| 1. |
- Norlén, Olov
(författare)
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Small Intestinal Neuroendocrine Tumor : A Rare Malignancy with Favorable Outcome
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Small intestinal neuroendocrine tumor (SI-NET) is the most common small bowel tumor in Europe and USA, with an annual incidence of around 0.3-1.3/100000 persons. SI-NETs are the most common type of gastroenteropancreatic NETs (GEP-NETs), and they are known for their ability to produce hormones such as tachykinins and serotonin, as well as for their favorable long-term prognosis in comparison to gastrointestinal adenocarcinoma. The overall aim of the thesis was to investigate unknown or unclear aspects of SI-NET disease, in connection with prognosis, treatment and follow-up. Paper I confirmed several known negative prognostic factors and also showed, for the first time, that para-aortal lymph node metastases and peritoneal carcinomatosis were associated with worse survival by multivariable analyses. Locoregional surgery was associated with a low post-operative mortality, and a prolonged long-term survival by multivariable analysis. In Paper II we continued to investigate peritoneal carcinomatosis and found it be a risk factor not only for death, but also for emergency re-surgery. Furthermore, genetic analyses of samples from primary tumors in patients with and without peritoneal carcinomatosis showed a difference in the DNA between these two groups. In Paper III the outcome after liver surgery and/or radiofrequency ablation of liver metastases was investigated. To summarize, no difference in survival was seen in patients treated with surgery/radiofrequency ablation in comparison with matched controls. However, a superior radiological response of liver metasases and lower U-5-HIAA values were seen in patients subjected to liver surgery and/or radiofrequency ablation compared to matched controls. Paper IV compared ultrasonography, computed tomography and 11C-5HTP-PET in the follow-up after radiofrequency ablation of NET liver metastases. The study concluded that 11C-5HTP-PET depicted all residual tumors after RFA and that it, if used, should be combined with computed tomography for easier interpretation, as RFA areas are not clearly distinguishable with 11C-5HTP-PET alone. Paper V studied gallstone complications after somatostatin analog treatment in SI-NET patients, and concluded that there was a rather high risk to be subjected to a cholecystectomy due to biliary colic, cholecystitis, cholangitis or pancreatitis after primary surgery in somatostatin analog treated patients.
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| 2. |
- Sackey, Peter, et al.
(författare)
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Short- and long-term follow-up of intensive care unit patients after sedation with isoflurane and midazolam : A pilot study
- 2008
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Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 36:3, s. 801-806
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare memories from the intensive care unit (ICU) and short- and long-term psychological morbidity in patients after sedation with intravenous midazolam or inhaled isoflurane. DESIGN: Prospective long-term follow-up after randomized controlled trial. SETTING: General ICU at Karolinska University Hospital, Solna, Stockholm. PATIENTS: Forty patients in need of sedation during ventilator treatment. INTERVENTIONS: Patients were randomized to receive isoflurane or midazolam for goal-directed sedation until extubation or for a maximum of 96 hrs. MEASUREMENTS AND MAIN RESULTS: For short-term follow-up, doctors', nurses', and physiotherapists' notes from the 4 days following exposure to the study drugs were reviewed for words indicating adequate or pathologic cognitive and psychological recovery. For long-term follow-up, all 6-month survivors received questionnaires including the ICU Memory Tool (ICU-MT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Well-Being Index. Additionally, several screening questions for previous posttraumatic stress symptoms were included. In the short term follow-up, no significant differences were found between groups. In the long-term follow-up, a trend toward fewer hallucinations/delusions after isoflurane sedation than after midazolam (two of ten isoflurane patients vs. five of seven midazolam patients) was found (p = .06). None of the five solely isoflurane-sedated patients reported hallucinations/delusions from the ICU. There was no difference in groups in long-term psychological morbidity as measured with HADS and IES. Memories of negative feelings in the ICU (ICU-MT) were associated with high HADS and IES scores (Fisher's exact test, p = .02 and p = .01, respectively). CONCLUSIONS: Sedation of ICU patients with isoflurane may result in fewer delusional memories or hallucinations from the ICU compared with more commonly used intravenous sedation. Memories of negative feelings from the ICU were associated with symptoms of depression or anxiety or symptoms indicating posttraumatic stress disorder. Further study of memory and cognitive/psychological recovery after prolonged isoflurane sedation beyond 96 hrs is warranted.
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| 3. |
- Sundin, Maria, 1965, et al.
(författare)
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Mars - a target for teachers and science students
- 2020
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Ingår i: Contribution to IAU 367S, Education and Heritage in the Era of Big Data in Astronomy, 8-12 December 2020..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A case study is here presented of an interdisciplinary course about Mars for teachers and science students. We aim to share the experience of creating an interdisciplinary approach with lecturers spanning physics, geology, radiation physics and philosophy. Issues in ethics, morality, rights and obligations, conflict management and human psychology as well as rocket orbits, fuel economy, radiation hazards and knowledge of the solar system have proven to be a valued and successful initiative for the further training of teachers and science students. The focus of the course is on planning for a journey with humans to the planet Mars. This provides a great opportunity to package complex societal problems in a physics context. The course is offered with a special sustainability content mark. Mankind has always had a strong and dependent relationship with the physical landscape. The land has given us food and shelter but also imposed challenges and disasters. Understanding the physical environment has been crucial for our survival and development. The same will be equally, or more important for Mars where life conditions are much more extreme. We highlight similarities and differences in the geologic processes that have shaped Earth and Mars. What conditions do the future explorers on Mars have to manage? We then enter the modern era and explore the dynamic Martian landscape of today. Also, by learning to read the landscape we may find locations of shelter such as vast systems of lava tubes, or locations of essential resources such as preserved glacial ice etc. A journey to Mars will cause substantially higher personal irradiation than obtained on Earth. The radiation part of the course lectures starts with defining the different radiation types and the biological effects these different types of radiation will cause. Then, the difference between the irradiation on Earth to the elevated irradiation in space and on Mars is described. Thereafter, it is discussed if this elevated radiation burden can cause acute biological effects, e.g. fatigue, vomiting and death, and late biological effects as cancer induction. Last, possible radiation protection strategies are described and discussed. The philosophy of space exploration consists of philosophical approaches to ethics, presently applied to the topic of Mars exploration and colonization, with environmental ethics (anthropocentric vs ecocentric) and value theory at its core. Four main uses of philosophy are distinguished: ethics, aesthetics, cognition and existentialism. Research has shown that visual representation is an important part for students to be able to create a deeper understanding of concepts as well as context about the material that is taught. Interdisciplinary and complex societal problems have also been shown to be important in science teaching. One way for the teacher to develop his/her teaching is to take further education courses in universities whose focus is to seek and discuss the complex societal problems as well as its solutions from a physics and teacher perspective. Future research could be done on the impact of this course on the education in different levels.
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| 4. |
- Sundin, Maria, 1965, et al.
(författare)
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Mars – a target for teachers and science students
- 2021
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Ingår i: Proceedings of the International Astronomical Union, Vol 15, Symposium 367S. - 1743-9213 .- 1743-9221.
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Konferensbidrag (refereegranskat)abstract
- An interdisciplinary course about Mars for teachers and science students is presented. The focus of the course is on planning for a journey with humans to the planet Mars. Issues in ethics, morality, rights and obligations, conflict management and human psychology as well as rocket orbits, fuel economy, radiation hazards and knowledge of the solar system are included. Examination of the teacher students include interpretation of the course material for future pedagogical usage.
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| 5. |
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| 6. |
- Ambrosini, Valentina, et al.
(författare)
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Use and perceived utility of [18 F]FDG PET/CT in neuroendocrine neoplasms : A consensus report from the European Neuroendocrine Tumor Society (ENETS) Advisory Board Meeting 2022.
- 2024
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Ingår i: Journal of neuroendocrinology. - 0953-8194 .- 1365-2826. ; 36:1, s. e13359-
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Tidskriftsartikel (refereegranskat)abstract
- Somatostatin receptor (SST) PET/CT is the gold standard for well-differentiated neuroendocrine tumours (NET) imaging. Higher grades of neuroendocrine neoplasms (NEN) show preferential [18F]FDG (FDG) uptake, and even low-grade NET may de-differentiate over time. FDG PET/CT's prognostic role is widely accepted; however, its impact on clinical decision-making remains controversial and its use varies widely. A questionnaire-based survey on FDG PET/CT use and perceived decision-making utility in NEN was submitted to the ENETS Advisory Board Meeting attendees (November 2022, response rate = 70%). In 3/15 statements, agreement was higher than 75%: (i) FDG was considered useful in NET, irrespective of grade, in case of mis-matched lesions (detectable on diagnostic CT but negative/faintly positive on SST PET/CT), especially if PRRT is contemplated (80%); (ii) in NET G3 if curative surgery is considered (82%); and (iii) in NEC prior to surgery with curative intent (98%). FDG use in NET G3, even in the presence of matched lesions, as a baseline for response assessment was favoured by 74%. Four statements obtained more than 60% consensus: (i) FDG use in NET G3 if locoregional therapy is considered (65%); (ii) in neuroendocrine carcinoma before initiating active therapy as a baseline for response assessment (61%); (iii) biopsy to re-assess tumour grade prior to a change in therapeutic management (68%) upon detection of FDG-positivity on the background of a prior G1-2 NET; (iv) 67% were in favour to reconsider PRRT to treat residual SST-positive lesions after achieving complete remission on FDG of the SST-negative disease component. Multidisciplinary opinion broadly supports the use of FDG PET/CT for characterisation of disease biology and to guide treatment selection across a range of indications, despite the lack of full consensus in many situations. This may reflect existing clinical access due to lack of reimbursement or experience with this investigation, which should be addressed by further research.
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| 7. |
- Andersdotter, Amelia, et al.
(författare)
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Godtyckligt regelverk hotar friheten på nätet
- 2013
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Ingår i: Dagens Nyheter. - 1101-2447. ; :2013-09-03
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Reglerna som möjliggör stängning av hemsidor på internet präglas av godtycke och otydlighet. Men det behöver inte vara särskilt svårt att skapa ett nytt och rättssäkert regelverk. Här har Sveriges EU-kommissionär Cecilia Malmström en viktig roll. Frågan är om hon tar sitt ansvar, skriver politiker och nätdebattörer.
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| 8. |
- Andersson Ersman, Peter, et al.
(författare)
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Integration of Screen Printed Piezoelectric Sensors for Force Impact Sensing in Smart Multifunctional Glass Applications
- 2022
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Ingår i: Advanced Engineering Materials. - : John Wiley & Sons, Ltd. - 1438-1656 .- 1527-2648. ; 24:11
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Tidskriftsartikel (refereegranskat)abstract
- Screen printed piezoelectric polyvinylidene fluoride?trifluoro ethylene (PVDF?TrFE)-based sensors laminated between glass panes in the temperature range 80?110?°C are presented. No degradation of the piezoelectric signals is observed for the sensors laminated at 110?°C, despite approaching the Curie temperature of the piezoelectric material. The piezoelectric sensors, here monitoring force impact in smart glass applications, are characterized by using a calibrated impact hammer system and standardized impact situations. Stand-alone piezoelectric sensors and piezoelectric sensors integrated on poly(methyl methacrylate) are also evaluated. The piezoelectric constants obtained from the measurements of the nonintegrated piezoelectric sensors are in good agreement with the literature. The piezoelectric sensor response is measured by using either physical electrical contacts between the piezoelectric sensors and the readout electronics, or wirelessly via both noncontact capacitive coupling and Bluetooth low-energy radio link. The developed sensor concept is finally demonstrated in smart window prototypes, in which integrated piezoelectric sensors are used to detect break-in attempts. Additionally, each prototype includes an electrochromic film to control the light transmittance of the window, a screen printed electrochromic display for status indications and wireless communication with an external server, and a holistic approach of hybrid printed electronic systems targeting smart multifunctional glass applications.
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| 9. |
- Andersson, Rebecca, 1987-, et al.
(författare)
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Tracing ISP Graduates 2008-2013
- 2016
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Rapport (populärvet., debatt m.m.)abstract
- The International Science Programme (ISP) at Uppsala University, Sweden, aims to contribute to the growth of scientific knowledge in Africa, Asia and Latin America. The ISP model is designed to prevent brain drain by improving local facilities and conditions for research and by promoting local postgraduate training. When local training is not possible, sandwich postgraduate training is employed, where students spend part of their training at their home university and part at a more resourceful scientific host institution abroad, in the North or in the region.The focus of this report is PhD graduates from ISP supported research groups and networks during the granting period 2008-2013, to trace where they are today and what they are doing.Most of the 154 traced PhD graduates (92%) are currently working in their home countries (126) or regions (16), most as Lecturers or Senior Lecturers at universities or research institutes. Twelve graduates are currently living in OECD countries, all but two of them employed in academia. A slightly higher share of students trained locally have stayed in their home countries or relocated within the regions, compared to sandwich students.
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| 10. |
- Backman, Samuel, et al.
(författare)
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The Evolutionary History of Metastatic Pancreatic Neuroendocrine Tumours Reveals a Therapy Driven Route to High-Grade Transformation.
- 2024
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Ingår i: medRxiv : the preprint server for health sciences.
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Tidskriftsartikel (refereegranskat)abstract
- Tumour evolution with acquisition of more aggressive disease characteristics is a hallmark of disseminated cancer. Metastatic pancreatic neuroendocrine tumours (PanNETs) in particular, show frequent progression from a low/intermediate to a high-grade disease. To understand the molecular mechanisms underlying this phenomenon, we performed multi-omics analysis of 32 longitudinal samples from six metastatic PanNET patients. Following MEN1 inactivation, PanNETs exhibit genetic heterogeneity on both spatial and temporal dimensions with parallel and convergent tumuor evolution involving the ATRX/DAXX and mTOR pathways. Following alkylating chemotherapy treatment, some PanNETs develop mismatch repair deficiency and acquire a hypermutator phenotype. This DNA hypermutation phenotype was only found in cases that also showed transformation into a high-grade PanNET. Overall, our findings contribute to broaden the understanding of metastatic PanNET, and suggests that therapy driven disease evolution is an important hallmark of this disease.
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