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- Eriksson, Jesper, et al.
(författare)
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Temporal patterns of organ dysfunction after severe trauma
- 2021
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Ingår i: Critical Care. - : Springer Nature. - 1364-8535 .- 1466-609X. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Understanding temporal patterns of organ dysfunction (OD) may aid early recognition of complications after trauma and assist timing and modality of treatment strategies. Our aim was to analyse and characterise temporal patterns of OD in intensive care unit-admitted trauma patients. Methods We used group-based trajectory modelling to identify temporal trajectories of OD after trauma. Modelling was based on the joint development of all six subdomains comprising the sequential organ failure assessment score measured daily during the first two weeks post trauma. Further, the time for trajectories to stabilise and transition to final group assignments were evaluated. Results Six-hundred and sixty patients were included in the final model. Median age was 40 years, and median ISS was 26 (IQR 17-38). We identified five distinct trajectories of OD. Group 1, mild OD (n = 300), median ISS of 20 (IQR 14-27), had an early resolution of OD and a low mortality. Group 2, moderate OD (n = 135), and group 3, severe OD (n = 87), were fairly similar in admission characteristics and initial OD but differed in subsequent OD trajectories, the latter experiencing an extended course and higher mortality. In group 3, 56% of the patients developed sepsis as compared with 19% in group 2. Group 4, extreme OD (n = 40), received most blood transfusions, had the highest proportion of shock at admission and a median ISS of 41 (IQR 29-50). They experienced significant and sustained OD affecting all organ systems and a 28-day mortality of 30%. Group 5, traumatic brain injury with OD (n = 98), had the highest mortality of 35% and the shortest time to death for non-survivors, median 3.5 (IQR 2.4-4.8) days. Groups 1 and 5 reached their final group assignment early, > 80% of the patients within 48 h. In contrast, groups 2 and 3 had a prolonged time to final group assignment. Conclusions We identified five distinct trajectories of OD after severe trauma during the first two weeks post-trauma. Our findings underline the heterogeneous course after trauma and describe some potentially important clinical insights that are suggested by the groupings and temporal trajectories.
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| 2. |
- Holst, Anders, et al.
(författare)
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Intertwining operators in inverse scattering
- 2004
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Ingår i: New Analytic and Geometric Methods in Inverse Problems: Lectures Given at the Ems Summer School and Conference Held in Edinburgh, Scotland 2000. - 3540406824 ; , s. 51-92
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Konferensbidrag (refereegranskat)abstract
- In these notes we are going to present a technique which is a multi-dimensional analogue of some methods which are nowadays standard inscattering theory on the real line for the Schrödinger operator. These methods are based on the construction of operators intertwining the Schrödinger operator with the free operator, obtained when the potential term is removed. The multi-dimensional technique using intertwining operators as a tool for the study of Schrödinger operators has its origin in a famous paper by L. D. Faddeev. Various extensions of this technique have been developed during the last years by the second author of this article.
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| 3. |
- Kans, Mirka, 1971-, et al.
(författare)
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Data Driven Maintenance : A Promising Way of Action for Future Industrial Services Management
- 2022
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Ingår i: International Congress and Workshop on Industrial AI 2021. IAI 2021. - Cham : Springer. - 9783030936389 - 9783030936396 ; , s. 212-223, s. 212-223
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Konferensbidrag (refereegranskat)abstract
- Maintenance and services of products as well as processes are pivotal for achieving high availability and avoiding catastrophic and costly failures. At the same time, maintenance is routinely performed more frequently than necessary, replacing possibly functional components, which has negative economic impact on the maintenance. New processes and products need to fulfil increased environmental demands, while customers put increasing demands on customization and coordination. Hence, improved maintenance processes possess very high potentials, economically as well as environmentally. The shifting demands on product development and production processes have led to the emergency of new digital solutions as well as new business models, such as integrated product-service offerings. Still, the general maintenance problem of how to perform the right service at the right time, taking available information and given limitations is valid.The project Future Industrial Services Management (FUSE) project was a step in a long-term effort for catalysing the evolution of maintenance and production in the current digital era. In this paper, several aspects of the general maintenance problem are discussed from a data driven perspective, spanning from technology solutions and organizational requirements to new business opportunities and how to create optimal maintenance plans. One of the main results of the project, in the form of a simulation tool for strategy selection, is also described.
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| 7. |
- Malmberg, Anders, et al.
(författare)
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A real-time assimilation algorithm applied to near-surface ocean wind fields
- 2008
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Ingår i: Environmetrics. - : Wiley. - 1099-095X .- 1180-4009. ; 19:3, s. 319-330
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedMarine operations depend on the ability to forecast suddenly appearing storms, and failures often cause great damage. As part of a sea-state alarm study, meteorological forecasts overlaid with satellite observations sent to ships have been found to be a useful too]. In this paper we present a real-time assimilation algorithm that extends this tool using statistical methods. The algorithm is applied to near-surface ocean wind fields. A Kalman filter based on a spatio-temporal state-space model provides a basis for emulation of the atmospheric model. The main contribution of this paper is the algorithm that makes it possible to use the information in the satellite observations over the full spatial domain of interest at a real-time basis.
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| 8. |
- Malmberg, Anders, et al.
(författare)
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Forecasting near-surface ocean winds with Kalman filter techniques
- 2005
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Ingår i: Ocean Engineering. - : Elsevier BV. - 1873-5258 .- 0029-8018. ; 32:3-4, s. 273-291
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Tidskriftsartikel (refereegranskat)abstract
- In this paper a statistical forecasting model designed for bounded areas of near-surface ocean wind speeds is implemented. Dimension reduction is achieved by decomposing the covariance structure into one large-scale and one small-scale component using empirical orthogonal functions. The large-scale component is modelled with an AR process and forecasts are calculated by applying a Kalman filter. The model is suited for stable weather situations as for unsteady situations it requires more frequent wind information. From the prediction variance fields it is possible to identify where unexpected weather usually enters the area.
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| 9. |
- Nelson, David W., et al.
(författare)
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Multivariate outcome prediction in traumatic brain injury with focus on laboratory values
- 2012
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Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert Inc. - 0897-7151 .- 1557-9042. ; 29:17, s. 2613-2624
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Tidskriftsartikel (refereegranskat)abstract
- Traumatic brain injury (TBI) is a major cause of morbidity and mortality. Identifying factors relevant to outcome can provide a better understanding of TBI pathophysiology, in addition to aiding prognostication. Many common laboratory variables have been related to outcome but may not be independent predictors in a multivariate setting. In this study, 757 patients were identified in the Karolinska TBI database who had retrievable early laboratory variables. These were analyzed towards a dichotomized Glasgow Outcome Scale (GOS) with logistic regression and relevance vector machines, a non-linear machine learning method, univariately and controlled for the known important predictors in TBI outcome: age, Glasgow Coma Score (GCS), pupil response, and computed tomography (CT) score. Accuracy was assessed with Nagelkerke's pseudo R2. Of the 18 investigated laboratory variables, 15 were found significant (p<0.05) towards outcome in univariate analyses. In contrast, when adjusting for other predictors, few remained significant. Creatinine was found an independent predictor of TBI outcome. Glucose, albumin, and osmolarity levels were also identified as predictors, depending on analysis method. A worse outcome related to increasing osmolarity may warrant further study. Importantly, hemoglobin was not found significant when adjusted for post-resuscitation GCS as opposed to an admission GCS, and timing of GCS can thus have a major impact on conclusions. In total, laboratory variables added an additional 1.3-4.4% to pseudo R2.
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