Publikationer från Uppsala Universitet
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Positive surgical margin and oncological outcomes after robot-assisted radical prostatectomy in different Cancer of the Prostate Risk Assessment risk groups
No full textObjective To evaluate the impact of a positive surgical margin (PSM) in relation to the risk of biochemical recurrence (BCR) and additional treatment in different preoperative Cancer of the Prostate Risk Assessment (CAPRA) risk groups after robot-assisted radical prostatectomy (RARP). Patients and methods Retrospective cohort study of 1039 patients subjected to RARP for prostate cancer at a single European institution. PSM was stratified by extent (focal extensive). The CAPRA score was used for risk group stratification. BCR was defined as a prostate-specific antigen level >0.2 ng/mL. Additional treatment was defined as salvage radiotherapy (sRT) and/or androgen-deprivation therapy (ADT). Results In total 227 patients had a PSM (21.8%). When compared to a negative surgical margin, an extensive PSM was associated with an increased risk of BCR (hazard ratio [HR] 2.16, 95% confidence interval [CI] 2.09–8.29; HR 3.76, 95% CI 2.33–6.06; HR 2.35, 95% CI 1.03–5.38) and sRT (HR 3.75, 95% CI 1.45–9.7; HR 4.57, 95% CI 2.47–8.43; HR 9.32, 95% CI 1.06–14.82) in the low-, intermediate- and high-risk groups, respectively. In high-risk patients a focal PSM was associated with an increased risk of BCR (HR 5.79, 95% CI 1.62–20.65), sRT (HR 9.32, 95% CI 1.7–50.95) and ADT (HR 4.11, 95% CI 1.08–15.57) whereas in low- and intermediate-risk patients a modest effect on BCR but no significant effect on sRT or ADT was found. We found no significant interaction between CAPRA risk group and PSM (P = 0.25). Conclusions While an extensive PSM was associated with an increased risk of recurrence in all risk groups, a focal PSM was associated with additional treatment only among men with high-risk tumours
The Experience of Abuse and Depressive Symptoms Among Adolescents in a Post-Conflict Setting : A Cross-Sectional Study
No full textThis study aimed to explore the relationship between the experience of abuse and depressive symptoms among children and adolescents in a post-conflict setting while controlling for perceived support and individual background factors. This cross-sectional study was conducted in the post-conflict setting of Borama, Somaliland. A total of 645 adolescents that attended upper primary and lower secondary schools were included. The exposure variables were (a) experience of physical abuse, (b) experience of psychological abuse, and (c) experience of either or both forms of abuse. The outcome was depressive symptoms as measured by the Patient Health Questionnaire-9. Physical and psychological abuse were associated with higher levels of depressive symptoms (B = 2.74, p < 0.001 and B = 1.62, p < 0.001, respectively). The girls had higher levels of depressive symptoms than the boys (B = 0.71, p = 0.004). Moreover, a greater age was associated with higher levels of symptoms (B = 0.17, p = 0.033). Higher social support levels were associated with lower levels of depressive symptoms (B = -0.08, p = 0.001). Our findings suggest that interventions providing social support to adolescents who experience abuse may be beneficial in reducing depressive symptoms
The spatiotemporal distribution of human pathogens in ancient Eurasia
No full textInfectious diseases have had devastating effects on human populations throughout history, but important questions about their origins and past dynamics remain1. To create an archaeogenetic-based spatiotemporal map of human pathogens, we screened shotgun-sequencing data from 1,313 ancient humans covering 37,000 years of Eurasian history. We demonstrate the widespread presence of ancient bacterial, viral and parasite DNA, identifying 5,486 individual hits against 492 species from 136 genera. Among those hits, 3,384 involve known human pathogens2, many of which had not previously been identified in ancient human remains. Grouping the ancient microbial species according to their likely reservoir and type of transmission, we find that most groups are identified throughout the entire sampling period. Zoonotic pathogens are only detected from around 6,500 years ago, peaking roughly 5,000 years ago, coinciding with the widespread domestication of livestock3. Our findings provide direct evidence that this lifestyle change resulted in an increased infectious disease burden. They also indicate that the spread of these pathogens increased substantially during subsequent millennia, coinciding with the pastoralist migrations from the Eurasian Steppe4,5
Challenges Pertaining to the Optimization of Therapy and the Management of Asthma-Results from the 2023 EU-LAMA Survey
No full textBackground: Treatment compliant with the Global Initiative for Asthma (GINA) can promote more effective disease control. Single-inhaler triple therapy (SITT) is one method that is used to optimize therapy in this context, but TRIPLE therapy is still employed by physicians to a limited extent. Objective: This study aimed to describe the factors influencing challenges in optimizing asthma therapy. Methods: A 19-question survey, created via the CATI system, was distributed among pulmonologists, allergologists, general practitioners, and internal medicine specialists in Poland, Greece, Sweden, Slovenia, and Austria. Results: Statistically significant percentage differences in the use of TRIPLE therapy in the context of asthma management were observed among countries as well as between pulmonologists, allergists, and other specialists. Overuse of oral corticosteroids (OCSs) to treat nonsevere and severe asthma in the absence of an approach that focuses on optimizing inhalation therapy among asthma patients receiving TRIPLE therapy was observed in different countries as well as among physicians with different specialties. Twenty elements associated with the challenges involved in diagnosing and managing difficult-to-treat and severe asthma were identified. Six clinical categories for the optimization of asthma therapy via SITT were highlighted. The degree of therapeutic underestimation observed among severe asthma patients was assessed by comparing actual treatment with the recommendations of the GINA 2023 guidelines. Conclusions: Physicians of various specialties in Europe are subject to therapeutic inertia in terms of their compliance with the GINA 2023 guidelines
Atypical Carcinoid of the Thymus : Early Diagnosis in a Case Report
No full textBackground: Atypical carcinoid of the thymus is an exceptionally rare neuroendocrine tumor originating from neuroendocrine cells within the thymus. These tumors often present with no symptoms or with nonspecific clinical signs, making early diagnosis particularly challenging. Despite their rarity, atypical carcinoids are clinically significant due to their aggressive nature and relatively poor prognosis. Early detection and appropriate management are therefore crucial to improving patient outcomes. Results: In this report, we present the case of a 64-year-old patient in whom an atypical carcinoid of the thymus was incidentally discovered following a thoracic computed tomography scan performed for unrelated reasons. Imaging revealed a suspicious anterior mediastinal mass, which was subsequently surgically resected. Histopathological examination, supported by immunohistochemical analysis, confirmed the diagnosis of an atypical carcinoid of the thymus. The tumor demonstrated coexpression of epithelial and neuroendocrine markers, consistent with this rare entity. Conclusions: This case adds to the limited body of literature on atypical carcinoid of the thymus and highlights the importance of considering this diagnosis when evaluating anterior mediastinal masses. It also underscores the value of thorough radiological and pathological assessment in identifying early-stage disease, which may significantly influence prognosis and therapeutic strategies
ROCKE-3D 2.0 : an updated general circulation model for simulating the climates of rocky planets
No full textWe present the second generation of ROCKE-3D (Resolving Orbital and Climate Keys of Earth and Extraterrestrial Environments with Dynamics), a generalized three-dimensional general circulation model (GCM) for use in Solar System and exoplanetary simulations of rocky planet climates. ROCKE-3D version 2.0 is a descendant of ModelE2.1, the flagship Earth system model of the NASA Goddard Institute for Space Studies (GISS) used in the most recent Intergovernmental Panel on Climate Change (IPCC) assessments. ROCKE-3D is a continuous effort to expand the capabilities of GISS ModelE to handle a broader range of planetary conditions, including different atmospheric planet sizes, gravities, pressures, and rotation rates; more diverse chemistry schemes and atmospheric compositions; diverse ocean and land distributions and topographies; and potential basic biosphere functions. In this release we present updated physics and many more supported configurations which can serve as starting points to simulate the atmospheres of rocky terrestrial planets of interest. Two different radiation schemes are supported, the GISS radiation, valid only for atmospheres similar to that of modern Earth, and SOCRATES, which is more generalized but more computationally expensive. While ROCKE-3D can simulate a very wide range of planetary and atmospheric configurations, we describe here a small subset of them, with the goal of demonstrating the structural capabilities, rather than the scientific breadth, of the model. Three different atmospheric composition options (preindustrial Earth, the aerosol-free and ozone-free atmosphere used in ROCKE-3D 1.0, and an anoxic atmosphere with no aerosols), three ocean configurations (prescribed, Q-flux, and dynamic), and two resolutions are described: the medium resolution (4x5° in latitude and longitude, previously used in ROCKE-3D 1.0) and the fine resolution, which has double the resolution in the atmosphere and 4 times the horizontal and 3 times the vertical resolution in the ocean. Finally, for the land surface hydrology, we have introduced generalized physics for arbitrary topography in the pooling and evaporation of water and river transport of water between grid cells, as well as for the vertical stratification of temperature in dynamic lakes. We quantify how the different component choices affect model results and discuss the strengths and limitations of using each component, together with how one can select which component to use. ROCKE-3D is publicly available, and tutorial sessions are available for the community, greatly facilitating its use by any interested group
Comparative study of lung cancer care and survival outcomes across the Nordic countries
No full textBackground: Lung cancer (LC) is the leading cause of cancer-related deaths worldwide. Despite societal, economic and genetic similarities, 5-year age-standardized relative survival rate is lower in Finland compared to the other Nordic countries. Previous studies have identified discrepancies in LC guidelines, but research on actual care practices remains limited. We aim to address this knowledge gap by conducting a comprehensive examination of the current care practices for LC patients in the Nordic countries. Methods: We employed a non-interventional, prospective study design. We conducted an expert workshop involving LC specialists from Finland to formulate relevant questions for a structured survey. This survey was distributed to healthcare professionals (HCPs) across Nordic hospitals and primary care units. The survey results were then analyzed, and a follow-up Nordic LC expert workshop was held to identify the most relevant factors potentially influencing LC survival outcomes. Results: Four key differences in care practices between Finland and other Nordic countries were identified: (1) resources available in primary care units, (2) waiting times in primary care, (3) availability of novel treatments and (4) tracking of LC survival and mortality outcomes by the hospital. Finland has the lowest access to computed tomography (CT) from primary care, longest waiting times in primary care, and lacks a national outcome tracking system. Some medical doctors in Finland and Iceland highlighted observed limitations in specific cases involving access to neoadjuvant immunotherapy and chemotherapy. Interpretation: Several factors unrelated to specialized LC care are likely contributing to poorer 5-year survival rates for LC in Finland. These findings may be applicable to other healthcare systems as well
Multimodal large language models and physics visual tasks : comparative analysis of performance and costs
No full textMultimodal large language models (MLLMs) capable of processing both text and visual inputs are increasingly being explored for uses in physics education, such as tutoring, formative assessment, and grading. This study evaluates a range of publicly available MLLMs on a set of standardized, image-based physics research-based conceptual assessments (concept inventories). We benchmark 15 models from three major providers (Anthropic, Google, and OpenAI) across 102 physics items, focusing on two main questions: (1) How well do these models perform on conceptual physics tasks involving visual representations? and (2) What are the financial costs associated with their use? The results show high variability in both performance and cost. The performance of the tested models ranges from 81.5% to as low as 21%. We also found that expensive models do not always outperform cheaper ones and that, depending on the demands of the context, cheaper models may be sufficiently capable for some tasks. This is especially relevant in contexts where financial resources are limited or for large-scale educational implementation of MLLMs. By providing these analyses, our aim is to inform teachers, institutions, and other educational stakeholders so that they can make evidence-based decisions about the selection of models for use in AI-supported physics education
Differential Gastric Motility, Gut Hormone, and Appetite Changes Following A Mixed Meal in People With Obesity and Healthy Controls
No full textIntroduction Understanding meal-induced changes of gut hormones, gastric motility, and appetite is crucial for developing therapies for obesity. We investigated glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), ghrelin, and motilin influences on gastric motility and appetite, to compare healthy individuals and people with obesity. Methods Subjects (healthy n = 41; obesity n = 32) consumed a 270-kcal meal and a wireless motility capsule. GIP, active GLP-1, acyl-ghrelin, and motilin were measured by electrochemiluminescence. MotiliGI and GIMS software were used for motility analysis, while visual analog scoring measured appetite. Results Gastric emptying was more rapid in people with obesity than in healthy individuals (p < 0.01). Gastric emptying time was negatively associated with motility index and hunger contractions (p < 0.01, p < 0.05) in healthy individuals, but not in individuals with obesity. In controls, gastric motility index correlated positively with acyl-ghrelin (p < 0.01) and motilin (p < 0.0001), and negatively with GIP (p < 0.05), but not aGLP-1. In people with obesity, no gut hormones correlated with the motility index. In both groups, GIP and aGLP-1 correlated with decreased hunger (p < 0.0001, p = 0.001) and (p < 0.0001, p < 0.05), along with increased satiety in controls (p < 0.0001, p = 0.001) and people with obesity (p = 0.049, p = 0.01). Acyl-ghrelin correlated positively with hunger (p < 0.0001) and negatively with satiety (p = 0.049) in controls, but not in obesity. Motilin was neither associated with hunger nor satiety. Conclusion In the gastric phase, people with obesity show rapid gastric emptying with altered hormone and motility meal responses. In healthy individuals, GIP promotes satiety, and ghrelin and motilin promote hunger through actions on motility. Like GIP, GLP-1 promotes satiety along with trending suppression of gastric motility
Measurements of ψ\u88(2S) and χc1(3872) production within fully reconstructed jets
No full textThis paper presents the first measurement of ψ(2S) and χc1(3872) meson production within fully reconstructed jets. Each quarkonium state (tag) is reconstructed via its decay to the J/ψ(→μ+μ-)π+π- final state in the forward region using proton-proton collision data collected by the LHCb experiment at the center-of-mass-energy of 13TeV in 2016, corresponding to an integrated luminosity of 1.64 fb-1. The fragmentation function, presented as the ratio of the quarkonium-tag transverse momentum to the full jet transverse momentum (pT(tag)/pT(jet)), is measured differentially in pT(jet) and pT(tag) bins. The distributions are separated into promptly produced quarkonia from proton-proton collisions and quarkonia produced from displaced b-hadron decays. While the displaced quarkonia fragmentation functions are in general well described by parton-shower predictions, the prompt quarkonium distributions differ significantly from fixed-order non-relativistic QCD (NRQCD) predictions followed by a QCD parton shower.For complete list of authors see http://dx.doi.org/10.1140/epjc/s10052-025-13852-4</p