| 1. |
- Gunnarsson, Rebeqa, et al.
(författare)
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Array-based genomic screening at diagnosis and during follow-up in chronic lymphocytic leukemia
- 2011
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Ingår i: Haematologica. - : Ferrata Storti Foundation (Haematologica). - 1592-8721 .- 0390-6078. ; 96:8, s. 1161-1169
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Tidskriftsartikel (refereegranskat)abstract
- Background High-resolution genomic microarrays enable simultaneous detection of copy-number aberrations such as the known recurrent aberrations in chronic lymphocytic leukemia [del(11q), del(13q), del(17p) and trisomy 12], and copy-number neutral loss of heterozygosity. Moreover, comparison of genomic profiles from sequential patients' samples allows detection of clonal evolution. Design and Methods We screened samples from 369 patients with newly diagnosed chronic lymphocytic leukemia from a population-based cohort using 250K single nucleotide polymorphism-arrays. Clonal evolution was evaluated in 59 follow-up samples obtained after 5-9 years. Results At diagnosis, copy-number aberrations were identified in 90% of patients; 70% carried known recurrent alterations, including del(13q) (55%), trisomy 12 (10.5%), del(11q) (10%), and del(17p) (4%). Additional recurrent aberrations were detected on chromosomes 2 (1.9%), 4 (1.4%), 8 (1.6%) and 14 (1.6%). Thirteen patients (3.5%) displayed recurrent copy-number neutral loss of heterozygosity on 13q, of whom 11 had concurrent homozygous del(13q). Genomic complexity and large 13q deletions correlated with inferior outcome, while the former was linked to poor-prognostic aberrations. In the follow-up study, clonal evolution developed in 8/24 (33%) patients with unmutated IGHV, and in 4/25 (16%) IGHV-mutated and treated patients. In contrast, untreated patients with mutated IGHV (n=10) did not acquire additional aberrations. The most common secondary event, del(13q), was detected in 6/12 (50%) of all patients with acquired alterations. Interestingly, aberrations on, for example, chromosome 6q, 8p, 9p and 10q developed exclusively in patients with unmutated IGHV. Conclusions Whole-genome screening revealed a high frequency of genomic aberrations in newly diagnosed chronic lymphocytic leukemia. Clonal evolution was associated with other markers of aggressive disease and commonly included the known recurrent aberrations.
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| 2. |
- Holst, Mette, et al.
(författare)
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Nutritional screening and risk factors in elderly hospitalized patients : association to clinical outcome?
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 27:4, s. 953-961
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to test the intervalidity of three different nutrition screening tools towards a broad population of elderly hospitalized patients. The association with risk factors and mortality was investigated. This is a prospective cohort study in three medical, surgical and geriatric settings, in Denmark and Sweden. Patients >65years were consecutively included. Patients were screened by mini-nutritional assessment (MNA), malnutrition universal screening tool (MUST) and nutritional risk screening (NRS-2002). Anthropometrics, cognitive test (SPMSQ), as well as a questionnaire investigation regarding eating problems and life situation, were performed. Mortality within 12months was investigated. In total, 233 patients mean (SD) age 81(7.64) years were included. A large variation in prevalence of nutritional risk was determined between the screening tools, MNA was 68% vs. MUST, 47% and NRS 54%, p<0.0001. An overall agreement of 67% was seen ( 0.52-0.55). Risk factors were associated with nutritional risk, including depressive mood. Only handgrip strength, fungus in mouth, serum albumin, CRP and cognitive function were associated with mortality. Fungus had the strongest association (OR 3.7; CI 1.19-11.30). The overall mortality rate was 27% during 12months. However, none of the three screening tools predicted 12-month mortality. The findings show great variation in the prevalence of nutritional risk of under nutrition both between the tools and the settings. The level of agreement between the tools was moderate, and none of the three tools were capable of predicting 12-month mortality. A functional and psychological evaluation including oral health seems recommendable in elderly patients at nutritional risk.
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| 3. |
- Neumann, Tim, et al.
(författare)
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Gold standard program for heavy smokers in a real-life setting.
- 2013
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 10:9, s. 4186-4199
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Tidskriftsartikel (refereegranskat)abstract
- Background: High-intensity smoking cessation programs generally lead to more continuous abstinence, however, lower rates of success have been reported among heavy smokers. The aim was to evaluate continuous abstinence among heavy smokers during the intensive 6-week Gold Standard Program (GSP) and to identify modifiable factors associated with continuous abstinence. Methods: In this nationwide clinical study based on 36,550 smokers attending an intensive cessation program in Denmark. Heavy smoking was defined as ≥7 points in the Fagerström Nicotine Dependency Test, smoking ≥20 cigarettes daily or ≥20 pack-years. Results: Overall, 28% had a Fagerström score ≥7 points, 58% smoked ≥20 cigarettes daily and 68% smoked ≥20 pack-years. Continuous abstinence was 33% in responders (6-months response rate: 78%); however, abstinence was approximately 1-6% lower in the heavy smokers than the overall population. Attending GSP with an individual format (vs. group/other, OR 1.23-1.44); in a hospital setting (vs. pharmacy/municipality services, OR 1.05-1.11); and being compliant (attending the planned meetings OR 4.36-4.89) were associated with abstinence. Abstinence decreased in a dose-dependent manner with increasing smoking severity. Conclusions: Abstinence after GSP was 1-6% lower in the heavy smokers than in the overall study population. Modifiable factors may be used for small improvements in continued abstinence. However attempts to improve compliance seemed especially promising.
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| 4. |
- Neumann, Tim, et al.
(författare)
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The Gold Standard Programme: smoking cessation interventions for disadvantaged smokers are effective in a real-life setting
- 2013
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Ingår i: Tobacco Control. - : BMJ. - 1468-3318 .- 0964-4563. ; 22:6, s. 9-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates. Design Observational prospective cohort study. Setting GSPs in pharmacies, hospitals and communities in Denmark, reporting to the national Smoking Cessation Database. Participants Disadvantaged patients, defined as patients with a lower level of education and those receiving unemployment benefits. Interventions 6-week manualised GSP smoking cessation interventions performed by certified staff. Main outcome measures 6months of continuous abstinence, response rate: 80%. Results Continuous abstinence of the 16?377 responders was 34% (of all 20?588 smokers: 27%). Continuous abstinence was lower in 5738 smokers with a lower educational level (30% of responders and 23% of all) and in 840 unemployed (27% of responders and 19% of all). In respect to modifiable factors, continuous abstinence was found more often after programmes in one-on-one formats (vs group formats) among patients with a lower educational level, 34% (vs 25%, p=0.037), or among unemployed, 35% (vs 24%, p=0.099). The variable format' stayed in the final model of multivariable analyses in patients with a lower educational level, OR=1.31 (95% CI 1.05 to 1.63). Conclusions Although continuous abstinence was lower among disadvantaged smokers, the absolute difference was small. If the programme had been as effective in disadvantaged as in non-disadvantaged groups, there would have been an extra 46 or 8 quitters annually, respectively. Promoting individual interventions among those with a low education may increase the effectiveness of GSP.
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| 5. |
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| 6. |
- Parducci, Laura, et al.
(författare)
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Glacial Survival of Boreal Trees in Northern Scandinavia
- 2012
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 335:6072, s. 1083-1086
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Tidskriftsartikel (refereegranskat)abstract
- It is commonly believed that trees were absent in Scandinavia during the last glaciation and first recolonized the Scandinavian Peninsula with the retreat of its ice sheet some 9000 years ago. Here, we show the presence of a rare mitochondrial DNA haplotype of spruce that appears unique to Scandinavia and with its highest frequency to the west-an area believed to sustain ice-free refugia during most of the last ice age. We further show the survival of DNA from this haplotype in lake sediments and pollen of Trondelag in central Norway dating back similar to 10,300 years and chloroplast DNA of pine and spruce in lake sediments adjacent to the ice-free Andoya refugium in northwestern Norway as early as similar to 22,000 and 17,700 years ago, respectively. Our findings imply that conifer trees survived in ice-free refugia of Scandinavia during the last glaciation, challenging current views on survival and spread of trees as a response to climate changes.
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| 7. |
- Rasmussen, Mette, et al.
(författare)
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Effectiveness of the gold standard programmes (GSP) for smoking cessation in pregnant and non-pregnant women
- 2013
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 10:8, s. 3653-3666
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Tidskriftsartikel (refereegranskat)abstract
- Smoking is considered the most important preventable risk factor in relation to the development of complications during pregnancy and delivery. The aim of this study was to evaluate the effectiveness of an intensive 6-week gold standard programme (GSP) on pregnant women in real life.
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| 8. |
- Rasmussen, Mette, et al.
(författare)
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Smoking cessation intervention activities and outcomes before, during and after the national Healthcare Reform in Denmark
- 2012
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Ingår i: Clinical Health Promotion. - : Clinical Health Promotion Centre. - 2226-5864. ; 2:1, s. 26-35
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMany countries and regions undergo structural changes that intent to improve the effectiveness and quality of care. Until 2007, the municipalities, counties, hospitals and pharmacies shared the smoking cessation activities almost equally in Denmark. Among others, the Danish Healthcare Reform 2007 intended to add responsibility for smoking cessation intervention at county level to the municipality level. New regions should run the hospital services; exclusively. AimTo evaluate the influence of the Danish Healthcare Reform 2007 on national smoking cessation interventions.MethodsFrom 2006 to 2010 35,087 smokers were registered in the Danish Smoking Cessation Database. The large majority underwent the 6-weeks gold standard programme for smoking cessation; a manual based patient education, motivational counseling and nicotine replacement therapy. The data collection included the setting and compliance, self-reported quitting and overall satisfaction. ResultsThe total number of interventions reduced from 7,320 in 2006 to 6,119 in 2010 (16.4%). The municipalities doubled their smoking cessation interventions from 2007, when the counties closed down. The pharmacies stayed relatively stable, but the hospitals significantly reduced to almost no intervention. Accordingly, patients and pregnant women contributed to 85.5% (1,027 persons) of the overall reduction. A replacement from employees as a target group to general citizens took place. The follow-up rate increased after the implementation of the Healthcare Reform, but completing the programme, quit rates and satisfaction were relatively stable throughout the study period. ConclusionOne sixth of the smoking cessation interventions were lost after the Danish Healthcare Reform 2007, especially those reaching hospital patients and pregnant women. A major shift from employees to general citizens took place in the other settings.
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| 9. |
- Scott, Robert A, et al.
(författare)
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No interactions between previously associated 2-hour glucose gene variants and physical activity or BMI on 2-hour glucose levels
- 2012
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Ingår i: Diabetes. - Alexandria, VA : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 61:5, s. 1291-1296
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Tidskriftsartikel (refereegranskat)abstract
- Gene-lifestyle interactions have been suggested to contribute to the development of type 2 diabetes. Glucose levels 2 h after a standard 75-g glucose challenge are used to diagnose diabetes and are associated with both genetic and lifestyle factors. However, whether these factors interact to determine 2-h glucose levels is unknown. We meta-analyzed single nucleotide polymorphism (SNP) × BMI and SNP × physical activity (PA) interaction regression models for five SNPs previously associated with 2-h glucose levels from up to 22 studies comprising 54,884 individuals without diabetes. PA levels were dichotomized, with individuals below the first quintile classified as inactive (20%) and the remainder as active (80%). BMI was considered a continuous trait. Inactive individuals had higher 2-h glucose levels than active individuals (β = 0.22 mmol/L [95% CI 0.13-0.31], P = 1.63 × 10(-6)). All SNPs were associated with 2-h glucose (β = 0.06-0.12 mmol/allele, P ≤ 1.53 × 10(-7)), but no significant interactions were found with PA (P > 0.18) or BMI (P ≥ 0.04). In this large study of gene-lifestyle interaction, we observed no interactions between genetic and lifestyle factors, both of which were associated with 2-h glucose. It is perhaps unlikely that top loci from genome-wide association studies will exhibit strong subgroup-specific effects, and may not, therefore, make the best candidates for the study of interactions.
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| 10. |
- Sørud, Mai, et al.
(författare)
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DEMFIL - treatment of stormwater for recreational use
- 2013
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Ingår i: Proceedings of the 13th Nordic Wastewater Conference. - Malmö : Svenskt Vatten.
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Konferensbidrag (refereegranskat)abstract
- Decoupling of stormwater (road runoff) in a residential area has been implemented in order to reduce flooding and to increase the hydraulic capacity of a lake with a high recreational value. The object here was to evaluate a disc filter technology in combination with a green polymer for flocculation for its feasibility of particle removal. Secondary, the particulate pollution in the separate road runoff should be assessed.The road runoff was found not to be highly contaminated with particle pollution, here measured as turbidity and total suspended solids (TSS). The particles were generally small (< 10 μm) and negatively charged. The disc filtration was hampered during the winter season and by the large fraction of small particles, but supplementing it with flocculation increased the removal efficiencies. The inlet particle concentrations (mg/L) affected the removal efficiencies, and events with inlet concentrations < 10 mg TSS/L or FNU had no statistically significant removal of the particle pollution whereas the events with the highest concentrations yielded among the highest removal efficiencies. The green polymer is as efficient as previously tested commercial coagulant/ flocculent and the disc technology is promising but need to be further tested with higher hydraulic loadings.
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