| 1. |
- van Bragt, JJMH, et al.
(författare)
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Characteristics and treatment regimens across ERS SHARP severe asthma registries
- 2020
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Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 55:1
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg·m−2 (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 µg·day−1 between those from Slovenia versus Poland when starting anti-interleukin (IL)-5 antibody and from 772 to 1344 µg·day−1 in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries.
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| 2. |
- Calleja, Manuel, 1984, et al.
(författare)
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Implementation of hybrid simulation schemes in COBAYA3/SUBCHANFLOW coupled codes for the efficient direct prediction of local safety parameters
- 2014
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Ingår i: Annals of Nuclear Energy. - : Elsevier BV. - 0306-4549 .- 1873-2100. ; 70, s. 216-229
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Forskningsöversikt (refereegranskat)abstract
- The precise prediction of power generation, heat transfer and flow distribution within a reactor core is of great importance to asses the safety features of any reactor design. The necessity to better describe the most important safety related physical phenomena prevailing in LWRs drive the extensions of current neutronic (N)/thermal-hydraulic (TH) coupled methodologies. Nowadays, several computer codes that solve the time dependent neutron diffusion or transport equations are coupled with TH codes at nodal level. This coarse spatial discretization of both N and TH does not allow direct prediction of local phenomena at pin or subchannel levels. Moreover, pin by pin simulations are currently performed using different strategies and methodologies. The main drawback of these approaches is the considerable computational time needed when addressing whole core solutions. Consequently, new fast running and accurate approaches are needed to simulate reactor cores using multi physics and multi scale methodologies. This type of analysis includes for instance, the use of mixed nodal based solutions with pin level solutions for both N and TH. This paper discusses a methodology implemented to achieve coupled N/TH simulations based on hybrid schemes. First, an overview of the state of the art involving non-conform geometry is presented, followed with the description of the codes used for this purpose and their extensions to perform hybrid simulations. Results for the coupled N/TH scheme are presented for a full size PWR core in steady state.
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| 3. |
- Menchon, JM, et al.
(författare)
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A prospective international multi-center study on safety and efficacy of deep brain stimulation for resistant obsessive-compulsive disorder
- 2021
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Ingår i: Molecular psychiatry. - : Springer Science and Business Media LLC. - 1476-5578 .- 1359-4184. ; 26:4, s. 1234-1247
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Tidskriftsartikel (refereegranskat)abstract
- Deep brain stimulation (DBS) has been proposed for severe, chronic, treatment-refractory obsessive-compulsive disorder (OCD) patients. Although serious adverse events can occur, only a few studies report on the safety profile of DBS for psychiatric disorders. In a prospective, open-label, interventional multi-center study, we examined the safety and efficacy of electrical stimulation in 30 patients with DBS electrodes bilaterally implanted in the anterior limb of the internal capsule. Safety, efficacy, and functionality assessments were performed at 3, 6, and 12 months post implant. An independent Clinical Events Committee classified and coded all adverse events (AEs) according to EN ISO14155:2011. All patients experienced AEs (195 in total), with the majority of these being mild (52% of all AEs) or moderate (37%). Median time to resolution was 22 days for all AEs and the etiology with the highest AE incidence was ‘programming/stimulation’ (in 26 patients), followed by ‘New illness, injury, condition’ (13 patients) and ‘pre-existing condition, worsening or exacerbation’ (11 patients). Sixteen patients reported a total of 36 serious AEs (eight of them in one single patient), mainly transient anxiety and affective symptoms worsening (20 SAEs). Regarding efficacy measures, Y-BOCS reduction was 42% at 12 months and the responder rate was 60%. Improvements in GAF, CGI, and EuroQol-5D index scores were also observed. In sum, although some severe AEs occurred, most AEs were mild or moderate, transient and related to programming/stimulation and tended to resolve by adjustment of stimulation. In a severely treatment-resistant population, this open-label study supports that the potential benefits outweigh the potential risks of DBS.
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| 4. |
- Taniguchi, M., et al.
(författare)
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Submarine Groundwater Discharge: Updates on Its Measurement Techniques, Geophysical Drivers, Magnitudes, and Effects
- 2019
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Ingår i: Frontiers in Environmental Science. - : Frontiers Media SA. - 2296-665X. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The number of studies concerning Submarine Groundwater Discharge (SGD) grew quickly as we entered the twenty-first century. Many hydrological and oceanographic processes that drive and influence SGD were identified and characterized during this period. These processes included tidal effects on SGD, water and solute fluxes, biogeochemical transformations through the subterranean estuary, and material transport via SGD from land to sea. Here we compile and summarize the significant progress in SGD assessment methodologies, considering both the terrestrial and marine driving forces, and local as well as global evaluations of groundwater discharge with an emphasis on investigations published over the past decade. Our treatment presents the state-of-the-art progress of SGD studies from geophysical, geochemical, bio-ecological, economic, and cultural perspectives. We identify and summarize remaining research questions, make recommendations for future research directions, and discuss potential future challenges, including impacts of climate change on SGD and improved estimates of the global magnitude of SGD.
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| 5. |
- Farina, D., et al.
(författare)
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Toward higher-performance bionic limbs for wider clinical use
- 2021
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Ingår i: Nature Biomedical Engineering. - : Springer Science and Business Media LLC. - 2157-846X. ; 7:4, s. 473-85
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Tidskriftsartikel (refereegranskat)abstract
- Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs. This Perspective argues that technologies for the neural interfacing of robotic devices with the body that have been clinically tested in humans should be leveraged toward the creation of a new generation of high-performance bionic limbs.
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