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- Fahnestock, Jesse, et al.
(författare)
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Waste Incineration for the Future : Scenario analysis and action plans
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report is a deliverable from a project within the Swedish Strategic Innovation Program RE:Source, financed by the Swedish Energy Agency, Formas and Vinnova. The project, Waste Incineration for the Future, aims to produce a knowledge base for the development of energy recovery from waste that suits the future circular economy. In order to identify and prioritize relevant innovations, a scenario process has been undertaken with stakeholders from the energy, waste and recycling, and manufacturing industries. The result is two distinct, complementary scenarios for the circular economy in Sweden, each with different implications for innovation in waste incineration and energy recovery.With these scenarios as a starting point, the project has defined prioritized areas for innovation and produced action plans for promoting innovation.
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| 4. |
- Sahlén, Klara, et al.
(författare)
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Predictive value of secondary signs of obstruction in follow-up computed tomography of ureteral stones : a study with dynamic computed tomography
- 2018
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis Group. - 2168-1805 .- 2168-1813. ; 52:1, s. 59-64
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study aimed to determine the ratio of obstruction and predictive values of secondary signs in follow-up computed tomography (CT) of ureterolithiasis patients; to correlate stone characteristics with obstruction; to compare enhancement of obstructed and non-obstructed kidneys; and to compare radiation dose of the dynamic CT protocol to an excretory-phase protocol.MATERIALS AND METHODS: This retrospective study assessed 49 follow-up CT scans of patients with remaining ureterolithiasis after a renal colic episode. Obstruction was measured as time taken to excretion of contrast medium in dynamic CT. Degree of secondary signs of obstruction was evaluated from the unenhanced CT. Data were collected on patients' gender and age, stone size and location, time from renal colic to follow-up, attenuation of the renal cortex and radiation dose.RESULTS: Obstruction was present in 28% (n = 14) at follow-up. Predictive values (sensitivity, specificity, positive predictive value, negative predictive value) were calculated for hydronephrosis (1.0, 0.63, 0.52, 1.0), hydroureter (1.0, 0.4, 0.4, 1.0), perirenal stranding (0.21, 0.94, 0.6, 0.75), Gerota's fascia (0.21, 0.97, 0.75, 0.76) and renal swelling (0.21, 0.97, 0.75, 0.76). Obstruction was not correlated with stone characteristics. Enhancement was lower in obstructed kidneys (p < 0.01). Radiation dose was reduced by 43% (1.8 mSv).CONCLUSIONS: Obstruction was found in 28% of patients. Secondary signs were scarce and of indeterminate value to the diagnosis of obstruction. The absence of hydronephrosis and hydroureter contradicted obstruction. Stone characteristics were not correlated with obstruction. Enhancement of the renal cortex was lower in obstructed kidneys. The dynamic protocol reduced the radiation dose.
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| 5. |
- Aagaard, Philip, et al.
(författare)
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Early Repolarization in Middle-Age Runners-Cardiovascular Characteristics.
- 2014
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Ingår i: Medicine & Science in Sports & Exercise. - 0195-9131 .- 1530-0315. ; 46:7, s. 1285-1292
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to assess the prevalence and patterns of early repolarization (ER) in middle-age long-distance runners, its relation to cardiac structure and function, and its response to strenuous physical activity. Methods: Male first-time cross-country race participants >45 yr were assessed pre-and postrace by medical history and physical examination, 12-lead ECG, vectorcardiography, blood tests, and echocardiography. ER was defined either as ST elevation or J wave and categorized according to localization and morphology. Results: One hundred and fifty-one subjects (50 +/- 5 yr) were evaluated before the race, and 47 subjects were evaluated after the race. Altogether, 67 subjects (44%) had ER. Subjects with versus without ER had a lower resting HR (56 +/- 8 vs 69 +/- 9 bpm, P = 0.02), lower body mass index (24 +/- 2 vs 25 +/- 3 kg.m(-2), P < 0.001), higher training volume (3.0 +/- 2.6 vs 2.1 +/- 2.7 h.wk(-1), P = 0.03), and faster 30-km running times (194 +/- 28 vs 208 +/- 31 min, P = 0.01). Vectorcardiography parameters in subjects with ER showed more repolarization heterogeneity: vector gradient (QRS-T-area) (120 +/- 25 vs 92 +/- 29 mu Vs, P < 0.001), T-area (105 +/- 18 vs 73 +/- 23 mu Vs, P < 0.001), and T-amplitude (0.63 +/- 0.13 vs 0.53 +/- 0.16 mm, P < 0.001); these parameters were inversely related to HR (r = -0.37 to -0.48, P < 0.001). ER disappeared in 15 (75%) of 20 subjects after the race. Conclusions: ER is a common finding in middle-age male runners. This ECG pattern, regardless of morphology and localization, is associated with normal cardiac examinations including noninvasive electrophysiology, features of better physical conditioning, and disappears after strenuous exercise in most cases. These findings support that ER should be regarded as a common and training-related finding also in middle-age physically active men.
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| 7. |
- Böös, Malin, et al.
(författare)
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Who should record surgical complications? : Results from a third-party assessment of complications after radical cystectomy
- 2019
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Ingår i: Scandinavian journal of urology. - : Informa Healthcare. - 2168-1805 .- 2168-1813. ; 53:5, s. 339-343
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In Sweden complications after radical cystectomy have been reported to the nationwide population-based Swedish Cystectomy Registry since 2011. Here, validation of the reporting was assessed in two healthcare regions.Materials and methods: Complications were ascertained from patient records by a third party not involved in the care delivered to 429 randomly selected patients from 949 who had undergone radical cystectomy since 2011 in four hospitals. Without knowledge of the outcome in the primary registration, post-operative complications within 90 days post-operatively were assessed by an independent review of patient charts, and the results were compared with the primary reports in the Swedish Cystectomy Registry.Results: The third-party assessment identified post-operative complications in 310 patients (72%). Low-grade complications (Clavien-Dindo I-II) were noted in 110 (26%) of the patients in the primary registration, but increased to 182 (42%) in the validation (p < 0.00001). High-grade complications (Clavien-Dindo III-V) were reported in 113 (26%) patients in the primary registration, but in 128 (30%) of the patients in the validation (p = 0.02). According to the third-party assessment, 18 patients (4%) had Clavien-Dindo grade IV complications and 12 (3%) died within 90 days of surgery (Clavien-Dindo grade V); corresponding values in the primary registration were 15 (3%) and 9 (2%), respectively. The readmission rate within 90 days increased from 27 to 32% in the validation (p < 0.00001).Conclusions: Compared with registry data, third-party assessment revealed more complications and readmissions after radical cystectomy. Hence such evaluation may improve the validity of reported complication data.
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| 9. |
- da Silva, Cristina, et al.
(författare)
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Hemodynamic outcomes of transcatheter aortic valve implantation with the CoreValve system : an early assessment
- 2015
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961 .- 1475-097X. ; 35:3, s. 216-222
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: Transcatheter aortic valve implantation (TAVI) is an established method for the treatment of high-risk patients with aortic stenosis (AS). The beneficial effects of TAVI in cardiac hemodynamics have been described in recent studies, but those investigations were mostly performed after an interval of more than 6 months following aortic valve implantation. The aim of this study is to investigate the acute and short-term alterations in hemodynamic conditions using the echocardiography outcomes in patients undergoing TAVI. Methods and Results: A total of 60 patients (26 males, 34 females; age 84·7 ± 5·8) who underwent TAVI with CoreValve system were included in the study. Echocardiography was performed before hospital discharge and at 3 months follow-up. As expected, TAVI was associated with an immediate significant improvement in aortic valve area (AVA) (from 0·64 ± 0·16 cm2 to 1·67 ± 0·41 cm2, P-value<0·001) and mean gradient (from 51·9 ± 15·4 mmHg to 8·8 ± 3·8 mmHg, P-value<0·001). At 3-month follow-up, systolic LV function was augmented (EF: 50 ± 14% to 54 ± 11%, P-value = 0·024). Left ventricle (LV) mass and left atrium (LA) volume were significantly reduced (LV mass index from 126·5 ± 30·5 g m-2 to 102·4 ± 32·4 g m-2; LA index from 42·9 ± 17·3 ml m-2 to 33·6 ± 10·6 ml m-2; P-value<0·001 for both). Furthermore, a decrement in systolic pulmonary artery pressure (SPAP) from 47·5 ± 13·5 mmHg to 42·5 ± 11·2 mmHg, P-value = 0·02 was also observed. Despite the high incidence of paravalvular regurgitation (PVR) (80%), most of the patients presented mild or trace PVR and no significant progress of the regurgitation grade was seen after 3 months. Conclusion: This study demonstrates that the beneficial effects of TAVI in cardiac function and hemodynamics occur already after a short period following aortic valve implantation.
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| 10. |
- da Silva, Cristina, et al.
(författare)
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Prosthesis-patient mismatch after transcatheter aortic valve implantation : impact of 2D-transthoracic echocardiography versus 3D-transesophageal echocardiography
- 2014
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Ingår i: The International Journal of Cardiovascular Imaging. - : Springer Science and Business Media LLC. - 1569-5794 .- 1875-8312 .- 1573-0743. ; 30:8, s. 1549-1557
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the role of 2D-transthoracic echocardiography (2D-TTE) and 3D-transesophageal echocardiography (3D-TEE) in the determination of aortic annulus size prior transcatheter aortic valve implantation (TAVI) and its' impact on the prevalence of patient prosthesis mismatch (PPM). Echocardiography plays an important role in measuring aortic annulus dimension in patients undergoing TAVI. This has great importance since it determines both eligibility for TAVI and selection of prosthesis type and size, and can be potentially important in preventing an inadequate ratio between the prosthetic valvular orifice and the patient's body surface area, concept known as prosthesis-patient mismatch (PPM). A total of 45 patients were studied pre-TAVI: 20 underwent 3D-TEE (men/women 12/8, age 84.8 +/- A 5.6) and 25 2D-TTE (men/women 9/16, age 84.4 +/- A 5.4) in order to measure aortic annulus diameter. The presence of PPM was assessed before hospital discharge and after a mean period of 3 months. Moderate PPM was defined as indexed aortic valve area (AVAi) a parts per thousand currency sign 0.85 cm(2)/m(2) and severe PPM as AVAi < 0.65 cm(2)/m(2). Immediately post-TAVI, moderate PPM was present in 25 and 28 % of patients worked up using 3D-TEE and 2D-TTE respectively p value = n.s) and severe PPM occurred in 10 % of the patients who underwent 3D-TEE and in 20 % in those with 2D-TTE (p value = n.s). The echocardiographic evaluation 3 months post-TAVI showed 25 % moderate PPM in the 3D-TEE group compared with 24 % in the 2D-TTE group (p value = n.s) and no cases of severe PPM in the 3DTEE group comparing to 20 % in the 2D-TTE group (p = 0.032). Our results indicate a higher incidence of severe PPM in patients who performed 2DTTE compared to those performing 3DTEE prior TAVI. This suggests that the 3D technique should replace the 2DTTE analysis when investigating the aortic annulus diameter in patients undergoing TAVI.
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