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- Baldewpersad Tewarie, N., et al.
(författare)
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An overview of Clinical Quality Registries (CQRs) on gynecological oncology worldwide
- 2022
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Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983. ; 48:10, s. 2094-2103
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Clinical Quality Registries (CQRs) were initiated in order to compare clinical outcomes between hospitals or regions within a country. To get an overview of these CQRs worldwide the aim of this study was to identify these CQRs for gynecological oncology and to summarize their characteristics, processes and QI's and to establish whether it is feasible to make an international comparison in the future. Methods: To identify CQRs in gynecological oncology a literature search in Pubmed was performed. All papers describing the use of a CQR were included. Administrative, epidemiological and cancer registries were excluded as these registries do not primarily serve to measure quality of care through QI's. The taskforce or contact person of the included CQR were asked to participate and share information on registered items, processes and indicators. Results: Five nations agreed to collaborate: Australia, Denmark, Italy, the Netherlands and Sweden. Denmark, Netherlands and Sweden established a nationwide registry, collecting data on multiple tumor types, and various QI's. Australia and Italy included patients with ovarian cancer only. All nations had a different process to report feedback results to participating hospitals. Conclusion: CQRs serve the same purpose to improve quality of care but vary on different aspects. Although similarities are observed in the topics measured by the QI's, an international comparison was not feasible as numerators or denominators differ between registries. In order to compare on an international level it would be useful to harmonize these registries and to set an international standard to measure the quality of care with similar indicators.
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- Tjellstrom, B, et al.
(författare)
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A Role for Bacteria in Celiac Disease?
- 2016
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Ingår i: Digestive diseases and sciences. - : Springer Science and Business Media LLC. - 1573-2568 .- 0163-2116. ; 61:7, s. 2140-2140
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Hoffecker, Ian T., et al.
(författare)
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Antibodies as programmable, bipedal walkers
- 2022
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Ingår i: NATURE COMPUTATIONAL SCIENCE. - : Springer Nature. - 2662-8457. ; 2:4, s. 221-222
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Stochastic modeling of antibody binding dynamics on patterned antigen substrates suggests the separation distance between adjacent antigens could be a control mechanism for the directed bipedal migration of bound antibodies.
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- Hogberg, M., et al.
(författare)
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Linear feedback control and estimation of transition in plane channel flow
- 2003
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Ingår i: Journal of Fluid Mechanics. - : Cambridge University Press (CUP). - 0022-1120 .- 1469-7645. ; 481, s. 149-175
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Tidskriftsartikel (refereegranskat)abstract
- Modern linear control theory has recently been established as a viable tool for developing effective, spatially localized convolution kernels for the feedback control and estimation of linearized Navier-Stokes systems. In the present paper, the effectiveness of these kernels for significantly expanding the basin of attraction of the laminar state in a subcritical nonlinear channel flow system is quantified using direct numerical simulations for a range of Reynolds numbers (Re-q = 2000, 3000 and 5000) and for a variety of initial conditions of physical interest. This is done by quantifying the change in the transition thresholds (see Reddy et al. 1998) when feedback control is applied. Such transition thresholds provide a relevant measure of performance for transition control strategies even in the nonlinear regime. Initial flow perturbations with streamwise vortices, oblique waves, and random excitations over an array of several Fourier modes are considered. It is shown that the minimum amplitude of these initial flow perturbations that is sufficient to excite nonlinear instability, and thereby promote transition to turbulence, is significantly increased by application of the control feedback. The kernels used to apply the feedback are found to decay exponentially with distance far from the origin, as predicted by the analysis of Bamieh, Paganini & Dahleh (2002). In the present paper, it is demonstrated via numerical simulation that truncation of these spatially localized convolution kernels to spatially compact kernels with finite non-zero support does not significantly degrade the effectiveness of the control feedback. In addition to the new state-feedback control results, exponential convergence of a localized physical-space state estimator with wall measurements is also demonstrated. The estimator and the full-state feedback controller are then combined to obtain a wall-information-based linear compensator. The compensator performance is also quantified, and key issues related to improving the performance of this compensator, which is degraded compared with the full-state feedback controller, are discussed.
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- Hogberg, M., et al.
(författare)
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Relaminarization of Re-tau=100 turbulence using gain scheduling and linear state-feedback control
- 2003
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Ingår i: Physics of fluids. - : AIP Publishing. - 1070-6631 .- 1089-7666. ; 15:11, s. 3572-3575
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Tidskriftsartikel (refereegranskat)abstract
- The first successful application of linear full-state feedback optimal control theory to consistently relaminarize turbulent channel flow at Re-tau=100 with full state information and gain scheduling is reported. The actuation is zero-net mass-flux blowing and suction on the channel walls. Two key issues central to the success of this strategy are: (a) the choice of the mean-flow profile about which the equations are linearized for the computation of the linear feedback gains, and (b) the choice of an objective function which targets the control effort on the flow perturbations of interest. A range of mean-flow profiles between the laminar and fully turbulent profiles and a weighted energy measure which targets flow perturbations in the near-wall region were found to provide effective feedback gains. A gain-scheduling strategy to tune the feedback gains to the nonstationary mean-flow profile is introduced, resulting in consistent relaminarization of the turbulent flow in all realizations tested.
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- Huang, M, et al.
(författare)
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Small scale integrated technology for HTS RSFQ circuits
- 2001
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Ingår i: IEEE TRANSACTIONS ON APPLIED SUPERCONDUCTIVITY. - : IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC. - 1051-8223. ; 11:1, s. 558-561
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Tidskriftsartikel (refereegranskat)abstract
- A technology for fabrication of YBCO ramp junctions on a superconducting ground plane Is developed and evaluated. The technology is based on a two-layer, S-I, structure or on a four-layer, S-I-S-I, structure grown in situ with YBCO superconductor and with
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- Lee, C.K., et al.
(författare)
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Prognostic nomogram to predict progression-free survival in patients with platinum-sensitive recurrent ovarian cancer
- 2011
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Ingår i: British Journal of Cancer. - : Cancer Research UK. - 0007-0920 .- 1532-1827. ; 105:8, s. 1144-1150
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with platinum-sensitive recurrent ovarian cancer are a heterogeneous group, and it is not possible to accurately predict the progression-free survival (PFS) in these patients. We developed and validated a nomogram to help improve prediction of PFS in patients treated with platinum-based chemotherapy. METHODS: The nomogram was developed in a training cohort (n = 955) from the CALYPSO trial and validated in the AGO-OVAR 2.5 Study (n = 340). The proportional-hazards model (nomogram) was based on pre-treatment characteristics. RESULTS: The nomogram had a concordance index (C-index) of 0.645. Significant predictors were tumour size platinum-chemotherapy-free interval, CA-125, number of organ metastatic sites and white blood count. When the nomogram was applied without CA-125 (CA-125 was not available in validation cohort), the C-indices were 0.624 (training) and 0.594 (validation). When classification was based only on the platinum-chemotherapy-free interval, the indices were 0.571 (training) and 0.560 (validation). The calibration plot in the validation cohort based on four predictors (without CA-125) suggested good agreement between actual and nomogram-predicted 12-month PFS probabilities. CONCLUSION: This nomogram, using five pre-treatment characteristics, improves prediction of PFS in patients with platinum-sensitive ovarian cancer having platinum-based chemotherapy. It will be useful for the design and stratification of patients in clinical trials and also for counselling patients.
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- Marcickiewicz, J., et al.
(författare)
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The wait time to primary surgery in endometrial cancer - impact on survival and predictive factors: a population-based SweGCG study
- 2022
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 61:1, s. 30-37
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Tidskriftsartikel (refereegranskat)abstract
- Background Poor survival rates in different cancer types are sometimes blamed on diagnostic and treatment delays, and it has been suggested that such delays might be related to sociodemographic factors such as education and ethnicity. We examined associations of the wait time from diagnosis to surgery and survival in endometrial cancer (EC) and explored patient and tumour factors influencing the wait time. Material and methods In this historical population-based cohort study, The Swedish Quality Registry for Gynaecologic Cancer (SQRGC) was used to identify EC patients who underwent primary surgery between 2010 and 2018. Factors associated with a wait time > 32 d were analysed with logistic regression. The 32-d time point was defined in accordance with the Swedish Standardisation Cancer Care programme. Adjusted Poisson regression analyses were used to analyse excess mortality rate ratio (EMRR). Results Out of 7366 women, 5535 waited > 32 d for surgery and 1098 > 70 d. The overall median wait time was 44 d. The factors most strongly associated with a wait time > 32 d were surgery at a university hospital (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.08-1.66) followed by country of birth (OR 1.31, 95% CI 1.10-1.55) and year of diagnosis. There were no associations between wait time and histology or age. A wait time < 15 d was associated with higher mortality (adjusted EMRR 2.29,95% CI 1.36-3.84) whereas no negative survival impact was seen with a wait time of 70 d. Age, tumour stage, histology and risk group were highly associated with survival, whereas education, country of origin and hospital level did not have any impact on survival. Conclusions Surgery within the first two weeks after EC diagnosis was associated with worsened survival. A prolonged wait time did not seem to have any significant adverse effect on prognosis.
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- Quist, E, et al.
(författare)
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Responses of a nitrogen-saturated forest to a sharp decrease in nitrogen input
- 1999
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Ingår i: Journal of Environmental Quality. - 0047-2425 .- 1537-2537. ; 28, s. 1970-1977
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Tidskriftsartikel (refereegranskat)abstract
- The reversibility of induced N saturation was investigated in a 46- yr-old pine (Pinus sylvestris L.) forest in northern Sweden Ammonium nitrate has been applied annually since 1971 to plots (30 by 30 m) at average dosages of 36 (N1), 72 (N2), and 108 (N3) kg N ha(-1) yr(-1): with or without P and K addition (background N deposition is <4 kg ha(-1) yr(-1)). In 1990, after two decades of treatment, the largest N application (N3) was suspended, while N1 and N2 still received ammonium nitrate applications. Seven gears after the last application in N3, the N availability measured as N concentration in plants spine roots and needles and in leaves of the grass Deschampsia flexuosa (L.) Trin.] and activity of the enzyme nitrate reductase in leaves of D. flexuosa, and N-15 uptake by excised pine roots, was at the same levels as in N1, although more than twice the amount of N has been applied in total to N3. The arginine concentrations in pine needles, concentrations of exchangeable mineral N in the organic layer and the uppermost 20 cm of the mineral soil were at the same levels as in the control plots. Thus, an experimentally induced N excess was, according to these measurements, to a high degree reversed 7 yr after the last N application. However, the composition of the understory vegetation still differed markedly from the untreated control 8 yr after the last N3 application.
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| 46. |
- Rosenberg, P., et al.
(författare)
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Data quality in the Swedish Quality Register of Gynecologic Cancer - a Swedish Gynecologic Cancer Group (SweGCG) study
- 2018
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 57:3, s. 346-353
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study is to evaluate the quality of data on endometrial (EC) and ovarian, fallopian tube, peritoneal, abdominal or pelvic cancers (OC) registered in the Swedish Quality Register of Gynecologic Cancer (SQRGC).Method: A random sample of 500 patients was identified in the SQRGC and their medical charts were reviewed for re-abstraction of 31 selected core variables by an independent validator. The data in the SQRGC and the re-abstracted data were compared. The data were collected from 25 hospitals evenly distributed throughout Sweden. The main outcomes were comparability, timeliness, completeness and validity. Coverage was compared with the National Cancer Register (NCR). Timeliness was defined as the speed of registration i.e. when patients were registered in the SQRGC relative to date of diagnosis. Internationally accepted coding systems for stage, grading and histologic type were used ensuring a high degree of comparability. Correlations were estimated using Pearson's correlation coefficient and Cohens kappa coefficient.Results: The completeness was 95%. The timeliness was 88-91% within 12 months of diagnosis. The median degree of agreement between re-abstracted data and data in the SQRGC was 82.1%, with a median kappa value of 0.73 for ordinate variables and a median Pearson's correlation coefficient of 0.96. The agreements for the type of surgery were 76% (95% CI 70-81%; kappa 0.49) and type of primary treatment 90% (95% CI 87-94%; kappa 0.85) in OC and in EC 88% (95% CI 84-93%; kappa 0.84). The agreements for the FIGO stage were in OC and EC 74% (95% CI 68-80%; kappa 0.69) and 87% (95% CI 82-91%; kappa 0.79), respectively.Conclusions: The data in the Swedish Quality Register for Gynecologic Cancer are of adequate quality in order to be used as a basis for research and to evaluate possible differences in treatment, lead times and treatment results.
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- Stalberg, K., et al.
(författare)
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Lymphovascular space invasion as a predictive factor for lymph node metastases and survival in endometrioid endometrial cancer - a Swedish Gynecologic Cancer Group (SweGCG) study
- 2019
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 58:11, s. 1628-1633
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study is to evaluate the impact of lymphovascular space invasion (LVSI) on the risk of lymph node metastases and survival in endometrioid endometrial adenocarcinoma. Material and methods: As regard the study design, this is a cohort study based on prospectively recorded data. Patients with endometrioid endometrial adenocarcinoma registered in the Swedish Quality Registry for Gynecologic Cancer 2010-2017 with FIGO stages I-III and verified nodal status were identified (n = 1587). LVSI together with established risk factors, namely DNA ploidy, FIGO grade, myometrial invasion and age, were included in multivariable regression analyses with lymph node metastases as the dependent variable. Associations between the risk factors and overall and relative survival were included in multivariable models. Estimates of risk ratios (RR), hazard ratios (HR), excess mortality rate ratios (EMR), and 95% confidence intervals (95% CI) were calculated. Results: The presence of LVSI presented the strongest association with lymph node metastases (RR = 5.46, CI 3.69-8.07, p < .001) followed by deep myometrial invasion (RR = 1.64, CI 1.13-2.37). In the multivariable survival analyses, LVSI (EMR = 7.69, CI 2.03-29.10,) and non-diploidy (EMR = 3.23, CI 1.25-8.41) were associated with decreased relative survival. In sub-analyses including only patients with complete para-aortic and pelvic lymphadenectomy and negative lymph nodes (n = 404), only LVSI (HR = 2.50, CI 1.05-5.98) was associated with a worsened overall survival. Conclusion: This large nationwide study identified LVSI as the strongest independent risk factor for lymph node metastases and decreased survival in patients with endometrioid adenocarcinomas. Moreover, decreased overall survival was also seen in patients with LVSI-positive tumors and negative lymph nodes, indicating that hematogenous dissemination might also be important.
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