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- Killander, F, et al.
(författare)
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No increased cardiac mortality or morbidity of radiotherapy in breast cancer patients after breast conserving surgery: 20 years follow-up of the randomised x trial.
- 2020
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Ingår i: International journal of radiation oncology, biology, physics. - : Elsevier BV. - 1879-355X .- 0360-3016. ; 107:4, s. 701-9
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Tidskriftsartikel (refereegranskat)abstract
- Radiotherapy (RT) after breast conserving surgery reduces loco-regional recurrences and improves survival, but may cause late side effects. The main purpose of this paper was to investigate long-term side effects after whole breast RT in a randomised clinical trial initiated in 1991 and to report dose-volume data based on individual 3D treatment plans for organs at risk (OR).The trial included 1187 T1-2 N0 breast cancer patients randomised to postoperative tangential whole breast radiotherapy or no further treatment. The prescription dose to the clinical target volume was 48-54 Gy. We present 20 year follow-up on survival, cause of death, morbidity and later malignancies. For a cohort of patients (n=157) with accessible CT-based 3D treatment plans in Dicom-RT format, dose-volume descriptors for OR were derived. In addition, these were compared with dose-volume data for a cohort of patients treated with contemporary RT techniques.The cumulative incidence of cardiac mortality was 12.4 % in the control group and 13.0 % in the RT group (P= 0.8). There was an increase in stroke mortality, 3.4 % in the control group versus 6.7 % in the RT group (P=0.018). Incidences of contra lateral breast cancer and lung cancer were similar between groups. The median Dmean (range) heart dose for left-sided treatments was 3.0 Gy (1.1-8.1) and the corresponding value for patients treated in 2017 was 1.5 Gy (0.4-6.0).In this trial serious late side effects of whole breast radiotherapy were limited and less than previously reported in large meta-analyses. We observed no increased cardiac mortality in irradiated patients with doses to the heart were median Dmean 3.0 Gy for left-sided RT. The observed increase in stroke mortality may partly be secondary to cardiac side effects, complications to anticoagulant treatment, or to chance, rather than a direct side effect of tangential whole breast irradiation.
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- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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- Forsberg, A., et al.
(författare)
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Once-only colonoscopy or two rounds of faecal immunochemical testing 2 years apart for colorectal cancer screening (SCREESCO): preliminary report of a randomised controlled trial
- 2022
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Ingår i: Lancet Gastroenterology & Hepatology. - : Elsevier BV. - 2468-1253. ; 7:6, s. 513-521
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Tidskriftsartikel (refereegranskat)abstract
- Background Screening for colorectal cancer is done with lower gastrointestinal endoscopy or stool-based tests. There is little evidence from randomised trials to show primary colonoscopy reduces mortality in colorectal cancer We aimed to investigate the effect of screening with once-only colonoscopy or two rounds of faecal immunochemical test screening on colorectal cancer mortality and incidence. Methods We did a randomised controlled trial in Sweden (SCREESCO). Residents in 18 of 21 regions who were age 60 years in the year of randomisation were identified from a population register maintained by the Swedish Tax Agency. A statistician with no further involvement in the trial used a randomised block method to assign individuals to once-only colonoscopy, two rounds of faecal immunochemical testing (OC-Sensor; 2 years apart), or a control group (no intervention; standard diagnostic pathways), in a ratio of 1:6 for colonoscopy versus control and 1:2 for faecal immunochemical testing versus control. Masking was not possible due to the nature of the trial. The primary endpoints of the trial are colorectal cancer mortality and colorectal cancer incidence. Here, we report preliminary participation rates, baseline findings, and adverse events from March, 2014, to December, 2020, in the two intervention groups after completion of recruitment and screening, up to the completion of the second faecal immunochemical testing round. Analyses were done in the intention-to-screen population, defined as all individuals who were randomly assigned to the respective study group. This study is registered with Clinical Trials.gov, NCT02078804. Findings Between March 1, 2014, and Dec 31, 2020, 278 280 people were induded in the study; 31 140 were assigned to the colonoscopy group, 60 300 to the faecal immunochemical test group, and 186 840 to the control group. 10 679 (35.1%) of 30 400 people who received an invitation for colonoscopy participated. 33 383 (55.5%) of 60 137 people who received a postal faecal immunochemical test participated. In the intention-to-screen analysis, colorectal cancer was detected in 49 (0.16%) of 31140 people in the colonoscopy group versus 121 (0. 20%) of 60 300 in the faecal immunochemical test group (relative risk [RR] 0.78, 95% CI 0.56-1.09). Advanced adenomas were detected in 637 (2.05%) people in the colonoscopy group and 968 (1.61%) in the faecal immunochemical test group (RR 1.27, 95% CI 1.15-1.41). Colonoscopy detected more right-sided advanced adenomas than faecal immunochemical testing. There were two perforations and 15 major bleeds in 16 555 colonoscopies. No intervention-related deaths occurred. Interpretation The diagnostic yield and the low number of adverse events indicate that the design from this trial, both for once-only colonoscopy and faecal immunochemical test screening, could be transferred to a population-based screening service if a benefit in disease-specific mortality is subsequently shown. Copyright (C) 2022 Elsevier Ltd. All rights reserved.
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- Hadid, L. Z., et al.
(författare)
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Ambipolar electrostatic field in negatively charged dusty plasma
- 2022
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Ingår i: Journal of Plasma Physics. - : Cambridge University Press. - 0022-3778 .- 1469-7807. ; 88:2
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Tidskriftsartikel (refereegranskat)abstract
- We study the effect of negatively charged dust on the magnetic-field-aligned polarisation electrostatic field (E-parallel to) using Cassini's RPWS/LP in situ measurements during the `ring-grazing' orbits. We derive a general expression for E-parallel to and estimate for the first time in situ parallel to E-parallel to parallel to (approximately 10(-5) V m(-1)) near the Janus and Epimetheus rings. We further demonstrate that the presence of the negatively charged dust close to the ring plane (vertical bar Z vertical bar less than or similar to 0.11 R-s) amplifies parallel to E-parallel to parallel to by at least one order of magnitude and reverses its direction due to the effect of the charged dust gravitational and inertial forces. Such reversal confines the electrons at the magnetic equator within the dusty region, around 0.047 R-s above the ring plane. Furthermore, we discuss the role of the collision terms, in particular the ion-dust drag force, in amplifying E-parallel to. These results imply that the charged dust, as small as nanometres in size, can have a significant influence on the plasma transport, in particular ambipolar diffusion along the magnetic field lines, and so their presence must be taken into account when studying such dynamical processes.
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- Holmberg, M. K. G., et al.
(författare)
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Cassini-Plasma Interaction Simulations Revealing the Cassini Ion Wake Characteristics : Implications for In-Situ Data Analyses and Ion Temperature Estimates
- 2021
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Ingår i: Journal of Geophysical Research - Space Physics. - : American Geophysical Union (AGU). - 2169-9380 .- 2169-9402. ; 126:8
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Tidskriftsartikel (refereegranskat)abstract
- We have used Spacecraft Plasma Interaction Software (SPIS) simulations to study the characteristics (i.e., dimensions, ion depletion, and evolution with the changing spacecraft attitude) of the Cassini ion wake. We focus on two regions, the plasma disk at 4.5-€“4.7 RS, where the most prominent wake structure will be formed, and at 7.6 RS, close to the maximum distance at which a wake structure can be detected in the Cassini Langmuir probe (LP) data. This study also reveals how the ion wake and the spacecraft plasma interaction have impacted the Cassini LP measurements in the studied environments, for example, with a strong decrease in the measured ion density but with minor interference from the photoelectrons and secondary electrons originating from the spacecraft. The simulated ion densities and spacecraft potentials are in very good agreement with the LP measurements. This shows that SPIS is an excellent tool to use for analyses of LP data, when spacecraft material properties and environmental parameters are known and used correctly. The simulation results are also used to put constraints on the ion temperature estimates in the inner magnetosphere of Saturn. The best agreement between the simulated and measured ion density is obtained using an ion temperature of 8 eV at ∼4.6 RS. This study also shows that SPIS simulations can be used in order to better constrain plasma parameters in regions where accurate measurements are not available.
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- Huybrighs, H. L. F., et al.
(författare)
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An Active Plume Eruption on Europa During Galileo Flyby E26 as Indicated by Energetic Proton Depletions
- 2020
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Ingår i: Geophysical Research Letters. - : American Geophysical Union (AGU). - 0094-8276 .- 1944-8007. ; 47:10
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Tidskriftsartikel (refereegranskat)abstract
- Strong depletions of energetic protons (115-244 keV) were observed during Galileo flyby E26 of Europa. We simulate the flux of energetic protons using a Monte Carlo particle backtracing code and show that energetic proton depletions during E26 are reproduced by taking into account the perturbations of the electromagnetic fields calculated by magnetohydrodynamic (MHD) simulations and charge exchange with a global atmosphere and plume. A depletion feature occurring shortly after closest approach is driven by plume associated charge exchange, or a combination with plume associated field perturbations. We therefore conclude, with a new method and independent data set, that Galileo could have encountered a plume during E26.
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