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 32:2, s. 217-22
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVES: Sleep reduction normally causes a homeostatic response during subsequent recovery sleep, but this does not seem to be true for repeated partial sleep loss. The aim of the present study was to test the response to repeated partial sleep loss through detailed focus on spectral data and parts of sleep. DESIGN: The experiment involved 4 h of sleep across 5 days in the laboratory (partial sleep deprivation [PSD]), followed by 3 days of recovery sleep. PSD was achieved through a delayed bedtime. Nine individuals participated. To avoid "laboratory monotony," subjects were permitted to leave the lab for a few hours each day. MEASUREMENTS AND RESULTS: All sleep stages and the latencies to sleep and slow wave sleep (SWS) showed a significant reduction during PSD. However, SWS and TST (total sleep time) during the first half of sleep increased gradually across days with PSD. During the first recovery sleep, SWS was significantly increased, while stage 1 and latency to stage 3 were reduced. All were back to baseline on the second night of recovery sleep. Summed spectral power during the first 3.8 h of sleep showed a gradual and robust increase (50% above baseline) in the range 1.25-7.25 Hz across days with PSD up to first recovery sleep and then returned to baseline. CONCLUSIONS: SWS and summed power density in a broad low-frequency band respond to repeated partial sleep deprivation in a dose-response fashion during the first 4 h sleep, apparently reflecting a robust and stable homeostatic response to sleep loss.
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| 8. |
- Axelsson, John, et al.
(författare)
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Effects of acutely displaced sleep on testosterone.
- 2005
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Ingår i: J Clin Endocrinol Metab. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 90:8, s. 4530-5
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: It is not yet clear whether the diurnal variation in testosterone is regulated by circadian or homeostatic (sleep) influences. OBJECTIVE: The present study tested whether testosterone is driven by a circadian-independent sleep effect by shifting sleep acutely to daytime in a 24-h sampling regiment. DESIGN, SETTING, AND PARTICIPANTS: In the sleep laboratory, seven healthy young men (age, 22-32 yr) participated in three conditions: habituation (sleep between 2300-0700 h), night sleep (2300-0700 h), and day sleep (0700-1500 h), the latter two in a balanced order. INTERVENTION AND MAIN OUTCOME MEASURE: Serum testosterone was, in all conditions, sampled by hourly blood drawing for 24 h during constant bed rest. RESULTS: Mean testosterone levels increased as a log-linear function of time (hours) across both sleep periods (b = 4.88; P < 0.001), from 15.3 +/- 2.1 to 25.3 +/- 2.2 nmol/liter during night sleep and from 17.3 +/- 2.1 to 26.4 +/- 2.9 nmol/liter during day sleep. Similarly, mean testosterone levels decreased with time (log-linear) awake (b = -1.80; P < 0.001). There was also evidence of a weak circadian component (acrophase ranging between 0651-0924 h) and an increase with time in the laboratory. Moreover, all these effects, except for the increase during sleep, differed significantly between individuals. CONCLUSION: In conclusion, testosterone increased during sleep and fell during waking, whereas circadian effects seemed marginal. Individual differences were pronounced.
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| 9. |
- Axelsson, John, 1969-
(författare)
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Long shifts, short rests and vulnerability to shift work
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- At the same time as many urban economies are developing into 24-hour societies it is becoming increasingly popular amongst shift workers to compress their working hours. This is done by working longer shifts (>8h) and/or restricting free time (<16h) in between shifts – the main reasons are to gain longer bouts of free time and extra free weekends. However, there is a limited knowledge of the effects of such arrangements on sleep and wakefulness. Thus, the main purposes of the present thesis were to evaluate the effects of long working hours (in the form of 12h shifts) and short recovery periods. Another aim was to evaluate possible mechanisms that could suggest why some individuals develop problems with shift work while others do not.We used a combination of methods - sleep diaries, wake diaries, blood samples and objective measures of sleep and cognitive performance - across whole or large parts of shift schedules to evaluate acute effects of particularly demanding working periods, as well as the total effects of a shift cycle. Study I evaluated the effect of changing from an 8h- to a 12h-shift system. Study II evaluated the effects of long shifts in a shift schedule with both 8h- and 12h-shifts. Study III evaluated the effects of several consecutive short recovery periods (8-9h of recovery) and whether satisfaction with ones’ work hours was associated to problems with sleep and sleepiness. Study IV evaluated whether endocrinological markers of catabolic (cortisol) and anabolic (testosterone) activity changed across a shift sequence and whether satisfaction were related to them. Study V was a laboratory simulation of the effects of a short recovery period (4h of sleep) and whether a short nap could counteract any detrimental effects.There was no convincing evidence for 12h shifts inducing more problems with sleep and sleepiness than 8h shifts. With regard to recovery time between shifts, the shortest recovery times (only 8h) seriously shortened sleep duration and increased sleepiness, while 12h of recovery (between two consecutive 12h shifts) was judged as having no or limited effects on acute measures. The problems with the shortest recovery periods were worse in a schedule with several consecutive shifts and less pronounced in a schedule with few consecutive shifts. With regard to individual differences, it was found that subjects being dissatisfied with their working hours were vulnerable to short recovery periods, which was evident by less sufficient sleep and an accumulation of sleepiness across work periods with limited recovery time. Interestingly, these problems disappeared when they were allowed to recover after the work period. In addition, dissatisfied male shift workers had lower testosterone levels at the end of work periods, indicating disturbed anabolic activity. The simulated quick return supported that curtailed sleep affected sleepiness and performance and that a short nap could counteract these effects temporarily.It is concluded that long shifts (up to 12h) may be acceptable, whereas short recovery time (8h or less) is not. Most of the problems with short recovery periods were related to short sleep and sleepiness, and there is, clearly, a subgroup of workers that suffer more from this than others. It is argued that insufficient sleep and low testosterone levels (in males) might be key factors for developing shift intolerance, mainly by reducing the capacity to recover from shift work.
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| 10. |
- Axelsson, John, et al.
(författare)
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Sleepiness and performance in response to repeated sleep restriction and subsequent recovery during semi-laboratory conditions.
- 2008
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Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 297-308
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Tidskriftsartikel (refereegranskat)abstract
- Sleepiness and performance in response to repeated sleep restriction and subsequent recovery during semi-laboratory conditions.Axelsson J, Kecklund G, Akerstedt T, Donofrio P, Lekander M, Ingre M.Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. john.axelsson@ki.seThere is an ongoing debate of how best to measure the effects of sleep loss in a reliable and feasible way, partly because well controlled laboratory studies and field studies have come to different conclusions. The aims of the present study were to investigate both sleepiness and performance in response to long-term sleep restriction and recovery in a semi-laboratory environment, investigate order effects (i.e., whether levels return to baseline) in a study with seven days of recovery, and characterize individual differences in tolerance to restricted sleep. Nine healthy men (age 23-28 yrs) participated in the protocol, which included one habituation day (sleep 23:00-07:00 h), two baseline days (23:00-07:00 h), five days with restricted sleep (03:00-07:00 h), and seven recovery days (23:00-07:00 h). Participants went outdoors at least twice each day. Reaction-time tests were performed at 08:00, 14:00, and 20:00 h each day in the laboratory. Sleepiness was self-rated by the Karolinska Sleepiness Scale (KSS)after each test. The mixed-effect regression models showed that each day of restricted sleep resulted in an increase of sleepiness by 0.64+/- .05 KSS units (a nine-step scale, p < .001), increase of median reaction times of 6.6+/- 1.6 ms ( p = .003), and increase of lapses/test of 0.69 +/- .16 ms ( p < .001). Seven days of recovery allowed participants to return to the baseline for sleepiness and median reaction time, but not for lapses.The individual differences were larger for performance measures than for sleepiness; the between-subject standard deviation for the random intercept was in the magnitude of the effects of 1.1 days of restricted sleep for sleepiness, 6.6 days of restricted sleep for median reaction time, and 3.2 days for lapses. In conclusion, the present study shows that sleepiness is closely related to sleep pressure, while performance measures, to a larger extent, appear determined by specific individual traits. Moreover, it is suggested to measure sleepiness in a standardized situation so as to minimize the influences of contextual factors.
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