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| 4. |
- Jakosky, B. M., et al.
(author)
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MAVEN observations of the response of Mars to an interplanetary coronal mass ejection
- 2015
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In: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 350:6261
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Journal article (peer-reviewed)abstract
- Coupling between the lower and upper atmosphere, combined with loss of gas from the upper atmosphere to space, likely contributed to the thin, cold, dry atmosphere of modern Mars. To help understand ongoing ion loss to space, the Mars Atmosphere and Volatile Evolution (MAVEN) spacecraft made comprehensive measurements of the Mars upper atmosphere, ionosphere, and interactions with the Sun and solar wind during an interplanetary coronal mass ejection impact in March 2015. Responses include changes in the bow shock and magnetosheath, formation of widespread diffuse aurora, and enhancement of pick-up ions. Observations and models both show an enhancement in escape rate of ions to space during the event. Ion loss during solar events early in Mars history may have been a major contributor to the long-term evolution of the Mars atmosphere.
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| 5. |
- Bethlehem, RAI, et al.
(author)
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Brain charts for the human lifespan
- 2022
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In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 604:79057906, s. 525-
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Journal article (peer-reviewed)abstract
- Over the past few decades, neuroimaging has become a ubiquitous tool in basic research and clinical studies of the human brain. However, no reference standards currently exist to quantify individual differences in neuroimaging metrics over time, in contrast to growth charts for anthropometric traits such as height and weight1. Here we assemble an interactive open resource to benchmark brain morphology derived from any current or future sample of MRI data (http://www.brainchart.io/). With the goal of basing these reference charts on the largest and most inclusive dataset available, acknowledging limitations due to known biases of MRI studies relative to the diversity of the global population, we aggregated 123,984 MRI scans, across more than 100 primary studies, from 101,457 human participants between 115 days post-conception to 100 years of age. MRI metrics were quantified by centile scores, relative to non-linear trajectories2 of brain structural changes, and rates of change, over the lifespan. Brain charts identified previously unreported neurodevelopmental milestones3, showed high stability of individuals across longitudinal assessments, and demonstrated robustness to technical and methodological differences between primary studies. Centile scores showed increased heritability compared with non-centiled MRI phenotypes, and provided a standardized measure of atypical brain structure that revealed patterns of neuroanatomical variation across neurological and psychiatric disorders. In summary, brain charts are an essential step towards robust quantification of individual variation benchmarked to normative trajectories in multiple, commonly used neuroimaging phenotypes.
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| 6. |
- Brain, D., et al.
(author)
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A comparison of global models for the solar wind interaction with Mars
- 2010
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In: Icarus. - : Elsevier BV. - 0019-1035 .- 1090-2643. ; 206:1, s. 139-151
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Journal article (peer-reviewed)abstract
- We present initial results from the first community-wide effort to compare global plasma interaction model results for Mars. Seven modeling groups participated in this activity, using MHD, multi-fluid, and hybrid assumptions in their simulations. Moderate solar wind and solar EUV conditions were chosen, and the conditions were implemented in the models and run to steady state. Model output was compared in three ways to determine how pressure was partitioned and conserved in each model, the location and asymmetry of plasma boundaries and pathways for planetary ion escape, and the total escape flux of planetary oxygen ions. The two participating MHD models provided similar results, while the five sets of multi-fluid and hybrid results were different in many ways. All hybrid results, however, showed two main channels for oxygen ion escape (a pickup ion 'plume' in the hemisphere toward which the solar wind convection electric field is directed, and a channel in the opposite hemisphere of the central magnetotail), while the MHD models showed one (a roughly symmetric channel in the central magnetotail). Most models showed a transition from an upstream region dominated by plasma dynamic pressure to a magnetosheath region dominated by thermal pressure to a low altitude region dominated by magnetic pressure. However, calculated escape rates for a single ion species varied by roughly an order of magnitude for similar input conditions, suggesting that the uncertainties in both the current and integrated escape over martian history as determined by models are large. These uncertainties are in addition to those associated with the evolution of the Sun, the martian dynamo, and the early atmosphere, highlighting the challenges we face in constructing Mars' past using models.
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| 7. |
- Jakosky, B. M., et al.
(author)
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The Mars Atmosphere and Volatile Evolution (MAVEN) Mission
- 2015
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In: Space Science Reviews. - : Springer Science and Business Media LLC. - 0038-6308 .- 1572-9672. ; 195:1-4, s. 3-48
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Research review (peer-reviewed)abstract
- The MAVEN spacecraft launched in November 2013, arrived at Mars in September 2014, and completed commissioning and began its one-Earth-year primary science mission in November 2014. The orbiter's science objectives are to explore the interactions of the Sun and the solar wind with the Mars magnetosphere and upper atmosphere, to determine the structure of the upper atmosphere and ionosphere and the processes controlling it, to determine the escape rates from the upper atmosphere to space at the present epoch, and to measure properties that allow us to extrapolate these escape rates into the past to determine the total loss of atmospheric gas to space through time. These results will allow us to determine the importance of loss to space in changing the Mars climate and atmosphere through time, thereby providing important boundary conditions on the history of the habitability of Mars. The MAVEN spacecraft contains eight science instruments (with nine sensors) that measure the energy and particle input from the Sun into the Mars upper atmosphere, the response of the upper atmosphere to that input, and the resulting escape of gas to space. In addition, it contains an Electra relay that will allow it to relay commands and data between spacecraft on the surface and Earth.
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| 8. |
- Ring, A., et al.
(author)
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Bridging The Age Gap: observational cohort study of effects of chemotherapy and trastuzumab on recurrence, survival and quality of life in older women with early breast cancer
- 2021
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In: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 125, s. 209-219
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Journal article (peer-reviewed)abstract
- Background: Chemotherapy improves outcomes for high risk early breast cancer (EBC) patients but is infrequently offered to older individuals. This study determined if there are fit older patients with high-risk disease who may benefit from chemotherapy. Methods: A multicentre, prospective, observational study was performed to determine chemotherapy (±trastuzumab) usage and survival and quality-of-life outcomes in EBC patients aged ≥70 years. Propensity score-matching adjusted for variation in baseline age, fitness and tumour stage. Results: Three thousands four hundred sixteen women were recruited from 56 UK centres between 2013 and 2018. Two thousands eight hundred eleven (82%) had surgery. 1520/2811 (54%) had high-risk EBC and 2059/2811 (73%) were fit. Chemotherapy was given to 306/1100 (27.8%) fit patients with high-risk EBC. Unmatched comparison of chemotherapy versus no chemotherapy demonstrated reduced metastatic recurrence risk in high-risk patients(hazard ratio [HR] 0.36 [95% CI 0.19–0.68]) and in 541 age, stage and fitness-matched patients(adjusted HR 0.43 [95% CI 0.20–0.92]) but no benefit to overall survival (OS) or breast cancer-specific survival (BCSS) in either group. Chemotherapy improved survival in women with oestrogen receptor (ER)-negative cancer (OS: HR 0.20 [95% CI 0.08–0.49];BCSS: HR 0.12 [95% CI 0.03–0.44]).Transient negative quality-of-life impacts were observed. Conclusions: Chemotherapy was associated with reduced risk of metastatic recurrence, but survival benefits were only seen in patients with ER-negative cancer. Quality-of-life impacts were significant but transient. Trial Registration: ISRCTN 46099296. © 2021, The Author(s).
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| 9. |
- Wheelwright, S, et al.
(author)
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International validation of the EORTC QLQ-ELD14 questionnaire for assessment of health-related quality of life elderly patients with cancer.
- 2013
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In: British journal of cancer. - : Springer Science and Business Media LLC. - 1532-1827 .- 0007-0920. ; 109:4, s. 852-8
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Journal article (peer-reviewed)abstract
- Background:Older people represent the majority of cancer patients but their specific needs are often ignored in the development of health-related quality of life (HRQOL) instruments. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-ELD15 was developed to supplement the EORTC's core questionnaire, the QLQ-C30, for measuring HRQOL in patients aged >70 years in oncology studies.Methods:Patients (n=518) from 10 countries completed the QLQ-C30, QLQ-ELD15 and a debriefing interview. Eighty two clinically stable patients repeated the questionnaires 1 week later (test-retest analysis) and 107 others, with an expected change in clinical status, repeated the questionnaires 3 months later (response to change analysis, RCA).Results:Information from the debriefing interview, factor analysis and item response theory analysis resulted in the removal of one item (QLQ-ELD15QLQ-ELD14) and revision of the proposed scale structure to five scales (mobility, worries about others, future worries, maintaining purpose and illness burden) and two single items (joint stiffness and family support). Convergent validity was good. In known-group comparisons, the QLQ-ELD14 differentiated between patients with different disease stage, treatment intention, number of comorbidities, performance status and geriatric screening scores. Test-retest and RCA analyses were equivocal.Conclusion:The QLQ-ELD14 is a validated HRQOL questionnaire for cancer patients aged 70 years. Changes in elderly patients' self-reported HRQOL may be related to both cancer evolution and non-clinical events.
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| 12. |
- Battisti, N. M. L., et al.
(author)
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Adapting care for older cancer patients during the COVID-19 pandemic: Recommendations from the International Society of Geriatric Oncology (SIOG) COVID-19 Working Group
- 2020
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In: Journal of Geriatric Oncology. - : Elsevier BV. - 1879-4068. ; 11:8, s. 1190-1198
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Journal article (peer-reviewed)abstract
- The COVID-19 pandemic poses a barrier to equal and evidence-based management of cancer in older adults. The International Society of Geriatric Oncology (SIOG) formed a panel of experts to develop consensus recommendations on the implications of the pandemic on several aspects of cancer care in this age group including geriatric assessment (GA), surgery, radiotherapy, systemic treatment, palliative care and research. Age and cancer diagnosis are significant predictors of adverse outcomes of the COVID-19 infection. In this setting, GA is particularly valuable to drive decision-making. GA may aid estimating physiologic reserve and adaptive capability, assessing risk-benefits of either providing or temporarily withholding treatments, and determining patient preferences to help inform treatment decisions. In a resource-constrained setting, geriatric screening tools may be administered remotely to identify patients requiring comprehensive GA. Tele-health is also crucial to ensure adequate continuity of care and minimize the risk of infection exposure. In general, therapeutic decisions should favor the most effective and least invasive approach with the lowest risk of adverse outcomes. In selected cases, this might require deferring or omitting surgery, radiotherapy or systemic treatments especially where benefits are marginal and alternative safe therapeutic options are available. Ongoing research is necessary to expand knowledge of the management of cancer in older adults. However, the pandemic presents a significant barrier and efforts should be made to ensure equitable access to clinical trials and prospective data collection to elucidate the outcomes of COVID-19 in this population. © 2020 Elsevier Inc.
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| 18. |
- Camara-Costa, H., et al.
(author)
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Quality of survival and cognitive performance in children treated for medulloblastoma in the PNET 4 randomized controlled trial
- 2017
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In: Neuro-Oncology Practice. - : Oxford University Press (OUP). - 2054-2577 .- 2054-2585. ; 4:3, s. 161-170
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Journal article (peer-reviewed)abstract
- Background. The relationship between direct assessments of cognitive performance and questionnaires assessing quality of survival (QoS) is reported to be weak-to-nonexistent. Conversely, the associations between questionnaires evaluating distinct domains of QoS tend to be strong. This pattern remains understudied. Methods. In the HIT-SIOP PNET4 randomized controlled trial, cognitive assessments, including Full Scale, Verbal and Performance IQ, Working Memory, and Processing Speed, were undertaken in 137 survivors of standard-risk medulloblastoma from 4 European countries. QoS questionnaires, including self-reports and/or parent reports of the Behavior Rating Inventory of Executive Function (BRIEF), the Health Utilities Index, the Strengths and Difficulties Questionnaire, and the Pediatric Quality of Life Inventory, were completed for 151 survivors. Correlations among direct cognitive assessments, QoS questionnaires, and clinical data were examined in participants with both assessments available (n = 86). Results. Correlations between direct measures of cognitive performance and QoS questionnaires were weak, except for moderate correlations between the BRIEF Metacognition Index (parent report) and working memory (r = .32) and between health status (self-report) and cognitive outcomes (r = .35-.44). Correlations among QoS questionnaires were moderate to strong both for parent and self-report (r = .39-.76). Principal Component Analysis demonstrated that questionnaires and cognitive assessments loaded on 2 separate factors. Conclusions. We hypothesize that the strong correlations among QoS questionnaires is partially attributable to the positive/negative polarity of all questions on the questionnaires, coupled with the relative absence of diseasespecific questions. These factors may be influenced by respondents' personality and emotional characteristics, unlike direct assessments of cognitive functioning, and should be taken into account in clinical trials.
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| 19. |
- Edberg, Niklas J. T., et al.
(author)
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Magnetosonic Mach number effect of the position of the bow shock at Mars in comparison to Venus
- 2010
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In: Journal of Geophysical Research. - 0148-0227 .- 2156-2202. ; 115, s. A07203-
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Journal article (peer-reviewed)abstract
- We study the effect of the magnetosonic Mach number on the position of the bow shock (BS) at Mars. The magnetosonic Mach number is calculated from solar wind data obtained by the ACE satellite upstream of Earth and extrapolated to Mars during two intervals, starting in 2005 and 2007, when Mars and Earth were close to opposition. An increased Mach number is observed to cause the Martian BS to move to lower altitudes and the variation in the terminator altitude is proportional to the Mach number change. When the Mach number is lowered, the BS flares more. We also compare our results to previous studies at Venus. The variation in BS altitude with magnetosonic Mach number is found to be very similar to the variation of the Venusian BS, which has previously been shown to decrease linearly in altitude with increasing Mach number.
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| 20. |
- Edberg, Niklas, et al.
(author)
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Rosetta and Mars Express observations of the influence of high solar wind pressure on the Martian plasma environment
- 2009
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In: Annales Geophysicae. - : Copernicus GmbH. - 0992-7689 .- 1432-0576. ; 27:12, s. 4533-4545
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Journal article (peer-reviewed)abstract
- We report on new simultaneous in-situ observations at Mars from Rosetta and Mars Express (MEX) on how the Martian plasma environment is affected by high pressure solar wind. A significant sharp increase in solar wind density, magnetic field strength and turbulence followed by a gradual increase in solar wind velocity is observed during similar to 24 h in the combined data set from both spacecraft after Rosetta's closest approach to Mars on 25 February 2007. The bow shock and magnetic pileup boundary are coincidently observed by MEX to become asymmetric in their shapes. The fortunate orbit of MEX at this time allows a study of the inbound boundary crossings on one side of the planet and the outbound crossings on almost the opposite side, both very close to the terminator plane. The solar wind and interplanetary magnetic field (IMF) downstream of Mars are monitored through simultaneous measurements provided by Rosetta. Possible explanations for the asymmetries are discussed, such as crustal magnetic fields and IMF direction. In the same interval, during the high solar wind pressure pulse, MEX observations show an increased amount of escaping planetary ions from the polar region of Mars. We link the high pressure solar wind with the observed simultaneous ion outflow and discuss how the pressure pulse could also be associated with the observed boundary shape asymmetry.
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| 21. |
- Holmes, G. R., et al.
(author)
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Cost-Effectiveness Modeling of Surgery Plus Adjuvant Endocrine Therapy Versus Primary Endocrine Therapy Alone in UK Women Aged 70 and Over With Early Breast Cancer
- 2021
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In: Value in Health. - : Elsevier BV. - 1098-3015. ; 24:6, s. 770-779
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Journal article (peer-reviewed)abstract
- Objectives: Approximately 20% of UK women aged 70+ with early breast cancer receive primary endocrine therapy (PET) instead of surgery. PET reduces surgical morbidity but with some survival decrement. To complement and utilize a treatment dependent prognostic model, we investigated the cost-effectiveness of surgery plus adjuvant therapies versus PET for women with varying health and fitness, identifying subgroups for which each treatment is cost-effective. Methods: Survival outcomes from a statistical model, and published data on recurrence, were combined with data from a large, multicenter, prospective cohort study of over 3400 UK women aged 70+ with early breast cancer and median 52-month follow-up, to populate a probabilistic economic model. This model evaluated the cost-effectiveness of surgery plus adjuvant therapies relative to PET for 24 illustrative subgroups: Age {70, 80, 90} × Nodal status {FALSE (F), TRUE (T)} × Comorbidity score {0, 1, 2, 3+}. Results: For a 70-year-old with no lymph node involvement and no comorbidities (70, F, 0), surgery plus adjuvant therapies was cheaper and more effective than PET. For other subgroups, surgery plus adjuvant therapies was more effective but more expensive. Surgery plus adjuvant therapies was not cost-effective for 4 of the 24 subgroups: (90, F, 2), (90, F, 3), (90, T, 2), (90, T, 3). Conclusion: From a UK perspective, surgery plus adjuvant therapies is clinically effective and cost-effective for most women aged 70+ with early breast cancer. Cost-effectiveness reduces with age and comorbidities, and for women over 90 with multiple comorbidities, there is little cost benefit and a negative impact on quality of life. © 2021 ISPOR–The Professional Society for Health Economics and Outcomes Research
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| 22. |
- Morgan, J. L., et al.
(author)
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Observational cohort study to determine the degree and causes of variation in the rate of surgery or primary endocrine therapy in older women with operable breast cancer
- 2021
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In: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983. ; 47:2, s. 261-268
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Journal article (peer-reviewed)abstract
- Background: In the UK there is variation in the treatment of older women with breast cancer, with up to 40% receiving primary endocrine therapy (PET), which is associated with inferior survival. Case mix and patient choice may explain some variation in practice but clinician preference may also be important. Methods: A multicentre prospective cohort study of women aged >70 with operable breast cancer. Patient characteristics (health status, age, tumour characteristics, treatment allocation and decision-making preference) were analysed to identify whether treatment variation persisted following case-mix adjustment. Expected case-mix adjusted surgery rates were derived by logistic regression using the variables age, co-morbidity, tumour stage and grade. Concordance between patients’ preferred and actual decision-making style was assessed and associations between age, treatment and decision-making style calculated. Results: Women (median age 77, range 70–102) were recruited from 56 UK breast units between 2013 and 2018. Of 2854/3369 eligible women with oestrogen receptor positive breast cancer, 2354 were treated with surgery and 500 with PET. Unadjusted surgery rates varied between hospitals, with 23/56 units falling outside the 95% confidence intervals on funnel plots. Adjusting for case mix reduced, but did not eliminate, this variation between hospitals (10/56 units had practice outside the 95% confidence intervals). Patients treated with PET had more patient-centred decisions compared to surgical patients (42.2% vs 28.4%, p < 0.001). Conclusions: This study demonstrates variation in treatment selection thresholds for older women with breast cancer. Health stratified guidelines on thresholds for PET would help reduce variation, although patient preference should still be respected. © 2020 The Authors
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| 23. |
- Opgenoorth, Hermann J., et al.
(author)
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Day-side ionospheric conductivities at Mars
- 2010
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In: Planetary and Space Science. - : Elsevier BV. - 0032-0633 .- 1873-5088. ; 58:10, s. 1139-1151
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Journal article (peer-reviewed)abstract
- We present estimates of the day-side ionospheric conductivities at Mars based on magnetic field measurements by Mars Global Surveyor (MGS) at altitudes down to similar to 100 km during aerobraking orbits early in the mission. At Mars, the so-called ionospheric dynamo region, where plasma/neutral collisions permit electric currents perpendicular to the magnetic field, lies between 100 and 250 km altitude. We find that the ionosphere is highly conductive in this region, as expected, with peak Pedersen and Hall conductivities of 0.1-1.5 S/m depending on the solar illumination and induced magnetospheric conditions. Furthermore, we find a consistent double peak pattern in the altitude profile of the day-side Pedersen conductivity, similar to that on Titan found by Rosenqvist et al. (2009). A high altitude peak, located between 180 and 200 km, is equivalent to the terrestrial peak in the lower F-layer. A second and typically much stronger layer of Pedersen conductivity is observed between 120 and 130 km, which is below the Hall conductivity peak at about 130-140 km. In this altitude region, MGS finds a sharp decrease in induced magnetic field strength at the inner magnetospheric boundary, while the day-side electron density is known to remain high as far down as 100 km. We find that such Titan-like behaviour of the Pedersen conductivity is only observed under regions of strongly draped magnetospheric field-lines, and negligible crustal magnetic anomalies below the spacecraft. Above regions of strong crustal magnetic anomalies, the Pedersen conductivity profile becomes more Earth-like with one strong Pedersen peak above the Hall conductivity peak. Here, both conductivities are 1-2 orders of magnitude smaller than the above only weakly magnetised crustal regions, depending on the strength of the crustal anomaly field at ionospheric altitudes. This nature of the Pedersen conductivity together with the structured distribution of crustal anomalies all over the planet should give rise to strong conductivity gradients around such anomalies. Day-side ionospheric conductivities on Mars (in regions away from the crustal magnetic anomalies) and Titan seem to behave in a very similar manner when horizontally draped magnetic field-lines partially magnetise a sunlit ionosphere. Therefore, it appears that a similar double peak structure of strong Pedersen conductivity could be a more general feature of non-magnetised bodies with ionised upper atmospheres, and thus should be expected to occur also at other non-magnetised terrestrial planets like Venus or other planetary bodies within the host planet magnetospheres.
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| 24. |
- Paillaud, E., et al.
(author)
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Multidisciplinary development of the Geriatric Core Dataset for clinical research in older patients with cancer: A French initiative with international survey
- 2018
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In: European Journal of Cancer. - : Elsevier BV. - 0959-8049. ; 103, s. 61-68
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Journal article (peer-reviewed)abstract
- Background: To define a core set of geriatric data to be methodically collected in clinical cancer trials of older adults, enabling comparison across trials. Patients and methods: Following a consensus approach, a panel of 14 geriatricians from oncology clinics identified seven domains of importance in geriatric assessment. Based on the international recommendations, geriatricians selected the mostly commonly used tools/items for geriatric assessment by domain (January-October 2015). The Geriatric Core Dataset (G-CODE) was progressively developed according to RAND appropriateness ratings and feedback during three successive Delphi rounds (July-September 2016). The face validity of the G-CODE was assessed with two large panels of health professionals (55 national and 42 international experts) involved both in clinical practice and cancer trials (March-September 2017). Results and discussion: After the last Delphi round, the tools/items proposed for the G-CODE were the following: (1) social assessment: living alone or support requested to stay at home; (2) functional autonomy: Activities of Daily Living (ADL) questionnaire and short instrumental ADL questionnaire; (3) mobility: Timed Up and Go test; (4) nutrition: weight loss during the past 6 months and body mass index; (5) cognition: Mini-Cog test; (6) mood: mini-Geriatric Depression Scale and (7) comorbidity: updated Charlson Comorbidity Index. More than 70% of national experts (42 from 20 cities) and international experts (31 from 13 countries) participated. National and international surveys showed good acceptability of the G-CODE. Specific points discussed included age-year cut-off, threshold of each tool/item and information about social support, but no additional item was proposed. Conclusion: We achieved formal consensus on a set of geriatric data to be collected in cancer trials of older patients. The dissemination and prospective use of the G-CODE is needed to assess its utility. (C) 2018 Elsevier Ltd. All rights reserved.
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