1. |
- Abe, O, et al.
(författare)
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Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials
- 2005
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Ingår i: The Lancet. - 1474-547X. ; 365:9472, s. 1687-1717
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Tidskriftsartikel (refereegranskat)abstract
- Background Quinquennial overviews (1985-2000) of the randomised trials in early breast cancer have assessed the 5-year and 10-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival. Here, we report the 10-year and 15-year effects. Methods Collaborative meta-analyses were undertaken of 194 unconfounded randomised trials of adjuvant chemotherapy or hormonal therapy that began by 1995. Many trials involved CMF (cyclophosphamide, methotrexate, fluorouracil), anthracycline-based combinations such as FAC (fluorouracil, doxombicin, cyclophosphamide) or FEC (fluorouracil, epirubicin, cyclophosphamide), tamoxifen, or ovarian suppression: none involved taxanes, trastuzumab, raloxifene, or modem aromatase inhibitors. Findings Allocation to about 6 months of anthracycline-based polychemotherapy (eg, with FAC or FEC) reduces the annual breast cancer death rate by about 38% (SE 5) for women younger than 50 years of age when diagnosed and by about 20% (SE 4) for those of age 50-69 years when diagnosed, largely irrespective of the use of tamoxifen and of oestrogen receptor (ER) status, nodal status, or other tumour characteristics. Such regimens are significantly (2p=0 . 0001 for recurrence, 2p<0 . 00001 for breast cancer mortality) more effective than CMF chemotherapy. Few women of age 70 years or older entered these chemotherapy trials. For ER-positive disease only, allocation to about 5 years of adjuvant tamoxifen reduces the annual breast cancer death rate by 31% (SE 3), largely irrespective of the use of chemotherapy and of age (<50, 50-69, &GE; 70 years), progesterone receptor status, or other tumour characteristics. 5 years is significantly (2p<0 . 00001 for recurrence, 2p=0 . 01 for breast cancer mortality) more effective than just 1-2 years of tamoxifen. For ER-positive tumours, the annual breast cancer mortality rates are similar during years 0-4 and 5-14, as are the proportional reductions in them by 5 years of tamoxifen, so the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis. These results combine six meta-analyses: anthracycline-based versus no chemotherapy (8000 women); CMF-based versus no chemotherapy (14 000); anthracycline-based versus CMF-based chemotherapy (14 000); about 5 years of tamoxifen versus none (15 000); about 1-2 years of tamoxifen versus none (33 000); and about 5 years versus 1-2 years of tamoxifen (18 000). Finally, allocation to ovarian ablation or suppression (8000 women) also significantly reduces breast cancer mortality, but appears to do so only in the absence of other systemic treatments. For middle-aged women with ER-positive disease (the commonest type of breast cancer), the breast cancer mortality rate throughout the next 15 years would be approximately halved by 6 months of anthracycline-based chemotherapy (with a combination such as FAC or FEC) followed by 5 years of adjuvant tamoxifen. For, if mortality reductions of 38% (age <50 years) and 20% (age 50-69 years) from such chemotherapy were followed by a further reduction of 31% from tamoxifen in the risks that remain, the final mortality reductions would be 57% and 45%, respectively (and, the trial results could well have been somewhat stronger if there had been full compliance with the allocated treatments). Overall survival would be comparably improved, since these treatments have relatively small effects on mortality from the aggregate of all other causes. Interpretation Some of the widely practicable adjuvant drug treatments that were being tested in the 1980s, which substantially reduced 5-year recurrence rates (but had somewhat less effect on 5-year mortality rates), also substantially reduce 15-year mortality rates. Further improvements in long-term survival could well be available from newer drugs, or better use of older drugs.
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3. |
- Caballero, L., et al.
(författare)
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Two-phonon octupole excitation in 146Gd
- 2006
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Ingår i: AIP Conf. Proc.. - : AIP. - 0735403236 - 9780735403239 ; , s. 213-216
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Konferensbidrag (refereegranskat)abstract
- The excited states in 146Gd have been re-investigated with the 144Sm(α,2n) reaction using a modern Ge γ-ray array including a polarimeter. Amongst the non-yrast states populated in this reaction we have identified the aligned 6 + member of the two-phonon octupole quartet from the observation of the E3 branching to the one phonon 3 - state. Our results represent the first observation of a 6 +→ 3 -→0 + E3 cascade in an even-even nucleus.
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5. |
- Grahn, T., et al.
(författare)
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Collectivity and configuration mixing in Pb186,188 and Po194
- 2006
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Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 97:6
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Tidskriftsartikel (refereegranskat)abstract
- Lifetimes of prolate intruder states in Pb186 and oblate intruder states in Po194 have been determined by employing, for the first time, the recoil-decay tagging technique in recoil distance Doppler-shift lifetime measurements. In addition, lifetime measurements of prolate states in Pb188 up to the 8+ state were carried out using the recoil-gating method. The B(E2) values have been deduced from which deformation parameters |β2|=0.29(5) and |β2|=0.17(3) for the prolate and the oblate bands, respectively, have been extracted. The results also shed new light on the mixing between different shapes.
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6. |
- Niggemann, B., et al.
(författare)
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Five-year follow-up on the PAT study : specific immunotherapy and long-term prevention of asthma in children
- 2006
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : Wiley. - 0105-4538 .- 1398-9995. ; 61:7, s. 855-859
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Tidskriftsartikel (refereegranskat)abstract
- Background: A 3-year course of specific immunotherapy (SIT) in children with hay fever to grass and/or birch pollen significantly reduced the risk of developing asthma. To investigate the long-term preventive effect, we performed a follow up – 2 years after termination of immunotherapy.Methods: A total of 183 children, aged 6–14 years with grass and/or birch pollen allergy could be investigated 2 years after discontinuation of SIT or no treatment. Conjunctival provocation tests (CPTs) and methacholine bronchial provocation tests were carried out during the season and winter after 5 years. The development of asthma was assessed by clinical evaluation.Results: The significant improvement in hay fever and CPT results observed after 3 years of SIT persisted at the 5-year follow-up. No difference in bronchial responsiveness to methacholine was found after 5 years because of spontaneous improvement during the follow-up period in the control patients. The immunotherapy-treated children had significantly less asthma after 5 years as evaluated by clinical symptoms [odds ratio 2.68 (1.3–5.7)] in favor of SIT for prevention of development of asthma and significantly less patients reported an increase in asthma scores (P < 0.01).Conclusion: Immunotherapy for 3 years with standardized allergen extracts of grass and/or birch shows long-term clinical effect and preventive effect on development of asthma in children with seasonal rhinoconjunctivitis.
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8. |
- Chapman, Henry N, et al.
(författare)
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Femtosecond time-delay X-ray holography
- 2007
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 448:7154, s. 676-679
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Tidskriftsartikel (refereegranskat)abstract
- Extremely intense and ultrafast X-ray pulses from free-electron lasers offer unique opportunities to study fundamental aspects of complex transient phenomena in materials. Ultrafast time-resolved methods usually require highly synchronized pulses to initiate a transition and then probe it after a precisely defined time delay. In the X-ray regime, these methods are challenging because they require complex optical systems and diagnostics. Here we propose and apply a simple holographic measurement scheme, inspired by Newton's 'dusty mirror' experiment1, to monitor the X-ray-induced explosion of microscopic objects. The sample is placed near an X-ray mirror; after the pulse traverses the sample, triggering the reaction, it is reflected back onto the sample by the mirror to probe this reaction. The delay is encoded in the resulting diffraction pattern to an accuracy of one femtosecond, and the structural change is holographically recorded with high resolution. We apply the technique to monitor the dynamics of polystyrene spheres in intense free-electron-laser pulses, and observe an explosion occurring well after the initial pulse. Our results support the notion that X-ray flash imaging2, 3 can be used to achieve high resolution, beyond radiation damage limits for biological samples4. With upcoming ultrafast X-ray sources we will be able to explore the three-dimensional dynamics of materials at the timescale of atomic motion.
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11. |
- Jacobsen, L., et al.
(författare)
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Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma : 10-year follow-up on the PAT study
- 2007
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : Wiley. - 0105-4538 .- 1398-9995. ; 62:8, s. 943-948
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Tidskriftsartikel (refereegranskat)abstract
- Background: 3-year subcutaneous specific immunotherapy (SIT) in children with seasonal allergic rhinoconjunctivitis reduced the risk of developing asthma during treatment and 2 years after discontinuation of SIT (5-year follow-up) indicating long-term preventive effect of SIT.Objective: We evaluated the long-term clinical effect and the preventive effect of developing asthma 7-years after termination of SIT.Methods: One hundred and forty-seven subjects, aged 16–25 years with grass and/or birch pollen allergy was investigated 10 years after initiation of a 3-year course of SIT with standardized allergen extracts of grass and/or birch or no SIT respectively. Conjunctival provocations were performed outside the season and methacholine bronchial provocations were performed during the season and winter. Asthma was assessed by clinical evaluation.Results: The significant improvements in rhinoconjunctivitis and conjunctival sensitivity persisted at the 10-year follow-up. Significantly less actively treated subjects had developed asthma at 10-year follow-up as evaluated by clinical symptoms [odds ratio 2.5 (1.1–5.9)]. Patients who developed asthma among controls were 24/53 and in the SIT group 16/64. The longitudinal treatment effect when adjusted for bronchial hyper-responsiveness and asthma status at baseline including all observations at 3, 5 and 10 years follow-up (children with or without asthma at baseline, n = 189; 511 observations) was statistically significant (P = 0.0075). The odds ratio for no-asthma was 4.6 95% CI (1.5–13.7) in favor of SIT.Conclusion: A 3-year course of SIT with standardized allergen extracts has shown long-term clinical effects and the potential of preventing development of asthma in children with allergic rhinoconjunctivitis up to 7 years after treatment.Clinical implication: Specific immunotherapy has long-term clinical effects and the potential of preventing development of asthma in children with allergic rhino conjunctivitis up to 7 years after treatment termination.
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12. |
- Lonn, Stefan, et al.
(författare)
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Long-term mobile phone use and brain tumor risk
- 2005
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 161:6, s. 526-535
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Tidskriftsartikel (refereegranskat)abstract
- Handheld mobile phones were introduced in Sweden during the late 1980s. The purpose of this population-based, case-control study was to test the hypothesis that long-term mobile phone use increases the risk of brain tumors. The authors identified all cases aged 20-69 years who were diagnosed with glioma or meningioma during 2000-2002 in certain parts of Sweden. Randomly selected controls were stratified on age, gender, and residential area. Detailed information about mobile phone use was collected from 371 (74%) glioma and 273 (85%) meningioma cases and 674 (71%) controls. For regular mobile phone use, the odds ratio was 0.8 (95% confidence interval: 0.6, 1.0) for glioma and 0.7 (95% confidence interval: 0.5, 0.9) for meningioma. Similar results were found for more than 10 years' duration of mobile phone use. No risk increase was found for ipsilateral phone use for tumors located in the temporal and parietal lobes. Furthermore, the odds ratio did not increase, regardless of tumor histology, type of phone, and amount of use. This study includes a large number of long-term mobile phone users, and the authors conclude that the data do not support the hypothesis that mobile phone use is related to an increased risk of glioma or meningioma.
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14. |
- Anderheim-Söderqvist, Lisbeth, 1952, et al.
(författare)
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Extended encounters with midwives at the first IVF cycle: a controlled trial
- 2007
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Ingår i: Reproductive biomedicine online. - 1472-6483. ; 14:3, s. 279-87
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this prospective, controlled study was to investigate the impact of participation in extended encounters with midwives on the psychological well-being of women undergoing IVF treatment and on their experience of treatment procedures. A total of 166 couples were studied during their first IVF treatment at the authors' IVF unit, of which 49 underwent intervention via extended midwife encounters. Participants answered questionnaires on three occasions. Psychological effects of infertility and questions regarding the relationship with the partner were considered. On the third occasion, two open-ended questions regarding perception of the treatment and the support by the staff were assessed. Regarding the psychological effects of infertility and the relationship with the partner, no significant differences were found between the intervention group versus the control group. Analysis of the open-ended questions resulted in the finding that significantly (P = 0.01) more women in the intervention group expressed satisfaction with the care. No impact of the intervention on psychological well-being was noted. However, the intervention seemed to be an effective method to give couples a feeling of security, continuity and an opportunity to be seen as individuals and as couples, for which the women expressed their appreciation.
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15. |
- Beckers, M., et al.
(författare)
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Nucleation and growth of Ti2 AlN thin films deposited by reactive magnetron sputtering onto MgO(111)
- 2007
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Ingår i: Journal of Applied Physics. - : AIP Publishing. - 0021-8979 .- 1089-7550. ; 102:7
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Tidskriftsartikel (refereegranskat)abstract
- The nucleation and growth of Ti2 AlN thin films on MgO(111) substrates during dual direct current reactive magnetron cosputtering from Ti and Al targets in an Ar N2 atmosphere at a substrate temperature of 690 °C have been investigated. Time and thickness dependent in situ specular x-ray reflectivity and x-ray diffraction in combination with cross-sectional transmission electron microscopy and Rutherford backscattering spectroscopy reveal the formation of competing phases for slight N superstoichiometry with respect to Ti2 AlN. The stoichiometry deviations initiate the layer-by-layer growth of a ∼380 Å thick epitaxial N-substoichiometric cubic (Ti1-x Alx) Ny layer. N-vacancy driven diffusion of Ti and Al leads to decomposition of this metastable solid solution into nanosized cubic TiN y′ and AlN y″ domains as well as to a solid-state reaction with the MgO(111) by formation of a Mg2 (Al:Ti) O4 spinel, reducing the transformed (Ti1-x Alx) Ny layer thickness down to ∼60 Å. Local AlN y″ domains serve as templates for Ti2 AlN nucleation at higher thicknesses. At the same time TiN y′ and AlN y″ serve as a sink for excess gas phase N during the subsequent polycrystalline Ti2 AlN growth with random (Ti1-x Alx) Ny renucleation as a tissue phase along Ti2 AlN grain boundaries. The individual Ti2 AlN grains with vertical sizes up to the total thickness retain local epitaxy to the substrate, with basal planes nonparallel to the substrate interface. Concurrently the (Ti1-x Alx) Ny layer is further reduced by inward Ti2 AlN grain growth along the basal planes. © 2007 American Institute of Physics.
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16. |
- Björkqvist, Maria, et al.
(författare)
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A novel pathogenic pathway of immune activation detectable before clinical onset in Huntington's disease.
- 2008
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Ingår i: Journal of Experimental Medicine. - : Rockefeller University Press. - 1540-9538 .- 0022-1007. ; 205, s. 1869-1877
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Tidskriftsartikel (refereegranskat)abstract
- Huntington's disease (HD) is an inherited neurodegenerative disorder characterized by both neurological and systemic abnormalities. We examined the peripheral immune system and found widespread evidence of innate immune activation detectable in plasma throughout the course of HD. Interleukin 6 levels were increased in HD gene carriers with a mean of 16 years before the predicted onset of clinical symptoms. To our knowledge, this is the earliest plasma abnormality identified in HD. Monocytes from HD subjects expressed mutant huntingtin and were pathologically hyperactive in response to stimulation, suggesting that the mutant protein triggers a cell-autonomous immune activation. A similar pattern was seen in macrophages and microglia from HD mouse models, and the cerebrospinal fluid and striatum of HD patients exhibited abnormal immune activation, suggesting that immune dysfunction plays a role in brain pathology. Collectively, our data suggest parallel central nervous system and peripheral pathogenic pathways of immune activation in HD.
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- Ekqvist, Susanne, et al.
(författare)
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Does gold concentration in the blood influence the result of patch testing to gold?
- 2009
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 160:5, s. 1016-1021
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Tidskriftsartikel (refereegranskat)abstract
- We have recently found a correlation between contact allergy to gold sodium thiosulphate (GSTS) and gold concentration in the blood (B-Au) in a stented population: the higher the B-Au, the stronger the patch-test reaction. To further investigate the correlation between B-Au and patch-test reactivity to gold. In this provocation control cross-over trial of 24 patients with dermatitis with a known contact allergy to gold, the patients were randomized into two groups where one was topically provoked to gold (15 mg GSTS) and one to the control. All patients were simultaneously patch tested with GSTS in 10 aqueous dilutions (1.1 mg GSTS). Patch-test readings were performed and blood was drawn. After 6 weeks, the experiment was repeated and the group that had previously been provoked with gold was now provoked with the control and vice versa. B-Au was higher after gold provocation whereas no treatment effect was discerned for minimal eliciting concentration (MEC) or summarized test score (STS). Instead, significant differences in period effect were observed implying higher B-Au and STS and lower MEC on test occasion II. The most likely explanation is the increased B-Au and/or booster effect from test occasion I. There was a correlation between B-Au and MEC: the higher the B-Au, the lower the MEC. The correlation between B-Au and MEC indicates that the B-Au is of importance for the skin reactivity to gold.
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20. |
- Fiorenzi, Marco, et al.
(författare)
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Enhancing TCP over HSDPA by cross-layer signalling
- 2007
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Ingår i: GLOBECOM 2007: 2007 IEEE GLOBAL TELECOMMUNICATIONS CONFERENCE. - 9781424410422 ; , s. 5362-5366
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Konferensbidrag (refereegranskat)abstract
- A comprehensive performance evaluation of a cross-layer solution to increase users' downlink data rates over HSDPA is provided. The solution consists of a proxy entity between a server and the Radio Network Controller, and cross-layer signalling from the base station to the proxy. The performance of the solution is evaluated though a detailed ns-2 simulator environment, which includes all HSDPA features, as well as some existing TCP enhancing protocols widely adopted for internet traffic over wireless links. Numerical results show that the proxy significantly increases the users' throughput, while also improving the utilization of the radio resources.
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21. |
- Fjeldsoe-Nielsen, H, et al.
(författare)
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Phenotypic and genotypic characterization of prolyliminopeptidase-negative Neisseria gonorrhoeae isolates in Denmark.
- 2005
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Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - : Springer Science and Business Media LLC. - 0934-9723 .- 1435-4373. ; 24:4, s. 280-283
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Tidskriftsartikel (refereegranskat)abstract
- In the study presented here 26 recent Danish clinical isolates of prolyliminopeptidase (PIP)-negative Neisseria gonorrhoeae were phenotypically and genotypically characterized to investigate whether one or more PIP-negative strains are circulating in the Danish community. The profiles of these isolates were compared with those of three isolates from a recent outbreak of PIP-negative N. gonorrhoeae infection in the UK. Twenty-five of the Danish isolates and all three UK isolates had similar antibiograms and were designated serovar IB-4. Genotypic characterization by pulsed-field gel electrophoresis, porB1b gene sequencing, and opa-typing revealed that these isolates were indistinguishable or closely related. The results indicate that at least one PIP-negative N. gonorrhoeae strain is currently circulating in the Danish community, and this strain is indistinguishable from the one that caused an outbreak in the UK.
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22. |
- Fredriksson Möller, Björn, et al.
(författare)
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Azep gas turbine combined cycle power plants thermo-economic analysis
- 2005
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Ingår i: Proceedings of Ecos 2005, Vols 1-3 - Shaping our future energy systems. ; , s. 819-826
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Konferensbidrag (refereegranskat)abstract
- Conventional power plants based on fossil fuel without CO2 capture produce flue gas streams with concentrations Of CO2 between 3% and 15%, contributing to the threat of increasing global warming. Existing capture technologies such as post-combustion flue gas treatment using chemical absorption or pre-combustion carbon removal suffer from significant efficiency penalties as well as major increase in investment costs. Alternatively, combustion in O-2/CO2 atmospheres also requires expensive and energy-consuming oxygen supplies. A less energy intensive concept for oxygen production is a Mixed Conducting Membrane (MCM) reactor which produces pure oxygen from compressed air. The MCM reactor is best integrated into a conventional gas turbine combined cycle, called Advanced Zero Emissions Plant (AZEP), to provide an efficient and cost-effective power plant altogether. In this paper the economic performance of four different combined cycle alternatives in two different gas turbine sizes are evaluated; a 50 MWe size based on the Siemens SGT800 gas turbine and a 400 MWe size based on the Siemens SGT5-4000F gas turbine. ne evaluated combined cycles are one conventional combined cycle, one combined cycle with post-combustion CO2 capture and two optimised AZEP cases from a previous thermodynamic study. One AZEP alternative provides 100% CO2 capture and is thus a true zero emissions alternative, whereas the second alternative uses a sequential combustion system which enables 85% of the CO2 to be captured, making a comparison with traditional post-combustion treatment easier. The results show that the AZEP concept presents a more competitive system in terms of efficiency and economy compared to traditional capture systems.
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23. |
- Gago, R., et al.
(författare)
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Synthesis of carbon nitride thin films by low-energy ion beam assisted evaporation : On the mechanisms for fullerene-like microstructure formation
- 2005
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Ingår i: Thin Solid Films. - : Elsevier BV. - 0040-6090 .- 1879-2731. ; 483:1-2, s. 89-94
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Tidskriftsartikel (refereegranskat)abstract
- Carbon nitride (CNx) thin films were grown at different substrate temperatures by low-energy (<100 eV) ion beam assistance deposition (LE-IBAD) in order to discern possible formation mechanisms of a fullerene-like (FL) microstructure. The samples are compared to those of well-structured FL-CNx films synthesized by reactive magnetron sputtering (MS). The comparison yields similar trends for both techniques, such as limitation of the nitrogen content at 20–25 at.%, dominance of sp2 hybrids, as well as thermally activated chemical desorption of CxNy species from the substrate during growth. However, CNx films produced by LE-IBAD are amorphous. The lack of FL structural features correlates with a lower degree of sp2 clustering, attributed to the promotion of nitrile groups. Therefore, low-energy ion bombardment is shown not to be a sufficient condition for the growth of FL-CNx. This result reinforces the eventual relevance of pre-formed CxNy species at the sputtering target in MS for the introduction and/or evolution of FL arrangements.
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24. |
- Häggblom, A.M.E., et al.
(författare)
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Nurses' attitudes and practices towards abused women
- 2005
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Ingår i: Nursing and Health Sciences. - Carlton, Vic, Australia : Blackwell Publishing. - 1441-0745 .- 1442-2018. ; 7:4, s. 235-242
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Tidskriftsartikel (refereegranskat)abstract
- The present article is a descriptive survey assessing nurses' knowledge, training, and practices regarding the care of abused women. A self-administered questionnaire was sent to all nurses working within the government health organization on the Åland Islands, Finland. The response rate was 57%. Most nurses had no formal training in domestic violence and were less likely than the in-service-trained nurses to intervene with abused women. Nurses' knowledge, beliefs, and practices were found to be unsystematic and had drawbacks. Nurses were not familiar with the formal structure provided by the health administration. The results suggest that in order to meet the urgent need for training among nurses, an in-service training program needs to be set up. This program would help the nurses in identifying survivors of abuse and make them prepared to intervene more effectively to promote the health of these women.
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25. |
- Iwarsson, Susanne, et al.
(författare)
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Trivsel och tillgänglighet i äldres boende.
- 2008
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Ingår i: Trivsel i plejeboligen - en antologi om trivselsfaktorer i plejeboliger. - 9788776743123 ; , s. 131-144
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Bokkapitel (populärvet., debatt m.m.)
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