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1.
  • Andrén, Oliver C. J., et al. (author)
  • Therapeutic Nanocarriers via Cholesterol Directed Self-Assembly of Well-Defined Linear-Dendritic Polymeric Amphiphiles
  • 2017
  • In: Chemistry of Materials. - : American Chemical Society (ACS). - 0897-4756 .- 1520-5002. ; 29:9, s. 3891-3898
  • Journal article (peer-reviewed)abstract
    • A novel platform of fluorescently labeled nanocarriers (NCs) is herein proposed based on amphiphilic linear-dendritic polymeric hybrids. These sophisticated polymers were synthesized with a high degree of structural control at a macro-molecular level, displayed hydrophobic cholesterol compartments as chain-terminus groups of the dendritic block and hydrophilic bifunctional linear poly(ethylene glycol) (PEG) block. Spherical supramolecular assemblies with therapeutically relevant properties were successfully achieved including (i) sizes in the region of 100 to 200 nm; (ii) narrow dispersity profile with values close to 0.12; and (iii) self-assembly down to nanomolar concentrations. The modular nature of the NCs permitted the encapsulation of single or dual anticancer drugs and in parallel provide intracellular fluorescent traceability. As polymer therapeutics, the NCs were proven to penetrate the cancerous cell membranes and deliver the cargo of drugs into the nuclei as well as the cytoplasm and mitochondria. The dual drug delivery of both doxorubicin (DOX) and triptolide substantially enhanced the therapeutic efficacy with a 63% significant increase against resistant breast cancer cells when compared to free DOX.
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  • de Capretz, Pontus Olsson, et al. (author)
  • Machine learning for early prediction of acute myocardial infarction or death in acute chest pain patients using electrocardiogram and blood tests at presentation
  • 2023
  • In: BMC Medical Informatics and Decision Making. - London : BioMed Central (BMC). - 1472-6947. ; 23:1, s. 1-10
  • Journal article (peer-reviewed)abstract
    • Aims: In the present study, we aimed to evaluate the performance of machine learning (ML) models for identification of acute myocardial infarction (AMI) or death within 30 days among emergency department (ED) chest pain patients. Methods and results: Using data from 9519 consecutive ED chest pain patients, we created ML models based on logistic regression or artificial neural networks. Model inputs included sex, age, ECG and the first blood tests at patient presentation: High sensitivity TnT (hs-cTnT), glucose, creatinine, and hemoglobin. For a safe rule-out, the models were adapted to achieve a sensitivity > 99% and a negative predictive value (NPV) > 99.5% for 30-day AMI/death. For rule-in, we set the models to achieve a specificity > 90% and a positive predictive value (PPV) of > 70%. The models were also compared with the 0 h arm of the European Society of Cardiology algorithm (ESC 0 h); An initial hs-cTnT < 5 ng/L for rule-out and ≥ 52 ng/L for rule-in. A convolutional neural network was the best model and identified 55% of the patients for rule-out and 5.3% for rule-in, while maintaining the required sensitivity, specificity, NPV and PPV levels. ESC 0 h failed to reach these performance levels. Discussion: An ML model based on age, sex, ECG and blood tests at ED arrival can identify six out of ten chest pain patients for safe early rule-out or rule-in with no need for serial blood tests. Future studies should attempt to improve these ML models further, e.g. by including additional input data. © 2023, The Author(s).
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4.
  • Delisle Nyström, Christine, et al. (author)
  • The paediatric option for BodPod to assess body composition in preschool children: what fat-free mass density values should be used?
  • 2018
  • In: British Journal of Nutrition. - : CAMBRIDGE UNIV PRESS. - 0007-1145 .- 1475-2662. ; 120:7, s. 797-802
  • Journal article (peer-reviewed)abstract
    • Air displacement plethysmography utilises a two-component model to assess body composition, which relies on assumptions regarding the density of fat-free mass (FFM). To date, there is no evidence as to whether Lohmans or Wells et al.s FFM density values are more accurate in young children. Therefore, the aims of this study were to compare total body fat percentage (TBF%) assessed using the BodPod with both Lohmans and Wells et al.s FFM density values with TBF% from the three-component (3C) model in forty healthy Swedish children aged 5.5 years. Average TBF% calculated using Lohmans FFM density values underestimated TBF% in comparison with the corresponding value assessed using the 3C model (22.2 (SD 5.7) and 25.1 (SD 5.5)%, respectively; P amp;lt;0.001). No statistically significant difference was observed between TBF% assessed using Wells et al.s FFM density values and the 3C model (24.9 (so 5.5) and 251 (so 5.5)%, respectively; P= 0.614). The Bland and Altman plots for TBF% using both Lohmans and Wells et al.s FFM density values did not show any bias across the range of body fatness (Lohman: r0.056, P= 0.733 and Wells el al.: r-0.006, P= 0.970). These results indicate that Wells Cl al.s FFM density values should be used when assessing body composition with the paediatric option for BodPod in 5-year-old children. However, future studies are needed to confirm these results in other populations, including a wider age range of children.
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  • Ek, Anna, et al. (author)
  • Effectiveness of a 3-Month Mobile Phone-Based Behavior Change Program on Active Transportation and Physical Activity in Adults : Randomized Controlled Trial.
  • 2020
  • In: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 8:6, s. 1-15
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking.OBJECTIVE: The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA).METHODS: For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months.RESULTS: No effect on MVPA was observed after 3 months (P=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; P=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day.CONCLUSIONS: No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA.TRIAL REGISTRATION: ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-018-5658-4.
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6.
  • Ekelund, Ulf, et al. (author)
  • The skåne emergency medicine (SEM) cohort
  • 2024
  • In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - London : BioMed Central (BMC). - 1757-7241. ; 32, s. 1-8
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: In the European Union alone, more than 100 million people present to the emergency department (ED) each year, and this has increased steadily year-on-year by 2-3%. Better patient management decisions have the potential to reduce ED crowding, the number of diagnostic tests, the use of inpatient beds, and healthcare costs.METHODS: We have established the Skåne Emergency Medicine (SEM) cohort for developing clinical decision support systems (CDSS) based on artificial intelligence or machine learning as well as traditional statistical methods. The SEM cohort consists of 325 539 unselected unique patients with 630 275 visits from January 1st, 2017 to December 31st, 2018 at eight EDs in the region Skåne in southern Sweden. Data on sociodemographics, previous diseases and current medication are available for each ED patient visit, as well as their chief complaint, test results, disposition and the outcome in the form of subsequent diagnoses, treatments, healthcare costs and mortality within a follow-up period of at least 30 days, and up to 3 years.DISCUSSION: The SEM cohort provides a platform for CDSS research, and we welcome collaboration. In addition, SEM's large amount of real-world patient data with almost complete short-term follow-up will allow research in epidemiology, patient management, diagnostics, prognostics, ED crowding, resource allocation, and social medicine.
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  • Henriksson, Hanna, et al. (author)
  • Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers
  • 2017
  • In: Medicine & Science in Sports & Exercise. - : LIPPINCOTT WILLIAMS & WILKINS. - 0195-9131 .- 1530-0315. ; 49:10, s. 2078-2085
  • Journal article (peer-reviewed)abstract
    • Purpose: This study aimed to investigate longitudinal associations of objectively measured physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness at a 12-month follow-up in healthy Swedish 4-yr-old children. Methods: The data from the population-based MINISTOP trial were collected between 2014 and 2016, and this study included the 138 children who were in the control group. PA and SB were assessed using the wrist-worn ActiGraph (wGT3x-BT) accelerometer during seven 24-h periods and, subsequently, defined as SB, light-intensity PA, moderate-intensity PA, vigorous-intensity PA (VPA), and moderate-to-vigorous PA (MVPA). Body composition was measured using air-displacement plethysmography and physical fitness (cardiorespiratory fitness, lower and upper muscular strength as well as motor fitness) by the PREFIT fitness battery. Linear regression and isotemporal substitution models were applied. Results: Greater VPA and MVPA at the age of 4.5 yr were associated with higher fat-free mass index (FFMI) at 5.5 yr (P amp;lt; 0.001 and P = 0.044, respectively). Furthermore, greater VPA and MVPA at the age of 4.5 yr were associated with higher scores for cardiorespiratory fitness, lower body muscular strength, and motor fitness at 12-month follow-up (P = 0.001 to P = 0.031). Substituting 5 min.d(-1) of SB, light-intensity PA, or moderate-intensity PA for VPA at the age of 4.5 yr were associated with higher FFMI, and with greater upper and lower muscular strength at 12-month follow-up (P amp;lt; 0.001 to P = 0.046). Conclusion: Higher VPA and MVPA at the age of 4.5 yr were significantly associated with higher FFMI and better physical fitness at 12-month follow-up. Our results indicate that promoting high-intensity PA at young ages may have long-term beneficial effects on childhood body composition and physical fitness, in particular muscular strength.
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  • Henriksson, Pontus, et al. (author)
  • Body composition, physical fitness and cardiovascular risk factors in 9-year-old children
  • 2022
  • In: Scientific Reports. - : Nature Portfolio. - 2045-2322. ; 12:1
  • Journal article (peer-reviewed)abstract
    • The independent associations of body composition and physical fitness components with cardiovascular disease (CVD) risk factors in childhood are not fully understood. Thus, this cross-sectional study examined the independent associations of body composition and physical fitness with CVD risk factors in Swedish 9-year-old children (n = 411). Unadjusted linear regression analyses showed that body mass index (BMI), % fat mass and fat mass index were all positively associated with systolic and diastolic blood pressure, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Metabolic Syndrome (MetS) score (all β ≥ 0.229, P ≤ 0.001). These associations were virtually unaffected by adjustments for basic covariates (child’s age and sex, maternal educational level and maternal BMI), fat-free mass and physical fitness. Fat-free mass index had generally weak associations with CVD risk factors and no associations were statistically significant after adjustments (all P > 0.27). Greater cardiorespiratory fitness and motor fitness were associated with lower HOMA-IR and MetS score in unadjusted models (all β ≤ − 0.158, P ≤ 0.039) but not after adjustments for basic covariates and body composition. These findings indicate that cardiovascular health promotion in childhood may focus on the maintenance of a healthy fat mass. 
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  • Hidalgo Migueles, Jairo Hidalgo, et al. (author)
  • Revisiting the cross-sectional and prospective association of physical activity with body composition and physical fitness in preschoolers : A compositional data approach
  • 2022
  • In: Pediatric Obesity. - : Wiley. - 2047-6302 .- 2047-6310. ; 17:8
  • Journal article (peer-reviewed)abstract
    • Background Information is limited for the benefits of physical activity (PA) in preschoolers. Previous research using accelerometer-assessed PA may be affected for multicollinearity issues. Objectives This study investigated the cross-sectional and prospective associations of sedentary behaviour (SB) and PA with body composition and physical fitness using compositional data analysis. Methods Baseline PA and SB were collected in 4-year-old (n = 315) using wrist-worn GT3X+ during seven 24 h-periods. Body composition (air-displacement plethysmography) and physical fitness (PREFIT test battery) were assessed at baseline and at the 12-month follow-up. Results Increasing vigorous PA at expenses of lower-intensity behaviours for 4-year-old was associated with body composition and physical fitness at cross-sectional and longitudinal levels. For example, reallocating 15 min/day from lower intensities to vigorous PA at baseline was associated with higher fat-free mass index (+0.45 kg/m(2), 95% confidence intervals [CI]: 0.18-0.72 kg/m(2)), higher upper-body strength (+0.6 kg, 95% CI: 0.1-1.19 kg), higher lower-body strength (+8 cm, 95% CI: 3-13 cm), and shorter time in completing the motor fitness test (-0.4 s, 95% CI: -0.82 to [-0.01] s) at the 12-month follow-up. Pairwise reallocations of time indicated that the behaviour replaced was not relevant, as long as vigorous PA was increased. Conclusions More time in vigorous PA may imply short- and long-term benefits on body composition and physical fitness in preschoolers. These findings using compositional data analysis corroborate our previously published results using isotemporal substitution models.
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  • Leppänen, M. H., et al. (author)
  • Physical activity intensity, sedentary behavior, body composition and physical fitness in 4-year-old children: results from the ministop trial
  • 2016
  • In: International Journal of Obesity. - : NATURE PUBLISHING GROUP. - 0307-0565 .- 1476-5497. ; 40:7, s. 1126-1133
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Existing knowledge on associations of physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness in preschoolers is limited. OBJECTIVE: To examine associations of PA and SB with body composition and physical fitness in healthy Swedish 4-year-old children. METHODS: We utilized baseline data collected in 2014 for the population-based MINISTOP trial (n = 307). Light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA), moderate-to-vigorous PA (MVPA) and SB were measured using accelerometry (ActiGraph-wGT3x-BT). Body composition was measured using air-displacement plethysmography, and physical fitness (that is, cardiorespiratory fitness, lower and upper body muscular strength and motor fitness) was measured using the PREFIT fitness test battery. Multiple linear regression models adjusted for relevant confounders, and in addition, isotemporal substitution models were applied. RESULTS: Greater MVPA was associated with lower fat mass percent (%FM, P = 0.015), and greater VPA and MVPA were associated with higher fat-free mass index (FFMI, P = 0.002 and P = 0.011). In addition, greater VPA and MVPA were associated with higher scores for all physical fitness tests (P = 0.042 to Pamp;lt;0.001). The results for MVPA were primarily due to VPA. SB was associated with weaker handgrip strength (P = 0.031) when PA was not adjusted, but after adjusting also for VPA, the significant association disappeared (P = 0.25). Substituting 5 min per day of SB, LPA or MPA with 5 min per day of VPA was associated with higher FFMI and better scores for cardiorespiratory fitness and motor fitness. Correspondingly, substituting 5 min per day of VPA with SB or LPA was associated with weaker performance for lower muscular strength. CONCLUSIONS: Time spent on VPA was associated with higher FFMI and better physical fitness. The results suggest that promoting VPA may be important to improve childhood body composition and physical fitness already at an early age.
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  • Lundberg, Pontus, et al. (author)
  • pH-triggered self-assembly of biocompatible histamine-functionalized triblock copolymers
  • 2013
  • In: Soft Matter. - : Royal Society of Chemistry (RSC). - 1744-683X .- 1744-6848. ; 9:1, s. 82-89
  • Journal article (peer-reviewed)abstract
    • Histamine functionalized poly(allyl glycidyl ether)-b-poly(ethylene glycol)-b-poly(allyl glycidyl ether) (PAGE-PEO-PAGE) triblock copolymers represent a new class of physically cross-linked, pH-responsive hydrogels with significant potential for biomedical applications. These telechelic triblock copolymers exhibited abrupt and reversible hydrogelation above pH 7.0 due to a hydrophilic/hydrophobic transition of the histamine units to form a network of hydrophobic domains bridged by a hydrophilic PEO matrix. These hydrophobic domains displayed improved ordering upon increasing pH and self-assembled into a body centered cubic lattice at pH 8.0, while at lower concentrations formed well-defined micelles. Significantly, all materials were found to be non-toxic when evaluated on three different cell lines and suggests a range of medical and biomedical applications.
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  • Lundberg, Pontus, et al. (author)
  • Poly(ethylene glycol)-Based Thiol-ene Hydrogel Coatings-Curing Chemistry, Aqueous Stability, and Potential Marine Antifouling Applications
  • 2010
  • In: ACS Applied Materials and Interfaces. - : American Chemical Society (ACS). - 1944-8244 .- 1944-8252. ; 2:3, s. 903-912
  • Journal article (peer-reviewed)abstract
    • Photocured thiol-ene hydrogel coatings based on poly(ethylene glycol) (PEG) were investigated for marine antifouling purposes. By varying the PEG length, vinylic end-group, and thiol cross-linker, a library of hydrogel coatings with different structural composition was efficiently accomplished, with or without ester linkages. The thiol-methacrylate and thiol-allyl systems were evaluated with respect to curing, degradation, as well as antifouling properties. Moth acrylate-based systems exhibited homopolymerization, whereas allyl-based systems reacted more selectively through thiol-ene couplings reaction. The ester-free hydrogels elucidated higher hydrolytic stability whereas longer PEG chains accelerated the degradation process. The antifouling properties were evaluated by protein adsorption With Bovine serum albumin (BSA) and bioassays with the marine bacteria, Cobetia marina, and the marine diatom, Amphora coffeaeformis; in all tests, longer PEG lengths improved the antifouling properties.
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  • Lång, Kristina, et al. (author)
  • Can horizontally oriented breast tomosynthesis image volumes or the use of a systematic search strategy improve interpretation? An eye tracking and free response human observer study
  • 2011
  • In: Proc. SPIE. - : SPIE. ; 7966:796606
  • Conference paper (peer-reviewed)abstract
    • Our aim was to evaluate if there is a benefit in diagnostic accuracy and efficiency of viewing breast tomosynthesis (BT) image volumes presented horizontally oriented, but also to evaluate the use of a systematic search strategy where the breast is divided, and analyzed consecutively, into two sections. These image presentations were compared to regular vertical image presentation. All methods were investigated using viewing procedures consisting of free scroll volume browsing, and a combination of initial cine loops at three different frame rates (9, 14, 25 fps) terminated upon request followed by free scroll volume browsing if needed. Fifty-five normal BT image volumes in MLO view were collected. In these, simulated lesions (20 masses and 20 clusters of microcalcifications) were randomly inserted, creating four unique image sets for each procedure. Four readers interpreted the cases in a random order. Their task was to locate the lesions, mark and assign a five level confidence scale. The diagnostic accuracy was analyzed using Jackknife Free Receiver Operating Characteristics (JAFROC). Time efficiency and visual search behavior were also investigated using eye tracking. Results indicate there was no statistically significant difference in JAFROC FOM between the different image presentations, although visual search was more time efficient when viewing horizontally oriented image volumes in medium cine loops.
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  • Lång, Kristina, et al. (author)
  • Optimizing viewing procedures of breast tomosynthesis image volumes using eye tracking combined with a free response human observer study
  • 2011
  • In: Medical Imaging 2011: Image Perception, Observer Performance, and Technology Assessment / SPIE Proceedings. - : SPIE. ; 7966:796602
  • Conference paper (peer-reviewed)abstract
    • The purpose of this study was to evaluate four different viewing procedures as part of improving viewing conditions of breast tomosynthesis (BT) image volumes. The procedures consisted of free scroll volume browsing, and a combination of initial cine loops at three different frame rates (9, 14 and 25 fps) terminated upon request followed by free scroll volume browsing. Fifty-five normal BT image volumes in MLO view were collected. In these, simulated lesions (20 masses and 20 clusters of microcalcifications) were randomly inserted, creating four unique image sets for each procedure. Four readers interpreted the cases in a random order. Their task was to locate a lesion, mark and assign a five level confidence scale. The diagnostic accuracy was analyzed using Jackknife Free Receiver Operating Characteristics (JAFROC). Time efficiency and visual search behavior were also investigated using eye tracking. The results indicate that there was no statistically significant difference in JAFROC FOM between the different viewing procedures, however the medium cine loop speed seemed to be the preferred viewing procedure in terms of total analyze time and dwell time.
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  • Mohanty, Soumitra, et al. (author)
  • Diabetes downregulates the antimicrobial peptide psoriasin and increases E. coli burden in the urinary bladder
  • 2022
  • In: Nature Communications. - : Springer Nature. - 2041-1723. ; 13
  • Journal article (peer-reviewed)abstract
    • Diabetes is known to increase susceptibility to infections, partly due to impaired granulocyte function and changes in the innate immunity. Here, we investigate the effect of diabetes, and high glucose on the expression of the antimicrobial peptide, psoriasin and the putative consequences for E. coli urinary tract infection. Blood, urine, and urine exfoliated cells from patients are studied. The influence of glucose and insulin is examined during hyperglycemic clamps in individuals with prediabetes and in euglycemic hyperinsulinemic clamped patients with type 1 diabetes. Important findings are confirmed in vivo in type 2 diabetic mice and verified in human uroepithelial cell lines. High glucose concentrations induce lower psoriasin levels and impair epithelial barrier function together with altering cell membrane proteins and cytoskeletal elements, resulting in increasing bacterial burden. Estradiol treatment restores the cellular function with increasing psoriasin and bacterial killing in uroepithelial cells, confirming its importance during urinary tract infection in hyperglycemia. In conclusion, our findings present the effects and underlying mechanisms of high glucose compromising innate immunity. Patients with diabetes have an increased susceptibility to infections. Here the authors show that high glucose impairs innate immunity through reduced levels of the antimicrobial peptide psoriasin and impaired epithelial barrier function, resulting in an increased risk of urinary tract infection.
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  • Nedelcu, Robert, et al. (author)
  • Accuracy and precision of 3 intraoral scanners and accuracy of conventional impressions : A novel in vivo analysis method
  • 2018
  • In: Journal of Dentistry. - : ELSEVIER SCI LTD. - 0300-5712 .- 1879-176X. ; 69, s. 110-118
  • Journal article (peer-reviewed)abstract
    • Objective: To evaluate a novel methodology using industrial scanners as a reference, and assess in vivo accuracy of 3 intraoral scanners (IOS) and conventional impressions. Further, to evaluate IOS precision in vivo.Methods: Four reference-bodies were bonded to the buccal surfaces of upper premolars and incisors in five subjects. After three reference-scans, ATOS Core 80 (ATOS), subjects were scanned three times with three IOS systems: 3M True Definition (3M), CEREC Omnicam (OMNI) and Trios 3 (TRIOS). One conventional impression (IMPR) was taken, 3M Impregum Penta Soft, and poured models were digitized with laboratory scanner 3shape D1000 (D1000). Best-fit alignment of reference-bodies and 3D Compare Analysis was performed. Precision of ATOS and D1000 was assessed for quantitative evaluation and comparison. Accuracy of IOS and IMPR were analyzed using ATOS as reference. Precision of IOS was evaluated through intra-system comparison.Results: Precision of ATOS reference scanner (mean 0.6 mu m) and D1000 (mean 0.5 mu m) was high. Pairwise multiple comparisons of reference-bodies located in different tooth positions displayed a statistically significant difference of accuracy between two scanner-groups: 3M and TRIOS, over OMNI (p value range 0.0001 to 0.0006). IMPR did not show any statistically significant difference to IOS. However, deviations of IOS and IMPR were within a similar magnitude. No statistical difference was found for IOS precision.Conclusion: The methodology can be used for assessing accuracy of IOS and IMPR in vivo in up to five units bilaterally from midline. 3M and TRIOS had a higher accuracy than OMNI. IMPR overlapped both groups. Clinical significance: Intraoral scanners can be used as a replacement for conventional impressions when restoring up to ten units without extended edentulous spans.
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  • Nedelcu, Robert, et al. (author)
  • In vivo trueness and precision of full-arch implant scans using intraoral scanners with three different acquisition protocols
  • 2023
  • In: Journal of Dentistry. - : Elsevier. - 0300-5712 .- 1879-176X. ; 128, s. 104308-104308
  • Journal article (peer-reviewed)abstract
    • Objectives: To evaluate an in situ reference acquisition method for implant positions in complete edentulous maxillae using an industrial scanner and allowing for in vivo trueness analysis of the restorative workflow. To assess in vivo trueness and precision of intraoral scanners (IOS) using different acquisition protocols. Furthermore, to compare IOS trueness with impression-based models and implant-supported fixed dentures (IFD) in a parallel study on the same cohort using the same in situ reference scan.Methods: Six scan-bodies mounted to maxillary implants in five subjects were reference scanned (REF) using an industrial scanner. Subjects were scanned with IOS three times using three different protocols: control (CT), dental floss assisted (DF), and acrylic splint (SP). CAD-files of scan-bodies with inter-aligned analogues were geometry-aligned to REF, and SP. Scan-bodies were aligned to CT and DF in proprietary dental laboratory software and exported with analogue positions. Resulting six CAD-analogues per scan were Globally Aligned using a consistent geometry-based alignment. Deviations were computed after a Reference Point System Alignment at the implant/prosthetic platform for Cartesian axes with a linear Resultant.Results: Resultant trueness was CT: 41±11 μm, DF: 49±22 μm, SP: 55±8 μm. Resultant precision was CT: 48±7μm, DF: 50±7 μm, SP: 45±6 μmConclusions: This method is applicable for assessing trueness of maxillary full-arch implant scans in vivo. The CTprotocol was most accurate. CT trueness showed no difference to digitised impression-based models in parallelstudy. CT was more accurate than IFD in a parallel study. CT displayed similar numerical trueness as existing invitro studies.Critical significance: Using IOS to acquire full-arch implant scans is controversial. The modified protocol in thispilot shows promising results in the maxilla where great care was taken to manage non-attached tissues when amodified scanning pattern was used. However, other IOS may show varying results in vivo. A completed scan doesnot necessarily equate to an accurate scan.
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  • Nedelcu, Robert, et al. (author)
  • In vivo trueness of full-arch implant-supported CAD/CAM restorations and models based on conventional impressions
  • 2023
  • In: Journal of Dentistry. - : Elsevier. - 0300-5712 .- 1879-176X. ; 128, s. 104381-104381
  • Journal article (peer-reviewed)abstract
    • Objectives: To evaluate a method for in situ reference acquisition of implant positions in complete edentulous maxillae using an industrial scanner. To assess in vivo trueness of full-arch implant-supported fixed dentures (IFD) and dental models based on conventional impressions.Methods: In five subjects, scan-bodies were mounted to six maxillary implants and scanned three times using an industrial scanner (REF). Original impression-based models used to manufacture existing IFDs, (MOD1), and models fabricated from new polyether impressions, (MOD2), were scanned three times with a laboratory scanner. Scan-bodies were aligned and exported with analogue positions corresponding to implant positions. Implant analogues were mounted onto existing IFDs and scanned three times (BRIDGE). CAD files of scan-bodies with inter-aligned CAD-analogues were geometry-aligned to REF. CAD-analogues were aligned to exported files of MOD1 and MOD2, and to BRIDGE. Resulting six CAD-analogues were Globally Aligned using a consistent geometry-based alignment. Deviations were computed after a Reference Point System Alignment at the implant/prosthetic platform for Cartesian axes and a linear Resultant.Results:REF precision was 9.3 ± 1 µm. In vivo trueness for Resultant was MOD1: 36±16 µm, MOD2: 28±7 µm and BRIDGE: 70±23 µm, where MOD1 and MOD2 were statistically significantly different from BRIDGE. In vitro manufacturing trueness of Resultant when MOD1 acted reference for BRIDGE was: 69 ± 22.Conclusions: This method can be applied for assessing in vivo trueness. CAD/CAM processed IFD showed deviations twice that of impression-based models, however, errors from impressions and subsequent model scans were not additive to the entire workflow.
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  • Nedelcu, Robert (author)
  • In Vivo Accuracy and Precision in Prosthodontics
  • 2020
  • Doctoral thesis (other academic/artistic)abstract
    • Background: There has been a dramatic increase in commercially available intraoral scanners (IOS) in the last decade, offering to replace indirect digitization of models (MOD) fabricated from impressions (IMPR). IOS has benefits of less patient discomfort and a faster workflow to fabricate fixed dental prosthesis (FDP), and implant-supported prostheses (IFD). However, in vivo evidence is lacking not only for IOS, but also for MOD, FDP and IFD fit.Aims: Paper I: to evaluate in vitro finish line distinction and accuracy in seven IOS and one MOD. To assess parameters of resolution, tessellation, topography, and color. Paper II: to evaluate a method of acquiring an in vivo reference measurement in dentate subjects and analyse accuracy and precision of IOS and MOD. Paper III: to evaluate an in vivo reference-measurement method in fully edentulous maxillae with full-arch implant treatments and to analyse accuracy of MOD and fit of existing IFD. Paper IV: to analyse precision and accuracy of IOS using different acquisition protocols compared to the reference-measurement in Paper III.Material and Methods: Paper I: A model with a crown preparation was reference-scanned with an industrial scanner, (ATOS), scanned with seven IOS and the MOD of an IMPR was digitized. Best-fit Alignment and 3D Compare Analysis was followed by descriptive analysis. Paper II: A reference-scan was acquired with ATOS. Subjects were scanned with IOS and one MOD of an IMPR was digitized. Accuracy and precision were evaluated after Best-Fit Alignment and 3D Compare Analysis. Paper III: A reference-measurement of implant positions was acquired with ATOS. MOD from IMPR was digitized and IFD scanned. Datum and Relative Point System Alignment was followed by accuracy and precision analysis. Paper IV: Subjects in Paper III were scanned with IOS using three different protocols, followed by accuracy and precision analysis.Results: Paper I: There were considerable differences between IOS depiction of finish line and finish line accuracy. Paper II: IOS presented varying results for impressions in up to ten units. No differences were found for MOD. Paper III: IFD was significantly less accurate than MOD. Paper IV: Differences were found between scanning protocols. Compared to Paper III, IFD was less accurate. No differences were found for MOD.Conclusion: There are relevant differences between IOS when scanning subgingival preparations. Some IOS are better suited for long-span scans. Some IOS can be used for full-arch impressions for IFD in the maxilla, however, adequate soft-tissue management is crucial.  
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24.
  • Nordin, Erik, et al. (author)
  • Influence of ozone initiated processing on the toxicity of aerosol particles from small scale wood combustion
  • 2015
  • In: Atmospheric Environment. - : Elsevier BV. - 1352-2310 .- 1873-2844. ; 102, s. 282-289
  • Journal article (peer-reviewed)abstract
    • Black carbon containing emissions from biomass combustion are being transformed in the atmosphere upon processing induced by tropospheric ozone and UV. The knowledge today is very limited on how atmospheric processing affects the toxicological properties of the emissions. The aim of this study was to investigate the influence of ozone initiated (dark) atmospheric processing on the physicochemical and toxicological properties of particulate emissions from wood combustion. Emissions from a conventional wood stove operated at two combustion conditions (nominal and hot air starved) were diluted and transferred to a chamber. Particulate matter (PM) was collected before and after ozone addition to the chamber using an impactor. Detailed chemical and physical characterization was performed on chamber air and collected PM. The collected PM was investigated toxicologically in vitro with a mouse macrophage model, endpoints included: cell cycle analysis, viability, inflammation and genotoxicity. The results suggest that changes in the organic fraction, including polycyclic aromatic hydrocarbons (PAHs) are the main driver for differences in obtained toxicological effects. Fresh hot air starved emissions containing a higher organic and PAH mass-fraction affected cell viability stronger than fresh emissions from nominal combustion. The PAH mass fractions decreased upon aging due to chemical degradation. Dark aging increased genotoxicity, reduced viability and reduced release of inflammatory markers. These differences were statistically significant for single doses and typically less pronounced. We hypothesize that the alterations in toxicity upon simulated dark aging in the atmosphere may be caused by reaction products that form when PAHs and other organic compounds react with ozone and nitrate radicals. (C) 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).
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25.
  • Nysjö, Fredrik, 1985-, et al. (author)
  • Signed Distance Fields for Modeling Surgical Guides and Plates from CT Images
  • 2016
  • In: Proc, Swedish Symposium on Image Analysis.
  • Conference paper (other academic/artistic)abstract
    • User-friendly virtual surgery planning(VSP) systems for reconstructive surgery, such as cranio-maxillofacial (CMF) surgery, that can be used by the surgeons themselves without help of a technician have the potential to shorten the pre-operative planning from days to hours. An important part of such systems is the design of surgical guides and plates for osteosynthesis. We describe a method for generating surgical guide and plate models from computed tomography (CT) images, using signed distance fields and constructive solidgeometry (CSG). We implement the method as an extension to our Haptics-Assisted Surgery Plan-ning (HASP) system that enables a user to quickly design guide and plate models with stereo graphics and haptic feedback. We find that surgical guide and plate models can be efficiently generated from segmented CT images with our method. We also find that an anti-aliased distance transform can improve the accuracy and precision of the modelingin this application.
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26.
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27.
  • Nyström, Axel, et al. (author)
  • Prior electrocardiograms not useful for machine learning predictions of major adverse cardiac events in emergency department chest pain patients
  • 2024
  • In: Journal of Electrocardiology. - Philadelphia, PA : Elsevier. - 0022-0736 .- 1532-8430. ; 82, s. 42-51
  • Journal article (peer-reviewed)abstract
    • At the emergency department (ED), it is important to quickly and accurately determine which patients are likely to have a major adverse cardiac event (MACE). Machine learning (ML) models can be used to aid physicians in detecting MACE, and improving the performance of such models is an active area of research. In this study, we sought to determine if ML models can be improved by including a prior electrocardiogram (ECG) from each patient. To that end, we trained several models to predict MACE within 30 days, both with and without prior ECGs, using data collected from 19,499 consecutive patients with chest pain, from five EDs in southern Sweden, between the years 2017 and 2018. Our results indicate no improvement in AUC from prior ECGs. This was consistent across models, both with and without additional clinical input variables, for different patient subgroups, and for different subsets of the outcome. While contradicting current best practices for manual ECG analysis, the results are positive in the sense that ML models with fewer inputs are more easily and widely applicable in practice. © 2023 The Authors
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28.
  • Nyström, Christine Delisle, et al. (author)
  • A 12-month follow-up of a mobile-based (mHealth) obesity prevention intervention in pre-school children: the MINISTOP randomized controlled trial
  • 2018
  • In: BMC Public Health. - : BIOMED CENTRAL LTD. - 1471-2458. ; 18
  • Journal article (peer-reviewed)abstract
    • Background: To date, few mobile health (mHealth) interventions aimed at changing lifestyle behaviors have measured long term effectiveness. At the 6-month follow-up the MINISTOP trial found a statistically significant intervention effect for a composite score comprised of fat mass index (FMI) as well as dietary and physical activity variables; however, no intervention effect was observed for FMI. Therefore, the aim of this study was to investigate if the MINISTOP intervention 12-months after baseline measurements: (i) improved FMI and (ii) had a maintained effect on a composite score comprised of FMI and dietary and physical activity variables. Methods: A two-arm parallel randomized controlled trial was conducted in 315 healthy 4.5 year old children between January 2014 and October 2015. Parents of the participating children either received the MINISTOP intervention or a basic pamphlet on dietary and physical activity behaviors (control group). After 6 months, participants did not have access to the intervention content and were measured again 6 months later (i.e. the 12-month follow-up). The Wilcoxon rank-sum test was then used to examine differences between the groups. Results: At the 12-month follow-up, no statistically significant difference was observed between the intervention and control groups for FMI (p = 0.57) and no maintained effect for the change in composite score was observed (mean +/- standard deviation for the intervention and control group: + 0.53 +/- 1.49 units and + 0.35 +/- 1.27 units respectively, p = 0.25 between groups). Conclusions: The intervention effect observed at the 6-month follow-up on the composite score was not maintained at the 12-month follow-up, with no effect on FMI being observed at either follow-up. Future studies using mHealth are needed to investigate how changes in obesity related markers in young children can be maintained over longer time periods.
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29.
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30.
  • Nyström, Ingela, et al. (author)
  • Virtual Cranio-Maxillofacial Surgery Planning with Stereo Graphics and Haptics
  • 2016
  • In: Computer-Assisted Musculoskeletal Surgery. - Cham : Springer International Publishing. - 9783319129433 ; , s. 29-42
  • Book chapter (peer-reviewed)abstract
    • Computer-Assisted Surgery (CAS) is a new tool for performing complex procedures in a predictable and safe way. This book is designed to serve as a comprehensive review of Computer-Assisted Surgery, covering the current status of both research and applications.CAS includes Virtual Preoperative Planning (VPP) and Intraoperative Virtual Navigation (IVN), which are a set of technologies used to measure oncological margins in 3-Dimensions (3D), to locate small intraosseous tumors and apply controlled resections preserving anatomical structures. During VPP, patient acquired multimodal images are processed and an interactive virtual scenario is created. This can then be used as a  platform to  measure oncological distances and preplan osteotomies in safe areas. IVN is a procedure which allows the execution of the VPP with a mean error of less than 3mm.For the student, medical doctors, research and development scientists or new researchers, the protocols are central to the performance of Computer-Assisted technologies.  
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31.
  • Nyström, Tobias, et al. (author)
  • A constitutive endogenous osteopontin production is important for macrophage function and differentiation.
  • 2007
  • In: Experimental Cell Research. - : Elsevier BV. - 1090-2422 .- 0014-4827. ; 313:6, s. 1149-1160
  • Journal article (peer-reviewed)abstract
    • Macrophages are involved in the pathological process underlying atherosclerosis and constitutively express the multifunctional protein osteopontin which has important exogenous effects on these cells. However, the effect of the endogenous osteopontin expression on macrophage function has been sparsely studied. To shed light on the importance of the endogenous osteopontin expression, RAW 264.7 macrophage-like cells were silenced in osteopontin expression using RNAi. The cells were analysed for basic functions including attachment, migration, apoptosis and for the expression of macrophage differentiation markers and cytokines. The macrophages with silenced osteopontin expression showed impaired migration and an increased rate of serum starvation-induced apoptosis as compared to osteopontin-producing control cells. Furthermore, the cells with silence osteopontin expression had an altered phenotype with monocyte-like characteristics, including decreased expression of macrophage scavenger receptor A type 1. The altered phenotype of these cells could not be reversed by presence of extracellular osteopontin. In addition the cells with silenced osteopontin expression had a lower expression of IL-12 mRNA and the anti-apoptotic Flip mRNA. We conclude that a constitutive endogenous osteopontin production is important for proper basic functions of macrophages and our study indicates that the constitutive osteopontin production is involved in maintaining macrophages in a differentiated phenotype.
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32.
  • Nyström, Veronica, et al. (author)
  • Microsatellite genotyping reveals end-Pleistocene decline in mammoth autosomal genetic variation
  • 2012
  • In: Molecular Ecology. - 0962-1083 .- 1365-294X. ; 21:14, s. 3391-3402
  • Journal article (peer-reviewed)abstract
    • The last glaciation was a dynamic period with strong impact on the demography of many species and populations. In recent years, mitochondrial DNA sequences retrieved from radiocarbon-dated remains have provided novel insights into the history of Late Pleistocene populations. However, genotyping of loci from the nuclear genome may provide enhanced resolution of population-level changes. Here, we use four autosomal microsatellite DNA markers to investigate the demographic history of woolly mammoths (Mammuthus primigenius) in north-eastern Siberia from before 60 000 years ago up until the species final disappearance c. 4000 years ago. We identified two genetic groups, implying a marked temporal genetic differentiation between samples with radiocarbon ages older than 12 thousand radiocarbon years before present (ka) and those younger than 9 ka. Simulation-based analysis indicates that this dramatic change in genetic composition, which included a decrease in individual heterozygosity of approximately 30%, was due to a multifold reduction in effective population size. A corresponding reduction in genetic variation was also detected in the mitochondrial DNA, where about 65% of the diversity was lost. We observed no further loss in genetic variation during the Holocene, which suggests a rapid final extinction event.
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33.
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34.
  • Parekh, Niyati, et al. (author)
  • Associations of Parental Self-Efficacy With Diet, Physical Activity, Body Composition, and Cardiorespiratory Fitness in Swedish Preschoolers: Results From the MINISTOP Trial
  • 2018
  • In: Health Education & Behavior. - : SAGE PUBLICATIONS INC. - 1090-1981 .- 1552-6127. ; 45:2, s. 238-246
  • Journal article (peer-reviewed)abstract
    • Background. High parental self-efficacy (PSE) has been associated with healthy diets and higher levels of physical activity (PA) in children; however, data on PSE in relation to body weight and body composition are scarce. The objective of this study was to investigate associations of PSE with measures of diet, PA, body composition, and physical fitness in early childhood. Method. We used baseline data from the MINISTOP trial in healthy Swedish children (n = 301; 4.5 +/- 0.15 years). PSE was assessed using a questionnaire, dietary data were collected using a mobile technology-assisted methodology, and PA was obtained (sedentary behavior and moderate-to-vigorous) by accelerometry. Body composition was measured using the pediatric option for BodPod and cardiorespiratory fitness by the 20 m shuttle run. Linear regression was conducted to evaluate cross-sectional associations of the outcomes in relation to total PSE and scores computed for the individual PSE factors: (1) diet, (2) limit setting of unhealthful behaviors, and (3) PA. Results. Higher scores of total PSE and the diet factor were associated with higher fruit intake ( = 0.82 g/point and 1.99 g/point; p = .014 and .009, respectively) and lower consumption of unhealthy snacks ( = -0.42 g/point and -0.89 g/point; p = .012 and .020, respectively) after adjustment for parental body mass index and education, respondent, and childs sex and age. No associations were observed between PSE and PA, body composition, or cardiorespiratory fitness. Conclusions. Our study noted that PSE should be considered in conjunction with other strategies for a sustainable impact on childhood obesity.
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35.
  • Selegård, Robert, et al. (author)
  • Plantaricins markedly enhance the effects of traditional antibiotics against Staphylococcus epidermidis
  • 2019
  • In: Future Microbiology. - : Future Medicine. - 1746-0913 .- 1746-0921. ; 14:3, s. 195-206
  • Journal article (peer-reviewed)abstract
    • AIM: Bacteriocins are considered as promising alternatives to antibiotics against infections. In this study, the plantaricins (Pln) A, E, F, J and K were investigated for their antimicrobial activity against Staphylococcus epidermidis.MATERIALS & METHODS: The effects on membrane integrity were studied using liposomes and viable bacteria, respectively.RESULTS: We show that PlnEF and PlnJK caused rapid and significant lysis of S. epidermidis, and induced lysis of liposomes. The PlnEF and PlnJK displayed similar mechanisms by targeting and disrupting the bacterial cell membrane. Interestingly, Pln enhanced the effects of different antibiotics by 30- to 500-fold.CONCLUSION: This study shows that Pln in combination with low concentrations of antibiotics is efficient against S. epidermidis and may be developed as potential treatment of infections.
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36.
  • Timberg, Pontus, et al. (author)
  • Investigation of viewing procedures for interpretation of breast tomosynthesis image volumes: a detection-task study with eye tracking.
  • 2013
  • In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 23:4, s. 997-1005
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: To evaluate the efficiency of different methods of reading breast tomosynthesis (BT) image volumes. METHODS: All viewing procedures consisted of free scroll volume browsing and three were combined with initial cine loops at three different frame rates (9, 14 and 25 fps). The presentation modes consisted of vertically and horizontally orientated BT image volumes. Fifty-five normal BT image volumes in mediolateral oblique view were collected. In these, simulated lesions were inserted, creating four unique image sets, one for each viewing procedure. Four observers interpreted the cases in a free-response task. Time efficiency, visual attention and search were investigated using eye tracking. RESULTS: Horizontally orientated BT image volumes were read faster than vertically when using free scroll browsing only and when combined with fast cine loop. Cine loops at slow frame rates were ruled out as inefficient. CONCLUSIONS: In general, horizontally oriented BT image volumes were read more efficiently. All viewing procedures except for slow frame rates were promising when assuming equivalent detection performance. KEY POINTS : • Breast tomosynthesis is increasingly used for breast cancer detection • There is a benefit in reading breast tomosynthesis image volumes presented horizontally • Align image content to visual field, especially for dynamic 3D images • Reading at slow frame rates was considered inefficient.
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37.
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38.
  • Valachis, Antonis, 1984-, et al. (author)
  • Treatment patterns, risk for hospitalization and mortality in older patients with triple negative breast cancer
  • 2021
  • In: Journal of Geriatric Oncology. - : Elsevier. - 1879-4068 .- 1879-4076. ; 12:2, s. 212-218
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: To study the treatment patterns, potential risk factors for hospitalization within one year from diagnosis, and causes of death in older patients with triple negative breast cancer (TNBC).MATERIALS AND METHODS: We performed a registry-based cohort study using the BCBaSe database which links cases of breast cancer from three Swedish healthcare regions with socioeconomic factors, hospitalizations and causes of death. Women ≥70 years old with non-metastatic TNBC, between 1/12007 and 31/122012 were included (n = 413).RESULTS: In total, 168 patients (40.7%) received chemotherapy after surgery and 123 patients (30.0%) in the whole cohort had at least one hospitalization within one year from diagnosis. The risk of hospitalization overall was increased in the group receiving chemotherapy (Odds Ratio 2.35, 95% Confidence Intervall: 1.30-4.26) mainly due to toxicities. Cumulative incidence of breast cancer mortality was comparable among different age groups (70-74 vs. 75-79 vs. ≥ 80 years old) whereas non-breast cancer mortality was higher in patients ≥80 years old. Stage at diagnosis and comorbidities were independently associated with both breast cancer-specific- and overall mortality whereas age was only associated with overall mortality.CONCLUSIONS: The use of chemotherapy in older patients with TNBC was associated with age, tumor stage, and comorbidities. Chemotherapy use was also associated with increased risk for hospitalization within one year from diagnosis. Although the impact of chemotherapy on mortality was analyzed in a multivariate manner showing neither increased or decreased mortality, no firm conclusion can be drawn due to unmeasured confounders.
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39.
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40.
  • Wu, Zhihua, et al. (author)
  • Linear-Dendritic Polymeric Amphiphiles as Carriers of Doxorubicin-In Vitro Evaluation of Biocompatibility and Drug Delivery
  • 2012
  • In: Journal of Polymer Science Part A. - : Wiley-Blackwell. - 0887-624X .- 1099-0518. ; 50:2, s. 217-226
  • Journal article (peer-reviewed)abstract
    • In our recent work, we have explored the formation of chemotherapeutic delivery vehicles constructed from four different amphiphilic linear-dendritic hybrid block copolymers. These micelles were found to form about 100-nm-sized structures that were capable of sequestering doxorubicin at loading efficiencies up to 22%. Here, the cellular toxicity of these biocompatible and biodegradable linear-dendritic hybrid materials was evaluated on two breast cancer cell lines and primary human macrophages. The micelles were found not to affect the cellular viability at concentrations below 35 mu g mL(-1). After drug loading, these constructs could deliver an efficient dose of drugs, resulting in significant decreases in cell viability. Kinetic studies indicated that the drug formulation in the poly-mer micelles slowed down the cell uptake compared with the nonformulated drug, but similar efficacy in viability reduction and cell apoptosis were found. Taken together, these linear-dendritic hybrid materials represent an interesting novel architecture for the construction of drug delivery systems. (C) 2011 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 50: 217-226, 2012
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41.
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