| 1. |
- Keppler, M., et al.
(författare)
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Discovery of a planetary-mass companion within the gap of the transition disk around PDS 70
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 617
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Tidskriftsartikel (refereegranskat)abstract
- Context. Young circumstellar disks are the birthplaces of planets. Their study is of prime interest to understand the physical and chemical conditions under which planet formation takes place. Only very few detections of planet candidates within these disks exist, and most of them are currently suspected to be disk features.Aims. In this context, the transition disk around the young star PDS 70 is of particular interest, due to its large gap identified in previous observations, indicative of ongoing planet formation. We aim to search for the presence of an embedded young planet and search for disk structures that may be the result of disk-planet interactions and other evolutionary processes.Methods. We analyse new and archival near-infrared images of the transition disk PDS 70 obtained with the VLT/SPHERE, VLT/NaCo, and Gemini/NICI instruments in polarimetric differential imaging and angular differential imaging modes.Results. We detect a point source within the gap of the disk at about 195 mas (similar to 22 au) projected separation. The detection is confirmed at five different epochs, in three filter bands and using different instruments. The astrometry results in an object of bound nature, with high significance. The comparison of the measured magnitudes and colours to evolutionary tracks suggests that the detection is a companion of planetary mass. The luminosity of the detected object is consistent with that of an L-type dwarf, but its IR colours are redder, possibly indicating the presence of warm surrounding material. Further, we confirm the detection of a large gap of similar to 54 au in size within the disk in our scattered light images, and detect a signal from an inner disk component. We find that its spatial extent is very likely smaller than similar to 17 au in radius, and its position angle is consistent with that of the outer disk. The images of the outer disk show evidence of a complex azimuthal brightness distribution which is different at different wavelengths and may in part be explained by Rayleigh scattering from very small grains.Conclusions. The detection of a young protoplanet within the gap of the transition disk around PDS 70 opens the door to a so far observationally unexplored parameter space of planetary formation and evolution. Future observations of this system at different wavelengths and continuing astrometry will allow us to test theoretical predictions regarding planet-disk interactions, planetary atmospheres, and evolutionary models.
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| 2. |
- Desgrange, C., et al.
(författare)
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In-depth direct imaging and spectroscopic characterization of the young Solar System analog HD 95086
- 2022
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 664
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Tidskriftsartikel (refereegranskat)abstract
- Context. HD 95086 is a young nearby Solar System analog hosting a giant exoplanet orbiting at 57 au from the star between an inner and outer debris belt. The existence of additional planets has been suggested as the mechanism that maintains the broad cavity between the two belts.Aims. We present a dedicated monitoring of HD 95086 with the VLT/SPHERE instrument to refine the orbital and atmospheric properties of HD 95086 b, and to search for additional planets in this system.Methods. SPHERE observations, spread over ten epochs from 2015 to 2019 and including five new datasets, were used. Combined with archival observations, from VLT/NaCo (2012-2013) and Gemini/GPI (2013-2016), the extended set of astrometric measurements allowed us to refine the orbital properties of HD 95086 b. We also investigated the spectral properties and the presence of a circumplanetary disk around HD 95086 b by using the special fitting tool exploring the diversity of several atmospheric models. In addition, we improved our detection limits in order to search for a putative planet c via the K-Stacker algorithm.Results. We extracted for the first time the JH low-resolution spectrum of HD 95086 b by stacking the six best epochs, and confirm its very red spectral energy distribution. Combined with additional datasets from GPI and NaCo, our analysis indicates that this very red color can be explained by the presence of a circumplanetary disk around planet b, with a range of high-temperature solutions (1400–1600 K) and significant extinction (Av ≳ 10 mag), or by a super-solar metallicity atmosphere with lower temperatures (800–300 K), and small to medium amount of extinction (Av ≲ 10 mag). We do not find any robust candidates for planet c, but give updated constraints on its potential mass and location.
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| 3. |
- Engler, N., et al.
(författare)
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The high-albedo, low polarization disk around HD 114082 that harbors a Jupiter-sized transiting planet Constraints from VLT/SPHERE completed with TESS, Gaia, and radial velocities
- 2023
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 672
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Tidskriftsartikel (refereegranskat)abstract
- Aims. We present new optical and near-infrared images of the debris disk around the F-type star HD 114082 in the Scorpius-Centaurus OB association. We obtained direct imaging observations and analyzed the TESS photometric time series data of this target with the goal of searching for planetary companions to HD 114082 and characterizing the morphology of the debris disk and the scattering properties of dust particles. Methods. HD 114082 was observed with the VLT/SPHERE instrument in different modes - the IRDIS camera in the K band (2.0-2.3 mu m) together with the IFS in the Y, J, and H bands (0.95-1.66 mu m) using the angular differential imaging technique as well as IRDIS in the H band (1.5-1.8 mu m) and ZIMPOL in the I_PRIME band (0.71-0.87 mu m) using the polarimetric differential imaging technique. To constrain the basic geometrical parameters of the disk and the scattering properties of dust grains, scattered light images were fitted with a 3D model for single scattering in an optically thin dust disk using a Markov chain Monte Carlo approach. We performed aperture photometry to derive the scattering and polarized phase functions, the polarization fraction, and the spectral scattering albedo for the dust particles in the disk. This method was also used to obtain the reflectance spectrum of the disk and, in turn, to retrieve the disk color and study the dust reflectivity in comparison to the debris disk HD 117214. We also performed the modeling of the HD 114082 light curve measured by TESS using models for planet transit and stellar activity to put constraints on the radius of the detected planet and its orbit. Last, we searched for additional planets in the system by combining archival radial velocity data, astrometry, and direct imaging. Results. The debris disk HD 114082 appears as an axisymmetric debris belt with a radius of similar to 0.37 '' (35 au), an inclination of similar to 83 degrees, and a wide inner cavity. Dust particles in HD 114082 have a maximum polarization fraction of similar to 17% and a higher reflectivity when compared to the debris disk HD 117214. This high reflectivity results in a spectral scattering albedo of similar to 0.65 for the HD 114082 disk at near-infrared wavelengths. The disk reflectance spectrum exhibits a red color at the position of the planetesimal belt and shows no obvious features, whereas that of HD 117214 might indicate the presence of CO2 ice. The analysis of TESS photometric data reveals a transiting planetary companion to HD 114082 with a radius of similar to 1 R-Jup on an orbit with a semimajor axis of 0.7 +/- 0.4 au. No additional planet was detected in the system when we combined the SPHERE images with constraints from astrometry and radial velocity. We reach deep sensitivity limits down to similar to 5 M-Jup at 50 au and similar to 10 M-Jup at 30 au from the central star.
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| 4. |
- Keppler, M., et al.
(författare)
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Gap, shadows, spirals, and streamers : SPHERE observations of binary-disk interactions in GG Tauri A
- 2020
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 639
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Tidskriftsartikel (refereegranskat)abstract
- Context. A large portion of stars is found to be part of binary or higher-order multiple systems. The ubiquity of planets found around single stars raises the question of whether and how planets in binary systems form. Protoplanetary disks are the birthplaces of planets, and characterizing them is crucial in order to understand the planet formation process.Aims. Our goal is to characterize the morphology of the GG Tau A disk, one of the largest and most massive circumbinary disks. We also aim to trace evidence for binary-disk interactions.Methods. We obtained observations in polarized scattered light of GG Tau A using the SPHERE/IRDIS instrument in the H-band filter. We analyzed the observed disk morphology and substructures. We ran 2D hydrodynamical models to simulate the evolution of the circumbinary ring over the lifetime of the disk.Results. The disk and also the cavity and the inner region are highly structured, with several shadowed regions, spiral structures, and streamer-like filaments. Some of these are detected here for the first time. The streamer-like filaments appear to connect the outer ring with the northern arc. Their azimuthal spacing suggests that they may be generated through periodic perturbations by the binary, which tear off material from the inner edge of the outer disk once during each orbit. By comparing observations to hydrodynamical simulations, we find that the main features, in particular, the gap size, but also the spiral and streamer filaments, can be qualitatively explained by the gravitational interactions of a binary with a semimajor axis of similar to 35 au on an orbit coplanar with the circumbinary ring.
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| 5. |
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| 6. |
- Olofsson, J., et al.
(författare)
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Resolving faint structures in the debris disk around TWA 7 Tentative detections of an outer belt, a spiral arm, and a dusty cloud
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 617
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Tidskriftsartikel (refereegranskat)abstract
- Context. Debris disks are the intrinsic by-products of the star and planet formation processes. Most likely due to instrumental limitations and their natural faintness, little is known about debris disks around low mass stars, especially when it comes to spatially resolved observations. Aims. We present new VLT/SPHERE IRDIS dual-polarization imaging (DPI) observations in which we detect the dust ring around the M2 spectral type star TWA 7. Combined with additional angular differential imaging observations we aim at a fine characterization of the debris disk and setting constraints on the presence of low-mass planets. Methods. We modeled the SPHERE DPI observations and constrain the location of the small dust grains, as well as the spectral energy distribution of the debris disk, using the results inferred from the observations, and performed simple N-body simulations. Results. We find that the dust density distribution peaks at similar to 0.72 '' (25 au), with a very shallow outer power-law slope, and that the disk has an inclination of similar to 13 degrees with a position angle of similar to 91 degrees east of north. We also report low signal-to-noise ratio detections of an outer belt at a distance of similar to 1.5 '' (similar to 52 au) from the star, of a spiral arm in the southern side of the star, and of a possible dusty clump at 0.11 ''. These findings seem to persist over timescales of at least a year. Using the intensity images, we do not detect any planets in the close vicinity of the star, but the sensitivity reaches Jovian planet mass upper limits. We find that the SED is best reproduced with an inner disk at similar to 0.2 '' (similar to 7 au) and another belt at 0.72 '' (25 au). Conclusions. We report the detections of several unexpected features in the disk around TWA 7. A yet undetected 100 M-circle plus planet with a semi-major axis at 20-30 au could possibly explain the outer belt as well as the spiral arm. We conclude that stellar winds are unlikely to be responsible for the spiral arm.
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| 7. |
- Singh, G., et al.
(författare)
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Revealing asymmetrical dust distribution in the inner regions of HD 141569
- 2021
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 653
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Tidskriftsartikel (refereegranskat)abstract
- Context. The combination of high-contrast imaging with spectroscopy and polarimetry offers a pathway to studying the grain distribution and properties of debris disks in exquisite detail. Here, we focus on the case of a gas-rich debris disk around HD 141569A, which features a multiple-ring morphology first identified with SPHERE in the near-infrared.Aims. We obtained polarimetric differential imaging with SPHERE in the H-band to compare the scattering properties of the innermost ring at 44 au with former observations in total intensity with the same instrument. In polarimetric imaging, we observed that the intensity of the ring peaks in the south-east, mostly in the forward direction, whereas in total intensity imaging, the ring is detected only at the south. This noticeable characteristic suggests a non-uniform dust density in the ring. With these two sets of images, we aim to study the distribution of the dust to solve for the actual dust distribution.Methods. We implemented a density function varying azimuthally along the ring and generated synthetic images both in polarimetry and in total intensity, which are then compared to the actual data. The search for the best-fit model was performed both with a grid-based and an MCMC approach. Using the outcome of this modelization, we further measured the polarized scattering phase function for the observed scattering angle between 33 degrees and 147 degrees as well as the spectral reflectance of the southern part of the ring between 0.98 and 2.1 mu m. We tentatively derived the grain properties by comparing these quantities with MCFOST models and assuming Mie scattering.Results. We find that the dust density peaks in the south-west at an azimuthal angle of 220 degrees similar to 238 degrees with a rather broad width of 61 degrees similar to 127 degrees. The difference in the intensity distributions observed in polarimetry and total intensity is the result of this particular morphology. Although there are still uncertainties that remain in the determination of the anisotropic scattering factor, the implementation of an azimuthal density variation to fit the data proved to be robust. Upon elaborating on the origin of this dust density distribution, we conclude that it could be the result of a massive collision when we account for the effect of the high gas mass that is present in the system on the dynamics of grains. In terms of grain composition, our preliminary interpretation indicates a mixture of porous sub-micron sized astro-silicate and carbonaceous grains.Conclusions. The SPHERE observations have allowed, for the first time, for meaningful constraints to be placed on the dust distribution beyond the standard picture of a uniform ring-like debris disk. However, future studies with a multiwavelength approach and additional detailed modeling would be required to better characterize the grain properties in the HD 141569 system.
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| 8. |
- Muro-Arena, G. A., et al.
(författare)
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Spirals inside the millimeter cavity of transition disk SR 21
- 2020
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 636
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Tidskriftsartikel (refereegranskat)abstract
- Context. Hydrodynamical simulations of planet-disk interactions suggest that planets may be responsible for a number of the substructures frequently observed in disks in both scattered light and dust thermal emission. Despite the ubiquity of these features, direct evidence of planets embedded in disks and of the specific interaction features like spiral arms within planetary gaps are still rare.Aims. In this study we discuss recent observational results in the context of hydrodynamical simulations in order to infer the properties of a putative embedded planet in the cavity of a transition disk.Methods. We imaged the transition disk SR 21 in H-band in scattered light with SPHERE/IRDIS and in thermal dust emission with ALMA band 3 (3 mm) observations at a spatial resolution of 0.1 ''. We combine these datasets with existing Band 9 (430 mu m) and Band 7 (870 mu m) ALMA continuum data.Results. The Band 3 continuum data reveals a large cavity and a bright ring peaking at 53 au strongly suggestive of dust trapping. The ring shows a pronounced azimuthal asymmetry, with a bright region in the northwest that we interpret as a dust overdensity. A similarly asymmetric ring is revealed at the same location in polarized scattered light, in addition to a set of bright spirals inside the millimeter cavity and a fainter spiral bridging the gap to the outer ring. These features are consistent with a number of previous hydrodynamical models of planet-disk interactions, and suggest the presence of a similar to 1 M-Jup planet at 44 au and PA = 11 deg. This makes SR21 the first disk showing spiral arms inside the millimeter cavity, and the first disk for which the location of a putative planet can be precisely inferred.Conclusions. The main features of SR 21 in both scattered light and thermal emission are consistent with hydrodynamical predictions of planet-disk interactions. With the location of a possible planet being well constrained by observations, it is an ideal candidate for follow-up observations to search for direct evidence of a planetary companion still embedded in its disk.
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| 9. |
- Pittman, S. J., et al.
(författare)
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Seascape ecology : identifying research priorities for an emerging ocean sustainability science
- 2021
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Ingår i: Marine Ecology Progress Series. - : INTER-RESEARCH. - 0171-8630 .- 1616-1599. ; 663, s. 1-29
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Tidskriftsartikel (refereegranskat)abstract
- Seascape ecology, the marine-centric counterpart to landscape ecology, is rapidly emerging as an interdisciplinary and spatially explicit ecological science with relevance to marine management, bio-diversity conservation, and restoration. While important progress in this field has been made in the past decade, there has been no coherent prioritisation of key research questions to help set the future research agenda for seascape ecology. We used a 2-stage modified Delphi method to solicit applied research questions from academic experts in seascape ecology and then asked respondents to identify priority questions across 9 interrelated research themes using 2 rounds of selection. We also invited senior management/conservation practitioners to prioritise the same research questions. Analyses highlighted congruence and discrepancies in perceived priorities for applied research. Themes related to both ecological concepts and management practice, and those identified as priorities include seascape change, seascape connectivity, spatial and temporal scale, ecosystem-based management, and emerging technologies and metrics. Highest-priority questions (upper tercile) received 50% agreement between respondent groups, and lowest priorities (lower tercile) received 58% agreement. Across all 3 priority tiers, 36 of the 55 questions were within a +/- 10% band of agreement. We present the most important applied research questions as determined by the proportion of votes received. For each theme, we provide a synthesis of the research challenges and the potential role of seascape ecology. These priority questions and themes serve as a roadmap for advancing applied seascape ecology during, and beyond, the UN Decade of Ocean Science for Sustainable Development (2021-2030).
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| 10. |
- Rieth, M., et al.
(författare)
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A brief summary of the progress on the EFDA tungsten materials program
- 2013
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Ingår i: Journal of Nuclear Materials. - : Elsevier BV. - 0022-3115 .- 1873-4820. ; 442:1-3, s. S173-S180
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Tidskriftsartikel (refereegranskat)abstract
- The long-term objective of the European Fusion Development Agreement (EFDA) fusion materials programme is to develop structural and armor materials in combination with the necessary production and fabrication technologies for reactor concepts beyond the International Thermonuclear Experimental Reactor. The programmatic roadmap is structured into four engineering research lines which comprise fabrication process development, structural material development, armor material optimization, and irradiation performance testing, which are complemented by a fundamental research programme on "Materials Science and Modeling." This paper presents the current research status of the EFDA experimental and testing investigations, and gives a detailed overview of the latest results on materials research, fabrication, joining, high heat flux testing, plasticity studies, modeling, and validation experiments.
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| 11. |
- Rieth, M., et al.
(författare)
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Recent progress in research on tungsten materials for nuclear fusion applications in Europe
- 2013
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Ingår i: Journal of Nuclear Materials. - : Elsevier BV. - 0022-3115 .- 1873-4820. ; 432:1-3, s. 482-500
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Forskningsöversikt (refereegranskat)abstract
- The current magnetic confinement nuclear fusion power reactor concepts going beyond ITER are based on assumptions about the availability of materials with extreme mechanical, heat, and neutron load capacity. In Europe, the development of such structural and armour materials together with the necessary production, machining, and fabrication technologies is pursued within the EFDA long-term fusion materials programme. This paper reviews the progress of work within the programme in the area of tungsten and tungsten alloys. Results, conclusions, and future projections are summarized for each of the programme's main subtopics, which are: (1) fabrication, (2) structural W materials, (3) W armour materials, and (4) materials science and modelling. It gives a detailed overview of the latest results on materials research, fabrication processes, joining options, high heat flux testing, plasticity studies, modelling, and validation experiments.
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| 12. |
- van Battum, P., et al.
(författare)
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Differences in minor amputation rate in diabetic foot disease throughout Europe are in part explained by differences in disease severity at presentation
- 2011
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Ingår i: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 28:2, s. 199-205
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Tidskriftsartikel (refereegranskat)abstract
- P>Objectives The incidence of minor amputation may vary significantly, and determinants of minor amputation have not been studied systematically. We evaluated minor amputation rate, the determinants of minor amputation and differences in amputation rate between European centres. Methods In the Eurodiale study, a prospective cohort study of 1232 patients (1088 followed until end-point) with a new diabetic foot ulcer were followed on a monthly basis until healing, death, major amputation or up to a maximum of 1 year. Ulcers were treated according to international guidelines. Baseline characteristics independently associated with minor amputation were examined using multiple logistic regression modelling. Based on the results of the multivariable analysis, a disease severity score was calculated for each patient. Results One hundred and ninety-four (18%) patients underwent a minor amputation. Predictors of minor amputation were depth of the ulcer (odds ratio 6.08, confidence interval 4.10-9.03), peripheral arterial disease (odds ratio 1.84, confidence interval 1.30-2.60), infection (odds ratio 1.56, confidence interval 1.05-2.30) and male sex (odds ratio 1.42, confidence interval 0.99-2.04). Minor amputation rate varied between 2.4 and 34% in the centres. Minor amputation rate in centres correlated strongly with disease severity score at the moment of presentation to the foot clinic (r = 0.75). Conclusions Minor amputation is performed frequently in diabetic foot centres throughout Europe and is determined by depth of the ulcer, peripheral arterial disease, infection and male sex. There are important differences in amputation rate between the European centres, which can be explained in part by severity of disease at presentation. This may suggest that early referral to foot clinics can prevent minor amputations.
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| 13. |
- Berntorp, Erik, et al.
(författare)
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Sixth Åland Island Conference on von Willebrand disease
- 2022
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Ingår i: Haemophilia. - : Wiley. - 1351-8216 .- 1365-2516. ; 28:S5, s. 3-15
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The sixth Åland Islands Conference on von Willebrand disease (VWD) on the Åland Islands, Finland, was held from 20 to 22 September 2018. Aim: The meeting brought together experts in the field of VWD from around the world to share the latest advances and knowledge in VWD. Results and discussion: The topics covered both clinical aspects of disease management, and biochemical and laboratory insights into the disease. The clinical topics discussed included epidemiology, diagnosis and treatment of VWD in different countries, management of children with VWD, bleeding control during surgery, specific considerations for the management of type 3 VWD and bleeding control in women with VWD. Current approaches to the management of acquired von Willebrand syndrome were also discussed. Despite significant advances in the understanding and therapeutic options for VWD, there remain many challenges to be overcome in order to optimise patient care. In comparison with haemophilia A, there are very few registries of VWD patients, which would be a valuable source of data on the condition and its management. VWD is still underdiagnosed, and many patients suffer recurrent or severe bleeding that could be prevented. Awareness of VWD among healthcare practitioners, including non-haematologists, should be improved to allow timely diagnosis and intervention. Diagnosis remains challenging, and the development of fast, simple assays may help to facilitate accurate and rapid diagnosis of VWD.
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| 14. |
- Due, P., et al.
(författare)
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Socioeconomic position, macroeconomic environment and overweight among adolescents in 35 countries
- 2009
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 33:10, s. 1084-1093
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Tidskriftsartikel (refereegranskat)abstract
- Objective: It is important to understand levels and social inequalities in childhood overweight within and between countries. This study examined prevalence and social inequality in adolescent overweight in 35 countries, and associations with macroeconomic factors. Design: International cross-sectional survey in national samples of schools. Subjects: A total of 11-, 13- and 15-year-olds from 35 countries in Europe and North America in 2001-2002 (N = 162 305). Measurements: The main outcome measure was overweight based on self-reported height and weight ( body mass index cut-points corresponding to body mass index of 25 kg/m(2) at the age of 18 years). Measures included family and school affluence (within countries), and average country income and economic inequality (between countries). Results: There were large variations in adolescent overweight, from 3.5% in Lithuanian girls to 31.7% in boys from Malta. Prevalence of overweight was higher among children from less affluent families in 21 of 24 Western and 5 of 10 Central European countries. However, children from more affluent families were at higher risk of overweight in Croatia, Estonia and Latvia. In Poland, Lithuania, Macedonia and Finland, girls from less affluent families were more overweight whereas the opposite was found for boys. Average country income was associated with prevalence and inequality in overweight when considering all countries together. However, economic inequality as measured by the Gini coefficient was differentially associated with prevalence and socioeconomic inequality in overweight among the 23-high income and 10-middle income countries, with a positive relationship among the high income countries and a negative association among the middle income countries. Conclusion: The direction and magnitude of social inequality in adolescent overweight shows large international variation, with negative social gradients in most countries, but positive social gradients, especially for boys, in some Central European countries. Macroeconomic factors are associated with the heterogeneity in prevalence and social inequality of adolescent overweight. International Journal of Obesity (2009) 33, 1084-1093; doi:10.1038/ijo.2009.128; published online 21 July 2009
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| 15. |
- Pickwell, K., et al.
(författare)
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Minor amputation does not negatively affect health-related quality of life as compared with conservative treatment in patients with a diabetic foot ulcer : An observational study
- 2017
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Ingår i: Diabetes/Metabolism Research and Reviews. - : Wiley. - 1520-7552. ; 33:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health-related quality of life (HRQoL) is poor in patients with persistent diabetic foot ulcers and poor HRQoL predicts worse outcomes in these patients. Amputation is often considered a treatment failure, which is why conservative treatment is generally preferred over amputation. However, it is unclear whether minor amputation negatively affects HRQoL compared with conservative treatment in patients with diabetic foot ulcers. Methods: In the cohort of the multicenter, prospective, observational Eurodiale study, we determined difference in change of HRQoL measured by EQ-5D between patients with a diabetic foot ulcers that healed after conservative treatment (n = 676) and after minor amputation (n = 145). Propensity score was used to adjust for known confounders, attempting to overcome lack of randomization. Results: Baseline HRQoL was not significantly different between patients treated conservatively and undergoing minor amputation. In addition, there was no difference in the change of HRQoL between these groups. In patients who healed 6 to 12 months after the first visit, HRQoL on the anxiety/depression subscale even appeared to improve more in those who underwent minor amputation. Conclusions: Minor amputation was not associated with a negative impact on HRQoL in patients with a diabetic foot ulcers. It may therefore not be considered treatment failure in terms of HRQoL but rather a viable treatment option. A randomized controlled trial is warranted to further examine the influence of minor amputations on health-related quality of life.
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| 16. |
- Prompers, L, et al.
(författare)
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Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study
- 2008
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Ingår i: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 25:6, s. 700-707
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Tidskriftsartikel (refereegranskat)abstract
- Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6-55%). At study entry, 77% of the patients had no or inadequate offloading. During follow-up, casting was used in 35% (0-68%) of the plantar fore- or midfoot ulcers. Predictors of use of casting were male gender, large ulcer size and being employed. Vascular imaging was performed in 56% (14-86%) of patients with severe limb ischaemia; revascularization was performed in 43%. Predictors of use of vascular imaging were the presence of infection and ischaemic rest pain. Conclusion Treatment of many patients is not in line with current guidelines and there are large differences between countries and centres. Our data suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot disease.
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| 17. |
- Prompers, L., et al.
(författare)
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High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study
- 2007
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 50:1, s. 18-25
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Tidskriftsartikel (refereegranskat)abstract
- Large clinical studies describing the typical clinical presentation of diabetic foot ulcers are limited and most studies were performed in single centres with the possibility of selection of specific subgroups. The aim of this study was to investigate the characteristics of diabetic patients with a foot ulcer in 14 European hospitals in ten countries. The study population included 1,229 consecutive patients presenting with a new foot ulcer between 1 September 2003 and 1 October 2004. Standardised data on patient characteristics, as well as foot and ulcer characteristics, were obtained. Foot disease was categorised into four stages according to the presence or absence of peripheral arterial disease (PAD) and infection: A: PAD -, infection -; B: PAD -, infection +; C: PAD +, infection -; D: PAD +, infection +. PAD was diagnosed in 49% of the subjects, infection in 58%. The majority of ulcers (52%) were located on the non-plantar surface of the foot. With regard to severity, 24% had stage A, 27% had stage B, 18% had stage C and 31% had stage D foot disease. Patients in the latter group had a distinct profile: they were older, had more non-plantar ulcers, greater tissue loss and more serious comorbidity. According to our results in this European cohort, the severity of diabetic foot ulcers at presentation is greater than previously reported, as one-third had both PAD and infection. Non-plantar foot ulcers were more common than plantar ulcers, especially in patients with severe disease, and serious comorbidity increased significantly with increasing severity of foot disease. Further research is needed to obtain insight into the clinical outcome of these patients.
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| 18. |
- Prompers, L., et al.
(författare)
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Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study
- 2008
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 51:5, s. 747-755
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis Outcome data on individuals with diabetic foot ulcers are scarce, especially in those with peripheral arterial disease (PAD). We therefore examined the clinical characteristics that best predict poor outcome in a large population of diabetic foot ulcer patients and examined whether such predictors differ between patients with and without PAD. Methods Analyses were conducted within the EURODIALE Study, a prospective cohort study of 1,088 diabetic foot ulcer patients across 14 centres in Europe. Multiple logistic regression modelling was used to identify independent predictors of outcome (i.e. non-healing of the foot ulcer). Results After 1 year of follow-up, 23% of the patients had not healed. Independent baseline predictors of non-healing in the whole study population were older age, male sex, heart failure, the inability to stand or walk without help, end-stage renal disease, larger ulcer size, peripheral neuropathy and PAD. When analyses were performed according to PAD status, infection emerged as a specific predictor of non-healing in PAD patients only. Conclusions/Interpretation Predictors of healing differ between patients with and without PAD, suggesting that diabetic foot ulcers with or without concomitant PAD should be defined as two separate disease states. The observed negative impact of infection on healing that was confined to patients with PAD needs further investigation.
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| 19. |
- Prompers, L., et al.
(författare)
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Resource utilisation and costs associated with the treatment of diabetic foot ulcers. Prospective data from the Eurodiale Study
- 2008
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 51:10, s. 1826-1834
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis The aim of the present study was to investigate resource utilisation and associated costs in patients with diabetic foot ulcers and to analyse differences in resource utilisation between individuals with or without peripheral arterial disease (PAD) and/or infection. Methods Data on resource utilisation were collected prospectively in a European multicentre study. Data on 1,088 patients were available for the analysis of resource use, and data on 821 patients were included in the costing analysis. Costs were calculated for each patient by multiplying the country-specific direct and indirect unit costs by the number of resources used from inclusion into the study up to a defined endpoint. Country-specific costs were converted into purchasing power standards. Results Resource use and costs varied between outcome groups and between disease severity groups. The highest costs per patient were for hospitalisation, antibiotics, amputations and other surgery. All types of resource utilisation and costs increased with the severity of disease. The total cost per patient was more than four times higher for patients with infection and PAD at inclusion than for patients in the least severe group, who had neither. Conclusions/interpretation Important differences in resource use and costs were found between different patient groups. The costs are highest for individuals with both peripheral arterial disease and infection, and these are mainly related to substantial costs for hospitalisation. In view of the magnitude of the costs associated with in-hospital stay, reducing the number and duration of hospital admissions seems an attractive option to decrease costs in diabetic foot disease.
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| 20. |
- Rieth, M., et al.
(författare)
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Review on the EFDA programme on tungsten materials technology and science
- 2011
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Ingår i: Journal of Nuclear Materials. - : Elsevier BV. - 0022-3115 .- 1873-4820. ; 417:1-3, s. 463-467
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Tidskriftsartikel (refereegranskat)abstract
- All the recent DEMO design studies for helium cooled divertors utilize tungsten materials and alloys, mainly due to their high temperature strength, good thermal conductivity, low erosion, and comparably low activation under neutron irradiation. The long-term objective of the EFDA fusion materials programme is to develop structural as well as armor materials in combination with the necessary production and fabrication technologies for future divertor concepts. The programmatic roadmap is structured into four engineering research lines which comprise fabrication process development, structural material development, armor material optimization, and irradiation performance testing, which are complemented by a fundamental research programme on "Materials Science and Modeling". This paper presents the current research status of the EFDA experimental and testing investigations, and gives a detailed overview of the latest results on fabrication, joining, high heat flux testing, plasticity, modeling, and validation experiments.
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| 21. |
- Rääf, Christopher, et al.
(författare)
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Hair as an indicator of the body content of polonium in humans: preliminary results from study of five male volunteers.
- 2015
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Ingår i: Journal of Environmental Radioactivity. - : Elsevier BV. - 0265-931X .- 1879-1700. ; 141, s. 71-75
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Tidskriftsartikel (refereegranskat)abstract
- The radionuclide (210)Po is of importance from a radiation protection view and has properties that cause special problems when attempting to determine the body content in humans. Estimates have traditionally been made from either urine and/or fecal samples, which require a time-consuming radiochemical preparation before alpha spectrometric determination. In order to find a more simple and less labor intensive method hair has been used as a bioindicator and investigated in this study. The relationship between intake and excretion in hair has been estimated in five volunteers who ingested radioactive polonium ((209)Po as a bio-tracer for (210)Po) in well determined quantities. Four of the volunteers were given 5-10Bq (209)Po in a single intake (acute intake) and one volunteer has ingested a daily intake of 58.7mBq (209)Po for a period of 180d. Human hair was found to reflect the daily clearance of ingested polonium peaking at 0.001-0.01%d(-1) of the ingested amount, thereafter decreasing mono-exponentially, corresponding to a biological half-time of 10-20 days. For the case of protracted intake a mono-exponential build-up was observed with a half-time of 40±5d. In addition, after cessation of intake, a short-term component (74%) with a biological half-time of 16±4d, and a long-term component (26%) with a half-time of 93±53d were observed. It is concluded that hair can be used to detect not only the amount of ingested polonium but also whether the intake was protracted or acute.
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| 22. |
- Siersma, V., et al.
(författare)
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Importance of factors determining the low health-related quality of life in people presenting with a diabetic foot ulcer: the Eurodialestudy
- 2013
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Ingår i: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 30:11, s. 1382-1387
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Tidskriftsartikel (refereegranskat)abstract
- AimTo identify the factors responsible for the low health-related quality of life associated with foot ulcers and the relative importance of these factors. MethodsA total of 1232 patients with a new foot ulcer, who presented at one of the 14 centres in 10 European countries participating in the Eurodiale study, were included in this cross-sectional study. Patient and ulcer characteristics were obtained as well as results from the Euro-Qol-5D questionnaire, a health-related quality of life instrument with five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). To analyse the relative importance of comorbidities and ulcer- and patient-related factors for health-related quality of life, linear regression models were used to calculate the relative contributions of each factor to the fit (R-2) of the model. ResultsPatients reported poor overall health-related quality of life, with problems primarily in the mobility and pain/discomfort domains. Among the comorbidities, the inability to stand or walk without help was the most important determinant of decreased health-related quality of life in all five domains. Among ulcer-related factors, ulcer size, limb-threatening ischaemia and elevated C-reactive protein concentration also had high importance in all domains. The clinical diagnosis of infection, peripheral arterial disease and polyneuropathy were only important in the pain/discomfort domain. ConclusionsThe factors that determine health-related quality of life are diverse and to an extent not disease-specific. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important. What's new? The inability to stand or walk without help is the most important determinant of poor health-related quality of life. Other factors with high importance are ulcer size, elevated C-reactive protein concentration and limb-threatening ischaemia. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important.
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