| 1. |
- Lund, Johan, et al.
(författare)
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Lenalidomide versus lenalidomide plus dexamethasone prolonged treatment after second-line lenalidomide plus dexamethasone induction in multiple myeloma
- 2018
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Ingår i: Cancer Medicine. - : WILEY. - 2045-7634. ; 7:6, s. 2256-2268
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Tidskriftsartikel (refereegranskat)abstract
- Lenalidomide (Len) plus dexamethasone (Dex) is approved for the treatment of relapsed or refractory multiple myeloma (RRMM). It is possible that single-agent Len may be effective as prolonged treatment regimen in RRMM once patients demonstrate an initial response to Len+Dex induction. Patients with RRMM who responded to first-line Len+Dex in an observational study (NCT01430546) received up to 24 cycles of either Len (25mg/day) or Len+Dex (25mg/day and 40mg/week) as prolonged treatment in a subsequent phase 2 clinical trial (NCT01450215). In the observational study (N = 133), median time to response was 1.7 (range 0.6-9.6) months. A complete response to all treatments received in both studies was observed in 11% of patients; very good partial response and partial response rates were 31% and 38%, respectively. Corresponding response rates in the subgroup of patients who did not enter the phase 2 trial (n = 71) were 3%, 18%, and 39%, respectively. Rates of disease progression at 2years in the phase 2 trial were 47% versus 31% for Len versus Len+Dex (P = 0.14). After 36months median follow-up in surviving patients, median time to progression was not reached with Len+Dex and was 24.9months (95% confidence interval 12.5-not calculable, P amp;lt; 0.001) with Len. Three-year OS among the total observational study population was 61% (95% CI, 52-69%). The corresponding rate among patients who entered the phase 2 clinical trial was 73% (95% CI, 60-83%) and was significantly lower among those patients who achieved PR but did not proceed into the phase 2 trial (55%; P = 0.01). In the phase 2 trial, OS was 73% in both treatment arms (P = 0.70). Neutropenia and thrombocytopenia were more common with prolonged (phase 2 trial) versus short-term (observational study) Len administration but remained manageable. Prolonged treatment with Len with or without Dex provides sustained, clinically relevant responses and demonstrates an acceptable safety profile.
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| 2. |
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| 3. |
- Blimark, Cecilie, et al.
(författare)
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Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients.
- 2015
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Ingår i: Haematologica. - : Ferrata Storti Foundation (Haematologica). - 1592-8721 .- 0390-6078. ; 100:1, s. 107-13
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Tidskriftsartikel (refereegranskat)abstract
- Infections are a major cause of morbidity and mortality in patients with multiple myeloma. To estimate the risk of bacterial and viral infections in multiple myeloma patients, we used population-based data from Sweden to identify all multiple myeloma patients (n=9253) diagnosed from 1988 to 2004 with follow up to 2007 and 34,931 matched controls. Cox proportional hazard models were used to estimate the risk of infections. Overall, multiple myeloma patients had a 7-fold (hazard ratio =7.1; 95% confidence interval = 6.8-7.4) risk of developing any infection compared to matched controls. The increased risk of developing a bacterial infection was 7-fold (7.1; 6.8-7.4), and for viral infections 10-fold (10.0; 8.9-11.4). Multiple myeloma patients diagnosed in the more recent calendar periods had significantly higher risk of infections compared to controls (P<0.001). At one year of follow up, infection was the underlying cause in 22% of deaths in multiple myeloma patients. Mortality due to infections remained constant during the study period. Our findings confirm that infections represent a major threat to multiple myeloma patients. The effect on infectious complications due to novel drugs introduced in the treatment of multiple myeloma needs to be established and trials on prophylactic measures are needed.
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| 4. |
- Holmberg, Linnéa, 1983-
(författare)
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Konsten att producera lärande demokrater
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation builds on the basic question of how individuals are formed and created as citizens in society today, and how individuals construct themselves as citizens in this society. It takes interest in how they are managed to govern themselves through specific constructions of citizenship, and looks at how the exercise of power establishes certain knowledge that affects their view of themselves and generates truths about how they are expected to live their lives. Simultaneously, the dissertation deals with the concept of freedom: what does it mean in contemporary society, how can one be free today, and what dangers might this liberty involve?In a broad sense, the analysis centres on the relationship between education and society; more specifically, it engages with the Swedish education system and its construction and production of desirable citizen subjects. The concrete example deals with the institution called leisure-time centre, with a purpose to investigate and problematise how institutionalised leisure-time is staged and legitimised in Sweden today. The studies take as a common starting point the following research question: how are children and personnel governed discursively in and through leisure-time centres?The first empirical contribution provides historical context for the study. In this, the `problematic leisure-time´ of today is outlined based on education policy documents relevant for children aged 6–13 years. These texts are discussed together with similar texts gathered from two other periods in history in order to give perspective on aspects of the leisure-time centre that may seem obvious in our own time.The first separate article investigates how talk about activities in leisure-time centres is couched in terms of meaningfulness and consists of an analysis of the ideological tension between democracy and authority, which the governmental authority, the Swedish Schools Inspectorate (Skolinspektionen), must address in its discursive work. The second article explores how the production of systematic reporting and documentation by personnel in leisure-time centres works through specific self-technologies in the form of confessional practices and which can be said to be primarily about constructing a free but loyal collective subject.The third article problematises the use of democracy as a method to produce specific citizen subjects in leisure-time centres. Children’s councils are analysed, focusing on how different nuances of influence are staged discursively by participating children and personnel. The article highlights how democracy – through pastoral care and in the name of children’s influence – becomes a governmentalising technology that produces an active, responsible and learning citizen.In summary, this dissertation highlights how leisure-time centres are staged and legitimised in Sweden today. The analysis shows how an administration of children and control of the development of society through the autonomous, competent, and voluntarily active individual is apparent; power operates through a perceived freedom in a way that makes the free choice the `right´ choice. With political ideas about forming a forward-looking mentality, children – and personnel – are constructed as a project of learning and improvement.
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| 5. |
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| 6. |
- Holmberg, Max, et al.
(författare)
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On Surface Losses in Direct Metal Laser Sintering Printed Millimeter and Submillimeter Waveguides
- 2018
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Ingår i: Journal of Infrared, Millimeter and Terahertz Waves. - : SPRINGER. - 1866-6892 .- 1866-6906. ; 39:6, s. 535-545
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Tidskriftsartikel (refereegranskat)abstract
- Different lengths of WR3 (220-330 GHz) and WR10 (75-110 GHz) waveguides are fabricated through direct metal laser sintering (DMLS). The losses in these waveguides are measured and modelled using the Huray surface roughness model. The losses in WR3 are around 0.3 dB/mm and in WR10 0.05 dB/mm. The Huray equation model is accounting relatively good for the attenuation in the WR10 waveguide but deviates more in the WR3 waveguide. The model is compared to finite element simulations of the losses assuming an approximate surface structure similar to the resulting one from the DMLS process.
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| 7. |
- Holmberg, Ulf, 1959-, et al.
(författare)
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A pole-projection approach to robust control design
- 2015
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Konferensbidrag (refereegranskat)abstract
- A pole-projection approach is proposed as a useful tool for multi-objective robust control design. Different load conditions or nonlinearities are considered in the design by simultaneously stabilizing a set of linear models. The idea is to repeatedly project the poles for each model (one at a time) to a generalized stability region until all models are stabilized. Similarly, pole projections are also performed for an auxiliary set of models. Stability of the latter gives guaranteed bounds on different sensitivity functions for the former. The method solves a benchmark problem for which a controller of lower complexity than has been reported before is obtained. © 1999 EUCA.
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| 8. |
- Hållmarker, Ulf, et al.
(författare)
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Cancer incidence in participants in a long-distance ski race (Vasaloppet, Sweden) compared to the background population
- 2015
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 51:4, s. 558-568
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Tidskriftsartikel (refereegranskat)abstract
- Background: We studied the association between taking part in a long distance ski race and cancer incidence to address the hypothesis that a lifestyle involving a high degree of physical activity (PA) lowers cancer incidence with a pattern that is different by cancer site. Methods: Cancer incidence was estimated in a large cohort of skiers (n = 185,412) participating in the Vasaloppet long distance ski race in Sweden 1989-2010 and non-participants in the ski race, randomly selected from the Swedish general population (n = 184,617). Data include race finishing times as a measurement of physical fitness. Hazard ratios (HRs) and net probability of cancer over twenty years of follow-up were estimated for all invasive cancer, and separately for prostate, breast, colo-rectal and lung cancer, and groups of cancers with presumed relation to lifestyle. Findings: Participating in Vasaloppet was associated with a relative risk reduction for all invasive cancer of 6% (95% confidence interval 2-9%) and a relative risk reduction of 32% (95% confidence interval 28-37%) of cancer sites where there is epidemiological evidence that smoking, bodyweight, regular PA and consumption of fruit and vegetables are aetiological factors. For skin cancer the risk was increased, as for prostate cancer. Skiers with shorter finishing times had lower incidence of cancer. Interpretation: This study indicates that it is unrealistic to reduce overall population cancer incidence drastically with life style. However, cancers that are epidemiologically associated with life style factors were significantly reduced by what presumably is a blend of nonsmoking, normal body weight, sound dietary habits and PA. Our data thus provide additional support for present days' recommendations about life style prevention. Higher health awareness is associated with attendance to screening, which may explain our results for prostate cancer.
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| 9. |
- Lennernäs, Bo, 1963, et al.
(författare)
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Radical prostatectomy versus high-dose irradiation in localized/locally advanced prostate cancer: A Swedish multicenter randomized trial with patient-reported outcomes.
- 2015
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa Healthcare. - 1651-226X .- 0284-186X. ; 54:6, s. 875-881
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Tidskriftsartikel (refereegranskat)abstract
- Background. Treatment of localized prostate cancer (PC) is controversial. This is the first randomized study comparing an open surgery procedure (radical prostatectomy) with a combination of high-dose rate brachytherapy (2 × 10 Gy) and external beam radiotherapy (25 × 2 Gy) in PC patients in Sweden 1996-2001. The two randomization arms were compared regarding differences in patients-reported outcomes, such as complications and health-related quality of life (HRQoL). Material and methods. The patients had localized/locally advanced PC, clinical category T1b-T3a, N0, M0 and PSA ≤ 50 ng/ml. All underwent total androgen blockade (six months). Self-reported HRQoL and symptoms including urinary, bowel, and sexual side effects were investigated prospectively before randomization and 12 and 24 months after randomization. A total of 89 patients were randomized and completed the EORTC QLQ C-33 and EORTC PR-25 questionnaires. Results. Over the study period, there were no discernible differences in HRQoL, or complications between the two groups. Emotional functioning, however, improved statistically significantly over time, whereas Social functioning decreased, and financial difficulties increased. No statistically significant differences in group-by-time interactions were found. The survival rate was 76%. Only eight patients (9%) died of PC. Conclusion. Open radical prostatectomy and the combined high-dose rate brachytherapy with external beam radiation appeared to be comparable in the measured outcomes. It was not possible to draw any conclusion on the efficacy of the two treatments due to insufficient power of the study.
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| 10. |
- Madsen, Kent, 1957-, et al.
(författare)
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Interviewees' psychological well-being in investigative interviews : a therapeutic jurisprudential approach
- 2015
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Ingår i: Psychiatry, Psychology and Law. - : Taylor & Francis Group. - 1321-8719 .- 1934-1687. ; 22:1, s. 60-74
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Tidskriftsartikel (refereegranskat)abstract
- Therapeutic jurisprudence sees the law as a social force; its underlying idea is that legal procedures should promote the psychological well-being (PWB) of individuals involved in juridical actions. In this experimental study, 146 subjects were assigned to one of two groups: one undergoing humanitarian rapport interviews, the other undergoing non-rapport interviews. Each group underwent two interviews separated by a six-month interval. The causal effects of interview style on interviewees’ PWB were measured using sense of coherence and StateTrait Anxiety inventories, both pre and post interview at Interviews I and II. Analysis of covariance of scores from both interviews showed interaction effects between interview style and interviewees’ anxiety and sense of coherence, respectively. At Interview I, a non-rapport approach was related to increased anxiety, that is, decreased PWB when comparing pre- and post-interview testing. At Interview II, a humanitarian rapport approach promoted improved sense of coherence, thus, increased PWB. More empirical research on PWB in relation to therapeutic jurisprudence is needed. The discussion focuses on how PWB should be measured in a therapeutic jurisprudential context of investigative interviews.
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