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- Halliday, Alison, et al.
(författare)
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10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1) : A multicentre randomised trial
- 2010
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 376:9746, s. 1074-1084
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Tidskriftsartikel (refereegranskat)abstract
- Background If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Methods Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0·3-2·5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6-11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392. Findings 1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89·7 versus 4·8 at 1 year (and 92·1 vs 16·5 at 5 years). Perioperative risk of stroke or death within 30 days was 3·0 (95 CI 2·4-3·9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4·1 versus 10·0 at 5 years (gain 5·9, 95 CI 4·0-7·8) and 10·8 versus 16·9 at 10 years (gain 6·1, 2·7-9·4); ratio of stroke incidence rates 0·54, 95 CI 0·43-0·68, p<0·0001. 62 versus 104 had a disabling or fatal stroke, and 37 versus 84 others had a non-disabling stroke. Combining perioperative events and strokes, net risks were 6·9 versus 10·9 at 5 years (gain 4·1, 2·0-6·2) and 13·4 versus 17·9 at 10 years (gain 4·6, 1·2-7·9). Medication was similar in both groups; throughout the study, most were on antithrombotic and antihypertensive therapy. Net benefits were significant both for those on lipid-lowering therapy and for those not, and both for men and for women up to 75 years of age at entry (although not for older patients). Interpretation Successful CEA for asymptomatic patients younger than 75 years of age reduces 10-year stroke risks. Half this reduction is in disabling or fatal strokes. Net benefit in future patients will depend on their risks from unoperated carotid lesions (which will be reduced by medication), on future surgical risks (which might differ from those in trials), and on whether life expectancy exceeds 10 years. Funding UK Medical Research Council, BUPA Foundation, Stroke Association.
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- Tabakov, S, et al.
(författare)
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Development of educational image databases and e-books for medical physics training
- 2005
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Ingår i: Medical Engineering & Physics. - : Elsevier BV. - 1873-4030 .- 1350-4533. ; 27:7, s. 591-598
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Tidskriftsartikel (refereegranskat)abstract
- Medical physics education and training requires the use of extensive imaging material and specific explanations. These requirements provide an excellent background for application of e-Learning. The EU projects Consortia EMERALD and EMIT developed five volumes of such materials, now used in 65 countries. EMERALD developed e-Learning materials in three areas of medical physics (X-ray diagnostic radiology, nuclear medicine and radiotherapy). EMIT developed e-Learning materials in two further areas: ultrasound and magnetic resonance imaging. This paper describes the development of these e-Learning materials (consisting of e-books and educational image databases). The e-books include tasks helping studying of various equipment and methods. The text of these PDF e-books is hyperlinked with respective images. The e-books are used through the readers' own Internet browser. Each Image Database (IDB) includes a browser, which displays hundreds of images of equipment, block diagrams and graphs, image quality examples, artefacts, etc. Both the e-books and IDB are engraved on five separate CD-ROMs. Demo of these materials can be taken from www.emerald2.net.
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- Jönsson, Bo-Anders, et al.
(författare)
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EMERALD & EMIT – worldwide computer aided education and training packages in medical physics
- 2005
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Ingår i: CAL-laborate. - 1443-4482. ; 13:June, s. 10-15
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Tidskriftsartikel (refereegranskat)abstract
- This paper describes the development of two web based education and training packages EMERALD and EMIT designed to meet the training needs of professional medical physicists. The programme has been developed over a number of years by collaboration between hospitals and universities across Europe. The programme concentrates on assisting competence development in five initial areas; diagnostic radiology, nuclear medicine, magnetic resonance tomography, ultrasound and radiotherapy. Each of the topic areas includes around 50 training tasks in 5 hypertext workbooks, which are supplemented by an image database relevant to each topic. The training materials have been extensively refereed during their development and are now in use in 65 countries across the globe. Initial evaluation has shown that the material enhances the training experience and produces a more consistent output.
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- Dillier, N, et al.
(författare)
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Measurement of the electrically evoked compound action potential via a neural response telemetry system
- 2002
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Ingår i: Annals of Otology, Rhinology & Laryngology. - 0003-4894. ; 111:5, s. 407-414
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Tidskriftsartikel (refereegranskat)abstract
- The main aim of this study was to validate a new technique, neural response telemetry (NRT), for measuring the electrically evoked compound action potential in adult cochlear implant users via their Nucleus CI24M implant. Thirty-eight adults were evaluated with a variety of measurement procedures with the NRT software. Electrically evoked compound action potentials were obtained in 31 of the 38 adults (81.6%) and in 132 of the 160 electrodes (82.5%) tested. In addition to validating this technique, We also established a set of default clinical test parameters.
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- Franks, P. W., et al.
(författare)
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Technological readiness and implementation of genomic-driven precision medicine for complex diseases
- 2021
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 290:3, s. 602-620
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Forskningsöversikt (refereegranskat)abstract
- The fields of human genetics and genomics have generated considerable knowledge about the mechanistic basis of many diseases. Genomic approaches to diagnosis, prognostication, prevention and treatment - genomic-driven precision medicine (GDPM) - may help optimize medical practice. Here, we provide a comprehensive review of GDPM of complex diseases across major medical specialties. We focus on technological readiness: how rapidly a test can be implemented into health care. Although these areas of medicine are diverse, key similarities exist across almost all areas. Many medical areas have, within their standards of care, at least one GDPM test for a genetic variant of strong effect that aids the identification/diagnosis of a more homogeneous subset within a larger disease group or identifies a subset with different therapeutic requirements. However, for almost all complex diseases, the majority of patients do not carry established single-gene mutations with large effects. Thus, research is underway that seeks to determine the polygenic basis of many complex diseases. Nevertheless, most complex diseases are caused by the interplay of genetic, behavioural and environmental risk factors, which will likely necessitate models for prediction and diagnosis that incorporate genetic and non-genetic data.
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- Hoglund, L, et al.
(författare)
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Selective optical doping to predict the performance and reveal the origin of photocurrent peaks in quantum dots-in-a-well infrared photodetectors
- 2009
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Ingår i: INFRARED PHYSICS and TECHNOLOGY. - Exeter : Elsevier BV. - 1350-4495 .- 1879-0275. ; 52:6, s. 272-275
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Tidskriftsartikel (refereegranskat)abstract
- Resonant optical pumping across the band gap was used as artificial doping in InAs/In0.15Ga0.85As/GaAs quantum dots-in-a-well infrared photodetectors. Through efficient filling of the quantum dot energy levels by simultaneous optical pumping into the ground states and the excited states of the quantum dots, the response was increased by a factor of 10. Low temperature photocurrent peaks observed at 120 and 148 meV were identified as intersubband transitions emanating from the quantum dot ground state and the quantum dot excited state, respectively by a selective increase of the electron population in the different quantum dot energy levels.
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| 9. |
- Höglund, Linda, 1974-, et al.
(författare)
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Bias and temperature dependence of the escape processes in quantum dots-in-a-well infrared photodetectors
- 2008
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Ingår i: Applied Physics Letters. - New York : American Institute of Physics (AIP). - 0003-6951 .- 1077-3118. ; 93:10, s. 103501-
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Tidskriftsartikel (refereegranskat)abstract
- The performance of quantum dots-in-a-well infrared photodetectors (DWELL IPs) has been studied by means of interband and intersubband photocurrent measurements as well as dark current measurements. Using interband photocurrent measurements, substantial escape of electrons from lower lying states in the DWELL structure at large biases was revealed. Furthermore, a significant variation in the escape probability from energy states in the DWELL structure with applied bias was observed. These facts can explain the strong temperature and bias dependence of both photocurrent and dark currents in DWELL IPs.
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| 10. |
- Höglund, Linda, 1974-, et al.
(författare)
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Bias mediated tuning of the detection wavelength in asymmetrical quantum dots-in-a-well infrared photodetectors
- 2008
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Ingår i: Applied Physics Letters. - New York : AIP Publishing. - 0003-6951 .- 1077-3118. ; 93:20
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Tidskriftsartikel (refereegranskat)abstract
- Bias-mediated tuning of the detection wavelength within the infrared wavelength region is demonstrated for quantum dots-in-a-well and dots-on-a-well infrared photodetectors. By positioning the InAs quantum dot layer asymmetrically in an 8 nm wide In0.15Ga0.85As/GaAs quantum well, a shift in the peak detection wavelength from 8.4 to 10.3 mu m was observed when reversing the polarity of the applied bias. For a dots-on-a-well structure, the peak detection wavelength was tuned from 5.4 to 8 mu m with small changes in the applied bias. These tuning properties could be essential for applications such as modulators and dual-color infrared detection.
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