| 1. |
- Almdalal, T., et al.
(författare)
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Clinical T1a Renal Cell Carcinoma, Not Always a Harmless Disease-A National Register Study
- 2022
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Ingår i: European Urology Open Science. - : Elsevier BV. - 2666-1691 .- 2666-1683. ; 39, s. 22-28
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Tidskriftsartikel (refereegranskat)abstract
- Background: T1a renal cell carcinoma (RCC) is typically considered a curable dis-ease, irrespective of the choice of local treatment modality.& nbsp;Objective: To identify factors associated with the risk of local and distant recur-rence, and overall survival (OS) in patients with primary nonmetastatic clinical T1a RCC.& nbsp;Design, setting, and participants: A population-based nationwide register study of all 1935 patients with cT1a RCC, diagnosed during 2005-2012, identified through The National Swedish Kidney Cancer Register, was conducted.& nbsp;Outcome measurements and statistical analysis: Outcome variables were recur-rence (local or distant) and OS. Possible explanatory variables included tumor size, RCC type, T stage, surgical technique, age, and gender. Associations with disease recurrence and OS were evaluated by multivariable regression and Cox multivari-ate analyses, respectively.& nbsp;& nbsp;Results and limitations: Among 1935 patients, 938 were treated with radical nephrectomy, 738 with partial nephrectomy, and 169 with ablative treatments, while 90 patients had no surgery. Seventy-eight (4%) patients were upstaged to pT3. Local or metastatic recurrences occurred in 145 (7.5%) patients, significantly more often after ablation (17.8%). The risk of recurrence was associated with tumor size, upstaging, and ablation. Larger tumor size, disease recurrence, and older age adversely affected OS, whereas partial nephrectomy and chromophobe RCC (chRCC) were associated with improved survival. Limitations include register design and a lack of comorbidity or performance status data.& nbsp;Conclusions: Upstaging and recurrence occurred, respectively, in 4.0% and 7.5% of patients with nonmetastatic RCCs <= 4 cm. Tumor size upstaging and ablation were associated with the risk for recurrence, while tumor size and recurrence were associated with decreased OS. Patients with chRCC and partial nephrectomy had prolonged OS in a real-world setting.& nbsp;Patient summary: We studied factors that may influence the risk of disease recurrence and overall survival, in a large nationwide patient cohort having non metastatic renal cell carcinoma < 4 cm. Tumor size, tumor type, and treatment were associated with the risk of recurrence and overall death. Partial nephrectomy prolonged overall survival. (C)2022 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology.
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| 2. |
- Almdalal, Tarik, et al.
(författare)
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Predictive characteristics for disease recurrence and overall survival in non-metastatic clinical T1 renal cell carcinoma : results from the National Swedish Kidney Cancer Register
- 2023
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 57:1-6, s. 67-74
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivePatients with clinical T1 renal cell carcinoma (cT1RCC) have risks for recurrence and reduced overall survival despite being in the best prognostic group. This study aimed to evaluate the association of different treatments on disease recurrence and overall survival using clinical and pathological characteristics in a nation-wide cT1RCC cohort.Materials and methodsA total of 4,965 patients, registered in the National Swedish Kidney Cancer Register (NSKCR) between 2005 and 2014, with ≥ 5-years follow-up were identified: 3,040 males and 1,925 females, mean age 65 years. Times to recurrence and overall survival were analyzed with Kaplan-Meier curves, log-rank test, and Cox regression models.ResultsAge, TNM-stage, tumor size, RCC-type, and performed treatment were all associated with disease recurrence. Patients selected for ablative treatments had increased risk for recurrent disease: hazard ratio (HR) = 3.79 [95% confidence interval (CI) = 2.69–5.32]. In multivariate analyses, age, gender, tumor size, RCC-type, N-stage, recurrence and performed treatment were all independently associated with overall survival. Patients with chRCC had a 41% better overall survival (HR = 0.59, 95% CI = 0.44–0.78; p < 0.001) than ccRCC. Patients treated with partial nephrectomy (PN) had an 18% better overall survival (HR = 0.83, 95% CI = 0.71–0.95, p < 0.001) than patients treated with radical nephrectomy.ConclusionsAge, gender, T-stage, tumor size, RCC type and treatment modality are all associated with risk of recurrence. Furthermore, age, male gender, tumor size, N-stage and recurrence are associated with reduced overall survival. Patients with chRCC, compared with ccRCC and pRCC patients, and PN compared with RN treated patients, had an advantageous overall survival, indicating a possible survival advantage of nephron sparing treatment.
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| 3. |
- Carlsson, Jessica, 1984-, et al.
(författare)
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PD-L1 Expression is Associated With Poor Prognosis in Renal Cell Carcinoma
- 2020
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Ingår i: Applied immunohistochemistry & molecular morphology (Print). - : Lippincott Williams & Wilkins. - 1541-2016 .- 1533-4058. ; 28:3, s. 213-220
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Tidskriftsartikel (refereegranskat)abstract
- Programmed death ligand 1 (PD-L1) is a protein which, when interacting with its receptor programmed death 1, acts as a negative regulator of the antitumor T-cell-mediated immune response. The prognostic value of PD-L1 expression in renal cell carcinoma (RCC) has been controversial. In this study, the prognostic value of PD-L1 expression in RCC was evaluated by analyzing PD-L1 immunoreactivity in tumor cells and tumor-infiltrating immune cells (TIICs) in 346 RCC patients with long-term follow-up. PD-L1 positivity in tumor cells was associated with higher World Health Organization nucleolar grade (P<0.001), recurrence (P=0.011), and death due to RCC (P=0.031). PD-L1 positivity in TIICs was associated with higher nucleolar grade (P<0.001), higher T-stage (P=0.031), higher N-stage (P=0.01), recurrence (P=0.007), and death due to RCC (P=0.001). A significant positive association of time to cancer-specific death with both PD-L1-positive tumor cells and TIICs were also found. The data indicate that RCC patients with PD-L1-positive tumor cells and TIICs are at significant risk for cancer progression and the expression may be used as a complementary prognostic factor in the management of RCC patients.
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| 4. |
- Davidsson, Sabina, 1972-, et al.
(författare)
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Infiltration of M2 Macrophages and Regulatory T Cells Plays a Role in Recurrence of Renal Cell Carcinoma
- 2020
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Ingår i: European Urology Open Science. - : Elsevier. - 2666-1691 .- 2666-1683. ; 20, s. 62-71
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Tidskriftsartikel (refereegranskat)abstract
- Regulatory T cells (Tregs) and M2 macrophages have been hypothesized to contribute to tumor progression. We found that M2 macrophages and Tregs are associated with more aggressive renal cell carcinoma, and that they have a synergistic effect on clinical outcome. Background: It has been hypothesized that M2 macrophages and regulatory T cells (Tregs) may contribute to tumor progression by suppression of antitumor immunity. Objective: To investigate the association between infiltration of CD163+ M2 macrophages and CD4+FOXP3+ Tregs with clinical outcomes in renal cell carcinoma patients. Design, setting, and participants: A cohort of 346 patients diagnosed with renal cell carcinoma at Örebro University Hospital between 1986 and 2011 was evaluated for CD163+ M2 macrophage and CD4+FOXP3+ Treg infiltration by immunohistochemistry. Outcome measurements and statistical analysis: Associations between clinicopathological features and infiltration of CD163+ M2 macrophages and/or CD4+FOXP3+ Tregs were estimated with chi-square or Fisher's exact tests. For survival analyses, Kaplan-Meier curves with log-rank tests and multivariate Cox proportional hazards regression models were used. Results and limitations: We found that infiltration of CD163+ M2 macrophages and CD4+FOXP3+ Tregs were associated with adverse clinical outcomes. Our data further demonstrate that CD163+ M2 macrophages and CD4+FOXP3+ Tregs colocalize in tumor and normal tissue, and that this colocalization may have synergistic effects on tumor aggressiveness. The use of tissue microarrays rather than whole sections may be viewed as a limitation. Conclusions: Infiltration of CD163+ M2 macrophages and CD4+FOXP3+ Tregs is associated with recurrence of renal cell carcinoma, and colocalization of these cell types may have an association with clinical outcome. Patient summary: The aim of this study was to investigate the association between infiltration of M2 macrophages and regulatory T cells with clinical outcomes in renal cell carcinoma. We demonstrated that renal cell carcinoma patients with high infiltration of both these cell types are at an increased risk of poor clinical outcomes.
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| 5. |
- Davidsson, Sabina, 1972-, et al.
(författare)
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Soluble Levels of CD163, PD-L1, and IL-10 in Renal Cell Carcinoma Patients
- 2022
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Ingår i: Diagnostics. - : MDPI. - 2075-4418. ; 12:2
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Tidskriftsartikel (refereegranskat)abstract
- CD163+ M2 macrophages have been suggested to counteract tumor immunity by increasing immunosuppressive mechanisms including PD-L1 and IL-10 expression. Soluble levels of PD-L1, IL-10, and CD163 have been reported as potential biomarkers in various cancers, although the prognostic value in renal cell carcinoma (RCC) has to be further elucidated. In the present study, we measured the levels of sPD-L1, sIL-10, and sCD163 in 144 blood samples from patients with RCC. The levels were determined by using enzyme linked immunosorbent assays. Soluble PD-L1 and CD163 were detectable in 100% of the serum samples, and sCD163 in 22% of the urine samples, while only a minority of the samples had detectable sIL-10. Significantly higher serum levels of sPD-L1 and sCD163 were observed in patients with metastatic disease (p < 0.05). The results also showed that patients with high levels of sPD-L1 in serum had shorter cancer-specific survival compared with patients with low levels (p = 0.002). The results indicate that sPD-L1 most significantly reflects tumor progression in RCC.
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| 6. |
- Engström, Susanne, et al.
(författare)
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Approaches to industrial processes in technology textbooks
- 2023
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Ingår i: The 40th International Pupils’ Attitudes Towards Technology Conference Proceedings 2023, 1 (October)..
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Konferensbidrag (refereegranskat)abstract
- The aim of this study is to explore how technology textbooks can provide students with a basis for expressing knowledge about technical solutions within industrial processes. The base and the delimitation for the study is the formulation of the specific content on industrial processes that must be taught to 13 to 15-year-olds in Swedish schools pursuant to the national syllabus. Textbooks constitute an important foundation for teaching, particularly in the subject of technology, in which teachers may find the breadth of content they are expected to teach challenging. The study analyses the sections concerning industrial processes in four different technology textbooks commonly used for students in the age group 13–15. Analysis involved interpreting content in the form of text, images, assignments etc. related to aspects that are expected to characterise students’ descriptions and explanations of technical solutions: understanding of technical solutions purpose and functionality, how components interact as a whole, similarities to other technical solutions and relating them to their own experiences. The results show that these aspects emerge in different ways depending on, among other things, how the area is presented. We found three different ways in which industrial processes are presented in the textbooks: A unique industrial process is described carefully and in detail, Sub-processes and methods are presented systematically and Industrial processes are described as technological systems at a general level. One interpretation is that, as a teacher, you can teach about industrial processes in these different ways and that which one you choose affects to what extent certain aspects of technical solutions are visualised for the students.
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| 7. |
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| 8. |
- Glombik, Dominik, 1988-, et al.
(författare)
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Penile cancer : long-term infectious and thromboembolic complications following lymph node dissection - a population-based study (Sweden)
- 2023
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 62:5, s. 458-464
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess the long-term risks of infectious and thromboembolic events following inguinal (ILND) and pelvic (PLND) lymph node dissection in men with penile cancer.MATERIAL AND METHODS: A total of 364 men subjected to ILND with or without PLND for penile cancer between 2000 and 2012 were identified in the Swedish National Penile Cancer Register. Each patient was matched based on age and county of residence with six penile cancer-free men. The Swedish Cancer Register and other population-based registers were used to retrieve information on treatment and hospitalisation for selected infectious and thromboembolic events. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models with multiple imputation.RESULTS: The risk of infectious events remained increased for more than five years postoperatively in men with penile cancer compared with matched controls. The palpable nodal disease was the only predictor of these events, with risk increasing with the cN stage. The HR at one, three and five years and six months postoperatively was 8.60 (95% CI 5.16-14.34), 4.02 (95% CI 2.65-6.09) and 1.93 (95% CI 1.11-3.38), respectively. An increased risk of thromboembolic events persisted for three years postoperatively. The HR at one and three years postoperatively was 13.51 (95% CI 6.53-27.93) and 2.12 (95% CI 1.07-4.20). The results correspond well with the over-prescription of anticoagulants observed during this period. An association with bulky disease (cN3) was observed.CONCLUSIONS: Lymph node dissection for penile cancer is associated with an increased risk of infectious and thromboembolic events. The findings of this population-based study show that the risks of these events remain increased more than five years for infectious and three years for thromboembolic events. Improved awareness of long-term complications following ILND is of importance both among patients and care givers to ensure early detection and treatment.
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| 9. |
- Glombik, Dominik, 1988-, et al.
(författare)
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Risk of second HPV-associated cancers in men with penile cancer
- 2021
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Ingår i: Acta Oncologica. - : Informa Healthcare. - 0284-186X .- 1651-226X. ; 60:5, s. 667-671
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to examine the risk of HPV-associated oral cavity, oropharyngeal or anal cancer in men with penile cancer to test the hypothesis of an increased risk to develop a second HPV-associated cancer later in life.MATERIAL AND METHODS: We conducted a population-based register study including all men in Sweden diagnosed with penile cancer between 2000 and 2012. For each patient, six men without penile cancer were matched based on age and county of residence. Data were retrieved from Swedish cancer and population registers, to assess the risk of oral cavity, oropharyngeal or anal cancer in patients with penile cancer. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Risks in men with penile cancer were also compared with the background Swedish male population by use of standardized incidence ratios.RESULTS: In total, 1634 men with and 9804 without penile cancer were included in the study. Among men with penile cancer, four men were subsequently diagnosed with oral cavity cancer, one with oropharyngeal cancer and one with anal cancer. Corresponding numbers among the penile cancer-free men were ten, two and three, respectively. There was evidence of an increased risks of all three cancers under study with an HR of 2.84 (95% CI 0.89-9.06) for oral cavity cancer, 3.66 (95% CI 0.33-40.39) for oropharyngeal cancer and 2.34 (95% CI 0.24-22.47) for anal cancer. When comparing the incidence of these malignancies between penile cancer patients and the background population, the patterns of association were similar.CONCLUSIONS: Our findings indicate that men with penile cancer are at an increased risk of a second HPV-associated cancer of the oral cavity, oropharynx and anal canal. Considering that our study was based on small numbers reflecting the rarity of these cancers, larger studies are needed to confirm our findings.
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| 10. |
- Hermann, Maria, et al.
(författare)
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Rate of incisional hernia after minimally invasive and open surgery for renal cell carcinoma : a nationwide population-based study
- 2021
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 55:5, s. 372-376
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the rate of incisional hernia after surgery for renal cell carcinoma, to compare the rate after open vs minimally invasive surgery and radical nephrectomy vs partial nephrectomy and to identify risk factors for incisional hernia.MATERIALS AND METHODS: From the Renal Cell Cancer Database Sweden we identified all patients (n = 9,638) diagnosed with renal cell carcinoma in Sweden between January 2005 and November 2015. Of these, 6,417 were included in the analyses to determine comorbidity and subsequent diagnosis of or surgery for incisional hernia.RESULTS: In all, 6,417 patients underwent surgery for renal cell carcinoma between January 2005 and November 2015, of these 5,216 (81%) underwent open surgery and 1,201 (19%) underwent minimally invasive surgery. Altogether 140 patients were diagnosed with incisional hernia. The cumulative rate of incisional hernia after 5 years was 5.2% (95% confidence interval [CI] = 4.0-6.4%) after open surgery and 2.4% (95% CI = 1.0-3.4%) after minimally invasive surgery (p < 0.05). In Cox proportional hazard analysis, age and left-sided surgery were associated with incisional hernia in the open surgery group (both p < 0.05), whereas in the minimally invasive group, no statistically significant risk factors for incisional hernia were found.CONCLUSIONS: Open surgery for renal cell carcinoma is associated with a significantly higher risk for developing incisional hernia. If open surgery is the only option, care should be taken when choosing the approach and closing the wound. More studies are needed to find strategies to reduce the risk of abdominal wall complications following open kidney surgery.
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| 11. |
- Karlsson Rosenblad, Andreas, Fil. dr, 1973-, et al.
(författare)
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A psychometric evaluation of the Functional assessment of cancer therapy-kidney symptom index (FKSI-19) among renal cell carcinoma patients suggesting an alternative two-factor structure
- 2021
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Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 30:9, s. 2663-2670
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To psychometrically evaluate the hypothesized four-factor structure of the 19-item Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19) health-related quality of life (HRQoL) instrument in a sample of surgically treated renal cell carcinoma (RCC) patients and examine if an alternative factor structure with good psychometric properties may be derived from the available items.METHODS: The model fit of the hypothesized four-factor structure was examined using confirmatory factor analysis on cohort data from 1731 individuals included in the National Swedish Kidney Cancer Register who had undergone surgery for RCC during the three years 2016-2018 and answered the FKSI-19 instrument within 6-12 months after surgery. Exploratory factor analysis was applied to the same dataset to derive a possible alternative factor solution.RESULTS: -value or the Comparative Fit Index, although the Standardized Root Mean Square Residual and Root Mean Square Error of Approximation measures indicated good and acceptable model fits, respectively. An alternative 14-item trimmed FKSI version (FKSI-14) with a two-factor structure derived from the available FKSI-19 items was found to measure the same aspects of HRQoL as the full FKSI-19 instrument.CONCLUSION: The present study is the first to use psychometric methods for examining the factor structure of the FKSI-19 instrument. The hypothesized four-factor structure of FKSI-19 provided a barely acceptable model fit. The two-factor FKSI-14 structure may be used as an alternative or complement to the four-factor structure when interpreting the FKSI-19 instrument.
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| 12. |
- Landberg, Anna, 1988-, et al.
(författare)
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The renal cell cancer database Sweden (RCCBaSe)–a new register-based resource for renal cell carcinoma research
- 2020
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 54:3, s. 235-240
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: In 2005, the National Swedish Kidney Cancer Register (NSKCR) was set up to collect data on newly diagnosed patients with renal cell carcinoma (RCC). In 2015, the NSKCR was linked to a number of national healthcare and demographic registers to construct the Renal Cell Cancer Database Sweden (RCCBaSe). The aim was to facilitate research on trends in incidence, effects of treatment and survival, with detailed data on tumour characteristics, treatment, pharmaceutical prescriptions, socioeconomic factors and comorbidity. Material and methods: All patients registered in the NSKCR between 2005 and 2014 were included. For each case, ten controls and first-degree relatives for cases and controls were identified. The RCCBaSe was created linking all cases, controls and first-degree relatives to a number of national registers with information on co-morbidity, socioeconomic factors and pharmaceutical prescriptions. Results: Between 2005 and 2014, a total of 9,416 patients with RCC were reported to the NSKCR. 94,159 controls and a total cohort of 575,007 individuals including cases, controls and first-degree relatives were identified. Linkage to the Swedish cancer register resulted in 106,772 matches. When linked to the National patient register, 432,677 out-patient and 471,359 in-patient matches were generated. When linked to the Swedish renal registry 1,778 matches were generated. Linkage to the Prescribed drug register resulted in 448,084 matches and linkage to the The Longitudinal integration database for health insurance and labour market studies database resulted in 450,017 matches. Conclusion: By linking the NSKCR to several Swedish national databases, a unique database for RCC research has been created. © 2020, © 2020 Acta Chirurgica Scandinavica Society.
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| 13. |
- Landberg, Anna, 1988-, et al.
(författare)
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Validation of data quality in the National Swedish Kidney Cancer Register
- 2021
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 55:2, s. 142-148
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The National Swedish Kidney Cancer Register (NSKCR) was launched in 2005. It is used for health care quality improvement and research. The aim of this study was to validate the register's data quality by assessing the timeliness, completeness, comparability and validity of the register. Material and Methods To assess timeliness we evaluated the number of days between date of diagnosis and date of reporting the patient to the NSKCR. For completeness, we used data on number of cancer cases reported to the NSKCR compared to cases reported to the Swedish Cancer Register. Comparability was evaluated by reviewing coding routines and comparing data collected in the NSKCR to national and international guidelines. Validity was assessed by reabstraction of data from medical charts from 431 randomly selected patients diagnosed in 2007, 2010, 2013 and 2016. Results Timeliness has improved since the register started. In 2016, 76.9% and 96.5% of the patients were reported within 6 and 12 months respectively. Completeness was high, with a 99.5% coverage between 2008 and 2017. Registration forms and manuals were updated according to national and European guidelines. Improvements have been made continuously to decrease the risk of reporting mistakes and misunderstandings. Validity was high where a majority of the variables demonstrated an exact agreement >90% and few missing values. Conclusion Overall, the data quality of the NSKCR is high. Completeness, comparability and validity is high. Timeliness can be further improved, which will make it easier to follow changes and improve the care and research of RCC patients.
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| 14. |
- Ljungberg, Börje, Professor, 1949-, et al.
(författare)
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Survival advantage of upfront cytoreductive nephrectomy in patients with primary metastatic renal cell carcinoma compared with systemic and palliative treatments in a real-world setting
- 2020
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 54:6, s. 487-492
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Tidskriftsartikel (refereegranskat)abstract
- Background Recently, the CARMENA and SURTIME studies, suggested that upfront cytoreductive nephrectomy (CN) should be abandoned for patients with intermediate and high-risk metastatic renal cell carcinoma (mRCC). However, CN remains an indication in low-risk and when immediate systemic treatment is not required. The aim was to evaluate the long-term overall survival (OS) in patients with primary mRCC, based on the first line treatment. Methods There were 1483 patients with primary mRCC in the National Kidney Cancer Registry from 2005 to 2013. Data on primary treatment, TNM stage, RCC type, tumor size, patient age and sex were extracted. Survival time was calculated from time of diagnosis to time of death or until July 2019. Mann-Whitney U and Chi-square tests, the Kaplan-Meyer method and Cox regression analyses were used. Results Patients primary treated with CN had a significantly longer OS (p < .001) than patients primary treated with systemic therapy or palliation. In a Cox regression multivariate analysis, the hazard ratio for CN compared with no CN was 1.600, 95%Ci (1.492 - 1.691),p < .001. Also occurrence of lymph node metastases, T-stage, patients age and year of diagnosis, remained as independent predictors of OS. Conclusion Patients primary treated with CN survived significantly longer than patients primary treated with systemic therapy or palliation, in all age groups. CN was an important first-line treatment option in mRCC patients.
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| 15. |
- Nestor, David, 1992-, et al.
(författare)
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Early prediction of blood stream infection in a prospectively collected cohort
- 2021
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Ingår i: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Blood stream infection (BSI) and sepsis are serious clinical conditions and identification of the disease-causing pathogen is important for patient management. The RISE (Rapid Identification of SEpsis) study was carried out to collect a cohort allowing high-quality studies on different aspects of BSI and sepsis. The aim of this study was to identify patients at high risk for BSI who might benefit most from new, faster, etiological testing using neutrophil to lymphocyte count ratio (NLCR) and Shapiro score.METHODS: Adult patients (≥ 18 years) presenting at the emergency department (ED) with suspected BSI were prospectively included between 2014 and 2016 at Örebro University Hospital. Besides extra blood sampling, all study patients were treated according to ED routines. Electronic patient charts were retrospectively reviewed. A modified Shapiro score (MSS) and NLCR were extracted and compiled. Continuous score variables were analysed with area under receiver operator characteristics curves (AUC) to evaluate the ability of BSI prediction.RESULTS: The final cohort consisted of 484 patients where 84 (17%) had positive blood culture judged clinically significant. At optimal cut-offs, MSS (≥3 points) and NLCR (> 12) showed equal ability to predict BSI in the whole cohort (AUC 0.71/0.74; sensitivity 69%/67%; specificity 64%/68% respectively) and in a subgroup of 155 patients fulfilling Sepsis-3 criteria (AUC 0.71/0.66; sensitivity 81%/65%; specificity 46%/57% respectively). In BSI cases only predicted by NLCR> 12 the abundance of Gram-negative to Gram-positive pathogens (n = 13 to n = 4) differed significantly from those only predicted by MSS ≥3 p (n = 7 to n = 12 respectively) (p < 0.05).CONCLUSIONS: MSS and NLCR predicted BSI in the RISE cohort with similar cut-offs as shown in previous studies. Combining the MSS and NLCR did not increase the predictive performance. Differences in BSI prediction between MSS and NLCR regarding etiology need further evaluation.
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| 16. |
- Nilsson, Tor, 1980-, et al.
(författare)
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Children’s interactions with technology in teachers’ self‑reported activities in Sweden’s preschools
- 2022
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Ingår i: International journal of technology and design education. - : Springer Science and Business Media LLC. - 0957-7572 .- 1573-1804. ; 32:1, s. 129-147
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates preschool children’s interactions with technology in a Swedish context. The purpose is to broaden our knowledge about children, technology and preschool activities—not only the meanings of technology that is present in everyday preschool activities, but also how children interact with it. Collier-Reed’s (Pupils’ experiences of technology: exploring dimensions of technological literacy, PhD thesis, University of Cape Town, Cape Town, 2006) category system has been used to analyse data generated in two research circles. The participating preschool teachers were asked to present teacher- and children-initiated activities from their daily practices. 54 cases were identified, of which 40 included children’s interactions with technology according to the definitions provided by Collier-Reed. Mapping the results in a matrix representation based on Collier-Reed’s two sets of categorisation systems shows two clusters. The first mainly includes teacher-initiated activities, in which children were instructed how to use different artefacts. The second also includes children-initiated activities requiring more engagement as part of Collier-Reed’s notion of the core. Also, labelling was added to the category system in order to adapt it to the Swedish preschool setting.
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| 17. |
- Popiolek, Marcin, 1981-, et al.
(författare)
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Finding the optimal candidate for shock wave lithotripsy : external validation and comparison of five prediction models
- 2023
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Ingår i: Urolithiasis. - : Springer. - 2194-7228 .- 2194-7236. ; 51:1
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to externally validate five previously published predictive models (Ng score, Triple D score, S3HoCKwave score, Kim nomogram, Niwa nomogram) for shock wave lithotripsy (SWL) single-session outcomes in patients with a solitary stone in the upper ureter. The validation cohort included patients treated with SWL from September 2011 to December 2019 at our institution. Patient-related variables were retrospectively collected from the hospital records. Stone-related data including all measurements were retrieved from computed tomography prior to SWL. We estimated discrimination using area under the curve (AUC), calibration, and clinical net benefit based on decision curve analysis (DCA). A total of 384 patients with proximal ureter stones treated with SWL were included in the analysis. Median age was 55.5 years, and 282 (73%) of the sample were men. Median stone length was 8.0 mm. All models significantly predicted the SWL outcomes after one session. S3HoCKwave score, Niwa, and Kim nomograms had the highest accuracy in predicting outcomes, with AUC 0.716, 0.714 and 0.701, respectively. These three models outperformed both the Ng (AUC: 0.670) and Triple D (AUC: 0.667) scoring systems, approaching statistical significance (P = 0.05). Of all the models, the Niwa nomogram showed the strongest calibration and highest net benefit in DCA. To conclude, the models showed small differences in predictive power. The Niwa nomogram, however, demonstrated acceptable discrimination, the most accurate calibration, and the highest net benefit whilst having relatively simple design. Therefore, it could be useful for counselling patients with a solitary stone in the upper ureter.
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| 18. |
- Rosenblad, Andreas, Fil. dr, 1973-, et al.
(författare)
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Surgical waiting times and all-cause mortality in patients with non-metastatic renal cell carcinoma
- 2022
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 56:5-6, s. 383-390
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine the association between surgical waiting times (SWTs) and all-cause mortality (ACM) in non-metastatic patients with RCC, in relation to tumour stage. Patients and methods This nation-wide population-based cohort study included 9,918 M0 RCC patients registered in the National Swedish Kidney Cancer Register, between 2009 and 2021, followed-up for ACM until 9 December 2021, and having measured SWTs. The associations between primarily SWTs from date of radiological diagnosis to date of surgery (WRS) and secondarily SWTs from date of radiological diagnosis to date of treatment decision (WRT) and date of treatment decision to date of surgery (WTS), in relation to ACM, were analysed using Cox regression analysis, adjusted for clinical and demographic characteristics, stratified and unstratified according to T-stage. Results During a mean follow-up time of 5 years (49,873 person-years), 23% (n = 2291) of the patients died. The adjusted hazard ratio (AHR) for WRS (months) for all patients was 1.03 (95% confidence interval [CI] = 1.02-1.04; p < 0.001). When subdividing WRS on T-stage, the AHRs were 1.03 (95% CI = 1.01-1.04; p < 0.001) and 1.05 (95% CI = 1.02-1.08; p = 0.003) for stages T1 and T3, respectively, while non-significant for T2 (p = 0.079) and T4 (p = 0.807). Similar results were obtained for WRT and WTS. Conclusions Prolonged SWTs significantly increased the risk of early overall death among patients with RCC. The increased risk of early death from any cause show the importance of shortening SWTs in clinical work of patients with this malignant disease.
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| 19. |
- Sundqvist, Avalon, et al.
(författare)
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Post-conization surveillance in an organized cervical screening program with more than 23,000 years of follow-up
- 2023
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Ingår i: Infectious Agents and Cancer. - 1750-9378. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cervical cancer is preventable through screening and vaccination against high-risk human papillomavirus (hr-HPV). For a screening program to be successful it is vital that the clinical management and follow-up regime of patients with abnormal screening results is well developed and that the attendance rate for follow-up is high. The aim of the study was to analyze how effective conization with recommended follow-up was in preventing subsequent cervical cancer, and to evaluate how clinical follow-up recommendations are obeyed in the region of Skåne, Sweden. Methods: All women (n = 8835) who had undergone conization in the region of Skåne, Sweden, between the years of 2015 and 2021 were identified. Individuals with confirmed cervical cancer in the conization material were referred for additional treatment (n = 114), leaving 8721 included in the follow-up. Adherence to follow-up and cytological, histopathological and HPV status at follow-up were collected at eight, 12 and 24 months post-conization. The total follow-up time was from January 1, 2015, to January 30, 2023. Results: Within 12 months post-conization, 90% of the patients conducted a cytological cervical sample. The rates of a negative test of cure (HPV negative and normal cytology) were 69.7%, 76.3% and 84.4% at eight, 12 and 24 months post-conization respectively. The clearance of HPV was 79.6%, 80.8% and 87.8% at eight, 12 and 24 months post-conization respectively. Out of 5613 patients with a negative test of cure within one year after conization, no cervical cancer was found during follow-up and 11 (0.2%) women developed high-grade intraepithelial lesions/adenocarcinoma in situ (HSIL/AIS) with an average time from conization to new diagnosis of 42 months. The mean follow-up time was 32.1 months. Conclusions: The clearance rate of hr-HPV post cervical conization due to dysplasia appears to be high within eight months. With a negative test of cure post cervical conization, the risk of cervical cancer within the following three years seems to be extremely low and the risk of developing HSIL/AIS was lower than the incidence of HSIL/AIS in the general screening population.
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| 20. |
- Sundqvist, Pernilla, 1979-
(författare)
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Characterizations of preschool technology education : analyses of seven individual preschool teachers’ and childcare attendants’ descriptions of their teaching
- 2022
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Ingår i: International journal of technology and design education. - : Springer. - 0957-7572 .- 1573-1804. ; 32:4, s. 2003-2018
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Tidskriftsartikel (refereegranskat)abstract
- In recent decades the preschool has leaned more towards a learning-oriented pedagogy, where the subject of technology has been given a more prominent place. Still, studies on how individual preschool staff members perceive and teach technology is scarce. This study shows how seven preschool staff in Sweden describe their work with the subject of technology and how technology education is characterized in these descriptions. The data was produced by means of semi-structured interviews and a questionnaire and analyzed with narrative analysis. The results show very diverse practices of technology education, implying the learning possibilities for children in different preschools are not equal. Some of the staff describe a clear and conscious teaching of technology, while others describe teaching what can be viewed as a limited and/or shallow technology education, where technology is sometimes used as means for learning other subjects or contents rather than being the learning objective. Six ways to characterize technology education was found, namely: technology education (1) concerns technological objects and systems in children’s environment, (2) concerns learning to handle technological objects, (3) is doing experiments, (4) involves developing abilities, (5) is naturally included in children’s play and (6) departs from digital technology.
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| 21. |
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| 22. |
- Sundqvist, Pernilla, et al.
(författare)
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Preschool Heads’ Perceptions of Technology and Technology Education.
- 2021
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Ingår i: Techne serien - Forskning i slöjdpedagogik och slöjdvetenskap. ; , s. 418-424
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Konferensbidrag (refereegranskat)abstract
- Teachers need support in how to organize teaching in technology to meet the preschool curriculum goals. In Sweden, the head of the preschool has a pedagogical responsibility with a task to support teachers and ensure that the work corresponds to national goals stated in the school act and the curriculum. In this paper, we investigate preschool heads’ perceptions of technology (RQ1) and of teaching technology (RQ2) as a precondition for their pedagogical responsibility. Data were gathered from two two-hour seminars with five heads of preschool attending a professional development programme. The seminars were audio recorded and the recordings were transcribed for analysis. Research question 1 was analyzed using Collier-Reeds categories for Nature of Technology, and research question 2 was analyzed using a conventional content analysis. The heads perceptions of technology varies between individuals having a narrow view of technology as only being artefacts, or a great insecurity entailing not knowing what separates technology from natural science, to a developed and complex view of technology. Regarding the teaching of technology the heads talked about the preschool teachers´ competence, including subject knowledge as a basis for teaching and pedagogical and didactical knowledge and skills. They also discussed content and method for teaching technology, which included the concept of technology, the nature of preschool teaching and a progression through the preschool years. The results also show that the heads believe the characteristics of preschool education demand that the preschool teachers have a high level of subject knowledge.
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| 23. |
- Sundqvist, Pernilla, 1979-, et al.
(författare)
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Preservice teachers´ attitudes towards mathematics
- 2023
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Ingår i: 31st EECERA ANNUAL CONFERENCE Children’s Curiosity, Agency and Participation :Challenges for Professional Action and Development Cascais near Lisbon, Portugal 30th August – 2nd September 2023 CONFERENCE PROCEEDINGS. ; , s. 208-
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Konferensbidrag (refereegranskat)abstract
- Researchers emphasise the importance for early childhood teacher education (ECTE) to promote positive attitudes towardsmathematics (Hollingsworth & Knight McKennas, 2018). The aim of this study is to investigate preservice teachers' attitudes totowards mathematics, whether and how attitudes change during ECTE and what might cause the changes. Previous research showsthat many preservice and early childhood teachers have low self-confidence and negative attitudes towards mathematics (Gresham& Burleigh, 2019; Hollingsworth & Knight McKenna, 2018; Linder & Simpson, 2018; Palmer, 2010). These negative attitudesinfluence their teaching of mathematics, which in turn affects children’s possibilities to learn (Geist, 2015; Knaus, 2017; Linder &Simpson; 2018; Youmans et al., 2018). We use the concept of attitude and adopt a multidimensional definition, where cognitive aswell as affective and behavioral components are included (Wen & Dube, 2022). We will use a short form of Tapia and Marsh's (2004)Attitudes Towards Mathematics Inventory (ATMI) questionnaire, developed and tested by Lim and Chapman (2013), together withcomplementing open questions. Ethical considerations are made according to the guidelines of the Swedish Research Council (2017).Based on the results, we will describe preservice teachers' attitudes towards mathematics during different parts of their education,as well as what influences these and how ECTE can contribute to promoting positive attitudes. The study can provide knowledgeabout how ECTE can support the development of positive attitudes towards mathematics, with the ultimate aim to enable earlychildhood education teachers to teach mathematics using children’s curiosity and interest.
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| 24. |
- Sundqvist, Pernilla, 1979-, et al.
(författare)
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Results of the Technological Profile Inventory Questionnaire among Swedish Preschool Staff
- 2022
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Ingår i: PATT39 On the Edge. Technology, Innovation and Education. - : Memorial University of Newfoundland. - 9780889015050 ; , s. 164-170
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Konferensbidrag (refereegranskat)abstract
- The competence and knowledge of the preschool teacher is the most important factor for how the teaching is organised, and what the children are given opportunities to learn. For teaching technology, technological literacy (TL) constitutes such a competence. The TPI was created from a phenomenographic study on upper secondary students in South Africa and has thereafter been tested and validated for several groups of students in South Africa. We used the TPI to test the TL of 184 preschool teachers and childcare attendants. To test the validity and reliability of the instrument in this context, we performed an exploratory factor analysis followed by a test of internal consistency using Cronbach alpha. This resulted in five factors/categories, two for conceptions of technology and three for interaction with technology: Technology is conceived of as an artefact or a process, and interaction with technology is through direction, instruction or tinkering. This differs somewhat from the categories presented by Luckay and Collier-Reed. We discuss possible reasons for this. The technological profile of the preschool staff was then explored for the group by calculating the mean score for each category. Regarding the conceptions of technology, the scores for artefact and process are similar, implying that the preschool staff view technology as both artefacts and a process. For the interaction with technology, the category instruction got the highest score, followed by tinkering, while the score for direction was considerably lower. This shows an unafraid and curious approach to technological objects, which can be considered valuable in the teaching of technology.
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| 25. |
- Sundqvist, Pernilla, 1979-
(författare)
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Teaching Technology in a Play-Based Preschool—Views and Challenges
- 2022. - 1
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Ingår i: Applications of Research in Technology Education. - Singapore : Springer. - 9789811678844 ; , s. 219-232
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Bokkapitel (populärvet., debatt m.m.)abstract
- This chapter is based on studies that investigated technology education in preschool focusing on the content described and taught by the staff, how this content is taught and what children are enabled to learn through this teaching. Three methods were used to investigate this. First a questionnaire, then interviews and finally an ethnographically inspired perspective where data was generated from observations and interviews. Participants were preschool teachers and childcare attendants in Sweden. Departing from those studies, this chapter will provide a picture of what preschool technology education is to the participants of the study as well as what preschool staff find challenging when it comes to teaching technology. The results show that the view on preschool technology education is broad and varies between preschool staff. Two specific challenges were: what is included in the concept and the content area of technology, and how some specific content can be taught in the context of a play-based preschool. The last part of this chapter will address these challenges and try to provide some clarification and suggestions.
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| 26. |
- Sundqvist, Pernilla, 1979-
(författare)
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Technological Knowledge in Early Childhood Education: Provision by staff of learning opportunities
- 2020
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Ingår i: International journal of technology and design education. - : Springer Netherlands. - 0957-7572 .- 1573-1804. ; 30:2, s. 225-242
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Tidskriftsartikel (refereegranskat)abstract
- Developments in early childhood education (ECE) over the last two decades have for many countries meant a change towards a more subject-oriented pedagogy in which preschool staff are commissioned to teach technology to young children. This has been proved to be a challenge to the staff. Through analysis of activities at two preschool units, this study shows how technology education can be provided in ECE, and what kind of knowledge-learning by children can be facilitated in different activities and depending on the actions of the staff. An ethnographically inspired perspective was employed, using methods such as participant observation and formal and informal interviews, in order to investigate the technological knowledge encouraged by the staff at two preschool units in Sweden. The results show that staff promote children’s learning of a variety of technological content, mainly relating to technological objects and creative processes. This range from simple knowledge of how to handle a knife or a pair of scissors to more complex knowledge of how to build something to be fit for purpose and how different tools or materials are more or less adequate for a specific activity or design. The result also show that the way in which the staff address these contents effect which abilities and skills children are promoted to develop.
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| 27. |
- Ugge, Henrik, 1987-, et al.
(författare)
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Diagnostic outcomes from transrectal and transperineal prostate biopsies : experiences from a Swedish tertiary care Centre
- 2021
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 55:6, s. 434-440
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to compare diagnostic and infectious outcomes between MRI-guided transrectal (TR) and transperineal (TP) prostate biopsies, in order to evaluate implementation of local-anaesthesia TP biopsies in a Swedish university hospital setting.METHODS: In this non-randomized observational study, we recruited 105 patients who underwent TR or TP software-based MRI-ultrasound fusion prostate biopsies between April and August 2020. Information on outcome and covariates were obtained from hospital records. We compared detection rates of overall prostate cancer (PCa) and clinically significant PCa (≥ISUP2) between the two groups using simple and multivariable-adjusted analyses. As a secondary outcome, we descriptively compared infection-related outcomes between the two groups.RESULTS: Of the total population, 72 patients underwent TR and 33 patients underwent TP biopsies. Biopsies were positive for PCa in 50 (69.4%) patients of the TR group and 23 (69.7%) patients of the TP group. Clinically significant cancer was found in 28 (38.9%) patients of the TR group and 10 (30.3%) patients of the TP group. Simple and multivariable-adjusted analyses did not indicate any statistically significant difference between groups. Post-biopsy infection was diagnosed in one patient (3%) of the TP group and eight patients (11.1%) in the TR group, conforming to previous reports of low infection rates after TP biopsies.CONCLUSIONS: Our results conform to data suggesting that the transition from TR to TP MRI-guided biopsies is feasible and safe, maintaining a high diagnostic quality while possibly reducing the risk of infection-related complications.
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| 28. |
- Åkerlund, John, et al.
(författare)
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Predictors for complication in renal cancer surgery : a national register study
- 2023
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 58:1, s. 38-45
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Nationwide register data provide unique opportunities for real-world assessment of complications from different surgical methods. This study aimed to assess incidence of, and predictors for, post-operative complications and to evaluate 90-day mortality following different surgical procedures and thermal ablation for renal cell carcinoma (RCC).MATERIAL AND METHODS: All patients undergoing surgical treatment and thermal ablation for RCC in Sweden during 2015-2019 were identified from the National Swedish Kidney Cancer Register. Frequencies and types of post-operative complications were analysed. Logistic regression models were used to identify predictors for 90-day major (Clavien-Dindo grades III-V) complications, including death.RESULTS: The overall complication rate was 24% (1295/5505), of which 495 (8.7%) were major complications. Most complications occurred following open surgery, of which bleeding and infection were the most common. Twice as many complications were observed in patients undergoing open surgery compared to minimally invasive surgery (20% vs. 10%, P < 0.001). Statistically significant predictors for major complications irrespective of surgical category and technique were American society of anesthiologists (ASA) score, tumour diameter and serum creatinine. Separating radical and partial nephrectomy, surgical technique remained a significant risk factor for major complications. Most complications occurred within the first 20 days. The overall 90-day readmission rate was 6.2%, and 30- and 90-day mortality rates were 0.47% and 1.5%, respectively.CONCLUSIONS: In conclusion, bleeding and infection were the most common major complications after RCC surgery. Twice as many patients undergoing open surgery suffer a major post-operative complication as compared to patients subjected to minimally invasive surgery. General predictors for major complications were ASA score, tumour size, kidney function and surgical technique.
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