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BioMEL: a translational research biobank of melanocytic lesions and melanoma

Por: Helkkula · T. · Christensen · G. · Ingvar · C. · Isaksson · K. · Harbst · K. · Persson · B. · Ingvar · A. · Hafström · A. · Carneiro · A. · Gaspar · V. · Jönsson · G. · Nielsen · K.
Introduction

Diagnosing invasive cutaneous melanoma (CM) can be challenging due to subjectivity in distinguishing equivocal nevi, melanoma in situ and thin CMs. The underlying molecular mechanisms of progression from nevus to melanoma must be better understood. Identifying biomarkers for treatment response, diagnostics and prognostics is crucial. Using biomedical data from biobanks and population-based healthcare data, translational research can improve patient care by implementing evidence-based findings. The BioMEL biobank is a prospective, multicentre, large-scale biomedical database on equivocal nevi and all stages of primary melanoma to metastases. Its purpose is to serve as a translational resource, enabling researchers to uncover objective molecular, genotypic, phenotypic and structural differences in nevi and all stages of melanoma. The main objective is to leverage BioMEL to significantly improve diagnostics, prognostics and therapy outcomes of patients with melanoma.

Methods and analysis

The BioMEL biobank contains biological samples, epidemiological information and medical data from adult patients who receive routine care for melanoma. BioMEL is focused on primary and metastatic melanoma, but equivocal pigmented lesions such as clinically atypical nevi and melanoma in situ are also included. BioMEL data are gathered by questionnaires, blood sampling, tumour imaging, tissue sampling, medical records and histopathological reports.

Ethics and dissemination

The BioMEL biobank project is approved by the national Swedish Ethical Review Authority (Dnr. 2013/101, 2013/339, 2020/00469, 2021/01432 and 2022/02421-02). The datasets generated are not publicly available due to regulations related to the ethical review authority.

Trial registration number

NCT05446155.

Physical activity, acute severity and long-term consequences of COVID-19: an 18-month follow-up survey based on a Swedish national cohort

Por: Palstam · A. · Seljelid · J. · Persson · H. C. · Sunnerhagen · K. S.
Objective

To investigate how changes in levels of physical activity (PA) in regard to acute disease severity relate to perceived difficulties in performing daily life activities 18 months after COVID-19 infection.

Design

An observational study with an 18-month follow-up survey based on registry data from a national cohort.

Participants

5464 responders to the 18-month follow-up survey of a Swedish national cohort of 11 955 individuals on sick leave due to COVID-19 during the first wave of the pandemic.

Outcomes

The follow-up survey included questions on daily life activities, as well as present and retrospective level of PA. Changes in PA level from before COVID-19 to follow-up were assessed by the Saltin-Grimby PA Level Scale and analysed by the Wilcoxon signed-rank test. Comparisons of groups were analysed by the Student’s t-test, Mann-Whitney U test and 2. Multiple binary logistic regression was performed to assess the association of changes in PA with perceived difficulties in performing daily life activities.

Results

Among the 5464 responders (45% of national cohort), the PA level decreased. Hospitalised individuals had a lower PA level both prior to COVID-19 (p=0.035) and at the 18-month follow-up (p=0.008) compared with non-hospitalised responders. However, the level of PA decreased in both groups. A decrease in PA level increased the odds (OR 5.58, 95% CI 4.90 to 6.34) of having difficulties performing daily life activities.

Conclusions

PA levels were reduced 18 months after COVID-19 infection. A decrease in PA over that time was associated with perceived difficulties performing daily life activities 18 months after COVID-19. As PA is important in maintaining health and deconditioning takes time to reverse, this decline may have long-term implications for PA and health.

Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis: cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study

Por: Ekblom-Bak · E. · Börjesson · M. · Ekblom · O. · Angeras · O. · Bergman · F. · Berntsson · C. · Carlhäll · C.-J. · Engström · G. · Engvall · J. · Fagman · E. · Flinck · A. · Johansson · P. · Jujic · A. · Kero · T. · Lind · L. · Mannila · M. · Ostenfeld · E. · Persson · A. · Persson
Objectives

The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours.

Design

Cross-sectional.

Setting

Multisite study at university hospitals.

Participants

A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer.

Primary and secondary outcomes

Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound.

Results

High daily SED (>70% 10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% 8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% 20 min/day, associated with lower OR for significant CA (OR range 0.61–0.67), CACS (OR range 0.71–0.75) and CarA (OR range 0.72–0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73).

Conclusions

MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.

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