| 1. |
- Düking, Peter, et al.
(författare)
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Monitoring and adapting endurance training on the basis of heart rate variability monitored by wearable technologies : A systematic review with meta-analysis
- 2021
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Ingår i: Journal of Science and Medicine in Sport. - : Elsevier. - 1440-2440 .- 1878-1861. ; 24:11, s. 1180-1192
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Forskningsöversikt (refereegranskat)abstract
- Objectives: To systematically perform a meta-analysis of the scientific literature to determine whether the outcomes of endurance training based on heart rate variability (HRV) are more favorable than those of predefined training.Design: Systematic review and meta-analysis.Methods: PubMed and Web of Science were searched systematically in March of 2020 using keywords related to endurance, the ANS, and training. To compare the outcomes of HRV-guided and predefined training, Hedges' g effect size and associated 95% confidence intervals were calculated.Results: A total of 8 studies (198 participants) were identified comprising 9 interventions involving a variety of approaches. Compared to predefined training, most HRV-guided interventions included fewer moderate- and/or high-intensity training sessions. Fixed effects meta-analysis revealed a significant medium-sized positive effect of HRV-guided training on submaximal physiological parameters (g = 0.296, 95% CI 0.031 to 0.562, p = 0.028), but its effects on performance (g = 0.079, 95% CI −0.050 to 0.393, p = 0.597) and V̇O2peak (g = 0.171, 95% CI −0.213 to 0.371, p = 0.130) were small and not statistically significant. Moreover, with regards to performance, HRV-guided training was associated with fewer non-responders and more positive responders.Conclusions: In comparison to predefined training, HRV-guided endurance training had a medium-sized effect on submaximal physiological parameters, but only a small and non-significant influence on performance and V̇O2peak. There were fewer non-responders regarding performance with HRV-based training.
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| 2. |
- Elliott, Daisy, et al.
(författare)
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Understanding and Improving Recruitment to Randomised Controlled Trials : Qualitative Research Approaches
- 2017
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838 .- 1873-7560. ; 72:5, s. 789-798
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Forskningsöversikt (refereegranskat)abstract
- Context: The importance of evidence from randomised trials is now widely recognised, although recruitment is often difficult. Qualitative research has shown promise in identifying the key barriers to recruitment, and interventions have been developed to reduce organisational difficulties and support clinicians undertaking recruitment. Objective: This article provides an introduction to qualitative research techniques and explains how this approach can be used to understand- and subsequently improve-recruitment and informed consent within a range of clinical trials. Evidence acquisition: A literature search was performed using Medline, Embase, and CINAHL. All studies with qualitative research methods that focused on the recruitment activity of clinicians were included in the review. Evidence synthesis: The majority of studies reported that organisational difficulties and lack of time for clinical staff were key barriers to recruitment. However, a synthesis of qualitative studies highlighted the intellectual and emotional challenges that arise when combining research with clinical roles, particularly in relation to equipoise and patient eligibility. To support recruiters to become more comfortable with the design and principles of randomised controlled trials, interventions have been developed, including the QuinteT Recruitment Intervention, which comprises in-depth investigation of recruitment obstacles in real time, followed by implementation of tailored strategies to address these challenges as the trial proceeds. Conclusions: Qualitative research can provide important insights into the complexities of recruitment to trials and inform the development of interventions, and provide support and training initiatives as required. Investigators should consider implementing such methods in trials expected to be challenging or recruiting below target. Patient summary: Qualitative research is a term used to describe a range of methods that can be implemented to understand participants' perspectives and behaviours. Data are gathered from interviews, focus groups, or observations. In this review, we demonstrate how this approach can be used to understand- and improve-recruitment to clinical trials. Taken together, our review suggests that healthcare professionals can find recruiting to trials challenging and require support with this process. (C) 2017 European Association of Urology. Published by Elsevier B.V.
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| 3. |
- Hagfeldt, A., et al.
(författare)
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A system approach to molecular solar cells
- 2004
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Ingår i: Coordination chemistry reviews. - : Elsevier BV. - 0010-8545 .- 1873-3840. ; 248:13-14, s. 1501-1509
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Forskningsöversikt (refereegranskat)abstract
- This paper gives an overview of the research and development of dye-sensitized solar cells (DSC) within the Swedish research program 'Angstrom Solar Center'. A path towards low production cost is the development of a continuous process, which allows the production of solar cells in large volumes and with a high productivity. We have developed a deposition method for the production of the mesoporous TiO2, electrode layer that is based on compression of a powder film at room temperature. This technique allows us to use flexible substrates-a prerequisite fora continuous process. A novel interconnect technology, compatible with a continuous production process, is described. Stability data of plastic DSC, exposed to indoor light for more than 10,000 h, demonstrates the possibility for the technology to be explored for various types of indoor applications. Optimization of the DSC is a challenging task as it is a complex highly interacting molecular system. A system approach is proposed, where the complete DSC is investigated with a series of measurement techniques ('toolbox') that allows the study of the internal processes under relevant conditions. Two examples of such techniques are given.
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| 4. |
- Holmberg, Ellinor, et al.
(författare)
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Allopregnanolone involvement in feeding regulation, overeating and obesity
- 2018
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Ingår i: Frontiers in neuroendocrinology (Print). - : Academic Press. - 0091-3022 .- 1095-6808. ; 48, s. 70-77
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Forskningsöversikt (refereegranskat)abstract
- Obesity is strongly associated with ill health, primarily caused by consumption of excessive calories, and promoted (inter alia) by gamma-amino-butyric-acid (GABA) stimulating food intake by activating GABA(A) receptors (primarily with alpha 3 and alpha 2 subunits) in the hypothalamic arcuate nucleus and paraventricular nucleus. Allopregnanolone is a potent positive GABAA receptor modulating steroid (GAMS). As reviewed here, elevated allopregnanolone levels are associated with increases in food intake, preferences for energy-rich food, and obesity in humans and other mammals. In women with polycystic ovarian disease, high serum allopregnanolone concentrations are linked to uncontrolled eating, and perturbed sensitivity to allopregnanolone. Increases in weight during pregnancy also correlate with increases in allopregnanolone levels. Moreover, Prader-Willis syndrome is associated with massive overeating, absence of a GABA(A) receptor (with compensatory > 12-, > 5- and > 1.5-fold increases in alpha 4, gamma 2, and alpha 1, alpha 3 subunits), and increases in the alpha 4, beta x, delta receptor subtype, which is highly sensitive to allopregnanolone. GABA and positive GABA-A receptor modulating steroids like allopregnanolone stimulates food intake and weight gain.
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| 5. |
- Pettersson, Andreas, et al.
(författare)
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The ABC model of prostate cancer : A conceptual framework for the design and interpretation of prognostic studies
- 2017
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Ingår i: Cancer. - Hoboken, USA : John Wiley & Sons. - 0008-543X .- 1097-0142. ; 123:9, s. 1490-1496
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Forskningsöversikt (refereegranskat)abstract
- There has been limited success in identifying prognostic biomarkers in prostate cancer. A partial explanation may be that insufficient emphasis has been put on clearly defining what type of marker or patient category a biomarker study aims to identify and how different cohort characteristics affect the ability to identify such a marker. In this article, the authors put forth the ABC model of prostate cancer, which defines 3 groups of patients with localized disease that an investigator may seek to identify: patients who, within a given time frame, will not develop metastases even if untreated (category A), will not develop metastases because of radical treatment (category B), or will develop metastases despite radical treatment (category C). The authors demonstrate that follow-up time and prostate-specific antigen screening intensity influence the prevalence of patients in categories A, B, and C in a study cohort, and that prognostic markers must be tested in both treated and untreated cohorts to accurately distinguish the 3 groups. The authors suggest that more emphasis should be put on considering these factors when planning, conducting, and interpreting the results from prostate cancer biomarker studies, and propose the ABC model as a framework to aid in that process.
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| 6. |
- Sadler, J. E., et al.
(författare)
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Update on the pathophysiology and classification of von Willebrand disease: a report of the Subcommittee on von Willebrand Factor
- 2006
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Ingår i: Journal of Thrombosis and Haemostasis. - : Elsevier BV. - 1538-7933 .- 1538-7836. ; 4:10, s. 2103-2114
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Forskningsöversikt (refereegranskat)abstract
- von Willebrand disease (VWD) is a bleeding disorder caused by inherited defects in the concentration, structure, or function of von Willebrand factor (VWF). VWD is classified into three primary categories. Type 1 includes partial quantitative deficiency, type 2 includes qualitative defects, and type 3 includes virtually complete deficiency of VWF. VWD type 2 is divided into four secondary categories. Type 2A includes variants with decreased platelet adhesion caused by selective deficiency of high-molecular-weight VWF multimers. Type 2B includes variants with increased affinity for platelet glycoprotein Ib. Type 2M includes variants with markedly defective platelet adhesion despite a relatively normal size distribution of VWF multimers. Type 2N includes variants with markedly decreased affinity for factor VIII. These six categories of VWD correlate with important clinical features and therapeutic requirements. Some VWF gene mutations, alone or in combination, have complex effects and give rise to mixed VWD phenotypes. Certain VWD types, especially type 1 and type 2A, encompass several pathophysiologic mechanisms that sometimes can be distinguished by appropriate laboratory studies. The clinical significance of this heterogeneity is under investigation, which may support further subdivision of VWD type 1 or type 2A in the future.
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| 7. |
- Wennerholm, Ulla-Britt, 1948, et al.
(författare)
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Timing of umbilical cord clamping for neonatal and maternal outcomes
- 2012
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Ingår i: Health Technology Assessment, HTA center Region Västra Götaland. ; :48, s. 1-51
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Forskningsöversikt (refereegranskat)abstract
- Method and patient group Late versus early clamping of the umbilical cord- maternal and infant effects Question at issue Is early umbilical cord clamping not different from or better than late umbilical cord clamping regarding postpartum infant iron deficiency and iron deficiency anaemia variables, long-term cognitive function, loss of stem cells, maternal postpartum haemorrhage, manual removal of retained placenta and correct sampling for blood gas analysis? Studied risks and benefits for patients of the new health technology Level of evidence: The literature search identified four studies that fulfilled the selection criteria; a systematic review (SR) and three subsequently published randomised controlled trials (RCTs). The definition of early cord clamping varied from within 10 to < 60 sec between studies. The SR was methodologically of high quality but included mainly studies with high risk of bias. One of the RCTs was of high and the others of low quality. Infant outcomes O1 No studies evaluated cognitive function or loss of stem cells. Conclusions: There is some support for an increased risk of immediate anaemia (6.3% vs 1.2%) (GRADE ⊕⊕??) and support for lower immediate Hb (mean difference 18g/l) and haematocrit (GRADE ⊕⊕⊕?) with early as compared with late clamping. There is support for little or no difference regarding these outcomes at long-term (at 2 to 6 months of age) (GRADE ⊕⊕⊕?). There is some support for an increased risk of long-term iron deficiency (5.7% vs. 0.6%) (GRADE ⊕⊕??) and support for lower long-term ferritin levels (GRADE ⊕⊕⊕?). There is some support for little or no difference regarding jaundice requiring phototherapy and a low Apgar score (<7 at 5 min) (GRADE⊕⊕??) and insufficient support for an effect on the need for admittance to special baby care nursery or neonatal intensive care unit (GRADE ⊕???) ). Maternal outcomes O2 There is some support for little or no difference regarding severe postpartum bleeding (GRADE ⊕⊕??) and insufficient support for an effect on the need for manual removal of placenta (GRADE ⊕??? ).. Methodological outcome O3 There is insufficient scientific documentation to evaluate the rate of correct sampling for cord blood acid-base and gas analysis after early versus late clamping. Ethical questions Is early cord clamping of the healthy term neonate ethically acceptable in view of unknown long-term infant risks regarding cognitive function? Presently, late cord clamping does not allow cord blood collection. Future research may identify optimal timing of cord clamping, to resolve these ethical issues. Economical aspects There are no reasons to believe that initial costs are different.
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