| 1. |
- Persson, Magnus, et al.
(author)
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Precision thinning : a comparison of optimal stand-level and pixel-level thinning
- 2022
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In: Scandinavian Journal of Forest Research. - : Taylor & Francis Group. - 0282-7581 .- 1651-1891. ; 37:2, s. 99-108
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Journal article (peer-reviewed)abstract
- Precision forestry allows decision-making on tree level or pixel level, as compared to stand-level data. However, little is known about the importance of precision in thinning decisions and its long-term effects on within-stand variation, stand economy and growth. In this study, silviculture was optimized for Net Present Value (NPV) in 20 conifer-dominated forest stands in hemi-boreal southern Sweden. The precision-thinning approach, Precision Thinning (PT), is compared with a stand-level approach, Stand Level Thinning (SLT) that is optimized for the same criteria but based on stand-level data. The results suggest no substantial long-term benefit or drawback in implementing thinning decisions based on pixel-level data as compared to stand-level data when optimizing stand economy. The result variables NPV and Mean annual increment of living stem volume (MAI(net)) were not higher for PT than for SLT. The within-stand variation in basal area (m(2)/ha(-1)) was lower at the end of the rotation compared to the start of the simulation for both SLT and PT. At the end of the rotation, SLT had higher variation in basal area compared to PT. However, pixel-level information enables adapting the silviculture to the within-stand variation which may favour other forest management goals than strictly financial goals.
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| 2. |
- Acs, Balazs, et al.
(author)
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Variability in Breast Cancer Biomarker Assessment and the Effect on Oncological Treatment Decisions: A Nationwide 5-Year Population-Based Study
- 2021
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In: Cancers. - : MDPI AG. - 2072-6694. ; 13:5
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Journal article (peer-reviewed)abstract
- We compared estrogen receptor (ER), progesterone receptor (PR), human epidermal growth-factor receptor 2 (HER2), Ki67, and grade scores among the pathology departments in Sweden. We investigated how ER and HER2 positivity rates affect the distribution of endocrine and HER2-targeted treatments among oncology departments. All breast cancer patients diagnosed between 2013 and 2018 in Sweden were identified in the National Quality Register for Breast Cancer. Cases with data on ER, PR, HER2, Ki67, grade, and treatment were selected (43,261 cases from 29 departments following the guidelines for biomarker testing). The ER positivity rates ranged from 84.2% to 97.6% with 6/29 labs out of the overall confidence intervals (CIs), while PR rates varied between 64.8% and 86.6% with 7/29 labs out of the CIs. HER2 positivity rates ranged from 9.4% to 16.3%, with 3/29 labs out of the overall CIs. Median Ki67 varied between 15% and 30%, where 19/29 labs showed significant intra-laboratory variability. The proportion of grade-II cases varied between 42.9% and 57.1%, and 13/29 labs were outside of the CI. Adjusting for patient characteristics, the proportion of endocrine and anti-HER2 treatments followed the rate of ER and HER2 positivity, illustrating the clinical effect of inter- and intra-laboratory variability. There was limited variability among departments in ER, PR, and HER2 testing. However, even a few outlier pathology labs affected endocrine and HER2-targeted treatment rates in a clinically relevant proportion, suggesting the need for improvement. High variability was found in grading and Ki67 assessment, illustrating the need for the adoption of new technologies in practice.
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| 3. |
- Akhiani, Aliasghar, 1957, et al.
(author)
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Idelalisib Rescues Natural Killer Cells from Monocyte-Induced Immunosuppression by Inhibiting NOX2-Derived Reactive Oxygen Species.
- 2020
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In: Cancer immunology research. - 2326-6074. ; 8:12, s. 1532-1541
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Journal article (peer-reviewed)abstract
- The phosphatidylinositol-4,5-bisphosphate-3 kinase-δ (PI3Kδ) inhibitor idelalisib, used alone or in combination with anti-CD20, is clinically efficacious in B-cell lymphoma and chronic lymphocytic leukemia (CLL) by promoting apoptosis of malignant B cells. PI3K regulates the formation of reactive oxygen species (ROS) by the myeloid NADPH oxidase NOX2, but the role of PI3Kδ in myeloid cell-induced immunosuppression is unexplored. We assessed the effects of idelalisib on the spontaneous and IgG antibody-induced ROS production by human monocytes, on ROS-induced cell death of human natural killer (NK) cells, and on tumor cell clearance in an NK cell-dependent mouse model of metastasis. Idelalisib potently and efficiently inhibited the formation of NOX2-derived ROS from monocytes and rescued NK cells from ROS-induced cell death. Idelalisib also promoted NK cell cytotoxicity against anti-CD20-coated primary human CLL cells and cultured malignant B cells. Experiments using multiple PI3K inhibitors implicated the PI3Kδ isoform in regulating NOX2-induced ROS formation and immunosuppression. In B6 mice, systemic treatment with idelalisib significantly reduced the formation of lung metastases from intravenously injected melanoma cells but did not affect metastasis in B6.129S6-Cybbtm1Din (Nox2-/-) mice or in NK cell-deficient mice. Our results imply that idelalisib rescues NK cells from NOX2/ROS-dependent immunosuppression and thus exerts antineoplastic efficacy beyond B-cell inhibition.
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| 4. |
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| 5. |
- Bergh, Andreas, et al.
(author)
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Deliberative communication : Stimulating collective learning?
- 2020
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In: Leading higher education as and for public good. - Abingdon : Routledge. - 9780367205102 - 9780367205126 - 9780429261947 ; , s. 92-106
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Book chapter (peer-reviewed)abstract
- Chapter 6 reports on a study of how an academic developer (AD) plans and leads a seminar in university pedagogy on constructive alignment by the means of deliberative communication. The overriding purpose is to deepen our understanding of the promises and challenges of deliberative communication as a means of leading and teaching as, and for, public good. To fulfil this aim, we use a combination of self-reflection, deliberative communication and insider–outsider perspectives to examine if, and how, such an approach opens up and stimulates collective learning between the AD and the two critical friends. The chapter concludes by emphasising how fruitful it is to reflect and collaborate among colleagues in a structured way. Raising awareness of the limitation of all models, tools or approaches, like constructive alignment, may help academics to acknowledge that the improvement of leadership and teaching needs be far more of a collective endeavour than at present. An important issue for further exploration, therefore, is how creative meetings between individual professional and inter-professional skills, through communication, can contribute to raising awareness of what teaching as, and for, public good might mean, and how it can be enacted.
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| 6. |
- Bergh, Cecilia, 1972-, et al.
(author)
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Effects of Bilberry and Oat intake on lipids, inflammation and exercise capacity after Acute Myocardial Infarction (BIOAMI): study protocol for a randomized, double-blind, placebo-controlled trial
- 2021
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In: Trials. - : Springer Science and Business Media LLC. - 1745-6215 .- 1745-6215. ; 22:1
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Journal article (peer-reviewed)abstract
- Background: Bilberries from Sweden, rich in polyphenols, have shown cholesterol-lowering effects in small studies, and the cholesterol-lowering properties of oats, with abundant beta-glucans and potentially bioactive phytochemicals, are well established. Both may provide cardiometabolic benefits following acute myocardial infarction (AMI), but large studies of adequate statistical power and appropriate duration are needed to confirm clinically relevant treatment effects. No previous study has evaluated the potential additive or synergistic effects of bilberry combined with oats on cardiometabolic risk factors. Our primary objective is to assess cardioprotective effects of diet supplementation with dried bilberry or with bioprocessed oat bran, with a secondary explorative objective of assessing their combination, compared with a neutral isocaloric reference supplement, initiated within 5 days following percutaneous coronary intervention (PCI) for AMI. Methods: The effects of Bilberry and Oat intake on lipids, inflammation and exercise capacity after Acute Myocardial Infarction (BIOAMI) trial is a double-blind, randomized, placebo-controlled clinical trial. A total of 900 patients will be randomized post-PCI to one of four dietary intervention arms. After randomization, subjects will receive beverages with bilberry powder (active), beverages with high-fiber bioprocessed oat bran (active), beverages with bilberry and oats combined (active), or reference beverages containing no active bilberry or active oats, for consumption twice daily during a 3-month intervention. The primary endpoint is the difference in LDL cholesterol change between the intervention groups after 3 months. The major secondary endpoint is exercise capacity at 3 months. Other secondary endpoints include plasma concentrations of biochemical markers of inflammation, metabolomics, and gut microbiota composition after 3 months. Discussion: Controlling hyperlipidemia and inflammation is critical to preventing new cardiovascular events, but novel pharmacological treatments for these conditions are expensive and associated with negative side effects. If bilberry and/or oat, in addition to standard medical therapy, can lower LDL cholesterol and inflammation more than standard therapy alone, this could be a cost-effective and safe dietary strategy for secondary prevention after AMI. Trial registration: ClinicalTrials.gov NCT03620266. Registered on August 8, 2018.
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| 7. |
- Chen, Xinsong, et al.
(author)
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Breast cancer patient-derived whole-tumor cell culture model for efficient drug profiling and treatment response prediction
- 2023
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In: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 120:1
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Journal article (peer-reviewed)abstract
- Breast cancer (BC) is a complex disease comprising multiple distinct subtypes with different genetic features and pathological characteristics. Although a large number of antineoplastic compounds have been approved for clinical use, patient-to-patient variability in drug response is frequently observed, highlighting the need for efficient treatment prediction for individualized therapy. Several patient-derived models have been established lately for the prediction of drug response. However, each of these models has its limitations that impede their clinical application. Here, we report that the whole-tumor cell culture (WTC) ex vivo model could be stably established from all breast tumors with a high success rate (98 out of 116), and it could reassemble the parental tumors with the endogenous microenvironment. We observed strong clinical associations and predictive values from the investigation of a broad range of BC therapies with WTCs derived from a patient cohort. The accuracy was further supported by the correlation between WTC-based test results and patients' clinical responses in a separate validation study, where the neoadjuvant treatment regimens of 15 BC patients were mimicked. Collectively, the WTC model allows us to accomplish personalized drug testing within 10 d, even for small-sized tumors, highlighting its potential for individualized BC therapy. Furthermore, coupled with genomic and transcriptomic analyses, WTC-based testing can also help to stratify specific patient groups for assignment into appropriate clinical trials, as well as validate potential biomarkers during drug development.
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| 8. |
- Cornford, Philip, et al.
(author)
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EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer-2024 Update. Part I: Screening, Diagnosis, and Local Treatment with Curative Intent.
- 2024
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In: European urology. - 1873-7560.
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Journal article (peer-reviewed)abstract
- The European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Urological Pathology (ISUP)-International Society of Geriatric Oncology (SIOG) guidelines provide recommendations for the management of clinically localised prostate cancer (PCa). This paper aims to present a summary of the 2024 version of the EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on the screening, diagnosis, and treatment of clinically localised PCa.The panel performed a literature review of all new data published in English, covering the time frame between May 2020 and 2023. The guidelines were updated, and a strength rating for each recommendation was added based on a systematic review of the evidence.A risk-adapted strategy for identifying men who may develop PCa is advised, generally commencing at 50yr of age and based on individualised life expectancy. The use of multiparametric magnetic resonance imaging in order to avoid unnecessary biopsies is recommended. When a biopsy is considered, a combination of targeted and regional biopsies should be performed. Prostate-specific membrane antigen positron emission tomography imaging is the most sensitive technique for identifying metastatic spread. Active surveillance is the appropriate management for men with low-risk PCa, as well as for selected favourable intermediate-risk patients with International Society of Urological Pathology grade group 2 lesions. Local therapies are addressed, as well as the management of persistent prostate-specific antigen after surgery. A recommendation to consider hypofractionation in intermediate-risk patients is provided. Patients with cN1 PCa should be offered a local treatment combined with long-term intensified hormonal treatment.The evidence in the field of diagnosis, staging, and treatment of localised PCa is evolving rapidly. These PCa guidelines reflect the multidisciplinary nature of PCa management.This article is the summary of the guidelines for "curable" prostate cancer. Prostate cancer is "found" through a multistep risk-based screening process. The objective is to find as many men as possible with a curable cancer. Prostate cancer is curable if it resides in the prostate; it is then classified into low-, intermediary-, and high-risk localised and locally advanced prostate cancer. These risk classes are the basis of the treatments. Low-risk prostate cancer is treated with "active surveillance", a treatment with excellent prognosis. For low-intermediary-risk active surveillance should also be discussed as an option. In other cases, active treatments, surgery, or radiation treatment should be discussed along with the potential side effects to allow shared decision-making.
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| 9. |
- Eldhagen, Per, et al.
(author)
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Phenotypic and HLA-DRB1 allele characterization of Swedish cardiac sarcoidosis patients.
- 2022
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In: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 359, s. 108-112
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Journal article (peer-reviewed)abstract
- Early detection and initiation of treatment in cardiac sarcoidosis (CS) is believed to be crucial to reduce morbidity and mortality. The diagnosis of CS is challenging, especially in isolated CS (ICS). Certain human leukocyte antigen (HLA-DRB1) alleles associate with different phenotypes of sarcoidosis. Phenotypic and genotypic characterization of patients with CS may improve our ability to identify patients being at risk for developing CS.87 patients with CS, identified at two Swedish university hospitals were included. Phenotypic characteristics were extracted from the medical records and the patients were HLA-DRB1 typed.Median age at diagnosis was 55years, 37% were women. HLA-DRB1 distribution was similar to a general sarcoidosis population. A majority of patients (51/87) had CS as the first sarcoidosis presentation. They were younger (p=0.04), more often presenting with ventricular tachycardia (VT) or atrioventricular block (AVB) grade II or III (p<0.001), had lower left ventricular ejection fraction (LVEF) (p=0.002), lower serum angiotensin converting enzyme (s-ACE) (p=0.025), and fewer extra cardiac manifestations (ECM) (p=0.02) than those presenting with CS later.Of Swedish CS patients, 59% presented with cardiac involvement as first manifestation. They had more severe cardiac symptoms than patients presenting with CS later. This phenotype disclosed less ECM and lower s-ACE thus diagnosis can be missed or delayed. We did not observe significant differences in HLA-DRB1 allele frequency between patients with CS compared to sarcoidosis in general. Awareness of CS as a primary manifestation can enable early detection and adequate intervention.
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| 10. |
- Eriksson, Ljusk Ola, et al.
(author)
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A Tool for Long-Term Forest Stand Projections of Swedish Forests
- 2022
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In: Forests. - : MDPI. - 1999-4907 .- 1999-4907. ; 13:6
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Journal article (peer-reviewed)abstract
- The analysis of forest management strategies at landscape and regional levels forms a vital part of finding viable directions that will satisfy the many services expected of forests. This article describes the structure and content of a stand simulator, GAYA, which has been adapted to Swedish conditions. The main advantage of the GAYA implementation compared to other resources is that it generates a large number of management programmes within a limited time frame. This is valuable in cases where the management programmes appear as activities in linear programming (LP) problems. Two methods that are engaged in the projections, a climate change response function and a soil carbon model, are designed to complement other methods, offering transparency and computational effectiveness. GAYA is benchmarked against projections from the Heureka system for a large set of National Forest Inventory (NFI) plots. The long-term increment for the entire NFI set is smaller for GAYA compared with Heureka, which can be attributed to different approaches for modelling the establishment of new forests. The carbon pool belonging to living trees shows the same trend when correlated to standing volume. The soil carbon pool of GAYA increases with increased standing volume, while Heureka maintains the same amount over the 100-year projection period.
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