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- Pivodic, Aldina, 1978, et al.
(författare)
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Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity
- 2022
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 106:11, s. 1573-1580
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Prematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights.METHODS: Data, including infants born at 24-30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6-14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions.RESULTS: ROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6-14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%.CONCLUSIONS: DIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24-30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.
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| 2. |
- Wolf, Anna, et al.
(författare)
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Energy-efficient pellet production in the forest industry - a study of obstacles and success factors
- 2006
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Ingår i: Biomass and Bioenergy. - : Elsevier BV. - 0961-9534 .- 1873-2909. ; 30:1, s. 38-45
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Tidskriftsartikel (refereegranskat)abstract
- With an expanding market for upgraded biofuel in many countries, it is important to develop efficient production methods for upgrading wet biomass. The possibilities for heat recovery can be improved if the upgrading process is integrated with other energy-intensive processes, as for example a pulp mill or a sawmill, in a biofuel combine. This work evaluates obstacles and Success factors for forming such biofuel combines with the forest industry. Case Studies and calculations on theoretical cases have been used together with literature references to evaluate how a biofuel combine can be realised and to compile obstacles and success factors for a combine. It could be seen from the case studies that an excess of by-products and waste heat, together with an existing need for investments are important driving forces for the formation of biofuel combines in the forest industry. The market was also identified as an important factor, which can be both an obstacle and a success factor depending on the situation. It was concluded that the existence of a small-scale pellet market near the plant is important for economic feasibility when sawdust is used as raw material. The conditions for the biofuel combine are different depending on the form of ownership. When a pulp mill or sawmill owns the pellet factory, it was concluded that minimising the risk by using well-known technologies can be an important factor for the realisation of the combine.
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