Malmbanan Diaries

This booklet is a report for a case study visit during four day field trip, a group of nine PhD students and their supervisors – all part of the National Research School for Architecture and Planning in the Urban Landscape, APULA – set out to explore what may be considered the outback of Western Europe’s conurbations, the transnational region of Kiruna -Narvik.Both “remote” and “resourceful”, “threatened” and “thriving” (equally relative notions), this region seemed to offer possibilities to reflect upon many of the current tendencies influencing contemporary planning practice and research

Long-term tolerability and efficacy after initial PegIFN-alpha addition to dasatinib in CML-CP : Five-year follow-up of the NordCML007 study

Objectives Treatment-free remission (TFR) has emerged as a treatment goal in chronic myeloid leukemia in the chronic phase (CML-CP). Attempts to increase proportion of patients achieving TFR include combination of tyrosine kinase inhibitors (TKI) and other drugs. Interferon-alpha in addition to TKI has shown promising efficacy but with dose-dependent toxicity and discontinuations. NordCML007 was initiated to study the efficacy and safety of low dose pegylated IFN-alpha (PegIFN-alpha) in combination with dasatinib (DAS) in CML-CP. Methods Forty patients with newly diagnosed CML-CP were given DAS upfront. After month 3 (M3) 15 mu g/wk of PegIFN-alpha was added and increased to 25 mu g/wk from M7 until M15. DAS treatment was continued and adverse events and BCR-ABL1 qRT-PCR values were reported yearly after M24. Results from M1 to M18 have previously been published, and here we present long-term data. Results After 5 years of follow-up, there were no suspected unexpected serious adverse reactions, no increase in serosal effusions, no disease progressions and no CML-related deaths. Rates of MR3.0 (MMR), MR4.0 and MR4.5 were 84.6%, 64.1% and 51.3% respectively at M60, and 95% of patients reached MMR at some point during the study. Conclusion Initial addition of PegIFN-alpha to DAS shows good long-term efficacy without increased toxicity.Peer reviewe

Molecular status 36 months after TKI discontinuation in CML is highly predictive for subsequent loss of MMR-final report from AFTER-SKI

Non peer reviewe

IFN-α with dasatinib broadens the immune repertoire in patients with chronic-phase chronic myeloid leukemia

In chronic myeloid leukemia (CML), combination therapies with tyrosine kinase inhibitors (TKIs) aim to improve the achievement of deep molecular remission that would allow therapy discontinuation. IFN-alpha is one promising candidate, as it has long-lasting effects on both malignant and immune cells. In connection with a multicenter clinical trial combining dasatinib with IFN-alpha in 40 patients with chronic-phase CML (NordCML007, NCT01725204), we performed immune monitoring with single-cell RNA and T cell receptor (TCR) sequencing (n = 4, 12 samples), bulk TCR beta sequencing (n = 13, 26 samples), flow cytometry (n = 40, 106 samples), cytokine analyses (n = 17, 80 samples), and ex vivo functional studies (n = 39, 80 samples). Dasatinib drove the immune repertoire toward terminally differentiated NK and CD8+ T cells with dampened functional capabilities. Patients with dasatinib-associated pleural effusions had increased numbers of CD8(+) recently activated effector memory T (Temra) cells. In vitro, dasatinib prevented CD3-induced cell death by blocking TCR signaling. The addition of IFN-alpha reversed the terminally differentiated phenotypes and increased the number of costimulatory intercellular interactions and the number of unique putative epitope-specific TCR clusters. In vitro IFN-alpha had costimulatory effects on TCR signaling. Our work supports the combination of IFN-alpha with TKI therapy, as IFN-alpha broadens the immune repertoire and restores immunological function.Peer reviewe

Property-level environmental assessment tools for outdoor areas

There is an increasing interest for building environmental assessment tools in the society. These tools simultaneously consider differing aspects in the built environment although when the aspects most often are of various environmental significance. The structures of the tools i.e. offer a framework to deal with a lot of aspects at the same time. Many actors regard tools to be valuable support for decision making, marketing purposes, communication, and for gaining information. This thesis is focussing on tools that assess outdoor environments within the structure of building environmental assessment tools. There are two parts in the study. The first part is dealing with tool development; three tools in various levels were developed. One comprehensive tool, including both building and site; one tool for outdoor area assessment; and one tool for in-depth assessment of a single aspect of the outdoor environment, namely biodiversity. The second part is a comparative analysis of ten building environmental assessment tools. In the comparison of the tools, many differences were found. For example in scope, structure, metrics and the weighting procedure. All these differences are hindering the transparency of the tools and the comparability between various tools. In addition the concept use among the tools is not standardized. The fundamental values and presuppositions for tools have to be declared to reach more transparent tools for making comparison possible and reliable assessments that are societal accepted

Miljövärdering av utemiljöer

Ett av fem delområden i miljövärderingsmetoden för bebyggelse, EcoEffect, ärv miljöbedömning av utemiljöer. Verktyget kallas EcoEffect Ute. Övriga delområden som värderas är energi, material, innemiljö och livscykelkostnader. Utemiljöbedömningen är tillsammans med innemiljövärderingen en värdering av intern miljöpåverkan, det vill säga den påverkan som sker här och nu. Effekter som uppkommer av flöden av energi eller material genom fastigheten, till exempel bränsleförbrukning, är exempel på extern miljöpåverkan. Det värderas i delområdena energi och material. Det femte området, livscykelkostnader, är ett sätt att visa miljörelaterade kostnader, det vill säga kostnader som är direkt bundna till aktiviteter som innebär miljöpåverkan i det långa perspektivet. Syftet med verktyget är att ge underlag för beslut och jämförelser; att upplysa aktörer, köpare, förvaltare och boende; samt att formulera och utvärdera miljömål. EcoEffect Ute försöker kvantifiera risken för att människor som vistas på fastigheten ska påverkas negativt av förhållandena i utemiljön. I EcoEffect Ute värderas egenskaper och tillstånd, förhållanden i den fysiska miljön som kan ha betydelse för människors hälsa. Det kallas skyddsobjekt och all värdering sker med påverkan på människors hälsa som bedömningsgrund. I utemiljön påverkas människor på ett flertal sätt och påverkan kommer både utifrån och uppstår inom fastigheten. Fastighetens läge och omgivningar bestämmer hur utsatt en plats är för exempelvis luftföroreningar och buller. Det är påverkan utifrån. Fördelningen mellan sol och skugga samt blåsighet bestäms främst av hur fastigheten är utformad. Det är exempel på påverkan som uppstår inom fastigheten. Bedömningen är möjlig att genomföra både för befintlig fastighet och för planerad fastighet. När en befintlig fastighet ska värderas ingår en enkät till brukare, besiktning, beräkningar och ett fåtal provtagningar och mätningar. För en planerad fastighet ligger främst bygghandlingarna till grund för värderingen. Följande utemiljöfaktorer bedöms i EcoEffect Ute: luftkvalitet, närklimat, ljudförhållanden, elmiljö, föroreningar, biologisk mångfald, markförhållanden och dagvattenavledning. Värderingen är hierarkiskt uppbyggd och utemiljöfaktorena kan innefatta flera underfaktorer. Den lägsta nivån i hierarkin består av de mätbara parametrarna som bedöms och tilldelas ett belastningsvärde. Skalan sträcker sig mellan 0 och 3. Belastningsvärde 0 innebär försumbar risk för påverkan och belastningsvärde 3 innebär större risk än normalt för påverkan. Belastningsvärde 2 motsvarar normal risk, praxisvärde eller gränsvärde som myndighet har fastställt. Resultatet kan presenteras på olika sätt, aggregerat, det vill säga sammanviktat eller varje parameter för sig då resultatet kan presenteras i detalj som till exempel ett staplediagram. Det är också möjligt att presentera olika nyckeltal med en värdering

Evaluación de la posición sentada en niños colombianos con parálisis cerebral

IP 1101-04-002-95Vol. 8, no.3 (Dic.1995-Mar.1996); p. 15-17. -- ISSN 01211234.--Colombiaen el Karolinska / Aydei Luisa;Robayo de M. -- En: Venciendo Barreras. -- Vol. 9, no.1 (Abr.-Jun.1996); p. 18-19. -- ISSN 01211234. -- Una; Vol.10, no. 2 (Ago.- Nov. 1997); p. 7-9. -- Disertandosobrerehabilitacion / Aydei Luisa Robayo de M. --;En: Venciendo Barreras. -- Vol. 10, no. 2 (ago-nov 1997);p. 1-415. -- ISSN 01211232. -- La rehabilitacion en;progreso : nuevas tendencias y desafios / Jorge Rincon Viatela.'-- en: Asociacion Colombiana de Fisioterapia.; Vol. 31, no. 19; p. 25-27.;modelo de la dinamica de una discapacidad / Aydei Luisa Robayode M. ... [et al.]. -- En: Venciendo Barreras.;propuesta de investigacion para la discapacidad en Colombia /Aydei LuisaRobayo de M., Jorge Rincon. -- En:;Venciendo Barreras. -- Vol. 9, no.3 (Dic.1996-Mar.1997); p. 23-25. -- ISSN01211232 -- La paralisis cerebral:;ARTICULO(S) EN REVISTA: Una observacion sentada / Aydei LuisaRobayo de M.-- En: Venciendo Barreras.-

Adverse outcomes in chronic myeloid leukemia patients treated with tyrosine kinase inhibitors : Follow-up of patients diagnosed 2002–2017 in a complete coverage and nationwide agnostic register study

Tyrosine kinase inhibitors (TKIs) have profoundly improved the clinical outcome for patients with chronic myeloid leukemia (CML), but their overall survival is still subnormal and the treatment is associated with adverse events. In a large cohort-study, we assessed the morbidity in 1328 Swedish CML chronic phase patients diagnosed 2002–2017 and treated with TKIs, as compared to that in carefully matched control individuals. Several Swedish patient registers with near-complete nationwide coverage were utilized for data acquisition. Median follow-up was 6 (IQR, 3–10) years with a total follow-up of 8510 person-years for the full cohort. Among 670 analyzed disease categories, the patient cohort showed a significantly increased risk in 142 while, strikingly, no category was more common in controls. Increased incidence rate ratios/IRR (95% CI) for more severe events among patients included acute myocardial infarction (AMI) 2.0 (1.5–2.6), heart failure 2.6 (2.2–3.2), pneumonia 2.8 (2.3–3.5), and unspecified sepsis 3.5 (2.6–4.7). When comparing patients on 2nd generation TKIs vs. imatinib in a within-cohort analysis, nilotinib generated elevated IRRs for AMI (2.9; 1.5–5.6) and chronic ischemic heart disease (2.2; 1.2–3.9), dasatinib for pleural effusion (11.6; 7.6–17.7) and infectious complications, for example, acute upper respiratory infections (3.0; 1.4–6.0). Our extensive real-world data reveal significant risk increases of severe morbidity in TKI-treated CML patients, as compared to matched controls, particularly for 2nd generation TKIs. Whether this increased morbidity may also translate into increased mortality, thus preventing CML patients to achieve a normalized overall survival, needs to be further explored