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- Rogers, P. J., et al.
(författare)
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Does low-energy sweetener consumption affect energy intake and body weight? : A systematic review, including meta-analyses, of the evidence from human and animal studies
- 2016
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 40:3, s. 381-394
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Forskningsöversikt (refereegranskat)abstract
- By reducing energy density, low-energy sweeteners (LES) might be expected to reduce energy intake (EI) and body weight (BW). To assess the totality of the evidence testing the null hypothesis that LES exposure (versus sugars or unsweetened alternatives) has no effect on EI or BW, we conducted a systematic review of relevant studies in animals and humans consuming LES with ad libitum access to food energy. In 62 of 90 animal studies exposure to LES did not affect or decreased BW. Of 28 reporting increased BW, 19 compared LES with glucose exposure using a specific 'learning' paradigm. Twelve prospective cohort studies in humans reported inconsistent associations between LES use and body mass index (-0.002 kg m(-2) per year, 95% confidence interval (CI) -0.009 to 0.005). Meta-analysis of short-term randomized controlled trials (129 comparisons) showed reduced total EI for LES versus sugar-sweetened food or beverage consumption before an ad libitum meal (-94 kcal, 95% CI -122 to -66), with no difference versus water (-2 kcal, 95% CI -30 to 26). This was consistent with EI results from sustained intervention randomized controlled trials (10 comparisons). Meta-analysis of sustained intervention randomized controlled trials (4 weeks to 40 months) showed that consumption of LES versus sugar led to relatively reduced BW (nine comparisons; -1.35 kg, 95% CI -2.28 to -0.42), and a similar relative reduction in BW versus water (three comparisons; -1.24 kg, 95% CI -2.22 to -0.26). Most animal studies did not mimic LES consumption by humans, and reverse causation may influence the results of prospective cohort studies. The preponderance of evidence from all human randomized controlled trials indicates that LES do not increase EI or BW, whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.
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- Sonnenblick, Amir, et al.
(författare)
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Final 10-year results of the Breast International Group 2-98 phase III trial and the role of Ki67 in predicting benefit of adjuvant docetaxel in patients with oestrogen receptor positive breast cancer
- 2015
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Ingår i: European Journal of Cancer. - : Elsevier. - 0959-8049 .- 1879-0852. ; 51:12, s. 1481-1489
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Breast International Group (BIG) 2-98 is a randomised phase III trial that tested the effect of adding docetaxel, either in sequence to or in combination with anthracycline-based adjuvant chemotherapy, in women with node-positive breast cancer (BC). Here, we present the 10-year final trial safety and efficacy analyses. We also report an exploratory analysis on the predictive value of Ki67 for docetaxel efficacy, in the BIG 2-98 and using a pooled analysis of three other randomised trials. Patients and methods: 2887 patients were randomly assigned in a 2 x 2 trial design to one of four treatments. The primary objective was to evaluate the overall efficacy of docetaxel on disease free survival (DFS). Secondary objectives included comparisons of sequential docetaxel versus sequential control arm, safety and overall survival (OS). Ki67 expression was centrally evaluated by immunohistochemistry. Results: After a median follow-up of 10.1 years, the addition of docetaxel did not significantly improve DFS or OS (hazard ratio (HR) = 0.91, 95% confidence interval (CI) = 0.81-1.04; P = 0.16 and HR = 0.88, 95% CI = 0.76-1.03; P = 0.11, respectively). Sequential docetaxel did not improve DFS compared to the sequential control arm (HR = 0.86, 95% CI = 0.721.03; P = 0.10). In oestrogen receptor (ER)-positive tumours with Ki67 greater than= 14%, the addition of docetaxel resulted in 5.4% improvement in 10-year OS (P = 0.03, test for interaction = 0.1). In a multivariate model, there was a trend for improved DFS and OS in ER-positive patients with high Ki67 and treated with docetaxel (HR = 0.79, 95% CI = 0.63-1.01; P = 0.05 and HR = 0.76, 95% CI = 0.57-1.01; P = 0.06, respectively). A pooled analysis of four randomised trials showed a benefit of taxanes in highly proliferative ER-positive disease but not in low proliferating tumours (interaction test P = 0.01). Conclusion: The DFS benefit previously demonstrated with sequential docetaxel is no longer observed at 10 years. However, an exploratory analysis suggested a benefit of docetaxel in patients with highly proliferative ER-positive BC.
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- Hagert, E, et al.
(författare)
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The role of proprioception and neuromuscular stability in carpal instabilities
- 2016
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Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:1, s. 94-101
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Tidskriftsartikel (refereegranskat)abstract
- Carpal stability has traditionally been defined as dependent on the articular congruity of joint surfaces, the static stability maintained by intact ligaments, and the dynamic stability caused by muscle contractions resulting in a compression of joint surfaces. In the past decade, a fourth factor in carpal stability has been proposed, involving the neuromuscular and proprioceptive control of joints. The proprioception of the wrist originates from afferent signals elicited by sensory end organs (mechanoreceptors) in ligaments and joint capsules that elicit spinal reflexes for immediate joint stability, as well as higher order neuromuscular influx to the cerebellum and sensorimotor cortices for planning and executing joint control. The aim of this review is to provide an understanding of the role of proprioception and neuromuscular control in carpal instabilities by delineating the sensory innervation and the neuromuscular control of the carpus, as well as descriptions of clinical applications of proprioception in carpal instabilities.
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- Lluch, E., et al.
(författare)
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Analysis of 210Pb in water samples with plastic scintillation resins
- 2016
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Ingår i: Analytica Chimica Acta. - : Elsevier BV. - 0003-2670. ; 940, s. 38-45
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Tidskriftsartikel (refereegranskat)abstract
- 210Pb is a radioactive lead isotope present in the environment as member of the 238U decay chain. Since it is a relatively long-lived radionuclide (T1/2 = 22.2 years), its analysis is of interest in radiation protection and the geochronology of sediments and artwork. Here, we present a method for analysing 210Pb using plastic scintillation resins (PSresins) packaged in solid-phase extraction columns (SPE cartridge). The advantages of this method are its selectivity, the low limit of detection, as well as reductions in the amount of time and reagents required for analysis and the quantity of waste generated. The PSresins used in this study were composed of a selective extractant (4′,4″(5″)-Di-tert-butyldicyclohexano-18-crown-6 in 1-octanol) covering the surface of plastic scintillation microspheres. Once the amount of extractant (1:1/4) and medium of separation (2 M HNO3) were optimised, PSresins in SPE cartridges were calibrated with a standard solution of 210Pb. 210Pb could be fully separated from its daughters, 210Bi and 210Po, with a recovery value of 91(3)% and detection efficiency of 44(3)%. Three spiked water samples (one underground and two river water samples) were analysed in triplicates with deviations lower than 10%, demonstrating the validity of the PS resin method for 210Pb analysis.
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- Mobargha, N, et al.
(författare)
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The effect of individual isometric muscle loading on the alignment of the base of the thumb metacarpal: a cadaveric study
- 2016
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Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:4, s. 374-379
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Tidskriftsartikel (refereegranskat)abstract
- Stability of the thumb carpometacarpal joint relies upon equilibrium between its ligaments, muscular support and joint congruity. We wanted to identify the muscles important in preventing or increasing dorsoradial subluxation of this joint. In ten cadaveric hands, a Fastrak® motion tracking device was used to assess the effects of individual isometric muscle loading on the base of the thumb metacarpal relative to the radius and to the base of the middle finger metacarpal. We found that the first dorsal interosseous muscle caused the least dorsoradial translation and highest distal migration of the base of the first metacarpal, whereas abductor pollicis longus was the primary destabilizer, increasing dorsoradial misalignment. The findings show different impacts of these muscles on joint alignment and stability, which suggests that treatment should be targeted to enhance the action of the primary stabilizing muscle, the first dorsal interosseous muscle.
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- Semisch, M, et al.
(författare)
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Histological assessment of the triangular fibrocartilage complex
- 2016
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Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:5, s. 527-533
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Tidskriftsartikel (refereegranskat)abstract
- The morphological structure of the seven components of triangular fibrocartilage complexes of 11 cadaver wrists of elderly people was assessed microscopically, after staining with Hematoxylin-Eosin and Elastica van Gieson. The articular disc consisted of tight interlaced fibrocartilage without blood vessels except in its ulnar part. Volar and dorsal radioulnar ligaments showed densely parallel collagen bundles. The subsheath of the extensor carpi ulnaris muscle, the ulnotriquetral and ulnolunate ligament showed mainly mixed tight and loose parallel tissue. The ulnolunate ligament contained tighter parallel collagen bundles and clearly less elastic fibres than the ulnotriquetral ligament. The ulnocarpal meniscoid had an irregular morphological composition and loose connective tissue predominated. The structure of the articular disc indicates a buffering function. The tight structure of radioulnar and ulnolunate ligaments reflects a central stabilizing role, whereas the ulnotriquetral ligament and ulnocarpal meniscoid have less stabilizing functions.
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- Teira, E., et al.
(författare)
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Bacterioplankton responses to riverine and atmospheric inputs in a coastal upwelling system (Ria de Vigo, NW Spain)
- 2016
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Ingår i: Marine Ecology Progress Series. - : Inter-Research Science Center. - 0171-8630 .- 1616-1599. ; 542, s. 39-50
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Tidskriftsartikel (refereegranskat)abstract
- Anthropogenic pressures are changing the magnitude and nature of matter inputs into the ocean. The Ria de Vigo (NW Spain) is a highly productive and dynamic coastal system that is likely affected by such alterations. Previous nutrient-addition microcosm experiments conducted during contrasting hydrographic conditions suggested that heterotrophic bacteria are limited by organic carbon (C) and occasionally co-limited by inorganic nutrients in this coastal area. In order to assess short-term responses in biomass, production, and respiration of heterotrophic bacteria from the Ria de Vigo to increasing amounts of natural inputs of matter, we conducted 6 microcosm experiments, wherein surface seawater collected in spring, summer, and autumn was mixed with increasing amounts of dissolved natural matter concentrates from riverine and atmospheric origin. Simultaneous experiments with controlled inorganic and/or organic additions indicated that bacteria were co-limited by inorganic nutrients and C in spring and summer and primarily limited by C in autumn. Production responded more than biomass to increasing inputs of matter, whereas respiration did not change. The bacterial production response to increasing dissolved organic C load associated with riverine and atmospheric inputs was strongly related to the relative phosphorus (P) content of the dissolved matter concentrates. Our data suggest that bacterial production might decrease with the increase of P-deficient allochthonous matter inputs, which would have important biogeochemical consequences for C cycling in coastal areas.
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- Westberg, Margreta, et al.
(författare)
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Personal smartphones for neonatal diagnostic imaging: A prospective crossover study
- 2017
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Ingår i: Journal of Paediatrics and Child Health. - : WILEY. - 1034-4810 .- 1440-1754. ; 53:4, s. 343-347
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Tidskriftsartikel (refereegranskat)abstract
- AimNeonatal clinicians may be asked to review X-ray images when unable to directly access the original image. Transmitting an X-ray image to a smartphone is a technique increasingly being used by clinicians in a number of settings. Minimal data exist on its use in the neonatal setting. Our aim was to compare the ability of neonatal clinicians to correctly diagnose a pneumothorax from a chest radiograph (CXR) viewed on a smartphone, paralleled with the same image viewed on a computer screen. MethodsWe investigated the accuracy, sensitivity, specificity, positive predictive value and negative predicative value of two methods of viewing CXR images to diagnose pneumothorax, compared with a gold standard radiologist report. Clinicians were presented with 40 CXR images on two occasions, at least 1 week apart. Images were viewed once on a smartphone and once on a computer screen. Both the viewing method and viewing order of the images were randomised. The clinical details of the infant at the time the CXR was taken were provided, and participants were asked if a pneumothorax was present. ResultsTwenty-one clinicians viewed all CXR images using both viewing methods (840 paired observations). There was no difference in accuracy of detecting pneumothorax between viewing methods, 81% correctly identified a pneumothorax using the smartphone, versus 80% using the computer screen (P = 0.40 (95% CI), difference -4 to 1.5%). ConclusionDiagnosis of neonatal pneumothorax was as accurate using a smartphone as viewing CXR images displayed on a computer screen when clinicians were presented with X-rays with diagnosis of pneumothorax.
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- Zeidan, Youssef H., et al.
(författare)
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Postmastectomy Radiation Therapy in Women with T1-T2 Tumors and 1 to 3 Positive Lymph Nodes: Analysis of the Breast International Group 02-98 Trial
- 2018
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Ingår i: International Journal of Radiation Oncology, Biology, Physics. - : ELSEVIER SCIENCE INC. - 0360-3016 .- 1879-355X. ; 101:2, s. 316-324
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To analyze the impact of postmastectomy radiation therapy (PMRT) for patients with T1-T2 tumors and 1 to 3 positive lymph nodes enrolled on the Breast International Group (BIG) 02-98 trial. Methods and Materials: The BIG 02-98 trial randomized patients to receive adjuvant anthracycline with or without taxane chemotherapy. Delivery of PMRT was nonrandomized and performed according to institutional preferences. The present analysis was performed on participants with T1-T2 breast cancer and 1 to 3 positive lymph nodes who had undergone mastectomy and axillary nodal dissection. The primary objective of the present study was to examine the effect of PMRT on risk of locoregional recurrence (LRR), breast cancer-specific survival, and overall survival. Results: We identified 684 patients who met the inclusion criteria and were included in the analysis, of whom 337 (49%) had received PMRT. At 10 years, LRR risk was 2.5% in the PMRT group and 6.5% in the no-PMRT group (hazard ratio 0.29, 95% confidence interval 0.12-0.73; P=.005). Lower LRR after PMRT was noted for patients randomized to receive adjuvant chemotherapy with no taxane (10-year LRR: 3.4% vs 9.1%; P=.02). No significant differences in breast cancer-specific survival (84.3% vs 83.9%) or overall survival (81.7% vs 78.3%) were observed according to receipt of PMRT. Conclusion: Our analysis of the BIG02-98 trial shows excellent outcomes in women with T1-T2 tumors and 1 to 3 positive lymph nodes found in axillary dissection. Although PMRT improved LRR in this cohort, the number of events remained low at 10 years. In all groups, 10-year rates of LRR were relatively low compared with historical studies. As such, the use of PMRT in women with 1 to 3 positive nodes should be tailored to individual patient risks. (C) 2018 Elsevier Inc. All rights reserved.
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