| 1. |
- Kohls, Mirjam, et al.
(författare)
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Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer : a multi-centre cohort study
- 2022
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Ingår i: BMC Cancer. - : BioMed Central (BMC). - 1471-2407 .- 1471-2407. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Body mass index (BMI) and cardiometabolic comorbidities such as cardiovascular disease and type 2 diabetes have been studied as negative prognostic factors in cancer survival, but possible dependencies in the mechanisms underlying these associations remain largely unexplored. We analysed these associations in colorectal and breast cancer patients.Methods: Based on repeated BMI assessments of cancer-free participants from four European countries in the European Prospective Investigation into Cancer and nutrition (EPIC) study, individual BMI-trajectories reflecting predicted mean BMI between ages 20 to 50 years were estimated using a growth curve model. Participants with incident colorectal or breast cancer after the age of 50 years were included in the survival analysis to study the prognostic effect of mean BMI and cardiometabolic diseases (CMD) prior to cancer. CMD were defined as one or more chronic conditions among stroke, myocardial infarction, and type 2 diabetes. Hazard ratios (HRs) and confidence intervals (CIs) of mean BMI and CMD were derived using multivariable-adjusted Cox proportional hazard regression for mean BMI and CMD separately and both exposures combined, in subgroups of localised and advanced disease.Results: In the total cohort of 159,045 participants, there were 1,045 and 1,620 eligible patients of colorectal and breast cancer. In colorectal cancer patients, a higher BMI (by 1 kg/m2) was associated with a 6% increase in risk of death (95% CI of HR: 1.02–1.10). The HR for CMD was 1.25 (95% CI: 0.97–1.61). The associations for both exposures were stronger in patients with localised colorectal cancer. In breast cancer patients, a higher BMI was associated with a 4% increase in risk of death (95% CI: 1.00–1.08). CMDs were associated with a 46% increase in risk of death (95% CI: 1.01–2.09). The estimates and CIs for BMI remained similar after adjustment for CMD and vice versa.Conclusions: Our results suggest that cumulative exposure to higher BMI during early to mid-adulthood was associated with poorer survival in patients with breast and colorectal cancer, independent of CMD prior to cancer diagnosis. The association between a CMD diagnosis prior to cancer and survival in patients with breast and colorectal cancer was independent of BMI.
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| 2. |
- Laskar, Tanmoy, et al.
(författare)
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The Radio to GeV Afterglow of GRB 221009A
- 2023
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Ingår i: Astrophysical Journal Letters. - : American Astronomical Society. - 2041-8205 .- 2041-8213. ; 946:1
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Tidskriftsartikel (refereegranskat)abstract
- GRB 221009A ($z=0.151$) is one of the closest known long $gamma$-ray bursts (GRBs). Its extreme brightness across all electromagnetic wavelengths provides an unprecedented opportunity to study a member of this still-mysterious class of transients in exquisite detail. We present multi-wavelength observations of this extraordinary event, spanning 15 orders of magnitude in photon energy from radio to $gamma$-rays. We find that the data can be partially explained by a forward shock (FS) from a highly-collimated relativistic jet interacting with a low-density wind-like medium. The jet's beaming-corrected kinetic energy ($E_K sim 4times10<^>{50}$ erg) is typical for the GRB population, but its opening angle ($sim2<^>{circ}$) is one of the narrowest. The radio and mm data provide strong limiting constraints on the FS model, but require the presence of an additional emission component. From equipartition arguments, we find that the radio emission is likely produced by a small amount of mass ($lesssim6times10<^>{-7} M_odot$) moving relativistically ($Gammagtrsim9$) with a large kinetic energy ($gtrsim10<^>{49}$ erg). However, the temporal evolution of this component does not follow prescriptions for synchrotron radiation from a single power-law distribution of electrons (e.g. in a reverse shock or two-component jet), or a thermal electron population, perhaps suggesting that one of the standard assumptions of afterglow theory is violated. GRB 221009A will likely remain detectable with radio telescopes for years to come, providing a valuable opportunity to track the full lifecycle of a powerful relativistic jet.
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| 3. |
- Urban, Mark C., et al.
(författare)
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When and how can we predict adaptive responses to climate change?
- 2024
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Ingår i: Evolution Letters. - : Oxford University Press. - 2056-3744. ; 8:1, s. 172-187
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Tidskriftsartikel (refereegranskat)abstract
- Predicting if, when, and how populations can adapt to climate change constitutes one of the greatest challenges in science today. Here, we build from contributions to the special issue on evolutionary adaptation to climate change, a survey of its authors, and recent literature to explore the limits and opportunities for predicting adaptive responses to climate change. We outline what might be predictable now, in the future, and perhaps never even with our best efforts. More accurate predictions are expected for traits characterized by a well-understood mapping between genotypes and phenotypes and traits experiencing strong, direct selection due to climate change. A meta-analysis revealed an overall moderate trait heritability and evolvability in studies performed under future climate conditions but indicated no significant change between current and future climate conditions, suggesting neither more nor less genetic variation for adapting to future climates. Predicting population persistence and evolutionary rescue remains uncertain, especially for the many species without sufficient ecological data. Still, when polled, authors contributing to this special issue were relatively optimistic about our ability to predict future evolutionary responses to climate change. Predictions will improve as we expand efforts to understand diverse organisms, their ecology, and their adaptive potential. Advancements in functional genomic resources, especially their extension to non-model species and the union of evolutionary experiments and "omics," should also enhance predictions. Although predicting evolutionary responses to climate change remains challenging, even small advances will reduce the substantial uncertainties surrounding future evolutionary responses to climate change. Preventing biological impacts from climate change will require accurate predictions about which species and ecosystems are most at risk and how best to protect them. Despite some progress, most predictive efforts still omit the potential for evolution to mediate climate change impacts. Here, we evaluate what is predictable now, in the future, and likely never based on recent literature, a survey of authors, and authors' contributions to a special issue on climate change evolution. Evidence indicates a growing ability to predict at least some components underlying evolutionary dynamics. For instance, the direct effects of climate change often alter natural selection regimes that could elicit evolutionary responses assuming sufficient additive genetic variation. We found no evidence for an increase or decrease in evolvability under future climate conditions, but we did find an overall moderate level of evolvability. However, the specific genetics underlying potential adaptive changes are still a "black box" that remains difficult to predict. We not only discuss the opportunities afforded by new genomic techniques to elucidate these genetic black boxes but also caution that the costs and limitations of such techniques for many species might not warrant their general practicality. We highlight further progress and challenges in predicting gene flow and population persistence, both of which can facilitate evolutionary rescue. We finish by listing ten activities that are needed to accelerate future progress in predicting climate change evolution. Despite the many complexities, we are relatively optimistic that evolutionary responses to climate change are becoming more accurate through time, especially assuming a more focused effort to fill key knowledge gaps in the coming years.
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| 4. |
- van den Oever, Selina R., et al.
(författare)
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Childhood cancer survivorship care during the COVID-19 pandemic : an international report of practice implications and provider concerns
- 2022
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Ingår i: Journal of Cancer Survivorship. - : Springer Science and Business Media LLC. - 1932-2259 .- 1932-2267. ; 16:6, s. 1390-1400
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Long-term follow-up (LTFU) care is essential to optimise health outcomes in childhood cancer survivors (CCS). We aimed to assess the impact of the COVID-19 pandemic on LTFU services and providers. Methods: A COVID-19 working group within the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) distributed a questionnaire to LTFU service providers in 37 countries across Europe, Asia, North America, Central/South America, and Australia. The questionnaire assessed how care delivery methods changed during the pandemic and respondents’ level of worry about the pandemic’s impact on LTFU care delivery, their finances, their health, and that of their family and friends. Results: Among 226 institutions, providers from 178 (79%) responded. Shortly after the initial outbreak, 42% of LTFU clinics closed. Restrictions during the pandemic resulted in fewer in-person consultations and an increased use of telemedicine, telephone, and email consultations. The use of a risk assessment to prioritise the method of LTFU consultation for individual CCS increased from 12 to 47%. While respondents anticipated in-person consultations to remain the primary method for LTFU service delivery, they expected significantly increased use of telemedicine and telephone consultations after the pandemic. On average, respondents reported highest levels of worry about psychosocial well-being of survivors. Conclusions: The pandemic necessitated changes in LTFU service delivery, including greater use of virtual LTFU care and risk-stratification to identify CCS that need in-person evaluations. Implications for Cancer Survivors: Increased utilisation of virtual LTFU care and risk stratification is likely to persist post-pandemic.
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| 5. |
- Verbruggen, Lisanne C., et al.
(författare)
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Guidance regarding COVID-19 for survivors of childhood, adolescent, and young adult cancer : A statement from the International Late Effects of Childhood Cancer Guideline Harmonization Group
- 2020
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Ingår i: Pediatric Blood and Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 67:12
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Tidskriftsartikel (refereegranskat)abstract
- Childhood, adolescent, and young adult (CAYA) cancer survivors may be at risk for a severe course of COVID-19. Little is known about the clinical course of COVID-19 in CAYA cancer survivors, or if additional preventive measures are warranted. We established a working group within the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) to summarize existing evidence and worldwide recommendations regarding evidence about factors/conditions associated with risk for a severe course of COVID-19 in CAYA cancer survivors, and to develop a consensus statement to provide guidance for healthcare practitioners and CAYA cancer survivors regarding COVID-19.
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