| 1. |
- Bryhn, Andreas, et al.
(författare)
-
Fisk- och skaldjursbestånd i hav och sötvatten 2019 : Resursöversikt
- 2020
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Fisken i havet är en resurs som rör sig fritt över nationella gränser. EU har därför en gemensam fiskeripolitik (GFP). Många arter som är viktiga för Sverige regleras inte i GFP och förvaltas därför nationellt.Denna rapport syftar till att:beskriva utvecklingen av fiskeripolitikenförklara den nuvarande politikens mål och regelverk och dess relation till mål och regler på miljöområdetförklara politikens nationella genomförande och det nationella handlingsutrymmetexemplifiera hur Havs- och vattenmyndigheten arbetat med att reglera fisket.
|
|
| 2. |
- Dareng, EO, et al.
(författare)
-
Polygenic risk modeling for prediction of epithelial ovarian cancer risk
- 2022
-
Ingår i: European journal of human genetics : EJHG. - : Springer Science and Business Media LLC. - 1476-5438 .- 1018-4813. ; 30:3, s. 349-362
-
Tidskriftsartikel (refereegranskat)abstract
- Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. Joint estimation of Single Nucleotide Polymorphism (SNP) effects in models could improve predictive performance over standard approaches of PRS construction. Here, we implemented computationally efficient, penalized, logistic regression models (lasso, elastic net, stepwise) to individual level genotype data and a Bayesian framework with continuous shrinkage, “select and shrink for summary statistics” (S4), to summary level data for epithelial non-mucinous ovarian cancer risk prediction. We developed the models in a dataset consisting of 23,564 non-mucinous EOC cases and 40,138 controls participating in the Ovarian Cancer Association Consortium (OCAC) and validated the best models in three populations of different ancestries: prospective data from 198,101 women of European ancestries; 7,669 women of East Asian ancestries; 1,072 women of African ancestries, and in 18,915 BRCA1 and 12,337 BRCA2 pathogenic variant carriers of European ancestries. In the external validation data, the model with the strongest association for non-mucinous EOC risk derived from the OCAC model development data was the S4 model (27,240 SNPs) with odds ratios (OR) of 1.38 (95% CI: 1.28–1.48, AUC: 0.588) per unit standard deviation, in women of European ancestries; 1.14 (95% CI: 1.08–1.19, AUC: 0.538) in women of East Asian ancestries; 1.38 (95% CI: 1.21–1.58, AUC: 0.593) in women of African ancestries; hazard ratios of 1.36 (95% CI: 1.29–1.43, AUC: 0.592) in BRCA1 pathogenic variant carriers and 1.49 (95% CI: 1.35–1.64, AUC: 0.624) in BRCA2 pathogenic variant carriers. Incorporation of the S4 PRS in risk prediction models for ovarian cancer may have clinical utility in ovarian cancer prevention programs.
|
|
| 3. |
- Lindqvist, Pelle G., et al.
(författare)
-
Women with fair phenotypes seem to confer a survival advantage in a low UV milieu. A nested matched case control study
- 2020
-
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Sun exposure in combination with skin pigmentation is the main determinant for vitamin D status. Human skin color seems to be adapted and optimized for regional sun ultraviolet (UV) intensity. However, we do not know if fair, UV-sensitive skin is a survival advantage in regions with low UV radiation. Methods A population-based nested case-control study of 29,518 Caucasian women, ages 25 to 64 years from Southern Sweden who responded to a questionnaire regarding risk-factors for malignant melanoma in 1990 and followed for 25 years. For each fair woman, defined as having red hair or freckles (n = 11,993), a control was randomly selected from all non-fair women from within the cohort of similar age, smoking habits, education, marital status, income, and comorbidity, i.e., 11,993 pairs. The main outcome was the difference in allcause mortality between fair and non-fair women in a low UV milieu, defined as living in Sweden and having low-to-moderate sun exposure habits. Secondary outcomes were mortality by sun exposure, and among those non-overweight. Results In a low UV milieu, fair women were at a significantly lower all-cause mortality risk as compared to non-fair women (log rank test p = 0.04) with an 8% lower all-cause mortality rate (hazard ratio [HR] = 0.92, 95% CI 0.84-1.0), including a 59% greater risk of dying from skin cancer among fair women (HR 1.59, 95% CI 1.26-2.0). Thus, it seem that the beneficial health effect from low skin coloration outweigh the risk of skin cancer at high latitudes. Conclusion In a region with low UV milieu, evolution seems to improve all-cause survival by selecting a fair skin phenotype, i.e., comprising fair women with a survival advantage.
|
|
| 4. |
- Moll, Ulrika, et al.
(författare)
-
Women with a predisposition for diabetes have an increased risk of pregnancy complications, especially in combination with pregestational overweight
- 2020
-
Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 20
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Overweight and gestational diabetes are risk factors for pregnancy complications. We hypothesized that the metabolic impact of overweight on pregnancy outcome, would be different if it was combined with a predisposition for diabetes. The aim of this study was to compare the outcome of pregnancies in women with diabetes diagnosed later in life, to the outcome of pregnancies of women who did not develop diabetes. METHODS: Women in a population-based cohort who also were registered in the Swedish Medical Birth Registry (n = 4738) were included. A predisposition for diabetes (GDM or diabetes after pregnancy) was found in 455 pregnancies. The number of pregnancies with maternal BMI ≥ 25 kg/m2 and without diabetes were 2466, and in 10,405 pregnancies the mother had a BMI < 25 kg/m2 without diabetes at any time. Maternal BMI, gestational length, gestational weight gain, frequency of caesarean section, infant birth weight, frequency of large for gestational age (LGA) and Apgar score were retrospectively compared. RESULTS: Pregnancies with normal maternal BMI ≤25 kg/m2, with predisposition for diabetes had a higher frequency of LGA (11.6% vs. 2.9%; p < 0.001), a higher frequency of macrosomia (28.6% vs. 17.6%; p < 0.001), and a shorter gestational length (39.7 vs. 40 weeks; p = 0.08) when compared to pregnancies in women without a predisposition for diabetes. In addition, pregnancies with both maternal predisposition for diabetes and BMI ≥ 25 kg/m2 there was a higher frequency of LGA (23.3% vs. 7.1%; p < 0.001), caesarean section (24.0% vs. 14.9%, p = 0.031) compared to pregnancies in women who were only overweight. A predisposition for diabetes significantly increases the risk of macrosomia (OR1.5; 95% CI 1.07-2.15; p = 0.02). CONCLUSIONS: In pregnancy, there is an increased frequency of LGA, macrosomia and caesarean section if the woman has a predisposition for diabetes. The frequency of overweight young women is increasing, and it is urgent to identify pregnant women with a predisposition to diabetes. How to distinguish the women with the highest risk for adverse pregnancy outcome and the highest risk of future disease, remains to be studied.
|
|
| 5. |
- Olsson, Håkan Lars, et al.
(författare)
-
The Menstrual Cycle and Risk of Breast Cancer : A Review
- 2020
-
Ingår i: Frontiers in Oncology. - : Frontiers Media SA. - 2234-943X. ; 10
-
Forskningsöversikt (refereegranskat)abstract
- Cyclic hormonal stimulation of the breast tissue plays a significant role in breast carcinogenesis. Current risk factor models do not include direct measures of cycle characteristics although the effects of possible surrogates of cycle activity such as age at menarche and menopause, parity, and nursing time have been investigated. Future risk models should also include menstrual cycle length, regularity, number of cycles before first full-term pregnancy, and life-time number of cycles. New risk factor models for pre- and postmenopausal breast cancer are proposed here. Furthermore, there is a need for more long-term, prospective studies investigating menstrual cycle characteristics as data currently available are primarily retrospective and collected at one time-point only.
|
|
| 6. |
|
|
| 7. |
- Adelsköld, Göran, et al.
(författare)
-
GET-tjänsten och infrastrukturen för distribution av geodata till universitet och högskolor
- 2020
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Geodata Extraction Tool (GET) är en tjänst för att tillgängliggöra myndigheters digitala geografiska data till universitet och högskolor i Sverige. GET-tjänsten startades 2012 för att tillgodose studenters och forskares behov av att enkelt och kostnadsfritt kunna få tillgång till Lantmäteriets digitala geodata som annars var avgiftsbelagda. Tjänsten har senare utvidgats med geodata från andra myndigheter, och idag kan förutom det mesta av Lantmäteriets geografiska data, även en del data från SGU, SCB och Sjöfartsverket nås via GET. Tjänsten är utvecklad av, och sköts av, Sveriges lantbruksuniversitet (SLU). I denna rapport sammanfattas tillkomsten av GET, vilka avtal som ligger till grund för tjänsten, hur man använder den och vilka data som distribueras via denna samverkan mellan berörda myndigheter. Dessutom redovisas senaste årets statistik för nedladdade geodatamängder samt resultaten från en användarenkät 2019. Rapporten avslutas med en framåtblick.
|
|
| 8. |
- Ahearn, Thomas U., et al.
(författare)
-
Common variants in breast cancer risk loci predispose to distinct tumor subtypes
- 2022
-
Ingår i: Breast Cancer Research. - : Springer Nature. - 1465-5411 .- 1465-542X. ; 24:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundGenome-wide association studies (GWAS) have identified multiple common breast cancer susceptibility variants. Many of these variants have differential associations by estrogen receptor (ER) status, but how these variants relate with other tumor features and intrinsic molecular subtypes is unclear.MethodsAmong 106,571 invasive breast cancer cases and 95,762 controls of European ancestry with data on 173 breast cancer variants identified in previous GWAS, we used novel two-stage polytomous logistic regression models to evaluate variants in relation to multiple tumor features (ER, progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and grade) adjusting for each other, and to intrinsic-like subtypes.ResultsEighty-five of 173 variants were associated with at least one tumor feature (false discovery rate < 5%), most commonly ER and grade, followed by PR and HER2. Models for intrinsic-like subtypes found nearly all of these variants (83 of 85) associated at p < 0.05 with risk for at least one luminal-like subtype, and approximately half (41 of 85) of the variants were associated with risk of at least one non-luminal subtype, including 32 variants associated with triple-negative (TN) disease. Ten variants were associated with risk of all subtypes in different magnitude. Five variants were associated with risk of luminal A-like and TN subtypes in opposite directions.ConclusionThis report demonstrates a high level of complexity in the etiology heterogeneity of breast cancer susceptibility variants and can inform investigations of subtype-specific risk prediction.
|
|
| 9. |
- Akil, Shahnaz, et al.
(författare)
-
Appropriate coronary revascularization can be accomplished if myocardial perfusion is quantified by positron emission tomography prior to treatment decision
- 2021
-
Ingår i: Journal of Nuclear Cardiology. - : Springer Science and Business Media LLC. - 1071-3581 .- 1532-6551. ; 28:4, s. 1664-1672
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients undergo percutaneous coronary intervention (PCI) without the use of non-invasive stress testing prior to treatment. The aim of this study was to determine the potential added value of guiding revascularization by quantitative assessment of myocardial perfusion prior to intervention. Methods and Results: Thirty-three patients (10 females) with suspected or established CAD who had been referred for a clinical coronary angiography (CA) with possibility for PCI were included. Adenosine stress and rest 13N-NH3 PET, cardiac magnetic resonance (CMR), and cardiopulmonary exercise test were performed 4 ± 3 weeks before and 5 ± 1 months after CA. The angiographer was blinded to the PET and CMR results. Myocardial flow reserve (MFR) < 2.0 by PET was considered abnormal. A PCI was performed in 19/33 patients. In 41% (11/27) of the revascularized vessel territories, a normal regional MFR was found prior to the PCI and no improvement in MFR was found at follow-up (P = 0.9). However, vessel territories with regional MFR < 2.0 at baseline improved significantly after PCI (P = 0.003). Of the 14 patients not undergoing PCI, four had MFR < 2.0 in one or more coronary territories. Conclusion: Assessment of quantitative myocardial perfusion prior to revascularization could lead to more appropriate use of CA when managing patients with stable CAD.
|
|
| 10. |
- Augustinsson, Annelie, et al.
(författare)
-
Genetic testing in women with early-onset breast cancer : a Traceback pilot study
- 2021
-
Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 190:2, s. 307-315
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: In Sweden, a Traceback approach, i.e., a retrospective genetic outreach activity, among cancer patients is not normally used in clinical practice. In this pilot study, we wanted to evaluate a Traceback strategy for possible future clinical implementation and investigate why not all women with early-onset breast cancer underwent genetic testing when they were first diagnosed. Methods: Out of all women (n = 409) diagnosed with breast cancer at ≤ 35 years in Southern Sweden between 2000 and 2017, 63 had not previously been tested. These women were offered an analysis of the genes BRCA1, BRCA2, PALB2, CHEK2, and ATM through a standardized letter. Subsequently, women with normal test results were informed through a letter and carriers of pathogenic variants were contacted through a telephone call and offered in-person genetic counseling. All tested women were asked to complete a follow-up questionnaire regarding previously not having attended genetic counseling and testing and their experiences of the current retrospective approach. Results: Out of the invited women, 29 (46%) underwent genetic testing and 27 (43%) answered the questionnaire. Pathogenic variants were identified in BRCA1 (n = 2), CHEK2 (n = 1), and ATM (n = 1). The main reason for previously not having undergone genetic testing was not having received any information from their physicians. Most study participants were satisfied with both written pre- and post-test information. Conclusion: The process with retrospective identification, written pre-test information, and genetic testing, followed by in-person counseling for carriers of pathogenic variants only, was well accepted. This has implications for future Traceback implementation programs.
|
|
| 11. |
- Augustinsson, Annelie, et al.
(författare)
-
Variations in the Referral Pattern for Genetic Counseling of Patients with Early-Onset Breast Cancer : A Population-Based Study in Southern Sweden
- 2020
-
Ingår i: Public Health Genomics. - : S. Karger AG. - 1662-8063 .- 1662-4246. ; 23:3-4, s. 100-109
-
Tidskriftsartikel (refereegranskat)abstract
- Swedish national breast cancer guidelines recommend that all women diagnosed with breast cancer (BC) at the age of 35 years or younger should be referred to their regional oncogenetic clinic for genetic counseling and testing, regardless of family history of cancer. The main objective of this study was to evaluate whether place of residence at BC diagnosis and treating hospital were associated with the fact that not all BC patients diagnosed at ≤35 years in the southern part of Sweden have attended genetic counseling and testing. Between 2000 and 2013, 279 women in the South Swedish Health Care Region were diagnosed with BC at ≤35 years. Information regarding place of residence at BC diagnosis, treating hospital, time of registration and first meeting at the Oncogenetic Clinic in Lund, and genetic testing was collected. With a follow-up period until August 2018, 64% were registered at the clinic (60% underwent genetic testing) and 36% were not. BC patients from 2 counties and from rural settings with a population of <10,000 inhabitants were significantly less likely to be registered at the clinic. Our results suggest that place of residence at BC diagnosis and treating hospital were associated with the probability of referral for genetic counseling and testing for women diagnosed with BC at ≤35 years in the South Swedish Health Care Region. We propose, as a generalizable finding, that further educational and outreach activities within the health care system and the community may be needed to ensure that all women diagnosed with early-onset BC receive proper genetic counseling.
|
|
| 12. |
- Axelsson, Arvid, et al.
(författare)
-
Tree species classification using Sentinel-2 imagery and Bayesian inference
- 2021
-
Ingår i: International Journal of Applied Earth Observation and Geoinformation. - : Elsevier BV. - 1569-8432 .- 0303-2434. ; 100
-
Tidskriftsartikel (refereegranskat)abstract
- The increased temporal frequency of optical satellite data acquisitions provides a data stream that has the potential to improve land cover mapping, including mapping of tree species. However, for large area operational mapping, partial cloud cover and different image extents can pose challenges. Therefore, methods are needed to assimilate new images in a straightforward way without requiring a total spatial coverage for each new image. This study shows that Bayesian inference applied sequentially has the potential to solve this problem. To test Bayesian inference for tree species classification in the boreo-nemoral zone of southern Sweden, field data from the study area of Remningstorp (58°27′18.35″ N, 13°39′8.03″ E) were used. By updating class likelihood with an increasing number of combined Sentinel-2 images, a higher and more stable cross-validated overall accuracy was achieved. Based on a Mahalanobis distance, 23 images were automatically chosen from the period of 2016 to 2018 (from 142 images total). An overall accuracy of 87% (a Cohen’s kappa of 78.5%) was obtained for four tree species classes: Betula spp., Picea abies, Pinus sylvestris, and Quercus robur. This application of Bayesian inference in a boreo-nemoral forest suggests that it is a practical way to provide a high and stable classification accuracy. The method could be applied where data are not always complete for all areas. Furthermore, the method requires less reference data than if all images were used for classification simultaneously.
|
|
| 13. |
|
|
| 14. |
- Bergström, Lena, et al.
(författare)
-
Integration methods for Marine Strategy Framework Directive’s biodiversity assessments
- 2021
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report reviews the integration methods for MSFD biodiversity assessments under Descriptor 1 for species that are not covered by the Habitats Directive and are not commercial fish assessed under Descriptor 3 and used in Descriptor 1 assessments. It was carried out by experts from the MSFD Biodiversity expert network, which is coordinated by the JRC. It constitutes a knowledge base to support MSFD Article 8 assessments by evaluating the methods to integrate assessments of species at different levels: i) criteria to species, ii) species to species group, and iii) species groups/species to ecosystem component. Real data and realistic estimates were used to provide a robust evaluation of the main MSFD integration approaches, i.e. one out all out, proportional method, averages, weighted averages, and conditional rules. Results show that integration methods have advantages and disadvantages depending on the level of integration, the species group (including threatened species), and the available indicators for primary and secondary criteria. Therefore, different scenarios are proposed and evaluated from criteria to ecosystem components, for fish and bird species groups. To conclude, a common integration approach is feasible, when it is based on the commonly agreed ecological impact of each D1 criterion to the species groups, and can be used in all regions.
|
|
| 15. |
|
|
| 16. |
- Betancourt, Lazaro Hiram, et al.
(författare)
-
The human melanoma proteome atlas-Defining the molecular pathology
- 2021
-
Ingår i: Clinical and Translational Medicine. - : Wiley. - 2001-1326. ; 11:7, s. 1-20
-
Tidskriftsartikel (refereegranskat)abstract
- The MM500 study is an initiative to map the protein levels in malignant melanoma tumor samples, focused on in-depth histopathology coupled to proteome characterization. The protein levels and localization were determined for a broad spectrum of diverse, surgically isolated melanoma tumors originating from multiple body locations. More than 15,500 proteoforms were identified by mass spectrometry, from which chromosomal and subcellular localization was annotated within both primary and metastatic melanoma. The data generated by global proteomic experiments covered 72% of the proteins identified in the recently reported high stringency blueprint of the human proteome. This study contributes to the NIH Cancer Moonshot initiative combining detailed histopathological presentation with the molecular characterization for 505 melanoma tumor samples, localized in 26 organs from 232 patients.
|
|
| 17. |
- Burden, Håkan, et al.
(författare)
-
Proposed EU Regulations’ Impact on Data Utilisation– A Multi-Case Study within Public Transport
- 2023
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Motivation: In a broad sense data sharing onboard public transport vehicles is governed by two different business models – interoperable and free of charge access for some data versus data that is restricted to specific uses by commercial contracts and existing legislation. Under the Digital Decade the EU has proposed new legislation with the ambition to promote a single digital market. The question then arises – how will the upcoming regulations affect existing business models for data utilisation?Method: We have investigated two different cases where existing technology meets upcoming EU legislation. The questions have been framed through dialogue with actors in the industry, to cover topics and questions that are both concrete and current. Using the policy lab methodology, we have investigated the possibility to re-use surveillance film from public transport vehicles for passenger counting. The analysis compares GDPR and the Swedish camera surveillance act with the proposed AI Act, to see what new possibilities or obstacles arise. We have also explored the changes that the Data Act may impose on different actors’ access to data derived from the batteries installed in an electric bus.Results: The AI Act will not change the business models within the eco-system but facilitate access to more personal data (including personal data where GDPR otherwise would be a barrier), useful for training automated passenger counting. Those responsible for placing the system on the market will still need to ensure that they are compliant with GDPR in terms of processing personal data. In terms of the Data Act the outcome is more disruptive as the owner and user of a vehicle is entitled to all data representing their usage, free of charge, and this will impair existing business models for data access. It is also possible for multiple actors to be users, for instance if the vehicle is owned by a public transport authority and leased by an operator.Discussion: Our analysis shows that while the impact of the Data Act can resonate with the ambitions behind the regulation in terms of making more data interoperable and available free of charge, it can also have the opposite effect. The latter is specifically the case where altruistic data sharing already is in place and the Data Act imposes standard contracts for and role-based restrictions towards utilisation. Both the AI Act and the Data Act are complex and often difficult to assess. In relation to the Data Act, the recitals were helpful for interpreting the application of articles and definitions. For understanding the relationship between the AI Act and GDPR we combined the legal analysis with prototyping the impacts and relied on sharing insights with other actors. This highlights the need for multiple ways of performing the data collection and analysis as well as the suitability of policy labs as a research method
|
|
| 18. |
- Burden, Håkan, et al.
(författare)
-
Självkörande landsbygd
- 2021
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Hur skulle autonoma fordon kunna användas inom kollektivtrafiken på landsbygden? Genom intervjuer, workshops och en RFI (request for information, ett första steg mot upphandling) har vi undersökt frågan utifrån fyra konkreta områden i Sverige – Lund, Gotland, Eskilstuna och Skellefteå. Med en definition av landsbygd baserad på individens mobilitet har vi sett att Sveriges landsbygd rymmer mindre orter på väg att avfolkas där äldre, barn och de utan körkort hade kunnat få bättre tillgång till samhällelig service med autonoma fordon. Vi har också sett att flera av landets nya arbetsplatser kommer befinna sig på landsbygden och därmed skapa ett mobilitetsbehov från staden till landet. För att kunna realisera de identifierade möjligheterna finns ett behov av att framföra fordonen i högre hastigheter samt att de ska kunna hantera mer komplexa trafiksituationer än vad dagens piloter i städerna visat. På landsbygden finns alltså ett utrymme för nya fordon att visa upp sig. Samtidigt ser vi hur man inte ska förvänta sig att investeringarna i autonoma fordon kommer betala sig på en linje, snarare behöver man lyfta blicken och se systemeffekten när stomlinjetrafiken blir mer attraktiv då bussarna går raka vägen istället för via mindre samhällen. Vi har inte sett några belägg på att den digitala infrastrukturen behöver utvecklas för att möjliggöra försök med autonoma fordon på någon av de undersökta rutterna. Dagens 4G-täckning är fullgod och fordonen borde ha tillgång till tillräckligt bra positioneringsdata för att bedriva verksamheten. Däremot ställs flera frågor om hur ersättningstrafiken organiseras när fordonen inte klarar av vädret, vem som står för säkrare hållplatser och hur chaufförens övriga ansvar realiseras när fordonet är förarlöst.
|
|
| 19. |
- Cabrita, Rita, et al.
(författare)
-
Tertiary lymphoid structures improve immunotherapy and survival in melanoma
- 2020
-
Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 577:7791, s. 561-565
-
Tidskriftsartikel (refereegranskat)abstract
- Checkpoint blockade therapies that reactivate tumour-associated T cells can induce durable tumour control and result in the long-term survival of patients with advanced cancers1. Current predictive biomarkers for therapy response include high levels of intratumour immunological activity, a high tumour mutational burden and specific characteristics of the gut microbiota2,3. Although the role of T cells in antitumour responses has thoroughly been studied, other immune cells remain insufficiently explored. Here we use clinical samples of metastatic melanomas to investigate the role of B cells in antitumour responses, and find that the co-occurrence of tumour-associated CD8+ T cells and CD20+ B cells is associated with improved survival, independently of other clinical variables. Immunofluorescence staining of CXCR5 and CXCL13 in combination with CD20 reveals the formation of tertiary lymphoid structures in these CD8+CD20+ tumours. We derived a gene signature associated with tertiary lymphoid structures, which predicted clinical outcomes in cohorts of patients treated with immune checkpoint blockade. Furthermore, B-cell-rich tumours were accompanied by increased levels of TCF7+ naive and/or memory T cells. This was corroborated by digital spatial-profiling data, in which T cells in tumours without tertiary lymphoid structures had a dysfunctional molecular phenotype. Our results indicate that tertiary lymphoid structures have a key role in the immune microenvironment in melanoma, by conferring distinct T cell phenotypes. Therapeutic strategies to induce the formation of tertiary lymphoid structures should be explored to improve responses to cancer immunotherapy.
|
|
| 20. |
- Cabrita, Rita, et al.
(författare)
-
Tertiary lymphoid structures improve immunotherapy and survival in melanoma.
- 2020
-
Ingår i: Nature. - : Nature Publishing Group. - 1476-4687 .- 0028-0836. ; 577:7791, s. 561-565
-
Tidskriftsartikel (refereegranskat)abstract
- Checkpoint blockade therapies that reactivate tumour-associated T cells can induce durable tumour control and result in the long-term survival of patients with advanced cancers1. Current predictive biomarkers for therapy response include high levels of intratumour immunological activity, a high tumour mutational burden and specific characteristics of the gut microbiota2,3. Although the role of T cells in antitumour responses has thoroughly been studied, other immune cells remain insufficiently explored. Here we use clinical samples of metastatic melanomas to investigate the role of B cells in antitumour responses, and find that the co-occurrence of tumour-associated CD8+ T cells and CD20+ B cells is associated with improved survival, independently of other clinical variables. Immunofluorescence staining of CXCR5 and CXCL13 in combination with CD20 reveals the formation of tertiary lymphoid structures in these CD8+CD20+ tumours. We derived a gene signature associated with tertiary lymphoid structures, which predicted clinical outcomes in cohorts of patients treated with immune checkpoint blockade. Furthermore, B-cell-rich tumours were accompanied by increased levels of TCF7+ naive and/or memory T cells. This was corroborated by digital spatial-profiling data, in which T cells in tumours without tertiary lymphoid structures had a dysfunctional molecular phenotype. Our results indicate that tertiary lymphoid structures have a key role in the immune microenvironment in melanoma, by conferring distinct T cell phenotypes. Therapeutic strategies to induce the formation of tertiary lymphoid structures should be explored to improve responses to cancer immunotherapy.
|
|
| 21. |
- Cabrita, Rita, et al.
(författare)
-
The Role of PTEN Loss in Immune Escape, Melanoma Prognosis and Therapy Response
- 2020
-
Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 12:3
-
Tidskriftsartikel (refereegranskat)abstract
- Checkpoint blockade therapies have changed the clinical management of metastatic melanoma patients considerably, showing survival benefits. Despite the clinical success, not all patients respond to treatment or they develop resistance. Although there are several treatment predictive biomarkers, understanding therapy resistance and the mechanisms of tumor immune evasion is crucial to increase the frequency of patients benefiting from treatment. The PTEN gene is thought to promote immune evasion and is frequently mutated in cancer and melanoma. Another feature of melanoma tumors that may affect the capacity of escaping T-cell recognition is melanoma cell dedifferentiation characterized by decreased expression of the microphtalmia-associated transcription factor (MITF) gene. In this study, we have explored the role of PTEN in prognosis, therapy response, and immune escape in the context of MITF expression using immunostaining and genomic data from a large cohort of metastatic melanoma. We confirmed in our cohort that PTEN alterations promote immune evasion highlighted by decreased frequency of T-cell infiltration in such tumors, resulting in a worse patient survival. More importantly, our results suggest that dedifferentiated PTEN negative melanoma tumors have poor patient outcome, no T-cell infiltration, and transcriptional properties rendering them resistant to targeted- and immuno-therapy.
|
|
| 22. |
- Chorell, Elin, 1981-, et al.
(författare)
-
Lysophospholipids as Predictive Markers of ST-Elevation Myocardial Infarction (STEMI) and Non-ST-Elevation Myocardial Infarction (NSTEMI)
- 2021
-
Ingår i: Metabolites. - : MDPI. - 2218-1989 .- 2218-1989. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- The present study explored patterns of circulating metabolites and proteins that can predict future risk for ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). We conducted a prospective nested case-control study in northern Sweden in individuals who developed STEMI (N = 50) and NSTEMI (N = 50) within 5 years and individually matched controls (N = 100). Fasted plasma samples were subjected to multiplatform mass spectrometry-based metabolomics and multiplex protein analyses. Multivariate analyses were used to elucidate infarction-specific metabolite and protein risk profiles associated with future incident STEMI and NSTEMI. We found that altered lysophosphatidylcholine (LPC) to lysophosphatidylethanolamine (LPE) ratio predicted STEMI and NSTEMI events in different ways. In STEMI, lysophospholipids (mainly LPEs) were lower, whereas in NSTEMI, lysophospholipids (mainly LPEs) were higher. We found a similar response for all detected lysophospholipids but significant alterations only for those containing linoleic acid (C18:2, p < 0.05). Patients with STEMI had higher secretoglobin family 3A member 2 and tartrate-resistant acid phosphate type 5 and lower platelet-derived growth factor subunit A, which are proteins associated with atherosclerosis severity and plaque development mediated via altered phospholipid metabolism. In contrast, patients with NSTEMI had higher levels of proteins associated with inflammation and macrophage activation, including interleukin 6, C-reactive protein, chemerin, and cathepsin X and D. The STEMI risk marker profile includes factors closely related to the development of unstable plaque, including a higher LPC:LPE ratio, whereas NSTEMI is characterized by a lower LPC:LPE ratio and increased inflammation.
|
|
| 23. |
- Coignard, J, et al.
(författare)
-
A case-only study to identify genetic modifiers of breast cancer risk for BRCA1/BRCA2 mutation carriers
- 2021
-
Ingår i: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1, s. 1078-
-
Tidskriftsartikel (refereegranskat)abstract
- Breast cancer (BC) risk for BRCA1 and BRCA2 mutation carriers varies by genetic and familial factors. About 50 common variants have been shown to modify BC risk for mutation carriers. All but three, were identified in general population studies. Other mutation carrier-specific susceptibility variants may exist but studies of mutation carriers have so far been underpowered. We conduct a novel case-only genome-wide association study comparing genotype frequencies between 60,212 general population BC cases and 13,007 cases with BRCA1 or BRCA2 mutations. We identify robust novel associations for 2 variants with BC for BRCA1 and 3 for BRCA2 mutation carriers, P < 10−8, at 5 loci, which are not associated with risk in the general population. They include rs60882887 at 11p11.2 where MADD, SP11 and EIF1, genes previously implicated in BC biology, are predicted as potential targets. These findings will contribute towards customising BC polygenic risk scores for BRCA1 and BRCA2 mutation carriers.
|
|
| 24. |
- Eklundh, Lars, et al.
(författare)
-
Insamling av geografiska data
- 2020. - 7
-
Ingår i: Geografisk informationsbehandling. - : Studentlitteratur AB. - 9789144131740 ; , s. 85-126
-
Bokkapitel (populärvet., debatt m.m.)abstract
- Det här kapitlet fokuserar på att förklara de grundläggande principerna för insamling av geografiska data, och vi lägger tonvikten på fjärranalys och geodetiska metoder. Fjärranalys innefattar olika tekniker som fotogrammetri, laserskanning och analys av bilder från mark, flyg och satelliter. Geodetiska datainsamling används för att mäta in koordinater för objekt på marken och innefattar satellitbaserade tekniker såväl som användning av fältinstrument. Olika tekniker, avseende både fjärranalys och geodesi, används i olika situationer beroende på krav på noggrannhet och innehåll, och kompletterar därför varandra. Vi börjar med att beskriva satellitfjärranalys som kan täcka stora områden med relativt begränsad detaljeringsgrad, beskriver sedan flygbilder och laserskanning där detaljnivån ökar, för att till sist beskriva de geodetiska metoderna för noggranna mätningar på marknivå.
|
|
| 25. |
- Escala-Garcia, Maria, et al.
(författare)
-
A network analysis to identify mediators of germline-driven differences in breast cancer prognosis
- 2020
-
Ingår i: Nature Communications. - : NATURE PUBLISHING GROUP. - 2041-1723. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- Identifying the underlying genetic drivers of the heritability of breast cancer prognosis remains elusive. We adapt a network-based approach to handle underpowered complex datasets to provide new insights into the potential function of germline variants in breast cancer prognosis. This network-based analysis studies similar to 7.3 million variants in 84,457 breast cancer patients in relation to breast cancer survival and confirms the results on 12,381 independent patients. Aggregating the prognostic effects of genetic variants across multiple genes, we identify four gene modules associated with survival in estrogen receptor (ER)-negative and one in ER-positive disease. The modules show biological enrichment for cancer-related processes such as G-alpha signaling, circadian clock, angiogenesis, and Rho-GTPases in apoptosis.
|
|
| 26. |
- Escala-Garcia, M, et al.
(författare)
-
Germline variants and breast cancer survival in patients with distant metastases at primary breast cancer diagnosis
- 2021
-
Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1, s. 19787-
-
Tidskriftsartikel (refereegranskat)abstract
- Breast cancer metastasis accounts for most of the deaths from breast cancer. Identification of germline variants associated with survival in aggressive types of breast cancer may inform understanding of breast cancer progression and assist treatment. In this analysis, we studied the associations between germline variants and breast cancer survival for patients with distant metastases at primary breast cancer diagnosis. We used data from the Breast Cancer Association Consortium (BCAC) including 1062 women of European ancestry with metastatic breast cancer, 606 of whom died of breast cancer. We identified two germline variants on chromosome 1, rs138569520 and rs146023652, significantly associated with breast cancer-specific survival (P = 3.19 × 10−8 and 4.42 × 10−8). In silico analysis suggested a potential regulatory effect of the variants on the nearby target genes SDE2 and H3F3A. However, the variants showed no evidence of association in a smaller replication dataset. The validation dataset was obtained from the SNPs to Risk of Metastasis (StoRM) study and included 293 patients with metastatic primary breast cancer at diagnosis. Ultimately, larger replication studies are needed to confirm the identified associations.
|
|
| 27. |
|
|
| 28. |
|
|
| 29. |
- Forsberg, Magnus, et al.
(författare)
-
RAPPORT GEODATARÅDETS HANDLINGSPLAN 2020 : Aktivitet – 4i, Långsiktig kompetensförsörjning inom geodataområdet
- 2020
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I den nationella geodatastrategin som gäller för åren 2016–2020 återfinns målet ”Samverkan är välutvecklad” (mål nummer 4). Inom ramen för detta mål ingår en aktivitet (4i) som syftar till att säkerställa den långsiktiga kompetensförsörjningen inom geodataområdet. För att arbeta med frågan tillsattes en arbetsgrupp med representanter från Lantmäteriet och ett antal lärosäten. I denna rapport redovisas resultatet av den tillsatta arbetsgruppens undersökningar. Arbetet är i första hand inriktat på att hitta en väg framåt som kan leda till att kompetensen inom geodataområdet långsiktigt kan säkerställas och utvecklas. I uppdraget ingår även en internationell utblick. Denna har avgränsats till att avse våra nordiska grannländer, dvs. Norge, Finland, Danmark samt Nederländerna och Österrike. Geodataområdet har avgränsats till att omfatta följande områden:Geodesi Tekniska aspekter av geografiska informationssystem (GIS) och geografisk informationsteknologi (GIT)FjärranalysFotogrammetri inklusive laserskanningTekniskt lantmäteriMånga av slutsatserna från äldre rapporter och utredningar gäller fortfarande. Flera initiativ har genomförts för att komma till rätta med de identifierade problemen: samarbeten i olika forum, kostnadsfri tillgång till geodata för universitet och högskolor (via FUK-avtal), en förbättrad infrastruktur för geodata (genom forskning och regeringsuppdrag) samt utbildningssatsningar i tidig ålder (Geoskolan). Geodatarådets tidigare initiativ för att driva kompetensfrågorna i enlighet med 2012 års geodatastrategi har inte följts upp med motsvarande nya satsningar mellan åren 2016 till 2019.Det finns ett stort utbud av utbildningar inom geodataområdet utspridda på olika platser i Sverige. Kompetensförsörjningen inom geodataområdet är beroende av tillgången på välfungerande forskningsmiljöer. Goda forskningsmiljöer knyter till sig värdefulla resurser, exempelvis professorer, forskare, postdocs och doktorander. Förutom att bidra med kunskap och allokera ekonomiska resurser till forskning, förbättras lärosätenas möjligheter att kunna bedriva en attraktiv utbildning. Många gånger är en professur en nödvändighet för att åstadkomma den önskvärda forsknings- och utbildningsmiljön. Trots att flertalet utbildningsvarianter finns valbara vid ett antal lärosäten tycks tillgången på kompetens inte motsvara marknadens behov. Särskilt kritiskt tycks situationen vara för kompetenstillgången inom ämnesområdet fotogrammetri, där det idag inte finns någon profe-ssur i Sverige.Vid de tekniska högskolorna i Stockholm och Lund är söktrycket för de granskade utbildningarna gott, men få studenter väljer en inriktning mot geodata längre fram. Ämnesområdet geodata är relativt litet i förhållande till andra teknikområden och det finns en konkurrens mellan lärosätena. Detta har gjort ämnesområdet fragmentiserat med följden att inget lärosäte för närvarande tillhandahåller en komplett utbildnings- och forskningsmiljö. Det finns ett nationellt behov av en högkvalitativ masterutbildning som omfattar kärnämnena geodesi, fotogrammetri och geoinformatik. Om Sverige lyckas med att skapa en komplett masterutbildning som stöds av vitala forskargrupper bör det locka fler studenter till fortsätt utbildning, både på master- och forskarnivå. Forskningsverksamheten har flera viktiga funktioner i samhället. God forskning bidrar till att värna om Sveriges ställning som kunskapsnation och ger förutsättningar för vilken industri som etableras och stannar i landet. Aktiva forskargrupper bidrar till att skapa kompetensnätverk och får en särskild betydelse vid utbildningen av doktorander, lärare och studenter som sedan kan förse samhället med nödvändig expertkompetens. De ansträngningar som har gjorts för att försöka påverka forskningsfinansiärerna att prioritera geodataområdet har hittills varit fruktlösa. Medel får sökas inom ramen för andra forskningsprojekt. En långsiktig finansiell försörjning är en förutsättning för att forskning ska kunna bedrivas uthålligt och hålla en hög kvalitet. I Sverige finns det ingen utsedd huvudfinansiär för forskning inom geodataområdet, något som uppmärksammades redan i Geodatarådets utredning från 2008. Situationen ser likadan ut i dag, tillgången på forskningsmedel är bristfällig och det saknas en långsiktig forskningsförsörjning. I denna rapport presenteras en handlingsplan för att säkerställa den fram-tida kompetensuppbyggnaden inom geodataområdet. Arbetet bör initieras och följas upp av Geodatarådet samt utgöra en grund för inspel till kommande forskningsproposition (närmast år 2025) och dialog med berörda departement. Tre av de föreslagna aktiviteterna återges nedan:Arbeta för att skapa minst en komplett utbildnings- och forskningsmiljö som kan fungera som kompetenscentrum, och som inkluderar ämnesområdena geodesi, fotogrammetri (inklusive laserskanning) samt geoinformatik.Bilda en marknadsföringsgrupp med representanter från Geodatarådets medlemmar samt lärosäten och branschföretag som tillsammans arbetar fram en gemensam handlingsplan med aktivi-teter och kampanjer för att öka söktrycket till utbildningar med inriktning mot geodata.Ge Lantmäteriet ett forskningsfinansierande uppdrag. Formerna för ett sådant uppdrag behöver utredas närmare med andra forsknings-finansierande myndigheter som förebild. Denna lösning kräver ändringar i Lantmäteriets instruktion samt ett höjt ramanslag vilket måste tas med i beräkning vid ärendets beredning.
|
|
| 30. |
- Fritz, Ildikó, et al.
(författare)
-
Desloratadine and loratadine stand out among common H1-antihistamines for association with improved breast cancer survival
- 2020
-
Ingår i: Acta oncologica (Stockholm, Sweden). - 1651-226X. ; 59:9, s. 1103-1109
-
Tidskriftsartikel (refereegranskat)abstract
- Background: As tumors maintain an inflammatory microenvironment, anti-inflammatory medication can be useful in cancer therapy. We have previously shown an association with improved survival in melanoma for use of the H1-antihistamines desloratadine and loratadine, and here we examine use of H1-antihistamines and breast cancer mortality.Material and methods: We investigated use of the six major H1-antihistamines (cetirizine, clemastine, desloratadine, ebastine, fexofenadine and loratadine) and breast cancer-specific and overall mortality in a nation-wide register-based study of all 61,627 Swedish women diagnosed with breast cancer 2006-2013. Both peri- and post-diagnostic antihistamine use was analyzed using Cox regression models. Analyses were stratified for age and subgroup analyses based on estrogen receptor status and menopausal status were performed.Results: We found a consistently improved survival of desloratadine users (HR = 0.67; 95% CI 0.55-0.81, p < .001), as well as of loratadine users (HR = 0.80; 95% CI 0.67-0.95, p = .012), relative to nonusers, regardless of patient age, menopause, estrogen receptor status or stage of the tumor, or whether breast cancer-specific or overall survival was analyzed. The survival of users of other antihistamines varied relative to non-users.Conclusion: Based on their safety and current use within the patient population, together with our observations, we suggest the initiation of trials of desloratadine and loratadine as treatment of breast cancer as well as studies of the mechanism behind their possible effect. Further studies on any effects of other H1-antihistamines may also be merited, as well as of H1-antihistamine use and survival in other malignancies.
|
|
| 31. |
|
|
| 32. |
- Fritz, Ildikó, et al.
(författare)
-
Improved survival in several cancers with use of H1-antihistamines desloratadine and loratadine
- 2021
-
Ingår i: Translational Oncology. - : Elsevier BV. - 1936-5233. ; 14:4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: We have previously shown an association with substantially improved survival in breast cancer and melanoma for desloratadine and loratadine users, and set out to find whether an improved survival can be seen in tumors with and without a known response to immune checkpoint therapy, such as anti-CTLA-4 or anti-PD-1. Methods: We investigated survival and use of six common H1-antihistamines (cetirizine, clemastine, desloratadine, ebastine, fexofenadine and loratadine) in a nation-wide cohort of all 429,198 Swedish patients with ten types of immunogenic (gastric, colorectal/anal, pancreatic, lung, breast, prostate, kidney, and bladder cancer, melanoma and Hodgkin lymphoma) and six non-immunogenic (liver, uterine, ovarian, brain/CNS, and thyroid cancer and non-Hodgkin lymphoma) tumors diagnosed 2006–2017. Follow-up was until 2019–02–24. Findings: Desloratadine use was associated with an improved survival for all immunogenic tumors, but not for the non-immunogenic ones. Loratadine use was associated with improved survival for some tumors. Use of the other antihistamines could not be shown to be consistently associated with improved survival to a statistically significant degree. Interpretation: Our hypothesis is that our findings result from immune checkpoint inhibition, and we believe both desloratadine and loratadine should be tested in randomized clinical trials as treatment of immunogenic tumors, with priority given to trials of desloratadine as treatment of tumors with few therapy options and dismal prognoses, such as pancreatic cancer. If our results can be confirmed in a clinical setting, new, potentially curative, therapies could result for several tumors, including ones with dire prognoses and limited treatment options.
|
|
| 33. |
- Gavali, Hamid, et al.
(författare)
-
Outcome of Radical Surgical Treatment of Abdominal Aortic Graft and Endograft Infections Comparing Extra-anatomic Bypass with In Situ Reconstruction : A Nationwide Multicentre Study
- 2021
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Saunders Elsevier. - 1078-5884 .- 1532-2165. ; 62:6, s. 918-926
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Abdominal aortic graft and endograft infection (AGI) is primarily treated by resection of the infected graft and restoration of distal perfusion through extra-anatomic bypass (EAB) or in situ reconstruction/repair (ISR). The aim of this study was to compare these surgical strategies in a nationwide multicentre retrospective cohort study.Methods: The Swedish Vascular Registry (Swedvasc) was used to identify surgically treated abdominal AGIs in Sweden between January 1995 and May 2017. The primary aim was to compare short and long term survival, as well as complications for EAB and ISR.Results: Some 126 radically surgically treated AGI patients were identified – 102 graft infections and 24 endograft infections – treated by EAB: 71 and ISR: 55 (23 neo-aorto-iliac systems, NAISs). No differences in early 30 day (EAB 81.7% vs. ISR 76.4%, p =.46), or long term five year survival (48.2% vs. 49.9%, p =.87) were identified. There was no survival difference comparing NAIS to other ISR strategies. The frequency of recurrent graft infection during follow up was similar: EAB 20.3% vs. ISR 17.0% (p =.56). Survival and re-infection rates of the new conduit did not differ between NAIS and other ISR strategies. Age ≥ 75 years (odds ratio [OR] 4.0, confidence interval [CI] 1.1 – 14.8), coronary artery disease (OR 4.2, CI 1.2 – 15.1) and post-operative circulatory complications (OR 5.2, CI 1.2 – 22.5) were associated with early death. Prolonged antimicrobial therapy (> 3 months) was associated with reduced long term mortality (HR 0.3, CI 0.1 – 0.9).Conclusion: In this nationwide multicentre study comparing outcomes of radically treated AGI, no differences in survival or re-infection rate could be identified comparing EAB and ISR.
|
|
| 34. |
- Gavali, Hamid, et al.
(författare)
-
Semi-Conservative Treatment Versus Radical Surgery in Abdominal Aortic Graft and Endograft Infections
- 2023
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier. - 1078-5884 .- 1532-2165. ; 66:3, s. 397-406
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Abdominal aortic graft and endograft infections (AGIs) are rare complications following aortic surgery. Radical surgery (RS) with resection of the infected graft and reconstruction with extra-anatomical bypass or in situ reconstruction is the preferred therapy. For patients unfit for RS, a semi-conservative (SC), graft preserving strategy is possible. This paper aimed to compare survival and infection outcomes between RS and SC treatment for AGI in a nationwide cohort.Methods: Patients with abdominal AGI related surgery in Sweden between January 1995 and May 2017 were identified. The Management of Aortic Graft Infection Collaboration (MAGIC) criteria were used for the definition of AGI. Multivariable regression was performed to identify factors associated with mortality.Results: One hundred and sixty-nine patients with surgically treated abdominal AGI were identified, comprising 43 SC (14 endografts; 53% with a graft enteric fistula [GEF] in total) and 126 RS (26 endografts; 50% with a GEF in total). The SC cohort was older and had a higher frequency of cardiac comorbidities. There was a non-significant trend towards lower Kaplan -Meier estimated five year survival for SC vs. RS (30.2% vs. 48.4%; p = .066). A non-significant trend was identified towards worse Kaplan -Meier estimated five year survival for SC patients with a GEF vs. without a GEF (21.7% vs. 40.1%; p = .097). There were significantly more recurrent graft infections comparing SC with RS (45.4% vs. 19.3%; p < .001). In a Cox regression model adjusting for confounders, there was no difference in five year survival comparing SC vs. RS (HR 1.0, 95% CI 0.6 -1.5).Conclusion: In this national AGI cohort, there was no mortality difference comparing SC and RS for AGI when adjusting for comorbidities. Presence of GEF probably negatively impacts survival outcomes of SC patients. Rates of recurrent infection remain high for SC treated patients.
|
|
| 35. |
- Gavali, Hamid, et al.
(författare)
-
Semi-Conservative Treatment Versus Surgery in Abdominal Aortic Graft and Endograft Infections
- 2023
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier. - 1078-5884 .- 1532-2165. ; 66:3, s. 397-406
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Abdominal aortic graft and endograft infections (AGIs) are rare complications following aortic surgery. Radical surgery (RS) with resection of the infected graft and reconstruction with extra-anatomical bypass or in situ reconstruction is the preferred therapy. For patients unfit for RS, a semi-conservative (SC), graft-preserving strategy is possible. This paper aimed to compare survival and infection outcomes between RS and SC treatment for AGI in a nationwide cohort.METHODS: Patients with abdominal AGI-related surgery in Sweden between January 1995 and May 2017 were identified. The Management of Aortic Graft Infection Collaboration (MAGIC) criteria were used for definition of AGI. Multivariable regression was performed to identify factors associated with mortality.RESULTS: A total of 169 patients with surgically treated abdominal AGI were identified, comprising 43 SC [14 endografts; 53% with a graft-enteric fistula (GEF) in total] and 126 RS [26 endografts; 50% with a GEF in total]. The SC cohort was older and had a higher frequency of cardiac comorbidities. There was a non-significant trend towards lower Kaplan-Meier estimated 5-year survival for SC versus RS (30.2% vs. 48.4%; p = .066). A non-significant trend was identified towards worse Kaplan-Meier estimated 5-year survival for SC patients with a GEF versus without a GEF (21.7% vs. 40.1%; p = .097). There were significantly more recurrent graft infections comparing SC versus RS (45.4% vs. 19.3%; p < .001). In a Cox regression model adjusting for confounders, there was no difference in 5-year survival comparing SC versus RS (HR 1.0, 95% CI 0.6 - 1.5).CONCLUSION: In this national AGI cohort, we could not identify any mortality difference comparing SC versus RS for AGI when adjusting for comorbidities. Presence of GEF likely negatively impacts survival outcomes of SC patients. Rates of recurrent infection remain high for SC-treated patients.
|
|
| 36. |
- Glubb, Dylan M, et al.
(författare)
-
Cross-Cancer Genome-Wide Association Study of Endometrial Cancer and Epithelial Ovarian Cancer Identifies Genetic Risk Regions Associated with Risk of Both Cancers
- 2021
-
Ingår i: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. - 1538-7755. ; 30:1, s. 217-228
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Accumulating evidence suggests a relationship between endometrial cancer and ovarian cancer. Independent genome-wide association studies (GWAS) for endometrial cancer and ovarian cancer have identified 16 and 27 risk regions, respectively, four of which overlap between the two cancers. We aimed to identify joint endometrial and ovarian cancer risk loci by performing a meta-analysis of GWAS summary statistics from these two cancers.METHODS: Using LDScore regression, we explored the genetic correlation between endometrial cancer and ovarian cancer. To identify loci associated with the risk of both cancers, we implemented a pipeline of statistical genetic analyses (i.e., inverse-variance meta-analysis, colocalization, and M-values) and performed analyses stratified by subtype. Candidate target genes were then prioritized using functional genomic data.RESULTS: Genetic correlation analysis revealed significant genetic correlation between the two cancers (rG = 0.43, P = 2.66 × 10-5). We found seven loci associated with risk for both cancers (PBonferroni < 2.4 × 10-9). In addition, four novel subgenome-wide regions at 7p22.2, 7q22.1, 9p12, and 11q13.3 were identified (P < 5 × 10-7). Promoter-associated HiChIP chromatin loops from immortalized endometrium and ovarian cell lines and expression quantitative trait loci data highlighted candidate target genes for further investigation.CONCLUSIONS: Using cross-cancer GWAS meta-analysis, we have identified several joint endometrial and ovarian cancer risk loci and candidate target genes for future functional analysis.IMPACT: Our research highlights the shared genetic relationship between endometrial cancer and ovarian cancer. Further studies in larger sample sets are required to confirm our findings.
|
|
| 37. |
- Hedlund, Katarina, et al.
(författare)
-
Utmaningar och möjligheter
- 2022
-
Ingår i: Markanvändning för en klimatpositiv framtid : En rapport om utmaningar och möjligheter i Skåne - En rapport om utmaningar och möjligheter i Skåne. - 9789198434996 - 9789198434989 ; , s. 48-60
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 38. |
- Helgadottir, H., et al.
(författare)
-
Efficacy of novel immunotherapy regimens in patients with metastatic melanoma with germline CDKN2A mutations
- 2020
-
Ingår i: Journal of Medical Genetics. - : BMJ. - 0022-2593 .- 1468-6244. ; 57:5, s. 316-321
-
Tidskriftsartikel (refereegranskat)abstract
- Background Inherited CDKN2A mutation is a strong risk factor for cutaneous melanoma. Moreover, carriers have been found to have poor melanoma-specific survival. In this study, responses to novel immunotherapy agents in CDKN2A mutation carriers with metastatic melanoma were evaluated. Methods CDKN2A mutation carriers that have developed metastatic melanoma and undergone immunotherapy treatments were identified among carriers enrolled in follow-up studies for familial melanoma. The carriers' responses were compared with responses reported in phase III clinical trials for CTLA-4 and PD-1 inhibitors. From publicly available data sets, melanomas with somatic CDKN2A mutation were analysed for association with tumour mutational load. Results Eleven of 19 carriers (58%) responded to the therapy, a significantly higher frequency than observed in clinical trials (p=0.03, binomial test against an expected rate of 37%). Further, 6 of the 19 carriers (32%) had complete response, a significantly higher frequency than observed in clinical trials (p=0.01, binomial test against an expected rate of 7%). In 118 melanomas with somatic CDKN2A mutations, significantly higher total numbers of mutations were observed compared with 761 melanomas without CDKN2A mutation (Wilcoxon test, p<0.001). Conclusion Patients with CDKN2A mutated melanoma may have improved immunotherapy responses due to increased tumour mutational load, resulting in more neoantigens and stronger antitumorous immune responses.
|
|
| 39. |
- Helgadottir, Hildur, et al.
(författare)
-
Multiple primary melanoma incidence trends over five decades, a nation-wide population-based study
- 2021
-
Ingår i: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 113:3, s. 318-328
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Over the past decades many regions have experienced a steady increase in the incidence of cutaneous melanoma. Here, we report on incidence trends for subsequent primary melanoma.METHODS: In this nationwide population-based study, patients diagnosed with a first primary cutaneous melanoma reported to the Swedish Cancer Registry, were followed for up to ten years for a diagnosis of subsequent primary melanoma. Patients were grouped with patients diagnosed with first melanoma in the same decade (1960s, 1970s, 1980s, 1990s and 2000s, respectively). Frequencies, incidence rates (IRs), standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for second melanomas were calculated. All tests of statistical significance were two-sided.RESULTS: 54,884 patients with melanoma were included and 2,469 were diagnosed, within ten years, with subsequent melanomas. Over the five decades there was a statistically significant steady increase in the frequency, IR and SIR for second primary melanoma. For example, in the 1960s cohort, <1% (1.0 (95% CI = 0.5-1.7) and 1.1 (95% CI = 0.5-1.9) per 1,000 person-years in women and men, respectively) had second primary melanoma and this rose to 6.4% (7.5 (95% CI = 6.8-8.3) per 1,000 person-years) in the women and 7.9% (10.3 (95% CI = 9.3-11.2) per 1,000 person-years) in the men in the 2000s cohort. This rise was seen, independent of age, sex, invasiveness or site of the melanoma. Further, in patients diagnosed with a second melanoma, the frequency of those having >2 melanomas increased statistically significantly and was 0.0% in the 1960s and rose to 18.0% in the 2000s (P <.001).CONCLUSIONS: This is the first study to evaluate and report on a rising trend for subsequent primary melanoma. Additional primary melanomas worsen the patients' survival and precautions are needed to turn this steep upgoing trend.
|
|
| 40. |
- Hörnsten, Carl, et al.
(författare)
-
Measurement error of the Mini-Mental State Examination among individuals with dementia that reside in nursing homes
- 2021
-
Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 18:1, s. 109-115
-
Tidskriftsartikel (refereegranskat)abstract
- Few studies have investigated the measurement error of the Mini-Mental State Examination (MMSE) in the same unit of measurement, also known as absolute reliability. This measurement can help determine whether an observed score change for an individual is likely to represent true change. The aim of this study was to investigate the absolute reliability of the MMSE among individuals with dementia that reside in nursing homes. Among 88 participants, 19 (21.6%) were men, 35 (39.8%) had Alzheimer's disease, 35 (39.8%) had vascular dementia, and the mean age was 84.0 years (range 65-98). The participants were tested and retested with the MMSE within 1-6 days. Both tests were administered by the same assessor at the same time of day. The mean MMSE score was 13.7 (range 0-28). The absolute difference between MMSE scores varied from 0 to 6 points, and the differences did not correlate with the corresponding score means (p = 0.874). The smallest detectable change (SDC) between two measurements was 4.00. The SDC was independent of depression, impaired vision and hearing, delirium within the last week, dementia type and age. However, the SDC was 5.56 among men and 3.50 among women (p = 0.003). In conclusion, for individuals with dementia that reside in nursing homes, it seems like their MMSE score needs to change by four or more points between two measurements in order for their score change to be reliably higher than the measurement error.
|
|
| 41. |
- Ingvar, Åsa M, et al.
(författare)
-
Participation in a Prospective Cohort Study on Melanoma did not Affect the Incidence and Mortality of the Studied Disease
- 2020
-
Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 100:1
-
Tidskriftsartikel (refereegranskat)abstract
- Prospective observational studies have shown previously that study participants have lower morbidity and mortality than non-participants. The aim of the current study was to determine whether participants in a prospective cohort study on melanoma have a different incidence and mortality of melanoma compared with non-participants and the background population. Information was collected from Swedish National Registers on participants (n = 30,501) and non-participants (n = 10,499) in the "Melanoma In Southern Sweden" (MISS) study and the background population (n = 243,032). Hazard ratios were calculated for overall incidence of cancer and melanoma, and all-cause and melanoma-specific mortality, using Cox regression. Participants had a lower overall incidence of cancer and all-cause mortality than non-participants and the background population. There was no difference in incidence of melanoma or melanoma-specific characteristics between participants and the background population. In conclusion, participants in the MISS study have a slightly better general health, but are a representative sample of the population with regard to studies of melanoma risk factors.
|
|
| 42. |
|
|
| 43. |
- Jeppsson, Knut-Håkan, et al.
(författare)
-
Cooling growing/finishing pigs with showers in the slatted area: Effect on animal occupation area, pen fouling and ammonia emission
- 2021
-
Ingår i: Livestock Science. - : Elsevier BV. - 1871-1413 .- 1878-0490. ; 243
-
Tidskriftsartikel (refereegranskat)abstract
- Growing and finishing pigs kept in insulated buildings are often exposed to high ambient temperature during summer. In high-temperature conditions, pigs in partly slatted pens change their behaviour to increase lying on the slatted area and fouling on the solid Hoor area, resulting in increased ammonia emissions. One way to cool the animals is to shower/sprinkle water in the slatted area, allowing pigs to wet their skin to increase heat loss. This study examined the effects of providing showers on pig activity and occupation area in pens, pen fouling and ammonia emission from the room. The investigation was performed in a commercial growing-finishing house with 10 identical rooms, each containing 16 pens for 9-13 pigs growing from 25-30 kg to 115-120 kg. Pigs were introduced into two parallel rooms in the house. During two summers and four batches, one room with showers in the slatted area and one room without per batch were compared in terms of concentrations of carbon dioxide (CO2) and ammonia (NH3), pig activity and occupation area in the pen, pen fouling and NH3 emissions, recorded on four measuring occasions (M1-M4) during the growing period. Gas concentrations were measured using a photoacoustic analyser, pig activity and occupation area detected by machine vision techniques and pen fouling was visually investigated. Climate parameters (air temperature and relative humidity) were logged continuously during the entire growing period. Ammonia emission was calculated from ventilation rate (determined by the indirect CO2 tracer gas method) and the difference in ammonia concentration between outlet and inlet air.The results showed that the pigs spent less time lying on the slats (p < 0.05) and the solid Hoor was cleaner (p < 0.05) on measuring occasions M2, M3 and M4 in rooms with showers than in control rooms. Mean NH3 emission for the four measurement occasions were 3.0-5.1 g pig(-1) day(-1) and 4.2-10.0 g pig(-1) day(-1) for the shower and control rooms, respectively. The differences were significant (p < 0.05) for all measuring occasions. The results also show improved animal environment when using showers to cool pigs at high ambient temperatures.Overall, providing showers in the slatted area in partly slatted pens encouraged growing/finishing pigs to lie in the lying area, reduced problems with pen fouling and decreased NH3 emissions by 45%. The latter could be partly due to reduced pen fouling and partly to dilution of urine on the slatted area and on the surface of slurry in the pit.
|
|
| 44. |
- Jeppsson, Knut-Håkan, et al.
(författare)
-
Environmental and economic consequences of pig-cooling strategies implemented in a European pig-fattening unit
- 2021
-
Ingår i: Journal of Cleaner Production. - : Elsevier BV. - 0959-6526 .- 1879-1786. ; 290
-
Tidskriftsartikel (refereegranskat)abstract
- The increased frequency of hot days due to climate change can potentially impair the environmental and economic performance of pig-fattening farms. Several pig-cooling strategies have been proposed to address these impacts, however their implementation is not always economically viable and the potential environmental-economic trade-offs not well understood. Here, we propose and implement a novel framework for environmental and economic evaluation of pig-cooling strategies in a whole farm context. We also demonstrate through a sensitivity analysis how such models can be integrated with projected climate data to investigate how climate change may affect the assessment of capital investments that are made over significant timescales. We considered two strategies implemented in a pig fattening farm in south Sweden: pig-cooling with showers and with increased air velocity. Operation of the farm under non-cooling conditions was considered as the baseline system against which the analysis was conducted. We calculated whole-farm annual equivalent values (AEV) with the implementation of each strategy through a discounted cash flow analysis and annualised system environmental impact through a life cycle assessment. Both cooling strategies significantly reduced system environmental impact across all categories except water footprint. Acidification potential was reduced the most, exhibiting a-3.28% reduction with pig showers and-1.51% with increased air velocity. Farm profitability improved by +6.79% with showers and +3.37% with increased air velocity. Ambient temperature increase under non-cooling conditions significantly increased all impact categories with acidification being affected the most (+2.24%), and caused a-4.43% decrease in AEV. Both pig-cooling strategies mitigated these effects on system environmental performance. With increased air velocity we observed a +0.718% increase in acidification, while pig showers were the more resilient option exhibiting a +0.690% increase. The study represents a case-in-point for how to rationalise economically environmental management technologies in pig housing systems based on their cost-effectiveness in mitigating environmental impacts.(c) 2021 Elsevier Ltd. All rights reserved.
|
|
| 45. |
- Jeppsson, Knut-Håkan, et al.
(författare)
-
Increased air velocity in the lying area improves pen hygiene and reduces ammonia emissions from houses with partly slatted pens for growing/finishing pigs
- 2021
-
Ingår i: Livestock Science. - : Elsevier BV. - 1871-1413 .- 1878-0490. ; 251
-
Tidskriftsartikel (refereegranskat)abstract
- Partly slatted pens can offer growing/finishing pigs a better house environment than pens with fully slatted floors. Under thermoneutral conditions, pigs prefer to rest on a solid area and some litter can be provided as enrichment. Ammonia emissions are lower in systems with partly slatted pens, provided the pens are kept clean. However, under high-temperature conditions, pigs in partly slatted pens may begin lying on the slatted area and fouling on the solid floor area, resulting in increased ammonia emissions. This study examined the effects of increasing the air velocity (IAV) in the lying area from max 0.5 m s(-1) to max 1.0 m s(-1) on conditions for pigs in partly slatted pens during warm periods. Air velocity was increased by redirecting the inlet air from the ceiling inlets down into the animal zone.The study was performed in a commercial growing/finishing house with 10 identical moms, each containing 16 pens for 9-14 pigs growing from 25-30 kg to 115-120 kg live weight. Pigs were introduced simultaneously into two parallel rooms, one with IAV in the lying area and one without (control treatment). During two summers with six batches, concentrations of carbon dioxide (CO2) and ammonia (NH3), pig activity and choice of lying area in the pen, pen fouling and NH3 emissions were recorded in both moms on four measuring occasions (M1-M4) during the growing period. Gas concentrations were measured by photoacoustic analyser, pig activity and pig choice of lying area by machine vision techniques, and pen fouling by visual inspection. Climate parameters (air temperature, relative humidity) were logged continuously during the growing period. Ammonia emissions were calculated from the ventilation rate (determined by the indirect CO2 tracer gas method) and the difference in ammonia concentration between outlet and inlet air.Under high ambient temperatures, pigs in the IAV treatment were observed lying significantly more often (p<0.05) in the part of the lying area with the highest air velocity. Pigs tended to lie less in the slatted area (p=0.052) in the IAV treatment than in the control. Problems with pen fouling were significantly reduced with increased air velocity in the lying area and NH3 emissions were reduced by 21% (p=0.009), from 8.4 to 6.6 g pig(-1) da(-1) , during the late growing period (M4).In conclusion, increasing air velocity in the lying area of partly slatted pens from max 0.5 to max 1.0 m s(-1) influenced pigs choice of lying area, improved pen hygiene and reduced ammonia emissions.
|
|
| 46. |
- Jeppsson, Knut-Håkan, et al.
(författare)
-
Åtgärder för att förbättra boxhygien och reducera ammoniakemission i konventionella slaktgrisboxar
- 2021
-
Ingår i: LTV-fakultetens faktablad.
-
Annan publikation (populärvet., debatt m.m.)abstract
- Genom att duscha vatten över spaltgolvet får grisarna möjlighet att blöta huden och därmed öka värmeavgivningen under varma perioder. Systemet ändrar var i boxen grisarna väljer att ligga så att de ligger mindre på spaltgolvet och mer på liggytan. När spaltgolvet inte är upptaget av liggande grisar tvingas inte grisarna att gödsla/urinera på den fasta liggytan. Därmed förbättras boxhygienen och ammoniakförlusterna minskar. Ökad lufthastighet på liggytan ger också grisarna bättre möjlighet till kylning, vilket medför bättre boxhygien och mindre ammoniakförluster. Detta är två metoder att kyla grisarna som kan utföras i befintliga stallar. Åtgärderna har studerats under två varma sommarperioder i ett EU-projekt med samarbete mellan sex länder
|
|
| 47. |
- Johnsson, Anna, et al.
(författare)
-
Immediate increase in perceived energy after exercise during the course of chemotherapy treatment for breast cancer
- 2022
-
Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 58
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Exercise during chemotherapy has beneficial long-term effects on women with breast cancer, but shortterm beneficial changes have been less investigated. Though short-term changes may be important as a encouraging factor, this study aimed to investigate immediate changes in self-reported energy, stress, nausea and pain following a single exercise session during chemotherapy.Methods: Forty-six women who were exercising while undergoing adjuvant chemotherapy for breast cancer were included between October 2016 and April 2018. Self-reported energy and stress were assessed before, immediately after and 3 h after exercise sessions by the Stress-Energy Questionnaire. On the same questionnaire nausea and pain were assessed by a Visual Analog Scale. The measurements were completed at four time points during cycles 2 and 5 of the 6-cycle chemotherapy course.Results: Energy level increased immediately after a single exercise session for three out of four periods during the chemotherapy course (p < 0.01), with a larger increase when energy was lower before the session (p < 0.01). Three hours after the exercise session, the energy was about the same level as before the exercise session. Stress decreased immediately after the session during cycle two (p < 0.01) but not cycle five. There were no changes in nausea or pain.Conclusions: Patients undergoing chemotherapy should be informed not only about the long-term advantages of exercise, but also immediate benefits in terms of increased energy. The energy increase both while exercise in the beginning and toward the end of the chemotherapy course, this short-term advantageous consequence may strengthen patients' motivation to exercise. Clinicians should also inform patients that exercise does not seem to worsen nausea and pain.
|
|
| 48. |
- Julian, Valerie, et al.
(författare)
-
Association between alanine aminotransferase as surrogate of fatty liver disease and physical activity and sedentary time in adolescents with obesity
- 2022
-
Ingår i: European Journal of Pediatrics. - : Springer. - 0340-6199 .- 1432-1076. ; 181:8, s. 3119-3129
-
Tidskriftsartikel (refereegranskat)abstract
- To compare patterns of sedentary (SED) time (more sedentary, SED + vs less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA + vs less active, MVPA-), and combinations of behaviors (SED-/MVPA + , SED-/MVPA-, SED + /MVPA + , SED + /MVPA-) regarding nonalcoholic fatty liver diseases (NAFLD) markers. This cross-sectional study included 134 subjects (13.4 +/- 2.2 years, body mass index (BMI) 98.9 +/- 0.7 percentile, 48.5% females) who underwent 24-h/7-day accelerometry, anthropometric, and biochemical markers (alanine aminotransferase (ALT) as first criterion, and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), AST/ALT ratio as secondary criteria). A subgroup of 39 patients underwent magnetic resonance imaging-liver fat content (MRI-LFC). Hepatic health was better in SED- (lower ALT, GGT, and MRI-LFC (p < 0.05), higher AST/ALT (p < 0.01)) vs SED + and in MVPA + (lower ALT (p < 0.05), higher AST/ALT (p < 0.01)) vs MVPA- groups after adjustment for age, gender, and Tanner stages. SED-/MVPA + group had the best hepatic health. SED-/MVPA- group had lower ALT and GGT and higher AST/ALT (p < 0.05) in comparison with SED + /MVPA + group independently of BMI. SED time was positively associated with biochemical (high ALT, low AST/ALT ratio) and imaging (high MRI-LFC) markers independently of MVPA. MVPA time was associated with biochemical markers (low ALT, high AST/ALT) but these associations were no longer significant after adjustment for SED time. Conclusion: Lower SED time is associated with better hepatic health independently of MVPA. Reducing SED time might be a first step in the management of pediatric obesity NAFLD when increasing MVPA is not possible.
|
|
| 49. |
- Julian, Valerie, et al.
(författare)
-
Sedentary time has a stronger impact on metabolic health than moderate to vigorous physical activity in adolescents with obesity : a cross-sectional analysis of the Beta-JUDO study
- 2022
-
Ingår i: Pediatric Obesity. - : John Wiley & Sons. - 2047-6302 .- 2047-6310. ; 17:7
-
Tidskriftsartikel (refereegranskat)abstract
- Background Relationships between movement-related behaviours and metabolic health remain underexplored in adolescents with obesity.Objectives To compare profiles of sedentary time (more sedentary, SED+ vs. less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA-) and combinations of behaviours (SED-/MVPA+, SED-/MVPA-, SED+/MVPA+, SED+/MVPA-) in regard to metabolic health.Methods One hundred and thirty-four subjects (mean age 13.4 +/- 2.2 yrs, mean body mass index [BMI] 98.9 +/- 0.7 percentile, 48.5% females) underwent 24 h/7 day accelerometry, anthropometric, body composition, blood pressure (BP), lipid profile and insulin resistance (IR) assessments.Results Metabolic health was better in SED- [lower fat mass (FM) percentage (p < 0.05), blood pressure (BP) (p < 0.05), homeostasis model assessment of insulin resistance (HOMA-IR) (p < 0.001) and metabolic syndrome risk score (MetScore) (p < 0.001), higher high-density lipoprotein-cholesterol (HDL-c) (p = 0.001)] vs. SED+ group and in MVPA+ [lower triglyceridemia (TG), (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.001), higher HDL-c (p < 0.01)] vs. MVPA- group after adjustment with age, gender, maturation and BMI. SED-/MVPA+ group had the best metabolic health. While sedentary (p < 0.001) but also MVPA times (p < 0.001) were lower in SED-/MVPA- vs. SED+/MVPA+, SED-/MVPA- had lower FM percentage (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.05) and higher HDL-c (p < 0.05), independently of BMI. Sedentary time was positively correlated with HOMA-IR and Metscore and negatively correlated with HDL-c after adjustment with MVPA (p < 0.05). MVPA was negatively correlated with HOMA-IR, BP and MetScore and positively correlated with HDL-c after adjustment with sedentary time (p < 0.05).Conclusion Lower sedentary time is associated with a better metabolic health independently of MVPA and might be a first step in the management of pediatric obesity when increasing MVPA is not possible.
|
|
| 50. |
- Jung, Audrey Y, et al.
(författare)
-
Distinct reproductive risk profiles for intrinsic-like breast cancer subtypes : pooled analysis of population-based studies
- 2022
-
Ingår i: Journal of the National Cancer Institute. - : Oxford University Press. - 0027-8874 .- 1460-2105. ; 114:12, s. 1706-1719
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Reproductive factors have been shown to be differentially associated with risk of estrogen receptor (ER) positive and ER-negative breast cancer. However, their associations with intrinsic-like subtypes are less clear.METHODS: Analyses included up to 23,353 cases, and 71,072 controls pooled from 31 population-based case-control or cohort studies in the Breast Cancer Association Consortium across 16 countries on 4 continents. Polytomous logistic regression was used to estimate the association between reproductive factors and risk of breast cancer by intrinsic-like subtypes (luminal A-like, luminal B-like, luminal B-HER2-like, HER2-enriched-like, and triple-negative) and by invasiveness. All statistical tests were 2-sided.RESULTS: Compared to nulliparous women, parous women had a lower risk of luminal A-like, luminal B-like, luminal B-HER2-like and HER2-enriched-like disease. This association was apparent only after approximately 10 years since last birth and became stronger with increasing time (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.49 to 0.71; and OR = 0.36, 95% CI = 0.28 to 0.46; for multiparous women with luminal A-like tumors 20-<25 years after last birth and 45-<50 years after last birth, respectively). In contrast, parous women had a higher risk of triple-negative breast cancer right after their last birth (for multiparous women: OR = 3.12, 95%CI = 2.02 to 4.83) that was attenuated with time but persisted for decades (OR = 1.03, 95%CI = 0.79 to 1.34, for multiparous women 25 to < 30 years after last birth). Older age at first birth (P-heterogeneity<.001 for triple-negative compared to luminal-A like) and breastfeeding (P-heterogeneity<.001 for triple-negative compared to luminal-A like) were associated with lower risk of triple-negative but not with other disease subtypes. Younger age at menarche was associated with higher risk of all subtypes; older age at menopause was associated with higher risk of luminal A-like but not triple-negative breast cancer. Associations for in situ tumors were similar to luminal A-like.CONCLUSION: This large and comprehensive study demonstrates a distinct reproductive risk factor profile for triple-negative breast cancer compared to other subtypes, with implications for the understanding of disease etiology and risk prediction.
|
|
