| 1. |
- Korsholm, Kasper, et al.
(författare)
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Left Atrial Appendage Occlusion versus Novel Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation: Rationale and Design of the Multicenter Randomized Occlusion-AF Trial.
- 2021
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Ingår i: American heart journal. - : Elsevier BV. - 1097-6744 .- 0002-8703. ; 243, s. 28-38
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of atrial fibrillation (AF) is increasing globally, which is a major clinical and public health concern due to the five-fold increased risk of stroke. Oral anticoagulation with novel oral anticoagulants (NOACs) is the current primary option for stroke prevention in patients with AF, although it increases the risk of major bleeding. Patients with prior ischemic cerebrovascular events are at particularly high risk of both recurrent ischemic events and major bleeding. Left atrial appendage occlusion (LAAO) provides an alternative option for stroke prevention in high-risk patients, however, with currently limited evidence. Thus, randomized trials comparing LAAO to NOACs are needed.The Occlusion-AF trial is designed to assess whether LAAO is non-inferior to NOAC therapy for reduction of the combined endpoint of stroke, systemic embolism, major bleeding (Bleeding Academic Research Consortium ≥ 3) and all-cause mortality in patients with AF and a recent ischemic stroke or transient ischemic attack (TIA).Investigator-initiated multicenter, multinational, randomized open-label non-inferiority trial with blinded outcome evaluation (PROBE design). Patients with documented AF, and an ischemic stroke or TIA within 6 months will be eligible for enrollment. Major exclusion criteria are modified Rankin Scale > 3 at enrollment, glomerular filtration rate < 15 ml/min, and life-expectancy less than 2 years. A total of 750 patients will be randomized 1:1 to receive either a NOAC or LAAO using the Amplatzer Amulet (Abbott, MN, USA) or Watchman FLX (Boston Scientific, MN, USA) with subsequent life-long aspirin 75 mg daily. Follow-up will be based on in-office and telephone follow-up in combination with long-term follow-up (10 years) through national hospital discharge registries in the individual Nordic countries. The primary outcome will be a composite endpoint of stroke, systemic embolism, major bleeding (BARC ≥ 3) and all-cause mortality at 2-year follow-up.The Occlusion-AF trial is designed to compare LAAO to NOAC therapy for secondary stroke prevention in AF patients with a high risk of recurrent thromboembolic events, i.e. with previous ischemic stroke or TIA, and otherwise eligible for anticoagulation. The results are expected to contribute significantly to the understanding of the effects of LAAO compared to the standard contemporary pharmacological treatment in these patients.
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| 2. |
- Marciniak, Magdalena, et al.
(författare)
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Impact of Stripe Shape on the Reflectivity of Monolithic High Contrast Gratings
- 2021
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Ingår i: ACS Photonics. - : American Chemical Society (ACS). - 2330-4022. ; 8:11, s. 3173-3184
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Tidskriftsartikel (refereegranskat)abstract
- Monolithic high contrast gratings (MHCGs) composed of a one-dimensional grating patterned in a monolithic layer provide up to 100% optical power reflectance and can be fabricated in almost any semiconductor and dielectric material used in modern optoelectronics. MHCGs enable monolithic integration, polarization selectivity, and versatile phase tuning. They can be from 10 to 20 times thinner than distributed Bragg reflectors. The subwavelength dimensions of MHCGs significantly reduce the possibility of ensuring the smoothness of the sidewalls of the MHCG stripes and make precise control of the shape of the MHCG stripe cross-section difficult during the etching process. The question is then whether it is more beneficial to improve the etching methods to obtain a perfect cross-section shape, as assumed by the design, or whether it is possible to find geometrical parameters that enable high optical power reflectance using the shape that a given etching method provides. Here, we present a numerical study supported by the experimental characterization of MHCGs fabricated in various materials using a variety of common surface nanometer-scale shaping methods. We demonstrate that MHCG stripes with an arbitrary cross-section shape can provide optical power reflectance of nearly 100%, which greatly relaxes their fabrication requirements. Moreover, we show that optical power reflectance exceeding 99% with a record spectral bandwidth of more than 20% can be achieved for quasi-Trapezoidal cross-sections of MHCGs. We also show that sidewall corrugations of the MHCG stripes have only a slight impact on MHCG optical power reflectance if the amplitude of the corrugation is less than 16% of the MHCG period. This level of stripe fabrication precision can be achieved using the most current surface etching methods. Our results are significant for the design and production of a variety of photonic devices employing MHCGs. The flexibility with regard to cross-section shape facilitates the reliable fabrication of highly reflective subwavelength grating mirrors. This in turn will enable the manufacture of monolithically integrated high-quality-factor optical micro-and nanocavity devices.
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| 3. |
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| 5. |
- Andersson, Joakim, et al.
(författare)
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Diamanter blir var mans egendom
- 2003
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Ingår i: Forskning & Framsteg. ; :1, s. 38-41
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Andersson, Jan, et al.
(författare)
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Traffic safety effects when overtaking 30 meter trucks
- 2012
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Ingår i: Advances in Human Factors and Ergonomics 2012- 14 Volume Set. - : Taylor & Francis. - 146655262X - 9781466552623
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Konferensbidrag (refereegranskat)abstract
- The purpose of this paper is to investigate if the introduction of extra-long and heavy trucks has an effect on traffic safety on Swedish roads, especially in relation to overtaking maneuvers. Traffic safety effects will be measured in terms of road user behavior concerning accelerations and time slots. First, focus group interviews with heavy truck drivers. Truck drivers that do not drive extra-long trucks believe that the introduction of extra-long trucks will create a number of traffic safety problems especially in terms of conflicts with ordinary road users. The drivers of extra-long trucks do not experience the problems that ordinary truck drivers predict. The problems they experience can be taken care of with more planning (thinking ahead). They also believe that the traffic sign on the back of the extra-long vehicle has a positive effect. The truck company, working environment and truck equipment are other important aspects mentioned by the drivers of the extra-long vehicles.The simulator study investigates overtaking situations on a 2+1-lane highway, with extra-long trucks (30.4 m) and ordinary trucks (18.75 m). The results reveal that the distance from the rear/front of the truck to the point where only one lane exists affects car drivers’ decision to overtake, independently of truck length. If the truck is in the relatively same position, the timeslot for a safe overtaking maneuver before next one-lane section was reduced significantly for extra-long trucks compared to ordinary trucks. The conclusion is that there exist small tendencies which point in the direction of enhanced traffic safety problems with the introduction of extra-long trucks. The results should, however, be interpreted with caution as the number of data points was few and collected in specific situations and in specific conditions. It was neither considered how the introduction of longer and heavier trucks, given a constant amount of goods, reduces the number of heavy trucks on the road network.
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| 7. |
- Andersson, Jan, et al.
(författare)
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Trafiksäkerhetspåverkan vid omkörning av 30-metersfordon
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Trafikverket överväger att tillåta längre och tyngre fordon på vägarna förutsatt att de inte påverkar trafiksäkerheten negativt. Syftet med studien var att undersöka säkerhetseffekten av fordonslängd, speciellt med avseende på olycksrisken vid omkörningar. Intervjuade förare av en 30-meters timmerbil hade inte upplevt de farhågor som förare av normallånga lastbilar uttryckt i samband med trånga rondeller och korsningar, men de nämner betydelsen av stödjande åkeri, arbetsmiljö och fordonsutrustning. En simulatorstudie studerade bilförares omkörningar av ett 30- och ett 18,75-metersfordon på en 2+1-väg i situationen då två körfält går ihop till ett. Tidluckan till ett återstående körfält var i genomsnitt 0,2 s (sign.) kortare efter omkörningar av 30-metersfordonet i situationer då bakänden var i samma relativa position som för 18,75-metersfordonet vid början av omkörningen. En fältstudie analyserade videoinspelade omkörningar av en 30- och en 24-meters timmerbil på en 2+1-väg och en tvåfältig väg. Ingen signifikant skillnad i tidluckor kunde påvisas mellan omkörningar av de två fordonen för någon av vägtyperna. Det senare resultatet ska dock tolkas med försiktighet på grund av ojämnt distribuerad data som insamlats under specifika förhållanden. Slutsatserna är att det finns en liten tendens till negativ säkerhetseffekt vid omkörningar av längre fordon, och att fler fältstudier är nödvändiga.
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| 8. |
- Blauenfeldt, Rolf Ankerlund, et al.
(författare)
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Remote Ischemic Conditioning for Acute Stroke : The RESIST Randomized Clinical Trial
- 2023
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Ingår i: JAMA. - 0098-7484. ; 330:13, s. 1236-1246
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Despite some promising preclinical and clinical data, it remains uncertain whether remote ischemic conditioning (RIC) with transient cycles of limb ischemia and reperfusion is an effective treatment for acute stroke. Objective: To evaluate the effect of RIC when initiated in the prehospital setting and continued in the hospital on functional outcome in patients with acute stroke. Design, Setting, and Participants: This was a randomized clinical trial conducted at 4 stroke centers in Denmark that included 1500 patients with prehospital stroke symptoms for less than 4 hours (enrolled March 16, 2018, to November 11, 2022; final follow-up, February 3, 2023). Intervention: The intervention was delivered using an inflatable cuff on 1 upper extremity (RIC cuff pressure, ≤200 mm Hg [n = 749] and sham cuff pressure, 20 mm Hg [n = 751]). Each treatment application consisted of 5 cycles of 5 minutes of cuff inflation followed by 5 minutes of cuff deflation. Treatment was started in the ambulance and repeated at least once in the hospital and then twice daily for 7 days among a subset of participants. Main Outcomes and Measures: The primary end point was improvement in functional outcome measured as a shift across the modified Rankin Scale (mRS) score (range, 0 [no symptoms] to 6 [death]) at 90 days in the target population with a final diagnosis of ischemic or hemorrhagic stroke. Results: Among 1500 patients who were randomized (median age, 71 years; 591 women [41%]), 1433 (96%) completed the trial. Of these, 149 patients (10%) were diagnosed with transient ischemic attack and 382 (27%) with a stroke mimic. In the remaining 902 patients with a target diagnosis of stroke (737 [82%] with ischemic stroke and 165 [18%] with intracerebral hemorrhage), 436 underwent RIC and 466 sham treatment. The median mRS score at 90 days was 2 (IQR, 1-3) in the RIC group and 1 (IQR, 1-3) in the sham group. RIC treatment was not significantly associated with improved functional outcome at 90 days (odds ratio [OR], 0.95; 95% CI, 0.75 to 1.20, P =.67; absolute difference in median mRS score, -1; -1.7 to -0.25). In all randomized patients, there were no significant differences in the number of serious adverse events: 169 patients (23.7%) in the RIC group with 1 or more serious adverse events vs 175 patients (24.3%) in the sham group (OR, 0.97; 95% CI, 0.85 to 1.11; P =.68). Upper extremity pain during treatment and/or skin petechia occurred in 54 (7.2%) in the RIC group and 11 (1.5%) in the sham group. Conclusions and Relevance: RIC initiated in the prehospital setting and continued in the hospital did not significantly improve functional outcome at 90 days in patients with acute stroke. Trial Registration: ClinicalTrials.gov Identifier: NCT03481777.
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| 9. |
- Bodén, Roger, et al.
(författare)
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A metallic micropump for high-pressure microfluidics
- 2008
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Ingår i: Journal of Micromechanics and Microengineering. - : IOP Publishing. - 0960-1317 .- 1361-6439. ; 18:11, s. 115009-
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents one of the strongest mechanical sub-cm(3) sized micropumps for microfluidics. It consists of two active valves and one pumping chamber, each operated by a paraffin actuator that is driven by a low-voltage square pulse waveform. The pump is fabricated in a simple process using parylene-coated stainless steel stencils, paraffin and copper clad polyimide. When driving the pump at 0.07 Hz and 2.0 V (0.8 W) per actuator, it pumped water without leakage at a flow rate of 0.75 mu L min(-1) up to above 50 bar (5 MPa) back-pressure. The frequency dependence was evaluated and a maximum flow rate of 1 mu L min(-1) at 0.21 Hz and 1.8 V was observed. A thermomechanical FEM analysis, which was in good agreement with experiments at low frequencies, predicts the behaviour at higher frequencies.
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