| 1. |
- 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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| 2. |
- Wemming, Hannes, 1984-
(författare)
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Experiments and Modelling of Composite–Aluminium Bolted Joints
- 2022
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aeronautical industry has always strived towards weight-efficient structures since they improve aircraft performance, enable more fuel or payload, reduce cost of manufacturing and operating the aircraft, and reduce the fuel consumption and emissions. Modern airframes are often built in materials with high strength-toweight and stiffness-to-weight ratio, such as aluminium or fibre composites. Fibre composite materials are becoming increasingly common, requiring bolted joints between composite and aluminium parts. Bolted joints are often weak points in the structure, and understanding their mechanical properties in terms of stiffness and strength is of great importance for designing aircraft that are safe to fly. The aim of the research presented in this licentiate thesis is to improve the understanding of shear-loaded, composite–aluminium, bolted joints in terms of structural compliance, deformation, load distribution, strength and failure, by performing experiments and developing simulation models that describe those experiments. Experiments are performed where the optical digital image correlation (DIC) technique is used to measure the deformation of the test specimen surface during quasistatic load application until specimen failure. The DIC method enables more detailed deformation measurements compared to traditional methods. Data processing algorithms for noise reduction of DIC measurement data are developed and the results are used in a novel way to detect beginning bearing damage within the material by observing the specimen surface. The experimental DIC data is used for adapting models, where the goal is to create a structural element that represents a fastener. A structural element is computationally efficient and suitable for implementation in large scale models of airframe structures in an industrial context. A model is proposed and the selection of parameters for this model are investigated. The parameters are identified by fitting to experimental data. This licentiate thesis is divided into two parts, where the first part gives an introduction and background to the research, while the second part consists of two appended papers.
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| 3. |
- Wennerberg, Johan, et al.
(författare)
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Results from a prospective, randomised study on (accelerated) preoperative versus (conventional) postoperative radiotherapy in treatment of patients with resectable squamous cell carcinoma of the oral cavity : The ARTSCAN 2 study
- 2022
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Ingår i: Radiotherapy and Oncology. - : Elsevier. - 0167-8140 .- 1879-0887. ; 166, s. 26-32
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Tidskriftsartikel (refereegranskat)abstract
- Background and purposeAn earlier prospective randomised multicentre study (ARTSCAN) in head and neck cancer patients that compared conventionally fractionated radiotherapy (CF) with accelerated radiotherapy (AF) was inconclusive. In the subgroup of oral cavity squamous cell cancer (OCSCC) a large absolute, but not statistically significant, difference in local control was seen in favour of AF. This difference was more pronounced in resectable tumours. The finding raised the hypothesis that AF could be beneficial for OCSCC patients. In addition, the longstanding controversy on pre- or postoperative radiotherapy was addressed.Materials and methodsPatients with OCSCC, judged to withstand and likely benefit from combined therapy, were recruited. Subjects were randomised to either preoperative AF with 43 fractions given as a concomitant boost with two fractions/day to the tumour bearing volume to a total dose of 68 Gy in 4.5 weeks followed by surgery, or primary surgery with postoperative CF, total dose 60 or 66 Gy in 6–7 weeks. For patients whose tumours had high-risk features, 66 Gy and concomitant cisplatin was prescribed.Results250 patients were randomised. Median follow-up was 5 years for locoregional control (LRC) and 9 years for overall survival (OS). There were no statistically significant differences between the two treatment arms regarding LRC and OS. LRC at five years was 73% (95% CI, 65–82) in preoperative AF and 78% (95% CI, 70–85) in postoperative CF.Toxicity was more pronounced in preoperative AF.ConclusionThis study does not support that AF prior to surgery improves outcome in oral cavity cancer compared with postoperative CF.
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| 4. |
- Anderberg, Stefan, 1957-, et al.
(författare)
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Utsläppshandel kan vara en lönsam vägtill lägre utsläpp från sjöfarten
- 2017
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Ingår i: Åtgärder för att minska sjöfartens påverkan på havsmiljön. - Göteborg : Havsmiljöinstitutet. - 9789198229158 ; , s. 14-16
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Handel med utsläppsrätter under ett fastställt ”tak” av totalautsläpp som efterhand sänks, har i en del regioner i världenvisat sig vara en både kostnadseffektiv och framgångsrikstrategi för att minska luftföroreningarna. Frågan är om utsläppshandelskulle kunna vara ett effektivt sätt för att minskasjöfartens utsläpp i Europa eller Östersjöregionen?
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| 5. |
- Andersson, Nils-Eric, et al.
(författare)
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Face milling of AA7010 at high cutting speeds
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Face milling using different commercial tools and inserts at varying cutting speeds on a high strength aluminium alloy has been performed. The surface integrity of the machined samples has been investigated in terms of surface roughness, residual stresses, hardness and peak broadening from x-ray diffraction at grazing angle incidence. Some fatigue testing of the machined surfaces has been done. The cutting chips from the different machining parameters are investigated and compared to one another. The results show a strong influence of tool insert on surface roughness, residual stress, peak broadening, and hardness profile and fatigue properties. The influence of cutting speed on the surface integrity is much smaller. The cutting speed does however influence the size and shape of the cutting chips. There is also a general decrease in peak broadening from x-ray diffraction very near the machined surface after high cutting speeds. This could be explained by a higher local heating of the work piece at very high cutting speeds.
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| 6. |
- Andrén, Eva, et al.
(författare)
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Öppna prioriteringar inom nya områden : logopedi, nutritionsbedömning, habilitering och arbetsterapi
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det finns fortfarande ett behov av att öka kunskapen om och stödja den praktiska tillämpningen av riksdagens riktlinjer för öppna prioriteringar inom svensk hälso- och sjukvård. Flera förslag på hur ett sådant stöd kan se ut har tagits fram de senaste åren. Spridning av goda exempel är ett sådant förslag, metodstöd ett annat (PrioriteringsCentrum 2007). En mer påtaglig form av metodstöd är den nationella modell som vuxit fram för att konkretisera innebörden i riktlinjerna (Carlsson m fl 2007). Den får idag anses som välbeprövad inom ett flertal områden och har bidragit till att samsynen och kommunicerbarheten kring prioriteringar har ökat i landet. Erfarenheter visar dock att det behövs pedagogisk vägledning i hur modellen kan tillämpas. För att möta upp efterfrågan på sådant metodstöd erbjuder Prioriteringscentrum handledning i grupp. Den första handledningsgruppen är nu avslutad och det är deltagarnas prioriteringsarbeten som presenteras i denna rapport i syfte att sprida konkreta exempel på försök att tillämpa prioriteringsriktlinjerna.I rapporten presenteras fyra prioriteringsarbeten med fokus på: Regionsamverkan inom arbetsterapi Logopedi Yrkesspecifika prioriteringar på väg till teamet Från projekt till integrerat redskapExemplet med prioriteringar i regionsamverkan utgörs av det prioriteringsarbete som genomförts i det s k femklövernätverket bestående av en samverkansgrupp för arbetsterapeuter i ledningsposition på sjukhusen i Uppland, Västmanland, Södermanland, Gävleborg och Dalarna. Arbetet var ett försök att skapa gemensamma prioriteringar i regionen för ett sjukdomsområde som kändes relevant. Valet kom att falla på arbetsterapi inom reumatologi. Arbetet har sedan huvudsakligen bedrivits i en projektgrupp, bestående av en representant från varje sjukhus där arbetet växlat mellan arbete på hemmaplan och avstämningsträffar i projektgruppen.Försöket har visat att det finns en samsyn inom regionen kring prioriteringar inom arbetsterapi och reumatologi. Säkerheten i prioriteringarna har ökat i och med att fem arbetsterapiorganisationer tillsammans bidragit med ett stort underlagsmaterial bl a genom att delge varandra sina kliniska erfarenheter. Förutsättningarna för en mer likartad vård i regionen har ökat. Arbetet har också gett upphov till frågor om i vilka situationer det är att föredra att prioriteringsarbete bedrivs lokalt, regionvis och/eller nationellt.
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| 7. |
- Appleton, O, et al.
(författare)
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The next-generation ARC middleware
- 2010
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Ingår i: ANNALS OF TELECOMMUNICATIONS-ANNALES DES TELECOMMUNICATIONS. - : Presses Polytechniques Romandes. - 0003-4347 .- 1958-9395. ; 65:11-12, s. 771-776
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Tidskriftsartikel (refereegranskat)abstract
- The Advanced Resource Connector (ARC) is a light-weight, non-intrusive, simple yet powerful Grid middleware capable of connecting highly heterogeneous computing and storage resources. ARC aims at providing general purpose, flexible, collaborative computing environments suitable for a range of uses, both in science and business. The server side offers the fundamental job execution management, information and data capabilities required for a Grid. Users are provided with an easy to install and use client which provides a basic toolbox for job- and data management. The KnowARC project developed the next-generation ARC middleware, implemented as Web Services with the aim of standard-compliant interoperability.
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| 8. |
- Bergman, Filip, 1992-
(författare)
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Sustainability performance of multi-utility tunnels : Sustainability assessments for furthering knowledge and understanding
- 2022
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The multi-utility tunnel has received increased attention as an alternative method for the installation of subsurface infrastructure for the distribution of electricity, water, sewage and district heating. In previous research, the multi-utility tunnel (MUT) has been described as a more sustainable technology compared to the conventionally used technique where the cables and pipes are placed with open-cut excavation (OCE), especially when the entire life cycle is taken into account. This thesis aims to contribute to an improved understanding of MUT's sustainability performance in relation to conventional installation using open-cut excavation. This is done by using literature study, interview study and quantitative sustainability assessments to gain an understanding of the current state of knowledge. Furthermore, this thesis also focuses on how knowledge can be deepened with the help of quantitative sustainability assessments and the challenges of conducting this type of assessment. This thesis shows that the state of knowledge regarding MUT's sustainability performance is low and scattered, with a lack of a holistic approach. Direct economic performance has gained the most attention, followed by indirect and social impact, and the environmental impact has so far barely been assessed. The sustainability performance depends to a large extent on the conditions of the specific case, and these should be considered when assessing the technology. Quantitative assessments have the potential to help deepen the knowledge of the sustainability implications of using MUT. The characteristics of MUT have some similarities with other types of physical infrastructure. Similarities are that the systems are long-lived, have project conditions that affect sustainability performance, and impact a broad spectrum of actors. One difference to typical infrastructure systems is that the owner and management structure of MUT is, by design, more complex as several types of utility systems are in use. The characteristics of MUT give some practical considerations that need to be addressed: data availability, including practitioners; detailed data; transparency; and flexibility. This thesis highlights the complexity of assessing MUT´s sustainability performance and advocates that future studies should have a learning-oriented approach so that the knowledge level can collectively and gradually improve over time rather than focusing on decision-oriented studies.
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| 9. |
- Bill-Axelson, Anna, et al.
(författare)
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Radical prostatectomy versus watchful waiting in early prostate cancer.
- 2011
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Ingår i: The New England journal of medicine. - : Massachussetts Medical Society. - 1533-4406 .- 0028-4793. ; 364:18, s. 1708-17
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Forskningsöversikt (refereegranskat)abstract
- In 2008, we reported that radical prostatectomy, as compared with watchful waiting, reduces the rate of death from prostate cancer. After an additional 3 years of follow-up, we now report estimated 15-year results.
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| 10. |
- Bill-Axelson, Anna, et al.
(författare)
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Radical prostatectomy versus watchful waiting in early prostate cancer
- 2005
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 352:19, s. 1977-1944
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:In 2002, we reported the initial results of a trial comparing radical prostatectomy with watchful waiting in the management of early prostate cancer. After three more years of follow-up, we report estimated 10-year results.METHODS:From October 1989 through February 1999, 695 men with early prostate cancer (mean age, 64.7 years) were randomly assigned to radical prostatectomy (347 men) or watchful waiting (348 men). The follow-up was complete through 2003, with blinded evaluation of the causes of death. The primary end point was death due to prostate cancer; the secondary end points were death from any cause, metastasis, and local progression.RESULTS:During a median of 8.2 years of follow-up, 83 men in the surgery group and 106 men in the watchful-waiting group died (P=0.04). In 30 of the 347 men assigned to surgery (8.6 percent) and 50 of the 348 men assigned to watchful waiting (14.4 percent), death was due to prostate cancer. The difference in the cumulative incidence of death due to prostate cancer increased from 2.0 percentage points after 5 years to 5.3 percentage points after 10 years, for a relative risk of 0.56 (95 percent confidence interval, 0.36 to 0.88; P=0.01 by Gray's test). For distant metastasis, the corresponding increase was from 1.7 to 10.2 percentage points, for a relative risk in the surgery group of 0.60 (95 percent confidence interval, 0.42 to 0.86; P=0.004 by Gray's test), and for local progression, the increase was from 19.1 to 25.1 percentage points, for a relative risk of 0.33 (95 percent confidence interval, 0.25 to 0.44; P<0.001 by Gray's test).CONCLUSIONS:Radical prostatectomy reduces disease-specific mortality, overall mortality, and the risks of metastasis and local progression. The absolute reduction in the risk of death after 10 years is small, but the reductions in the risks of metastasis and local tumor progression are substantial.
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