| 1. |
- Brosché, Johan, 1978-, et al.
(author)
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Nio punkter för global fred (Nine Points for Global Peace)
- 2015
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Other publication (pop. science, debate, etc.)abstract
- Insatserna för global fred måste stärkas skriver tolv företrädare för institutionen för freds- och konfliktforskning apropå att världens ledare samlas i dag i New York för att anta 17 nya globala mål för en bättre värld och mer hållbar utveckling.
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| 2. |
- Svensson, Sara, 1981, et al.
(author)
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Monocytes and pyrophosphate promote mesenchymal stem cell viability and early osteogenic differentiation
- 2022
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In: Journal of Materials Science-Materials in Medicine. - : Springer Science and Business Media LLC. - 0957-4530 .- 1573-4838. ; 33:1
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Journal article (peer-reviewed)abstract
- Pyrophosphate-containing calcium phosphate implants promote osteoinduction and bone regeneration. The role of pyrophosphate for inflammatory cell-mesenchymal stem cell (MSC) cross-talk during osteogenesis is not known. In the present work, the effects of lipopolysaccharide (LPS) and pyrophosphate (PPi) on primary human monocytes and on osteogenic gene expression in human adipose-derived MSCs were evaluated in vitro, using conditioned media transfer as well as direct effect systems. Direct exposure to pyrophosphate increased nonadherent monocyte survival (by 120% without LPS and 235% with LPS) and MSC viability (LDH) (by 16-19% with and without LPS). Conditioned media from LPS-primed monocytes significantly upregulated osteogenic genes (ALP and RUNX2) and downregulated adipogenic (PPAR-gamma) and chondrogenic (SOX9) genes in recipient MSCs. Moreover, the inclusion of PPi (250 mu M) resulted in a 1.2- to 2-fold significant downregulation of SOX9 in the recipient MSCs, irrespective of LPS stimulation or culture media type. These results indicate that conditioned media from LPS-stimulated inflammatory monocytes potentiates the early MSCs commitment towards the osteogenic lineage and that direct pyrophosphate exposure to MSCs can promote their viability and reduce their chondrogenic gene expression. These results are the first to show that pyrophosphate can act as a survival factor for both human MSCs and primary monocytes and can influence the early MSC gene expression.
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| 3. |
- Abarenkov, Kessy, et al.
(author)
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Annotating public fungal ITS sequences from the built environment according to the MIxS-Built Environment standard – a report from a May 23-24, 2016 workshop (Gothenburg, Sweden)
- 2016
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In: MycoKeys. - : Pensoft Publishers. - 1314-4057 .- 1314-4049. ; 16, s. 1-15
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Journal article (peer-reviewed)abstract
- Recent molecular studies have identified substantial fungal diversity in indoor environments. Fungi and fungal particles have been linked to a range of potentially unwanted effects in the built environment, including asthma, decay of building materials, and food spoilage. The study of the built mycobiome is hampered by a number of constraints, one of which is the poor state of the metadata annotation of fungal DNA sequences from the built environment in public databases. In order to enable precise interrogation of such data – for example, “retrieve all fungal sequences recovered from bathrooms” – a workshop was organized at the University of Gothenburg (May 23-24, 2016) to annotate public fungal barcode (ITS) sequences according to the MIxS-Built Environment annotation standard (http://gensc.org/mixs/). The 36 participants assembled a total of 45,488 data points from the published literature, including the addition of 8,430 instances of countries of collection from a total of 83 countries, 5,801 instances of building types, and 3,876 instances of surface-air contaminants. The results were implemented in the UNITE database for molecular identification of fungi (http://unite.ut.ee) and were shared with other online resources. Data obtained from human/animal pathogenic fungi will furthermore be verified on culture based metadata for subsequent inclusion in the ISHAM-ITS database (http://its.mycologylab.org).
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| 4. |
- Asad, Danna, et al.
(author)
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A prospective multicenter study of visual response-evaluation by cystoscopy in patients undergoing neoadjuvant chemotherapy for muscle invasive urinary bladder cancer
- 2022
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In: Scandinavian journal of urology. - : Informa UK Limited. - 2168-1805 .- 2168-1813. ; 56:1, s. 20-26
-
Journal article (peer-reviewed)abstract
- Purpose To evaluate a method of transurethral visual response-staging in patients with urothelial muscle-invasive urinary bladder cancer (MIBC), undergoing neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Methods A prospective study at four Swedish cystectomy centers, cystoscopy was performed after final NAC-cycle for MIBC. Fifty-six participants underwent cystoscopy for visual staging of the tumor immediately pre-RC. Visual assessments were correlated to pathoanatomical outcomes post-RC. Results Seventeen tumors were classified as complete response (CR), i.e. pT0. Twenty-five patients had residual MIBC and 14 had non-muscle invasive residual tumors (NMIBC). Of the 39 patients with residual tumor, 25 were correctly identified visually (64%). Eleven patients were pN+. The diagnostic accuracy of cystoscopy to correctly identify complete response or remaining tumor was 70% (CI = 56-81%) with a sensitivity of 64% (CI = 47-79%), specificity 82% (CI = 57-96%), PPV 89% (CI = 74-96%) and NPV 50% (CI =38-61%). Twenty-eight cystoscopy evaluations showed signs of residual tumors and 3/28 (11%) were false positive. In 4/14 patients assessed having residual NMIBC the estimates were correct, 8/14 had histopathological MIBC and 2/14 had CR. In 11/14 patients (79%), the suggested visual assessment of MIBC was correct, 2/14 had NMIBC and 1/14 had CR. Twenty-eight cystoscopies had negative findings, 14 were false negatives (50%), when cystoscopy falsely predicted pT0. Among them there were eight patients with pTa, pT1 or pTis and six MIBC-tumors. In 17 patients with histopathological pT0, 14 were correctly identified with cystoscopy (82%). Conclusion Cystoscopy after the final NAC-cycle cannot robustly differentiate between NAC-responders and non-responders. Visually, negative MIBC-status cannot be determined safely.
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| 5. |
- Bjärstig, Therese, 1978-, et al.
(author)
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Grön översiktsplanering i fjäll- och fjällnära landskap : Deltagande planering för en innovativ och hållbar översiktsplan för Vilhelmina kommun
- 2018
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Reports (other academic/artistic)abstract
- Översiktsplaneringen i fjällkommunerna skulle kunna vara det självklara verktyget i arbetet med att uppnå miljökvalitetsmålet "Storslagen fjällmiljö". Kommunen har som lokal myndighet en central roll i hållbar utveckling och översiktsplaneringen ska, per definition, hantera markanvändningsfrågor i ett landskapsperspektiv. Detta sker dock inte i någon större utsträckning idag och därför finns ett stort behov av att utveckla bättre metoder och processer för att göra det kommunala planeringsverktyget mer nytänkande, kunskapsbaserat och förutseende.I Vilhelmina kommun har forskarna tillsammans med myndigheter, lokala aktörer och kommunmedborgare utvecklat metoder för att ta fram en grön översiktsplan. Översiktsplanen baseras på uthållig markanvändning och omfattar faktiska natur- och kulturvärden, såväl som nuvarande och framtida förutsättningar för strategisk planering för hur olika intressen kan samsas i fjällandskapet. I projektet analyseras möjligheter och hinder en process av detta slag möter, metoder för att uppnå ett ökat engagemang och en större lokal medverkan i planprocessen.Arbetet med den gröna översiktsplanen har resulterat i ett samrådsdokument som antagits av politikerna i Vilhelmina kommun. Rapporten redovisar en stegvis modell av planeringsprocessen som ska kunna ligga till grund för liknande processer även i andra fjällkommuner och/eller landsbygdskommuner med stora landskaps- och naturtillgångar. Exempel på lärdomar är att tidigt och kontinuerligt förankra det deltagande planeringsarbetet gentemot den lokala politiken och att deltagandeprocesser måste få ta tid.
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| 6. |
- Bjärstig, Therese, 1978-, et al.
(author)
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Implementing collaborative planning in the swedish mountains : The case of Vilhelmina
- 2018
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In: WIT Transactions on Ecology and the Environment. - Southampto : WIT Press. - 9781784662912 ; , s. 781-796, s. 781-795
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Conference paper (peer-reviewed)abstract
- Critical appraisals have stressed the need for participation and social learning in spatial planning, and planning is now seen as a process of innovative collaboration by multiple actors. During such ‘collaborative planning’, various parties try to develop new inclusive strategies through dialog. Collaborative planning is a major strand of current planning theory and highlights the need for new methods that involve citizen participation. In Sweden, the realization of collaborative planning in practice remains elusive, and research on the subject is limited, so further studies are needed. Thus, in the project “Green planning: Vilhelmina as a testbed for innovative land use planning in the mountain region”, we tested and implemented methods for involving citizens and other land-use stakeholders in the process of developing Vilhelmina municipality’s comprehensive plan (MCP). This paper presents lessons learned from that process and data obtained from a set of focus groups, a workshop, surveys, and personal communication. From these activities in the Swedish mountain region, we learned that collaborative practices have both pros and cons that must be addressed for practical realization of the widely embraced ideal of collaborative planning.
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| 7. |
- Bjärstig, Therese, Docent, 1978-, et al.
(author)
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Is large-scale wind power a problem, solution, or victim? A frame analysis of the debate in Swedish media
- 2022
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In: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 83
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Journal article (peer-reviewed)abstract
- Media content analysis was used with the aim of developing an understanding of how the debate on large-scale wind power has played out over time in Sweden, especially in relation to the enactment of national interest areas for wind power. Covering the period 1999 to 2019 and using NVivo for coding and analysis, we reviewed a total of 788 articles in both national and regional daily newspapers. To identify which actors are present in media and how they frame large-scale wind power, we conducted a frame analysis by applying three theoretical elements developed by previous media studies. The first is a diagnostic element used to pinpoint the cause to a problem, the second a prognostic element used to pinpoint the solution to a problem, and the third a motivating element used to identify the person(s) or object(s) suffering from the problem, that is, victim. Our results emphasize that wind power in recent years has been framed as a solution more often than a cause to a problem. One prevailing framing is the localization of large-scale wind power per se and conflicts with other land-uses and national interests. We also identify a tension between international and national policy objectives and local implementation of large-scale wind power. Governmental agencies are the most common framers over time, together with individuals (e.g. locals and second home owners) and wind entrepreneurs. Importantly, whereas politicians and wind entrepreneurs most often frame wind power as a solution, individuals frame it as a cause to a problem.
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| 8. |
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| 9. |
- Flach, Carl-Fredrik, 1977, et al.
(author)
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Does antifouling paint select for antibiotic resistance?
- 2017
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In: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 590, s. 461-468
-
Journal article (peer-reviewed)abstract
- There is concern that heavy metals and biocides contribute to the development of antibiotic resistance via co-selection. Most antifouling paints contain high amounts of such substances, which risks turning painted ship hulls into highly mobile refuges and breeding grounds for antibiotic-resistant bacteria. The objectives of this study were to start investigate if heavy-metal based antifouling paints can pose a risk for co-selection of antibiotic-resistant bacteria and, if so, identify the underlying genetic basis. Plastic panels with one side painted with copper and zinc-containing antifouling paint were submerged in a Swedish marina and biofilms from both sides of the panels were harvested after 2.5-4 weeks. DNA was isolated from the biofilms and subjected to metagenomic sequencing. Biofilm bacteria were cultured on marine agar supplemented with tetracycline, gentamicin, copper sulfate or zinc sulfate. Biofilm communities from painted surfaces displayed lower taxonomic diversity and enrichment of Gammaproteobacteria. Bacteria from these communities showed increased resistance to both heavy metals and tetracycline but not to gentamicin. Significantly higher abundance of metal and biocide resistance genes was observed, whereas mobile antibiotic resistance genes were not enriched in these communities. In contrast, we found an enrichment of chromosomal RND efflux system genes, including such with documented ability to confer decreased susceptibility to both antibiotics and biocides/heavy metals. This was paralleled by increased abundances of integron-associated integrase and ISCR transposase genes. The results show that the heavy metal-based antifouling paint exerts a strong selection pressure on marine bacterial communities and can co-select for certain antibiotic-resistant bacteria, likely by favoring species and strains carrying genes that provide cross-resistance. Although this does not indicate an immediate risk for promotion of mobile antibiotic resistance, the clear increase of genes involved in mobilizing DNA provides a foundation for increased opportunities for gene transfer in such communities, which might also involve yet unknown resistance mechanisms.
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| 10. |
- Jansson, Malin, 1978-, et al.
(author)
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Stromal type I collagen in breast cancer : correlation to prognostic biomarkers and prediction of chemotherapy response
- 2024
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In: Clinical Breast Cancer. - : Elsevier. - 1526-8209 .- 1938-0666.
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Journal article (peer-reviewed)abstract
- Introduction: Fibrillar collagens accumulate in the breast cancer stroma and appear as poorly defined spiculated masses in mammography imaging. The prognostic value of tissue type I collagen remains elusive in treatment-naïve and chemotherapy-treated breast cancer patients. Here, type I collagen mRNA and protein expression were analysed in 2 large independent breast cancer cohorts. Levels were related to clinicopathological parameters, prognostic biomarkers, and outcome.Method: COL1A1 mRNA expression was analysed in 2509 patients with breast cancer obtained from the cBioPortal database. Type I collagen protein expression was studied by immunohistochemistry in 1395 women diagnosed with early invasive breast cancer.Results: Low COL1A1 mRNA and protein levels correlated with poor prognosis features, such as hormone receptor negativity, high histological grade, triple-negative subtype, node positivity, and tumour size. In unadjusted analysis, high stromal type I collagen protein expression was associated with improved overall survival (OS) (HR = 0.78, 95% CI = 0.61-0.99, p = .043) and trended towards improved breast cancer–specific survival (BCSS) (HR = 0.65, 95% CI = 0.42-1.01, P = 0.053), although these findings were lost after adjustment for other clinical variables. In unadjusted analysis, high expression of type I collagen was associated with better OS (HR = 0.70, 95% CI = 0.55-0.90, P = .006) and BCSS (HR = 0.55, 95% CI = 0.34-0.88, P = .014) among patients not receiving chemotherapy. Strikingly, the opposite was observed among patients receiving chemotherapy. There, high expression of type I collagen was instead associated with worse OS (HR = 1.83, 95% CI = 0.65-5.14, P = .25) and BCSS (HR = 1.72, 95% CI = 0.54-5.50, P = .357).Conclusion: Low stromal type I collagen mRNA and protein expression are associated with unfavourable tumour characteristics in breast cancer. Stromal type I collagen might predict chemotherapy response.
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| 11. |
- Schulz Hägersten, Emma, et al.
(author)
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The risk of thromboembolism in patients with muscle invasive bladder cancer before and after cystectomy depending on blood group and neoadjuvant chemotherapy : a multicentre retrospective cohort study
- 2023
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In: Journal of Personalized Medicine. - : MDPI. - 2075-4426. ; 13:9
-
Journal article (peer-reviewed)abstract
- PURPOSE: Previous studies have indicated that patients with muscle-invasive bladder cancer with non-O blood types have an increased risk of experiencing thromboembolic events (TEEs). This is finding is in relation to neoadjuvant-chemotherapy (NAC)-naïve patients.AIM: to establish the risk of TEEs and any association with blood types among NAC patients as well as NAC-naïve patients.METHODS: Cystectomized patients at four centres treated from 2009 to 2018 (n = 244) were analysed. The quantities of patients corresponding to each blood group were as follows: A-108 (44%); O-99 (41%); B-30 (12%); and AB-7 (3%). NAC patients (n = 167) and NAC-naïve NAC-eligible patients (n = 77) were assessed. In total, 54 women (22%) and 190 men (78%), with a median age of 69 years, were included in the study. The occurrence of any type of TEE from six months pre-cystectomy to 12-24 months after was analysed using logistic regression adjusted for NAC and confounders.RESULTS: Sixty-six TEEs were detected in 21% of the patients (n = 52). Pulmonary embolus (n = 33) and deep venous thrombosis (n = 11) were the most common forms. No significant differences between blood types were found in the analysis, although B blood type had a nearly significant increased crude risk compared with O blood type, for which there was an OR of 2.48 (95% CI 0.98-6.36). Adjustment for NAC and covariates weakened the OR, which plummeted to 1.98 (95% CI 0.71-5.51).CONCLUSIONS: No significant associations were found between blood types and TEE occurrences in this cohort including both NAC and NAC-naïve NAC-eligible patients.
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| 12. |
- Svensson, Johan, et al.
(author)
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Landscape approaches to sustainability : aspects of conflict, integration and synergy in national public land-use interests
- 2020
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In: Sustainability. - : MDPI. - 2071-1050. ; 12:12
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Journal article (peer-reviewed)abstract
- Strong land-use pressure challenges sustainable development and calls for landscape approaches that balance economic, ecological, and socio-cultural aspects and interests. In the boreal, sub-alpine, and alpine regions in Sweden, encompassing 32 million ha, many and different land-use interests overlap, which causes risks for conflict, but potentially also suggests integration and synergy opportunities. Based on geographic information system (GIS) analyses of geographically delineated national interests regulated in the Swedish Environmental Code, including, amongst others, Natura 2000, contiguous mountains, recreation, reindeer husbandry, and wind power, and based on forestry as a dominating land use, we found extensive overlap among similar but also between dissimilar types of interest. In some mountain municipalities, our results show that the designated national interest area is four times as large as the available terrestrial area. Moreover, the overlap is much higher in the alpine than in the boreal biome, and there is increasing designation for nature conservation and a decreasing designation for national interests for culture, recreation, and tourism from south to north. We interpret the results with reference to multiple-use needs and opportunities for landscape approaches to sustainable planning. Departing from biodiversity conservation values, we also discuss opportunities to focus planning strategies on assessing synergy, integration, and conflict based on nature-based and place-based land-use characteristics.
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| 13. |
- Svensson, Johan, 1978-, et al.
(author)
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Rollspelsövningar för undervisning av matematiska modeller
- 2017
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In: Universitetspedagogiska konferensen 2017. - Umeå : Universitetspedagogik och lärandestöd (UPL), Umeå universitet. ; , s. 52-53
-
Conference paper (other academic/artistic)abstract
- Syftet med denna presentation är att redovisa och diskutera resultat från ett pågående PUNKTUM-projekt med syfte att utveckla och utvärdera rollspel som metod för undervisning i högre matematik och statistik.
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| 14. |
- Tenninge, S., et al.
(author)
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Control computerized tomography in neoadjuvant chemotherapy for muscle invasive urinary bladder cancer, has no value for treatment decisions and low correlation with nodal status
- 2021
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In: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 55:6, s. 455-460
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Control computerized tomography (cCT) is routinely used in many cystectomy centres before the final treatment cycle in patients with muscle-invasive urinary bladder cancer (MIBC) undergoing neoadjuvant chemotherapy (NAC). This is for evaluating response or nonresponse to NAC treatment. In a real-world retrospective cohort, we intended to evaluate the frequency of changed individual treatment strategies following cCT and to investigate any discrepancies between cCT-results on nodal staging and final pN-stages.METHODS: We performed a retrospective data-based, multicenter study of 242 MIBC-patients, staged cT2N0M0-cT4aN0M0, having undergone NAC and radical cystectomy (RC) between 2008 and 2019 at four Swedish cystectomy centres. Statistical analysis was performed using IBM SPSS statistics 26.RESULTS: Overall, 139/242 patients were examined with cCT. Six patients were staged as progressive at cCT and 5/139 (3.6%) underwent a change of previously planned treatment strategy. 2/6 patients with suspected progression (33%) did not change strategy and underwent all preplanned NAC-cycles plus RC. Only 1/6 patients assigned as progressive at the cCT, showed progression in the postoperative pathology specimen. In total 133/139 patients were considered being without progress on cCT, yet 28/133 (21%) presented with nodal progression at postoperative pathology examinations. Only 1/29 patients with histopathologically verified nodal dissemination were detected with cCT, thus 28/29 (96.6%) with pN + were undetected. The sensitivity for cCT to predict pTNM was 17% CI [0%-64%] and the specificity was 78% CI [71%-86%].CONCLUSIONS: CCT prior to the final treatment cycle of NAC in MIBC, leads to a low percentage of treatment strategy changes and cCT cannot accurately predict pN-status.
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| 15. |
- Thellbro, Camilla, et al.
(author)
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Readiness and planning for more wind power : municipalities as key actors implementing national strategies
- 2022
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In: Cleaner energy systems. - : Elsevier. - 2772-7831. ; 3
-
Journal article (peer-reviewed)abstract
- In the global context of rapidly developing wind-power technology, local governments have to balance local interests with larger scale targets when implementing national and international strategies. An implication of a new Swedish national strategy for wind-power development is considerable intrusion into natural resource-rich northern landscapes, where municipalities already strive to manage diverse surface demanding and legally valued land-use interests. Municipalities will thus play a key role in wind-power development. Results of our survey suggest that most municipalities have functioning wind-power plans, linked to their municipal comprehensive planning (MCP). However, so far, relatively few wind-power farms have been established, and municipalities have rarely used their right to veto, suggesting that most have not yet experienced significant problems linked to wind-power development. The municipalities rely on their right to veto, and only a third highlighted planning as a tool for handling the increasing demand for wind-power developments. Legislative changes regarding the right to veto and the status of MCP could affect local self-government considerably. Wind-power development could have major consequences for local landscapes and governments, and a municipal-wide policy regarding future wind-power development and MCP as a mediating tool must be secured to balance local interests with national ambitions.
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| 16. |
- Zachrisson, Anna, Docent, 1978-, et al.
(author)
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Participatory comprehensive planning to handle competing land-use priorities in the sparsely populated rural context
- 2021
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In: Journal of Rural Studies. - : Elsevier. - 0743-0167 .- 1873-1392. ; 88, s. 1-13
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Journal article (peer-reviewed)abstract
- Rural areas supply the planet's natural resources while simultaneously harbor refuges for most of the world's remaining biodiversity and intact, resilient ecosystems. Since traditional extractive activities must increasingly co-exist with non-exploitative activities such as tourism and conservation, sustainable land use planning is essential for managing trade-offs between incompatible interests in rural areas. With "communicative planning" being promoted since decades, participation is considered crucial for reconciling different planning interests. However, the implementation of participation remains patchy and uneven, not least in sparsely populated regions with low capacity where participation could be a game-changer. Here, we consider municipal comprehensive planning as an existing arena to explore participatory planning approaches potentially capable of simultaneously managing competing land uses and promoting sustainable development in sparsely populated rural contexts. Collaborative work between researchers and public managers resulted in the co-development of an approach based on qualitative village- and interest-based focus groups that facilitated the formulation, negotiation, and legitimization of concrete and detailed local guidelines that prioritize between different land uses. Consequently, the resulting comprehensive plan draft was more readily adopted than the output of a traditional planning process. We found that citizens in sparsely populated municipalities seem willing to actively contribute to rural development processes if they have significant influence.
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| 17. |
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| 18. |
- Almgren, Torgny, 1962, et al.
(author)
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Optimization of opportunistic replacement activities: A case study in the aircraft industry
- 2007
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Other publication (other academic/artistic)abstract
- In the aircraft industry maximizing availability is essential. Maintenance schedules must therefore be opportunistic, incorporating preventive maintenance activities within the scheduled as well as the unplanned ones. At the same time, the maintenance contractor should utilize opportunistic maintenance to enable the minimization of the total expected cost to have a functional aircraft engine and thus to provide attractive service contracts. This paper provides an opportunistic maintenance optimization model which has been constructed and tested together with Volvo Aero Corporation in Trollhättan, Sweden for the maintenance of the RM12 engine. The model incorporates components with deterministic as well as with stochastic lives. The replacement model is shown to have favourable properties; in particular, when the maintenance occasions are fixed the remaining problem has the integrality property, the replacement polytope corresponding to the convex hull of feasible solutions is full-dimensional, and all the necessary constraints for its definition are facet-inducing. We present an empirical crack growth model that estimates the remaining life and also a case study that indicates that a non-stationary renewal process with Weibull distributed lives is a good model for the recurring maintenance occasions. Using one point of support for the distribution yields a deterministic replacement model; it is evaluated against classic maintenance policies from the literature through stochastic simulations. The deterministic model provides maintenance schedules over a finite time period that induce fewer maintenance occasions as well as fewer components replaced.
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| 19. |
- Andersson, Magnus N., et al.
(author)
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Prophylactic mastectomy – Correlation between skin flap thickness and residual glandular tissue evaluated postoperatively by imaging
- 2022
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In: Journal of Plastic, Reconstructive & Aesthetic Surgery. - : Elsevier. - 1748-6815 .- 1878-0539. ; 75:6, s. 1813-1819
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Journal article (peer-reviewed)abstract
- Background: Women with an increased hereditary risk of breast cancer can undergo risk-reducing prophylactic mastectomy. However, there is a balance between how much subcutaneous tissue should be resected to achieve maximal reduction of glandular tissue, while leaving viable skin flaps.Methods: Forty-five women previously operated with prophylactic mastectomy underwent magnetic resonance tomography (MRT) and ultrasound (US) to investigate the correlation between skin flap thickness and residual glandular tissue. Residual glandular tissue was documented as being present or not present, but not quantified, as the amount of residual glandular tissue in many cases was considered too small to make reliable volume quantifications with available tools. Since a mastectomy skin flap thickness of 5 mm is discussed as an oncologically safe thickness in the literature, this was used as a cut-off.Results: Following prophylactic mastectomy, residual glandular tissue was detected in 39.3% of all breasts and 27.9% of all the breast quadrants examined by MRT, and 44.1% of all breasts and 21.7% of all the breast quadrants examined by US. Residual glandular tissue was detected in 6.9% of the quadrants in skin flaps ≤ 5 mm and in 37.5% of the quadrants in skin flaps > 5 mm (OR 3.07; CI = 1.41–6.67; p = 0.005). Furthermore, residual glandular tissue increased significantly already when the skin flap thickness exceeded 7 mm.Conclusions: This study highlights that complete removal of glandular breast tissue during a mastectomy is difficult and suggests that this is an unattainable goal. We demonstrate that residual glandular tissue is significantly higher in skin flaps > 5 mm in comparison to skin flaps ≤ 5 mm, and that residual glandular tissue increases significantly already when the flap thickness exceeds 7 mm.
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| 20. |
- Arnelo, Urban, et al.
(author)
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Intraoperative pancreatoscopy can improve the detection of skip lesions during surgery for intraductal papillary mucinous neoplasia : a pilot study
- 2023
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In: Pancreatology (Print). - : Elsevier. - 1424-3903 .- 1424-3911. ; 23:6, s. 704-711
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Journal article (peer-reviewed)abstract
- Objectives: Intraoperative pancreatoscopy is a promising procedure that might guide surgical resection for suspected main duct (MD) and mixed type (MT) intraductal papillary mucinous neoplasms (IPMNs). The aim of the present study was to assess the diagnostic yield and clinical impact of intraoperative pancreatoscopy in patients operated on for MD and MT-IPMNs.Methods: This is a retrospective cohort study. Patients undergoing surgery for suspected MD or MT-IPMN underwent intraoperative pancreatoscopy and frozen section analysis. In all patients who required extended resection due to pancreatoscopic findings, we compared the final histology with the results of the intraoperative frozen section analysis.Results: In total, 46 patients, 48% females, mean age (range) 67 years (45–82 years) underwent intraoperative pancreatoscopy. No mortality or procedure related complications were observed. Pancreatoscopy changed the operative course in 30 patients (65%), leading to extended resections in 20 patients (43%) and to parenchyma sparing procedures in 10 patients (22%). Analyzing the group of patients who underwent extended resections, 7 (35%) displayed lesions that needed further surgical treatment (six high grade dysplasia and one with G1 pancreatic neuroendocrine tumor) and among those 7, just 1 (14%) would have been detected exclusively with histological frozen section analysis of the transection margin. The combination of both pancreatoscopy and frozen section analysis lead to 86% sensitivity and 92% specificity for the detection of pathological tissue in the remnant pancreas.Conclusion: Intraoperative pancreatoscopy is a safe and feasible procedure and might allow the detection of skip lesions during surgery for suspect MD-involving IPMNs.
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| 21. |
- Back, Erik, et al.
(author)
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Mucosal blood flow in the remaining rectal stump is more affected by total than partial mesorectal excision in patients undergoing anterior resection : a key to understanding differing rates of anastomotic leakage?
- 2021
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In: Langenbeck's archives of surgery (Print). - : Springer. - 1435-2443 .- 1435-2451. ; 406:6, s. 1971-1977
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Journal article (peer-reviewed)abstract
- PURPOSE: Anterior resection is the procedure of choice for tumours in the mid and upper rectum. Depending on tumour height, a total mesorectal excision (TME) or partial mesorectal excision (PME) can be performed. Low anastomoses in particular have a high risk of developing anastomotic leakage, which might be explained by blood perfusion compromise. A pilot study indicated a worse blood flow in TME patients in an open setting. The aim of this study was to further evaluate perianastomotic blood perfusion changes in relation to TME and PME in a predominantly laparoscopic context.METHOD: In this prospective cohort study, laser Doppler flowmetry was used to evaluate the perianastomotic colonic and rectal perfusion before and after surgery. The two surgical techniques were compared in terms of mean differences of perfusion units using a repeated measures ANOVA design, which also enabled interaction analyses between type of mesorectal excision and location of measurement. Anastomotic leakage until 90 days after surgery was reported for descriptive purposes.RESULTS: Some 28 patients were available for analysis: 17 TME and 11 PME patients. TME patients had a reduced blood perfusion postoperatively compared to PME patients in the aboral posterior area (mean difference: -57 vs 18 perfusion units; p = 0.010). An interaction between mesorectal excision type and anterior/posterior location was detected at the aboral level (p = 0.007). Two patients developed a minor leakage, diagnosed after discharge.CONCLUSION: Patients operated on using TME have a decreased blood flow in the aboral posterior quadrant of the rectum postoperatively compared to patients operated on using PME. This might explain differing rates of anastomotic leakage.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02401100.
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| 22. |
- Bjärstig, Therese, 1978-, et al.
(author)
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Between protocol and reality : Swedish municipal comprehensive planning
- 2018
-
In: European Planning Studies. - : Informa UK Limited. - 0965-4313 .- 1469-5944. ; 26:1, s. 35-54
-
Journal article (peer-reviewed)abstract
- Spatial planning using a landscape approach has been recognized as being essential for reconciling ecological, cultural and socioeconomic dimensions in sustainable development (SuD). Although embraced as a concept, there is a lack of planning tools capable of incorporating multi-level, multifunctional and multi-sectoral perspectives, especially in a rural context. The departure point in this paper is the legal requirements for municipal comprehensive planning (MCP) in Sweden and an e-mail survey about incentives, stakeholder involvement, policy integration and implementation in MCP in all 15 Swedish mountain municipalities. The purpose of this explorative study is to examine whether MCP could be a tool in planning for SuD. Results indicate a general lack of resources and a low status of MCP that affect, and even limit, stakeholder involvement, policy integration and implementation. However, legal requirements for MCP are targeted at SuD, and municipal personnel responsible for planning appreciate the potential of MCP. Therefore, there is potential to develop the MCP into an effective landscape planning tool. To accomplish this, the status of an active planning process has to be raised, the mandate of the local planning agency has to be secured, and residents and land users have to be involved throughout the planning process.
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| 23. |
- Björkström, Niklas K, et al.
(author)
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Characterization of natural killer cell phenotype and function during recurrent human HSV-2 infection.
- 2011
-
In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 6:11
-
Journal article (peer-reviewed)abstract
- Human natural killer (NK) cell differentiation, characterized by a loss of NKG2A in parallel with the acquisition of NKG2C, KIRs, and CD57 is stimulated by a number of virus infections, including infection with human cytomegalovirus (CMV), hantavirus, chikungunya virus, and HIV-1. Here, we addressed if HSV-2 infection in a similar way drives NK cell differentiation towards an NKG2A(-)NKG2C(+)KIR(+)CD57(+) phenotype. In contrast to infection with CMV, hantavirus, chikungunya virus, and HIV-1, recurrent HSV-2 infection did not yield an accumulation of highly differentiated NK cells in human peripheral blood. This outcome indicates that human HSV-2 infection has no significant imprinting effect on the human NK cell repertoire.
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| 24. |
- Boström, Petrus, et al.
(author)
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Early postoperative pain as a marker of anastomotic leakage in colorectal cancer surgery
- 2021
-
In: International Journal of Colorectal Disease. - : Springer-Verlag New York. - 0179-1958 .- 1432-1262. ; 36:9, s. 1955-1963
-
Journal article (peer-reviewed)abstract
- Purpose: Even though anastomotic leakage after colorectal surgery is a major clinical problem in need of a timely diagnosis, early indicators of leakage have been insufficiently studied. We therefore conducted a population-based observational study to determine whether the patient’s early postoperative pain is an independent marker of anastomotic leakage.Methods: By combining the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry, we retrieved prospectively collected data on 3084 patients who underwent anastomotic colorectal surgery for cancer in 2014–2017. Postoperative pain, measured with the numerical rating scale (NRS), was considered exposure, while anastomotic leakage and reoperation due to leakage were outcomes. We performed logistic regression to evaluate associations, estimating odds ratios (ORs) and 95% confidence intervals (CIs), while multiple imputation was used to handle missing data.Results: In total, 189 patients suffered from anastomotic leakage, of whom 121 patients also needed a reoperation due to leakage. Moderate or severe postoperative pain (NRS 4–10) was associated with an increased risk of anastomotic leakage (OR 1.69, 95% CI 1.21–2.38), as well as reoperation (OR 2.17, 95% CI 1.41–3.32). Severe pain (NRS 8–10) was more strongly related to leakage (OR 2.38, 95% CI 1.44–3.93). These associations were confirmed in multivariable analyses and when reoperation due to leakage was used as an outcome.Conclusion: In this population-based retrospective study on prospectively collected data, increased pain in the post-anaesthesia care unit is an independent marker of anastomotic leakage, possibly indicating a need for further diagnostic measures.
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| 25. |
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| 26. |
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| 27. |
- Carlsson, Anna K, 1966, et al.
(author)
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Review of Child Car Occupant Fatalities in Sweden During Six Decades
- 2013
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In: Proceedings: IRCOBI Conference; September 11-13; Gothenburg, Sweden. ; , s. 1-14
-
Conference paper (peer-reviewed)abstract
- The development of fatal outcome was reviewed based on crash data including all fatally injured 0–14 year old car occupants in Sweden during 1956–2011 and put in relation to general improvements in vehicle and road safety and implementation of restraint systems.The review revealed a substantial decrease in crash‐related fatalities among 0–14 year old car occupants during the past three decades, representing a significant drop of 83% compared to the highest scores in the 1960s–70s. During 1992–2011, a total of 194 crash‐related fatalities were registered; the majority occurred on high‐speed roads. Head injury was a primary cause of death, in a total of 54% of all cases. Two fifths of the crashes involved a single car, while three fifths involved other vehicles. In total, 24% of the children were unrestrained, and 59% of those were ejected during crashes. Among the restrained children, 56% were considered to be appropriately restrained according to Swedish recommendations. Crash severity, complex crash situation, fire and drowning were factors that contributed to the fatal outcome, even though the restraint usage was considered to be optimal.
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| 28. |
- Carlsson, Julia, et al.
(author)
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Att planera för hela skogslandskapet : utmaningar och möjligheter
- 2016
-
Reports (pop. science, debate, etc.)abstract
- Skogens många värden behöver samplaneras och sättas i sitt sammanhang utifrån ett landskapsperspektiv. Vi intervjuade skogsägare och skogliga intressenter om hur de ser på skogens värden, äganderätten och skogspolitiska förutsättningar, samt synen på att samarbeta och ta hänsyn till varandras intressen. Vi utgår från behov identifierade i planeringsprocesser som inkluderar många deltagare och intressen, när det gäller att förbättrakommunikation, information och mötesplatser. Vi ser tre möjliga verktyg för att skapa förutsättningar för ett landskapsperspektiv i planeringen av skogens värden: en landskapslots, en samverkansarena, samt utformningen och användandet av skogsbruksplanen.
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| 29. |
- Carlsson, Julia, et al.
(author)
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Opportunites for Integrated Landscape Planning : the Broker, the Arena, the Tool
- 2017
-
In: Landscape Online. - 1865-1542. ; 55, s. 1-20
-
Journal article (peer-reviewed)abstract
- As an integrated social and ecological system, the forest landscape includes multiple values. The need for a landscape approach in land use planning is being increasingly advocated in research, policy and practice. This paper explores how institutional conditions in the forest policy and management sector can be developed to meet demands for a multifunctional landscape perspective. Departing from obstacles recognised in collaborative planning literature, we build an analytical framework which is operationalised in a Swedish context at municipal level. Our case illustrating this is Vilhelmina Model Forest, where actual barriers and opportunities for a multiple-value landscape approach are identified through 32 semi-structured interviews displaying stakeholders’ views on forest values, ownership rights and willingness to consider multiple values, forest policy and management premises, and collaboration. As an opportunity to overcome the barriers, we suggest and discuss three key components by which an integrated landscape planning approach could be realized in forest management planning: the need for a landscape coordinator (broker), the need for a collaborative forum (arena), and the development of the existing forest management plan into an advanced multifunctional landscape plan (tool).
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| 30. |
- Cheraghchi, M., et al.
(author)
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Approximating Linear Threshold Predicates
- 2010
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In: Lecture Notes in Computer Science. 13th International Workshop on Approximation Algorithms for Combinatorial Optimization Problems, APPROX 2010 and 14th International Workshop on Randomization and Computation, RANDOM 2010, Barcelona, 1-3 September 2010. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 0302-9743 .- 1611-3349. - 9783642153686 ; 6302, s. 110-123
-
Conference paper (peer-reviewed)abstract
- We study constraint satisfaction problems on the domain {-1,1}, where the given constraints are homogeneous linear threshold predicates. That is, predicates of the form sgn(w1 x1+⋯+wn x n ) for some positive integer weights w 1, ..., w n . Despite their simplicity, current techniques fall short of providing a classification of these predicates in terms of approximability. In fact, it is not easy to guess whether there exists a homogeneous linear threshold predicate that is approximation resistant or not. The focus of this paper is to identify and study the approximation curve of a class of threshold predicates that allow for non-trivial approximation. Arguably the simplest such predicate is the majority predicate sgn(x 1+⋯+xn ), for which we obtain an almost complete understanding of the asymptotic approximation curve, assuming the Unique Games Conjecture. Our techniques extend to a more general class of "majority-like" predicates and we obtain parallel results for them. In order to classify these predicates, we introduce the notion of Chow-robustness that might be of independent interest.
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| 31. |
- Cheraghchi, M., et al.
(author)
-
Approximating linear threshold predicates
- 2012
-
In: ACM Transactions on Computation Theory. - : Association for Computing Machinery (ACM). - 1942-3454 .- 1942-3462. ; 4:1
-
Journal article (peer-reviewed)abstract
- We study constraint satisfaction problems on the domain {-1, 1}, where the given constraints are homogeneous linear threshold predicates, that is, predicates of the form sgn(w 1 x 1 + · · · + w n x n ) for some positive integer weights w 1 , . . . , w n . Despite their simplicity, current techniques fall short of providing a classification of these predicates in terms of approximability. In fact, it is not easy to guess whether there exists a homogeneous linear threshold predicate that is approximation resistant or not. The focus of this article is to identify and study the approximation curve of a class of threshold predicates that allow for nontrivial approximation. Arguably the simplest such predicate is the majority predicate sgn(x 1 + · · · + x n ), for which we obtain an almost complete understanding of the asymptotic approximation curve, assuming the Unique Games Conjecture. Our techniques extend to a more general class of "majority-like" predicates and we obtain parallel results for them. In order to classify these predicates, we introduce the notion of Chow-robustness that might be of independent interest.
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| 32. |
- Deutschmann, Mats, 1964-, et al.
(author)
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"It ain't what you say. It's the way you say it" : adapting the matched guise technique (MGT) to raise awareness of accentedness stereotyping effects among Swedish pre-service teachers
- 2023
-
In: Language Awareness. - : Routledge. - 0965-8416 .- 1747-7565. ; 32:2, s. 255-277
-
Journal article (peer-reviewed)abstract
- The study describes a pedagogic adaptation of the matched guise technique with the aim to raise linguistic self-awareness of L2 accentedness stereotyping effects among Swedish pre-service teachers. In the experiment, 290 students attending teacher training programs were exposed to one of two matched guises, representing either L1 accented Swedish, or L2 accented Swedish. Both guises were based on the same recording, but the L2 accented version had been digitally manipulated using cut-and-paste techniques in order to replicate certain vowel sounds (the [u:]-sound in particular) associated with low-prestige Swedish L2 accentedness. The findings from this experiment were then used as starting point for language awareness raising activities. Our overall results show that the L2 accented manipulated recording was evaluated more favourably than the original L1 accented recording on all investigated variables. One proposed explanation is that respondents were inadvertently influenced by so-called shifting standards effects, i.e. lower standards/expectations are being used as reference points when evaluating the L2 accented recording. This tendency, however, seemed to be less apparent among respondents with bi/multilingual linguistic identities. Following debriefing discussions based on the experiment findings, there were clear indications that respondents did become more aware of inadvertent linguistic stereotyping by participating in the activities.
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| 33. |
- Djerf, Henrik, et al.
(author)
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Absence of Long-Term Benefit of Revascularization in Patients with Intermittent Claudication: Five-Year Results from the IRONIC Randomized Controlled Trial
- 2020
-
In: Circulation: Cardiovascular Interventions. - 1941-7640 .- 1941-7632. ; 13:1
-
Journal article (peer-reviewed)abstract
- © 2020 Lippincott Williams and Wilkins. All rights reserved. Background: The long-term benefit of revascularization for intermittent claudication is poorly understood. The aim of this study was to investigate the long-term effectiveness and cost-effectiveness compared with a noninvasive approach. Methods: The IRONIC trial (Invasive Revascularization or Not in Intermittent Claudication) randomized patients with mild-to-severe intermittent claudication to either revascularization + best medical therapy + structured exercise therapy (the revascularization group) or best medical therapy + structured exercise therapy (the nonrevascularization group). The health-related quality of life short form 36 questionnaire was primary outcome and disease-specific health-related quality of life (vascular quality of life questionnaire) and treadmill walking distances were secondary end points. Health-related quality of life has previously been reported superior in the revascularization group at 1- and 2-year follow-up. In this study, the 5-year results were determined. The cost-effectiveness of the treatment options was analyzed from a payer/healthcare standpoint. Results: Altogether, 158 patients were randomized in a 1:1 ratio. Regarding the primary end point, no intergroup differences were observed for the short form 36 sum or domain scores from baseline to 5 years, except for the short form 36 role emotional domain score, with greater improvement in the nonrevascularization group (n=116, P=0.007). No intergroup differences were observed in the vascular quality of life questionnaire total and domain scores (n=116, NS) or in treadmill walking distances (n=91, NS). A revascularization strategy resulted in almost twice the cost per patient compared with a noninvasive treatment approach ($13 098 versus $6965, P=0.02). Conclusions: After 5 years of follow-up, a revascularization strategy had lost its early benefit and did not result in any long-term improvement in health-related quality of life or walking capacity compared to a noninvasive treatment strategy. Revascularization was not a cost-effective treatment option from a payer/healthcare point of view. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01219842.
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| 34. |
- Eckerström, Carl, et al.
(author)
-
Characteristic Biomarker and Cognitive Profile in Incipient Mixed Dementia.
- 2020
-
In: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 73:2, s. 597-607
-
Journal article (peer-reviewed)abstract
- Research has shown that mixed dementia is more common than previously believed but little is known of its early stages.To examine if incipient mixed dementia can be differentiated from incipient Alzheimer's disease (AD) and subcortical ischemic vascular dementia (SVD) using neuropsychological tests, cerebrospinal fluid (CSF) markers, and magnetic resonance imaging markers.We included 493 patients and controls from the Gothenburg MCI study and used the dementia groups for marker selection (CSF total-tau (T-tau), phospho-tau (P-tau), and amyloid-β42 (Aβ42), 11 neuropsychological tests, and 92 regional brain volumes) and to obtain cut-off values which were then applied to the MCI groups.Incipient mixed dementia was best differentiated from incipient AD by the Word fluency F-A-S test and the Trail making test A. CSF T-tau, P-tau, and Aβ42 differentiated incipient mixed dementia from incipient SVD.Incipient mixed dementia is characterized by an AD-like biomarker profile and an SVD-like cognitive profile. Incipient mixed dementia can be separated from incipient AD and incipient SVD using CSF markers and cognitive testing.
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| 35. |
- Eckerström, Marie, 1981, et al.
(author)
-
Longitudinal evaluation of criteria for subjective cognitive decline and preclinical Alzheimer's disease in a memory clinic sample.
- 2017
-
In: Alzheimer's & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 16:8, s. 96-107
-
Journal article (peer-reviewed)abstract
- Subjective cognitive decline (SCD) and biomarker-based "at-risk" concepts such as "preclinical" Alzheimer's disease (AD) have been developed to predict AD dementia before objective cognitive impairment is detectable. We longitudinally evaluated cognitive outcome when using these classifications.Memory clinic patients (n=235) were classified as SCD (n=122): subtle cognitive decline (n=36) and mild cognitive impairment (n=77) and subsequently subclassified into SCDplus and National Institute on Aging-Alzheimer's Association (NIA-AA) stages 0 to 3. Mean (standard deviation) follow-up time was 48 (35) months. Proportion declining cognitively and prognostic accuracy for cognitive decline was calculated for all classifications.Among SCDplus patients, 43% to 48% declined cognitively. Among NIA-AA stage 1 to 3 patients, 50% to 100% declined cognitively. The highest positive likelihood ratios (+LRs) for subsequent cognitive decline (+LR 6.3), dementia (+LR 3.4), and AD dementia (+LR 6.5) were found for NIA-AA stage2.In a memory clinic setting, NIA-AA stage 2 seems to be the most successful classification in predicting objective cognitive decline, dementia, and AD dementia.
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| 36. |
- Eklund, Johan, 1991, et al.
(author)
-
Field exposure of FeCrAl model alloys in a waste-fired boiler at 600°C: The influence of Cr and Si on the corrosion behaviour
- 2019
-
In: Materials and Corrosion. - : Wiley. - 0947-5117 .- 1521-4176. ; 70:8, s. 1476-1485
-
Journal article (peer-reviewed)abstract
- Materials and Corrosion WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim The aim of this study was to examine the performance of FeCrAl model alloys in a waste-fired boiler and investigate the influence of chromium and silicon content on the corrosion behaviour. The investigation was executed by utilising an air-cooled probe, giving a material temperature of 600°C throughout a 672 hr exposure. The material loss measurements were performed by utilizing an ultrasonic thickness gauge in combination with scanning electron microscopy analysis. It was found that increasing the chromium content significantly reduced the overall material loss of the FeCrAl model alloys but further accelerated the corrosion attack on the windward side. Simultaneously, the increased chromium content caused embrittlement of the material. Minor additions of silicon drastically reduced the material loss of the FeCrAl model alloys, whereas the sample ring with no silicon present was completely deteriorated. The trends observed in this field study correlated well with what has been observed in previous laboratory studies. A state-of-the-art alloy in the present environment, Inconel 625, was simultaneously exposed and showed similar performance to the silicon-containing FeCrAl model alloys with ≥10 wt% Cr.
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| 37. |
- Eklund, Johan, 1991, et al.
(author)
-
The influence of silicon on the corrosion properties of FeCrAl model alloys in oxidizing environments at 600 °C
- 2018
-
In: Corrosion Science. - : Elsevier BV. - 0010-938X. ; 144, s. 266-276
-
Journal article (peer-reviewed)abstract
- The present study investigates the influence of Si on the high temperature corrosion behaviour of FeCrAl model alloys in O2, O2+H2O and O2+H2O + KCl at 600 °C for up to 168 h. The investigation by SEM/EDX showed that all alloys displayed a protective behaviour in dry O2. In the more corrosive environments (O2+H2O and O2+H2O + KCl) the addition of Si affected the oxidation properties in two ways; Alloys containing Si resisted breakaway oxidation caused by Cr-evaporation (O2+H2O) and the thickness of the oxide formed after breakaway oxidation decreased with increasing amount of Si (O2+H2O + KCl).
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| 38. |
- Eriksson, Victoria, et al.
(author)
-
A retrospective analysis of the de ritis ratio in muscle invasive bladder cancer, with focus on tumor response and long-term survival in patients receiving neoadjuvant chemotherapy and in chemo naïve cystectomy patients : a study of a clinical multicentre database
- 2022
-
In: Journal of Personalized Medicine. - : MDPI. - 2075-4426. ; 12:11
-
Journal article (peer-reviewed)abstract
- Background: A high pre-treatment De Ritis ratio, the aspartate transaminase/alanine aminotransferase ratio, has been suggested to be of prognostic value for mortality in muscle-invasive bladder cancer (MIBC). Our purpose was to evaluate if a high ratio was associated with mortality and downstaging. Methods: A total of 347 Swedish patients with clinically staged T2-T4aN0M0, with administered neoadjuvant chemotherapy (NAC) or eligible for NAC and undergoing radical cystectomy (RC) 2009–2021, were retrospectively evaluated with a low ratio < 1.3 vs. high ratio > 1.3, by Log Rank test, Cox regression and Mann–Whitney U-test (MWU), SPSS 27. Results: Patients with a high ratio had a decrease of up to 3 years in disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS) (p = 0.009, p = 0.004 and p = 0.009) and 5 years in CSS and OS (p = 0.019 and p = 0.046). A high ratio was associated with increased risk of mortality, highest in DFS (HR, 1.909; 95% CI, 1.265–2.880; p = 0.002). No significant relationship between downstaging and a high ratio existed (p = 0.564 MWU). Conclusion: A high pre-treatment De Ritis ratio is on a population level, associated with increased mortality post-RC in endpoints DFS, CSS and OS. Associations decrease over time and require further investigations to determine how strong the associations are as meaningful prognostic markers for long-term mortality in MIBC. The ratio is not suitable for downstaging-prediction.
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| 39. |
- Eriksson, Victoria, et al.
(author)
-
Adverse events during neoadjuvant chemotherapy for muscle invasive bladder cancer - a Swedish retrospective multicentre study of a clinical database
- 2022
-
In: Translational Andrology and Urology. - : AME Publishing Company. - 2223-4683 .- 2223-4691. ; 11:8, s. 1105-1115
-
Journal article (peer-reviewed)abstract
- Background: Adverse events (AEs) during neoadjuvant chemotherapy (NAC) for muscle invasive bladder cancer (MIBC) are known but insufficiently reported. Clinical implications include affected cardiac, pulmonary, urinary, vascular and haematological organ systems. The main purpose was to evaluate the incidence and severity of AEs for ascertaining possible clinical significance. Further investigating possible effects of AEs on downstaging outcomes-downstaging is considered a surrogate marker for overall survival (OS).Methods: A retrospective evaluation of AEs during ongoing NAC for MIBC patients analysing individual patient data in a clinical database. We identified 687 cystectomies between 2009-2020 at four Swedish urological centres. Inclusion criteria were cT2-4aN0M0 in 261 NAC patients undergoing radical cystectomy (RC). Medical files were reviewed and AEs were assessed and graded, including detailed measurements by the Common Terminology Criteria for Adverse Events (CTCAE) v.5. Data were retrospectively analysed in SPSS statistics 27.0 with Spearman rank-order correlation coefficient and Mann-Whitney U-test (MWU).Results: A total of 251/261 patients [95% confidence interval (CI), 93-98%] experienced AEs during NAC pre-RC (mean two AEs/patient). In total, 208 (80%) patients received methotrexate, vinblastine, adriamycin (doxorubicin) and cisplatin (MVAC). In the total cohort, 200 (76.6%) received all pre-planned NAC-cycles. Most common AEs were anaemia (88.9%), thrombocytopenia (44.8%) and acute kidney injury (40.6%). Patients with prematurely terminated cycles had higher AE-grades (P=0.042 MWU). A correlation between higher AE-grades and decrease in downstaging existed, in the entire cohort (-0.133; P=0.033) and in patients undergoing all pre-planned NAC-cycles (-0.148; P=0.038). Anaemia and acute kidney injury were individually associated with decreased downstaging (-0.360, P=0.025 and -0.183, P=0.010, respectively).Conclusion: NAC in MIBC poses a significant risk for AEs before RC with clinical implications. For instance, patients terminating chemotherapy prematurely, have higher AE-grades and decreased downstaging. Further, acute kidney injury and anaemia are individually associated with decreased downstaging. We propose that early detection and prevention of AEs may increase downstaging of the primary tumour.
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| 40. |
- Franklin, Karl A., et al.
(author)
-
Effects of a palaeolithic diet on obstructive sleep apnoea occurring in females who are overweight after menopause-a randomised controlled trial
- 2022
-
In: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 46, s. 1833-1839
-
Journal article (peer-reviewed)abstract
- Background/Objectives Obesity is the main risk factor for obstructive sleep apnoea, commonly occurring in females who are overweight after menopause. We aimed to study the effect of a palaeolithic diet on sleep apnoea in females with overweight after menopause from the population. Methods Seventy healthy, non-smoking females with a mean age of 60 years and a mean BMI of 33 kg/m(2) were randomised to a palaeolithic diet or to a control low-fat diet according to Nordic Nutritional Recommendations, for 2 years. The apnoea-hypopnoea index was measured and daytime sleepiness was estimated during the intervention. Results The mean apnoea-hypopnoea index at baseline was 11.6 (95% CI 8.6-14.5). The mean weight loss was 7.2 kg (95% CI 5.3-9.2 kg) in the palaeolithic diet group and 3.9 kg in the control group (95% CI 1.9-5.9 kg); p < 0.021 for the group difference. The reduction in weight corresponded to a reduction in the apnoea-hypopnoea index in the palaeolithic diet group (r = 0.38, p = 0.034) but not in the control group (r = 0.08, p = 0.69). The apnoea-hypopnoea index was reduced in the palaeolithic diet group when the weight was reduced by more than 8 kg. Daytime sleepiness according to the Epworth Sleepiness Scale score and the Karolinska Sleepiness Scale score was unaffected by dietary group allocation. Conclusions A substantial decrease in body weight of 8 kg was needed to achieve a reduction in sleep apnoea in this small trial of women who are overweight after menopause. The palaeolithic diet was more effective for weight reduction than a control low-fat diet and the reduction in sleep apnoea was related to the degree of weight decrement within this diet group.
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| 41. |
- Gislén, Ylva, 1965-, et al.
(author)
-
Människans politiska natur
- 2011
-
In: Fronesis. - Stockholm : Tidskriftsföreningen Fronesis. - 1404-2614. - 9789197747929 ; :35, s. 8-15
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Journal article (pop. science, debate, etc.)
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| 42. |
- Gundlegård, David, 1978-
(author)
-
Transport Analytics Based on Cellular Network Signalling Data
- 2018
-
Doctoral thesis (other academic/artistic)abstract
- Cellular networks of today generate a massive amount of signalling data. A large part of this signalling is generated to handle the mobility of subscribers and contains location information that can be used to fundamentally change our understanding of mobility patterns. However, the location data available from standard interfaces in cellular networks is very sparse and an important research question is how this data can be processed in order to efficiently use it for traffic state estimation and traffic planning.In this thesis, the potentials and limitations of using this signalling data in the context of estimating the road network traffic state and understanding mobility patterns is analyzed. The thesis describes in detail the location data that is available from signalling messages in GSM, GPRS and UMTS networks, both when terminals are in idle mode and when engaged in a telephone call or a data session. The potential is evaluated empirically using signalling data and measurements generated by standard cellular phones. The data used for analysis of location estimation and route classification accuracy (Paper I-IV in the thesis) is collected using dedicated hardware and software for cellular network analysis as well as tailor-made Android applications. For evaluation of more advanced methods for travel time estimation, data from GPS devices located in Taxis is used in combination with data from fixed radar sensors observing point speed and flow on the road network (Paper V). To evaluate the potential in using cellular network signalling data for analysis of mobility patterns and transport planning, real data provided by a cellular network operator is used (Paper VI).The signalling data available in all three types of networks is useful to estimate several types of traffic data that can be used for traffic state estimation as well as traffic planning. However, the resolution in time and space largely depends on which type of data that is extracted from the network, which type of network that is used and how it is processed.The thesis proposes new methods based on integrated filtering and classification as well as data assimilation and fusion that allows measurement reports from the cellular network to be used for efficient route classification and estimation of travel times. The thesis also shows that participatory sensing based on GPS equipped smartphones is useful in estimating radio maps for fingerprint-based positioning as well as estimating mobility models for use in filtering of course trajectory data from cellular networks.For travel time estimation, it is shown that the CEP-67 location accuracy based on the proposed methods can be improved from 111 meters to 38 meters compared to standard fingerprinting methods. For route classification, it is shown that the problem can be solved efficiently for highway environments using basic classification methods. For urban environments the link precision and recall is improved from 0.5 and 0.7 for standard fingerprinting to 0.83 and 0.92 for the proposed method based on particle filtering with integrity monitoring and Hidden Markov Models.Furthermore, a processing pipeline for data driven network assignment is proposed for billing data to be used when inferring mobility patterns used for traffic planning in terms of OD matrices, route choice and coarse travel times. The results of the large-scale data set highlight the importance of the underlying processing pipeline for this type of analysis. However, they also show very good potential in using large data sets for identifying needs of infrastructure investment by filtering out relevant data over large time periods.
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| 43. |
- Gårdhagen, Roland, 1978-, et al.
(author)
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Assessment of Geometrical Influence on WSS Estimation in the Human Aorta
- 2006
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In: WSEAS Transactions on Fluid Mechanics. - 1790-5087. ; 4:1, s. 318-326
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Journal article (peer-reviewed)abstract
- Computational fluid dynamics simulations were performed on a stenosed human aorta with poststenotic dilatation, in order to estimate wall shear stress (WSS). WSS is important due to its correlation with atherosclerosis. Both steady-state and non-stationary simulations were conducted. Three different models were created from a set of MRI images. Comparison of geometrically different models was accomplished by using geometrical landmarks and a comparison parameter. Geometrical differences had larger influence on WSS magnitude than inflow rotation in steady-state results for the models used. In non-stationary flow the largest differences in WSS are found when the flow velocity near the wall is low e.g. when the inflow is low or in recirculation regions.
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