| 1. |
- Chew, Michelle S., et al.
(författare)
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Identification of myocardial injury using perioperative troponin surveillance in major noncardiac surgery and net benefit over the Revised Cardiac Risk Index
- 2022
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Ingår i: British Journal of Anaesthesia. - : Elsevier. - 0007-0912 .- 1471-6771. ; 128:1, s. 26-36
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with perioperative myocardial injury are at risk of death and major adverse cardiovascular and cerebrovascular events (MACCE). The primary aim of this study was to determine optimal thresholds of preoperative and perioperative changes in high-sensitivity cardiac troponin T (hs-cTnT) to predict MACCE and mortality.METHODS: Prospective, observational, cohort study in patients ≥50 yr of age undergoing elective major noncardiac surgery at seven hospitals in Sweden. The exposures were hs-cTnT measured before and days 0-3 after surgery. Two previously published thresholds for myocardial injury and two thresholds identified using receiver operating characteristic analyses were evaluated using multivariable logistic regression models and externally validated. The weighted comparison net benefit method was applied to determine the additional value of hs-cTnT thresholds when compared with the Revised Cardiac Risk Index (RCRI). The primary outcome was a composite of 30-day all-cause mortality and MACCE.RESULTS: We included 1291 patients between April 2017 and December 2020. The primary outcome occurred in 124 patients (9.6%). Perioperative increase in hs-cTnT ≥14 ng L-1 above preoperative values provided statistically optimal model performance and was associated with the highest risk for the primary outcome (adjusted odds ratio 2.9, 95% confidence interval 1.8-4.7). Validation in an independent, external cohort confirmed these findings. A net benefit over RCRI was demonstrated across a range of clinical thresholds.CONCLUSIONS: Perioperative increases in hsTnT ≥14 ng L-1 above baseline values identifies acute perioperative myocardial injury and provides a net prognostic benefit when added to RCRI for the identification of patients at high risk of death and MACCE.CLINICAL TRIAL REGISTRATION: NCT03436238.
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| 2. |
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| 3. |
- Nordanstig, Joakim, et al.
(författare)
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Mortality with Paclitaxel-Coated Devices in Peripheral Artery Disease.
- 2020
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Ingår i: The New England journal of medicine. - : Massachusetts Medical Society. - 1533-4406 .- 0028-4793. ; 383, s. 2538-46
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Tidskriftsartikel (refereegranskat)abstract
- The results of a recent meta-analysis aroused concern about an increased risk of death associated with the use of paclitaxel-coated angioplasty balloons and stents in lower-limb endovascular interventions for symptomatic peripheral artery disease.We conducted an unplanned interim analysis of data from a multicenter, randomized, open-label, registry-based clinical trial. At the time of the analysis, 2289 patients had been randomly assigned to treatment with drug-coated devices (the drug-coated-device group, 1149 patients) or treatment with uncoated devices (the uncoated-device group, 1140 patients). Randomization was stratified according to disease severity on the basis of whether patients had chronic limb-threatening ischemia (1480 patients) or intermittent claudication (809 patients). The single end point for this interim analysis was all-cause mortality.No patients were lost to follow-up. Paclitaxel was used as the coating agent for all the drug-coated devices. During a mean follow-up of 2.49 years, 574 patients died, including 293 patients (25.5%) in the drug-coated-device group and 281 patients (24.6%) in the uncoated-device group (hazard ratio, 1.06; 95% confidence interval, 0.92 to 1.22). At 1 year, all-cause mortality was 10.2% (117 patients) in the drug-coated-device group and 9.9% (113 patients) in the uncoated-device group. During the entire follow-up period, there was no significant difference in the incidence of death between the treatment groups among patients with chronic limb-threatening ischemia (33.4% [249 patients] in the drug-coated-device group and 33.1% [243 patients] in the uncoated-device group) or among those with intermittent claudication (10.9% [44 patients] and 9.4% [38 patients], respectively).In this randomized trial in which patients with peripheral artery disease received treatment with paclitaxel-coated or uncoated endovascular devices, the results of an unplanned interim analysis of all-cause mortality did not show a difference between the groups in the incidence of death during 1 to 4 years of follow-up. (Funded by the Swedish Research Council and others; ClinicalTrials.gov number, NCT02051088.).
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| 4. |
- Tang, Zheng, et al.
(författare)
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Interlayer for Modified Cathode in Highly Efficient Inverted ITO-Free Organic Solar Cells
- 2012
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Ingår i: Advanced Materials. - : Wiley. - 0935-9648 .- 1521-4095. ; 24:4, s. 554-
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Tidskriftsartikel (refereegranskat)abstract
- Inverted polymer solar cells with a bottom metal cathode modified by a conjugated polymer interlayer show considerable improvement of photocurrent and fill factor, which is due to hole blocking at the interlayer, and a modified surface energy which affects the nanostructure in the TQ1/[70]PCBM blend.
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| 5. |
- Thollander, Patrik, 1976-, et al.
(författare)
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Energinyckeltal och växthusgasutsläpp baserade på industrins energianvändande processer
- 2021
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Rapport (refereegranskat)abstract
- Svensk industri bör strategiskt arbeta mot ökad energi- och resurseffektivitet på en global marknad med knappare resurser. I detta sammanhang spelar beslutsunderlag och nyckeltal en central roll för att nå ökad effektivitet. Även för tillsynsmyndigheter är rättvisande nyckeltal avseende slutenergianvändning av mycket stor vikt för att kunna bedriva ett rättvist förebyggande och proaktivt arbete med svenska företag. De nyckeltal som finns på internationell och nationell nivå är baserade på tillförd energi och ofta relaterade till en ekonomisk output, till exempel förädlingsvärde. Det saknas emellertid nyckeltal kring slutenergianvändningen inom svensk industri fördelat på energibärare såsom el och olja och fördelat på slutenergiprocesser såsom ugnar, tryckluftskompressorer, etc. De siffror som ibland anges är baserade på grova uppskattningar. Projektets mål har därför varit att generera ett processträd avseende flera av de största, till slutenergianvändning räknat, svenska industribranscherna avseende hur slutenergianvändningen är fördelad på processnivå och olika energibärare, samt att allokera växthusgasutsläpp på dessa olika processer. Resultaten indikerar att nyckeltal baserade på energianvändning och indirekta växthusgasutsläpp på processnivå kan bidra till bättre kunskap om i vilka industriella energianvändande processer den största potentialen för energieffektivisering och minskning av växthusgasutsläpp finns. För att upprätthålla kunskap om var den största potentialen för förbättring finns krävs att energidata regelbundet samlas in efter en standardiserad kategorisering av energianvändande processer. Även om projektet har avgränsats till svensk industri kan resultatet vara till nytta också för andra medlemsstater inom EU liksom globalt.
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| 6. |
- Alijagic, Andi, 1992-, et al.
(författare)
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Particle Safety Assessment in Additive Manufacturing : From Exposure Risks to Advanced Toxicology Testing.
- 2022
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Ingår i: Frontiers in Toxicology. - : Frontiers Media S.A.. - 2673-3080. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Additive manufacturing (AM) or industrial three-dimensional (3D) printing drives a new spectrum of design and production possibilities; pushing the boundaries both in the application by production of sophisticated products as well as the development of next-generation materials. AM technologies apply a diversity of feedstocks, including plastic, metallic, and ceramic particle powders with distinct size, shape, and surface chemistry. In addition, powders are often reused, which may change the particles' physicochemical properties and by that alter their toxic potential. The AM production technology commonly relies on a laser or electron beam to selectively melt or sinter particle powders. Large energy input on feedstock powders generates several byproducts, including varying amounts of virgin microparticles, nanoparticles, spatter, and volatile chemicals that are emitted in the working environment; throughout the production and processing phases. The micro and nanoscale size may enable particles to interact with and to cross biological barriers, which could, in turn, give rise to unexpected adverse outcomes, including inflammation, oxidative stress, activation of signaling pathways, genotoxicity, and carcinogenicity. Another important aspect of AM-associated risks is emission/leakage of mono- and oligomers due to polymer breakdown and high temperature transformation of chemicals from polymeric particles, both during production, use, and in vivo, including in target cells. These chemicals are potential inducers of direct toxicity, genotoxicity, and endocrine disruption. Nevertheless, understanding whether AM particle powders and their byproducts may exert adverse effects in humans is largely lacking and urges comprehensive safety assessment across the entire AM lifecycle-spanning from virgin and reused to airborne particles. Therefore, this review will detail: 1) brief overview of the AM feedstock powders, impact of reuse on particle physicochemical properties, main exposure pathways and protective measures in AM industry, 2) role of particle biological identity and key toxicological endpoints in the particle safety assessment, and 3) next-generation toxicology approaches in nanosafety for safety assessment in AM. Altogether, the proposed testing approach will enable a deeper understanding of existing and emerging particle and chemical safety challenges and provide a strategy for the development of cutting-edge methodologies for hazard identification and risk assessment in the AM industry.
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| 7. |
- Andersson, Anna, et al.
(författare)
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Microarray-based classification of a consecutive series of 121 childhood acute leukemias: prediction of leukemic and genetic subtype as well as of minimal residual disease status.
- 2007
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Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 1476-5551 .- 0887-6924. ; 21:6, s. 1198-1203
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Tidskriftsartikel (refereegranskat)abstract
- Gene expression analyses were performed on 121 consecutive childhood leukemias (87 B-lineage acute lymphoblastic leukemias (ALLs), 11 T-cell ALLs and 23 acute myeloid leukemias (AMLs)), investigated during an 8-year period at a single center. The supervised learning algorithm k-nearest neighbor was utilized to build gene expression predictors that could classify the ALLs/AMLs according to clinically important subtypes with high accuracy. Validation experiments in an independent data set verified the high prediction accuracies of our classifiers. B-lineage ALLs with uncharacteristic cytogenetic aberrations or with a normal karyotype displayed heterogeneous gene expression profiles, resulting in low prediction accuracies. Minimal residual disease status (MRD) in T-cell ALLs with a high (40.1%) MRD at day 29 could be classified with 100% accuracy already at the time of diagnosis. In pediatric leukemias with uncharacteristic cytogenetic aberrations or with a normal karyotype, unsupervised analysis identified two novel subgroups: one consisting mainly of cases remaining in complete remission (CR) and one containing a few patients in CR and all but one of the patients who relapsed. This study of a consecutive series of childhood leukemias confirms and extends further previous reports demonstrating that global gene expression profiling provides a valuable tool for genetic and clinical classification of childhood leukemias.
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| 8. |
- Andersson, Elias, et al.
(författare)
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A study of the comparability of energy audit program evaluations
- 2017
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Ingår i: Journal of Cleaner Production. - : ELSEVIER SCI LTD. - 0959-6526 .- 1879-1786. ; 142, s. 2133-2139
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Tidskriftsartikel (refereegranskat)abstract
- There is a large untapped potential for improved energy efficiency in various sectors of the economy. Governmental industrial energy audit programs subsidizing the companies to conduct an energy audit are the most common policy in trying to overcome the energy efficiency gap. Evaluation studies have been carried out to gain knowledge about the success of a completed energy audit policy program. The evaluations were made in different ways and in addition focused on different performance indicators and used different ways of categorizing data. In this article, a literature review has been made of five evaluation studies from different energy audit programs, where the problems of the present incomparability between programs due to differences are discussed. The policy implication of this paper is that new energy audit policy programs must distinguish a harmonized way of categorizing data, both regarding energy efficiency measures and energy end-use. Further, a proposition for a standard for how to evaluate energy audit policy programs is suggested. Conclusions from this study are that important elements, such as the free-rider effect and harmonized energy end-use data, should be defined and included in evaluation studies. A harmonized standard for evaluating audit programs is not least needed within the EU, where member states are obliged to launch audit programs for large enterprises, and preferably also for small and medium-sized enterprises. This paper serves as an important contribution for the development of such a standard in further research. (C) 2016 Elsevier Ltd. All rights reserved.
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| 9. |
- Andersson, Elias, et al.
(författare)
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Benchmarking energy performance of industrial small and medium-sized enterprises using an energy efficiency index: Results based on an energy audit policy program
- 2018
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Ingår i: Journal of Cleaner Production. - : ELSEVIER SCI LTD. - 0959-6526 .- 1879-1786. ; 182, s. 883-895
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Tidskriftsartikel (refereegranskat)abstract
- Improved energy efficiency among industrial companies is recognized as a key effort to reduce emissions of greenhouse gases. In this context, benchmarking industrial energy efficiency plays an important part in increasing industrial companies awareness of their energy efficiency potential. A method for calculating an energy efficiency index is proposed in this paper. The energy efficiency index is used to benchmark the energy performance of industrial small and medium-sized companies support and production processes. This enables the possibility to compare the energy performance of single energy end-use processes. This papers proposed energy efficiency index is applied to energy data from 11 sawmills that participated in the Swedish national energy audit program. The index values were compared with each sawmills energy saving potential, as stated in the energy audits. One conclusion is that the energy efficiency index is suitable as an energy strategy tool in industrial energy management and could be used both by industrial SMEs and by governmental agencies with an auditing role. However, it does require a harmonized categorization of energy end-use processes as well as quality assured energy data. Given this, a national energy end-use database could be created to facilitate the calculation of an energy efficiency index. (C) 2018 Elsevier Ltd. All rights reserved.
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| 10. |
- Andersson, Elias, 1989-, et al.
(författare)
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Decarbonization of industry : Implementation of energy performance indicators for successful energy management practices in kraft pulp mills
- 2021
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Ingår i: Energy Reports. - : Elsevier. - 2352-4847. ; 7, s. 1808-1817
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Tidskriftsartikel (refereegranskat)abstract
- Energy management is the most prominent means of improving energy efficiency, and improved energy efficiency constitutes the cornerstone in decarbonization. For successful industrial energy management, defining accurate energy performance indicators (EnPIs) is essential. Energy-intensive industries have previously been found to have an improvement potential regarding the current monitoring of EnPIs, especially at process level. While general models for developing and implementing EnPIs exist, manufacturing industries are diverse in terms of their production processes, which is why industry-tailored models for EnPI development are needed. One major outcome of this paper is a unique model specifically tailored for kraft pulp mills. The model derives from a practice-based approach for EnPI development, building on real-life experiences from a Swedish group of companies. This paper’s developed model, and the validation of the EnPIs, further increase the understanding of the kraft pulp industry’s processes and how to apply descriptive and explanatory indicators. The developed model can potentially be generalized to other sectors.
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