| 1. |
- Albin, Cecilia, 1962-, et al.
(author)
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International Negotiation : Theories and Practices
- 2009. - 7
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In: Peace, Justice, and Security Studies. - Boulder : Lynne Rienner Publisher. - 9781588266255 ; , s. 321-327
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Book chapter (pop. science, debate, etc.)
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| 2. |
- Almroth, Henrik, et al.
(author)
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Atorvastatin and persistent atrial fibrillation following cardioversion : a randomized placebo-controlled multicentre study
- 2009
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In: European Heart Journal. - Philadelphia : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 30:7, s. 827-833
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Journal article (peer-reviewed)abstract
- AIMS: To evaluate the effect of atorvastatin in achieving stable sinus rhythm (SR) 30 days after electrical cardioversion (CV) in patients with persistent atrial fibrillation (AF). METHODS AND RESULTS: The study included 234 patients. The patients were randomized to treatment with atorvastatin 80 mg daily (n = 118) or placebo (n = 116) in a prospective, double-blinded fashion. Treatment was initiated 14 days before CV and was continued 30 days after CV. The two groups were well-balanced with respect to baseline characteristics. Mean age was 65 +/- 10 years, 76% of the patients were male and 4% had ischaemic heart disease. Study medication was well-tolerated in all patients but one. Before primary endpoint 12 patients were excluded. In the atorvastatin group 99 patients (89%) converted to SR at electrical CV compared with 95 (86%) in the placebo group (P = 0.42). An intention-to-treat analysis with the available data, by randomization group, showed that 57 (51%) in the atorvastatin group and 47 (42%) in the placebo group were in SR 30 days after CV (OR 1.44, 95%CI 0.85-2.44, P = 0.18). CONCLUSION: Atorvastatin was not statistically superior to placebo with regards to maintaining SR 30 days after CV in patients with persistent AF.
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| 3. |
- Aminlashgari, Nina, et al.
(author)
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Degradation profile and preliminary clinical testing of a resorbable device for ligation of blood vessels
- 2013
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In: Acta Biomaterialia. - : Elsevier BV. - 1742-7061 .- 1878-7568. ; 9:6, s. 6898-904
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Journal article (peer-reviewed)abstract
- A resorbable device for ligation of blood vessels was developed and tested in vitro to reveal the degradation profile of the device and to predict the clinical performance in terms of adequate mechanical support during a healing period of I week. In addition, preliminary clinical testing was performed that showed complete hemostasis and good tissue grip of renal arteries in five pigs. The device was made by injection molding of poly(glycolide-co-trimethylene carbonate) triblock copolymer, and it consisted of a case with a locking mechanism connected to a partly perforated flexible band. A hydrolytic degradation study was carried out for 7, 30 and 60 days in water and buffer medium, following the changes in mass, water absorption, pH and mechanical properties. A new rapid matrix-free laser desorption ionization-mass spectrometry (LDI-MS) method was developed for direct screening of degradation products released into the degradation medium. The combination of LDI-MS and electrospray ionization-mass spectrometry analyses enabled the comparison of the degradation product patterns in water and buffer medium. The identified degradation products were rich in trimethylene carbonate units, indicating preferential hydrolysis of amorphous regions where trimethylene units are located. The crystallinity of the material was doubled after 60 days of hydrolysis, additionally confirming the preferential hydrolysis of trimethylene carbonate units and the enrichment of glycolide units in the remaining solid matrix. The mechanical performance of the perforated band was followed for the first week of hydrolysis and the results suggest that sufficient strength is retained during the healing time of the blood vessels.
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| 4. |
- Andersson, Jonas, et al.
(author)
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Markers of fibrinolysis as predictors for maintenance of sinus rhythm after electrical cardioversion
- 2011
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In: Thrombosis Research. - : Elsevier BV. - 0049-3848 .- 1879-2472. ; 127:3, s. 189-192
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Journal article (peer-reviewed)abstract
- No fibrinolytic component alone was found to be a predictor of recurrence of atrial fibrillation. In multivariate models lower PAI-1 mass was associated with sinus rhythm even after adjusting for CRP, markers of the metabolic syndrome and treatment with atorvastatin. Our findings suggest a patophysiological link between AF and PAI-1 mass but the relation to inflammation remains unclear.
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| 5. |
- Bertmar, Sofia, et al.
(author)
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Who's Most Targeted and Does My New Adblocker Really Help : A Profile-based Evaluation of Personalized Advertising
- 2021
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In: Proc. ACM CCS Workshop on Privacy in the Electronic Society (ACM WPES @CCS). - New York, NY, USA : ACM Digital Library. - 9781450385275
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Conference paper (peer-reviewed)abstract
- There is limited prior work studying how the ad personalization experienced by different users is impacted by the use of adblockers, geographic location, the user's persona, or what browser they use. To address this void, this paper presents a novel profile-based evaluation of the personalization experienced by carefully crafted user profiles. Our evaluation framework impersonates different users and captures how the personalization changes over time, how it changes when adding or removing an extension, and perhaps most importantly how the results differ depending on the profile's persona (e.g., interest, occupation, age, gender), geographic location (US East, US West, UK), what browser extension they use (none, AdBlock, AdBlock Plus, Ghostery, CatBlock), what browser they use (Chrome, Firefox), and whether they are logged in to their Google account. By comparing and contrasting observed differences we provide insights that help explain why some user groups may feel more targeted than others and why some people may feel even more targeted after having turned on their adblocker.
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| 6. |
- Blomström-Lundqvist, Carina, et al.
(author)
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Effect of Catheter Ablation vs Antiarrhythmic Medication on Quality of Life in Patients With Atrial Fibrillation : The CAPTAF Randomized Clinical Trial
- 2019
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In: JAMIA Journal of the American Medical Informatics Association. - Chicago : American Medical Association (AMA). - 1067-5027 .- 1527-974X .- 0098-7484 .- 1538-3598. ; 321:11, s. 1059-1068
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Journal article (peer-reviewed)abstract
- IMPORTANCE Quality of life is not a standard primary outcome in ablation trials, even though symptoms drive the indication. OBJECTIVE To assess quality of life with catheter ablation vs antiarrhythmic medication at 12 months in patients with atrial fibrillation. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial at 4 university hospitals in Sweden and 1 in Finland of 155 patients aged 30-70 years with more than 6 months of atrial fibrillation and treatment failure with 1 antiarrhythmic drug or beta-blocker, with 4-year follow-up. Study dateswere July 2008-September 2017. Major exclusionswere ejection fraction <35%, left atrial diameter > 60 mm, ventricular pacing dependency, and previous ablation. INTERVENTIONS Pulmonary vein isolation ablation (n= 79) or previously untested antiarrhythmic drugs (n= 76). MAIN OUTCOMES AND MEASURES Primary outcomewas the General Health subscale score (Medical Outcomes Study 36-Item Short-Form Health Survey) at baseline and 12 months, assessed unblinded (range, 0 [worst] to 100 [best]). There were 26 secondary outcomes, including atrial fibrillation burden (% of time) from baseline to 12 months, measured by implantable cardiac monitors. The first 3 months were excluded from rhythm analysis. RESULTS Among 155 randomized patients (mean age, 56.1 years; 22.6% women), 97% completed the trial. Of 79 patients randomized to receive ablation, 75 underwent ablation, including 2 who crossed over to medication and 14 who underwent repeated ablation procedures. Of 76 patients randomized to receive antiarrhythmic medication, 74 received it, including 8 who crossed over to ablation and 43 for whom the first drug used failed. General Health score increased from 61.8 to 73.9 points in the ablation group vs 62.7 to 65.4 points in the medication group (between-group difference, 8.9 points; 95% CI, 3.1-14.7; P=.003). Of 26 secondary end points, 5 were analyzed; 2 were null and 2 were statistically significant, including decrease in atrial fibrillation burden (from 24.9% to 5.5% in the ablation group vs 23.3% to 11.5% in the medication group; difference -6.8%[95% CI, -12.9% to -0.7%]; P=.03). Of the Health Survey subscales, 5 of 7 improved significantly. Most common adverse events were urosepsis (5.1%) in the ablation group and atrial tachycardia (3.9%) in the medication group. CONCLUSIONS AND RELEVANCE Among patients with symptomatic atrial fibrillation despite use of antiarrhythmic medication, the improvement in quality of life at 12 months was greater for those treated with catheter ablation compared with antiarrhythmic medication. Although the study was limited by absence of blinding, catheter ablation may offer an advantage for quality of life.
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| 7. |
- Borg, Carola, 1973-, et al.
(author)
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Subject- and experience-bound differences in teachers' conceptual understanding of sustainable development
- 2014
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In: Environmental Education Research. - : Routledge. - 1350-4622 .- 1469-5871. ; 20:4, s. 526-551
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Journal article (peer-reviewed)abstract
- This article describe the results of a nationwide questionnaire study of 3229 Swedish upper secondary school teachers’ understanding of sustainable development in relation to their subject discipline and teaching experience. Previous research has shown that teachers have difficulties understanding the complex concept of sustainable development. According to the Swedish curriculum all teachers in all subjects should integrate a holistic perspective of sustainable development including economic, ecological and social dimensions. This study shows that teachers differ in their understanding of the concept mostly according to their subject traditions. Social science teachers emphasize social dimensions, and science teachers’ ecological dimensions, respectively. Teachers are aware of the relevance of the three dimensions to various degrees, but do not generally have a holistic understanding. The greatest uncertainty in teachers’ understanding is related to the economic dimension. Science and social science teachers are critical of incorporating economic growth into the concept of sustainable development while language, vocational and esthetical-practical teachers are not. No experience-bound differences of the teachers’ understanding could be found, but recently qualified teachers consider their understanding of sustainable development to be poorer in comparison to more experienced teachers’ self-evaluation. The study highlights the need for further training in sustainable development since more than 70 % of the questioned teachers stated that they need such training.
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| 8. |
- Borg, Carola, 1973-, et al.
(author)
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The barriers encountered by teachers implementing education for sustainable development
- 2012
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In: Research in Science & Technological Education. - : Informa UK Limited. - 0263-5143 .- 1470-1138. ; 30:2, s. 185-207
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Journal article (peer-reviewed)abstract
- Background : According to the Swedish curriculum teachers in all subjects have a responsibility to integrate a holistic perspective of sustainable development (SD) and teach according to an education for sustainable development (ESD) approach. However previous research has shown that teachers from different subjects perceive SD differently. Purpose : The study aimed at investigating if and how teachers’ subject area influences their ability to implement a holistic perspective of ESD; we investigated both the impact of teaching traditions and the barriers that teachers experienced. Sample : A stratified sample of 224 Swedish upper secondary schools participated. An online questionnaire was sent and answered by a total of 3229 teachers at these schools. In total, there were 669 science teachers, 373 social science teachers, 483 language teachers, 713 vocational and esthetical–practical teachers, and 739 teachers from other disciplines who participated in the survey. Design and methods : The questionnaire consisted of questions requiring Likert-scale responses and multiple-choice questions. The data from the questionnaire were analyzed using Pearson’s Chi-square test and one-way ANOVA. The significance level accepted was p < 0.05. Results : Teachers were influenced by their own subject traditions. Science teachers in our study were grounded in the fact-based tradition and lectures were the most common teaching method used. The teaching tradition of the social science teachers seemed to be most in line to an ESD approach. Many language teachers (41%) stated they did not include SD issues in their teaching at all. Among the barriers identified, the most common obstacles were that the teachers lacked inspiring examples of how to include SD in their teaching and that they lacked the necessary expertise about SD. Conclusion : This study highlights the need for the management within schools to create opportunities for teachers to work collaboratively when teaching ESD. It is also important to provide further training that is adjusted to the needs of different disciplines.
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| 9. |
- Borg, Carola, 1973-
(author)
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Utbildning för hållbar utveckling ur ett lärarperspektiv : Ämnesbundna skillnader i gymnasieskolan
- 2011
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Licentiate thesis (other academic/artistic)abstract
- This thesis investigates how teachers from different disciplines understand and implement education for sustainable development in their teaching. A nationwide questionnaire study was conducted with 3229 upper secondary school teachers representing 224 schools in Sweden. The concept of sustainable development is complex and research has shown that teachers exhibit uncertainties in their understanding of it, and that the way they conceptualize sustainable development can have consequences for how they incorporate it into their teaching. Previous research has emphasized that Education for Sustainable Development (ESD) should promote interdisciplinary and holistic learning rather than traditional subject-based learning. This is in accordance with the Swedish curriculum, which emphasizes that all teachers in all subjects should integrate education for sustainable development. The teachers in the study were grouped into four disciplines; science-, social science-, language-, and vocational/esthetical-practical teachers. The results showed that there were many subject-bound barriers to successful implementation of ESD. Teachers were influenced by their subject tradition in: 1) how they understand sustainable development, 2) which teaching methods they use, 3) which barriers they experience, and 4) which teaching tradition they work within. Because of these differences it is important to adjust any further training of teachers according to their discipline. This study highlights the need for improved teacher education and further training of in-service teachers; more than 70% of the teachers stated that they need such training. It also highlights the issue how strong subject-bound traditions make it difficult to implement general goals of the curricula such as sustainable development.
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| 10. |
- Ekman, Mattias, et al.
(author)
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Kostnadseffektivt att behandlakronisk hjärtsvikt med bisoprolol [Cost-effectiveness of bisoprolol in chronic heart failure]
- 2002
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 14, s. 646-650
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Journal article (other academic/artistic)abstract
- Kliniska prövningar har visat att betablockerare har gynnsamma effekter på dödlighet och sjuklighet vid kronisk hjärtsvikt.Hjärtsvikt är ett vanligt och allvarligt tillstånd, som dessutom orsakar samhällsekonomiska kostnader på minst 2 miljarder kronor per år.Den kliniska studien CIBIS II, som omfattade 2 647 patienter i funktionsklass III och IV, visade en signifikant minskning av mortaliteten på 32 procent när beta-blockeraren bisoprolol adderades till konventionell hjärtsviktsbehandling.Som ett led i en ekonomisk utvärdering av bisoprolol undersöktes kostnader och hälsoeffekter i samband med behandlingen. Uppgifter om läkemedelsförbrukning och sjukhusinläggningar hämtades från CIBIS II-studien. Uppgifter om patienternas överlevnad är dels hämtade från CIBIS-II-studien, dels baserade på uppgifter från tidigare studier.Den ekonomiska utvärderingen indikerar att behandling av kronisk hjärtsvikt med bisoprolol är ett kostnadseffektivt alternativ.
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| 11. |
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| 12. |
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| 13. |
- Fang, Fang, et al.
(author)
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Maternal bereavement and childhood asthma-analyses in two large samples of Swedish children
- 2011
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:11, s. e27202-
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Journal article (peer-reviewed)abstract
- BACKGROUND: Prenatal factors such as prenatal psychological stress might influence the development of childhood asthma. METHODOLOGY AND PRINCIPAL FINDINGS: We assessed the association between maternal bereavement shortly before and during pregnancy, as a proxy for prenatal stress, and the risk of childhood asthma in the offspring, based on two samples of children 1-4 (n = 426 334) and 7-12 (n = 493 813) years assembled from the Swedish Medical Birth Register. Exposure was maternal bereavement of a close relative from one year before pregnancy to child birth. Asthma event was defined by a hospital contact for asthma or at least two dispenses of inhaled corticosteroids or montelukast. In the younger sample we calculated hazards ratios (HRs) of a first-ever asthma event using Cox models and in the older sample odds ratio (ORs) of an asthma attack during 12 months using logistic regression. Compared to unexposed boys, exposed boys seemed to have a weakly higher risk of first-ever asthma event at 1-4 years (HR: 1.09; 95% confidence interval [CI]: 0.98, 1.22) as well as an asthma attack during 12 months at 7-12 years (OR: 1.10; 95% CI: 0.96, 1.24). No association was suggested for girls. Boys exposed during the second trimester had a significantly higher risk of asthma event at 1-4 years (HR: 1.55; 95% CI: 1.19, 2.02) and asthma attack at 7-12 years if the bereavement was an older child (OR: 1.58; 95% CI: 1.11, 2.25). The associations tended to be stronger if the bereavement was due to a traumatic death compared to natural death, but the difference was not statistically significant. CONCLUSIONS/SIGNIFICANCE: Our results showed some evidence for a positive association between prenatal stress and childhood asthma among boys but not girls.
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| 14. |
- Gad, Helge, et al.
(author)
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MTH1 inhibition eradicates cancer by preventing sanitation of the dNTP pool
- 2014
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In: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 508:7495, s. 215-221
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Journal article (peer-reviewed)abstract
- Cancers have dysfunctional redox regulation resulting in reactive oxygen species production, damaging both DNA and free dNTPs. The MTH1 protein sanitizes oxidized dNTP pools to prevent incorporation of damaged bases during DNA replication. Although MTH1 is non-essential in normal cells, we show that cancer cells require MTH1 activity to avoid incorporation of oxidized dNTPs, resulting in DNA damage and cell death. We validate MTH1 as an anticancer target in vivo and describe small molecules TH287 and TH588 as first-in-class nudix hydrolase family inhibitors that potently and selectively engage and inhibit the MTH1 protein in cells. Protein co-crystal structures demonstrate that the inhibitors bindin the active site of MTH1. The inhibitors cause incorporation of oxidized dNTPs in cancer cells, leading to DNA damage, cytotoxicity and therapeutic responses in patient-derived mouse xenografts. This study exemplifies the non-oncogene addiction concept for anticancer treatment and validates MTH1 as being cancer phenotypic lethal.
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| 15. |
- Gunnarsson, Niklas, 1986-
(author)
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Chronic myeloid leukemia and cancer
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Background Chronic myeloid leukemia (CML) is a relatively rare hematological malignancy with a constant incidence of approximately 90 new cases each year in Sweden (0.9 cases/100 000 inhabitants). The etiology is largely unknown but high doses of ionizing radiation are a known but rare risk factor. The treatment options were for a long time limited to chemotherapies i.e. hydroxyurea and busulfan, interferon’s and allogeneic hematopoietic stem cell transplantation and the median survival were only about four years.Since the beginning of the 21st century a new way of treating CML has been introduced, the tyrosine kinase inhibitors (TKI), leading to a rapid decrease in leukemic cells and symptoms. Due to the TKIs, the overall 5-year survival is nowadays approximately 85 % and CML patients have time to develop other diseases, including other malignancies.The aims of this thesis was to investigate the present and future prevalence of CML and the prevalence of other malignancies prior and subsequent to the diagnosis of CML, malignancies among first-degree relatives of persons with CML. In addition, the incidence of autoimmune and chronic inflammatory diseases among patients with CML was also investigated. Methods From the Swedish CML register, data over nearly all Swedish CML patients from 2002 and forward were obtained for paper II-IV.For paper I, the Swedish cancer register was used to identify all Swedish CML patients since 1970 and the Swedish cause of death register was used to identify an eventual date of death for these patients. With a constant incidence and the relative survival rates for CML patients between 2006 and 2012 as a model, the present and future prevalence was calculated.For paper II-IV, data from the Swedish cancer register was used to identify other malignancies than CML. For paper II, information about autoimmune and chronic inflammatory diseases was retrieved from the Swedish national patient register.For paper II and IV, five controls matched for year of birth, gender and county of residence were randomly selected from the Swedish register of the total population. To calculate odds ratio (OR), conditional logistic regression was used.To calculate the risk of a second malignancy for paper III, Standardized incidence ratio (SIR) was used.In paper IV, first-degree relatives (parents, siblings and offsprings) for both cases and controls were retrieved from the Swedish multi-Generation Register, where persons born later than 1932 and registered in Sweden at some time since 1961 are registered. Results Prevalence and survivalAs shown in paper I, the 5-year overall survival for CML patients increased remarkably from 0.18 to 0.82 between 1970 and 2012. The prevalence increased from 3.9 to 11.9 per 100 000 inhabitants in Sweden between 1985 and 2012. By assuming no further improvements in relative survival as compared to the survival rates between 2006 and 2012, the prevalence by 2060 is expected to increase to 22.0 per 100 000 inhabitants. This corresponds to 2 587 CML patients as compared to 1 137 CML patients in 2012. Malignancies, autoimmune and chronic inflammatory diseases prior to CMLIn study II, more than 45 000 person-years of follow-up were evaluated in 984 CML patients diagnosed between 2002 and 2012. With an OR of 1.47 (95 % CI 1.20–1.82) and 1.55 (95 % CI 1.21–1.98), respectively, the prevalence of prior malignancies and autoimmune diseases were significantly increased as compared to matched controls. On the other hand, no association between CML and chronic inflammatory diseases was shown. Second malignanciesIn 868 CML patients, diagnosed between 2002 and 2011, 52 malignancies were observed in the Swedish cancer register, as shown in paper III. When compared to expected rates in the background population, a significantly increased risk of second malignancies with a SIR of 1.52 (95 % CI 1.13–1.99) was shown. When looking at specific cancer types, gastrointestinal as well as nose and throat cancer were significantly increased. Familial aggregation of malignancies984 CML patients were identified in paper IV. However, 184 had a birth date prior to 1932, subsequently only 800 patients were analyzed. Among them, 4 287 first-degree relatives were identified, compared to 20 930 first-degree relatives of the matched controls. 611 malignancies were retrieved; no significant increase of malignancies in first-degree relatives of CML patients was shown (OR 1.06; 95 % CI: 0.96–1.16). ConclusionSince CML patients nowadays have a high survival rate, the calculations in this thesis shows that the prevalence of CML will almost double by 2060. CML patients have an increased risk of developing malignancies prior and subsequent to the diagnosis of CML, suggesting a hereditary or acquired predisposition to develop cancer. Since there is no familial aggregation of malignancies in CML patients, a hereditary predisposition to develop cancer is unlikely to be part of the pathogenesis of CML, leaving an acquired predisposition more likely.
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| 16. |
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| 17. |
- Gunnarsson, Niklas, et al.
(author)
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Increased prevalence of prior malignancies and autoimmune diseases in patients diagnosed with chronic myeloid leukemia
- 2016
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In: Leukemia. - : Springer Science and Business Media LLC. - 0887-6924 .- 1476-5551. ; 30:7, s. 1562-1567
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Journal article (peer-reviewed)abstract
- We recently reported an increased incidence of second malignancies in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKI). To elucidate whether this increase may be linked, not to TKI but rather to a hereditary or acquired susceptibility to develop cancer, we estimated the prevalence of malignancies, autoimmune disease (AD) and chronic inflammatory disease (CID) in CML patients prior to their CML diagnosis. Nationwide population-based registers were used to identify patients diagnosed with CML in Sweden 2002-2012 and to estimate the prevalence of other malignancies, AD and CID prior to their CML diagnosis. For each patient with CML, five matched controls were selected from the general population. Conditional logistic regression was used to calculate odds ratios (OR). Nine hundred and eighty-four CML patients were assessed, representing more than 45 000 person-years of follow-up. Compared with matched controls, the prevalence of prior malignancies and AD was elevated in CML patients: OR 1.47 (95% confidence interval (CI) 1.20-1.82) and 1.55 (95% CI 1.21-1.98), respectively. No associations were detected between CML and previous CID. An increased prevalence of other malignancies and AD prior to the diagnosis of CML suggest that a hereditary or acquired predisposition to cancer and/or autoimmunity is involved in the pathogenesis of CML.
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| 18. |
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| 19. |
- Gunnarsson, Niklas, et al.
(author)
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Population-based assessment of chronic myeloid leukemia in Sweden : striking increase in survival and prevalence
- 2016
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In: European Journal of Haematology. - : Wiley. - 0902-4441 .- 1600-0609. ; 97:4, s. 387-392
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Journal article (peer-reviewed)abstract
- The clinical outcome for patients with chronic myeloid leukemia (CML) has improved dramatically following the introduction of tyrosine kinase inhibitors. An improved survival, combined with a constant incidence, is expected to increase the prevalence of CML. However, data on the prevalence of CML remain scarce. We examined the overall and relative (age and gender matched) survival and assessed the past, present, and projected future prevalence of CML in Sweden. Data on all patients diagnosed with CML between 1970 and 2012 were retrieved from the Swedish Cancer Register and the Swedish Cause of Death Register. The 5-year overall survival increased from 0.18 to 0.82, during the observed time period. Between 2006 and 2012, the 5-year relative survival was close to normal for 40-year-old, but considerably lower for 80-year-old CML patients. The observed prevalence tripled from 1985 to 2012, from 3.9 to 11.9 per 100 000 inhabitants. Assuming no further improvements in relative survival, the prevalence is projected to further increase by 2060 to 22.0 per 100 000 inhabitants (2587 persons in Sweden). The projected dramatic increase in CML prevalence has major medical and health economic implications and needs to be considered in planning how to organize future care of CML patients.
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| 20. |
- Gunnarsson, Niklas, et al.
(author)
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Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era
- 2015
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In: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 169:5, s. 683-688
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Journal article (peer-reviewed)abstract
- Given that tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with chronic myeloid leukaemia (CML), we were interested in examining the possible risk of long-term adverse events, such as the emergence of other neoplasms. Therefore, we studied the development of second malignancies in 868 patients diagnosed with CML between 2002 and 2011 using the Swedish CML register, cross-linked to the Swedish Cancer register. With a median follow-up of 37 (range 0-99)years, 65 (75%) patients developed 75 second malignancies (non-haematological), 52 of which were of the invasive type. Compared to expected rates in the background population, the risk of second malignancies was higher in the CML cohort, with a standardized incidence ratio (SIR) of 152 (95% CI 113-199). The SIR before and after the second year following diagnosis of CML was 158 and 147, respectively. Among specific cancer types, gastrointestinal and nose and throat cancer were significantly increased. Founded on a population-based material, our results indicate that CML patients treated in the TKI era are at an increased risk of developing a second malignancy, with indications that this risk may more likely be linked to CML itself rather than to the TKI treatment.
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| 21. |
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| 22. |
- Holmqvist, Fredrik, et al.
(author)
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A decade of catheter ablation of cardiac arrhythmias in Sweden : ablation practices and outcomes
- 2019
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In: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 40:10, s. 820-830
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Journal article (peer-reviewed)abstract
- Aims: Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing 'real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported.Methods and Results: Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Follow-up (repeat ablation and vital status) was collected through 31 December 2016. A total of 26 642 patients (57 ± 15 years, 62% men), undergoing a total of 34 428 ablation procedures were included in the study. In total, 4034 accessory pathway/Wolff-Parkinson-White syndrome (12%), 7358 AV-nodal re-entrant tachycardia (21%), 1813 atrial tachycardia (5.2%), 5481 typical atrial flutter (16%), 11 916 atrial fibrillation (AF, 35%), 2415 AV-nodal (7.0%), 581 premature ventricular contraction (PVC, 1.7%), and 964 ventricular tachycardia (VT) ablations (2.8%) were performed. Median follow-up time was 4.7 years (interquartile range 2.7-7.0). The spectrum of treated arrhythmias changed over time, with a gradual increase in AF, VT, and PVC ablation (P < 0.001). Decreasing procedural times and utilization of fluoroscopy with time, were seen for all arrhythmia types. The rates of repeat ablation differed between ablation types, with the highest repeat ablation seen in AF (41% within 3 years). The rate of reported adverse events was low (n = 595, 1.7%). Death in the immediate period following ablation was rare (n = 116, 0.34%).Conclusion: Catheter ablations have shifted towards more complex procedures over the past decade. Fluoroscopy time has markedly decreased and the efficacy of catheter ablation seems to improve for AF.
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| 23. |
- Höglund, Johan, Professor, 1967-, et al.
(author)
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Climate diaspora and future food cultures in Snowpiercer(2013) and The Road (2009)
- 2024
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In: Food, Culture, and Society. - : Taylor & Francis Group. - 1552-8014 .- 1751-7443. ; 27:2, s. 310-325
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Journal article (peer-reviewed)abstract
- This article takes as its starting point the realization that existing food regimes and the food systems that enable them are the main drivers of climate change. This, the article notes, is a systemic challenge, but also a profoundly cultural issue as the way that people eat is deeply connected to questions of identity and belonging. The article enters this field of inquiry by studying how the awareness that current food systems are unsustainable is being mediatized and narrated in popular fiction and film. This media often depicts humans in worlds where the current food system has collapsed, forcing also people in the Global North to move or otherwise adapt to a changing climate, and, in the process, to profoundly alter the way they eat. The article discusses two visual texts: Bong Joon-ho’s Snowpiercer (2013), and John Hillcoat’s The Road (2009). The analysis of these texts shows that they employ food, eating and migration to make life in a future transformed by climate change comprehensible to the reader. The article also investigates how the fiction studied connects food and eating to the existing world-system and thus to the material history that is driving the climate crisis.
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| 24. |
- Höglund, Niklas, 1968-
(author)
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Atrial fibrillation : treatment, associated conditions and quantification of symptoms
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Background: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia. There is a need for new pharmacological treatment strategies since the current antiarrhythmic drugs have a modest efficacy and may have severe side effects. Cardioversion (CV) of AF offers an opportunity to study related conditions in sinus rhythm (SR) and during AF. Since catheter ablation of AF is a symptomatic treatment, it is important to have tools for measurement of arrhythmia-related symptoms. Aims: To evaluate the effect of atorvastatin on maintaining SR after CV of persistent AF. To assess if highsensitivity C-reactive protein (hsCRP) predicts the recurrence of AF after CV in a population randomized to treatment with either atorvastatin or placebo. To quantify the symptomatic effect of left atrial catheter ablation of AF. To assess if the restoration of SR by CV, in a population with persistent AF, affects sleep apnea. Methods: Paper I: A total of 234 patients were randomized to treatment with either high dose atorvastatin or placebo prior to CV. Paper II: In a pre-specified substudy which included 128 of the patients in study I, hsCRP was analyzed before and after CV. Paper III: Umea 22 Arrhythmia Questions (U22) is a questionnaire that quantifies paroxysmal tachycardia symptoms. A total of 105 patients underwent first-time pulmonary vein isolation and answered U22 forms at baseline and follow-up 304 (SD 121) days after ablation. Paper IV: Polysomnography was performed before and after CV in 23 patients with persistent AF scheduled for elective CV. Results: Paper I: An intention-to-treat analysis with the available data, by randomization group, showed that 57 (51%) in the atorvastatin group and 47 (42%) in the placebo group were in SR 30 days after CV (OR 1.44, 95%CI 0.85–2.44, P=0.18). Paper II: HsCRP did not significantly predict recurrence of AF at 30 days. However, after adjusting for treatment with atorvastatin, hsCRP predicted the recurrence of AF (OR 1.14, 95% CI 1.01–1.27). Six months after CV, hsCRP at randomization predicted recurrence of AF in both univariate analysis (OR 1.30, 95% CI 1.06–1.60) and in multivariate logistic regression analysis (OR 1.33, 95% CI 1.06– 1.67). Paper III: The U22 scores for well-being, arrhythmia as cause for impaired well-being, derived timeaspect score for arrhythmia, and discomfort during attack detected relevant improvements of symptoms after the ablation. U22 showed larger improvement in patients undergoing only one procedure than in patients who later underwent repeated interventions. Paper IV: Obstructive sleep apnea occurred in 17/23 patients (74%), and central sleep apnea in 6/23 patients (26%). Five patients had both obstructive and central sleep apnea. SR at follow-up was achieved in 16 patients. The obstructive apnea-hypopnea index, central apneahypopnea index, and the number of patients with obstructive or central sleep apnea did not differ before and after restoration of SR. Conclusions: Atorvastatin is not a treatment option with regards to maintaining SR after CV in patients with persistent AF. HsCRP was associated with AF recurrence 1 and 6 months after successful CV of persistent AF. U22 quantifies the symptomatic improvement after AF ablation with adequate internal consistency and construct validity. Both obstructive and central sleep apneas are highly prevalent in patients with persistent AF. Obstructive sleep apneas are unaffected by the CV of AF to SR.
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- Höglund, Niklas, et al.
(author)
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Cardioversion of atrial fibrillation does not affect obstructive sleep apnea
- 2017
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In: Upsala Journal of Medical Sciences. - : Taylor & Francis. - 0300-9734 .- 2000-1967. ; 122:2, s. 114-118
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Journal article (peer-reviewed)abstract
- Background: Sleep apnea is common in patients with atrial fibrillation, but the effect of the cardioversion of atrial fibrillation to sinus rhythm on central and obstructive apneas is mainly unknown. The primary aim of the study was to analyze the association between cardioversion of atrial fibrillation and sleep apneas, to investigate whether obstructive or central sleep apneas are reduced following cardioversion. A secondary objective was to study the effect on sleep quality. Methods: Twenty-three patients with atrial fibrillation were investigated using overnight polysomnography, including esophagus pressure monitoring and ECG, before and after the cardioversion of persistent atrial fibrillation. Results: Obstructive sleep apnea occurred in 17/23 patients (74%), and central sleep apnea in 6/23 patients (26%). Five patients had both obstructive and central sleep apnea. Sinus rhythm at follow-up was achieved in 16 patients. The obstructive apnea-hypopnea index, central apnea-hypopnea index, and the number of patients with obstructive or central sleep apnea did not differ before and after restoration of sinus rhythm. Sleep time, sleep efficiency, time in different sleep stages, and subjective daytime sleepiness were normal and unaffected by cardioversion. Conclusions: Both obstructive and central sleep apneas are highly prevalent in patients with persistent atrial fibrillation. Obstructive sleep apneas are unaffected by the cardioversion of atrial fibrillation to sinus rhythm. The sleep pattern is normal and unaffected by cardioversion in patients with atrial fibrillation. Clinical Trial Registration: Trial number NCT00429884.
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