| 1. |
- Oddy, Carolyn, 1994, et al.
(author)
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Composite design for a foiling Optimist dinghy
- 2018
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In: Proceedings. - Basel Switzerland : MDPI. ; 2:6
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Conference paper (peer-reviewed)abstract
- In April 2017, a foiling Optimist dingy designed entirely by students, was successfully tested under standard sailing conditions in the waters outside Gothenburg. In order to achieve take of wind speeds as low as 6 m/s, a stiff and lightweight design of the dinghy and its foiling components was necessary. There have been few successful attempts to make an Optimist foil in a stable manner, as such there were no standards or recommendations available for the design. Therefore, a simulation driven structural design methodology for hydrofoils, centreboards, centreboard-to-hull connections, and necessary hull reinforcements using sandwich structures was adopted. The proposed design was then manufactured, allowing for a significantly stiffer hull and a 20% decrease in weight over a conventional Optimist. Excluding the rig and sail, the final weight came to 27 kg.
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| 2. |
- Arnelo, Urban, et al.
(author)
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Intraoperative pancreatoscopy can improve the detection of skip lesions during surgery for intraductal papillary mucinous neoplasia : a pilot study
- 2023
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In: Pancreatology (Print). - : Elsevier. - 1424-3903 .- 1424-3911. ; 23:6, s. 704-711
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Journal article (peer-reviewed)abstract
- Objectives: Intraoperative pancreatoscopy is a promising procedure that might guide surgical resection for suspected main duct (MD) and mixed type (MT) intraductal papillary mucinous neoplasms (IPMNs). The aim of the present study was to assess the diagnostic yield and clinical impact of intraoperative pancreatoscopy in patients operated on for MD and MT-IPMNs.Methods: This is a retrospective cohort study. Patients undergoing surgery for suspected MD or MT-IPMN underwent intraoperative pancreatoscopy and frozen section analysis. In all patients who required extended resection due to pancreatoscopic findings, we compared the final histology with the results of the intraoperative frozen section analysis.Results: In total, 46 patients, 48% females, mean age (range) 67 years (45–82 years) underwent intraoperative pancreatoscopy. No mortality or procedure related complications were observed. Pancreatoscopy changed the operative course in 30 patients (65%), leading to extended resections in 20 patients (43%) and to parenchyma sparing procedures in 10 patients (22%). Analyzing the group of patients who underwent extended resections, 7 (35%) displayed lesions that needed further surgical treatment (six high grade dysplasia and one with G1 pancreatic neuroendocrine tumor) and among those 7, just 1 (14%) would have been detected exclusively with histological frozen section analysis of the transection margin. The combination of both pancreatoscopy and frozen section analysis lead to 86% sensitivity and 92% specificity for the detection of pathological tissue in the remnant pancreas.Conclusion: Intraoperative pancreatoscopy is a safe and feasible procedure and might allow the detection of skip lesions during surgery for suspect MD-involving IPMNs.
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| 3. |
- Cárdenas-Jaén, Karina, et al.
(author)
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Chronic use of statins and acetylsalicylic acid and incidence of post-endoscopic retrograde cholangiopancreatography acute pancreatitis : A multicenter, prospective, cohort study
- 2021
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In: Digestive Endoscopy. - : Wiley-Blackwell. - 0915-5635 .- 1443-1661. ; 33:4, s. 639-647
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis (PEP) is a frequent complication of this endoscopic procedure. Chronic statin intake has been linked to lower incidence and severity of acute pancreatitis (AP). Periprocedural rectal administration of non-steroidal anti-inflammatory drugs is protective against PEP, but the role of chronic acetylsalicylic acid (ASA) treatment is unclear. We aimed to investigate whether statins and chronic ASA intake are associated with lower risk of PEP.METHODS: An international, multicenter, prospective cohort study. Consecutive patients undergoing ERCP in seven European centers were included. Patients were followed-up to detect those with PEP. Multivariate analysis by means of binary logistic regression was performed, and adjusted odds ratios (aORs) were calculated.RESULTS: A total of 1150 patients were included, and 70 (6.1%) patients developed PEP. Among statins users, 8.1% developed PEP vs. 5.4% among non-users (P = 0.09). Multivariate analysis showed no association between statin use and PEP incidence (aOR 1.68 (95% CI 0.94-2.99, P = 0.08)). Statin use had no effect on severity of PEP, being mild in 92.0% of statin users vs. 82.2% in non-statin users (P = 0.31). Chronic ASA use was not associated with PEP either (aOR 1.02 (95% CI 0.49-2.13), P = 0.96). Abuse of alcohol and previous endoscopic biliary sphincterotomy were protective factors against PEP, while >1 pancreatic guidewire passage, normal bilirubin values, and duration of the procedure >20 minutes, were risk factors.CONCLUSIONS: The use of statins or ASA is not associated with a lower risk or a milder course of PEP.
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| 4. |
- Jansson, Niklas, et al.
(author)
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A kinking-based failure model for engineering simulation of compressive crushing of composite structures
- 2024
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In: Composite Structures. - 0263-8223. ; 329
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Journal article (peer-reviewed)abstract
- The use of continuum damage models is state of the art for the finite element modelling of progressive damage and failure under compressive loading in composites during e.g. crash and impact simulations. However, after failure initiation the compressive stress is quickly degraded to zero alternatively to a plateau with constant stress and at a certain point the element needs to be deleted due to the damage level or large element deformation. This effectively represent a void in the material which contrasts with reality where a fully formed kink band would be expected to have compressive properties similar to the transverse direction of the ply. To better represent this physical behaviour is here a kinking formulation developed that instead of the common constant stress plateau after initial softening features a stiffening at larger strains. This formulation has been implemented in a commercial FE-code complemented by criteria for kinking initiation and kink band broadening. The results presented show the novelty of the model in that it describes a chain of events starting with initiation of kinking, progressing to the growth of kink bands through the element and finally including an increase in stress that initiate kinking in adjacent elements.
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| 5. |
- Kourie, Mourad, et al.
(author)
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ABC om Ikterus hos vuxna : [Jaundice in the adult patient]
- 2022
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 119:48-49, s. 34-38
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Journal article (peer-reviewed)abstract
- Jaundice is an alarm symptom that should always be treated urgently, regardless of whether the responsible doctor is in primary care or in the emergency room. The differential diagnoses can be significantly delimited (hepatocellular vs. cholestasis) and several clues to the etiology can be determined from a carefully performed anamnesis, clinical examination, and basic laboratory tests. Exclusion of cholestatic etiology is essential due to life-threatening differential diagnoses and complications, but acute medical conditions also occur, such as acute liver failure. Prompt processing at the correct instance can be crucial for the short-term and long-term prognosis of the patient.
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| 6. |
- Vehviläinen, Sini, et al.
(author)
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Single-operator peroral pancreatoscopy in the preoperative diagnostics of suspected main duct intraductal papillary mucinous neoplasms : efficacy and novel insights on complications
- 2022
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In: Surgical Endoscopy. - : Springer. - 0930-2794 .- 1432-2218. ; 36, s. 7431-7443
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Journal article (peer-reviewed)abstract
- Background: Distinguishing intraductal papillary mucinous neoplasms (IPMNs) from other pancreatic cystic lesions is essential since IPMNs carry the risk of becoming malignant. Differentiating the main pancreatic duct involving IPMNs (MD-IPMNs) through conventional imaging is deficient. Single-operator peroral pancreatoscopy (SOPP) represents a promising method offering additional information on suspected lesions in the pancreatic main duct (MD). We aimed to determine the role of SOPP in the preoperative diagnostics of suspected MD-IPMNs and identify factors contributing to SOPP-related complications.Materials and Methods: In this primarily retrospective study, SOPPs were performed at three high-volume centers on suspected MD-IPMNs. Primary outcome was the clinical impact of SOPP to subsequent patient care. Additionally, we documented post-SOPP complications and analyzed several assumed patient- and procedure-related risk factors.Results: One hundred and one (101) SOPPs were performed. Subsequent clinical management was affected due to the findings in 86 (85%) cases. Surgery was planned for 29 (29%) patients. A condition other than IPMN explaining MD dilatation was found in 28 (28%) cases. In 35 (35%) cases, follow-up with MRI was continued. Post-SOPP pancreatitis occurred in 20 (20%) patients and one of them was fatal. A decrease in odds of post-SOPP pancreatitis was seen as the MD diameter increases (OR 0.714 for 1.0 mm increase in MD diameter, CI 95% 0.514–0.993, p = 0.045). Furthermore, a correlation between lower MD diameter values and higher severity post-SOPP pancreatitis was seen (TJT = 599, SE = 116.6, z = − 2.31; p = 0.020). History of pancreatitis after endoscopic retrograde cholangiopancreatography was a confirmed risk factor for post-SOPP pancreatitis. Conclusions between complications and other risk factors could not be drawn.Conclusion: SOPP aids clinical decision-making in suspected MD-IPMNs. Risk for post-SOPP pancreatitis is not negligible compared to non-invasive imaging methods. The risk for pancreatitis decreases as the diameter of the MD increases.
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