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Sökning: WFRF:(Jeppsson Johan)

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2.
  • Ursby, Thomas, et al. (författare)
  • BioMAX the first macromolecular crystallography beamline at MAX IV Laboratory
  • 2020
  • Ingår i: Journal of Synchrotron Radiation. - Chichester : Wiley-Blackwell. - 0909-0495 .- 1600-5775. ; 27, s. 1415-1429
  • Tidskriftsartikel (refereegranskat)abstract
    • BioMAX is the first macromolecular crystallography beamline at the MAX IV Laboratory 3 GeV storage ring, which is the first operational multi-bend achromat storage ring. Due to the low-emittance storage ring, BioMAX has a parallel, high-intensity X-ray beam, even when focused down to 20 μm × 5 μm using the bendable focusing mirrors. The beam is tunable in the energy range 5-25 keV using the in-vacuum undulator and the horizontally deflecting double-crystal monochromator. BioMAX is equipped with an MD3 diffractometer, an ISARA high-capacity sample changer and an EIGER 16M hybrid pixel detector. Data collection at BioMAX is controlled using the newly developed MXCuBE3 graphical user interface, and sample tracking is handled by ISPyB. The computing infrastructure includes data storage and processing both at MAX IV and the Lund University supercomputing center LUNARC. With state-of-the-art instrumentation, a high degree of automation, a user-friendly control system interface and remote operation, BioMAX provides an excellent facility for most macromolecular crystallography experiments. Serial crystallography using either a high-viscosity extruder injector or the MD3 as a fixed-target scanner is already implemented. The serial crystallography activities at MAX IV Laboratory will be further developed at the microfocus beamline MicroMAX, when it comes into operation in 2022. MicroMAX will have a 1 μm × 1 μm beam focus and a flux up to 1015 photons s with main applications in serial crystallography, room-temperature structure determinations and time-resolved experiments.
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4.
  • Andersson, Magnus V., et al. (författare)
  • Kirurgi – omistligt komplement till medicinsk behandling
  • 2009
  • Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 106:45, s. 3003-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Kirurgi på rätt indikation och vid rätt tidpunkt är ett omistligt komplement till medicinsk behandling vid inflammatorisk tarmsjukdom, som förebygger sjukdomskomplikationer, förbättrar patienternas livskvalitet och ibland är livräddande. Kirurgi för ulcerös kolit görs oftast som ett tvåstegsförfarande: först kolektomi plus ileostomi med rektum lämnad intakt och i senare skede, med optimerad patient, tarmrekonstruktion anpassad efter patientens individuella livssituation. Kirurgi vid Crohns sjukdom korrigerar komplikationer (stenoser och fistlar) och sparar tarm genom begränsade resektioner och strikturplastiker. Laparoskopisk kir­urgi verkar ha viktiga fördelar vid primära tarmresektioner. Modern medicinsk behandling har förändrat indikationerna men ännu inte minskat behovet av kirurgi. Pågående antiinflammatorisk och immunmodulerande behandling är viktig att beakta i samband med kirurgi. Ett nära samspel mellan gastroenterolog och kolorektalkirurg är nödvändigt för att uppnå bästa möjliga långtidsprognos för de individer som lever med IBD.
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  • Bech-Hanssen, Odd, 1956, et al. (författare)
  • Pressure reflection in the pulmonary circulation in patients with severe mitral regurgitation indicates adverse postoperative outcome.
  • 2013
  • Ingår i: European Journal Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 44:6, s. 1037-1044
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Severe pulmonary hypertension (PH) is a known risk factor in valvular surgery. In the present study, we hypothesized that the assessment of pressure reflection (PR) in the pulmonary circulation, indicating increased pulmonary vascular resistance, might improve the identification of patients with increased morbidity and mortality following surgery for severe mitral regurgitation. METHODS: A total of 103 patients without atrial fibrillation were divided into three groups: Group 1 (n = 48), patients without PR; Group 2 (n = 36), patients with PR and pulmonary artery systolic pressure (PASP) ≤60 mmHg and Group 3 (n = 19), patients with PR and PASP >60 mmHg. Three variables related to PR were selected: the acceleration time in the right ventricular outflow tract (RVOT), the interval between peak velocity in the RVOT and peak tricuspid regurgitant jet velocity and the right ventricular pressure increase after peak RVOT velocity. RESULTS: There were no differences between groups in age, ejection fraction, need for coronary bypass grafting or creatinine. Patients with PR (Groups 2 and 3) had more use of vasoactive drugs (overall P < 0.0001, Group 1 vs Group 2 P = 0.018). The proportion of patients with >24 h in the intensive care unit was 27% in Group 1, 54% in Group 2 and 84% in Group 3 (overall P < 0.0001, Group 1 vs Group 2 P = 0.006). The in-hospital mortality in patients without PR (n = 49) was 0% compared with 10.9% in patients with PR (P = 0.029). CONCLUSIONS: Echocardiography assessment of PR in the pulmonary circulation and severe PH may identify patients with adverse outcome following mitral surgery.
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7.
  • Bjursten, Henrik, et al. (författare)
  • Once after a full moon : acute type A aortic dissection and lunar phases
  • 2022
  • Ingår i: Interactive Cardiovascular and Thoracic Surgery. - : Oxford University Press. - 1569-9293 .- 1569-9285. ; 34:1, s. 105-110
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).RESULTS: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated.CONCLUSIONS: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.
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8.
  • Björklund, Erik, et al. (författare)
  • Comparison of Midterm Outcomes Associated With Aspirin and Ticagrelor vs Aspirin Monotherapy After Coronary Artery Bypass Grafting for Acute Coronary Syndrome.
  • 2021
  • Ingår i: JAMA network open. - : American Medical Association (AMA). - 2574-3805. ; 4:8
  • Tidskriftsartikel (refereegranskat)abstract
    • Guidelines recommend dual antiplatelet therapy after coronary artery bypass grafting (CABG) for patients with acute coronary syndrome (ACS). However, the evidence for these recommendations is weak.To compare midterm outcomes after CABG in patients with ACS treated postoperatively with acetylsalicylic acid (ASA) and ticagrelor or with ASA monotherapy.This cohort study used merged data from several national registries of Swedish patients who were diagnosed with ACS and subsequently underwent CABG. All included patients underwent isolated CABG in Sweden between 2012 and 2017 with an ACS diagnosis less than 6 weeks before the procedure, survived 14 days after discharge from hospital, and were treated postoperatively with ASA plus ticagrelor or ASA monotherapy. A multivariable Cox regression model was used for the main analysis, and propensity score-matched models were performed as sensitivity analysis. Data were analyzed between May and September 2020.Postoperative antiplatelet treatment, defined as filled prescriptions, with either ASA and ticagrelor or ASA only.Major adverse cardiovascular events (MACE), defined as all-cause mortality, myocardial infarction, and stroke, and major bleeding, at 12 months and at the end of follow-up.A total of 6558 patients (5281 [80.5%] men; mean [SD] age at surgery, 67.6 [9.3] years) were included; 1813 (27.6%) were treated with ASA plus ticagrelor and 4745 (72.4%) were treated with ASA monotherapy. Crude MACE rate was 3.0 per 100 person years (95% CI, 2.5-3.6 per 100 person years) in the ASA plus ticagrelor group and 3.8 per 100 person years (95% CI, 3.5-4.1 per 100 person years) in the ASA group. After adjustment, there was no significant difference in MACE risk between ASA plus ticagrelor vs ASA only, neither during the first 12 months (adjusted hazard ratio [aHR], 0.84; 95% CI, 0.58-1.21; P=.34) or during total follow-up (aHR, 0.89; 95% CI, 0.71-1.11; P=.29). The use of ASA plus ticagrelor was associated with a significantly increased risk for major bleeding during the first 12 months (aHR, 1.90; 95% CI, 1.16-3.13; P=.011). Sensitivity analyses confirmed the results.In patients with ACS who survived 2 weeks after CABG, no significant difference in the risk of death or ischemic events could be demonstrated between ASA plus ticagrelor and patients treated with ASA only, while the risk for major bleeding was higher in patients treated with ASA plus ticagrelor. Sufficiently powered prospective randomized trials comparing different antiplatelet therapy strategies after CABG are warranted.
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9.
  • Björklund, Erik, et al. (författare)
  • Postdischarge major bleeding, myocardial infarction, and mortality risk after coronary artery bypass grafting
  • 2023
  • Ingår i: HEART. - 1355-6037 .- 1468-201X.
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To investigate the incidence and mortality risk associated with postdischarge major bleeding after coronary artery bypass grafting (CABG), and relate this to the incidence of, and mortality risk from, postdischarge myocardial infarction.Methods All patients undergoing first-time isolated CABG in Sweden in 2006-2017 and surviving 14 days after hospital discharge were included in a cohort study. Individual patient data from the SWEDEHEART Registry and five other mandatory nationwide registries were merged. Piecewise Cox proportional hazards models were used to investigate associations between major bleeding, defined as hospitalisation for bleeding, with subsequent mortality risk. Similar Cox proportional hazards models were used to investigate the association between postdischarge myocardial infarction and mortality risk.Results Among 36 633 patients, 2429 (6.6%) had a major bleeding event and 2231 (6.1%) had a myocardial infarction. Median follow-up was 6.0 (range 0-11) years. Major bleeding was associated with higher mortality risk <30 days (adjusted HR (aHR)=20.2 (95% CI 17.3 to 23.5)), 30-365 days (aHR=3.8 (95% CI 3.4 to 4.3)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event. Myocardial infarction was associated with higher mortality risk <30 days (aHR=20.0 (95% CI 16.7 to 23.8)), 30-365 days (aHR=4.1 (95% CI 3.6 to 4.8)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event.Conclusions The increase in mortality risk associated with a postdischarge major bleeding after CABG is substantial and is similar to the mortality risk associated with a postdischarge myocardial infarction.
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10.
  • Björklund, Erik, et al. (författare)
  • Postoperative platelet function is associated with severe bleeding in ticagrelor-treated patients
  • 2019
  • Ingår i: Interactive Cardiovascular and Thoracic Surgery. - : Oxford University Press (OUP). - 1569-9293 .- 1569-9285. ; 28:5, s. 709-715
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Preoperative testing of platelet function predicts bleeding risk in cardiac surgery patients treated with dual antiplatelet therapy, but the value of postoperative platelet function testing, reflecting both preoperative antiplatelet therapy and perioperative changes in platelet function, has not been evaluated. Methods: Seventy-four patients with acute coronary syndrome treated with acetylsalicylic acid and ticagrelor within 5 days before cardiac surgery were included in a prospective observational study. Platelet aggregation induced by adenosine diphosphate, arachidonic acid and thrombin receptor-activating peptide was assessed with multiple electrode impedance aggregometry immediately before surgery and 2 h after weaning off cardiopulmonary bypass. Receiver operating characteristic curves were used to determine any association between platelet aggregation and severe bleeding according to the universal definition of perioperative bleeding in adult cardiac surgery. Results: Severe bleeding occurred in 25 of 74 patients (34%). Preoperative and postoperative adenosine diphosphate-induced platelet aggregations were associated with bleeding, with comparable areas under the receiver operating characteristic curve [0.77 (95% confidence interval 0.65-0.89) vs 0.75 (0.62-0.87)]. Postoperative arachidonic acid-and thrombin receptor-activating peptide-induced aggregation had markedly smaller areas under the curve. There were significant correlations between preoperative and postoperative platelet aggregation induced by adenosine diphosphate (r2 = 0.77, P < 0.001), arachidonic acid (r2 = 0.24, P < 0.001) and thrombin receptoractivating peptide (r2 = 0.21, P < 0.001) but with large interindividual variations. Conclusions: Poor postoperative platelet function was associated with severe bleeding, with accuracy comparable to that of preoperative platelet function. There was a correlation between preoperative and postoperative platelet function, but the predictability in an individual patient was limited. © 2018 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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11.
  • Björklund, Erik, et al. (författare)
  • Secondary prevention medications after coronary artery bypass grafting and long-term survival : a population-based longitudinal study from the SWEDEHEART registry.
  • 2019
  • Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 41:17, s. 1653-1661
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To evaluate the long-term use of secondary prevention medications [statins, β-blockers, renin-angiotensin-aldosterone system (RAAS) inhibitors, and platelet inhibitors] after coronary artery bypass grafting (CABG) and the association between medication use and mortality.METHODS AND RESULTS: All patients who underwent isolated CABG in Sweden from 2006 to 2015 and survived at least 6 months after discharge were included (n = 28 812). Individual patient data from SWEDEHEART and other mandatory nationwide registries were merged. Multivariable Cox regression models using time-updated data on dispensed prescriptions were used to assess associations between medication use and long-term mortality. Statins were dispensed to 93.9% of the patients 6 months after discharge and to 77.3% 8 years later. Corresponding figures for β-blockers were 91.0% and 76.4%, for RAAS inhibitors 72.9% and 65.9%, and for platelet inhibitors 93.0% and 79.8%. All medications were dispensed less often to patients ≥75 years. Treatment with statins [hazard ratio (HR) 0.56, 95% confidence interval (95% CI) 0.52-0.60], RAAS inhibitors (HR 0.78, 95% CI 0.73-0.84), and platelet inhibitors (HR 0.74, 95% CI 0.69-0.81) were individually associated with lower mortality risk after adjustment for age, gender, comorbidities, and use of other secondary preventive drugs (all P < 0.001). There was no association between β-blockers and mortality risk (HR 0.97, 95% CI 0.90-1.06; P = 0.54).CONCLUSION: The use of secondary prevention medications after CABG was high early after surgery but decreased significantly over time. The results of this observational study, with inherent risk of selection bias, suggest that treatment with statins, RAAS inhibitors, and platelet inhibitors is essential after CABG whereas the routine use of β-blockers may be questioned.
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12.
  • Chen, Q., et al. (författare)
  • Analytical treatment of diffusion during precipitate growth in multicomponent systems
  • 2008
  • Ingår i: Acta Materialia. - : Elsevier BV. - 1359-6454 .- 1873-2453. ; 56:8, s. 1890-1896
  • Tidskriftsartikel (refereegranskat)abstract
    • We propose an approximate growth rate equation that takes into account both cross-diffusion and high supersaturations for modeling precipitation in multicomponent systems. We then apply it to an Fe-alloy in which interstitial C atoms diffuse much faster than substitutional solutes, and predict a spontaneous transition from slow growth under ortho-equilibrium to fast growth under the non-partitioning local equilibrium condition. The transition is caused by the decrease in the Gibbs-Thomson effect as the growing particle becomes larger. The results agree with DICTRA simulations where full diffusion fields are calculated.
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13.
  • Ding, Jielan, et al. (författare)
  • The link between ethnic diversity and scientific impact : the mediating effect of novelty and audience diversity
  • 2021
  • Ingår i: Scientometrics. - : Springer Nature. - 0138-9130 .- 1588-2861. ; 126:9, s. 7759-7810
  • Tidskriftsartikel (refereegranskat)abstract
    • Understanding the nature and value of scientific collaboration is essential for sound management and proactive research policies. One component of collaboration is the composition and diversity of contributing authors. This study explores how ethnic diversity in scientific collaboration affects scientific impact, by presenting a conceptual model to connect ethnic diversity, based on author names, with scientific impact, assuming novelty and audience diversity as mediators. The model also controls for affiliated country diversity and affiliated country size. Using path modeling, we apply the model to the Web of Science subject categories Nanoscience & Nanotechnology, Ecology and Information Science & Library. For all three subject categories, and regardless of if control variables are considered or not, we find a weak positive relationship between ethnic diversity and scientific impact. The relationship is weaker, however, when control variables are included. For all three fields, the mediated effect through audience diversity is substantially stronger than the mediated effect through novelty in the relationship, and the former effect is much stronger than the direct effect between the ethnic diversity and scientific impact. Our findings further suggest that ethnic diversity is more associated with short-term scientific impact compared to long-term scientific impact.
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14.
  • Forsberg, Anton, et al. (författare)
  • Low background and high contrast PET imaging of amyloid-β with [11C]AZD2995 and [11C]AZD2184 in Alzheimer's disease patients
  • 2013
  • Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer-Verlag New York. - 1619-7070 .- 1619-7089. ; 40:4, s. 580-593
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The aim of this study was to evaluate AZD2995 side by side with AZD2184 as novel PET radioligands for imaging of amyloid-β in Alzheimer's disease (AD).METHODS: In vitro binding of tritium-labelled AZD2995 and AZD2184 was studied and compared with that of the established amyloid-β PET radioligand PIB. Subsequently, a first-in-human in vivo PET study was performed using [(11)C]AZD2995 and [(11)C]AZD2184 in three healthy control subjects and seven AD patients.RESULTS: AZD2995, AZD2184 and PIB were found to share the same binding site to amyloid-β. [(3)H]AZD2995 had the highest signal-to-background ratio in brain tissue from patients with AD as well as in transgenic mice. However, [(11)C]AZD2184 had superior imaging properties in PET, as shown by larger effect sizes comparing binding potential values in cortical regions of AD patients and healthy controls. Nevertheless, probably due to a lower amount of nonspecific binding, the group separation of the distribution volume ratio values of [(11)C]AZD2995 was greater in areas with lower amyloid-β load, e.g. the hippocampus.CONCLUSION: Both AZD2995 and AZD2184 detect amyloid-β with high affinity and specificity and also display a lower degree of nonspecific binding than that reported for PIB. Overall [(11)C]AZD2184 seems to be an amyloid-β radioligand with higher uptake and better group separation when compared to [(11)C]AZD2995. However, the very low nonspecific binding of [(11)C]AZD2995 makes this radioligand potentially interesting as a tool to study minute levels of amyloid-β. This sensitivity may be important in investigating, for example, early prodromal stages of AD or in the longitudinal study of a disease modifying therapy.
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15.
  • Forsberg, Ulrika, et al. (författare)
  • First Experiment at TASCA Towards X-Ray Fingerprinting of Element 115 Decay Chains
  • 2012
  • Ingår i: Acta Physica Polonica. Series B: Elementary Particle Physics, Nuclear Physics, Statistical Physics, Theory of Relativity, Field Theory. - 0587-4254. ; 43:2, s. 305-311
  • Tidskriftsartikel (refereegranskat)abstract
    • To identify the atomic number of superheavy nuclei produced in Ca-48-induced fusion-evaporation reactions, an experiment aiming at measuring characteristic X-rays is being prepared at GSI, Darmstadt, Germany. The gas-filled separator TASCA will be employed, sending the residues towards the multi-coincidence detector setup TASISpec. Two ion-optical modes relying on differing magnetic polarities of the quadrupole magnets can be used at TASCA. New simulations and experimental tests of transmission and background suppression for these two focusing modes into TASISpec are presented.
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16.
  • Granbom, Ylva, et al. (författare)
  • Simulation of the Soaking and Gas Jet Cooling in a Continuous Annealing Line using Dilatometry
  • 2010
  • Ingår i: Steel Research International. - : Wiley. - 1611-3683 .- 1869-344X. ; 81:2, s. 158-167
  • Tidskriftsartikel (refereegranskat)abstract
    • The present study concerns the simulation of a continuous annealing line (CAL), using dilatometry. Simulations of CAL have been performed on four commercial steel grades with different chemical compositions in order to investigate how the alloying elements C, Mn, Si and B affect the microstructure and hardness of dual phase (DP) and martensitic steels. Three annealing cycles corresponding to those used in a CAL have been applied. When annealing intercritically, as is the case in DP-steel production, the materials do not reach equilibrium during soaking. Mn and C increase the austenite content and consequently the hardness of the materials. Higher levels of Si (0.4 wt %) are required to retard the formation of new ferrite during cooling in the gas jet section, prior to quenching. 6 increases hardenability effectively when annealing in the austenite region but is not as efficient during intercritical annealing, which implies that boron restrains ferrite nucleation rather than impeding ferrite growth. Results from DICTRA calculations show that it is possible to simulate the phase transformations during soaking, gasjet cooling and quenching.
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17.
  • Gudbjartsson, Tomas, et al. (författare)
  • Sternal wound infections following open heart surgery – a review
  • 2016
  • Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 50:5-6, s. 341-348
  • Forskningsöversikt (refereegranskat)abstract
    • Surgical site infections (SSIs) are common complications after open heart surgery. Fortunately, most are superficial and respond to minor wound debridement and antibiotics. However, 1–3% of patients develop deep sternal wound infections that can be fatal. Late infections with sternocutaneous fistulas, are encountered less often, but represent a complex surgical problem. This evidence-based review covers etiology, risk factors, prevention and treatment of sternal SSIs following open heart surgery with special focus on advances in treatment, especially negative-pressure wound therapy.
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18.
  • Gäbel, Jakob, 1971, et al. (författare)
  • Cell saver processing mitigates the negative effects of wound blood on platelet function
  • 2016
  • Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 60:7, s. 901-909
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundWound blood is highly activated and has poor haemostatic properties. Recent data suggest that retransfusion of unwashed wound blood may impair haemostasis. We hypothesized that cell saver processing of wound blood before retransfusion reduces the negative effects. MethodsWound blood was collected from 16 cardiac surgery patients during cardiopulmonary bypass. One portion of the wound blood was processed in a cell saver and one portion left unprocessed. Increasing amounts of unprocessed blood (10% and 20% of the systemic blood volume) or corresponding volumes of processed blood were added ex vivo to whole blood samples from the same patient. Clot formation was assessed by modified thromboelastometry (ROTEM (R)) and platelet function with impedance aggregometry (Multiplate((R))). ResultsAddition of unprocessed wound blood significantly impaired clot formation and platelet aggregability. Cell saver processing before addition did not influence clot formation but abolished completely the negative effects of wound blood on platelet aggregability tested with all agonists. Median adenosine diphosphate-induced platelet aggregation was 51 (25th and 75th percentiles 42-69) when 20% processed cardiotomy suction blood was added vs. 34 (24-52) U when 20% unprocessed blood was added, P < 0.001. The corresponding figures for arachidonic acid-, thrombin receptor activating peptide- and collagen-induced aggregation was 21 (17-51) vs. 13 (10-25) U, 112 (87-128) vs. 78 (65-103) U and 58 (50-73) vs. 33 (28-44) U, respectively, all P < 0.001). ConclusionThe results suggest that cell saver processing before retransfusion mitigates the negative effects of wound blood on platelet function despite that cell saver processing reduces platelet count.
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19.
  • Hansson, Emma C., 1985, et al. (författare)
  • Platelet function recovery after ticagrelor withdrawal in patients awaiting urgent coronary surgery
  • 2017
  • Ingår i: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 51:4, s. 633-637
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Dual antiplatelet therapy with ticagrelor and aspirin is associated with an increased risk of perioperative bleeding complications. Current guidelines recommend therefore discontinuation of ticagrelor 5 days before surgery to allow sufficient recovery of platelet function. It is not known how the time to recovery varies between individual patients after discontinuation of ticagrelor. METHODS: Twenty-five patients accepted for urgent coronary artery bypass surgery and treated with ticagrelor and aspirin were included in a prospective observational study. Platelet aggregation was evaluated with impedance aggregometry at five timepoints 12-96 h after discontinuation of ticagrelor. In a subset of patients (n = 15), we also tested the ex vivo efficacy of platelet concentrate supplementation on platelet aggregation. RESULTS: There was a gradual increase in mean adenosine diphosphate-induced platelet aggregation after discontinuation of ticagrelor. After 72 h, mean aggregation was 38 +/-23 aggregation units (U), which is above a previously suggested cut-off of 22 U, when patients can be operated without increased bleeding risk. However, there was a large interindividual variability (range 488 U at 72 h) and 6/24 patients (25%) had <22 U after 72 h. Ex vivo administration of platelet concentrate did not improve adenosine diphosphate-induced aggregation at any timepoint after ticagrelor discontinuation. CONCLUSIONS: Adenosine diphosphate-induced aggregation was acceptable after 72 h in the majority of patients but with a large interindividual variability. Due to the large variability, platelet function testing may prove to be a valuable tool in timing of surgery in patients with ongoing or recently stopped ticagrelor treatment. Adenosine diphosphate-induced aggregation was not improved by addition of platelet concentrate.
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20.
  • Isaksson, Ola, et al. (författare)
  • Trends in product modelling : an ENDREA perspective
  • 2000
  • Ingår i: Proceedings / Produktmodeller 2000. - Linköping : Linköping universitet.
  • Konferensbidrag (refereegranskat)abstract
    • The success of engineering companies is highly dependent on how well product information is managed, engineered and communicated. From marketing through development to after sales activities, data needs to be accessible and used in the best way. Today, geographical distance, the need for close co-operation and data complexity are all natural parts of the working environment. Product modelling techniques are continuously evolving with new requirements and opportunities emerging daily. This paper will outline and discuss some of these trends, and at the same time present some of the areas where research is being carried out within projects in the Product Model Cluster in the national graduate school - The Swedish Engineering Design Research and Education Agenda (ENDREA).
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21.
  • Jeppsson, Johan, et al. (författare)
  • Inverse Saltykov analysis for particle-size distributions and their time evolution
  • 2011
  • Ingår i: Acta Materialia. - : Elsevier BV. - 1359-6454 .- 1873-2453. ; 59:3, s. 874-882
  • Tidskriftsartikel (refereegranskat)abstract
    • In this work a new method for transforming 2-D to 3-D size distributions is proposed. A representation of the 2-D size distributions is constructed from the data of measured radii with a statistical method called the kernel density estimator. The method yields a smooth density estimation that is more accurate than the classic histogram. The 3-D distribution is optimized from the 2-D density estimate in an iterative manner. (C) 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
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22.
  • Jeppsson, Johan, et al. (författare)
  • Modeling of dispersoid precipitation in multicomponent alloys
  • Ingår i: Acta Materialia. - 1359-6454 .- 1873-2453.
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • A model for nucleation, growth and coarsening of precipitates in multicomponent, multiphase systems is presented. High supersaturation and volume fraction of theprecipitate phase are considered. Deviation from local equilibrium at the phaseinterface is treated by means of a model based on trans-interface diffusion. Anexample simulation predict a sudden transition from diffusion-controlled to massivegrowth during continues cooling of an Fe-5%Ni alloy. The precipitation model iscompared with experiments in the Al-Sc-Mg system. To calculate the equilibriumphases, the chemical driving forces, equilibrium concentrations and diffusivities, thecommercial softwares Thermo-Calc and Dictra were used. The main advantage ofthis strategy is that there is nearly no restriction on a special alloy system.
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23.
  • Jeppsson, Johan, et al. (författare)
  • Modified mean field models of normal grain growth
  • 2008
  • Ingår i: Acta Materialia. - : Elsevier BV. - 1359-6454 .- 1873-2453. ; 56:18, s. 5188-5201
  • Tidskriftsartikel (refereegranskat)abstract
    • Models of normal grain growth can either start from a postulated kinetic law for individual grains and yield a distribution of grain sizes or they can start from a postulated distribution and the kinetic law may be derived. Both methods are studied and a whole family of distributions based on new kinetic laws are derived using the first method. Both methods have recently been applied using Onsager's extremum principle but it is now shown that more classical procedures are sufficient. Kinetic laws give an indication of what physical factors govern the growth or shrinkage of individual grains. A Rayleigh's distribution seems to indicate that large grains are surrounded by grains smaller than the critical size and small grains are surrounded by grains larger than the critical size. The effects of the new family of kinetic laws on the development of grain size distributions are studied by numerical simulations.
  •  
24.
  • Jeppsson, Johan (författare)
  • Simulation of Phase Transformations and coarsening : Computational tools for alloy development
  • 2011
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The final properties of an alloy are highly interlaced with its microstructure. It is therefore essential to control the evolution of the microstructure of the material during the fabrication process. Nowadays, materials design involves an increasing part of computational design to complement the traditional experimental trial and error approach. Such simulations of the process can decrease the number of material prototypes and shorten the development time for new alloys. In this thesis several microstructure models, aimed for process design, have been suggested. The ambition has been to develop physically based models that are capable to represent the evolution of hundreds of grain or particle sizes, where the models should be possible to run on a standard computer with simulation times less than one day. To achieve this goal, simplified approaches have been suggested, which are accurate enough for the growth rate of grains and particles. The microstructure models have all in common that size distributions of grains or particles are simulated with mean-field approaches. Several of the models also utilize composition and temperature dependent thermodynamic and kinetic properties continually throughout the simulations. These properties have been calculated with programming interfaces to Thermo-Calc and DICTRA together with appropriate thermodynamic and kinetic databases. The materials that have been considered in the present thesis are low alloyed steels, aluminium alloys and cemented carbides. The models are however generic in the sense that all materials can be handled if appropriate thermodynamic, kinetic and property databases exist for the alloy.
  •  
25.
  • Malm, Carl Johan, et al. (författare)
  • Dual or single antiplatelet therapy after coronary surgery for acute coronary syndrome (TACSI trial): Rationale and design of an investigator-initiated, prospective, multinational, registry-based randomized clinical trial
  • 2023
  • Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 259, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The TACSI trial (ClinicalTrials.gov Identifier: NCT03560310) tests the hypothesis that 1-year treatment with dual antiplatelet therapy with acetylsalicylic acid (ASA) and ticagrelor is superior to only ASA after isolated coronary artery bypass grafting (CABG) in patients with acute coronary syndrome. The TACSI trial is an investor-initiated pragmatic, prospective, multinational, multicenter, open-label, registry-based randomized trial with 1:1 randomization to dual antiplatelet therapy with ASA and ticagrelor or ASA only, in patients undergoing first isolated CABG, with a planned enrollment of 2200 patients at Nordic cardiac surgery centers. The primary efficacy end point is a composite of time to all-cause death, myocardial infarction, stroke, or new coronary revascularization within 12 months after randomization. The primary safety end point is time to hospitalization due to major bleeding. Secondary efficacy end points include time to the individual components of the primary end point, cardiovascular death, and rehospitalization due to cardiovascular causes. High-quality health care registries are used to assess primary and secondary end points. The patients will be followed for 10 years. The TACSI trial will give important information useful for guiding the antiplatelet strategy in acute coronary syndrome patients treated with CABG.
  •  
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