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Sökning: WFRF:(Cipriani P)

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1.
  • Glasbey, JC, et al. (författare)
  • 2021
  • swepub:Mat__t
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  • Asbun, H.J., et al. (författare)
  • The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection
  • 2020
  • Ingår i: Annals of Surgery. - : Lippincott Williams and Wilkins. - 0003-4932 .- 1528-1140. ; 271:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of this study was to develop and externally validate the first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019).Summary Background Data: MIPR has seen rapid development in the past decade. Promising outcomes have been reported by early adopters from high-volume centers. Subsequently, multicenter series as well as randomized controlled trials were reported; however, guidelines for clinical practice were lacking. Methods: The Scottisch Intercollegiate Guidelines Network (SIGN) methodology was used, incorporating these 4 items: systematic reviews using PubMed, Embase, and Cochrane databases to answer clinical questions, whenever possible in PICO style, the GRADE approach for assessment of the quality of evidence, the Delphi method for establishing consensus on the developed recommendations, and the AGREE-II instrument for the assessment of guideline quality and external validation. The current guidelines are cosponsored by the International Hepato-Pancreato-Biliary Association, the Americas Hepato-Pancreato-Biliary Association, the Asian-Pacific Hepato-Pancreato-Biliary Association, the European-African Hepato-Pancreato-Biliary Association, the European Association for Endoscopic Surgery, Pancreas Club, the Society of American Gastrointestinal and Endoscopic Surgery, the Society for Surgery of the Alimentary Tract, and the Society of Surgical Oncology. Results: After screening 16,069 titles, 694 studies were reviewed, and 291 were included. The final 28 recommendations covered 6 topics; laparoscopic and robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, as well as patient selection, training, learning curve, and minimal annual center volume required to obtain optimal outcomes and patient safety.Conclusion: The IG-MIPR using SIGN methodology give guidance to surgeons, hospital administrators, patients, and medical societies on the use and outcome of MIPR as well as the approach to be taken regarding this challenging type of surgery. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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  • Furukawa, T. A., et al. (författare)
  • Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual data
  • 2021
  • Ingår i: Lancet Psychiatry. - : Elsevier BV. - 2215-0374 .- 2215-0366. ; 8:6, s. 500-511
  • Tidskriftsartikel (refereegranskat)abstract
    • Findings We identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42.0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD -1.83 [95% credible interval (CrI) -2.90 to -0.80]) and that relaxation might be harmful (1.20 [95% CrI 0.17 to 2.27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduced dropouts from treatment (incremental odds ratio, 0.32 [95% CrI 0.13 to 0.93]). The risk of bias was low for the randomisation process, missing outcome data, or selection of reported results in most of the included studies, uncertain for deviation from intended interventions, and high for measurement of outcomes. There was moderate to high heterogeneity among the studies and their components. 511
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  • Ammirati, Enrico, et al. (författare)
  • Fulminant Versus Acute Nonfulminant Myocarditis in Patients With Left Ventricular Systolic Dysfunction
  • 2019
  • Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 74:3, s. 299-311
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Fulminant myocarditis (FM) is a form of acute myocarditis characterized by severe left ventricular systolic dysfunction requiring inotropes and/or mechanical circulatory support. A single-center study found that a patient with FM had better outcomes than those with acute nonfulminant myocarditis (NFM) presenting with left ventricular systolic dysfunction, but otherwise hemodynamically stable. This was recently challenged, so disagreement still exists. Objectives: This study sought to provide additional evidence on the outcome of FM and to ascertain whether patient stratification based on the main histologic subtypes can provide additional prognostic information. Methods: A total of 220 patients (median age 42 years, 46.3% female) with histologically proven acute myocarditis (onset of symptoms <30 days) all presenting with left ventricular systolic dysfunction were included in a retrospective, international registry comprising 16 tertiary hospitals in the United States, Europe, and Japan. The main endpoint was the occurrence of cardiac death or heart transplantation within 60 days from admission and at long-term follow-up. Results: Patients with FM (n = 165) had significantly higher rates of cardiac death and heart transplantation compared with those with NFM (n = 55), both at 60 days (28.0% vs. 1.8%, p = 0.0001) and at 7-year follow-up (47.7% vs. 10.4%, p < 0.0001). Using Cox multivariate analysis, the histologic subtype emerged as a further variable affecting the outcome in FM patients, with giant cell myocarditis having a significantly worse prognosis compared with eosinophilic and lymphocytic myocarditis. In a subanalysis including only adults with lymphocytic myocarditis, the main endpoints occurred more frequently in FM compared with in NFM both at 60 days (19.5% vs. 0%, p = 0.005) and at 7-year follow up (41.4% vs. 3.1%, p = 0.0004). Conclusions: This international registry confirms that patients with FM have higher rates of cardiac death and heart transplantation both in the short- and long-term compared with patients with NFM. Furthermore, we provide evidence that the histologic subtype of FM carries independent prognostic value, highlighting the need for timely endomyocardial biopsy in this condition.
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  • Calati, R, et al. (författare)
  • Cancer and suicidal ideation and behaviours: protocol for a systematic review and meta-analysis
  • 2018
  • Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 8:8, s. e020463-
  • Tidskriftsartikel (refereegranskat)abstract
    • Prevalence of suicidal ideation (SI) and behaviours are higher among patients with cancer than general population. No systematic review/meta-analysis investigated this topic; therefore, our aim will be to assess the relationship between cancer and SI and behaviours.MethodsWe will search PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO and Cochrane Library databases from their inception until 30 June 2018. Case–control and cohort studies focused on the association between cancer (any type) and suicidal outcomes (suicide, suicide attempt and SI) will be included. Two team members will independently: (A) perform the selection of the included studies and data extraction, with the supervision of a third member in case of discrepancies and (B) assess each study with: (1) Newcastle-Ottawa Scale (NOS); (2) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement; (3) Grading of Recommendations Assessment, Development and Evaluation (GRADE). We will conduct a random-effects meta-analysis. Individual and pooled ORs and associated 95% CIs will be calculated as well as between-study heterogeneity. We will examine the potential for publication bias. If possible, we will explore reasons for potential between-study heterogeneity.Ethics and disseminationThis study does not require ethical approval. The study will be submitted to a peer-reviewed journal, will be publicly disseminated and will be the topic of research presentations.PROSPERO registration numberCRD42017072482.
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  • Furukawa, Toshi A., et al. (författare)
  • Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression : a systematic review and component network meta-analysis using individual data
  • 2021
  • Ingår i: Lancet psychiatry. - London, United Kingdom : Elsevier. - 2215-0374 .- 2215-0366. ; 8:6, s. 500-511
  • Forskningsöversikt (refereegranskat)abstract
    • Findings We identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42.0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD -1.83 [95% credible interval (CrI) -2.90 to -0.80]) and that relaxation might be harmful (1.20 [95% CrI 0.17 to 2.27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduced dropouts from treatment (incremental odds ratio, 0.32 [95% CrI 0.13 to 0.93]). The risk of bias was low for the randomisation process, missing outcome data, or selection of reported results in most of the included studies, uncertain for deviation from intended interventions, and high for measurement of outcomes. There was moderate to high heterogeneity among the studies and their components. 511
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  • Goodwin, G. M., et al. (författare)
  • Evidence-based guidelines for treating bipolar disorder : Revised third edition recommendations from the British Association for Psychopharmacology
  • 2016
  • Ingår i: Journal of Psychopharmacology. - : SAGE PUBLICATIONS LTD. - 0269-8811 .- 1461-7285. ; 30:6, s. 495-553
  • Forskningsöversikt (refereegranskat)abstract
    • The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.
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  • Johansson, Fredrik, et al. (författare)
  • A charging model for the Rosetta spacecraft
  • 2020
  • Ingår i: Astronomy and Astrophysics. - : EDP SCIENCES S A. - 0004-6361 .- 1432-0746. ; 642
  • Tidskriftsartikel (refereegranskat)abstract
    • Context. The electrostatic potential of a spacecraft, V-S, is important for the capabilities of in situ plasma measurements. Rosetta has been found to be negatively charged during most of the comet mission and even more so in denser plasmas.Aims. Our goal is to investigate how the negative V-S correlates with electron density and temperature and to understand the physics of the observed correlation.Methods. We applied full mission comparative statistics of V-S, electron temperature, and electron density to establish V-S dependence on cold and warm plasma density and electron temperature. We also used Spacecraft-Plasma Interaction System (SPIS) simulations and an analytical vacuum model to investigate if positively biased elements covering a fraction of the solar array surface can explain the observed correlations.Results. Here, the V-S was found to depend more on electron density, particularly with regard to the cold part of the electrons, and less on electron temperature than was expected for the high flux of thermal (cometary) ionospheric electrons. This behaviour was reproduced by an analytical model which is consistent with numerical simulations.Conclusions. Rosetta is negatively driven mainly by positively biased elements on the borders of the front side of the solar panels as these can efficiently collect cold plasma electrons. Biased elements distributed elsewhere on the front side of the panels are less efficient at collecting electrons apart from locally produced electrons (photoelectrons). To avoid significant charging, future spacecraft may minimise the area of exposed bias conductors or use a positive ground power system.
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  • Malešević, Nebojša, et al. (författare)
  • A database of high-density surface electromyogram signals comprising 65 isometric hand gestures
  • 2021
  • Ingår i: Scientific Data. - : Springer Science and Business Media LLC. - 2052-4463. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Control of contemporary, multi-joint prosthetic hands is commonly realized by using electromyographic signals from the muscles remaining after amputation at the forearm level. Although this principle is trying to imitate the natural control structure where muscles control the joints of the hand, in practice, myoelectric control provides only basic hand functions to an amputee using a dexterous prosthesis. This study aims to provide an annotated database of high-density surface electromyographic signals to aid the efforts of designing robust and versatile electromyographic control interfaces for prosthetic hands. The electromyographic signals were recorded using 128 channels within two electrode grids positioned on the forearms of 20 able-bodied volunteers. The participants performed 65 different hand gestures in an isometric manner. The hand movements were strictly timed using an automated recording protocol which also synchronously recorded the electromyographic signals and hand joint forces. To assess the quality of the recorded signals several quantitative assessments were performed, such as frequency content analysis, channel crosstalk, and the detection of poor skin-electrode contacts.
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  • Mastinu, Enzo, 1987, et al. (författare)
  • Grip control and motor coordination with implanted and surface electrodes while grasping with an osseointegrated prosthetic hand
  • 2019
  • Ingår i: Journal of Neuroengineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Replacement of a lost limb by an artificial substitute is not yet ideal. Resolution and coordination of motor control approximating that of a biological limb could dramatically improve the functionality of prosthetic devices, and thus reduce the gap towards a suitable limb replacement. Methods: In this study, we investigated the control resolution and coordination exhibited by subjects with transhumeral amputation who were implanted with epimysial electrodes and an osseointegrated interface that provides bidirectional communication in addition to skeletal attachment (e-OPRA Implant System). We assessed control resolution and coordination in the context of routine and delicate grasping using the Pick and Lift and the Virtual Eggs Tests. Performance when utilizing implanted electrodes was compared with the standard-of-care technology for myoelectric prostheses, namely surface electrodes. Results: Results showed that implanted electrodes provide superior controllability over the prosthetic terminal device compared to conventional surface electrodes. Significant improvements were found in the control of the grip force and its reliability during object transfer. However, these improvements failed to increase motor coordination, and surprisingly decreased the temporal correlation between grip and load forces observed with surface electrodes. We found that despite being more functional and reliable, prosthetic control via implanted electrodes still depended highly on visual feedback. Conclusions: Our findings indicate that incidental sensory feedback (visual, auditory, and osseoperceptive in this case) is insufficient for restoring natural grasp behavior in amputees, and support the idea that supplemental tactile sensory feedback is needed to learn and maintain the motor tasks internal model, which could ultimately restore natural grasp behavior in subjects using prosthetic hands. © 2019 The Author(s).
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  • Nakamura, R., et al. (författare)
  • Initial Results From the Active Spacecraft Potential Control Onboard Magnetospheric Multiscale Mission
  • 2017
  • Ingår i: IEEE Transactions on Plasma Science. - : Institute of Electrical and Electronics Engineers (IEEE). - 0093-3813 .- 1939-9375. ; 45:8, s. 1847-1852
  • Tidskriftsartikel (refereegranskat)abstract
    • NASA's magnetospheric multiscale (MMS) mission was successfully launched in March 2015. The scientific objectives of MMS are to explore and understand fundamental plasma physics processes in the earth's magnetosphere: magnetic reconnection, particle acceleration, and turbulence. The region of scientific interest of MMS is in a tenuous plasma environment where the positive spacecraft potential may reach an equilibrium as high as several tens of volts. The active spacecraft potential control (ASPOC) instrument neutralizes the spacecraft potential by releasing the positive charge produced by indium ion emitters. While the method has successfully been applied to other spacecraft such as Cluster and Double Star, new developments in the design of the emitters and the electronics are enabling lower spacecraft potentials and higher reliability compared to previous missions. In this paper, we report the initial results from the tests of the ASPOC performance during the commissioning phase and discuss the different effects on the particle and field instruments observed at different plasma environments in the magnetosphere.
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  • Ortiz Catalan, Max Jair, 1982, et al. (författare)
  • A highly integrated bionic hand with neural control and feedback for use in daily life
  • 2023
  • Ingår i: Science Robotics. - 2470-9476. ; 8:83
  • Tidskriftsartikel (refereegranskat)abstract
    • Restoration of sensorimotor function after amputation has remained challenging because of the lack of human-machine interfaces that provide reliable control, feedback, and attachment. Here, we present the clinical implementation of a transradial neuromusculoskeletal prosthesis-a bionic hand connected directly to the user's nervous and skeletal systems. In one person with unilateral below-elbow amputation, titanium implants were placed intramedullary in the radius and ulna bones, and electromuscular constructs were created surgically by transferring the severed nerves to free muscle grafts. The native muscles, free muscle grafts, and ulnar nerve were implanted with electrodes. Percutaneous extensions from the titanium implants provided direct skeletal attachment and bidirectional communication between the implanted electrodes and a prosthetic hand. Operation of the bionic hand in daily life resulted in improved prosthetic function, reduced postamputation, and increased quality of life. Sensations elicited via direct neural stimulation were consistently perceived on the phantom hand throughout the study. To date, the patient continues using the prosthesis in daily life. The functionality of conventional artificial limbs is hindered by discomfort and limited and unreliable control. Neuromusculoskeletal interfaces can overcome these hurdles and provide the means for the everyday use of a prosthesis with reliable neural control fixated into the skeleton.
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  • Soucek, J., et al. (författare)
  • EMC Aspects Of Turbulence Heating Observer (THOR) Spacecraft
  • 2016
  • Ingår i: Proceedings Of 2016 Esa Workshop On Aerospace Emc (Aerospace Emc). - : Institute of Electrical and Electronics Engineers (IEEE). - 9789292213039
  • Konferensbidrag (refereegranskat)abstract
    • Turbulence Heating ObserveR (THOR) is a spacecraft mission dedicated to the study of plasma turbulence in near-Earth space. The mission is currently under study for implementation as a part of ESA Cosmic Vision program. THOR will involve a single spinning spacecraft equipped with state of the art instruments capable of sensitive measurements of electromagnetic fields and plasma particles. The sensitive electric and magnetic field measurements require that the spacecraft-generated emissions are restricted and strictly controlled; therefore a comprehensive EMC program has been put in place already during the study phase. The THOR study team and a dedicated EMC working group are formulating the mission EMC requirements already in the earliest phase of the project to avoid later delays and cost increases related to EMC. This article introduces the THOR mission and reviews the current state of its EMC requirements.
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