| 1. |
- Berve, Per Olav, et al.
(författare)
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Mechanical active compression-decompression versus standard mechanical cardiopulmonary resuscitation : A randomised haemodynamic out-of-hospital cardiac arrest study
- 2022
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572. ; 170, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) utilises a suction cup to lift the chest-wall actively during the decompression phase (AD). We hypothesised that mechanical ACD-CPR (Intervention), with AD up to 30 mm above the sternal resting position, would generate better haemodynamic results than standard mechanical CPR (Control). Methods: This out-of-hospital adult non-traumatic cardiac arrest trial was prospective, block-randomised and non-blinded. We included intubated patients with capnography recorded during mechanical CPR. Exclusion criteria were pregnancy, prisoners, and prior chest surgery. The primary endpoint was maximum tidal carbon dioxide partial pressure (pMTCO2) and secondary endpoints were oxygen saturation of cerebral tissue (SctO2), invasive arterial blood pressures and CPR-related injuries. Intervention device lifting force performance was categorised as Complete AD (≥30 Newtons) or Incomplete AD (≤10 Newtons). Haemodynamic data, analysed as one measurement for each parameter per ventilation (Observation Unit, OU) with non-linear regression statistics are reported as mean (standard deviation). A two-sided p-value < 0.05 was considered as statistically significant. Results: Of 221 enrolled patients, 210 were deemed eligible (Control 109, Intervention 101). The Control vs. Intervention results showed no significant differences for pMTCO2: 29(17) vs 29(18) mmHg (p = 0.86), blood pressures during compressions: 111(45) vs. 101(68) mmHg (p = 0.93) and decompressions: 21(20) vs. 18(18) mmHg (p = 0.93) or for SctO2%: 55(36) vs. 57(9) (p = 0.42). The 48 patients who received Complete AD in > 50% of their OUs had higher SctO2 than Control patients: 58(11) vs. 55(36)% (p < 0.001). Conclusions: Mechanical ACD-CPR provided similar haemodynamic results to standard mechanical CPR. The Intervention device did not consistently provide Complete AD. Clinical trial registration: ClinicalTrials.gov identifier (NCT number): NCT02479152. The Haemodynamic Effects of Mechanical Standard and Active Chest Compression-decompression During Out-of-hospital CPR.
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| 2. |
- Bonnier, Gaga, et al.
(författare)
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Kirunas Framtid - Kan man flytta en stad? : restaureringskonst på sin spets
- 2010
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Rapport (populärvet., debatt m.m.)abstract
- Ar 2004 konstaterade gruvbolaget LKAB att en på världsmarknaden ökad efterfrågan på järnmalm innebär att marken ovanför brytningsområdet i Kiruna spricker i takt med att malmen bryts. Detta deformationsområde kommer att omfatta större delen av den gamla staden inklusive kyrkan och stadshuset. Osäkerheten är stor om hur man skall gå till väga och de konkreta frågorna är ännu obesvarade. Diskussionen handlar om vart man skall flytta och den pendlar mellan ytterligheterna att helt avstå från det gamla och bygga helt nytt eller skapa ett nytt område med de gamla husen musealt återuppbyggda i ett landskapssammanhang som så långt möjligt påminner om det gamla. Den avgörande frågan är, menar vi, hur staden och dess invånare kan behålla sin identitet och sitt minne - framtiden för kulturmiljön i vidaste bemärkelse.Omvandlingen och den successiva flytten av Kirunas centrala delar är en av de riktigt stora samhällsbyggnads- och bevarandefrågorna i vår samtid, en samhällsförändring med global räckvidd - restaureringskonst på sin spets.
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| 3. |
- Dogan, Emanuel M., 1984-
(författare)
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Endovascular occlusion methods in non-traumatic cardiac arrest
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Approximately 10% of out-of-hospital cardiac arrest patients survive to hospital discharge. An important factor for survival is perfusion to the coronary and cerebral circulations during cardiopulmonary resuscitation (CPR). Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular method used to centralize the circulation and augment blood flow to the heart and brain. REBOA is mostly used in trauma patients but its use in non-traumatic cardiac arrest (NTCA) is evolving. The effects and optimal location of REBOA during CPR are, however, not well-known. Intra-aortic balloon pump (IABP) is another endovascular method which, unlike REBOA, inflates and deflates in correlation with the heart’s contraction and relaxation cycles. IABP is mostly used in patients with cardiogenic shock and its usage has been sparsely studied in NTCA. In addition, there are no studies evaluating if an intra-caval balloon pump (ICBP) could increase venous return during CPR. The aim of this thesis was to investigate endovascular occlusion methods in NTCA and how they influence the hemodynamic parameters during CPR. All studies were experimental where a total of 133 pigs were included.In Study I, REBOA increased systemic blood pressures while causing an ischemic insult to organs distal to the occlusion, already at 30 min of occlusion.Study II showed that a REBOA placed below the heart and outside of the compression field increased arterial blood pressures more than if the REBOA was placed behind the heart during NTCA and CPR.Study III compared REBOA in zone I (thoracic) with REBOA in zone III (infrarenal) during experimental CPR. Zone III REBOA did not yield the same favorable circulatory response as zone I REBOA.Study IV showed that IABP increased hemodynamic values if it was inflated before the chest compression. An ICBP did not improve hemodynamic values.Conclusion: REBOA caused a time-dependent ischemic insult, a maximum total occlusion time of 15-30 min is suggested. When an optimally placed REBOA and an optimally synchronized IABP are used in NTCA and CPR, they improve hemodynamic variables.
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| 5. |
- Johansson, Kurt, et al.
(författare)
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Industrial minerals and rocks, aggregates and natural stones in the Nordic countries
- 2008
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Ingår i: Episodes. - : International Union of Geological Sciences. - 0705-3797 .- 2586-1298. ; 31:1, s. 133-138
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Tidskriftsartikel (refereegranskat)abstract
- The Nordic countries, including Greenland, have a long tradition in mining. The industrial minerals sector is expanding in most Nordic countries and extensive development has taken place during the last few years. The main commodities mined are carbonate rocks, quartz, feldspar, apatite, olivine and talc. A number of different types of dimension stones are quarried in all countries. Rock aggregates are increasingly important, replacing sand and gravel aggregate as construction materials in some countries due to the need to protect ground water supplies.
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| 6. |
- Magnusson, Monika, 1965-, et al.
(författare)
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Information Systems for Disaster Management Training : Investigating User Needs with a Design Science Research Approach
- 2018
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Ingår i: Proceedings of the 15th International Conference on Information Systems for Crisis Response and Management ISCRAM2018. - : ISCRAM. - 9780692127605 ; , s. 841-850
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Konferensbidrag (refereegranskat)abstract
- Societal threats such as global warming and terror attacks make crisis preparedness and crisis training a major priority in governments worldwide. Unfortunately, training is limited, partly due to complex and resource-demanding planning of traditional exercises. Several crisis training software have been developed as a complement. However, reports in research on their usage are rare, which indicates that the diffusion is limited. A potential explanation is that the systems fail to meet important needs in the organizations and/or sound information systems (IS) design principles. This paper describes the first phase of a design science research (DSR) project aiming at developing information systems for disaster management (ISDM) training, and accompanying training methods in local and regional governments. The purpose of this paper is to investigate perceived problems in current crisis training and identify opportunities for ISDM training in the application domain. Another purpose is to outline expected artifacts in the project.
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| 7. |
- Milosevic, Vladan, et al.
(författare)
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Vessel size as a marker of survival in estrogen receptor positive breast cancer
- 2023
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Ingår i: Breast Cancer Research and Treatment. - : Springer Nature. - 0167-6806 .- 1573-7217. ; 200:2, s. 293-304
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Tidskriftsartikel (refereegranskat)abstract
- PurposeAngiogenesis is crucial for tumor growth and is one of the hallmarks of cancer. In this study, we analyzed microvessel density, vessel median size, and perivascular a-SMA expression as prognostic biomarkers in breast cancer.MethodsDual IHC staining was performed where alpha-SMA antibodies were used together with antibodies against the endothelial cell marker CD34. Digital images of stainings were analyzed to extract quantitative data on vessel density, vessel size, and perivascular alpha-SMA status.ResultsThe analyses in the discovery cohort (n = 108) revealed a statistically significant relationship between large vessel size and shorter disease-specific survival (p = 0.007, log-rank test; p = 0.01, HR 3.1; 95% CI 1.3–7.4, Cox-regression analyses). Subset analyses indicated that the survival association of vessel size was strengthened in ER + breast cancer. To consolidate these findings, additional analyses were performed on a validation cohort (n = 267) where an association between large vessel size and reduced survival was also detected in ER + breast cancer (p = 0.016, log-rank test; p = 0.02; HR 2.3, 95% CI 1.1–4.7, Cox-regression analyses).ConclusionAlpha-SMA/CD34 dual-IHC staining revealed breast cancer heterogeneity regarding vessel size, vessel density, and perivascular a-SMA status. Large vessel size was linked to shorter survival in ER + breast cancer.
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| 10. |
- Trovik, Jone, et al.
(författare)
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Stathmin Overexpression Identifies High-Risk Patients and Lymph Node Metastasis in Endometrial Cancer.
- 2011
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Ingår i: Clinical cancer research : an official journal of the American Association for Cancer Research. - 1078-0432. ; 17:10, s. 3368-3377
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Overexpression of the oncogen Stathmin has been linked to aggressive endometrial carcinoma and a potential for PI3Kinase inhibitors in this disease. We wanted to validate the prognostic value of Stathmin expression in a large prospective multicenter setting. As lymph node sampling is part of current surgical staging, we also aimed to test if Stathmin expression in endometrial curettage specimens could predict lymph node metastasis. EXPERIMENTAL DESIGN: A total of 1,076 endometrial cancer patients have been recruited from 10 centers to investigate the biological tumor marker Stathmin in relation to clinicopathologic variables, including lymph node status and survival. Stathmin immunohistochemical staining was carried out in 477 hysterectomy and 818 curettage specimens. RESULTS: Seventy-one percent of the patients (n = 763) were subjected to lymph node sampling, of which 12% had metastatic nodes (n = 94). Overexpression of Stathmin was detected in 37% (302 of 818) of the curettage and in 18% (84 of 477) of the hysterectomy specimens investigated. Stathmin overexpression in curettage and hysterectomy specimens were highly correlated and significantly associated with nonendometrioid histology, high grade, and aneuploidy. Stathmin analysis in preoperative curettage samples significantly correlated with, and was an independent predictor of, lymph node metastases. High Stathmin expression was associated with poor disease-specific survival (P ≤ 0.002) both in curettage and hysterectomy specimens. CONCLUSIONS: Stathmin immunohistochemical staining identifies endometrial carcinomas with lymph node metastases and poor survival. The value, as a predictive marker for response to PI3Kinase inhibition and as a tool to stratify patients for lymph node sampling in endometrial carcinomas, remains to be determined. Clin Cancer Res; 17(10); 3368-77. ©2011 AACR.
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