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  • Ancelle-Park, R., et al. (författare)
  • Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet
  • 2012
  • Ingår i: Journal of Medical Screening. - : SAGE Publications. - 0969-1413 .- 1475-5793. ; 19, s. 5-13
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women. Methods From the studies reviewed, the primary benefit of screening, breast cancer mortality reduction, was compared with the main harms, over-diagnosis and false-positive screening results (FPRs). Results Pooled estimates of breast cancer mortality reduction among invited women were 25% in incidence-based mortality studies and 31% in case-control studies (38% and 48% among women actually screened). Estimates of over-diagnosis ranged from 1% to 10% of the expected incidence in the absence of screening. The combined estimate of over-diagnosis for screened women, from European studies correctly adjusted for lead time and underlying trend, was 6.5%. For women undergoing 10 biennial screening tests, the estimated cumulative risk of a FPR followed by non-invasive assessment was 17%, and 3% having an invasive assessment. For every 1000 women screened biennially from age 50-51 until age 68-69 and followed up to age 79, an estimated seven to nine lives are saved, four cases are over-diagnosed, 170 women have at least one recall followed by non-invasive assessment with a negative result and 30 women have at least one recall followed by invasive procedures yielding a negative result. Conclusions The chance of saving a woman's life by population-based mammographic screening of appropriate quality is greater than that of over-diagnosis. Service screening in Europe achieves a mortality benefit at least as great as the randomized controlled trials. These outcomes should be communicated to women offered service screening in Europe.
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  • Melin, Anna K., Assistant Professor, 1965-, et al. (författare)
  • Energy availability and the female athlete triad in elite endurance athletes
  • 2015
  • Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 25:5, s. 610-622
  • Tidskriftsartikel (refereegranskat)abstract
    • The female athlete triad (Triad), links low energy availability (EA), with menstrual dysfunction (MD), and impaired bone health. The aims of this study were to examine associations between EA/MD and energy metabolism and the prevalence of Triad-associated conditions in endurance athletes. Forty women [26.2 +/- 5.5 years, body mass index (BMI) 20.6 +/- 2.0 kg/m(2), body fat 20.0 +/- 3.0%], exercising 11.4 +/- 4.5 h/week, were recruited from national teams and competitive clubs. Protocol included gynecological examination; assessment of bone health; indirect respiratory calorimetry; diet and exercise measured 7 days to assess EA; eating disorder (ED) examination; blood analysis. Subjects with low/reduced EA (< 45 kcal/kg FFM/day), had lower resting metabolic rate (RMR) compared with those with optimal EA [28.4 +/- 2.0 kcal/kg fat-free mass (FFM)/day vs 30.5 +/- 2.2 kcal/kg FFM/day, P < 0.01], as did subjects with MD compared with eumenorrheic subjects (28.6 +/- 2.4 kcal/kg FFM/day vs 30.2 +/- 1.8 kcal/kg FFM/day, P < 0.05). 63% had low/reduced EA, 25% ED, 60% MD, 45% impaired bone health, and 23% had all three Triad conditions. 53% had low RMR, 25% hypercholesterolemia, and 38% hypoglycemia. Conclusively, athletes with low/reduced EA and/or MD had lowered RMR. Triad-associated conditions were common in this group of athletes, despite a normal BMI range. The high prevalence of ED, MD, and impaired bone health emphasizes the importance of prevention, early detection, and treatment of energy deficiency.
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  • Melin, Anna K., Assistant Professor, 1965-, et al. (författare)
  • Low-energy density and high fiber intake are dietary concerns in female endurance athletes
  • 2016
  • Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 26:9, s. 1060-1071
  • Tidskriftsartikel (refereegranskat)abstract
    • Low or reduced energy availability (LEA) is linked to functional hypothalamic oligomenorrhea/amenorrhea (FHA), which is frequently reported in weight-sensitive sports. This makes LEA a major nutritional concern for female athletes. The aim of this study was to describe dietary characteristics of athletes with LEA and/or FHA. Endurance athletes (n=45) were recruited from national teams and competitive clubs. Protocols included gynecological examination, body composition, eating disorder evaluation, and 7-day dietary intake and EA assessment. Athletes with disordered eating behavior/eating disorders (n=11), menstrual dysfunction other than FHA (n=5), and low dietary record validity (n=4) were excluded. Remaining subjects (n=25) were characterized by EA [optimal:45kcal (188kJ)/kg fat-free mass (FFM)/day (n=11), LEA:<45kcal (188kJ)/kg FFM/day (n=14)] and reproductive function [eumenorrhea (EUM; n=10), FHA (n=15)]. There was no difference in EA between FHA and EUM subjects. However, FHA and LEA subjects shared the same dietary characteristics of lower energy density (ED) [(P=0.012; P=0.020), respectively], and fat content [(P=0.047; P=0.027), respectively]. Furthermore, FHA subjects had a lower intake of carbohydrate-rich foods (P=0.019), higher fiber content (P<0.001), and drive for thinness score (P=0.003). Conclusively, low ED together with high fiber content may constitute targets for dietary intervention in order to prevent and treat LEA and FHA in female athletes.
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  • Andersen, SB, et al. (författare)
  • Measuring the burden of interval cancers in long-standing screening mammography programmes
  • 2015
  • Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 22:2, s. 83-92
  • Tidskriftsartikel (refereegranskat)abstract
    • Mammography screening programme sensitivity is evaluated by comparing the interval cancer rate (ICR) with the expected breast cancer incidence without screening, ie. the proportional interval cancer rate (PICR). The PICR is usually found by extrapolating pre-screening incidence rates, whereas ICR is calculated from data available in the screening programmes. As there is no consensus regarding estimation of background incidence, we seek to validate the ICR measure against the PICR. Methods Screening data from the three mammography screening programmes of Stockholm, Copenhagen, and Funen in the period 1989-2011 provided data to calculate the ICR. The most commonly described methods of extrapolating pre-screening incidence rates to calculate the PICR were illustrated and PICRs were calculated by year and programme using these different methods and compared with the ICRs. Results PICRs varied greatly, reaching a difference of 32–34% in Stockholm, 79% in Copenhagen, and 100–106% in Funen between the highest and the lowest value, depending on which method was applied. PICRs exhibited large variations yearly and from programme to programme. ICRs did not vary to the same extent, ranging on average from 0.100 to 0.136 in the first 12-months and between 0.201 and 0.225 in the last 12-months of the two-year period after a negative screen across the three programmes. Conclusion The value of the PICR is hugely influenced by which method is applied, whereas the ICR is calculated purely on data available within programmes. We find that the PICR, the establishing indicator for sensitivity, could preferably be replaced by the ICR.
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  • Bishop, Lev S., et al. (författare)
  • Proposal for generating and detecting multi-qubit GHZ states in circuit QED
  • 2009
  • Ingår i: New Journal of Physics. - : IOP Publishing. - 1367-2630. ; 11, s. 073040-
  • Tidskriftsartikel (refereegranskat)abstract
    • We propose methods for the preparation and entanglement detectionof multi-qubit Greenberger–Horne–Zeilinger (GHZ) states in circuit quantumelectrodynamics. Using quantum trajectory simulations appropriate for thesituation of a weak continuous measurement, we show that the joint dispersivereadout of several qubits can be utilized for the probabilistic production ofhigh-fidelity GHZ states. When employing a nonlinear filter on the recordedhomodyne signal, the selected states are found to exhibit values of theBell–Mermin operator exceeding 2 under realistic conditions. We discuss thepotential of the dispersive readout to demonstrate a violation of the Merminbound, and present a measurement scheme avoiding the necessity for fulldetector tomography.
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  • Chow, J.M., et al. (författare)
  • Randomized benchmarking and process tomography for gate errors in a solid-state qubit
  • 2009
  • Ingår i: Physical Review Letters. - 1079-7114 .- 0031-9007. ; 102:9
  • Tidskriftsartikel (refereegranskat)abstract
    • We present measurements of single-qubit gate errors for a superconducting qubit. Results from quantum process tomography and randomized benchmarking are compared with gate errors obtained from a double pulse experiment. Randomized benchmarking reveals a minimum average gate error of 1.1±0.3% and a simple exponential dependence of fidelity on the number of gates. It shows that the limits on gate fidelity are primarily imposed by qubit decoherence, in agreement with theory.
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  • Dent, T, et al. (författare)
  • Stratified cancer screening: the practicalities of implementation
  • 2013
  • Ingår i: Public health genomics. - : S. Karger AG. - 1662-8063 .- 1662-4246. ; 16:3, s. 94-99
  • Tidskriftsartikel (refereegranskat)abstract
    • <b><i>Background:</i></b> Improving understanding of the genetic basis of disease susceptibility enables us to estimate individuals' risk of developing cancer and offer them disease prevention, including screening, stratified to reflect that risk. Little attention has so far been given to the implementation of stratified screening. This article reviews the issues that would arise in delivering such tailored approaches to prevention in practice. <b><i>Results:</i></b> Issues analysed include the organisational context within which implementation of stratified prevention would occur, how the offer of screening would be made, making sure consent is adequately informed, how individuals' risk would be assessed, the age at which risk estimation should occur, and the potential use of genetic data for other purposes. The review also considers how management might differ depending on individuals' risk, how their results would be communicated and their follow-up arranged, and the different issues raised by modification of an existing screening programme, such as that for breast cancer, and the establishment of a new one, for example for prostate cancer. <b><i>Conclusion:</i></b> Stratified screening based on genetic testing is a radically new approach to prevention. Various organisational issues would need to be considered before it could be introduced, and a number of questions require further research.
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  • Andersson, B E, et al. (författare)
  • Three-dimensional outgrowth of a wood-rotting fungus added to a contaminated soil from a former gasworks site
  • 2001
  • Ingår i: Bioresource Technology. - 1873-2976. ; 78:1, s. 37-45
  • Tidskriftsartikel (refereegranskat)abstract
    • The capability of wood-rotting fungi (WRF) to colonise contaminated soil is an important fungal characteristic in the development of WRF-based soil bioremediation, it is also important to have methods that monitor the presence of the WRF in the soil. In this lab-scale study, it was shown that it was possible to re-capture, localise and identify a brown-rot fungus, Antrodia vaillantii, after it has been inoculated into, and grown in, a contaminated soil from a former gasworks site. The three-dimensional outgrowth of A. vaillantii was monitored by allowing it to grow into fungicide-treated wood baits, temporarily placed in the soil. After two weeks, the baits were withdrawn from the soil and surface sterilised with hydrogen peroxide to favour fungi growing inside baits, i.e., A. vaillantii. After subsequent plating of baits on selective agar medium the presence of A. vaillantii was confirmed with PCR/RFLP. A. vaillantii was found to be viable throughout the 54 days long study and exhibited a surface growth pattern similar to other well-known cord-forming basidiomycetes. Firstly, the upper part of the soil closest to the place of inoculation was colonised, however, over a period of time, the area of colonisation spread deeper into the soil. The detection method employed in the current study gave a conservative estimate of the fungal proliferation and did not require extensive sampling. Its use could be applicable in both applied research, such as soil bioremediation, and in pure microbial ecology studies.
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  • Andersson, Erik, et al. (författare)
  • Incomplete degradation of polycyclic aromatic hydrocarbons in soil inoculated with wood rotting fungi and their effect on the indigenous soil bacteria.
  • 2003
  • Ingår i: Rangeland Ecology & Management. - : Wiley. - 1550-7424. ; 22:6, s. 1238-1243
  • Tidskriftsartikel (refereegranskat)abstract
    • Soil artificially contaminated with fluorene, phenanthrene, pyrene, and benz[a]anthracene was inoculated with the wood-rotting fungi Pleurotus ostreatus and Antrodia vaillantii. During 12 weeks of incubation, polycyclic aromatic hydrocarbon (PAH) degradation and the formation of persistent degradation products were monitored by chemical analysis. In addition, the effect on the indigenous soil bacteria was studied by plate count techniques and by measuring the concentration of bacteria-specific phospholipid fatty acids (PLFAs). In both soils inoculated with fungi, the PAH degradation was enhanced compared to the control soil without fungi. The white-rot fungus P. ostreatus accelerated the degradation rate radically the first weeks, while the effect of the brown-rot fungus was more pronounced at later stages during the 12-week study. In a soil with no amendments, the final degradation result was similar to that in the soil with added fungi, although the degradation pattern for the individual PAHs was different. Furthermore, the degradation by P. ostreatus was accompanied by an accumulation of PAH metabolites, that is, 9-fluorenone, benz[a]anthracene-7,12-dione, and two compounds identified as 4-hydroxy-9-fluorenone and 4-oxapyrene-5-one, that was not seen in the other soils. The inoculation with the white-rot fungus also had a large negative effect on the indigenous soil bacteria. This could be an important drawback of using the white-rot fungus P. ostreatus in soil bioremediation since a sequential fungal–bacterial degradation probably is needed for a complete degradation of PAHs in soil. In the soil inoculated with A. vaillantii, on the other hand, no metabolites accumulated, and no negative effects were observed on the indigenous microorganisms.
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  • Blom, J, et al. (författare)
  • Five-year experience of organized colorectal cancer screening in a Swedish population - increased compliance with age, female gender, and subsequent screening round
  • 2014
  • Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 21:3, s. 144-150
  • Tidskriftsartikel (refereegranskat)abstract
    • To evaluate compliance by age, gender, and screening round in the population based Stockholm/Gotland colorectal cancer screening programme. Methods All individuals aged between 60 and 69 living in the counties of Stockholm and Gotland (Sweden) have, since 2008, successively been included in a colorectal cancer screening programme using biennial faecal occult blood tests (Hemoccult®). Personal invitations including test kits have been sent to home addresses, and individuals with a positive test result have been called to a defined clinic for an assessment colonoscopy. Descriptive statistics have been used to evaluate different aspects of compliance. Results Over the five-year period 2008–2012, more than 200,000 individuals from nine different birth cohorts have been invited, with a compliance rate of approximately 60%, which increased by age, female gender, and subsequent screening round. In total, 4,300 individuals (2.1%) with positive tests were referred to assessment colonoscopy, where 213 colorectal cancers were diagnosed. The compliance with the follow-up colonoscopies varied by year, and ranged from 85.6–92.4%. Conclusion The strong organization of the programme contributed to a high compliance rate, that increased by screening round. The lower participation rate among men and among individuals at younger ages needs further attention.
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  • Blom, J, et al. (författare)
  • Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate
  • 2019
  • Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 26:2, s. 92-97
  • Tidskriftsartikel (refereegranskat)abstract
    • Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evaluated participation and positivity rates switching from guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) to FIT (OC-Sensor), using gender-specific cut-offs. Methods The colorectal cancer screening programme of Stockholm-Gotland, Sweden, started in 2008 and invited individuals aged 60–69 to biennial testing using gFOBT. From 1 October 2015 the test was switched to FIT, with positivity cut-offs of 40 (200) and 80 (400) µg Hb/g (ng/mL) faeces for women and men, respectively. The first year was evaluated for compliance and positivity, number of reminders and incorrect/inadequate tests, compared with gFOBT in the preceding 12-month period. Results There were 127,030 and 87,269 individuals invited to screening with gFOBT and FIT, respectively. The change of test increased overall participation by 11.9% (95% confidence interval 11.5%–12.3%) from 56.5% to 68.4% ( p < 0.001). The increase was larger in men (14.3%) than women (9.7%), and in those aged 60–64 (14.2%) than those aged 65–69 (8.7%). The positivity rate was 2.6% in women and 2.5% in men. There was a lower rate of reminders and incorrect/inadequate tests with FIT. Conclusions Within a well-organised colorectal cancer screening programme, changing the test from gFOBT to FIT markedly increased participation, especially among men, and in the younger age group. With a lower cut-off in women than men, the positivity rate was similar.
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  • Blom, J, et al. (författare)
  • Interval cancers in a guaiac-based colorectal cancer screening programme: Consequences on sensitivity
  • 2017
  • Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 24:3, s. 146-152
  • Tidskriftsartikel (refereegranskat)abstract
    • To evaluate interval cancers in the population-based colorectal cancer screening programme of Stockholm/Gotland, Sweden. Methods From 2008, individuals aged 60–69 were invited to colorectal cancer screening using biennial guaiac-based faecal occult blood test (Hemoccult®). Interval cancers, defined as colorectal cancer among participants not diagnosed by the screening programme but registered in the Swedish cancer register, were evaluated by cross-checking the screening histories for all cancers in the region 2008–2012. Results Of 203,848 individuals from nine different birth cohorts who participated (∼60%), 4530 (2.2%) tested positive. All invited individuals were followed up for 24 months after invitation. The cancer register reported 557 colorectal cancer, 219 (39.3%) screen-detected cancers and 338 (60.7%) interval cancers, generating both test- and episode sensitivities of approximately 40% and an interval cancer-rate of 17.1/10,000 tests. Among individuals with positive tests without colorectal cancer diagnosed at work-up colonoscopy, 37 interval cancers (10.9%) occurred. There was statistically significant lower sensitivity in women, ranging 22.4–32.2%, compared with 43.2–52.0% in men. Age-group and tumour location were not strongly correlated to screen-detected cancer rates. The programme sensitivity increased by year (20.3–25.0%), with successively more colorectal cancers diagnosed within the expanding programme (11.6–16.2%). Conclusion Interval cancer is a quality indicator of a screening programme. As the interval cancer-rate determined in a well-organized population-based screening programme was actually higher than the screen-detected cancer rate, a change to a more sensitive screening test is indicated. The lower screen-detected cancers among women, and compliance and quality of work-up colonoscopies also need attention.
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  • Cortes, Diana S., et al. (författare)
  • Effects of aging on emotion recognition from dynamic multimodal expressions and vocalizations
  • 2021
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Age-related differences in emotion recognition have predominantly been investigated using static pictures of facial expressions, and positive emotions beyond happiness have rarely been included. The current study instead used dynamic facial and vocal stimuli, and included a wider than usual range of positive emotions. In Task 1, younger and older adults were tested for their abilities to recognize 12 emotions from brief video recordings presented in visual, auditory, and multimodal blocks. Task 2 assessed recognition of 18 emotions conveyed by non-linguistic vocalizations (e.g., laughter, sobs, and sighs). Results from both tasks showed that younger adults had significantly higher overall recognition rates than older adults. In Task 1, significant group differences (younger > older) were only observed for the auditory block (across all emotions), and for expressions of anger, irritation, and relief (across all presentation blocks). In Task 2, significant group differences were observed for 6 out of 9 positive, and 8 out of 9 negative emotions. Overall, results indicate that recognition of both positive and negative emotions show age-related differences. This suggests that the age-related positivity effect in emotion recognition may become less evident when dynamic emotional stimuli are used and happiness is not the only positive emotion under study.
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  • Cortes S., Diana, et al. (författare)
  • Effects of aging on emotion recognition from dynamic multimodal expressions and vocalizations
  • Tidskriftsartikel (refereegranskat)abstract
    • Age-related differences in emotion recognition have predominantly been investigated usingstatic pictures of facial expressions. Previous studies have also mainly studied recognition ofnegative emotions, and positive emotions beyond happiness have rarely been included. Thecurrent study instead used dynamic facial and vocal stimuli, and included a wider than usualrange of positive emotions. In Task 1, younger and older adults were tested for their abilities torecognize 12 positive and negative emotions from brief video recordings presented in visual,auditory and multimodal blocks. Task 2 assessed recognition of 18 positive and negativeemotions conveyed by non-linguistic vocalizations (e.g., laughter, sobs, and sighs). Resultsfrom both tasks showed that younger adults had higher overall recognition rates than olderadults. In Task 1, significant age-related differences (younger > older) were only observed inthe auditory condition, and for relief, anger, and irritation. In Task 2, significant groupdifferences were instead observed for most of the emotions. Overall, results indicate thatrecognition of both positive and negative emotions show age-related differences. This suggeststhat the age-related positivity effect in emotion recognition may become less evident whendynamic emotional stimuli are used and happiness is not the only positive emotion under study.
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  • Fahrenholtz, I. L., et al. (författare)
  • Within-day energy deficiency and reproductive function in female endurance athletes
  • 2018
  • Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 28:3, s. 1139-1146
  • Tidskriftsartikel (refereegranskat)abstract
    • We aimed to estimate and compare within-day energy balance (WDEB) in athletes with eumenorrhea and menstrual dysfunction (MD) with similar 24-hour energy availability/energy balance (EA/EB). Furthermore, to investigate whether within-day energy deficiency is associated with resting metabolic rate (RMR), body composition, S-cortisol, estradiol, T-3, and fasting blood glucose. We reanalyzed 7-day dietary intake and energy expenditure data in 25 elite endurance athletes with eumenorrhea (n=10) and MD (n=15) from a group of 45 subjects where those with disordered eating behaviors (n=11), MD not related to low EA (n=5), and low dietary record validity (n=4) had been excluded. Besides gynecological examination and disordered eating evaluation, the protocol included RMR measurement; assessment of body composition by dual-energy X-ray absorptiometry, blood plasma analysis, and calculation of WDEB in 1-hour intervals. Subjects with MD spent more hours in a catabolic state compared to eumenorrheic athletes; WDEB<0kcal: 23.0hour (20.8-23.4) vs 21.1hour (4.7-22.3), P=.048; WDEB<-300kcal: 21.8hour (17.8-22.4) vs 17.6hour (3.9-20.9), P=.043, although similar 24-hour EA: 35.6 (11.6) vs 41.3 (12.7) kcal/kg FFM/d, (P=.269), and EB: -659 (551) vs -313 (596) kcal/d, (P=.160). Hours with WDEB <0kcal and <-300kcal were inversely associated with RMRratio (r=-.487, P=.013, r=-.472, P=.018), and estradiol (r=-.433, P=.034, r=-.516, P=.009), and positively associated with cortisol (r=.442, P=.027, r=.463, P=.019). In conclusion, although similar 24-hour EA/EB, the reanalysis revealed that MD athletes spent more time in a catabolic state compared to eumenorrheic athletes. Within-day energy deficiency was associated with clinical markers of metabolic disturbances.
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  • Forsberg, A., et al. (författare)
  • Once-only colonoscopy or two rounds of faecal immunochemical testing 2 years apart for colorectal cancer screening (SCREESCO): preliminary report of a randomised controlled trial
  • 2022
  • Ingår i: Lancet Gastroenterology & Hepatology. - : Elsevier BV. - 2468-1253. ; 7:6, s. 513-521
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Screening for colorectal cancer is done with lower gastrointestinal endoscopy or stool-based tests. There is little evidence from randomised trials to show primary colonoscopy reduces mortality in colorectal cancer We aimed to investigate the effect of screening with once-only colonoscopy or two rounds of faecal immunochemical test screening on colorectal cancer mortality and incidence. Methods We did a randomised controlled trial in Sweden (SCREESCO). Residents in 18 of 21 regions who were age 60 years in the year of randomisation were identified from a population register maintained by the Swedish Tax Agency. A statistician with no further involvement in the trial used a randomised block method to assign individuals to once-only colonoscopy, two rounds of faecal immunochemical testing (OC-Sensor; 2 years apart), or a control group (no intervention; standard diagnostic pathways), in a ratio of 1:6 for colonoscopy versus control and 1:2 for faecal immunochemical testing versus control. Masking was not possible due to the nature of the trial. The primary endpoints of the trial are colorectal cancer mortality and colorectal cancer incidence. Here, we report preliminary participation rates, baseline findings, and adverse events from March, 2014, to December, 2020, in the two intervention groups after completion of recruitment and screening, up to the completion of the second faecal immunochemical testing round. Analyses were done in the intention-to-screen population, defined as all individuals who were randomly assigned to the respective study group. This study is registered with Clinical Trials.gov, NCT02078804. Findings Between March 1, 2014, and Dec 31, 2020, 278 280 people were induded in the study; 31 140 were assigned to the colonoscopy group, 60 300 to the faecal immunochemical test group, and 186 840 to the control group. 10 679 (35.1%) of 30 400 people who received an invitation for colonoscopy participated. 33 383 (55.5%) of 60 137 people who received a postal faecal immunochemical test participated. In the intention-to-screen analysis, colorectal cancer was detected in 49 (0.16%) of 31140 people in the colonoscopy group versus 121 (0. 20%) of 60 300 in the faecal immunochemical test group (relative risk [RR] 0.78, 95% CI 0.56-1.09). Advanced adenomas were detected in 637 (2.05%) people in the colonoscopy group and 968 (1.61%) in the faecal immunochemical test group (RR 1.27, 95% CI 1.15-1.41). Colonoscopy detected more right-sided advanced adenomas than faecal immunochemical testing. There were two perforations and 15 major bleeds in 16 555 colonoscopies. No intervention-related deaths occurred. Interpretation The diagnostic yield and the low number of adverse events indicate that the design from this trial, both for once-only colonoscopy and faecal immunochemical test screening, could be transferred to a population-based screening service if a benefit in disease-specific mortality is subsequently shown. Copyright (C) 2022 Elsevier Ltd. All rights reserved.
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  • Forss, A, et al. (författare)
  • 'I got a letter ...' a qualitative study of women's reasoning about attendance in a cervical cancer screening programme in urban Sweden
  • 2001
  • Ingår i: Psycho-Oncology. - 1057-9249 .- 1099-1611. ; 10:1, s. 76-87
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: This explorative study aims at investigating how 'healthy' women describe and reason about participation in a cervical cancer screening programme in Sweden. The study is part of a multidisciplinary research project studying a population-based cervical cancer-screening programme from the perspective of different actors. Setting and methods: Data collection took place at three ante-natal health centres (ANHCs) in demographically diverse areas in the Stockholm region in spring 1995. Interviews were conducted and audiotaped with 66 'healthp' women at the ANHCs immediately before taking a Papanicolau test. Open questions such as 'Why have you come here today?' and 'What kind of test will you take?' were used to initiate the interview. Verbatim transcripts were analysed with a modified phenomenographical method to identify and describe qualitatively different ways of understanding cervical cancer screening. Results: Four different ways of reasoning about cervical cancer screening are described, with only one similar to the biomedical rationale for screening with focus on attending for the test/results. Two types of reasoning refer to the invitation letter as a catalyst, with one emphasizing benefits in attendance and the second emphasizing hinders to attendance. A final way of reasoning focuses on the individual's own proactive role in prevention. Common themes are also identified. Implications: This study complements the research literature by providing a better knowledge base of the variations in reasoning among women attending screening, often seen as a homogenous group. It can contribute to better adapting the screening situation to the varied needs and expectations of the women who attend. Copyright (C) 2001 John Wiley & Sons, Ltd.
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  • Heimburg, Katarina, et al. (författare)
  • Physical activity after cardiac arrest; protocol of a sub-study in the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2)
  • 2021
  • Ingår i: Resuscitation Plus. - : Elsevier BV. - 2666-5204. ; 5
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: The primary aim of this study is to investigate whether out-of-hospital cardiac arrest (OHCA) survivors have lower levels of self-reported physical activity compared to a non-cardiac arrest (CA) control group who had acute myocardial infarction (MI). Additional aims are to explore potential predictors of physical inactivity (older age, female gender, problems with general physical function, global cognition, mental processing speed/attention, anxiety symptoms, depression symptoms, kinesiophobia, fatigue), and to investigate the relationship between self-reported and objectively measured physical activity among OHCA-survivors. Methods: The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial) collects information regarding age, gender, self-reported physical activity, general physical function, global cognition and mental processing speed/attention at 6 months after OHCA. In this TTM2-trial cross-sectional prospective sub-study, participants at selected sites are invited to an additional follow-up meeting within 4 weeks from the main study follow-up. At this meeting, information regarding anxiety symptoms, depression symptoms, kinesiophobia and fatigue is collected. The OHCA-survivors are then provided with an objective measure of physical activity, a hip-placed accelerometer, to wear for one week, together with a training diary. At the end of the week, participants are asked to once again answer two self-reported questions regarding physical activity for that specific week. MI-controls attend a single follow-up meeting and perform the same assessments as the OHCA-survivors, except from wearing the accelerometer. We aim to include 110 OHCA-survivors and 110 MI-controls in Sweden, Denmark and the United Kingdom. Conclusion: The results from this sub-study will provide novel information about physical activity among OHCA-survivors.
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48.
  • Heimburg, Katarina, et al. (författare)
  • Self-reported limitations in physical function are common 6 months after out-of-hospital cardiac arrest
  • 2022
  • Ingår i: Resuscitation Plus. - : Elsevier BV. - 2666-5204. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Out-of-hospital cardiac arrest (OHCA) survivors generally report good health-related quality of life, but physical aspects of health seem more affected than other domains. Limitations in physical function after surviving OHCA have received little attention. Aims: To describe physical function 6 months after OHCA and compare it with a group of ST elevation myocardial infarction (STEMI) controls, matched for country, age, sex and time of the cardiac event. A second aim was to explore variables potentially associated with self-reported limitations in physical function in OHCA survivors. Methods: A cross-sectional sub-study of the Targeted Temperature Management at 33 degrees C versus 36 degrees C (TTM) trial with a follow-up 6 months post-event. Physical function was the main outcome assessed with the self-reported Physical Functioning-10 items scale (PF-10). PF-10 is presented as T-scores (0-100), where 50 represents the norm mean. Scores <47 at a group level, or <45 at an individual level indicate limitations in physical function. Results: 287 OHCA survivors and 119 STEMI controls participated. Self-reported physical function by PF-10 was significantly lower for OHCA survivors compared to STEMI controls (mean 46.0, SD 11.2 vs. 48.8, SD 9.0, p= 0.025). 38% of OHCA survivors compared to 26% of STEMI controls reported limitations in physical function at an individual level (p = 0.022). The most predictive variables for self-reported limitations in physical function in OHCA survivors were older age, female sex, cognitive impairment, and symptoms of anxiety and depression after 6 months. Conclusion: Self-reported limitations in physical function are more common in OHCA survivors compared to STEMI controls.
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49.
  • Henriksson, J., et al. (författare)
  • Performance Analysis of Out-of-Distribution Detection on Various Trained Neural Networks
  • 2019
  • Ingår i: 2019 45th Euromicro Conference on Software Engineering and Advanced Applications (SEAA), Kallithea, Greece, 28-30 Aug. 2019. - : IEEE. - 9781728134215
  • Konferensbidrag (refereegranskat)abstract
    • Several areas have been improved with Deep Learning during the past years. For non-safety related products adoption of Al and ML is not an issue, whereas in safety critical applications, robustness of such approaches is still an issue. A common challenge for Deep Neural Networks (DNN) occur when exposed to out-of-distribution samples that are previously unseen, where DNNs can yield high confidence predictions despite no prior knowledge of the input. In this paper we analyse two supervisors on two well-known DNNs with varied setups of training and find that the outlier detection performance improves with the quality of the training procedure. We analyse the performance of the supervisor after each epoch during the training cycle, to investigate supervisor performance as the accuracy converges. Understanding the relationship between training results and supervisor performance is valuable to improve robustness of the model and indicates where more work has to be done to create generalized models for safety critical applications.
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50.
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